Male, age mid-60s with allergies, chemical sensitivities to paint, chlorine, history of anxiety and mood issues, yo-yo weight loss and gain, food addictions, high quinolinate, colonate, 5-HIAA forming a glutamic acid and very low power of glutamate. Patient’s doing liver detox and some methylated B vitamins, but would you advise an HDRI methylation panel and SIBO testing?

Chris Kresser: Yeah, I would advise a full gut panel with allergies and chemical sensitivities and anxiety and mood issues, gut-brain axis, and then there’s the quinolinate often corresponds to gut information and 5-HIAA as well. And then the high formula glutamic acid is an indicator of folate deficiencies, so I probably would do HGRI testing. Although we’re going to talk about this when we get to methylation in the blood chem unit, I’m increasingly moving away from higher-dose methylation supplements because of research that I’ve seen over the past several months. As I’ve been doing the deep dive that makes me increasingly concerned about the possibility of over-methylation. So it’s just with the HGRI panel, if there’s significant methylation problems, some supplementation may be appropriate for some length of time. But ultimately, we want to get patients on a diet that’s optimizing their methylation status.