A patient did a retest on a stool sample and it came back with moderately elevated lysozyme but normal calprotectin and lactoferrin. Lysozyme level was 1,400, there were seven or eight different bacteria in the commensal column that were +1 or +2 and no pathogenic bacteria, yeast, or parasites noted. His symptoms of high anxiety and phobia remain. His retest on organic acid only showed one marker: 40 yeast elevation and the bacterial markers were negative with Great Plains testing. My question is would you continue to do another round of pediatric herbal antimicrobials, or just do the rebuilding stage?

Chris Kresser:  If you didn’t have any improvement on the herbal botanicals, which it doesn’t sound like he did, then I would probably not do that. Again, I might switch to the rebuilding stage or one thing you haven’t mentioned yet is SIBO breath testing and if he had SIBO. If he does have SIBO, then I would treat that perhaps with you could start with something like Atrantil, which we didn’t talk about in the SIBO unit because I only recently became aware of it. But it’s a supplement that has some ingredients that are effective in some cases against SIBO, and with kids I always try to consider the most conservative approach. It seems to be more effective with SIBO, with this constipation-predominant or IBS-C. So yeah I think the next step would be to test for SIBO in this case before you make a decision about how to proceed with either fibers that could potentially exacerbate SIBO in the absence of antimicrobials or doing more antimicrobials. I see that he had improvement in his yeast numbers, so that’s good news, but since this main symptom hasn’t improved, I would do a little further investigation.

The supplement that I mentioned is called Atrantil, A-t-r-a-n-t-i-l. I’m going to have the creator of Atrantil, who is a gastroenterologist in Dallas, come on my podcast for an interview in August. So that probably won’t show up until September as the podcast, but you’re going to learn all about it there and it’s interesting. I don’t have enough experience with it yet to contact, to make an evaluation. But it’s worth trying I think and I think it’s safe. And we’ve seen some initial good results and I’ve heard some positive results from other practitioners.