Dr. Amy Nett: Burning mouth … Have you sent her to see a dentist? I honestly haven’t heard of a burning mouth in patients before. That’s one that I’m not familiar with. Burning started with a metallic, so metallic phase, I would start thinking about nutrient insufficiencies, yeast overgrowth. I’m guessing you looked in your mouth and made sure it’s not a rash and that there’s not yeast overgrowth. “Going to a functional dentist this week.” Awesome, so that’ll be a good evaluation. Gut testing, nutrient deficiency, making sure you started her on the Candida cleanse. Yes, agreed there. And maybe some nutrients testing or a multimineral, depending on what her diet looks like, making sure she’s on an elimination diet, that she’s not eating gluten or anything that could be triggering an immune response or triggering some irritation within her mouth.
“She is in a gut protocol with another practitioner and hopping into this in the past month. Should I redo?” Well, I don’t know, because I think you need a gut testing. I’m never a fan of doing like any sort of antimicrobial treatment unless I know what I’m treating because sometimes there can be issues with insufficiency dysbiosis as well. Depending on what they can do, Candida cleanse is, and depending on what she was thinking, you want to wait at least generally for two to four weeks and do some sort of gut testing that you want patients to be off of any antimicrobials for about two to four weeks and that the testing is somewhat reliable.
I think gut testing is a good place and again, probably doing some nutrient testing, actually have that metallic taste in your mouth and the burning. Again, if she hasn’t already, I think an elimination diet, making sure she does at least 30 days, a very strictly grain-free, dairy-free, I would take out nuts, maybe even for her, if she can, an autoimmune Paleo diet because she’s already got Hashimoto’s and we know that her immune system is already a little bit off, so you could do 30-day autoimmune Paleo diet and then very slowly do food reintroductions, and then at that time, she would be ready for gut testing because you would have at least 30 days off of any antimicrobial. So check in and see if there still yeast overgrowth.
You could even do urine organic acids testing, which would give you both the markers of gut dysbiosis, some markers of nutrient deficiency, and then consider something like, whether it’s the NutrEval or Genova ION, but something to get an idea, or even basic blood work starting with serum zinc, serum copper. They’re not perfect, but you could at least get some general markers that way and then see what the dentist says. I would be very curious.
You can see what are her other symptoms are, right? Like if she is having GI symptoms or if it’s just the burning mouth. Think about foods that she’s eating that are triggering that, and the Functional Medicine dentist will often do testing for the oral microbiome and looking to see if there any pathogens within that oral microbiome that need to be treated. “So I’ll start with the elimination diet and go from there.” Yes. It’s always a good starting place, the elimination diet. Every once in a while I will have a patient who comes with symptoms. They’ve never done an elimination diet, and we figured out a couple of foods that are triggering them, and it’s pretty
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remarkable. Most often I think the patients who come to see us are generally savvy enough that they’ve already figured out which food they need to eliminate from their diet, but if someone has not done it, it can be surprisingly powerful, so definitely a good place to start.