Hi @Vidu – it’s always a good thing when they can’t find anything to diagnose. 🙂 But I understand how chest pain can be concerning. And I can totally relate to your daughter’s symptom as it also happened to me as a young competitive gymnast. I used to train in gymnastics 4 hours per day, 5 days per week, and suddenly developed these random chest pains exactly the way you described.

In my case, it turned out to be costochondritis – inflammation of the cartilage between the ribs and the breastbone from lots of physical activity. It wasn’t dangerous, but it was definitely uncomfortable and scary at the time. It resolved on its own with time. Looking back, I wasn’t given anything, but my diet also wasn’t the best. My mom used to drive me to McDonald’s regularly after gymnastics because I was SO famished and couldn’t wait to get home to eat dinner. So, how is your daughter’s diet? Is it rich in anti-inflammatory foods with lots of different colored vegetables, fruits, healthy fats like avocado, nuts, seeds, and good quality animal proteins?

Given that your daughter’s BP was elevated, there could be the possibility of dehydration combined with the stress of being at the hospital. “White coat syndrome” is very real and can temporarily elevate BP. So if you have a blood pressure monitor at home, you can track it at the same time daily to see if it was just a 1-off temporary increase or if it remains elevated day to day. Normal BP for a 9-year-old is usually around 90–110 systolic, so 120 is elevated but not dangerous.

Were any blood tests taken that you can share? If dehydration is present, that can cause a temporary rise in blood pressure by reducing blood volume and triggering blood vessel constriction, and it may also lead to muscle cramps or chest wall pain (like costochondritis) due to electrolyte imbalances.

Other signs of dehydration can include dry lips or mouth, headaches, fatigue, dizziness, or dark or infrequent urine. Has she shown any of these lately? Is she drinking enough water throughout the day, especially before and after gymnastics? Does she sweat a lot? You may want to consider adding in “sole” (saturated salt water) or an electrolyte to her water to help replenish lost electrolytes from training.

Hope this helps.

Hi @Tatjana – it wasn’t lost and I saw your reply in the activity feed. But seeing that you’ve started a thread in the forum, I will copy/paste my original reply, and my 2nd reply so we can continue our back and forth conversations here instead of the activity feed.

—REPLY 1—

Hi @Tatjana – welcome to the community! I will reply to you here, but please note that for more complex case questions and replies, I’d highly recommend posting in the “Ask a Question” discussion forum so that it’s easier for you to refer back to later. https://bbettermembership.com/groups/private-members/forum/ask-your-questions-2/

All of your discussions, documents, photos, etc get saved in your profile so you can easily access them in the future (from Profile or your Home page), whereas posting here directly in the activity feed can easily get lost between all of the messages (plus we can’t hyperlink words in comments).

Nonetheless, I’d like to offer some guidance given the labs and symptom of random shakes you’ve shared. Please keep in mind that your lab results are more than a year old, so there could be many changes since that time, especially if you’ve worked on the issues during this time.

The lab tests confirmed bacterial overgrowth (SIBO) as well as lactose intolerance so there is a strong need to work on gut health if you haven’t already. We actually have a SIBO/IBS Relief program that can help you figure out root causes, and offers rapid relief solutions, dietary guidance, as well as root cause resolution support. You can find that in Take Action > Programs: https://bbettermembership.com/courses/sibo-ibs-relief-2/

The blood tests also showed clinically high levels of direct bilirubin which may point to bile flow issues, liver detox overload, or gut-liver axis dysfunction. Lack of bile flow is a common factor in the development of SIBO so addressing the congestion and addressing what lead to biliary tract congestion is priority. This will also impact a person’s ability to digest and absorb fats, including fat soluble vitamins A, D, E and K.

My go-to for biliary tract congestion is D-limonene (1,000mg 1-2 x per day with food). You can learn more about that as well as other liver/gallbladder support in the Gut Health Masterclass lesson here: https://bbettermembership.com/courses/gut-health-masterclass-2/lessons/liver-gallbladder-support/

Along the same lines, MCV is suboptimally elevated which can point to a need for B vitamins. With a clinically low MCHC, vitamin B6 and iron are often required. If a person is not consuming enough animal proteins (or digesting/absorbing them properly), supplementing with a methylated B complex supplement is a good idea. This also helps with phase 1 liver detoxification.

Now going back to why you may get random shakes, there could be a few possibilities:

1. With SIBO and lactose intolerance, there is likely a lot of wear and tear on the gut lining which can lead to malabsorption of nutrients, loss of enzyme production (like lactase to breakdown lactose, and DAO to breakdown histamine). Pizza can be a perfect storm of triggers: refined carbs, gluten, cheese (lactose), and possibly fermentable fibers — all of which can worsen SIBO symptoms. This could cause post-meal bloating, pressure on the vagus nerve, and trigger autonomic symptoms (like shaking, dizziness, and feeling “off”).

2. Pizza contains histamine-rich foods (cheese, tomato, processed meat perhaps?). If your gut bugs aren’t breaking histamine down properly (common with SIBO), or your liver is overburdened, you may react with nervous system symptoms like shaking, anxiety, nausea, and feeling “unwell”.

3. Possible reactive hypoglycemia? Your fasting glucose seemed “normal” at the time, but fasting insulin wasn’t measured. If it’s elevated, this could decrease glucose levels and make it appear “normal”. You didn’t mention your typical diet or stress levels, but if this is something that resonates with you, you might want to retest a blood sugar panel which includes fasting glucose, fasting insulin, HbA1c for starters. Alternatively, you can look at getting a glucometer or CGM (glucose monitor) which have become quite trendy amongst biohackers.

4. Food intolerances/sensitivities may also lead to shakes. If the pizza had cheese which you’re intolerant to, not only will it cause GI distress, but it can also cause a nervous system response leading to shakes. Does this only happen when you consume dairy? Or does it also happen with other foods? Have you ever kept a journal or done a food sensitivity test?

In terms of action steps, here are things to consider:

1. Support the 3 digestive players “GPS” (gallbladder/bile, pancreas/enzymes, stomach/stomach acid). Consider digestive enzymes, ox bile support, betaine HCl (if no H Pylori overgrowth).

2. Reduce histamine overload by trying a low-histamine diet for a few weeks to see if symptoms improve/go away. If it’s only once in a while, it might be hard to tell, but if you have any other symptoms, it could help us be more targeted with our suggestions. https://bbettermembership.com/resource-library/diet/histamine-elimination-diet/

3. Support liver/gallbladder bile flow: dandelion, artichoke, phosphatidylcholine, castor oil packs, and D-limonene are all helpful. Please watch the video I shared above for more suggestions.

4. LOTS of gut healing to help support the intestinal lining and brush border: https://bbettermembership.com/courses/gut-health-masterclass-2/lessons/gut-healing-therapies/

5. Checkout the SIBO/IBS Relief program to walk you through it step by step.

If you have any other questions in the meantime, please feel free to let us know!

—–REPLY 2—–

@Tatjana regarding the clinically high serum zinc. Keep in mind that anything in serum will be highly influenced by what you ate/consumed the day or so before testing. I doubt you’ll remember what you ate the day before testing a year ago. But a steak dinner for example or consuming a supplement or shake containing zinc the day before testing can definitely lead to false highs. Also, I always encourage testing zinc together with copper since they compete, and always as RBC (red blood cell) instead of serum. And if serum is the only option, then make sure to avoid any supplements or foods high in those nutrients before testing as a general rule of thumb. You can learn more about how to improve lab accuracy in the Interpreting Basic Blood Chemistry course lesson here: https://bbettermembership.com/courses/interpreting-basic-blood-chemistry-2/lessons/best-practices-for-successful-labs-preparing-for-a-blood-test/

If the shaking also happened when you were tired and hungry, this would most likely point to a blood sugar dip and possible hypoglycemia. The body should be able to handle blood sugar lows thanks to its ability to release glycogen for energy. However, if it’s not able to do so or well enough, then the adrenals kick in and release cortisol and adrenaline as an emergency response. The surge of adrenaline can lead to shakes.

The same things could have happened with the pizza situation, but there could also be more than 1 possible cause. It could be a combination of any of those reasons. But my hunch would be a combo of food sensitivity/histamine reaction (due the gut dysfunctions) and possible hypoglycemia (blood sugar dysregulation) leading to an adrenaline nervous system response.

Regarding the super fatty and floating stool. This is due to the strong biliary tract congestion as indicated by the clinically high Direct Bilirubin which is impacting bile flow and fat absorption (so it’s ending up in stool). D-Limonene (1000mg 1-2x per day, taken 3/4 way through a meal) for 60-90 days together with phosphatidyl choline has been very effective at breaking up congestion in my clients. The sharp pain you’re experiencing is likely from the gallbladder. Have you ever had an ultrasound to see if there are stones forming?

Happy you’re a part of this community as well and we look forward to continue supporting you on your journey to feeling your best!

Hi @yasminatassi – Yes, I personally use and recommend Home Care because I’ve taken the time to research their products and ingredients. As for Healthy Home, I haven’t looked into them as thoroughly. I did reach out once to ask if they offered mold inspections, and while they said yes, I couldn’t find any of the proper certifications typically required for that service. That raised some concerns for me, so I chose not to pursue them further.

Home Care UAE describes its pest control services as organic and emphasizes safety for pregnant individuals, children, and pets right on their website here: https://homecare-uae.com/#services

@Kkol 100% YES! I had mentioned in a previous reply in a separate thread that sleep apnea should be explored given it’s connection to NAFLD, insulin resistance, metabolic syndrome, and dyslipidemia.

The American Hospital have a sleep clinic. Check with your insurance to see if it would be covered.

I’m glad you’re willing to explore this. It’s one of those foundational issues that often gets overlooked for years, yet it can be at the root of so many health problems.

@Vidu

I did a quick search to find self-pay clinics in Mississauga, ON. I would call them to see if you need a referral, or if you can can schedule an appt directly and self-pay.

1. Pediatric Urgent Care – Mississauga

Children’s Clinic

3885 Duke of York Blvd, Unit C107, Mississauga, ON L5B 4P2

Website: pediatricurgentcare.ca

Offers pediatric echocardiograms for newborns to 17 years old. Call to confirm availability.

2. Ontario Heart Center – Etobicoke

100 Humber College Blvd, Suite 207, Etobicoke, ON M9V 5G4

Website: ontarioheartcenter.ca

Offers pediatric echo and accepts self-pay patients.

3. Indus Heart Care Centre – Toronto

229 Yonge St, Toronto, ON M5B 1N9

Website: indusheart.com

Private cardiology clinic with pediatric echocardiogram services.

4. Toronto Centre for Medical Imaging – Downtown Toronto

150 York Street, Suite 910, Toronto, ON M5H 3S5

Website: tcfmi.com

Low wait times. Call to confirm if they accommodate pediatric patients.

5. Ontario Diagnostic Centres – Mississauga

3950 Grand Park Drive, Mississauga, ON L5B 2C4

Website: ontdc.com

Offers echocardiograms. Call to ask about self-pay and pediatric options.

6. Trillium Health Centre (Cardiology Clinic)

71 King Street West, Mississauga, ON L5B 4A2

Public/private hybrid clinic offering pediatric echos. Check for self-pay options.

Hope one of these options work!

@Vidu how long are you staying in Canada for and where are you located? Unfortunately the health care system there has become abysmal! My mom had a mini-stroke and 11 months later is still waiting for an appointment to see a neurologist!! Even when we offered to self-pay and not go through the Canadian healthcare system, the wait time was still unforgiving.

With that said, I would call the pediatric cardiologist’s office directly and explain the symptoms. Mention the chest pain, history of fever, and pain with breathing – this may help get her in sooner (hopefully). You can also ask the referring physician to mark the referral as urgent if they haven’t already done so.

But your best bet honestly is to go private, if possible. Some provinces or cities like Toronto, Vancouver, Montreal have private diagnostic clinics where you can pay out-of-pocket for an echo. It will likely cost hundreds of dollars, but it bypasses the queue.

Given the recent fever and pain with deep breathing, yes, an echo is the proper next step to help confirm or rule out inflammation or fluid around the heart which can sometimes follow viral infections.

And yes, some basic blood work could also be helpful, even if it’s just to check for inflammation markers like:

• CRP or ESR – inflammation

• Troponin – heart muscle stress/damage

• CBC – to rule out infection

• Electrolytes – just for completeness

These can also be requested through self-pay from a walk-in lab. Depending on where you live, https://bloodtestscanada.com/ offers private blood tests to get around the system.

@Vidu yes, it’s best to get a child or small adult cuff to ensure accurate results. Look for a cuff labeled “pediatric” or “small adult”.

It may also be a good idea to run a basic set of blood tests (like a CBC and CMP including electrolytes) with her pediatrician when you’re back if she’s not afraid of needles. If you have insurance, these basic tests are typically covered.

@Tatjana from desktop, click on the “Home” tab in the menu. From mobile, click on the green hamburger menu, then click on “Home”. Beneath your Profile picture, you’ll see the upgrade options with green buttons. See screenshot of my Home page from desktop view:

Just click on whichever option you prefer and follow the checkout steps. Let me know if you have any questions.

@Tatjana the Yearly all inclusive package breaks down to the same amount as the Starter which you are currently enrolled in. The Starter allows members to get a taste of what we offer if they aren’t sure they want to commit. But if you feel an all inclusive package is the way to go (either monthly or yearly), you can upgrade anytime from your Home page. Let me know if you have any questions in the meantime.

@Tatjana ok, glad that celiac was also ruled out.

Regarding the greenish stool color… our liver makes bile, a green fluid that helps us digest fats (one of its roles). ⁣A fast transit time (i.e. loose stool & diarrhea) won’t have time to change the stool color to brown (bilirubin – the breakdown of hemoglobin in bile, colors the stool brown.) However, iron supplements, green leafy foods, and green food dyes can also make it green.⁣ You can read more about what stool color means in our blog article HERE.

Oregano oil is both antimicrobial and antifungal. That’s the beauty of herbs! They often have more than 1 action. And yes, it’s possible that along with bacterial overgrowth there is also fungal overgrowth. It’s not uncommon to see both actually.

Now in terms of root causes of SIBO, I would highly encourage you to go through the SIBO/IBS Relief program. I share a 12-minute video explaining the most common causes HERE. I will list them out as well:

-Medications (NSAIDs, hormones/birth control, antibiotics, PPIs, SSRIs, etc)

-Low vitamin D (want to aim for 50-70ng/mL)

-Poor immune function (check vitamin D, zinc, vitamin A, also WBC and sIgA)

-Alcohol

-Hypothyroid function (check TSH, T4, T3, Free T4, Free T3, Reverse T3, anti-TPO, anti-TG)

-Pesticides/herbicides, artificial ingredients, etc

-Persistent stress

-Poor digestion (stomach acid, digestive enzymes, bile flow (we know this was an issue given the high Direct Bilirubin))

–Poor eating hygiene, grazing/frequent snacking (this is very often a major root cause!)

Hope this helps!

@Tatjana indeed that is good news! When they can’t find anything, this is where functional medicine shines in fact!

I just thought of another possible reason after you mentioned the other symptoms you experienced. Did you ever rule out celiac disease? If you’re gluten sensitive or have undiagnosed celiac disease, even small exposures could lead to inflammation, shakiness, or neurological symptoms. Not all reactions involve the gut – some involve the nervous system.

@Hasnaa

From experience, I’ve found it more effective to take lower dosages of vitamin D but more frequently. For example, many of my clients who need to increase their D levels will take 5000 IU daily as to not deplete their magnesium and vitamin A levels which can happen with higher doses.

Do keep us posted after starting the B complex if you notice any nausea, weird rashes, or any other new symptom as this does push detoxification and if there is biliary congestion, taking D-limonene alongside or even before adding in B vitamins, could be helpful.

Just a note about glutathione… it’s to be taken in the daytime and not close to bedtime as it can be stimulating.

Low and slow is the best way to go when working on elimination pathways and detox. There’s no quick fix, and healing root causes does takes time. Just to give you an idea, my initial programs with new clients is never less than 3 months because that’s how long it takes for the body to start making changes at the root. Allow yourself at least 1 to 3 months to start noticing improvements with the changes you’re making.

Good to know you did the baking soda challenge. While it’s not diagnostic, it can help give a clue about stomach acid status. Burping within 1 minute is a positive sign since acid mixed with sodium bicarbonate creates a gas that leads to a burp.

What about the mold situation at home? Any water leaks or high humidity areas to determine if this is a possible source of toxin exposure?

And please do keep us posted so we can continue guiding you.

@Hasnaa the body has an incredible ability to heal itself. Through our 7 detox organs, it can eliminate toxins, and with our immune system, it can fight pathogens. If we improve the terrain so to speak, we don’t necessarily have to know which specific “bug” or “toxin” is burdening the system.

However, given that mold is suspected, I do still recommend going down that path of seeing if mold is in your environment because avoidance is the #1 step to detoxification. Has there ever been a water leak or water intrusion at home? Have you ever had a building biologist come to see if there might be an environmental issue at home?

Nevertheless, working to open detox pathways in the meantime is the best plan of action. That’s detox in itself!

Action Steps:

1. If you haven’t yet watched the video on how to open drainage pathways, please start with that HERE.

2. Support elimination pathways (in this order):

a. Bowels: the goal is to aim for 2-3 well formed, easy to pass stools per day (later on a parasite cleanse can be considered)

• Constipation can be addressed with magnesium citrate 400mg up to 1200mg/ day to bowel tolerance. I like the Pure Encapsulations brand of magnesium citrate.
• Enemas at home 2-3 x per week (starting with water/herbal and then gradually introducing coffee) can help remove compacted stool & strengthen motility if needed (see handout)

b. Liver:

• Castor oil packs before bed at least 5 days per week over the liver & abdomen can help support liver
• Consuming 1 cup cruciferous veggies per day (see handout) can help with liver detox
• Consider B complex to support detoxification. Those with a strong need for B vitamins need to go very low and slow, even opening up a capsule and sprinkling it over food day by day until they can work up to 1 full capsule, and then increase again to 3 per day (1-1-1 with meals)

c. Bile:

• D-limonene from supplement (1000mg 1-2 x per day 3/4 way through a meal) or from the inside peel of 1 large orange per day (eat the white part) can help “decongest” the biliary tract
• Consuming bitter foods before meals or Digestive bitters tincture 10 mins before meals can help support bile flow. I like Quicksilver’s Bitters No. 9 (this helps with overall digestion too)

d. Lymph:

• Weekly lymph massage
• Perform Big 6 points (work up to daily). Please watch Dr. Perry’s session to learn technique: https://bbettermembership.com/resource-library/guest-expert-recordings/lymphatic-revelations-for-pain-with-dr-perry-nickelston-february-23-2024/
• Dry brushing before shower
• Consider compression therapy: https://ballancerpro.com/
• Acupuncture – I can recommend Dr. Hu at Shanghai Medical in Dubai

e. Lungs:

• Daily breathwork (download Balance app (first year free) or The Breathing App – free)
• Exercise/daily walking if there’s energy to do so

f. Kidneys:

• Increase water intake. Make sure it’s filtered water and not from plastic bottles/jugs.
• Consuming lemon water twice daily can help prevent oxalate stone formation in the kidneys.

g. Skin:

• Consider sauna therapy to sweat if there’s no energy to exercise. I love my Therasage portable sauna. Use code BERN for 10% off.
• Dry brushing before shower

Questions you never replied to & other points to consider from previous replies:

1. There is still suspicion of hypochlorhydria and possible H Pylori overgrowth. Have you tried the at-home baking soda challenge yet? If not, here’s the video (3 min mark) to watch and consider. Please report back once you do it so we can guide you on how to support stomach acid.

2. Vitamin D is also suboptimal. Ideally 50-70ng/ml is what’s generally recommended with autoimmunity. Here’s our vitamin D handout to help with dosage. It’s also important for the supplement to have Vitamin D3 and K2 to help with calcium absorption into bones like Seeking Health’s D3/K2 liquid for example.

3. Don’t forget the foundations! Grounding outside on natural surface daily for minimum 30 minutes is a very powerful anti-inflammatory. Getting sunshine to help boost vitamin D production naturally is also foundational.

4. Finally – I’ve recently come across Fascial Maneuvers by Garry Lineham from Human Garage. He will be our guest expert in May. I am absolutely mind blown by the results millions of people are experiencing using his techniques and it’s super simple. He’s on a mission to help 1Billion people help themselves heal. Go to HumanGarage.net and register for his program. You set the amount you’d like to pay so you can get access with only $1! Commit to doing it for at least 28 days in a row. You’ll be surprised by how good you’ll start to feel too!

Hope this gives you a clear roadmap and actionable tools to start! Please let me know if you have any other questions.

@adoobeh99 can you please specify what they are prescribing. Typically, bisphosphonates like alendronate (Fosamax) or risedronate (Actonel) are prescribed orally to slow down bone loss by reducing osteoclast activity (the cells that break down bone). These can definitely be used alongside natural remedies (as I mentioned above) to help with bone formation, and in fact often work better when paired with the right nutritional and lifestyle support.

@Kkol if you’re suspecting sleep apnea, then take him to the sleep clinic directly. If you’d like to take him to a ENT first who may recommend a sleep study if she suspects a need, then I’d recommend Dr. Annelyse Ballin who takes a more holistic approach.