Dr. Amy Nett: If a patient doesn’t tolerate it—it sounds like that was a terrible rash!—Prescript-Assist is out. OK. The next one you would bring in is MegaSporeBiotic. This patient is probably understandably going to have a fear around probiotics. I can imagine. I can imagine I would. So in that case, what I would do is start MegaSporeBiotic next. Start with a quarter of a capsule. On Amazon, you can buy empty veggie caps. You can get, like, a hundred or a thousand veggie caps. I’ll have patients get those sometimes, or you can just mix it straight in water, but some people just prefer to put it in a veggie cap. You can buy the veggie caps, open up a capsule of MegaSporeBiotic, empty out a quarter of it, and just start with a quarter of a capsule of MegaSporeBiotic. Again, depending on what their level of anxiety around taking probiotics is, maybe have them do a quarter capsule every other day for two weeks. If they’re OK with that, then go up to a quarter capsule daily, then a half capsule daily. See how they do on that for a while, incredibly slowly.
I have a patient I just followed up with yesterday, and I saw her … I think it was in October. We were going to start the antimicrobial protocol, and she knows that she’s really sensitive, so we talked about starting things exactly like that—a quarter of a capsule every other day and then a quarter of a capsule daily. I followed up with her yesterday, and it’s been maybe five months since I’ve seen her, and I’m like, “Great! How did the antimicrobial protocol go?” thinking that she had finished it and had moved on. She said, “Well, I haven’t quite gotten to the Lauricidin or GI-Synergy, but I have my probiotics in and I have the PHGG and the InterFase Plus.” She had been making progress. She was happy. She felt confident in being able to safely introduce all of these probiotics and various supplements.
It sounds painfully slow, and some people don’t have the patience for it, but I think it’s really a good approach when you’re worried or the patient is worried about how they’re going to respond to things. Just remind patients that they’ve had this dysbiosis probably for a while, and this is a marathon, it’s not a sprint. Just take it slowly. Try MegaSporeBiotic. Prescript-Assist is out, so depending on what other tests show, if the organic acids test doesn’t show high levels of D-lactate, you could do something like GutPro probiotic. That comes in a powder, so they can start that really slowly. Maybe Saccharomyces boulardii. Maybe Ideal Bowel Support. Choose something else other than the Prescript-Assist, and just start nice and slowly.