Functional Medicine Tests for IBS (and more)

daylatedollarshort

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NW-Bound asked me around 6 months ago to post what I'd found out about the functional medicine test we were doing that might help IBS. It is a big topic. I put off posting because I didn't know how to make a single post on a topic books get written about. But I think our latest tests will be really helpful for DH and me. I started out following the Recode protocol by Dale Breseden from his book The End of Alzheimer's for general testing ideas and also found the articles on the Rupa Health site helpful.

The tests that have really helped us the most have been Genova Diagnostic's Metabolomix+ (nutrients, toxic metals, amino acids and more) and Diagnostic Solution's GI Map (microbiome). Plus we've used the local Quest lab for nutrients not covered by either those tests or the tests our doctor ordered, plus some other markers like IGF-1 and Omega-3. There are other nutrition, organic acids and microbiome tests out there and I don't know if these are the best. They are just the ones I picked to do so far. We've ordered these tests ourselves from sites like Directlabs and Walkinlabs, but they can also be ordered through a functional medical practitioner.

DH and I live in the same house, eat similar diets and have wildly different test results. However, so far the information has been invaluable to both of us for finding out nutritional deficiencies, out of balance amino acids, gluten sensitivities, leaky gut, etc. We've been following the advice in the interpretive guides and that has been clearing up a number of our health issues already that conventional medicine had no answers for. I'm still pouring through the goldmine of out of range markers and how to correct them.
 
There are other, unaffiliated studies supporting diet and lifestyle changes for cognitive decline, such as the:

The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): study design and progress - PubMed (nih.gov) - Findings from this large, long-term, randomised controlled trial suggest that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population.

MIND diet slows cognitive decline with aging - PubMed (nih.gov)

Is Alzheimer's Disease Preventable? - Low Alzheimer rates in Adventist Community.

Everything "off" we have found in the tests so far, between different family members, like various nutritional deficiencies, high arsenic levels, elevated estrogen levels and elevated amino acids, are all pretty mainstream conditions well documented in Pubmed research. It is just that most people only get tested regularly by conventional medical doctors for a handful of these items instead of 100 - 200.

One of my relatives has a neurological disorder, and the expanded testing uncovered 2 correctable vitamin deficiencies, an out of range uric acid score, and one off the charts high amino acid and more that are all linked to the disorder in Pubmed research, but conditions that conventional medical doctors, even one supposedly experts in this area, do not test for. And my relative has been steadily improving by correcting these issues, just like the research suggests.

Related links -
Uric acid and Alzheimer's - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115794/
Link between Alzhimer's and Gut Microbiota confirmed - https://www.sciencedaily.com/releases/2020/11/201113124042.htm
Link between vitamin D and dementia confirmed - https://www.aan.com/PressRoom/Home/PressRelease/1300
And there are literally thousands more like this on Pubmed.

The expanded testing is the main point of the Breseden book. The other experts some of his patients go to don't even get tested for the basics, like most nutritional deficiencies or low uric acid levels, before being declared incurable.

The Breseden protocol is here, most of it consists of pretty mainstream lab tests, just a lot more than regular doctors normally test for - Bredesen Protocol - ApoE4.Info Wiki. He tests in 36 different key areas and says that most patients with cognitive decline are off in 10 - 25 key areas.
 
NW-Bound asked me around 6 months ago to post what I'd found out about the functional medicine test we were doing that might help IBS. It is a big topic. I put off posting because I didn't know how to make a single post on a topic books get written about. But I think our latest tests will be really helpful for DH and me. I started out following the Recode protocol by Dale Breseden from his book The End of Alzheimer's for general testing ideas and also found the articles on the Rupa Health site helpful.

The tests that have really helped us the most have been Genova Diagnostic's Metabolomix+ (nutrients, toxic metals, amino acids and more) and Diagnostic Solution's GI Map (microbiome). Plus we've used the local Quest lab for nutrients not covered by either those tests or the tests our doctor ordered, plus some other markers like IGF-1 and Omega-3. There are other nutrition, organic acids and microbiome tests out there and I don't know if these are the best. They are just the ones I picked to do so far. We've ordered these tests ourselves from sites like Directlabs and Walkinlabs, but they can also be ordered through a functional medical practitioner.

DH and I live in the same house, eat similar diets and have wildly different test results. However, so far the information has been invaluable to both of us for finding out nutritional deficiencies, out of balance amino acids, gluten sensitivities, leaky gut, etc. We've been following the advice in the interpretive guides and that has been clearing up a number of our health issues already that conventional medicine had no answers for. I'm still pouring through the goldmine of out of range markers and how to correct them.



I ordered the GI Map test but haven’t gotten the results back yet. Then I listened to Peter Attias latest podcast in the gut and micro biome with someone who has been studying it for 60 years, and his judgment is that those stool tests are useless cos they don’t have enough resolution. It’s in the last 30 mins of his podcast.

On a separate note I looked into some functional medical docs over here in Marin. One charges $1100 for initial 2 hour consultation 🤷*♂️
 
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I ordered the GI Map test but haven’t gotten the results back yet. Then I listened to Peter Attias latest podcast in the gut and micro biome with someone who has been studying it for 60 years, and his judgment is that those stool tests are useless cos they don’t have enough resolution. It’s in the last 30 mins of his podcast.

On a separate note I looked into some functional medical docs over here in Marin. One charges $1100 for initial 2 hour consultation ��*♂️

The GI map and Metabolomix test can both be done for less than $1.1K combined and they have interpretive guides online. The Metabolomix test seems pretty accurate to us as the results seem to match up with the blood tests we already had done previously at a Quest lab, the lab our regular doctor uses.

I don't really follow Peter Attlius but did he say that specifically about the GI Map test or gut tests in general? There are many kinds of gut tests. The GI Map tests for things like H pylori, d-diff, e-coli, and leaky gut which are all pretty common issues in Pubmed research with established testing methodologies, and the test comes from a CLI lab. Is he against testing for those kinds of gut issues?
 
The GI map and Metabolomix test can both be done for less than $1.1K combined and they have interpretive guides online. The Metabolomix test seems pretty accurate to us as the results seem to match up with the blood tests we already had done previously at a Quest lab, the lab our regular doctor uses.

I don't really follow Peter Attlius but did he say that specifically about the GI Map test or gut tests in general? There are many kinds of gut tests. The GI Map tests for things like H pylori, d-diff, e-coli, and leaky gut which are all pretty common issues in Pubmed research with established testing methodologies, and the test comes from a CLI lab. Is he against testing for those kinds of gut issues?



Actually he was interviewing someone else, so not his response. No, I’m sure he’s fine with things like H pylori. Here’s the guy he’s interviewing.

“Mike Gershon is a Professor of Pathology and Cell Biology at Columbia University and has been at the forefront of studying neural control of the gut for the past 60 years. “

Here’s the link to the podcast. He asks about it at around 1hr50mins. The whole podcast is very interesting but deep in places.

https://peterattiamd.com/michaelgershon/
 
Actually he was interviewing someone else, so not his response. No, I’m sure he’s fine with things like H pylori. Here’s the guy he’s interviewing.

“Mike Gershon is a Professor of Pathology and Cell Biology at Columbia University and has been at the forefront of studying neural control of the gut for the past 60 years. “

Here’s the link to the podcast. He asks about it at around 1hr50mins. The whole podcast is very interesting but deep in places.

https://peterattiamd.com/michaelgershon/


I tend to watch the videos (also podcasts) by Mark Hyman and the other doctors in his practice (The Doctor's Farmacy) since they actually see patients and aren't just academic researchers. They have a lot of examples in their podcasts of actual patients with common issues, what tests they give them that the conventional medical doctors often didn't bother with, and how many people even with diagnosis like multiple sclerosis show improvement. Multiple sclerosis is pretty clearly linked to nutrition and gut issues on Pubmed, so they've got the science to back them up.
 
From my link:

There are elements of the Bredesen protocol that could be beneficial and are largely free to patients. It is standard of care in dementia clinics to educate patients, without cost, on the lifestyle interventions for brain health that are supported to some extent in the scientific literature, including aerobic exercise, a Mediterranean diet, social and cognitive engagement, and management of cerebrovascular risk factors. Health insurance generally covers testing for reversible causes of cognitive change, such as thyroid disorders, vitamin B12 deficiency, or sleep apnoea. Some elements of the Bredesen protocol that have not been shown to be effective for brain health are the intensive, costly regimens of dietary supplements. A recent international consensus document concluded that “supplements have not been demonstrated to delay the onset of dementia, nor can they prevent, treat, or reverse Alzheimer’s disease or other neurological diseases that cause dementia”.
 
From my link:

We are using the Breseden testing checklist as a model. He says in his book to test, then treat, but doesn't always follow his own advice on the supplement recommendation front. There is no point in taking random supplements if you don't know you need them. But 95% of his book otherwise is simply common sense.

For a condition one of my relatives has, the regular doctor and the specialist ran basic lab panels, did one MRI and that was it. But in PubMed I probably found 100 conditions linked to the disorder that can be tested for like vitamin E deficiency, low uric acid levels and H pylori. It seems crazy then to not run tests for everything that has simple tests and easy, cheap fixes that might be contributing factor when you have a serious illness. These tests are not largely free, as your article suggests. It would cost at least a couple of thousand dollars to do them all. How would you know if you had low molybdenum levels, high mercury counts, high glyphosate levels, a vitamin E deficiency and a high urinary fungal count unless you ran all these tests? Those test are the basics of the book so that critique doesn't seem logical or else the person who wrote it never actually read any of his books.

In Pubmed papers, Alzheimer's is linked to fungal infections, an altered gut microbiome, low uric acid, malabsorption, vitamin D deficiency and maybe 100 or more other testable and very often easily correctable factors. There are probably another 100 or so lifestyle factors that might help. Yet as Breseden points out in his book, he gets many patients from supposed leading experts in Alzheimer's that run few tests beyond basic lab panels and they have not given their patients any useful diet and lifestyle advice. What they don't test for, despite an abundance of Pubmed papers of common cofactors / risk factors, is shocking.
 
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Sure there are a lot of associations between AD and various tests but other than the handful mentioned in the article and typically covered by insurance there is no evidence of benefit from testing and intervention.

Low vitamin D is associated with cognitive impairment but there is no evidence that supplementation prevents AD or progression of issues. I agree with Bredesen that you don't need 100% proof to intervene with an inexpensive and generally safe supplement.

The nature of medical testing is that results may be considered abnormal if they fall outside some range but there may or may not be a deleterious health effect to being outside the range. Statistically, if you do enough tests you will get abnormalities.
 
Sure there are a lot of associations between AD and various tests but other than the handful mentioned in the article and typically covered by insurance there is no evidence of benefit from testing and intervention.

Low vitamin D is associated with cognitive impairment but there is no evidence that supplementation prevents AD or progression of issues. I agree with Bredesen that you don't need 100% proof to intervene with an inexpensive and generally safe supplement.

The nature of medical testing is that results may be considered abnormal if they fall outside some range but there may or may not be a deleterious health effect to being outside the range. Statistically, if you do enough tests you will get abnormalities.

Take a look at Pubmed and type Alzheimer's improvement in the search bar. There's a ton of stuff that has been shown to help in either human or animal studies. The first one that came up for me is improvement with coconut oil, which is an antifungal botanical, and fungus is one of the latest research topics in Alzheimer's. Vitamin D is also antifungal.

Fungi in gut linked to higher Alzheimer's risk can be reduced through ketogenic diet. - https://www.sciencedaily.com/releases/2020/08/200831131633.htm

Improvement of Main Cognitive Functions in Patients with Alzheimer's Disease after Treatment with Coconut Oil Enriched Mediterranean Diet: A Pilot Study - https://pubmed.ncbi.nlm.nih.gov/30056419/

In summary, we found obvious evidence that daily oral vitamin D supplementation (800 IU/day) for 12 months can significantly improve cognitive function in patients with Alzheimer's disease. - https://jnnp.bmj.com/content/90/12/1347

Dementia Linked to Vitamin D Deficiency, Study Shows - https://www.webmd.com/alzheimers/news/20220620/dementia-linked-to-vitamin-d-deficiency-study-says

The study found that people with low levels of vitamin D had a 53 percent increased risk of developing dementia and those who were severely deficient had a 125 percent increased risk compared to participants with normal levels of vitamin D. - https://www.aan.com/PressRoom/Home/PressRelease/1300

Fungal overgrowth and vitamin D levels are just two of the many analytes tested for in the Breseden checklist.

Nutrition, Gut Microbiota, and Alzheimer's Disease - https://www.frontiersin.org/articles/10.3389/fpsyt.2021.712673/full - mentions around 50 or more research based factors that may hurt or help.

Current studies indeed demonstrate that uric acid may exert neuroprotective actions in Alzheimer's disease and Parkinson's dementia, with hypouricemia representing a risk factor for a quicker disease progression and a possible marker of malnutrition. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115794/


For a relative with a neurological disorder, so far the functional medicine tests have shown fungal overgrowth, vitamin D deficiency, and very low uric acid, among about 20 factors that were off and they've only done a fraction of the Breseden checklist so far. The neurological specialist did zero of these tests. The uric acid test cost $13 and the vitamin D test cost $29.
 
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There is no doubt that low D is associated with low cognitive function. What is doubtful is that it is causative or that treatment helps

In summary, we found obvious evidence that daily oral vitamin D supplementation (800 IU/day) for 12 months can significantly improve cognitive function in patients with Alzheimer's disease. - https://jnnp.bmj.com/content/90/12/1347

So when I click on that link, this is the conclusion from the abstract:

Conclusions Daily oral vitamin D supplementation (800 IU/day) for 12 months may improve cognitive function and decrease Aβ-related biomarkers in elderly patients with AD. Larger scale longer term randomised trials of vitamin D are needed.

I didn't look at the paper since it is behind a paywall. I guess that's where you got your more positive quote. Since that 2019 paper with 210 participants there has been this:

Effect of vitamin D on cognitive decline: results from two ancillary studies of the VITAL randomized trial.

In conclusion, among generally well-educated healthy adults aged 60+ years, supplementation of vitamin D3 (2000 IU/day) did not slow cognitive decline over 2–3 years, although there were modest benefits observed specifically in Black older adults that should be confirmed in future studies.

https://www.nature.com/articles/s41598-021-02485-8#Sec2

4200 patients and 2-3 years. The full paper is available and they review the disappointing history of Vitamin D to prevent cognitive decline and the reasons that the positive benefits in a racial subgroup are suspect.

Vitamin D is just one of many of these factors that one can speculate about and spin stories of potential benefit.

Bredesen has good motivation to promote his ideas. He sell books, has $150 a month supplements, and sells a training program for $1500 where physicians, PAs, chiropractors, nurse practitioners and others take a class and are listed on his web site. It looks like a good business.
 
There is no doubt that low D is associated with low cognitive function. What is doubtful is that it is causative or that treatment helps

So when I click on that link, this is the conclusion from the abstract:

I didn't look at the paper since it is behind a paywall. I guess that's where you got your more positive quote. Since that 2019 paper with 210 participants there has been this:

Effect of vitamin D on cognitive decline: results from two ancillary studies of the VITAL randomized trial.

In conclusion, among generally well-educated healthy adults aged 60+ years, supplementation of vitamin D3 (2000 IU/day) did not slow cognitive decline over 2–3 years, although there were modest benefits observed specifically in Black older adults that should be confirmed in future studies.

https://www.nature.com/articles/s41598-021-02485-8#Sec2

4200 patients and 2-3 years. The full paper is available and they review the disappointing history of Vitamin D to prevent cognitive decline and the reasons that the positive benefits in a racial subgroup are suspect.

Vitamin D is just one of many of these factors that one can speculate about and spin stories of potential benefit.

Bredesen has good motivation to promote his ideas. He sell books, has $150 a month supplements, and sells a training program for $1500 where physicians, PAs, chiropractors, nurse practitioners and others take a class and are listed on his web site. It looks like a good business.

We aren't paying Breseden anything. I'm not recommending his services. One can have innovative health approaches and also be an opportunist. The two factors are not mutually exclusive. We are just using his checklist as a starting guide for what functional medicine tests to do, as well as the tests mentioned in the Doctor's Farmacy and Rupa Health's article. His checklist is online and free - https://wiki.apoe4.info/wiki/Bredesen_Protocol.

You are trying to make my post about Breseden. It is not. It is about finding out what functional medicine tests to do for good health and he was simply one of the many resources we used.

I typed in "vitamin D improves cognitive decline" in Google and got 22 million results. It is a $29 test, a very common deficiency in the U.S., especially among the elderly. "Epidemiologic evidence indicates an association between low levels of vitamin D and diseases associated with aging such as cognitive decline, depression, osteoporosis, cardiovascular disease, hypertension, type 2 diabetes, and cancer. " https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399494/. Not to mention Covid severity: Vitamin D deficiency linked to Covid severity - https://www.webmd.com/lung/news/20220208/vitamin-d-deficiency-tied-to-severe-covid. There is no downside to having optimal vitamin D levels, the effects are all positive and there are many potentially tragic consequences for a deficiency.

It is sad that many doctors in the U.S. are resistant to basic nutritional testing. Some very inexpensive and simple tests could do so much to improve the health of the elderly.

Uric acid is another simple, inexpensive, $13 test that could potentially add years to ones life, "both low and high uric acid levels were predictive of increased mortality, supporting a U-shaped association between serum uric acid levels and adverse health outcomes. - U-Shaped Association Between Serum Uric Acid Level and Risk of Mortality: A Cohort Study - PubMed (nih.gov)

My post above had 50 or more factors linked to Alzheimer's, if you read all the articles. Breseden calls his checklist looking for and fixing 36 holes in the roof. Dementia care in the U.S. can cost over $100K a year. It seems logical to do as many relatively inexpensive tests as one can in order to avoid that fate, as well as experience good health in all other areas of life, especially as we age.
 
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braumeister - I don't really understand the point of your cartoon in a thread about gut and nutrition testing. Are you comparing testing for health factors like vitamin D deficiency, homocysteine levels, H pylori and uric acid in the same category as crystals?
 
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Yes, I realize that. It was a joke.

I get that you think the cartoon is funny, but I still don't understand why you thought it was relevant to this thread. What is the connection? There hasn't been any mention of crystals or anything like that in this thread.
 
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My little attempt at a joke didn't work in your case. Let's just drop it, OK?


It didn't work in my case because I'm posting in a thread about tests that helped a relative with a very serious brain disorder similar to Alzheimer's that they might die from and the regular doctors have no answers. You are right, it is not a joking matter to me.
 
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I typed in "vitamin D improves cognitive decline" in Google and got 22 million results. It is a $29 test, a very common deficiency in the U.S., especially among the elderly. "Epidemiologic evidence indicates an association between low levels of vitamin D and diseases associated with aging such as cognitive decline, depression, osteoporosis, cardiovascular disease, hypertension, type 2 diabetes, and cancer.

I failed to do an adequate job of explaining the difference between an association and an effective intervention.

It is sad that many doctors in the U.S. are resistant to basic nutritional testing. Some very inexpensive and simple tests could do so much to improve the health of the elderly.

You can find a few here and there that will do tests of no known benefit and recommend and likely sell supplements. What you will find is that they have no actual specialized training in neurology. Bredesen isn't taken seriously by his peers. The same applies to his followers.

Here is a link to the 2020 Lancet article on dementia prevention intervention and care.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392084/
Anyone interested can click through to the full article.

It is good for people to have hope but not if this entails chasing futile interventions and enriching scammers. I am done.
 
I failed to do an adequate job of explaining the difference between an association and an effective intervention.



You can find a few here and there that will do tests of no known benefit and recommend and likely sell supplements. What you will find is that they have no actual specialized training in neurology. Bredesen isn't taken seriously by his peers. The same applies to his followers.

Here is a link to the 2020 Lancet article on dementia prevention intervention and care.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392084/
Anyone interested can click through to the full article.

It is good for people to have hope but not if this entails chasing futile interventions and enriching scammers. I am done.

This extensive gut, nutrition, and organic acids testing is the approach used by most functional medicine doctors. The benefits to correcting nutritional deficiencies, out of range amino acids, and eradicating conditions like H pylori and e-coli are all positive. The costs for all the tests are minimal and the potential benefits huge for good health, whether or not they treat cognitive decline, even though most evidence suggest they might be factors. Surely you are not advocating not treating a vitamin D deficiency or not treating a fungal infection merely because it might not help Alzheimer's? These are all conditions that should be treated anyway, the benefits of identifying and treating are all positive and the costs to test and treat are all minimal.

We can do all of these tests in my initial posts in my family for around $1.6K a person. So far we've found 3 vitamin D deficiencies, out of range mast cell activation indicators, multiple high toxic metal issues, a likely glyphosate overload, one case of anemia, and many, many other correctable issues the regular doctors missed simply because they don't test enough with very, very simple and inexpensive tests compared to most prescription drugs, much more invasive tests and surgical options.

These are all mainstream medical tests that identify correctable issues if you know you have them, but you have to run much more extensive testing than the average doctors does, in order to find that out.

I asked my doctor for a B6 test because a deficiency of B6 is linked in the research to a genetic disorder that I and others in my family have. She did not only not suggest the test herself, even when I asked for it, she was resistant. She said she would have to research it herself first before she could recommend the test. That is crazy. Those tests alone cost like $50, even less in a panel, which is a lot less than her time. I did a nutrition panel myself with over 100 markers for $400, so the B6 part cost was around $4. And yes, I was deficient in it, along with several other easily correctable issues identified by the test.
 
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RetMD21;2808091Here is a link to the 2020 Lancet article on dementia prevention intervention and care. [URL said:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392084/[/URL]
Anyone interested can click through to the full article.

This article mentions association with other disorders, also linked to nutritional deficiencies -

Association of nutritional factors with hearing loss - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412883/

Potential micronutrient deficiency lacks recognition in diabetes - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2032692/

Understanding nutrition, depression and mental health - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/

“In individuals at high risk of diabetes or with newly diagnosed type 2 diabetes, vitamin D supplementation for 6 months significantly increased peripheral insulin sensitivity and ß-cell function, suggesting that it may slow metabolic deterioration in this population,” explained the recent report." - https://www.healthline.com/health-news/vitamin-d-may-diminish-risk-of-t2d

Vitamin D deficiency--a new cause of cochlear deafness - https://pubmed.ncbi.nlm.nih.gov/6602194/

To name just a few of the thousands upon thousands of studies like these on Pubmed.
 
I think it's good to do different diagnostic tests, but what if you find out you have H pylori, d-diff, high levels of heavy metal, etc? Tons of antibiotics and chelation therapy? I think courses of treatments are warranted if you're experiencing severe symptoms, but if the results are positive for those diseases and if you're experiencing very very mild symptoms, I am not sure if you'd want to go through with some of the established drugs/procedures... I'm curious to know how you're dealing with this.
 
I think it's good to do different diagnostic tests, but what if you find out you have H pylori, d-diff, high levels of heavy metal, etc? Tons of antibiotics and chelation therapy? I think courses of treatments are warranted if you're experiencing severe symptoms, but if the results are positive for those diseases and if you're experiencing very very mild symptoms, I am not sure if you'd want to go through with some of the established drugs/procedures... I'm curious to know how you're dealing with this.

Most of the tests we've done have interpretive guides and videos with natural treatment suggestions. We aren't doing any prescription drugs or chelation therapies. It turns out many vitamins and minerals have antibiotic and antifungal properties, so we are starting with just getting all our vitamins and minerals in the optimal ranges with supplements like vitamin D and diet changes. One person had a gluten sensitivity, so that's an obvious fix. Another mast cell issues, so there are diets and herbs to help with that. Another had anemia so they went to their regular doctor for further testing. One person has had their IBS improve with diet changes suggest by the tests (gluten free, low FODMAP).

We've seem a lot of improvements so far. It has been working out great. Since every individual biomarker that has been off so far has known, natural treatment fixes, I'm excited to see if we can get all of everybody's test scores in the optimal zones on all the tests.


ETA - A person with a tremor had a B1 deficiency, which can cause tremors. The list of easy improvements just goes on and on - too much to put in one forum post.
 
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