March 12, 2018 at 2:00 pm #836Diane StephensonParticipant
CDSA&P showed high beta-glucuronidase and low putrefactive SCFAs and low beneficial bacteria. Supported following this and symptoms improved but have returned. Constipation is resolved but continues to have pain in centre of abdomen, just below rib cage, which feels like trapped wind and affects sleep – worsens as day goes on. Diet is gluten free, omnivore and healthy and home prepared. Active, positive client other than this. Just has lactulose breath SIBO test results showing Hydrogen at 60ppm (methane 11ppm). Also been back to GP who has done blood tests which show Ferritin at 452 ug/L and a week later at 482 ug/L – serum iron not tested for. This is the only measure out of range and most are in optimum range. B12 and Folate not checked.
Seeing client shortly and would be grateful for any thoughts – particularly about the ferritin levels. Thanks in advance
Posted by Diane Stephenson 12.03.18
March 5, 2019 at 2:01 pm #837Christine BaileyModerator
Many thanks for your question about your client diagnosed with coeliac disease who is still experiencing ongoing pain. It appears from the lab tests undertaken that the client has bacterial dysbiosis and potentially SIBO although it is not our role to make a formal diagnosis. This would also link to the raised beta glucuronidase levels as this enzyme can be upregulated by pathogenic bacteria. So, it would appear that your client may benefit from some anti-microbial support.
With regards to the raised ferritin level this could be due to a number of reasons. It can indicate inflammation. It is one of the proteins that can be raised in the case of inflammation, infection or trauma. Elevated levels without raised iron can also reflect inflammation, liver dysfunction, obesity, oxidative stress. Elevated levels can indicate cardiovascular risk. It can be linked to haemochromatosis the genetic condition that leads to iron to be deposited in tissue. Genetic mutations in the hemochromatosis gene (HFE) make up the most common genetic cause of elevated ferritin levels and are usually seen in Caucasian patients with northern European ancestors.
I would suggest that in view of the recent tests you look to including an anti-microbial programme and consider adding in anti-inflammatories if you suspect inflammation. In addition, checking liver function would also be recommended. Ferritin is stored in many types of cells, including liver cells. With liver damage from any cause, ferritin is leaked into the blood. Therefore, serum ferritin can be an indirect measurement of liver necrosis. It may also indicate viral hepatitis. Many laboratories consider serum ferritin levels greater than 200 ng/mL in women and greater than 300 ng/mL in men to be abnormal. However, a large percentage of the general population has a serum ferritin level between 200 and 1,000 ng/mL. This may be related to the epidemic of obesity and fatty liver, which may elevate ferritin levels on the basis of inflammation rather than iron overload. So, it may be appropriate to refer back to the GP for further assessment. Blood donation is also often recommended as a way to lower levels.
Adams Management of Elevated Serum Ferritin Levels Gastroenterol Hepatol (N Y). 2008 May; 4(5): 333–334. https://tinyurl.com/yaqh9hgo
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. 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.
ADP Oregano (BRC) – take 3 with each meal – https://tinyurl.com/hdjg9c5
To lower the raised Beta glucuronidase
Calcium-D-Glucarate (BRC) – take 2 with breakfast, 1 with lunch and 1 with dinner
BioBifidobacT Powder (BRC) – take 1 tspn daily mid afternoon (so it is away from the ADP Oregano).
Lower inflammation and support gut health
Arthred Collagen Powder (ARG) – take 1tbsp three times daily – https://tinyurl.com/j2arfe4
I hope this helps answer your question
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