[Daniel]

Hey ,

Attention and concentration difficulties can be caused by a variety of reasons. Math on top of that can be a specific obstacle for a lot of kids as well. You mention your daughter has an issue with focus and is quickly distracted. Of course, other possibilities and circumstances in her life can play a role in this dynamic as well.

But that being said, a wide range of causes can result in concentration problems. From more lifestyle-related causes related to sleep hygiene, and screen time (tv/laptop/phone) to more esoteric possibilities like slow thyroid, food sensitivities & toxin exposure.

To help your daughter better, maybe you can describe to us how your daughter would describe her concentration/memory problem.

Does your daughter for example complain about slow or sluggish thinking? Is it difficult for her to put her thoughts into words? Is she forgetful?

If she is experiencing some kind of brain fog, this can make it harder to take difficult subjects in school.

Also, nutrient deficiencies can contribute to concentration/memory problems. Here are the most common ones that can lead to cognitive challenges:
• Vitamin D
• Vitamin B12
• Iron (for signs & symptoms click here)
• Magnesium
• Zinc
• and yes, Omega 3’s

Omega 3’s are important for brain development and can help reduce inflammation in the brain. Optimizing these nutrients can be helpful for brain function in general.

For rapid relief I have had a good experience with:
• L-theanine (You can find this in tea)
It relaxes and helps with focus. Especially a few cups of tea can bring some relaxation to the mind & clarity.
• Rhodiola (it is an adaptogen and can be quite stimulating for some people, so be cautious with trying Rhodiola in the evening)

Personally, I don’t have experience with supplementing with B1 for optimizing focus. Maybe has.

If you think there is a possibility that ADHD/ADD plays a role, artificial colors and all preservatives, especially potassium or sodium benzoate have been shown to be an exacerbating factor.

Last but not least: math is a difficult subject. Not only to study but also to explain in simple language. Do you feel her tutor can explain the topics at a level that fits her age?

I hope these tips help!

[Daniel]

Hey ,

Great! I do see only the front page of the report. Is it possible to screenshot the other pages as well?

And how old is your daughter?

[Daniel]

Hey ,

In general, magnesium is necessary to relax muscles. Magnesium also helps you to deal better with emotional stress. One mechanism through which we think this works is because magnesium is making it less easy for the NMDA receptor in the brain to get excited. 

The NMDA receptor is a receptor for stimulating the neurotransmitter glutamate. With a magnesium deficiency, this receptor gets more easily stimulated.

So all absorbable magnesium can work calming in the presence of a magnesium deficiency.

The ‘bonus’ molecule attached to the magnesium determines how absorbable the magnesium gets. For example, magnesium glycinate is really good absorbable. On top of that, the glycinate molecule has calming properties as well and definitely would fit really good in a supplement targeting mental health.

Magnesium citrate gets absorbed as well, so it can improve mental health… because it has magnesium.

But magnesium citrate attracts also water to the column causing loose stools much faster than most other forms of magnesium. That’s why we recommend it when you experience constipation.

And a little insiders secret: Functional medicine practitioners always look up supplements by the ingredient list, and mostly ignore marketed names

[Daniel]

Hey ,

Detoxing your body is usually done from a place of strength. When toxins come back into circulation they are temporarily free before they get bound up and excreted. Does your kid feel a bit better? I would recommend ramping up detoxification only after your kid feels a bit better and meanwhile focusing on supporting the immune system.

Detoxification goes for a big part through the gut. If there is constipation, I would recommend addressing this first because toxins can be reabsorbed in the gut. Do you know if your kid has regular bowel movements? Preferably once a day?

Do you suspect some form of toxicity? Did you for example test for heavy metals? If so, would you mind sharing the test results with us? (If you have by chance an organic acid test, that would be insightful too)

Are there other toxins you suspect? Mycotoxins from mold or fungi? Bacterial toxins from for example clostridium?

It will be helpful to know so we can support you with the right kind of supplements to advise. 

There are still things you can do. Possibly you have already done this or are doing them. Here are some basics for detoxification. The first part helps you reduce toxin exposure. The second part are some detoxification recommendations for foods & nutrients. 

Here are some exposure sources for heavy metals. The list is inconclusive, but it contains sources that are more common:
• Community/School/Home playground equipment or decking made with pressure-treated wood –>  Dominant heavy metal: Arsenic
• Smoking (or lived/worked with) –> Dominant heavy metal: Cadmium.
• Heavy intake of large fish (e.g. tuna, swordfish) –>  Dominant heavy metal: Mercury.
• Heavy intake of shellfish (e.g. shrimps, scallops) –>  Dominant heavy metal: Arsenic
• Lived in old home with original plumbing & paint –>  Dominant heavy metal: Lead
• Silver/amalgam fillings –>  Dominant heavy metal: Mercury.
• Frequent intake of pesticide-laden foods (includes home gardens grown in prior farming land) –>  Dominant heavy metal: Arsenic, Cadmium, Lead.
• Welding and metalworking –>  Dominant heavy metal: Cadmium. (I guess your kid didn’t do such a thing, but I’m just giving you a complete list!)

Recommendations for foods:
The liver needs nutrients to make toxins water soluble so they can be excreted.

Some important detox pathways that you can support with nutrition:
• The Methylation Pathway. 
This needs foods rich in vitamin B12, folate, vitamin B6 & B2. If you are supporting with a b complex, make sure the b vitamins are in the bioactive form! So choose • methyl-cobalamine for B12, 
• methyl-folate for folate and 
• Pyridoxal-5-Phosphate (P-5-P) for vitamin B6
• The Sulfation Pathway
Foods that are rich in sulfur. Like:• Everything in the onion family: Leach, Onion, garlic, etc
• Everything in the cruciferous vegetable family: Broccoli, Brussels sprouts, Cabbages, Arugula, etc.
• Glutathione Pathway
Needs:• Vitamin B6
• Selenium (Think Brazil nuts, beef, turkey, chicken, beans & lentils)
• Amino acids (Because Glutathione is made of Glycine, Glutamine & Cysteine)

Although it doesn’t help the pathways above, I would like to mention cilantro as well, since it is often used for detoxification as well.

Let us know what type of toxins you suspect and why, so we can support you in the best way possible!

[Daniel]

Hey 

As you may recall from the mineral balance course (click here if you would like to see the playback) iron absorption is regulated by a hormone called Hepcidin. Hepcidin induction by inflammation is presumed to have evolved to sequester iron from pathogenic microorganisms.

An overgrowth of candida or another type of dysbiosis could definitely impair iron absorption by raising hepcidin. Candida (but also other microbes) can also exquisite iron for its own survival.
Reasons why we lose iron.Men and Women store between 1 and 3 grams of iron. Around 70% of your iron is stored as hemoglobin in the red blood cells. 10-20% is stored in the liver bound in a molecule called ferritin. 
• Heavy menstrual bleeding: Because so much iron is stored in blood menstruating women are in need of more than double the amount of iron than men on a daily basis. At the beginning of the menstrual cycle, women lose 2mg of iron extra. Heavy menstrual bleeding can contribute to her loss of iron
• Blood loss somewhere in the GI tract: A dark stool usually can be a sign of that. Do you know if she has a dark stool?
• Shedding of the skin & mucosal lining:  We lose 1 mg due to the shedding of the skin & mucosal surfaces like the lining of your gut. Possibly she is losing more iron because a dysbiosis/candida overgrowth is taxing the lining of her gut making her shed more on a daily basis. If she loses more skin (for example with dandruff) this can contribute as well.
• Long-distance running & intense frequent workouts exercise can also contribute to increased iron loss. 

Starting to reduce inflammation in the gut sounds like a very good first step in healing the body and making it more ready for iron absorption again.

If you need more tips, let us know!

[Daniel]

Hey ,

To be complete you can also ask your sister a few questions to see if her low energy levels are related to her thyroid health. Her medications could still be a problem, but other dynamics at play could be missed by having the focus on the thyroid only.

Here are some other reasons why people can be fatigued and some other symptoms that can result from that. You can explore together with your sister if she might be experiencing some of these other symptoms:

Vitamin B12, folate or B6 deficiency:
• Shortness of breath
• Cold hands & feet (A slow thyroid causes people often to have a cold feeling in the entire body. If she is experiencing this type of coldness, that could ‘mask’ this symptom of course)
• Pale skin
• Tingling sensations in the arms or feet
• A ringing sound in the ear
• Problems with the eyes

Not all symptoms have to be present of course. But she has a few of them, let her also check with her doctor for macrocytic anemia. 

Iron deficiency
• Same symptoms, because an iron deficiency can cause iron deficiency anemia. But in the case of iron deficiency, pale skin is often a more present symptom. You can also take a look at her lips or the mucous membrane behind her lips.
• Restless legs

Vitamin D deficiency:
• Muscle cramps
• pain in bones or back pain
• frequently sick
• Being more depressed in the winter (a slow thyroid can make people depressed as well, so this might not be the most helpful ‘symptom’

Magnesium deficiency
• GERD/Heartburn
• Stiffness in muscles
• Also Muscle cramps
• High blood pressure
• Being irritated/stressed more easily

Insulin resistance
• Need to urinate frequently
• Tired between meals
• Cravings for sweets/sugar after dinner
• Getting angry when hungry (hangry)
• Hard to lose weight as well

It might not be diagnostic, but it can give you some insight if there are other underlying dynamics at play as well.

Good luck!

[Daniel]

 

Usually what works really well with allergic rhinitis is a combination of quercetin and stinging nettle leaf. The leaf (don’t choose the root!) is usually freeze-dried. 

Especially the combination can reduce the histamine load on the body

If you are going to choose these supplements, then the dosage for stinging nettle leaf is as followed: for children between 5-12 take somewhere between 1/3 and 1/4 of the adult dosage (The therapeutic adult dosage is 300 mg 2-3x per day with allergic rhinitis).

I like the open-minded vision of your doctor. If you are going to try this, do it in collaboration with your doctor!

And if you sticking to NAET only, definitely share your results with us!

[Daniel]

Hey 

If you aren’t using any anti-histamine medication you can try a therapeutic dosage of 50 – 100 mg 2x spread over the day, taken on an empty stomach!

It might take 6-12 weeks to see some effects though!

As for the use of stinging nettle, I will let  answer that!

I hope this advice can give some relief!

[Daniel]

 

Thank you for providing us with so many details! In addition, could you tell us when your FSH was measured in your period? Was it during the follicular phase, luteal phase (or ovulation?)

When it comes to your questions on what labwork would provide us additional information:
• The Dutch test is a test I would highly recommend. In particular, The DUTCH Plus (click here) can provide us insight in • If you are estrogen dominant (and if so, what type of dominance)
• It provides us insight into how you breakdown estrogen
• It will show us how your androgen levels are
• It shows us your cortisol metabolism.

          How to prepare on The DUTCH complete you can find here.
• A full thyroid panel which includes:• TSH, fT4, fT3
• Anti-TPO & Anti-TG
• Reverse T3
• Fasting Insulin

Did I read correctly that you were low on energy? Or did you mean you had no low energy symptoms? If you are low on energy:
• Iron & Ferritin are important to check as well (could also cause brittle nails)
• RBC Zinc (Low zinc status could cause low thyroid symptoms and brittle nails as well)
• Vitamin D (which also helps with estrogen metabolism)

Magnesium is needed to break down estrogen. Although you didn’t mention any other symptoms of magnesium deficiency (except for low energy) I like to be thorough. Other symptoms of magnesium deficiency are GERD, Stiffness of muscles, and feeling easily irritated. Are those symptoms you experience? If you want to be sure about your magnesium status then test also for
• RBC Magnesium 

Maybe  has some additional lab tests she likes, but these are my recommendations!
 

[Daniel]

 Needles to say that a 7 day workweek can put a lot of mental pressure on someone. And yes, that can make someone very tired.

But the iron deficiency is real. She needs to address this if she wants to feel energetic again. Iron is needed for oxygen transport.

I don’t know her gut related problems of course, but be aware that those problems can be part of the root why she can’t absorb iron.

If she has trouble eating a healthy diet, start there. Her gut symptoms might already improve. Remember that iron supplements can sometimes cause constipation. If she is constipated, start with magnesiumcitrate to stimulate her bowel movements first.

If she has a normal bowel movement you can try dosing with iron. Just remember to do this when she isn’t sick. 

Remember to give her immune system more support as well!

Good luck and let us know if you need any more help!

[Daniel]

Hi ,

Fortunately, she shared her lab results with you! Since I only know her labs, I will only discuss some numbers and what they could indicate. Meanwhile, could you share a bit more about this person? For example, do you know:
• If she has any health complaints. And in particular, • do you also know if she has cold hands & feet, is feeling low on energy and do you know if she is having some cognitive issues for example problems with focusing or dizziness?
• Is she short of breath? Does she experience headaches? Possible ringing in the ears? Or pains in her legs?
• was she feeling sick at the moment of drawing blood?
• does she have gut-related complaints? (feeling bloated, constipation/diarrhoea, IBS or other complaints)
• How is her diet? Is she struggling for example with eating healthy?
• How would you assess her stress levels?
• How would she describe her menstrual flow? Is there a lot of blood loss?

So let’s discuss some of the ‘easy’ numbers!

Vitamin D
Optimal numbers for vitamin D are around 120 nmol/l or 50 ng/ml. Having a vitamin D3 supplement (and not a vitamin D2!) can be an easy way to bring her levels up. If she lives in a sunny area, some sun exposure can help her as well of course. Just remember that people with dark skin can need up to 6x longer sun exposure to raise vitamin D levels compared to people with light skin.

Iron
A lot of markers point to an iron deficiency. For example: her hemoglobin is clinically low and hemoglobin can drop when iron is insufficient.

Her ‘volume globulaire moyen’ is clinically low. This means that the average size of her red blood cells is too small. This can happen when there isn’t enough hemoglobin in the red blood cells present.

And on top of everything, her storage form of iron ‘ferritin’ is almost clinically low.

Based on these numbers I would say she is experiencing iron deficiency anemia.

Thyroid
Also, we see hints of a starting hypothyroid state on her thyroid panel. TSH is clinically elevated, but free T3 and free T4 are still in range. TSH is the hormone from the pituitary telling (or in this case perhaps screaming is the better word)to the thyroid to make thyroid hormones T3 & T4. The thyroid is still reacting, but in her situation, I wouldn’t be surprised as this will start to change. These elevations could also be caused by an iron deficiency since iron is needed for optimal thyroid hormone balance.

Prolactin
Prolactin is elevated and this can be caused by a low thyroid state. But be aware that small elevations of prolactin can also mean other things. It could be an indication of a prolactinoma as well, so this does deserve special attention from her doctor in my opinion.

Vitamin B6
Her liver enzymes are in the reference range (which is good), but really low. Especially the value of ALAT is so low like the body is struggling with producing the enzymes. This is a picture we often see when there is a lack of vitamin B6. A lack of vitamin B6 can cause anemia as well and can cause worsening of the already playing anemia.

Vitamin B12
Her vitamin B12 is on the lower end of the range. Ideally, we want B12 on the high end of the reference range.

White blood cells
Something seems to be going on there. It looks like an infection dynamic. This could also make her C reactive protein (a marker for inflammation) go up. But assessing white blood cells purely on numbers isn’t going to give us the complete picture. It would be better to know if there were any symptoms.

What to do first?
I would definitely support her with iron but only if she isn’t experiencing infections! This is why having more details is important. Infections can get worse on iron supplements. 

If she had an acute infection, let her recover from this first before working with iron supplements (which I will discuss in a moment)

Support also means thinking about why she is iron deficient in the first place:
• Is iron in her diet? Is she vegan? Or is she struggling with healthy food choices?
• Is she experiencing absorption problems? Does she have low stomach acid? IBS? SIBO? Crohn’s disease? Celiac disease? Has she surgically removed parts of her GI tract?
• Is she experiencing a lot of blood loss? For example, does she have a heavy menstrual flow? Did she donate blood recently? Or maybe she had an accident?
• Pregnancy sometimes can cause iron deficiency as well.

Supporting iron
In most scenario’s supporting her with iron is a good idea. Either through healthy food choices (which are hard with an iron deficiency because people experience a lot of fatigue often) or through the use of a liquid iron formula from pure encapsulations for example (click here)

It will take a while (at least 3 months) before all her red blood cells died off and are replaced with healthy ones. Having a regular workout routine can speed up the process, although again, because of fatigue, this can be hard.

Be aware, sometimes supplementing with iron can cause constipation. Make sure when you start supplementing iron she is not constipated, because you won’t be able to tell if her iron supplement is causing a worsening of the dynamic.

Support her with the right multivitamin
Giving her a good quality multivitamin with the b vitamins in the methylated form would give her nutrients that support thyroid health as well. A healthy thyroid hormone balance depends for example also on iodine, selenium, zinc, and vitamin A & D. Supporting her for example with an iron-free multivitamin like vita-prime iron free from Klaire Labs (click here) will make it easier with dosing the right amount of iron.

Because of the possible B6 deficiency, start low and slow with the multivitamin. In the Klaire Labs formulation is 15 mg of B6 per serving. 1 serving is 2 tablets. So you can start with 1 tablet per day or even every other day and slowly work your way to a full serving size per day. Vitamin B6 is essential for detoxification and opening detoxification pathways too fast can cause problems.

Vitamin D
The multivitamin has 15 mcg (600 IU) of vitamin D. This probably won’t be enough to raise her vitamin D levels to the optimal zone. I would recommend somewhere from 2000IU to 5000IU to start with and then retest her values after a while.

I hope this helped!

[Daniel]

Hie  

I would just like to add that the book ‘Dirty Genes’, from Ben Lynch is also a really good recommendation. It’s easy to read and gives a lot of practical advice as well!

[Daniel]

Hi ,

Being aware of the MTHFR mutation or better said a Single Nucleotide Polymorphism(SNP) can make people more aware of how important some lifestyle choices are for them. But because not everyone with an MTHFR SNP has health problems I base my recommendations normally on a clinical picture.

MTHFR, as you probably know,  is an enzyme that is needed in the so-called methylation cycle. In this cycle, methionine gets converted into homocysteine and back. The goal of the methylation cycle is to donate methyl groups to other molecules, which is important for so many things:
• It is needed to create neurotransmitters
• It is needed for cardiovascular health
• It is needed to protect & read our DNA
• Detoxification (for example of heavy metals)

And the list goes on.

Let’s say someone comes to me with a clinical picture, for example, elevated homocysteïne, which we know is a risk factor for heart disease.

Even with a possible MTHFR SNP present, there are many reasons why homocysteine can be elevated, like
• Kidney problems
• Low thyroid hormone levels
• B12, B9 or B6 deficiency (through malnutrition or malabsorption)
• Psoriasis is associated with high homocysteïne
• and other genetic conditions.

First I will, without testing, support the methylation cycle by recommendations like taking a b complex or a multivitamin with the B vitamins in the methylated form, because the enzyme MTHFR helps folate to transform in the methylated form.

Pay in your recommendations also attention to Riboflavin
Another pearl is that vitamin B2 or riboflavin is needed to activate the enzyme MTHFR.  Vitamin B2 is important for people who carry MTHFR SNP, but people deficient in B2 can display the same symptoms, since the enzyme MTHFR cannot be activated. Food sources of B2 are for example eggs, meat, chicken, salmon, almonds and spinach, but make sure they are enough in the diet.

Supporting methylation with choline
I will also support the conversion from homocysteine to methionine via the second pathway which depends on choline. You could use choline supplements or focus on foods rich in choline like eggs, liver, kidney salmon, shiitake, soybeans (GMO free & organic are best choices here), beef, chicken & turkey, and many more. Daily recommendations for men and women are 550 and 425 mg. (And are often not met!)

Homocysteine can also be broken down in the transsulfuration pathway which is needed for detoxification. This pathway needs nutrients like selenium, B6 & serine.

When do I test for SNPs?
Usually, I support the body by overcoming a possible MTHFR SNP first. Then I focus on ruling out other possibilities that could lead to the clinical picture my client comes for. Testing for mutations comes third or later. Just be aware: SNPs on MTHFR are common. But other SNPs are known to influence the methylation cycle as well. MTR & MTRR for example.

Slow versions of these enzymes can lead to a build-up of homocysteine as well, but won’t be overcome by supplementing methyl folate.

If I would do SNP testing I would check for more than MTHFR alone. you could for example test at 23andme.com.

Obviously, if family members are tested positive for an MTHFR SNP, this would influence my priorities, but as a rule of thumb, DNA testing isn’t usually the first thing I would do.

Remember that also here: genetics loads the gun and the environment pulls the trigger!

Hope this helps

[Daniel]

 Thank you for sharing your experience   I hope you by now could reduce the heartburn symptoms!

Sharing the social obstacles is very insightful and could help us share better tailored tips and advices!

Is there by the way any help right now you need on reducing your heartburn symptoms?

[Daniel]

 Great! In other posts you also mentioned you have low ferritin (the storage form of iron). Since iron is a key nutriënt for thyroid hormone metabolism, I have some additional tips. Possibly you are already aware, consider them then as gentle reminders

Increasing iron absorption
• Iron needs stomach acid to be absorbed, so the betain HCl can help. If you are using iron as a supplement, combine this when you use betain HCl.
• In addition: vitamin C increases iron absorption as well.
• Iron coming from meat is also better absorbed than iron from plant-based foods.

Another thing to be aware of
If you are low on iron, this could lead to iron deficiency anaemia. Treating it doesn’t change anything, but… in this case, ferritin goes up until your red blood cells have enough Hemoglobin. In the case of iron deficient anaemia, this can take from 3 to 6 months.

Tips for additional thyroid tests:
If you are considering additional thyroid testing because you want to know why your thyroid hormones are low I would recommend you test besides your T4 & T3 hormones also for thyroid antibodies. Just to rule out that your low thyroid is caused by an autoimmune dynamic. If you express your concerns to your doctor, they could test them.

Reverse T3
If you want to be really comprehensive in your testing, test also for reverse T3. Reverse T3 looks just like T3, except it’s the mirror image of T3. So if reverse T3 occupies the thyroid receptor, it doesn’t lead to an activated metabolism. The body usually elevates reverse T3 when you are stressed or with prolonged sickness

I don’t know the protocol for doctors in your country, but reverse T3 isn’t tested often by doctors. Reverse T3 can however provide insight into why your thyroid is low.

Back to your initial question: How long does it take for stomach acid to return?
Depending on the dynamics that are at play. It might depend on how fast your Thyroid hormones are getting back in balance. If aneamia is at play it could take longer because the red blood cell quality might get priority first.