[Daniel]

 That’s fantastic! You should be proud! I hope you enjoyed it!

[Daniel]

Hey ,

It depends a bit on the goal and the person. When fasting, your body tries to keep your blood sugar level stable. Since there is no food, these sugars are released from the liver or made from fats and proteins from gluconeogenesis. This process is stimulated by cortisol production. Fasting therefore can increase cortisol production during the fasting window.

Performance or Muscle Mass
The increase in cortisol isn’t a bad thing by the way. It is functional, to keep you alive. But after a fast, your energy levels are depleted. The advantage of eating first and training second with strength training is that, if you have eaten and are hydrated, you are able to perform better. If the goal is increasing muscle mass or getting stronger, this is an advantage, however…

… some people sleep worse since fasting and training both increase stress hormones. With these people, I would advise them to train before dinner since a lack of sleep might make it harder to recover and fast the next day.

Fat loss
For a lot of people training before dinner can reduce the feeling of being hungry. This can impact the amount they eat after their workout leading to more fat loss. But you will have to ask your clients how their feeling of hunger is impacted since it doesn’t apply to everybody. Some people might feel too exhausted which can lead to poor performance. In these cases, I might recommend training after dinner since the benefit of the hunger suppression is often gone as well.

Personally, I don’t recommend a lot of liquid carbs before or during training. Most people don’t train hard and long enough for it to be meaningful. The only exception to this was when they had fasted. I personally liked to recommend carbs with a low fructose content. You probably already know this, especially if you follow Bernadette, but fructose isn’t used by muscle tissue and most of the fructose doesn’t pass the liver. 

Since the goal is to help stabilize blood glucose levels to optimize performance, I always educated my clients to stay off sugar-like drinks because of the high fructose content. In this context cyclic dextrin for example is a better choice than honey.

[Daniel]

Hey ,

I am curious: did the anti-histamine bring relief to her itchiness?

Fatigue
Your friend has low ferritin values. Ferritin is a stored form of iron. Since her storage form is depleted, her serum iron levels are probably low. Do you know if her doctor measured serum iron as well?

Iron is needed to make hemoglobin, the molecule that transports oxygen and is stored in red blood cells. If hemoglobin cant be made, this can cause anemia from which fatigue is a symptom.

Your friend already has iron prescribed. But usually, it can take a few weeks before she will feel improvement in energy. I would suspect that her doctor also ran a Complete Blood Count(CBC) Panel.

If part of her fatigue is caused by anemia, it can take around 6 weeks before she feels a noticeable difference in her energy levels. It can take 3 months before all red blood cells have been replaced and her anemia is gone. Once anemia is gone, only then ferritin starts to come up significantly. 

You could help her by exploring why her iron was low in the first place. Is she eating animal products? Does she experience heavy blood loss during her menstrual cycle? Does she experience heartburn? Is she constipated? Does she have diarhea? Does she feel bloated? Does she experience cramps?

These are all powerful questions that could help you find out why her iron might be low.

Important little side note: iron supplements could cause constipation. When you ask her about constipation, you should ask about the differences between pre-and post-iron supplementation.

If her doctor did measure her Red Blood Cells, feel free to post them as well! The more details we have, the better we are able to help!

[Daniel]

Hey ,

Strengthening the immune function of your children can be done. We even have a nice document (just click here) that could give you some tips!

Asthma
Helping kids with asthma can be done by avoiding typical asthma triggers. Asthma triggers vary from child to child. Common asthma triggers include:
• Colds or other respiratory infections
• Allergens such as dust mites or pollen
• Pet dander
• Exercise
• Cold weather
• Mold and dampness
• Cockroach exposure
• Cigarette smoke and other irritants in the air
• Severe heartburn (gastroesophageal reflux disease, or GERD)

Water in ears
I’m sure  might have some better tips than I do since I don’t have kids. If you tried drying the outer ear with a soft towel or cloth but it didn’t work, you could also try:
• Tip your kid’s head to one side to help the water drain. Gently pull on the earlobe so that the ear canal will be straightened. This can help the water flow.
• Turn your blow dryer on the lowest setting and blow it toward the ear. Hold it at least a foot away.
• Tilt the head sideways and seal it tightly with a cupped palm. Pushing your hand back and forth in a rapid motion against your ear creates a vacuum, forcing the water to drain out of the ear.
• A homemade ear drop combining rubbing alcohol and white vinegar in equal proportion helps the ear to get rid of that trapped water. It also acts as an anti-bacterial medication as helps in keeping the growth of bacteria at bay and thus prevents infection. Pour a tablespoon of this ear drop into your ear and let it drain out after 30 seconds tilting your head sideways. While the acid breakdown cerumen trapping the water, alcohol helps in taking out the water along with it.
• Performing the ‘Valsalva Manoeuvre. This is the method when tried to help in opening blocked Eustachian tubes, pushing water out of the ear. Just close your mouth and press your nostrils close with your fingers, taking a deep breath. Blow air out gently from your nose. While doing so if you hear a popping sound, this means your Eustachian tube is now opened. Be careful not to blow too hard as it may cause damage to your eardrum.

Again: Bernadette might have some better tips here, but right now she is travelling!

I hope this helps!

[Daniel]

Hey ,

H. Pylori
Even if H. Pylori has increased on this test, I wouldn’t focus too much on that. The numbers are still in the lowest part of the reference range. Make sure you focus on the basics. Perhaps you could help me by scoring the next items. Give yourself a 10 when you do these things really great and a 1 if you feel there is room for lots of improvements:
• Chewing until your food feels semi-liquid in your mouth
• Taking time to eat
• Eating without distractions like laptops, phones or other screens
• Eating sugar, flour products and other refined foods 
• Going to bed on time
• Sleeping 7-8 hours
• Waking up with energy

These things are really basic but powerful!

Zonulin & ‘Leaky Gut’
You can’t really ‘heal’ zonulin. It is something that is produced for example by eating gluten. Perhaps you draw the conclusion of the presence of a leaky gut.

Your intestinal barrier assessment from 25 January showed low serum zonulin. This test shows elevations of zonulin in the gut. Although there is some time between these tests, it supports the impression that zonulin is staying in the gut.

Do you know if you consumed wheat products before the test? Mild elevations of zonulin (like yours) in the gut can be present for very normal reasons (like eating wheat before the test). Interpretation of this one marker is not a strong case for the presence of a leaky gut. On the stool test, it would be best to asses the complete ‘intestinal health markers’ section.

sIgA is low, which can be caused by damage to the gut lining. But stress can lower immune function as well, just like low vitamin D.

The test didn’t detect parasites, worms, yeast, which are also good signs. But some imbalanced bacterial markers do point to there might be leaky gut present to a certain degree.

What could you do?
Try to focus on what you feel. If avoiding gluten makes your symptoms less, try to avoid them. If you believe you aren’t eating gluten, you could replace rice and see if you feel better without rice. Things you eat a lot of can lead to food sensitivities. Food sensitivities can also influence gut barrier function.

Secretory IgA
Your thought of trying IGG was a good one. If you are sensitive to milk however this could cause some side effects. Do you know if you are sensitive to milk products?

[Daniel]

 There are some difficulties with playing videos in the UAE unfortunately, but under the video you will find an explanation on how to get acces as well!!

[Daniel]

Hey ,

Finding a liquid version is hard. There are a lot of soft gel supplements that you could cut open like d-limonene from integrative therapeutics and d-limonene from Wellness Resources, but other then that I didn’t find any liquid supplements. I normally would have recommended Jarrow or Swanson as well.

[Daniel]

Hey ,

Thank you for uploading your test results!

Selective IgA
What stands out to me is the low secretory IgA (sIgA). Let me first explain what it is. sIgA is part of the gut epithelial barrier and plays an important role in the development of immune tolerance and plays an important role in balancing the normal and beneficial commensal gut organism.

sIgA is low, which can lead to imbalances in the gut microbiome. sIgA also prevents pathogens to get into the bodies circulation.

The good news is, although you are still short on sIgA, the levels are higher as in 2022. Perhaps the little bit of vitamin D you have used in the past weeks/months could contribute to this. We talked about this before, so not exactly a new conclusion comes from this test particular value, but it does emphasize the importants of helping the body raising vitamin D levels. Other key nutrients that help to support the immune system are vitamin A and folate.

Zonulin
You noticed indeed that Zonulin is high. Elevations in Zonulin open the tight junctions between the cells in the gut lining making it more easy for undigested parts of stool to enter the body.  These tight junctions in order to close need vitamin D as well by the way.

Reducing Zonulin might give your body more protection from what happens in the gut. Therefore I would avoid gluten containing grains for now.

Bacterial Markers
Most of the bacterial markers point to some form of inflammation in the gut.  Bacteroides fragilis (which is low on your most recent test) is anti-inflammatory, while high levels of Enterobacter spp,  for example can contribute to inflammation. There are some clues to low stomach acid, maldigestion and SIBO on the test, which is a confirmation to what we know.

Occult Blood
Elevations in occult blood occur when there is more human hemoglobin present in the stool. The colonoscopy you shared looks good, so the problem isn’t there. I am curious about the results on the `histology report. `

Blood loss because of a small wound can sometimes just happen.`Other reasons why Occult blood can be elevated can be for example due to
• IBS
• Bleeding Ulcers
• Upper GI bleeds that cause iron deficiency anemia

Bringing balance to the microbiome starts with bringing in the nutrients first. Treating the gut with antimicrobes result in a bigger die-off of the gut bacteria. Some of these bacteria are Gramm negative which means when they die you will be exposed to more lipopolysaccharides(LPS).

With zonulin elevated and the tight junction being open this could make you more vulnerable. Having your immune system in the most optimal condition will give you more defense and could even contribute to balancing the microbiome as well.

[Daniel]

Hey ,

For some reason, I didn’t see your reply. Sorry if I am replying a little late!

I think you mean the supplements for the hydrochloric acid dosing challenge right?

You can for example use Thorne’s Betaine HCl & Pepsin for that. It is also available in fullscript and there you can get a discount, but I’m not sure if you are available to use that where you live. If you don’t have a login to the page yet, watch this movie. It explains how to create an account.

Let me know how things went!

[Daniel]

Hey ,

How did things go with the Facebook group? Did you get what you wanted?

[Daniel]

Sorry, I forgot to mention! I would start with half a dose extra and see how you feel first!

[Daniel]

Hey ,

There can be several reasons why you experience chronic coughing. The most common reasons are tobacco, postnasal drip, asthma and acid reflux. With a postnasal drip, you can feel a liquid running through the back of your throat. Food sensitivities could cause these, in particular dairy.

If you also have a postnasal drip, I recommend seeing what happens when you eliminate dairy products for 4 weeks. A clear sign of food sensitivities causing your cough is when symptoms reduce after a few weeks. Another clear warning that food sensitivities cause these problems is when the symptoms come back when you reintroduce the foods you eliminated.

Be aware that you need to eliminate these foods 100%.

If you want to know the specific details on how to do an elimination diet and reintroduce foods, I recommend you read this handout. Since most of the time post nasal drip is caused by dairy products I would recommend you to look at this document where you can find hidden dairy products.

Supporting the immune system is also important. Nutrients like vitamin D, zinc, vitamin A and folate are specifically important to the immune system. Make sure you have enough of them in the diet. Here is a handout in which you can find B’s immune-boosting protocol. It also has a homemade cough remedy you could try.

Again, let us know if you experience other symptoms as well, like wheezing and shortness of breath, or heartburn because they need a different approach.

Hashimoto’s
If you like to go a step further, there is a connection between Hashimoto’s and food sensitivities.

Hashimoto’s is an autoimmune disease. With an autoimmune disease, there is often a connection to gut health. The gut might have an increased enhanced gut permeability (often called ‘leaky gut’) causing undigested foods to enter the body. The immune system then, in time, starts to react more efficiently and aggressively to these undigested foods. In fact, this is exactly how food intolerances are created. But if these undigested foods might resemble tissues from the body (and with Hashimoto’s, this is of course the thyroid tissue), the immune system starts affecting these tissues. Things that cause a leaky gut are for example:
• Stress
• Medications like antibiotics, oral contraceptives and use of NSAIDs
• Gluten
• Gut diseases like Celiac disease and Irritated Bowel Syndrome (IBS)
• Other sources of inflammation in the gut for example high histamine levels.

It is therefore helpful for us to know if you also experience gut-related symptoms like: gas, bloating, diarrhoea, constipation, pain & cramps.

What can you do?
Supporting the gut can be done on various levels. I already mentioned vitamin D. Having optimal vitamin D levels will also help to close the doors (tight junctions) between the cells in the gut.

With autoimmune diseases, I often recommend my clients to eliminate dairy and gluten. Preferably not only gluten, but all grains.

Adding in nutrients and supplements that heal the gut might help as well. Things like zinc l-carnosine, aloe vera, miscellaneous herbs, bone broth, L- glutamine, and cabbage juice are all options. There are also really great supplements on the market that are blends of these ingredients, for example:
• DGL PLus from Pure Encapsulations (doesn’t contain glutamine)
• GI Revive from Designs for Health (which does contain glutamine)

Labs
Thank you for posting your labs! I assume you are using thyroid medication. Did you recently change the dosage of your medication? And are you currently experiencing any thyroid-related symptoms?

There are some elevations in bilirubin. This can be caused by biliary congestion for example or an increased breakdown of red blood cells since bilirubin is a breakdown product of red blood cells.

Did your doctor choose to explore why your bilirubin is elevated? Tests that usually are done are
• Liver function tests. Blood tests measure certain enzymes or proteins in your blood. Besides ALT (which was measured in your labs) there are other liver function tests, like AST and Alkaline Phosphatase
• Albumin and total protein. Levels of albumin — a protein made by the liver — and total protein show how well your liver is making certain proteins. These proteins are necessary for your body to fight infections and perform other functions.
• Complete blood count. This test measures several components and features of your blood.

If biliary congestion is at play I often recommend the use of D-limonene, D-limonene is a supplement that is often used to help bile flow. I usually recommend my clients around 1000 mg/day for 2 months.

Having an optimal bile flow is important for gut health as well since bile helps to grow the beneficial bacteria in your gut and keep the opportunistic bacteria away.

I know I spend a lot of time diving into gut health. It often is important when the auto-immune disease is at play.

[Daniel]

Hey ,

I would stay with this B complex. With my clients, I would recommend to ad a liquid folate product so you can finetune serum levels. For example Super Liquid Folate from Designs for Health. It also contains a little bit of vitamin B12.

Vitamin D is fat-soluble and gets even better absorbed with food. I would definitely recommend combining all fat-soluble vitamins with foods that contain a little bit of fat.

Epsom salts can be used as a source of magnesium. I personally don’t recommend them often because of 2 reasons:
• If you like to use Epsom salt in baths, you need to do this consistently. I find that most of my clients don’t stay consistent with this method.
• Magnesium Sulphate is also used as a supplement. It has a more laxative effect and we aren’t exactly sure how well magnesium sulphate is absorbed in the gut.

A well-absorbable alternative for magnesium is magnesium glycinate. Did you try this form of magnesium?

If you are low on calcium and vitamin D, raising vitamin D could impact calcium absorption already a lot raising your serum levels. If you like to use supplements temporarily (since vitamin D isn’t raised in a few days), you could add a supplement, and see how it makes you feel.

Just go low and slow since calcium can cause constipation.

I hope these tips help you!

[Daniel]

Hey ,

I was just wondering if you already tried the baking soda test!

Corn is one of the more common food sensitivities and yes, that can cause bloating.

Often we can develop food sensitivities to the foods we eat the most. The list of foods you mentioned could therefore be something you could try to replace for a few weeks. See if the bloating gets reduced.

Are you craving chips because you crave salty foods? If so, this can be an indication to stress. With depressed cortisol, we tend to loose sodium leaving us with cravings to salty snacks. And unfortunately, chips can cause bloating for a variety of reasons. But if it is the salt you need, you could try sole!

[Daniel]

Hey ,

How was your cleanse experience? Did it went well?