Podcasts about citrate

In this episode, Jeff Sarris and Jill Harris discuss the relationship between vitamin C and kidney stones, exploring how excessive intake of vitamin C can increase the risk of kidney stones, particularly in men. They emphasize the importance of a healthy diet rich in fruits and vegetables over supplements, and provide practical dietary recommendations for kidney stone prevention. Additionally, they share natural strategies to boost the immune system, highlighting the significance of hydration and overall lifestyle choices.TakeawaysToo much vitamin C can increase kidney stone risk.Men are more affected by vitamin C than women.Citrate levels in women may protect against stones.A healthy diet is more effective than supplements.Fruits and vegetables boost immune system better than pills.Stay hydrated to reduce kidney stone risk.Low citrate levels can lead to higher stone risk.Vitamin C supplements should be approached with caution.Natural sources of vitamin C are preferable.Regular check-ups and urine tests are essential for prevention.00:00 Introduction to Vitamin C and Kidney Stones05:41 Dietary Recommendations for Kidney Stone Prevention——HAVE A QUESTION? _Leave us a voicemail at (773) 789-8764.KIDNEY STONE DIET® APPROVED PRODUCTSProtein Powders, Snacks, and moreWORK WITH JILL _Start HereKidney Stone Diet® All-Access PassKidney Stone Diet® CourseKidney Stone Diet® Meal PlansKidney Stone Diet® BooksPrivate Consultation with JillOne-on-One Deep Dive24-Hour Urine AnalysisSUPPORT THE SHOW _Join the PatreonRate Kidney Stone Diet on Apple Podcasts or Spotify——WHO IS JILL HARRIS? _Since 1998, Jill Harris has been the #1 kidney stone prevention nurse helping patients reduce their kidney stone risk. Drawing from her work with world-renowned University of Chicago nephrologist, Dr. Fred Coe, and the thousands of patients she's worked with directly, she created the Kidney Stone Diet®. With a simple, self-guided online video course, meal plans, ebooks, group coaching, and private consultations, Kidney Stone Diet® is Jill's effort to help as many patients as possible prevent kidney stones for good.

In this conversation, Jeff Sarris and Jill Harris discuss the relationship between diet, particularly lemonade, and kidney stone prevention. Jill emphasizes the importance of specific dietary guidelines and the role of citrate in preventing kidney stones. They explore the misconceptions surrounding lemonade as a remedy and advocate for healthier dietary choices, including fruits and vegetables, while stressing the need for urine analysis to tailor dietary recommendations.TakeawaysLemonade can be misleading in kidney stone prevention.Specific dietary guidelines are crucial for kidney stone formers.Citrate plays a protective role against kidney stones.Urine analysis is essential for personalized dietary advice.Fruits and vegetables are preferred over sugary drinks.Lowering sodium and sugar intake benefits overall health.Generic dietary advice often lacks necessary specifics.Understanding the reasons behind dietary recommendations is important.Healthy lifestyle changes can reduce kidney stone risk.Regular follow-ups are necessary to assess dietary effectiveness.00:00 Understanding Kidney Stones and Diet02:53 The Role of Lemonade in Kidney Stone Prevention05:55 Importance of Citrate and Urine Analysis08:48 Healthy Alternatives to Lemonade11:57 Final Thoughts on Kidney Stone Prevention——HAVE A QUESTION? _Leave us a voicemail at (773) 789-8764.KIDNEY STONE DIET® APPROVED PRODUCTSProtein Powders, Snacks, and moreWORK WITH JILL _Start HereKidney Stone Diet® All-Access PassKidney Stone Diet® CourseKidney Stone Diet® Meal PlansKidney Stone Diet® BooksPrivate Consultation with JillOne-on-One Deep Dive24-Hour Urine AnalysisSUPPORT THE SHOW _Join the PatreonRate Kidney Stone Diet on Apple Podcasts or Spotify——WHO IS JILL HARRIS? _Since 1998, Jill Harris has been the #1 kidney stone prevention nurse helping patients reduce their kidney stone risk. Drawing from her work with world-renowned University of Chicago nephrologist, Dr. Fred Coe, and the thousands of patients she's worked with directly, she created the Kidney Stone Diet®. With a simple, self-guided online video course, meal plans, ebooks, group coaching, and private consultations, Kidney Stone Diet® is Jill's effort to help as many patients as possible prevent kidney stones for good.

This conversation delves into the role of potassium citrate in kidney stone prevention and management, particularly focusing on its effectiveness for uric acid stones. Jill Harris emphasizes the importance of medical consultation before taking potassium citrate, the necessity of urine tests to determine citrate levels, and the impact of diet on kidney stone formation. The discussion also highlights the potential side effects of potassium citrate and the benefits of incorporating fruits and vegetables into one's diet to naturally manage urine pH and citrate levels.The TRUTH about potassium citrate and your kidney stonesTakeawaysPotassium citrate is effective for dissolving uric acid stones.Medical consultation is crucial before taking potassium citrate.A 24-hour urine collection is necessary to assess citrate levels.Citrate protects calcium in the urine, reducing stone formation risk.Diet plays a significant role in managing kidney stone risk.High urine pH can lead to calcium phosphate stones.Potassium citrate can cause stomach upset and diarrhea.Increasing fruits and vegetables can naturally raise urine pH.Moonstone may be beneficial for patients with malabsorption issues.Regular follow-ups can help adjust potassium citrate dosage.00:00 Understanding Potassium Citrate and Kidney Stones09:43 The Role of Diet in Kidney Stone Prevention——HAVE A QUESTION? _Leave us a voicemail at (773) 789-8764. NEW NUMBER!KIDNEY STONE DIET® APPROVED PRODUCTSProtein Powders, Snacks, and moreWORK WITH JILL _Kidney Stone Diet®Kidney Stone Prevention CourseKidney Stone Diet® Meal PlansSUPPORT THE SHOW _Join the PatreonRate Kidney Stone Diet on Apple Podcasts or Spotify——WHO IS JILL HARRIS? _For over 25 years, Jill Harris has been a kidney stone prevention nurse helping patients reduce their kidney stone risk. Drawing from her work with world-renowned University of Chicago nephrologist, Dr. Fred Coe, and the thousands of patients she's worked with directly, she created the Kidney Stone Diet®. With a simple, self-guided online video course, meal plans, ebooks, and group coaching, Kidney Stone Diet® is Jill's effort to help as many patients as possible stop making kidney stones for good.

In this episode of the Kidney Stone Diet podcast, Jill Harris discusses the importance of understanding nutritional deficiencies and their impact on preventing kidney stones. She explores how deficiencies in hydration, calcium, and other nutrients can increase the risk of kidney stones, particularly in individuals with malabsorption issues or those who have undergone bariatric surgery. She emphasizes a balanced diet and gives practical strategies to reduce kidney stone risk, while also encouraging listeners to maintain hope and consistency in their diet.TakeawaysNutritional deficiencies can significantly increase the risk of kidney stones.Hydration is crucial; insufficient water intake leads to concentrated urine and stone formation.Calcium deficiency can lead to higher oxalate levels, increasing stone risk.Malabsorption issues, such as those from bariatric surgery, can complicate nutrient absorption.Citrate plays a protective role against kidney stones by surrounding calcium in urine.Eating less processed food can help reduce nutritional deficiencies.Consistency in dietary practices is more important than perfection.Bariatric patients often require higher calcium supplementation due to malabsorption.There is always hope for kidney stone formers; lifestyle changes can lead to improvement.00:00 Introduction02:09 Exploring the Deficiency that Causes Kidney Stones05:31 The Impact of Malabsorption on Stone Formation06:00 Different Types of Deficiencies and Their Effects07:24 Addressing Deficiencies through Diet and Medical Interventions08:20 Consistency and Enjoyment in Maintaining a Healthy Lifestyle09:45 The Link Between Deficiency and Kidney Stone Risk10:49 Resources for Kidney Stone Prevention11:16 Encouragement and Hope for Kidney Stone Formers11:43 Conclusion and Call to Action——HAVE A QUESTION? _Leave us a voicemail at (773) 789-8764. NEW NUMBER!KIDNEY STONE DIET® APPROVED PRODUCTSProtein Powders, Snacks, and moreWORK WITH JILL _Kidney Stone Diet®Kidney Stone Prevention CourseKidney Stone Diet® Meal PlansSUPPORT THE SHOW _Join the PatreonRate Kidney Stone Diet on Apple Podcasts or Spotify——WHO IS JILL HARRIS? _For over 25 years, Jill Harris has been a kidney stone prevention nurse helping patients reduce their kidney stone risk. Drawing from her work with world-renowned University of Chicago nephrologist, Dr. Fred Coe, and the thousands of patients she's worked with directly, she created the Kidney Stone Diet®. With a simple, self-guided online video course, meal plans, ebooks, and group coaching, Kidney Stone Diet® is Jill's effort to help as many patients as possible stop making kidney stones for good.

In this episode of The Metabolic Classroom, Dr. Bikman introduces the concept of the Randle Cycle, also known as the glucose fatty acid cycle, in a lecture aimed at providing a better understanding of metabolism. The Randle Cycle, first identified by Dr. Philip Randle and his colleagues in the 1960s, explores how cells decide between using glucose or fatty acids for fuel. Dr. Bikman emphasized that this cycle has been misinterpreted on social media and aims to clarify its relevance in metabolic functions and nutritional decisions.https://www.insuliniq.com 00:00 - Introduction to the Metabolic Classroom and Dr. Ben Bikman01:00 - Overview of the Randle Cycle (Glucose Fatty Acid Cycle)02:00 - Historical Background: Philip Randle's Research03:00 - Experimental Model: Perfused Rat Hearts04:00 - Key Terms: Glucose and Fatty Acids05:00 - Concept of Substrate Competition06:00 - Reciprocal Inhibition: Fats vs. Glucose08:00 - Fatty Acid Oxidation Process10:00 - Biochemical Pathways: Acetyl-CoA, NADH, and Pyruvate Dehydrogenase12:00 - Role of Citrate in Glycolysis Inhibition14:00 - Glucose Utilization and Malonyl-CoA16:00 - Insulin's Role in Fuel Selection18:00 - Insulin's Impact on Glucose and Fat Burning20:00 - Diabetes Case Study: Type 1 and Type 222:00 - Type 1 Diabetes: High Glucose and Fatty Acids24:00 - Ketones Production in the Liver26:00 - Type 2 Diabetes: Insulin Resistance and Metabolic Inflexibility28:00 - Insulin Resistance in Fat Cells30:00 - Metabolic Inflexibility in Type 2 Diabetes32:00 - Insulin Resistance in the Brain34:00 - The Impact on Hunger and Neurological Disorders36:00 - Conclusion: Importance of Insulin in Metabolic Health#Metabolism #RandleCycle #DrBenBikman #InsulinResistance #GlucoseMetabolism #FattyAcidOxidation #MetabolicHealth #DiabetesResearch #Ketosis #Type1Diabetes #Type2Diabetes #InsulinRole #CellBiology #NutritionalScience #MetabolicFlexibility #Ketones #GlucoseUtilization #FatBurning #BiomedicalScience #HealthLectureMy favorite meal-replacement shake: https://gethlth.com (discount: BEN10)My favorite electrolytes (and more): https://redmond.life (discount: BEN15)My favorite allulose source: https://rxsugar.com (discount: BEN20)References:https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/randle-cycle Insulin Regulation of Ketone Body Metabolism: https://onlinelibrary.wiley.com/doi/10.1002/0470862092.d0308The Effects of a Ketogenic Diet and Exercise Interventions on Cognitive Function: https://faseb.onlinelibrary.wiley.com/doi/10.1096/fasebj.31.1_supplement.lb810(Due to character length constraints, not every reference is posted above. For a complete list, please email: support@insuliniq.com with your request.) Hosted on Acast. See acast.com/privacy for more information.

In this episode, Melanie answers a listener question about urine citrate. She dives into what citrate is, why it is so important, and what we can do nutritionally to increase urine citrate levels.   Blog: Potassium Citrate in Food Blog: Can Too Much Protein Cause Kidney Stones?   Submit a question for Melanie to answer on the podcast! Connect with The Kidney Dietitian!  Instagram | Facebook | Pinterest | Facebook Group | Newsletter www.thekidneydietitian.org All information in this podcast is meant for educational purposes only and should not be used in place of advice from a medical professional.  

Is bicarbonate supplementation for metabolic acidosis in chronic kidney disease (CKD) a thing we do for no reason? We cover the pathophysiology and long-term consequences of metabolic acidosis, the history of bicarbonate use, alternative options for bicarbonate repletion including baking soda, lemon juice, fruits and veggies, whether the renal diet works, counseling patients with CKD, and common mistakes and pitfalls in managing metabolic acidosis in CKD. Our guest is Dr. Timothy Yau (@Maximal_Change, @WUNephrology, @AJKDOnline). It's NephMadness 2024! Fill out your bracket today and check out the other podcasts participating in the NephMadness pod crawl! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Time stamps refer to the ad-free version 00:00 Introduction and Guest Bio 07:46 Case Presentation 08:42 Initial Approach to CKD Management 09:10 Metabolic Acidosis in CKD 13:30 Consequences of Metabolic Acidosis 22:28 Administration of Bicarbonate 23:54 Alternative Options for Bicarbonate Repletion 24:47 Citrate and Bicarbonate 26:02 Sodium Bicarbonate for CKD 30:19 Dietary Modifications 33:35 Renal Diet 38:20 Counseling CKD Patients 41:39 Veverimer and Other Treatments 44:36 Mistakes and Pitfalls 46:55 Conclusion Credits Writer and Producer: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Timothy Yau MD Sponsor: Rocket Money  Cancel your unwanted subscriptions by going to RocketMoney.com/CURB Sponsor: Freed You can try Freed for free right now by going to freed.ai And listeners of Curbsiders can use code CURB 50 for $50 off their first month. 

Pills or Topical. Oral vs Transdermal. Mesoderm or Ectoderm? Piece meal or Abundance?The Heart of Tradition Podcast- For everything magnesium but also life changing ideas, European wisdom, health tips and more from the speartip!ALSO: Goodbye Industrial Grade Magnesium claiming to be Zechstein. Hello Clear-stone, Zero Solvent Magnesium !! Can you call the source? With us you can.Always in healthy blue GLASS. Only One Ingredient. Verifiable Zechstein.For our videos check out our website. Click on Videos. OR for our Blog, Click on Blog.20% off with code HEART20 theheartoftradition.com

Supplements are meant to supplement a healthy lifestyle, not act as a bandaid to mitigate poor lifestyle choices. While choosing whole foods sources to get certain nutrients is ideal instead of supplements, sometimes we can't make the best choices due to our modern world or environment.  In this episode, I share 6 supplements that I take daily for optimal health, the benefits of these supplements, my go-to brands, and how much I take daily.   In this episode, I discuss: 01:30 - The critical role of sodium in our health, debunking of the misconception that excessive sodium leads to cardiovascular diseases 09:23 - The different types of magnesium salts and their specific advantages 13:18 - Creatine for muscle mass and brain health 15:15 - ION Gut Support, a unique supplement that is sourced from ancient soil and contains bacterial metabolites that can help with gut health and immunity. 20:09 - How bovine colostrum dramatically improves gut health, boosts immune support, and also improves exercise performance 23:30 - The nutritional benefits of beef organs and the importance of maintaining natural ratios when consuming organ supplements   Learn more from Michael Kummer: Use code “primalshift” to save 15% on your order at https://shop.michaelkummer.com/ Website: https://michaelkummer.com/ Instagram: @mkummer82   Resources: Salt (Sodium) Sodium is just one of the minerals important for optimal electrolyte balance. That's why we like LMNT: https://michaelkummer.com/go/lmnt Redmond and Oryx are the salt brands we use. Salts that are unprocessed and contain trace minerals: https://michaelkummer.com/go/realsalt Urinary sodium and potassium excretion and risk of cardiovascular events: https://pubmed.ncbi.nlm.nih.gov/22110105/ Magnesium Different types of magnesium salts: Citrate → constipation Sulfate → relaxation Threonate → cognition Taurate → heart health Chloride → digestion Malate → muscles Glycinate → sleep CALM from Natural Vitality (magnesium carbonate): https://amzn.to/49OysWx Magnesium Breakthrough from BiOptimizers (mix of different types of magnesium. Code MK10 for 10% off): https://michaelkummer.com/go/bioptimizersmagnesium Creatine Found in meat. Carnivores may not need it (1lb of beef has 1-2 grams of creatine), but it won't hurt. We use Creatine Monohydrate from Bulk Supplements: https://amzn.to/47rkOal ION Gut Support ION's humic extract is US-sourced from ancient soil (roughly 60 million years old!) and contains a blend of bacterial metabolites (fulvate) as well as less than 1% of a variety of trace minerals and amino acids.  We use it while traveling and during the colder seasons of the year. They also have a nasal spray. ION* Gut Support: https://michaelkummer.com/go/restore Also available for pets Bovine colostrum Colostrum is the first milk that mammals produce when giving birth. Full of micronutrients, including: lactoferrin, growth factors, immunoglobulins, lysozyme Immune support: reduced the incidence of complications and hospital admissions (related to the flu) by 300%: https://pubmed.ncbi.nlm.nih.gov/17456621/ Additional resources: https://michaelkummer.com/health/bovine-colostrum-benefits/ Top 4 Reasons You Should Supplement with Colostrum (Based on Science): https://youtu.be/HcdguwrV8aE Product we use: Equip Core Colostrum during the colder time of the year. Code MK15 for 15% off at https://michaelkummer.com/go/equipcorecolostrum Freeze-dried beef organs My wife and I founded MK Supplements in 2021 to provide a convenient source of regeneratively raised and 100% grass-fed beef organs for the entire family. My regimen: Full serving of Beef Organs, half a serving of Bone & Marrow and half a serving of Heart & Spleen. Wife does the same. The kids (10 and 8) get Half a serving of each. Use code PRIMALSHIFT for 15% off at https://shop.michaelkummer.com/products/freeze-dried-beef-organs?selling_plan=689239851324

In this podcast, the Richard Smith discusses the misconceptions surrounding antioxidants, plant-based diets, and the impact on human health and the environment. He also delves into the harmful effects of plant toxins, the benefits of animal proteins, and the importance of proper nutrition. Coach Stephen and Richard also address questions about chapped lips, sodium-potassium ratios, and cholesterol levels. This informative and eye-opening discussion challenges common beliefs and sheds light on a controversial topic.Timestamps:0:00 - Introduction0:08 - Discussion about Astaxanthin0:36 - Impact of TV on Researching1:18 - Exploration into Antioxidants and Astaxanthin1:38 - Difference between Antioxidants in Plants and Astaxanthin2:11 - Elevation of Glutathione as Prooxidant Effect2:35 - True Antioxidant Effects and Elevation of Glutathione3:07 - Importance of Environmental Homemesis and Astaxanthin4:34 - Personal Research Habits and Rabbit Hole of Antioxidants4:48 - Discussion about the Noaks Foundation4:53 - Housekeeping and Viewer Interactions6:32 - Carbohydrate Intake and Blood Sugar Handling9:40 - Potential Carbohydrate Limits and Brain Glucose Needs10:38 - Effects of Carbohydrate on Blood Pressure and Glucose Needs18:34 - Effects of Carbs on Chapped Lips and Lip Balm Ingredients29:50 - Discussion about Cholesterol and Lipid Profiles41:46 - Effects of Low Insulin on Sodium Excretion and Blood Pressure43:13 - Effects of Low Insulin on Sodium Excretion and Blood Pressure Continues47:54 - Discussion about Veganism and Environmental ImpactThank you so much for listening to my podcast. I hope you enjoyed it. Your support means the absolute world to me. And if you're enjoying the show, I've got a small favor to ask you. I'd be incredibly grateful if you would consider becoming a supporter and make a small monthly donation. Your contribution will really help to improve the show. It's a small monthly contribution. You can cancel at any time, and the link is in the show notes. Support the showAll my links in 1 easy list, including booking and personal training workout plans at LINKTREE You can now download the carnivore experience appApple direct link for apple devices Google play store direct link to app for Android Coach Stephen's Instagram Book me for coaching My growing UK carnivore YouTube channel I have set up a community that is all about eating low-carb and specifically carnivore. CLICK HERE Support my podcast from just £3 per monthBECOME A SUPPORTER Success stories Optimal Health 5 Star reviews All my facebook and other reviews are here Thanks to www.audionautix.com for any music included. Ple...

Richard Smith believes that potassium citrate supplementation can help manage oxalate dumping and fight calcium oxalate stone formation. Sally K Norton is on the show to talk about oxalates and how they can wreak havoc on our bodies. She recommends caution when it comes to tinkering with our calcium intake and recommends a book as a great resource for further learning. High oxalate intake causes the kidneys to waste sodium which contributes to keto flu and kidney stones, and clearing oxalates is important to maintain good health long-term. Sally and both the hosts believe that people are finally realizing that meat isn't what's causing their health problems and they're also beginning to supplement with electrolytes, magnesium, and calcium. Excess sodium depletes potassium, which can lead to all of these other issues. When eating a low carb ketogenic diet, it's important to keep an eye on electrolytes to make sure that we're not losing any essential minerals.Sally's book Toxic Superfoods is now available.Order via the Affiliate Link on Amazon https://amzn.to/3T2b2Dqwww.sallyknorton.comInstagram: @sknortonFor more information, visit SallyKNorton.com or follow Sally on social media. She's @sknorton and @toxicsuperfoods_oxalate_book (on Instagram), @BeFreeToThrive (on Facebook), Better with Sally K. Norton (on YouTube), and @BetterLowOx (on Twitter.)Thank you so much for listening to my podcast. I hope you enjoyed it. Your support means the absolute world to me. And if you're enjoying the show, I've got a small favor to ask you. I'd be incredibly grateful if you would consider becoming a supporter and make a small monthly donation. Your contribution will really help to improve the show. It's a small monthly contribution. You can cancel at any time, and the link is in the show notes. Support the showAll my links in 1 easy list, including booking and personal training workout plans at LINKTREE You can now download the carnivore experience appApple direct link for apple devices Google play store direct link to app for Android Coach Stephen's Instagram Book me for coaching My growing UK carnivore YouTube channel I have set up a community that is all about eating low-carb and specifically carnivore. CLICK HERE Support my podcast from just £3 per monthBECOME A SUPPORTER Success stories Optimal Health 5 Star reviews All my facebook and other reviews are here Thanks to www.audionautix.com for any music included. Ple...

Sally K Norton offers advice for everyday people who want to be healthier and lessen their risk for chronic diseases such as heart disease, cancer, and kidney stones. Sally mentions that Vitamin C, collagen, and other supplements can increase endogenous oxalate production.Gout is an inflammatory reaction to crystals, and oxalates can be a big part of it. Calcium supplementation is not always necessary for breaking down oxalates, but it is an effective way to improve overall health. oxalic dumping is an extreme event of purging from the tissues. The way you would know that oxalates are the source of your pain and fatigue is that you might see some outward signs like cloudy urine or tartar in the teeth. If you're clearing quickly, you may experience gritty or burning stools, skin things like rashes and boils, or bone pain, you may want to slow this down. Adding oxalate every day can help achieve this? Oxalate is a natural compound. Plants make it. It's in nature and lots of places, and it's toxic when you eat too much of it. Oxalates are found in many different foods, but notable sources include sweet potatoes, spinach, rhubarb, and strawberries. Oxalate can form kidney stones when consumed in high amounts. If you're a kidney stone patient, it's important to limit your intake of oxalates. If you're not a kidney stone patient, it's still important to watch your intake of oxalates because they can form in many different foods. Enlightened nutritionists can provide advice on how to eat healthily and reduce your risk for chronic diseases.Sally's book via the Affiliate Link on Amazon https://amzn.to/3T2b2Dqwww.sallyknorton.comInstagram: @sknorton and @toxicsuperfoods_oxalate_book, @BeFreeToThrive (on Facebook), Better with Sally K. Norton (on YouTube), and @BetterLowOx (on X.)Thank you so much for listening to my podcast. I hope you enjoyed it. Your support means the absolute world to me. And if you're enjoying the show, I've got a small favor to ask you. I'd be incredibly grateful if you would consider becoming a supporter and make a small monthly donation. Your contribution will really help to improve the show. It's a small monthly contribution. You can cancel at any time, and the link is in the show notes. Support the showAll my links in 1 easy list, including booking and personal training workout plans at LINKTREE You can now download the carnivore experience appApple direct link for apple devices Google play store direct link to app for Android Coach Stephen's Instagram Book me for coaching My growing UK carnivore YouTube channel I have set up a community that is all about eating low-carb and specifically carnivore. CLICK HERE Support my podcast from just £3 per monthBECOME A SUPPORTER Success stories Optimal Health 5 Star reviews All my facebook and other reviews are here Thanks to www.audionautix.com for any music included. Ple...

Just the boys on this episode and we talk:Noosa Tri / 70.3 Melbourne / Busso IM (0.35)Pro athletes that retired too early & age groupers going Pro (18.14)Potentially negative impacts of Ibuprofen & Sodium Citrate (38.55)Fan questions:Peeing on long bike sessions (46.40)Favourite key run session (49.29)Dan Plews sub 8hr IM (53.24)Street fight between Danny and Steve (57.57)Follow us at:Insta: @triathlon_therapy_podcastTiktok: @triathlontherapypodcast

Pamela M. Peeke MD, MPH, FACP, FACSM, is joined by Rajesh Speer, PharmD, MSHA, MS, to delve into continuous renal replacement therapy (CRRT) and anticoagulation. Unravel the intricacies of anticoagulation options, with an emphasis on citrate variations. Understand low- versus high-concentrate citrate and the nuances between compounding and commercially available products. Gain invaluable insights from a pharmacist's standpoint about the ideal anticoagulation strategies for CRRT. This podcast is sponsored by Baxter Healthcare Corporation.

The written and referenced version is available to everyone now. The video and podcast will be released soon. On September 1, the written and referenced version will become permanently subscribers-only while the methylene blue content will be made public.

Ooohhhh we gonna glow up girls!

Transfusion's monthly podcast - read the associated article here: onlinelibrary.wiley.com/doi/10.1111/trf.17420

I've selected 2 key metabolic ingredients, Acetyl CoA and Citrate, to explain nutrition metabolism in further detail. I've also selected a different storyline, the mitochondrial amusement park and the Kreb's merry-go-round, to help you visualize some of the most fundamental steps of metabolism. In this episode we cover: Acetyl CoA's role as a key metabolic conductor The metabolic merry-go-round used to explain Kreb's cycle The importance of the Citrate sensor in switching between anabolism and catabolism How these concepts are tied to the root cause for weight gain and insulin resistance A critique of B-vitamin supplements as "energy producers"

This week, Jill answers a listener question about potassium citrate and whether too much can be a problem for kidney stone formers.——This podcast is designed to entertain and inform — not provide medical advice. Always consult your doctor before starting any treatment.——HAVE A QUESTION? _Leave us a voicemail at (773) 789-8763.SUPPORT THE SHOW _ Join the Patreon Rate Kidney Stone Diet on Apple Podcasts or Spotify BUY JILL'S FAVORITE PRODUCTS _ Silk Coconut Milk, Unsweetened Good Karma Non Dairy Unsweetened Flaxmilk Ripple Unsweetened Pea Milk Oatly Unsweetened Oat Milk Healthy ‘N Fit 100% Egg Protein Fairlife Core Power Elite High Protein Shake, Vanilla Hydroflask WORK WITH JILL _ Kidney Stone Prevention Course Kidney Stone Diet Meal Plans Safe Snacks and Desserts Ebook 24 Hour Urine Collection Analysis Private Coaching KIDNEY STONE RESOURCES _ Kidney Stone Diet Kidney Stone Diet Resources Oxalate Food List Kidney Stone Diet Recipes Meat Protein Calculator Kidney Stone Diet Podcast ——WHO IS JILL HARRIS? _Jill is a nurse and health coach that specializes in educating patients on kidney stone prevention. For more than 20 years she's helped patients understand that kidney stones can be prevented with the right treatment plan. It's one thing to be told to lower oxalate or drink more water, but HOW do you do it? That's where she comes in. Through the educational resources at kidneystonediet.com, stone formers can learn everything they need to know to significantly lower new stone risk.——Some of the links above may be affiliate links which means that we earn a small commission from qualifying purchases at no additional cost to you. Thanks for your support!——Kidney Stone Diet is a SPYR Podcast _More SPYR Podcasts _Starting Now / By Amara

ReferencesWe considered the complexity of the machinery to excrete ammonium in the context of research on dietary protein and how high protein intake may increase glomerular pressure and contribute to progressive renal disease (many refer to this as the “Brenner hypothesis”). Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal diseaseA trial that studied low protein and progression of CKD The Effects of Dietary Protein Restriction and Blood-Pressure Control on the Progression of Chronic Renal Disease(and famously provided data for the MDRD eGFR equation A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study GroupWe wondered about dietary recommendations in CKD. of note, this is best done in the DKD guidelines from KDIGO Executive summary of the 2020 KDIGO Diabetes Management in CKD Guideline: evidence-based advances in monitoring and treatment.Joel mentioned this study on red meat and risk of ESKD. Red Meat Intake and Risk of ESRDWe referenced the notion of a plant-based diet. This is an excellent review by Deborah Clegg and Kathleen Hill Gallant. Plant-Based Diets in CKD : Clinical Journal of the American Society of NephrologyHere's the review that Josh mentioned on how the kidney appears to sense pH Molecular mechanisms of acid-base sensing by the kidneyRemarkably, Dr. Dale Dubin put a prize in his ECG book Free Car Prize Hidden in Textbook Read the fine print: Student wins T-birdA review of the role of the kidney in DKA: Diabetic ketoacidosis: Role of the kidney in the acid-base homeostasis re-evaluatedJosh mentioned the effects of infusing large amounts of bicarbonate The effect of prolonged administration of large doses of sodium bicarbonate in man and this study on the respiratory response to a bicarbonate infusion: The Acute Effects In Man Of A Rapid Intravenous Infusion Of Hypertonic Sodium Bicarbonate Solution. Ii. Changes In Respiration And Output Of Carbon DioxideThis is the study of acute respiratory alkalosis in dogs: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC293311/?page=1And this is the study of medical students who went to the High Alpine Research Station on the Jungfraujoch in the Swiss Alps https://www.nejm.org/doi/full/10.1056/nejm199105163242003Self explanatory! A group favorite! It Is Chloride Depletion Alkalosis, Not Contraction AlkalosisEffects of chloride and extracellular fluid volume on bicarbonate reabsorption along the nephron in metabolic alkalosis in the rat. Reassessment of the classical hypothesis of the pathogenesis of metabolic alkalosisA review of pendrin's role in volume homeostasis: The role of pendrin in blood pressure regulation | American Journal of Physiology-Renal PhysiologyInfusion of bicarbonate may lead to a decrease in respiratory stimulation but the shift of bicarbonate to the CSF may lag. Check out this review Neural Control of Breathing and CO2 Homeostasis and this classic paper Spinal-Fluid pH and Neurologic Symptoms in Systemic Acidosis.OutlineOutline: Chapter 11- Regulation of Acid-Base Balance- Introduction - Bicarb plus a proton in equilibrium with CO2 and water - Can be rearranged to HH - Importance of regulating pCO2 and HCO3 outside of this equation - Metabolism of carbs and fats results in the production of 15,000 mmol of CO2 per day - Metabolism of protein and other “substances” generates non-carbonic acids and bases - Mostly from sulfur containing methionine and cysteine - And cationic arginine and lysine - Hydrolysis of dietary phosphate that exists and H2PO4– - Source of base/alkali - Metabolism of an ionic amino acids - Glutamate and asparatate - Organic anions going through gluconeogenesis - Glutamate, Citrate and lactate - Net effect on a normal western diet 50-100 mEq of H+ per day - Homeostatic response to these acid-base loads has three stages: - Chemical buffering - Changes in ventilation - Changes in H+ excretion - Example of H2SO4 from oxidation of sulfur containing AA - Drop in bicarb will stimulate renal acid secretion - Nice table of normal cid-base values, arterial and venous- Great 6 bullet points of acid-base on page 328 - Kidneys must excrete 50-100 of non-carbonic acid daily - This occurs by H secretion, but mechanisms change by area of nephron - Not excreted as free H+ due to minimal urine pH being equivalent to 0.05 mmol/L - No H+ can be excreted until virtually all of th filtered bicarb is reabsorbed - Secreted H+ must bind buffers (phosphate, NH3, cr) - PH is main stimulus for H secretion, though K, aldo and volume can affect this.- Renal Hydrogen excretion - Critical to understand that loss of bicarb is like addition of hydrogen to the body - So all bicarb must be reabsorbed before dietary H load can be secreted - GFR of 125 and bicarb of 24 results in 4300 mEq of bicarb to be reabsorbed daily - Reabsorption of bicarb and secretion of H involve H secretion from tubular cells into the lumen. - Thee initial points need to be emphasized - Secreted H+ ion are generated from dissociation of H2O - Also creates OH ion - Which combine with CO2 to form HCO3 with the help of zinc containing intracellular carbonic anhydrase. - This is how the secretion of H+ which creates an OH ultimately produces HCO3 - Different mechanisms for proximal and distal acidification - NET ACID EXCRETION - Free H+ is negligible - So net H+ is TA + NH4 – HCO3 loss - Unusually equal to net H+ load, 50-100 mEq/day - Can bump up to 300 mEq/day if acid production is increased - Net acid excretion can go negative following a bicarb or citrate load - Proximal Acidification - Na-H antiporter (or exchanger) in luminal membrane - Basolateral membrane has a 3 HCO3 Na cotransporter - This is electrogenic with 3 anions going out and only one cation - The Na-H antiporter also works in the thick ascending limb of LOH - How about this, there is also a H-ATPase just like found in the intercalated cells in the proximal tubule and is responsible for about a third of H secretion - And similarly there is also. HCO3 Cl exchanger (pendrin-like) in the proximal tubule - Footnote says the Na- 3HCO3 cotransporter (which moves sodium against chemical gradient NS uses negative charge inside cell to power it) is important for sensing acid-base changes in the cell. - Distal acidification - Occurs in intercalated cells of of cortical and medullary collecting tubule - Three main characteristics - H secretion via active secretory pumps in the luminal membrane - Both H-ATPase and H-K ATPase - H- K ATPase is an exchange pump, k reabsorption - H-K exchange may be more important in hypokalemia rather than in acid-base balance - Whole paragraph on how a Na-H exchanger couldn't work because the gradient that H has to be pumped up is too big. - H-ATPase work like vasopressin with premise H-ATPase sitting on endocarditis vesicles a=which are then inserted into the membrane. Alkalosis causes them to be recycled out of the membrane. - H secretory cells do not transport Na since they have few luminal Na channels, but are assisted by the lumen negative tubule from eNaC. - Minimizes back diffusion of H+ and promotes bicarb resorption - Bicarbonate leaves the cell through HCO3-Cl exchanger which uses the low intracellular Cl concentration to power this process. - Same molecule is found on RBC where it is called band 3 protein - Figure 11-5 is interesting - Bicarbonate resorption - 90% in the first 1-22 mm of the proximal tubule (how long is the proximal tubule?) - Lots of Na-H exchangers and I handed permeability to HCO3 (permeability where?) - Last 10% happens distally mostly TAL LOH via Na-H exchange - And the last little bit int he outer medullary collecting duct. - Carbonic anhydrase and disequilibrium pH - CA plays central role in HCO3 reabsorption - After H is secreted in the proximal tubule it combines with HCO# to form carbonic acid. CA then dehydrates it to CO2 and H2O. (Step 2) - Constantly moving carbonic acid to CO2 and H2O keeps hydrogen combining with HCO3 since the product is rapidly consumed. - This can be demonstrated by the minimal fall in luminal pH - That is important so there is not a luminal gradient for H to overcome in the Na-H exchanger (this is why we need a H-ATPase later) - CA inhibitors that are limited tot he extracellular compartment can impair HCO3 reabsorption by 80%. - CA is found in S1, S2 but not S3 segment. See consequence in figure 11-6. - The disequilibrium comes from areas where there is no CA, the HH formula falls down because one of the assumptions of that formula is that H2CO3 (carbonic acid) is a transient actor, but without CA it is not and can accumulate, so the pKa is not 6.1. - Bicarbonate secretion - Type B intercalated cells - H-ATPase polarity reversed - HCO3 Cl exchanger faces the apical rather than basolateral membrane- Titratable acidity - Weak acids are filtered at the glom and act as buffers in the urine. - HPO4 has PKA of 6.8 making it ideal - Creatinine (pKa 4.97) and uric acid (pKa 5.75) also contribute - Under normal cinditions TA buffers 10-40 mEa of H per day - Does an example of HPO4(2-):H2PO4 (1-) which exists 4:1 at pH of 7.4 (glomerular filtrate) - So for 50 mEq of Phos 40 is HPO4 and 10 is H2PO4 - When pH drops to 6.8 then the ratio is 1:1 so for 50 - So the 50 mEq is 25 and 25, so this buffered an additional 15 mEq of H while the free H+ concentration increased from 40 to 160 nanomol/L so over 99.99% of secreted H was buffered - When pH drops to 4.8 ratio is 1:100 so almost all 50 mEq of phos is H2PO4 and 39.5 mEq of H are buffered. - Acid loading decreases phosphate reabsorption so more is there to act as TA. - Decreases activity of Na-phosphate cotransporter - DKA provides a novel weak acid/buffer beta-hydroxybutyrate (pKa 4.8) which buffers significant amount of acid (50 mEq/d).- Ammonium Excretion - Ability to excrete H+ as ammonium ions adds an important amount of flexibility to renal acid-base regulation - NH3 and NH4 production and excretion can be varied according to physiologic need. - Starts with NH3 production in tubular cells - NH3, since it is neutral then diffuses into the tubule where it is acidified by the low pH to NH4+ - NH4+ is ionized and cannot cross back into the tubule cells(it is trapped in the tubular fluid) - This is important for it acting as an important buffer eve though the pKa is 9.0 - At pH of 6.0 the ratio of NH3 to NH4 is 1:1000 - As the neutral NH3 is converted to NH4 more NH3 from theintracellular compartment flows into the tubular fluid replacing the lost NH3. Rinse wash repeat. - This is an over simplification and that there are threemajor steps - NH4 is produced in early proximal tubular cells - Luminal NH4 is partially reabsorbed in the TAL and theNH3 is then recycled within the renal medulla - The medullary interstitial NH3 reaches highconcentrations that allow NH3 to diffuse into the tubular lumen in the medullary collecting tubule where it is trapped as NH4 by secreted H+ - NH4 production from Glutamine which converts to NH4 and glutamate - Glutamate is converted to alpha-ketoglutarate - Alpha ketoglutarate is converted to 2 HCO3 ions - HCO3 sent to systemic circulation by Na-3 HCO3 transporter - NH4 then secreted via Na-H exchanger into the lumen - NH4 is then reabsorbed by NaK2Cl transporter in TAL - NH4 substitutes for K - Once reabsorbed the higher intracellular pH causes NH4 to convert to NH3 and the H that is removed is secreted through Na-H exchanger to scavenge the last of the filtered bicarb. - NH3 diffuses out of the tubular cells into the interstitium - NH4 reabsorption in the TAL is suppressed by hyperkalemia and stimulated by chronic metabolic acidosis - NH4 recycling promotes acid clearance - The collecting tubule has a very low NH3 concentration - This promotes diffusion of NH3 into the collecting duct - NH3 that goes there is rapidly converted to NH4 allowing more NH3 to diffuse in. - Response to changes in pH - Increased ammonium excretion with two processes - Increased proximal NH4 production - This is delayed 24 hours to 2-3 days depending on which enzyme you look at - Decreased urine pH increases diffusion of ammonia into the MCD - Occurs with in hours of an acid load - Peak ammonium excretion takes 5-6 days! (Fig 11-10) - Glutamine is picked up from tubular fluid but with acidosis get Na dependent peritublar capillary glutamine scavenging too - Glutamine metabolism is pH dependent with increase with academia and decrease with alkalemia - NH4 excretion can go from 30-40 mEq/day to > 300 with severe metabolic acidosis (38 NaBicarb tabs) - Says each NH4 produces equimolar generation of HCO3 but I thought it was two bicarb for every alpha ketoglutarate?- The importance of urine pH - Though the total amount of hydrogren cleared by urine pH is insignificant, an acidic urine pH is essential for driving the reactions of TA and NH4 forward.- Regulation of renal hydrogen excretion - Net acid excretion vary inverse with extracellular pH - Academia triggers proximal and distal acidification - Proximally this: - Increased Na-H exchange - Increased luminal H-ATPase activity - Increased Na:3HCO3 cotransporter on the basolateral membrane - Increased NH4 production from glutamine - In the collecting tubules - Increased H-ATPase - Reduction of tubular pH promotes diffusion of NH3 which gets converted to NH4…ION TRAPPING - Extracellular pH affects net acid excretion through its affect on intracellular pH - This happens directly with respiratory disorders due to movement of CO2 through the lipid bilayer - In metabolic disorders a low extracellular bicarb with cause bicarb to diffuse out of the cell passively, this lowers intracellular pH - If you manipulate both low pCO2 and low Bicarb to keep pH stable there will be no change in the intracellular pH and there is no change in renal handling of acid. It is intracellular pH dependent - Metabolic acidosis - Ramps up net acid secretion - Starts within 24 hours and peaks after 5-6 days - Increase net secretion comes from NH4 - Phosphate is generally limited by diet - in DKA titratable acid can be ramped up - Metabolic alkalosis - Alkaline extracellular pH - Increased bicarb excretion - Decrease reabsorption - HCO3 secretion (pendrin) in cortical collecting tubule - Occurs in cortical intercalated cells able to insert H-ATPase in basolateral cells (rather than luminal membrane) - Normal subjects are able to secrete 1000 mmol/day of bicarb - Maintenance of metabolic alkalosis requires a defect which forces the renal resorption of bicarb - This can be chloride/volume deficiency - Hypokalemia - Hyperaldosteronism - Respiratory acidosis and alkalosis - PCO2 via its effect on intracellular pH is an important determinant of renal acid handling - Ratios he uses: - 3.5 per 10 for respiratory acidosis - 5 per 10 for respiratory alkalosis - Interesting paragraph contrasting the response to chronic metabolic acidosis vs chronic respiratory acidosis - Less urinary ammonium in respiratory acidosis - Major differences in proximal tubule cell pH - In metabolic acidosis there is decreased bicarb load so less to be reabsorbed proximally - In respiratory acidosis the increased serum bicarb increases the amount of bicarb that must be reabsorbed proximally - The increased activity of Na-H antiporter returns tubular cell pH to normal and prevents it from creating increased urinary ammonium - Mentions that weirdly more mRNA for H-Na antiporter in metabolic acidosis than in respiratory acidosis - Net hydrogen excretion varies with effective circulating volume - Starts with bicarb infusions - Normally Tm at 26 - But if you volume deplete the patient with diuretics first this increases to 35+ - Four factors explain this increased Tm for bicarb with volume deficiency - Reduced GFR - Activation of RAAS - Ang2 stim H-Na antiporter proximally - Ang2 also stimulates Na-3HCO3 cotransporter on basolateral membrane - Aldosterone stimulates H-ATPase in distal nephron - ALdo stimulates Cl HCO3 exchanger on basolateral membrane - Aldo stimulates eNaC producing tubular lumen negative charge to allow H secretion to occur and prevents back diffusion - Hypochloremia - Increases H secretion by both Na-dependent and Na-independent methods - If Na is 140 and Cl is 115, only 115 of Na can be reabsorbed as NaCl, the remainder must be reabsorbed with HCO3 or associated with secretion of K or H to maintained electro neutrality - This is enhanced with hypochloridemia - Concurrent hypokalemia - Changes in K lead to trans cellular shifts that affect inctracellular pH - Hypokalemia causes K out, H in and in the tubular cell the cell acts if there is systemic acidosis and increases H secretion (and bicarbonate resorption) - PTH - Decreases proximal HCO3 resorption - Primary HyperCard as cause of type 2 RTA - Does acidosis stim PTH or does PTH stim net acid excretion

Citrate? Glycinate? Threonate? Magnesium comes in many different forms. It's an important mineral in many different bodily functions. Unfortunately most people don't get as much magnesium as they should. The good news is that magnesium is found in many foods as well as convenient dietary supplements. Tune in to this weeks episode of Ask a Nutritionist to learn all about magnesium.

Citrate? Glycinate? Threonate? Magnesium comes in many different forms. It's an important mineral in many different bodily functions. Unfortunately most people don't get as much magnesium as they should. The good news is that magnesium is found in many foods as well as convenient dietary supplements. Tune in to this weeks episode of Ask a Nutritionist to learn all about magnesium.

ReferencesWe considered the effect of a high protein diet and potential metabolic acidosis on kidney function. This review is of interest by Donald Wesson, a champion for addressing this issue and limiting animal protein: Mechanisms of Metabolic Acidosis-Induced Kidney Injury in Chronic Kidney DiseaseHostetter explored the effect of a high protein diet in the remnant kidney model with 1 ¾ nephrectomy. Rats with reduced dietary acid load (by bicarbonate supplementation) had less tubular damage. Chronic effects of dietary protein in the rat with intact and reduced renal massWesson explored treatment of metabolic acidosis in humans with stage 3 CKD in this study. Treatment of metabolic acidosis in patients with stage 3 chronic kidney disease with fruits and vegetables or oral bicarbonate reduces urine angiotensinogen and preserves glomerular filtration rateIn addition to the effect of metabolic acidosis from a diet high in animal protein, this diet also leads to hyperfiltration. This was demonstrated in normal subjects; ingesting a protein diet had a significantly higher creatinine clearance than a comparable group of normal subjects ingesting a vegetarian diet. Renal functional reserve in humans: Effect of protein intake on glomerular filtration rate.This finding has been implicated in Brenner's theory regarding hyperfiltration: The hyperfiltration theory: a paradigm shift in nephrologyOne of multiple publications from Dr. Nimrat Goraya whom Joel mentioned in the voice over: Dietary Protein as Kidney Protection: Quality or Quantity?We wondered about the time course in buffering a high protein meal (and its subsequent acid load on ventilation) and Amy found this report:Effect of Protein Intake on Ventilatory Drive | Anesthesiology | American Society of Anesthesiologists Roger mentioned that the need for acetate to balance the acid from amino acids in parenteral nutrition was identified in pediatrics perhaps because infants may have reduced ability to generate acid. Randomised controlled trial of acetate in preterm neonates receiving parenteral nutrition - PMCHe also recommended an excellent review on the complications of parenteral nutrition by Knochel https://www.kidney-international.org/action/showPdf?pii=S0085-2538%2815%2933384-6 which explained that when the infused amino acids disproportionately include cationic amino acids, metabolism led to H+ production. This is typically mitigated by preparing a solution that is balanced by acetate. Amy mentioned this study that explored the effect of protein intake on ventilation: Effect of Protein Intake on Ventilatory Drive | Anesthesiology | American Society of AnesthesiologistsAnna and Amy reminisced about a Skeleton Key Group Case from the renal fellow network Skeleton Key Group: Electrolyte Case #7JC wondered about isolated defects in the proximal tubule and an example is found here: Mutations in SLC4A4 cause permanent isolated proximal renal tubular acidosis with ocular abnormalitiesAnna's Voiceover re: Gastric neobladder → metabolic alkalosis and yes, dysuria. The physiology of gastrocystoplasty: once a stomach, always a stomach but not as common as you might think Gastrocystoplasty: long-term complications in 22 patientsSjögren's syndrome has been associated with acquired distal RTA and in some cases, an absence of the H+ ATPase, presumably from autoantibodies to this transporter. Here's a case report: Absence of H(+)-ATPase in cortical collecting tubules of a patient with Sjogren's syndrome and distal renal tubular acidosisCan't get enough disequilibrium pH? Check this out- Spontaneous luminal disequilibrium pH in S3 proximal tubules. Role in ammonia and bicarbonate transport.Acetazolamide secretion was studied in this report Concentration-dependent tubular secretion of acetazolamide and its inhibition by salicylic acid in the isolated perfused rat kidney. | Drug Metabolism & DispositionIn this excellent review, David Goldfarb tackles the challenging case of a A Woman with Recurrent Calcium Phosphate Kidney Stones (spoiler alert, many of these patients have incomplete distal RTA and this problem is hard to treat). Molecular mechanisms of renal ammonia transport excellent review from David Winer and Lee Hamm. OutlineOutline: Chapter 11- Regulation of Acid-Base Balance- Introduction - Bicarb plus a proton in equilibrium with CO2 and water - Can be rearranged to HH - Importance of regulating pCO2 and HCO3 outside of this equation - Metabolism of carbs and fats results in the production of 15,000 mmol of CO2 per day - Metabolism of protein and other “substances” generates non-carbonic acids and bases - Mostly from sulfur containing methionine and cysteine - And cationic arginine and lysine - Hydrolysis of dietary phosphate that exists and H2PO4– - Source of base/alkali - Metabolism of an ionic amino acids - Glutamate and asparatate - Organic anions going through gluconeogenesis - Glutamate, Citrate and lactate - Net effect on a normal western diet 50-100 mEq of H+ per day - Homeostatic response to these acid-base loads has three stages: - Chemical buffering - Changes in ventilation - Changes in H+ excretion - Example of H2SO4 from oxidation of sulfur containing AA - Drop in bicarb will stimulate renal acid secretion - Nice table of normal cid-base values, arterial and venous- Great 6 bullet points of acid-base on page 328 - Kidneys must excrete 50-100 of non-carbonic acid daily - This occurs by H secretion, but mechanisms change by area of nephron - Not excreted as free H+ due to minimal urine pH being equivalent to 0.05 mmol/L - No H+ can be excreted until virtually all of th filtered bicarb is reabsorbed - Secreted H+ must bind buffers (phosphate, NH3, cr) - PH is main stimulus for H secretion, though K, aldo and volume can affect this.- Renal Hydrogen excretion - Critical to understand that loss of bicarb is like addition of hydrogen to the body - So all bicarb must be reabsorbed before dietary H load can be secreted - GFR of 125 and bicarb of 24 results in 4300 mEq of bicarb to be reabsorbed daily - Reabsorption of bicarb and secretion of H involve H secretion from tubular cells into the lumen. - Thee initial points need to be emphasized - Secreted H+ ion are generated from dissociation of H2O - Also creates OH ion - Which combine with CO2 to form HCO3 with the help of zinc containing intracellular carbonic anhydrase. - This is how the secretion of H+ which creates an OH ultimately produces HCO3 - Different mechanisms for proximal and distal acidification - NET ACID EXCRETION - Free H+ is negligible - So net H+ is TA + NH4 – HCO3 loss - Unusually equal to net H+ load, 50-100 mEq/day - Can bump up to 300 mEq/day if acid production is increased - Net acid excretion can go negative following a bicarb or citrate load - Proximal Acidification - Na-H antiporter (or exchanger) in luminal membrane - Basolateral membrane has a 3 HCO3 Na cotransporter - This is electrogenic with 3 anions going out and only one cation - The Na-H antiporter also works in the thick ascending limb of LOH - How about this, there is also a H-ATPase just like found in the intercalated cells in the proximal tubule and is responsible for about a third of H secretion - And similarly there is also. HCO3 Cl exchanger (pendrin-like) in the proximal tubule - Footnote says the Na- 3HCO3 cotransporter (which moves sodium against chemical gradient NS uses negative charge inside cell to power it) is important for sensing acid-base changes in the cell. - Distal acidification - Occurs in intercalated cells of of cortical and medullary collecting tubule - Three main characteristics - H secretion via active secretory pumps in the luminal membrane - Both H-ATPase and H-K ATPase - H- K ATPase is an exchange pump, k reabsorption - H-K exchange may be more important in hypokalemia rather than in acid-base balance - Whole paragraph on how a Na-H exchanger couldn't work because the gradient that H has to be pumped up is too big. - H-ATPase work like vasopressin with premise H-ATPase sitting on endocarditis vesicles a=which are then inserted into the membrane. Alkalosis causes them to be recycled out of the membrane. - H secretory cells do not transport Na since they have few luminal Na channels, but are assisted by the lumen negative tubule from eNaC. - Minimizes back diffusion of H+ and promotes bicarb resorption - Bicarbonate leaves the cell through HCO3-Cl exchanger which uses the low intracellular Cl concentration to power this process. - Same molecule is found on RBC where it is called band 3 protein - Figure 11-5 is interesting - Bicarbonate resorption - 90% in the first 1-22 mm of the proximal tubule (how long is the proximal tubule?) - Lots of Na-H exchangers and I handed permeability to HCO3 (permeability where?) - Last 10% happens distally mostly TAL LOH via Na-H exchange - And the last little bit int he outer medullary collecting duct. - Carbonic anhydrase and disequilibrium pH - CA plays central role in HCO3 reabsorption - After H is secreted in the proximal tubule it combines with HCO# to form carbonic acid. CA then dehydrates it to CO2 and H2O. (Step 2) - Constantly moving carbonic acid to CO2 and H2O keeps hydrogen combining with HCO3 since the product is rapidly consumed. - This can be demonstrated by the minimal fall in luminal pH - That is important so there is not a luminal gradient for H to overcome in the Na-H exchanger (this is why we need a H-ATPase later) - CA inhibitors that are limited tot he extracellular compartment can impair HCO3 reabsorption by 80%. - CA is found in S1, S2 but not S3 segment. See consequence in figure 11-6. - The disequilibrium comes from areas where there is no CA, the HH formula falls down because one of the assumptions of that formula is that H2CO3 (carbonic acid) is a transient actor, but without CA it is not and can accumulate, so the pKa is not 6.1. - Bicarbonate secretion - Type B intercalated cells - H-ATPase polarity reversed - HCO3 Cl exchanger faces the apical rather than basolateral membrane- Titratable acidity - Weak acids are filtered at the glom and act as buffers in the urine. - HPO4 has PKA of 6.8 making it ideal - Creatinine (pKa 4.97) and uric acid (pKa 5.75) also contribute - Under normal cinditions TA buffers 10-40 mEa of H per day - Does an example of HPO4(2-):H2PO4 (1-) which exists 4:1 at pH of 7.4 (glomerular filtrate) - So for 50 mEq of Phos 40 is HPO4 and 10 is H2PO4 - When pH drops to 6.8 then the ratio is 1:1 so for 50 - So the 50 mEq is 25 and 25, so this buffered an additional 15 mEq of H while the free H+ concentration increased from 40 to 160 nanomol/L so over 99.99% of secreted H was buffered - When pH drops to 4.8 ratio is 1:100 so almost all 50 mEq of phos is H2PO4 and 39.5 mEq of H are buffered. - Acid loading decreases phosphate reabsorption so more is there to act as TA. - Decreases activity of Na-phosphate cotransporter - DKA provides a novel weak acid/buffer beta-hydroxybutyrate (pKa 4.8) which buffers significant amount of acid (50 mEq/d).- Ammonium Excretion - Ability to excrete H+ as ammonium ions adds an important amount of flexibility to renal acid-base regulation - NH3 and NH4 production and excretion can be varied according to physiologic need. - Starts with NH3 production in tubular cells - NH3, since it is neutral then diffuses into the tubule where it is acidified by the low pH to NH4+ - NH4+ is ionized and cannot cross back into the tubule cells(it is trapped in the tubular fluid) - This is important for it acting as an important buffer eve though the pKa is 9.0 - At pH of 6.0 the ratio of NH3 to NH4 is 1:1000 - As the neutral NH3 is converted to NH4 more NH3 from theintracellular compartment flows into the tubular fluid replacing the lost NH3. Rinse wash repeat. - This is an over simplification and that there are threemajor steps - NH4 is produced in early proximal tubular cells - Luminal NH4 is partially reabsorbed in the TAL and theNH3 is then recycled within the renal medulla - The medullary interstitial NH3 reaches highconcentrations that allow NH3 to diffuse into the tubular lumen in the medullary collecting tubule where it is trapped as NH4 by secreted H+ - NH4 production from Glutamine which converts to NH4 and glutamate - Glutamate is converted to alpha-ketoglutarate - Alpha ketoglutarate is converted to 2 HCO3 ions - HCO3 sent to systemic circulation by Na-3 HCO3 transporter - NH4 then secreted via Na-H exchanger into the lumen - NH4 is then reabsorbed by NaK2Cl transporter in TAL - NH4 substitutes for K - Once reabsorbed the higher intracellular pH causes NH4 to convert to NH3 and the H that is removed is secreted through Na-H exchanger to scavenge the last of the filtered bicarb. - NH3 diffuses out of the tubular cells into the interstitium - NH4 reabsorption in the TAL is suppressed by hyperkalemia and stimulated by chronic metabolic acidosis - NH4 recycling promotes acid clearance - The collecting tubule has a very low NH3 concentration - This promotes diffusion of NH3 into the collecting duct - NH3 that goes there is rapidly converted to NH4 allowing more NH3 to diffuse in. - Response to changes in pH - Increased ammonium excretion with two processes - Increased proximal NH4 production - This is delayed 24 hours to 2-3 days depending on which enzyme you look at - Decreased urine pH increases diffusion of ammonia into the MCD - Occurs with in hours of an acid load - Peak ammonium excretion takes 5-6 days! (Fig 11-10) - Glutamine is picked up from tubular fluid but with acidosis get Na dependent peritublar capillary glutamine scavenging too - Glutamine metabolism is pH dependent with increase with academia and decrease with alkalemia - NH4 excretion can go from 30-40 mEq/day to > 300 with severe metabolic acidosis (38 NaBicarb tabs) - Says each NH4 produces equimolar generation of HCO3 but I thought it was two bicarb for every alpha ketoglutarate?- The importance of urine pH - Though the total amount of hydrogren cleared by urine pH is insignificant, an acidic urine pH is essential for driving the reactions of TA and NH4 forward.- Regulation of renal hydrogen excretion - Net acid excretion vary inverse with extracellular pH - Academia triggers proximal and distal acidification - Proximally this: - Increased Na-H exchange - Increased luminal H-ATPase activity - Increased Na:3HCO3 cotransporter on the basolateral membrane - Increased NH4 production from glutamine - In the collecting tubules - Increased H-ATPase - Reduction of tubular pH promotes diffusion of NH3 which gets converted to NH4…ION TRAPPING - Extracellular pH affects net acid excretion through its affect on intracellular pH - This happens directly with respiratory disorders due to movement of CO2 through the lipid bilayer - In metabolic disorders a low extracellular bicarb with cause bicarb to diffuse out of the cell passively, this lowers intracellular pH - If you manipulate both low pCO2 and low Bicarb to keep pH stable there will be no change in the intracellular pH and there is no change in renal handling of acid. It is intracellular pH dependent - Metabolic acidosis - Ramps up net acid secretion - Starts within 24 hours and peaks after 5-6 days - Increase net secretion comes from NH4 - Phosphate is generally limited by diet - in DKA titratable acid can be ramped up - Metabolic alkalosis - Alkaline extracellular pH - Increased bicarb excretion - Decrease reabsorption - HCO3 secretion (pendrin) in cortical collecting tubule - Occurs in cortical intercalated cells able to insert H-ATPase in basolateral cells (rather than luminal membrane) - Normal subjects are able to secrete 1000 mmol/day of bicarb - Maintenance of metabolic alkalosis requires a defect which forces the renal resorption of bicarb - This can be chloride/volume deficiency - Hypokalemia - Hyperaldosteronism - Respiratory acidosis and alkalosis - PCO2 via its effect on intracellular pH is an important determinant of renal acid handling - Ratios he uses: - 3.5 per 10 for respiratory acidosis - 5 per 10 for respiratory alkalosis - Interesting paragraph contrasting the response to chronic metabolic acidosis vs chronic respiratory acidosis - Less urinary ammonium in respiratory acidosis - Major differences in proximal tubule cell pH - In metabolic acidosis there is decreased bicarb load so less to be reabsorbed proximally - In respiratory acidosis the increased serum bicarb increases the amount of bicarb that must be reabsorbed proximally - The increased activity of Na-H antiporter returns tubular cell pH to normal and prevents it from creating increased urinary ammonium - Mentions that weirdly more mRNA for H-Na antiporter in metabolic acidosis than in respiratory acidosis - Net hydrogen excretion varies with effective circulating volume - Starts with bicarb infusions - Normally Tm at 26 - But if you volume deplete the patient with diuretics first this increases to 35+ - Four factors explain this increased Tm for bicarb with volume deficiency - Reduced GFR - Activation of RAAS - Ang2 stim H-Na antiporter proximally - Ang2 also stimulates Na-3HCO3 cotransporter on basolateral membrane - Aldosterone stimulates H-ATPase in distal nephron - ALdo stimulates Cl HCO3 exchanger on basolateral membrane - Aldo stimulates eNaC producing tubular lumen negative charge to allow H secretion to occur and prevents back diffusion - Hypochloremia - Increases H secretion by both Na-dependent and Na-independent methods - If Na is 140 and Cl is 115, only 115 of Na can be reabsorbed as NaCl, the remainder must be reabsorbed with HCO3 or associated with secretion of K or H to maintained electro neutrality - This is enhanced with hypochloridemia - Concurrent hypokalemia - Changes in K lead to trans cellular shifts that affect inctracellular pH - Hypokalemia causes K out, H in and in the tubular cell the cell acts if there is systemic acidosis and increases H secretion (and bicarbonate resorption) - PTH - Decreases proximal HCO3 resorption - Primary HyperCard as cause of type 2 RTA - Does acidosis stim PTH or does PTH stim net acid excretion

  Vidcast:  https://youtu.be/Em9TU8x5nkA   The FDA and Vi-Jon LLC are extending the recall of multi-branded Magnesium Citrate Saline Laxative Oral Solutions to include cherry and grape flavors as well as the initially recalled lemon flavor.  Again, the brands involved include: Best Choice, Care One, Cariba, Cruz Blanc, CVS,  Discount Drug Mart, Equaline, Equate Exchange Select, Family Wellness, Good Sense, Harris Teeter, HEB, Health Mart, Kroger, Leader, Major, Meijer, Premier Value, Publix, Quality Choice, Recall Rite Aid Signature Care, Sound Body, Sunmark, Swan, Tricare, Up & Up and Walgreens.  All of these laxative products are potentially contaminated with the bacterium Gluconacetobacter liquefaciens.  Immunocompromised persons infected with the bacterium can develop serious and life-threatening invasive infections. Stop using these products and return them to the place of purchase for a refund.  For additional information, contact Vi-Jon, LLC via e-mail Recalls@Vijon.com.   https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/vi-jon-llc-expands-voluntary-nationwide-recall-all-flavors-and-lots-within-expiry-magnesium-citrate   #magnesiumcitrate #laxative #contamination #infection #recall   

La carence en magnésium est considérée comme l'une des carences nutritives les plus répandues chez les adultes, pour des raisons telles que la mauvaise qualité du sol, les problèmes d'absorption et le manque de fruits ou de légumes dans l'alimentation.  Le citrate de magnésium peut non seulement aider à lutter contre les symptômes de carence tels que la fatigue, les douleurs musculaires et les troubles du sommeil, mais il est également couramment utilisé par les médecins pour soulager la constipation. Mais ce n'est pas tout.   Dans cet épisode de Hey Naturo ! je vous explique ce qu'est précisément le citrate de magnésium, quels sont ses principaux bienfaits, quels types et dosages prendre ainsi que les effets secondaires et contre-indications. *** Je vous invite à vous abonner au podcast Hey Naturo ! dès maintenant sur Apple Podcast et à le partager à votre famille, vos amis et vos collègues si vous pensez qu'ils pourraient être intéressés. Ce podcast est également disponible sur Spotify, Deezer et Amazon Music. 

En este nuevo episodio hablo del Diamante letal en trauma. Pasamos de la triada letal con la acidosis, coagulopatía e hipotermia y añadimos hipocalcemia en el manejo al paciente con trauma grave. Espero que os guste. Bibliografía consultada: - Ditzel, Ricky, Anderson, Justin, Eisenhart, William, Rankin, Cody, DeFeo, Devin, Oak, Sangki, et al. (2020). A review of transfusion- and trauma-induced hypocalcemia: Is it time to change the lethal triad to the lethal diamond?. Journal of Trauma and Acute Care Surgery, 88, 434-439. https://doi.org/10.1097/TA.0000000000002570 - Bjerkvig CK, Strandenes G, Eliassen HS, Spinella PC, Fosse TK, Cap AP, Ward KR. "Blood failure" time to view blood as an organ: how oxygen debt contributes to blood failure and its implications for remote damage control resuscitation. Transfusion. 2016;56(Suppl 2):S182-S189. - Dyer M, Neal MD. Defining the lethal triad. In: Pape HC, Peitzman A, Rotondo M, Giannoudis P, eds. Damage Control Management in the Polytrauma Patient. Cham, Switzerland: Springer; 2017:41-53. - Dobson GP, Letson HL, Sharma R, Sheppart FR, Cap AP. Mechanisms of early trauma-induced coagulopathy: the clot thickens or not? J Trauma. 2015;79(2):301-309. - Eddy VA, Morris JA Jr., Cullinane DC. Hypothermia, coagulopathy, and acidosis. Surg Clin North Am. 2000;80(3):845-854. - Niles SE, McLaughlin DF, Perkins JG, Wade CE, Li Y, Spinella PC, Holcomb JB. Increased mortality associated with the early coagulopathy of trauma in combat casualties. J Trauma. 2008;64(6):1459-1465. - Martini WZ, Holcomb JB. Acidosis and coagulopathy: the differential effects on fibrinogen synthesis and breakdown in pigs. Ann Surg. 2007;246(5):831-835. - Armand R, Hess JR. Treating coagulopathy in trauma patients. Transfus Med Rev. 2003;17(3):223-231. - Hastbacka J, Pettila V. Prevalence and predictive value of ionized hypocalcemia among critically ill patients. Acta Anaesthesiol Scand. 2003;47:1264-1269. - Cherry RA, Bradburn E, Carney DE, Shaffer ML, Gabbay RA, Cooney RN. Do early ionized calcium levels really matter in trauma patients? J Trauma. 2006;64(4):774-779. - Holcomb JB, Jenkins D, Rhee P, et al. Damage control resuscitation: directly addressing the early coagulopathy of trauma. J Trauma. 2007;62(2):307-310. - Lier H, Krep H, Schroeder S, Stuber F. Preconditions of hemostasis in trauma: a review. The influence of acidosis, hypocalcemia, anemia, and hypothermia on functional hemostasis in trauma. J Trauma. 2008;65(4):951-960. - Hoffman M, Monroe DM. Coagulation 2006: a modern view of hemostasis. Hematol Oncol Clin North Am. 2007;21:1-11. - Hoffman M. A cell-based model of coagulation and the role of factor VIIa. Blood Rev. 2003;17(suppl 1):S1-S5. - Ho KM, Leonard AD. Concentration-dependent effect of hypocalcaemia on mortality of patients with critical bleeding requiring massive transfusion: a cohort study. Anaesth Intensive Care. 2011;39(1):46-54. - Magnotti LJ, Bradburn EH, Webb DL, Berry SD, Fischer PE, Zarzaur BL, Schroeppel TJ, Fabian TC, Croce MA. Admission ionized calcium levels predict the need for multiple transfusions: a prospective study of 591 critically ill trauma patients. J Trauma. 2011;70(2):391-397. - Kornblith LZ, Howard BM, Cheung CK, et al. The whole is greater than the sum of its parts: hemostatic profiles of whole blood variants. J Trauma Acute Care Surg. 2014;77(6):818-827. - Li K, Xu Y. Citrate metabolism in blood transfusions and its relationship due to metabolic alkalosis and respiratory acidosis. Int J Clin Exp Med. 2015;8(4):6578-6584. - Giancarelli A, Liu-Deryke X, Birrer K, Hobbs B, Alban R. Hypocalcemia in trauma patients receiving massive transfusion. J Surg Res. 2016;202:182-187. - Webster S, Todd S, Redhead J, Wright C. Ionised calcium levels in major trauma patients who received blood in the emergency department. Emerg Med J. 2016;33(8):569-572. - Kyle T, Greaves I, Beynon A, Whittaker V, Brewer M, Smith J. Ionised calcium levels in major trauma patients who received blood en route to a military medical treatment facility. Emerg Med J. 2017;35(3):176-179. - MacKay EJ, Stubna MD, Holena DN, Reilly PM, Seamon MJ, Smith BP, Kaplan LJ, Cannon JW. Abnormal calcium levels during trauma resuscitation are associated with increased mortality, increased blood product use, and greater hospital resource consumption: a pilot investigation. Anesth Analg. 2017;125(3):895-901. - Shackelford SA, Del Junco DJ, Powell-Dunford N, Mazuchowski EL, Howard JT, Kotwal RS, Gurney J, Butler FK Jr., Gross K, Stockinger ZT. Association of prehospital blood product transfusion during medical evacuation of combat casualties in Afghanistan with acute and 30-day survival. JAMA. 2017;318(16):1581-1591. - DailyMed - Teruflex blood bag system anticoagulant citrate phosphate dextrose adenine (CPDA-1) - anticoagulant citrate phosphate dextrose adenine (cpda-1) solution. US National Library of Medicine. 2012. - Cap AP, Gurney J, Spinella PC, et al. Damage Control Resuscitation (CPG ID:18). Joint Trauma Service Clinical Practice Guideline. Joint Trauma System, the Department of Defense Center of Excellence for Trauma. 2019. - Pedersen KO. Binding of calcium to serum albumin. II. Effect of pH via competitive hydrogen and calcium ion binding to the imidazole groups of albumin. Scand J Clin Lab Invest. 1972;29(1):75-83. - Maxwell MJ, Wilson MJ. Complications of blood transfusion. BJA Educ. 2006;6(6):225-229. - Lang RM, Fellner SK, Neumann A, Bushinsky DA, Borow KM. Left ventricular contractility varies directly with blood ionized calcium. Ann Intern Med. 1988;108(4):524-529.

Different forms of magnesium: what is each one good for? - Dr. Jason Jones Elizabeth City NC, Chiropractor Magnesium is a vital nutrient needed for many processes in the body, including nerve function, blood sugar and pressure regulation, bone formation, and more. Magnesium is a macromineral along with sodium, phosphorus, calcium, chloride, potassium, and sulfur. You can obtain this mineral mainly by eating a healthy diet made up of a wide range of foods. However, studies have shown that a lot of people, especially those in the Western world, do not meet their magnesium needs with diet. Little wonder, health care providers might recommend a mineral supplement. More so, some people have health conditions that require them to take a mineral supplement. Different forms of magnesium There are at least 11 different forms of magnesium that can be taken in supplement form or found in food. However, specific types of magnesium are recommended for certain conditions. The different magnesium forms may be better for your needs than others. But, they have their pros and cons. Without much ado, let's take a look at the different forms of magnesium: Magnesium Citrate This is a very common form of magnesium used to treat and prevent magnesium deficiency. This magnesium form is bound with citric acid and has a natural laxative effect. It is sometimes used at higher doses to treat constipation and soften stool. Magnesium citrate often comes in powdery form, and it is mixed with a liquid and taken orally. The good thing is that it is one of the most absorbable and bioavailable forms of magnesium. Magnesium chloride Magnesium chloride is a salt that combines magnesium and chlorine. It is well absorbed in your digestive tract, a characteristic that makes it a great multi-purpose supplement. Magnesium chloride is often used to treat low magnesium levels, constipation, and heartburn. You can take this form of magnesium in capsule or tablet form. Some topical products that include this mineral, including ointments and lotions. Magnesium oxide Magnesium oxide is a magnesium salt mixed with oxygen. It is the active ingredient in the milk of magnesia – a common OTC medication for constipation relief. This magnesium form naturally forms a white, powdery substance and it is often sold in capsule or powder form. However, magnesium oxide is not typically used to treat or prevent magnesium deficiencies, as many studies show that it is poorly absorbed by the gut. Instead, this magnesium form is often used for short-term relief of uncomfortable digestive symptoms, such as indigestion, heartburn, and constipation. It is sometimes used to prevent and treat migraines. Magnesium lactate Magnesium lactate is a salt formed from a combination of magnesium and lactic acid. This magnesium form is naturally produced by your blood cells and muscles, and your digestive system absorbs it easily. This makes magnesium lactate an excellent option for people who need to take large doses since it is well tolerated than some other forms of magnesium. In other words, supplementing with magnesium lactate is a good way to replete a magnesium deficiency. It is also helpful for pain relief during a woman's menstrual cycle. Magnesium Aspartate This form of magnesium combines aspartic acid and magnesium to form a salt. It is one of the best in terms of absorbability. It is often combined with zinc to increase serum testosterone levels. Magnesium taurate This form of magnesium contains the amino acid taurine. Research shows that taking an adequate amount of magnesium and taurine plays an important role in regulating blood sugar. Magnesium taurate also helps to prevent high blood pressure. Some studies also show that it helps to reduce hypertension. Other forms of magnesium that may be better for your needs include: Magnesium malate Magnesium L-Threonate Magnesium Sulfate Magnesium Orotate Magnesium Glycinate Choosing the right form of magnesium should be based on why you need them and how much you already get through your diet. However, it is important to speak with your doctor before trying any supplement. You can consult Dr. Jason Jones in our chiropractic office at Elizabeth City, NC, to learn more about different forms of magnesium that works for different conditions, such as heartburn, indigestion, constipation, and many others.    

This podcast describes the role of cytosolic citrate in regulating glycolysis, fatty acid synthesis and providing thd vehicle to transport Acetyl CoA to the cytoplasm where it is needed for lipid synthesis. This biochemistry content may be useful to premedical and medical students. Similar content is available at: MEDBIOCHEM.ORG --- Send in a voice message: https://anchor.fm/a-j-ghalayini/message

Dr. Ravi Mehta and Dr. Ashita Tolwani discuss best practices on anticoagulation and citrate use, why circuit patency and integrity are important for CRRT, and how and when to use anticoagulation. They also discuss preferred methods for anticoagulation and the parameters that should be monitored for circuit integrity. This episode was supported by Baxter.

Let's talk about this mineral. 80% of the American population is deficient. Deficiency affects the way our brain works. Let's talk about all the different forms, what they do and which is best. There are 4 brands that Dr. Carmen trusts: Nature's Way Jarrow Life-Extension Now Or FullScript for physician-grade supplements. Are you looking for books to help you learn about holistic healing? Books that address mental well-being, physical well-being, soul well-being. Join us in our monthly Holistic Book Club to explore the different areas. https://www.thriveandalignedhealing.com/book-club For more information about working with Dr. Carmen Jones ND https://www.drcarmenjones.com For more information about working with Life Coach Kimberly Jarman https://www.kimberlyjarmancoaching.com

Bienvenue sur RARE à l'écoute, la chaîne de Podcast dédiée aux maladies rares. Pour ce cinquième épisode sur l'hyperoxalurie primitive, nous recevons Mme Ouertani, patiente atteinte d'hyperoxalurie primitive et membre active de l'association AIRG France, l'Association pour l'Information et la Recherche sur les maladies Rénales et Génétiques. Nous abordons aujourd'hui la survenue des premiers symptômes de la maladie, la prise en charge des patients atteints d'hyperoxalurie primitive et les objectifs de l'association AIRG France. Si vous désirez vous informer et aller plus loin dans la connaissance de cette pathologie, nous vous donnons rendez-vous sur notre site internet www.rarealecoute.com. L'orateur n'a reçu aucune rémunération pour la réalisation de cet épisode.   Invitée : Mme Ouertani – Membre de l'association AIRG France https://www.airg-france.fr/  L'équipe : Virginie Druenne - Programmation Cyril Cassard - Animation Hervé Guillot - Production Crédits : Sonacom

Supplements Every Man Should Be Taking – Dr. Jason Jones Elizabeth City NC, Chiropractor Most men in our today's fast-paced environment are constantly overworking themselves and sleeping less. More so, a large percentage of men keep poor nutrition habits on top of poor stress management. So why would supplements not be a necessity? Supplements make a huge difference as they supply the body with the needed vitamins and minerals to maintain healthy living and prevent health issues. Nutrient deficiencies are commonly implicated in low testosterone levels and prostate issues. But with the right supplements, these conditions are avoidable. Here is a list of supplements every man should be taking: Zinc As a man, your testosterone level tends to drop with age, stress, and obesity. And low testosterone has been linked to osteoporosis, depression, heart disease, obesity, and even death. That's more reason why you should add enough zinc to your diet. This supplement helps to boost testosterone levels in the blood. More so, studies show that men are more likely to have erectile dysfunction if they have a zinc deficiency. Zinc is also essential for immune function, as well as DNA and protein production. Vitamin B-complex Your body needs a continuous supply of B-vitamins because it cannot store them. These vitamins are important for a man's heart health. Vitamin B3 (Niacin) is needed to boost your good HDL cholesterol and keep your bad LDL cholesterol at low levels. Vitamin B5 (Pantothenic acid) is essential for red blood cell formation. Besides, it supports the production of sex and stress hormones. Basically, all the B vitamins bring a plethora of benefits and taking them covers all bases. Omega-3 Fish oils are good supplements for heart and prostate health. This oil helps to protect the heart, eyes, brain, and blood vessels. If you keep a stressful lifestyle, your brain and heart are at risk of breakdown. That's why you need fish oil because it contains nutrients that help to keep your brain and heart in good form. Besides, fish oil is anti-inflammatory. More so, studies have shown that men with cancer who eat low-fat foods combined with fish oil supplements record a reduced growth rate of cancer cells. Omega-3 is known for its anti-inflammatory effect. It supports joint, cardiovascular, and brain health. Taking omega-3 supplements is also important for healthy hormone production. It can also help to lower your blood sugar levels, hence, boosting the stability of hormones and the management of stress. Vitamin D Vitamin D is essential for every man's health. This vitamin helps to boost the immune system and ward off infections. More so, it helps boost your testosterone levels. When you add vitamin D supplements to your diet, you also get to enjoy better cardiovascular health and bone growth. Magnesium Magnesium is also called the “master mineral,” as it is essential for many body functions. It is needed for protein synthesis, blood glucose control, hormonal health, and nerve function. If you are deficient in magnesium, you tend to experience constant tiredness, decreased libido, and poor sleep quality. Magnesium helps to increase testosterone levels and boosts fertility. Hence, add magnesium supplements to your diet, and choose options that contain Magnesium Malate, Citrate, and Glycinate. Taking up to two grams of this supplement daily will boost your testosterone levels, reduce muscle cramps, improve sleep quality, and speed up your exercise recovery There are more supplements you can add to your diet. Consult Dr. Jason Jones at our chiropractic office at Elizabeth City, NC to learn more about these supplements and how to improve your overall health.

There are two commonly used forms of potassium. Potassium chloride (to treat hypokalemia) and potassium citrate (as an alkalinizing agent). Unlike potassium chloride, potassium citrate is also measured in “mg” in addition to “mEq”. It comes in a 5 mEq (540 mg), 10 mEq (1080 mg), and 15 mEq (1620 mg) strength ER tablet. The main indication for potassium citrate in in the management of kidney stones. In mild-moderate treatment you initiate 15 mEq PO bid or 10 mEq PO tid with a max dose of 100 mEq per day. Since potassium citrate is an alkalinizing agent the way it works is it makes urine less acidic. It raises the pH of urine to 6-7 which will help rid uric acid from the body. The reduction of uric acid helps manage gout and kidney stones. Since potassium citrate is a known GI irritant it is recommended to take the tablets whole with a glass of water to remain upright after taking it with food or at least within 30 minutes of a meal or snack. Go to DrugCardsDaily.com for my episode show notes which will contain a drug summary, quiz, and a link to FREE drug card sheets. SUBSCRIBE on Spotify or Apple Podcasts or search for us on your favorite place to listen to podcasts. I will go over the Top 100-200 Drugs as well as throwing in some recently released drugs that peak my interest. Also, if you'd like to say hello, suggest a drug, or leave any constructive feedback on the show I'd really appreciate it! Leave a voice message at anchor.fm/drugcardsdaily or message us through twitter @drugcardsdaily --- Send in a voice message: https://anchor.fm/drugcardsdaily/message

My AP Biology ThoughtsUnit 3 Episode #74 Krebs CycleWelcome to My AP Biology Thoughts podcast, my name is Corrinna and I am your host for episode 74 called Unit 3 cell energetics: the Krebs Cycle. Today we will be discussing the Krebs Cycle.  Segment 1: Defining The Krebs CycleThe Krebs cycle, also known as the citric acid cycle, is the third step in cellular respiration, the process by which organisms combine oxygen and other molecules into energy that is used in life-sustaining activities. Before the Krebs cycle, glycolysis and pyruvate oxidation occur.  The Krebs cycle occurs in the mitochondrial matrix in eukaryotes. The matrix of the mitochondria is the part of the mitochondria inside the inner membrane. This process occurs twice for every glucose molecule that goes through glycolysis. The Krebs cycle is a very detailed process.  First, acetyl coenzyme A, which was produced in the previous step of cellular respiration, combines with oxaloacetate to form citrate. This molecule is converted to its isomer, which is then oxidized and releases carbon dioxide. During this process, NAD+ is reduced to form NADH. Next, another molecule is oxidized and NAD+ is again reduced to NADH, and a molecule of carbon dioxide is released. THe coenzyme A of succinyl coensyme A is replaced by a phosphate group which is transferred to ADP to produce ATP, or in some cases, GDP. A four carbon molecule called succinate is also produced. Next, succinate is oxidized and FAD is reduced to FADH2. Water is then added to the resulting molecule, and another molecule of NAD+ is reduced to NADH. 2 Oxaloacetate is also produced which allows the cycle to start again.  Those are the very detailed steps of the Krebs cycle, but the most important part to remember is the energy transfers that occur and what the krebs cycle produces. In the Krebs cycle NAD+ is reduced to NADH, and FAD is reduced to FADH2. ADP and phosphate are combined to produce ATP. Citrate is oxidized, and heat is lost in the process. In the end, the krebs cycle produces 4 CO2, 2 ATP, 6 NADH, and 2 FADH2. Carbon dioxide is the waste product and is moved into the blood, and acetyl coa is used to convey the carbon atoms to the cycle.  Segment 2: Examples of the Krebs CycleThe Krebs cycle is important because it produces molecules that are required for cellular respiration, which enables organisms to create energy that they need to function. The Krebs cycle occurs in all organisms that undergo cellular respiration. It happens in an aerobic environment.  Segment 3: Digging Deeper into the Krebs CycleThe Krebs cycle also supports the endosymbiotic theory. Prokaryotes go through the Krebs cycle in the cytoplasm. One main aspect of the endosymbiotic theory is that mitochondria used to be prokaryotic cells, but were absorbed by larger cells to form eukaryotic cells with membrane bound organelles. Since eukaryotic cells go through the krebs cycle in the mitochondria, this supports the endosymbiotic theory.  Thank you for listening to this episode of My AP Biology Thoughts. For more student-run podcasts, make sure that you visit http://www.hvspn.com (www.hvspn.com). See you next time on My AP Biology thoughts podcast! Music Credits: "Ice Flow" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 4.0 License http://creativecommons.org/licenses/by/4.0/ Subscribe to our Podcast https://podcasts.apple.com/us/podcast/my-ap-biology-thoughts/id1549942575 (Apple Podcasts) https://open.spotify.com/show/1nH8Ft9c9f6dmo75V9imCk (Spotify) https://podcasts.google.com/search/my%20ap%20biology%20thoughts (Google Podcasts )   https://www.youtube.com/channel/UC07e_nBHLyc_nyvjF6z-DVg (YouTube)   Connect with us on Social Media Twitterhttps://twitter.com/thehvspn ( @thehvspn)

My AP Biology Thoughts  Unit 3 Cellular EnergeticsWelcome to My AP Biology Thoughts podcast, my name is Nidhi and I am your host for episode #71 called Unit 3 Cellular Energetics: Cellular Respiration:An overview. Today we will be discussing what cellular respiration is,who uses it, and why it's important.  Segment 1: Introduction to Cellular Respiration All organisms perform cellular respiration. The reactants of cellular respiration are glucose, which is oxidized, and oxygen which is reduced and they both produce carbon dioxide, water, and ATP. The purpose of cellular respiration is to make energy for cell work in the form of ATP. This occurs in a series of metabolic reactions. The reactions involved are catabolic reactions, which break down large molecules into smaller ones, releasing energy in the process which is supported by the overall reactions negative delta G. The ATP produced is eventually recycled and used to make more ATP. Most of the energy is released when reduced molecules are fully oxidized to create CO2. The oxidation occurs in a series of small steps allowing the cell to harvest 34% of the energy released. The rest of the energy is lost as heat. Segment 2: More About Cellular Respiration The two types of cellular respiration are anaerobic and aerobic. Anaerobic respiration can occur without oxygen while aerobic respiration requires oxygen to be present. Anaerobic respiration does not release enough energy to power human cells for long. It primarily occurs in muscle cells during hard exercise, after the oxygen has been used up. It also occurs in yeast during fermentation. Many prokaryotes perform anaerobic respiration.Through Anaerobic respiration, glucose is broken down to form 2 pyruvates. The purpose is to regenerate NAD plus for glycolysis, which is a part of aerobic respiration. Anaerobic respiration also keeps the pyruvate produced in the cytoplasm and uses it there. The main reactants are glucose, ADP, and Pi. This then produces ethanol, carbon dioxide and 2 atp. Anaerobic respiration has different products in animals. In animals instead of ethanol being produced, lactic acid is produced.  Aerobic respiration has 4 steps, glycolysis, pyruvate oxidation, the krebs cycle also known as the citric acid cycle, and the electron transport system. Glycolysis occurs in the cytoplasm, pyruvate oxidation and the citric acid cycle occur in the mitochondrial matrix, and the electron transport system occurs in the cristae of the mitochondria. In glycolysis, glucose is converted to pyruvate, ATP is produced, and NADH is produced. The energy transfers include 2 ATP used to produce 4 ATP ,NAD+ being reduced, Glucose being oxidized, and energy lost as heat. Overall, 2 net ATP are produced and no oxygen is used. Next, in pyruvate oxidation, Pyruvate is oxidized which reduces NAD+ to NADH. Coenzyme A reacts with the decarboxylated pyruvate to create acetyl CoA. This process occurs two times per glucose molecule. Again, energy is lost as heat is released. This time, CO2 is produced as a waste product. In the citric acid cycle, Acetyl CoA reacts with oxaloacetic acid to form citric acid . Citrate gets oxidized and loses carbons in the form of CO2. In that process, NAD+ and FAD are reduced into NADH and FADH2. Oxaloacetate is also regenerated since the process is a cycle. ADP+Pi makes ATP and total of 2 ATP is produced. Acetyl COA from the pyruvate oxidation and Pyruvate is needed for the reaction and CO2 is produced and heat is released. Lastly, in the electron transport system, Cells transfer energy from NADH and FADH2 to ATP by oxidative phosphorylation. NADH oxidation is used to actively transport H plus across the inner mitochondrial membrane, resulting in a proton gradient. Electrons from the oxidation of NADH and FADH2 pass from one carrier to the next in the chain. The oxidation reactions are exergonic and the energy released is used to actively transport H+...

You’ve probably never thought about whether you’re deficient in magnesium, but it is extremely common. Greater than 50% of Americans have this deficiency. But, when it comes to supplementation, how do you know which form is best for your needs? Take advantage of an exclusive podcast offer today by visiting www.invitehealth.com/podcast or by clicking here. For more information on the products or studies mentioned in this episode, click here. 

Be aware of marketing to sell patented molecules instead of giving you the full truth!"Why did the ancient inhabitants of the region known today as Greece, which became the founding culture of Western civilization, begin around Magnesia? Did the Greeks have knowledge of the regional soft stone that could be dissolved with water into a viscous brine and used on the skin, directly or through natural spring formations? Did that knowledge allow for zero magnesium deficiency, contrary to our 95% deficient Western culture of today, and therefore allow for the stronger bones, tissues, nerves and brains of our ancestors?. Can we truly find full health if this valuable wisdom of the past is not recovered and brought into a modern light and application?”theheartoftradition.com

With widespread utilization of continuous renal replacement therapy, its critical to know about how citrate may have a role.

With widespread utilization of continuous renal replacement therapy, its critical to know about how citrate may have a role.

On today’s ID the Future, Rob Crowther continues his conversation with Casey Luskin, the intelligent design proponent who previously worked for Discovery Institute’s Center for Science and Culture and has now returned. As Luskin explains, he left to pursue a PhD in geology at the University of Johannesburg in South Africa. The two discuss the wild conspiracy theories circulated by opponents of intelligent design when Luskin stepped away from Discovery Institute five years ago. Luskin also tells about an upcoming book he’s been working on with William Dembski, another intelligent design proponent who stepped away from day-to-day ID work and is now putting a foot back in the ID waters. Also on tap in today’s conversation, Luskin and Dembski’s upcoming appearance Read More › Source

Today’s ID the Future extends the discussion of A Mousetrap for Darwin: Michael Behe Answers His Critics, the newest book from Discovery Institute Press. Here the focus is on Parts 4 and 7 of the new book, and in particular Richard Lenski’s Long Term Evolution Experiment at Michigan State. What has this long-running project demonstrated? As Behe explains in the book (and elaborates on in today’s podcast), “The study has addressed some narrow points of peculiar interest to evolutionary population geneticists, but for proponents of intelligent design the bottom line is that the great majority of even beneficial mutations have turned out to be due to the breaking, degrading, or minor tweaking of pre-existing genes or regulatory regions. There have Read More › Source

Editor's Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the October 27, 2020 issue

In this episode of the Kidney Stone Diet Podcast Jill answers a listener question. Kidney Stone Diet Kidney Stone Prevention Program Oxalate Food List Find the full transcript at BYLT.co/show/kidney-stone-diet

Question: Nutritional suggestions for SI joint pain and sulfur sensitivity? So certainly if it's autoimmunity, I'm thinking you might have problems with folate, where you might want to lower folate intake. You might benefit from having more A and D. You might benefit from removing hypothetically pro-inflammatory foods. Magnesium is important. Acid-base balance is important. Citrate is probably helpful. And then on the sulfur issue, molybdenum and manganese are both important for properly dealing with sulfur. And then you might also want to be looking at your gut microbiome as well. This Q&A can also be found as part of a much longer episode, here.   If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, a private discussion group, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up at https://chrismasterjohnphd.com/masterpass/ and use the code QANDA to get 10% off the membership for life. There are two ways to discuss this episode: Discuss it in The Masterpass FREE Forum, which is freely open to everyone, at https://chrismasterjohnphd.com/discuss  If you’re a Masterpass member, discuss it in the Masterpass Discussion Group, found in your dashboard. DISCLAIMER: I have a PhD in Nutritional Sciences and my expertise is in performing and evaluating nutritional research. I am not a medical doctor and nothing herein is medical advice.

An interesting question that I get a lot. I finally decided to do a video on my thoughts on this subject.

Dr. Tamara Grubb, boarded anesthesiologist, discusses the 5 reasons why it is important to address perioperative vomiting and how injectable maropitant citrate fits into your perioperative protocols. Dr. Grubb addresses the benefits from the perspective of the patient, the practice and the pet owner.

Hallo und Herzlich Willkommen zu einer neuen Folge von Gesundheit next Level. Gesundes essen, regelmäßig Sport hält nicht jeder durch. Eine einfache Maßnahme hingegen schon. Zitronenwasser trinken. Am besten gleich morgens nach dem Aufstehen. Der Zitronendrink benötigt nur eine Minute und diese kleine Tat macht sich irgendwann positiv bemerkbar. Al-Natura: Bio-Zitronensaft Direktsaft: https://amzn.to/3dayxWM Hier 9 Gründe warum Zitronenwasser gut ist. Erstens: Zitronenwasser fördern und verbessern die Verdauung, die Gallenproduktion wird angeregt, Fettverdauung optimiert und Verstopfung vorgebeugt. Zweitens: Zitronenwasser stärkt das Immunsystem. Das Vitamin C wirkt antioxidativ. Zitronenwasser hilft sogar bei bakteriellem belasteten Wasser. Eine 2 prozentige Zugabe von Zitronensaft, kann nach 30 Minuten die Cholera-Bakterien abtöten. Drittens: Zitronenwasser schützt die Gelenke. Im Zitronenwasser haben wir Cirate, die lösen calciumhaltige Nierensteine auf. Diese bestehen meist aus Harnsäurekristallen die sich auch in den Gelenken befinden können. Durch Zitronenwasser schützt man vor der Einlagerung von Harnsäurekristallen. Viertens: Zitronenwasser entgiftet. Er wirkt entwässernd und beschleunigt die Ausscheidung von Schad und Giftstoffen mit dem Urin. Fünftens: Zitronenwasser reinigt die Nieren. Wie gesagt enthält es Citrate, die auch Nierensteine auflösen können und vorbeugen können. Sechtens: Zitronenwasser entsäuert. Zitronenwasser schmeckt zwar sauer, wird im Körper aber zu basisch umgewandelt. Siebtens: Zitrone hilft beim Abnehmen. Da es verdauungsfördernd wirkt, Besonders wenn man bei einer Biozitrone die geriebene Schale verwendet. Sie enthält reichhaltige Polyphenole, diese aktivieren Gene, die den Fettabbau fördern. Achtens: Zitronenwasser heilt Schleimhäute. Das regelmäßige Trinken kann allergiebedingte Schleimhautentzündungen in der Nase wieder abheilen uns somit auch Bindehautentzündungen bessern lassen. Worauf man achten sollte. Zitronenwasser auf nüchternen Magen trinken und mindestens einen Abstand zur ersten Mahlzeit von 30 Minuten einhalten. Und Neuntens: Zitronenwasser kann zu Hautpflege verwendet werden. Als Gewichtswasser bekämpft es Bakterien, strafft das Bindegewebe und schützt vor freien Radikalen. Bitte teilt das Video. Abonnieren nicht vergessen. Ist Kostenlos. Schreibt mir mal unten in die Kommentare ob ihr Zitronenwasser gerne trinkt oder auch nicht. Und bis zum nächsten Video alles gute Ciau.

There is magic in magnesium! Just listen to Dr. Yim expound on its many benefits and you will agree. In this podcast Dr. Yim talks about eight different types of magnesium and how they positively impact your health.With 45% of Canadians living with low or deficient levels of magnesium, this is a podcast well worth listening to. Types of Magnesium mentioned in the podcast.CitrateCitramateBisglycinateMalateThreanateChlorideWant to learn more details about how magnesium can help you? Dr. Yim will be putting together an 3 part audio and video course on the magic of magnesium. For those looking for information about how this mighty mineral can help their health condition, this is a must listen to, for those interested in improving performance, overall health and living their best life ever...this is a must have course for you.www.vita-care.ca Noticeable mentionsWhole Body Healing and Getting to the CauseSuffering with Fibromyalgia by Dr. Jesin

Magnesium deficiency is an obstacle to the chelation of toxins. Magnesium Disodium versions of EDTA (Magnesium Disodium EDTA (C10H12MgN2Na2O8)), the most widely recognized chelation agent for heavy metals and certain minerals, can be easily found in medical literature and needs no introduction here (1). This EDTA stands as proof of magnesium's role in the synergy of chelation in the human body. How acids and metals or certain mineral salts react outside of the body, by mixing industrially produced acids to specific metals to produce combined forms, should not be confused with the “seemingly identical” process mirrored within the living human body.In the living body, enzymes play a key role in these interactions. Magnesium is involved in all of these interactions through the enzymes' own dependence on magnesium for a more perfect transformation, catalyzation, chelation or conjugation. Magnesium is an essential factor for enzyme efficiency. Magnesium is also a natural calcium channel blocker, reducing the cell's rigidity.

BiOptimizers founders Wade Lightheart and Matt Gallant join me on Bulletproof Radio to share exciting new research about magnesium and why you need the right kinds in the right amounts to get all the benefits.Wade and Matt are known fondly as the “we fix digestion” guys. You may know them from their previous Bulletproof Radio episodes: #515—How to BiOptimize Your Gut & Digestion and #611—Every Little Enzyme Does Its Magic. (If not, take a listen!) After experiencing some unexpectedly stressful life events, they turned their attention to researching magnesium. Especially the types of magnesium that play a critical role in your body functions. “What's amazing about magnesium is we know it's involved in 300 different metabolic processes,” Matt says. In this episode, you’ll learn about the big 7: Magnesium Chelate, Citrate, Bisglycinate, Malate, L-Threonate, Taurate and Orotate. Getting all of these forms of magnesium, in the optimum dose, can upgrade virtually every function in your body. It’s especially important when combating all the stressors of our modern life—physiological and environmental. “One of the stress responses is that you actually burn out a lot more magnesium out of your nervous system,” Wade says.Supplementing a little bit of magnesium won’t cut it—especially if you’re aiming for superhuman-level performance of brain, body and mood. Listen on for tips on how to change up your approach to magnesium.Enjoy the show!*Special Bonus*Go to magbreakthrough.com/DAVE. Enter coupon code DAVE10 to get 10% off your purchase.

BiOptimizers founders Wade Lightheart and Matt Gallant join me on Bulletproof Radio to share exciting new research about magnesium and why you need the right kinds in the right amounts to get all the benefits.Wade and Matt are known fondly as the “we fix digestion” guys. You may know them from their previous Bulletproof Radio episodes: #515—How to BiOptimize Your Gut & Digestion and #611—Every Little Enzyme Does Its Magic. (If not, take a listen!) After experiencing some unexpectedly stressful life events, they turned their attention to researching magnesium. Especially the types of magnesium that play a critical role in your body functions. “What's amazing about magnesium is we know it's involved in 300 different metabolic processes,” Matt says. In this episode, you’ll learn about the big 7: Magnesium Chelate, Citrate, Bisglycinate, Malate, L-Threonate, Taurate and Orotate. Getting all of these forms of magnesium, in the optimum dose, can upgrade virtually every function in your body. It’s especially important when combating all the stressors of our modern life—physiological and environmental. “One of the stress responses is that you actually burn out a lot more magnesium out of your nervous system,” Wade says.Supplementing a little bit of magnesium won’t cut it—especially if you’re aiming for superhuman-level performance of brain, body and mood. Listen on for tips on how to change up your approach to magnesium.Enjoy the show!*Special Bonus*Go to magbreakthrough.com/DAVE. Enter coupon code DAVE10 to get 10% off your purchase.

Question: How to interpret the pattern of high citrate, low cis-aconitate, low glutamate, and high glutamine.   The aconitate and citric acid are markers on the citric acid cycle where we metabolize most of our energy. If citric acid is high and isocitric acid is low, (this must be the Great Plains Test which doesn't have isocitrate/cis-aconitate) that would indicate oxidative stress.   In terms of the glutamate being low --- if your glutamate is low and your glutamine is on the high side, then you probably have ammonia generation from somewhere that you're mopping up with glutamate. That would be my guess, but that's another can of worms to open.   This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/   If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a

Did you know that the body produces the natural R-form of all of these fancy sounding L-form molecules from magnesium chloride, which is created when hydrochloric acid digests our magnesium-rich foods, or when magnesium chloride is supplied transdermally and combines with fats and acids in the skin. Lets get clear on how this works in the body so that the babylon of confusion doesn't  block the light of simple and powerful solutions to the biggest deficiency of modern times.Check out our books on Amazon "The Mysteries of Nutrition", "The Mysteries of the Heart", our audiobook version "The Mysteries of Nutrition Audiobook - Life Changing Ideas to Heal the Body" and the master supplement we sell at theheartoftradition.comOur podcasts can be found on Stitcher, iTunes, Pandora, Heart Radio and more.

200mg Viagra is the highest dosage prescribed by the doctors for the patients to treat erectile dysfunction (ED) in men. When a man finds himself unable to get an erection, the first medication doctor prescribes to solve this erectile dysfunction is these pills. The generic viagra contains sildenafil citrate that acts as an active property that helps men suffering from impotence with treatment. The medicinal effect will bring the ejection power in just 30 minutes once the tablet is taken. This is one of the best medications available in the market for the curing of erection problems. --- Send in a voice message: https://anchor.fm/garrettbrown/message

 Continuous Renal Replacement Therapy (CRRT) involves pumping blood through a dialysis circuit. When the blood comes in contact with this surface it tends to clot which is why we anticoagulate blood that is being dialysed. CRRT involves and extended period of treatment at slower blood pump rates and is therefore more likely to clot. Citrate has quickly become the gold standard for anticoagulation due to the limited adverse events and a decrease in cost compared to the use of heparin. Citrate works by binding to ionised calcium therefore rendering it unable to perform in the clotting cascade. GCUH will be rolling out citrate for CRRT in November, so we had a chat to the driving force behind this Lisa Gray (Nursing educator) and Matt Ostwald (ICU Consultant).

  Episode 278 is an all inclusive guide to kidney anatomy, health, bloodwork, and MORE for physique and performance based athletes! First I dig into some basics on kidney anatomy and function before moving into some considerations for athletes looking to get bloodwork done to track kidney health, and all before ending with practical application on how to maintain kidney health while pushing for your goals! Also, theres a few references I'll provide below for those looking to take things further!   REFERENCES Adelstein RS, Sellers JR. Effects of calcium on vascular smooth muscle contraction. The American journal of cardiology. Jan 30 1987;59(3):4b-10b.   Agre P, King LS, Yasui M, Guggino WB, Ottersen OP, Fujiyoshi Y, . . . Nielsen S. Aquaporin water channels--from atomic structure to clinical medicine. The Journal of physiology. Jul 1 2002;542(Pt 1):3-16.   AHA. American Heart Association. Kidney Damage and High Blood Pressure. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Kidney-Damage-and-High-Blood-Pressure_UCM_301825_Article.jsp. Last updated 9/11/2014a. Accessed 8/10/2014.     Akinwusi PO, Oluyombo R, Ogunro PS, Adeniji AO, Okunola OO, Ayodele OE. Low dose aspirin therapy and renal function in elderly patients. International journal of general medicine. 2013;6:19-24.   Al-Awqati Q, Barasch J, Goldman L (ed.), SchaferAI (ed.). Goldman's Cecil Medicine, Twenty-Fourth Edition. Chapter 117: Structure and Function of the Kidneys; 716-720. Copyright 2012 Saunders, an imprint of Elsevier, Inc. Available at: www.clinicalkey.com Accessed: 6/9/2014.   Alpern RJ, Sakhaee K. The clinical spectrum of chronic metabolic acidosis: homeostatic mechanisms produce significant morbidity. American journal of kidney diseases : the official journal of the National Kidney Foundation. Feb 1997;29(2):291-302.   Amodu A, Abramowitz MK. Dietary acid, age, and serum bicarbonate levels among adults in the United States. Clinical journal of the American Society of Nephrology : CJASN. Dec 2013;8(12):2034-2042.   Anders HJ, Andersen K, Stecher B. The intestinal microbiota, a leaky gut, and abnormal immunity in kidney disease. Kidney international. Jun 2013;83(6):1010-1016.   Babaei-Jadidi R, Karachalias N, Ahmed N, Battah S, and Thornalley PJ. Prevention of incipient diabetic nephropathy by high-dose thiamine and benfotiamine. Diabetes. 2003;52(8):2110–20   Bae EH, Lee J, Ma SK, et al. alpha-Lipoic acid prevents cisplatin-induced acute kidney injury in rats. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association - European Renal Association. 2009;24(9):2692–700   Balakumar P, Bishnoi HK, Mahadevan N. Telmisartan in the management of diabetic nephropathy: a contemporary view. Current diabetes reviews. 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Life Extension Magazine. http://www.lef.org//Magazine/2004/5/awsi/Page-01. May 2004. Accessed 1/26/2015.   Feng B, Yan X-F, Xue J-L, Xu L, and Wang H. The Protective Effects of α-Lipoic Acid on Kidneys in Type 2 Diabetic Goto-Kakisaki Rats via Reducing Oxidative Stress. Int J Mol Sci. 2013;14(4):6746–56   Fenton TR, Tough SC, Lyon AW, Eliasziw M, Hanley DA. Causal assessment of dietary acid load and bone disease: a systematic review & meta-analysis applying Hill's epidemiologic criteria for causality. Nutrition journal. 2011;10:41.   Ferri FF. Ferri's Clinical Advisor. Chronic Kidney Disease. Available at: www.clinicalkey.com. Copyright © 2014c. Accessed 6/12/2014.   Ferri FF. Ferri's Clinical Advisor. Acute Kidney Injury. Available at: www.clinicalkey.com. Copyright © 2014a. Accessed 6/12/2014.   Ferri FF. Ferri's Clinical Advisor. Polycystic Kidney Disease. Available at: www.clinicalkey.com. Copyright © 2014b. Accessed 6/12/2014.   Finkielstein VA, Goldfarb DS. Strategies for preventing calcium oxalate stones. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. May 9 2006;174(10):1407-1409.   Fjellstedt E, Denneberg T, Jeppsson JO, Tiselius HG. A comparison of the effects of potassium citrate and sodium bicarbonate in the alkalinization of urine in homozygous cystinuria. Urological research. Oct 2001;29(5):295-302.   Fliser D, Ritz E. Serum cystatin C concentration as a marker of renal dysfunction in the elderly. American journal of kidney diseases : the official journal of the National Kidney Foundation. Jan 2001;37(1):79-83.   Forbes JM, Cooper ME, Oldfield MD, Thomas MC. Role of advanced glycation end products in diabetic nephropathy. Journal of the American Society of Nephrology : JASN. Aug 2003;14(8 Suppl 3):S254-258.     Fung TT, Chiuve SE, McCullough ML, Rexrode KM, Logroscino G, Hu FB. Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Archives of internal medicine. Apr 14 2008;168(7):713-720.   Gaedeke J, Fels LM, Bokemeyer C, Mengs U, Stolte H, Lentzen H. Cisplatin nephrotoxicity and protection by silibinin. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. Jan 1996;11(1):55-62.   Gazdíková K, Gvozdjáková A, Kucharská J, Spustová V, Braunová Z, and Dzúrik R. Oxidative stress and plasma concentrations of coenzyme Q10, alpha-tocopherol, and beta-carotene in patients with a mild to moderate decrease of kidney function. Nephron. 2001;88(3):285   Geleijnse JM, Giltay EJ, Grobbee DE, Donders ART, and Kok FJ. Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. J. Hypertens. 2002;20(8):1493–9   Genazzani AR, Mannella P, Simoncini T. Drospirenone and its antialdosterone properties. Climacteric : the journal of the International Menopause Society. Feb 2007;10 Suppl 1:11-18.   GHR. Genetics Home Reference. Conditions page. Renal tubular dysgenesis. Available at: http://ghr.nlm.nih.gov/condition/renal-tubular-dysgenesis. 1/5/2015. Accessed 1/6/2015. 2015.     Goraya N, Simoni J, Jo C, Wesson DE. Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney international. Jan 2012;81(1):86-93.   Goraya N, Wesson DE. Dietary management of chronic kidney disease: protein restriction and beyond. Current opinion in nephrology and hypertension. Nov 2012;21(6):635-640.   Goraya N, Wesson DE. Does correction of metabolic acidosis slow chronic kidney disease progression? Current opinion in nephrology and hypertension. Mar 2013;22(2):193-197.   Gowda S, Desai PB, Kulkarni SS, Hull VV, Math AA, Vernekar SN. Markers of renal function tests. North American journal of medical sciences. 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Dec 2004(145):46-49.   Zoccali C, Curatola G, Panuccio V, Tripepi R, Pizzini P, Versace M, . . . Mallamaci F. Paricalcitol and endothelial function in chronic kidney disease trial. Hypertension. 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Today this episode is again focusing on kidney stone prevention. Today's focus is on a mineral called citrate.  Citrate is a naturally occurring substance. It is a salt or ester of citric acid. Citric acid is found in relatively high amounts in citrus foods and juices, lemon and lime juice have some of the highest amounts of citric acid. Citric acid is not to be confused with Vitamin C which is ascorbic acid. Urinary citrate is an inhibitor of kidney stone formation due in part to binding of calcium in urine. Citrate in the urine inhibits crystal formation, growth and aggregation. If you don't have enough citrate in your urine, something we call hypocitraturia, you may be at risk for forming kidney stones. Here is the point of this episode. If you want to increase your urinary citrate and decrease your kidney stone risk you can drink, you guessed it, lemonade.

Dr. Madeira discusses Clomid for men with low Luteinizing Hormone (LH) and low normal Testosterone levels who want to optimize their Testosterone levels for overall Men's Health benefits - energy, brain health, cardiovascular health, sexual health, bone health, and still keep fertility intact.

Hardcore ICU: Anticoagulation for RRT: Heparin or Citrate?

Magnesium is arguably the most important mineral in the body, which is why magnesium deficiency can be such an issue. We discuss causes, symptoms of deficiency including: leg cramps, insomnia, muscle pain/fibromyalgia, anxiety, high blood pressure, type 2 diabetes, fatigue, migraine headaches, and osteoporosis. We also discuss people who are at increased risk of magnesium deficiency, and the best supplements to replenish your magnesium levels.

Running CRRT in the ICU presents challenges. To ensure optimum dose of dialysis there are several tricks that can be employed to ensure the dialysis machine runs smoothly. Citrate anticoagulation, pre-dilution, reducing the blood flow and providing a reliable vascath are key to achieving good flow through the dialysis machine.

Deputy Editor-in-Chief, Dr Patrick Chien, discusses his top papers from the October issue of BJOG. This podcast is an abridged version of the original Editor's Choice, available http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.14347/full.

Do you want beautiful, flawless, radiantly healthy skin? Want to stay healthy during cold season? Want to eat that bagel without your blood sugar spiking through the roof? Then it's time to think about zinc. Zinc is critical to every aspect of our biology, but the first things to go when we run low are our skin health, our immune system, and our glucose tolerance. Zinc, moreover, is critical to antioxidant defense, so should be considered broadly protective against all of the degenerative diseases that occur with aging. Wait, are you too young to care about aging? No problem. You at least want healthy skin, great sex, or a lean physique, so listen up. Zinc-rich foods are harder to come by then you'd think. Nutritional databases can be wildly inaccurate if you don't adjust for inhibitors of zinc absorption in natural foods. And zinc supplements can be valuable, but they're not a panacea. In fact, used wrongly, they can quickly induce a deficiency of copper and other minerals that are just as critical to your health.  The show notes can be found at chrismasterjohnphd.com/36. They contain recommendations for specific supplements. This episode is brought to you by Kettle and Fire Bone Broth. Use the link kettleandfire.com/chris to get $10 off your first order. This episode is also brought to you by US Wellness Meats. Head to grasslandbeef.com and enter "Chris" at checkout to get 15% off your order as long as the final price is over $75 and you order fewer than 40 pounds of meat. You can use "Chris" to get the same discount twice. In this episode, you'll find all of the following and more:  0:00:35 Cliff Notes; 11:40 The discovery of zinc deficiency on diets of whole wheat bread with small amounts of milk and potatoes, a quarter pound of clay, and no meat: dry skin, hypogonadism, lack of secondary sex characteristics, short stature, frequent infections; 17:25 The biochemical and physiological roles of zinc; 19:00 structural roles of zinc, with an emphasis on zinc finger motifs; interactions with vitamins A and D, thyroid hormone, adrenal hormones, and sex hormones 24:07 Catalytic roles of zinc, including the RNA polymerases that make it necessary for the production of every single thing in the body; 26:30 Interactions with vitamin A, from transport via retinol-binding protein (RBP) through activation by alcohol dehydrogenases to retinal and retinoic acid through creating vision via rhodopsin and regulating gene transcription via DNA-binding of the retinoic acid receptor; 29:20 Regulatory roles of zinc 32:25 Zinc and oxidative stress (necessity for hydrogen peroxide production in the thyroid gland and immune phagocytes, zinc release from zinc-thiolate clusters; protective effects of metallothionein exchanging zinc for other metals; negative effects of uncoupling of endothelial nitric oxide synthase [eNOS] on blood vessel function and oxidative stress; 42:45 Regulation at the cellular level (metallothionein, MT; ZIP and ZnT transporters) 44:20 Regulation of metallothionein (metal transcription factor-1 [MTF-1] through the metal response element [MRE] controlled primarily by zinc but also heavy metals, antioxidant response element [ARE] via Nrf1 and Nrf2, which provides regulation by oxidative stress and copper, glucocorticoid response element [GRE] which provides regulation by adrenal hormones and inflammation; 53:40 What happens when we eat zinc (effects of phyate, amino acids, calcium, organic acids, and iron) 1:01:00 Plasma zinc and the exchangeable zinc pool 1:06:00 Factors that affect plasma zinc status (variation according to meals, diurnal variation, stress, inflammation, menstruation) 1:10:25 Causes and effects of deficiency 1:14:20 Variations in soil zinc; 1:15:40 Balance of animal protein and phytate in the diet 1:19:00 Causes and effects of toxicity (especially with respect to copper deficiency) 1:27:20 What is the best marker of zinc status? 1:29:45 Plasma zinc as a marker of zinc nutritional status; 1:37:00 Copper deficiency markers as the most sensitive markers of zinc excess 1:38:10 Dietary strategies (animal foods, especially oysters, red meat, and cheese; soaking, sprouting, and fermenting to neutralize phytate) 1:40:35 Zinc supplementation on a plant-based diet (especially relevant to vegan diets but also to vegetarian diets) 1:42:25 Supplementation of zinc (what form? Citrate, acetate, gluconate, picolinate, oxide? What dose? When to take it?) 1:44:35  Recommendations for timing of diet and supplements across the day for best absorption 1:47:00 Wrapping up

In episode #3 of The Whole Circle we discuss zinc and magnesium. According to current research 85% of women do not get enough zinc in their diets and this can lead to some serious health concerns. Being zinc deficient affects your metabolism and is super important for your immune system. Naomi discusses all of this, and more, and provides easy, achievable advice on how to increase the intake of zinc in your diet. As well as discussing zinc, we also talk about magnesium and the health issues around this mineral. And again, this is an underrated mineral but one we should all know about. For example, did you know that magnesium deficiency can increase symptoms of: Depression Chronic fatigue syndrome ADHD Epilepsy Parkinson's disease Sleep problems Migraines Osteoporosis Premenstrual syndrome Asthma This is an episode you don't want to miss, Seriously we learnt so much from talking to Naomi and we are definitely going to have her back on the show to delve deeper into some of the issues we discuss. Some questions we ask: What is Zinc? How do you know if you are zinc deficient? What are some of the symptoms? Did you know that one of the signs of zinc deficiency can be ‘fussy' kids, we certainly didn't. As well as weight gain, eczema, dandruff, dry skin and so much more. Ever heard of the zinc taste test? You'll be rushing out to grab one after this podcast. What are the best foods and/or supplements to take if you are zinc deficient? What is Magnesium? How does this affect your body? Are magnesium and Epsom salts that same thing? How do Epsom salts work? Why should we take magnesium? Did you know that magnesium is fantastic for energy, nope we didn't either? For more information about zinc or magnesium testing, please see your health care professional, but as discussed, Naomi recommends to stay away from oxide as it doesn't absorb, that's way magnesium oxide is good for constipation as it stays in the bowel. Phosphate forms are natural and and very similar to what we get from food so highly bio available. Most commonly found is amino chelated forms, these are also highly bio available. Citrate forms are good to help alkalise and also absorb. More about Naomi Naomi is passionate about helping people with lifestyle and health issues using natural methods which include: western herbal medicine, nutritional medicine, iridology, homeopathy, vitamin therapy and Metabolic Typing. Website - http://www.naomijudge.com/ Facebook - https://www.facebook.com/NaomiJudgeNaturopath/ Instagram - https://www.instagram.com/naturopathnaomi/

Ligands are ions, molecules or a molecular group that bind to another chemical entity to form a larger complex. In this episode we're exploring the world of mineral ligands, the combinations of mineral complexes commonly found in nutritional supplementation and the many myths and misnomers perpetuated largely by marketing and hype. But what are the facts? What is the clinical opportunity or drawback to using say Calcium Sulphate vs. Citrate, or Magnesium Oxide vs. Magnesium Aspartate?. What is the evidence for amino-acid chelates and how they work in the body? How can you choose the right combination to yield the highest bioavailability or the best clinical outcome? Today we welcome back Dr Bob Buist arguably one of Australia's foremost leading experts in the field of nutritional biochemistry to dispel some myths and deliver some clinical pearls of wisdom about selecting the right combinations.

David Gattas gives an update on today's go-to anti-coagulant for renal replacement therapy. David is an ANZICS CTG power player, with a growing list of publications and was involved in the RENAL and POST-RENAL studies. This was recorded live at an ICN NSW / ANZICS meeting in September 2014.

Dr. Nina Radford, Director of Clinical Research and a cardiologist at Cooper Clinic, talks with Todd Whitthorne about calcium and heart disease. Dr. Radford, board certified in Internal Medicine and Cardiovascular Disease, gives her opinions about calcium consumption (in both food and supplements) for women who are concerned about both bone health and heart health.  

Author Michael Zelefsky talks to Anthony Zietman about the benefits of prophylactic sildenafil citrate.

Our guest is Dr. Robert Heaney from Creighton University. Dr. Haney has spent over 50 years in the study of osteoporosis, vitamin D, and calcium physiology. He's authorized three books and has published over 400 original papers, chapters and monographs in the scientific and educational fields. In the interview today, Dr. Haney covers the following topics: The relationship of vitamin D and calcium and how they work together In terms of osteoporosis, and prevention of osteoporosis, is it possible to separate the importance of vitamin D and calcium, or do they go hand-in-hand? Calcium deficiency - is it possible? If so, what's the impact? Recommended calcium levels for adult men and women Calcium rich food sources, and bioavailability of various foods Various forms of calcium supplements evaluated The relationship between calcium and prostate cancer The relationship between calcium and coronary calcification The relationship between calcium and kidney stones The relationship between calcium and weight loss Emerging calcium and Vitamin D research

"How Does Lithium Orotate compare to Lithium Carbonate and/or Citrate in MY Very Humble Opinion?  Tune in today for mental health self-experimentation results thus far!  Also... The Year of The Metal Rabbit???  What in Sam Hell Does That Mean?  It is oxymoronic...almost...or something.  Please join me today for all of this... a reading from my debut novel "Dear Prudence" and MORE!!!" Please join Amanda Grieme, Author of "Dear Prudence," and English/Creative Writing Educator.  Amanda LIVES with Bipolar Disorder choosing writing as her catharsis and creative medium to help those that falter.  Her life experience with mental illness, self-medication and 10 years as an educator will lend listeners invaluable and often quirky life advice.  Tune in to share in life's struggles, folly, laughter, tears... idiosyncratic oddities...cradled by ecclectic music selections. "Dear Prudence" Radio - Life Advice To Help YOU Cope will provide you with entertaining and informative fodder about life stuff, backed by research, justified by public opinion perhaps... and humbled by ill-experience. Please write to Amanda at dearprudenceadvice@gmail.comwith questions and commentary.  Sharing and communication is the key to coping. Check out Amanda's debut novel "Dear Prudence" athttp://www.eloquentbooks.com/dearprudence.html and intermittent blogs...http://pendulumpregnancy.blogspot.comhttp://dearprudence-peekintoanassecretworld.blogspot.com

"For the sake of Mental Health... Bartender, May I have a tall Orotate, with a side of Carbonate and a splash of Citrate please?  On second thought... make that a double!"  Please join Amanda Grieme, Author of "Dear Prudence," and English/Creative Writing Educator.  Amanda LIVES with Bipolar Disorder choosing writing as her catharsis and creative medium to help those that falter.  Her life experience with mental illness, self-medication and 10 years as an educator will lend listeners invaluable and often quirky life advice.  Tune in to share in life's struggles, folly, laughter, tears... idiosyncratic oddities...cradled by ecclectic music selections. "Dear Prudence" Radio - Life Advice To Help YOU Cope will provide you with entertaining and informative fodder about life stuff, backed by research, justified by public opinion perhaps... and humbled by ill-experience. Please write to Amanda at dearprudenceadvice@gmail.comwith questions and commentary.  Sharing and communication is the key to coping. Check out Amanda's debut novel "Dear Prudence" athttp://www.eloquentbooks.com/dearprudence.html and intermittent blogs...http://pendulumpregnancy.blogspot.comhttp://dearprudence-peekintoanassecretworld.blogspot.com

An Access to Health Experts interview with special guest Dr. Russel Jaffe. He discusses how using choline citrate might help you better absorb magnesium. He also tells us about taking magnesium combined with calcium. Access to Health Experts is not only an interview series, it's also a membership website featuring user forums, special reports, 20% discounts on professional grade nutritional supplements, monthly teleseminars, and much more. Visit http://www.AccessToHealthExperts.com for more information.

Investigations on the effects of Rare earth Element Citrates on growth promoting parameters in pigs and on ruminal fermentation in an artificial rumen (RUSITEC) For decades Rare Earth Elements, such as lanthanum, cerium, and praseodymium have been used in Chinese agriculture and farming for yield increase and growth promoting effects. Many Chinese studies showed partly enormous growth promoting effects whereas the most spectacular is seen in poultry and pig production. Several feeding trials with Rare Earth Elements were already carried out in our working group. So far mineral salt chlorides were used in previous studies. In the present study we tested for the first time the effects of Rare Earth Elements Citrate in grower pigs as well as in an in vitro trial in ruminants. A feeding study with 28 piglets (German Landrace x Piétrain) was carried out. They were separated in 4 dietary groups, each containing 7 animals. These animals received a regular diet, supplemented with a mixture of Rare Earth Elements Citrate in concentrations of 0, 50, 100, and 200 mg/kg feed for a 6 week period. A positive effect of the Rare Earth Elements Citrate on fattening performance parameters was determined. In the trial period the daily body weight gain of the two high supplemented groups increased between 8.6 % to 22.6 % compared to the control group. The low dosage group showed no difference. An increase in the feed conversion rate from 2 % to 6 % was shown in all Rare Earth Elements supplemented groups. This indicates that within the pig feeding highly increased growth-promoting effects were determined when supplemented with Rare Earth Elements Citrate compared with the studies in which the chloride form was used. The study on possible effects of Rare Earth Elements in ruminal fermentation was carried out with the Rumen Simulation Technique (RUSITEC), an artificial rumen. The effect of Rare Earth Elements in different dosages was compared to a negative control (without supplement) and a positive control (Tetracycline). Each trial lasted for a period of 10 days. The influence on the parameters pH-value, NH3, redox potential, fatty acid pattern, and gas production was analysed. Since the ruminal fermentation was not influenced, the conclusion can be drawn, that in this respect microorganisms are not affected by Rare Earth Elements.

Mon, 1 Jan 2001 12:00:00 +0100 https://epub.ub.uni-muenchen.de/16610/1/10_1159_000046075.pdf Schiffl, Helmut; Spannagl, M.; Schramm, W.; Toepfer, Marcel; Calatzis, A.

The majority of mitochondrial proteins are synthesized on cytoplasmic ribosomes and transferred to the mitochondria where they are assembled to supramolecular structures. The intracellular transfer of these proteins appears to occur by a post-translational mechanism, i.e., it involves extramitochondrial precursor forms which are translocated in a step independent from translation. The synthesis and transfer of individual proteins was investigated in vivo, or in vitro employing homologous and heterologous cell free systems for protein synthesis. Cytochrome c was initially made as the apoprotein. This precursor protein was converted to the holoprotein on uptake by mitochondria in reconstituted systems. Integrity of mitochondria was essential for the apo to holo conversion. In the case of the ADP/ATP carrier protein, an integral transmembrane protein of the inner mitochondrial membrane, the initial translation product had the same apparent molecular weight as the mature protein. It was found in soluble form in the post-ribosomal supernatant. Citrate synthase, a matrix protein, was synthesized as a precursor with an apparent molecular weight of 47 000. Transfer to the mitochondria was accompanied by cleavage to yield a molecular weight of 45 000. The significance of these results in relation to the mechanisms of intracellular transfer and of assembly of the individual proteins is discussed.

Sat, 1 Dec 1979 12:00:00 +0100 http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T36-44DSR1F-B5&_user=616146&_coverDate=12%2F15%2F1979&_rdoc=18&_fmt=high&_orig=browse&_srch=doc-info(%23toc%234938%231979%23998919997%23272157%23FLP%23display%23Volume)&_cdi=4938&_sort=d&_docancho https://epub.ub.uni-muenchen.de/7342/1/Neupert_Walter_7342.pdf Neupert, Walter; Harmey, Matthew A. ddc:610, Medizin