Tests, Results, Recommendations - Comments? Integrative Med.

[DJ]

These are my test results from my last Integrative Medicine visit. I'm going back on Monday. Can you provide me with insight or questions to ask? I was diagnosed with LC over two years ago and continue to live a very careful life with intestinal ups and downs. I have an extreme cough of nearly 20 years that is relieved by pushing on my left side and burping (a lot). I chronically have gas right below my stomach. I know this because it's pointed out on ultrasound results. It obstructs the view.

CBC - within reference
Comp. Metabolic Panel - within reference
Celiac genetic test - super duper negative
MTHFR - C677T/C677T (methylfolate & B vitamins prescribed in megadose. I took a small fraction of the dose and had a systemic rash. I gave up the two B12 enriched foods I was eating, refrigerated coconut beverage, and GF Chex.
B12 - 1663 (recent range 1500 to 2500)
Folate - 19.9(within reference)
Epstein Barr and H. Pylori - negative
DHEA Sulfate - 35 (within reference)
Cortisol - 12.6 (within reference)
Vitamin B6, plasma - 23.5 (within reference)
Zinc, RBC - 1184 (within reference)
Reverse T3, Serum - 16.1 (within reference)
C-Reactive Protein, Cardiac - 1.09 (low risk)
Homocystine, Plasma - 10.3 (within reference)
Iron, serum - 134 (within reference)
Insulin - 6.2
Ferritin, Serum - 104 (within reference)
Thyroid Peroxidase - 6 (within reference)
Magnesium, RBC - 4.8 (within reference) I supplement
Genova
Bacteria diversity - lower
No ova or parasites seen
GI Effects Comprehensive Stool Profile
Digestion and Absorption
Pancreatic Elastase >500 (ref >200)
Products of protein breakdown 2.2 (ref 1.8 - 9.9)
Fecal Fat 5.4 ( ref 3.2 - 38.6)
Triglycerides 0.4 (ref 0.3 - 2.8)
Long Chain Fatty Acids 1.8 (ref 1.2 - 29.1)
Cholesterol 2.8 (ref 0.4 - 4.8
Phospholipids 0.4 (ref 0.2 - 6.9)
Inflammation and Immunology
Calprotectin <16 (ref <50)
Eosinophil Protein <DL (ref <7.0)
Fecal Secretory IGA 271 (ref <885>23.3)
n-Butyrate concentration 6.1 (ref >3.6)
n-Butyrate % 12.1 (ref 11.8 - 33.3%)
Acetate % 64.8 (ref 48.1 - 69.2)
Propionate % 23.1 (<29.3%)
Beta-glucuronidase 1,412 (ref 368 - 6,266)

Gastrointestinal Microbiome (measurement scale 1+ to 4+)
Lactobacillus spp. 4+
Bifidobacterium 3+
Citrobacter braakii 3+
Klebsiella Pneumoniae 1+
famma haemolytic Streptococcus 4+
No pathogens
No parasites

Medications/Supplements Recommended
Simillase GFCF - Took digestive enzymes in the past and it didn't help. I didn't try this suggestion at this point.
5-MTHF (folate) and Active B Complex - I found a methylated, less potent version and used it only once or twice per week. I stopped after having a systemic rash.
DGL Plus - I owned some of this. I tried it again. Still didn't help.
Adrenevive I tried one cap daily. I think it gives me a little more energy but it seems to cause a bit of upset. It contains a derivative of soy lecithin
Zinc Piccolinate 50 mg. I am trying 25 mg. At times, I feel a little buzzy when I take this, a bit like when I had the B12 rash.
l-Glutamine - I took this in the past without results. I take it on rare occasion.
Pro Omega Liquid fish oil - Expensive and it didn't rest well. I purchase low-dose krill oil gel caps and I tolerate them well.

I developed foot and leg cramps since I gave up fortified coconut beverage (B12 issue). It was my main calcium source and it must have been working! Calcium tablets don't prevent the leg cramps. I have liquid calcium coming in the mail.

[tex]

Based on the test results, you appear to be totally healthy.

FWIW, the leg cramps are almost certainly due to a deficiency of either magnesium or potassium (I didn't notice a test for potassium). The RBC test for magnesium is better than the regular serum test, but it still only tells you how much magnesium is in your blood. It gives no indication of how much magnesium is available in your muscle cells to replenish the serum magnesium as it is used up in the blood. Prior to when my symptoms began to be serious, my magnesium test result was always normal. But I would wake up in the wee hours of the morning, with serious magnesium deficiency symptoms (because that's when my body would run out of magnesium). On a day when the symptoms were severe, and I skipped taking my supplements, the deficiency finally showed up in the blood test.

The moral of the story — serum tests for magnesium are pretty much worthless unless our body has already run out of magnesium, and we are at risk of having a heart attack or stroke because of the loss of an essential electrolyte (magnesium).

Tex

[Gabes-Apg]

My only advice is trying to find B12 that you can tolerate....

Lingual versions????
Get a transdermal form made up?
I recently used injections for active form of B12.

Also the leg cramps, even though the test states magnesium is within range and you supplement, how much elemental magnesium are you getting per day??

(Sorry for any typos... Up early morning watching the rugby World Cup final... That the Aussies are about to lose)

[DJ]

Hi Tex, I was pleasantly surprised with the results too. My stamina has partially returned but it's nowhere near normal and I'm having rapid transit digestion but true WD only a couple of times this week. I'm focusing on the cough/volcano/spasms/mega-burping on my upcoming medical visit. I wonder how long I'll need to use cholestyramine before having improvement or determining that it won't help.

I think my gut is acting up because my workplace is stressful right now. Have you ever watched those bizarre reality survival shows? I'm watching one daily from my desk....no TV needed

[tex]

That kind of stress could certainly be the problem.

If I recall correctly, Polly suggests about a 2-week trial for cholestyramine.

Tex

[Gabes-Apg]

while there is increased stress around - i would suggest increasing Vit D3, magnesium

[DJ]

Thanks Tex, I'll give it a try for two weeks.

Gabes, I'll need to have a truckload of D3 and magnesium. Maybe Fentanyl and Versed would work better. It's often used for colonoscopies. Going to work these days feels a lot like a colonoscopy....hahaha.

[DJ]

Gabes 34 to 17 ....sorry. Maybe next year.

[Gabes-Apg]

it was 21-7 when i got out of bed to watch it

Rugby world cup only happens every 4 years....