Bernadette_Abraham
Forum Replies Created
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@Kkol did you consult with Dr Donatella Casiglia? I checked a few health groups I’m in, and here are other names that were recommended:
–Dr. Suhel in Mubadala Health Dubai (bio includes thyroid disorders)
–Dr. Hubert at American Hospital (seems mostly related to diabetes)
–Dr. Rabia Cheraquaoui at MediClinic (supposedly has a more functional approach and her bio includes thyroid autoimmune disease)
I do not personally know any of these doctors, but they came in highly recommended by others in health groups I’m in. Hope this helps!
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@adoobeh99 – thank you for sharing your results with us. Based on the DEXA scan results, the spine shows osteoporosis, which indicates significant bone loss and increased fracture risk.
Contrary to popular belief, bone health goes beyond just consuming enough calcium, and should be addressed holistically to include the right nutrient co-factors, hydration, movement, hormone balance and gut health/digestion. Please watch this video from the Mineral Balance course to better understand the holistic approach to increasing calcium and supporting bone health.
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Nutritional support to consider:
- Calcium: 1,200–1,500 mg/day, in split doses, preferably from food (sardines with bones, leafy greens, dairy, sesame seeds) is generally recommended for osteopenia/osteoporosis
- Magnesium: 400–600 mg/day (citrate form if there’s constipation or glycinate for general health) to support calcium absorption. Taking too much will lead to loose stools.
- Vitamin D3: Test your levels. The optimal range is 50-70 ng/mL
- Vitamin K2 (MK7): 100–200 mcg/day to direct calcium into bones, not the arteries
- Collagen: 10–20 g/day to support bone matrix
- Protein: Get in at least 1.2 g/kg body weight daily. Here’s a handout that can help.
- Multi-Nutrient Formula with trace minerals: my preference for osteoporosis is the Grow Bone kit by Renew Life because it has all of the nutrient co-factors and trace minerals. You can learn more about it by watching this video here.
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Movement:
- If you’re not already exercising, consider adding in more weight-bearing exercises like walking, light jogging, and hiking to strengthen bones.
- Add in resistance training 2 to 3 times / week to stimulate bone formation
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Hormonal Balance:
- Check thyroid (TSH, Free T3, Free T4, Reverse T3, anti-TPO, anti-TG) and parathyroid (PTH) function.
- Measure estrogen levels, as low estrogen accelerates bone loss. If low, consider bio-identical hormone replacement therapy. If you missed our guest expert call last month with Dr. Berkson – it is a MUST WATCH!!
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Gut Health/Digestion:
- We need good strong stomach acid, good production bile & flow, and robust pancreatic enzyme release to break down our minerals. We also need healthy brush border to absorb our minerals in the small intestine. Therefore, if you have any gut related symptoms, this could be affecting nutrient/mineral absorption. Let us know if you have any gut related symptoms so we can guide you further. Reducing gut inflammation and supporting microbiome health is key.
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Lifestyle:
- Avoid smoking, excess caffeine and alcohol
- Hydrate well; re-mineralize with electrolytes if using a reverse osmosis filter or sweat a lot
- Prioritize sleep and mitigate stress
As you can see, there’s a lot that can be done besides “taking a calcium supplement” which is the typical recommendation for osteoporosis. Most people aren’t deficient in calcium; they’re deficient in the co-factors needed to get calcium into the bones.
So ultimately we must increase bone-building nutrients including more protein & collagen, strength train, address hormone imbalance or deficiency, and make bone-friendly lifestyle choices. Hope this is helpful!
If and when you repeat the DEXA scan again in 6 months to a year, please feel free to share your results. I have seen dramatic improvements in clients so just know that it’s possible!
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@resh1016 my replies are numbered below:
1. You can definitely substitute water for herbal teas like stinging nettle leaf, oatstraw and dandelion leaf which can provide minerals for better hydration. I also love bone broth, but for someone with histamine intolerance, an alternative is low-simmer fish bones (1-2 hours vs. 12-24 hours with chicken or beef bones), or vegetable broths like zucchini, carrots, celery, and herbs like parsley. Coconut water is also a great way to get in electrolytes and potassium.
2. Yes, it’s best to alternate days when doing sauna and enemas since both of these are dehydrating so better not to be done on the same day even if you weren’t sensitive. Dry brushing can be done daily, ideally before any physical activity or sauna use. It can be combined with castor oil packs as well. So dry brushing, then castor oil pack, take a binder 30-45 mins before sauna, then sauna. Castor oil packs can also be done separately when relaxing in the evenings or right before bed.
3. Great question. Daily enemas are generally safe for short-term use (up to 4 weeks), especially water enemas. However, long-term daily use may weaken natural bowel function by reducing muscle tone and rectal sensitivity so it’s best to find other ways to stimulate bowels during a cleanse if support is needed. Have you seen our Constipation Relief Program? I share many rapid relief solutions to consider.
4. If you’re concerned about histamine, DAO enzyme is the enzyme to consider. And no, the body won’t get lazy and stop producing its natural DAO production in the gut due to supplementation. DAO is primarily produced in the intestinal mucosa, and its activity is influenced by factors such as gut health and nutrient availability, not supplementation.
5. Not a big selection to choose from. I have the PuriCare by LG. Seems to work well.
6. In the Mold course, I share many incredible resources one of which is SurvivingToxicMold.com. It’s a treasure trove of knowledge on all things mold. On this page, she shares exactly what to do for saving different possessions.
7. Step 1 – Avoidance. So congratulations on making the decision to leave the apartment. That’s already 50% of the battle.
Step 2 – Support drainage! Candida & parasites are leading to heavy metal storage and histamine intolerance, so it’s important to create a terrain where these pathogens cannot thrive! Think of a dirty pond. What do you need to do to get it clean? Open drainage, expose it to sunshine and get the water & dirty pond flowing outward instead of sitting there stagnant in shady areas! Same with the body.
In the Mold & Mycotoxin Illness course, I actually detail the steps to be done. Here is Step 2 about how to open the drainage pathways in our body AND the order in which they should be prioritized.
Once Steps 1 and 2 are in order, carry on with Steps 3 to 5 to tackle the rest.
Hope this helps!
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Hi @Hasnaa – I’m glad you’re both asking questions and wanting to get to the root of the problem.
There’s no coincidence that her hormones were affected after taking Accutane. Isotretinoin (the generic name for Accutane) reduces the production of sebum or the amount of oils made in certain glands which often leads to dry skin (that’s the common side effect).
Because of this loss of lubrication and loss of barrier function, a person becomes more prone to hair loss from degradation of the hair follicle, and all kinds of skin abnormalities like fungal infections.
And since Accutane causes dryness in general, it also wreaks tremendous havoc on all mucous membranes which can affect the mouth, lips, nasal cavities, gut lining, urinary tract or bladder potentially leading to irritable bladder dynamic that can lead to urinary urgency/frequency, and increasing permeability of the skin, gut, blood brain barrier (so there can also be neurological side effects).
It can also lead to liver and kidney damage.
And it can also suppress the brain’s trigger to our glands to produce hormones (specifically in the brain), including cortisol and sex hormones. And the effect can last a long time even after a person stops the drug.
That’s why I seriously hate this drug, because these risks are rarely discussed between patients and physicians.
Nonetheless, there are always ways to offer support from the side effects of Accutane:
Since Accutane causes mucosal erosion and leads to loss of barrier function, including “leaky gut” and malabsorption, supporting mucosal membranes and providing gut healing nutrients can be helpful during and way after treatment:
- Encourage lots of phytonutrients in fruits/veggies to help restore mucous membranes
- Add in oleic acid like extra virgin olive oil
- Healthy fats like omega-3 and phosphatidyl choline for cell membrane integrity
- 1 gram of fish oil taken at the same time of the medication twice a day was shown to make a big difference in terms of dryness. It can also help with joint pain. PMID: 30002675
- Ginger & turmeric as shots, teas, supplements to help reduce oxidative stress and inflammation.
- Liver supportive foods like cruciferous vegetables for example. And in supplement form, milk thistle, artichoke and curcumin can all be beneficial.
- To support liver detox, a supplement that includes both B vitamins and amino acids to help make glutathione can be helpful. Avoid supplements containing vitamin A during treatment!
- For kidney support and detox, hydration is key! Water and herbal teas. Parsley is also helpful for kidney health.
Now with regards to PCOS, it would be a good idea to start investigating possible root causes of that dynamic. Please read the Symptom Dictionary handout on PCOS which sheds light on the most common causes so you can start to dig deeper and get proper testing for her. This handout also includes initial action steps to take with regards to dietary and lifestyle changes to make.
Here are suggested tests to consider getting done:
-Blood sugar (fasting glucose, fasting insulin, HbA1C)
-Sex hormone panel (Estradiol, progesterone, FSH, LH, Testosterone, DHEA, SHBG, prolactin)
-Cortisol (24-hour collection if possible). My preference is the DUTCH test which includes both sex hormones and cortisol in urine, but this is expensive (~$500 USD) and takes about 4-6 weeks for results.
-Full thyroid hormone (TSH, Free T3, Free T4, anti-TPO, anti-TG, Reverse T3)
-CBC with differentials & CMP (complete metabolic profile) which you can find listed out in this handout HERE on p.5.
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Hi @naslam1603 – we have a protocol for canker sores which may help. You can find that HERE which is located in Succeed>Protocols>Health Conditions.
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Hi @Hasnaa – welcome to B Better! I’d encourage you to read through our Symptom Dictionary handout on arthritis HERE to help you start thinking about possible root causes of autoimmune arthritis.
Please keep in mind that regardless of the diagnosis, all autoimmune disease conditions have these 3 things in common:
1- Gut dysfunction leading to intestinal permeability (aka “leaky gut”)
2- Weakened and imbalanced immune function
3- Environmental /inflammatory trigger(s) (can be stress, trauma, toxins, stealth infections, etc)
I explain this in more detail in this short video from the Gut Health Masterclass. Please watch it.
Since leaky gut is seen in all autoimmune conditions, supporting the main digestive players (liver/gallbladder, pancreas and stomach), the gut microbiome, and prioritizing gut healing is a great place to start.
I encourage you to watch the next video on the causes and triggers of leaky gut HERE which goes over the many causes of leaky gut so you can start to take action and reverse that dynamic. I mention gut healing therapies towards the end of that video, so if you’d like to start adopting some of these strategies as well, you can watch that lesson HERE.
And finally, since the majority of our immune system resides in the gut, please take our Gut Health Quiz and let us know your score so that we can guide you on the best digestive support for your unique case.
As to not overwhelm you, please let me know when you’re done watching these 3 recommended videos, reading the Symptom Dictionary handout, and taking the quiz as I’m sure these will raise more questions.
Now regarding the detox you’re currently doing, would you mind sharing more details about that? Are you taking any supplements? Is it a diet? Please share more – sometimes doing a detox before the body’s elimination pathways are ready can actually create more inflammation, which we clearly don’t want for you.
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Hi @iryna_klevetenko – I generally prefer to avoid giving supplements to infants and toddlers unless there’s a clear need. They’re best used to fill specific gaps rather than as a routine addition. Could you share more about why you feel supplements might be needed? Specifically, any symptoms, health concerns, or dietary factors that play a role?
I’ll be able to guide you better once I have a clearer understanding of the need.
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@Kkol I’m also interviewing people who have never signed up to B Better before, so it’s all relevant. If you can spare an hour, I’d appreciate your insights regardless.
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@Kkol I completely agree with you. Our Android app officially released yesterday, and our iOS version is soon to follow. So hopefully, accessing the community will become much easier again soon!
I’m actually conducting member interviews to gather feedback about the new website. Would you be available and interested in sparing an hour of your time to share what you like, don’t like, what we can improve, and what is missing? If so, I’ll get in touch by email privately to arrange a time to speak over zoom. No pressure if you don’t have time, or prefer not to share. 🙂
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@Hasnaa thank you for sharing. There’s a lot to unpack here but I’ll try to stay as close as possible to her main concern, which is amenorrhea (loss of periods), and how to bring that back.
Based on the results you shared, there is very clear hypothyroid function. When thyroid hormone levels are low, the hypothalamus and pituitary gland, which control ovulation, are disrupted, leading to irregular or absent menstrual cycles.
Despite a normal TSH, her “normal” Free T4 is actually suboptimal. You can see it’s very close to the lower end of the clinical reference range. Ideally, free thyroid values should be in the upper half of the reference range.
To make T4 thyroid hormone, we need iodine and tyrosine. That’s what T4 stands for… 1 tyrosine molecule (an amino acid protein) and 4 iodine molecules. Therefore, if she’s not consuming enough iodine in her diet, it’s helpful to start including food sources such as kelp granules and seaweed snacks for example. If she’s not consuming enough animal protein sources, encourage her to ensure that her meals follow my “VPF” principle, which you can share with her here. If she does consume a lot of animal proteins with every meal, then we have to consider suboptimal stomach acid and maldigestion or malabsorption.
Her Free T3 is actually flagged as clinically low. This is the active thyroid hormone that regulates metabolism and affects reproductive health. We need certain nutrients to convert Free T4 to Free T3 thyroid hormone. For that we need vitamin A, zinc, selenium, and iron. All of these can be tested. If possible, ask for RBC zinc and RBC copper instead of serum measurements.
- Here’s a video with food suggestions from the Thyroid Balance Course
- Here’s a video with supplement suggestions for healthy thyroid function
Given the clinically low RBC, there is a chance of iron deficiency anemia. Was iron ever tested? If not, probably a good idea to run a full iron panel as well, especially that we need iron for thyroid conversion. Low RBC can also be due to a need for folate (B9), B12 or copper. All of these can be tested in blood as well.
Insulin resistance often coexists with hypothyroid function, but these markers weren’t measured. I would also ask for a blood sugar assessment (fasting insulin, fasting glucose, and HbA1C) as a starting point. Insulin resistance is a major root cause in PCOS so it’s important to be checking.
Other things of note:
-There was in fact signs of dehydration (high albumin and protein), so please encourage her to drink more water if she’s not in the habit.
-There are many markers pointing to possible biliary tract congestion/liver dysfunction. The lower ALT can also be due to a need for vitamin B6 since we need B6 to make this liver enzyme. You can watch this Liver/Glallbladder support video to learn more about how to support biliary tract congestion. My favorite supplement is D-Limonene for 30-60 days (1000mg, taken 1-2 x per day, 3/4 way through a meal).
-Her WBC is at the low end of the reference range, so something is taxing her immune system or once again, there is a need for nutrients. Was she sick a week or so before testing? If not, then the pattern of suboptimal high Monocytes (8.2%), Eosinophils (3.7%) and Basophils (1.3%) can indicate parasitic infection and/or some form of allergies/sensitivities/asthma. If she doesn’t have any respiratory conditions, parasites are likely. This in itself can lead to malabsorption and nutrient depletions. If she has well formed, easy to pass, daily bowel movements, it might be worth considering a Parasite Cleanse program.
I realize I’ve shared quite a bit, but this really highlights what I mean when I say that “a lot can be missed” when results are viewed through a conventional lens. I’d appreciate it if you could take some time to watch the videos I’ve shared, and I’ll be here for any clarifying questions you might have.
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@Hasnaa – If the doctor reviewing her results lacks additional training in functional medicine or naturopathy, what is deemed “normal” may not truly reflect what is optimal for her health.
If you’re open to sharing her results with us, we can offer a functional interpretation, which goes beyond the standard reference ranges to provide deeper insights into what her results could indicate.
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@Hasnaa – it’s absolutely normal to feel overwhelmed. Give yourself grace and time to absorb all that you’re going to uncover and learn here. And most importantly, know that you don’t have to do everything all at once to start seeing progress. Small steps can make a big difference. And… you’re supported here, so feel free to ask as many questions as you need to gain clarity.
The reason I asked about menopause status is because with the decline of estrogen, we lose bone mass, which is where we store lead, cadmium, mercury and aluminum over the years. With the loss of bone mass due to lowering estrogen, we can have an influx of heavy metals into the blood stream. So it’s at the back of my mind given the low WBC and RBC. Heavy metals can suppress overall blood cell production. It might be worth asking your doctor to run a heavy metal panel in blood as well. The body doesn’t usually allow heavy metals to be circulating in blood, so if there is any elevation in metals, this could be a reason for the sudden high inflammation.
Was the H Pylori test done using PCR technology as a stool test or was it a breath test? Unfortunately, I have seen a lot of false negatives with breath testing, so my preference is the PCR stool test by Diagnostic Solutions, which is ordered through the same lab as the OAT test.
And since you scored high in the Upper GI, it’s worth repeating the H Pylori test as a standalone test or as part of the full GI Map with Zonulin if budget allows.
In the meantime, you can also try the at-home baking soda challenge test as a tool to determine stomach acid status. It’s not diagnostic, but it can provide insights and it’s free/easy to do. Here’s the video with written instructions attached in “Materials” above the video. Scroll to the 3-minute mark.
Let us know if you have any clarifying questions regarding liver/gallbladder support which I touch on in the detoxification video I shared.
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@Hasnaa it’s not our place to make a diagnosis regarding the autoimmune test results. And in functional medicine, a diagnosis simply tells us the collection of possible symptoms so it doesn’t actually provide insights into WHY a person is displaying those symptoms. In fact, 2 people with the same diagnosis can have entirely different root causes, and so the approach needs to be individualized.
This is why in functional medicine we don’t really care about labels but instead focus on the “maximize/ minimize/prioritize” model for each individual; maximize what their body needs (find deficiencies), minimize what the body doesn’t need (remove toxins, pro-inflammatories, food sensitivities, emotional baggage, etc), and prioritize an environment for healing (e.g., sleep quality, mindset/meditation, etc).
If you’re saying the high inflammation has been there for the past 3 months, does this correlate to any particular event that you can recall? Also, are you menopausal or still cycling? If you’re taking any hormones, are they bio-identical or synthetic, and when have you started taking them?
The OAT test will definitely provide us with more insights. The full GI Map with Zonulin or H Pylori only stool tests as well.
In the meantime, please re-read my replies as I provide a few action steps in terms of food, supplements and lifestyle therapies to consider getting started with. For example, if Vitamin D is low, start spending more time in the sun and/or supplement with a vitamin D3/K2 supplement along with magnesium glycinate. The free Dminder app can help you track your vitamin D levels from sun exposure.
Please watch the videos I shared if you haven’t already, and also take the Gut Health Quiz that I shared in my previous replies and provide us with your score. Also let us know about your menopausal status and meds. Thanks
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Hi @Hasnaa – here’s an overview of key insights from these lab results from a functional lens. This means that although a marker may be “normal” within the clinical reference ranges, it may not be optimal from a functional perspective. Also keep in mind that these lab results represent only a specific moment in time.
Key Insights:
- All of the autoimmune antibody markers including ANA and rheumatoid arthritis are negative.
- Inflammation markers ESR & CRP are both clinically elevated which means there’s significant systemic inflammation present. This could be due to hidden/stealth infections, chronic inflammatory conditions, or oxidative stress from things like toxicity, high blood sugar levels, etc. You can find more sources of oxidative stress in this handout HERE.
- Total bilirubin (from the breakdown of red blood cells) is at the low end of the normal reference range. Low levels is also associated with elevated oxidative stress states because the body will use/recycle bilirubin to serve as an antioxidant to counteract the oxidative damage. Bilirubin is a potent antioxidant! Since we need zinc to make bilirubin (indirectly), lower bilirubin level could also be due to low zinc! So it’s a good idea to check RBC zinc. (which is also a critical immune nutrient, and needed to make stomach acid… you’ll see the connection next)
- Total Protein is also sub-optimal low. This can be due to a low protein diet, liver dysfunction, digestive dysfunction and/or inflammation, and hypochlorhydria (low stomach acid). I know we discussed getting an OAT urine test done for a good general overview, but it might also be worth investing in a functional stool test to assess overall gut health (~$450 USD). If cost is an issue however, then testing for H Pylori overgrowth only as a minimum is a good idea, since it can suppress stomach acid and lead to downstream digestive dysfunction. This is a separate functional stool test and costs $175 USD. Do you have any digestive symptoms like gas, bloating, acid reflux/heartburn, IBS, constipation, diarrhea, abdominal cramps/pains? Please let us know your score from the Gut Health Quiz once you take it as this will provide more information for us to be able to help you.
- ALT from the liver panel is suboptimal low, which can indicate a need for vitamin B6 (which is measured in the OAT test) but also possible liver dysfunction. A methylated B complex such as Thorne’s Basic B Complex can help support liver detoxification as well as consuming a cup of cruciferous vegetables daily (examples here). Supplement formulas that include taurine, milk thistle, curcumin, N-acetyl cysteine such as Seeking Health’s Liver Nutrients can support liver health.
- RBC and WBC values are both sub-optiomal low. I’m now really suspicious of toxicity in your case, especially that Monocytes are clinically elevated which can indicate liver dysfunction, parasites, or the recovery phase of an infection (were you sick 1-2 weeks ago?). Toxicity can suppress overall blood cell production leading to these low values. The most insidious sources of toxins today are heavy metals and mold. Both of these can be tested as well through a hair elements test for heavy metals and urine test of mycotoxins if there’s mold exposure. What’s important in testing however isn’t to confirm WHAT toxin it is, but to be able to avoid the exposure. The solution would be the same regardless of the test result. Avoid the exposure to reduce toxic load, support the liver & digestion, and get the body detoxifying. The OAT test, although it won’t tell us “WHAT” the toxin is, will show an overview of the body’s detox status.
- Although TSH and Free T4 were measured and seem optimal, checking Free T3 and Reverse T3 will help determine if you’re converting thyroid hormone effectively. Without a full thyroid panel, these markers don’t provide the full picture.
In Summary, Action Steps to Take:
Additional blood tests to consider:
-RBC Zinc
-Vitamin A
-Viral panels (EBV or Cytomegalovirus) (chronic viral infections can also lead to low WBCs)
-Liver panel again, but include Direct Bilirubin to see if there’s biliary tract congestion and determine if gallbladder support is needed
Functional tests to consider:
-OAT urine test (good overview of overall health)
-GI Map stool test or H Pylori only to save on cost
-Mycotox test (to assess if there’s current/previous exposure to mold)
-HTMA (hair elements to assess heavy metal toxicity)
To keep cost under control, the OAT test & H Pylori only test would be great starting points. Once those results are back after 2-4 weeks, the picture/direction might become clearer.
Also supporting liver detox using food, supplements and lifestyle therapies is a great proactive effort that can only benefit overall health. You can find additional ways to support detoxification in this video. All of the supplements and tools mentioned in the video are linked below the video, and handouts such as how to do a castor oil pack are attached under the tab called “Materials” above the video from desktop view. And finally, sweat daily (and hydrate)! Investing in a portable sauna is a great health investment. Use code BERN for 10% off.
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@LAK – yes, the protocol is for an adult, so dosages need to be adjusted for children.
Black seed oil is also an amazing anti-inflammatory! Regarding dosages, there is limited clinical research on its use in children, but it has been shown to be safe in low doses. One study investigated the effects of black seed oil as an add-on therapy for children with intractable epilepsy. The study found that while the oil was generally well-tolerated, higher doses (80 mg/kg/day) were associated with gastrointestinal side effects. So a dose of 40 mg/kg/day is considered safer for pediatric use.
So for example, if she weighs 50 lbs (divide by 2.2 to get her weight in kg), so you’d multiply weight in kg by 40. So 50 pounds / 2.2 * 40 = 910mg/day. Check the serving size on the bottle to determine how much to then give.
Hope that helps!
