@Vidu – thanks for sharing your reports. It’s actually common to get a sore throat, chest discomfort, or difficulty with dry foods 1 to 2 weeks after an endoscopy, especially if biopsies were taken. So the pain you’re experiencing is most likely a result of the lining getting irritated and inflamed post-op, especially that your report states there were no strictures and the esophagus was otherwise normal. The lining can get irritated and temporarily more sensitive, and if you already have reflux or gastritis, it can feel more intense.

If however your swallowing gets worse, like food keeps getting stuck and you can’t swallow liquids, definitely seek medical attention.

From a functional perspective, here are some possible drivers that could be at play:

Inflammation

• Chronic mild gastritis causing irritation

• Stress and sympathetic dominance

• Bile reflux, which was noted in your 2023 report

• Food triggers

• NSAID use

• Prior H. pylori history

Bile reflux is important because it burns differently than acid and does not respond well to PPIs.

Low acid and motility issues

• Long term PPI use

• Poor protein digestion

• Delayed gastric emptying

• Increased intra abdominal pressure

• More reflux symptoms over time

Pressure dynamics

• Diaphragm tension

• Breath holding

• Constipation

• Heavy lifting

• Abdominal weight gain

• Chronic stress

To help you rule things out, can you please answer the following questions:

1. Do you feel bloated after meals?
2. Do you burp frequently?
3. Does food feel like it sits in your stomach?
4. Are you constipated or straining?
5. Are symptoms worse with stress?
6. Are they worse when lying flat?
7. Do you notice a bitter taste versus a sour acidic taste?
8. Are you on daily PPIs or only using them occasionally?
9. Any history of anemia or B12 deficiency?

And in the meantime, focus on calming the inflammation and reducing upward pressure by:

-Eating smaller meals and chewing thoroughly (eating hygiene is powerful!)

-Don’t lie down for 3 hours after eating. Go for a gentle walk after meals instead.

-Avoid heavy lifting or tight clothing

-If constipated, this is a priority to be addressed. Let us know!

-Consider gut and throat soothing support like:

• Slippery elm tea or lozenges
• DGL before meals
• Zinc carnosine
• Small amounts of aloe vera (inner fillet)

Also consider daily diaphragmatic breathing to lower intra abdominal pressure. If you’re stressed, deep breathing can help regulate the nervous system as well. Consider doing slow nasal box breathing (ex. inhale for 4, hold for 4, exhale for 4 to 6), humming, gargling… all of these help with vagal tone as well.

@Vidu – I can personally relate to this, and I agree, cyclical pain without a lump is most often hormone related. That said, because this episode has lasted longer than usual, imaging is still the responsible next step. If you’re concerned about getting a mammogram, you can request an ultrasound and physical examination by a gynecologist instead. Breast pain alone is rarely cancer, especially without a lump, but some imaging and professional assessment can give you clarity and peace of mind. I wouldn’t ignore that part.

Personally, I’ve had months where my breast tenderness lasted almost all month long as well. In fact, breast tenderness and headaches were the first signs of perimenopause for me. I never used to get any headaches or breast pain, and then suddenly they started appearing randomly until I realized they were cyclical. And there were times where they were so tender that I couldn’t hug my kids or husband. Even the sheets at night would hurt! So you’re not imagining the pain…

Since you still have your ovaries, you’re still cycling even without periods. At 42, perimenopause commonly causes estrogen fluctuations and lower progesterone. That pattern often shows up as:

• Breast tenderness (can be one sided)
• Pain with touch, tight clothes, or hugs
• Symptoms that come and go every couple of months

From a functional perspective, the usual drivers are:

• Relative estrogen dominance
• Slower estrogen clearance through the liver
• Constipation
• Stress suppressing ovulation
• Lymph stagnation

Simple things you can start now:

• Make sure you’re having daily bowel movements
• Increase cruciferous veggies to help with estrogen detox
• Reduce caffeine for a few weeks and see if that helps
• Support sleep and stress regulation
• Gentle movement or rebounding to support lymph

Also, I have personally seen a lot of benefits from doing the “Specific 7” lymphatic drainage technique every day as part of my morning routine. You can watch the tutorial video here by Dr. Caitlin. She has other videos that break down each point one by one if you need more guidance. But since implementing the Specific 7, the tenderness has reduced considerably! I realized that the soreness in my breasts was actually lymph nodes close to the breast tissue. So it’s worth giving this technique a try!

I would also suggest tracking your hormones with an at-home device called Mira. This has been a game-changer for me too because I can now associate my symptoms to my hormones every single day! It’s much cheaper than a DUTCH hormone test, and it allows you to test throughout the month instead of just 1 snapshot in a month.

It allows you to track FSH, LH, Estrogen and Progesterone metabolites in urine. The wands are similar to a pregnancy or ovulation test. You simply collect urine each morning, dip the wand in it for 20 secs and stick it into the Mira analyzer device to get a reading. It then uploads the results to your app and starts tracking. You can also input symptoms so that you can keep track and see patterns. It’s honestly been a game changer for me to see that some months I’m not ovulating, and how that translates into symptoms as a result of low progesterone (no ovulation = no progesterone = relative estrogen dominance!). I wish it also tested testosterone, but it doesn’t at this point in time.

I reached out and got B Better members a discount. You can check it out here.

Hope this helps. Let me know if you have any questions.

@rugiyashamilli this is the thread about air fryers

Hi @Jyl – I’m glad that our conversation gave you some hope. And thanks for sharing more about Jake’s situation. I know how heavy and confusing it can feel when you’re trying to support your child and make the right decisions.

Daniel has already given you some great information, so I’d like to add my perspective and experience with this as well.

First off, I’d like to reassure you that Jake’s profile is actually very promising. The working memory is processed by the prefrontal cortex (front part of the brain), which is responsible for attention, organization, and holding information in mind while using it. The good thing is that this part of the brain is very responsive and trainable, especially in children.

My son also had weak working memory, and the approach we took was very holistic to address it, so please don’t feel overwhelmed by what I’m about to share. I’ll help break it up into actionable next steps later.

Here are things that can help support the prefrontal cortex (PFC):

1. Good quality sleep (this is a big one)

You already noticed how lack of sleep affects him, and that’s because the PFC is the FIRST area to suffer from sleep loss. So good sleep is non-negotiable. Daniel already provided some sleep tips to help him wind down, but I’d also to mention a few other things to keep in mind.

If he’s using iPads or other electronics in the evenings before bed, this is something to discontinue. The blue light from screens and lights will 100% affect his ability to produce melatonin and wind down before bed. If it’s a struggle to get him off electronics, then a compromise is to wear blue-light blocking glasses and set a “no electronics 1 hour before bed” rule. Also get into the habit of dimming lights at home once the sun sets to help set a calmer mood.

->Instead encourage reading, coloring books, a bath with Epsom salt for additional magnesium and calming benefits, or playing with legos if he likes them for more calming activities in the evenings.

2. Blood sugar stability

As Daniel already mentioned, the PFC is metabolically expensive. It needs steady fuel, and hates blood sugar swings.

Would you mind sharing more details about his diet and what he eats/drinks for breakfast, lunch, dinner, and snacks? In our Beginner’s Health Roadmap, I share my VPF+C principle if you feel that you need some help ensuring that he’s having balanced meals. I’d encourage you to watch the “Food Pillar” starting here. You can also fill in this 3-Day Food Journal and share it with us for additional input about his diet.

->In terms of testing, if he doesn’t mind needles, then a simple blood test to measure fasting glucose, fasting insulin, HbA1C, LDH and HOMA-IR could be helpful.

3. Anti-inflammatory support

Daniel also touched on chronic inflammation and the impact it can have on the brain. This can lead to slower signaling in the PFC. And this is where the gut-brain connection really comes in as well. Given his recent flare of eczema, there is likely still some ongoing gut inflammation from possible dysbiosis and/or even histamine overload. Eczema is very often histamine mediated. While bone broth is an excellent food for gut healing, keep in mind that it’s also higher in histamine. If his ability to break down histamine is compromised (vitamin B6 deficiency/insufficiency and lack of DAO enzyme production is often at play), then foods higher in histamine can lead to an overload and possible flares.

When the gut is inflamed, the gut barrier integrity also becomes compromised and can lead to weaker intestinal junctions that can increase intestinal permeability (i.e. leaky gut). This can eventually develop into food sensitivities, which I suspect may also be at play with the random skin flares.

Gluten naturally increases zonulin which temporarily “opens” the intestinal junctions. This is why many functional practitioners recommend going gluten-free regardless of testing. And because of “molecular mimicry” and cross contamination, dairy and gluten-free grains are also often removed as additional supportive layers.

The goal in removing these possible food sensitivities temporarily is to help reduce inflammation if the immune system is seeing them as “foreign threats”.

With my son, we started out by removing dairy first. Within 2 months, he noticed his brain fog lifted. In his words, he said he could think clearer. We then removed gluten, and went DF/GF for 1 year before reintroducing them back into his diet given the progress he was making.

You could also consider getting a KBMO test done (it’s a finger prick blood spot test) to rule out IgG food sensitivities, but it’s pricey in Dubai. Much cheaper in the US.

With regards to other possibilities of gut inflammation, does your son have any digestive complaints? Does he have daily, well formed, easy-to-pass bowel movements 1-2 x per day? Any gas, bloating, indigestion that could point to possible dysbiosis?

4. Oxygen, hydration & blood flow

It’s important that his brain is getting enough oxygen and blood flow to the PFC. Cardiovascular exercise is key here. My son loved parkour so I signed him up to classes 5 x per week. Find a sport or another physical activity that your son enjoys and encourage him to get in daily cardio exercise (min. 30 minutes). Even brisk walks or running around at the park works! In the summer, playing in the pool is a great way to get in more cardio.

Hydration matters as well. If he has lots of sweaty play time and does lots of sports, make sure he’s replenishing with enough electrolytes. Coconut water, adding “sole” are natural options.

Another thing to consider is his breathing. Is he a mouth breather or nasal breather? Let us know if he’s a mouth breather so we can suggest additional tests/steps to take. Nasal breathing especially during exercise and sleep helps get more oxygen to the brain.

5. Micronutrients the PFC actually uses

As Daniel already mentioned, there are key brain nutrients that you’ll want to make sure are sufficient. Iron/ferritin, zinc, magnesium, B vitamins (especially B6, B9, B12) and iodine.

->All of these can be tested in blood. Request that zinc and magnesium be tested as RBC magnesium and zinc, instead of serum magnesium and zinc.

6. Brain exercises for the PFC

There are specific exercises that can help train the PFC. Here are some things we incorporated into my son’s protocol:

• ping pong or any activity that requires ball/hand coordination (we turned our kitchen table into a ping pong table by placing a white tape across the middle) – it was lots of fun during Covid
• games, especially ones that involve rules & memory like UNO, memory card games, chess/checkers, Simon Says, clapping patterns to repeat, etc.
• playing a musical instrument (my son really got into Piano)

7. Neurofeedback

Once the first 6 items were in place, and we started noticing some progress at school, we then layered in neurofeedback. This was a game-changer for my son and dramatically improved his working memory and auditory processing by training the brain to increase electrical activity where it’s needed most.

Warning, it’s expensive. We were able to add it as a benefit with our insurance so we claimed most of it back, but each session costs 790 Dhs plus the initial QEEG assessment which is ~1500 Dhs. We ended up doing 40 sessions of neurofeedback so it adds up. But it was honestly worth every penny because of how much it helped my son.

If that’s really cost-prohibitive, then you can look into the at-home neurofeedback device called the Mendi which is being clinically studied and recommended by doctors at the Amen Clinic.

8. Things to Avoid (actively harm the PFC)

I also wanted to include a list of no-no’s to avoid.

• Chronic sleep deprivation (again, this is a non-negotiable. Let us know if you need more tips to help improve his sleep)

• Excess screen time / constant notifications – this is another big one

• Repeated high-stress without recovery – if his schedule is overwhelming, that’s not good for his PFC

• Ultra-processed foods – diet matters. Let us know if you need more support here too.

As you can see, there are LOTS that you can do help support the PFC and working memory. The best approach is a holistic one. I know this might feel overwhelming, but we can help you piece it all together to make it feel more doable.

For now, please answer all of my questions asked above, and we carry the conversation forward.

Hi @Sheena – thanks for sharing. A few things jump out from what you’ve described, so I’ll share my initial thoughts, some additional clarifying questions, and also share a referral as requested.

There can be many non-oral reasons for bad breath/halitosis (please see our handout here) and given the fact that your son is also experiencing alternating symptoms of constipation and diarrhea, it is likely being caused by some sort of gut dysfunction such as dysbiosis (gut microbiome imbalance/overgrowths), low stomach acid due to chronic stress, possible H Pylori infection (and/or other reasons), and/or liver/gallbladder dysfunction (which often contributes to nausea).

Holding the urge to have a bowel movement can surely contribute to feeling unwell, but I suspect this is a secondary issue to the reasons I mentioned above.

Questions:

1. How long does it normally take him to have a bowel movement on the weekends when he’s not feeling rushed?

2. Does he experience these symptoms during extended holiday breaks when he’s not in school?

3. Does he have a bowel movement every day? If so, what type is it? (Look up Bristol Stool Chart for the 7 different types)

4. Does he experience any other GI symptoms like gas or bloating after eating? Any reflux or burping/belching?

In Dubai, I can recommend Dr. Zain at Joint Space in Al Quoz. She is a Canadian board certified naturopathic doctor who is also certified in hypnotherapy. So she can help address any mental/emotional blocks as well. She was our guest in B Better a few months ago – she’s lovely!

I’m also happy to suggest next steps, and tests to consider once I hear back from you on the above.

@Vidu – just a note about the slippery elm capsules. If it’s for gut irritation, then capsule form is fine. But if your goal is to soothe the sore/irritated throat, then consider removing then content from the capsule and drinking it in water. The idea is to help coat the throat with something mucilaginous like slippery elm. That’s why the recommendation was in tea or lozenge form.

@Vidu – thanks for sharing the additional details. It’s helpful when trying to connect the pieces and figure out root causes.

From what you’re describing, it sounds like a long-standing pressure and motility issue layered with stress physiology.

Given the symptoms you’ve mentioned (long history of bloating, constipation that’s on/off, breath holding and shallow breathing, chest and shoulder tightness, B12 deficiency, occasional severe abdominal pressure, smelly gas and stress clearly triggering reflux), the following dynamics are likely at play:

1. Impaired motility

2. Pressure dynamics in the abdomen

3. Nervous system dysregulation

4. Possible small intestinal overgrowth or fermentation

5. Intermittent bile irritation

The severe bloating episodes where you felt you couldn’t breathe are very telling. That is pressure. When the abdomen distends, it pushes upward against the diaphragm. If the diaphragm is already tight, the pressure goes upward toward the esophagus. That alone can cause reflux, throat pressure, and burping.

You being in the habit of holding your breath is also huge. Chronic shallow breathing keeps the diaphragm locked. A locked diaphragm weakens the lower esophageal sphincter and worsens reflux. It could also explain your chest and shoulder tightness.

The B12 level of 116 is low which likely indicates that acid production has likely been suboptimal for a long time. And yes, the PPI just worsens that. Low stomach acid impairs protein digestion, slows gastric emptying, and increases fermentation downstream. That can explain the smelly gas and pressure.

Now about your question on deep belly breathing pulling on your throat and chest. That pulling sensation is most likely tight fascia and a restricted diaphragm. It is safe to continue, but go gently. Do not force big inhales. Start with slow, small, relaxed breaths. Think soft expansion, not pushing. Please look up Human Garage and start their free fascia release program.

About slippery elm capsules, yes, it’s usually a safe supplement to start with. But always go low and slow, such as 2 caps twice daily for a few days to a week, and see how the body responds before increasing.

Whenever someone has smelly gas, there’s likely fermentation happening in the gut. That doesn’t mean probiotics are bad, but the combination of inconsistent use plus underlying motility issues can potentially cause flare ups. Right now I would not focus on adding more supplements. You are overwhelmed already.

Here is what I would prioritize next:

1. Stabilize the nervous system daily. Five to ten minutes morning and evening of slow nasal breathing. This is simple, but very powerful. Consider a device like the Truvaga or Pulsetto to help achieve parasympathetic state if needed.

2. Support regular daily bowel movements. Keep magnesium citrate steady and consistent rather than alternating forms. Regularity reduces upward pressure.

3. Chew meals thoroughly and stop when you’re 3/4 way full. Avoid large evening meals.

4. Go for gentle walks after meals. If it’s too cold outside, find a step or stairs to walk up and down on.

5. Consider doing the Fascial Maneuvers by Human Garage.

Can you please answer the following questions:

1. Are you waking at night with reflux?
2. Do symptoms improve when bowels are regular?
3. Do certain foods clearly worsen bloating?
4. How is your sleep overall?

@Vidu – one more suggestion… if you like listening to podcasts, I highly recommend Dr. Carrie Jones’ podcast called “Hello Hormones”. She focuses on perimenopause and it can really help you feel less alone and more in control of the changes that are happening.

As for books to read on the subject, consider reading:

• Dr. Felice Gersh’s book “Menopause: 50 Things You Need to Know”
• Dr. Lisa Mosconi’s book “The Menopause Brain”

It’s important to know and understand what to expect as our body enters this new phase of life which can begin as early as 35 in some women, and can last for a decade before menopause.

Knowing what to expect is empowering and can remove a lot of fear and lack of control. And of course, we’re always here when you need us too. 🙂

@Vidu – yes, both vitamin E and evening primrose oil may help, especially if the pain is hormonal and cyclical.

Vitamin E has actually been studied for breast tenderness, and many women notice improvement when they take around 200 to 400 IU daily for a couple of months. It works more on the inflammatory side since it’s an antioxidant and helps stabilize breast tissue. It is not an overnight fix, but it can take the edge off over 6 to 8 weeks. When choosing a form, look for a mixed tocotrienols (d-alpha, d-beta, d-delta, d-gamma) version and avoid the synthetic dL-alpha tocopherol. It should be taken with food.

Evening primrose oil is probably the one I’d reach for first when the pain clearly feels hormonal. It contains GLA, which helps regulate prostaglandins. Some women with cyclical breast pain have sensitivity in that pathway, and this can calm the tissue response. A typical dose is around 1,000 to 1,300 mg once or twice daily, again giving it a good 6 to 8 weeks before deciding if it is working.

@Jyl with regards to lab tests, in addition to the ones already mentioned, it’s helpful to get a basic CBC (complete blood count) with differentials to look at immune status and signs of histamine overload, along with a CMP (complete metabolic profile).

You can find the full list of these markers in this handout on p.5.

Hi @Jyl – sorry, I somehow missed your reply.

With regards to daily bone broth… Yes, it is a great food that can support gut healing by providing easily digestible protein and amino acids like glycine and proline, which help reduce inflammation and support the integrity of the intestinal lining. However, it is also high in histamine, especially if it’s reheated, long simmered, and stored for several days. So individuals with histamine overload (eczema is often evidence of excess histamine), this can become a trigger for flares if his “histamine bucket” overflows.

For example, if a person has low vitamin B6 combined with gut inflammation leading to low DAO enzyme production (to break down histamine), then eats leftovers and fermented foods (both of which are high in histamine), that could be enough in some to create histamine overload. And that’s why symptoms histamine sensitivity can “come and go” with no clear pattern.

We have several resources on histamine that can help. This one shares a sample list of foods and beverages that are high and low in histamine. This handout shares the various symptoms of high and low histamine to be aware of. And this is an article to understand more about histamine overload and how that can happen.

In the meantime, please watch this lesson from the Gut Health Masterclass to find other gut healing alternatives.

@R-S for nausea, ginger would help offer more rapid relief support. Not sure if you saw our Nausea Relief protocol here.

Castor oil packs and dandelion root tea, if tolerated, would also be great additions to support better liver/bile flow (and therefore nausea relief), and overall digestion until you’re ready to add in your digestive supplements again.

Regarding shortness of breath (SOB), there can be multiple contributing factors beyond the lungs themselves. Nutritional insufficiencies like low B vitamins, CoQ10, and omega-3s can affect cellular energy production and how efficiently the body uses oxygen. Anemia can reduce oxygen delivery to tissues, which often shows up as breathlessness, especially with exertion. The liver can also play an indirect role when it is under strain (think toxicity), which contributes to inflammation and metabolic stress. Gut-related issues like certain forms of SIBO, particularly hydrogen sulfide–producing bacteria, can interfere with cellular respiration and nervous system signaling, which creates a sensation of air hunger rather than true oxygen deprivation.

@R-S Your current NS program seems comprehensive and if you felt it made a positive difference, then definitely continue doing it daily. It’s especially important to continue doing this work even when you start to feel better as it should remain your main anchor while you layer things on top.

As for magnesium, chloride is well absorbed through the skin which is why it’s often the form you find in magnesium sprays/oils.

@R-S – First, please don’t apologize for sharing all of this. This is exactly why we built the community feature in B Better – to support, guide, educate and empower our members. So feel free to share as much as you’d like and ask as many questions as you need.

I agree with you that this feels less like a single trigger and more like a system that is hypervigilant. Which brings me back to my very first reply to you about prioritizing nervous system regulation over everything else, even though a person might be nutrient depleted.

This is important because it’s only when a body feels safe, that it will begin to absorb and respond favorably to what you are taking. Otherwise, it’s just adding fuel to a fire, even though the intentions are well meaning and needed.

I know you said previously that you’re doing nervous system work, but I’d like to dig a little deeper into that. What are the types of exercises or the program that you are following for that?

You’re attending the live sessions, but have you purchased the MastCell 360 course and following the exercises she recommends?

Right now, rather than thinking about adding in supplement support, really focus on your nervous system state. At the moment, your body is giving a lot of signals of overload and low capacity. In that state, stabilization usually looks very simple, very boring, and very consistent.

That looks like:

• Keeping food as predictable and gentle as possible for as long as needed, even if it feels repetitive.
• Prioritizing hydration and electrolytes, especially with the dizziness and low blood pressure feelings
• Supporting your nervous system through non-supplement inputs to help your body feel safe again.

With magnesium malate, I would not rush it. It can be supportive for some, but in a system that is already feeling activated, I would wait until things feel a little more settled before introducing something new. Stability first, then gentle rebuilding. An Epsom salt foot soak could be a good place to start as a way to bring on board more magnesium through the skin.

I also think it’s very wise that you’re bringing in a homeopath who understands MCAS and histamine patterns. Having someone walk alongside you in real time can take a lot of pressure off you to self-navigate every turn.

@R-S if constipation is at play, then magnesium citrate would be a good option to consider in the evenings or with dinner since it’s more stimulating and can help move the bowels the next morning.

The typical starting dose is 200-400mg up to bowel tolerance or 1200mg/day, which means a person increases the dose each day by 100mg until a well formed bowel movement is achieved. If a person takes too much, they’ll get loose stools. Magnesium is contraindicated in those with kidney disease.