Next question also from Ariel, “Even if a patient is a wheat consumer, would you test for intestinal permeability prior to running the Cyrex 3 panel?” Related questions, “Does intestinal permeability typically result in numerous immune reactions to food that disappear after you restore barrier integrity? How common is intestinal permeability among patients? Under what conditions and in what order do you consider testing for immune responses to other foods? Thank you for your fabulous course.” You’re welcome. Glad you’re enjoying it.
Let’s break this down. Generally, as I said in the course, [I] don’t test for intestinal permeability right off the bat, and I often don’t ever end up testing for it because intestinal permeability is almost always driven by something else, whether it’s SIBO, fungal overgrowth, parasites, H. pylori, or some other gut infection, and so testing for it just tells you what you probably already know, that they have this challenge because of these other conditions that are affecting their gut permeability and that we always want to address those conditions anyway. Going ahead and doing what is generally the best approach, and then if the patient is still having problems, we might go ahead and address—do the intestinal permeability testing later.
In terms of the Cyrex 3 panel, I wouldn’t necessarily test her gut permeability before that because I haven’t seen as that kind of relationship. People will still test positive for gluten intolerance even if they have normal gut permeability function on those tests. I don’t think you need to worry about that.