[Bernadette_Abraham]

Hi @Kkol – I’m really sorry to hear about what your son is going through. But I want to commend you on the swift actions you are taking and the additional tests you are considering pursuing.

Unfortunately, there is no direct or immediate way to lower CK levels. But rest and hydration are critical first steps to help flush out CK through urine, which you’re already doing.

Low levels of potassium, calcium, or magnesium can make muscle tissue more prone to damage so ensuring he’s getting in enough of these electrolytes is important too. You may want to test these. Check both serum and RBC magnesium.

In the meantime, consider adding in food-based sources of these into his diet. Coconut water is great! A diet rich in potassium (bananas, sweet potatoes), magnesium (leafy greens, nuts), and calcium (dairy products) can support muscle health as well.

Also consider anything that reduces muscle inflammation and promotes recovery like omega-3 rich foods (salmon, chia seeds, walnuts)/fish oil and curcumin.

Proteins are also important for muscle recovery, but just be careful not to overconsume it while CK levels are still high. If he’s taking any protein or creatine supplements, please ask him to stop that. But a moderate amount of protein sources like chicken, fish, eggs, and plant-based options can help with muscle recovery. Combine that with antioxidant-rich foods like berries, leafy greens, turmeric, and ginger.

Given that this episode of rhabo happened after he got sick, the cause could be infection related. Viral and bacterial infections can sometimes cause muscle inflammation and breakdown. But since it’s not his first episode, it’s not a bad idea to work with a geneticist to rule out genetic conditions like GSD and carnitine deficiency.

I would also test ANA marker as a starting point to see whether or not some autoimmune dynamic is at play that can be contributing to enhanced muscle breakdown. Checking his vitamin D, RBC zinc, copper, and vitamin A would also help look at nutrients that support overall immunity.

A full thyroid panel can also be considered, since CK is often elevated in hypothyroid states. I’d encourage you to read this study on CK elevation to learn more about potential causes to help you ask the right questions to the doctors: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871266/

And if you’d like to be more specific and know the location of muscle damage, different isoenzymes can be measured to determine the location of the damage. M (muscle) and B (brain) are used to differentiate, and the three isoenzyme tests are CK-MM, CK-BB, and CK-MB.

Hope this helps give you additional areas to explore. Please keep us posted.

[Bernadette_Abraham]

Hi @Nadine – I can’t seem to open your attachments. I’ll double check with tech to see if it’s an internal issue, but can you also try uploading a lab result again (just 1 page for testing), perhaps as a jpeg or pdf to help us figure out why it’s not opening?

In the meantime, I went back to Circle to look at the results you uploaded there to help answer your question about whether or not to get an OAT Test. I’m glad to see the abdominal ultra sound results are positive. There’s gas however obstructing the pancreas, which was in question. Was the 2nd MRI ever done? I saw the one from July 22 2024 but unsure if that’s the first or 2nd MRI. But the results were reassuring and ruled out any pathology in the liver, spleen, pancreas, kidneys, and adrenals. ANA was also negative which is a marker that checks for possible autoimmunity.

Curious to know what the doctors have told you given these normal findings yet the high inflammation hs-CRP marker and CA 19-9 tumor marker.

If conventional medicine has cleared you with the “everything is normal” pass, I’d now be thankful and grateful that there’s nothing to diagnose and definitely pursue functional testing such as the OAT given the previous results which did show potential toxicity/mold exposure.

I will copy/paste my previous reply to you about possible causes for CA 19-9 from the old post so that we can start looking at it again with a fresh set of eyes since pathology is hopefully now ruled out.

—

First let me share a few key findings from a functional lens. This means that although the marker is not flagged clinically high, it may still be suboptimal.

Based on her results and assuming they were taken in a fasting state, a fasting glucose above 90 can possibly indicate insulin resistance. HbA1C should ideally also be a bit lower. (her latest test on Aug 10 2024 shows HbA1C at 5.5% – ideally it should be <5.3% so blood sugar regulation is on my radar)

How is her diet? Does she consume a lot of sweets and flour based products (i.e. croissant, bread, pasta, crackers, muffins, etc)?

Her liver markers ALT and AST are suboptimally high (not clinically high, but ideally should be <30). These are liver enzymes and so they represent how much liver turnover is taking place, so something seems to be taxing her liver. (her GGT in Aug 10 2024 results is below 10, which could mean she has a need for more vitamin B6 and is masking the "true" values of liver enzymes since they are B6 dependent and may not be reflecting the actual value. Vitamin B6 also helps with detox if toxins are at play. The OAT test would help us see this better as it measures vitamin B6.)

Globulin is also suboptimally high which can occur if there’s hypochlorhydria (i.e. low stomach acid), liver damage/infections, oxidative stress (i.e. high blood sugar, heavy metal toxicity, etc), immune activation.

The pattern of her white blood cell differentials (suboptimally high lymphocytes compared to neutrophils) can also happen when there’s either an acute viral or low grade chronic viral infection. And an Eosinophil above 3% can also point to the possibility of parasites (which can also be a cause for an increased Globulin). In her Aug 10 2024 results, was she sick?

CA 19-9 is a tumor marker primarily used to monitor certain types of cancer, particularly pancreatic cancer. In children, it’s rare. But there are also other benign conditions that can elevate this marker and are worth investigating:

• Liver Dysfunction: Hepatitis, cirrhosis, or other liver disorders (MRI ruled this out)

• Gallbladder Issues: Cholecystitis or gallstones (Ultra sound and MRI ruled these out)

• Pancreatitis: Inflammation of the pancreas, which can occur due to various reasons, including infections, trauma, or genetic conditions. (MRI ruled this out)

• Cystic Fibrosis: A genetic disorder that affects the exocrine glands, including the pancreas. If she has respiratory or gastrointestinal symptoms, screening for cystic fibrosis might be warranted.

• Biliary Obstruction: Any blockage in the bile ducts (ultrasound/MRI ruled this out)

• Inflammatory Bowel Disease: If she has gastrointestinal symptoms such as abdominal pain, diarrhea, or weight loss, evaluating for Crohn’s disease or ulcerative colitis could be beneficial (does she have any digestive complaints?)

• General Infections or Inflammation: I would repeat her CRP since this a marker of general inflammation. We want it to be as low as possible. I would ask for the more sensitive inflammation marker hs-CRP. Ideally we want it to be <1. (Given the persistent high hs-CRP on each blood test, I would pursue additional functional testing to help determine the cause of the inflammation in her body. Her recent test on Aug 10 2024 showed a high Reverse T3 – there's definitely something stressing out her body)

And given her suboptimal liver enzymes and possible insulin resistance, taking a closer look at her liver and pancreas would be warranted. (pathology in the liver/pancreas were ruled out with MRI/ultrasound)

Definitely consult with a pediatrician when you’re back to pursue these tests. Your doctor can order an abdominal ultrasound or MRI if they see the necessity.

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I saw that they tested for heavy metals. I’m assuming this was done in blood correct? Unfortunately, unless there’s an acute exposure, it’s not a great way to get a picture of heavy metal body burden. Here’s a video from the Heavy Metal Detox Program that discusses the different types of heavy metal testing and each of their limitations. No test is perfect, but in children, urine and hair samples are the least invasive. I would personally pursue heavy metal testing again if finances allow.

I would also get the MycoTox test along with the OAT test to see if there’s mold being excreted in her urine since the old OAT test showed possible mold exposure.

And if she doesn’t mind getting pricked again, I would want to see her iron panel (Total iron, TIBC, ferritin, %saturation)

Hope this helps give you some new direction to consider. Waiting for your reply to my questions above.

[Bernadette_Abraham]

Hi @Annie – it’s hard to say what the potential causes are so I’m curious to know more. What did your doctor say about this? Were they concerned or request additional labwork to rule things out?

Do you have any other symptoms related to the eyes such as gradual loss of your peripheral vision, blurred vision, halos around lights, eye pain, redness, sensitivity to light, severe headaches, nausea?

Are you overweight? Do you have high blood pressure? How’s your blood sugar status (fasting insulin, fasting glucose, HbA1C)? Any systemic inflammation (hs-CRP)? Have you had these checked recently?

Please share more insights if you have any so we can help guide you better. Otherwise, I’d get those tests I mentioned above as a starting point.

[Bernadette_Abraham]

Hi – I cover that question in the latest “Understanding Basic Blood Chemistry” course HERE.

You might want to call Life Pharmacy as well. I know they were running a fantastic deal on blood testing as a New Years offer – a full CBC, CMP, thyroid, lipids, CRP, iron, and vitamin D for something like 99 or 150 Dhs!!

And Valeo Health offers convenient at-home testing if the offer is no longer running. B Better members get a discount as well. All the details are in the video I shared above.

Let me know if you have any other questions.

[Bernadette_Abraham]

Hi @Maryam Al – I love that you’re thinking about home health! Super important. If you’re not already consulting with a building biologist, I would highly recommend that you invest in one. They will be the best ones to guide you in selecting the safest building materials.

Here in Dubai, I can highly recommend Valentina Cereda. She was a guest in B Better and you can watch her recording and access all of her suggested resources HERE. Her number is +971 55 284 2881. She’s also well versed in EMF mitigation so she’s your go-to for all things home health!

You can also take a look at the Building Biology Institute’s website to find other experts, and also find companies using safer building materials that you can browse through to help with your search.

I hope this was helpful.

[Bernadette_Abraham]

@nikolovaart we have a whole course on mold & mycotoxin illness so my question to you is how bad / long was the exposure? Are you suffering from mold illness or simply want to be proactive after a weekend in a moldy hotel room for example.

If you can share more details about why you feel it’s needed, I can be a little more targeted with my suggestions.

[Bernadette_Abraham]

Hi @nik – yes I’m a fan of amino acid supplementation in those with hypochlorhydria (low stomach acid), compromised digestion and overall nutrient malabsorption. I normally recommend it for 30 to 90 days as we’re working on all of the above, and their body usually gives signs when it’s no longer needed such as making them nauseous or having an aversion to it.

I know you’re transitioning from a vegan diet, and believe this would help in your situation as well.

I have had client success with Apex Energetics ClearVite-ChC or -CLA (just different flavors).

[Bernadette_Abraham]

Replying to your questions one by one:

1. Regarding ANA. It can be positive in individuals with autoimmune thyroid diseases, but not everyone with thyroid autoimmunity will have a positive ANA because it’s organ specific. ANA tests typically screen for systemic autoimmune conditions (such as lupus, RA, etc) that involve multiple organs, not just a single organ like the thyroid so that’s why it can vary from one person to another with an organ-specific autoimmune diagnosis like Hashi’s or Graves.

2. Yes, vitamin A is a regular blood test. It’s not commonly ordered so you’ll likely have to pay out of pocket. I do not know a geneticist in Dubai personally, but I reached out and chatted with First Genomix who are CAP accredited (College of American Pathologists). I’m waiting to hear back to see if they can help. You may want to call them: +971 4 344 0238

3. Given that your son has an existing autoimmune thyroid condition, it’s not uncommon to develop a 2nd autoimmune disease unfortunately, so I would explore autoimmunity further and still request an ANA from the doctor.

And with rhabdomyolysis, the following specific tests can help identify underlying autoimmune or inflammatory muscle diseases (myopathies) that might trigger rhabdo. So in addition to ANA, speak to your doctor about these:

• Anti-Signal Recognition Particle (Anti-SRP)
• Anti-HMGCR Antibodies (especially for statin-induced myopathy) – may not be relevant
• Anti-Jo-1 Antibodies (associated with polymyositis and dermatomyositis)
• Other Myositis-Specific Autoantibodies (e.g., Anti-Mi-2, Anti-TIF1γ)

But from a functional perspective, the diagnosis is not as important as much as determining the underlying cause. If it’s determined to be autoimmune, we then focus on the 3 main pillars to reverse that immune hypervigilance; gut health, immune health, and removing triggers (i.e. traumas, toxins, metals, mold, etc). Here’s a video to better understand how autoimmunity develops.

4. The only doctor I can confidently recommend that will look at your son holistically and from a root cause perspective is Dr. Heather Eade at Novomed.

Please keep us posted.

[Bernadette_Abraham]

@nik  in that case, I would recommend you watch the entire module “Detoxing From Mold” HERE from the Mold & Mycotoxin Illness course. In that section, I discuss the drainage pathways, how to support each one, which order to prioritize first, and also offer 2 different protocols. A “done-for-you” protocol by CellCore or your own DIY protocol where I share guidelines on what it should include.

Have a look and let me know if you have any questions after watching those videos.

[Bernadette_Abraham]

no that’s not it. Now that you’re logged into the B Better dispensary, go back and click on the links I shared above they should open to the product’s page directly

[Bernadette_Abraham]

log out, and select the B Better dispensary when you log back in. You now have 2 Fullscript dispensaries so you have to choose the right one.

[Bernadette_Abraham]

@niko  you’ll need to be signed into the B Better Fullscript dispensary. https://us.fullscript.com/welcome/bbetterbybernadette

It seems you’ve created an account under my personal name (probably from my Instagram linktree link).