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Thank you for asking questions on how we may best help your client who has digestive concerns, fatigue and headaches, along with being sensitive to most supplements.
One of my clinical focuses is on these difficult to treat cases, so I do hope to be able to help.
I would also like to thank Shevonne for your input; as it is quite valuable and some of your suggestions is exactly how I would proceed.
Joanne, you have done well thus far in attempting much through diet, particularly an anti-inflammatory one.
Given her symptoms, you may wish to consider the Microbiology Profile (www.gdx.net/uk/product/74) or CDSA 2.0 (www.gdx.net/uk/product/63), both from Genova Diagnostics. Doctor’s Data also carries very similar stool tests and are of extremely high quality. They are available from http://www.regeneruslabs.com.
Organic causes to some of her symptoms should also be looked into. TSH, FT3, FT4, 25(OH)D3 and an iron panel (ferritin, serum iron, transferrin, % iron sat rate) will look into thyroid function and iron deficiency anaemia. Performing a chemistry panel to look at kidney and liver function, along with total protein, may also prove to be useful. Lastly, I typically run DHEA-S in cases like this to assess adrenal function.
In cases like these, I typically tonify the patient first before removing anything. I would also discuss eating hygiene and an angle to stimulate digestion.
To strengthen digestion, organic apple cider vinegar: 1/2 teaspoon in a small amount of water, swish and swallow before meals. This will stimulate digestion and enable her to break down proteins, fats and carbohydrates easier.
Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects. Eur J Clin Nutr. 2005 Sep;59(9):983-8. (http://tinyurl.com/88cd2ns).
Fermented foods such as sauerkraut, miso, coconut kefir, coconut yogurt, etc., will provide beneficial flora and l-glutamine.
Regulatory effects of a fermented food concentrate on immune function parameters in healthy volunteers. Nutrition. 2009 May;25(5):499-505. Epub 2009 Jan 3. (http://tinyurl.com/85mueb4)
Prebiotic effects: metabolic and health benefits. Br J Nutr. 2010 Aug;104 Suppl 2:S1-63. (http://tinyurl.com/7vuv23m)
Modification of intestinal flora in the treatment of inflammatory bowel disease. Curr Pharm Des. 2003;9(4):333-46. (http://tinyurl.com/8a6r79r)
You may also wish to consider stewed apples at 2-3 apples per day for 3-6 weeks; 1-2 daily thereafter (http://tinyurl.com/64wpvrl), which are extremely useful in GI concerns.
Topical castor oil is extremely effective treatment and very low cost (http://tinyurl.com/m5yppjj).
When I have patients that react to supplements, I will look at the brands of what they’re actually taking. Inferior products may be difficult for many sensitive patients/clients to tolerate. Particularly, if the patient is reacting to probiotics, I suggest you consider suggesting one that is dairy and FOS free.
After the above for 4-6 weeks, you’ll better be able to assess as to the next course of action.
Typically, the client will feel 25-60% better in all parameters. My next step then is usually the allergy elimination diet, which is the gold standard for food intolerances and sensitivities. There are numerous ways to perform this. In my practice, to garner greater patient adherence I have them remove a handful of foods that usually cause problems (soy, citrus, dairy, gluten, corn, nightshades [if pain or autoimmune disease], eggs, artificial food colours, preservatives and sweeteners) for 2 weeks.
Then, one by one, they challenge a food by eating it three times in one day, stopping when and if they have a reaction. If after 3 days they don’t react, they can challenge the next food. During this entire time, they should keep a diary of their symptoms, during both the elimination and challenge phases.
Sicherer SH. Food allergy: when and how to perform oral food challenges. Pediatr Allergy Immunol. 1999 Nov;10(4):226-34. (http://tinyurl.com/92kcjqd).
Mayo Clinic Staff. Food allergies: understanding food labels. 4 Jan 2011. (http://tinyurl.com/2acbwp).
By the time your tonifying portion of the treatment is finished, along with the allergy elimination and rechallange diet, it’s been approximately 3 months since the first visit. By now, the sensitive individual is not as sensitive and whatever symptoms are addressed are easier to deal with via supplements.
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. It is not intended for them all to be taken, but rather just those that you select. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Please consider these suggestions in light of the other clinical information pertaining to this individual. If you have any more information about the specific problems this individual is experiencing, further refinement of these suggestions may be considered. I hope this information is helpful, and if you have any further questions or information specific to the problems this individual is experiencing, please do provide feedback.
Lactozyme (BRC): 2 tabs with each meal. (http://tinyurl.com/lcmxyme)
Saccharomyces boulardii (ARG): 2 caps upon waking, 2 before bed. (http://tinyurl.com/35392bw)
NT Factor Energy Lipids Powder (ARG): 1 scoop, twice daily (breakfast and lunch). (http://tinyurl.com/9x4lctq).
Bio-D-Mulsion Forte (BRC): 1 drop daily in mouth. (http://tinyurl.com/2wsbmas).
Note, with sensitive patients, introduce only supplement at a time, in a very small dose and titrate up until tolerated at above dosages.
I hope this helps and please feel free to keep us posted.
Registered Nutritional Therapist Helen Perks is collaborating with Clinical Education to bring you the first-ever Functional Medicine book club for Practitioners.
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