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Can you help me with appropriate protocol for a three-year-old with these results on Doctor’s Data? Gets stomach aches and seems to crave sugary things, though mostly the sweet foods she has access to on a daily basis only contain raw honey or 70 percent dark chocolate. Feel a bit lost with how to help children. Appreciate your guidance.

Chris Kresser: So she’s got some low levels of Lactobacillus but otherwise really good beneficial bacteria. Some commensal imbalance, normal...

Do you think with kids and neurological issues, is it ever appropriate to do the DUTCH test or use CBD oil or any of the HPA treatments? I know that pursuit isn’t analytical, doesn’t have ranges for kids, but it seems to make sense to explore HPA-D with this population.

Chris Kresser: I completely agree, Laura. I think that population is one of the most affected by HPA axis dysregulation,...

You discussed glutamine supplementation in the gut section. This information from Memorial Sloan Kettering Cancer Center indicates that glutamine may fuel cancer cell growth. Do you have any suggestions on weighing the risk versus benefit?

Chris Kresser: And this is a quote from the study. “Recent findings show that glutamine transporters upregulated tumor cells and...

Nineteen-year-old male patient with active UC. Raised unvaccinated but on antibiotic six times in life with three rounds when a baby toddler. Recent antibiotics in high school for acne prescription, college baseball player just finished first year of college upon diagnosis of UC. Has got low levels of some beneficial bacteria. 2+ of alpha-hemolytic strep, 1+ for Citrobacter, 2+ for gamma-hemolytic strep, 1+ for Pseudomonas and staph, no pathogens or yeast. Many white blood cells, low lymphs, high monocytes, that’s all consistent with IBD and ulcerative colitis, as is lactoferrin of 219. Calprotectin of 541, wow. Lysozyme of 27,500, wow, wow. sIgA of 251, low short-chain fatty acid production and acidic fecal pH, iron deficient based on the functional medicine iron panel. Not surprising given the extent of the gut inflammation. Anemia based on CBC with normal B12, MMA and homocysteine. So that’s iron-deficient anemia. Excretion of liver burden detected from metabolic panel, low vitamin D. Three weeks into the low-FODMAP diet, low in soluble fiber, gut reset diet with motility improvement of 14 bowel movements per day down to four to five. That’s great. Visible blood in stools and fecal incontinence is resolved. Still experiencing immediate BMs following meals and mitochondrial dysfunction. Tell me again why 4+ Clostridium is in the commensal column. Given the symptoms, it seems like a warning sign to me when correlated with symptoms. Number two, is it okay to perform the Rebuilding Healthy Gut Protocol on GAPS Level 1, or should we layer that in? Three, is vitamin C okay to take for iron repletion when motility is hyper?

Chris Kresser: So you have to do, in this situation there is a follow-up test you do from Doctor’s Data....

Thoughts on our case review prescription. Gut support, GAPS Level 1 with ox bile enzymes, phosphatidylcholine butyrate, probiotics, dairy kefir, and kraut juice.

Chris Kresser: I would be very cautious with the dairy kefir. Natasha Campbell-McBride approaches that differently in different people. When...

So I know we’ve spoken about enzymes in the past. A SIBO patient is tolerating foods much better with three caps of HCl but still notices fruit intolerance. Would a more diverse enzyme be helpful here? Or is it a fructose intolerance?

Dr. Amy Nett: So you could certainly try Digestzymes or something like that, or even like Now Brand or Jarrow...

At what age would you look at Doctor’s Data stool test for children? Literature suggests gut microbiomes not formed until two to three years of age. So we would wait until then.

Chris Kresser: Yes, great question and that’s true. I probably wouldn’t run a stool panel on a kid until they...

In a client who has Helicobacter pylori and dysbiosis, it was being treated with a botanical protocol plus the H. pylori add-ons, which, as you guys all remember, that’s Broccomax, Saccharomyces boulardii, GastroMend, and then we also often recommend unsweetened cranberry juice if the patients tolerate. So the patient had to build up the particle really slowly in order to control her symptoms. After about eight weeks in total of taking the supplements around three weeks would the almost complete protocol. So she stopped the treatment, she got much better. So what would we recommend that she does next?

Dr. Amy Nett: Okay, so she did about, let’s see, three weeks of full dose with five weeks building up....

Much of the course content notes if high inflammatory markers for IBD, then refer out, but there’s not a large mention of how to support someone with active IBD. Nineteen-year-old male with very high IBD markers astronomically high, actually white blood cell count high, high sIgA, low lymphs. Family physician and I have hooked arms to help him. So far we have him on one pharm, which is LDN. Began this week at two milligrams working his way up to four. Beyond that he’s on a lot of anti-inflammatory nutraceuticals and botanicals, namely curcumin, resveratrol, boswellia, butyrate, aromatic plants. Improving steadily but with inflammatory markers like his, I’m curious if he needs more conventional intervention. Also his C. diff clarification is pending.

Chris Kresser: Yeah, so it depends on the patient. In some cases we’ve been able to reset really severe IBD...

I did a Cyrex Array 4, I’m only finding a case of morphine antibodies in the equivocal range. I’m on week three of the protocol to get rid of many Blastocystis hominis parasites, I’m doing the reset diet with it. After I heal and seal my gut, could I provocate with dairy again, do the test over, and see if I’m still producing antibodies? Or is it recommended that I go off dairy like I had with gluten for the rest of my life? Designs for Health also has a product called Digestzymes that claims it can help break down casomorphin. So could that be added later if I do eat dairy? And if there are circumstances in my life that can create leaky gut, would it be suggested that I stay away from dairy on those days because of the potential of my immune system being sparked up again?

Chris Kresser: Yeah, good question. We talked about this a little bit in the Cyrex testing weeks and my answer...

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