Amy Nett: Okay, so Teresa’s asking, “Crohn’s diagnosis in an 18-year-old female at age 18, diagnosed hyperthyroid three months, no insomnia or anxiety, just low TSH, allergies 2014, formerly eczema, symptoms okay. The following supplements cause bleeding—butyrate, VSL#3, quercetin, fish oil, phytosomes—” I’m not sure what you mean by phytosomes. “Does somewhat better on azedas, oregano oil, and fasting. Won’t do infectious testing, GI Effects unremarkable.” But I don’t know how well we can kind of trust GI Effects. I think there are some questions about the technology that Genova uses for sampling, just for what it’s worth. “Takes colostrum and collagen, doesn’t know if it helps, doesn’t seem to cause bleeding. Had a bad reaction to malaria vaccine. Not sure where to go with her. Difficult patient. Mom team to work with. They’ve been through a lot of doctors and want answers without much investigations.”
Okay, so 18-year-old female, I guess one of the questions, too, is what is her diet because, again, I think one of the reasonable places here might be starting with autoimmune Paleo diet or at least Paleo doing pretty strict gluten-free. So, very restricted, done intro SCV, GAPS AIP, and she is not willing to do—I mean, I think it’s a little bit difficult if someone’s not really willing to do testing. I think I do often ask them what their goals are and what ideas they have in terms of moving forward. I think a low-dose naltrexone is one thing that I don’t see mentioned here, and low-dose naltrexone would potentially be a pretty good option for Crohn’s, but did recommend LDN. Okay. And if you’re able to use the Q&A box, that would help me a little bit. For whatever reason, it’s a lot easier for me in the format to use. And you’re saying you recommended LDN but she was opposed to trying it?
I mean, they, they’re against all—okay, so they’re against pharmaceuticals and they’re against testing. I mean, it’s a little unclear to me what their expectations are, and I think it sounds, honestly, you need to just sit down and have the discussion what their expectations are and what they’re open to. Reacts to most supplements, so you could start with DNRS, the dynamic neural retraining system, so if she’s reacting to most things, look at DNRS, or Amy Scher has a book called How to Heal Yourself and has an online program, so you could think about starting with the stress management piece, but if the mom is also that difficult, I wonder if there’s a stress component to it. If you’re not able to use pharmaceuticals, she’s reacting to supplements, and unwilling to test, then it sounds like you’re going to have to start with the kind of stress management piece of things. It sounds like you’re quite limited and it might warrant just having a discussion with them to figure out what they’re open to because I think this is going to be more of kind of a … Working with them, this isn’t really a medical issue so much from what I’m hearing, since, again, there are plenty of other things to try here, but it just has to be done really slowly with their buy-in. It sounds like a really challenging case that warrants sitting down and figuring out what they’re really open to.
And saying, what testing would I start with? Certainly comprehensive blood panel, if you haven’t already done that, I would want to see B vitamin levels, D vitamin, histamine intolerance, or MCAS. No, I wouldn’t start with any of those. I mean, I would go to just the basic Functional Medicine workup. I mean, if she’s willing, I would probably do the CSAP x3 so you can at least get a baseline lysozyme, calprotectin, and lactoferrin. Make sure there are no parasites. We’re probably going to be switching to using the GI-MAP testing. I still think gut testing is warranted because I don’t know that the GI Effects is enough. You need to figure out, does she have any potential toxin exposures? Is it worth looking at heavy metals, the Great Plains environmental toxin profile? Again, the insomnia and the anxiety, I think I would really do a big push on kind of the adrenals and stress management piece there.