MTHFR?

Skyped with Dr. Keller today.  Very funny, she popped up and said, "I feel totally unprepared, I don't have any lab results".  We are waiting for results on my ASI which should be in any day.  I knew they probably weren't going to be ready but wanted to talk anyway because I always have so many questions about what I should or shouldn't be doing.  The herbal protocols are somewhat easier to figure out and I feel like I can experiment with that on my own (to some extent) but there are other pieces I just can't wrap my head around.

Concerns I have: dysbiosis in my large intestine and my inability to support that given the fact that I cannot eat starch without getting C.  My last stool test showed my Butyrate was borderline low and my SCFA's were low.  Both of these things are necessary for a healthy large intestine.  She had concerns about this as well and said she thinks of me often because we have tried so many things without much result.  I find this oddly reassuring and disturbing.  I don't want to be the kind of case that a doctor has to ruminate about.  I want to be the easy fix, the success story, the happily ever after.  She's wondering about MTHFR and thinks we should test (you can do this specifically with a saliva test or through a more comprehensive 23andme.com and then have the results translated for you through a service such as Genetic Genie).  23andme is actually less expensive and you can a wealth of information (that I probably don't need! Who needs more to worry about?).  

She also wants me to consider a barium study to look for any anatomical abnormalities and/or adhesions from my c-section.  That sounds expensive!  My insurance will probably just apply it toward my astronomical deductible.  Which makes me wonder why I'm paying through the nose every month for coverage!

White rice and white potatoes are recommended to help introduce some starch but keep the fermentation potential low.  She thought I may need to add back in the LDE in addition to the LDN while my body gets used to the starch.  My digestion is feeling so good right now that I am a bit reluctant.

She asked about my Vit D levels because Dr. Weinstock has been researching LDN and found that it doesn't work optimally as a prokinetic unless you have enough Vitamin D on board.  Thankfully I just had mine tested and it's in the 50's so were were able to rule that out without more labs.

Another way to support my large intestine bacterial health would be probiotic enemas.  She recommended once every 3 days to see how it goes.  I have both PrescriptAssist and Lactoprime Plus on hand and she thought the PrescriptAssist would be best.  Sounds like fun!  I still think I should add a little resistant starch or some other prebiotic to feed them as well :)

I also had thyroid specific questions.  Why do I need to be on T3 when the issue I am having is not with lack of hormone but with my body's inability to convert from T4 to T3?  She says we need to get my temperatures regulated (they are all over the place) and then we can work to support conversion.  Okay, but ugh, I hate taking these little white pills.  She didn't have any concerns with occasional seaweed or iodine in my multi's which is a relief.  She also doesn't think I need to worry about TH1 and TH@ dominance.  If I react to one of the triggers then we'll figure it out. 

I asked about Glutamine powder and Liposomal Glutathione but she wants me to wait before adding anything else in.  She is also researching Glutathione to figure out which one she trusts the most.

Oh, and she said I could experiment with fermented foods again.  I've eaten them in past and didn't notice any issue so I'll try again.

30 minutes goes so quick but I always find it so helpful.