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This patient had elevated lysozyme at 651 and suppressed sIgA at 10.6. Does it mean he is not able to mount any immune response to the parasite or are the parasites are suppressing his immune response to survive? Or that they’re not pathogenic?

Chris Kresser: I don’t think we can say anything about what that means specifically. If you recall back to our...

So on the case before, if you got improvement on the yeast with the antimicrobial protocol, should I still not try the antimicrobial herbs again with the elevated lysozyme? Not sure everybody can do this SIBO test easily with him as a child.

Chris Kresser: I’ve done the SIBO test. I’ve had four-year-olds, even three-year-olds, do the SIBO test. So there may be...

This is the first patient I’ve had with truly high stomach acid. He has a history of heavy NSAID use for migraines starting around the age of nine. He’s now 21, can’t even drink water without burping. Trying nearly anything gives him reflux. Bread is the only thing that helps. He has a bleeding ulcer resulting in surgery and was put on PPIs a year and a half ago. He stopped these and all medications, still gets headaches, but less severe. We’re doing a reset diet. I’ve suggested slippery elm along with licorice tea. H. pylori has been ruled out, stools are oily. Due to limited finances, we’ll do labs one at a time. Plan to start with Doctor’s Data comprehensive stool test. Any suggestions regarding a treatment plan or to relieve the symptoms are welcome. He manages stress well by working a low-stress job and cut out partying. He’s active, which seems to help his headaches.

Dr. Amy Nett: Yeah, so this is really interesting that a patient actually has elevated stomach acid. There’s not a...

A patient did a retest on a stool sample and it came back with moderately elevated lysozyme but normal calprotectin and lactoferrin. Lysozyme level was 1,400, there were seven or eight different bacteria in the commensal column that were +1 or +2 and no pathogenic bacteria, yeast, or parasites noted. His symptoms of high anxiety and phobia remain. His retest on organic acid only showed one marker: 40 yeast elevation and the bacterial markers were negative with Great Plains testing. My question is would you continue to do another round of pediatric herbal antimicrobials, or just do the rebuilding stage?

Chris Kresser: If you didn’t have any improvement on the herbal botanicals, which it doesn’t sound like he did, then...

A client with no colon, one kidney, FAP, and gastroparesis that has come up before. Last week she began antimicrobial protocol with rebuild to follow. For her Doctor’s Data retest, I’d like to challenge the test prep here for this particular case and would like your input. My logic and reasoning states that someone without a colon will need probiotics and prebiotics, fermented foods, possible butyrate, etc., for life to maintain healthy beneficial flora without falling back into the trap of pathogenic infection dysbiosis and severe SIBO and symptoms. We have her down to four healthy bowel movements a day and are settling into a long-term plan to keep her here. She has a large polyp in her small intestine, so her gut environment is very delicate. For someone missing a crucial part of her GI tract, it would seem she would drift quickly back to a negative gut state without permanent support for life. I would like to retest her while she is on her rebuild protocol and long-term food plan to test the efficacy of it.

Chris Kresser: Yeah, I think that’s a good idea in that situation.

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