[bernadette]

Hi  – regarding Prucalopride, it’s best to ask your doctor that question as it is not within our scope to make specific recommendations about medications.

Regarding Motility Activator, is this the one you’re referring to by Integrative Therapeutics? Did your doctor recommend this or was it self-prescribed?

[bernadette]

 yes, correct. Keep an eye out for a few weeks for any side effects.

[bernadette]

Hi – thank you for sharing these additional details. There’s a lot to unpack and I have my suspicions, but before I start sharing some of my thoughts, I have more questions for you. I’ll number them so it makes it easier for you to reply to them one by one:

1. Do you have any labs you can share prior to your diagnosis? I’d like to compare your labs prior to being on any medication since meds will impact certain lab markers.

2. Were you fighting an acute illness when the labs were drawn in March 2023?

3. Have you ever had/ do you still have any root canals and/or silver amalgam fillings?

4. Please fill in these mold symptom questionnaires to assess the possibility of mold illness, and tell me your scores (Dr. Jill assessment / CellCore’s assessment).

5. When was the last time you felt your most vibrant and well? And what changed in your life after that?

Medications:
Now regarding the Drug Induced Nutritional Deficiencies being caused by your medications, there’s a website call MyTavin that lists nutrients depleted by common drugs with research to back it up to help you take a proactive approach.

->Methotrexate for example depletes folate (B9). Your B12 can also be boosted based on your labs but that was almost a year ago. The drug also depletes glutathione. In fact, your GGT value being clinically low can also indicate a need for more glutathione, our most potent antioxidant in the body. If your GGT has been low for some time, I’d be suspicious of toxicity in your case. This study in particular shows the important role that antioxidants play in sarcoidosis.

Here’s a post I did on the different food forms of antioxidants you can start to incorporate more of into your diet. Quercetin, glutathione, curcumin are all available in supplement forms as well.

->Your hypertension medication is a beta blocker, which depletes CoQ10 and melatonin. CoQ10 is needed in almost every stage of the energy production cycle, so this can directly be contributing to your fatigue. It’s usually recommended that a person supplements with 100mg ubiquinol (the reduced form), twice daily to compensate for the drug induced nutrient depletion.

Melatonin, although it’s mostly known as our sleep hormone, is another powerful antioxidant in the body. If you’re struggling with sleep, melatonin supplementation might be something to consider. Always check with your doctor first for any contraindications before starting any new supplements.

Additional Tests:
Since you’re dealing with an autoimmune dynamic and being given immunosuppressants, vitamin D’s role is a bit of a balancing act. While boosting Vitamin D can help to arrest autoimmune activity, it may also upregulate innate immunity and contribute to sarcoidosis development and/or exacerbation, which we don’t want.

Check your levels of vitamin D, calcitriol and calcium (check calcium in both blood and urine). If there is no history of hypercalcemia, supplementation with vitamin D3 (and K2) to at least reach minimal levels (e.g. 30 ng/ml) would potentially be quite helpful to balance immune function. There is a critical balance here of keeping enough vitamin D in the system to avoid making the body highly vulnerable to other disease processes.

Adequate levels of vitamin A and RBC zinc (also test copper at the same time) will also help to keep the immune system strong and balanced and well supporting tissue healing. Test levels and supplement as appropriate.

Diet:
In terms of dietary guidance, following an AIP (autoimmune protocol) diet would help reduce overall inflammation and calm the immune system while working to address gut dysfunction/intestinal permeability.

You can take a look at this e-book by Meal Plan Club which shares a 4-week AIP friendly meal plan with recipes. AIP means gluten-free, dairy-free, grain-free, nightshade- and legume-free, soy-free, nut- and seed-free. So yes, it is quite restrictive, but it’s very effective at reducing inflammation and calming autoimmune reactivity while working to address root causes.

If you find this too restrictive initially, then a 100% gluten elimination and dairy elimination for at least 4 months while supporting the gut with healing nutrients like glutamine, aloe vera, slippery elm, marshmallow root, zinc carnosine, etc, can help calm the immune system and lessen “leaky gut” which gluten increases. Here are some gut healing therapy food and supplement suggestions.

Other helpful considerations:
• Practice mindful breathing. This helps maintain a parasympathetic nervous system that promotes healing. Feeling short of breath is a potent stressor and source of fatigue.

• Hydration is particularly important for smooth lymph flow that enables immune clearance. Do you drink enough filtered water?

• Appropriate movement is also key without over exertion. Consider using a rebounder to jump in place which can be helpful for stimulating lymph circulation. Yoga, pilates, and regular stretching would also be helpful.

• Proteolytic enzymes such as serrapeptase (taken between meals on an empty stomach) may also be helpful in degrading granulomas.

• Daily probiotics are a great way to balance and calm the immune system, especially ones with Saccharomyces bBoulardii and/or L. rhamnosus or L. plantarum (e.g. Metagenics Ultra Flora Acute Care).

• And of course, anything you can do to lessen inflammation will help. This may include: • A low glycemic and anti-inflammatory diet (e.g. avoiding sugar, inflammatory oils, pesticides, GMOs, artificial colors, preservatives, sweeteners and flavors, etc.)
• Fish oil containing at least 1,000 of EPA+DHA taken BID
• Curcumin – starting with 1,000 mg BID in a highly absorbable form such as Meriva formulation, titrating up as necessary

I hope this helps give you some areas to explore in the meantime. I realize there’s a lot to take in, but with autoimmunity, it’s always multi-faceted, and involves a combination of rapid relief while investigating and working to address the root cause(s).

We’re here to help you figure it out step by step, so feel free to ask any clarifying questions.

In the meantime, I’ll wait to hear back from you regarding my questions above.

[bernadette]

it depends on the type of supplement. You can find more information about how to take supplements in this “When to take supplements” handout in the Resource Library.

[bernadette]

Energy medicine is fascinating!! I’d love to know if any of you end up trying ANF therapy and what your thoughts are of it and your experience/results! Please let us know.

[bernadette]

 no not necessarily. I used that as an example to show how we can use nutraceutical supplements and lifestyle changes to positively alter genes (called epigenetics). Once a person gets well, I like to look at genes to help them stay well.

[bernadette]

 note, the form of magnesium will also make a difference in terms of how much he can take. Citrate form is stimulating to the bowels so he might not be able to tolerate as much as glycinate form for example.

There is some research like this one that shows a positive effect in pain reduction in those taking oral glucosamine and chondroitin for those with osteoarthritis, but I can’t say if it will be helpful in this type of situation.

Collagen and cofactors to help build collagen would probably be something I’d personally consider instead.

[bernadette]

 if there’s no prior issues with constipation, “high” is considered “to bowel tolerance”, which for most can be anywhere between 400mg to 1200mg short term. I’m not comfortable with anyone taking more than 800mg long term.

The body lets us know if we’ve taken too much magnesium by causing loose stools the next day. Adjusting the dosage according to bowel tolerance is usually how high dose magnesium is suggested, and in increments of 100mg per day. If there’s loose stool, decrease the dosage by 100mg.

Magnesium is best taken split throughout the day with food for better absorption.

[bernadette]

 that’s a great question with a lot of variables. 

Knowing when to stop taking supplements or following a certain protocol depends on your symptoms (progress, no progress, or worsening of symptoms) and labwork. If progress has been made by addressing the root cause of the issue, you can usually stop supplementation and maintain your level of health.

When someone is actively working to reduce their body burden from mold, in general, it can take 6 months to a year once they’re out of mold. Once they feel optimal again, they can go on a “maintenance” protocol which may or may not include supplements.

However genetics do come into play as well. I will usually factor in genetics once a person is feeling better after being on a protocol to help ensure they stay well as “maintenance”. If for example, someone has a strong history of cancers in their family, I’m usually suspicious of a genetic SNP that compromises their ability to detoxify. In that case, knowing their genetic “weaknesses” can help maintain their health by supplementing accordingly. And for some, yes, that might be lifelong supplementation to compensate for these genetic SNPs.

Hope that makes sense?

[bernadette]

supporting detoxification and mitochondria is key in this situation. You can find more information about the energy production cycle in this video about mitochondrial support, and how to support detox pathways in the body with this video and this video inside the Mold & Mycotoxin Illness course.

Magnesium and antioxidant supplementation in the meantime can hopefully help offset the side effects caused by Cipro since fluoroquinolones chelate magnesium and iron out of cells leading to epigenetic changes within the mitochondria. So high dose magnesium is important in the early phase (as long as there’s no kidney disease).

To help counter oxidative stress, ensuring he’s eating a diet that’s high in antioxidants and/or supplementing with antioxidants might also help with prevention of toxicity. Here’s a post I did as a reference for high antioxidant foods/spices. And you can also watch this video inside the Mold & Mycotoxin Illness course for more antioxidant support nutrients/supplements to strengthen the defenses.

Hopefully these help your friend! Please encourage him to join B Better if he needs further support.

[bernadette]

 thank you for sharing these resources!! I’m still researching the mechanism behind floxing to better understand how to help from a functional perspective, and will let you know if anything interesting/new comes up.

[bernadette]

 yes, Klaire Labs probiotics need to be refrigerated. They can stay outside for a week or so but not months.

S boulardii can be combined with other probiotics.

[bernadette]

 he’s usually quick to respond by email. He conducts virtual sessions as well, so distance doesn’t become a factor in working together.

[bernadette]

 I also mention a few probiotic suggestions in the video I shared above in case you missed that. After 1 course of antibiotics, it can take up to 6-9 months to repopulate the gut microbiome, so whatever he decides to take (fermented food and/or probiotic supplements), should be done long term.

After a course of antibiotics, I usually recommend something with S. Boulardii, a beneficial type of yeast, to help prevent opportunistic yeast overgrowth for a month or two. Klaire Labs ABx Support is one example. 

[bernadette]

I share the different nutrients and some sample formulas/brands for energy production in the video I shared.

If those aren’t available or you don’t have time to wait for them to be shipped through Fullscript, you can search by ingredient or “energy formulas” and see if they contain the below ingredients.

The energy cycle needs these key nutrients:
-Magnesium
-CoQ10
-Carnitine
-B vitamins
-Alpha lipoid acid
-Zinc
-Copper
-oxygen/iron (only take iron if needed)

There are many different types of formulas out there, each focusing on a different part of the citric acid cycle and cellular metabolism as I explain in the video. It’s a big process with many steps and conversions that rely on many different nutrients to create energy.

There are also many things that can hinder that process like toxins, lack of oxygen (sleep apnea, asthma, histamine mediated response of airways, etc), stress, insulin resistance, anything that causes the immune system to be inflamed (cytokines, interleukins, nfkb, etc). All of these will affect energy production negatively.

So again, even with supplementation, it’s important to work on what is hindering energy production along with supplementing with cofactors needed to make energy to have effect.

Hope this helps.