DUTCH

First of all, the timing is hilarious.  Mike Mutzel interviewed the Medical Director of Precision Analytical the company that makes the DUTCH test.  They talked in a secret geek code for snippets of time which made to hard to follow, enough to make me listen 3 times trying to get it all. I loved her statement that we need to stop saying adrenal fatigue (or burnout) because the adrenals don't stop making their hormones, the whole hormone system is off from repeated stressors.  In our case a big part of the problem is SIBO and the amount of nutrients the bacteria steal from us.  I think it has a big impact on our ability to make neurotransmitters and to properly synthesize all these hormones correctly and man we feel it! In a weird coincidence I got my DUTCH results the same day I listened to the podcast.  I watched a lot of Precision Analytical videos but they seem to be on an older report so it didn't match up well.  

I have an appointment tomorrow evening to go over the results with Dr. Pomeroy (the medical director of my nutrition certification program).  It will be good to make heads or tails out of all this.  

So what do I think so far???  My thyroid may be playing a big part.  I've wanted to think I can get off my thyroid medications (S-R T-3) but all these hormones have such an interplay that I may have to just suck it up and realize I just may never convert T-4 to T-3 effectively. Dr. Keller believed I wouldn't kick SIBO until I straightened out my thyroid, maybe she had a point.  So on to the results.  I stopped using any adrenal support 2-3 weeks prior to testing and immediately started feeling better.  If you remember from my previous post supplementing caused my cortisol to plummet.  Off supplements my cortisol bounced back and boy could I feel it.  Not like I was ready to conquer the world but I enjoyed physical activity again, it didn't feel so hard.  So it appears my body makes a decent amount of cortisol but shunts much of it to cortisone, the unusable form.  It can synthesize it back and forth in various parts of the body.  My sex hormones are all low and it looks like I have issues with hormone methylation.  My cortisol metabolites were all low which means while I am making plenty of cortisol my body just isn't processing it, my actual metabolized cortisol was really low.

The program I am in likes to supplement hormones (DHEA and Pregenolone) to get the body back on tract but I'm not sure it's necessary, especially when you do a more indepth test like this and find out it's not about the actual production of the hormone itself but more the body's ability to process those hormones into usable forms.  How do I support that other than the obvious, heal the gut?  Not sure.  Stay tuned.

Results finally - Breath Test #8

Results from May 2015. Breath test number 7.

Results from this month after gacking down guar gum with my herbal kill supplements.  

Not really what I was expecting given that my C and bloating have pretty much resolved. I'm still trying to wrap my head around it.  And it's not negative (like it says) because any methane at or above 3 is positive and really you shouldn't have any methane at all. And if there were no methanogens to eat the hydrogen gas, the hydrogen numbers would be higher. That said, I'm not having any real SIBO symptoms, maybe a little mild bloating throughout the day but not enough to change what I wear (I'm really self conscious when I have a gut and great at hiding it).  I am having D which is a super nice change.  Those with C understand :)

AND notice the date tested is 10/17, a full 10 days ago.  I sent an email questioning why I didn't get the results sooner, especially since I called on the 21st and was told they weren't ready.  Their response:

Hi Shari,

Our turn around time for sending results to the ordering provider for tests taken with kits at home is no later than 2 weeks from the date the completed kit is received in the lab. After samples are tested, they also must be interpreted and the results finalized before we release the results. This depends on how many other kits we received ahead of your kit.

We also do not release results directly to patients unless/until we receive a signed release of information form.

For SIBO tests taken here at the clinic, the turn around time for results is faster, either same day or next day.

Let us know if you have any other questions.

Best,

Audra
--
Audra Lee, M.S.
NCNM SIBO Lab
P 503-552-1931
F 503-444-6709

My response was along the lines of "the numbers are the numbers", it's not like they add any sort of interpretation or add a narrative or really anything.  I also may have said I recommend to others in the SIBO community that they find another lab with a reasonable turnaround time :)

Okay, enough ranting!!  

I'm good where I am so I'm just going to sit on it for awhile, continue with the MegaSpore and hope that the hype is right and it does contain the number one strain used in Europe to treat SIBO.  Although I've never seen anyone from Europe actually talk about MegaSpore or using probiotics in the forums (I guess if their SIBO is gone they wouldn't need to be there too!).  I'll stick with low FODMAPs for at least 6 weeks and decide what to do then.  Until then I'll focus on getting my adrenals and thyroid noodled out.  My worry is until this infecton is gone nothing else will heal.  Guess time will tell!

I think I'm almost there....

Was it the Red Rice Yeast or the addition of a crapton of probiotics??? I'm not sure but my guess is it's a combination of both.  I have been taking Red Rice Yeast with the herbal biotics (Biocidin, Oliverix, garlic in some form and for 10 days oreganol) before every meal. I drink the juice from sauerkraut with breakfast, just a shot.  Between breakfast and lunch I am taking 1/3 tsp of Garden of Life Primal Defense in water (blech!).  I am taking a soil based probiotic (PrescriptAssist) or MegaSpore Biotic with lunch.  Then I lay off because in my experience if I do any probiotics after dinner I generally wake up in the middle of the night bloated.

I'm also being really good about not eating anything that I could be sensitive too which is really hard since we traveled over the weekend.  Does this mean my inflammation is down too?? Hopefully yes and it definitely seems so.

My gut has been happy.  My kid and I stopped at the Alberta cart Cultured Caveman in Portland, OR last weekend and there were 3 other food carts there that were either vegan or paleo, which means no dairy.  I'm pretty sure all the trucks were gluten free as well.  We ate like piggies - chicken strips, ice cream, donuts (2 orders), and a fudge bar. Not the healthiest but oh well.  The ice cream was strawberry-banana and the fruit chunks were a little big for his liking so I ate it. Bananas!  I ate banana with no reaction.  Everything did hit my stomach like a brick but I ate a ton of heavy, fatty food so that's reasonable :)  I have been eating cashew cheese too.  I was missing my cheezy kale chips.  No more.  And french fries!  Too many french fries over the weekend :)

My hormones have not been so good.  I had a lot of stress last week, PMS through the roof and my body temperatures have plummeted.  I know it will resolve as my gut heals but it's hard to ride the wave sometimes while waiting. I went online to schedule a follow up with Dr. Keller but she has increased her prices to $250 for 30 minutes of skype so that's just not going to happen.  AND, the new policy is you can't get breath test results without a consult with her.  In the past I was able to order tests and get results whenever I want.  Ah well, I have a local ND and I can get the tests through him, it's just more annoying because he travels and teaches a lot.  Anyway, I searched online and found both thyroid and adrenal support that is similar to what I was taking.

This webinar does really good at explaining how your gut can mess up your thyroid, adrenals, etc. etc.  I know nothing about the program and am not recommending you buy it but I did think the information was worth watching.  The link will expire on Monday, July 20th.

Next up.... adding in Lion's Mane (which seems to be on sale everywhere right now, which I took as a sign :) to help support rebuilding the nerves in the gut.

Then maybe in a few months I can start adding in resistant starch.  YIKES!

Where have I been???

I started my new protocol a few days ago.  This is not to say that you should try this and especially at these amounts.  I am fairly tolerant of all the protocols I have tried, have never experienced anything I would call die off and I think my bacterial levels are now pretty low so I had no concerns of a reaction.  That said, I have been more tired now that I have all the supplements on board.

Before meals:

1. Biocidin - 10 drops
2. Gi Microbex - 2 capsules
3. Allimed - 2 capsules

With lunch:

1. Megaspore Biotic - 1 capsule

Bedtime:

1. LDN - 5mg
2. Mag Citrate - as needed 

I'm taking resveratrol and fermented cod liver oil with breakfast and lunch, turmeric with all meals for inflammation and Endozin on days when I have some belly itch.  If you don't recall Endozin has zinc carnosine in it, this supplement helps to support tight junctions in the digestive tract.  I also put doTERRA DigestZen on my belly when it itches.

I'm taking Restorative Formulas Adrenal PX Balance and Adrenal PX DHEA to help support my adrenals and hopefully restore normal pathways.  I am also taking Restorative Formulas Thyrocare in hopes of stimulating my body to start converting T4>T3 more efficiently.

Over the next week I plan to start adding fermented veggies back into my diet.  The only reason I stopped is because I was having trouble chewing them (braces/open bite) and I don't really need to add any fuel to the fire.

I've been working with my ND and toying with my T3 medication.  I'm trying to see how low I can get it and still keep my temperature stable.  I wish I didn't need it but I crashed when I stopped.

Still haven't done my Cyrex tests.  My son is having them done too and we are waiting on his serum kit so we can do them together.  He's 9 and more than a little frightened about having a needle put in his arm but his sigmoid colon was swollen and the doctor is concerned if we aren't better about his diet (no gluten/diary) then he's going to develop problems.  Thought best to check for immune response to foods before we eliminate them.

So that's prettty much where I've been and what I am up to.  Things are going good, plugging right along.

Ahhh, that's better.

I hate to admit it but I feel much better on the T3.  I started with a 7.5mcg dose, took it for 6 days then bumped up to 15mcg.  My energy and strength is better.  I'm able to concentrate better which means I am having an easier time with the online course I am doing.  This time maybe my body will be able to reset itself and if not, hopefully I'll be able to tell which dose make me feel the best.

Learned yesterday that 500 times more melatonin is produced in the gut than in the pineal gland.  If you are having trouble sleeping, this could be why!  On a hormone panel if your melatonin is low it almost always is due to a gut issue.  I am one of the lucky ones, sleep has never been an issue for me!

I've completely gone off all anti-microbials for the first time in over a year.  It's a little scary, I must admit.  As always I'm being really careful with diet so as to not feed any of the buggers still hanging about.

I changed my Magnesium from a Citrate-Oxide blend (el cheapo) to a more expensive Glycinate.  One of the presenters in the Digestion Sessions says your body uses more of the glycinate, whereas the citrate and oxides are less absorbable and move on through.  For me this seems to be the case.  I can take a ton of glycinate throughout the day and if I don't add in some citrate in the evening I start to get a bit C.  Then again I also too out the anti-microbials at the same time (of course!).

Up, Up, Up...

For the past 10 days I have been packing on the pounds, like 8lbs!  I haven't changed my diet except for eating jasmine rice 3 or 4 times, maybe a little more honey than I should (still well under 2 tsp a day), certainly not an extra 28,000 calories :)  I've been walking less than usual too, now that I think about it.  I usually walk 2 miles every day.  I've been taking days off here and there.  I'm sitting more with school - watching videos, taking notes, studying. So overall less active.  Still attending 5 or 6 yoga classes a week.  Still not sure that should add up to that much extra weight and when I measured last night I was a full 2" bigger around my belly. Yowza!  No wonder I feel like crud.

The other thing I have done is discontinued the T3 and added in the Adrenomend, Thyrocare and Adrenal PX.  Seems like hormones more likely are having a bigger impact than the above.  I added back in the T3 two days ago as my temps have been too low again (although my temporal thermometer just told me I'm at 100.00 degrees!).  Wonder how long it will get everything to normalize??

And the 3rd thing is the festering infection in my face that I mostly ignored until it started traveling down my neck and up my face. This last screw is a bugger. It just won't heal and I'm sure I'm getting food trapped in the wound so I've become diligent the last several days about using my Hydrofloss after every meal and then oil pulling with MCT and a few drops of OnGuard, Melaleuca and Clove.  I made a topical formula that I am rubbing on the outside of my cheek and on the bottom of my feet every couple of hours.  Thankfully it is resolving because my husband was about to drag my butt to the doctor.  That kind of physical stress can provoke a cortisol response which further messes with hormones.  I have one week to get it completely healed and then they place one on the other side. Hopefully I've learned my lesson with this one and will do better next time.

I think I've got things back under control again and was down 1/2 lb this morning, the first drop I've seen in weeks.  Phew!

The sucky part is with all the new herbals for adrenal and thyroid (6), and the anti-inflammatory supps (3) I've added I am up to more than 20 pills with breakfast.  There is only ONE capsule that is a SIBO killer.  ONE!

New Supplements for the HPA axis crapola

These came via UPS today (like that matters).  

The Adrenal PX is a crap-ton of Vitamin B5 with some calcium, magnesium, DHEA, Pregnenalone and Ashwagandha root.

The ThyroCare is iodine (which I eat fairly regularly), selenium (which I was taking and just stopped), Bladderwrack, Blue Iris, Myrrh, Nettle, Ashwagandha root, Triphala, Ginger root, and 3,5 Diiodotyrosine.  This one should stimulate motility a bit too with the Triphala and ginger, we'll see!

Just when I was getting away with taking less pills!!!  I've added 4 Adrenatone with breakfast and now 1 of each of these both morning and night.  Dr. Keller is going to send a new T3 kit too and that will add 2 more.  So that's 8 more a day.

Jasmine rice, my friend

So far, so good.  First attempt last week, I had one tablespoon of jasmine rice with dinner.  It may have been coincidental but the intermittent stomach pains that I had been having went away.  They came back during my accidental sugaring of myself and my experimentation with potatoes (that were far too old) and a banana (which has a high ferment potential).  So no idea if somehow the rice helped those pains or if they were just on their way out anyway.

Last night I tried again and had 2 tablespoons of jasmine rice with dinner.  So far so good.  I made the Butter Chicken recipe from My Heart Beets.  It was really good, the husband even approved.  This morning I woke up quite stiff and sore but I did a very different yoga class than usual yesterday, then got a massage.  Both activities targeted the shoulders so I don't think it was the tomatoes, peppers or the jasmine rice.  But it's still something to keep an eye on.

I've been having a lot of cramping down the right side of my neck due to a new screw that was placed in my jaw.  My massage therapist said the whole right side of my neck was tight and there was puffiness along the spine. It doesn't seem like it should impact the muscles but the screw is so high up above my teeth that it pushes into my cheek and a little crater has to form and then heal, the ball head of the screw nestles in the crater.  I get spasms in my cheek for up to 2 weeks while this happens and I fight infection as the food gets trapped in there.  It's not fun and I do not recommend it.  Alas things are healing and I ate actual stir fried vegetables today, such a treat after trying not to chew for 2 weeks!  I've been eating mostly creamed vegetable soup and mashed squash alongside fish and scrambled eggs.

My freaking temp has gone back down below 98 so it looks like I'll be going on another T3 taper, increasing dose every 6 days and then decreasing dose every 3 days.  Waiting to hear back from Dr. Keller.

I've been using Melaleuca/Rosemary/Thyme for a couple of days to treat my SIBO.  The melaleuca is pretty harsh so only a couple of days and then I'm going to switch to the same formula as in Candibactin-AR (Thyme/Oregano/Sage/Melissa).  I may stay on it a full 7 days, we'll see.  Disclaimer - please don't try this on your own, if you are interested in trying anything like this, talk to your healthcare provider.  For all you know I could be burning holes in my gut and ruining my health and not killing anything (or worse yet, killing everything!).

ASI Update and more supplements (of course!)

Finally made time to talk with Dr. Keller about my ASI results.  It's quite evident that I need a bit of support which is not surprising to me.  I worked a high stress/long hours job for quite a while and didn't take care of myself, up too late, drank waaaaaay too much and ate like crap.  I exercised occasionally but probably in a way that creates more stress than relieves it.  So I'm adding the following to my supplements:

• Arenomend - 2 a day with a meal, after a week or two, increase to 4
• Adrenal PX - one in the morning and one at bedtime

Arenomend is an herbal support blend and I thought she said Adrenal PX is a pharmaceutical, it contains DHEA (mine is depressed), Pregnenalone (which is a hormone your body steals away to make more Cortisol), and Ashwaganda.

My Insulin both fasting and non-fasting was low.  My non-fasting insulin was no higher than my fasting insulin.  What??  I'm doing a low carb/high fat thing but nothing drastic and I certainly don't think I'm in ketosis. So we're going to give jasmine rice a try.  Wish me luck!!! My digestion has been great, I just want to keep it that way.

My Secretory IgA (sIgA) was borderline low.  Not good! "Secretory IgA (SIgA) serves as the first line of defense in protecting the intestinal epithelium from enteric toxins and pathogenic microorganisms.", from this article on Nature.com.  Definitely need more of that!  Ha!  Thankfully all it takes is another quick search and I found ways to increase it naturally here.  Unfortunately I am already doing most all of them.  I could incorporate more bone broth I guess but I already have soup every day.  I just upped my doseage of fish oil so that should help too.  It's always something!

In good news, it looks like the T3 taper may have helped kick my body in gear.  In a couple of days I will be done with the taper and if my temperature stays up then I don't have to add T3 back in.  Dr. Keller does want me to add:

• Thyrocare - one in the morning and one at bedtime.

This will help support my body's conversion of T4 to T3.  Just when I had finally decreased the number of pills I am taking she adds 3 more :)

I asked her about digestive enzymes and betaine hcl because I will be out in a day and she recommended Klaire Labs Vitalzymes and Designs for Health Digestzymes.

Off to enjoy the sunshine, in other words feed the chickens, gather eggs and pick up dog poop before my son comes home and runs around the yard.

J..J..J...Jittery!

I've been on this T3 taper, increasing my dose of T3 every 3 days.  You go up and then come back down to see when you feel the best and your temperature regulates.  It's been hard getting my temp, this time of year I always drink hot liquids making oral temps out and I always wear a hat making temporal temps difficult too.  Plus I forget :)

Cut to Tuesday of this week when I went up to 60mcg.  Holy moly!  I became jittery and almost manic.  It was like I had chugged a 2 liter of Coke.  I don't drink much caffiene, the occasional Jasmine tea, because I don't tolerate it well.  So I skipped my nighttime dose and the next day woke up and quickly became jittery again.  I skipped the morning dose and luckily was able to skype with Dr. Keller.  She said, "wow!  I can see it and feel it".  It didn't help that I was also easily distracted and the chickens were raising a ruckus outside the open door.  She had me take T4, and restart up my T3 that night, try to stay on it the next day, using T4 to level me out and then taper back down the day after.  Thank goodness my body adjusted, I just couldn't imagine being that hyped up.  Whew!

She says that I should only need to take T3 for a short period of time while we work on my conversion because I am making enough TSH and T4, just not converting it to the usuable Free T3. 

LDN

I've been on low dose Naltrexone (LDN) for several days now.  I started out at 1.5mg and have been tapering up, currently at 3mg at bedtime.  I was expecting difficulty sleeping and vivid dreams but have not experienced anything different than normal.  That's probably a good thing!  I've taken the low dose erythromycin (LDE) out of my nighttime routine.  My motility remains top notch.  I think (for me) the high fat, low carb diet definitely helps.  My gut  seems really happy as of late.  

Now if only I could figure out why I am running so darned hot.  My ND requested I start taking my temperature before I started my thyroid medicine and it's been in the high 99's to low 100's for probably 2 weeks.  Normally I run in the mid 97 range.  Not sure what the heck is going on unless it's my diet.  I started the thyroid meds a week ago and it hasn't really changed my body temp so not sure what to think.  I swear you could spend all day every day just trying to figure out what's going on with your body.  That's not really living however.

At least my gut is happy!

There's always more to learn!

Went and saw my ND on Wednesday.  He dove right into treatment (visceral manipulation).  All my abdominal pulses were really sluggish.  My body is trying to starve out the infection/inflammation in my small intestine by reducing blood flow.  Not the most effective method.  My blood pressure has been really low in general.  I'm probably remembering wrong but when I was at the Chiropractor on Friday they measured it as 90 something over 50 something.  No wonder I've been feeling so bloody tired, rundown and stiff and sore.  My bloods not pumping!

Anyway, he made no mention of my recent labs.  Free T3 measured in at a whopping 1.5.  When I had it tested 18 months ago it was at 2.8.  My microsomal AB (antithyroid antibodies) came in high at 36.5.  Not way above the acceptable 35, but still of concern to me.  When I said, Hey wait, what about my thyroid tests, he said there was nothing to worry about.  He was more concerned that my Vit D was at 52, I usually keep it in the 80's.  He said not to worry about the thyroid, things would get better when my SIBO was gone.  He gave me NADH to help with my muscle stiffness and soreness.  Not sure I like that.  I want to know why I am crashing.  So I did some research when I got home and found this on Chris Kresser's site.  Gut issues lead to thyroid issues and the gut cannot heal when there are thyroid issues.  Great!  And then there's this all about low T3 and how it's caused by inflammation (check!), not eating enough carbs (check! that actually may have been from a separate article), and physiological distress (check!). "In emotional, psychological or physiological stress, the body will convert excess T4 to reverse T3 (rT3) as a means of conserving energy for healing and repair." - from the Low T3 article.  And of course, I have lots of reverse T3.  Ugh!  Supplementing with T3 doesn't seem to be a solution but he did mention LDN (low dose Naltrexone) would be beneficial.  2 birds, one stone - a prokinetic and thyroid support all in one.  So I emailed my ND and he called me in a script.  I had been taking LDE (low dose Erythromycin) but never really liked the idea of a low dose antibiotic.  Can't remember why I was taking LDE and not LDN but it really seems like I screwed myself there!

Oh, AND when I was rooting through my labs I came across my Urine Organix test that recommend I take more selenium, which I overlooked somehow, probably because I have had umpteen millions tests.  Selenium is necessary for the body to convert T4 into T3. See here.

I also scheduled an appointment with Dr. Keller on Tuesday to skype from NCNM SIBO Center.  I have lots of questions that my ND doesn't seem able to answer.

Then today I went in to get the results of my chiropractic reexam.  My heart rate variability score was pathetic and my chiropractor is worried about my adrenals.  A low HRV indicates dominance of the sympathetic response, the fight or flight side of the nervous system associated with stress, overtraining, and inflammation. - From Mark's Daily Apple.  She said it's an indication that cortisol is just coursing through my system.  Again, good explanation for not recovering from my workouts and feeling generally rundown.  She wants me to talk to my ND about getting this test.  It's all so overwhelming and I feel like I need to study in order to put it all together.

In the end I really have no complaints.  When my family talked about what we were grateful for at dinner the first thing I always say is "my health".  Because even though I have all this nasty crap in my gut, I am still a productive functioning human who can pretty much do anything I want.  It seems like so many people who have SIBO don't have access to good doctors who understand the proper treatment protocols, struggle with how they are going to pay for the doctors who don't take insurance, the herbals which aren't covered by insurance,  they have many symptoms most of which are far worse than mine and they also have other autoimmune or yeast or whatever issues that make the treatment of their SIBO even more difficult.  I'm a lucky girl, that's for sure.

Oh and I had Brazilian Fish Stew from The Zenbelly Cookbook for dinner.  Yep, life is good :)