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  4. I have a 23-year-old female patient with multiple food allergies since she was an infant to eggs, peanuts, other nuts, peas, and some legumes. She has eczema, food sensitivities. As an 18-year-old, she presented with chronic infection, Lyme, newly diagnosed chronic inflammatory response syndrome, or CIRS, from exposure to mold.”—Or it may be possibly Lyme as well, is what I would add there.—“Also traveled to Europe and had immediate illness after eating a hamburger. She has significant reactions—detox, intolerance, or both—to most supplements and probiotics, but also to plain glutamine. Could this have anything to do with tTG since it’s involved in transforming glutamine to glutamic acid? She can’t be tested on Cyrex labs, as she was put on cortef four years ago, 30 milligrams.”—That’s a steroid, for those of you that don’t know, which means it would suppress immunity and antibody production, which means the Cyrex results would not be accurate. It also means HPA axis, cortisol testing, would be inaccurate, which we’ll talk about in the next unit, little side note there.—“She can’t get off cortef without horrible and skin redness, rashes, and swelling.”—This is one of the biggest problems with cortef and why I’m so reluctant to see people take it.—“After listening in class this week, I think she has severe loss of oral tolerance and polyreactive antibody production.

I have a 23-year-old female patient with multiple food allergies since she was an infant to eggs, peanuts, other nuts, peas, and some legumes. She has eczema, food sensitivities. As an 18-year-old, she presented with chronic infection, Lyme, newly diagnosed chronic inflammatory response syndrome, or CIRS, from exposure to mold.”—Or it may be possibly Lyme as well, is what I would add there.—“Also traveled to Europe and had immediate illness after eating a hamburger. She has significant reactions—detox, intolerance, or both—to most supplements and probiotics, but also to plain glutamine. Could this have anything to do with tTG since it’s involved in transforming glutamine to glutamic acid? She can’t be tested on Cyrex labs, as she was put on cortef four years ago, 30 milligrams.”—That’s a steroid, for those of you that don’t know, which means it would suppress immunity and antibody production, which means the Cyrex results would not be accurate. It also means HPA axis, cortisol testing, would be inaccurate, which we’ll talk about in the next unit, little side note there.—“She can’t get off cortef without horrible and skin redness, rashes, and swelling.”—This is one of the biggest problems with cortef and why I’m so reluctant to see people take it.—“After listening in class this week, I think she has severe loss of oral tolerance and polyreactive antibody production.

Chris Kresser: Yes, this is exactly what that sounds like, Julie. We do have several patients that have this kind of presentation, and they are the most difficult patients to work with, for sure. I think the real key here, when you have this extreme immune hyperactivity, is to try to get to the root of what’s provoking that. You mentioned chronic infection, you mentioned CIRS, and those along with heavy metal toxicity are probably the three things that I would look for first in a situation where you have this multiple polyreactive antibody production and hyperactive immune response, where they just can’t tolerate anything and they’re reacting to everything. If it is CIRS and it is related to current mold exposure, then you’d want to get them out of that environment, and you’d want to start the binders—you know, cholestyramine—get some of those toxins out of the body because that’s what’s going to allow the immune system to start calming down and slowly become less hyperactive. If there’s still an active chronic infection, of course, that needs to be treated, and you may want to test for heavy metals with Quicksilver Labs to see if that’s an issue because that’s another situation where we see this kind of intense hyperreactivity.

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