Hi ,

It would help us to get a little bit more insight into your lifestyle. For example, can you share with us what your diet looks like? Do you exercise? How are your stress levels? Do you consume alcohol or do you have a history of smoking? Just some general questions that could help us point you the right way!

If you could share your labs, it could give us a better understanding of what is at play as well. But let me share with you some suggestions based on what you have shared.

High Hematocrit
Hematocrit as you maybe know is a simple blood test that measures the percentage of red blood cells in your body. Finding out the root cause of your elevation is important since it determines how to approach that.

The reasons why hematocrit can be elevated can vary from dehydration, b vitamin deficiencies to scarring on the lung tissues (could be caused by for example asthma, emphysema, maybe COVID or smoking). Usually, hematocrit isn’t evaluated alone. Haemoglobin, MCV, Reb Bloodcell Count(RBC), vitamin B12, folate and serum ferritin would provide us with some extra insight.

hypochlorhydria (low stomach acid) connections
Low iron could definitely be caused by hypochlorhydria. And hypochlorhydria can be caused by an H. pylori infection. The soda baking test in the morning is a cheap way that could confirm low stomach acid as well. Just remember, low stomach acid can be caused by other things like
• zinc & magnesium deficiencies 
• stress (especially eating in a stressed state)
• hiatal hernia, 
• long-term use of medications like antacids & PPIs

Addressing stress, and supplementing with zinc & magnesium would definitely be something you can do in addition to addressing H. pylori and taking a B vitamin…

…talking about B vitamins
Congratulations, you are thinking in the right way! Low stomach acid could cause low vitamin B12 for example. B vitamins also play a role in keeping homocysteïne at the right levels. A deficiency in bioavailable B vitamins could cause elevations in homocysteine.

But make sure your brand uses the bio-available B vitamins. Choose:
• “methylcobalamin” over “cyanocobalamin” for B12
• “methyl folate” over “folic acid” for B9
• “P-5-P (or pyridoxal-5-phosphate)” over “pyridoxine HCl” for B6.

Elevated CRP
You posted recently about a UTI. Although there can be several reasons why CRP elevates, bacterial infections can be one of them. A UTI would do the trick. Addressing the root cause and retesting CRP can confirm that your CRP has been elevated by a UTI. 

Pain under the right rib
A sudden sharp pain under the right rib could be evidence of gallstones. Gallstones are usually made of cholesterol. D-limonene is a potent cholesterol solvent. You could use that. But a discussion with your doctor could provide more insight since there are different types of pain as well.

I’m quite sure Bernadette has some input as well, but it would help us if you could provide us with some extra information!

  Daniel provided you with some excellent feedback. Keep in mind the North to South approach when addressing dysfunctions. Tackling an H Pylori overgrowth is definitely a priority, however always ask why. Why did the overgrowth happen in the first place. What environment allowed that to happen? Reviewing the section on Hypochlorhydria (low stomach acid) and H Pylori in the Gut Health Masterclass will help narrow it down for you.

In terms of rapid relief for the pain you’re experiencing under your right rib cage, in addition to d-limonene, castor oil packs applied topically over the liver/gallbladder area can help. I will create a handout on how to do this in case you’ve never tried it before. But basically, a person rubs 1 Tbsp of castor oil directly on the affected area (wear gloves, it’s sticky). Place a damp washcloth over top, and then a heating pad, and sit or lie down for 35-45 minutes or until the castor oil has been absorbed through the skin. Alternatively, it can be applied before getting into a sauna.

Let me know if that helps!

 do you also have electrolyte markers and kidney markers to see if it’s dehydration? These are sodium, potassium, chloride, BUN, and creatinine. Would you also have a marker called methylmalonic acid or MMA? And what is the lab’s reference range for serum folate please?

Since MCV and homocysteine are both high, and your serum B12 seems to be optimal, I’m curious about your cellular status of B12. Do you have amalgam fillings in your mouth by any chance or have known exposures to heavy metals?

Pain on the left side could be stomach or spleen as you suspected, however since hematocrit is not high all on its own, the elevation is more likely to be due to dehydration. You mentioned that these are follow-up labs… do you have a similar pattern in previous labs?

 Your hemoglobin is elevated again so there seems to be a pattern there. How is your level of hydration? Do you drink enough water and add electrolytes? Do you take diuretics? Drink a lot of caffeine? Exercise and sweat a lot? 

The suboptimally high sodium and chloride could also indicate a pattern of hyperadrenal function (stress), and again dehydration.

So again, stress, hydration status and possible hypochlorhydria seem to stand out for me based on what you’ve shared so far. Remember we need good strong stomach acid to absorb minerals like iron and make intrinsic factor to absorb B12, so if we’re trying to focus on basics first, this is where I would focus my attention.  It would be interested to try the baking soda challenge test (there’s a handout in the resources and in the Gut Health Masterclass course) and then perhaps testing H Pylori only with Diagnostic Solutions to see if the pain you’re experiencing may be a result of an overgrowth.

And remember, stress puts us into a sympathetic dominant state and will directly impact the level of stomach acid. So if this resonates with you, addressing stressors (mental/emotional but also physical like lack of sleep, exercising too intensely/too frequently, very low calorie diet, etc) should be a priority. 

And hydration – if this resonates with you, I share my tips for increasing hydration in the Beginner’s Health Roadmap “Hydration” pillar.

Do let me know what you plan on trying, and please keep us posted so we can continue to guide you better.

Hey 

You’re providing us with great details, thanks! I think focussing on the basics until it is clear on what is playing is the best approach.

I in addition would like to know how you would describe your pain. Is it for example:

A) A left sides chest pain, a feeling of pressure under the chest
B) Does the pain worsen when you lie down?
C) Is the pain intense, under the ribcage and radiating to the back?
D) Does the pain worsen with breathing, coughing or sneezing? Do you have difficulty breathing with that, experience shortness of breath or are there even fever-like symptoms?
E) With kidney stones there can be a deep back pain radiating to the front and upwards to the ribs. I guess it might not be this type of pain,  since you already had experience with that.
F) Is the pain sharp in nature? 

Or would you describe the pain differently?

, there are still several options possible. Here are some other options you could investigate yourself and discuss with your doctor:
• Intestinal diverticulosis (a bulge in the intestine) can describe your pain. Usually, pain caused by diverticulosis gets aggravated after having a meal. Eating more fibre can help. If you are already eating a lot of vegetables, fibre is usually richer in grains (a lot). A low whole grain diet can by accident lead to low fibre diets.
• Pain that gets relieved with warmth applications like a hot shower or a hot pack can be more indicative that the problem is muscular.

Once you have a better diagnosis it would be easier to help you!