By Dr. George Goodheart
Summary: Dr. George Goodheart, the founder of Applied Kinesiology, reports on interpreting urine analysis in relation to nutritional biochemistry. As a bonus Dr. Goodheart provides a brilliant list of eleven factors that influence the amount and distribution of calcium in the body—required reading for any nutrition practitioner. This was the first of more than fifty articles Dr. Goodheart published in the seminal journal the Digest of Chiropractic Economics, 1964. Reprinted by the Lee Foundation for Nutritional Research.
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Quick, Simple, Valid Urinary Testing Methods
Many tests have been proposed and used for urine diagnosis and analysis. Kits of unusual reagents have been assembled and offered to the [chiropractic] profession. All the tests on urine are useful in excluding gross pathology, but of what value in treating a patient is a urine analysis report that is negative for albumin, sugar, blood, pus cells, and possibly indican, bile, and casts?
A negative response is an assurance, not always valid, of some sort of freedom from gross pathology, but it is of little value in treatment and maintenance of a particular patient.[Photo of Dr. Goodheart, with caption:] Dr. Goodheart.[spacer height=”20px”]
Tests that do have a biochemical significance and that materially help in the care of patients directly are sometimes little known. An evaluation of the specific gravity, total calcium, chlorides, phosphates, judgment as to liver function, and vitamin C level is possible and can be simply done in a matter of minutes without expensive kits or equipment by use of simple yet fully authentic and standardized tests on urine samples. These tests are regularly performed in our office, take little time, require little equipment, and yield much positive information in the care and management of patients’ habits and diet as well as specific indications for treatment.
Urine specific gravity is usually checked and, if within normal limits, forgotten or disregarded. Yet this simple test is an aid if interpreted properly to liver—and not just kidney—function. Generally speaking, a value of 1.018, not 1.021 or 1.022, is normal. If specific gravity is as low as 1.010, [one or all of] three factors may be present:
1. Kidney elimination is poor.
2. Assimilation is faulty.
3. Mineral intake is low.
The most common cause of low specific gravity is a sluggish or torpid liver; body wastes do not eliminate when the liver fails to function properly. Some low gravities are the result of the low food intake of individuals trying to control hypothyroidism by diet. Only a very few low specific gravities are caused by kidney dysfunction (Applied Nutrition, Hawkins).
These facts justify the thought that low specific gravity in a urine specimen indicates poor liver and thyroid function rather than a possible kidney difficulty. Treatment suggestions therefore would be to stimulate liver and thyroid function. Since the liver is supplied roughly by [thoracic vertebrae] 5, 6, 7, 8, and 9, the spinal sympathetics, and the vagal parasympathetic, inhibitory adjusting in parasympathetic regions—upper cervical and lower lumbars and sacrum—would be a good approach; use of the specific gravity as an indication of treatment. Liver and thyroid techniques and support would also be indicated. There is biochemical application of treatment based on a simple specific gravity test. What could be easier?
The well known Sulkowitch reagent, for estimation of urinary calcium, is available through the California supplier Uri-Blood-Cal, or it can be made up as follows: combine 2.5 g oxalic acid, 2.5 g ammonium oxalate, and 5 cc glacial acetic acid, and dilute up to 150 cc with distilled water. Combine equal parts of this solution and morning, prebreakfast urine, and observe the mixture for about 20 seconds for cloudiness and flocculation. A hazy cloudiness is the general rule in most patients since most patients have a disordered Ca-P ratio. This indicates heavy amounts of urinary calcium. An absolutely clear solution indicates low urinary calcium.
This test takes about 40 seconds, can be performed while the patient is dressing, and yields useful information. Unless the patient is ingesting a high-calcium diet—which is well nigh impossible with our super-refined foods—or supplementing with calcium in some form, then the heavy calcium indicates, generally speaking, loss of calcium via the urinary route. Foods high in vitamin D will help bind calcium to the bloodstream; foods high in vitamin F will help transport calcium from the bloodstream to tissues; foods high in vitamins A and C help keep it there.
Many factors influence calcium in the body. Rather than neglect any, here they all are. Some are useful, some are not:
1. The amount and character of calcium in the diet.
2. The hydrochloric acid level. Special attention is directed here to the fact that if the HCl level is good, then it doesn’t seem to make much difference which form of calcium is ingested. If not, the lactate or the gluconate form is best. Also, try to raise the HCl by adjusting—this is also best! HCl support may be needed.
3. The amount of phosphorus assimilated. A high-protein-and-cereal diet—along with nuts, chocolate, and beans—is high in phosphorus and causes an increased loss of calcium in the urine.
4. The amount of potassium. Assimilated potassium has a high electrochemical activity and can displace calcium and increase it in the urine. Modern diet trends make it difficult to keep the level of potassium-rich foods, such as juices, fruit, vegetables, wheat bran, and soft drinks, low enough in the diet.
5. The amount of magnesium in diet. Magnesium, like potassium, displaces calcium, but with the exception of milk of magnesia addicts, it is not essential to consider.
6. Basal metabolic rate. High thyroids lose calcium easily to the urine; low thyroids do not assimilate it. Therefore both cause high urine calcium.
7. Vitamin D and bile both act alike on calcium: they increase its excretion into the urine but increase its assimilation [from food], with an edge toward assimilation.
8. Rate of growth is self-explanatory. A decrease during this period would be explainable this way.
9. The level of iron in the body. A high urine calcium along with poor assimilation is often associated with a low iron or hemoglobin level.
10. The activity of parathyroids. Calcium levels are raised in both blood and urine levels by parathyroid increase in activity, but this is followed later by a decrease.
11. Intestinal rates that are too fast will decrease calcium in urine and blood.
So, find out what that calcium level is and apply the yardstick of above items, and generally speaking an increase in vitamin F, liver function, HCl, or calcium intake will change the urinary calcium incredibly quick. Here again, adjusting for better liver function is important. Loosening of the neck musculature and the lymphatics promotes parathyroid activity. Certainly, enough gastric disorders resulting from low HCl have responded to adjusting in the upper dorsal region (even though this is a sympathetic area) to warrant careful, but not overly stimulating, adjusting. Apply logic in analysis, use adjustment as indicated, and watch the calcium level change. A a simple test 40 seconds long, a few minutes thought, and common sense in treatment give a biochemical control.
A simple test for chloride level and adrenal function—also important in the control of hypertension, in the treatment of hypertension, and in general use—is the Koenigsberg Test. Two solutions are used: potassium chromate, 10 percent, and silver nitrate, 0.74 percent.
Take 10 drops of morning urine, add 1 drop of potassium chromate, and shake well. Add the silver nitrate drop by drop until a brick red color develops. A low-sodium diet gives about 8 drops to the end point. A regular diet, based on about 1000 specimens tested, runs 23–35 drops.
The urine chlorides is a good index of total intake and can be used in all but a few liver and kidney and adrenal pathologies. A low level with hypertension would warrant an increase in table salt; a high level with hypertension would warrant a decrease in salt and high-sodium foods. A high level of fats in the diet shows an increase in urine chlorides, as is the case also with potassium. Since a good HCl level favors better calcium levels, and since many patients [who] suffer from calcium losses and hypertension [have] low gastric acidity, causing gastric symptoms, two problems can be solved by getting the chlorides normal.
Urinary phosphates can be detected microscopically or by boiling urine. If a cloudiness develops following boiling and disappears upon addition of acid, then [this indicates the presence of] phosphates. Another method is via pH determination, using pHydrion paper or Squibb’s Nitrazine pH Testing Strip. It’s simple and quick. Usually, the greater the acidity, the greater the phosphorus.
The same factors controlling calcium control phosphorus, since in the main it is excreted in combination with calcium or potassium. Therefore, these factors are involved:
1. The level of phosphorus in the diet.
2. The level of fatty unsaturates.
3. The level of HCl.
4. The level of bile and vitamin D.
5. Pancreatic function.
6. Vitamin B. Vitamin B stimulates the pancreas and aids phosphorus assimilation.
7. Presence of infections. Infections seem to increase the phosphate level tremendously in our experience, [the phosphate level] slowing up almost always and changing with the subsidence of the infection. How many of you recall seeing a urine loaded with some deposit in [patients with] infection and then clearing? Again, phosphates.
Therefore, to sum up: Modify the diet to provide adequate amounts of phosphorus—generally present in meat, fish, and eggs; supply foods high in vitamin F; adjust to get better HCl and liver function, as mentioned before; and try careful amounts of high vitamin B foods or concentrates to improve phosphorus assimilation.
The following chart, if copied and kept near the urinalysis table, will materially aid in dietary changes to be made based on the tests run.
|Food||Specific Gravity / Acidity / Phosphorus||Urine Calcium||Urine Chloride|
|Eggs, Cottage Cheese, Vegetables||Decreases*||Decreases*||Decreases*|
|Potato, Fruit, Cereals, Grains||Decreases**||Decreases*||Decreases**|
|Butter, Cream, Milk||Increases**||Increases*||Increases**|
*Same action on blood
**Opposite action on blood
The Ames Company of Elkhart, Indiana, produces excellent enzyme reactant strips that will quickly give [determinations of] pH, albumin, sugar, blood—and for those interested in infant care, the presence or absence of phenylalanine in the urine. These enzyme-coated strips are marketed as Combi-stix (albumin, sugar, and pH). Their Hemi-stix give blood in urine and other solutions; the Pheni-stix give phenylalanine; and the Keto-stix give acetone. A multiple dipping of Combi-stix, Keto-stix, and Hemi-stix gives a yes or no answer to sugar, albumin, blood, acetone, and pH levels within 15 seconds after dipping, with no other preparation. What could be simpler or quicker for detecting gross urinal pathology? Hemicombistix are now are available.
Vitamin C levels can be estimated by the use of dichlorophenolindophenol indicator material [DCPIP], using equal quantities of urine and indicator material. This indicator, in tablet form, can be secured from Good Health Supply Company, 16 Gothic Avenue, Toronto, Canada. The Sulkowitch agent for calcium is also available from this source.
By George J. Goodheart, DC, 542 Michigan Theater Building, Detroit, Michigan. Reprinted from the Digest of Chiropractic Economics, July/August 1964, by the Lee Foundation for Nutritional Research.
The above article has been reproduced for Chiropractic Physicians as a professional service. Certain persons considered experts might disagree with one or more of the conclusions expressed by Dr. Goodheart, author of the article. In any event nothing stated by Dr. Goodheart shall be construed as a claim or representation regarding any product or products.