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New Doctor. Need help navigating her many recommended tests. Which one’s to take?

Member Forum >> General Discussion >> New Doctor. Need help navigating her many recommended tests. Which one’s to take?

Ian989

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Posted: 12/14/2020 6:13:49 PM
 
I’ve found a GI specialist to work with. My main symptoms are very bad hunger (hyperphagia maybe from gut-brain connection creating a leptin resistance) and numerous intolerances to foods with the main symptom being a protracted skin itch and in some cases a rash when eating them. She’s analyzed my stool tests and says my butyrate producers are at good levels although Bacteroides and other gram negative bacteria may be contributing to symptoms due to shedding of LPS. I’ve told her about my AIRE results (levels rising no more than about 3-4 points from baseline after consuming pure inulin or raw potato, testing every 20 minutes or so on multiple days). The results have only ever read "medium" in Food Marble’s terminology. I took that to mean that I don’t have SIBO. She says she wants me to get a formal lab test though assessing hydrogen and methane. I was under the impression that the AIRE device was sufficient. Apparently not, she seems to think. Also, I don’t have constipation (almost never) so it seems unusual she would want a test done assessing that. Thoughts?


The tests she has recommended are (quotes indicate her words):


SIBO Breath Testing with glucose, fructose, and lactulose

"It will tell us whether fructose is being malabsorbed and fermented and importantly, where this is occurring in your gut"

$510 (Wow). Would rather avoid paying this if possible. I wonder if there’s any substitute


Intestinal Permeability (lactulose and mannitol)

"This test will tell us if the (lack) of integrity of your small intestine could be contributing to your inflammatory load and predisposing to food reactions"

Makes sense, but if the test was positive wouldn’t patching things up not really address the underlying reason as to why there’s permeability in the first place?

$179 (USD?)


H. Pylori Stool Antigen Test or Urea Breath Test 

I know that the stool antigen test seems to be the best for detecting H. Pylori, although I know I already have it as my GI MAP test has shown a positive reading (although with no virulence factors and in lower amounts than the labs cut off). She says antibodies detected on the antigen test will determine if it’s actually a problem for me (is this true?). I know that it can affect leptin and ghrelin levels, but it was my understanding that it makes people not want to eat rather than eating a ton. I also have no gastritis, ulcers, etc. Could this thing we call H. Pylori just be selective in some and cause specific symptoms rather than the constellation of symptoms caused by H. Pylori? If so, that could be worth investigating via the previous two tests


*Price unknown and don’t know where to get it


She also recommended:

"Dr’s Best Curcumin Phytosome (Meriva Turmeric extract 500mg) – 1 capsule twice daily – am and pm The aims of this treatment is to decrease underlying low-grade inflammation & visceral hypersensitivity. The Meriva will also assist with healing the small and large intestine reducing “leaky gut”   "

Makes sense and could be useful as a temporary way of alleviating symptoms (reducing LPS translocation) although I’m not sure if a phytosome preparation would offer advantages over one that has different kinetics (we’ve discussed that we don’t need to force absorption with this stuff for it to have an effect). If it’s helping it get to the gut though and the effect needs to take place through direct contact, then that could make more sense


"AOR SoluFiber (Partially hydrolysed guar gum) – start with a 1 teaspoon dose and gradually build up to one level tablespoon daily. This is a prebiotic that assists in building up butyrate-producing bacteria. Butyrate is an important fuel for your colon cells. It also has important anti-inflammatory effects - body-wide as well as in the gut – and promotes healing of the small intestine"


I’m not sure why, as she had said that I have good levels of butyrate producing bacteria. Maybe PHGG is more location specific where she thinks the gut damage is? I do react to gums and emulsifiers so I’m not sure if this will agree with me



This process and all these test recommendations piled on have created more stress than have actually helped. I now have to figure out the best prices, where to get them, the elaborate instructions. Damn. I’m not even sure I need all these tests. If I could avoid the SIBO test that would save me a lot of money.  The H. Pylori antigen test and intestinal permeability do make some sense

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Bob Niland

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Posted: 12/14/2020 6:49:19 PM
 
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Ian989

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Posted: 12/14/2020 7:33:08 PM
 
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