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Appropriate protocol for a three-year-old with the following results, which I’ll go through. On Doctor’s Data symptoms are stomach aches and crave sweet foods. Although mostly the sweet food she has access to contains only raw honey and/or 70 percent-plus dark chocolate. Sometimes had access to foods containing unrefined sugars like rapadura. I feel a bit lost generally how to help children. Appreciate your guidance.

Chris Kresser:  So the Doctor’s Data, she’s pretty good about beneficial bacteria with the exception of the 1+ for Lactobacillus,...

I have a case I wanted to run by you because I don’t typically see kids. But this nine-year-old daughter, this is a nine-year-old daughter of a coworker, so I was trying to help them out. This nine-year-old has a history of GI issues for as long as her mom can remember. She was born by C-section, difficult time breastfeeding, complained of tummy issues frequently after eating for years, and she’s always had a very sensitive skin or dry skin. So Megan advised them to go gluten-free and dairy-free in the past year, and this has made a really big difference with her GI upset. Mom thinks she’s about 75 percent better in terms of frequency. Recently, however, she had a recent bout of what I call gastroenteritis for several days, and she still sometimes complains of extreme abdominal pain and nausea after eating. I ran a Doctor’s Data CSAPx3 on her and got the results back yesterday. Key points are 4+ of all beneficial bacteria except no growth of Lactobacillus, many yeast on all three microscopy samples, lysozyme, 679, which is just mildly elevated because the upper limit of normal is about 600. So my questions, number one, could the high lysozyme be due to the yeast overgrowth alone? Number two, my plan was to treat the yeast with A-FNG since she can’t swallow pills. Or do you ever open the capsule of Yeastonil and sprinkle it on food for kids? Would you include anything else for that? Third part of this question, treat the Lactobacillus insufficiency with Clara Labs, their biotic children’s chewable probiotic, which is multiple strains of Lactobacillus and Bifidobacterium, maybe also include Prescript-Assist. I want to make sure I’m treating her sufficiently, but she is a very picky kiddo who might balk at over-supplementation. Fourth part of the question- My plan was to treat her for 21 to 30 days and see how that goes.

Dr. Amy Nett:  It probably could. You would want to think about are any other foods triggering her? So is...

I’d like to ask a question about dosing, length of treatment, and retesting for a boy I’m working with. He’s eight years old and his main complaints in his mom’s words are skin rashes on cheeks and back of upper arms and hips; pooing issues, including lack of urge, usually needs to be prompted and then has bad-smelling stool; bad breath, especially in the mornings; lack of resilience to daily struggles; underperforming at school. So tests that have been performed: Doctor’s Data, NutriPATH, CDSA 4+, SIBO breath test, Great Plains OAT, and C Array 3. So Doctor’s Data beneficial bacteria, all of them are 4+ except Lactobacillus, commensal 1+ alpha-hemolytic; okay, yeast culture, basically rare; parasitology, Blastocystis hominis was identified on all three samples as few, moderate, and few. All other markers within range except secretory IgA, which was low at 24.3. And then the next test is the Australian CBSA through NutriPATH. And it also came back with Blastocystis, which was measured as high if I’m interpreting that correctly. And then the digestive markers showed that there were some food remnants, putrefactive short-chain fatty acids were elevated, that sounds unappealing, fecal triglycerides were elevated, and phospholipids were elevated. And then PCR also detected both Blasto and D. fragilis. I prescribed the pediatric protocol, which is Biociden, CSA tincture, Lauricidin, PHGG, Prescript-Assist, Lactobacillus planetarium, S. boulardii, and Iberogast. I’m wondering if it’s too much for an eight-year-old.

Dr. Amy Nett: Okay, so skin issues, gut issues and question if there’s some sort of like developmental delay, or...

I also did a Doctor’s Data stool test which showed that she had yeast overgrowth. I advised the antifungal protocol and the mother recently sent photos to say that the daughter is doing very well. The mom also asked whether she could or should take maintenance pro- and prebiotics. Do you have any thoughts on this?

Dr. Amy Nett: I’m a little perplexed as to why they did the stool testing if they don’t want to...

It seems like a patient is not tolerating the antimicrobial protocol. What are some of the supplements that you would first consider reducing her stomach pain? So which ones are most likely to be problematic?

Dr. Amy Nett: Well, what I would do is, so often I have patients start each of the supplements one...

On a Doctor’s Data stool test, a patient had moderate yeast and many Blasto in all three samples. Low short-chain fatty acids, fairly good levels of beneficial bacteria. The handout says to treat for 30 to 60 days for mild to severe fungal overgrowth. So I’d like to check whether in this case I should advise treating for 60 days.

Dr. Amy Nett: If there is many Blasto on all three samples, I would do 60 to 90 days because...

I need a little help with a case. So 48-year-old male, no significant past medical history, diarrhea is the chief complaint. SIBO and stool testing. SIBO’s negative, stool test showed Blasto and insufficiency dysbiosis. Everything else looked great. Treated with a modified protocol, specifically using Parastonil. But the components of GI-Synergy that are specifically for parasites. So treated with that antimicrobial Saccharomyces boulardii and Prescript-Assist for 60 days. But now secretory IgA, beta-glucuronidase, and PP bacteria (Citrobacter) are elevated. Any ideas on why this would happen? Is Citrobacter one of the organisms that promote recirculation? I didn’t pick GI-Synergy initially because I wanted to protect his already fragile microbiome, so now I’m unsure what to do

Dr. Amy Nett: Okay, so I’m wondering did you use Genova for both the tests, or did you do Doctor’s...

Follow-up to a patient on an antimicrobial protocol. She’s on an IUD and is spotting significantly throughout the month since she started her Paleo diet and protocol. Unfortunately, underweight, hard time tolerating many carbs. Focused on keeping her calorie intake up with healthy fats. Seen spotting with other patients and weight loss. What mechanisms do you think are going on? Is it detox, fat loss? Do you see this often? Do you think the IUD or other birth controls can prevent healing the gut?

Dr. Amy Nett:  So IUD, you mean just an intrauterine device? And I don’t know, too, there’s the Mirena and...

A couple questions regarding results of two Doctor’s Data tests. The first is for a 60-year-old female with many complaints. Mood, neuropathy, back pain, sleep disturbance, dizziness, low blood pressure. She’s been on an anti-inflammatory diet since she started with me although not specifically Paleo mostly. I’ve suspected autoimmune problems but that’s just a hunch and not part of my diagnostic experience. I ran the stool cultures for her because I thought she had a yeast infection, because the look of her tongue and symptoms of burning tongue and vaginal/vulvar burning which responded to small doses of antifungal medicine prescribed by one of her doctors. The results of the Doctor’s Data was 4+ Bacteroides.

Dr. Amy Nett:  I think you mean Bacteroides fragilis? Oh 4+ Bacteroides, E. coli and Clostridium. 1+ Lactobacillus and Enterococcus...

85-year-old woman with extreme mood problems of anxiety and hopelessness had two years of recurring bladder infections and lots of antibiotics. Last antibiotic was a shot of antibiotics that brought on diarrhea that lasted for two months with significant weight loss. At the same time she was eating nothing but vegetables, long story which I stopped and put her on to more solid food diet. The diarrhea is improving. Doctor’s Data stool culture was all she felt she could afford. Results are all 4+ except no growth Bifido and 3+ Clostridium. Negative for C. difficile. Commensal flora are all 4+ and Pseudomonas aeruginosa 2+. All other markers in the normal range. Is no growth Bifido enough reason to give it deficiency diagnosis? What about the number and extent of commensals?

Dr. Amy Nett:  No. So if all beneficial bacteria are 4+ except Bifidobacterium, no I don’t think that’s enough to...
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