March 1, 2014 at 5:28 am #8627
I am struggling with what t suggest to a client who initially came to see me six weeks ago. She initially came with the following symptoms:
-Digestive issues including sluggish digestion and cramps
-Recent high blood pressure
She also has menopausal symptoms in that she has cyclical cramps that affect her sleep and cause other symptoms to worsen. She has not had a bleed for eight years and all other symptoms such as flushes have gone, but her GP says it is normal for some women to continue suffering cyclical cramps. (seed cycling)
She has had the symptoms for over 10 years and controls them with a restrictive diet and eating more earlier in the day, with only crackers and a little topping for dinner.
She has taken Paracetamol with caffeine for many years – it was at the rate of two every four hours for a long time, but was down to half a day when she came to see me.
Ten years ago when symptoms started she was also under a lot of stress, working long hours and with lots of travel.
She has seen a Nutritional Therapist before and taken various supplements including probiotics, B vitamins and Zinc, but these now irritate her digestion so she can not take them.
Due to stress, poor diet and Paracetamol for years there is obviously a lot of irritation and inflammation and most likely permeability.
As she is very sensitive I tried to start slowly with the introduction of new foods with a view to making the diet anti inflammatory with good fats, herbs and spices and including more vegetables and more protein. With supplements I gave her only a probiotic to be taken in tiny doses and built up. (well done)
The probiotic she could not take as even in tiny doses it resulted in pain and bloating. She has made changes to her diet and stopped the Paracetamol with caffeine and initially the headaches went and she had more energy, but if she introduces too many new foods her digestive symptoms flare up. Try one that is lactose free and FOS free
This week her headaches have returned and her energy is very low as well as sleep being fitful.
I am struggling for what to suggest as even though there is a lot to be done any supplements seem to irritate further and diet changes have to be made very slowly to avoid her symptoms worsening. (allergy elimination diet; first castor oil fermented foods and stewed apples; apple cider vinegar)
Any suggestions would be welcome.
May 12, 2019 at 5:31 am #8629
I’ve had gut issues myself where I was unable to eat any fibrous veg, complex carbs or most supplements (especially if they were in capsule form because of the casing/cellulose). As the restrictions were severe I just wanted to focus on trying to ‘eat’ normal foods, so I narrowed my focus down initially on gut repair, this is what helped me:
– Regular bone broths (using a slow cooker was a great time saver as it could cook away for 8-24 hours giving hot instant broth/cuppa soups for two days in a row)
– The only fibre I could handle was porridge oats (I couldn’t handle rolled oats initially) and ground flax; I also started off with stewed apples but initially I had to peel the apples to get rid of that extra fibrousness..
– I took kefir/probiotic yoghurt as and when I remembered and sometimes I bought unsweetened coconut yoghurt
– I later used apple cider vinegar to support my digestion….
– I was able to take sublingual supplements (spray form)
– Glutagenics by Metagenics in powder form (has aloe vera, diglycerrhinitate licorice and L-glutamine) helped alsods, I took twice the recommended dose for a few months… then dropped down to normal dose
– I used a lot of flax oil although fish oil might have been better albeit the taste/smell
I wish I could say I took lots of other wonderful nutrients that might be available, but it was hard finding a form that was easy to digest/take, I was on a student budget and so even with these limited actions I did achieve a great deal. I’m sure one of the expert nutritionist here will direct you better, I’d be keen to know what they advise especially with extremely sensitive stomachs.
May 12, 2019 at 5:31 am #8630
Thanks so much for this Shevonne, it’s great to have first hand advice of what has worked for you and I will suggest some of this,
May 12, 2019 at 5:32 am #8631Todd A. Born, ND, CNSModerator
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.
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