[Daniel]

Hey 

If you aren’t using any anti-histamine medication you can try a therapeutic dosage of 50 – 100 mg 2x spread over the day, taken on an empty stomach!

It might take 6-12 weeks to see some effects though!

As for the use of stinging nettle, I will let  answer that!

I hope this advice can give some relief!

[Daniel]

 

Thank you for providing us with so many details! In addition, could you tell us when your FSH was measured in your period? Was it during the follicular phase, luteal phase (or ovulation?)

When it comes to your questions on what labwork would provide us additional information:
• The Dutch test is a test I would highly recommend. In particular, The DUTCH Plus (click here) can provide us insight in • If you are estrogen dominant (and if so, what type of dominance)
• It provides us insight into how you breakdown estrogen
• It will show us how your androgen levels are
• It shows us your cortisol metabolism.

          How to prepare on The DUTCH complete you can find here.
• A full thyroid panel which includes:• TSH, fT4, fT3
• Anti-TPO & Anti-TG
• Reverse T3
• Fasting Insulin

Did I read correctly that you were low on energy? Or did you mean you had no low energy symptoms? If you are low on energy:
• Iron & Ferritin are important to check as well (could also cause brittle nails)
• RBC Zinc (Low zinc status could cause low thyroid symptoms and brittle nails as well)
• Vitamin D (which also helps with estrogen metabolism)

Magnesium is needed to break down estrogen. Although you didn’t mention any other symptoms of magnesium deficiency (except for low energy) I like to be thorough. Other symptoms of magnesium deficiency are GERD, Stiffness of muscles, and feeling easily irritated. Are those symptoms you experience? If you want to be sure about your magnesium status then test also for
• RBC Magnesium 

Maybe  has some additional lab tests she likes, but these are my recommendations!
 

[Daniel]

 Needles to say that a 7 day workweek can put a lot of mental pressure on someone. And yes, that can make someone very tired.

But the iron deficiency is real. She needs to address this if she wants to feel energetic again. Iron is needed for oxygen transport.

I don’t know her gut related problems of course, but be aware that those problems can be part of the root why she can’t absorb iron.

If she has trouble eating a healthy diet, start there. Her gut symptoms might already improve. Remember that iron supplements can sometimes cause constipation. If she is constipated, start with magnesiumcitrate to stimulate her bowel movements first.

If she has a normal bowel movement you can try dosing with iron. Just remember to do this when she isn’t sick. 

Remember to give her immune system more support as well!

Good luck and let us know if you need any more help!

[Daniel]

Hi ,

Fortunately, she shared her lab results with you! Since I only know her labs, I will only discuss some numbers and what they could indicate. Meanwhile, could you share a bit more about this person? For example, do you know:
• If she has any health complaints. And in particular, • do you also know if she has cold hands & feet, is feeling low on energy and do you know if she is having some cognitive issues for example problems with focusing or dizziness?
• Is she short of breath? Does she experience headaches? Possible ringing in the ears? Or pains in her legs?
• was she feeling sick at the moment of drawing blood?
• does she have gut-related complaints? (feeling bloated, constipation/diarrhoea, IBS or other complaints)
• How is her diet? Is she struggling for example with eating healthy?
• How would you assess her stress levels?
• How would she describe her menstrual flow? Is there a lot of blood loss?

So let’s discuss some of the ‘easy’ numbers!

Vitamin D
Optimal numbers for vitamin D are around 120 nmol/l or 50 ng/ml. Having a vitamin D3 supplement (and not a vitamin D2!) can be an easy way to bring her levels up. If she lives in a sunny area, some sun exposure can help her as well of course. Just remember that people with dark skin can need up to 6x longer sun exposure to raise vitamin D levels compared to people with light skin.

Iron
A lot of markers point to an iron deficiency. For example: her hemoglobin is clinically low and hemoglobin can drop when iron is insufficient.

Her ‘volume globulaire moyen’ is clinically low. This means that the average size of her red blood cells is too small. This can happen when there isn’t enough hemoglobin in the red blood cells present.

And on top of everything, her storage form of iron ‘ferritin’ is almost clinically low.

Based on these numbers I would say she is experiencing iron deficiency anemia.

Thyroid
Also, we see hints of a starting hypothyroid state on her thyroid panel. TSH is clinically elevated, but free T3 and free T4 are still in range. TSH is the hormone from the pituitary telling (or in this case perhaps screaming is the better word)to the thyroid to make thyroid hormones T3 & T4. The thyroid is still reacting, but in her situation, I wouldn’t be surprised as this will start to change. These elevations could also be caused by an iron deficiency since iron is needed for optimal thyroid hormone balance.

Prolactin
Prolactin is elevated and this can be caused by a low thyroid state. But be aware that small elevations of prolactin can also mean other things. It could be an indication of a prolactinoma as well, so this does deserve special attention from her doctor in my opinion.

Vitamin B6
Her liver enzymes are in the reference range (which is good), but really low. Especially the value of ALAT is so low like the body is struggling with producing the enzymes. This is a picture we often see when there is a lack of vitamin B6. A lack of vitamin B6 can cause anemia as well and can cause worsening of the already playing anemia.

Vitamin B12
Her vitamin B12 is on the lower end of the range. Ideally, we want B12 on the high end of the reference range.

White blood cells
Something seems to be going on there. It looks like an infection dynamic. This could also make her C reactive protein (a marker for inflammation) go up. But assessing white blood cells purely on numbers isn’t going to give us the complete picture. It would be better to know if there were any symptoms.

What to do first?
I would definitely support her with iron but only if she isn’t experiencing infections! This is why having more details is important. Infections can get worse on iron supplements. 

If she had an acute infection, let her recover from this first before working with iron supplements (which I will discuss in a moment)

Support also means thinking about why she is iron deficient in the first place:
• Is iron in her diet? Is she vegan? Or is she struggling with healthy food choices?
• Is she experiencing absorption problems? Does she have low stomach acid? IBS? SIBO? Crohn’s disease? Celiac disease? Has she surgically removed parts of her GI tract?
• Is she experiencing a lot of blood loss? For example, does she have a heavy menstrual flow? Did she donate blood recently? Or maybe she had an accident?
• Pregnancy sometimes can cause iron deficiency as well.

Supporting iron
In most scenario’s supporting her with iron is a good idea. Either through healthy food choices (which are hard with an iron deficiency because people experience a lot of fatigue often) or through the use of a liquid iron formula from pure encapsulations for example (click here)

It will take a while (at least 3 months) before all her red blood cells died off and are replaced with healthy ones. Having a regular workout routine can speed up the process, although again, because of fatigue, this can be hard.

Be aware, sometimes supplementing with iron can cause constipation. Make sure when you start supplementing iron she is not constipated, because you won’t be able to tell if her iron supplement is causing a worsening of the dynamic.

Support her with the right multivitamin
Giving her a good quality multivitamin with the b vitamins in the methylated form would give her nutrients that support thyroid health as well. A healthy thyroid hormone balance depends for example also on iodine, selenium, zinc, and vitamin A & D. Supporting her for example with an iron-free multivitamin like vita-prime iron free from Klaire Labs (click here) will make it easier with dosing the right amount of iron.

Because of the possible B6 deficiency, start low and slow with the multivitamin. In the Klaire Labs formulation is 15 mg of B6 per serving. 1 serving is 2 tablets. So you can start with 1 tablet per day or even every other day and slowly work your way to a full serving size per day. Vitamin B6 is essential for detoxification and opening detoxification pathways too fast can cause problems.

Vitamin D
The multivitamin has 15 mcg (600 IU) of vitamin D. This probably won’t be enough to raise her vitamin D levels to the optimal zone. I would recommend somewhere from 2000IU to 5000IU to start with and then retest her values after a while.

I hope this helped!

[Daniel]

Hie  

I would just like to add that the book ‘Dirty Genes’, from Ben Lynch is also a really good recommendation. It’s easy to read and gives a lot of practical advice as well!

[Daniel]

Hi ,

Being aware of the MTHFR mutation or better said a Single Nucleotide Polymorphism(SNP) can make people more aware of how important some lifestyle choices are for them. But because not everyone with an MTHFR SNP has health problems I base my recommendations normally on a clinical picture.

MTHFR, as you probably know,  is an enzyme that is needed in the so-called methylation cycle. In this cycle, methionine gets converted into homocysteine and back. The goal of the methylation cycle is to donate methyl groups to other molecules, which is important for so many things:
• It is needed to create neurotransmitters
• It is needed for cardiovascular health
• It is needed to protect & read our DNA
• Detoxification (for example of heavy metals)

And the list goes on.

Let’s say someone comes to me with a clinical picture, for example, elevated homocysteïne, which we know is a risk factor for heart disease.

Even with a possible MTHFR SNP present, there are many reasons why homocysteine can be elevated, like
• Kidney problems
• Low thyroid hormone levels
• B12, B9 or B6 deficiency (through malnutrition or malabsorption)
• Psoriasis is associated with high homocysteïne
• and other genetic conditions.

First I will, without testing, support the methylation cycle by recommendations like taking a b complex or a multivitamin with the B vitamins in the methylated form, because the enzyme MTHFR helps folate to transform in the methylated form.

Pay in your recommendations also attention to Riboflavin
Another pearl is that vitamin B2 or riboflavin is needed to activate the enzyme MTHFR.  Vitamin B2 is important for people who carry MTHFR SNP, but people deficient in B2 can display the same symptoms, since the enzyme MTHFR cannot be activated. Food sources of B2 are for example eggs, meat, chicken, salmon, almonds and spinach, but make sure they are enough in the diet.

Supporting methylation with choline
I will also support the conversion from homocysteine to methionine via the second pathway which depends on choline. You could use choline supplements or focus on foods rich in choline like eggs, liver, kidney salmon, shiitake, soybeans (GMO free & organic are best choices here), beef, chicken & turkey, and many more. Daily recommendations for men and women are 550 and 425 mg. (And are often not met!)

Homocysteine can also be broken down in the transsulfuration pathway which is needed for detoxification. This pathway needs nutrients like selenium, B6 & serine.

When do I test for SNPs?
Usually, I support the body by overcoming a possible MTHFR SNP first. Then I focus on ruling out other possibilities that could lead to the clinical picture my client comes for. Testing for mutations comes third or later. Just be aware: SNPs on MTHFR are common. But other SNPs are known to influence the methylation cycle as well. MTR & MTRR for example.

Slow versions of these enzymes can lead to a build-up of homocysteine as well, but won’t be overcome by supplementing methyl folate.

If I would do SNP testing I would check for more than MTHFR alone. you could for example test at 23andme.com.

Obviously, if family members are tested positive for an MTHFR SNP, this would influence my priorities, but as a rule of thumb, DNA testing isn’t usually the first thing I would do.

Remember that also here: genetics loads the gun and the environment pulls the trigger!

Hope this helps

[Daniel]

 The pale color and the tiredness can be signs of iron deficient anemia. But let’s focus first on what you can do with supplements & foods.

With choosing supplements and focussing on foods it is important to be aware of a few things. For a 6 year old the safe Upper Limit(UL) for iron is 20mg. For a 6 year old 10 mg is the recommended daily amount.

A supplement for kids unfortunately is hard to find. Liquid iron drops usually have some preservatives but are extremely well absorbed and might be worth the chemical additive trade-off for short-term use.

You could for example try these drops from La Sante.

Liquid iron should also be taken in a little (1/8 cup) juice to improve taste, and brushing teeth right afterwards is key to prevent staining (and a win-win for oral hygiene!).

A food based approach is possible as well:

Foods containing a lot of iron are for example:
• Spinach (2.7 mg of iron for 100 grams or 3.5 ounces)
• Lentils  (3.3 mg of iron for 100 grams or 3.5 ounces cooked)
• Red meat (roughly around 3 mg of iron for 100 grams or 3.5 ounces)
• Turkey (1.4 mg of iron for 100 grams or 3.5 ounces)
• Chicken (1 mg of iron for 100 grams or 3.5 ounces)
• Dark Chocolate (3.4 mg of iron per 28 gram or 1 ounce)
• Tofu (3.4 mg mg of iron for 126 grams or 1/2 a cup)
• Pumpkin seeds (2.5 mg of iron for 28 grams or 1 ounce)
• Liver is high in iron as well and  has recipes to make it tasty!

Foods can also reduce iron absorption:
• Calcium can decrease iron absorption, so avoid high calcium foods like milk & milk products.
• Oxalates can bind to iron making it unavailable for absorption. Examples of foods that are high in oxalates are coffee, thee, spinach & chocolate (I realize that spinach & dark chocolate are also high in iron. They might not work for everyone. Each person’s gut is different)

So try to avoid combining iron foods & supplements with milk products, calcium supplements or multivitamins containing calcium.

When a kid swallows a coin it can take 48 hours and 5 days before they poop it out. If you saw dark stools it could indicate that the coin might have damaged the intestinal wall. Your child might also experience some stomach pain and vomiting.

If this is the case or you are worried, just ask your doctor to examine your kid.

If your doctor says everything is fine, but you feel the gut might be damaged, you could try some gut healing. In the Gut Health Masterclass you will find strategies on how you can approach this with foods & supplements.

A final note on raising ferritin levels: in the presence of iron deficiency anemia it can take a few months to raise ferritin since the body will use the iron to create more hemoglobin first. It takes around 3 months to replace all red blood cells. Seeing ferritin go up can take even longer (Upto 6 months!)

Following other blood markers like for example Hemoglobin, MCV & iron might provide you a better insight on functional iron status.

[Daniel]

 Before I recommend an iron supplement: is there anything known about why the iron count in the blood is low? And are there other blood markers you can share?

For example, do you know anything about the body’s storage form of iron ‘Ferritin’?

Usually markers like Erythrocytes, RBC count, hematocrit, MCV, Hemoglobin can provide us more insight as well. Do you have them and would you like to share them if you have them?

Could you provide me with some information about your kid’s diet? Is it for example mostly plant-based?

I have some additional tips for increasing iron absorption. Possibly you are already aware, consider them then as gentle reminders 🙂

Increasing iron absorption
• Iron needs stomach acid to be absorbed. In the Gut Health Masterclass there is explained a cheap and quick test with baking soda you could do to check if stomach acid is low. It isn’t a diagnostic test, but it could help you to decide if you can supplement with betain HCl (which helps making the stomach more acid).
• In addition: vitamin C increases iron absorption as well.
• Iron coming from meat is also better absorbed than iron from plant-based foods.

Can you tell me if your kid had an infection recently? Infections sometimes can lead to a lower iron count as well. The body can sequester iron away and store it as ferritin as a way to protect the body against infections becoming bigger.

In order to find a working strategy to raise the iron count, we need to find out first why the iron count is low!

[Daniel]

Hi ,

My name is Daniel and I help Bernadette on the platform.

… and welcome! Let me give you a quick ‘tour’ around here:

In the ‘Beginners Health Roadmap’ (just click on the bold text), you will find a lot of simple lifestyle recommendations on which all the other courses build on.

The ‘Gut Health Masterclass’will guide you through how the digestive tract works, where it could go wrong and what possible supplements you can use.

If you have any questions, you can post them here on the forum. Feel free to ask anything (and turn your question into a learning opportunity for everyone!).

In the ‘Monthly Courses’, there is even more great content like the course on Blood sugar regulation & Fatty Acid Balance. And don’t forget to take a look here. You will find guest speakers on the platform who share their expertise on various topics and supplements.

Do you already have an idea of what things you would like to change in your life(style)?

[Daniel]

 Thank you for sharing your experience   I hope you by now could reduce the heartburn symptoms!

Sharing the social obstacles is very insightful and could help us share better tailored tips and advices!

Is there by the way any help right now you need on reducing your heartburn symptoms?

[Daniel]

Hey ,

Welcome around here! My name is Daniel (and I help Bernadette on the platform!)

What a challenging journey to start with . I love how you want to keep your health in your own hands! There is a lot of content that could help here. My advice is to reserve some ‘me’ time in the week in which you can relax and explore the content.

Feel free to ask any questions on the forum. By posting your questions, you can turn your question into a learning opportunity for everyone!

The Gut Health Masterclass explains why some GI symptoms can arise and it also explains what to do with them.

And most importantly: have fun with the content!

Have you already made some progress with dealing with the H. Pylori overgrowth?

[Daniel]

 Great! In other posts you also mentioned you have low ferritin (the storage form of iron). Since iron is a key nutriënt for thyroid hormone metabolism, I have some additional tips. Possibly you are already aware, consider them then as gentle reminders 🙂

Increasing iron absorption
• Iron needs stomach acid to be absorbed, so the betain HCl can help. If you are using iron as a supplement, combine this when you use betain HCl.
• In addition: vitamin C increases iron absorption as well.
• Iron coming from meat is also better absorbed than iron from plant-based foods.

Another thing to be aware of
If you are low on iron, this could lead to iron deficiency anaemia. Treating it doesn’t change anything, but… in this case, ferritin goes up until your red blood cells have enough Hemoglobin. In the case of iron deficient anaemia, this can take from 3 to 6 months.

Tips for additional thyroid tests:
If you are considering additional thyroid testing because you want to know why your thyroid hormones are low I would recommend you test besides your T4 & T3 hormones also for thyroid antibodies. Just to rule out that your low thyroid is caused by an autoimmune dynamic. If you express your concerns to your doctor, they could test them.

Reverse T3
If you want to be really comprehensive in your testing, test also for reverse T3. Reverse T3 looks just like T3, except it’s the mirror image of T3. So if reverse T3 occupies the thyroid receptor, it doesn’t lead to an activated metabolism. The body usually elevates reverse T3 when you are stressed or with prolonged sickness

I don’t know the protocol for doctors in your country, but reverse T3 isn’t tested often by doctors. Reverse T3 can however provide insight into why your thyroid is low.

Back to your initial question: How long does it take for stomach acid to return?
Depending on the dynamics that are at play. It might depend on how fast your Thyroid hormones are getting back in balance. If aneamia is at play it could take longer because the red blood cell quality might get priority first.

[Daniel]

Hi 

In addition, I would like to add that if your stomach didn’t produce acid for a while, the lining of the stomach might need some healing first. Part of the reason why H. Pylori causes low stomach acid is because the infection weakens the lining of the stomach.

This is also a great moment to think about what might have caused the H. Pylori infection in the first place. Remember that H. Pylori is an endemic bacteria. Everyone has some H. Pylori. An overgrowth is often a ‘symptom’ from something more upstream. For example:

Stressful events in life can cause low stomach acid all in itself, giving room for H. Pylori to grow.

A low thyroid state can also cause a low stomach situation, leading to an H. Pylori overgrowth. A low stomach on its turn can cause a low thyroid state as well, so the 2 dynamics feed each other. I’m mentioning this, because hair loss was a symptom you mentioned in other posts right?

Hair loss can be caused by a low thyroid. Other low thyroid symptoms are feeling cold, feeling low on energy, having a hard time concentrating and losing weight.  Are those symptoms you recognise?

Zinc insufficiency is common. We need strong stomach acid to absorb zinc, but zinc is also necessary to create stomach acid. A zinc insufficiency can also lead to hair loss.

In the Gut Health Masterclass, we talk about other reasons why stomach acid can be low as well.

Is there something above here that resonates with you?

[Daniel]

In addition I would like to add that someone who mastered the Active Release Technique can do wonders. I have treated a few frozen shoulders with this as well.

In a few sessions someone can experience great relieve. Although the deep pressure that comes along with that can be pretty uncomfortable, but this massage helps break down the fibrotic tissue that can causes part of the pain & reduced range of motion.

[Daniel]

Hi ,

First of all, what a heartbreaking circumstances! I hope these tips can help you improve the situation a bit!

Since the premise of both chemotherapy and radiation is to poison and kill cancer cells, there is, in fact, typically a concern about the use of anything anti-inflammatory or detoxifying during cancer treatment. The reality is that chemo & radiation therapy is also a burden on the healthy cells in the body.

This is why I wouldn’t recommend taking anti-inflammatory supplements and anti-oxidants a few days before chemo or radiation therapy until a few days after the therapy.

Since every cancer is unique, I always recommend discussing supplement tips with the treating doctor.

That being said, here are some general tips I can recommend to you:
• To help to boost the immune system ensure that vitamin D is at least 50 ng/ml (120 nmol/l). A lot of people are deficient and boosting vitamin D from a place of deficiency requires different dosages. Here in the Netherlands, you can take up to 4000IU daily without consulting your doctor. However, in her case, I would strongly recommend discussing testing vitamin D levels with her treating doctor for determining what is the best approach.
• Keep in mind that sugar is a fuel source for cancer cells. Your body will always have some sugar in the blood, but staying away from a high-carb diet, a diet high in refined carbs, flour & sugar might be a piece of good advice.
• Make sure there is enough zinc in the diet or supplement with zinc. Zinc is an essential mineral needed for the immune system… and a lot of people are deficient in zinc as well. Zinc supplementation is expected to have beneficial effects because it can inhibit NF-kappa B. (See this study)

If you are going to recommend zinc as a supplement: the upper limit from zinc is age dependent (Look here for an overview). The upper limit for an 18-year-old girl is 34 mg daily.

Going over the upper limit can cause nausea, dizziness, headaches, gastric distress, vomiting, and loss of appetite. This can be hard to distinguish from chemo/radiation therapy.

Daily dosing with 10mg is a safe starting point. Again, It is always a good idea to discuss this with the treating doctor.
• In order to help the body detoxify I would recommend a B complex. Be sure that vitamin B12 en folate are in the methylated form. The brand Thorne has a great basic B complex you could use.
• Eating food can be difficult for a lot of patients. Liquid calories are often easier to consume. Daily green smoothies with ingredients like avocado, broccoli, kale, fresh lemon juice, cucumber, celery, and green apple can help boost anti-oxidants for cellular healing. These smoothies can also help to boost nutrients required by the liver for detoxification.
• Talking about detoxification by the liver: Cruciferous vegetables are a source of sulfur. Sulfur is needed for the trans-sulfuration pathway. The trans-sulfuration pathway is a chemical pathway used by the liver for detoxification as well. Cruciferous vegetables are vegetables like broccoli, cauliflower, kale, cabbage, Brussels sprouts, bok choy and many more. Everything in the onion family will help as well.
• Daily sunlight exposure can be helpful.Believe it or not, but most of your melatonin production is done in the mitochondria (the energy factories of your cell). The melatonin in mitochondria will act as an anti-oxidant giving your mitochondria more protection. The infrared light from the sun stimulates the release of melatonin in the mitochondria giving healthy cells more stamina. 
• In order to boost energy, a twice-daily dose of Acetyl-L-Carnitine can help to improve fatigue. This supplement is taken on an empty stomach.
• Radiation & Chemo can cause enhanced intestinal permeability (leaky gut). We talk about this in the Gut Health Masterclass. Enhanced intestinal permeability can cause extra inflammation. Supplements like GI Revive made by Designs for Health can help regenerate the intestinal villi and nourish the mucosal lining of the intestines.
• Incorporate a variety of anti-inflammatory herbs and nutrients.  I typically recommend Meriva curcumin (e.g. Thorne), mushroom extracts (e.g. Gaia or EcoNugenics, especially maitaki), and EGCG (a green tea extract).
• I also recommend a modified citrus pectin formula which has been researched significantly and shown to inhibit cancer cell growth, to encourage apoptosis of cancer cells, and to inhibit metastasis. It’s called PectaSol-C by EcoNugenics. (Look here and here)

Take out the tips you feel you can recommend. I know it’s a lot! I have put the more exotic solutions at the bottom of the list. I also feel that the more ‘simple’ solutions will have the biggest impact (vitamin D, eating a clean, low sugar, high vegetable diet, B vitamins). 

The more exotic solutions will build on the fundament laid down by the more ‘simple’ solutions. 

I hope this helps!