Hi ,

First of all, I hope your daughter is doing weel considering the circumstances. These labtest (although some labvalues still show status ‘pending’) can provide us some insights already.

You mentioned you were doing lab tests since September. Does that mean you have other tests done as well? Posting them as well can provide us even more insight into what might be playing.

I will be sharing some key insights I see on the labresults. These insights give us directions on what to do.

Low Iron
You might have seen the low iron on the labresults yourself as well. Iron is needed for the production of hemoglobin – which carries oxygen and gives the red blood cells a certain size. On this labresult you can see other markers related to Hemoglobin as well:
• MCH (Mean Corposcular Hemoglobin) – A value that refers to the average quantity of hemoglobin present in a single red blood cell. 
• MCHC (Mean Corposcular Hemoglobin Concentratioon) – A value that refers to the average concentration of hemoglobin inside a single red blood cell.
• Transferrin saturation – Transferrin is a carrier protein for iron. The saturation refers to the percentage of transferring carrying the iron
• Ferritin – A storage form of iron.

What you can see here is that all these markers are either just bearly in the reference range – or low. The symptoms (pale, hair loss – if you want to learn more about signs & symptoms of an iron deficiency just click here) you are describing are fitting with anemia which can be caused by an iron deficiency.

Low iron can be caused by a low iron diet which can happen on plant based diets, but also due to absorption problems. Here is a video on how to correct an iron deficiency. Just be aware that (simmering) infections can make it hard for the body to absorb the iron. Its the an attempt of the body to protect itself because microbes/viruses can use iron to make things worse. If you are going to use iron supplements when an infection is going on, raising iron can be hard or cause problems. 

Before you consider iron supplements you might want to answer these questions first:
• Was your daughter feeling ill around the time when this test was done?
• Does your daughter have any digestive complaints (Bloating/gass/diarrea/constipation/cramps/etc)

Hormone balance
Another thing to keep in the back of your mind when it comes to iron is that your daughters body is starting to change. Her female hormones are becoming more active. This process more often than we would like is going to cause a temporary disbalance. 

This is normal. 

But getting periods is new to her body. When women are starting their menstual cycle the blood loss can increase the risc of an iron deficiency as well and the needs for iron go up.

Vitamin D & Immune system
I have mentioned that infections can impair iron absorption. On the labresults you can see that the amount of white blood cells is enough. However, the ratio between the neutrophils and lymphocytes tells us that either something was going on – or still is going on to a certain degree. Neutrophils are the primary mediators of the rapid innate host defense against most bacterial and fungal pathogens. With an immune system in rest we usually see the percentage of neutrophils higher and the percentage of lymphocytes lower.

We also see a low vitamin D on the lab results. Correcting vitamin D levels will give the immune system more support to what might be at play. Zinc & B12 play also an important role in the creation of white blood cells. I usually with my clients aim for B12 levels of 600 or higher since I consider that as optimal.

Low thyroid hormones
You also might have noticed the low T4 and free T4 (fT4). fT3 is the metabolic most active thyroid hormone and is in the lower half of the reference range. Insufficient iodine is the most known nutrient deficiency that can cause a low thyroid, but iron is crucial as well for balanced thyroid hormones. Stress, for example caused by an infection, can lower thyroid hormones as well. Lastly, thyroid hormones can also be influenced as a result from the sudden change in her female hormones.

Therefore my advice would be: focus on correcting the vitamin D & the iron deficiency first. Usually it can take a few months before anemia disappears, but since her hemoglobin looks like it is borderline you might see improvements faster. You might need to wait at least 6 weeks when you start correcting her iron levels before you notice any improvements. Most people recover from an iron deficiency anemia in 2 to 3 months.

I hope this helps!

 I’d like to add some additional videos for you to watch in addition to Daniel’s excellent suggestions above to help you figure out the root cause of her iron anemia:
• Reasons for low iron
• The test markers that point to iron deficiency anemia to help you understand your daughter’s labs a bit better
• Reasons for low T4

After watching these short videos, and absorbing Daniel’s message above, please let us know which reasons for low iron/T4 you feel are at play so that we can help you figure out why her iron and thyroid function is low, and how best to correct it.

 Have you ruled out an H Pylori overgrowth before? Given the fact that she eats a carnivorous diet but has low B12 and iron, low stomach acid and/or thyroid hypofunction are likely at play. You can watch the following short video on reasons for low stomach acid and the solutions for it.

One you receive the latest results (there were some key markers pending), please upload them here.

Given the autoimmune thyroid activation, please watch this video on autoimmune disease facts, and then this video for autoimmune thyroid recommendations.

Is she currently consuming dairy and gluten? If so, this should be eliminated short-term (minimum 4 months) to help calm the immune system while working on gut healing therapies. Here’s a handout for gluten elimination and dairy elimination.

You mentioned that you are also anemic. Have you ever ruled out genetic factors like thalassemia?

And I will also address your mold question here. How long was the mold exposure, and does she have any other symptoms other than fatigue and pale skin?

 I replied above.

Hey ,

Did you have her tested, for example with an OAT, a MycoTOX profile or some other test? Do you know if there is an environmental exposure? Is the mold infection in the sinus, longs, GI tract? Or at another place? Right now I will give you some tips if you believe there is mold in the gut.

With any treatment of mold I would recommend finding out where and how she was exposed.
 
• Was there water damage somewhere in the home/school or other places she visits regularly?• Think for example of basements, wall cavities, showers, leaks in roofs, windows or pipes but also behind floor & ceilings
• Mold can also grow in areas around heating and cooling appliances. 
• Mold grows well on paper products, cardboard, ceiling tiles, and wood products. Mold can also grow in dust, paints, wallpaper, insulation, drywall, carpet, fabric, and upholstery.
• Do you suspect she was contaminated by moldy foods?

If you think environmental mold exposure isn’t a problem anymore, you could help her by getting rid of mycotoxins and mold. Here are some strategies:

Mold
If you would like to use botanical antifungals I usually recommend my clients. In the general tip section, I have written about Candida here & here. Goldenseal (active ingredient is berberine), black walnut, garlic, echinacea, grapefruit seed extract are all ingredients that have antifungal properties. A Broad spectrum antifungal product I like is for example Biocidin from biotic research (always use in combination with GI Detox – click here and here to find them in Fullscript)

Mycotoxins
Molds produce toxins called mycotoxins. Even when you address mold, mycotoxins could still stay in the body. You can remove them by supporting the body with detoxification.
• NAC is a precursor for glutathione, an antioxidant which also helps detoxification
• Glutathione as supplement is also possible. Make sure its a liposomal form though
• GI Detox has a lot of binders that bind to toxins in the gut. If you are using antifungal (yes, also botanicals) the fungi die and their toxins are freed up in the GI tract. Binders can prevent some of those toxins to make someone feel worse.
• Probiotics in foods an beverages can also help. With kids I like to work as much with foods as possible. The B Better library (click here and scroll down) has some powerful recipes for probiotic foods & beverages.
• Bitter plant foods can increase bile flow which can help to get rid of mold as well. Here are some bitter foods that I sometimes recommend to my clients: broccoli sprouts, chicory, radishes, dandelion greens, and arugula contain phytochemicals that activate bitter taste receptors, causing a chain reaction of physiological events that lead to enhanced bile flow. You could also brew Organic Danelion tea as an option.

 I know – I’ve had to do it with my son, but it’s all about getting her to buy into the idea of removing them first and foremost, and then finding substitutes for the things she loves most so she doesn’t feel deprived or missing out.

If she’s more mature, go ahead and watch the videos I shared above together with her. Perhaps hearing it from a third party will help convince her to remove these foods (at least temporarily) to help reduce the autoimmune activation that’s happening and reverse the dynamics while gut healing.

And you can have H Pylori overgrowth and also be asymptomatic. Resolving her constipation should be the main priority, even if it’s using rapid relief measures like magnesium citrate in the evenings. Here’s a video on constipation solutions.

Regarding the mold exposure – do you feel her symptoms began or worsened after this exposure? Does the timing make sense for you?

 before running expensive functional tests like an OAT or mycotoxin test for mold, there are simple steps you can begin implementing that will make a positive difference:
• eliminate dairy & gluten for at least 4 months (this will help not only with calming autoimmune activation, but it may help with her constipation as well)
• introduce magnesium citrate in the evenings for rapid relief of constipation
• in addition to removing likely food sensitivities, heal the gut lining
• since her selenium looks good, I would slowly begin adding in iodine rich food sources like kelp sprinkles but monitor her thyroid levels every 1-2 months to make sure her antibodies aren’t going up
• ensure she’s consuming VPF with each meal, to make sure she’s bringing on board all the macronutrients, especially protein for thyroid production
• begin introducing a variety of fermented foods every other day into her diet to help support gut health and immunity with beneficial probiotics. Please see recipes in Discounts & Resources. Coconut kefir would be the easiest introduction.
• check and rule out with a gynecologist the position of her uterus (yours too). A retroflexed uterus can lead to constipation.
• Request gynecologist to test her sex hormones estrogen & progesterone during days 19-21 of her cycle to see if there’s estrogen dominance or low progesterone production. Both of these can impact total and Free T4. But keep in mind that a young women just getting her period will need time for her brain to adjust and produce optimal levels of sex hormones so this may not be necessary. Just an FYI.
• Support her low vitamin D levels with a combination of more sun exposure and/or supplementation with cod liver oil or vitamin D3 supplements to support her immunity. 
• Given the autoimmune activation, I would also measure RBC zinc and vitamin A if she doesn’t mind getting pricked again. Otherwise, cod liver oil and chicken liver can also provide a good dose of vitamin A which thyroid & immune function both depend on.

In terms of additional functional testing, I would prioritize:
1. H Pylori (I’m suspicious of low stomach acid, and although it’s likely due to hypothyroid function, low stomach acid can create a vicious cycle that allows an overgrowth to happen)
2. RBC iodine or a 24-hour urine iodine test (not loaded since there is autoimmune activation)

Hope this helps give you some direction and areas to begin working on. If you focus on supporting her immune system, her body may be able to counter whatever overgrowth or pathogen that may or may not be present.