A 60-year-old female on bioidentical hormones. Last year had high TPO antibodies and went gluten-free, still ate dairy not Paleo. This year came back for fungal overgrowth on an organic acids test, decided to treat yeast with caprylic acid and RN Microbinate. But her vitamin A, D, and K came back deficient on SpectraCell, but her antibodies are normal. Do you frequently see when treating the yeast, TPO antibodies get better and with not absorbing fat-soluble vitamins? Any recommendations for gut to help absorption?

Dr. Amy Nett:  TPO antibodies can fluctuate quite a bit, so I absolutely do see changes in thyroid antibodies with treatment. I will see that when we treat gut or lower heavy metal toxicity, that TPO antibodies will decrease. Her fat-soluble vitamins are low, so that is surprising. You would suspect that if the fat-soluble vitamins were low, then that would throw the immune system off a little bit. Then, in terms of improving absorption, it depends a little bit. Is she having difficulties with absorption, or is she just not getting enough? You have to think both about supply and demand. What does her diet look like? Is she eating organ meats? What her sources of A, D, and K? If she is not eating organ meats, then you might want to encourage her to get some liver in her diet or maybe take cod liver oil daily. Make sure that she’s getting the fat-soluble vitamins. If she’s getting enough of these vitamins through food sources or through supplements but just not absorbing them, then you may think about does she need a lipase or maybe digestive bitters something to help increase bile flow and help support fat digestion and absorption. First, to figure out how to make sure she’s getting enough A, D and K, you need to know is this a supply or a demand issue for her.