Dr. Amy Nett: So IUD, you mean just an intrauterine device? And I don’t know, too, there’s the Mirena and the copper IUDs. And then you said she’s experiencing fatigue, so I’m worried about iron. So spotting with an IUD is actually not normal. So I think it’s worth looking at the underlying, look at her hormone profile. Consider doing the DUTCH complete hormone profile. I actually haven’t seen a lot of spotting with patients on IUDs nor have I seen weight loss with IUDs. So I’m a little bit unclear if you’re saying because of the IUD you’re seeing spotting and weight loss. Or you think it’s because of the antimicrobial protocol and Paleo diet that you’re seeing spotting and weight loss. So I’ll give you a minute to answer. I think you’re saying. Oh, because okay, so not because of the IUD but because the diet. So because she’s on the Paleo diet and losing weight. Yeah, I’m not sure about, I don’t know what’s causing the spotting and if that’s new.
So you’re saying it’s new since she started the Paleo diet. Is it detox or fat loss? I’m not sure what’s driving that. I don’t think that an IUD prevents healing of the gut. Oral contraceptives may have some effect on the gut, certainly much more so than an IUD would. I don’t think it would prevent healing of the gut. Did she have SIBO or a dysbiosis? SIBO and she’s still not able to tolerate carbohydrates you think because of the SIBO? How long has she been on the antimicrobial protocol? She’s been on it for two weeks. So what you could try doing is have her lower the doses. Like what I might do is if she’s been losing weight and spotting specifically since starting the antimicrobial protocol, I would probably stop it. Have her get back to a baseline and then introduce things one at a time. And if she is underweight and if she’s on the petite side, I wonder if you just want to aim for lower doses in general. Like maybe have her do half a scoop of lauricidin three times a day.
The GI-Synergy is a little bit more difficult in terms of doing lower doses unless patients literally just empty out half of the capsules. But I might reintroduce the supplements one at a time. She’s on half-dose right now already, okay. The other thing you could do is if you suspect the supplements again, you could take them out. What about just doing rifaximin? Because I don’t think the Paleo diet would cause spotting. It could cause weight loss like you said if she’s not finding other sources of calories. But if she’s already underweight, normally she should be able to maintain weight. So unless she’s just not figuring out how to get those calories in otherwise. And I would look for other carb sources like maybe white rice would be something. And again I know technically white race isn’t on a Paleo diet, but if you just need to get carbohydrates in her. She does eat white rice. Shoot, okay.
What about plantains? I don’t know. You have to get, I feel like you have to get some carbs in her, make sure she’s getting enough calories. If you think it’s, I’m not going to buy that it’s the diet that’s causing these symptoms. I haven’t seen this type of response to the antimicrobial protocol. I would suspect it’s more the SIBO or whatever is causing her underlying symptoms that’s leading to the spotting and weight loss. I would probably encourage her, she’s only been on it for two weeks, have a pep talk. Try to get her to push through a little bit longer. Let her know that sometimes because of the SIBO she might not be absorbing all the nutrients. Maybe that’s why she’s not gaining weight. Try to just stick with it a little bit longer.
If symptoms get worse, weight loss gets worse, spotting gets worse, then I would stop it and maybe just try rifaximin. Do like 400 mg or something TID. What do you think? Is that a place to go? Oh, and then regarding the fatigue, yeah it would be great to run a comprehensive blood panel on her. Because her nutrient intake is a little bit limited, I would want to look at iron, but I would also want to look at B12, folate. So it might just be helpful to do a full comprehensive blood panel. All right, so hopefully that gives you somewhere to go with her. Keep us posted.