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Pregnancy & Breastfeeding

How do you proceed with a patient that is breastfeeding in terms of testing and treatment for gut issues? I would imagine running Cyrex Arrays 3, 4, and 10, if indicated, could be helpful because eliminating foods wouldn’t be contraindicated, but what about in the case of stool testing or SIBO? Is there a botanical protocol that’s safe while breastfeeding, and would it be more advantageous to run the test closer to when treatment can begin so you have a recent picture of what’s happening in the gut?

Dr. Amy Nett: If patients come to the clinic and they’re either pregnant or breastfeeding, I definitely have a conversation...

Since the botanicals are unsafe for breastfeeding women, would you recommend grapefruit seed extract for the treatment of pathogenic bacteria?

Dr. Amy Nett: I would not. Again, I tend to be pretty conservative in terms of treatment, and if something...

Is chronic acne that’s located only below the ears and along the edge of the jawbone or neck area, along with dry skin, associated with any specific diagnosis? Also, this patient appears to have good digestion. Acne did not start until after pregnancy. She’s now 20 months postpartum. She follows a primal diet, but not 100 percent gluten free. Cyrex Array 3 results pending.

Dr. Amy Nett: Absolutely, gluten is a place you have to look. The two primary triggers I see contributing to...

A 39-year-old female patient in the first trimester of pregnancy, presenting with hyperthyroidism, prior history of subclinical hypothyroidism, and hyperemesis gravidarum. Do you have a preference in prescription?”—PTU is one drug that’s used for hyperthyroidism, for Graves, versus methimazole, which is another drug that’s used. Both are extremely hepatotoxic. PTU is more hepatotoxic, and methimazole, as Debbie points out, has risk of potential birth defects in the first trimester.—“The patient showed negative for Graves antibodies, but endocrinologist felt strongly that the patient did have Graves.”

Chris Kresser: Yeah, I have some personal experience with this, actually. Back when my wife and I were trying to...

This is the case: Patient in late 30s referred for me to help with weight loss. Has struggled with obesity for many years, trying multiple diets. Also struggles with falling pregnant and has failed attempts with IVF. Our initial plan of attack was Paleo template. She was very responsive to removing inflammatory foods from her diet. She has also cut back from her total carbohydrate intake to 85 g a day, has recently taken an interest in keto, and has reduced carbohydrates to below 30 g a day, and she feels amazing. My concern is will this be detrimental for her fertility? We’re trying and juggling trying to help her get the weight off but also not compromising her ability to fall pregnant.

Chris: It is a little tricky in this situation because part of the difficulty conceiving could be related to insulin...

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