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This month I would like to discuss a commonly overlooked reason why our patients do not respond to neural therapy as well as they should. I am speaking here of course about those in whom an interference has been identified and treated, sometimes with a good initial response, but where the response to repeat treatments is disappointing. When this happens, we think of underlying conditions affecting cell membrane stability. Environmental neurotoxins and nutritional deficiencies come first to mind, but a simple, easily remedied condition is probably almost as common ‐ namely, dehydration. Chronic, low-grade dehydration is easily missed, perhaps because patients do not feel dehydrated. What they are more likely to experience is cold hands and feet, dry skin, weakness, postural hypotension and fatigue. They may also have stomach problems and/or constipation. These symptoms are often mild and seldom volunteered by the patient. Dehydration can be detected on physical examination. Low blood pressure may be present. The hands and feet are often cool and a pinch of skin on the dorsum of the hand should immediately flatten when released. If the skin pinch does not disappear within a second or two, the subcutaneous tissues are probably drier than they should be. Some people simply do not drink enough, especially in warm, windy weather or after vigorous exercise. Or they may drink the wrong things. In my experience, coffee drinkers are frequently dehydrated. Drinking coffee and other caffeinated drinks result in a net loss of fluid because of the diuretic effect of caffeine. Alcohol does the same thing and too much of it may be part of the explanation for "hangovers". Pharmacologic diuretics may also cause dehydration, if adequate liquids are not consumed to compensate for them. Hydration is not just a matter of water. Some health-conscious patients aim to drink eight glasses of water a day. They are often the ones with plastic water bottles in hand, as if preparing to walk the Sahara! Paradoxically, they may not be able to "hold" their water; the water just passes through them. The reason they cannot "hold" their water (I am not speaking about bladder capacity!) is that their extracellular space does not contain enough minerals to maintain isotonicity. The body makes the tonicity of the extracellular space a priority over volume, so if the extracellular minerals are lacking, the volume decreases. This leads to reduced tissue circulation and to the symptoms mentioned above. Minor changes in blood chemistry (i.e. changes within the reference range) can be markers of dehydration. Low or high serum sodium, or high BUN should be watched for. A low chloride (a neglected element in clinical medicine!) is a particularly good sign. Health Equations http://www.healthequations.com/ provides a "hydration index" quantitating these and other serum components. The minerals most commonly lacking are sodium and chloride. Often the most health conscious patients are salt deficient, as they have been lead to believe that salt is bad for them. Because excess dietary salt can exacerbate hypertension in some people, the prevailing belief that everyone should restrict dietary salt has taken hold. As with so many other medical fashions, a good idea carried too far has unintended consequences. Encouraging increased consumption of salt in addition to water can be very helpful in many of these cases. However electrolyte solutions (containing other minerals such as phosphorus, bicarbonate, sulfates, potassium, and magnesium) work even better. Some commercially available products are Health Equations'http://www.healthequations.com/ Lyte solutions and Body Bio's http://www.bodybio.com/ E-Lyte solutions. If dehydrated patients are hypertensive, I always make sure that they are taking adequate magnesium before recommending increased salt consumption. (I suspect that sodium-sensitivity in hypertensives is an indication of magnesium deficiency.) They should also check their blood pressure regularly, holding back on salt if blood pressure increases. A good way of remembering the importance of hydration when practicing neural therapy is to remember that interference fields are associated with disturbance of the electrical properties of cell membranes. Electrolytes both within and without the cell, separated by the hydrophobic cell membrane, maintain the electrical charge of the cell membrane. Some failures of neural therapy occur because the electrolyte solutions are simply inadequate for maintaining the electrical charge. Since procaine's role in neural therapy is to restore the cell membrane's resting potential, maintaining adequate hydration and extracellular electrolytes can be looked upon as adjuncts to neural therapy. Sincerely, Robert F. Kidd, MD, CM |