Hey @Naveed Aslam,

I think I understand how you’ve read some of the lab values now! Let’s start with some general stuff!

Having some opportunistic bacteria is normal

In fact, I would like you to move away from the idea of ‘opportunistic bacteria’. It’s true that when we have too much of them, we like to reduce them. Too much of these bacteria can cause some health issues. However, small amounts of them might be necessary for a balanced microbiome.

Let’s take H. Pylori as an example. Most people have H. pylori living in the stomach.

This is normal.

If the environment of the GI tract is balanced and the immune system works like it supposed to, H.Pylori is there, but it’s under control.

How to read the numbers
The numbers you see on the report are in scientific notation. Let’s take H. Pylori as an example again. In the column ‘reference’ you see ‘< 1.00 e3’. e3 means you have to multiply the number with 1000 (a 1 with 3 zeros). ‘e2’ means: multiple with 100 (a 1 with 2 zeros). If your values of H. Pylori are below ‘1.00 e3’ or ‘1000’, this is considered good. Your most recent values are ‘2.58 e2’ (which means 2.58 multiplied by 100) or ‘258’. According to this test, these values are good. Antibodies Having all kinds of antibodies is normal as well. Low levels of Antigliadin IgA are present, but not in ways you need to worry about. Eosinophils are a type of white blood cells that are present in the gut. When they are activated, they release Eosinophil Active Protein that helps destroy cells from invaders. There will always be some degree of activation, especially in the gut where everything you eat from the outside world is passing through. High levels are a sign something is out of control. Low levels are usually indicative that there might be a lonely invader passing through that needs to be taken care of, but everything is ok. I hope these explanations make sense and put your mind at rest. Final note Getting the Akkermansia Muciniphila up can help you with diversity in the microbiome. A ‘healthy microbiome’ usually has between 1-3% of Akkermansia present. Diversity can influence the elevated numbers in the ‘opportunistic bacteria’ section. I often recommend probiotics with a wider spectrum, however introducing this keystone bacteria provides nutrition to a lot of other bacteria and can help good bacteria thrive. It might be something you could explore. I hope this answer helps Naveed!

Hey @Naveed Aslam,

I’m curious: why do you believe you’ve got H. Pylori back? This report says the opposite I believe. It says on the front of H. Pylori you’ve improved. Perhaps I’m looking at the wrong report?

The occult blood went down as well and that’s a good thing!

There are some things I would pay attention to. The elevations in the opportunistic/overgrowth microbes section for example. Staphylococcus aureus and Streptococcus spp are elevated on your lab reports. If you’re otherwise asymptomatic, bringing back some diversity in the microbiome can help bring back balance in the opportunistic section.

Akkermansia Muciniphila (one of the ‘keystone bacteria’) is undetectable on both your lab results. Akkermansia is a keystone bacteria because it supports a lot of other ‘good bacteria’ by producing Short Chain Fatty Acids. It also helps strengthen the gut lining and has been seen to reduce leaky gut.

I can find some research that Akkermansia is low in people with histamine intolerance. However, how supplementing with Akkermansia affects people who have histamine intolerance is not described (or at least not to my knowledge).

If you are going to try a supplement, finding good Akkermansia supplements is hard. I would recommend using this product from the brand pendulum. You might find the website informative as well.

B Glucuronidase

There are a few reasons why B Glucuronidase goes up. Eating sugary/processed foods is a big one. Smoking, alcohol and a high-fat diet can do it as well. Antibiotics could cause elevations as well.

Mildly elevated calprotectin
Calprotectin in the stool is an inflammatory marker. It is a little bit elevated, but to me, it just means something in your gut is going on. The upper part of the GI Map in this case is more important to me since it tells me what is going on.

I’m not seeing the elevations of anti-gliadin IgA as well. Or perhaps you meant something else?

If so, please let me know and I can help you clarify!

Hey @Bahareh Safapour,

Since you’re already doing many supporting things that can increase the HRV, I would like to start with the Oura ring itself. The Oura ring is an accurate device to check for heart rate and HRV (this wasn’t always the case. If you’re using an older model it might be an idea to try a newer model!)

The Oura ring also becomes less accurate if it doesn’t fit well. If you notice it is a bit loose (for example after losing some weight this could happen as well), its accuracy can drop. Good to check how the ring fits first.

I’m writing the rest of my answer on the assumption your ring fits well.

Usually, the HRV goes down when the sympathetic nervous system takes over from the parasympathetic nervous system.

Many things strengthen the vagal tone. As a general rule finding some form of ‘joy’ in life can help. However, if some joy in life is lost, if there are some unresolved emotional issues like trauma, the HRV might go down despite your efforts. Doing the things that should help you relax can be overpowered by thoughts and feelings that tell your body the environment isn’t safe.

This study even shows that perfectionism can make it difficult to raise your HRV after meditation and mindfulness. Especially if perfectionism is driven by the fear of something.

Other things that cause a disbalance in your stress hormones can play a role as well. This includes allergies, autoimmune flares and infections. Hypothyroidism can lower HRV as well (see this study). A small reminder that a lot of hypothyroidism is caused by Hashimoto’s, an autoimmune condition that can cause hypothyroidism. It does however need a different approach than non-autoimmune hypothyroidism.

If you feel the emotional component doesn’t play a role, working on your known health issues can improve your HRV. When your HRV starts rising, it could be an indication you’re resolving those issues and your Oura ring might provide a great daily metric to see if you are on the right path.

I’ve mentioned a few health conditions that can lower HRV like hypothyroidism, allergies, and flares. Take a look at your personal health. Perhaps there are some other health conditions you are aware of that you like to add to your personal list. Once you start to resolve them, you’re HRV is more likely to go up.

One last thing I like to add. Rebuilding mitochondria can be done in a lot of ways. You are probably quite familiar with some nutritional ways.

Here is a powerful way to rebuild mitochondria with your training:

I’m a big fan of strength training. However, if my clients have a low HRV, I usually choose to work on their cardiovascular development. I like to incorporate zone 2 training (at least 45 minutes of steady-state cardio at a rate it’s still possible to have a conversation, but not without effort).

Another thing I like to incorporate is big compound movements like squats or deadlifts. The weight shouldn’t be too heavy. 8 sets of 8 repetitions with 30 seconds rest between the sets. The last 2 sets should feel heavy.

This type of training can help build mitochondria, muscle, and strength and it helps develop cardiovascular strength. This method can also help build a better physiological base to handle stress.

If one of your symptoms is being deprived of energy during the day, the 8×8 method might be out of your reach. You could try with low weights (which results in the last 2 sets feeling challenging but not heavy) and work your way up.

To summarize my tips:

Examine if there are unresolved emotional issues like trauma or a lack of joy.

Make a list of possible health issues that can lower HRV and work on them. When HRV goes up, this could be an early indication you resolving health problems

Adopt some cardio into your training program. It helps build stress resiliency.

If you like to share known health issues which you like to resolve, feel free! We might be able to help you better.

If you like to have our view on nutritional ways to support mitochondria, let us know as well!

@Sarah Mohler,

Am I right you’re experiencing some problems with your joints? If so, we have a handout that you might find interesting right here!

If you could describe your symptoms, I might be able to help you even better!

Hey @Sarah Mohler,

Could I ask you what you hope the KBMO diet will help you with? Perhaps we could give you some additional tips!

Hey @KK,

Perhaps you could explain to me in more detail what you mean by minimizing the crowd of SIBO.

I don’t think it matters when you start a low FODMAP diet in relation to the treatment.

From practice, I can tell you this: it takes some practice before someone implements a low FODMAP diet correctly. It’s a diet with a lot of rules and it often takes a while before someone understands what he/she knows what to eat. To implement such a diet quicker it helps if someone guides them, but even then it takes a few weeks before the patient knows what to do.

I usually combine the treatment and the diet.

@Yasmin atassi

It all depends on the amount of time you like to spend in the sauna. Another factor is where you spend your time outside the sauna. The bedroom would be my first place to optimize for EMF. Other rooms where you spend a lot of time would be on top of my priority list as well.

Hey @KK,

The working compound of Allimax is a compound found in fresh garlic called allicin. Allicin in its pure form was found to exhibit

Antibacterial activity against a wide range of Gram-negative and Gram-positive bacteria, including multidrug-resistant strains of Escherichia coli;

Antifungal activity, particularly against Candida albicans

Antiparasitic activity, including some major human intestinal protozoan parasites such as Entamoeba histolytica and Giardia lamblia

Antiviral activity.

(You can find more details in this study)

That sounds like a lot and can be a great addition to help your friend rebalance the microbiome.

When people discover they have a Small Intestinal Bacterial Overgrowth (SIBO), I often recommend using a wide range of antimicrobials. Often it’s unknown what the composition of bacteria from the overgrowth looks like.

This is reflected in my supplement recommendations. I would use a full-spectrum antimicrobial like Biocidin from Botanicals or the combination of Candibactin AR and Candibactin BR from Metagenics.

When bacteria start to die, the remaining residue can also be harmful. That is why I often recommend a supplement to which these residues can bind. An example of such a supplement is GI Detox from Botanicals. This is also a good idea if you use a product like Allicin.

I hope your friend is well-informed about how to approach SIBO. A common dietary strategy with SIBO is following a FODMAP diet. If your friend isn’t aware of such a diet, I recommend your friend explore this dietary strategy. In short, the purpose of this diet is to starve out the bacteria by cutting out the nutrients that they feed on. In the B Better library, you can find a handout right here.

In my opinion, a low FODMAP diet brings more success for several reasons:

Some strains are champion survivors and might not react hard on supplements only

Changing the diet is a very powerful way of influencing the microbiome. The microbiome is continuously adapting to the food entering the body

A root cause of why SIBO occurs can be a ‘dirty’ diet (containing sugar, refined carbs, etc) often accompanied by some degree of constipation. Cleaning up the diet consistently for a couple of months can change the taste pallet of your friend, which can help her to be more consistent in choosing better foods in the future.

Another tip: Don’t stop there.

SIBO is often a ‘symptom’!

You’ll need to look upstream and see if there are other root causes. Here are some:

Constipation

Having a frequent bowel movement makes it harder for bacteria to grow in the small intestines. If is constipation, this platform has a program that helps address that. I could only advise your friend to follow that program. Or at least let your friend take a look at this video.

The immune system not working properly
The immune system helps to balance the microbiome. If her immune system misses critical ingredients (low Vitamin D is common!), your friend might not be able to bring balance to the microbiome.

The pH in the small intestines isn’t right.
The pH in the GI tract plays an important role in which bacteria like to thrive as well. Depending on where you look in the GI tract, the ideal pH is different. We need a good strong acid environment in the stomach (our first line of defence against pathogens!) to start with. This stomach acid will be neutralized by digestive fluids made in the pancreas. The gallbladder (some people have them removed – ask your friend if this was done!) secretes bile and bile plays an important role in bringing balance to the microbiome as well.

Slow thyroid
If your friend has symptoms of a slow thyroid: a slow thyroid can cause constipation as well.

Insulin resistance
If the pancreas is for some reason inflamed, it might be hard to produce sufficient bicarbonate (this is what neutralizes stomach acid). In this case, helping your friend heal the pancreas becomes part of the healing journey (and I would recommend your friend the course Blood Sugar Regulation!)

There are other root causes possible. The risk of just focusing on SIBO only is that you might be able to address it now, but it could reoccur later.

I hope my answer is helpful to you and your friend!

Hey @KK,

Could you perhaps share the links to the products you want us to compare? Just to make sure there is no confusion!

Hey @Szilvia Bartalos,

Good luck with your detox program! I always tell my clients to have a good preparation! A detox program is great, but if there is some form of exposure present, taking away that exposure is the first step. Therefore take some time in your preparation to think about where you might get your exposure from.

Another important thing I tell my clients: start a detoxification program from a place of strength. If you’re sick for example, your body needs to heal. The purpose of detoxification is to get toxins that are stored, free them and get rid of them. When toxins get out of their hiding spaces and get into circulation, that’s when they can do their damage.

Since toxins in circulation need to be able to move out of the body, it’s important to have at least one bowel movement per day. If this is not the case if some form of constipation is present, it’s hard for the body to get rid of toxins. In my opinion, constipation needs to be solved first.

Amino acids are also important for detoxification. For example, glutathione (which is built from three amino acids) is an important antioxidant for detoxification. Amino acids help biotransform toxins into a form that makes toxins more water soluble as well. Making toxins more water soluble is often key to getting rid of them. Unfortunately, lots of detox programs don’t factor in for this. Lots of detox programs recommend no meat during the detoxification program causing the protein intake to be low. I would recommend in this case an organic vegan protein powder.

Getting enough of the amino acid cysteine in your diet can help your body to produce glutathione when necessary. NAC as a detox supplement can be valuable since it is a cysteine donor, but it helps detoxification in other ways as well.

The Gaia supplement has a lot of herbs that can stimulate the liver. I like the herbs they have chosen.

I have personally no experience with liquid chlorophyll supplements. For detoxification, I often recommend my clients chlorophyll supplements mentioning ‘broken cell walls’.

One last reminder: if detoxification causes symptoms. I would recommend to ‘slow down’ the detoxification program a bit. It might be that the toxins that became free into circulation are doing their damage before they have left the body. That’s not a situation you would like. You like to balance the body’s ability to get rid of the toxins with the amount of toxins that get into circulation.

There are many tips to give with detoxification programs, but these are some general ones.

Let us know how your detox is going!

Hey @Szilvia Bartalos,

The good news is that this platform is a pretty good resource for acid reflux, GERD and Barret’s Oesophagus! When the oesophagus is exposed to stomach acid on a regular base, the oesophagus gets inflamed. What in some cases can happen is that the tissue of the esophagus changes: they become more like the column-shaped cells in the lining of the stomach and bowel. This is what Barret’s Oesophagus is.

You could view Barret’s Oesophagus as an adaptation from the body to protect the oesophagus against regular exposure to acid from the stomach.

Some foods can trigger acid reflux and are recommended to be avoided. These foods include coffee, citrus fruits, tomato sauce, black tea, alcohol, soda and spicey foods.

When the sphincter is not closing properly, positions in which acid could flow in the oesophagus can cause a burning sensation as well. When your husband goes to sleep, it helps keep his head and upper part of the body a bit higher than the rest of the body. That will help to keep the stomach fluids in the stomach.

Root causes
There are several different causes that can lead to acid reflux:

Stress

A little breach in the diaphragm (Hiatus Hernia) can cause the stomach to push through the diaphragm which in turn can cause acid reflux

An overgrowth of H. Pylori (Which can lead to Ulcers, but often not. The absence of ulcers is therefore no proof of the absence of an H. Pylori overgrowth)

Nutrient insufficiencies like zinc, vitamin B1 and magnesium

Insufficient stomach acid

A slow thyroid (which can lead to insufficient stomach acid. If you like to test for a slow thyroid watch this movie)

More information about what you can do to prevent/heal from acid reflux can be found here in this handout!

Finding the root cause becomes important for addressing the problem. What works for a Hiatus Hernia, doesn’t work for a slow thyroid. Always keep in mind: there can be more than 1 root cause!

Hey @Yasmin atassi,

Are you referring to the brand Sunlighten? Although I’ve no personal experience with these sauna cabins, I know they advertise that their saunas are producing very low amounts of EMF. The brand Clearlight however emits lower amounts of EMF. If EMF is your main concern, I would probably go for them

I’m unsure if Clearlight is available in Dubai since I’m based in Europe. This is probably what I personally would do. If there is a shop there that sells low EMF radiating saunas, you could also ask if they tested their saunas by third independent parties. If they didn’t do that, you can bring your own Gauss meter and see how much EMF the sauna radiates in action.

If you’re looking for a sauna that has a therapeutic effect on the skin, you need to be aware of the difference between full-spectrum light and photobiomodulation therapy (PBMT). PBMT is the effect a lot of people want when they are looking for red light therapy. Most full-spectrum saunas aren’t emitting enough infrared light of a certain wavelength and strength for the PBMT effect. If you’re looking for such a sauna, the Clearlight Sanctuary (a sauna model from the brand Clearlight) has an add-on that gives the light frequencies and strength for PBMT.

If the EMF is your only concern, then forget the last part.

Maybe @Bernadette Abraham has some additional advice for where to look in Dubai.

Hey @KK,

When I recommend diets, it’s usually based on what that person would work on. For example, suppose someone has a lot of trouble balancing blood sugars (for example, when somebody has Type 2 Diabetes) and the ability of the pancreas to produce insulin is impaired. In that case, I might strategically choose to give the pancreas a break with a ketogenic diet. Not forever, but enough to destress the pancreas to allow it to heal.

If someone likes a ketogenic diet and decides to stick to it, I would say: go for it.

Another discussion is how the ketogenic diet is implemented. For me, a good implementation of a ketogenic diet goes beyond removing carbs and focusing on fats and proteins. The quality of the fats and proteins is equally important. I usually recommend eliminating all sweetened beverages and all-grain flours with a strong focus on vegetables, nuts/seeds, healthy fat sources, and moderate amounts of low-carb organic fruits.

I would recommend eating non-starchy fibre-rich vegetables. Fibres are consumed by the microbiome and are converted to short-chain fatty acids like butyrate. Although technically fibres are carbs (and we used to think they were undigestable), a degree of fibres does get broken down and absorbed as fat. Examples of non-starchy fibre-rich foods that could fit into a ketogenic diet are artichoke, leafy greens and nuts like hazelnuts, pecans and macadamia nuts.

Would I recommend keto to everyone who has insulin resistance? The degree of insulin resistance plays another role. One person might need a more drastic reduction in carbs than the other. For one person it might be enough to reduce the fast digestible carbs and focus more on slower carbs, for the other person such an intervention is not enough.

Supplements peri-menopause
In perimenopause, the female hormone ‘dance’ changes. Progesterone slowly declines, which can make women more sensitive to changes in estrogen. In the B Better library, you can find a protocol that has helped many. You can find it here.

I find lifestyle recommendations in this case extremely powerful as well.

The body goes through a change. Other things (besides perimenopause) that throw female hormones out of balance as well can have more impact. For example, in perimenopause production of progesterone slowly goes down. Other stuff that lowers progesterone will have more impact, like:

Stress

Hypothyroidism

Low cholesterol

PCOS (in these cases improving insulin resistance, if there is insulin resistance at play, can help women find more balance in peri-menopause).

Make sure you sleep well! Being deprived is a quick way to stress the body.

Make sure the body can clear estrogen:

Make sure you’re not constipated. After 24 hours, estrogen that was bound and ready to leave the body through the stool can be reabsorbed.

Magnesium helps the enzyme COMT which helps break down estrogen.

Reduce caffeine.

Reduce Alcohol. Detoxification of alcohol uses the same pathway as estrogen detoxification… but alcohol will go first!

There are more tips in this handout. It helps you understand in what ways you can help the body to bring balance to the female hormone ‘dance’.

I hope these tips are of help to you!

Hey @Naveed Aslam,

Are you referring to the list of fruits and vegetables that the Environmental Working Group (EWG) releases yearly? The dirty dozen and the clean fifteen?

If so, you can find the list right here!

Hey @Sara Almansoori,

She could do many things to improve her lifestyle, but perhaps you could help us describe her lifestyle a bit more. For example:

– How would you describe her diet?

How would you describe her diet?

Is she continuously tired? Is she tired after eating food?

How is her sleep? Does she sleep easily? Does she wake up at night? And how many hours does she sleep?

What symptoms does she experience when she has indigestion? Is she easily full? Does she experience bloating? Heartburn? Nausea? Are her symptoms more in the upper GI tract? Or lower GI tract?

Another question which would help me to answer your question:

How do you know your sister suffers from viscosity in the bile fluid?

Regarding these lab values, your sister has indeed high cholesterol. Her HDL is slightly elevated (even if the arrow in the HDL bar has been drawn far to the right, the absolute value is just slightly too high). Her LDL cholesterol is in range. LDL is the type of cholesterol we often see elevated when people have insulin resistance or when people eat a high-calorie/high-fat diet.

Although less seen, HDL can be elevated. HDL cholesterol can for example act as an antioxidant, indicating the body is dealing with oxidative stress. I can’t tell you what the source of the oxidative stress is. It could be a lack of nutrients if she has trouble taking care of herself, something I often see when people are dealing with fatigue.

There could be more exposure to oxidative stress because her body is dealing with for example something inflammatory (like for example a simmering infection in the gut)

If you share a bit more about your sister’s lifestyle, I’ll see if I can give you more targeted tips!