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General Functional Medicine

I’m trying to understand how increasing acetylcholine precursors helps with a disrupted diurnal pattern. Could we explain? Additionally, have you heard of DMAE for increasing acetylcholine? Many people use it for ADHD.

Dr. Amy Nett: Let me see, DMAE. I don’t think I have actually. So let’s see, oh, dimethyl ethanolamine? I...

We have quite a few patients with chronic kidney disease, maybe 60 percent of them test low in serum magnesium and red blood cell magnesium. We then recommend dietary and/or supplemental magnesium and monitor levels. But invariably their nephrologist tells him to stop any intake of magnesium regardless of levels. Can you elaborate on the chronic kidney disease and magnesium connection and what to be cautious of? In all fairness, roughly 30 percent of our chronic kidney disease patients will have high levels of magnesium and we obviously don’t recommend magnesium to them. Are there alternatives to dialysis?

One of my clients with typical trigeminal neuralgia really wants to stop taking anticonvulsants that have helped her with pain up until now. Experienced rapid decline of other aspects of health since having started to take them. Desperate to find another option to control or eradicate the pain. Diet is fine. Testing seems a bit nonsensical since we already know her gut is messed up due to the meds. TSH is normal but free T3 is a little low and free T4 is a little low. Her gynecologist put her on 50 micrograms of thyroxine, TPO is 8.4, tracked below 0.3; serum ferritin, 47.8; DHEA sulfate, 60; and morning basal cortisol is 60.5. Sex hormones in the reference range but very high sex hormone-binding globulin at 233, has also consulted a specialized dentist for her TMJ, who made a full coverage occlusal splint for her lower jaw. Unfortunately, she’s found herself unable to use it since it gives her terrible headaches and muscle cramps in the back of her neck and shoulders. Although she meditates and is trying to get exposome factors in orders, she’s experiencing increased jaw clenching during the nights and strong feelings of misalignment during the past few weeks. Since the actual cause of trigeminal neuralgia is unknown, I’m working on nutritional lifestyle and relaxation techniques and was wondering if you have any other ideas how to help this young woman. Would you consider LDN?

Chris Kresser: Yeah, the dentist thing is interesting because I’ve talked about Dr. Jennings in Alameda and his work with...

You discussed organic acids testing as markers for microbial overgrowth and discussed a test from Genova and Great Plains. Number one, I’m unclear about the usefulness of these tests and the diagnosis of gut dysbiosis. Number two, are you going to present a more complete discussion of organic acid testing in the future? If not, which lab do you recommend for complete organic acid testing?

Chris Kresser: So as for number one, I think if you go back and you look at the organic acid...

Question about POTS which is postural orthostatic tachycardia syndrome. So my 13-year-old cousin was diagnosed with POTS after fainting 50, 5-0 times, for unknown reasons in the last six months. Every conventional test has come back normal. They’ve tested for a lot including brain scans, a 30-day Holter monitor. Her only symptom is this bout of lightheadedness and fainting. Outside of the episodes, she feels completely fine, high energy, low stress. Is there any insight on the functional medicine root cause of POTS or any treatment ideas? I’m working with her on improving her diet, which is pretty much the Standard American Diet right now. Otherwise, she is athletic, sleeps well, and tells me she isn’t stressed.

Dr. Amy Nett: Yeah, so POTS is really a tricky one and I think there’s a lot more to be...

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