Case Study Recordings

Health History & Symptom Presentation:

• 52 yo, male
• currently on medical leave since June 2018; would like to return to work
• born in Pakistan, living in London (moved when he was young; did a lot of traveling as a child)
• divorced (August 1998 separated; June 1999 divorced)
  • lots of stress; mom was hospitalized during this time which was added stress
  • didn't feel as though his health was effected; felt he could cope with the stress at the time
• noticed after traveling to Pakistan in 2017 digestive issues
  • solmeprozole and another stomach cramping medicine was suggested to him during his time in Pakistan when the symptoms started (pain would come and go)
• towards end of 2017, caught the flu - took 5 weeks for it to go (sign of immune dysfunction; inability to fight whatever is happening)
• weight: put on some weight but still wants to add weight
  • gain is from unhealthy means (i.e., nighttime sugar craving, comfort eating)
• more stress during the day: life, caring for mom, health issues and how/what foods to prepare
• does not sleep well; eats late
  • wakes up multiple times due to caring for mom or digestive issues
• stiffness in muscles and joints
• unable to exercise due to low energy
• as a child: tonsilities (many courses of antibiotics in his childhood)
• teen: acne (more antibiotics; tetracycline)
• 2018 to now: taking probiotics; lately no probiotics due to SIBO
• March 2017: H Pylori (symptoms: burning)
• 2019: diagnosed with gastroparesis (symptoms: would get full quickly; lot of pain)
• March 2019: colonoscopy done, nothing there
• Struggles with: constipation, gas, distention, bloating
• Key driver to his issues = stress (body will not be able to heal unless he deals with the stress!)
  • doesn't have healers supporting him; doesn't have any hobbies; doesnt have any stress relief/reduction practices
• Amalgam fillings
• Diet:
  • waits long after waking to eat
  • eats late; last meal comes right before bed

Suggestion:

Key Pearls:

Case Presentation: 52 year old female, 125 lbs, 4’ 11”. She is on 7 medications. Currently lives in Texas, has 4 children and wants more energy to be able to play with her grandkids. 

Health Goals: Have more energy in order to enjoy her grandchildren, feel better! (she can’t remember the last time she felt healthy), Lose weight: -15lbs, stop being addicted to soda, get off of all 7 medications and improve her mental health. 

• Symptoms:

• Constipation, gas, belching, bloating, diarrhea 
• Fatigue, low energy
• Poor focus, poor memory
• GI: Acid reflux, and heartburn, chest pain, nausea & vomiting 
• Mental health: depression, anxiety
• Gets tired/winded from walking, going upstairs
• High BP, High cholesterol
• Headaches, dizziness
• Stuffy nose, sinus symptoms, excess mucus production
• Chronic tooth and gum pain
• Restless leg syndrome
• Sleep: 2am-12pm unless working, if working 10:30pm-4:15am
• Joint stiffness and swelling (knees and right hand)
• Diet

• Didn’t mention much about childhood food, but was put on Ridalin as child
• Not eating breakfast & lunch
•  
• Family History

• Mother and father have dementia
• Mother has diabetes, high BP
• Red flag: could mean there is a heavy metal component (did you or your mother have amalgam fillings?)
• Other:

• Moderate alcohol abuse. Drinking leads to seizures
• Broke her pinkie, had to have wire inserted

The 3 pillars we are going to focus on: 1) diet, 2) sleep & 3) the trauma

• Diet & Sleep Recommendations:

• The 3 No’s I want you to implement are:
  • 1) NO liquid with your meals. If you need liquid near your mealtimes, drink it 30 minutes before, or 2 hours after
  • 2) NO fried foods. Make sure they are grilled, baked, steamed or maybe sauteed
  • 3) NO sleeping past 10:30 am
• For 1-2 weeks, replace your evening soda with something like “Zevia” or “Olipop”
• If that works, and you aren’t suffering withdrawal symptoms: in week 3 or 4 - replace your midday soda with the same options. Then replace all daily sodas with the above options. Eventually move from Zevia and Olipop to water/other options. 
• Drink the same volume of water, as you do soda. For example: after you finish you 20 oz of Coke, pour yourself 20 oz of water + electrolytes (LMNT is one brand I recommend)
• Use a straw when drinking your sodas
• Download the app “My Water” to help you remember to drink your water each day! (stop drinking water at 6-7pm to avoid waking up at night)
• Eat more vegetables! Think of the VPF Principle: vegetable, protein and fats! Even when ordering out, incorporate this VPF rule of thumb.
• Meal delivery services are a possibility if finances allow - they are easy and healthy!
• Find ways to enjoy, and slow down when eating. Not near the tv, your phone. All of that will help with your digestion, bloating, gas etc!
• Eat veggies and protein first! Fats and starch afterwards. Remember no liquids with your meal!
• Trauma Recommendations: 

• I would call this helpline and get some support from Dialectical Behavior Therapy (DBT) for Alcohol Addiction - a form of cognitive behavior therapy. 1-866-233-1131 for their info line. 
• Healing Modalities video in B Better resources would be another great resource for dealing with the emotions
• Group events on IG with Dr. G (Christian Gonzalez, @doctorgonzalez)
• Supplement Suggestions

• Magnesium Citrate (400 mg to start, increase by 100mg each night if you do not have a regular bowel movement. Do not exceed 1200mg)
• If there is diarhhea do NOT take Magnesium Citrate. Instead take a probiotic, Medegenix Ultra Flora Acute Care
• Make sure you are using a pack or two of electrolytes in your water!
• Multivitamin, daily (PureGenomics Multivitamin) - take ½ capsule, add the power to water for 3 days, then up it to a full capsule for 3 days etc.. go slow with incorporating this! 
• CoQ 10 as an additional supplement if taking a statin medication
• Consider a nutrient dense shake for breakfast, like MediBolic by Thorne
• Omega 3 (Biomega -1000)
• Additional Testing I suggest:

• Liver panel
• Fasting insulin, fasting glucose, HbA1c
• Stool test for H Pylori overgrowth (masterclass in the membership)

• Questions I have, if you could answer in the forum:
  • How often is your sleep shifted to the 2am-12pm?
  • Why are you not eating breakfast?
    • Is it about weight? bloating? 
  • Did you or your mom have amalgam fillings?
  • Are you exposed to other toxins?
  • What medications are you on? (all 7)
  • What is your reservation re: cooking for yourself?
    • Cost? Time? Knowledge? 

Key Pearls:

Case Presentation: 21 years old, struggling with severe morning nausea for 3-4 years; has done many functional tests; calprotectin (inflammatory marker for the gut) showed some elevation, possibly parasite); ultrasound showed gas in the abdomen; given antibiotic which led to lower calprotectin levels; SIBO breath tests, showed some intolerance to lactose; Gut Zoomer (functional gut test: issues with gallbladder; high MMp9 (inflammation marker); test thought maybe nausea a result of silent reflux; given D-limonene, first time he did not wake up with nausea but only lasted 3 days

Health Goals: 

• • Get rid of nausea: worse when he smokes (quit smoking in July)
  • Increase appetite: no appetite with nausea
  • Gain weight: 62k wants to be 72k
  • Symptoms:
    • Severe post-nasal drip
    • Acne
    • Gut: constipation, diarrhea, gas, belching 
    • No appetite, severe nausea
    • Mood: anger, poor memory (had fall on head 6yo and 16yo), anxiety, depression (triggered by circumstances)
    • Sleep: disrupted; bed at 12am, up at 9am, up 1-2x per night to urinate
    • Lactose and fructose intolerance
  • Hobbies:
    • Music
    • Gym
  • Diet:
    • High protein; high calorie
    • Used to eat 1-2 meals/day but wants to eat more
    • Craves salt
  • Other:
    • Zirconia implant
• Elevated Thyroid Antibodies:

• Needs to consider 100% removal of dairy and gluten due to molecular mimicry with thyroid tissue
• Consuming water should be between meals rather than with meals to avoid potentially diluting digestive enzymes
• Constipation, poor digestive function can contribute to nausea 
• LAB RESULTS:

• WBC: suboptimal; should be above 5 (something is taxing the immune system); make senses considering we notice the autoimmune dynamic (thyroid)
• Pancreatic Elastase: low, marker that shows how much digestive enzymes are being released
• Low bile acids: can contribute nausea
• Microbial overgrowth: imbalances in GI tract; can lead to inlammation, intestinal permeability, autoimmune dynamic
• Monocytes (found on CBC): should be < 7%; second line of defense (remove debris); usually see elevation after infection; has been above 7% - could be related to liver dysfunction (want to look at liver markers!)
• ALT (June 2020): clinically high; was given liver support, ALT marker dropped on later blood test
  • B6 used to make serotonin, then convert to melatonin
  • B6 contributes to motility (low levels = constipation)
  • B6 needed to make taurine, taurine needed to make bile salts (bile is antimicrobial; without enough of it can increase risk for microbial imbalances)
  • B6 needed for GABA production (which is necessary for good sleep)
  • B6 needed to breakdown histamine; has some symptoms of histamine overload
  • ALT dependent on B6; present in liver
  • Low ALT (in single digits): may be a need for more B6; may not be reflecting true ALT value; need more liver markers to get a true full picture
• Cortisol Awakening Response:
  • Low morning cortisol 
  • High sodium, lower potassium
  • Recommended to do a DUTCH test to look at CAR; cortisol
  • Relation between 16yo head collision and adrenal glands. TBI can impact the communication between the brain and the adrenal glands
  • Low adrenal function can lead to nausea
• RECOMMENDATIONS:

• Priority: improve gut function; need to have open elimination pathways to properly excrete waste and toxins
  • D-Limonene, Bile support, enzymes, HCL betaine with pepsin
• Constipation rapid relief: magnesium citrate (to bowel tolerance)
• Liver support: start with a B complex for 1 month, then switch to a B Complex higher in B6. Then re-test liver panel that includes Total and direct bilirubin.
• Castor oil packs over the liver/gallbladder area (under right rib cage) 4-5 days per week for 30-45 minutes.
• Focus on autoimmune thryoid & immune support (remove food sensitivities, optimize vitamins D, A, zinc if needed (test levels), histamine-friendly probiotic (ex. Seeking Health ProBiota HistaminX), immunoglobulin support (ex. IgG2000)
• Once digestion is supported, consider a parasite cleanse (15 days on, 10 days off, 15 days on) + Para 1 + Biotoxin Binder
• Limit snacking and focus on 3 main meals per day; focus on VPF+C (starchy carbs due to training schedule)
• Support morning cortisol: Sleep hygiene (sleep before midnight), morning cold showers, inversions, seeing the sun within 20 mins of waking. Consider Dutch Adrenal to check sex hormones, cortisol & B6, B12, glutathione organic acid markers.
• Try DAO enzyme to see if histamine intolerance is at play (or test histamine breakdown)
• Investigate brain-adrenal communication (test ACTH)