[Daniel]

,

Aloe vera gel is often made from the inner leaf and can help. The root seems beneficial as well (see this research).

You could use regular extra virgin coconut oil. The lauric acid and capric acid in the oil have anti-microbial effects. Some MCT oils (made from coconut) have even higher lauric and capric acid content. I like the MCT oil from Aman Prana for example. Make sure you choose the premium version. You can find the oil here. 

Famotidine is an H2 blocker and helps reduce stomach acid. The ‘H’ in H2 stands for histamine. Histamine is involved in stomach acid secretion. This is why medications like famotidine – which block the receptors where histamine in the stomach binds to – can reduce stomach acid production.

H1 blockers are often used as antihistamine medications. The type of receptors H1 blockers work on are however located differently (for example on T cells). To my knowledge famotidine is only an H2 blocker and not an H1 blocker. H2 blockers like Famotidine can make H1 blockers more effective (see this study) but shouldn’t affect the H1 receptors.

I know… a difficult answer!

[Daniel]

Hey ,

For some reason I didn’t see the pictures the first time, but these pictures help!

Dermatitis just means that the skin is inflamed. The cause can indeed be fungal or bacterial. And your right, this can be related to gut problems. Supporting the immune system with nutrients like vitamin D, vitamin A, zinc, folate and vitamin B12 (which you already do) helps.

On top of that, the blue discoloration on your ankles could be an indication of poor blood flow (although a doctor should be the judge of that). Poor circulation means that it is harder for white blood cells to reach your feet. Improving circulation can be done by exercise or moving more. If you have an inactive lifestyle, simply walking could improve blood flow a lot!

There are some natural remedies you could try as well. Coconut oil has some anti-microbial properties. Just apply the oil to your skin.

Aloe vera gel has antimicrobial properties and could help as well.

Some people use tea tree oil since it has anti-microbial properties as well.  In some sensitive persons tea tree oil can however cause irritated skin. Most people however don’t experience skin irritation. Just dilute the oil a bit since it is very strong with a carrier oil (olive oil for example).

I hope this can help!

[Daniel]

Hey ,

Excellent question! I regret to hear she had to see so many doctors. Often part of the health journey becomes eliminating options, which can take unfortunately a while. As a result: the last doctor is always right!

Getting to the true root cause of her unique case will help get her some relief. Psoriasis is an autoimmune disease. T-cells attack the body’s skin cells. This attack causes the body to make new skin cells more often. The extra skin cells pile up on the surface of the skin, and you see psoriasis.

With an autoimmune disease, we often see increased gut permeability (aka leaky gut). Often gut healing plays an incredibly important role.

It is well understood that poor bile function plays a role in many cases of psoriasis as well. Bile helps break down LPS or Lipopolysaccharides – which are ‘body parts’ of bacteria living in the gut that can cause problems in the body when they enter circulation.

Here are some key things to focus on:

Nutrient Deficiencies
The immune system needs nutrients like vitamin B12, folate, zinc, copper, vitamin D and vitamin A. With gut problems absorption of these nutrients can be impaired. Bile, which helps to bring balance to the gut microbiome through the regulation of the pH degree in the gut, is also needed for the absorption of fat-soluble nutrient vitamin A.

Getting her serum levels of vitamin D checked and bringing it up to 70 ng/ml if necessary is what I focus on with my clients.

Dysbiosis
Often some form of disbalance in the gut microbiome plays a role. Clostridia, yeast overgrowth, a parasite, or simply an insufficiency of or imbalance in indigenous gut bacteria can cause some malabsorption of nutrients or damage to the gut lining.  GI maps is a test that can provide you with insight into what type of disbalance is at play.

Bile flow
As I mentioned earlier, bile flow can be impaired in people with psoriasis. In the library of B Better you can find some excellent tips on how to improve bile flow (just click here). A liver enzyme panel can help examine if some biliary congestion might be at play. Testing for lab values like ALT, AST, GGT, alkaline phosphatase and bilirubin can help determine if this might be at play in her case.

Leaky Gut
If the gut lining is damaged (which we see often in auto-immune patients) helping to repair the gut lining becomes part of the healing journey as well. Zinc carnosine,  l-glutamine, Vitamin D, glycine, quercetin, and/or mucilaginous herbs are all nutrients that can help. GI Relief from Thorne and DGL Plus from Pure Encapsulations are blends without L-glutamine (in some people L glutamine can cause some problems like anxiety). GI Revive from Designs for Health is a nice blend with L-glutamine you could try. For additional tips, I recommend you watch this video explaining gut healing strategies.

Stress
Stress is also an important player in auto-immune disease. Stress can lower digestive enzyme secretion and stress impacts immune function. Just remember that stress can be emotional, but there are many other stressors like for example surgeries, a major car accident or other physical trauma, other autoimmune activation, pathogenic microbes, toxicity, and chronic viral infection.

Toxin build-ups
Toxin build-up can be caused by toxin exposure or poor detoxification abilities. In people with exposure to mercury for example (which you can find in amalgam teeth fillings) we often see candida overgrowth since candida can scavenge mercury and provide some protection against this heavy metal.

Food sensitivities/Gluten & Dairy
Last on the list, but maybe one of the first things to do are avoiding food sensitivities. Food sensitivities cause the immune system to be busy as well and cause inflammation in the body.

In people with leaky gut or people who experience auto-immune disease, I often recommend avoiding gluten & dairy in total. In the first period, if she has it in her, I would recommend going even grain free. Just temporary.

Can a plant-based diet be part of the cure?
Sure! Why not? Keep in mind that a plant-based diet often provides us with lots of copper which can prevent zinc to be absorbed and cause low zinc in the body. 

In these diets, we often remove a lot of ‘junk’ where part of the magic comes from. Clean plant-based diets are full of nutrients and can help as well.

Just keep in mind that some of these root causes might not be addressed by plant-based diets. No amount of vegetables will reduce stress and increase vitamin D. In the case of yeast/mold/parasites in the gut a plant-based diet might not be enough as well.

I hope this provides you with some information on where to start!

[Daniel]

Hey ,

Lab results can provide more insight into what might be at play. If you feel like sharing your husband’s results, we could give more targeted advice.

If there are any other symptoms present, these can help us find clues as to why your husband can’t lose weight as well. For example

Blood sugar dysregulation:
Blood sugar dysregulation can cause weight gain and can make it hard to lose weight. With insulin resistance, other symptoms can present as well, like:
• Frequent urination
• Increased thirst
• Fatigue, especially after eating a meal
• Blurred vision
• Cravings for sugar
• Insomnia
• Memory problems

A more detailed description of symptoms you can find in this video and this one as well.

Hypothyroidism
When we aren’t able to produce enough of the hormone free T3 (fT3) we call this hypothyroidism. This makes it hard to lose weight as well. Other symptoms that could present are:
• Feeling cold
• Hair loss
• Fatigue
• Thinning of eyebrows (especially the outer third of the eyebrow)
• Constipation (not able to get one bowel movement per day)
• Dry skin

A more detailed list of symptoms you can find here.

Stress
When the body experiences a lot of stress, this can interfere with the function of fT3. The body can produce in this case more reverse T3. Reverse T3 looks like free T3, but is slightly different. It fits on the same receptors as free T3, but it doesn’t cause activate it in the same way as free T3 causing metabolism to slow down.

Inflammation caused by stress can also reduce the body’s ability to form T3 from T4 (the metabolic inactive form of thyroid hormone)

Things that can cause a stress response, besides emotional stress are:
• (Chronic) Infections
• Sleep deprivation
• Inflammation
• (Chronic) pain

It’s usually not the first step for a doctor to measure minerals when people experience problems with losing weight. Was there another reason perhaps to measure minerals? What minerals were measured?

Digestive enzymes can play a role in digestion. The pancreas (which produces insulin to regulate blood sugars), when inflamed, can produce fewer pancreatic enzymes. A high-stress state can also negatively influence enzyme production.

What digestive enzymes were measured? And can you help us understand why these enzymes were measured in the first place?

If it was a regular doctor you have spoken to, it might be that your doctor measured liver enzymes. Although the liver is involved in digestion, liver enzymes don’t help digestion but help indicate when the liver struggles. Usually they are also measured for different reasons. You will find on your lab results abbreviations like ALT(or ALAT), AST (or ALAT) and GGT. Alkaline phosphatase is also often measured in a liver panel.

[Daniel]

Hey ,

There could be several reasons why skin can get discoloured. Eczema, allergies, some fungi, viruses and bacteria… all these reasons can cause discolouration of the skin. Skin can lose its colour when melanin production gets prevented. When the circulation is impaired and blood doesn’t go back to the heart, this can cause discolouration as well. 

There are many reasons, but perhaps you could tell us more about what discolouring looks like since there are many types of discolouration.

[Daniel]

Hey ,

When symptoms in winter appear (provided you live in an area where you might see less sunlight) I’m always curious about your serum vitamin D levels. As you may know, vitamin D is a nutrient/hormone needed to produce white blood cells.

The reason why corticosteroids like Betamethasone Valerate are prescribed is because corticosteroids reduce inflammation. Corticosteroids resemble the stress hormone cortisol. This is why a higher intake of corticosteroids can also reduce the body’s need to produce cortisol.

Am I understanding correctly that you have experienced acid reflux after using Betamethasone Valerate? This could be related since stress hormones impact the function of your digestive tract. Acid reflux is also seen when people experience a lot of stress for example.

You might want to check your vitamin D levels. I usually would like my clients to have serum vitamin D levels around 70 ng/ml.

Other nutrients that are needed to produce white blood cells are zinc, vitamin B12, folate and vitamin A.

Often debris trapped in pores can cause different kinds of skin issues. Topical retinoid creams (they contain vitamin A) might be helpful since they can help unclog and loosen pores. Warm baths can help as well. Make sure that your legs aren’t covered by tight clothing.

Hydration is important as well for the skin. This sounds simple and basic, but for skin care it is important.

Other nutrients that might be helpful with skin rashes are magnesium and B vitamins (B9, B12 and B6 are key for methylation, but also keep in mind that B2, B5 and biotin are important for skin health.)

Did your doctor take a look at your liver enzymes?  If you see ALAT (or ALT), ASAT (or ALT), bilirubin and alkaline phosphatase have been measured, you might want to share those results with us. If the hepatic-biliary system struggles, this can influence skin health as well. In this case, supporting liver and bile function can be helpful as well.

A lot of the recommendations for acne could be helpful for you as well. Therefore this handout might be helpful.

[Daniel]

Hey ,

Am I correct to assume sleep is the most important thing for you?

If it is, the Oura ring can provide you with the insight when your sleep is improving. It also is pretty accurate in recognizing deep sleep vs being awake.

It can also help you with what habbits (for example what behaviours in your evening) will influence the quality of your sleep. You will need to log these behaviours of course.

It’s just not really accurate in recognizing rem sleep/light sleep. This problem exists with most sleep trackers. I think the Oura ring is pretty good, but only in recognizing REM sleep it isn’t the best.

[Daniel]

Hey ,

Good question. Since it is a general question, I can only provide you with some guidelines.

To me, it depends on how the person feels. If this person has symptoms I might give a different answer versus if a person wants to learn how to optimize health.

If someone wants to reduce inflammation, removing food intolerances can help. Foods we often eat can become a problem when digestion is impaired and cause inflammation. Gut-related symptoms like constipation, diarrhea, bloating, gas, and cramps become clues to asses if I would like to do a food intolerance test. Auto-immune disease, joint pain, skin problems like acne, psoriasis, rashes and eczema as well.

When removing foods brings relief, addressing the root cause becomes important as well. Immune support and gut healing are often part of the health journey.

Something to keep in mind when doing a food intolerance test: the body can also react to lectins, mycotoxins, chemical additives, histamine and other triggers in food which will not always show up on a food intolerance test. This is why the gold standard is still an elimination diet.

If the goal is improving general health, variety, in general, would be better. If you would like to examine the impact of the current food pattern on how the immune system reacts a food intolerance test will provide you with insight. 

Just remember that other foods could still be a problem. Foods that this person hasn’t eaten for the last few months, won’t show up on a food intolerance test. 

If you like to know more about how this person would react to other foods, you could ask this person (if this is optional) to eat different foods for a few days before taking the food intolerance test. This might bring up other intolerance that otherwise won’t show up on the test.

I hope this helps!

[Daniel]

Hey ,

It also depends on what you like to learn from the Oura ring. For example, the Oura ring measures HRV which I think is an important measure that can help you learn if you experience stress. The HRV measurement is accurate when you are not moving too much, but becomes unreliable when you’re moving a lot.

For tracking sleep it can estimate well if you are in deep sleep. It is less accurate (compared to an EEG measurement) in estimating if you are in REM and light sleep. If sleep is something you like to track, it is pretty good, but not the best.

One important detail: when you choose an Oura ring, make sure the size is right. If your ring is too big, the readings become inaccurate.

[Daniel]

 If you were on vitamin D supplements for 3 months before you tested I would say that you are still on the low end. If not, retesting vitamin D might be an option. 

[Daniel]

Hey ,

I would first focus on getting in the nutrients that are needed for cortisol production. Vitamin B5 is needed as a cofactor to produce cortisol. Vitamin C is a very important nutrient for the adrenals as well. Nutrients that help the mitochondria like CoQ10, PQQ, folate and B12  and benfotiamine (the lipid-soluble version of vitamin B1) can help, because cortisol is made in the mitochondria.

If you experience constipation, I would address this as well. Estrogen in the gut can be reabsorbed. A noticeable amount of estrogen can be reabsorbed after 24 hours. I know this doesn’t zoom directly into the cortisol question, but if you expect toxicity issues (from mold for example), having a bowel movement at least once per day is important to help you detoxify.

Since we talk about, giving the body support to fight inflammation is important as well. Get your vitamin D in the right range, support with 2-4 grams of fish oil, and curcumin and follow, stimulate glutathione production (NAC will help, but nutrients like vitamin b6 and selenium are necessary too!) and an anti-inflammatory lifestyle/diet as well as you can.

My next tip would be supporting the circadian rhythm. Get sunlight in the morning max 30 minutes after waking up. If possible move/exercise in the morning. Make sure your evening is without too much stimulating activity. I know this part can be difficult for some people, but reducing the bad habits will usually impact a lot and will help the healing choices to make more impact.

If you are searching for a stimulating adaptogen, you could try Siberian ginseng. Rhodiola can be stimulatory as well, but research is mixed in combination with estrogen dominance symptoms.

Castor Oil packs can help with liver detoxification. Just keep in mind that cortisol has an anti-inflammatory function. When it’s low, your ability to fight inflammation is reduced as well. When upregulation detoxification with supplements makes you feel worse, I would reduce these supplements.

Again, a lot of this information you will find in the course called ‘Detoxifying from mold’ 

[Daniel]

Hey ,

In this case the conversion is really easy. If you want to go from nmol/l to ng/mL, you just divide through 2.5.

96 nmol/l is 38.4 ng/mL of serum vitamin D.

How long have you been on vitamin D supplementation? 

[Daniel]

Hey ,

I don’t know what Dr. Ben Lynch posted, unfortunately. However, on a traditional panel, triglycerides and HDL are always mentioned.

The Triglyceride/HDL ratio can be calculated from this – which isn’t often on the report (sometimes it is though). On a traditional panel, you will find the cholesterol ratio (which is total cholesterol devided by HDL). This ratio isn’t a ratio I personally pay a lot of attention to.

It is the triglyceride/HDL ratio that can help you assess your risk. You would like to have it below 2.

Other markers
The other markers in my previous response, which aren’t on a traditional panel, are ‘stronger’. Especially the pattern A/B information, the ApoB and the Lp(a) markers. I’m just mentioning it if you are considering more advanced labs.

One last note on Lp(a). Lp(a) doesn’t vary much in a lifetime. It is more genetically influenced. If you measure it only once in a lifetime, it would help you understand if you belong to the group of 20 per cent that is more vulnerable to plaque forming. 

[Daniel]

Hey ,

Mold toxins can definitely mess up female hormones! I would recommend you to watch the entire mold course (which you can find here).

Insulin resistance can cause elevated androgens (like DHT or dihydrotestosterone). However less known is that insulin resistance can lower SHBG (Sex Hormone Binding Globulin, which binds sex hormones making them inactive). When SHBG lowers, this can cause elevations in estrogen as well.

Having your fasting insulin measured can help you spot insulin resistance. Even when you work out, it still is a good idea. I once went to a course in Canada for personal trainers where we measured blood sugars. Half of the personal trainers there had elevations in blood sugar showing evidence of insulin resistance!

Liquorice can be a helpful supplement, but compounds found in liquorice root are also estrogenic and can activate estrogen receptors in the body. You can simply experiment with leaving the supplement out of your supplement stack for a while and see if you find some relief.

Your melatonin looks a bit on the higher end. This can be because of several reasons. Having lots of tryptophan in the diet can be a cause. Sometimes higher levels of vitamin B6 can cause melatonin to elevate as well.

Another reason for elevations in melatonin can be caused by the liver, Melatonin is also produced by the liver as an antioxidant to protect against free radicals. If mold is at play, the liver might be working harder.

The liver plays a role in detoxifying estrogen as well. Having liver enzymes tested can help you find clues if your liver is detoxifying well. 

[Daniel]

Hey ,

Thank you! It was written with pleasure!