[Daniel]

Hey  ,

Let me answer your questions!

Questions about the recording:
What Dr. Ralph is saying is that Atorvastatin & rosuvastatin have the potential to increase insulin resistance. He is a fan of red yeast rice as a natural alternative to statin medication. Red yeast rice contains chemicals that are similar to prescription statin medications. One of these, called monacolin K, has the same makeup as the drug lovastatin.

Questions related to your husband’s wish to increase protein:
Am I right to assume that the goal of your husband is to lose weight and that he would like to increase protein to decrease muscle loss as much as possible? If so, can you tell me a little more about his health & lifestyle? For example:  
• how are his kidneys functioning? 
• Is he on a plant-based diet? And can you give me an indication of how much protein he is currently having in his diet? 
• How high is his blood pressure with the medication?
• How high would his blood pressure be without the calcium channel blocker he uses?
• What type of workouts is he doing and what benefits would he like to get from his workouts? 

[Daniel]

Hey  ,

For some reason, I can’t open the pdf. Perhaps the password you gave isn’t the right one?

[Daniel]

,

I totally over focused on the iodine in the lab yesterday, I’m sorry! Low bodyweight, low muscle muscle mass and dietary choices like low protein intake can cause lower creatinine levels. With these values I would adv se you to rule out kidney and liver dysfunction as well. Especially in combination with symptoms of kidney problems!

[Daniel]

Hey ,

That’s exciting for both of you! Your son is lucky with such a caring mother! Is there anything in particular you are worried about?

There is a handout called B’s Medicine Cabinet Must Haves in which you can find some general inspiration if you like. 

If he is sick regularly, you can also perhaps teach him the importance of nutrients that are needed to build white blood cells like vitamin D, A, zinc and vitamin B12.

Let us know if you are searching for something more specific!

[Daniel]

Hey ,

While editing my response I must have by accident deleted the hyperlink to the supplement, I’m sorry! I was referring to this product from Designs for Health: Super Liquid Folate. It contains folate (but in a different form) and a tiny bit of vitamin B12.

I’m saying tiny. But compared to the amount of B12 in food it’s still a lot.

You can use it together with your current B complex. Make sure you combine both supplements with food.

You can use it in 2 ways:

1️⃣ Take it together with the other B complex. If you do it like this it will increase your serum B12, but not a lot. 

2️⃣ Take it away from the other B complex. If you do it like this, it will increase your serum B12 more.
The reason has to do with the 2 different ways in which vitamin B12 gets absorbed. One is very efficient. One is super inefficient. 

The efficient way depends on intrinsic factor (a taxi for B12) produced by the stomach. 

In the first scenario (1️⃣), you’re taking both supplements together. You might get more B12, but since all intrinsic factor is already being taken up, the extra B12 from Super Liquid Folate depends on the super inefficient way to enter the body.

In the second scenario (2️⃣), you’re taking super liquid folate away from the b complex. Now the B12 from super liquid folate doesn’t compete with the other B12 from the B complex for intrinsic factor. Taking the supplements in this way can push your serum B12 harder.

I hope it now makes sense now

[Daniel]

Hey ,

According to this test, it’s low. Testing Iodine however can be done in several ways and there is some discussion as to how accurate some of these tests are. A 24-hour iodine loading test looks like one of the most accurate ways to test iodine, but I don’t believe that this is the result of such a test. If you like to know more about the pros and cons of a 24 hours iodine loading test, I recommend you watch this movie as well. 

Tests alone never paint the entire picture. If symptoms of iodine deficiency are present (you can find a summary here) you might want to know if you’re iodine deficient. Low iodine can cause a hypothyroid state and this test might make you more suspicious. Just keep in mind that there are other ways to get symptoms of hypothyroidism.

[Daniel]

Hey     

Designs for Health has a liquid supplement that would fit. The form of folate would be slightly different – and perhaps you might react better to this one. 

You’ve encountered this form before I believe when you were exploring supplements for seeking health: folinic acid (or calcium folinate as it’s called as well). This form of folate is also suitable for people who have a common mutation of the MTHFR gene. If you aren’t familiar with this, don’t worry. Forget I wrote it!

The amount of B12 in the supplement is low. Still, it could impact your serum B12 significantly. B12 absorption goes either via diffusion (which is very very very inefficient) or B12 binds to intrinsic factor produced in the stomach. 

If you’re taking this supplement with a different meal as you would take your liquid B complex from Metabolix, the B12 can bind to the available unused intrinsic factor produced in the stomach, pushing your B12 up significantly.

If you don’t like to raise your B12 that much, you can take this supplement together with the liquid B complex. That probably won’t change your B12 status much since the extra B12 needs to enter the body via diffusion.

This is how you can play a bit with your vitamin B12 status. Just remember while doing this: your B12 status was always slightly below the ideal range. That means, to get it up in the ideal range, it probably needs a very gentle push. 

That’s why I would choose this one

[Daniel]

Hey  ,

Although your folate levels struggle to get up, I wouldn’t conclude that the supplement isn’t working. There can be more reasons for why folate isn’t going up:
• Impaired absorption: gut issues can decrease folate uptake. For example, people with celiac disease or yeast overgrowth can struggle to absorb different nutrients. 
• Increased need by the body: The body simply requires more folate than is absorbed. Folate is for example a cofactor for the enzyme HMNT that helps break down histamine. If you’re dealing with histamine intolerance, the body needs more folate. 

Folate is needed to create red blood cells as well.
• Alcohol: drinking alcohol can decrease folate absorption. Alcohol can also be internally produced by yeast when a yeast overgrowth is present. In fact, this is why we use yeast to brew beer for example.

In short, I think it might not be the supplement that is the problem. it is the folate balance that needs to be addressed. Serum folate is simply the sum of the folate being absorbed and used at that moment in time.

I know I’ve written in earlier posts you could increase the amount of methyl folate if serum folate wouldn’t come up. The amount of folate in the B complex you’re taking is the amount of folate recommended daily and might not be enough to bring serum folate up.

Have you tried that?

[Daniel]

Hey ,

I’m so sorry to hear this! Do you feel this is the result of being more alone? Or are you also worried there might be an underlying health condition?

I feel you like to change something, but are struggling to do so because something about this routine feels good. In those cases with my clients, before I make any plans, I like to have a good conversation about what keeps them in their routine. The most important questions to answer first in my opinion are related to the choices you are currently making and the behaviour you would like to change.

Then the second step is to build a plan from those answers.

These are the questions I usually ask my clients. The more detailed, the better:
• What are the downsides of continuing your current lifestyle choices? (I think you’ve answered this question, but if you like to add something, feel free to do so)
• What are the benefits of your current choices?
This question is important because if there is something you are getting out of the behaviour you like to change, it’s more likely you will get back to your old lifestyle choices.
• What are the benefits of the change you’re seeking?
• And what might be the downside of change?
Let me give an example: if you are a person that likes to have a lot of time alone, it might be difficult to build a plan that is based on social appointments.

If you feel the root cause of your memory problems might be related to your physical health let us know and we can steer you in the right direction as well. If your curious, we’ve got a handout that you might find interesting.

Just click here to find it!

[Daniel]

Hey   ,

With autoimmune urticaria (just like with every autoimmune disease in general) there are genetic components and environmental components. In this specific autoimmune disease, the body attacks mastcells. Mastcells produce histamine and this can lead to rashes as well.

It’s worth to discuss with your doctor the option to rule out autoimmune urticaria.

Depending on the cause, we’ve got some good handouts for viral support (click here) or how to approach autoimmune issues (just click here)

[Daniel]

 Hey ,

Contact dermatitis is a rash caused by an allergic reaction. It could be initiated by something he was exposed to on the skin. Fregnances, soaps, detergents, plants, pets etc. Removing the exposure source is hard, but it’s step one.

About the last pictures you shared: Once the allergen has entered the body, the body might react more systemically. Again, I can’t tell you what is on the last pictures, but it might be a more systemic allergic reaction. By this I mean a reaction coming from within the body. If you’re using corticosteroids, they might not help with the new skin rashes. This is something you should discuss with your doctor.

Here are some other practical tips:
• Histamine is released and can contribute to symptoms. Scratching the body against the itchy feeling on the skin causes more immune activation. It is the immune cells that release histamine. Scratching can make symptoms worse
• Quercetin and Stinging nettle leaf are natural antihistamines and can help reduce histamine in circulation.

If you’ve removed the allergen, you’re ready to address the root causes.

With allergies, the immune system reacts aggressively to an allergen. Often there is a gut component to it. If the gut is leaky, the immune system deals with stuff that shouldn’t be in the body and can start recognizing undigested foods as a threat. Here you can find more about what can cause a leaky gut.

More recent ideas about how allergies start are through the skin as well. Dry skin for example is associated with microscopic holes in the skin (similar to the gut you could say ‘leaky skin’). The immune system under the skin can react similarly to what enters through those microscopic wholes. Dr. Kari Nadeau explains this well if you like to learn more about allergies.

Making sure your son has good levels of vitamin D and good gut health is important. Constipation, diarrhoea, feeling bloated, cramps… if you’re noticing these symptoms you might want to dive into the gut health masterclass. Good levels of vitamin D are important for keeping the tight junctions closed (basically the doors between cells in the gut lining). When gut symptoms present, you could check him for lactose intolerance or try a food elimination diet and see if some foods contribute to this dynamic.

If some gut healing is necessary then this video might help you as well.

We also have a handout in the symptom dictionary that you might find helpful. Just check it out and if you’ve got any further questions, let me know!

Usually, if you’ve removed the trigger to contact dermatitis, the rashes will heal, but it can take 2 weeks or longer depending on the severity of the rash!

[Daniel]

Hey ,

I can imagine you are worried about your kid. We can help you guide through what to do once a diagnosis has been made. But a diagnosis must be made by a healthcare professional who sees your six-year-old. He/she needs to see the skin clearly, ask how the bumps have progressed over time and get feedback on how your kid is feeling and reacting.

It’s weird to say, but pictures never ever paint a full picture, unfortunately. 

I hope that made sense!

[Daniel]

Hey ,

Thank you for the compliment! It’s much appreciated! I hope I can answer your questions, but I might need some additional information here and there.
1. If someone has a variation on the COMT gene that makes the COMT enzyme less effective, it becomes a balancing act. Having enough magnesium will help the enzyme to become more effective. Besides estrogen, COMT breaks down catecholamines like (nor)adrenaline and dopamine. This is why stress reduction can help. More COMT enzyme is needed to break down adrenaline if more adrenaline is made. This can influence how women break down estrogen and contribute to higher estrogen concentrations, however…

COMT determines the speed at which estrogen gets broken down, but the most impact you can make on high estrogen states often is by focusing on what elevates estrogen. Here are some sources of what can elevate estrogen

– Bodyfat produces estrogen
– Histamine release can elevate estrogen
– Constipation can cause estrogen to be reabsorbed in the gut
– Sources of estrogen outside her body can cause elevations of estrogen
– Alcohol
– Sluggish liver function
2. Determining the ratio can be helpful when estrogen and progesterone are within the reference ranges, but estrogen dominance symptoms are still present.

In women with a healthy hormonal balance, the progesterone-to-estradiol ratio in blood (and not in saliva) typically falls between 100 to 500 (based on this research – which was done with women who became pregnant as a reference of a healthy hormone ratio). If the ratio exceeds 500, it may suggest progesterone dominance, while a percentage lower than 100 may indicate estrogen dominance. 

When women go through perimenopause I honestly don’t like to guide myself too much by this ratio. Estrogen levels can go up and down in an irregular pattern. This means the ratio can change and give you a false sense of what might be going on. 
3. I can’t help you based on numbers only, but I can give you some guidance. Using the ratio here wouldn’t make sense since she is 50. She is in perimenopause, close to menopause.

In this case, progesterone is low. For that reason, I would consider the low progesterone as a cause of her estrogen dominance symptoms. I can’t tell if the progesterone cream isn’t enough, isn’t well absorbed or isn’t well used. That’s best evaluated by a professional who sees her.

Progesterone is made in the ovaries and a little bit in the adrenals. Stress will lower her own progesterone production. You can consider adrenal support as well since her ovaries contribute less and less to her body’s progesterone production.

High testosterone
I don’t know if the progesterone cream from NOW could influence her testosterone. But taking a step back: have you checked her fasting insulin levels? Insulin resistance can cause elevations in testosterone. 

I hope this answers a few of your questions, without creating a lot of new ones!

[Daniel]

Hey ,

I wish I could help you with a diagnosis based on a picture, but that’s impossible. But I can help you get on your way. If you suspect this is an allergic reaction, I’m curious as to why you believe this and what you think you are reacting to. 

To help you find out what you’re dealing with, I’ve got some additional questions for you:
• Did these bumps appear after some form of physical activity like standing, walking or some form of sport (like playing golf for example)?
• Did the bumps appear as a reaction to heat?
• Did the bumps appear as a reaction to sweat?
• Are you using any medications?
• And what is your age?

Here are some ideas to consider:
• A heat allergy / or a reaction to heat that isn’t allergic
• Blood vessel congestion
• Bacterial/fungi infection (like early stages of candida for example)

To be sure what you’re dealing with I recommend you let a healthcare professional take a look at it. Once you know what it is, we can guide you in your healing journey by addressing the root cause.

[Daniel]

Hey ,

In addition to my response yesterday, I forgot to write down that calcium can also be deposited as a result of trauma in the rotator cuff tendon in an attempt to heal the body. You wrote you’ve experienced shoulder and neck problems in the past. Even treatments (like injections) can cause trauma to the area.

If the body is trying to heal from older trauma, then elevations in calcium and hormones that regulate calcium (I’m referring to ParaThryroid Hormone or PTH for short) can be functional.

Here are lab values that I personally would like to know:

To assess calcium balance in the body:
• Serum Calcium
• PTH
• Vitamin D

To assess kidney function:
• eGFR
• Creatinin
• BUN

To assess blood sugar balance:
• Fasting Insulin
• Fasting glucose / HbA1c

To assess inflammation:
• CRP
• Iron and Ferritin

To assess Thyroid hormone balance:
• Check out this movie since this topic requires a little more background.

To assess immune system function:
• A White Blood cell Count (WBC) including a differentiation of the types of white blood cells. If this is new to you I would recommend the next 2 videos in the newly launched course: this video and this one as well.

As a rule of thumb, In functional medicine, we like to know everything because we believe everything in the body is connected.

Tips for treatment
Because I can’t assess exactly what happened during your physiotherapy session, I can’t recommend the type of therapy I usually would recommend. I do recommend discussing with your therapist if strengthening muscles would help.

I would also recommend you to follow an anti-inflammatory lifestyle. to support your body.

Minimize sugar, flour products and other foods that spike blood sugar.

Maximize sleep quality and foods that are anti-inflammatory. Fish oil is a good supplement. I usually recommend 2000 to 4000 mg of EPA+DHA per day if inflammation is present. Curcumin and Boswellia are supplements that can with inflammation as well. If you’re low on vitamin D, getting your vitamin D levels up might be helpful as well. 

I hope these tips can help you!