Daniel
Forum Replies Created
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Hey ,
Yes, quite a bit actually. My primary focus although wouldn’t be really on TSH though. I look at it as a reflection or a ‘symptom’ of what is going on in the body, not a cause.
Her TSH is elevated when you compare the values to the ideal reference range. Perhaps you remember from the thyroid course that TSH is a ‘brain hormone’ that tells the thyroid to make thyroid hormones. What this means is that her brain ‘feels’ there is not enough thyroid hormone to function optimally.It elevates TSH in an attempt to let the thyroid work harder.
There could be several reasons for that.
• Insulin resistance could drive this. Since with insulin resistance, the cell’s energy production is slowed down, the brain might try to ‘speed up’ the metabolism by telling the thyroid to work harder.
• Her body might experience stress (for example, as a reaction to eating gluten). This can lead to elevations of reverse T3 which looks like the most potent thyroid hormone T3, but actually blocks the action of T3. Unfortunately, this panel didn’t measure reverse T3.
• Or at the cellular level, the cell decides to convert T3 to something else.Helping your sister by making her more insulin-sensitive and reducing stressors could already make an impact on her thyroid health.
But what we didn’t discuss in more detail was the presence of thyroid antibodies indicating there is an autoimmune reaction going on – which is not the only autoimmune reaction since your sister’s labs also show elevated antibodies that are indicative of coeliac disease.
For healthy thyroid function, it is important to address this.
The perfect storm for autoimmune issues is often a combination of a weakened immune system, leaky gut, genetics and an environmental trigger. There you could help her a lot.
• Give support to the immune system by making sure your sister has the nutrients in the diet. Make sure she has enough vitamin D, vitamin A, zinc (a zinc deficiency could also lead to hair loss), folate and B12 in her diet
• Focus on gut healing. Remove gluten for sure, since gluten will lead to inflammation and possibly more damage to the gut lining. Inflammation in the gut can also reduce iron absorption.With healing autoimmune issues I often recommend removing dairy and gluten-containing grains, but preferably all grains for a while. I didn’t mention this earlier since you mentioned that your sister was still struggling with self-care & food.
Supplements/foods that can help heal the gut are Zinc carnosine, Aloe Vera, bone broth, and L-glutamine… There are many options. Multi formulas like that from designs for health’s GI revive (with Glutamine) and Pure Encapsulations DGL Plus(without Glutamine) or Thorne’s GI Relief(also without Glutamine) could be really helpful here.
• Nutrients that play a role in thyroid health are of course iodine, but zinc, selenium, iron, vitamins A & D and protein (in particular the amino acid tyrosine needs to be available in the diet).My focus would mostly be on these things first and see how symptoms improve and work from there.
I hope this helps!
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Daniel
MemberFebruary 21, 2023 at 9:43 pm in reply to: My Book is Making Its First Live Appearance… (Eeeeekkkk!!), you mean we all have to go to Dubai for a signed copy???
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Hey ,
Welcome to B Better! My name is Daniel and I help Bernadette on the platform.
I think you will find a lot of information around here! I have seen Bernadette gave you some tips on where to start already.
I already noticed you posted questions. I like to encourage you to keep doing that. This is a safe space, so there are no ‘wrong’ questions possible!
I was curious about the bad habits you mentioned. We all have a few! For us, it can be insightful to know which ones you are struggling with. Would you like to share? Perhaps we could help you with some more targeted advice!
Welcome to the family!
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Hey ,
Bloating can be quite anoying. And there can be multiple reasons why bloating can occur. Here are some easy tips and a few more ‘exotic’ tips that you could try out.
• Food hygiene – Taking time for food, eating mindful, chewing… it seems so easy, but it is very easy to skip it as well. Often eating in a stressed state tells our body that our energy needs to be away from digestion, reduce the production of stomach acid and digestive enzymes. Reductions in all of these enzymes can contribute to bloating.
• Remove milk products for a while – Since a lot of people are lactose intolerant or sensitive to proteins in milk, removing dairy for a while could be something worth trying. I would recommend to leave milk products away for a couple of months, since with a milk sensitivity you need to ‘calm down’ the immune system. I will come back to that later. Here is a listwith products you might not have thought of that also contain dairy products
• Remove gluten containing products for a while – A sensitivity to gluten could also lead to gass and bloating and is a common reason for bloating. Again, the B Better library has a list that can help you with less obvious gluten sources, just click here.
• Remove other food intolerances & sensitivities – Practically all foods can cause intolerances. Besides milk and wheat other common food intolerances are soy products, eggs, peanuts, yeast, corn, pineapple, oranges (or other citrus fruits), beans and even beef, pork and shellfish. Quite a list! If you try this approach I would advise to start removing the foods you consume the most first. Remove these foods 100% for 30 days and reintroduce them for a couple of days. I would advise you to do this one by one. If your bloating returns you have a much better understanding of what foods causes your bloating.
• Try carminative herbs and teas – Ginger, fennel, anise, cinnamon, lemon balm and peppermint are all herbs that you could use in foods or teas to reduce bloating.
• Helping digestive enzymes with supplements – Consider if supplementing with digestive enzymes creates some relief. A supplement that I recommend my clients is digestive enzymes ultra from Pure encapsulations. It is also available in fullscript, just click here.The B Better library has a document right here with some other options you could try. But it is important to find the root cause, wether it is low stomach acid and digestive enzymes or something else like constipation, or dysbiosis.
Dysbiosis
I know you already made a few steps in your health journey. I believed you were struggling with heavy metals like mercury right? Sometimes the gut microbiome (in particular Candida) tries to protect the body against mercury by ‘catching’ it away. An organic acid test from GPL can give you insight into overgowths in Candida and other bacterial/fungal overgrowth.I also remembered you were struggling with mold issues, right? If you didn’t considered on OAT yet, perhaps this is something you could try. Here is a video which discusses the OAT and give you some other options to consider as well. We could help you with the interpretation of the results here.
I hope this provides you with some starting points! Let us know how things develop!
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Hey ,
I agree with Bernadette that a general check-up is a good choice when no other symptoms are present.
I would also like to add that you could choose labs based on other factors, like family history (for example – do heart problems run in your family? Then you could choose a full lipid panel as well) or if more subtle symptoms would present, you could try other other options. For example:
• If you experience cold hands & feet, feel fatigued and have problems with focusing, I for example would like to know my serum iron levels, and ferritin and do a Red Blood Cell.
• If you feel hormones might play an important role in your health you could choose a DUTCH test
• If you feel bloated, gas or other gut-related issues on GI Map or an OAT might fit you more.Just some other thoughts that could guide you in your choice!
Let us know what you have chosen!
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With rebalancing her iron I would use a cautious approach. Her tests show she is allergic to gluten. This means every time she eats gluten her body creates inflammation in the gut. When the gut is inflamed, iron absorption gets blocked. If you want to learn more about correcting an iron deficiency, just click here.
Right now I am assuming her labs were taken in the morning after an overnight fast. If this assumption is correct and if clients would come to me with these labs and symptoms you describe I would assume insulin resistance is at play.
Let me explain: although her blood sugar looks ideal and even her HbA1c shows no alarming signs, her insulin levels are in the upper half of the reference range. But for a fasting state, this is quite elevated. If you like to evaluate signs of insulin resistance, we do have an excellent video on this as well, just click here. Just be aware that the units used in your sister’s labs are different. The ideal reference range for insulin in the fasted state is between 2-6 uIU/ml. This is 14 pmol/L – 42 pmol/L
Another clue is that in your sister’s labs, you can see she is producing ketone bodies. Ketones are typically produced by cells when they don’t get sugar. This is for three reasons:
• On a ketogenic diet (which your sister is not)
• Fasting
• Insulin resistanceI hope you have a clear idea of where to start. Judging from what you have described I would probably start this way:
• Remove at least gluten from her diet, but with autoimmune we would like to remove milk products as well
• Avoid foods that will get her constipated. If your sister alternates between constipation & diarrhea this could also be a sign of an overgrowth of bacteria in the small intestine (SIBO). Addressing SIBO involves a diet that could feel overwhelming to her at this stage. Just be aware that we do have some documentation for that (just click here)
• Focus on foods that can heal her gut – (click here for another video that can help you with that)
• Adress her H. Pylori overgrowth (as I mentioned in my previous reply)
• Adress her insulin resistance (as I mentioned in my previous reply)
• Get her vitamin D upAnd most importantly – celebrate every win with her!
There are many more things you can do with her, but right now this might be already a lot for her.
Let us know if you need more help!
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Hey ,
My name is Daniel and I help Bernadette on the platform.
As Bernadette has mentioned there is already a lot of content! I have seen you have already posted a few questions on the forum. Feel free to ask anything. And if you ever are in doubt to ask us something: any question is a learning opportunity for the whole forum. Please do share!
Welcome to the family!
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Hey ,
Interpreting lab values can be quite overwhelming! It is true that with lab values we can do more targeted recommendations. But lab values can also often create a false sense of security. The thought that since we have measured labs and therefore solid answers can now be given often isn’t possible since we don’t treat lab values, but persons.
Stepping back and asking yourself: who is this person? What are their symptoms? What are their lifestyles and food choices? And why are they choosing these choices? These questions often help you to get started.
Since I don’t exactly know your sister’s symptoms, I will give you the best possible answer based on the lab values you gave. If you would like more targeted advice, it would help to know what symptoms are present. Here are some questions you can ask her:
• Is she fatigued? And if she feels fatigued, does she feel it in the muscles? Or in the mind?
• Does she feel fatigued after dinner? Especially after lunch or dinner?
• Does she experience bloating? Gas? Constipation, Diarrhea?
• How does she feel when she eats bread, pasta, and other gluten-containing products?
• Is she losing hair?
• Does she look pail?
• Does she experience tingling sensations in her body? Are they in her arms or legs?
• Is she feeling cold? Is she experiencing cold hands & feet? Or is it her total body?
• Was she sick recently?
• Does she notice blood in her urine?
• Does she feel or felt recent pain in her side and back, below the ribs?Interpretation of labs is also related to lifestyle factors:
• Is she on a ketogenic diet?
• How is her self-care? Does stress impair self-care?
• How does she sleep? Does she wake up with energy?
• Does she take time to eat? Does she chew? Can she do this without time pressure?
• Is she choosing a nutrient-rich diet?
• Does she see the sunlight enough?All these questions will help to interpret her lab values. All these questions could already give you a sense of where to start as well!
Low hanging fruits
From these labs you could already work on a few things:
• Ask a doctor to evaluate her kidney health. Her labs show white and red blood cells in the urine. Her uric acid is elevated. These are indications for something is going on there. Ask your sister about complaints related to kidney stones for example. But definitely advise her to see a doctor on this topic and find out what is going on.Here is a little extra tip: If kidney stones are at play, reducing oxalates in foods (here is a list!) can help since most kidney stones are crystals made from calcium oxalate. Ensuring enough vitamin K2 is in her diet before raising her serum vitamin D (more on vitamin D later!) since K2 helps transport calcium to bones. Hydration with kidney stones is important as well. If her kidney health allows (and only if) – supplements like magnesium can help her as well. But again, I would recommend finding out what is at play with her kidney health first.
• Remove gluten. Her labs indicate she is allergic to them. A second reason to remove gluten is she shows other autoimmune issues as well. But the gluten allergy can cause inflammation in her gut. The inflammation in the gut can lead to damage to her gut lining causing an enhanced intestinal permeability or often called a ‘leaky gut’. In the presence of autoimmune issues I often recommend to remove milk products as well.
• Raise her vitamin D levels. Either with supplements or sunlight. I personally aim with my clients for serum vitamin D levels of 120 nmol/l. Raising Vitamin D can reduce autoimmune symptoms. Vitamin D also helps to close the doors or ‘tight junctions’ in the gut lining, making the gut lining less ‘leaky’.
We do have a vitamin D handout. Just click here!
• Raise vitamin B12. Personally, I aim for serum B12 levels above 600. Your sister’s levels are on the lower side of the reference range.Optimizing the gut for iron and nutrient absorption.
We talked about vitamin D in relation to the gut. The next values need a little more thought. I have noticed that her iron, her iron storage (ferritin) and her iron transport saturation values are borderline low or low. 70% of the body’s iron is used to create hemoglobin to transport oxygen. Most of the red blood cell markers are ok. But once iron levels drop further, it wouldn’t surprise me that her capacity to transport oxygen will be influenced.Iron needs stomach acid to absorb. The enzymes in the stomach that digest iron need vitamin C as well to function. Stress influences the production of stomach acid negatively. The absence of zinc in her diet as well. A slow thyroid can also cause stomach acid to be low… but I will come back to that.
Low stomach acid can give rise to an overgrowth of a bacteria that often live in small amounts in the stomach: H. Pylori. This bacteria overgrowth is often asymptomatic but can cause ulcers. We do have a video on how to deal with an H. Pylori infection. Just click here.
The next part of iron absorption happens in the gut. Inflammation caused by coeliac disease can cause the iron (but also her B12) to be malabsorbed. If you like to learn more about how to correct an iron deficiency, just click here.
Insulin resistance
Elevations in uric acid, even when blood sugars appear to be normal can be an indication of insulin resistance. Elevations in uric acid can also be indicative of gout and kidney problems, including kidney stone formation. Ask your sister if she sees experiences pain in her side and back, below the ribs. Since her labs show blood in the urine, you could ask her about the color of her urine as well. If she feels worried about these symptoms, advise her to get help from a doctor.Back to the topic: insulin resistance.
Here we can see that timing of the lab draw gives us more information as well. If these labs have been taken in a fasting state (and my guess is that they are – but this is something I would always like to have confirmed by my client and I advise you to do the same) here insulin levels are quite high. Even if they are in the reference range. In this video, Bernadette explains it perfectly!
According to her labs, your sister produces a certain amount of ketones. These levels can be because of insulin resistance, but these levels could also be caused by fasting or a ketogenic diet.
The Blood sugar regulation course will give you a lot of tools on how to approach insulin resistance. I would advise you to at least watch Meet the players: PAAL, Blood sugar regulation: how it works, blood sugar regulation: how it dysfunctions, Summary: evaluating daily function and What is the best diet?
The most impact on reversing insulin resistance is by changing the diet. But supplements can help as well. In the library, we do have videos on that as well, but since her kidney markers are elevated I would be cautious
Thyroid Health
The labs show elevated thyroid antibodies. Right now, her free T3 and her free T4 look normal, although her TSH (the pituitary hormone that tells the thyroid to make thyroid hormones T4 and T3) is a little higher where we would like her TSH values ideally to be – but still in the reference range.Here I would again ask your sister about symptoms since stress can cause her T3 hormone to be blocked by reverse T3. If you want to find a comprehensive list of symptoms I would advise you to watch this video. Insulin resistance can also impact thyroid health, which is explained right here.
There is more to say about her values, but I hope this gives you a good feeling of where to start.
I can share with you a more detailed response, once I know the doctor’s opinion on her kidneys, and her possible other symptoms and once I know more about her food choices, sleep and stress levels!
I hope this helps!
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Hi ,
NAC vs Glutathione
Glutathione is made from 3 amino acids: glycine, glutamine and cysteine. NAC (or N-acetylcysteine) is a source of cysteine that can be used by the body to make glutathione. Glutathione is particularly concentrated in the liver.Often we see that the rate-limiting step to create glutathione is the amount of cysteine. The OAT has a marker (number 56 on the OAT test you have done with GPL in march) called N-acetylcysteine. If this marker is low, it means that you either
• don’t produce NAC or
• it is being used up because there is an increased need for NAC or
• both!Do we need both?
The advantage of using glutathione as a supplement is that you know you are having glutathione in your body. NAC still needs to be converted to glutathione, but in a lot of cases, it raises glutathione. To form glutathione, you still need the other amino acids and cofactors. If these are somehow a problem, glutathione is a better choice.Do blood tests and OATS show whether the liver and kidneys need detoxing?
Blood tests and OATS show often a lot of information that needs to be interpreted. The values of tests are just one part of the puzzle. Patterns seen in values are a second one. Let’s continue with the example above of Glutathione.Take a look at the picture below:[Glutathione production.png]
Here you can see a picture of all that is needed to create glutathione. Yes, detoxification uses up a lot of glutathione. But when you lack precursors and cofactors like B vitamins, it is hard to produce good amounts of glutathione as well.On your OAT from march 2022 for example, the results showed a low amount of vitamin B6. This can lead to a build-up of homocysteine, while homocysteine can’t be used to create glutathione.
Other markers are used to see if there is a pattern of toxic exposure, from which we then can conclude what is most likely at play.
This is why Bernadette and I always ask a lot of questions and provide you with different scenarios that could be at play.
To answer your question: we do often know that the body is trying to detoxify and it is struggling to do it based on lab values. But studying lab values, whether it is an OAT or a traditional blood panel from the doctor, is a reflection of what is happening in the body. Some lab values are more direct and some lab values need more context for an appropriate interpretation.
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Hey ,
The ‘Safer Choice’ logo on the products will in general guide you to healthier cleaning products. Reducing toxic exposure by avoiding a lot of materials is already a wonderful gift you can give yourself! But yes, you are right. In these products, you will still find some synthetic compounds that could be of influence.
Methylisothiazolinone and Benzisothiazolinone
For example, Methylisothiazolinone (found in the dishwashing liquid from the brand ‘Seventh Generation’) is a synthetic compound that can cause some irritation and allergic reactions on the skin in some people. Benzisothiazolinone is another synthetic ingredient in the same product. It is used to chelate metals from water often to make them softer or to conserve products when they lose effectiveness if they get in touch with metals. Benzisothiazolinone has caused in some people some skin reactions as well (you can find a detailed scientific opinion of this agent here).Phenoxyethanol
In the dish soap from Ecos you will find a synthetic chemical called Phenoxyethanol which is used as a substitute for parabens. You can find more information (and it is easy to read!) about Phenoxyethanol on this website here.Natural Flavors
Ingredients like ‘Natural Fragrances’ like on the last product are hard to decipher. According to the FDA this is what the term means:“a substance extracted, distilled, or similarly derived from natural sources like plants (fruits, herbs, veggies, barks, roots, yeast, etc.) or animals (meat, dairy products, eggs, etc.) via a method of heating, with its primary function in food being flavoring not nutritional”
To translate that: Natural flavors are complex mixtures and are created by specially trained food chemists known as flavorists.
Potassium Sorbate
Potassium sorbate (an ingredient in the last product) prevents the formation of fungi and has mild antibacterial properties. It doesn’t differentiate between good and bad bacteria. Cleaning with such types of ingredients can influence the microbiome of the skin. If you like to avoid contact with this all purpose cleaner, you could avoid contact by using gloves. -
Iliopsoas
Last but not least, with stress the psoas muscles often get tense as well. Trigger points there can lead in some cases to stiffness or pain in the lower back as well. Sometimes the stiffness in the iliopsoas can lead to some sensitive or tight feeling areas in the front of the body (in the region where the arrow of ‘lesser trochanter’ points too).
The shortened muscles can cause a pelvic tilt, influencing the position of the neck and the neck muscles. If stiffness slowly returns, the psoas could be part of the cause.
Releasing the psoas with dry needling is often hard since the psoas is located more inside the body. With active release techniques, the psoas is also harder to reach, but it is reachable. If you can’t find somebody who can release trigger points there, let me know and I will demonstrate exercises you could do that can help you.
I hope these tips and those mentioned by can help you find some relief!
[Psoas.jpg] -
The Shoulder muscles or “Deltoideus”
The Deltoideus is actually a group of 3 big muscles located around the X in the picture below. These muscles are more located at the sides of the shoulder joint and not on top. When trigger points or stiffness in these muscles aren’t released, the upper part of the trapezius will stiffen quite quickly again leading to a stiff neck.
Releasing this muscle is even more important than releasing the lower trigger points in the trapezius. I would advise you to discuss with your therapist if he can examine the deltoideus and the trapezius as well.[posterior-deltoid-trp.jpg]
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Here are some other tips for when you have found the right therapists. I often see therapists focusing on the neck only. But other muscles often play a role as well.
Trapezius
The trapezius is a big muscle often involved in stiffness in the neck. Most physical therapists will focus on the upper part of the trapezius. This should be done. Trigger points are often found at the X near Upper TrP2 (see the picture below) creating stiffness or hard muscles in this area as well. The muscles in this part will get stuck in a shortened position.However, sometimes the lower part of the trapezius can be weakened because of another trigger point located at Lower TrP3. The lower part of the trapezius pulls the shoulder down. If the lower part doesn’t function like it normally should, it is often likely that the upper part just gets stiff again.[upper-trap-trigger-points-functional-performace-physical-therapy.jpg]
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Hey ,
I used to work a lot with releasing trigger points and stiff necks and I do have some advice I can share. I will have to divide my reply into different posts. I will start by sharing some advice on what techniques are efficient in releasing trigger points. In the other parts, I will discuss some tips that you can share with your therapists since I noticed that a lot of therapists miss the contribution of these muscles when they treat a stiff neck.
Reducing tension in muscles can be done quickly with certain massage therapies. Although a lot of massage therapies can reduce tension in the muscles, only a few techniques remove trigger points. This results in that most massage techniques only give some temporary relief.
I often use a massage technique that is called “Active release”. These massages are quite intense, but they do remove trigger points. A second form of therapy that can work efficiently is a technique called dry needling.
Trigger points can come back. Sometimes trigger points can be functional. For example, when tissue is injured, the body sometimes stiffens an area to help the tissue heal. Movement in weakened tissue could potentially do more damage. Finding the reason why the body wants to create a trigger point is essential.
Often with a stiff neck stress plays a big role. The stiffness causes stress which can lead to more tension. The longer the stiffness is there, the more stubborn the stiffness is and the less likely it is that ‘normal’ massages will work.
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Hey ,
Unfortunately, many air fryers have non-stick coatings that may contain PFAS (Per- and Polyfluorinated Substances – or forever chemicals as I called them here). There are air fryer options with ceramic coatings that are being investigated for safety. Although the ceramic coating is safe there is some concern it exposes you to titanium dioxide nanoparticles when the ceramic breaks down (click here if you like to dive deeper into what the research says).
If you like to buy air fryers that are safe, search for labels that say PFAS-free. Here are some labels that are often used to create a feeling of safety, but unfortunately can be misleading:
• PFOA-free
• PFOS-free
• GenX-free
• FDA approved
• and just to be complete: the term ‘very safe’PFOA, PFOS and GenX are types of PFAS, but there are many many more. PFAS-free covers the complete group of Per- and Polyfluorinated substances.
If you like me to recommend alternatives, let me know!
As to you second question – am I assuming right you would like to use this against coughing? If so many people seem to have successfully used the Flaxseed cough remedy from the B Better Library (just click here to get there)
Vicks vapor rub
The active ingredients on the list are camphor (a cough suppressant and topical analgesic), eucalyptus oil (a cough suppressant) and menthol (a cough suppressant and topical analgesic). There are some inactive ingredients as well like cedarleaf oil, nutmeg oil, petrolatum (which is vaseline), thymol and turpentine oil.Some of the ingredients can irritate sensitive skin. Some people could experience an allergic reaction to the ingredients.
My personal main concern is the turpentine oil used in it. Turpentine oil is unsafe taken by mouth or used over a large area of skin. Usually, you inhale the oil vapor and lung tissue is much more sensitive.
WebMD has this to say about it and I quote:
“Inhaling turpentine oil can cause discomfort of the throat and lungs. It can also cause spasms of the airways in some people, particularly in those with asthma and whooping cough.”Although the active ingredient camphor oil, when used the right way, can have health benefits, it is also toxic to the liver. If you would use it, don’t rub it over injured skin since, because the body can absorb it.
Although it is often used, I personally would use other options (like the flaxseed cough remedy) first.