Dr. Al Danenberg ● Nutritional Periodontist
December 13, 2020
Image by Bruno /Germany from Pixabay
I’m obsessed with getting it right.
From all the research I’ve read and from my personal cancer journey, there is one fact that stands out above all: A robust immune system is critical for wellness.
It’s vital for healthy people; it’s vital for sick people; it’s vital for all who want to be proactive as well as those who are reactive.
A robust immune system is the ticket for fighting diseases arising from external and internal sources. It protects us from pathogens as well as our own cells which become cancerous.
I’m fixated on recreating my robust immune system and evaluating my success along the way. And I’ve assembled a toolbox – my biological measuring tools. It includes 5 biomarkers which tell me what I need to know. I’ve used these measurements to guide me on my journey to a healthier immune system.
You also can use these tools to assess your progress and success.
5 Important Tools
#1. Healthy Gum Tissue
Your mouth can tell a lot about the health of your immune system. One prominent sign is the gum tissue around your teeth. It should never bleed unless it is cut. Never!
If you were to scrub your nails with a nail brush, you should be concerned if the cuticles around your nails started bleeding. Similarly, when you brush your teeth with a toothbrush, you should be concerned if you see any bleeding. The gums are as tough and protective as are your cuticles.
However, if you have a compromised immune system, the gum tissues may become inflamed or infected (i.e., gingivitis). They then may bleed when you clean or rub them. They even may bleed spontaneously. This is a strong indication that your immune system is not functioning ideally.
An excellent method to determine if you have bleeding gums around any tooth is to use a TePe Easy Pick. This is a small, silicone brush used to clean between the teeth at the gum line.
If you see any bleeding when using the TePe Easy Pick around any tooth/gum area in your mouth, you have some form of gum disease. This suggests that you have a compromised immune system.
Here are two pictures demonstrating how to use the TePe Easy Pick between teeth at the gum/tooth margin.
#2. Ketone Breath Meter
Metabolic flexibility is necessary to support a responsive immune system. And ketosis is part of being metabolically flexible.
I want to be in ketosis 6 days a week and then cycle into a carb-burning mode on the 7th day. The benefits of ketosis and carb-cycling are documented in the medical literature. Travis Christofferson summarized the unique qualities of ketones in his book, Ketones: The Fourth Fuel.
To help me gauge my ketone levels and document how well I’m doing, I researched three options.
- Urine ketone strips are easy and inexpensive. But they are not accurate once your body begins to utilize its blood ketones efficiently and effectively.
- Blood ketone levels can be monitored with finger sticks using a blood ketone meter. The readings are accurate, but I would need to prick my finger several times a day, every day. Not for me! I don’t know about you, but it hurts when done repeatedly. Another drawback is that it only gives a static picture at that moment in time.
- A ketone breath meter recently came on the market that has clinical research to support its efficacy. It’s was created and is sold by MyBiosense. This meter is unique because it registers acetone levels that are blown out in the latter part of the exhale, which is called Deep Lung Sampling. The readings correlate to the mmol/L of blood ketone levels. Using this device, I can monitor my ketone levels as often as I want with no finger sticks! And the data is stored in the MyBiosense App on my phone for me to review.
My goal is to average a ketone level between 1.5 – 2.5 mmol/L per day while in ketosis. On my “carb” day, my ketone levels will drop below 0.5 mmol/L that day.
#3. Standard Deviation of Glycemic Variability
Glycemic variability is the up and down variations in blood glucose level. It indicates the efficiency of insulin to make glucose available as a fuel or to store it appropriately. If insulin is not effective, glucose levels will get out of control leading to diabetes and various forms of metabolic dysfunction.
Various medical papers have shown that the standard deviation of glycemic variability directly correlates with the risk of chronic disease and cancer. It is inversely correlated with the robustness of the immune system.
I want my glycemic variability to be as low as practical.
I could take finger sticks frequently using a glucometer to register my moment-in-time blood glucose level. But that would not give me a running graph 24/7. It certainly would leave me with painful fingertips. I prefer not.
However, a continuous glucose monitor (CGM) by NutriSense is a device that is worn for two continuous weeks. The CGM inserts a microfiber into the interstitial tissues and attaches to an inconspicuous area of the body with an adhesive. It is painless to insert and wear. But it registers glucose levels every 5 minutes, 24/7. The data is transferred to a NutriSense App, which calculates the standard deviation.
#4. Alpha Diversity of Gut Microbiome
The gut microbiome is made up of about 38 trillion microbes. Our body only has about 30 trillion human cells. We are more “microbial” than “human”!
Many studies have been published describing the variety of species in the gut. These medical papers clearly demonstrate that the greater the diversity and numbers of specific microbes, the healthier the immune system. ,,
A measurement including (1) the diversity of various microbial species in the gut and (2) the number of each of these species is called “Alpha Diversity”. It is generally reported as a percentile compared to the microbial ecosystem in a population of metabolically healthy individuals.
BiomeFx is a stool test marketed by Microbiome Labs and evaluated by CosmosID. Among the many biomarkers reported in this test, Alpha Diversity stands out to me as one of the most significant results.
#5. Blood Level of Vitamin D
Recently, blood levels of Vitamin D have been widely reported as important in the fight against the COVID-19 virus. Previous to the Pandemic, much research has been published emphasizing the importance of adequate levels of Vitamin D to assure a robust innate and adaptive immune function., ,,
Vitamin D is reported to …
- Prevent excessive expression of inflammatory cytokines
- Increase the “oxidative burst” potential of macrophages
- Stimulate the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection
- Affect the action of T cells, key players in adaptive immunity
My Personal Results
#1. Healthy Gum Tissues:
My gums do not bleed. I use the TePe Easy Picks every day.
If you have bleeding gums, you need to address your diet, the health of your gut microbiome, and your oral hygiene techniques. You also need to seek the services of a general dentist or a periodontist (a dentist specializing in periodontal disease).
I stay in ketosis with my animal-based diet 6 days a week. My highest mmol/L while in ketosis has been 2.8; the lowest on those days has been 0.5. My average for 6 days running is 1.5. On my cycle day out of ketosis, I eat between 100 – 150 grams of carbs for that day, and my ketone reading drops to an average of 0.3.
#3. Glycemic Variability:
In July 2020, I wore the CGM from NutriSense for two weeks. My average standard deviation of glycemic variability for that time period was 10. Here is a table showing ranges and their interpretations:
#4. Alpha Diversity:
My Alpha Diversity was reported in the BiomeFx stool test I took in August 2020. The results indicated my Alpha Diversity was in the 98th percentile. That meant that 98% of metabolically healthy individuals had less variation of species and numbers of individual microbes than I had.
#5. 25 Hydroxy Vitamin D:
My last blood test for 25 Hydroxy Vitamin D was in 6/2020. At that time, my blood level was 89 ng/mL. and I was taking 5,000 IU of Vitamin D3 daily. I have reduced that dosage to every other day, and I’ll have another test shortly. As a cancer patient, I want to keep my Vitamin D level between 60-80 ng/mL.
A robust immune system is our internal armed forces to fight the fight. My ultimate goal is to make my immune system as robust as I can. The 5 important tools I described will guide me along my path and document my success. They also will confirm that I am remaining where I want to be.
I firmly believe that my cancer journey has been as successful as it has because I have significantly improved my immune system along the way. You may find that my 5 Important Tools will help you monitor your journey to a stronger and more responsive immune system.
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Great article with very helpful resources, Dr. Danenberg. Several of us have been emphasizing lately that we really need to formally add gum health to our considerations in the Undoctored program. Thank you for sharing your expertise in this area.
These are great resources, but could you have some suggestions for those on a fixed income who can’t afford Mybiosense? I am on Medicare and can’t even get the GP to let me have a glucose monitor cause they think 109 fasting blood sugar is fine, and AIC of 5.4 is great. Very frustrating. I have been on carnivore diet for 6 months, but I still had those glucose problems. I had a ferritin level at 208 also, and GP thought that was fine too. I then switch to keto and trying to do the cycling in and out like you suggest. I donated blood to get the ferritin level down to 89. Perhaps I had iron overload from all the meat. It was really an almost zero carb diet, and I did lose 50 lbs.
Thank you for sharing. I’m inspired by your approach and willingness to share your experience with others.
I’m sad to say, my brother in Idaho lost his 6 month struggle with stage 4 lung cancer. He was not in an environment nor health philosophy to attack on all fronts as you found the will to do.
We each have our own mission to fulfill, I’m glad you are still fighting in the trenches and writing about your discoveries . I respect that my brother’s mission was achieved.
All the best-