Amy Nett: Remember that secretory IgA is a type of antibody that protects against infections of the mucous membranes and not just within the gastrointestinal or digestive tract but also in the airways, mouth, I think even in our tears. This is really the first line of defense for the mucosal lining, and it makes up a pretty significant portion of the entire immune system. We’ve talked about secretory IgA in that there can be a genetic deficiency, and you can see chronically low levels of secretory igA and sometimes low levels of IgA, just immunoglobulin A, with frequent infections. Other times we see more of an acquired low secretory IgA after the dysbiosis develops. If this is a 75-year-old patient and no significant history of infections, then we’re probably thinking this is more of an acquired secretory IgA. Again, normally we see secretary IgA production that’s driven largely in response to mucosal antigens, whether microbes or food. Those are the two most common triggers of secretory IgA. When we see low secretory IgA, I tend to think of things like chronic infection or chronic stress. Remember that chronic stress has a major effect on secretory IgA levels, so if you have cortisol testing, you could look at that, but remember both internal and external sources of stress are going to influence secretory levels. If you have severe dysbiosis, that could in and of itself explain the low SIgA. Also look at stress management. The other thing is we know that age and gender also influence, at least some studies suggest age and gender can influence secretory IgA levels. One study at least showed that male patients had lower levels of secretory IgA, and all their patients tend to have lower levels of secretory IgA. We’re looking at a 75-year-old female. It may be that age is contributing to this lower level. I don’t know whether or not that makes it okay or if it still is potentially having some effect on the gastrointestinal tract and healing. The other thing that you can think about is certain medications can also lower levels of secretory IgA, namely anti-inflammatories. Look at what she’s taking in terms of medications and also the nutritional status. Is she eating any foods that are triggering her? Food allergies? Those are all things that may also contribute to a low secretory IgA. That’s what I would want to think about in terms of seeing a low secretory IgA.
In terms of adding something additional to that herbal antimicrobial protocol, we don’t normally. I’ve seen mixed results with colostrum. I think it’s certainly something that you can try adding if the patient’s open to it and depending on what symptoms are, or if she’s not responding well to the herbal antimicrobials. Generally, I do just the core herbal antimicrobial protocol, and I do tend to see secretary IgA improve. I also talk to patients about stress management. We might look at cortisol and look at stress levels. And again, as you know with our consistent functional medicine approach, what are the sources of stress being internal or external, so looking at toxic burden in addition to the gut, just going down the stepwise approach. I don’t think you need to add anything specific to the core antimicrobial protocol. I think the secretory IgA should improve, or often in my experience it does improve with the core antimicrobial protocol, but I would certainly do a follow up secretory IgA level. If you want to try colostrums, I think that’s a reasonable approach. I just haven’t consistently seen benefit from doing it, so I’ve moved away from doing it.
Alright. That was the one question that we had for today. Any questions that you guys want to submit? Alright. Well, hopefully you guys will submit some more questions for our session next time, and I will look forward to that and see what questions you have. I really hope everyone has a good weekend. I’ll talk to you next time.