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I saw a 34-year-old female this week who came in to speak to me about depression related to her miscarriage last year with her first pregnancy. No prior history of depression. Healthy medically except for your ureteral reflux as a child with a history of multiple UTIs and frequent treatment with Septra and other antibiotics growing up. As an adult, still gets recurrent UTIs and often postcoital. Also note from a functional perspective she developed an adult food allergy as shellfish and gets frequent migraines which may be food related. Can you help me connect some dots between the vaginal microbiome issues, UTIs, recurrent antibiotics, migraines, food allergies and depression? Has been prescribed gluten-free Paleo, more exercise, and doing standard labs but haven’t ordered food sensitivity or stool yet. Plan to order probiotics for mood based on stool culture results. Any thoughts on how to avoid future UTIs?

Chris Kresser: Okay. Yes, a lot here. This makes perfect sense to me. It’s a great example of the gut-brain...

Do you have any experience using maca for low testosterone based on DUTCH test results? Patient has low libido, and his cortisol results are high free cortisol and low metabolized cortisol.

Kelsey Kinney: In terms of the maca, I have had some people that I’ve had on maca just for help...

Male patient, 52 years old, three years out from traumatic brain injury after a skiing accident with three prior concussions. How do I treat balance and ringing in the ears as his primary complaint. Wanted to continue to eat gluten, so I ran Cyrex 4 and didn’t come back with anything. His cholesterol is low at 135. LDL is 77, HDL 41. I told him about fat and cholesterol for the brain. Can’t convince him to go Paleo, low carb, or do food elimination like an elimination diet. How do I convince him to get rid of the gluten? He won’t eat any red meat. His thyroid hormones are normal except for low free testosterone, high levels of AST, MCV and creatinine although question dehydration. Micronutrient testing low in B12 shown by no red meat and high MCV, also low folate B2 and B5 even though he’s on a B complex in addition to B12 methyltetrahydrofolate. Plasma levels show low glucose insulin interaction. I asked him to start adding protein to breakfast, having veggies with every meal. He says he’s compliant, but the labs aren’t showing absorption. Am I missing something with fat and B absorption? He’s heterozygous for the FAD1 and 2 SNP. I tried the absorption issue and Perlmutter but he’s not convinced. Please advice on what I’m missing or what I can add as far as treatment.

Dr. Amy Nett: If I’m looking for gluten sensitivity, I would actually run Cyrex Array 3, so that might just...

I agree with an ancestral diet, but lately there’s a very strong push for a vegan plant-based diet in the alternative media lately, and they all cite evidence showing how animal protein and fat increase insulin resistance and increased IgF1 and cancer risk among other problems. I was very confused about this until I read your article last week about how methionine in the meat causes cancer, and we need to eat more glycine-rich foods. If someone doesn’t eat organ meats and bone broth, is it better then to avoid animal muscle meats?

Edina asks, “I agree with an ancestral diet, but lately there’s a very strong push for a vegan plant-based diet...

Do you have any opinion on the recent trend of drinking alkaline water? Could it potentially contribute to hypochlorhydria?

Next question from Ram is, “Do you have any opinion on the recent trend of drinking alkaline water? Could it...

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