[Bernadette_Abraham]

Hi @natkhoury20 – sorry to hear about your daughter’s discomfort. I have questions to help us dig a little deeper:

1. Even though you’re avoiding soap, what laundry detergent or fabric softeners are you using to wash her clothes in? There could be irritants or allergens in those.

2. What material is her underwear? It should be 100% cotton.

3. Is her underwear tight fitting that it can trap moisture? Are there times where she sweats a lot or does any activities like swimming that can lead to a lot of moisture?

4. Does she use any wipes or scented toilet paper? How about bubble baths?

5. Who helps her wipe after using the toilet? Any back to front wiping involved which can introduce bacteria from the anus into the vaginal area?

6. Have you taken her to see a doctor to rule out a possible yeast infection?

7. Have you noticed if it happens around a time when more sugar is consumed (which can promote yeast growth)?

8. How about potential food sensitivities (ex. to dairy, gluten) which might cause low-grade inflammation that affects sensitive areas like the skin and mucosa? I’d suggest keeping track with a food log to see if you notice any patterns if you haven’t already.

9. Does she consume any probiotic-rich foods like kefir, sauerkraut or other fermented vegetables for example?

10. Do you notice her itching her bum, especially at night? Pinworms (tiny parasites) can irritate the anal tissue but they can also migrate over to the vaginal region. Gross I know. But it’s something to rule out. You can try the “tape test” (placing sticky tape over the anus late at night or first thing in the morning) to see if you can visibly see pinworms.

11. Does she have any other skin issues elsewhere like rashes or eczema?

12. What are you currently using to help relieve the irritation and itch?

If she’s been experiencing this symptom twice per month for the past 4 months, I would definitely take her to see a pediatrician to physically examine her and do a swab, urine and stool test to rule out infections and pinworms.

Waiting to hear back from you.

[Bernadette_Abraham]

Hi @LAK – to avoid having you repeat yourself, can you please link the previous thread discussion we had so I can refresh my memory about your case. Additionally, I have a few follow-up questions:

1. When were these tests taken in your cycle?
2. How long after starting supplementation did you have your blood drawn?
3. How long have you been supplementing in total?
4. How are you feeling now? Any new updates or symptoms to report?

[Bernadette_Abraham]

Hi @Inga-55 – no not at all! I definitely would not want to be putting PEGs in my vagina which are likely derived from formaldehyde which is cancer causing. Same with pheoxyethanol which can be a carcinogen, endocrine disruptor, allergen or skin microbiome disruptor.

Your question is timely because I’m working on a protocol for vaginal dryness relief for December’s release. In the meantime, if you’re experiencing vaginal dryness because of low estrogen levels which is common post-menopause, there are a few things to consider:

• consult with a naturopath or functional doctor to discuss bio-identical hormone therapy which can include estrogen only, or all sex hormones (estrogen, progesterone and testosterone)
• also discuss with your doctor if vaginal DHEA cream like Dr. Anna Cabeca’s Julva Cream or vaginal estriol cream (available over the counter in the US) is appropriate
• consider consuming 2-3 rounded tbsp of ground flaxseed daily – an easy addition to a smoothie or salad. This natural, plant-based phytoestrogen is much weaker than the strong estrogens our body can produce, so they can give symptom relief without significant risk of estrogen toxicity.

• A few supplements that have shown some efficacy in vaginal dryness:

  • Vitamin D
  • Vitamin E suppositories (also common in natural lubricant oils)
  • Royal jelly cream
  • Maca (e.g. Feminessence)

Aside from low estrogen, there could be other reasons for vaginal dryness. Some adaptogenic herbs like rhodiola for example can result in overall dryness, including vaginal dryness. Anticholinergic medications are also drying so should be ruled out as a cause as well (as in some allergy and cold meds, tricyclic antidepressants, incontinence meds and others). Other things that can contribute to dry mucus membranes include any type of hypothyroidism and tannin consumption (e.g. coffee, black tea, red wine). And it goes without saying that dehydration overall will dry mucus membranes as well, including the vagina.

Which ones do you think are possible root cause reason(s) for you? Determining that will help you better address the issue.

In terms of cleaner lubricants, plain old coconut oil is safe and effective. If you prefer a product, then checkout Coconu’s line of lubricants.

Hope this helps offer relief and resolution!

[Bernadette_Abraham]

Hi @Annie – I would actually want to investigate liver / gallbladder health and fatty acid status first and foremost. Our skin’s outermost layer, contains a matrix of lipids (fats) and proteins that form a protective barrier to maintain hydration and protect against external damage. And since we need good liver function to produce bile, and we need bile to help absorb our fats, that’s where I would start looking.

A liver panel includes: ALT, AST, GGT, Alk Phos, Total bilirubin, Direct bilirubin, Protein, Albumin, Globulin

I would also add in vitamin B6 specifically because it’s a nutrient that’s needed for many liver enzymes.

For fatty acid testing, I would recommend OmegaQuant’s Complete test. We also have a discount code for B Better members.

Other nutrients I would test for are Vitamin A and RBC zinc. Vitamin A is critical for skin regeneration and zinc helps with wound healing and skin repair.

Feel free to share the results if you decide to get tested so we can further guide you.

Finally, was there a reason you are suspecting vitamin B deficiency?

[Bernadette_Abraham]

Hi @healthyliving99 – may I ask where you’re immigrating to? As far as I’m aware, flu and covid boosters are not mandatory vaccines. Same with Tdap for adults.

[Bernadette_Abraham]

Hello @adoobeh99 – d-limonene is indeed a wonderful component of citrus extract that can help decongest the biliary tract and has also been clinically proven to dissolve cholesterol-based gallstones. If you like to read literature, you can start with these:

• Medical dissolution of gallstones. Clinical experience of d-limonene as a simple, safe, and effective solvent

• D-Limonene: Safety and Clinical Applications (attached report – see p. 4 for more studies)

The typical adult dose is 1000mg, 1-2 x per day, for 30-60 days (or more) depending on the severity. It’s best taken 3/4 way through a meal. I also tell my clients to place it in the fridge or freezer to delay the release of citrus oils, to prevent burping citrus flavor. It also comes in liquid form, which is convenient for children.

Hope that helps!

And FYI – just letting you know that I’ve moved your discussion from “General Discussions” to the “Supplements & Medications” forum instead.

Limonene12-3.pdf 1 MB PDF - Click to view

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[Bernadette_Abraham]

Hi @LAK – PCOS is diagnosed using the Rotterdam Criteria (two of three criteria must be met):

1. Irregular or absent ovulation (anovulation)
2. High androgen levels
3. Polycystic ovaries on ultrasound

The blood tests the doctor wants to run sound correct. They usually check androgen levels (testosterone and DHEAs), LH, FSH (the ratio may suggest PCOS).

To rule out PCOS, they can test ACTH (to check brain-adrenal communication), prolactin, thyroid, and also blood sugar (fasting insulin & glucose).

Hope that helps.

[Bernadette_Abraham]

@LAK the fact that DHEA-s was low suggests that instead of it being converted into the sulfated, more stable storage form (DHEA-S), the DHEA you’re supplementing is being quickly converted to androstenedione. It could be that your body naturally has high enzyme activity to convert it that way or there could be PCOS which increases androgen production.

So yes, the high androstenedione levels could be entirely due to DHEA supplementation even if it’s only been 1 week. It could also be an initial spike and then your body will normalize. However, underlying hormonal imbalances (e.g., predisposition to androgen excess, PCOS, or adrenal overactivity) could also be amplifying the effect.

So you can discuss with your doctor to:

1. Continue supplementing and re-test again in 3 weeks see if levels normalize since you’re feeling good.

OR

2. Reduce by half or stop it temporarily and retest androstenedione levels after 4–6 weeks to establish a baseline level vs. the effect of supplementation.

[Bernadette_Abraham]

Hi @LAK – here’s what stood out from these latest labs:

• High LH (Luteinizing Hormone): in women, this hormone triggers ovulation and stimulates the ovaries to produce estrogen and progesterone. Your level is 13 mIU/mL when it should be 1.9-12.5 during the early follicular phase (day 2 of your period). Your FSH (9.10 mIU/mL) however is within the range but should be in a ratio of 1:1 with LH. So your LH:FSH ratio is slightly higher, ~1.4:1 (slightly above normal), which is often seen with PCOS (but more so when the ratio is 2:1). However, it could also be due to your recent supplementation with chaste tree (Vitex), which influences the hypothalamic-pituitary-ovarian (HPO) axis.
• High Androstenedione: this is more than likely due to the recent DHEA supplementation. The body converts DHEA into androstenedione an androgen hormone. Chaste tree’s effect on LH stimulation may also be enhancing androgen output. The fact that you’re feeling stronger at the gym is likely due to the increased androgen levels. And feeling less “snappy” may also be related since DHEA can boost mental clarity and wellbeing in some people. The Chaste Tree can also be a play since it helps regulate progesterone and prolactin, which can potentially improve mood.

• Low-Normal DHEA-S: despite you supplementing with DHEA, your DHEA-S (51.0 µg/dL) remains below the normal range (60.9–337 µg/dL). This suggests that you’re not converting it well from DHEA to its sulfated form DHEA-s or that your body is quickly converting it to androstenedione or other androgen hormones and bypassing the sulfation pathway altogether.

Since androstenedione is clinically high, I would discuss decreasing your dosage by half with your doctor to see if the levels normalize. Retest DHEA-s, androstenedione, LH, FSH, estradiol and testosterone after 4-6 weeks.

If you haven’t already, investigate the possibility of PCOS.

And since DHEA-s was low despite supplementing with DHEA, if it continues to be low, then consider optimizing sulfation enzymes with nutrients like magnesium, vitamin B6, sulfur-rich foods (like garlic, onions, eggs), and NAC to support detoxification and antioxidant pathways.

[Bernadette_Abraham]

@Inga-55 you can ask your doctor to run a sex hormone panel which includes estrogen, progesterone, testosterone, and DHEA.

Regarding flaxseeds. Any brand will do – ideally organic and whole (not ground). It’s better to grind a small batch at a time yourself and keep the rest of the ground flaxseed in a sealed jar in the fridge.

[Bernadette_Abraham]

Hi @Annie – there are many variables to consider when it comes to increasing vitamin D levels from sun exposure; amount of skin showing, color of skin, age, geographical location, UV index, time of day, weather, duration, etc.

That’s why I really love the D minder app to help track vitamin D intake. It accounts for all of these variables so that you can determine when and how much sun exposure you should be getting in to help improve your vitamin D levels.

The recommendation to avoid washing the skin immediately after sun exposure is partly true because it hinges on how vitamin D is synthesized and absorbed through the skin initially. When UVB rays hit the skin, they convert 7-dehydrocholesterol into pre-vitamin D3, which is then transformed into vitamin D3 in the skin. From there, vitamin D3 enters the bloodstream and makes its way to the liver and kidneys, where it’s converted into its active form, calcitriol. While this process begins in the skin, there’s no solid evidence proving that washing right after significantly reduces vitamin D levels. That said, waiting 1–2 hours before showering with soap might be a good precautionary step, but it’s not strictly necessary for everyone.

Hope that helps.

[Bernadette_Abraham]

@healthyliving99 I would personally look for a doctor who could write a medical exemption because if a vaccine is not medically appropriate due to a specific health condition or for moral/religious reasons, a civil surgeon can certify this exemption and annotate the form I-693. Here’s what it says on the USCIS.org website:

Q. What will happen if I refuse to receive one or all of the required vaccines?
A. Tell the civil surgeon if you do not wish to receive the required vaccines or a particular vaccine. You should also tell the civil surgeon the reason you do not wish to receive the vaccine(s). In this case, a waiver may be available to you, but only under the following circumstances:

• You are opposed to all vaccinations in any form– a waiver may not be granted if you only object to specific vaccinations;
• Your objection must be based on religious beliefs or moral convictions; and
• The religious or moral beliefs must be sincere.

The form used to apply for a waiver depends on the adjustment category under which you are seeking legal permanent residence status. For example, refugees and asylees seeking adjustment of status should file Form I-602, Application by Refugee for Waiver of Grounds of Excludability. Individuals seeking adjustment of status based on an approved Form I-130, Petition for Alien Relative, or Form I-140, Immigrant Petition for Alien Worker, are required to file Form I-601, Application for Waiver of Grounds of Inadmissibility.

If you can delay the application process, you can also likely avoid the flu vaccine altogether. I researched the green card vaccination requirements and it said that the seasonal influenza vaccine is required during the flu season, which generally runs from October through March. So if you can wait to apply outside of these months, a flu vaccine may not be available and therefore that’s one less vaccine you’d be required to take.

If none of the above are options for you, then I would definitely space them out to avoid taking them all at once, and make sure I’m not sick or immunocompromised at that time either.

Regarding the Tdap vaccine, it contains aluminum as the adjuvant to create a stronger immune response, along with preservatives. So anything that supports liver detox and binders to help escort toxins can help. However, since you’re breastfeeding, it would be wise to pump/discard breastmilk and supplement with formula during this time to prevent toxins from transferring into the breast milk.

I share different binders/chelators (food and supplement options) in the Heavy Metal Detox Program.

I also share different ways to support liver detox from the Mold & Mycotoxin Illness course. (watch video and scroll down for list of products mentioned on the slide)

Glutathione, a major antioxidant and detoxifier, can also be helpful after vaccination to assist the body’s detoxification
pathways and decrease inflammation.

And finally, if you can test and optimize vitamin D, A and RBC zinc, these nutrients can help support overall immunity.

uscis.gov

Vaccination Requirements | USCIS

These Questions and Answers provide basic information about the general vaccination requirements for immigrants (including individuals seeking adjustment of status), and specifically about the asse

[Bernadette_Abraham]

@adoobeh99 it’s generally very safe to be taken with other supplements. Are you concerned about a particular supplement?

Have you seen our liver/gallbladder support video from the Gut Health Masterclass? You’ll learn that in addition to d-limonene, taurine and phosphatidyl choline can be helpful additions in cases where D-limonene was not enough to dissolve gallstones. And keep in mind that it’s important to also support gallbladder emptying to help them pass through. Things like extra virgin olive oil, artichoke and bitter foods/digestive bitters in supplement form can also be helpful additions to promote bile flow.

I also share more potent options such as the cleanse by Dr. Schulze. Please spare 20 minutes to watch that video lesson if you haven’t already.

[Bernadette_Abraham]

@sheetalramchandani1 if stress is part of her picture, then you know it will impact digestion and absorption of nutrients. This is key for her to work on and reduce.

Secondly, let’s explore histamine intolerance a little closer. With high IgE levels, we know that her body’s immune system is responding to an allergen (a few have been determined). This triggers histamine release from immune cells, leading to the familiar symptoms of allergies like hay fever, asthma, eczema, and food allergies.

While histamine overload itself is not a direct cause of peeling skin, it can contribute indirectly by contributing to inflammation, itching, swelling which can cause scratching and lead to skin irritation or peeling. Histamine overload can also exacerbate conditions like atopic or contact dermatitis that can lead to flaky, dry or peeling skin.

What do we need to break down histamine after it’s produced? DAO enzyme, which is heavily dependent on vitamin B6, which we now know is suboptimal in her cas. We produce DAO enzyme in the gut, so if there is any dysbiosis or gut barrier dysfunction, this will impact her ability to produce DAO enzyme and break down histamine.

Her diet, even though it’s healthy, may also be contributing to her histamine overload. Since I don’t have a food journal to assess her exact food choices, as a test, she may want to consider following a low histamine diet (handout here) for a month to see if she notices any improvements.

There are many other things that can contribute to histamine overload, so please checkout our helpful guide HERE for more resources.

[Bernadette_Abraham]

Hi @sheetalramchandani1 – I saw these results already. It would be great if they can also check RBC zinc and get a full thyroid panel. Unfortunately, TSH, T4 and T3 does not give us a good enough idea of her thyroid function. A full thyroid panel included TSH, Total T4, Total T3 (which they did) but also Free T4, Free T3, Reverse T3, anti-TPO and anti-TG.

Given that her vit A and vit B6 are both at the low end, I’m questioning stomach acid sufficiency and her diet. And how’s stress?

If you can share more about her diet, this can help me help you puzzle piece further.