Carbonic anhydrase studies in red blood cells
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|Test||Carbonic anhydrase studies in red blood cells|
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Hyperventilation is a difficult diagnosis to make clinically and that is why having an objective test of hyperventilation is so useful. People who hyperventilate deplete their levels of red cell carbonic anhydrase and the ratio between the activity and the protein gives us a good indication of whether or not hyperventilation is a problem.
Hyperventilation is also difficult to treat and so this test tells us how much effort we have to put in to correcting this. Essentially, there is a two-pronged approach - firstly biochemical and secondly physical:
Biochemically, red cell carbonic anhydrase is a zinc dependent enzyme and will be depleted simply by zinc deficiency. Furthermore, a low red cell carbonic anhydrase drives hyperventilation and so this is another example of one of the many vicious cycles seen in patients with chronic fatigue. Zinc is best absorbed at night and I recommend taking 30mg last thing at night on an empty stomach. This should be in addition to zinc taken in my physiological mix of minerals, Mineral Mix.
Low magnesium often drives hyperventilation and again magnesium is present in my physiological mix of minerals in adequate amounts. Absorption of magnesium is enhanced by vitamin D, hence the need to continue with vitamin D supplements or ideally sunshine. I like all my patients to take 2,000 i.u. of vitamin D or get a good half-hour's sunshine daily.
Low potassium is also common in hyperventilation; furthermore in the short-term hyperventilation results in a respiratory acidosis and such pH changes may well be responsible for many of the peculiar symptoms seen in hyperventilation. I recommend using potassium bicarbonate as Sando-K, 1 tablet twice daily to help redress the pH balance - this is available on prescription as Sando-K.
We now come to the physical interventions. What seems to go wrong in hyperventilation is that the respiratory centre appears to be set incorrectly and this of course partly explains why hyperventilation continues throughout sleep. The idea is to use breathing exercises to consciously reduce and slow the rate of ventilation thereby increasing carbon dioxide retention. Initially the respiratory centre rails against this and tries to make the sufferer breathe more, but this is what must be resisted. If this is done consciously for long enough then eventually the respiratory centre readjusts to tolerate a higher degree of CO2 retention. There are many ways in which this technique can be learned - the best known is probably the Buteyko method and there are many practitioners trained to undertake breathing retraining. There are also some physiotherapists who are interested in hyperventilation and a list of therapists is available from Ann Pitman from the Physio-Hyperventilation interest group. The address is www.physiohypervent.org. There is also an e-mail address for Ann Pitman Physiopitman@aol.com. She does tapes which help greatly for DIY treatment.
I suspect hyperventilation is a much more common problem than actually realised and I have to say that the tests that I have been doing so far confirm this.
For more information go to Hyperventilation.
This test is performed on a blood sample.
The kit for this test includes a green topped blood tubes, packaging materials for transporting the blood sample in the post, a request form and a pre-paid envelope to post bloods to ACUMEN, in Devon.
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