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Autoimmune Disorders

Does vitamin D or omega-3 reduce T regulatory cells?

Dr. Amy Nett: I like, yeah, both vitamin D and omega-3s. Oh, yeah, you’re giving me more ideas, systemic enzymes,...

How do you tell exactly if hypothyroidism is autoimmune in nature? What would levels of TPO antibodies need to be? I’m asking because Chris talked about possibly using an AIP diet and how possibly people with Hashimoto’s don’t always respond well to iodine, but often it’s OK if you add selenium. How do you monitor their response to iodine, and how do you check their selenium levels via blood sample for both iodine and selenium? How long after trying to introduce iodine would you test their levels, and what dose would you try adding in the iodine, say, by kelp capsules or adding seaweed in the diet?

Dr. Amy Nett: I’m glad we get to follow up on this because, Laura, I think you and I were...

I have a patient with ME/CFS with a history of infections, a rare form of infective arthritis in her knee joint as a child and then a very serious chickenpox at age 20, after which things deteriorated. She got even worse after giving birth to her daughter. I’ve done some gut work with her and considering more with some minor improvements, but this history of chronic infection seems a probable factor. I know we’re not covering this in the course, but can you give some pointers, other recommended labs, and will they be useful if there are long-term hidden infections within the cells or the spinal fluid as I’ve read is possible? Are there nonpharmacological treatment options? Any pointers would be very useful, even if the upshot is that we’ll need to work on the gut, etc., for now and wait until future modules to delve further. On a related note, do you have any idea of the likely order and timescale for future modules?

Chris Kresser: Yeah, very complicated, and it’s long been posited that chronic infection plays a role in ME/CFS. At some...

What about probiotics for Crohn’s patients? If they’re over-responding to commensal bacteria, is it then a bad idea to prescribe probiotics, or are there certain probiotics that Crohn’s patients tend to do better with? If also giving Xifaxan, when is the appropriate timing for the probiotic along with Xifaxan three times a day?

Chris Kresser: They’re all really good questions, and the answer is we don’t really know. As you probably are aware,...

A female patient has an autoimmune disease, managing it with an opioid and a biological TNF blocker, doing well on this combo with a Paleo diet and FM. FM? Functional medicine? I’m not sure. Would you recommend she discontinue these medications and/or try LDN? She would need to lose the opioid first.

Dr. Amy Nett: Yeah, exactly. This is a tough one. I think it depends on what the patient wants. I...