Dr. Amy Nett: There’s a lot going on there. We can certainly take out a few points for this, and I would say that multiple sclerosis, as with any autoimmune condition, you still need to start with the basics, including the gut, and that would include a SIBO breath test, absolutely. I have had some patients with multiple sclerosis who have had pretty significant SIBO, and we have seen improvement after treating the small intestinal bacterial overgrowth. Again, it’s peeling the layers of the onion, and one of the first things you have to deal with is the gut. You’re mentioning that she’s having gas and bloating and not tolerating carbohydrates, including resistant starches, very well, so I think she absolutely needs to do a SIBO breath test. You mentioned she’s already done stool testing, so those are really the foundational pieces.
You also mentioned that the lead is elevated. Heavy metals can absolutely cause immune imbalance, so if lead is elevated, then I would also think about doing a gentle detoxification protocol. We generally don’t recommend chelation specifically, but rather upregulating detoxification. If you go to the Quicksilver Scientific website, Dr. Shade offers quite a few videos on detoxification, talks about his various approaches, including why he would recommend his more natural approach rather than chelation specifically, so you can get a lot more information on decreasing lead levels by going to the Quicksilver Scientific website and watching some of those webinars. I think he has a 3 1/2-hour one on … I think it’s called Mercury 101. It has a lot of great information if you want to get started on metal detox protocols. So decreasing lead to support immune balance.
Also think about methylation in this patient, so 23andMe and HDRI functional methylation profile, that could be something to help support immune balance.
You also mentioned that mycoplasma was high. If mycoplasma is high, that certainly suggests immune imbalance. We already know that because she has worsening MS, but if mycoplasma stays elevated while you’re working on balancing the immune system and working on all these underlying foundational pieces, think about some herbal support for mycoplasma to help the body deal. What are her major symptoms and concerns? If one of them in particular is fatigue, think about using some herbal treatments for mycoplasma. I would recommend, if you wanted to look into that a little bit more, Stephen Buhner does a lot. He has written quite a lot about herbs. He has a book called Natural Treatments for Lyme Coinfections, and there’s incredibly detailed information on how to work with mycoplasma using herbs and nutritional support. I would think about treating mycoplasma as well.
Based on the history you gave me, there are a lot of pieces that you could start working on there to help bring the immune system into better balance, and I think the first step is going to be explaining to her why she needs a SIBO breath test and maybe more recent stool testing as well to address that.