Dr. Amy Nett: Does she have at least a blood panel? I would get a blood panel because the tingling in her palms, hands and sole of feet, I’m assuming this is not a diabetic patient, but I would be thinking about B vitamins.
So maybe get her on some B vitamin support because I’m definitely worried about neuropathy. So if she has bloodwork, at least look at her hemoglobin, hematocrit, and mean corpuscular volume and see if there’s any evidence for functional B12 or folate deficiency. I would get an iron panel and ferritin on her also. Would I treat? I wouldn’t be excited about it but I probably would because of symptoms and you haven’t done a SIBO breath test. And it sounds like she probably has some nutrient deficiency, so if no additional testing is an option, then yes I would probably do a 30- to 45-day herbal antimicrobial protocol in her. Also make sure, I would do a Paleo Reset Diet, though. I think I would in this case, if you can’t do anymore testing, I would probably make a deal and say okay we can do the treatment, but we also need to do a pretty strict Paleo Reset Diet. Because the other thing with lysozyme and secretory IgA that are elevated like that, I’m also wondering is she eating the food that’s triggering her? So if she can do a strict Paleo Reset Diet and make sure it’s not a dietary trigger, then I would be a little bit more comfortable moving forward with the 30 to 45 days and see if she can at least get blood work, maybe through insurance. But just get some sense in particular of B12 and folate.
If you feel comfortable just starting some B vitamin supplementation, maybe consider that and we’ll talk more about B12 and folate when we get to the blood chemistry section of the course coming up pretty quickly.