From the perspective of Functional Medicine, do you attempt to interpret the body’s various external messages of imbalances such as fraying nails, thinning hairs, swollen tongue, [and] excess mucosa surrounding stool?

I’m going to make sure that I understand that right. So, from the perspective of Functional Medicine, do you attempt to interpret the body’s various external messages of imbalances, okay, such as thinning hair, fraying nails, swollen tongue, [and] excess mucosa surrounding stool? So, Ariel, I think you’re maybe mentioning do you try to maybe separate each of these external symptoms and try to, like, break them up individually when you’re trying to interpret a body’s external response? I would say that I think they’re all part of the picture. Sometimes, it’s hard to get really stuck on each individual symptom as an indication of a particular imbalance. I often will look at them as groups and, like, thinning hair, for instance. In women, a lot of the times, like, rule out autoimmune conditions, rule out thyroid and then hormone, like, those are kind of the top three things that I think of when I think of thinning hair. Swollen tongue, I would think of nutrient deficiencies, hormone imbalances, and then gut imbalance. Excess mucosa surrounding stool, are we talking about for sure gut, that’s definitely where I would start, looking at elastase enzymes, pancreatic function, what are their inflammatory enzymes within the stool testing, [and] what does their diet look like? So I do think that you can kind of look at these all as a group, and if you’re really coming across from a Functional Medicine perspective, I think you’re going to cover your bases with all of these because [if] you’re doing a very thorough kind of casting a wide net approach in the very kind of initial onset of treating this patient, hopefully, you’re doing gut testing, which is going to cover the gut portion of it. Hopefully, you’re doing some DUTCH [dried urine test for comprehensive hormones] testing or, like, hormone HPA axis dysfunction testing that’s going to give us some idea if there are some major imbalances in hormones. We are doing comprehensive serum and blood testing, which should give us some information on nutrient deficiencies along with maybe the organic acids panel that’s going to give us some more information on nutrient deficiencies, and if you’re starting to see patterns, then that starts to give you information. If you’re starting to see a lot of nutrient deficiencies, and they also have SIBO and they also have a gut infection, we have to look at [whether] there [is] a problem with intake. Let’s look at, maybe do a Cronometer app and track their diet. Are they having an issue with intake or is it maybe more likely absorption? Because they do have some gut infections or some inflammation in the small intestine that is preventing them from absorbing nutrients, and so I think that you can kind of start to cross things off the list when you have a variety of symptoms that are maybe nonspecific, and, usually, that’s what I tell my patients, like, a lot of these imbalances could explain all these symptoms that you’re having and how we approach things from a Functional Medicine perspective is [that] we start with the low-lying fruit. Optimize nutrients, treat [the] gut, see what symptoms improve, and then kind of keep moving down that pathway, and that’s often how it works; it’s not usually all or nothing. It’s this kind of longer process of treating nutrient deficiencies, treating the gut; maybe the swollen tongue improves and the mucosa improves, but the thinning hair and nails don’t. So it’s just kind of this process of elimination and tracking those symptoms as you treat the imbalances. I hope that answered your question. It wasn’t too [much] of a long-winded response, but I do think you have to take them in groups and continue to kind of cross things off the list as you address imbalances.

Okay, so I’ll repeat the answer for the ​H. pylori​ test to the people who came in late. I think for now, I would recommend the Diagnostic Solutions Lab (DSL) for ​H. pylori ​testing. It does have quantity and also virulence factors on the testing. I think that’s still, for me, that’s my preferred testing. There are still options that you could go through, like a standard lab, and do stool testing, but I don’t think it’s validated, at least right now. We will update you guys soon about the ​H. pylori​ testing that we’re doing through DSL during those split samples, so right now we’re using the DSL ​H. pylori​ test.