I have a low-income Medicare patient resistant to doing more testing. I did get to do a stool test, which came back with a high amount of all the commensal bacteria and yeast overgrowth. She has been doing a Paleo reset diet since January, about 80 to 90 percent compliant, and main complaint is diarrhea. No bloating. She’s overweight, but she’s lost about 15 pounds, has joint pain. Next plan was to do a trial of an antifungal supplement Yeastonil by Apex Energetics—yup, that’s a good one. And then if many were not a concern, we would run a SIBO test. Have you noticed any correlation one way or the other between SIBO and the bacteria or yeast pattern in the large intestine? No, I have not. And then, do you have any other suggestions?

Dr. Amy Nett:  Honestly, if she has a high level of the commensals, if she has adequate levels of the beneficial bacteria, I would probably use GI-Synergy, which is a little bit more comprehensive. Yeastonil contains the herbs that are slightly more targeted against yeast that are within GI-Synergy, and then GI-Synergy is just slightly more broad spectrum. But this way, if you’re missing small intestinal bacterial overgrowth, you’re going to have that covered, and then you’re going to kind of decrease some of those commensals. Because again, what you’re looking for is the balance, and it’s not that that higher level or the significant number of commensal microorganisms is inherently bad.

The question is more what’s the balance between the beneficial bacteria and the comments of microorganisms? Given that she has GI symptoms, I would probably want to just use GI-Synergy to be on that more conservative side. I mean, it’s kind of the more aggressive side, but because you can’t do all the testing you want, I would do our antimicrobial antifungal protocol, which again we’re going to get into, but it would be GI-Synergy, Lauricidin. You want to probably want to use a biofilm disruptor like InterFase Plus, and then if the yeast overgrowth is moderate to many, if you did a Doctor’s Data stool test and it’s moderate to many, then I might even add and something additional for yeast, which might be like A-FNG. Again, we’re going to go into detail on the treatment protocol, but I would probably do more than just Yeastonil based on what you said. The other thing is, of course, you want to make sure you run a comprehensive blood panel, especially given she’s overweight, so you want to think about, is there you know a high glucose-type picture? Is there inflammation? But that’s where I would go in terms of gut.