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Freddie.B – Case Study Age: 23 Main complaints: Debilitating bloating, nausea & digestion discomfort with very regular bowel movements Understandably, when Freddie first came to me, he was very concerned. The digestive issues he was experiencing were causing a lot of pain and discomfort and were significantly effecting his ability to return to work and do any kind of exercise. Prior to our first consultation, I asked Freddie to complete a detailed Health History form. From reviewing Freddie’s health history and from further discussion during his first consultation, we associated the start of his symptoms from an overseas bout of food poisoning which happened the previous year. Freddie was keen to do a food sensitivity test as he felt this was the likely cause of his symptoms. I recommended that we also do a Comprehensive stool test called the GI-MAP given the nature of his symptoms and also his history. Here is a summary of Toby’s results: GI-MAP • Staphylococcus spp. Bacterial overgrowth (indicative of SIBO) • Streptococcus spp. Bacterial overgrowth (indicative of SIBO) • Lactobacillus spp. – Low levels of beneficial bacterial flora • Bacteroides fragilis – High levels of bacterial flora • Escherichia spp. - High levels of bacterial flora (indicative of SIBO) • Geotrichum spp present in moderate amounts • Microsporidium spp. Present • Low levels of Elastase-1 (Pancreatic Enzyme insufficiency) • Low Secretory IgA (GI Tract Immune marker – Stress/Food Sensitivities likely cause of inflammation) • High levels of Calprotectin (Further Indication of Inflammation) Food Sensitivity Test Freddie’s food sensitivity test results showed a very strong reaction to Whey, Egg Whites & Egg Yolks as well as a moderate reaction to Beef, Gliadin (the protein in Gluten) and Kidney Beans. Freddie’s protocol Freddie’s results and the symptoms that he was suffering with were very indicative of what we tend to see in people suffering with Small Intestinal Bacterial Overgrowth (SIBO). This is where bacteria that would normally reside in the Large Intestine, becomes overgrown in the Small Intestine. These bacteria ferment the food that passes through (causing symptoms such as abdominal bloating, gas, and pain), damage the structure and function of the small intestine, and interfere with the absorption of nutrients (not ideal!) My recommendation to Freddie was to start on a SIBO therapeutic diet immediately whilst we complete a test for SIBO but Freddie was happy to start on the protocol without carrying out further testing. During Freddie’s results and recommendations session, we discuss the 3 options for addressing SIBO. These are: 1. Anti-biotics 2. Herbal Anti-microbials 3. Elemental Diet The benefit of Anti-biotics over Herbal supplementation is the length of time however both of these protocols have seen a higher rate of relapse or often require multiple rounds of treatment. Because of this reason, and the time pressures that Freddie was under regarding his career, he opted for the third option which was an Elemental diet. Although not a particularly pleasant protocol (which requires drinking a specific formula for 2 – 3 weeks), the elemental diet has a very high success rate in eliminating SIBO. Freddie is very strong willed so I was confident he would be able to cope with it. The issue that I had was finding a formula which was Whey free. I did some research and in the end, we opted for a home-made formula which consisted of: • Amino Acid Powder • MCT Oil • Carbohydrates (Glucose/Maltodextrin/Modified Starch combination) • + Vitamins (A, B’s, C, D, E, K), minerals and electrolytes During the time that Toby took the formula, his symptoms considerably reduced but he was very low in energy and had lost a lot of weight. We followed up the elemental diet with a period of time on the therapeutic SIBO diet and Freddie agreed to carry out a SIBO test as he was still experiencing some symptoms which got worse when he did any exercise. The SIBO breath Test by Aero Diagnostics involves drinking a lactulose solution and then taking multiple breath samples over a period of 3 hours. Freddie’s results were back within 1 week and although borderline, still showed a level of higher than normal methane gases at 100 – 120 minutes. His results were not as extreme as we often see but given Freddie’s fluctuating symptoms, my recommendation to Freddie was to compliment the Elemental diet with a herbal protocol which is formulated to address SIBO. This included: • Berberine • Oregano • Garlic Extract (Allicin) • Digestive Enzymes • HCL • Spore & Soil based Pro-biotics Freddie continued with the SIBO diet whilst carrying out the herbal protocol. He did 2 rounds of 30 days after which point we re-tested (the results were negative for SIBO!). I am pleased to say that Freddie’s symptoms are now completely gone and he is able to exercise and return to work with no issues. He sometimes experiences some bloating when carbohydrate levels are too high but he is now very in tune with his body and knows what he needs to keep himself at optimal health. Are you suffering with digestive issues? Why not book a free consultation and let’s get to the bottoms of it once and for all!

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