Testing, Labs, and Data from My Quest to Solve My Chronic Fatigue
I've been "officially" sick, like with chronic fatigue syndrome, since 2001. For a list of symptoms see this blog. But I bet if I'd had been tested with functional labs as a child lots of things would have shown up because I had a lot of problems even then. I've managed to lose most of my labwork prior to 2012. Not much happened lab-wise in the first ten years of my illness anyway since I couldn't afford much in the way of natural medicine and the conventional doctors simply did some basic tests, proceeded to dismiss anything that did show up on those basic tests even with their terribly broad reference ranges, and gave me prescriptions for anti-depressant and anti-anxiety medication.
Uggg. I have no more respect for the average doctor than I do for anyone else well-trained to do an terrible, unenlightened job, like the sleazy lawyer, the greedy CEO, or the fabulous dictator. Conventional doctors may mean well, but they basically promote disease and I find them horrifying.
I do remember from my lost labs that 2011 immune tests indicated elevated antibody titers for cytomegalovirus, HHV6, Epstein Barr, mycoplasma pneumoniae, and parvovirus. These are common opportunistic infections and ones that most adults have had at some point in their life, whether they know it or not, but they often become reactivated in the chronically ill. I took the heavy-duty prescription antiviral Valcyte for over one year, along with a full naturopathic supplement protocol some other odd treatments like autohemotherapy, with no improvement.
I also had a negative western blot. I'll report everything else I remember in the appropriate sections below, and update with new labs as they come in.
Here is a representative selection of CMPs highlighted for low (yellow) and high (red) values as per a functional reference range. When looking at the standard reference range the values that would be flagged would be the BUN/creatinine ratio, as well as the 1/16/17 Creatinine, and the 2/18/16 ALT and AST (liver enzymes). I don't know why those were high back then, but I was on a very high fat ketogenic diet which may have had something to do with it. They gave me a follow-up hepatitis test that was negative.
Usually a high BUN/creatinine ratio is due to dehydration and high BUN, whereas mine is due to low creatinine. This perplexed me greatly since most of the info on low creatinine online has to do with low protein intake, or other explanations that would be unconvincing for my case. Then I found out from Dr. Dan Kalish that low creatinine is a sensitive marker for methylation issues, and that makes a lot more sense.
Lowish carbon dioxide can be indicative of hyperventilation. Whatever the cause, low CO2 causes the blood to become alkaline, and the body to do all kinds of things in other areas, like the cells and kidneys to compensate, potentially leading to metabolic acidosis, but that is limit of my knowledge on that complicated subject at this time.
Low alkaline phosphatase is popularly related to zinc deficiency. I do get those white spots on my nails (leuconychia) and the zinc tally test always tastes sweet for me. Each of those is also supposed to indicate zinc deficiency. AND I was coincidentally taking 150 mg of zinc daily in the 10 days leading up to the 8/31/16 test, which has the highest alkaline phosphatase value. However, my whole blood zinc is average, in the 56th percentile, according to my Quicksilver blood metals test. Low alkaline phosphatase is also related to hypothyroidism and scurvy.
In 2012 I was not eating paleo and still eating all the food allergens like dairy and wheat. You can see not a lot has changed between diets, except my potassium is a bit worse now and chloride was higher then.
Here are all of the complete blood counts I have. Again with functional ranges. If you were to look at the standard lab reference range only MVC and the occasional MCH and a few other randos like the low RBC's would be flagged. I remember when I first got sick back in 2001 my white blood cells (WBC) were quite high on my CBCs, like 11, perhaps indicating that I had recently picked up a virus. They tend to go high in acute infection and low in chronic infection, like you see in my recent years. I think they were also quite low in 2011. The WBC values you see in 2012 are while I was on a number of treatments that may have been boosting them.
High monocytes can indicate intestinal parasites or some other kind of infection or inflammation.
I recall that my mean corpuscular volume (MCV) has always been high, dating back to at least 2001 if not even earlier. This, along with high MCH and RDW usually indicates B-12 or folate deficiency, or perhaps B-6, or B-1. Yet it has never responded to B-12 shots or supplementation including B-complexes and the various forms of methyl-, hydroxyl-, and cyanocobalamin. For example my medical records show that in 2011 I received several B vitamin injections with 1mg hydroxycobalamin, 100mg B6, 250mg B5, and 100mg B-complex (2-4 times/month). Later on I did twice per week home injections of 5 mg methyl B12, 50 mg B6, and150 mg glutathione. Mystery child that I am, my bloodwork showed absolutely no response to either of these treatments.
Perhaps folate has been the missing link?? It is likely that I took methylfolate in a b-complex vitamin, but perhaps the dose was too low. I have taken a bottle or two of 5mg/capsule L-5-MTHF (1250% daily value) in my time, but did not test afterward to see if it altered the MCV or take it for more than two months in a row. The results of my organic acid test further down the page indicate that I am low in folate and B-6. They suggest that I do not have a B-12 deficiency which corroborates with my serum B-12 as you can see below.
8/8/2016 9.3 ng/mL reference range >3.0
The weird thing is that if folate is the culprit behind my high MCV, my serum level (above) and homocysteine levels (further down) aren't that horrible and these are supposed to show deficiency long before megalobloastic anemia develops.
8/8/16 (had gotten nutrient IVs, and taken supplements in recent months, none for 2 weeks prior to draw): >2000 pg/mL reference range: 211-946
1/16/2017 (no supplements or IV's for 5 months): 735 pg/mL
In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL. At some point in my past I was only at 300-something. Intrinsic factor blocking antibody test was negative in Jan 2017.
Cholesterol is a very confusing subject. It seems the pharmaceutical lobby has pressured heart disease foundations in to making recommendations for very low total and LDL cholesterol in order to sell more drugs. Some doctors are now arguing that 200 is the lowest value they like to see for total cholesterol, whereas over 199 is considered the high cut-off point on conventional reference ranges.
Meanwhile, more advanced testing looking at particle size and number is overturning the simplistic stereotype of HDL= good, LDL= bad. My moderately low triglycerides probably just have to do with the low-carb diet I was eating during these draws, though they can also signal chemical/metal toxicity and oxidative stress. So I don't know what to think, but I feel pretty safe at this point in my life when it comes to my risk of heart disease. My grandmother and uncle on my mom's side both had heart attacks, but it seems all my other risk factors are low.
On 1/16/2017 these were my fasting values. I have also shown no signs of iron deficiency anemia on past lab work.
Iron: 148 ug/dL reference range: 35-175 optimal: 85-130
TIBC: 351 ug/dL reference range: 250-400 optimal: 250-350
% Saturation: 42% reference range: 15-50 optimal: 20-45%
Ferritin: 82 ng/mL reference range: 9-162 optimal: 30-70
These values are all slightly higher than optimal, which I gather is somewhat rare for a menstruating female. It may be because I eat about a pound of red meat a day and cook with a cast iron pan. Some might suggest that I donate blood to get the levels down a touch. I've coincidentally been using a stainless steel pan more frequently lately and eating less meat, so maybe that will be enough.
Iron: 190 ug/dL This is higher than optimal as well as higher than the standard reference range (27-159). My liver enzymes were a bit high on this test date so this may have been due to some supplement I was taking, perhaps too much vitamin A, negatively affecting my liver, and the liver contains a lot of iron.
LDH: 107 IU/L standard reference range: 119-226
Lactate dehydrogenase (LDH) is an enzyme required during the process of turning sugar into energy for your cells. People with a certain type of genetic deficiency experience fatigue and muscle pain during exercise. I have fatigue and muscle pain just sitting around. Related?
Here is a chart with all the thyroid values I could find. Actually there is one more for 2/2016: My TSH was .875, low as usual. I've noticed that the optimal range varies quite a bit between practitioners, more than for other tests, but the pattern I've highlighted here holds: low TSH, low FT3, normal FT4, high RT3. This is not the pattern of classical hypothyroidism which is high TSH and low T3 and T4. It appears to be the pattern associated with secondary hypothyroidism or Low T3 Syndrome also known as Euthyroid Sick Syndrome, and Non-thyroidal Illness Syndrome. The pituitary is not making enough TSH, although the thyroid itself might be okay. Causes include infections, autoimmunity, inflammation, and oxidative stress. The current thinking is that if the body is breaking down it will lower metabolic rate to protect itself from breaking down even faster.
Update on 4/8/2017 after being on supportive nutrients values were:
TSH: 1.180 (higher in many years, but still suboptimal)
T3 free: 2.6 (suboptimal)
T4: 5.7 (never had this one tested before, optimal range is 6.0-12.0 mg/dL)
T4 free: 1.17 (similar to always)
6/2016 Thyroid Peroxidase (TPO) Ab: 26 IU/mL reference range: 0-34 optimal: <4 IU/mL according to Amy Meyers. Others say <15.
6/2016 Thyroglobulin Antibody: 0.0 IU/mL reference range: 0- 0.9 optimal: same as reference
Thyroid peroxidase antibodies are indicative of autoimmune thyroid disease. There is a link between autoimmunity and chronic infections. This probably explains my supra-optimal TPO.
BASAL BODY TEMPERATURE
My waking temperature (orally) is typically 97.7 prior to ovulation and 98.4 after ovulation. It then rises throughout the day to 98.6 or above. These are normal temperatures and not indicative of hypothyroidism. A waking temperature of less than 97.5 is a cause for alarm. My temperature is also steady, the same each morning and following the same curve throughout the day. It is said that erratic temperatures are a sign of adrenal fatigue. Pretty sure I have some form of adrenal fatigue anyway, so I would not consider that an accurate test to rule it out, though it might be accurate to rule it in.
This is after taking high doses of supplemental iodine for a few weeks and then being off it for a few days (lab recommends 3 days before testing). Apparently what I was taking was plenty to replete my tissues, though I wonder what the results would be after taking none for a long time. Low bromide is a good thing. But I still had fibrocystic breasts at this time, which are supposed to respond to iodine supplementation.
Resting Heart Rate
About 66 BPM upon waking.
Optimal HR is 50-70 BPM, though if you are not an athlete and it is in the 50's you may have a hypothyroid issue.
VITAMIN D, 25-Hydroxy
Spring 2008: 30ish (no supplements). reference range: 30-100 optimal range: 50-70 (70-100 for treating cancer and heart disease.)
I was working outdoors in a botanical garden so I was surprised at the time it was so low, but looking back I am not surprised at all. It was still cool outside and I had to dress modestly in the garden due to our society's unhealthy social conventions. So really only my face and lower arms were exposed. Furthermore this was in Portland, OR which is both high latitude and notorious for its cloudy winters (and springs and falls).
Here are my values for living in Arizona (lower latitude, sunny year-round, dressing immodestly):
6/10/16 (no supplements) 40.6 ng/mL
8/8/2016 (no supplements): 56.3 ng/mL
1/16/2017 (had recently supplemented 50,000 IU daily for one week, followed by 10,000 IU daily for 3 more weeks): 81.2 ng/mL
I imagine that throughout August and September my natural vitamin D level continued to rise, perhaps peaking at around 65 or 70 before starting to retreat again. The naturopathic doctors I spoke to at Southwest College of Naturopathic Medicine felt it was important for it to be around 80 to reduce my autoimmune disease risk, so that is why I did the supplements in December, despite preferring natural sunlight. I am not supplementing at this time since the sun is coming back and I think I can maintain a naturally high level.
8/8/2016: 5.5 mg/dl reference range: 4.2 - 6.8
According to Carolyn Dean, the magnesium queen, 80% of the population is deficient and an optimal RBC magnesium is 6.0-6.5. Nevertheless, I think I would call this a "good" value, if not a "great" value. I'd like to take it again because I had IV nutrient therapy with some magnesium in it on 6/2, 6/28, and 7/22/2016 and I am not sure how much that contributed to my 8/8 magnesium level. My recent Quicksilver blood metals panel (toward end of page) put my whole blood magnesium in only the 33rd percentile. Pretty lame.
5/30/17: 2.1 mg/dL reference range: 1.7-2.4 optimal: 2-2.5
1/19/2017: 8.0 umol/L reference range: 0 - 15
4/9/2017: 5.8 umol/L
Life Extension labs suggests that under 7 - 8 is optimal. High homocysteine is associated with heart disease and methylation problems. The second value is after taking methylation supplements including B-12, B-6, and folate.
6/10/2016: .26 mg/L reference range: 0-3.
8/8/2016: .24 mb/L
Hs-CRP is a generic marker of inflammation. Optimal range for women is <1. The lower the better. So as far as I know, mine is looking great. I sure feel inflamed all the time, sickly and achy, but I guess it isn't like this. Perhaps my symptoms would be better reflected in measurements of inflammatory cytokines??
1/16/2017: 2 mm/hr reference range: 0-32
This is also low, suggesting low levels of inflammation, and corroborates with the low Hs-CRP values. It's weird, given my level of back pain and clear evidence of gut and viral infections, but along with my organic acids test (below) and my Oxidata test (below) I am just not showing that many markers for inflammation. I haven't been taking antioxidants or anything that would explain it. Maybe my pain (which feels like muscle tightness and knots and stagnation, but is also associated with a lot of crunching and popping in my spine) my has more to do with my low neurotransmitter levels, high oxylates, or mineral imbalances?? Maybe I could use some more inflammation for some reason!
2/18/2016: 5.3% reference range: 4.8-5.6 %
6/10/2016: 5.4 % reference range: 4.8-5.6 %
These are pretty normal values. Life Extension labs suggests that <5% is optimal while Chris Kresser cites <5.3%. Could be better but I'm not too worried. I'm interested to see if it goes down after going from a low-carb diet back to more moderate carb.
1/19/2017: 7.1 uIU/mL reference range: 2.6-24.9
4/9/2017: 5.9 uIU/mL
Dr. Mercola suggests that <5 is normal while <3 is optimal. Steven Guyenet writes that the average insulin level in the U.S. is 8.8 uIU/mL for men and 8.4 for women, while Kitavans (a non-industrialized society used in many Paleo diet studies) have an average fasting insulin of 3-6 uIU/mL, and the female Shuar hunter-gatherers of the Amazon rainforest have an average fasting insulin of 5.1 uIU/mL. He recounts a study where healthy urban people eating a "paleolithic"-type diet designed to maintain body weight saw fasting insulin drop from an average of 7.2 to 2.9 uIU/mL in just 10 days. And reports that his own fasting insulin is 2.3 uIU/mL.
Here we see that my fasting insulin was higher on a low carb diet, probably due to insulin resistance.
Also general stress can lead to insulin resistance. Perhaps the cortisol panel I list farther down helps explain why my insulin is higher than that of the paleo dieters in the experiment. In the 9 days leading up to the first test my diet looked something like this and was composed of organic meat and vegetables:
GLUCOSE TOLERANCE TEST
I did this test on myself by on 1/4/17 after being on a low carb diet for over a year and again two months later on 3/8/17 after being on a moderate carb diet for a month. I performed the test by consuming 75 grams of pure glucose in water first thing in the morning on an empty stomach and testing with a glucometer, similar to the test they would do in a doctor's office. You can see that under low carb conditions my blood sugar spiked higher and longer than a normal person, and eventually dropped lower 4 hours later, indicating reactive hypoglycemia.
Typically a doctor will inform their patient to eat 150 grams of carbs in the days leading up to the test to account for acute carb intolerance induced by low-carb dieting. I was only eating an average of 111 grams of carbs/day in the week leading up to this first test, which could have exacerbated the results, but I also have a history of dysglycemia/hypoglycemia regardless of diet type. This is affirmed by the second test that shows my blood sugar spiking quickly and then dropping a little lower than normal at three hours. All and all my response was much better on the second test. I didn't really count many grams of carbs I was eating in the week before the second test, but definitely over 150/day.
I felt kinda nauseated and weird during the first half-hour to hour of the test. I'm sure my blood sugar never spikes that high normally because I never eat large amount of quickly absorbed carbs by themselves these days. I felt hungry and very uncomfortable by hour 3.5, but it wasn't much worse than what I feel on most days if I don't eat any snacks. Eating low carb (non-ketogenic) and keeping my blood sugar more stable (between 80 and 100 all day) does not seem to save me from feeling hungry and hypoglycemic three hours after a meal, regardless of what my blood glucose is reading at the time.
It may be that the glucose is being buoyed both under high-fat/low-carb circumstances and under reactive hypoglycemic circumstances by cortisol and catecolamines. Sometimes you never even see the blood sugar dip low. But that boost comes at the cost of side-effects like racing heart feelings.
Eating ketogenic, really ketogenic by going under 50 grams of carbs a day, not just getting a purple pee-stick by eating more MCT oil, does keep me from feeling hungry and hangry, but also makes me quite anxious and shaky and prone to raging insomnia.
Supposedly it is common for those with adrenal fatigue to require glucose replenishment every 2-3 hours. It seems that for me, keeping myself from ever feeling too hungry by snacking often while eating moderate carbs may be the least-stressful on my body.
OMEGA CHECK- Cleveland Heart Lab
Arachidonic Acid/EPA Ratio: 2.6 reference range: <5 optimal: <1.7
Omega 6/Omega 3 Ratio: 3.2 reference range: <4.5
Omega 3 total: 11.1 % by weight reference range: >5.5 optimal:>10%
EPA 4.5% by weight reference range: >2.0
DPA 1.5% by weight reference range: >1
DHA 5.1% by weight reference range: >4
Omega-6 total 35.5% by weight reference range: not on my report but optimally <38% according to Life Extension Labs
Arachidonic Acid 11.9 % by weight reference range: <9
Linoleic Acid 21.1 % by weight reference range: <20
I made the graph. It didn't come with the lab. My interpretation of this lab is that I have a high % of omega 3 fatty acids in my blood (the greens, which is considered good) but also high omega 6 fatty acids in my blood (the reds, which is considered bad). But the ratio between the two is still good. So if you consider the one to be anti-inflammatory and the other to be inflammatory I am still doing well. I eat a Paleoish diet and was consuming salmon and salmon roe prior to this test so the healthy % of Omega 3 makes sense. In regions where seafood consumption is relatively high and rates of cardiovascular disease are relatively low (such as Japan and Greenland), people often have total omega-3 levels of over 15% of their total fatty acids, according to Life Extension Labs. I'd say I'm doing pretty good for land-locked desert dweller.
The remaining blue fatty acids are going to be mostly monounsaturated and saturated fats. Here is what I don't understand: Should these be in an even higher proportion in order to reduce the relative percent of AA and LA and make my results more normal? Or is it irrelevant if my Omega 6's are abnormal as long as Omega 3 is proportionately high? Should I aim to increase Omega 3's even more even though they don't seem to be what is driving the high Omega 6%? According to Life Extension Labs my sub-optimal AA/EPA ratio means there may be "preferred incorporation of AA into membranes over EPA, leading to a pro-inflammatory environment". But I could fix that ratio by lowering the AA% (which will happen if any other type of fat is increased) or by increasing EPA specifically.
This is one confusing issue with having a test that only reports percents and not total values. You can manipulate these values both by eating more of one food, or less of another food. I could eat the same amount of seafood, and less other meat. Or eat the same amount of other meat, and more seafood. I think, because they are so trendy right now, most people would say, "eh, just consume even more Omega 3's". But then you get into some questionable issues with seafood consumption and heavy metals. Plus fish oil, like the SCNM naturopaths wanted me to take in response to these values, gives me demon burps from hell.
H. pylori, IgG abs: .5 U/ml reference range <0.9 negative , .9-1.0=indeterminate, >1 positive
Occult Blood, Fecal: Negative
In response to the above lab I had a hard time believing I did not have H. pylori with my symptoms. I reasoned that perhaps my immune system was to weak to create enough antibodies. So I shelled out for this DNA stool test from Diagnostic Solutions, which came back not only "high" but with a positive virulence factor which means that strain is highly likely to cause symptoms.
I then underwent a course of herbal treatment which did not solve the symptoms. It would have been ideal for me to retake the DNA test at this time to see if the remaining symptoms still had to do with H. pylori or not, but because it was cost prohibitive I did the breath test below. I was sure this breath test on 10/24/16 would come back positive but it didn't:
After this test I finagled my way into getting prescribed a trial course of conventional antibiotics anyway, since the herbs had not worked, and the symptoms still seemed really convincing. The antibiotics were a bitch on my system both during and after the treatment, and I would not do it over if I could go back in time. I simultaneously took probiotics, and some herbal antimicrobials and biofilm busters known to aid the effectiveness of the antibiotics.
Yes, the research literature indicates that taking probiotics at the same time as antibiotics works better. Don't ask me why. For a brief period, about a week after stopping the prescription, I was free of the stomach pain that has plagued me for 20 years and could feel what it felt like to be genuinely hungry, without simultaneously feeling an uncomfortable gnawing, burning pain, but within 10 days the symptoms came back worse than ever.
Or maybe they didn't...maybe there used to be two kinds of pain and now there is only one, the pain associated with excessive stomach gas and burping. This burping thing used to only happen during times of extreme emotional duress but I've been struggling with it hardcore for over a year now. It is worsened by not eating, or eating too much fat. The thing that keeps it down the most is to keep eating every few hours, and making sure that food has adequate carbs mixed with it. I find the whole thing quite inexplicable.
Anyway, the experience was so awful there is no way I am ever going to try another round of prescription antibiotics. The negative/positive/negative test results were confusing. I'm inclined to believe the DNA test and not the others, but I also wonder if the antibiotics helped because they treated an infection other than, or in addition to H. pylori. And indeed my 2/13/2017 GI-MAP test further down shows no signs of H. pylori but shows a few other things. Stay with me as I continue to explore this mystery:
I thought the burping might be due to SIBO, but apparently not. Well, at least that explains why Atrantil (an herbal preparation for SIBO) doesn't do anything for me.
Oxidata Free Radical Urine Test
This a a cheap home test that is supposed to indicate the level of free radicals in your body. If your color matches 4 or 5 you may need more antioxidants. My color looks to be about a two, despite my ill health, and not taking any antioxidant supplements.
6/10/2016, drawn on day 12 of cycle, and the cycle was 29 days that month, so probably just shy of ovulation, (follicular phase).
Estradiol: 108.9 pg/mL reference range: 12.5 - 166
Progesterone: .5 ng/mL reference range: .2-1.5
Testosterone, Serum: 33 ng/dL reference range: 8-48
Free Testosterone (Direct): 1.0 pg/mL reference range: 0.0-4.2
I am not aware of any further interpretations for blood hormones during the follicular phase. In the luteal phase the estradiol/progesterone ratio is used to determine estrogen dominance.
Nothing to see here except high ketones because I was eating ketogenic.
ANA AUTOIMMUNE PANEL
Nothing here. I also had some sort of autoimmune test panel in 2011 that was negative.
DOCTOR'S DATA STOOL TESTING
In 2007 I had a basic stool test. I think it was the Doctor's Data test that only checks for ova and parasites. It came back with a score of 3+ out of 5+ for yeast overgrowth, which indicates a moderate yeast problem. I took medication, I think it was nystatin, while going on a low-carb anti-yeast diet for a month, and then did a follow up test. The follow up still came back as a 3+. I do recall having less pain with intercourse during that time suggesting mild yeast overgrowth was irritating my vaginal tissues, even though I've rarely get the full-on itchy yeast infection. My next doctor suggested that if the treatment didn't stick I probably had heavy metal toxicity. This new test below shows no yeast:
I was surprised not to have more things wrong on this test, since my digestive symptoms are fairly bad. I have chronic burping and stomach pain daily and during these months in recovery from antibiotics I was also experiencing some cramping, and occasionally foamy, loose stool, and mucus (mucus came out negative, even though I know there was at least some mucus in some of my samples I scooped). It appears that Proteus, the one pathogen that showed up, does cause excessive gas. So let us hope that is the culprit.
I really thought I would still see yeast overgrowth, since when I took nystatin last summer, as prescribed by one functional medicine doc, I did seem to have a die off reaction for the first three days with sudden, foamy, crampy, greenish-colored, bowel movements. I took it twice with a break in between and it happened both times the first three days. I figured it was simply killing the yeast, and then it was growing back. But after taking prescription antibiotics in December I had similar episodes without taking any herbal or prescription antifungal or antibiotic products (but perhaps altering the ecology suddenly by eating probiotics/prebiotics and/or taking other digestive aids like enzymes). So I really have no clue what is going on in there. Maybe the nystatin and antibiotics both opened a window that caused an opportunistic pathogen such as mirabilis to proliferate.
One reason that doctor gave me nystatin, and the reason I thought for sure I had yeast overgrowth is because myself and everyone else thought I had a ringworm on my hand (ringworm is a fungus). I thought the rash was growing every time I ate carbs, and going away when I stopped, but then I figured out it was only tomatoes! God, this stuff is confusing.
For instance, similar to my mucus-after-eating-most-things problem, my chronic-burping-and pain-due-to-stomach-full-of pressurized-gas problem is a problem that is not well-described on the internet by conventional or natural docs, only by other desperate people on forums looking for answers. You won't really find it in the descriptions for SIBO or H. pylori, except in relation to eating FODMAPS foods or not digesting foods and having them ferment in the stomach due to low stomach acid.
But I have fasted for 4 days on water only, while clearing out any remaining food from my intestines with salt water and vitamin c flushes and enemas, and the burping problem and pain only got worse and worse. If whatever this thing is can live and reproduce for four days on nothing, it doesn't give me much hope for the specific carbohydrate diet or similar! The carbon dioxide produced by H. pylori is supposed to be absorbed into the bloodstream and exhaled, which is how the breath test works. It is not supposed to cause a lot of burping. Meanwhile, conventional docs say chronic burping is just due to compulsive, accidental air swallowing, but I don't buy that at all, for a lot of reasons, one being that I did get a lot better briefly after taking antibiotic, two being my previously stated horror at the state of conventional medicine.
Oh, and prescription antacids like Omeprazole make the problem A LOT worse, and right away, and for days. Like within 15 minutes of taking a single dose. Taking extra betaine HCL conversely, does not make the problem better. It also doesn't cause any burning or discomfort at any dose (I think I've tried up to 16 pills or more of 650's). WTF?!
The second biggest finding on this stool test was that I am carrying no beneficial bacteria from the groups Bacteroides and Bifidobacterium, and low levels of Lactobacilli. This is more or less confirmed by the low levels of butyrate and low levels of short chain fatty acids in general on that test, as well as by the lowel levels of bacterial metabolites on my organic acids test. During and after finishing my antibiotics in November I took one bottle of Therbiotic-complete probiotics by Klaire Labs, followed by one bottle of Prescript Assist. Then I just went with eating my sauerkraut since it seems to have a much bigger impact on the quality of my bowel movements. Those are both very high-end expensive supplements, together containing the three types of species I am low in, but apparently they didn't work well enough in that time frame to restore my missing bugs.
I stopped the Prescript Assist on 1/16/2017 after about 3 weeks on it, and began the stool test on 1/21/2017, which is actually not recommended. You are supposed to be off probiotics for two whole weeks before testing. Nevertheless the test didn't catch the Bacteroides lipolyticum, or Bacteriodes succinogenes in the Prescript Assist blend. I don't think it tests for any of the other species in the blend like Bacillus.
I got this DNA stool test as a companion to my Doctor's Data stool test. It isn't from the same sample. It is from three weeks later. They cover some different ground and I wanted a follow-up on my H. pylori status.
No H. pylori. That's good. Three opportunistic infections. I haven't gotten this test professionally interpreted yet but my understanding is that the things that are positive are not always considered problematic conventionally, but in my case they are overgrown and/or it would be safer for someone in my health condition to get rid of them.
Notice there is some basic agreement with the Doctors Data test. Namely that:
-Bifidobacterium are low (not present on DD, below range on GI-MAP).
-Lactobacillus are lowish (2+ on DD, low end of range on GI-MAP)
-Enterococcus are high (4+ on DD, high end of range on GI-MAP)
-Escherichia are high (4+ on DD, above range on GI-MAP)
-Proteus mirabilis infection present on both tests
-Elastase okay on both tests (related to pancreatic enzyme sufficiency)
-Bacteriodes was mid-range on GI-MAP and not found at all on DD.
-Occult blood was positive on DD and negative on GI-MAP
-Secretory IgA was fine on DD and low on GI-MAP.
Secretory IgA protects against pathogens and low levels can be related to adrenal fatigue. Overall there definitely seems to be a need to lower bad guys and increase good guys, specifically Lactobacillus, and Bifidobacterium. I eat kraut everyday, but have been taking capsules of probiotics again since getting back my DD results.
I am not sure what the anti-gliadin antibiodies are about since I don't eat gluten. I did have one restaurant meal in late December that could have had hints of gluten. Or perhaps something is cross-reacting. The only food that is commonly cross-reactive with gluten that I sometimes consume is sesame.
ZRT SALIVARY CORTISOL
This test from January 2014 also includes a few results from back in 2011. You can see that my nighttime cortisol is high on both occasions that it was measured. I am unclear if the daytime cortisol measurement on this test being on the high side for the time of day it was measured is a good thing or it would be better if it were more average. Where doctors prefer to see their patients seems to depend on the test.
The better salivary tests also measure DHEA. I had the Diagnos-Techs Adrenal Stress Index way back in 2007, but can't totally remember it. I was definitely in some stage of adrenal burnout. I believe it showed low-normal cortisol during the day, and, as usual, high at night. And that 17-OH-Progesterone was normal, but DHEA was low. I think it also showed reduced salivary SIgA , as well as high Gliadin Ab, SIgA which is indicative of gluten sensitivity. After that time I went on and off gluten for years with no noticeable difference, but I've been off completely for nearly 3 years now, just to be on the safe side.
High nighttime cortisol can be the result of chronic pain and chronic infections and I have both. This is reflected in my unrefreshing sleep and a tendency toward waking at about 3 am to pee and not being able to get back to sleep.
DUTCH HORMONE TESTING
Not entirely unlike the 2014 saliva test, but more extreme, this test indicates that my cortisol is too high all day long. I am not clear if I have changed a lot since 2014 or if a saliva and urine test would even match if taken at the same time. Or how low carb dieting (which I was definitely not doing in 2014 on the saliva test) would effect these gauges.
I've seen anecdotal reports that people's Dutch tests don't match their saliva tests very well. Apparently the pattern shown on my DUTCH test (high free cortisol, low metabolites) is a rarer pattern that indicates that I am not actually making enough cortisol, but the stuff I am making is not being cleared. This will give a person all of the negative side effects of high cortisol like anxiety and none of the good ones. It also indicates thyroid dysfunction, which we know is accurate from my perpetually low TSH.
The second major finding of this test is that my estrogens, E1 and E2, are high, and that my progesterone is low (both high estrogen total, and relative estrogen dominance). That one could have been predicted from my symptoms like PMS and fibrocystic breasts, and it matches my blood hormone test up above as well. Additionally, less estrogen is being metabolized down the 2-OH-E1 path which is the "good" path. I will be taking supplemental pregnenolone and progesterone to treat all of these results.
GREAT PLAINS ORGANIC ACIDS TEST
There is more information online about interpreting the Genova Organix test, but I didn't know that when I ordered the Great Plains version. If I had I would have ordered that one. In any case an OAT gives you a lot of bang for your buck, information-wise. This test is displayed such that the middle red bar represents one standard deviation from the mean, or where the values fall for 68% of normal healthy people. An additional 27% of apparently healthy people fall with the blue bar. Together these total 95%. It flags you if you are in the 5% of people outside of either end. It is typically best to be close to the mean, but optimal values vary depending on the marker in question. Additionally markers may be examined for their patterns and groupings and for the relationship to one another.
This first page of the test covers bacterial and fungal markers. Although none are flagged as excessively high or low, The preponderance of values below the mean indicates a general lack of colonizing gut bacteria altogether. It is good for these markers to be in the mid-high center range. This could be reflective of the fact that I took 2 weeks of prescription antibiotics in late November and somewhat matches the stool test results above.
This second page shows an oxalic acid problem. I don't have kidney stones, which would be typical of high oxalic acid, but apparently the crystals can deposit in other areas and cause pain and problems. Since the marker is extremely far above the reference range it is unlikely to be from food consumption and may indicate a genetic problem breaking down oxalic acid. Oxalic acid can also be reduced by adequate gut bacteria like Lactobacillus and Bifidobacterium and vitamin B-6: both areas that we have now seen several indications of deficiency in.
The glycolitic and mitochondrial sections in the center of this page also show several markers below the mean, and one excessively high. This is all indicative of sub-optimal energy production. I'm tired all the time because my mitochondria are lazy jerks.
Perhaps of most concern on the whole test is the neurotransmitter metabolites section. This section indicates slightly low dopamine, fairly low adrenaline, and quite low serotonin. No wonder I'm a mess. It's likely these have been off my whole life because of my childhood history of social anxiety. On the plus side my quinolinic and kynurenic acid are not high, which would indicate brain inflammation. Both low levels of neurotransmitters and high levels of brain inflammation can cause mental issues. I seem to only have the one, which may be why I don't suffer from the dreaded "brain-fog". I am beginning an amino acid supplementation protocol to address this issue.
This page begins with high uracil which is indicative of folate deficiency. This diagnosis matches the perpetually high MCV and perpetually low creatinine in my bloodwork. Meanwhile, skipping to the nutritional markers, adequate B12 in marker #50 matches my high serum B-12, and the fact that more B-12 hasn't changed my MCV or creatinine.
B-6 is quite low on the other hand. There is a popular theory that low B-6 leads to poor dream recall, and you should supplement until you remember your dreams. I've always been an excellent dreamer with very vivid dreams and superior dream recall, so I have to reject dreaming as a good marker for B-6 deficiency and replacement. The more I look at these tests the less faith I have in symptomatic and folk diagnosis.
In the ketone and fatty acid oxidation section we see, as usual, a trend toward the low end of the scale indicating a lack of inflammation, but also weak fat burning skills.
Because the B vitamins, vitamin C, and NAC are detoxification agents, these low values indicate that my detox capacity is also impaired.
The final page of the test, once again all low, indicates that I am not metabolizing proteins very well. My carb (markers #22 & #23), fat (#42 - #49), and protein markers are all low. This is called a "hypometabolic state", which is symptomatically similar to hypothyroidism, but doesn't necessarily have to involve low thyroid hormones. I don't know where all the food I'm eating goes, it certainly isn't getting stored as fat tissue, but wherever it ends up I'm not making very much energy out of it.
Doctor's Data Urine Toxic Metals
Below is an 8/16/2012 Doctor's Data urine heavy metals test. This is a provoked challenge, meaning I took some prescribed amount of DMSA before the 6 hour collection period to pull out more metals than would normally be excreted. This test was a follow up test to one I took about 6 months earlier. I went through 12 or so rounds of oral DMSA chelation therapy during that time: 500 mg at breakfast and 500 mg at lunch, 3 days on and 11 days off.
I lost the first test, but remember that this one was almost exactly the same and did NOT show any improvement (or worsening), suggesting my body burden of metals was not substantially reduced, or that the DMSA has a limited capacity to bind metals and bound the same amount each time out of some larger (but potentially shrinking) pool. In any case people usually see these values go down after a 6 month course of treatment such as the one I undertook.
The reference ranges on a test like this are for a healthy population under unprovoked circumstances, thus many people will have higher ranges under provoked circumstances. Some will argue it isn't a fair test then because everyone will come up "in the red" and need to be treated. I'd argue that no amount of lead or mercury is good for you, though DMSA may not be the answer. Also you can see that most of the metals were still in the "normal" green range even under the provoked conditions.
Note that I do not, nor have I ever had any dental amalgams, so this mercury must be from fish, vaccines, my mother's womb, or other sources.
And here is the same test, also provoked with 2000 mg DMSA, from 3/6/17. Arsenic is up some. We do have a lot of arsenic in the water in here AZ. Bismuth is up a lot probably due to taking lots of Pepto Bismol in late 2016. Lead is down a lot, and mercury down a little.
QUICKSILVER LABS BLOOD METALS
Uh oh. Out of the 4 particularly bad metals: arsenic, cadmium, lead, and mercury. I have high amounts of three of them. That alone could cause all of my health problems. I haven't gotten a professional interpretation. My understanding is that Quicksilver makes its ranges based on the results of all the people who have taken the test, and because sick people tend to take the test, the metals are probably a little higher than for normal people, and the minerals probably a little lower. So to have, say, higher arsenic than 83% of the other sick people taking this test, and lower magnesium than 67% of the other sick people is not a good thing. Not to mention magnesium is too low in the majority of the "healthy" population as well.
I was expecting high lead, based on those 2012 urine results, but was expecting lower mercury than average since I have no fillings. No such luck. Probably due to my poor all-around detox capacity. If I get the test again I will have to take the mercury speciation portion to see how bad my "bad" mercury is. This mercury may be from eating a lot of fish. I've mostly eaten salmon, flounder, and cod in recent years. Sometimes I eat fish many times weekly. And big portions too. 8-10 oz. No piddly 3 oz servings. Mercury from fish isn't considered as bad as mercury from fillings, but it can change forms in the body.
Arsenic is naturally high in the local ground water here in Arizona. I drink reverse osmosis water mostly, sometimes local spring water. I bathe in unfiltered municipal tap water, and swim in the local streams. It could be helpful to get all the sources of water tested, and to understand if you can absorb a lot of arsenic through the skin, but you can see that arsenic was also highish in my urine before I ever lived in AZ.
I believe the lead may be a long-standing issue. Some say blood metals only reflect recent exposure but it makes more sense to me that although the body deposits excess metals into the tissues for safekeeping, that some lesser amount of those older metals can "leach out" back into the blood slowly over time. That's just my cockamamie theory.
As for the minerals, I am pleased there are none that are particularly high or low. Though it would be better if they were all a little higher and my toxic metals were all lower. Chris Shade, the creator of this test, likes to see minerals between the 40th-80th percentile, which mine mostly are, except copper and magnesium. Zinc has been one of my most consistently supplemented minerals and antagonizes copper. So that may be why my copper is now low.
Note that calcium is at 53% despite a "low" calcium diet for many years. Calcium need is hard to measure because the blood will draw it from the bones if it needs to, but I honestly don't agree with the American calcium RDA of 1000 mg. The WHO recommendation for preventing osteoporosis is 400-500 mg which just makes a lot more sense given the amount of calcium available in non-diary products (though I can't deny the possibility that our ancestors ate a lot more small animal bones. Whole rat paste was a thing in indigenous California).
I was taking epsom salt baths several times a week in the months leading up to this test. Unless my magnesium was really low to begin with--and my RBC test last summer suggests otherwise--they were not adequate for magnesium repletion.
ARL HAIR TISSUE MINERAL ANALYSIS
Well, you can see that nothing is in the ideal range on this test. What does it mean? It means I am in the exhaustion state of stress and suffering adrenal burnout. I may suffer the accumulation of heavy metals as detox mechanisms become impaired. I have impaired carbohydrate tolerance, impaired digestion, and allergies. I am in fight or flight mode and probably have anxiety. I have a copper imbalance associated with fatigue, emotional sensitivity, depression, mood swings, anxiety, insomnia, skin conditions, and yeast infections. I have impaired protein synthesis as indicated by low zinc levels. I likely have a reduction in hydrochloric acid and pancreatic enzymes. I'm in an unhealthy parasympathetic state due to exhaustion of the sympathetic nervous system and I have an inflammatory tendency. Sounds pretty accurate, don't you think?
US BIOTEk IGG & IGA FOOD ALLERGIES
This test is old, but seems no less relevant. Food allergies have always perplexed me because I get a lot of phlegm in my throat immediately upon consuming many foods and I don't know what that means. Like several other problems I have, this one just isn't a thing in the internet world. It doesn't quite fit with IgE allergies. It doesn't quite fit with IgG allergies. It doesn't quite fit with histamine intolerance.
My biggest reaction on this test was to dairy, and dairy is one of the things that gives me phlegm, but so do many more things that show up non-reactive on the test. So it that a coincidence? Do I have multiple kinds of allergies to dairy? Eggs, which showed up on the above test, don't give me an immediate reaction, but do give me a delayed reaction (itchy inner ears and post-nasal drip the next morning). Honey gives me night sweats, though I don't know if that is related to allergies or the type of sugar. I have noticed the phlegm with cranberry juice, but I do poorly with all things that have been processed, and I haven't really tested plain cranberries. Peanut butter gives me the phlegm, but so do many other nut butters because of the processing and oils and probably molds involved.
A lot of people, and I mean natural medicine types, dismiss food allergy tests as unsupported by scientific evidence, but the truth is there are just very few studies on these tests altogether, and not enough unfavorable ones to convince me they are not useful given all the anecdotal evidence. I'm willing to give them the benefit of the doubt given the modest correlations between what I have observed and what they say.
For a veteran health dieter and naturally diverse eater like me, taking out all of the foods that all of the tests combined list as reactive is mere child's play.
LRA FOOD ALLERGY TESTING
I can't really say why I chose the LRA over its similar competitor the MRT test. The LRA (and MRT) is unlike plain IgG testing because it is a functional tests that looks at the cell response to different foods to assess all types of delayed reactions: IgA, IgM, and IgG antibodies, immune complexes, and T-cell direct activation. Additionally it distinguishes between protective and pathogenic antibodies. Despite the different methods you can see that my US Biotek and my LRA test agree on dairy products, as does my body.
-Both tests also showed a reaction to lima beans, which is interesting. I am not aware of being reactive, but don't eat them too often these days.
-LRA shows a reaction to cashew and mango which I am quite aware of, specifically I react to the mango skin or any remnant/oils thereof. This may be related to the fact that both plants are in the poison ivy family although ginkgo nut and bay nut (not likely to be on any allergy panel!) have a similar effect for me. When I eat those products I get an itchy anus, and with mango I get itchy lips with tiny blisters on them, but only if I get the mango skin on my lips.
-I do get phlegmy when I eat gelatin products. I always figured that was something about the processing of it rather than the gelatin itself, but maybe not. I continue to take supplements in gel caps.
-I did shit out totally undigested apricots, (apricots being labelled a strong reaction on my LRA), last time I ate dried ones, but they were the sulfured kind, so I figured that was the issue. Maybe not.
- I don't commonly eat swordfish, rhubarb, black-eyed peas, or plums. I have not been aware of reactions to apple, lamb, and parsley, but it is entirely plausible given certain experiences.
-Despite what the test says, I do not think anything will change by avoiding these foods for 3 months or 6 months. I already do that with most sensitivities I'm aware of, and when I've tried them in a moment of weakness I still react. My whole body needs fixed before it will calm down, and I don't think it is going to happen just by avoiding all of the things on these two tests. Which isn't to say I won't avoid them. I just don't think that will be enough to make a noticeable impact. I also think I am reacting to many more foods in many more ways than these tests can reveal. Tomatoes, for example, give me a nasty hand rash.
Another reason many practitioners don't like this kind of testing, besides lack of research, is the theory that due to a leaky gut the patient will just become allergic to any food they eat a lot of over time, if the underlying cause of the allergy isn't treated. I'm not sure if that is true because NONE of the foods I've eaten the most of in the last three years showed up my LRA test. Lamb would be the only item that comes remotely close. On the contrary I rarely eat most of those foods, and definitely have not eaten some of them in over one year. Either the test hasn't caught all my new food allergies or the things that trigger me have been pretty consistent over time.
Below is a snapshot of all of the 20 weeks or so I've filled in of my diet since 2014. You can see some interesting things like:
-Despite being low in iron, my current iron levels are plenty high.
-Potassium intake is a bit low which corresponds to sub-optimal potassium on the CMP. I don't fill in table salt so sodium and the sodium/potassium ratio isn't accurate on here.
-Despite eating less than the RDA for Omega 6, the percent of Omega 6 in my blood came back high on my Omega Check test.
-But the predicted Omega 3/Omega 6 ratio of 3.866 is not far from the actual ratio of 3.2 in my blood in August 2016.
-It may not mean anything since I have also supplemented with B-12 more than the other vitamins, but you'll notice that I ate only between 112% and 222% of the RDA for B-6, folate, vitamin C and B-5, which were all low on my organic acids test. Meanwhile for B-12, which was adequate on the organic acids test, I ate 536% of the RDAper day.
There is a lot of information to be gleaned from genetic data. I'll just touch on some genes that people tend to talk about the most.
MTHFR C677T rs1801133 AG +/- ( A plus sign means a derivation from the norm)
I am heterozygous for this. Approximately 33% of people have this genotype. It is related to a 35% decrease in enzyme activity associated with this gene. This is more auspicious than having the homozygous variation which is associated with a 70% reduction in enzyme activity.
MTHFR A1298C rs1801131 GT+/-
I am heterozygous for this. It also impacts MTFHR activity but to a lesser extent than C677T.
Although I am not homozygous for either variant, having the two together, known as compound heterozygous, is not very good. According to my blood test I don't have very high homocysteine, which could be one outcome of having these genes. However, my organic acids folate marker, my low creatinine level, and my high MCV indicate possible methylation problems, and of course my symptoms of depression, chemical sensitivity, and heavy metal buildup are very consistent with these genes.
The compound heterozygous situation is common in Italians and in autism. Nearly all autistic children have these SNPs but not all people with these SNPs are autistic.
HLA-DQA1 rs2187668 CC -/-
intergenic rs7454108 TT -/-
These two SNPS are markers for celiac disease and the HLA-DQ2 or HLA-DQ8 alleles. 90-95% of people with celiac disease have HLA-DQ2.5. The SNP is found in about 25% of European caucasians but only about 1% of Europeans caucasians develop the disease. Additionally 5 – 10% of those with Celiac disease have HLA-DQ8. Mine are normal and therefore I am less likely to have celiac disease.
HFE rs1800562 GG -/-
HFE rs1799945 CC -/-
HFE rs1800730 AA -/-
All normal. Not at risk of genetic iron overload.
MCM6 rs4988235 AA +/+
MCM6 rs182549 TT +/+
In this case my less common genotypes, thanks to my Euopean milk-drinking ancestors, are protective against lactose intolerance. In practice however, I am extremely casein intolerant, which is worse, because no type of dairy is okay for me in any form. Hopefully it is something I can get rid of because dairy is delicious.
Despite some ongoing mysteries, there seems to be plenty enough wrong here to explain my situation:
-low neurotransmitters leading to fatigue, depression, anxiety, and pain
-methylation issues leading to low neurotransmitters and poor detox
-poor mitochondrial energy production leading to fatigue
-cortisol problems leading to anxiety, fatigue, progesterone deficiency and immune dysfunction
-immune dysfunction leading to chronic viral infections, gut infections, and cortisol problems
-chronic infections leading to low thyroid production
-low thyroid production leading to fatigue, coldness, and sluggish digestion
-poor detox capacity leading to estrogen dominance, multiple chemical sensitivity, and heavy metal toxicity
-heavy metal toxicity leading to anxiety, depression, and mitochondrial dysfunction
-nutrient deficiencies leading to methylation issues and reduced detoxification capacity
-gut dysbiosis leading to nutrient deficiencies, neurotransmitter imbalances and food allergies
And so on and so forth. It is impossible to pin down a root cause without being able to go back in time to my childhood and determining which problems showed up first. Did vaccinations or metals from the womb combined with my genetics start me off on the wrong foot? Did I pick up Epstein Barr in college when things really began to go south? I don't know that I'll ever know all the answers.
If you have any questions or insights please share them below!