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Commensal flora, 3+ alpha-hemolytic strep, no yeast. The only marker that was out of range was fat-stained many red blood cells. I’m thinking she has insufficiency of dysbiosis, I’m planning on putting her on MAT protocol. My concern is about the red blood cells. Yeah, this lady started having dizzy spells a couple months ago and her blood pressure varies from about 100/75 to 80/60 with a pulse in the low 60s and she gets very weak. Her pH is 6.2, negative occult blood, not complained of hemorrhoids. I think my question is, would intestinal bleeding cause the dizziness? And with this view red blood cells, results point to that. She’s seen a cardiologist, but no one is looking at the gut but me.

Dr. Amy Nett: Great question. I think that red blood cells and occult blood tend to be over-called on the...

Follow-up question regarding TTG6- A patient does not need to avoid all dairy and only chocolate milk.

Chris Kresser: Yeah, that’s what the test results would suggest. Although they may want to try avoiding dairy and see...

What would you do with a patient with a hemoglobin A1c of 5.9, positive islet cell, and insulin antibodies on Cyrex Array 5?

Dr. Amy Nett: I would probably check some additional markers of blood sugar, so fasting blood glucose. I’d probably have...

If someone has one functioning kidney, so a solitary kidney, no diabetes, and normal blood pressure, would you expect the EGFR to be a bit off? Would 78 be considered okay in this situation, or even with just one kidney, would you hope to have the results in the same range as if you had two kidneys?

Dr. Amy Nett: So, I’m just going to say right now I’m actually not an expert in solitary kidney. I...

Rheumatoid arthritis patient who was going off the opioids. Went successfully. She’s gotten to the point where she feels as good as she did on the opioid. My thoughts were using LDN after the opiate for the autoimmunity aspect of pain and because she has super-high methane SIBO. Before the opioid withdrawal, she needed laxatives. Now she can go without. So given that she is not having any more pain being off the opioid, do you think it’s still a good idea to try LDN for the autoimmunity and motility agent? Would there be any adverse effects? I know there is the potential for disrupted sleep. Anything else? And if she does try it for autoimmunity and migrating motor complex, how would I know if it’s working? She’s pooping, albeit not in a predictable fashion, so what markers could I use?

Dr. Amy Nett: Great questions. I think one thing that I would ask is like what are the RF levels?...

What are your favorite blood labs to screen for PCOS?

Dr. Amy Nett: I don’t even love the diagnosis of polycystic ovarian syndrome. PCOS here is polycystic ovarian syndrome. It’s...

Last week, you talked about secretory IgA and why it’s the last marker to normalize after treatment, but what I still don’t understand is why it’s sometimes very low or very high, and both abnormalities seem to indicate inflammation/pathology, but there doesn’t seem to be a more specific or consistent reason for this abnormality in one direction or the other. In last week’s gut case studies that Chris presented, the sIgA was almost always abnormal, but sometimes low and sometimes high. Why is this?

Dr. Amy Nett: This is a great question. At this point, I don’t think we know why sometimes it’s high...

On the CSAP, when secretory IgA is low, what does it mean? What should we be thinking possible causes are, and what are ways to bring up the sIgA levels?

Dr. Amy Nett: When I see a low secretory IgA, I definitely think about gut pathogens. That will include yeast...

Can you help me understand the implications of high thyroglobulin antibody level?

Chris Kresser: I’m going to answer this briefly, but I just want to remind everyone that we’re going to be...

I have run several Cyrex Array 3 panels where there are enough out-of-range results to request immunoglobulin panels. I would have suspected IgA deficiencies in these, which I have some idea how to address, but in these panels they are returning results showing low IgG and IgM. I’ve tried to find resources that are clinically useful in supporting these patients but have been unsuccessful. Do you have any input on the cause of IgG and IgM deficiencies and how to support these patients? It’s more of a general question, but if specific details are useful, here are the highlights.

Chris Kresser: The levels of IgG and IgM … Just for everyone listening, Holly gave me the exact values and...

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