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MoonDragon's Health & Wellness
WILSON'S DISEASE
(Hepatolenticular Degeneration)
(Inherited Copper Toxicosis)




DESCRIPTION

Wilson's disease, also called hepatolenticular degeneration or inherited copper toxicosis is a uncommon inherited (genetic) disorder that affects approximately 1 in 30,000 persons worldwide of all races and nationalities. The estimated heterozygous carrier rate is about 1 in 100, meaning that 1 in 100 people are unaffected carriers of this mutation. It is an autosomal recessive disorder, with a male preponderance. Its main feature is accumulation of copper in tissues, which manifests itself with neurological symptoms and liver disease.

In people with Wilson's disease, the body is unable to metabolize the trace element copper as it should, with the result that excess copper accumulates in the brain, kidneys, liver, and corneas of the eyes. This causes organ problems and psychotic behavior. Untreated, Wilson's disease leads to brain damage, cirrhosis of the liver, hepatitis, and, ultimately death from copper poisoning. Fortunately, early detection before serious illness and treatment of the disease can minimize the symptoms and complications and possibly even prevent them altogether.





HISTORY

The disease bears the name of the British physician Dr Samuel Alexander Kinnier Wilson (1878-1937), a neurologist who described the condition in 1912. Dr J.N. Cumings made the link with copper accumulation in 1948. The first effective chelation agent, penicillamine, was discovered in 1956 by Dr John Walshe. The genetic basis was elucidated in the 1980s and 1990s by several research groups.




CAUSE

Small amounts of copper are as essential as vitamins. Copper is present in most foods and most people have much more copper than they need. Healthy people excrete copper they do not need but Wilson's Disease patients cannot.

Copper begins to accumulate immediately after birth. Excess copper attacks the liver or brain, resulting in hepatitis, psychiatric, or neurologic symptoms. The symptoms usually appear in late adolescence. Patients may have jaundice, abdominal swelling, vomiting of blood, and abdominal pain. They may have tremors and difficulty walking, talking and swallowing. They may develop all degrees of mental illness including homicidal or suicidal behavior, depression, and aggression. Women may have menstrual irregularities, absent periods, infertility, or multiple miscarriages. No matter how the disease begins, it is always fatal if it is not diagnosed and treated.

The first part of the body that copper affects is the liver. In about half of Wilson's Disease patients the liver is the only affected organ. The initial physical changes in the liver are only visible under the microscope. When hepatitis develops, patients are often thought to have infectious hepatitis or infectious mononucleosis when they actually have Wilson's Disease hepatitis. Testing for Wilson's Disease should be performed in individuals with unexplained, abnormal liver tests.

GENETICS

Wilson's disease has an autosomal recessive pattern of inheritance, which means it is not sex-linked (it can occur equally in men and women). In order to inherit it, both of ones parents must carry a gene that each passes to the affected child. Two abnormal genes are required to have the disease. Most are transmitted from generation to generation. The Wilson's disease gene has been mapped to and located at a precisely known site on chromosome 13 (13q14.3). The gene is called ATP7B and is expressed primarily in the liver, kidney, and placenta but has also been found in the heart, brain, and lung, albeit at much lower levels. The gene codes for a P-type ATPase that transports copper into bile and incorporates it into ceruloplasmin.

Some cases of Wilson's Disease occur due to spontaneous mutations in the gene. Most patients have no family history of Wilson's Disease. People with only one abnormal gene are called carriers. Carriers (heterozygotes) may have mild, but medically insignificant, abnormalities of copper metabolism. Carriers do not become ill and should not be treated. More than 200 different mutations of ATP7B have been identified thus far. Therefore, it has been difficult to devise a simple genetic screening test for Wilson's Disease. However, in a particular family, if the precise mutation is identified, a genetic diagnosis is possible by haplotype analysis. This requires a blood sample from both the patient and a relative. The samples are compared to each other. Haplotype testing helps to find symptom-free siblings who have the disease so that they may be treated before they become ill.

The mutant form of ATP7B expressed in people with Wilson's disease inhibits the release of copper into bile. As the excretion of copper from the body is thus impaired, the copper builds up in the liver and injures liver tissue. Eventually, the damage causes the liver to release the copper directly into the bloodstream, which carries the copper throughout the body. The copper buildup leads to damage in the kidneys, brain, and eyes, presumably by generation of reactive oxygen species and binding to neuromelanin. If not treated, Wilson's disease can cause severe brain damage, liver failure, and death.

Someday a genetic test may help in genetic screening and prenatal diagnosis. However, at this time, there is no available test for these purposes.

CHANCES OF INHERITING WILSON'S DISEASE

One in 100 individuals in the general population carries one abnormal copy of the Wilson's Disease gene. Carriers have one normal and one abnormal gene. All (100 percent) children of those afflicted with Wilson's Disease receive at least one abnormal copy of the Wilson's Disease gene. One half (50 percent) of a carrier's children receive at least one abnormal copy of the Wilson's Disease gene.

Siblings of Wilson's Disease patients have a 1 in 4 chance of having the disease. Since both of a siblings' parents are carriers, 1/4 of the siblings' children have the disease, 1/2 are carriers, and 1/4 are disease free with no Wilson's Disease gene.

Children of patients have a 1 in 200 chance of having the disease. A child of a Wilson's Disease patient has a 100 percent chance of getting one abnormal gene. The patient's spouse has a 1 in 100 chance of carrying the abnormal Wilson's Disease gene and half the time he or she will pass it on.

Grandchildren of patients have a 1 in 400 chance of having the disease. A grandchild of a Wilson's Disease patient has a 50 percent chance of getting one abnormal gene, since each a patient's child is a carrier. From the other parent, a grandchild has a 1 in 200 chance of getting the gene (1/2 times 1/200, or 1/400).

Nieces and Nephews of patients with siblings who do not have Wilson's Disease have a 1/600 chance of having the disease. Two-thirds of unaffected siblings carry the gene. The risk both parents being carriers is 2/3 times 1/100, or 1 in 150. The risk of each of their children having the disease is 1 in 600 (1/4 times 1/150).

Cousins of Wilson's Disease patients have a 1 in 800 chance of having the disease. Fifty percent of aunts and uncles are carriers. The risk of both parents of a cousin carrying the abnormal gene is 1/2 times 1/100, or 1 in 200. Since 1 in 4 children of two Wilson's Disease patients is afflicted, the overall risk of a cousin of a Wilson's Disease patient being afflicted is 1/4 times 1/200, or 1/800.

All siblings and children of Wilson's Disease patients should be tested for Wilson's Disease. Other relatives who have had symptoms or laboratory tests that indicate liver or neurological disease also should be tested for Wilson's Disease.

People with Wilson's Disease may not have any signs, symptoms, or evidence of illness. However, people with mild or non-apparent Wilson's Disease will become seriously ill and eventually die if they are not treated.

Testing is simple and safe. There are excellent treatments available. Failure to treat Wilson's Disease causes severe disability and eventually death.





SIGNS & SYMPTOMS

Symptoms of Wilson's disease may include:
  • Bloody vomit.
  • Difficulty speaking.
  • Difficulty swallowing.
  • Difficulty walking.
  • Drooling.
  • An enlarged spleen.
  • Jaundice.
  • Loss of appetite.
  • Loss of coordination.
  • Progressive fatigue and/or weakness.
  • Progressive intellectual impairment.
  • Psychological deterioration manifested as personality changes and/or bizarre behavior.
  • Rigidity, spasms or tremors of the muscles.
  • Swelling and/or fluid accumulation in the abdomen.
  • Unexplained weight loss.

Sometimes the first sign is the development of a pigmented ring, known as Kayser-Fleischer ring, at the outer margin of the cornea, which may be detected during a routine eye examination.

In the advanced stages of the disease, symptoms due to chronic active hepatitis or cirrhosis may appear, menstrual cycles may cease, and an individual may experience chest pains, heart palpitations, light-headedness, pallor, and shortness of breath as a result of exertion.

SYMPTOMS TIME FRAME

Symptoms usually appear around the ages of 6 to 20 years, but sometimes not until the age of 30, and in rare instances at age 40 and even beyond. Presentation before 5 years of age is extremely rare, despite the biochemical defect being present at birth. The age of presentation seems to correlate with the organ system involved. About half (40-50 percent) of patients first present with hepatic symptoms and half (40-50 percent) with neurologic symptoms. The average age for hepatic symptoms is 10-14 years, compared with 19-22 years for neurologic symptoms. Patients rarely present after age 40.

COPPER TOXICITY-RELATED HEALTH PROBLEMS

Copper deposits in the basal ganglia, particularly in the putamen and globus pallidus (together called the lenticular nucleus), result in cell death, producing symptoms akin to Parkinson's disease.

The main features are liver and neuropsychiatric problems. Chronic active hepatitis, culminating in cirrhosis is the most common hepatic presentation, but some patients present with fulminant liver failure (which is characterized by remarkably low alkaline phosphatase and often high bilirubin levels compared to similar disease states) and a surprisingly rare incidence of hepatocellular carcinoma.

Neuropsychiatric phenomena are early dementia, mood disorders or psychosis and signs of asterixis (a flapping tremor of the hands) and parkinsonism (including ataxia, dyskinesia, and rigidity).

Disorders associated with Wilson's disease are:
  • Renal Disorders: Renal tubular acidosis, kidney stones.
  • Ophthalmic Disorders: Kayser-Fleischer rings, sunflower cataracts.
  • Cardiac Disorders: Cardiomyopathy, cardiac arrhythmias.
  • Dermal Disorders: Hidradenitis suppurativa.
  • Hemolysis (anemia due to destruction of red blood cells) is usually present only in severe cases.





DIAGNOSIS

The diagnosis of Wilson's Disease is made by relatively simple tests. The tests can diagnose the disease in both symptomatic patients and people who show no signs of the disease. These tests can include:
  • Opthalmalogic slit lamp examination for Kayser-Fleischer rings. An eye exam would detect the Kayser-Fleischer ring, although its absence does not rule out Wilson's and it may be missed on cursory examination. This sign is characterized by brown rings around the cornea in the eye that result from copper deposition in Descemet's membrane of the cornea. Wilson's disease is also associated with sunflower cataracts, brown or green pigmentation of the anterior and posterior lens capsule.


  • Serum ceruloplasmin test. This is a blood test for testing a suppressed level of ceruloplasmin that is present in over 80 percent of patients. This is commonly performed as a screening test in patients with liver problems.


  • 24-hour urine copper test. An accurate measurement is the direct testing for copper levels in the 24 hour specimen of urine.


  • Liver biopsy for histology and histochemistry and copper quantification. The average concentration of hepatic copper may reach 20 times normal levels, whilst plasma ceruloplasmin levels are typically less than 30 percent of normal.


  • Genetic testing, haplotype analysis for siblings and mutation analysis.

It is important to diagnose Wilson's Disease as early as possible, since severe liver damage can occur before there are any signs of the disease. Individuals with Wilson's Disease may falsely appear to be in excellent health. For additional information, refer to the Boston University Medical Campus website at www.bumc.bu.edu or consult with your health care provider.





TREATMENT

Wilson's Disease is a very treatable condition. With proper therapy, disease progress can be halted and oftentimes symptoms can be improved. Treatment is aimed at removing excess accumulated copper and preventing its re-accumulation. Therapy must be lifelong. Patients may become progressively more sick from day to day, so immediate treatment can be critical. Treatment delays may cause irreversible damage.

CHELATION THERAPIES

  • The newest FDA-approved drug is zinc acetate (Galzin). Taking extra zinc may be helpful and acts by blocking the absorption of copper in the intestinal tract in patients with Wilson's disease. This action both depletes accumulated copper and prevents its re-accumulation. It blocks the intestinal absorption of the metal both from the diet and endogenous secretions. It also acts by producing metallothionein, a protein that binds with copper to prevent its release into the blood, and facilitates elimination via the stool. Zinc's effectiveness has been shown by more than 30 years of considerable experience overseas. A major advantage of zinc therapy is its lack of side effects.


  • Other drugs approved for use in Wilson's Disease include D-penicillamine (Cuprimine, Depen) and trientine hydrochloride (Syprine). The disease is treated with lifelong use of these chelating agents that help remove copper from tissue. Both of these drugs act by chelation or binding of copper, causing its increased urinary excretion.


  • Tetrathiomolybdate is another chelating drug that is under investigation for initial treatment of Wilson's Disease. Thus far, it has not caused the neurological worsening often associated with penicillamine and even with trientine.


  • NUTRITION

  • Patients will also need to take vitamin B-6 and follow a low-copper diet (see Nutrition Recommendations further down on this page), which means avoiding mushrooms, nuts, chocolate, dried fruit, liver, and shellfish.


  • LIVER TRANSPLANT

  • Patients with severe hepatitis or liver failure may require liver transplant. Liver transplantation is effective in patients with fulminant Wilson disease that does not respond to the usual treatment. Because the primary defect resides within the liver, transplantation is curative, but as it is only undertaken in severely ill patients the prognosis is still mediocre.


  • TREATMENT CARE

    Patients being investigated or treated for Wilson's Disease should be cared for by specialists in Wilson's Disease or by specialists in consultation with their primary health care provider.

    Stopping treatment completely will result in death, sometimes as quickly as within three months. Decreasing dosage of medications also can result in unnecessary disease progression.





    HOLISTIC SUPPLEMENTS, RECOMMENDATIONS & NUTRIENTS


    HERBS

    NOTE: Herbal therapy is not meant to replace conventional medical treatment for Wilson's disease, but may be used with conventional therapy to help strengthen the immune system, provide vital nutrients for healing, and help with side effects of medications. Be sure to check with a qualified herbalist or Naturopathic health care provider before using any alternative or complimentary therapy to help design a therapy especially for you. Each person is unique and recommendations for one person may not be the same for another person, depending on their health status and severity of their condition.

    MoonDragon's Alternative Health: Find A Practitioner

    MoonDragon's Health & Wellness: Copper Toxicity

    HERBAL RECOMMENDATIONS

  • Use Alfalfa, Ginkgo Biloba, Gotu Kola Kava Kava, Lobelia, Oat Straw, Parsley, Periwinkle, and Skullcap are good for overall good health and the functioning of the brain and nervous system. Caution: Do not take Lobelia internally on an ongoing basis.


  • Herbal Remedies: Alfalfa Supplements & Products

    Herbal Remedies: Ginkgo Supplements & Products

    Herbal Remedies: Gotu Kola Supplements & Products

    Herbal Remedies: Kava Kava Supplements & Products

    Herbal Remedies: Lobelia Supplements & Products

    Herbal Remedies: Parsley Supplements & Products

    Herbal Remedies: Oat Straw Supplements & Products

    Herbal Remedies: Periwinkle Supplements & Products

    Herbal Remedies: Skullcap Supplements & Products

  • Astragalus, Echinacea, and Pau D'Arco are helpful for fatigue. Caution: Do not use Astragalus in the presence of a fever.


  • Herbal Remedies: Astragalus Supplements & Products

    Herbal Remedies: Echinacea Supplements & Products

    Herbal Remedies: Pau D'Arco Supplements & Products

  • Black Radish and Red Clover strengthen the liver.


  • Shaman Shop: Black Radish Powder, 1 lb. Bulk Herbs

    Shaman Shop: Black Radish Vegicaps, 60 VCaps

    Herbal Remedies: Red Clover Supplements & Products

  • Burdock, Dandelion, Milk Thistle, and Suma cleanse and support the liver and help to fight fatigue.


  • Herbal Remedies: Burdock Supplements & Products

    Herbal Remedies: Dandelion Supplements & Products

    Herbal Remedies: Milk Thistle Supplements & Products

    Herbal Remedies: Suma Supplements & Products

  • Cat's Claw is an anti-inflammatory, antioxidant, immune system enhancer, and internal cleanser. Cat's Claw Defense Complex from Source Naturals is a good source of this herb and also contains other beneficial ingredients. Caution: Do not use Cat's Claw during pregnancy.


  • Herbal Remedies: Cat's Claw Supplements & Products



  • Cayenne (Capsicum) eases blood pressure, fights fatigue, and helps support the nervous system.


  • Herbal Remedies: Cayenne (Capsicum) Supplements & Products

  • Goldenseal is helpful if symptoms include difficulty swallowing, and it can ease fatigue as well. Cautions: Do not take goldenseal internally on a daily basis for more than one week at a time, do not use it during pregnancy, and use it with caution if you are allergic to ragweed.


  • Herbal Remedies: Goldenseal Supplements & Products

  • Licorice is also beneficial for swallowing difficulties, as is gargling with Thyme tea. Cautions: Do not use Licorice on a daily basis for more than 7 days in a row, and avoid it completely if you have high blood pressure.


  • Herbal Remedies: Licorice Supplements & Products

    Herbal Remedies: Thyme Supplements & Products

  • St. John's Wort is beneficial for the nervous system and also helps to overcome fatigue and difficulty swallowing.


  • Herbal Remedies: St. John's wort Supplements & Products

  • Siberian Ginseng is a tonic herb that helps to reduce fatigue and supports brain and nervous system function. Caution: Do not use this herb if you have hypoglycemia, high blood pressure, or a heart disorder.


  • Herbal Remedies: Siberian Ginseng Supplements & Products

  • Valerian root is calming and is good for the brain and nervous system. It can also be beneficial for swallowing difficulties.


  • Herbal Remedies: Valerian Root Supplements & Products

    HERBAL SUPPLEMENTS FOR WILSON'S DISEASE






    NUTRITION & DIET RECOMMENDATIONS

  • Eliminate from the diet foods high in copper. Adherence to a low copper diet is most important during the initial phase of treatment. The recommendation is to avoid the foods highest in copper content such as organ meats, shellfish, chocolate, barley, beets, blackstrap molasses, broccoli, nuts, enriched cereals, lentils, salmon, and mushrooms. Other foods to avoid are avocados, beans and other legumes, egg yolks, oats, oranges, pecans, raisins, soybeans, whole grains, and green leafy vegetables. Once copper levels have stabilized at normal levels, these foods are allowed occasionally. For a comprehensive list refer to the U.S. Department of Agriculture (USDA) website at USDA Nutrients In Selected Foods or see the link below (has the same information but in html format instead of pdf format). If you are a vegetarian, please consult a dietician, as many of the foods and protein sources in a vegetarian diet are high in copper. Wilson disease cannot be managed by diet alone. Proper medication is necessary.

    MoonDragon's Health & Wellness: USDA Nutrients - Copper Levels In Selected Foods

  • Have the copper content of the drinking water you consume tested. Your local community or private water testing firms can perform the testing on your home water supply. Look in the yellow pages of your local telephone directory or consult with your state's environmental agency for laboratories that can do this type of testing. If the water is over 0.1 ppm (parts per million) (which is 0.1 mg/L), consider an alternative water source (such as quality bottled water or steam distilled water) or invest in a good filtering system that removes copper. If you have copper plumbing in your home, some of the copper content can be reduced by running the water for a while before you use it. As water sits in the pipes the copper leaches into the water. If you can determine that all or most of of the copper in your water is coming from the pipes, it may be worthwhile to replace them with copper-free ones. If you work or reside in a location where the water supply has not been tested, consider using quality bottled water that does not contain copper.


  • Do not use copper cookware or utensils. Copper can leach into your foods and these items should be avoided (see water above).

  • If you take a multi-vitamin and/or mineral supplement, be sure to choose a formula that does NOT contain copper. Consult your health care professional before taking a multi-vitamin. If your practitioner approves, find a good supplement that does not contain copper. If you are a woman who is pregnant, or wishes to become pregnant, please have your midwife or obstetrician consult with your hepatologist before prescribing prenatal vitamins. Most prenatal vitamins contain an abundance of copper and these should be avoided.


  • COPPER-FREE MULTI-VITAMIN SUPPLEMENTS



  • There are many over-the-counter dietary supplements and herbal preparations that claim to be beneficial for some part of your body. Be cautious about this because many can interact with other prescription medications you are taking. Some can be beneficial but others may actually be injurious to your health, depending on your existing health issues and the extent of disease damage that has been done to your body (such as the severity of existing liver damage). Many supplements are processed by the liver and may cause additional liver damage or, in the case of existing liver damage, may not be properly utilized by the body. Know what you are using. If in doubt, consult a Naturopathic practitioner or other health care provider familiar with herbal and dietary supplements and familiar with any medications or other therapies you are prescribed for your condition.


  • Increase your intake of onions. They contain sulfur, which helps to rid the body of copper.


  • Eat fresh (not canned) pineapple frequently. It contains bromelain, an enzyme that helps to keep down swelling and inflammation.


  • Herbal Remedies: Bromelain 2000 GDU Supplement, NOW Foods, 500 mg, 90 Tabs

    Herbal Remedies: Quercetin With Bromelain, Hypoallergenic, Bioflavonoid, NOW Foods, 800 mg, 120 VCaps

  • If you suffer from tremors, avoid caffeine.


  • Avoid alcohol consumption. Wilson's disease increases the risk of cirrhosis of the liver.


  • MoonDragon's Health & Wellness: Copper Toxicity





    CONSIDERATIONS

  • Wilson's disease can be neither prevented nor cured. With appropriate management, however, the prognosis is excellent. Anyone with a family history of Wilson's disease should undergo diagnostic testing - the sooner the better, and whether or not symptoms are present - so that treatment, if necessary, may begin as soon as possible.


  • Treatment of Wilson's disease is a lifelong proposition. Most often, it involves taking penicillamine (Cuprimine, Depen), a drug that removes copper from the body by increasing its excretion in the urine. Possible side effects of this drug include deficiencies of vitamin B-6 (pyridoxine) and iron, and many people experience an allergic reaction to the drug within 10 days of taking it. The most serious potential side effects of this medication include kidney disease, blood cell problems, and Goodpasture's syndrome (a potentially life threatening syndrome characterized by bleeding of the lungs and kidney failure). Penicillamine has also been linked to leukemia development in at least two cases. A person with a sensitivity to penicillamine may also be given a steroid such as prednisone (Deltasone and others) to decrease the reaction to penicillamine, or the drug trientine (Syprine) may be prescribed instead. This medication also chelates copper so that it can be eliminated from the body.


  • MoonDragon's Health Therapy: Chelation Therapy

    MoonDragon's Health & Wellness: Copper Toxicity

  • Some health care providers prescribe high doses of zinc in place of, or conjunction with, conventional drugs to keep copper levels under control. Zinc naturally balances with copper in the body. Zinc acetate (Galzin) is another medication that may be prescribed. It should be taken exactly as the health care provider has prescribed.


  • Elevated copper levels in the body result in the depletion of Vitamin C and zinc. Persons with Wilson's disease therefore always require a higher than normal intake of these nutrients.


  • Herbal Remedies: Zinc Supplements & Products

    Herbal Remedies: Vitamin C Supplements & Products

  • Regardless of the treatment regimen, regular checkups are required to monitor possible side effects from medication and to check the level of copper in the urine.


  • If you develop any personality changes or problems linked to Wilson's disease, consulting with a practitioner such as a psychologist or other mental health professional may be helpful.


  • Wilson's disease is not the only cause of elevated levels of copper in the body. Toxic levels of copper can also accumulate in the body as a result of excessive exposure to the metal. If a person with elevated copper levels has normal liver function and not corneal abnormalities, it is likely that the toxicity is due to something other than Wilson's disease. In addition, copper toxicity as a result of excessive copper ingestion can be demonstrated by hair analysis, whereas persons with Wilson's disease do not exhibit elevated levels of copper in the urine.


  • MoonDragon's Health Therapy: Hair Analysis

  • Tetrathiomolybdate is an experimental drug that shows promise in treating Wilson's disease.


  • Without proper treatment Wilson's disease is usually fatal by age 30. However, if treatment is begun early enough, symptomatic recovery is usually complete, and a life of normal length and quality can be expected.


  • The Wilson's Disease Association offers aid and support to people with Wilson's disease and related diseases.


  • FOR MORE INFORMATION

    Wilson's Disease Association International
    1802 Brookside Drive
    Wooster, OH 44691
    Toll-Free Phone: (888) 264-1450
    Phone: (330) 264-1450 E-Mail: info@wilsonsdisease.org
    Website: www.wilsonsdisease.org

    American Liver Foundation
    75 Maiden Lane, Suite 603
    New York, NY 10038-4810 Phone: (800)-GO-LIVER (1-800-465-4837) or (212) 668-1000 Fax: (212) 483-8179 E-Mail: info@liverfoundation.org
    Website: www.liverfoundation.org

    MoonDragon's Health Therapy: Chelation Therapy

    MoonDragon's Health & Wellness: Copper Toxicity

    MoonDragon's Health & Wellness: Environmental Toxicity

    MoonDragon's Health & Wellness: Cirrhosis

    MoonDragon's Health & Wellness: The Liver





    NUTRITIONAL SUPPLEMENTS

    The following nutrients are important for healing once appropriate local treatment has been administered. Unless otherwise specified, the following recommended doses are for those over the age of 18. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended amount.

    NUTRIENTS
    Supplement Suggested Dosage Comments
    Very Important
    Garlic (Kyolic) As directed on label. A powerful antioxidant that protects the liver and heart function. Promotes normal healing and prevents damage.
    Garlic Oil, NOW Foods, 1500 mg, 250 Softgels,
    Garlic Bulb Cloves Supplement, Nature's Way, 580 mg, 100 Caps,
    Super Odorless Garlic, NOW Foods, 5000 mg, 90 Caps,
    Aged Garlic Extract, Cardiovascular Formula 100, Wakunaga Kyolic, 300 Caps,
    Kyolic Liquid Aged Garlic Extract, Cardiovascular, Vegetarian, Wakunaga Kyolic, 4 fl. oz.,
    Kyolic Aged Garlic Extract, One Per Day, Vegetarian, Wakunaga Kyolic, 1000 mg, 30 Caps,
    Aged Garlic Extract, Cholesterol Formula 104, Wakunaga Kyolic, 200 Caps
    Iron As directed by health care provider. Take with 100 mg Vitamin C for better absorption. To correct and protect against anemia. Caution: Do not take iron unless anemia is diagnosed.
    Iron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz.,
    Ionic Iron Supplement With ConcenTrace, Trace Minerals, 2 oz.,
    Iron Complex With Vitamins & Herbs, Vegetarian, NOW Foods, 250 Tabs,
    Iron Gluconate, Nature's Way, 18 mg, 100 Caps
    Multi-Vitamin & Mineral Complex As directed on label. To improve overall health and assure proper nutrition. All nutrients are needed in balance for healing and repair of tissues and for immune response. Use a complex without copper.
    With
    Potassium
    99 mg daily. Necessary for proper muscle contractions. Warnings: Diabetics, persons with kidney disease, or those taking diuretics or prescription potassium supplements should consult their health care provider regarding the use of potassium supplements in their diet.
    Potassium Chelate, 100% Natural, Nature's Way, 99 mg, 100 Caps,
    Potassium Chloride Powder, NOW Foods, Vegetarian, 8 oz.,
    Potassium Ionic Mineral Supplement, Fully Absorbable, 340 +/- ppm, 16 fl. oz.
    And With
    Selenium
    200 mcg daily. If you are pregnant, do not exceed 40 mcg daily. Needed for proper adrenal gland function. Caution:Consult a health care provider before taking supplemental selenium if you are pregnant or have heart, kidney, or liver disease.
    Selenium Supplement, Yeast Free, NOW Foods, 200 mcg, 180 Caps,
    Selenium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.,
    Ionic Selenium, Trace Minerals, 300 mcg, 2 fl. oz.,
    Selenium, 100% Natural, Nature's way, 200 mcg, 100 Caps
    Vitamin A 10,000 IU daily. If you are pregnant, do not exceed 10,000 IU daily. Powerful antioxidants that also enhance immunity.
    Vitamin A, 100% Natural, Nature's Way, 10,000 IU, 100 Softgels,
    Vitamin A, Fish Liver Oil, NOW Foods, 25,000 IU, 250 Softgels,
    Dry Vitamin A & D, Nature's Way, 15,000 IU / 400 IU, 100 Caps,
    Shark Liver Oil, NOW Foods, 400 mg With 10,000 IU Vitamin A, 120 Softgels
    Plus
    Natural Beta-Carotene
    Or
    Carotenoid Complex (Betatene)
    15,000 IU daily. An antioxidant and precursor of vitamin A. Needed by all cells for repair and rebuilding.
    Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels,
    Multi-Carotene Antioxidant, Nature's Way, 60 Softgels
    Vitamin B Complex 75 mg of each B vitamin daily, with meals 3 times daily (amounts of individual vitamins in a complex will vary). Protects the liver and is needed for proper brain function.
    Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs,
    Liquid Yeast B Complex, Twinlab, 16 Fl oz.,
    Vitamin B-100 Complex, W/ Coenzyme B-2, Nature's Way, 631 mg, 100 Caps,
    Vitamin B=50 Complex, W/ Coenzyme B-2, Nature's Way, 330 mg, 100 Caps,
    And
    Vitamin B-6 (Pyridoxine)
    50 mg 3 times daily. Helps to prevent damage to the nervous system and guard against anemia. Also combats fluid retention.
    Vitamin B-6 / Pyridoxine, Nature's Way, 100 mg, 100 Caps
    Vitamin C
    With
    Bioflavonoids
    3,000-5,000 mg daily, in divided doses. Protects against inflammation, anemia, and hepatitis. Reduces copper levels in the body. Use an esterified form.
    Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz.,
    Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs,
    Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps,
    The Right C, Nature's Way, 1000 mg, 120 Tabs
    Vitamin E 100-600 IU daily. Take separately from iron. Promotes normal healing and prevents cell damage. Use d-alpha-tocopherol form.
    Ester E Natural Vitamin E, California Natural, 400 IU, 60 Softgels,
    Vitamin E, 400 IU, 100% Natural, NOW Foods, 100 Gels,
    Vitamin E-1000, NOW Foods, 1000 IU, 100 Gels,
    Vitamin E, d-alpha-tocopherol, 400 IU, 100 Softgels,
    Vitamin E Oil, D-Alpha, Vegetarian, 32,000 IU, NOW Foods, 1 oz.
    Zinc 75 mg daily. Do not exceed this amount. Decreases copper levels and enhances immunity. Zinc balances copper in the body. Use zinc gluconate lozenges or zinc methionate (Optizinc) for best absorption.
    Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.,
    Colloidal Silver & Zinc Lozenges, Silva Solution, 90 Lozenges,
    Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges,
    Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps
    Important
    Acetyl-L-Carnitine As directed on label. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B-6 and 100 mg of vitamin C for better absorption. Protects the liver and heart function. See Amino Acids for more information.
    Acetyl-L-Carnitine Powder, Vegetarian, NOW Foods, 635 mg, 2 oz.,
    L-Carnitine Liquid, Double-Strength, NOW Foods, 16 fl. oz.,
    Acetyl-L-Carnitine, Pharmaceutical Grade, NOW Foods, 500 mg, 100 Caps
    Advanced Carotenoid Complex
    (Solgar)
    As directed on label. Contains powerful free radical scavengers and immune enhancers.
    Calcium 1,500-2,000 mg daily. Calcium works with magnesium to prevent muscle spasms.
    Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz.,
    Liquid Calcium W/ConcenTrace, Orange Vanilla, Trace Minerals, 1000 mg, 32 fl. oz.,
    Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 Gelcaps
    Magnesium 750-1,000 mg daily. Magnesium works with calcium to prevent muscle spasms.
    Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz.,
    Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz.,
    Calcium & Magnesium Mineral Complex, 100% Natural, Nature's Way, 500 mg / 250 mg, 250 Caps
    Coenzyme Q-10 As directed on label. A powerful antioxidant and free radical scavenger that also increases the supply of oxygen to the cells and supplies oxygen to the liver. A potent liver protector and it increases circulation and energy.
    CoQ10, Vegetarian Coenzyme, NOW Foods, 30 mg, 60 VCaps,
    CoQ10, Now Foods, 400 mg, 60 Softgels
    Plus
    Coenzyme A
    As directed on label. Works with coenzyme Q-10 to support the immune system's detoxification of many dangerous substances.
    Pantethine (Coenzyme A Precursor), Highly Active Form of Vitamin B-5, 300 mg, NOW Foods, 60 Softgels,
    Essential Fatty Acids
    (Flaxseed Oil)
    As directed on label. To supply essential fatty acids, which are vital for brain and nerve function and enhance immunity.
    Barlean's Flax Oil, 100% Highest Lignan Content, Organic, Pesticide & Herbicide Free, 16 fl. oz.,
    Barlean's Flax Oil, Highest Lignan, 1000 mg, 250 Caps
    Free-Form Amino Acid Complex As directed on label. Take on empty stomach. A good source of protein that is easy on the liver because it has already been broken down. Necessary for protein synthesis. Use a formula containing all the essential amino acids.
    Amino 1000 Complete, NOW Foods, 120 Caps,
    Amino 1500, Chewable Blend of 20 Amino Acids, Predigested, NOW Foods, 150 Tabs
    Gamma-Amino-Butyric Acid (GABA) As directed on label. Take on empty stomach. Essential for proper brain function. Also has a tranquilizing effect. See Amino Acids for more information.
    GABA (Gamma Aminobutyric Acid) Supplement, NOW Foods, 500 mg, Plus B-6, 2 mg, 100 Caps,
    GABA Powder (Gamma Aminobutyric Acid), 100% Pure, Vegetarian, NOW Foods, 500 mg, 6 oz.
    L-Arginine
    And
    L-Ornithine
    As directed on label. Take on empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B-6 and 100 mg of vitamin C for better absorption. To aid in liver and kidney detoxification. See Amino Acids for more information.
    L-Arginine & L-Ornithine, NOW Foods, 500 mg/250 mg, 100 Caps,
    L-Arginine, Pharmaceutical Grade, Free Form, NOW Foods, 500 mg, 100 Caps,
    L-Arginine, Pharmaceutical Grade, Vegetarian, NOW Foods, 1000 mg, 120 Tabs,
    L-Ornithine, NOW Foods, 500 mg, 120 Caps
    Plus
    L-Cysteine
    As directed on label, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B-6 and 100 mg of vitamin C for better absorption. Reduces the body's absorption of copper. To aid in liver detoxification and protect the liver cells. See Amino Acids for more information.
    L-Cysteine Structural Support With Vitamin B-6 & C, Vegetarian, NOW Foods, 500 mg, 100 Tabs,
    NAC (N-Acetyl-Cysteine), NOW Foods, Selenium, Molybdenum, 600 mg, 100 Caps
    Methylsulfonylmethane (MSM) As directed on label. Contains sulfur, which aids in removing copper from the body.
    MSM Liquid, Pure Lignisul Methylsulfonylmethane, 16 fl. oz.,
    MSM, Pure Lignisul Methylsulfonylmethane, 500 mg, 250 Caps,
    MSM, Pure Lignisul Methylsulfonylmethane, 1000 mg, 240 Caps,
    MSM Powder, Pure Lignisul Methylsulfonylmethane, 4 oz.
    Pycnogenol
    And/Or
    Grape Seed Extract
    As directed on label.

    As directed on label.
    Powerful antioxidants that lessen mental deterioration.
    Pycnogenol W/ Vitamin E, 100% Natural, Nature's Way, 50 mg, 30 Tabs,
    Grape Seed (Grapeseed) (Vitus vinifera), 100% Pure, NOW Foods, 16 fl. oz.





    DETOXIFYING SUPPLEMENTS & PRODUCTS

    Information and supplements to help with environmental toxicity.

    MineralCheck Home Mineral Analysis, Mail-In Hair Test Kit

    MineralCheck Home Mineral Analysis Mail-in Hair Test Kit is a safe, easy-to-use, and reliable screen that uses a small hair sample to measure your mineral and toxin levels. Hair samples show the long-term accumulation of minerals and toxic elements in your system. Hair is nourished from your bloodstream where minerals and toxics are found. This non-invasive and inexpensive screen provides you with the accuracy of a laboratory analysis without leaving the comfort of your own home. When you order your screen, they will send you a complete kit. You collect the required hair sample and send it back to them in the prepaid return mailer provided. Within 7-10 working days of receiving your sample, they will send your results to you. MineralCheck by BodyBalance assesses your body's levels of the following 11 minerals and 9 toxic elements:

    MINERALS: Calcium, Chromium, Cobalt, Copper, Magnesium, Manganese, Molybdenum, Strontium, Sulfur, Vanadium, Zinc

    TOXIC ELEMENTS: Aluminum, Antimony, Arsenic, Bismuth, Cadmium, Lead, Mercury, Nickel, Tin
    Detox Foot Pads, 10 Detox Foot Patches Per Box

    The BodyPure brand detox foot pads are the most effective, 100% natural detox foot patches available. This detox pad has been the number one selling detox foot patch in Japan 12 times in a row! The Japanese and now many Americans have are using these detox foot patches to cleanse the body of unwanted toxins. These foot patches literally suck the toxins out of the body to help the body function better. Removing body toxins helps support liver function, and helps combat fatigue, attention deficit, allergies, and poor circulation, while increasing metabolism and enhancing sleep. Any time you can remove unwanted toxins from your body you support your body's wellbeing. These detox foot patches are designed to maximize the removal of toxins in the body. They are easy to use, and work quickly.

    Suggested Use: One self sticking detox foot patch is applied to each foot nightly for five days, and then repeated for 5 day periods for up to thirty days. For continued maintenance cleansing a foot patches may be applied one to two times per week. Patches may be applied on the heal, center or front of the foot. Best when used at night when sleeping. Complete application instructions and use are included in each box.

    1) The visual evidence of removed toxins is apparent after each application of the detox foot patch. The physical progress is apparent when used over a few consecutive days.
    2) Samples used detox pads were sent to SRC Analytical Lab, a highly accredited Environmental Laboratory. Their test results showed that the detox foot pads absorbed Nickel, Arsenic and Mercury into the pads.
    3) Multiple detox pads removed from various individuals were analyzed by using a syncrometer. The syncrometer is an electronic device used to detect numerous toxic substances. The following toxins have been identified in the used detox pads: benzene, isopropyl alcohol, methyl alcohol, aluminum, cadmium, copper, lead, mercury, nickel, thallium, arsenic, asbestos, DAB dye, fast green dye, sudan black dye and PCB (plastic byproduct).
    4) Extensive research in Japan has been conducted with the use of Thermography (infrared technology). The detox foot pads have been tested for their ability to stimulate circulation by means of these thermographic sensors.
    5) Further research was conducted on the healing and relaxation properties of the BodyPure pads through measurement of alpha brain waves.


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