[Bernadette_Abraham]

Hi @Dana – as a good starting point when someone requires a check-up, it’s a good idea to get a CBC with differentials, CMP (complete metabolic panel) and hs-CRP as the core markers. These are usually covered by insurance and can provide a lot of information as a starting point. You can find the list of these markers (CBC & CMP) on p. 5 in this handout.

Given the symptoms you shared, it would also be a good idea to add in some additional markers as well to be even more comprehensive:

-For blood sugar status (given the history with insulin resistance/weight loss resistance):

• Fasting insulin, fasting glucose, HbA1C, HOMA-IR or C-Peptide

-For thyroid function (given the low energy, metabolism, and desire for better hair growth)

• TSH, Free T4, Free T3, Reverse T3, Anti-TPO, Anti-TG

-For symptoms of low energy/metabolism/slow starter in the morning (adrenal status):

• Cortisol (AM only or 4-point saliva/urine test)
• DHEA-s

-For memory/cognition, energy, hair & mood:

• B12 and folate
• Iron panel (ferritin, iron, TIBC, % saturation)
• Homocysteine
• RBC magnesium
• Vitamin D
• RBC Zinc & copper

Please share your age. Given the PMS-like symptoms and sleep changes, you might want to check sex hormone status as well:

• Estradiol (E2)
• Progesterone (on day 19-21 of your cycle if it’s regular, and a 28-day cycle)
• LH & FSH
• Total and Free testosterone
• SHBG (sex hormone binding globulin to know what’s free and what’s not)

If you want to get these tests covered by insurance, you might need to see 2 different specialists; an OBGYN for sex hormones and an endocrinologist for thyroid/blood sugar/adrenal status. You can also request imaging for your thyroid from the endocrinologist given that you’re on medication.

Another option is to try and get whatever you can get done through insurance, and then pay out of pocket for the rest. B Better members get a discount on some panels with Valeo Health. You can find the details here. They offer convenient home phlebotomy service and their prices are competitive since they cut out the middle man and work directly with the lab.

Hope the above is clear. Let me know if you have any questions.

[Bernadette_Abraham]

Hi @healthyliving99 – no, enameled cast iron (the pretty colored cookware) is not something that I would recommend because the majority of them test high for lead, arsenic and other heavy metals on the cooking surface based on testing done by Lead Safe Mama.

The best options are always plain (undecorated) stainless steel, plain undecorated cast iron and plain undecorated clear glass.

I personally have and use pure ceramic by Xtrema cookware, which is surface tested to not leach metals, but if a chip or crack appears, I immediately toss them out since the inner material has heavy metals that can leach when broken.

[Bernadette_Abraham]

Hi @R-S – nutrition can be very confusing because you can find valid pros and cons to absolutely everything. And that’s why context matters so much, and why prioritizing goals with the correct order matters more.

In your case, even though SIBO/IBS are a part of your overall symptom picture, what you need right now are soothing remedies for both the gut and nervous system in a form that you can tolerate and absorb.

Eventually, you’ll be able to lessen these therapies and focus on the fight – but not before you soothe and strengthen your body first. The order matters.

Hope that makes sense?

[Bernadette_Abraham]

Hi @Vidu – if the bottle was kept in the fridge, you can probably still use it. But if it’s been out, then it’s best to throw it out unfortunately.

Have you gone through our Heartburn & Acid Reflux Resolution program to help you figure out/address the cause(s) and provide some rapid relief solutions?

bbettermembership.com

B Better – Holistic Health & Wellness Community

Join B Better, a holistic health community offering expert advice, live Q&A sessions, and wellness resources. Start your free trial today and take charge of your well-being—no credit card required!

[Bernadette_Abraham]

Hi @yasminatassi – the fact that she’s still playful, without fever or vomiting, is a very good sign.

Since her stool is watery though, you’ll want to make sure that she doesn’t get dehydrated. So first prioritize hydration with plenty of fluids (water, diluted coconut water).

If she doesn’t have an appetite, consider giving her easy to digest foods instead like smoothies, cooked carrots, boiled potato, and plain foods like rice, mashed banana and fresh apple sauce. These will help firm up her stool. Also notice if the kefir is helping or worsening the situation since dairy might aggravate the situation.

In terms of probiotics, something with the Lactobacillus rhamnosus GG, Lactobacillus plantarum and S. Boulardii (or a combo of these) strains can help alleviate diarrhea. You can learn more in this lesson from the Gut Health Masterclass. For example Culturelle Kids has L. Rhamnosus GG and is available on Amazon.ae and arrives same day with Prime. Florastor Kids has S. Boulardii. I suggest you call local pharmacies and ask if they have probiotics with these strains if you prefer in-store.

A stool test isn’t really necessary at this point unless diarrhea persists beyond a couple of days or if she develops fever/vomiting or show signs of regression in her daily activities.

However, if you notice that something remains “off” after the diarrhea passes, then it might be worth exploring functional stool tests such as Tiny Health (although I’ve never used them) or the GI Map for microbiome mapping.

Hope her gut feels better soon.

[Bernadette_Abraham]

@R-S as discussed on the live Q&A, please checkout this resource to find a practitioner who can guide you through the elemental diet: https://www.siboinfo.com/elemental-diet.html

And if you’d like to rewatch the session, it will be available in the library by tomorrow under “Learn”>”Member Call Replays” here.

siboinfo.com

The place for all things SIBO by Dr. Allison Siebecker

My mission is to share information and news about SIBO to empower people in their health. Dr. Allison Siebecker

[Bernadette_Abraham]

@yasminatassi glad to hear that her stool is starting to firm up again. And I’m glad that you’ll try the dairy elimination. I hope it will also eliminate the stomach pains she’s still experiencing. Please do keep us posted.

I understand the concern over calcium when eliminating dairy, but the good news is that it’s possible to get in the necessary amount through a combination of food and/or supplements.

According to the NIH, the RDA requirement for calcium for a toddler between the age of 1-3 years is 700mg per day. You can find a list of foods and the amount of calcium they provide HERE to help you see if she’ll eat any of those foods, and whether or not you’ll need to supplement. Here’s a practical list of what a toddler might be willing to eat that is also higher in calcium:

Vegetables

• Broccoli (½ cup cooked ≈ 30 mg)

• Kale (½ cup cooked ≈ 50 mg)

• Bok choy / Chinese cabbage (½ cup cooked ≈ 80 mg)

• Okra (½ cup cooked ≈ 60 mg)

Legumes & Beans

• White beans (½ cup cooked ≈ 80 mg)

• Chickpeas (½ cup cooked ≈ 40 mg)

• Lentils (½ cup cooked ≈ 20 mg)

Nuts & Seeds (best given as butters or finely ground to avoid choking)

• Almond butter (1 Tbsp ≈ 60 mg)

• Tahini (sesame seed paste) (1 Tbsp ≈ 65 mg)

• Chia seeds (1 Tbsp ≈ 75 mg)

• Ground flaxseed (1 Tbsp ≈ 25 mg)

Fish (with edible bones)

• Canned salmon with bones (2 oz ≈ 200 mg)

• Sardines with bones (2 oz ≈ 325 mg)

Other Options

• Tofu (calcium-set) (½ cup ≈ 250–300 mg)

• Amaranth or quinoa (1 cup cooked ≈ 100–120 mg)

• Blackstrap molasses (1 Tbsp ≈ 170 mg; can be added to smoothies or oatmeal)

In general, it’s a good idea to take a break from any supplement after a few months of being on it. If her stool firms up and there’s no other symptoms present, the probiotic can be discontinued and replaced with fermented foods instead longer term.

You can find multivitamin options in this handout.

Hope this helps!

ods.od.nih.gov

Office of Dietary Supplements - Calcium

Calcium overview for health professionals. Research health effects, dosing, sources, deficiency symptoms, side effects, and interactions here.

[Bernadette_Abraham]

@R-S regarding your question about whether or not you should eat when you feel nauseous, let your body be the guide. Try both and see what you prefer.

Nausea however is often rooted in the liver/gallbladder, so eliminating anything high in fats (like olive oil, olives, coconut, etc) during these episodes could potentially help as well.

Again, be aware of what you try and take notes of what helps, and what doesn’t.

Are you still working with your homeopath to help deal with acute situations?

[Bernadette_Abraham]

@R-S let me start off by saying that the symptoms you’re describing are very real physical experiences. Don’t doubt yourself. Many people with gut sensitivity and nervous system dysregulation feel exactly this way, and it can be overwhelming. You are NOT imagining it you’re not losing your mind.

With that said however, since these symptoms have been so persistent and you’re describing them as really intense, it’s probably a good idea to check in with a doctor to rule out anything that may require medical attention such as reflux, gastritis, hiatal hernia, or other upper GI issues. Even if nothing concerning is found, that alone can give you some reassurance and peace of mind that can help guide the next steps.

In the meantime, here are some other things to try that can hopefully help calm the flare that you’re in:

• I know you said your meals are quite bland and boring already, but you can simplify them even more. Try your chicken/veg combo without olive oil or herbs. Again, this can reduce potential irritants and variables.
• Instead of eating smaller and more frequent meals, stick to 3 main meals with at least 4-5 hours between them to allow more digest rest in between meals. Grazing/snacking is also one of the main root causes of SIBO/IBS, so you’ll be hitting 2 birds with 1 stone with this tip if it helps.
• In between meals, continue the soothing support if it’s helping like the slippery elm, fennel/ginger tea if you feel they are helping.
• Wait 15-20 minutes after eating before going for a walk. This might help reduce post-meal discomfort.

Your body is clearly in a heightened state right now, so please rule out anything requiring medical attention, and if that’s all clear, then continue with the “low and slow” approach, both with food and with nervous system work.

[Bernadette_Abraham]

@yasminatassi kids go through different eating phases so it’s normal that your once super-eater becomes extremely picky as she gets older. I discuss these transitions briefly in my book UNJUNK.

I also discuss how some children develop sensitivities to the foods they crave most. And by eating them, it is a way of self-medicating that stress response in the body. Dairy for example releases casomorphins during digestion, which are opioid-like substances that produce the same “feel-good high” as opioid drugs (like heroin). If she’s developed a sensitivity to dairy, the immune system will create an inner “stress” response, and as a way to attenuate that stress, her body will crave those opioid-like substances found in both dairy and gluten.

I’m not saying that this is the case for your daughter, but it is definitely a possibility, especially if that’s all she wants to eat sometimes.

And given that dairy is often a culprit with loose stools, it might be worth trying an elimination challenge for at least 2 weeks to see if it helps, if the probiotics alone don’t help. You can look at replacing her beloved yogurt with coconut yogurt instead as a transitionary phase to see what shifts in her gut with the removal of dairy. The same with kefir; coconut kefir instead of cow milk.

I know it can be difficult with young ones, but you can tell her it’s an experiment and temporary to see if it helps her poop become solid again. You can show her pictures of the Bristol stool chart (Type 7 – liquid diarrhea) and explain what it should look like (Type 3-4). That might convince her to try if she resists the changes.

[Bernadette_Abraham]

@R-S – if you’re tolerating ginger, you can also try some fennel too for additional anti-spasmodic support.

Artichoke is great for bile support, but won’t really help with spasms/cramps.

The goal of the “safe base” foods is to try and figure out what from that 3-day menu is causing a food sensitivity reaction. It’s fine to add in beef for variety if it’s something you’ve had in the past without issues. Same with dragon fruit and pumpkin seeds. If you’ve been having these in the past without issues, then you can keep eating them. But the idea is to keep the diet bland to minimize variables to help you isolate what might be the trigger when you add foods back in one at a time. Just keep monitoring with a food log.

Oh, and regarding the coconut milk. It’s unnecessary to have any other ingredient other than coconut milk. So please find another brand that offers pure coconut milk only – usually it’s only available in a can.

[Bernadette_Abraham]

Hi @naslam1603 – sorry to hear about your mom. I’m assuming they’ve already finished the procedure? Were they able to remove the stone that was blocking the bile duct?

Please keep us posted on how she’s doing. Wishing her an effective recovery.

[Bernadette_Abraham]

Hi @R-S – thanks for sharing your food log.

Question, is there a reason why you’re having the coconut oil + honey also in the mornings and afternoons? My suggestion was to have that before bed to help prevent a hypoglycemic reaction at night before rising. Just curious to know why you’re also taking it during the daytime.

If I compare your food journal from Sep 1-3 to this recent one, there are some new foods that you’ve introduced that could be culprits:

1. Eggs (on 4th and 5th). This wasn’t there Sep 1-3. Eggs are a common gut irritant/food sensitivity in alot of people, especially when “leaky gut” is already suspected.

2. Coconut milk + rice puff cereal on the 5th. Does your coconut milk have gums, oils, additives or stabilizers? Or is it pure coconut milk from a can? Rice puff cereal is obviously processed, even though it’s gluten-free, so that could be hard to tolerate if the gut lining is already sensitive.

3. Kale chips (on 4th and 5th). Kale (raw/dried forms) is high in insoluble fiber (the type that causes faster transit). The extra fiber can be irritating to an already inflamed gut, and that type of fiber can lead to faster transit (which can explain the greenish stool if the timing matches).

4. Potato (on 6th). Nightshades can sometimes aggravate some people.

5. Grapes (4th to 6th). This new fruit is very high in sugar which can quickly ferment in the gut. Depending on how many you had, this could also be a culprit for digestive discomfort.

Here’s how you can experiment to figure out which ones are causing you issues:

• Remove the newer foods (eggs, kale, coconut milk, rice puffs, grapes, potato) while keeping to the “safe base” of chicken, zucchini, carrots, cucumber, rice, slippery elm for for a few days.
• Once you’re back to steady-state, re-introduce one at a time after 3+ days to see if any symptoms return. Have a small portion earlier in the day and track symptoms (bowel changes, abdominal pain, anxiety, palpitations).

Here’s a reintroduction order you can try from what is likely “lowest risk” to “highest risk”:

1. Grapes – small amount only (3-4 pieces)

2. Potato (boiled, plain)

3. Egg (boiled, half first day) – very common sensitivity so observe carefully

4. Kale chips – lots of insoluble fiber

5. Coconut milk only – especially if your coconut milk has “other ingredients”

6. Rice puff cereal – test only if really desired to keep in your diet since it’s processed

Now in terms of rapid relief for anxiety/palpitations and the heightened nervous system state that some of these foods are likely causing, I’d suggest a few helpful hacks:

• Dunking face (up cheeks at least) in ice water in a bowl
• Box breathing – 4 breaths in, hold for 4, 4 breaths out. Can also do 8-8-8 or 4-4-8. Whatever works best for you.
• Humming/gargling/singing out loud
• Going outside and grounding in nature or walking by the beach

All of these help activate the parasympathetic system, which can help the body relax and “unfreeze” from that flight/flight state. I suspect the constipation is a result of the sympathetic dominance, so that should hopefully also get relieved once your body shifts to a more relaxed nervous system state.

And in terms of relieving the abdominal discomfort and cramps, did you try the Iberogast or digestive bitters or antispasmodic teas?

[Bernadette_Abraham]

@iryna_klevetenko – here is another option. Dr. Katerine Lemay has been recommended in another group that I’m in. I don’t know her personally though, but worth investigating.

https://tmtcdubai.com/about-us/dubai-psychologists-team/dr-katerine-lemay-ph-d-c-psych/

They offer family mediation services as well.

tmtcdubai.com

Dr. Katerine LeMay, Ph.D., C.Psych. (CAN) - Barsha Heights, Dubai | The MapleTree Center | Psychotherapy & Counselling

---

[Bernadette_Abraham]

@iryna_klevetenko – I believe I may have already shared this contact with you before, but I know the owner of Thrive Wellbeing Centre. They have a team of psychologists with diverse specializations that can help.

Please let me know if this is the type of clinic you’re looking for.

thrive.ae

Psychologist in Dubai | Thrive Wellbeing | Dr. Sarah Rasmi

Our team of psychologists in Dubai are here to support you. Our expert therapists offer treatment for anxiety and depression, relationship counselling and more.