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So we have a patient who has Helicobacter pylori. Do you treat only the patient or also his or her spouse?

Dr. Amy Nett: Great question. I actually test household members. So anyone living in the house over probably 30...

The client has a very severe insomnia and anxiety for at least 40 years and no gut symptoms. He has a stool test that came back with insufficiency dysbiosis and a few Blastocystis hominis in his three samples. Would you treat Blasto, or is treating the insufficiency dysbiosis enough?

Dr. Amy Nett: Yeah, great question. He has no gut symptoms, but he does have severe insomnia and anxiety. Yes...

I did a Doctor’s Data stool test on a 12-year-old girl, all the markers look good with the exception of having a few microscopic yeast and a stool pH of 5.8. She’s very underweight and gets occasional abdominal pain. My question is, would you treat the yeast and also if the low stool pH is a concern?

Chris Kresser: Low stool pH often occurs, it is often present with yeast and it’s another sign of fungal overgrowth....

Patient of mine with metabolic syndrome and significant hydrogen SIBO and significant gut bacterial overgrowth on Doctor’s Data. All metabolic syndrome markers with the lowering of moderate carb, Paleo, and gut treatment. However, her liver enzymes are not elevated and they were normal before. Could the treatment do this? Her doctor is concerned and wants to know what supplements she’s taking. Had her on NAC for biofilm and the label says that it can alter liver markers without altering liver function.

Chris Kresser: Yes, that is true. I would take her off the NAC and use something else for biofilm and...

Twenty-four-year-old male presenting with depression for seven to eight years but also lethargy and poor digestion after a trip to India four years ago. Doctor’s Data showed susceptible amounts of beneficial bacteria, five species of commensals and 1+ or 2+. 1+ of candida and Saccharomyces boulardii, but Blasto and giardia in all three stool samples. If Saccharomyces boulardii could be used to treat these parasites, is it possible that they could coexist? Patient opted for a course of Flagyl with S. boulardii. Would this be redundant given he already has it, and would you follow with another month or two of herbal antimicrobial parasitic protocol, SIBO results still pending?

Chris Kresser: I would definitely treat the giardia, and probably the Blasto in this case as well, given the symptoms...

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