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Autoimmune Disorders
43 Articles
How would you explain to a patient why autoantibodies, specifically TPO and thyroglobulin antibodies, are rising after 90 days of a full autoimmune Paleo diet with selenium and lifestyle changes, and now she’s worried about continuing with the intervention?
Are you seeing any correlation with particular microbes associated with MS? My patient has had EBV, has shown positive on 4+ on Citrobacter on the GI Effects panel we ran. Also discuss running Doctor’s Data to be current. Wanted your take on the viral microbial possible contribution.
Inflammation support, boswellia, curcumin, LDN, aromatic, medicine, colostrum, are extreme and immunoglobulin immunity.
I know we’re not covering CIRS, chronic inflammatory response syndrome, in this course, but I’m hoping you can give a couple of pointers. I’m sensitive to mold, which triggers sinus issues and asthma. I live on a boat in the UK, which is probably the worse place on earth for me, but no other option in the short term. What would be your go-to supplements to reduce symptoms?
There’s a case study of a 31-year-old female who was diagnosed with ulcerative colitis in 2007. And the iron markers were presented and the iron markers basically showed low serum iron, low iron saturation, low TIBC, low UIBC, and high ferritin, ferritin being about 162. And in that, Chris, in that presentation Chris mentioned she has chronic disease. Before I read the conclusions about the case, I thought that she would have low iron and the high ferritin was just due to inflammation. This patient does not have low iron. I believe you, obviously, and I can see why I did all the other markers that are there, but how do we know for sure this woman doesn’t have low iron? What is there in the information you have supplied that shows that her iron is not low?
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Blood Chemistry
66 Articles
I have a tough case of a 23-year-old obesity outpatient with recurrent pineal cysts, which started after trauma to the sacral area. And even after multiple surgeries and acne, she has very mild gut issues if any. She’s borderline anemic, low normal MCH, MCV, MCHC, hematocrit, and RBC. Her HbA1c was low at 4.3. Should be high with iron-deficiency anemia (although I have seen a lot of variation with HbA1c in anemias and that’s one of the problems with that marker). And low ferritin at 19. Considering Medihoney for the cysts and a Paleo diet with A, D, and K2 supplementation. All other tests normal, B12, hormones. TSH, fasting glucose normal, kidney function good. She can’t afford testing yet, but I was wondering if you could provide direction on this presentation. Looking forward to your thoughts.
Female patient with anemia. Here are test results according to the ranges for iron you provided, she’s on the lower end. What dose of iron would you recommend? And how long?
As a dietician can you please share which blood test you get your patients to do compared to Chris’s blood chemistry panel? And do you request to have these done before seeing patients yourself?
Iron deficiency addressed with iron-repletion protocol minus the alcohol. Should we add in liver support?
In my book on, in his book on B12 deficiency, Chris says a high serum B12 does not necessarily rule out functional active B12 deficiency. In fact, I’ve come to view high serum B12 in the absence of supplementation as a potential red flag for active B12 deficiency. Can you explain a little bit more about what the mechanisms are here?
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Blood Sugar Disorders
53 Articles
What do you recommend for someone who tests their blood sugar with a glucometer, and something like sweet potatoes in a meal raises their blood sugar pretty high? Should they try sprouted beans or something else that has a high fiber content instead?
Well-researched approach abridging conventional medicine, functional medicine has really helped increase confidence. How accurate of a marker is insulin? How are you using insulin in clinical practice? When you run the advanced metabolic workup with insulin C-peptide, etc., as markers, do you have guidelines on how to determine beta cell destruction?
What are your thoughts about keeping glucose at a stable level of 83 in diabetic patients, which is what’s recommended by Doctor Bernstein of the Diabetes Solution?
I saw a patient who wanted help with following a ketogenic diet. He has type 2 diabetes. He brought me a copy of his recent blood results, which he requested his GP to do. He has low platelets, low neutrophils and lymphocytes, and high B6 and MCHC. I have two questions. How long does it take to see raised blood ketones, and do you sometimes see ketones remaining normal despite eating minimal carbohydrate and not too much protein? Can you please comment on the raised B6? He doesn’t take any supplements.
In week 32, Chris discussed glucomannan powder for blood sugar control. I tried it mixed in liquid and it is so viscous that I could not drink it. Do you have any suggestions for making it more tolerable?
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Cognitive Disorders
16 Articles
I have a patient with long-standing depression, episodes of suicidal thoughts. Chief complaints are morning fatigue, bacterial vaginosis, skin issues, and depression. She believes depression can change even after 24 years. Gluten and dairy free for years. Recent labs indicated anemia. Not sure if it’s B12, B6, folate, or iron. She’s responsive to eating more animal protein, which is good. She doesn’t seem to eat enough in general. Her mom requested OAT lab as they’ve tried everything else, including working with a functional medicine practitioner. I’d like your input on the OAT results below and any other thoughts.
Any thoughts about the Feingold diet, which eliminates artificial colors, flavors, preservatives, and foods high in salicylates for ADHD kids? If patient is already on Paleo and not eating grains or dairy, to eliminate salicylates makes the diet very restrictive and hard for a child to follow. Do you think salicylates are a problem for ADHD kids and worth removing to find out?
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?
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?
Are there any contraindications that you know of to treat with CBD?
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Food Allergies
28 Articles
Have you seen Cyrex food sensitivity panel antibodies such as gluten or dairy drop after successful treatment of all heavy metals and/or SIBO? Have patients subjectively been able to tolerate more foods after healing their bodies that they previously could not?
Would it be possible that cross-reactive foods with gliadin could also cause elevated TPO antibodies? Also have you seen TPO antibodies decrease with removal of iodine supplementation?
I did a Cyrex Array 4 test on a father-daughter, both have celiac disease. Dad has antibodies to gluten-containing grains and milk chocolate. Can you safely say that he’s not a hundred percent compliant with the gluten-free diet, which is the reason for antibodies to the gluten-containing grains?
Since he’s making antibodies to milk chocolate, is it okay to continue having other dairy like milk and cheese or best to avoid all dairy?
With regards to the daughter, she is making antibodies to most of the dairy proteins. Do you advise removing all dairy forever or would it be okay to consider reintroducing?
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General Functional Medicine
372 Articles
Regarding histamine intolerance, is it preferable to supplement quercetin with bromelain or diamine oxidase? And if SIBO is not a causative factor in histamine intolerance, what other factors would one consider?
Liver detoxifies. Are there cases where it can cause more harm than good?
I’ve taken on new clients currently under care from another. All these clients are prescribed methylation supplements without a 23andMe or even basic MTHFR panel. Why is this happening? And then are there other leading indicators outside of genetic testing that reveal possible methylation problems?
Is there a methylation 101 resource for those of us new to the game?
Is there a resource that gives typical doses for supplements?
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Gut Health
251 Articles
Do you have any recommendations for constipation?
Do you have patients stay on the same probiotic or do you switch them up over time?
Has any connection been established between dysbiosis and hypothalamic-pituitary-adrenal axis dysfunction?
How can we help optimize health and digestion for someone who has had their gallbladder removed?
Do you consider L-glutamine supplementation and glycine-rich foods the first intervention to restore gut lining in cases of leaky gut before probiotics? And what’s your opinion about the GAPS protocol—‘low and slow’—in implementing probiotics?
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Heart Disease
6 Articles
With patients with heart disease who want to lose weight, what macro percentages do you usually recommend? Do you still shoot for about 15 percent carb or go a little higher to allow for less total daily fat intake while still focusing on total daily calories being about 10 to 20 percent deficit?
If a patient has heart disease and is on Plavix, is there a safe amount of vitamin K to supplement with?
Chris talked about supplements recommended for people with high cholesterol and heart disease. I think he suggested 5 milligrams of K2 as one of the supplements. Thoughts?
Chris said that someone with familial hypercholesterolemia might do better on a high-carb diet, and yet someone with insulin resistance blood sugar problems would do better on a much lower carb diet. Given the fact that the main cause of elevated lipids according your high cholesterol action plan is insulin and leptin resistance, would you go high carb or low carb on a patient with elevated lipids caused by insulin resistance?
I’m looking for an alternative to the True Health Diagnostic testing for the metabolic work-up. I am a chiropractor and True Health at this time does not allow chiropractors to order. Is there another lab I could look into that is close to the True Health testing for the metabolic workup including fructosamine, fasting insulin, etc., for blood sugar dysregulation?
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High Blood Pressure
5 Articles
My stepdad has very high blood pressure and I’m trying to encourage him to increase his intake of potassium in food on a daily basis. Can you recommend the best method for doing that? Which tracker applications would be most suited to potassium checking?
Chris mentions in the exposome unit on HPA axis dysfunction that if a patient is having low blood pressure to consider limiting high-potassium foods. To what extent do you think this is necessary? For example, would a medium banana and half an avocado in one day be too much? If the patient starts taking half to one teaspoon of sea salt in the morning, can they be a little more liberal with the potassium in the foods they’re eating? Lastly should the patient be monitoring blood pressure throughout the day? If so, how often and when?
What do you do for high blood pressure?
I’m looking for an alternative to the True Health Diagnostic testing for the metabolic work-up. I am a chiropractor and True Health at this time does not allow chiropractors to order. Is there another lab I could look into that is close to the True Health testing for the metabolic workup including fructosamine, fasting insulin, etc., for blood sugar dysregulation?
Do you have experience with Quest Cleveland HeartLab Advanced Lipid Profile? I’m trying to figure out which labs have good particle number and size testing to better understand LDL.
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HPA Axis
114 Articles
Has any connection been established between dysbiosis and hypothalamic-pituitary-adrenal axis dysfunction?
What do you recommend for someone who has adrenal fatigue and needs some safe starchy carbs but also has blood sugar issues?
Why does Chris call it “HPA axis dysfunction” versus “adrenal fatigue”?
Follow-up from last Q&A, recent Q&A where he asked about a DUTCH result with high cortisol and cortisone with severely blunted cortisol awakening response that he hacked from the saliva kit,” which is really cool. Congrats for doing that. “I know sex hormones are not covered in this level. I’m just wondering if you could briefly help to interpret this result. Total DHEA normal, etiocholanolone normal, androsterone high normal at 2,391, testosterone high at 221, total estrogen high at 41.7. All estrogen metabolites high with methylation activity marker in the center of the gauge. Patient is not on a prescription. I’m curious of differential diagnosis for high sex hormones. Patient is a 32 year old male.
Twenty-four-year-old female, 5’3”, 163 with complaints of anxiety, depression, thirst, alternating IBS-C and -D, hormone imbalance and infertility, history of miscarriage, poor sleep quality, brain fog, hypertension, chronic headaches with normal brain MRI. Does use progesterone cream but no other prescription. DUTCH test pending. Blood panel: A1c at 4.8. Fasting glucose, 71, so lower end there for blood sugar. Ferritin, 50, middle of the range. Iron sat, 41 percent, same, TIBC, 320, was all normal. RBCs are lab-high at 5.66. Hemoglobin lab-high at 16.9. Hematocrit lab-high at 50. Urine specific gravity was 1, CRP normal, homocysteine, 7. Vitamin D, 28. Findings suggest dehydration, but urine is so dilute and frequent polydipsia seems paradoxical. The previous testing about a month ago confirms the RBC indices. Curious that this may be related to dysfunction of the renin angiotensin aldosterone and erythropoietin system. Or maybe we’re just overthinking this. Any thoughts?
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IBD/IBS/GERD
25 Articles
Uncle, 75-year-old has been diagnosed with Parkinson’s early. Besides a very-low-carb diet and doing comprehensive gut testing, association with SIBO, etc., how would I know if I would supplement him with betaine hydrochloric acid empirically? He has no gut symptoms. Excess undigested food in the stool. Does he need HCI supplementation?
This is the first patient I’ve had with truly high stomach acid, and he has a history of heavy NSAID use for migraines from the age of nine. He is 21 now and can’t even drink water without burping. Nearly everything he eats 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 all these medications. He still gets headaches, although less severe. We’re doing a reset diet, and I’ve suggested slippery elm along with licorice tea. H. pylori has been ruled out. His stools are oily. Due to limited finances, we’ll do labs one at a time. Plan to start with Doctor’s Data, the comprehensive stool. Any suggestions regarding a treatment plan or to relieve his symptoms are welcome. He manages stress well by working a low-stress job and cutting out partying. He is active, which seems to help his headaches.
What about people on PPIs because of Barrett’s? How does the conversation go on these cases?
What are your thoughts on about the Prometheus IBD serology? It seems much more comprehensive than the Quest panel.
If SIBO and H. pylori are ruled out, what comes to mind next if someone has acid reflux immediately after eating carbs, but no problems after protein or fat, and in the Doctor’s Data test, the carb metabolism markers were normal? It feels very stomach based.
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Lifestyle
48 Articles
Recommended water filters
Can you recommend some biofeedback resources? Which devices do you use, and how would you approach implementing this?”
What do you think about changing small habits versus overhauling, such as a 30-day reset?
Thirteen-year-old patient with sleep issues. Have her working on increasing resistant starch. She tried doing potato starch and water at night, which helped her sleep but gave her horrible nightmares, so she wants to stop it. Have I seen this?
Brother with severe liver disease from long-term alcoholism. Has to have an iron panel done. They did some of the tests. He has an iron saturation of 91 percent. Holy moly. Iron, 230. Transferrin, 180. ABC, 3.4, HUB, sorry this is scrolling down, 13.6. HIT, 37.6, MCV, 109.4. I think MCHC, 39.6, RDW, 14.7. He has not had a drink for 13 months.
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Nutrition
346 Articles
Do you find that there are issues with Prescript-Assist, MegaSporeBiotic, or S. boulardii with mold toxicity or yeast sensitivity issues, and are there certain patients where this would not be recommended?
Are plantain chips OK during the 30-day reset?
What do you think about occasionally eating corn after the 30-day reset?
How often do you use a dietary approach that includes carb reduction?
How does your balance of macronutrients affect the gut microbiome?
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Practice Management
171 Articles
Many patients in the clinic that are alcoholics or have other addictions, in general, they tend to not be as compliant as other patients and have much lower success rates. Do you use a qualifying process to exclude these new patients or do you use specific functional medicine tools to address these addictions?
Does CCFM do gut testing on everyone?
Do you order genetic tests for all of your patients?
What is your process for the initial consult and case review?
Roughly how many clients do you start off on one of the resets (like the 30-day reset or the 14Four program) versus starting them with smaller changes?
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Pregnancy & Breastfeeding
31 Articles
In my obstetrical practice, we have a large Hispanic population with a high incidence of gestational diabetes. Seems to me that the ADA diet these patients are given is higher in refined carbohydrates than what we learned about in the ADAPT program. Any thoughts on dietary recommendations to help avoid the diabetes clinic putting them on insulin? Also, do you have any thoughts on using Metabolic Synergy or GlucoSupreme herbal and pregnancy?
Do you have any supplements you recommend for postpartum? Many doctors recommend continuing prenatal, but how long?
Elevated fasting blood sugar and pregnancy often occurs fairly early on in gestational diabetes, likely related to human placental oxygen enhancing insulin resistance. We often have to resort to insulin at bedtime to control the morning insulin. Is there anything specific you believe would work in pregnancy to avoid the use of insulin when diet fails?
In regards to calcium in pregnancy, I know you recommend Nutrient 950, which has 300 mg. I have a patient who is on a Paleo template following closely your guidelines and Healthy Baby Code. Her doctor wants her on an additional thousand milligrams of calcium, Tums, of all things. I read some research showing a thousand milligrams of calcium supplementation assisting in healthy baby weight. She’s eating a nutrient-dense diet that brings her over a thousand milligrams of calcium including her prenatal.
I have a patient who has been taking HCl on her maintenance protocol. She just got pregnant and was wondering if she should still take it. It has helped her significantly with her digestive issues, and she hasn’t had any issues in the past three years. During pregnancy, in general, which supplementation are you cautious with? Have you ever seen any issues with overmethylation?
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SIBO
108 Articles
How often do you see problems related to the MMC, migrating motor complex, in cases of SIBO? Do you think it’s important to supplement after negative testing for it?
If someone is on Cortef, will the stool test and SIBO breath test be accurate?
What is the most effective diet for someone with SIBO?
How do you determine if there is decreased gut motility in the setting of SIBO?
Do we use prokinetics in our treatment of SIBO?
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Skin Conditions
10 Articles
Would you recommend treating a person who has fungus in his nails, low income, and no chances for testing?
Is gluten in skin care products absorbed through the skin? And if so, does it have the same effects as ingested gluten?
As far as dandruff and work-ups, do I usually see a correlation with fungal issues? I was just curious if there was a strong indicator or have you seen other issues. Great article in regards to immune system. From experience working with these types of behaviors, what type of improvement have you seen? Can you give a case example?
For a severe acne protocol designed for a woman, would you use all food or also add in some supplements?
I’m on day 12 of the 30-day reset diet and have been perfect with the diet. Today, I woke up with an itchy, raised, red rash on the entire left side of my neck, partially in my cheek an arm. Is this possibly a detox reaction? I have not changed any cosmetics, detergent, creams. I don’t typically have food allergies. Last year, I went on a ketogenic diet and after a couple of weeks had a similar rash but on my trunk. What do you think, and how long does a detox skin reaction last?
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Supplements
250 Articles
\What is your opinion about supplementing D-mannose 2 g every three hours per day plus lactoferrin in cases of urinary tract infections that are positive for E. coli and C. koseri? Could be interesting, the use of probiotics, oral and vaginal, to restore local healthy microbiota.
Do you find that there are issues with Prescript-Assist, MegaSporeBiotic, or S. boulardii with mold toxicity or yeast sensitivity issues, and are there certain patients where this would not be recommended?
Do you have patients stay on the same probiotic or do you switch them up over time?
\What is your opinion about supplementing D-mannose 2 g every three hours per day plus lactoferrin in cases of urinary tract infections that are positive for E. coli and C. koseri? Could be interesting, the use of probiotics, oral and vaginal, to restore local healthy microbiota.
What do you think of using Prescript-Assist as a microbe replenishment supplement but also as a maintenance supplement?
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Thyroid Disorders
49 Articles
Running thyroid panels plus or minus reverse T3 and often finding tests within normal limits. Can you comment on how common it is of subclinical hypothyroidism, how the symptoms may differ from overt hypothyroidism, and common differentials for subclinical presentations?
Can you figure out these thyroid test results in a patient who’s taking three-quarters of a grain of WP Thyroid and 45 micrograms of T3. TSH is zero, not surprising given how much thyroid medication she’s on, free T4 is low, also not surprising given that she’s taking free T3 and WP Thyroid, which contains T3 in it. So T3 suppresses negative feedback system and the body’s only way of- What can we do to reduce the levels of thyroid hormone?
I have a case study for you. Patient had a comprehensive lab panel done, and with regard to her thyroid, all functional markers were normal. However, her thyroid antibodies were very high: antithyroglobulin was 234, thyroid peroxidase, 126. What do you make of these high antibody values with normal markers, and what suggestions would you have for treatment of exposome measures? She eats a gluten-free, dairy-free diet, exercises regularly, does yoga twice a week, several walks outside, not a daily meditator but working on it. Sleeps approximately seven to eight hours a night.
Patient that cannot tolerate associated thyroid meds because of lactose intolerance may also be insulin resistant. Currently taking T3 80 micrograms twice a day. She’s monitoring basal body temperature is between 97.1 and 97.5. It feels like she’s still hypothyroid. What would you suggest? Bump up the T3, give it multiple times a day? Is there a desiccated thyroid medication you’re aware of that does not contain lactose?
I noticed that Quest has recently significantly narrowed the thyroid antibody reference range to less than nine, while the LabCorp reference range is still less than 34. Any thoughts on still following the lab range or is a functional range needed?
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Uncatergorized
29 Articles
Last week’s content you mentioned some cases you had suspected biotoxin illness and mentioned the biotoxin illness survey, visual contrast sensitivity test, and biomarkers for service testing. I know you said you weren’t going to go into this in detail in ADAPT but unfortunately, I seem to be attracting these types of cases already. I need to know how to screen or point them in the right direction. And there are no functional med doctors anywhere near me that would know the first thing about this. Can you briefly describe this and or let us have access to that biotoxin survey?
We’re just starting to get comfortable interpreting DUTCH. Noticed something that was confusing. They provide age-specific ranges for select markers like testosterone, androgen, metabolites, and total DHEA. But the dial indicators of the patient do not reflect the age-specific ranges for the patient. As an example, 62-year-old male patient, total DHEA was 3,761, age-specific range is 1,000 to 2,500, but the arrow is in the middle range of the dial. Which range should you use?
I just heard about the CASI, C-A-S-I conference, Clinical and Scientifics Insights. Speakers include many from the functional medicine crowd. Have you ever attended this conference? Where does it fit in the landscape of functional medicine education?
Thoughts on vibration plates and mini trampolines?
Chris is great at debunking medical myths. What are your thoughts on My Blood Analysis? I know this is regarded as fake medicine from the mainstream, and blood is highly controlled by the body, but is there any diagnostic or assessment value in My Blood Analysis?
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Uncategorized
Is it better to do [a] cortisol or Dutch test after a good night’s sleep?
Seed’s Daily Synbiotic says [to take] two capsules a day; our antimicrobial protocol recommends three daily. I’m curious [about the] reasons behind this.
Should we attempt to support serotonin production in patients with high cortisol?
How do you go about introducing the supplement protocol? Do you introduce one at a time and monitor side effects, or start them all at once?
I’m treating HPAD. Under what circumstances, if any, do you attempt to treat it without any supplements, instead relying entirely on lifestyle behavior and diet and how common people get back to baseline that way?
What would you recommend for Herx reaction for those who have constipation SIBO who cannot tolerate modified citrus pectin because it aggravates SIBO?
Bioavailability of foods: is it the nature of the food or the health of [the] gut or both?
Should we treat hydrogen sulfide SIBO any differently or should we treat the patient by their main complaints, diarrhea or constipation?
How do you judge when even prolonged periods of inflammation are supporting [the] body’s healing process? Are we ever in danger of interfering with the natural healing process by administering botanical anti-inflammatories like curcumin and boswellia?
Will telemedicine restrictions lighten in the face of the pandemic? Can a licensed practitioner treat anyone from anywhere?
Do you know if oral steroids are a risk factor for SIBO?
For someone [doing] intermittent fasting, how do you recommend doing the botanical protocol? Does the time of day matter? Is it more important that some amount of food be taken with products that are at lunch and dinner?
For those with limited funds for testing, do you find that [the] Dutch test or cortisol gives a good start [to] figuring out what’s ailing those that are not feeling well because they’re not their usual self and their basic labs are normal?
How careful do we need to be with S. boulardii and those who are immunocompromised? Technically, diabetes makes people compromised, so is there something we need to watch out for? Any evidence of systemic infection with probiotics?
What’s the likelihood that [a] patient’s HPAD markers are highly variable over time? I’m concerned about the risk of recommending an incorrect protocol on this basis.
Can you speak on the new stool test from Microbiome Labs? How it compares, etc?
Looks like NeuroScience discontinued making Kavinace in 2019. Kavinace OS, [which] they now make, has no GABA, but has magnesium, zinc, selenium, melatonin 5 mg, and a blend of L-theanine and resveratrol.
Do you have any thoughts on Andy Cutler’s chelation protocol where he recommends using increasing doses of ALA to chelate mercury on a specific time schedule?
Can we potentially exacerbate HPAD if those are taken in inappropriate times and doses? How can we be confident that we are dosing those appropriately?
For reducing cortisol and decreasing stress, can a single botanical such as magnolia be effective or even a single combination like Kavinace or HPA Balance rather than several botanicals together?
How does one wear blue [light] blockers if they wear prescription glasses? [I’m] asking for a friend.
From my understanding, natural desiccated thyroid (NDT) has 150 mcg of iodine. For those patients on such replacement, do you still advocate additional iodine or ___ [2:20] food sources?
I’ve seen possible adverse effects on immunomodulators like elderberry for those taking immunosuppressants because of an autoimmune disease. How seriously should we take this precaution?
In the situation where you design to target Prevotella for treatment, do you currently have additional botanicals to attempt to increase [the] efficacy of treating it?
Is it possible that Doctor’s Data misses any species on this test, given the large number of species that result in GI-MAP results are not in Doctor’s Data results?
Are we going to learn about metal toxicity testing? Chris has referred to it but has not specified what he uses. I have used limited serum testing before chelation therapy, a test for mercury, lead, and calcium. Is this reliable?
Under what circumstances do you consider the presence of Prevotella to merit treatment, particularly if the patient has one or more autoimmune diseases?
What is the best probiotic that does not have prebiotic in it that you would recommend for patients?
Roughly what frequency of fish, tuna, or salmon consumption would cause you to order a metal toxicity lab?
Is there value in distinguishing probiotics for men versus women?
In Diagnostic Solutions results, which concentration of H. pylori do you consider to be high requiring treatment?
From the perspective of Functional Medicine, do you attempt to interpret the body’s various external messages of imbalances such as fraying nails, thinning hairs, swollen tongue, [and] excess mucosa surrounding stool?
Can the botanical intestinal peristalsis stimulants be effective in improving peristalsis even among diabetics? Is the effect equivalent for both [types 1 and 2] diabetes?
BioHealth Lab closing
What do you know about EverlyWell? I had two patients tell me they got tested, [and I’m] not sure [of the] quality.
In general, could you please mention if there are any additional Cyrex tests that you find particularly useful other than the 3, 4, and 10?
If sensitive patient[s] starting the botanical protocol do react in a strongly negative way to GI-Synergy, do you ever need to use an alternative? If so, what do you recommend?
I have a patient who has taken an unbelievable amount of antibiotics over five to seven years in the Army, [such as] Doxy [and] anthrax drugs. [The patient] reports no gut symptoms, [and] only reports rosacea. [I’m] curious what you think could be going on, as she has no gut symptoms, [or] maybe she doesn’t feel them, yet they are there. I’m going to order Doctor’s Data, yet [I’m] curious [about] your experience.
Do we cover genetic testing analysis, i.e., how to interpret? When is it indicated? [I was] wondering, as I saw this as an example in [the] Week 15 module and case review. I find genetics and epigenetics confusing, to say the least.
Do you find that the Cyrex 5 to 8 (the autoimmune reactivity screens) are useful for patients who have already been diagnosed with autoimmune disease? Under what circumstances would you run these tests?
I have a couple of patients who are in a lot of discomfort and pain, and I find that they have been doing research and taking things they find on their own. Have you had this happen, and how do you prevent [it]?
In treating IBD or IBS patients with dysbiosis and parasites using the botanical protocol, are they often intolerant of the Seed probiotic? If so, how do you adjust for that?
In treating SIBO with the botanical protocol, do you take any special precautions among highly sensitive patients, such as those with fibromyalgia, atrial fib[rillation], excessive blood clotting, IBD, [or] IBS? In such patients, do you consider introducing one botanical at a time? If so, what is your recommended order?
Do you often find that low serum ferritin can be resolved after treating H. pylori infections?
Are there specific antimicrobials for different pathogenic bacteria, i.e., Klebsiella? After stool test results show pathogenic, what antimicrobials are used? Maybe Chris has told us, yet [I’m] not sure where to find [the information].
What’s your view on colon hydrotherapy? Would it be beneficial during an AM protocol?
I have a one-off question. I have a patient on blood thinners, and he wanted to know if diet, nutrition, and lifestyle changes are enough to ever be able to come off the blood thinners. He has the Leiden V genetic clotting factor.
The next question, the last one for the presubmitted questions, is about MegaSporeBiotic, so the question is “Is it an endospore former and is it a synbiotic?
I found monolaurin on Emerson’s site. Can I use that for SIBO protocol instead of the Lauricidin brand? I’d like to be cost-conscious, and this will limit ship[ping] costs from multiple sources, and if so, can you please provide the dosing, as it comes in capsules of 300 mg?
In your experience, would you agree that ferritin over 90 is required for optimal thyroid health, as it drives T3 into receptors, and, if so, how [do you] get it there? Supplementation [with] iron with C?
I just listened to a lecture by Allison Siebecker. She always orders the three-hour breath test because if she sees a flatline the first two hours without the typical rise of hydrogen in the third hour, then she suspects hydrogen sulfide SIBO. Thoughts?
Why don’t you have your intake questionnaire forms before the initial consult? To me, it would seem like this would make more sense in order to have a better sense of what labs to get after the first appointment.
What is the optimal vitamin D range for those with IBD or another autoimmune condition, and what about those who do not have an autoimmune condition?” Then, there’s also a subquestion here, “Do you use a form that contains K2?
In reference to Evergreen Authority, any suggestions on how to be [a] common authority? What is the definition of one?
You cautioned to avoid long-term use of MagO7, [which is] oxygenated magnesium. What do you consider long-term?
In treating GERD, what conditions merit supplementing with GI Revive or GastroMend to support mucosal healing?
What role do you think nutraceutical protein powders and products are playing in Functional Medicine practice?
You mentioned that if patients experience detox symptoms on the botanical dysbiosis protocol, you may provide activated charcoal. What are the detox symptoms that would merit the use of activated charcoal?
Can you talk more about the neural connection and SIBO? How would this be related to lack of stimulation of the vagus nerve? If so, how can we address it?
I hear from a lot of people that their food guru also cites studies to back up their stands on veganism. I tell people there are many ways that studies are interpreted and this does seem to cause some distress. How do we handle those concerns?
For a patient with IBD/IBS, how long do you use low-carb-specific diets? You mentioned glutathione being important in IBD, but we will need carbs to produce the electron donors NADPH to make glutathione. How do you reconcile this?
Do you refer out to work with Dynamic Neural Retraining System (DNRS), or is it applied within your practice? How often have you applied this?
I’m having trouble sourcing out all the recommended supplements in Canada. Any recommendations? Could you put together a list of the top suppliers you use?
If [the] patient has H. pylori and is asymptomatic, doesn’t have access to the virulence test, and may or may not have the risk factors, if not serious risk factors, then leave it, if serious risk factors, then treat [it] as a judgment call?
In your experience, what’s the efficacy of the H. pylori botanical protocol for eradicating H. pylori?
What test would you recommend for pancreatic insufficiency? [The] patient is taking digestive enzymes and HCl with Pepsin with meals, but should there be additional pancreatic support? Would low elastase on [a] GI-MAP also be a consequence of SIBO, given the patient’s positive SIBO test result?
Subsequent to recording, the lecture”—I assume she means the content of the course—“what’s your experience with efficacy in treating methane-predominant SIBO or IBS-C with Atrantil plus botanicals?
Will you consider doing a webinar to review [the] diagnostic test GI-MAP, since our practice is now using it?
How do you know when to repeat SIBO and try pharmaceuticals, or shift to [a] leaky gut test and treatment?
For patients who don’t have stool lab results or cannot do them, how do you suggest we approach [getting] them back to basics with diet?
Do you prefer soil-based probiotics, or [are] both soil-based and regular similarly beneficial? Should we take and recommend both?
[There’s a] teenage female with a history of necrotizing enterocolitis at birth with subsequent removal of two-thirds of her colon. What are the implications for [the] gut microbiome with [a] missing colon and large amounts of antibiotics as [a] newborn for the above condition?
I’m working through Keith’s Evergreen audience program and brainstorming niche, as I’ll be working in a small town. I’m not sure that working with this specific group of patients, for example, gut would be feasible. [Are there] any other ways to develop a niche?
Do you ever send a patient results from a test without a consult, i.e., if that result or additionally measured diagnostic comes after a case review, how do you handle an assessment fee?
When do you really consider treating H. pylori? Truly, many people will be H. pylori positive, [so] who [would] you treat?
Can you please explain why you do not include apolactoferrin in your first-line, first 30 days H. pylori botanical treatment protocol?
On the last call, Chris mentioned that he doesn’t find the Cyrex 12 test helpful, and I’m curious why.
The patient complains of onion or garlic ‘allergy.’ She explains she has a threshold of how much she can eat before she gets brain fog and mucus production as well as GI discomfort. Can this solely be attributed to SIBO, or should I look elsewhere?
Explain dietary acid load. Is this the acid-alkaline conversation or a different topic?
I’m used to learning using a space repetition application, basically computer-augmented flashcards. I found lots of repetition video transcripts. Would you recommend only learning the handout info by heart or I miss out on things?
What’s your take on polyreactivity and the idea that chronic inflammatory syndrome can create false-positive food reactivity?
Are Lyme patients’ chronic illness that comes and goes under the category of immunocompromised patients that we should be careful with [for] the use of Saccharomyces boulardii?
I’m practicing in a small rural town where Functional medicine is a relatively unheard-of term. I don’t think it would be reasonable to do all the tests suggested in this course secondary to cost concerns. What are the most necessary labs?
Have you found that successful restoration of damaged microvilli is common?
On the SIBO breath test, what does it mean if the hydromethane [is] low but combined as high?
[A] patient had Functional Medicine type testing a few years ago, [and] now complains of multiple health issues and that food restrictions are made of more sensitive foods. What is a good time to retest [for] food sensitivities and stool testing? She is a 69-year-old, [who was] told she had no yeast, no parasites, some other food sensitivities, but now [has] immune dysfunction. [She] can’t fight off colds or flus, and is upset that she’s been unable to keep weight off despite avoiding sensitive foods. Also, [she] doesn’t believe she needs more testing, [and] had all that done not too long [ago]. [She’s] frustrated that she isn’t better.
In what percentage of your herbally treated H. pylori patients does reinfection occur subsequent [to] successful eradication?
n what proportion of patients with SIBO are you able to resolve their SIBO by treating their other underlying issues rather than directly treating their SIBO?
Under what circumstances do we run Dr. Pimentel’s ibs-smart test?
After initiating an intermittent fast that combines daily meals within eight hours, what’s the mechanism behind the two-phase effect in which some overworked exhausted people initially feel great on the fast but subsequently [feel] much worse?
Could you clarify how a single short-term incident of food poisoning would lead to long-term release of the anti-vinculin and anti-CdtB antibodies?
What are your thoughts on ProLon therapy, i.e., fasting with minimal calories for five days?
Can H. pylori, given this tendency to develop antibiotic resistance, also readily develop resistance to non-pharmaceutical treatments?
an treatment protocols for dysbiosis, like Saccharomyces boulardii in treating Blastocystis hominis, exacerbate on our immune response in some autoimmune patients? In those situations, do you continue the protocol nevertheless?
Would you treat H. pylori regardless of age and treat patients with pancreatic insufficiency?
When the Clostridia species are overabundant in [a] stool test, do you then conduct [a] microbial organic acids test to determine whether the overgrowth of species [is] pathogenic?
Can you give your opinion on red light therapy?
Are some dysbiotic organisms less responsive to herbal treatment, like Blastocystis hominis, [which] typically require resorting to pharmaceuticals?
In stool test results, can abundance of any of the following gram-negative genres potentially trigger autoimmune response: Prevotella, Fusobacterium, Proteus, and Citrobacter? If so, what testing would you then request to check for autoimmune antibodies? [Does] the presence or abundance of these organisms change your treatment method?
I just got on board on Doctor’s Data. I’m curious what your thoughts are on the iodine tests pre-/post-loading after reading your thyroid eBook. Also, do you like the cardiometabolic risk test on people and [the] metals test, as well?
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With the increased consumption of kombucha, do we tell patients to avoid, if they have sensitivity to yeast, Saccharomyces cerevisiae, or is the SCOBY a different yeast not to be concerned about?
When do you really consider treating H. pylori? Truly, many people will be H. pylori positive, [so] who [would] you treat?
In stool test results, can abundance of any of the following gram-negative genres potentially trigger autoimmune response: Prevotella, Fusobacterium, Proteus, and Citrobacter? If so, what testing would you then request to check for autoimmune antibodies? [Does] the presence or abundance of these organisms change your treatment method?
Can you please explain why you do not include apolactoferrin in your first-line, first 30 days H. pylori botanical treatment protocol?
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