Focal Infections Theory and Buteyko Focal Infections

1. Western medical research summary
1.1 Historical roots of the focal infections theory

Dr. Frank Billings (MD) was the most visible Western proponent of the theory of focal infections. He was quite an unusual President of the AMA (American Medical Association) by stating, “I place NO confidence in drugs. Drugs are valueless as cures.” Dr. Billings suggested in 1898 that microorganisms could contribute to numerous systemic diseases. Among his more recent publications was the article "Systemic Diseases of Focal Origin." Forchheimer'i Therapeusis, 1914, V, 169. 10.

His theory was at first very popular among medical professionals, causing widespread surgeries of tonsils (even after the slightest provocation) and extraction of dead teeth. Such over-zealous practice naturally resulted in reasonable criticism from other doctors. As a result, later his theory was largely forgotten. (For a historical review of his theory one can consult the recent paper, “Germs, Dr. Billings, and the theory of focal infection” by R.V. Gibbons published in 1998 in “Clinical Infectious Diseases”).
1.2 Modern focal infections research

However, recent works and studies confirmed the connection between certain local pathological processes (especially in teeth and tonsils) and various systemic diseases. In particular, there is impressive modern research collected by Japanese (Mizutani et al, 1997; Hattori, 1998; Okuda & Ebihara, 1998; Kataura, 2002), Norwegian (Debelian et al,1994; Li et al, 2000), American (Meyer & Fives-Taylor, 1998; Lockhart & Durack, 1999; Joshipura et al, 2000), and other medical professionals (e.g., Meurman, 1997; Gendron et al, 2000) in relation to oral focal infections.

The connection between the focal infections and various health problems is now a fact that is proven by detailed biochemical investigations, which show the mechanism of pathological interactions. For example, Japanese researchers summarized, “It is known that primary lesions of these chronic [oral] bacterial infections secondarily cause nephritis, rheumatoid arthritis, and dermatitis. Further, it has been demonstrated in recent years that bacteria inhabiting the oral cavity can cause bacterial pneumonia and endocarditis and that the periodontal-disease-associated bacteria become causative agents for pregnancy troubles and are involved in blood circulation problem and coronary heart disease” (Okuda & Ebihara, 1998). That is the reason why, for example, in Japan certain blood tests and troubles with skin, heart, blood vessels, kidneys and pregnancies can be the indications for tonsillectomy and other steps of oral sanitation.

Serious health complications are expected in cases of periodontal problems as American authors of the article “Periodontal disease and its association with systemic disease” revealed:
“…Currently, there is increasing evidence that the relationship between these entities may be bidirectional. Recent case-control and cross-sectional studies indicate that periodontitis may confer a 7-fold increase in risk for preterm low birth weight infants and a 2-fold increase in risk for cardiovascular disease. These early reports indicate the potential association between systemic and oral health. Additionally, these studies support the central hypothesis that periodontal disease involves both a local and a systemic host inflammatory response. This knowledge of disease interrelationships may prove vital in intervention strategies to reduce patient risks and prevent systemic disease outcomes” (Fowler et al , 2001).
1.3 Cavities as a common focal infection

A recent review by Dr. Shay from University of Michigan School of Dentistry suggested that “Dental caries occurs when acidic metabolites of oral streptococci dissolve enamel and dentin. Dissolution progresses to cavitation and, if untreated, to bacterial invasion of dental pulp, whereby oral bacteria access the bloodstream. Oral organisms have been linked to infections of the endocardium, meninges, mediastinum, vertebrae, hepatobiliary system, and prosthetic joints. Periodontitis is a pathogen-specific, lytic inflammatory reaction to dental plaque that degrades the tooth attachment. Periodontal disease is more severe and less readily controlled in people with diabetes; impaired glycemic control may exacerbate host response. Aspiration of oropharyngeal (including periodontal) pathogens is the dominant cause of nursing home-acquired pneumonia; factors reflecting poor oral health strongly correlate with increased risk of developing aspiration pneumonia. Bloodborne periodontopathic organisms may play a role in atherosclerosis. Daily oral hygiene practice and receipt of regular dental care are cost-effective means for minimizing morbidity of oral infections and their nonoral sequelae” (Shay, 2002).

Is there any Western data supporting the increased sensitivity of the immune system, for example, in case of caries or cavities, when the organism is healthier? That was the subject of part 3 of the review paper “Dental caries: a dent on dogma” written by Dr. John Gabrovsek (Gabrovsek, 1997). The subtitle of part 3 is “Stronger host response to dental caries infection. Result: ‘More dental caries development!’” There he starts with, “Is this an outrageous statement? Just think what a little pollen can do to you? If you are allergic to the pollen your body defenses can kill you. The fact that the host defense response may harm the host itself is recognized in pathology for quite some time. This fact is certainly not taken into account, or recognized in dental caries research” (Gabrovsek, 1997).

Is there a known biochemical mechanism that causes such an adverse reaction? As Dr. Gabrovsek explains, “For those who are not familiar with what inflammatory cells can do, I quote a short paragraph from Baer and Benjamin: “These cells are attracted to the site by the presence of bacteria and bacterial by-products, and conjugates of antigen-complement- antibody may not only act beneficially by phagocytizing these elements, with subsequent intracellular digestion, but may also liberate their cellular compliments of acid hydrolases, as lysosomal membrane dissolved. These enzymes are multiphasic in their effects, and serve to invoke collagen resorption, matrix dissolution, vascular dilation, and permeability - the destructive facet of the inflammatory state. The inflammatory cells with the greatest propensity for tissue destruction are neutrophil, and monocyte”” (p.21, Baer & Benjamin, 1974).

The most successful practical Western methods for treatment of, for example, cancer are also based on due attention to focal infections. Dr. Josef Issels, in his famous book "Cancer: a second opinion", wrote, "The emphasis I place on removal of devitalized teeth and chronically-diseased tonsils is one of the better-known aspects of my work, but also one of the most criticized and misunderstood. I do not, for instance, recommend that healthy tonsils and teeth be removed from a healthy person. But I believe if they are diseased, they cause the body's natural resistance to be lowered, thus acting as an important contributory factor to tumor development. In these cases, I insist on their removal" (p. 117, Issels, 1975).

Interestingly, his chart with the title "Hypothesis of pathogenesis of cancer" lists the following causal (or primary) factors for cancer development: foci, teeth, tonsils, fields of natural disturbance, abnormal intestinal flora, faulty diet, chemical factors, physical factors, and psychic factors (p. 53, Issels, 1975).
1.4 Effects of dead tonsils on health

The influence of tonsils on psoriasis was investigated by Japanese dermatologists who found, using a tonsillar provocation test, certain negative biochemical changes in the blood contributing to psoriasis (Mizutani et al, 1997).

Moreover, fever and other complications can be successfully treated by tonsillectomy (of course, if tonsils are dead), as another group of Japanese doctors reported.
“Thirty patients (above 18 years) who had complained of low grade fever were diagnosed as having tonsillar focal infection. We performed tonsillectomies on all the patients. A total of 24 were cured and 6 patients improved after the operation. These results indicate that tonsillectomy is often an effective treatment for tonsillar focal infection. However, the provocation test did not always give a good result” (Takeuchi et al, 1996). Thus, all 30 patients in this study benefited from the operation.
1.5 Athlete's feet as a focal infection

“About 15% of the population have fungal infections of the feet (tinea pedis or athlete's foot)” (Bell-Syer et al, 2002), as US researchers report. These infections also seriously affect the immune system.
“…Patients with mycoses of the soles with involvement of the nail plates, as well as those suffering from eczemas combined with mycoses developed a most marked reduction of the activity of the leukocyte migration inhibition factor (LMIF) and of the T lymphocyte mediator activity in the presence of the fungal antigen. The studies have detected the pattern of the leukocyte phagocytic reaction disturbances in the patients with mycoses and eczemas of the soles” (abstract, Iutskovskii, 1989).
1.6 Helminthes or large parasites living in humans

According to Dr. P. J. Brindley and his colleagues from the Department of Microbiology, Immunology, and Tropical Medicine (George Washington University Medical Center, Washington, D. C., USA), "More than two billion people (one-third of humanity) are infected with parasitic roundworms or flatworms, collectively known as helminthic parasites. These infections cause diseases that are responsible for enormous levels of morbidity and mortality, delays in the physical development of children, loss of productivity among the workforce, and maintenance of poverty" (Brindley et al, 2009).

Among the most common helminth species that affect humans are roundworms, tapeworms, pinworms, trichina spiralis, and flukes. Generally, only mature worms produce symptoms and these symptoms depend on the type of the parasite and personal parameters.

Since the official mainstream medicine does not know the cause and methods of treatment of chronic diseases, there are no published studies that explain interactions between large parasites and chronic diseases.
1.7 Non-surgical (or traditional) treatment of root canals

It is obvious that mainstream dentists, endodontists (dentists specializing in diseases of the dental pulp and nerve), and periodontists (dentists specializing in diseases of the gums and other structure surrounding the teeth) do not routinely deal with people who recover from chronic diseases and improve their health using breathing techniques. They simply do not have any clinical experience in relation to dynamic and interactions between endodontic infections and host defense response during breathing retraining. Therefore, while the information presented in their research is probably accurate, it cannot be applied directly for breathing retraining since most of their conclusions relate to the nearly static situations common for ordinary sick and relatively healthy people.

What are the findings?

1. All root canals contain anaerobic bacteria regardless of the methods and techniques used by dental professionals these days (Weiger et al, 1995; Debelian et al, 1998; Peters et al, 2002). Anaerobes, which produce most powerful toxins, as in the case of cavities, usually represent more than half of the different types of bacteria found in extracted root canals or root canals removed from human cadavers. It was also found that bacteria from the sinus cavities are usually identical to those found in root canals.

2. While main concerns of holistically-oriented people relate to toxins and inflammation produced by these anaerobes and other pathogens, the main danger of the root canal conventional operation is due to the apical part of the treated tooth. Up to 50-90% of root canals develop periodontitis (inflammation) in the apical part of root canals according to (Wu et al, 2006). The 2-part review study "Outcome of primary root canal treatment: systematic review of the literature" (Ng et al, 2008-2008) have found that the average short-term success rate of modern root canals treatments ranges between 68% and 85%. The same review discovered 4 factors that can improve the success rate: pre-operative absence of periapical radiolucency, root filling with no voids (this is often impossible due to complex shape of many root canals), root filling extending to 2 mm within the radiographic apex and satisfactory coronal restoration.

3. The most common cause of the failure of the root canal treatment operation is the incomplete blockage of the entire root canal system (Chevigny et al, 2008).
2. Buteyko focal infections and Russian clinical experience

It is only through considering the breathing retraining process that the full picture of the relationship between the focal infection and chronic disease can be provided. Dr. Buteyko and his colleagues clinically observed, tested and developed their theory of focal infections. They suggested that the ideal situation for clinical remission from chronic disease is to have holistically oriented dentists and otolaryngologists who are familiar with breathing training, know about the effects of focal infections on health of Buteyko students, and treat the focal infections with the goal of breathing normalization. Let us consider some of these effects.

The presence of focal infections interferes with the ability of patients to increase their CPs, normalize breathing, or even to recover from relapses of the main disease. The focal infections cannot be eliminated using the Buteyko breathing exercises and lifestyle changes. Moreover, due to the "rebound effect", the health of patients who have focal infections may get even worse when the breathing exercises are practiced and higher CPs are temporarily achieved.
2.1 How dead tonsils prevent high CPs

The effect of dead or degenerated tonsils on one's health and CP is easy to understand using a practical example. Imagine an asthmatic, who starts with about a 10 second CP and raises it up to 20-25 s. His asthma is then under control (no attacks at all) when his CP gets up to 20-23 s, but if this patient has, for example, dead tonsils, further progress (beyond 25 s CP) would cause high-grade fever and throat pain with coughing, angina, and copious mucosal discharges, all due to the severe reaction of the immune system which tries to fight the bacteria and toxins generated in the dead tonsils.

The problem is that the degenerated tonsils have no normal blood supply and the immune cells in the blood cannot reach the pathogens hiding in his tonsils. As a result, the immune system creates inflammation in the surrounding tissues and the pathogens use this inflamed area to their advance as a new breeding ground. That leads to fever and infection with heavier breathing and sudden CP drop down to about 10-15 s. As a result, this student may again get his asthma attacks due to the fact that the focal infection in the dead tonsils became worse due to the higher CP achieved (25-30 s) and this made the CP drop back down due to the rebound effect caused by his dead tonsils. This vicious circle (Breath work and better health → Higher CP→ Tonsillar infection and fever → Low CP and recovery from the infection → Breath work and better health→ Higher CP → Tonsillar infection and fever → Low CP ) can go on forever due to the rebound effect, even with application of other therapies (medication and antibiotics, throat gargling with best natural remedies, and many others), if these techniques do not kill the pathogens in the tonsils.

These adverse reactions cause the students to louse their enthusiasm for practicing the Buteyko method, as Russian MDs reported, and resulted in their quitting therapy (e.g., Souliagin, 1991). Indeed, why continue something that, seemingly, can be harmful?
2.2 How cavities in teeth block the CP growth

As another example, imagine that a student has cavities in her teeth. This person can improve her breathing, and thus recover from a chronic health condition. When her CP rises up to about 30-40 s, her immune system can turn its attention to cavity-causing pathogens, but cannot defeat them since these pathogens reside on the surface of teeth with no blood access. More breath work leads to an even stronger immune response, but this enemy (cavities) is beyond the immune abilities. Therefore, no further progress is possible although here there is no noticeable rebound effect if the student maintains good or normal dental hygiene. (Poor hygiene with higher CP will favor the advance of cavities in other teeth.)
2.3 Effects of breathing training on feet mycosis (athlete's feet)

If a student has low CP (e.g., below 20 s), his athlete's feet infection usually remains dormant. While there could be an affected area between the smallest fingers/toes and light skin peeling, there is no redness, bleeding or feeling hot. This status quo can be present for years. However, when his CP rises up to 25-40 s, mycosis of the feet advances to neighboring areas causing intense skin peeling, redness, deep lesions, bleeding and sensation of heat in the foot. The higher the CP achieved, the worse the spread of this fungal infection due to the same rebound effect.
2.4 Intestinal parasites prevent CP increase

The toxins produced by mature intestinal parasites intensify breathing regardless of the CP (immature parasites do not affect breathing to the same extent). Their negative effects depend mostly on their types and load, as well as their feeding cycles and food availability. Generally, depending on these factors, the presence of intestinal parasites restricts the CP to the range between 20 and 40 s CP.
2.5 Effects of root canals on health and CP

This is the most unpredictable focal infection. It can be deadly for some patients or hardly noticeable at medium CP levels depending on the quality of periodontal work done. Properly done root canal treatment, with the right disinfection and correct sealing procedures, would probably not cause any big problems for a person with a moderate CP (about 25-30 s). In this case, the immune system is strong enough to prevent the interaction of bacteria from dead teeth with other organs, while the toxins can be safely eliminated by the immune system from the organism.
3. Practical actions in relation to focal infections
3.1 Tonsils

If tonsils have been infected for several years, it is impossible to restore their functional abilities. In this case, tonsillectomy is necessary for breathing normalization and going beyond 25-30 s CP. Children who have had infected tonsils for only 1-2 years can sometimes restore their tonsils using special conservative and prophylactic measures.
3.2 Cavities in teeth

Regular visits to dentist are important for general health. However, sometimes caries can develop in tiny cracks of treated teeth (between the filling and tooth) so that they are invisible even during dental examination, but still a very small amount of toxins are able to leak out. When the Buteyko student gets a daily CP of over 40-50 CPs, while following the Level 3 course, he may notice that something prevents his further CP progress, while the morning CP remains below 40 s.

Gargling the mouth with a strong antiseptic solution for several minutes 3-4 times per day can suppress the pathogens and that can allow him to temporary achieve much higher CP numbers (e.g., 10 s more with the application of this method) and maybe even temporary break through 40 s. If the use of this method does not yield any CP improvements, there are no cavities present.
3.3 Feet mycosis

Application of over-counter creams and disinfection of all shoes and socks are necessary to deal with this fungus causing athlete's feet. There are new creams available on the market that have a double action. The cream is to be applied exactly as instructed: usually twice per day using a very thin layer, but for the whole affected area. The therapy should continue for some 5-7 days after all signs of the infections have disappeared. Natural remedies (including essential oils, garlic, hydrogen peroxide, alcohol, urine, and many others) have notoriously poor success rate against athlete's feet.
3.4 Intestinal parasites

When the parasitic load is high, the student can easily notice that while she eats more food, she does not gain weight, but possibly even lose it. If this is the case, a family physician can take fecal samples (2-3 more maybe required since many worms have cycles of laying eggs). Then either standard medication or some natural remedies (papaya diet and/or water fasting and certain herbs) can be used. It is much more difficult to identify the presence of intestinal parasites, when there are only a few worms, which are not large in size. Paying attention to symptoms is useful in such cases: for example, activities of hook worms usually cause anal itching (since these worms lay their eggs at night near the anus), roundworms cause cold feet even at high CPs, etc.
3.5 Root canals

Any student with a serious chronic health problem (cancer, COPD, ephysema, diabetes, arthritis, combinations of 2 or more chronic conditions, and many others) should not have root canals present.

The root canal not only generates toxins due to anaerobes and other pathogens living inside about 20 km tiny tubules (former blood vessels of the live teeth), but in addition there is a film formed around the dead tooth and, when the CP is below 20 s, even temporarily, the tissues of the dead-end artery leading to this tooth and the vein leaving the same tooth often become the source of infection and toxicity. Indeed, when the artery leading to the healthy live tooth is cut, the stagnated blood cannot offer resistance to pathogens at low CPs. Furthermore, these dead blood vessels, since they become available to pathogens often cause appearance of cardiovascular problems due to activities of the same pathogens in other parts of the human body causing the spread of this systemic disease. These processes and blood bacteremia are very active when the CP drops below 10 s (e.g., during early morning hours), since the immune system does not offer its resistance to bacteria, viruses and fungi in the blood for the last 2 stages of the disease (see the Buteyko Table of Health Zones for other parameters of the last 2 terminal stages). Even when the CP is between 10 and 20 s, the immune processes are severely suppressed by hyperventilation and cell hypoxia.

Hence, when the CP remains low for weeks after the root canal operation (less than 20 s), these dysfunctional tissues putrefy and become the source of spreading infection and inflammation that, at a certain stage, is even visible on X-Rays (see the picture at the top of this web page).

The presence of long-standing health problems often results in the situation when bacteria from the teeth start to interact with the pathogens existing in other diseased organs (that can probably happen due to their mutations since long time is available for these enemies to unite against the immune system). As a result, the treatment of other health problems becomes impossible (the teeth bacteria, which are inaccessible, provide a support for other pathogens) unless the dead teeth are extracted. Therefore, in cases of poor health, long-standing serious health problems or the weakened immune system, it is advisable to extract the dead teeth as soon as possible even without cardiovascular manifestations.

Several published studies found a link between root canals and increased incidence of the heart diseases (Mattila, 1993; Mattila et al, 2000; Dorn et al, 2002; Willershausen et al, 2009). In my view, existence or appearance of any cardiovascular problems is the definite indication for root canals removal. Only then progress with breathing training and higher CP is more certain.
References: Root canals and cardiovascular disease
3.6 Conclusions

Conclusions. The student may do the best breathing exercises, follow the best dietary suggestions and the optimum plan for physical activity, but if he or she has any of these focal problems, he/she will be forever stuck at the level of about 25-40 s CP or even less.

If somebody cannot eliminate any of these focal infections (e.g., an old person with severe periodontal disease does not want all his teeth to be extracted), it is not advisable and even dangerous to increase the CP beyond 30-40 s (Souliagin, 1991).
4. Mercury amalgams

This is not the classical Buteyko focal infection, but the biochemical and physiological effects of silver amalgam fillings, which are more than 50% mercury and which are often associated with chronic fatigue syndrome, digestive problems, and nerve diseases, are similar, in many ways, to cavities and root canals. There were separate cases when some Buteyko students, with no serious chronic health problems, were able to achieve very high CPs (up to 1-2 min) even with mercury amalgams present. However, with the presence of chronic diseases, mercury amalgams can become and often becomes the main factor that prevents personal recovery.

When mercury amalgams are present, consider using Selenium-antioxidant supplementation (about 200 mcg per day). Selenium forms an insoluble and absolutely harmless salt with mercury SeHg even in blood plasma (e.g., Yoneda & Suzuki, 1997; Cherdwongcharoensuk et al, 2010). Furthermore, if one chews the Se tablet and keep it in the mouth for some 2-3 minutes, selenium should even react with mercury present on the surface of the amalgam and form the same salt SeHg as a ceramic coating that prevents mercury leaking. Mercury leaking takes place 24/7 at a rate of about 1-10 mcg/day (depending on the total area of the mercury amalgams) and especially during chewing or having chemically active substances in the mouth (e.g., acids). Adding seaweeds to one's diet will also help to chelate Hg from the body, since seaweeds, especially when they are eaten in a raw form, are the best natural absorbents of heavy and radioactive metals.
5. Visiting a chiropractor

When the disks of the spine are not correctly aligned, various pains can appear, including chest pain, angina pain, stomach pain, appendix pain, etc. However all these organs may be healthy, and in such cases the student and his doctors cannot find the cause of pain since all tests would be negative. If the spine is poorly aligned, only manual correction can help. Moreover, pathological processes in the spine due to displacement of its disks can lead to inflammation, infections, bone overgrowth, intensive wear, and other negative effects. For these reasons Doctor Buteyko and his wife, Ludmila Buteyko learned professional chiropractic techniques to help their patients. If a student has a similar situation or suspects that the spine requires manual adjustment, a visit to a good chiropractor would be as important, in relation to health normalization and CP growth, as fixing dental cavities or removal of intestinal worms.

Proven and suggested benefits of taking cold shower

1. Knowing rules and restrictions of cold showering is very important for getting all benefits of this procedure. For example, "A cold shower could make the drunk person pass out or fall", as it is claimed by Harvard University Health Services. This effect takes place due to greatly improved perfusion of the brain, liver and other vital organs which can be overloaded with the negative effects of alcohol. Which other medical professionals investigate the effects and rules of taking cold shower?

Medical research suggested the following benefits of regular cold shower application:
- activation the sympathetic nervous system (Shevchuk, 2008)
- increase the blood level of beta-endorphin and noradrenaline and increase synaptic release of noradrenaline in the brain as well (Shevchuk, 2008)
- electrical stimulation of peripheral nerve endings to the brain, which could result in an anti-depressive effect (Shevchuk, 2008)
- significant analgesic effect without noticeable side effects or cause dependence (Shevchuk, 2008)
- reduction in muscle soreness after running a marathon (Liang et al, 2001)
- improved quality of sleep (Onen et al, 1994)
- decrease of uric acid level in blood plasma (Brenke et al, 1994)
- inhibition of purine metabolism (Brenke et al, 1994)
- long-term antioxidative adaptation (Brenke et al, 1994)
- improved tone of the skin and muscles (Mergeay et al, 1990)
- reduction in uremic pruritus (a major problem for patients with end-stage renal disease) (Zucker et al, 2003)
- increase in brown fat cells that protects from aging, fight obesity, diabetes, heart disease, etc.(Kanzleiter et al,2005; Mattson, 2010). All references and quotes are provided below.

Brown fat = special fat cells that have, unlike white fat cells, high concentrations of mitochondria and, therefore, able to generate heat without any muscular activity. Brown fat concentrations are very high in new-borns and infants, but gradually decline with aging due to absence of cold stimulation in the general population.

Medical research in relation to brown fat or brown adipose tissues is one of the top priorities in modern medical biochemistry and molecular biology, as potential treatment for obesity, diabetes and diseases of aging (see References and Abstracts for Brown Adipose Tissue Research - below on this page). While many doctors investigate how to increase brown fat concentrations in humans using medical drugs and transplantation, some natural doctors suggested the most natural way to increase our brown fat stores, cold showering.
2. Cold shower for better body oxygenation and breathing retraining

Dr. Buteyko and his MDs always viewed cold water adaptation (e.g., taking cold shower, cold water dowsing, bathing in snow, etc.) as an important part of the Buteyko method of breathing retraining. There are several known physiological processes that help us to achieve a better health state due to better adaptation to cold. (Note that this adaptation takes place only when the person follows certain rules.) Some of these beneficial processes are:

1. Cold showering favorably redistribute the blood in a way that is similar to effects of CO2 and NO on arteries and arterioles. Since cold water is applied on the surface of the body, the veins located near the surface constrict and the blood is pushed into arteries, arterioles and capillaries. Over two thirds of systemic resistance to blood flow in the cardiovascular system is in these blood vessels (arteries, arterioles and capillaries). Hence, this blood redistribution causes and leads to better perfusion (blood supply) of all tissues and organs and reduces heart rate. In this sense, application of cold water has some similarities with CO2 and NO effects on blood vessels.

2. Regular use of cold shower reduces heat losses (KP. Buteyko) and decreases core body temperature(Russian health nuts are preoccupied with having lower body temperature due to a wide-spread belief that just one degree reduction in core body temperature extends expected life span of humans by some decades.)

3. Cold water adaptation builds up brown fat cells that has a large concentration of mitochondria to generate heat without physical contraction or muscular movements.

4. A German study found positive effects of such body hardening on certain blood parameters.
“Whole-body cold stimuli lead to a dosage-depended decrease of uric acid level in blood plasma. This could be observed in own studies on winter-swimming and cold shower application and in studies on patients treated by cold-chamber-therapy. This uric acid decrease is due to an accelerated oxygen radical formation during cold exposition rather than to an inhibition of purine metabolism. The acute oxidative loading due to cold exposure and the long-term antioxidative adaptation may be interpreted as a new molecular mechanism resulting in body hardening” (Brenke et al, 1994).

5. Correct application of cold shower water (see Rule #3 below: gradual exposure) results in natural breath holding probably due to some reflexatory mechanism. Hence, taking, for example, cold shower results in all beneficial mechanisms and effects related to CO2 uses in the human body, including better oxygenation and perfusion of all vital organs, calmer mind, improved immunity, better sleep and digestion, and many others due to increased body oxygen content (DIY body oxygen test or the control pause) by about 2-3 s. In my view, application of cold shower has about the same effect on health and CP (control pause), although physiologically different, as one half of the typical Buteyko reduced breathing exercise session.

6. Most importantly, regular use of cold showers will help you to adapt to cold conditions and improve your morning CP due to improved thermoregulation and general adaptation to cold conditions provided that you challenge . This increase means better general health and well-being with improvements in all systems and organs of the human body.
3. Cold shower rules and RESTRICTIONS

The below rules and restrictions are based on clinical experience of 200 Russian doctors. They taught the Buteyko self-oxygenation breathing therapy to ten thousands of Russian patients. (This therapy is officially approved by the Russian Health Ministry). Taking cold showers is an integral part of the Buteyko breathing method. Why? Doctor Buteyko and his colleagues found that taking cold shower, when safe, increases oxygenation of the body and improves personal well-being.

For these reasons, all these doctors explained the main rules regarding water- and cold-tempering activities. When it is safe? Rule #1 is to have sufficient body oxygen stores. The patient should measure their own oxygen content using the stress-free breath holding time test: the CP (control pause) before taking cold shower. For this medical therapy, the CP is the key parameter of health. These Russian doctors tested many thousands of patients and discovered the following results since this test is the key parameter of health for the Buteyko technique.

Severely sick, terminally ill and hospitalized patients have from 1 to about 10 s CP. With approaching death, their breathing gets heavier (deeper and/or faster), while the CP approaches zero: 5, 4, 3, 2, and only 1 second of oxygen in the body just before the death. Over 90% of people die in conditions of severe overbreathing.

Sick patients with mild forms of the chronic disease (asthma, bronchitis, heart disease, cystic fibrosis, diabetes, cancer, etc.) have about 10-20 s CP. These patients are usually on medication to control their symptoms.

Asymptomatic asthmatics, heart patients with no symptoms and many others have slightly more than 20 s of oxygen in the body.

Healthy adults, according to published western results, should have about 40 s CP. This result corresponds to normal breathing pattern, but Doctor Buteyko found that 60 s CP is incompatible with about 150 chronic diseases or diseases of civilization (his norm corresponds to even slower breathing: about 4 L/min for minute ventilation and 8 breaths per minute for respiratory frequency at rest). Hence, he established 60 s as a standard of ideal health.

Rule #1, according to Russian doctors, is to have over 20 s of oxygen in the body when you take cold shower. If one’s oxygenation is less, the patient is likely to get an infection, fever, sore throat, blocked nose, and/or other negative symptoms. This is the key restriction for taking cold shower. (Note that if you have been taking it for months or years with less then 20 s CP, you could be able to continue to take it safely, but it is better if you increase your CP so that to enjoy better health and quality of life.)

Other rules are:

Rule #2. Start with warming up bones and deeper body tissues with warm water, if they got cold after prolonged cold exposure.

Rule #3. Very gradually change water temperature from warm to cold (or apply cold water to various body parts in sequence) so that transition to cold is very gradual (up to 40-60 s). If you use only cold water, apply cold water for one arm only. Then do the same with the other arm. After finishing both arms, apply cold water for one leg only. Then use cold water for the other leg. Finally, start with the lower trunk of the water and rise up to the shoulders, which are the most sensitive area.

Every time, when you take cold shower using this "slow" method, make sure and check that your breathing naturally becomes small and slow. Many healthy people even hold their breath naturally for some tens seconds.

Rule #4. Apply cold shower for about 30-60 s so that to cool down deep tissues of your body.

Rule #5. If you use contrast shower (cold-warm-cold-warm…), always finish with cold water.

Rule #6. Some Russian Buteyko MDs suggest that it is good to let water dry naturally without use of a towel. Others recommend vigorous rubbing with a towel until skin gets warm.

Warning. Note that you should not take cold shower immediately after too long and exhausting physical exercise, or when your blood glucose level is low, or soon after meals. Ideally, it should be done on empty stomach.
References for Cold Shower Benefits, Rules and RESTRICTIONS

Med Hypotheses. 2008;70(5):995-1001. Epub 2007 Nov 13.
Adapted cold shower as a potential treatment for depression.
Shevchuk NA.
Molecular Radiobiology Section, The Department of Radiation Oncology, Virginia Commonwealth University School of Medicine, 401 College St, Richmond, VA 23298, USA.
Depression is a debilitating mood disorder that is among the top causes of isability worldwide. It can be characterized by a set of somatic, emotional, and behavioral symptoms, one of which is a high risk of suicide. This work presents a hypothesis that depression may be caused by the convergence of two factors: (A) A lifestyle that lacks certain physiological stressors that have been experienced by primates through millions of years of evolution, such as brief changes in body temperature (e.g. cold swim), and this lack of "thermal exercise" may cause inadequate functioning of the brain. (B) Genetic makeup that predisposes an
individual to be affected by the above condition more seriously than other people. To test the hypothesis, an approach to treating depression is proposed that consists of adapted cold showers (20 degrees C, 2-3 min, preceded by a 5-min gradual adaptation to make the procedure less shocking) performed once or twice
daily. The proposed duration of treatment is several weeks to several months. The following evidence appears to support the hypothesis: Exposure to cold is known to activate the sympathetic nervous system and increase the blood level of beta-endorphin and noradrenaline and to increase synaptic release of noradrenaline in the brain as well. Additionally, due to the high density of cold receptors in the skin, a cold shower is expected to send an overwhelming amount of electrical impulses from peripheral nerve endings to the brain, which could result in an anti-depressive effect. Practical testing by a statistically insignificant number of people, who did not have sufficient symptoms to be diagnosed with depression, showed that the cold hydrotherapy can relieve depressive symptoms rather effectively.The therapy was also found to have a significant analgesic effect and it does not appear to have noticeable side effects or cause dependence. In conclusion, wider and more rigorous studies would
be needed to test the validity of the hypothesis.

Fish Oil, Cod Liver Oil, Salmon Oil, Krill Oil, Flaxseed Oil: Sources of Omega 3 DHA-EPA, for Body Oxygen and Breathing, Benefits, Side Effects and Dangers

(This is Part 2 of the Major Nutrients Guide for Better Breathing and Body Oxygen Level. Part 1 has a titleMacrominerals (Ca, Mg, Zn) and Fish Oil. Note that it is impossible to understand the key test of this Guide (3 day test or how to practically check nutritional deficiencies) without knowledge of the following topics: how to measure body oxygenation; breathing patterns and body oxygen test; CO2 uses in the human body; and web pages related to the Homepage of this website.)

Modern people, as it proven by numerous studies, consume too much omega 6 EFAs (essential fatty acids), with too little omega 3 fats. This review focuses on omega 3 EFAs supplements, including fish oil, cod liver oil, salmon oil, krill oil, algae oil, and many other sources of these supplements. Note that the main signs of EFAs deficiency are considered in Part 1. Here we are going to consider more fine details of EFAs supplementation and related challenges.
4.1 Omega 3 benefits

While medical research continues to discover new health benefits of fish oil, cod liver oil, and other sources of EFAs, it is clear that replenishing any missing nutrient is ultimately useful against any chronic disease since all chronic diseases have one common cause: alveolar hyperventilation that results in cellular hypoxia. Therefore, the previous list of related health problems (Coronary heart disease, High blood pressure, Angina pectoris, Epilepsy, Cancer, Crohn's disease, Diabetes, Rheumatoid arthritis, Depression, Sinusitis, Acne, Asthma, Bronchitis, Cystic fibrosis, and Other inflammatory disorders) from Part 1 of this Guide can be extended to include 150-200 common or chronic health disorders. In short, when someone asks, “What is fish oil for?”, “What does fish oil do for the body?”, “What are fish oil health benefits?”, “Why take fish oil?”, “Why is fish oil good for you?”, the answer is simple: to improve breathing and body oxygenation, thus curing chronic diseases. Physiologically, fish oil reduces inflammation and, hence, is useful for so many seemingly unrelated health problems.

Therefore, when one is sick and starts breathing retraining, regardless of the chosen source of EFAs, when conditions are right (the process of breathing retraining is active and the CP or body oxygen level is steadily growing) and no damage is done to the body (e.g., due to allergic reaction or toxicity of the dietary supplement), then the deficient student will benefit from having this missing nutrient in the diet. Hence, for example, fish oil will help with weight loss, cholesterol, prostate cancer, depression, arteries, inflammation, and many other problems, provided that you improve your body oxygen level. Therefore, it is not a particular supplement, but one’s health state and the corresponding health zone in the Buteyko Table of Health Zones that matters most.
4.2 Side effects, risks and dangers of fish oil and other EFAs

Dangers and side effects of fish oil and other sources of EFAs relate to various mechanisms and interactions of numerous factors. They also depend on the health state of the person.

Contamination of the environment with mercury (mostly from burning coal), lead, nickel, arsenic, cadmium, dioxins and PBCs (polychlorinated biphenyls), and other toxins is present in oceans due to activities of humans. To avoid these poisons, use purified dietary supplements;(e.g., molecular distillation) or pharmaceutical grade supplements. Using fish oil, for example, is generally much safer than eating whole fish (see abstracts below). Children, pregnant and nursing women are more sensitive mercury toxicity; avoiding contaminated fish and supplements is an especially high priority for these groups of people.

Concerns about safety and contamination of animal and fish products are legitimate. However, there is no indication in toxicological, nutritional, and environmental studies that there are dangers assocaited with purified fish oil or cod liver oil products. However, some studies warn of pollutants in whole fish.
Quotes and references (dangers in fish oil and fish due to pollution)
Allergic reactions

Many people are sensitive to fish (seafood allergy) and/or related products. It is crucial to avoid allergic reactions and to change the supplement source or brand or route of administration so as not to trigger any adverse side effects, including skin rashes. Algae oils may be a suitable altenative as they provide the most important essential fatty acid DHA (see below). If someone has adverse effects to all forms of EFAs when taken orally, omega fats can be successfully administered rectally or cutaneously (by rubbing small amounts of fish oil into arms and taking a shower afterwards).
Irritation of the stomach and other GI symptoms

Since gastritis (inflammation of the stomach lining) is almost the norm for modern people, many omega fat supplements often produce incessant burping, upset stomach, aftertaste, or even nausea, especially when taken on an empty stomach. Fish oil, cod liver oil and other EFAs can also cause abdominal discomfort, diarrhea, heartburn and indigestion. The suggested solution is to start with a small dose, avoid taking supplements on an empty stomach, and chew your omegas mixed with food and do it very well (more will be absorbed in the mouth too). If the problem persists, try freezing the capsules taking them on an empty stomach (so that they melt in your small intestine), or consider changing the brand, or buy enteric coated fish oil tablets (if your duodenum is in a normal state), or apply fish oil, cod liver oil, and other EFAs rectally or cutaneously. Rancid sources of omegas are more likely to cause these negative effects.

Polyunsaturated oils, including EFAs, are extremely susceptible to damage from oxygen, heat, and light. The unstable double bond between carbon atoms can easily attract oxygen atoms from air forming free radicals that can trigger chain reactions destroying many hundreds substances and/or structures of the human body. Rancidity changes the flavor and smell of the fish oil and other EFAs. Such supplements may still produce some positive effects on health, but excessive rancidity will increase one’s breathing and decrease the CP. Hence, all oils that are high in polyunsaturated fatty acids (including fish oil, krill oil, flaxseed oil, etc.) should be stored in dark tightly closed, glass containers in the refrigerator or freezer. Obviously, EFAs, as well as other unsaturated fats, should never be used for frying or in hot dishes. To avoid rancidity, it is wise to choose those EFAs supplements that are certified and organic, and have been refrigerated in a dark glass jar. Note that the same relates to capsules of fish oil and other supplements. Gelatin capsules do not protect unsaturated oils from oxidation since over periods of weeks or months, oxygen can easily penetrate through various plastic materials, while glass provides much better protection from oxygen damage. Presence of combinations of natural tocopherols (vitamin E) significantly reduces rancidity of these unstable oils.

When the person has been practicing breathing technique exercises and significantly improved their own CP, the temporary need for EFAs to reduce inflammation and do other useful jobs in the body can be much greater. In such conditions of deficiency, taking cod liver oil, fish oil, or krill oil supplements can produce a lasting invigorating effect (similar to barefoot walking) so that one can experience problems with sleep, if the supplement is taken in the second half of the day or even just before sleep. To avoid this, take fish oil, krill oil and other omega supplements in the morning with your breakfast.
Increased bleeding myth

It has been previously reported that fish oil components DHA and EPA can increase the chances of bruising and bleeding (e.g., nosebleeds, GI bleeding, strokes or blood in the urine). This myth has gained some popularity on various websites, including official medical sites, while medical research did not find any significant association between intake of fish oil and bleeding. Dr. Harris (see the reference and abstract below) analyzed about 20 medical studies where patients were given between 3 and 7 g of EPA. Most studies were very large (up to several hundred patients) and there were no reports of increased bleeding, while bleeding time increased moderately only in a few studies.
Quotes and References (Increased bleeding myth)
Concerns related to vitamin A toxicity

While there are many internet claims about too much vitamin A in cases of using cod liver oil, medical research does not support these claims. There are published cases of individuals taking too much cod liver oil and resultant liver problems, but these cases are confined to very large doses. The typical therapeutic dosage recommended is only between 1 teaspoon and 1 tablespoon daily. Additionally, inability of the organism to regulate vitamin A accumulation indicates very low CP (likely less than 10 s). Therefore, people taking therapeutic doses of cod liver oil and other EFAs sources do not need to worry about this effect. There are many published studies where doctors treated surgical patients with up to 7-8 g of DHA and EPA per day. In such cases they suggest using fish oil and other sources of these EFAs, to avoid overdoses of vitamin A in cod liver oil.
Other possible negative symptoms

Medical studies have revealed that fish oil may contribute to worsening of some health problems in certain patient population, for example: aggravation of symptoms of bipolar disorder and depression; drop in blood pressure due to reduction of inflammation in medicated hypertension; worsened blood sugar control in diabetes; possible contribution to some cancers in certain groups of people; lowered immune response in HIV/AIDS; and other similar situations. Such adverse effects would be expected for those people who improved their CPs (e.g., up to 5-10 s), but continue to use the same dose of their medication. This can be dangerous since, with higher CPs, most drugs have a much stronger effect. Hence, many such cases rather relate to interactions with medical drugs rarther than to effects of fish or cod liver oil.
Interactions with medication

During breathing retraining, it is sensible to explain to your family doctor (or general practitioner) that your symptoms subsided (or disappeared) depending on your progress and previous health problems. Since most MDs and GPs have no time to follow alternative medicine developments and are bombarded with papers representing official doctrines, very few MDs know in detail about the Buteyko method. Hence, you can emphasize healthy changes in your lifestyle as the likely cause of your health improvement. [Doctors do know about the benefits of exercise, better diet, etc.] Then it will be easier to convince them to reduce your medication.

There have been many Buteyko students who could achieve up to 5-10 s higher morning CP just by taking fish oil. Such changes in breathing modify the effects of many medical drugs so that their efficiency is greatly increased. This relates to medication that control blood pressure, blood glucose level, blood clotting, blood thinning and some other physiological parameters. Thus, potentially, it is not the direct effect of fish oil, but changes in breathing, that alter the reactions to usual dosages of medical drugs. Hence, ask you MD or GP to reduce medication accordingly.
4.3 Fish oil vs. flaxseed oil and other vegetable oils

Should everyone use fish oil or other animal-derived omegas? This depends on your body oxygenation (or health state). For hundreds of generations, many human communities, groups and tribes could thrive without eating fish, provided that they had high CPs. EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are normal components of the human blood and are necessary for numerous functions. These fatty acids can be synthesized from ALA (alpha-linolenic acid), which is also an omega fat, provided that the GI tract is healthy. ALA is abundant in various nuts and seeds. For example, flax oil and milled flax seeds are a rich vegetarian omega 3 source, but flax doesn’t have DHA or EPA. The same relates to hemp seed omega-3 oil, linseed oil, olive oil and sunflower oil. Among vegetarian sources, only algae oils have a high DHA content (see the Table below).

People with low CPs (less than 20 s) and/or GI problems are often unable to utilize vegetarian sources of EFAs, as it was confirmed by many published studies provided 2 paragraphs below. Hence, when most people try flaxseed (linseed) oil, hemp oil, sunflower oil, and other oils (usually extracted from seeds and nuts), they still experience their symptoms and deficiency in essential fatty acids. When they try cod liver oil or fish oil for 3 days, their morning CP can increase by 3, 5 sometimes up to 10 s. Hence, this supplementation can greatly assist health recovery.

If you have any, even very mild digestive problems, vegetarian sources of omegas cannot not be used to build and repair the body as effectively as animal sources of EFAs. However, if you are reluctant to use animal products, try a 3-day test with flaxseed oil and later with animal omega sources and compare the results.

There are some people, even with low CPs, who do not experience any improvement after a 3 day fish oil trial and then there is no need for them to use this animal product. They can use flaxseed, linseed, hemp and other seed- or nut-based oils or just regularly consume nuts and seeds or sunflower and other food grade, better cold-pressed oils.

This question (What is better for you: fish oil or flaxseed oil?) can be also answered using 2 different scientific ways. First, we can consider studies related to conversion rates in modern humans, who are, according to medical respiratory research, can be divided into sick (ordinary humans) and very sick people.
Quotes and references about conversion rates of ALA (alpha-linolenic acid) to EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid)
Why some people cannot convert EFAs or omega fats in their bodies

The situation with synthesis of EFA and DHA in the human body is similar to synthesis of vitamin B12 (cobalamin) in the human gut. Theoretically, as modern researchers claim, it can take place, but practical evidence suggests that most people are not able to synthesize B12 in the body due to absence of the intrinsic factor.

This is how Dr. K. Buteyko described some of the effects of chronic hyperventilation:

c) Change in the activity of enzymes and vitamins: some of them increase their activity, while others decrease. And this inevitably leads to:
d) Abnormalities of the metabolism, which is the foundation of life i.e. enzymes (there are about 700 of them which have already been discovered) and vitamins (there are more than 20), all these control units of the metabolism start to work abnormally. The metabolism is abnormal, the foundation of life is abnormal. If carbon dioxide decreases below the limiting norm, then there is a termination of the [normal] chemical processes, death of the cells and organism...”

Note that conversion of ALA into DHA and EPA depends on activity of enzymes.

Now we can also consider studies that compared supplementation with fish oil versus flaxseed oil and other vegetarian oils. Here are quotes from some recent research studies, most of which focus on fish oil vs. flaxseed oil effects and all claim higher efficacy of fish oil dietary supplementation.
Quotes and references (fish oil versus flaxseed oil)

Conclusions. Most people, due to low CP and tissue hypoxia, with the body’s inability to synthesize various vital substances (DHA and EPA included), do require supplementation with EPA omega 3 and DHA omega 3, which generally come from animal sources.
4.4 What is the difference between DHA and EPA?

Researchers agree that DHA is the most beneficial fatty acid for the human body. DHA is also the largest molecule among all considered EFAs. It has 22 carbon chain bonds and six double bonds. Furthermore, DHA is essential for infants. Quickly growing brains of babies constantly require large amounts of DHA. Apart from cardiovascular health, it is also crucial for cognitive and neurological function, learning ability, memory, focus, kidney function, etc..

EPA is another essential fatty acid, although it is not near as important as DHA. EPA has 20 carbon chain bonds and 5 double bonds. EPA is more involved in the work of the cardiovascular, hormonal and immune systems.

Another difference is that it is relatively easy for the human body to convert the larger DHA molecule (22 carbon chain bonds) into EPA (20 carbon chain bonds) than the other way around. Moreover, low CPs make the inverse conversion (from EPA to DHA) more difficult or even impossible. [All these concerns are not important for those whose CP is about 40 s or preferably no less than the Buteyko norm (60 s).]

Hence, it is sensible for many people to use supplements with higher DHA absolute and relative content.
4.5 How much fish oil is recommended?

The officially recommended dosage for fish oil does not exist since fats are macronutrients, and, hence, they are not assigned recommended daily allowances.

Macronutrients have AI (Acceptable Intake) and AMDR (Acceptable Macronutrient Distribution Range) instead of RDAs. The AI for omega-3 is 1.6 g/day for men and 1.1 g/day for women. The AMDR is from 0.6% to 1.2% of total energy intake. As about nutritionists and experts, their fish oil supplements dosage can range from about 300 to 2,000 mg of DHA and EPA per day depending on the health state and many other parameters of the person. Medical doctors often use up to 5-8 g of DHA and EPA daily for their patients during and after surgery.

The experience of my students indicates that personal requirements depend on many factors. First of all, not all people require animal sources of omega 3 EFAs. While most people cannot convert vegetarian sources of EFAs, some of those people who have very good digestion and use, for example, flaxseed oil would not benefit from switching to cod liver or fish oil for a 3-day trial.
How much fish oil should I use?

In order to have a good understanding of your particular requirements, consider the main benefits of taking fish oil, cod liver oil, and other EFAs sources. What is fish oil good for? The main effect is to reduce inflammation. However, inflammation is naturally reduced when one has higher CP (the adrenal gland starts to recover and produce more cortisol when the CP is more than 20 s). Physical exercise with strictly nasal breathing and breathing exercises improve body oxygenation index and are the most powerful and common tools to fight inflammation. [Note that a small number of breathing students cannot improve their CPs at all without cortisol supplementation and this effect is considered elsewhere.] Hence, aspiring breathing students can easily compensate their seemingly large requirements in EPAs and DHAs by smart changes in their lifestyle.
4.6 "3 day test"

When a person applies various breathing retraining techniques and their CP is growing, it is relatively easy to define the optimum amounts and types of omega supplements. It can be done using the same 3-day test that is used to test and define correct dosages of minerals (Ca, Mg and Zn). Take the full or even double dose, if you have a lot of inflammation, of EPA and DHA for 3 days while monitoring your CP, especially the morning CP, and heart rate. Then do not use the supplement for 5 days and again record your parameters in your daily log. If there is a definite improvement at the end of the 3 day trial, while your parameters drop later, you need this supplement. If you are uncertain and there are other healthy lifestyle changes that could also influence the results, you can repeat this test 2, 3 or even many more times. If there are no changes in your parameters (especially the morning CP), do not waste your time and money for this supplement.

How much fish oil should you take a day after this trial or in a long run? The dosage during this trial can be much larger then your optimum requirements and your next step is to define the optimum dose that produces the maximum effect. For example, if your morning CP is less than 20 s, your 3-day dose can be up to 2 tablespoons of fish oil or cod liver oil (or about 2-3 g of DHA and EPA daily). However, you may need only 1 tablespoon or even 1 teaspoon for a long term use later. If your morning CP is over 60 s, you may require only 1 teaspoon of cod liver or fish oil per day or you can even try to switch to nuts and seeds for 2-3 weeks, the most natural sources of omegas for healthy people. (The long term strategy is described at the end.)
4.7 What is the difference between fish oil and cod liver oil?

Cod liver oil is traditionally produced from livers of cod fish, while fish oil is produced from tissues of fatty fish. Cod liver oil has a fishy taste. Many companies now add peppermint, lemon or citrus flavors to make the taste more pleasant. Cod liver oil has a higher ratio of DHA to EPA (that is good for low CPs), while fish oils have a higher ratio of EPA to DHA (that is ok for high CP). If we take the same amount of both oils, fish oils have almost twice greater amount of total EPA plus DHA than cod liver oil. Cod liver oil, on the other hand, has additional vitamins A and D. Note that concerns about health problems due to excessive vitamin A consumption are reasonable for low CP people (especially for less than 10 s CP) and low CP pregnant women.
4.8 What is krill oil for (krill oil vs fish oil)?

If we compare krill oil vs fish oil, krill oil also contains EPA and DHA, but in a different form. In krill oil, the EFAs are linked in phospholipid form. It is the same structure as the fat cells in the human body. Hence, it is much easier for the human organism to absorb and use krill oil EPA and DHA for building human tissues. However, the most valuable components of krill oil are antioxidants, such as phospholipids, vitamins E, A and D, and astaxanthin, which is a very potent one.

Studies found benefits of krill oil in reducing inflammation and pain associated with rheumatoid arthritis, as well as other inflammatory conditions. It was useful to treat the symptoms associated with PMS and dysmenorrhea and to suppress autoimmune murine lupus. When the CP is over 30 s, the students generally require only one 500 mg capsule per day, while low CP students (less than 20 s of oxygen in the body), usually require 2 capsules daily in order to prevent or reduce, for example, joint pain due to arthritis.

Krill oil benefits and advantages also include: better absorption than fish oil, less pollution (krills are at the bottom of the food pyramid and hence accumulate less toxins), excellent antioxidant supply, stability against rancidity due to naturally present antioxidant, and less side effects.

Conclusion (fish oil versus krill oil). Due to high antioxidant power, but low content of DHA and EPA, krill oil can rather be used as an additional source of antioxidants, while fish oil or cod liver oil can be used as sources of omega 3 fats.
Quotes and References (Krill oil medical research)
4.9 Salmon oil vs fish oil

Which one is better? First of all, the supplement can have only salmon oil inside, while the main label and the name of the product can include “Fish Oil” words without any referral to salmon. Second, the choice depends on many factors that have been described above. Generally, salmon oil is better due to higher DHA content and higher DHA to EPA ratio, but this does not mean that any salmon oil supplement is better than any fish oil supplement. There are fish oil brands and varieties that can be much better than salmon oil. For more details on how to choose omega oils, see the summary of factors provided below.
4.10. Sources of Fish oil, cod liver oil, salmon oil and krill oil: their EPA and DHAcontents

How much omega 3 do you need? For most people, the dose can range from about 500 to 2,000 mg depending on 3-day test results and factors described above. Hence, it is important to know what the DHA and EPA content in your supplements is and what the best sources of these omega 3 fats are. Here are some average or typical results.
Type of omega 3 supplement DHA, mg EPA, mg Additional substances
and other parameters
Typical fish oil capsule (1000 mg) 120 180
Ethyl ester* fish oil capsule (1000 mg) 350 490
LOVAZA omega-3 fish oil 375 465 Is the only FDA-approved medicine made from fish oil
Carlson Cod Liver Oil capsule (1000 mg) 120 90 80 to 100 mg ALA; 1600 IU v. A; 800 IU v. D; 20 IU v. E (natural d-alpha tocopherol and mixed tocopherols)
Carlson Cod Liver Oil capsule (10 ml) 1090 860
Cod liver oil, Atlantic (10 ml) 1200 800 Vitamins A and D
Cod liver oil, Baltic (10 ml) 2000 900 Vitamins A and D
Extra-Virgin Salmon Oil capsule (1100 mg) 240 240 50 mg of mixed omega 3s; 40 mcg astaxanthin complex; antioxidant blend (natural lemon oil, rosemary extract, ascorbyl palmitate - fat-soluble vitamin C, natural tocopherols - vitamin E)
GNLD NeoLife Omega III Salmon Oil Plus capsule (1000 mg) 240 230 50 mg DPA and 40 mg of mixed omega 3s, including SDA, ETA(3), ETA, HPA and ALA
Salmon Oil Plus capsule (1000 mg) 160 90 17 mg DPA and 27 mg of mixed omega 3s, including SDA, ETA(3), ETA, HPA and ALA
Alaska Deep Fish Oil (Salmon Oil) capsule (1000 mg) 180 80
Salmon Oil Concentrate capsule (1000 mg) 120 80
DHA-Rich Omega-3 Algae Oil capsule (800 mg) 300 10 Vegetarian
Krill oil, 2 capsules (1000 mg in total) 90 150 420 mg phospholipids, omega-3 rich
(90% a phosphatidylcholine & lysophosphatidylcholine
10% as other phospholipids); 1.5 mg astaxanthin; lemon oil

* Ester forms of fish oil have better bioavailability and is more readily used by the body due to their optimum molecular geometrical configuration

Other available products that you can buy include:
1. Enteric coated EPA and DHA capsules or tablets (for those whose stomachs are sensitive to fish oils). They are more concentrated in EPA and DHA.
2. Emulsions of fish oils (e.g., for salad dressings)
3. Functional foods with fish oil (e.g., snack bars)
4. Infant formulas with DHA.
4.11 Criteria and summary for chosing EFAs or omega 3 supplements

* Your current personal needs (consider your health conditions or CP and symptoms)
* Purity of the product (choose those with special molecular distillation processes or pharmaceutical grades)
* DHA content (the more the better)
* EPA content (the more the better)
* Presence of protective antioxidants (good fish oil products must contain antioxidants such as tocopherol to protect against their oxidation during storage and/or others)
* Date of production (go for newer products)
* Storage conditions (go for those stored in the fridge)
* Packaging (go for dark glass containers, since capsules provide poorer protection from oxygen).

As you can see that choosing a right supplement can be a headache especially when one's CP is low. Better get over 60 s for your body oxygen level and make a transition to nuts and seeds without all these cautions, warning, concerns and rules. With maximum possible CPs (about 3 min), as hatha yoga ancient books claim, one can eat only meat and remain healthy (with high CP). For modern people, eating only meat can be a disaster since the sick ones will die probably in some weeks, while more healthy individuals may last for some months.

PS. There are very recent 2010 studies that found that long-term use (or lifetime) use of fish oil could cause more oxidative stress and cause other negative effects (see references below). The results could be generally true since it is not physiologically normal for humans to consume fish products on daily basis. After each 1 month course, you can take 1-2 week breaks and monitor your morning body oxygenation index and other parameters during this break and when you resume supplementation. This is another reason to raise the CP so that there are fewer complications with diet and supplements.

Major Nutrients Guide for Breathing and Body Oxygen Level

Part 1. Macrominerals (Ca, Mg, Zn) and Fish Oil

Q: Can this manual be used by those people who do not practice any breathing exercises, but want to know more about key nutrients in diet, minerals, and supplements on their general health and chronic diseases?
A: In my view, as many clinical trials have found, supplementation with missing major nutrients for an average person with any chronic disease produces very moderate, if any, changes in symptoms. A typical clinical study can find, for example, that Mg or fish oil improved a symptom score in a group of people with, for example, heart disease (or diabetes, or cancer, etc.) by only about 10-15%. Practically, one may expect that their morning morning CP (or body oxygen level), for those people who indeed experienced improvements, is modest or about 1-2, maximum 3 seconds in 1-2 weeks time. At the same time, many Buteyko students I taught, after use of required diet nutrients in correct doses, could get up to 5-10 s higher CP changes in 3-5 days due to their commitment to breathing retraining. This effect is explained in this manual.

Q: Are breathing exercises absolutely necessary in order to improve health and morning CP?
A: Apart from breathing exercises, only large amount of physical exercise with strictly nasal breathing (e.g., 1-2 hours or even more per day) can also produce a strong accumulative effect on basal or unconscious breathing at rest and during sleep so that their morning CPs start to increase. However, even this health program (exercise-based) requires correction of lifestyle factors that directly relate to breathing and body oxygenation. There are several modules-manuals that address these factors, including “How to prevent sleeping on one's back”, “How to maintain nasal breathing 24/7”, “How to Unblock the Nose in 2-3 Minutes”, “Who and when can safely take cold shower”, “Which Exercise Parameters Improve Breathing and Body Oxygenation”, etc.. All these Buteyko modules, web pages and articles can be found online.
1. Nutritional deficiencies promote chronic diseases

Hundreds of published scientific studies have shown that the lack of key diet nutrients can contribute to development of many chronic diseases. The most common major nutrients that are insufficient in western people are: essential fatty acids (cod liver oil or fish oil), calcium, magnesium, and zinc. Nutrient supplements, according to hundreds of clinical studies, can reduce symptoms for the following conditions.
Nutritional eficiency Chronic disease
Long chain omega-3 fatty acids Coronary heart disease, Angina pectoris, High blood pressure, Cancer, Epilepsy, Crohn's disease, Rheumatoid arthritis, Diabetes, Depression, Asthma, Bronchitis, Sinusitis, Acne, Cystic Fibrosis, Other inflammatory disorders
Calcium Heart disease, Tachycardia and palpitations, Insomnia, Arthritis, Depression, Osteoporosis, Delusions, Eczema, Hyperactivity, Nervousness, Irritability, Panic attacks, Periodontal disease, Tetany, Seizures, Tooth decay
Magnesium Diabetes, Hypertension, Coronary heart disease, Osteoporosis, Asthma, Tachycardia, Muscle pains and cramps, Constipation, Tremors, Vertigo, Menstrual headaches, Depression, Confusion, Anxiety, Tetany, Convulsions, Poor posture
Zinc Heart disease, Cancer, Diabetes, Acne, Depression, Loss of sense of taste, Reduced glucose tolerance, Suppressed immune system, Increased Inflammation, Anemia, Growth retardation, Skin lesions, ADHD, Acne, Impaired wound healing, Anorexia

Many other correlations between missing essential nutrients and chronic conditions are to be established since the past and current research has been limited and focused only on known and expected links.

Presence of any nutritional deficiency causes various abnormalities, which either directly or indirectly (through other pathological processes and mechanisms) intensify breathing. This leads to reduced body oxygenation and shorter CPs. For most people, especially morning CPs are going to be affected. Moreover, any missing major nutrient can distort bodily responses to hyperventilation in a shortage-dependent manner. Generally, personal symptoms become worse and lack of diet nutrients can even create new abnormalities and pathologies concealing the main health problems.

Indeed, chronic diseases require hyperventilation as a leading or accompanying factor, but personal symptoms and clinical picture depends, apart from genetic predisposition, on diet nutrients and other environmental and life-style factors. Hence, major nutrients are among the key factors which predict and define specific details of disease progress and experienced symptoms.

Taking into account drastic changes in food quality on Earth during last 100 years, use of nutrient supplements is an important and often necessary measure to efficiently and speedily normalize one’s breathing pattern, improve body oxygenation, and increase the morning CP.

It should be kept in mind though, that in rare conditions lack of some key nutrients may slow down progress of some conditions. For example, there is some evidence that magnesium deficiency can slow down growth of cancer tumors. Such situation suggests that magnesium deficiency can interfere with certain pathological processes connected with tumor growth, while also producing negative effects on other systems and organs of the human organism.

Breathing exercises temporary increase oxygenation and blood supply to GI organs. This leads to improved absorptions of nutrients and decreased losses of nutrients via urine and feces and, when major nutrients are added to one’s diet, the student’s rate of CP progress can be increased by 2-5 or even 10 times. Some people will never get even 20 or 30 s CP without getting essential nutrients in diet.

Our first goal is to find a general strategy in relation to supplements:
* How much to take?
* For how long?
* Does every student require, for example, calcium and magnesium supplements?
* Are the required amounts the same for the same person when they get higher CP?
* What are the ideal or optimum requirements in essential nutrients in diet?
* Does this ideal dose change when one’s CP is much higher?

There are similar questions related to other minerals and nutrients, for example, essential fatty acids, zinc, chromium, iodine, and others. While many people spend hundreds of dollars every year on useless supplements, there are simple criteria and rules that help to find the need and optimum amounts of nutrients in order to normalize one’s breathing, improve body oxygenation (the CP), and restore normal health.
2. General approach to key nutrients for breathing retraining

Supplemented or additional nutrients can have a profound effect on body oxygenation (especially, the morning CP), heart rate and other physiological and symptomatic parameters only for those students who have corresponding deficiencies. In order to check lack of nutrients in diet for a particular person during breathing retraining, one can try a 3-day test.
2.1 3-day test in order to identify main nutritional deficiencies

The answer to this list of questions (see above) could be based on our philosophy of health: restoration of normal breathing. Imagine that supplementation with some nutrient increases the CP by 3-5 s (a significant number). Later, when the same student stops taking this supplementation for some days, their CP decreases back to its previous values. Hence, one can practically measure and experience positive effects of supplementation with the missing nutrient.

When teaching Buteyko students, I explain them how to fill their daily logs (see Downloads), where all important health information is stored. The last column of the Table from the daily log is for recording the amounts and types of essential nutrients and minerals in diet. The effect of key nutrients in diet is especially strong, when the student uses them after several days (e.g., 4-7) of breath work. On one hand, this short delay is long enough so that the student can experience faster morning CP growth and have less symptoms related to missing essential nutrients. On the other hand, it is not too long so that the student does not spend too much time, while having little or almost no progress due to breath work and lifestyle changes.

Practically, during initial stages or after getting initial statistical data about the morning and daily CPs, heart rate and symptoms, the students should investigate possible contributions of missing essential nutrients on their symptoms, disease, and breathing recovery (or health restoration). What can be missing in the body?

Most modern people, if they follow a right breathing program, would benefit most from using fish oil, calcium, magnesium and/or zinc. These deficiencies are usually manifested in the following common symptoms:
Nutritional deficiency Symptom
Essential fatty acids deficiency Dry skin
Calcium deficiency Nervousness, poorer sleep, and elevated heart rate
Magnesium deficiency Muscular tension, costal or chest breathing and difficulties with learning diaphragmatic breathing, tendency to slouch, and constipation; muscle pain (spasms mainly in calves, possible in hamstrings and quadriceps) in severe cases
Zinc deficiency White spots on nails, decreased dark adaptation, problems with protein metabolism, suppressed immune system.

Note that marginal nutritional deficiencies often do not have any noticeable physical symptoms, but a student still can get significant improvements in their CP and health.

When a deficiency of some key nutrient is suspected, you can do a 3-day trial. Take this supplement for 3 days and record in your daily log the changes in the CP, heart rate and symptoms. After these 3 days, stop taking the supplement for 5-7 days. Again record your changes in the CP, pulse and other symptoms. If during these 3 days the CP increases and later, when the nutrient supplements are not taken, the CP drops, then the supplementation is useful. One’s morning CP should be used as the main criteria for this test.
2.2 Suggested nutrients intake

The suggested doses, which can be used during the 3-day test, are based on typical RDAs (recommended daily amounts).
Diet Nutrients and Minerals Nutrients intake or typical RDA amoun
Cod liver oil (or fish oil) 10 ml or 1 tablespoon per day (better in the morning or during the first half of the day due to its possible invigorating effect usually present in cases of existing deficiency; taking it before sleep can result in insomnia)
Calcium Supplement 800-1,000 mg per day of elemental Ca supplement, better in organic form and divided doses with each meal
Magnesium Supplement 400-500 mg per day of elemental Mg supplement, better in organic form and divided doses with each meal
Zinc Supplement 15-30 mg per day of elemental Zn

2.3 Organic vs inorganic minerals

Health food stores, online companies and pharmacies have many different versions of mineral supplements. They are usually divided on two types, organic and inorganic, depending on their chemical formula.
Inorganic forms Organic forms
Calcium Calcium carbonate, calcium phosphate Calcium citrate, calcium ascorbate, calcium lactate, calcium lactate gluconate, calcium gluconate, and numerous forms of chelated calcium (e.g., calcium amino acid chelate, calcium arginate, calcium lysinate, calcium ornithine, calcium L aspartate).
Magnesium Magnesium oxide (also called magnesia), magnesium phosphate, magnesium sulfate Magnesium citrate, magnesium citrate, magnesium ascorbate, magnesium fumarate, magnesium ketoglutarate, magnesium gluconate, magnesium aspartate
Zinc Zinc oxide Zinc citrate, zinc gluconate, zinc aspartate, zinc picolinate, zinc monomethionine, sodium-zinc EDTA, and zinc histidine

Several published studies have found improved absorption of these 3 minerals, when they are taken in organic forms. Generally, the best calcium supplements (the same relates to magnesium and zinc) are organic. They are more expensive (about 2-3 times) in comparison with inorganic forms, but have higher absorption rates (about 2-3 times for most people) depending on several other factors. With higher CPs (e.g., 40-60 s), this difference between various forms (organic vs. inorganic) becomes smaller, due to greatly improved ability to absorb nutrients from the gut. At very high CPs (over 90 s), this difference becomes negligible or unnoticeable.
2.4 Higher CP improves absorption and retention of nutrients

It should be also kept in mind that easier breathing and higher CPs increase blood supply and oxygenation of the GI tract, the small intestine included. This means improved absorption of many diet nutrients. In addition, better body oxygenation improves work and efficiency of the immune system and organs of elimination (kidneys, liver, colons and skin) and reduces self-pollution (due to infections, inflammation, and generations of free radicals due to hypoxia). Hence, easier breathing improves use and retention of useful vital nutrients and reduces excretion of these nutrients via urine and feces. This allows to reduce nutrients intake.

Therefore, once the student has large CPs (about 60 s or more), the needs in many minerals, vitamins, etc. are significantly smaller. Later, the student may find his or her new optimum level of supplementation using a similar 5-day or one-week trial. Practical experience has revealed that even high CP people (over 50 s MCP) often require small supplementation in Ca-Mg-Zn, e.g. a tablet or capsule per day.
2.5 Individual variability in required doses

During the first years of life, the human organism adapts to surrounding environmental conditions, including diet, types of foods, presence and availability of essential nutrients and many other factors. The human organism has numerous bio-feedback mechanisms in order to preserve certain various nutrients in case of lowered nutrients intake. It would be logical to expect that these formative years should have some effect on the efficiency of absorption and retention mechanisms. Hence, optimum amounts of supplements are individual and should be chosen according to the following idea.
2.6 The main strategy

Use such a minimum amount of the particular nutrient, so that to achieve maximum improvements in your CP, heart rate and bodily symptoms. If the student increases the dose, but there are no changes, then there is no need to use more since there are no further improvements in breathing.

If you try a certain supplement for 3 days and there is no improvement in your symptoms and parameters, do not waste your money for this particular supplement (fish oil, or calcium, or magnesium, or zinc). For example, it is known that some people can utilize essential fatty acids from nuts and seeds and when these students try fish oil, they do not notice any changes. Hence, there is no need for them to use fish oil or cod liver oil. Meanwhile, most modern people will benefit from having daily cod liver oil supplementation as it has been proven by many studies (see below).

What about minerals? Most students will experience better health, if they try Ca-Mg-Zn. It is difficult to get these minerals, especially Mg and Zn, even while eating large amounts of vegetables, fruits, nuts and other wholesome foods. Modern agriculture is not concerned and does not encourage farmers and producers to grow the products with high-mineral or high-vitamin content. Foods are usually valued by their look, taste and occasionally energetic value.

During this experimentation with supplements, remember that the key to better health remains in breathing, and other things, while being important or even necessary (e.g., minerals or vitamins in diet), remain only auxiliary in relation to breathing. Otherwise, use of supplements may result in the possible shift in priorities (“Aha! We are treated with fish oil!”), with the erroneous belief that it is not normalization of breathing, but, for example, some supplements, that matters most.
3. Other related topics
3.3 Antagonistic effects of some minerals

Another practical aspect relates to antagonistic effects of some minerals in relation to each other. Consider calcium and magnesium absorption. When one nutrient, e.g. magnesium, is missing and a student starts supplementation with magnesium only, the student would notice quick improvements. (When a therapeutic dose of the missing mineral, Ca or Mg, is provided, it takes about 2 hours to experience improvements in parameters and symptoms.) However, continuous supplementation with Mg only can naturally result in lowered Ca absorption since they are absorbed using active transport through the same ion channels in the mucosal surface of the intestines. Hence, Mg supplementation can cause Ca deficiency symptoms some 3-5 days later.

For these reasons, Ca and Mg supplements are usually combined in one pill or tablet with about 2:1 ratio (twice more Ca than Mg). Such ratio is optimum for most people. However, due to individual variability, the needs of various people differ. It would require some experimentation (up to weeks) and recording CP, heart rate and other symptoms to find out the minimum dosages and optimum ratios in order to achieve maximum effects.

Most people with low CPs (e.g., 10-20 s) often find 2:1 ratios and full dose supplementation (about 1,000 mg of Ca and about 500 mg of Mg every day) optimum. Other students prefer 1:1 ratio. In more rare cases, the best benefits are obtained when only taking Mg (especially if dairy products are frequently consumed) or only Ca.

Similarly, taking too much zinc (e.g., 50-100 mg) can suppress or reduce absorption of copper causing copper deficiency. (This may result in roughening of, for example, skin on the face.) Hence, when a student takes too large amount of zinc (over 50 mg) only, it is better to use a Zn supplement that has additional Cu. The typical RDA for copper is 2 mg daily.
3.4 Nutritional deficiencies and cleansing reactions

Dr. Buteyko started the section about the cleansing reaction in his small manual “Method of volitional elimination of deep breathing”, with the explanation of the main pathological mechanisms that undermine human health:

1. Physiological Grounds for Clearance Reaction

Deep respiration interferes with metabolic processes in cells, causes oxygen starvation, eliminates vital substances from the body (sodium, potassium, calcium, phosphorus) to compensate internal alkaline shifts, distorts immune reactions and results in the accumulation of incompletely oxidized products and substances which come into contact with incoming protein allergens and can provoke allegro-pathological responses.

Deep respiration impairs the functioning of kidneys, liver, intestines and other organs. As a result, a large amount of metabolites is accumulated in the organism, i.e. incompletely oxidized products, waste salts, residual drugs, toxins which cause focal infections, elevate the blood cholesterol and enhance calcium and phosphorus depositions in joints and blood vessels etc.

With the liquidation of deep respiration the metabolic processes become normal improving the excretory functions and clearing the body of harmful products…. [end of quote]

He obviously claims that elimination or deficiency in essential minerals causes abnormal immune reactions and accumulation of free radicals and other toxic substances in the body. In the practical section (the last part of his manual), Buteyko suggests following practical actions in relation to cleansing reactions:

The teacher must prepare a patient for the reaction to occur so that the latter would not have been frightened, convince him to continue with training and try to eliminate the symptoms by means of the VCDB method. In some cases such symptoms are not eliminated but on the contrary get more vividly expressed after the training. It testifies to an accelerated reaction and serves as an indication for retaining the achieved training intensity. Yet the training must not be interrupted otherwise the depth of respiration will grow and the clearance reaction will not be completed. If the depth of respiration returns to initial level, then the disease will also come back. This concerns primarily such symptoms as headaches, retrosternal and other pains associated with sodium, potassium and, occasionally, with other (magnesium, calcium, phosphorus) ions deficit which have been eliminated from the organism by deep breathing. In this case the teacher will recommend corresponding preparations: sodium chloride (0,5 teaspoonful), potassium (1 g), magnesium sulfate (2 g) per glass of water (drink in little swallows until the symptoms disappear or become weaker), a teaspoonful of chalk, 2-3 tablets of calcium glycerophosphate (chew to crushes) etc. …

It becomes clear here that essential minerals play a central role in the reduction of severity of the cleansing reaction. Furthermore, many other Russian Buteyko sources (written by other Russian MDs practicing the Buteyko method) speak about the precursors (early signs of the cleaning reaction). In this Buteyko manual, they are discussed in Part 2: Precursors of a Clearance Reaction.

What happens in the human body at these times? Why does the human organism require a certain time to start the cleansing reaction? Surely, in the case of deficiency of the main minerals, the human body will try to accumulate the required minerals in order to initiate the cleansing reaction that requires minerals in order to chelate waste products out of the human organism.

Hence, there are certain in-built physiological and biochemical mechanisms that are able to borrow required minerals from their main use in current physiological processes so that to eliminate harmful substances. This is done even in cases of limited or insufficient supply of nutrients and with increased temporary deficiency in these minerals.

It is also known that Russians did not teach testing and use of supplements of essential macro-minerals during breathing retraining. Taking supplemented minerals, for historical and cultural reasons, has not been popular in the USSR. There are four macro-minerals (sodium, potassium, calcium, and magnesium) which are required for the human body on the daily basis since they are water-soluble. Sodium can be obtained with regular consumption of sea salt; potassium is abundant in vegetables, grains, nuts, legumes, and seeds. Hence, during the clearing reaction, one can use extra sea salt and eat more cooked vegetables. (People low CPs, even those who have good digestion, usually do not have enough patience to chew raw foods very well, as it is required. Hence, eating cooked vegetables for less than 20 s CP is a sensible option.).

It is suggested here that cleansing reaction can be avoided or almost nullified when the student takes sufficient doses of Ca, Zn and Mg with a reasonable diet, as well as make steps to prevent morning hyperventilation (this situation leads to additional losses in useful electrolytes due to large blood pH fluctuations).

Moreover, presence of normal amounts of required nutrients greatly assist breathing normalization, as we are going to discuss below.
3.5 Further notes

There are several other diet nutrients and substances that can be beneficial for health and breathing improvement, particularly, when the CP is about 30 s and more. Further information will be available either online or in books and manuals.
Web Page: Fish oil vs Flaxseed and other vegetarian oils (under construction)
Appendix 4. Macro-minerals and their signs of deficiency

During the cleansing reaction there are many abnormal changes and unusual physiological processes (see sections 7.11 and 7.12). These processes often create additional demands in four main macro-minerals: potassium, sodium, calcium, and magnesium. Without sufficient supply of these electrolytes, normalization of breathing is impossible. Therefore, it is necessary to recognize these deficiencies (by observing the signs and symptoms of the patient) and timely correct them as soon as possible. The information given below is intended to facilitate this process of unmasking of deficiencies for quick recovery. Please, note that the usual dose used by Russian Buteyko doctors was about 1 g for all these minerals. Note that the signs of deficiencies are individual and in many cases only blood analysis can conclusively define a particular deficiency.

General information:
- about 140 g in the normal human body
- comprises 5% of the total mineral weight
- over 95 percent of the total body's potassium is in cells.

Potassium is crucial for having normal:
- water balance and distribution
- muscle and nerve cells functions (in conjunction with Ca and Mg)
- heart, kidney and adrenal functions
- conversion of blood sugar into glycogen
- regulation of blood pressure.

Some facts about potassium:
- is the main electrolyte to keep the cells alkaline
- reduces free radical formation
- activates a number of enzymes, particularly those concerned with energy production
- stimulates normal movements of the intestinal tract
- used in medicine for treatment of high blood pressure and heart arrhythmias
- the levels are regulated by the kidneys
- primarily excreted by kidneys through the urine (especially as a result of acute hyperventilation)
- easily lost by sweating, diarrhea (since digestive juices are not properly absorbed in the lower gut), frequent colonic irrigations, during prolonged fasting, due to polyuria and consuming aspirin, laxatives, alcohol, caffeine, and sugar
- often deficient in elderly, athletes and hypertensives
- should be kept in proportion to sodium (this ratio is very different for modern salt-rich and acid diets).

Deficiency signs:
- mild deficiency signs and symptoms include: muscle weakness, abdominal distension, abnormal posture, fatigue, mental confusion, irritability, heart disturbances, and problems in nerve conduction and muscle contraction (some people experience palpitations, others find they are not processing information quickly, etc.)
- severe deficiency signs and symptoms include: vomiting, acute muscular weakness, paralysis, pins and needles, loss of appetite, low blood pressure, intense thirst, drowsiness, concussion, and eventually coma.

Safety issues:
- usually, extremely safe; however, individuals taking potassium retention drugs, with dehydration or kidney disorders often need to restrict their potassium intake.

RDA or RNI: 2,000-5,500 mg.

Therapeutic doses: 2.5-5 g.

General information:
- about 70 g in the normal human body
- about 40% of the body’s sodium is contained in bone, approximately 2-5% occurs within organs and cells and the remaining 55% is in blood plasma and other extra cellular fluids
- comprises about 45% of the total electrolyte concentration and about 90% of the total extra cellular osmotically active solute
- 40% of table salt.

Sodium is crucial for having normal:
- water balance in the body and blood pH
- digestion, nerve function, and muscle contractions.

Some facts about sodium:
- easily absorbed in the small intestine and stomach
- lost with diarrhea, vomiting or excessive sweating
- baking soda is used intravenously to treat metabolic and respiratory acidosis, excessive potassium levels and to produce alkaline urine.
- optimal health requires a potassium-to-sodium ratio of about 2:1.

Deficiency signs:
- nausea, dizziness, muscle weakness, appetite loss, flatulence, diarrhea, intestinal gas, fatigue, headache, poor concentration, mental apathy, irritability, neuralgia, stomach cramps, and vomiting.

Safety issues:
- excess sodium levels in the body pull water from cells and can lead to water retention (i.e. puffy eyes, swollen feet and hands)
- can be dangerous for people with congestive heart failure, hepatic cirrhosis, hypertension, edema, blood vessel disease, bleeding problems, epilepsy, and kidney disease.

RDA or RNI: 1,000-3,500 mg (although 300-500 mg may suffice).

Therapeutic doses: 2 to 12 g.

General information:
- about 1-1.5 kg in the normal human body
- 99% of all calcium is in the skeletal system
- teeth comprise about 1% of total Ca.

Calcium is crucial for having normal:
- glycogen storage (ATP component)
- muscle tone and contractions (including heart beat regulation)
- nerve relaxation and conduction
- fat digestion and blood clotting.

Some facts about calcium:
- absorbed mainly via active transport in the duodenum
- absorption rate is about 20-40% and is greatly facilitated by the action of vitamin D, lactose, and certain amino acids
- better absorbed with food in small divided doses (e.g., 200-500 mg of Ca with each meal)
- absorption is hampered by aluminum-containing antacids, tobacco, alcohol, tea, coffee, oxalates, and phytates
- excreted with urine, feces, and sweat
- at risk for low calcium are: women over 45, men over 65, people who consume alcohol, have inactive lifestyle, low calorie diet, high protein diet, pregnant women, smokers, with lactose intolerance, frequent use of magnesium antacids and cortisone medication.

Deficiency signs:
- irritability, nervousness, insomnia, heart palpitations, hypertension, brittle nails, loss of muscle relaxation and contraction abilities, muscle cramps, numbness in the arms and legs, aching joints, poor blood clotting;
- convulsions, depression and delusions at later deficiency stages.

Safety issues:
- excessive calcium supplementation could result in kidney failure even if you don't have kidney disease
- caution is required for people with kidney disease.

RDA or RNI: 800-1,200 mg.

Therapeutic doses: 250-5,000 mg.

General information:
- about 22-26 g in the average 70 kg adult body
- about 65% of it is in the bones and teeth

Magnesium is crucial for having normal:
- synthesis of proteins and other vital substances, since magnesium is a cofactor in more than 300 enzymatic reactions (many of which contribute to the production of energy, and are involved in cardiovascular health)
- muscular relaxation and tone of the intestines.

Some facts about magnesium:
- most magnesium is inside the cells
- needs can be individual and different.

Deficiency signs:
- hypertension, numerous and various heart problems, premenstrual syndrome or menstrual cramps, tetany (sustained contractions and convulsions), insomnia, anxieties, chronic constipation, and hyperactivity (particularly with children).

Safety issues:
- frequent and excessive use of magnesium supplements can eventually trigger a number of medical problems resulting from other minerals (such as calcium, sodium, iron, or potassium) getting out of balance.

RDA or RNI: 300-400 mg.

Therapeutic doses: 50-2,500 mg.