Home
Knowledge Base
General Functional Medicine

General Functional Medicine

Last week’s content you mentioned some cases you had suspected biotoxin illness and mentioned the biotoxin illness survey, visual contrast sensitivity test, and biomarkers for service testing. I know you said you weren’t going to go into this in detail in ADAPT but unfortunately, I seem to be attracting these types of cases already. I need to know how to screen or point them in the right direction. And there are no functional med doctors anywhere near me that would know the first thing about this. Can you briefly describe this and or let us have access to that biotoxin survey?

Chris Kresser: Sure I’m totally open to you having access to the biotoxin survey. Maybe we can make a note...

Do you ever use modified citrus pectin for binding?

Chris Kresser: Yes, I do, however, the same story with the mold toxins. I haven’t seen any research that suggests...

This information made me wonder about the supposed zinc test where you swish liquid zinc in your mouth and if you taste it right away you have good stores of zinc. If it tastes like water you are deficient. Any evidence base for that?

Chris Kresser: Yeah, that’s called the zinc tally test and there’s not a lot of evidence, but there’s at least...

I have a patient with an extreme amount of muscular pain. She has to watch the way she sits, moves, walks in order to avoid pain. Every time she tries to build up her weak muscles, she has to deal with very bad cramping and muscle soreness that can last up to a week after training. It can only be resolved by the use of NSAIDs. She feels very fatigued and virtually permanently suffers from brain fog. Unfortunately, she can’t afford testing. Medication she’s taking is very likely affecting her gut but can’t be discontinued at this point. Also, her menstrual cycle is off, although regular hormone testing through her gynecologist has come back normal. Her diet is spotless and I rather suspect an HPA issue, but where would you start in this case?

Chris Kresser: Those are tough cases. If a patient can’t afford testing, your hands are tied somewhat. I mean just...

What do you use to directly raise elastase, type II-driven. I have a client who completed a four-month case review process taking Digestion GB, among other food supplement lifestyle interventions, and her follow-up tests revealed an even lower elastase. Granted this is a very complicated case in postmenopausal demographic.

Chris Kresser: I don’t know of anything specifically to do that, Ashley other than addressing the GI issues. But you...

I’m trying to understand how increasing acetylcholine precursors helps with a disrupted diurnal pattern. Could we explain? Additionally, have you heard of DMAE for increasing acetylcholine? Many people use it for ADHD.

Dr. Amy Nett: Let me see, DMAE. I don’t think I have actually. So let’s see, oh, dimethyl ethanolamine? I...

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?

One of my clients with typical trigeminal neuralgia really wants to stop taking anticonvulsants that have helped her with pain up until now. Experienced rapid decline of other aspects of health since having started to take them. Desperate to find another option to control or eradicate the pain. Diet is fine. Testing seems a bit nonsensical since we already know her gut is messed up due to the meds. TSH is normal but free T3 is a little low and free T4 is a little low. Her gynecologist put her on 50 micrograms of thyroxine, TPO is 8.4, tracked below 0.3; serum ferritin, 47.8; DHEA sulfate, 60; and morning basal cortisol is 60.5. Sex hormones in the reference range but very high sex hormone-binding globulin at 233, has also consulted a specialized dentist for her TMJ, who made a full coverage occlusal splint for her lower jaw. Unfortunately, she’s found herself unable to use it since it gives her terrible headaches and muscle cramps in the back of her neck and shoulders. Although she meditates and is trying to get exposome factors in orders, she’s experiencing increased jaw clenching during the nights and strong feelings of misalignment during the past few weeks. Since the actual cause of trigeminal neuralgia is unknown, I’m working on nutritional lifestyle and relaxation techniques and was wondering if you have any other ideas how to help this young woman. Would you consider LDN?

Chris Kresser: Yeah, the dentist thing is interesting because I’ve talked about Dr. Jennings in Alameda and his work with...

You discussed organic acids testing as markers for microbial overgrowth and discussed a test from Genova and Great Plains. Number one, I’m unclear about the usefulness of these tests and the diagnosis of gut dysbiosis. Number two, are you going to present a more complete discussion of organic acid testing in the future? If not, which lab do you recommend for complete organic acid testing?

Chris Kresser: So as for number one, I think if you go back and you look at the organic acid...

Question about POTS which is postural orthostatic tachycardia syndrome. So my 13-year-old cousin was diagnosed with POTS after fainting 50, 5-0 times, for unknown reasons in the last six months. Every conventional test has come back normal. They’ve tested for a lot including brain scans, a 30-day Holter monitor. Her only symptom is this bout of lightheadedness and fainting. Outside of the episodes, she feels completely fine, high energy, low stress. Is there any insight on the functional medicine root cause of POTS or any treatment ideas? I’m working with her on improving her diet, which is pretty much the Standard American Diet right now. Otherwise, she is athletic, sleeps well, and tells me she isn’t stressed.

Dr. Amy Nett: Yeah, so POTS is really a tricky one and I think there’s a lot more to be...

Prev Next