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General Functional Medicine

When we’re talking about the exposome, we’re talking about genetics plus epigenetics?

Dr. Amy Nett: Yeah, that’s a fair way of looking at it, but the exposome … Chris has the great...

How would I decide between A-FNG versus Yeastonil?

Dr. Amy Nett: I don’t know that there is any great guideline for that. I think A-FNG might be a...

Any thoughts on the patient I have with vaginal bleeding only during intercourse? She’s been checked out by the gynecologist, has thin epithelial, the vaginal exam caused some bleeding too, but she has no other signs of lack of estrogen. Eats Paleo, generally very healthy, any suggestions on perhaps topicals, EVCLO, or where to go next. Periods are regular, not too heavy, not too crampy.

Chris Kresser: I would definitely use the DUTCH comprehensive panel, Marcy, if you haven’t already. It sounds like she’s had...

Heavy metals have been mentioned a few times during the course, but as we’re not covering it in Level One, I hope you don’t mind me asking here. I did a Doctor’s Data urine challenge test on a patient six months ago, and it came back moderately high on lead and mercury. We worked on a natural detox protocol similar to Dr. Shade’s and also methylation, gut, and HPA axis. Retesting now showed mercury’s gone down, lead is similar, but several other models like arsenic, cadmium, barium, aluminum, etc., have crept up, though still within the reference range. Does this mean that the patient wasn’t able to detox these metals out of his system due to improved methylation or gut, or is it simply increased pollution?

Chris Kresser: I would be, I would guess the former rather than latter. Sometimes you see that when you improve...

This is a follow-up about the dental work for more advanced Parkinson’s, seven years diagnosis.

Chris Kresser: I have generally said the earlier it’s caught, the better the outcome. But several of Dr. Jennings’ patients...

Will 23andMe raw data reveal polycythemia?

Chris Kresser: It could reveal the primary version but not the secondary, and I’m not sure how to get at...

May be off-topic but I’d like to reach out for some guidance. Fifty-five-year-old recovering alcoholic. The survivor of serious MVA that resulted in the above-the-knee amputation of her right leg. Spent years bedridden, but about three years ago after getting sober able to obtain a prosthesis and started walking. Left knee became very painful with arthritis and she opted out a little over a year ago. Never healed properly and we now know is was because of a MRSA infection in that knee. Spent the last nine months in treatment with antibiotics, which are not working. Infectious disease doctor is giving her one last round of penicillin-based antibiotic before recommending amputation of her remaining leg. Unfortunately she’s allergic to penicillin and having a bad reaction to it. Contacted me for help.

Chris Kresser: Okay, yeah so I would definitely suggest a book, if you’re not familiar with these herbs already, called...

I have a 15-year-old patient with dysautonomia. I never know how to say that. Dysautonomia. That’s a tongue twister. I put her on an AIP protocol, but her nausea is so bad she has severe food aversions to some of the most nutrient-dense foods like bone broth. Can’t drink ginger teas, can’t really execute the protocol, so I recommended just focusing on avoiding the added sugars, processed oils, and flours. Unfortunately, she’s gravitating towards saltines and those types of foods, because they help with the nausea. She hasn’t been able to do her test yet and my concern is her not being able to even tolerate supplemental protocols to assist any underlying issues she has. I know dysautonomia has been associated with a series of other infections. I’m thinking of referring her out to someone that’s experienced with those types of chronic illnesses. In general, what would you do in those types of situations?

Chris Kresser: I would definitely work them up for CIRS and chronic infection. And if you don’t have experience there,...

We have quite a few patients with chronic kidney disease, maybe 60 percent of them test low in serum magnesium and red blood cell magnesium. We then recommend dietary and/or supplemental magnesium and monitor levels. But invariably their nephrologist tells him to stop any intake of magnesium regardless of levels. Can you elaborate on the chronic kidney disease and magnesium connection and what to be cautious of? In all fairness, roughly 30 percent of our chronic kidney disease patients will have high levels of magnesium and we obviously don’t recommend magnesium to them. Are there alternatives to dialysis?

Dr. Amy Nett: Yeah, I mean, the concern with patients who have chronic kidney disease, especially if they’re on dialysis,...

Do you see a role for LDN and/or CBD during CIRS treatment?

Dr. Amy Nett: That’s kind of a nuanced question. I think to get into that one, I’m probably going to...

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