Chris Kresser: The levels of IgG and IgM … Just for everyone listening, Holly gave me the exact values and the ranges. They’re not actually out of the reference range in most cases, although they are in one. They’re low normal, so I wouldn’t actually say that they’re deficiencies. You will find patients with IgA and IgG and IgM actual deficiencies, where the numbers are really low and well outside of the reference range and suggest in that case there may be a genetic cause that’s leading to deficiencies, or in some cases, some cancers or other problems can cause that.
You mentioned that there were many antibodies that were out of range on the Cyrex Array 3, and I’m not sure if you’ve done Array 4 or Array 10. I think I showed a case study when we were covering the Cyrex panels of a patient with polyreactive antibody production and talked a little bit about that. That was a patient for whom pretty much every single antibody on Cyrex Array 5 was out of range, and then Cyrex Arrays 3, 4, and 10, there was … not every single one, but almost, and if you removed all the foods on those panels, the patient would literally be eating chicken breasts and lettuce or something like that. It was ridiculous. There was no way the problem was going to be addressed by removing all those foods. What that indicates when they have this polyreactive antibody production is severe immune dysregulation, severe hyperreactivity of the immune system. Or if the antibody production is really low, that can also be just a severe dysregulation of the immune system on the other end, hypoactivity. Those are difficult cases to treat, and we’re not going into a lot of detail in this first year for that reason, but when I see that, I typically think of three things. I think of chronic infection, environmental toxins, particularly heavy metals, and then a mold or biotoxin-related illness, CIRS.
I see Holly following up, saying that some of the values were lower than the reference range. That’s true even if they’re below the reference range. It’s helpful if you know the history. If the patient always had these low antibodies, that would suggest a genetic cause, but if it’s more recent, if they had normal immunoglobulins at one time, but they’re low now and the low antibodies correspond with their other more recent health problems, then that’s useful information because it indicates that there’s some functional issue that’s causing the problem. I would look into infections, look into chronic inflammatory response syndrome—I have another interview that I just recorded with Dr. Shoemaker that’s going to be coming out soon on that—and then also heavy metal toxicity. Those are some of the things that I would consider in that situation.
As for how to address genetically low IgG and IgM, that’s something I don’t have a lot of experience with. I’ll look into it and report back what I find out.