Q&A 03.01.24

[Marsha]

Could you describe the POTS mechanism? Origin in autoimmunity?

23 y/o female with lifelong gut issues from infancy. Very pale in appearance, POTS, can only tolerate 2-3 hours of activity before requiring a rest break. Performing the OAT now.

[Dr. Andrew]

CC – I believe a mix of a vaginal infection, h pylori and stress.

ONSET – the pandemic stress triggered gut changes, and vaginal dysbiosis/infections;

TESTING – H.Pylori discovered via endoscopy

Rx TREATMENT – antibiotics for H.pylori and antibiotics for vaginal bacterial infections 2019-2021 time frame

Nausea, hard to digest food, Small food quantities
Bloating, body discomfort Clean diet
Lower back pain Apply heat, stretch,
Constipation Elimination of greasy, heavy meals,
Brain fog, headcahes Rest, clean diet, sleep
Genital skin changes, burning Prescribed all types of creams, no success
Muscle/bone discomfort Clean diet,
Anxiety Omega 3 fish oil, magnesium bisglycinate
Fatigue, tiredness Clean diet, rest,

DIGESTIVE:

DIET – not any seed or toxic oils, cooking and eating with Ghee, Gluten Free for the past few months;

Breakfast – small quantity

Lunch – often skips lunch, not hungry after breakfast

Dinner –

FOOD REACTIONS – Red meats (hard to digest)
Anything greasy/heavier (hard to digest)
Grabulated sugars/processed sweets (bloating, discomfort)

CHRONIC BLOATING / NAUSEA – can be triggered randomly, she basically eats the same foods – organic and clean oils, etc. – that don’t bother her on Monday but could irritate her again on Wednesday; food pattern inconsistent suggesting functional issues with her GI Tract; Stomach will actually INCREASE in size, abdominal swelling is worse in the evening; bloating and abdominal symptoms increase greatly when she cheat on her diet;

FAT DIGESTION – rich food, even clean rich food, is very hard to digest suggesting

MOLD EXPOSURE – living in a very moldy house as a teenager, visual mold on the walls and could smell the mold, etc.

STOOL – has white specs every day, has 1-2 bowel movements per day, usually well-formed

ANTIBIOTIC EXPOSURE – one round of antibiotic therapy every 2-3 years with a total life exposure of 8-10 rounds in her entire life; last couple of years AB therapy has been more frequent due to

SLEEP: Lights out 11pm, takes 1-2 hours to fall asleep; wakes up around 9:00am for total sleep of 8 hours or so;

NAPPING – does not nap, even when very tired after days of poor sleep;

HORMONES:

MENSTRUAL / PMS – very high depression, high anxiety and panic attacks, experiences anxiety, lasts a couple of weeks if not longer;

Bacterial VAGINOSIS – experienced concurrent infection during the GI problems that started during the Pandemic; treated with antibiotics but still an issue, resistent to topical treatments, etc.

FATIGUE –

DIZZINESS – orthostatic hypotension, been an issue for a long time since she

CRAVINGS – varies throughout the week; lots of cravings for sugars/flours/starches and worse in the evenings

VITS/SUPPS:

CURRENT SUPPLEMENTS:
Quercetin 500mg 1 capsules 1 morning Good
Betaine HCL 324 mg + 5mg pepsin 1 tablet 1 before main meal Good
Digestive enzymes 540mg 1 cpasule 1 before main meal Good
Vitamin D 1000IU 1 softgel 1 morning Good

MEDS/LABS:

GI MAP #1 –

GI MAP #2 – Low bacteroides, low fermicutes, low Enterococcus and low Enterobactor; Staphylococcus aureus 6.92e2 High; Streptococcus spp. 3.68e3 High ↑; Citrobacter spp. 8.99e4; Klebsiella pneumoniae 2.32e3;

Enterobacter spp. 5.43e5 < 5.00e7
Escherichia spp. 1.04e7 < 3.80e9
Fusobacterium spp. 1.67e6 < 1.00e8
Prevotella spp. 1.55e7 < 1.00e8

CURRENT MEDICATIONS:

None Found

HAPLOTYPE:

PHENOTYPE: Chronic reactive hypoglycemia, adrenal deficiency; irregular cycle suggestive of progesterone steal and estrogen dominance; likely SIBO and possible occult yeast/mold overgrowth including skin dermatological infection in perianal and vaginal area.

TODAY’S PLAN: OAT, MYCOTOXIN, Blackseed Oil topical groin area; HCl, Enzymes, D3, Glutamine

FUTURE PLAN: Review biome, progress with protocol and suggest DUTCH

Dr. Andrew Rostenberg