[Daniel]

,

Did you see the screen below? And did you click on the paperclip? Or do you see something else?[screenshot.jpg]Did you try uploading from another device?

[Daniel]

Hey ,

I’m glad you are feeling better!

Yes, you can feel dizzy the next day, especially if you didn’t eat much and your blood sugar became low. It can also happen because you might have been dehydrated.

Good call about using binders!

I would recommend you take a look at the CDC website here. It might be good to know when to contact the doctor. I hope there isn’t a next time, but you never know. It can be a trap to think ‘I feel sick, but my symptoms will probably pass!’.

You should see the doctor when:
• You see blood in your stools
• Have diarrhea longer than 3 days
• A temperature over 102 degrees Fahrenheit (or 39 degrees celsius)
• Have signs of dehydration
• You can’t keep liquids in since you vomit a lot.

I hope you feel better soon!

By the way, we do have documentation on what to do if you had food poisoning. You can find the link here.

[Daniel]

Hey ,

The typical reference range for insulin is between 2 and 25 uIU/ml. The ideal reference range is between 2-6 uIU/ml.

For HbA1c I personally use an ideal reference range between 4.5 and 5.2. Above 5.2 is indicative of some insulin resistance. Levels 5.7% and higher and usually diagnostic for physicians of pre-diabetes.

There is some variation between labs, don’t be surprised if the reference ranges sometimes look slightly different!

[Daniel]

Hey ,

The diagnosis ADD recently changed and means something different. 
The DSM (Diagnostic and Statistical Manual of Mental Disorders) makes no difference between ADHD and ADD anymore. This means that the diagnosis ADD these days could very well mean the old ADHD as well.

From the perspective of functional medicine, it doesn’t really matter, but from the perspective of what type of medications are used, it does.

The drugs that are prescribed for what once was called ADHD are stimulants. Non-stimulants weren’t used as much for ADHD, but they are more commonly prescribed for what once was called ADD.

Side effects of medications can differ per medicine, but here are the most common ones:

• Eating issues. The stimulants can suppress appetite which can look like someone doesn’t eat as much.
• Sleep problems. Some medications are short-acting. This means patients use typically 2-3 times per day their medications. The closer the medication is used to the evening, the more influence the medications have on their sleep.
• Tics: sometimes these medications can cause repetitive movements or sounds. Changing medications can help.
• Increase in blood pressure and heart rate
• Mood changes: when the dosage is too high people can get irritable, anxious or they might feel sedation.

I don’t know the kid who you are asking for, but some lifestyle factors might look like ADD. For example, a bad night of sleep can make kids easier distracted. Kids, to a certain degree, be full of energy and might have less focus. Having hearing problems might also contribute to a lack of focus. Even sitting in the back of the classroom in school or having a hard time reading things might result in a lack of focus. Some things to consider as well!

Sometimes nutrient deficiencies can be the root cause of ADD as well. Zinc is needed for focus for example. Vitamin B6 is needed to create dopamine and other neurotransmitters. Iron and magnesium deficiencies can also contribute. 

Other causes that can contribute are:

• Artificial colors, chemical preservatives or fluor
• Subclinical hypothyroidism 
• Food sensitivities.

There is more to say about this, if the person you are asking this for wants to learn more, let us know!

[Daniel]

Hey 

Thank you for sharing your labs with us!

To understand your labs better I will need to know what kind of symptoms you were experiencing with your blood draw. I know you mentioned a few, but I’m particularly interested in if you felt sick at the time (or in the days before) when you took your blood sample.

Your white blood cells were a bit low on the labs. This can happen for example with an infection that has been there a bit longer. With longer-lasting infections, the body also tries to reduce iron in circulation. It does this by storing iron in a substance produced by the liver called ferritin. Ferritin is elevated in your labs. Unfortunately, serum iron isn’t measured, but it is something you need to do.

But a zinc deficiency could also cause this – including a slowing of the thyroid function. To support the immune system nutrients like zinc, vitamin A, C & D and B vitamins are important. From your labs I can tell that you don’t need to have an extra focus on vitamin D. The amount of zinc in Thyroscin is a bit on the low side perhaps. It al depends on what other supplements and foods you consume. Are these the only supplements you use? And do you consume meat? If you are on a vegan diet, your diet might be rich in copper which can lead to lower zinc absorption since copper competes with zinc on the same receptors.

Red Blood Cells
What stands out to me as well is that the size of the red blood cells is suboptimally high. This can lead to lower oxygenation in regions where the blood vessels are extremely small. These regions include the brain (which can contribute to fatigue, lack of focus, brain fog, etc), the eyes and the hands and feet (which could cause cold hands and feet). Reasons, why red blood cells can be bigger, are a lack of vitamin B12, folate and/or vitamin B6. A B complex (for example Basic B from Thorne) can help you address that. It takes around 3 months to replace all red blood cells. Usually, these types of symptoms start to improve after 6 weeks.

The amount of red blood cells seems to be a bit low as well. Are you experiencing heavy blood loss during your menstruation cycle or did you lose blood for another reason? If not, the production of red blood cells is impaired. Nutrients that are needed to produce red blood cells are again zinc, vitamin A & D, folate and B12.

T4 to T3 conversion
Bernadette mentioned some nutrients needed for conversion. The conversion happens partly in the thyroid, but mostly in the rest of the body. Big players that convert T4 to T3 are the liver, the kidneys and the gut. Your kidneys don’t look damaged, although the kidney filtration rate isn’t assessed.

The liver enzyme ALT  is tested and scores on the lower end. We need vitamin B6 (again) to produce ALT, so if B6 is insufficient and the liver tries to produce ALT, it doesn’t have the building blocks to do so. This is a common reason for a low ALT. Elevations in ALT can be indicative of a struggling liver, but it might not show up on your test if you have low vitamin B6 in your body. It is important to know since ferritin is produced by the liver and can elevate when the liver is struggling as well.

The gut is also a major player. If you experience gut problems this can influence your gut’s ability to convert T4 to T3. Bloating can be caused by for example low stomach acid or food intolerances/sensitivities. It helps to find out what makes you feel bloated. Do you feel bloated all the time? Or are there particular meals that make you feel more bloated?

TPO Antibodies
Antibodies might tell us if there is some autoimmune issue going on. Once you’ve got the results back, let us know!

To summarize:
• Focus on having nutrients that support the white & red blood cell production: Vitamin A, the B vitamins, zinc and vitamin C
• Vitamin B6 might be insufficient since ALT is low.
• Ferritin is elevated. Make sure you discuss this with your doctor and measure serum iron as well.
• Make sure you share your TPO antibodies

[Daniel]

Hey ,

Unfortunately diagnosing people isn’t something we can do on this platform. It requires a medical doctor who can dive into personal circumstances.

That being said, it does fit the picture. There is definitely some auto-immune activity going on.

[Daniel]

I’m so sorry to hear !

Some markers point to dysbiosis. Compared to last year your bacterial markers did drop. Even your Carboxycitric levels dropped (which are indicative for yeast and fungal overgrowth) 

The lower amount of phosphor present on the test can be related to either low consumption of phosphor rich foods, but it might also be related to low vitamin D levels.

The B6 marker is also low which might indicate higher needs. Are you still using your B complex?

I will need some time to dive in deeper to the results.

With your gut you seem to be making progress, which means some other dynamic is still at play.

[Daniel]

Hey ,

Perhaps you could help me: what labs would you like to send to where? Or do you mean you cannot upload your labs to the platform?

[Daniel]

Hey ,

ACTH & Cortisol
Cortisol levels are regulated in a feedback loop. If cortisol is low in the body, the hypothalamus in the brain will sense this and will send a hormone called CRH to the pituitary to make more ACTH. ACTH then tells the adrenals to make cortisol. Once cortisol rises, the hypothalamus will produce less CRH and the cortisol production reduces.

When ACTH is high and cortisol is normal it generally means that your adrenals only produce enough cortisol under increased ACTH stimulation. Either the production in the adrenals is impaired or cortisol is removed from circulation.

The adrenals can be impaired by genes for example with a condition called Congenital adrenal hyperplasia. This can also increase testosterone production since ACTH regulates androgens. But it depends on the elevations in ACTH. Does she experience symptoms of high testosterone, like:
• Acne
• facial hair growth
• Abnormal menstruation
• Male pattern baldness (Androgenic alopecia)
• Infertility
• Deepening of the voice

A little damage to the adrenals can also give the same clinical picture. The adrenals might struggle with cortisol production and now the pituitary is actually ‘yelling’ to the adrenals: go make cortisol!
It can also be that your adrenal function is normal, but cortisol is being broken down fast by liver enzymes for example by genetics. It might also be that cortisol is more bound to Cortisol Binding Globulin (CBG). Reasons, why CBG can be elevated, are for example:
• Oral contraceptives or estrogen imbalances
• Inflammation to the liver from for example with chronic active hepatitis (click here if you like to see the research).

Perhaps you could share with us a little more details about your client so we can help you with more targeted advice. Things that can help us:
• What type of test was done? Was a DUTCH test done as well? And if it was a blood draw it is important to know when? In the morning it is normal to have higher ACTH and cortisol. It might have led to mild elevations in ACTH but normal cortisol levels as a result. Even excitement for the test could increase ACTH mildly, while cortisol levels usually respond later.
• What symptoms does she experience?
• Is she on any medications?
• Does she experience any high cortisol or low cortisol symptoms (Here you can find signs & symptoms of high and low cortisol)? It is important to know since she might have had normal cortisol levels at her blood draw, but that only tells you about her stress levels at the time.

Detoxify Mold
Have you seen the recording of our guest speaker dr. Jill Crista on mold? You can find the recording here. I’m sharing this since the first priority in removing mold in your life is removing the source. Supplements that can help you with mold detoxification are broad-spectrum anti microbial like Candibactin AR and Candibactin BR. Other anti microbial supplements that can help are biocidin from biocidin botanicals.

You should also work with binders like GI Detox to prevent the herxheimer reaction. I know Bernadette is almost done with filming her mold course, so there will be much more information on this topic available soon.

I hope this will help!

[Daniel]

Hey ,

The serum selenium measured in the functionalDX tests isn’t bad. With vitamins and minerals, I aim usually in the upper half of the reference range. Yours are a little lower, but not by much.

Serum levels however are reflective of what you have eaten the last few days. Red Blood Cell markers can provide you with an average of what you have eaten in the last few months since red blood cells live around 3 months before they are broken down by the body. So although the marker looks good, it has a limitation. But if your eating pattern was reflective of your normal eating pattern in the days before the blood draw, the serum levels are probably a good indication.

With regard to your question about Hashimoto’s: diagnosing isn’t what we can do. It requires a medical doctor that can assess your personal circumstances. With Hashimoto’s TPO antibodies are usually high. Yours aren’t. This is all I can say about it.

Graves results in a fast thyroid accompanied by a low TSH. Since your fT3 is low and your TSH is 2.1 it doesn’t fit the clinical picture.

I hope that answered your questions!

[Daniel]

Hey ,

Before you joined? Do you mean the quiz you took? Or do you perhaps mean other forms?

[Daniel]

Hey ,

It depends a bit on where you would use it for. The drops are also a great source of magnesium. From the lable I can’t tell you what source of magnesium though. It also contains electrolytes.

Sole is also a source of electrolytes and is made from natural ingredients and has a rich mineral profile. It does also contain some magnesium, but it is hard to asses the amount. It is lower then used in the drops though.

I guess it is a matter of what you find important and what you prefer for taste!

[Daniel]

Hey ,

Thank you for giving me some culinary inspiration. I never made Arayis myself. Unfortunately, I can’t help you with the first part of your question though since I don’t exactly know what brands are sold in Dubai. I’m sure  could give you some advice. But here are some tips for the second part of your question.

Insulin, blood sugar and feeling tired after a meal.
A good meal should make you feel saturated and provide you with energy. Big meals, especially when they contain quickly digestible carbohydrates can make you feel tired cause they raise blood sugar fast and as a consequence, the blood glucose levels can crash. A second reason for fatigue can be caused by tryptophan (an amino acid) rich foods that then get converted into serotonin and melatonin.

Everybody responds a little differently to a meal. But since too many carbohydrates can make you feel tired, you have a way to assess if your meal was too big so you can adjust accordingly. You can test this by consuming fewer carbohydrates the next day.

Lifestyle factors play a big role in the ability to store sugars. Sugars in cells are stored in the form of a molecule called glycogen. Once glycogen gets depleted, your cell’s ability to store glucose increases and you can handle more carbs as a result. Lifestyle factors that decrease glycogen are for example active lifestyle, working out and fasting.

Reducing glucose spikes and crashes
It is possible to affect the way your body handles the carbohydrates from your meal. Here are some simple tips:
• Eat proteins with your foods. Proteins, but also fats can help slow down the absorption of carbohydrates. Peanuts are rich in protein but are usually consumed in smaller amounts. If you have a few peanuts in your food, I would recommend adding another source of protein. Bernadette often talks about the VPF principle. This is an easy way to make a balanced meal. In this video, the VPF principle is explained. Let me know if the link works since I know people in Dubai had a few problems with playing the videos!
• Eat proteins first and carbohydrates last. The order in how you consume your foods can also influence the speed at which you absorb glucose. Eating carbs first will raise blood sugar quicker.
• Walk after your meal. Having a 10-20 minute walk after your meal can help you with reducing a blood sugar spike as well.

Big meals and tryptophan
Some foods are rich in tryptophan & melatonin. The body uses tryptophan to convert this amino acid to melatonin. Bigger meals can influence the amount of melatonin causing fatigue as well. Milk for example is a source of tryptophan and melatonin and can induce fatigue. In fact, you might know this from experience. A cup of black coffee is quite stimulating, but a cappuccino or latté macchiato is much less energizing. 

Almonds are also rich in tryptophan and melatonin and can cause tiredness as well. If you like to know if carbs are causing your blood sugar to crash, I would recommend other plant-based milk.

So to summarize:
• You can use your ‘after-dinner’ dip to asses if your meal was too big.
• Having protein with your meal slows down sugar absorption
• Just make sure you aren’t combining too many tryptophan and melatonin-rich foods with your meal, since they can cause fatigue as well.

I hope this helps!

[Daniel]

Hey ,

You are on a roll! I’m proud of you! Let’s go over your question:

How long before I work out should I eat?
It depends a little bit on what you do. When you work out I would advise you to keep at least 4-3 hours between your meal and your workout. Depending on the intensity of your workout your body is going from rest-and-digest to fight-and-flight mode. This is by the way functional and what we want when we exercise.

Once you are in fight-and-flight mode, the body will divert energy away from digestion and prioritizes fueling the muscles. The 4-3 hours window helps you to optimize for digestion

Since life isn’t always presenting us with optimal circumstances you could also go for plan B: eating smaller meals in the way Bernadette mentioned.

What kind of warmups should I do?
We need stress hormones to come up during a workout for optimal performance. It takes about 10-15 minutes for the adrenals to increase cortisol production. This is the time I recommend you spend warming up.

There are so many options for warming up. But during the warm-up phase, you should start easy and increase intensity during these 15 minutes. You could start with a more old-school way of warming up, like biking, using a cross trainer/treadmill or rowing machine. If you like variation you could spend 5 minutes on a bike, 5 minutes on a treadmill and 5 minutes on a rowing machine for example.

There are infinite other ways to warm up. You could spend time with dynamic stretches (these are stretching movements in contrast to static stretches where you spend time in one position) or do more balance exercises. The goal should become warm, not tired though!

Here you can find some other variations that you might enjoy. There are some static stretches in the warming-up phase here. I prefer to leave them out, especially if you are starting with strength training.

You don’t need to memorize them all. You could choose a few exercises, learn them and add with a few other exercises once you have memorized the others. Go slow and give yourself the time to learn them!

A last thing I would like you to point out: you are building your routine. What can happen is that these warming-up exercises might already feel heavy.

Don’t worry about that!

Your body needs some time to adjust to your new healthy habits! Just go a bit slower and most importantly: don’t ever… EVER… be disappointed about your performance. Firstly, you are already doing much more than the majority of people.  Secondly, if you feel fatigued much earlier than you would like, being fatigued means your body received a training stimulus and will now try to adapt. This is already a great result!

Should I be doing a cooldown?
I honestly didn’t spend a lot of time cooling down after a workout with my clients. Your body will cool down perfectly on its own. It is not necessarily what I would recommend doing though. When I train clients, I train them for one hour. In this hour I always spend time on nutrition, lifestyle or other pieces of advice, which means I have less time for the actual workout.

The end of training is a great place to work on flexibility. Spending 10 minutes on stretching will help keep your flexibility at a later age. It is a present to your future self!

Should I drink sports drinks during/at the end of my workout?
Most people don’t need the sugar after a workout, although advertisements can give you another signal. Even I as a personal trainer don’t need sugar after an hour in the gym. I agree with Bernadette on replenishing your electrolytes. Fresh organic coconut water is also a great option. It does contain a little sugar, but much less as in for example Gatorade.

The most important factor for starting a successful workout routine is by starting with exercises you love. Focussing on losing fat in the midsection is a great goal. Cardio like walking, jogging, swimming or rowing are great choices. Keeping your heartbeat around 120-130 beats per minute will help you to perform longer. At this rate, it should be hard to hold a conversation with someone, but still possible.

When you feel more confident, I would recommend you add in some strength training as well – but only after you have built some confidence in the gym! If you need more tips for this, I can definitely help you with some recommendations!

[Daniel]



The link worked for me for some reason. I have added the handout below. But you can also find it here.

I know there are some technical issues with watching videos in Dubai. We are working on that!
[Hydrochloric acid supplement recommended dosage challenge.pdf]