Hi @Inga-55 – it’s hard to say from your description alone whether this is vitiligo or something else, especially since it seemed to get worse after the irritation from the toothbrush. There could be many possible reasons for that; maybe the friction itself creating inflammation, or dryness, or even fungal infections could possibly cause lighter patches around the mouth.

If you can help clarify a few questions please:

• Is the area completely white or just lighter than the surrounding skin?
• Are the borders sharply defined?
• Any itching, dryness, cracking, or flaking?
• Have you noticed similar spots on other parts of your body?
• Is there a family history of autoimmune conditions and vitiligo?
• Has the size continued to get bigger since March or is it still the same size?

Since you’ve had this since March, it might be a good idea to see a dermatologist for a proper evaluation rather than trying to self-diagnose. A dermatologist should be able to help determine whether this is true depigmentation such as vitiligo or some kind of irritation/inflammation-related issue.

Please keep us posted.

@naslam1603 – great question. Both L-theanine and GABA can be helpful for supporting the nervous system, and they work a little differently.

L-theanine is a calming amino acid naturally found in green tea. Many people find it helps take the “edge off” anxiety or mental overstimulation without making them feel overly sedated or foggy. In my experience, it’s often one of the gentler and better-tolerated options, especially for people who are sensitive or dealing with digestive issues.

GABA is actually a neurotransmitter your body naturally produces to help promote calmness and relaxation. Some supplements contain GABA directly, while others combine it with cofactors or ingredients like L-theanine, magnesium, taurine, or B vitamins to help support the body’s own production and calming pathways.

Personally, I tend to lean toward starting with L-theanine first because it’s usually simple, gentle on the stomach, and easier for many people to tolerate. Some people do very well with combination formulas that include both L-theanine + GABA as they can work synergistically.

I share some additional natural strategies and product considerations for anxiety support in this article.

Typical ranges you’ll commonly see:

• L-theanine: ~100 to 400 mg, once or twice daily depending on the person and situation
• GABA: often ~100 to 500 mg, but responses can vary quite a bit person to person

Hope that helps.

Hi @Raahema – yes you are likely correct in connecting his allergies to an imbalanced gut microbiome as a result of several courses of antibiotics. If he can tolerate regular consumption of a variety of fermented foods (which are high in histamine and may make allergies in some worse), this would be highly encouraged to help bring on board transient probiotics. This protocol for kids also shares supplement probiotic suggestions post-antibiotics that can be considered as well. If he’s of an adult-size, this is the adult version.

Has he tried eliminating dairy by any chance? Very often with enlarged adenoids, there is unknown food sensitivities, especially to dairy and possibly gluten.

To help manage symptoms of allergies, you can also checkout this protocol. If he struggles seasonally, these therapies can be used a month or so before allergy-season begins.

Does your son have any other symptoms that would point to parasitic infection? Keep in mind that high eosinophils can also be an indication of a strong allergic response, so symptoms should always be taken into consideration instead of simply relying on 1 marker. You can learn more about this marker and its interpretation here.

Similarly, with a direct bilirubin of 0.3, there could be some biliary tract congestion. Does he have any digestive symptoms? His stools can help give clues as well; floating, greasy film layer on top, light colored.

What is his diet like? Does he consume animal products? The reason why I’m asking is because his MCV and homocysteine are both a little suboptimal high, which can indicate a need for B vitamins. You can learn more about these markers here and here from our Interpreting Basic Blood Chemistry course.

Hi @naslam1603 – I believe the most well known vagus nerve stimulators are Truvaga, Nurosym and Pulsetto as you’ve mentioned.

I think they each have their own pros/cons and it depends on the person’s needs.

I have personally recommended the Truvaga device to clients who struggle with a lot of anxiety & panic attacks. It’s also available in North America whereas Nurosym doesn’t ship to the US. They have a different product for the US market.

I have personally just purchased the Nurosym and currently testing it out. The reason why I chose this device over Pulsetto is 1) it’s a medical grade device and 2) it has clinical data and 3) it’s hardwired and doesn’t require Bluetooth. The downside is the higher cost.

Pulsetto fits more in the “wellness/biohacking” category whereas Nurosym is more medical.

Hope that helps.

Hi @Raahema – it’s good to have you back!

And I’m so happy to hear about the progress you’ve made so far. Well done!

I will answer each one of your questions below.

1. It depends on the dose of your Betaine HCL. If you reach 4900mg of Betaine HCL (in total) as a trial dose (that’s 7 caps of 700mg each) and don’t feel any warming sensation, then yes, that could mean a likely need for additional digestive support. In the Gut Health Masterclass, I discuss the 3 main digestive players “GPS” which stands for gallbladder (bile), pancreas (digestive enzymes), and stomach (stomach acid).

In point #4, you mentioned feeling a dull ache on the right side of your abdomen, which could suggest an issue in the liver/gallbladder area. A liver panel and ultrasound could help confirm or rule out pathology. Feel free to share the results here for a functional lens if everything comes back “normal”. We’ll then be able to guide you better in terms of liver/gallbladder support. In the meantime, you can review this video lesson from the Gut Health Masterclass.

2. There’s an important clarification to be made regarding zinc carnosine. Zinc carnosine is not the same as elemental zinc. It’s primarily designed for gut repair, not for correcting zinc deficiency. Keep in mind that it’s a chelated mix of zinc and L-carnosine, so you’ll have to look at the actual elemental dose of zinc on the label separate to zinc carnosine to see how much zinc you’re actually getting in. Don’t assume 75 mg zinc carnosine = 75 mg zinc. And you’re correct that zinc competes with copper, however if there is a need to replenish zinc, it would make sense to provide zinc without copper for a few months to help replenish low zinc levels. Once replenished, then a zinc/copper blend can be used for maintenance if needed. Hopefully your practitioner measured your zinc and copper levels?

3. Most of the research on zinc carnosine uses around 75 mg twice daily (150 mg total), so the 175 mg you heard isn’t a strict guideline – it’s just within that range. What’s more important than the exact dose is being consistent with splitting the dose because it works locally on the gut lining. Generally, taking it twice daily (morning and evening) for at least 8 to 12 weeks gives the best results.

4. As I mentioned in point #1, it’s a good idea to get that checked with a blood test (liver panel – and make sure they measure Direct bilirubin) and ultrasound. Has you practitioner measured your hormones levels? If not, be cautious using DIM blindly as that can deplete estrogen levels, so if they aren’t overtly high, it can create an imbalance. The addition of TUDCA and milk thistle is generally ok, but testing is always preferred to know exactly what you’re dealing with. If there’s any kind of biliary tract congestion, it’s important to deal with that first.

5. It’s important that stomach acid is well supported after clearing H Pylori. It’s very easy to get a reinfection if stomach acid remains low. If the need for Betaine remains after several months, then there’s likely a need to work on brain communication (pituitary support) and/or thyroid health.

6. There are many reasons why a person can gain weight. The basics are calories in vs. calories out. Do you track calories? Has your energy expenditure compared to calorie intake decreased by any chance? Blood sugar, thyroid, toxins, sex hormones, all of these can be at play. It’s hard to say what’s causing it for sure without diving deeper into each of the possible causes. But start with the basics, and start tracking your calorie and energy expenditure to see if that’s at play first. MyFitnessPal is a free app that you can use.

7. We need good strong stomach acid to absorb iron. Once this improves, ferritin should hopefully go back up.

@Raahema – although his allergy report doesn’t show an allergy towards milk (IgE antibodies), that doesn’t mean he doesn’t have a food sensitivity (IgG antibodies). These are 2 different immune responses so that test won’t pick up food sensitivities which is very common with adenoids. Food sensitivities are harder to pick up because unlike an IgE allergic response which is immediate, IgG responses can take several days to show up making them difficult to identify.

Since dairy is a common food sensitivity in those with enlarged adenoids, it would make sense to remove dairy 100% from the diet for at least 3-4 months to see what difference that would make.

Regarding parasite symptoms, the most common are rectal itching, random rashes, extreme appetite, weight loss despite eating well, loose stools and/or IBS, signs of systemic inflammation like joint pain, headaches, unexplained depression, insomnia/teeth grinding, and symptoms getting worse around the full moon. You can learn more and take a parasite symptom assessment in our Parasite Cleanse program here.

If he’s eating animal proteins, the next question to ask is why wouldn’t he be getting in enough B vitamins from his diet alone? That’s where stomach acid enters the chat. Has he ever checked for H Pylori as well? Given the fact that you had it, it would be a good idea to get him checked as well.

@Raahema – I forgot to attach the other resources:

https://bbettermembership.com/gallbladder-health/

I’ve already shared this video on Liver/Gallbladder support, but I’d encourage you to rewatch it as I do cover some options for bile support post-removal.

Hi @Raahema – yes, we have a few helpful videos and articles you can read to better understand the function of the gallbladder and how to support digestion after surgery.

I encourage you to watch the whole sections of “How Digestion Works” and “How Dysfunction Happens” from the Gut Health Masterclass course to fully understand how the organs work together, starting here with “Meet the Players“. This will give you a clear understanding of what optimal digestion looks like and how easily it can dysfunction. Just because the gallbladder is getting removed, doesn’t mean the reason for stone formation has been addressed. Yes, you can always support gallbladder function post-removal with bile salts with meals, but addressing liver health still remains a top priority.

And yes, while bile is naturally antimicrobial and can prevent SIBO/SIFO from occuring, bile should flow down into the small intestine, not the stomach. H Pylori is a bacteria that is located in the stomach and sometimes the first part of the small intestine (the duodenum) so under normal conditions, bile and H. pylori are not in the same area. However, in some people, bile can flow backward into the stomach (called bile reflux), which may irritate the stomach lining and change the stomach environment. This can potentially worsen inflammation, reflux symptoms, and overall gut imbalance. While poor bile flow is not considered a main root cause of H. pylori, healthy bile production and flow still play an important role in digestion, microbial balance, nutrient absorption, and supporting the overall digestive environment.

Removing a chronically inflamed or poorly functioning gallbladder can sometimes help reduce stress and inflammation on the body and improve digestive symptoms, especially if bile flow improves afterward. Better digestion and less inflammation may indirectly support gut healing, and since gut health and immune regulation are closely connected, this could potentially have a positive downstream effect on thyroid antibodies as well. Of course, it’s usually not one single factor, but rather part of a bigger picture involving the gut, immune system, infections, nutrient status, stress, and inflammation overall.

Hi @naslam1603 – thanks for sharing your personal experience and insights with these different devices. I would add that the only downside I’ve heard about with the Truvaga device is not knowing where to correctly place the device on the neck. But once that’s achieved, it’s been very effective for my clients.

Do report back and let us know your experience if you do end up trying it. And yes, while humming, gargling, etc are helpful free tools, sometimes people need stronger and more targeted tools such as vagus nerve modulators.

And please do keep us posted about your appointment and different treatment options for gastroparesis. Yes, mine started post-viral. It’s very mild though and is improving with time and consistent use of the Nurosym, but I can now empathize with those who consistently have that very full feeling/lack of appetite and nausea. Not fun at all.

@Raahema Sorry it wasn’t caught sooner…

I’m assuming you’ll be proceeding with surgery? If so, allow me to share this protocol “Preparing for Surgery – Pre & Post Op Recommendations” to help support overall immunity and a successful recovery.

@Raahema similar thinking to the cleanse, TUDCA promotes bile flow and that’s where speaking with your doctor to understand the severity of the blockage is important. Milk thistle promotes liver cell health and doesn’t really stimulate bile flow so that should be fine.

@Raahema it’s definitely an intense cleanse, both in taste and how the body can respond. A person might experience things like nausea, headaches, or low energy, and some people do feel better afterward.

However, if there are known gallstones (especially multiple or larger ones), these cleanses force the gallbladder to contract strongly, which can sometimes push a stone that can cause a more serious pain episode and even blockage.

Some prefer to take that risk if there only option is surgery anyway, so that’s why a discussion with your doctor/practitioner and surgeon is important here to really understand the severity of your situation.

@Raahema – first off, sorry you’re facing technical issues. My team let me know what’s going on and they’re keeping an eye out on your account to check and manually fix the settings throughout the working day. The issue is that our main developer who can provide a proper solution is based in the South of Lebanon and he was displaced during the war. We do have other developers who have taken over, but it’s creating time delays. I ask for your kind patience and understanding.

And I’m glad you got a scan and found out that there is indeed biliary tract blockage from gallstones. Given the size and location of some of them, d-limonene may or may not work, but it wouldn’t hurt since it helps break up sludge, and doesn’t really promote bile flow.

If you haven’t already, I would encourage you to watch the Liver/Gallbladder support video. Towards the end I also talk about a liver cleanse that has helped people prevent surgery, but again, it’s something to discuss with your doctor to see if there would be a risk of trying to push bile flow with such a cleanse.

Hi @sara_alm369 thank you for sharing more details about his birth and early feeding.

Did you offer him any probiotics during the first few months after delivery either through applying it on your nipple or adding it to the bottle directly?

The reason I’m asking is because as I mentioned in my previous reply, imbalances in the gut microbiome are very often at the root of eczema. And with c-section delivery, he bypassed what is called “the vaginal gulp” which in when the baby takes their first “sip” of the mother’s microbes as they pass through the vaginal birth canal during birth. This inoculates the baby’s gut with beneficial microbes which sets the stage for developing their immunity.

The good news is that even though he wasn’t able to get this at birth, it’s never too late to help the baby’s gut microbiome using a combination of infant probiotics and fermented foods if he is starting to eat solids.

In early life, a baby’s gut barrier is still developing and is naturally more permeable than an adult’s. As the microbiome and immune system mature, especially over the first couple of years, the gut lining becomes more regulated. Because of this, some babies may be more reactive to certain food proteins, including proteins in formula or milk, especially if there are digestive symptoms, eczema, or other signs of sensitivity. Therefore, there is a chance that he has developed food sensitivities to the protein in his milk.

Goat milk formula may be better tolerated by some babies because its protein and fat structure can form softer curds and may be easier to digest, but it’s not always tolerated, especially if there’s true cow’s milk protein allergy, because cross-reactivity can happen. May I know which brands of formula you’ve tried, and what you are currently giving him?

In the meantime, I encourage you to read through this “Medicine Cabinet Must-Haves for Newborns & Infants” handout & look into the infant probiotics by Smidge. Very often, it’s enough to resolve digestive issues, colic, as well as skin related issues.

@Raahema if you compare last year’s LFT to the most recent one, you’ll notice an increase in both the liver enzymes and direct bilirubin. Liver enzyme (ALT) above 30 implies a higher liver turnover from a functional lens. So something seems to be taxing the liver. And a direct bilirubin of >0.2 and above can also imply some form of biliary tract congestion or blockage in the liver or gallbladder. If you’re noticing stool floating, this could mean a lack of absorption of fats, which again points to poor or sluggish bile flow. It would be worth getting an ultrasound to rule things out. Please keep us posted if you do.

I encourage you to watch this video for a more detailed explanation on liver enzymes, and this video for an explanation on Bilirubin (total, direct & indirect).