Tracey O’Shea: Alright, so the next one is “Do you often find that low serum ferritin can be resolved after treating H. pylori infections?”
Yes, I think we’ve seen, especially with iron levels and nutrient levels in general, depending on how low the serum ferritin is and depending on how low iron saturation is in relation to ferritin, I would pay attention to kind of all those markers. If we’re extremely low and the patient is iron-deficient, and we know that there’s a reason, let’s say they have extremely heavy menstrual cycles or they have Crohn’s disease or something else where the suspicion for why iron and ferritin are low is more because of blood loss and volume versus absorption of nutrients, and in that case, I may still like support ferritin levels while I’m treating just as a goal for optimization and try to get the patient feeling better, and then I can kind of mess with that a little bit later. After H. pylori is treated, we can try to move our way down on iron supplementation and see if the ferritin and iron saturation will remain optimized, but in answer to that question, yes, I really have seen not just serum ferritin like iron but [vitamin] B12, folate, zinc, all the nutrients have improved after treatment for the gut infections, and SIBO I would say more importantly than H. pylori just as a general rule, but the iron and H. pylori c onnection is very real and I have seen this improve, but like I said, if the ferritin levels are low enough along with an iron saturation, I usually won’t wait around to treat H. pylori and see if it bounces up on its own. We’ll usually support iron levels and then, again, kind of experiment and test later by weaning down on the iron supplementation after H. pylori is resolved and see if ferritin and iron can kind of stay up on their own.