SIBO
Patient with Doctor’s Data results shows moderate to severe dysbiosis but no parasites and 2+ of candida. Would you call this moderate to severe fungal overgrowth or just mild? Second part of the question. You mentioned on a live call awhile back that you recommended a particular product with Longvida curcumin and boswellia. Can you please remind me of the name?
Chris Kresser: The candida overgrowth is maybe moderate, but if it’s severe dysbiosis, then that’s going to affect them worse...
25-year-old female with anxiety and depression, which is a very cyclical pattern tied to her menstrual cycle. Can you suggest some lab tests to order in treatment to consider? She’s already on Vitex or chaste tree berry, eats Paleo, exercises, and sleeps well.
Dr. Amy Nett: Of course, if they’re cyclical, you’d probably want to look at hormone levels, and since you have...
Female patient, 60-year-old. Grain-free Paleo for 30 days. Has asthma, abnormal glucose, hypothyroidism, granuloma annulare, which hasn’t gotten any better through diet. Stool test shows low short-chain fatty acid, low good bacteria. Any recommendation for the granuloma annulare?
Dr. Amy Nett: Again, I would approach this the same way I would any other case. You need to think...
I want to begin to do more SIBO breath testing. I looked at the test procedure, and it seems that to order these tests I need prescribing license due to the lactulose that’s included. Do you have a suggestion? I’m an acupuncturist.
Dr. Amy Nett: I think Chris has been able to order the NUNM SIBO breath test. I believe acupuncturists can....
I have a low-income Medicare patient resistant to doing more testing. I did get to do a stool test, which came back with a high amount of all the commensal bacteria and yeast overgrowth. She has been doing a Paleo reset diet since January, about 80 to 90 percent compliant, and main complaint is diarrhea. No bloating. She’s overweight, but she’s lost about 15 pounds, has joint pain. Next plan was to do a trial of an antifungal supplement Yeastonil by Apex Energetics—yup, that’s a good one. And then if many were not a concern, we would run a SIBO test. Have you noticed any correlation one way or the other between SIBO and the bacteria or yeast pattern in the large intestine? No, I have not. And then, do you have any other suggestions?
Dr. Amy Nett: Honestly, if she has a high level of the commensals, if she has adequate levels of the...
First test results were high positive 120 peak for methane, and then after three weeks of rifaximin, neomycin, and then 10 weeks of herbal protocol, retest showed great improvement, but both methane and hydrogen present with combined peak of 30. As there had been an improvement, would you continue herbal protocol for another month and retest or now switch to two weeks of elemental diet? Do you often find that it takes longer than three months for high test levels to reduce?
Chris Kresser: Great question and, yes, 120 is very very high, so you would expect a longer treatment protocol to...
What are your views on fermented foods for someone on a SIBO protocol and also once they’ve finished and had a clear test? Is it best to avoid for some time, or as probiotics are in the program, they’re okay as long as they’re tolerated.
Chris Kresser: Yes, it’s the latter actually. They’re okay as long as they’re tolerated, and that’s going to be determined...
What is the best treatment for Barrett’s esophagitis?
Amy Nett: I think if someone is diagnosed with esophagitis, you want to do a full array of gut testing...
Do you have any information on Meridian Valley Lab? What does Chris look for in a lab to ensure high-quality testing? And who do you prefer for hair mineral toxic element analysis?
Amy Nett: Okay, so breaking these down a little bit. In terms of Meridian Valley Lab, they offer a few...
You said you’ve become more conservative with your own SIBO diagnosis criteria, and you don’t follow the NUNM or Commonwealth guidelines. Can you explain in a bit more detail what your criteria are?
Chris Kresser: A few ways to answer that. Number one, in the presentation as you know, the criteria that I...
