I had my first visit with my functional medicine doctor (FMD) after receiving my lab results. We met for just over an hour
. The first two issues we're going to tackle are elevated metals and h. pylori
. My metals testing results from Quicksilver are posted as an attachment (I believe the percentiles are population percentiles) :
It's not clear the source of metals but she suspects part of the problem is a reduced ability to clear them (may or may not be APOE4 related). Right now the working theory is that the arsenic is from sardines and the mercury from filling and seafood.
Focus areas are on arsenic and mercury along with other troublemakers such as lead. She wants me to have my amalgam fillings removed/replaced and will start me on a protocol that will ramp up over time to help my body clear these metals. She believes that my liver is bogged down (infected, inflamed, ??) and needs some help. Other indicators of this are (from LabCorp and Dutch Comp Hormone):
-elevated Sex Hormone Binding Globulin (SHBG) at 89.6 nmol/L (was 47.1 in March 2015), which obviously impacts my free testosterone
-aspartate aminotransferase (AST) higher than desired at 36 IU/L (was 20 in March 2015)
-alanine aminotransferase (ALT) higher than desired at 39 IU/L (was also 20 in March 2015)
-high 2-hydroxyestrone (2-OH-E1)
-possible contributor of high Uron Bind. Cap of 219 ug/dL
-perhaps others I didn't catch
She indicated that the metal reduction will take about 6 months. She is hopeful that clearing the metals will help with brain fog although warned me that the treatment will likely make it worse before it gets better.
She said that iron is a serious concern but my levels were not too elevated and directed me to donate blood 1-2 x a year.
Next is helicobacter pylori. This was detected on a BioHealth Laboratory GI test. The plan here is to start an herbal protocol for 60 days, retest, and evaluate. The h. pylori could be impacting:
-gut lining health (food sensitivities)
-elevated fasting blood glucose levels
Other issues discussed but tabled until these two issues are resolved:
-low 5a-Androstanediol (hormone in the testosterone cycle)
-malabsorption of nutrients per the VCS test, possible CIRS connection
-low cortisol with a bump above band in the afternoon
-SIBO - testing showed a pop-up at 80 minutes, which could be normal for me
-Gut's Bacteria Culture - not very robust but no bad actors
Arsenic may be due to my sardines (2-3x a week), so she suggested Vital Choice brand and lower to 1-2x per week
Fish - eat SMASH = salmon, mackerel, anchovies, sardines, and herring. 2-3x per week for reduced mercury exposure. Absolutely no tuna.
She'd like to drive down my LDL-P (~1300) so we're going to reduce my saturated fat some more. Drop the coconut oil (she said some patients add back in coconut oil and have no changes in lipids, others do), add in macadamia oil and keep using the high polyphenol olive oil and avocado oil. She was onboard with my 1 pound of liverwurst, beef head cheese, or braunschweiger per week but limit other red meats.
She said to keep my current protein level of about 120 grams per day to maintain muscle mass (I weigh 170 with 5-10% body fat), and to substitute in chicken/turkey/duck for my reduction in seafood.
Eggs are OK (although I need to retest to see if egg whites cause me mild skin rashes still)
She was onboard with my mildly ketogenic diet (20% protein, 20% carbs, 60% fat)
Don't have full list yet, but she said it would be long
. She had me discontinue:
-Kirkland Vitamin C
-Now brand Omega-3 (will substitute with cod liver oil)
-ONE multivitamin (will substitute with a COQ10 supplement and others)
-Magnesium oxide based supplement, shift to magnesium glycinate
-My multitude of vitamin B supplements, shift to B Supreme
-Resveratrol, not convinced yet and didn't know brand
-My gut-healing supplements of glutamine, licorice, and mastic gum. She has another combined supplement.
She said I could continue with my curcumin (I'm using super bio-curcumin)
She said I could continue with 4,000 IU/day vitamin D (kirkland) and vitamin K (jarrow mk-7)
Lastly, she suggested that I join a group on the internet call APOE4.info. Anybody know anything about them?
Happy to share more - send along any questions.
You do not have the required permissions to view the files attached to this post.