L3 - Assessments & Diagnostics Flashcards
What’s the ‘Rule of 3’
Symptoms
Indicative Test findings
Other indicative test finding that the same system is under stress
What are microbes?
1 - Commensals
2 - Pathogens
3 - Pathobiont
4 - Gram Negative Bacteria
5 - LPS
1 - Microbes that live in harmony with us (hosts) & provide BENEFIT to us
2 - microbes that invade our microbiome @ cost of our health
3 - opportunistic microbes
4 - have an outer cell wall rich in Lipopolysaccharides (LPS)
5 - influence immune response & induce inflammation
What do Comprehensive Stool tests measure & what do we look for?
1 - Microbial markers; eg commensals, pathogens, worms
2 - Host markers made by human inc; immune, digestive, inflammatory, leaky gut
Look at symptoms in correlation to both
Host Markers
INFLAMMATION x 2
Calprotectin- leukocytes active in gut wall
Eosinophil Protein X - raised with leaky gut
METABOLIC Host marker : Beta-glucuronidase, what is it?
humans & bacteria make - basically DYSBIOSIS
Think Gluca = sugar in gut
What are 2 markers related to digestion? & how to support?
1- Pancreatic elastase (PE-1) = high protein pancreatic enzymes that don’t break down in gut
2 - Faecal fats = mal-digestion, poor pancreatic activity/bile
Increase pancreatic enzymes
Support HCI
Reduce stress
Name 2 IMMUNE host markers & what they indicate
sIgA - secreted my mucosa, thin protective paint layer in GIT. If low = chronic illness. If high = Acute GI infection eg food poisoning
Beta-DEFENsin 2 - antimicrobals produced by GI when wall breached
What is Zonulin?
A peptide host marker produced by epithelial cells when GI junctions open
INTESTINAL PERMIABILITY
4 signs of healthy Commensals?
Diversity!!
Lots of SCFA producers
Good levels of BIFDOBACTERIUM (crowding out ecoli)
Good levels of LACTOBACILLI (50% space of Bifo!
What are Shirt Chain Fatty Acids (SCFAs) & what’s the most common?
Bacteria gets hold of ingested fibre, digests it and produces SCFAs
Basically FIBRE FERMENTATION
BUTYRATE - main fuel source for epithelial cells in intestines/colon
Good & bad of Mucin-degrading bacteria & common examples?
We need some (but not too much) to keep mucous lining moving & turning over
If starved of carbs/fibre they will eat the lining
AKKERMANSIA - protective of mucosal barrier - if low METABOLIC endotaxemia patterns (Fat, T2DM, autoimmune)
RUMINOCOCCUS - if high + low diversity = autoimmune
Name 4 Natural anti-micro ale for the GIT
Oregano oil
Garlic
Berberine
Thyme
Sage
What is SIBO & how do we test for it?
Fermentation if carbs in SI resulting in raised HYDROGEN or METHANE
Breath test looking for carb substrates (Lactulose, glucose, fructose) every 20-30 mins up to 120mins
What creates a healthy vaginal microbiome?
Acidic ph (3.8-4.5) from Lactic Acid
Low diversity
LACTOBACILLI dominance - produce Lactice acid!
Why is a healthy oral microbiome important?
Prevent tooth decay, oral cancer, inflammation
Some oral bacteria assoc; CVD, autoimmune & Alzheimer’s (some release LPS into blood)
How to support oral microbiome?
- Optimise probiotic foods
- Minimise crap
- 4 hours between meals so ph can recover
- brush, floss, salt water
- scrape tongue
- avoid fillings
What is ‘Metabolic Endotaxemia’?
Immune response
Low grade inflammation
Leaky gut
> risk autoimmune & chronic disease
How to reduce ZONULIN & support leaky gut?
> Glutamine
O:3
Vit D
Zn
What are Organic Acids?
Metabolites of enzymatic pathways in body including MITOCHONDRIA activity
Why is Organic Acid Testing (OAT) useful?
- Measure cellular functioning
- Nutritional needs at cellular level
- Indirect way of identifying nutrient deficiencies
Eg; chronic fatigue, deficiencies, mood disorders
Alongside genetic testing can build picture
Watch outs with OAT?
- Hard to interpret
- Diet eaten st time impacts results (point in time)
- Snapshot in time
- Not measuring nutrient directly - an assumption based on function
Examples of what can OAT measure?
Markers assoc with nutritional function:
- Kerbs cycle metabolites
- Neurotransmitter metabolites
- Ketone & fatty acid oxidation
- AA metabolites
- Bacteria metabolites (dysbiosis)
- Environmental toxins
Common serum tests & pros/cons
Flag deficiencies but not how tissue is utilising the nutrient
B12
Folate
Ferritin
D3
Mg
Ca
B12 & Folate testing
High Homocysteine- bio marker of low B12 or Folate
Methymalonic Acid (MMA) more sensitive B12 testing vs just serum, also urine - if raised methyl B12 deficient
Serum Ferritin & Iron testing
Ferritin = Fe storage capacity (more accurate)
Optimal range 30-100 if/L
What is the Dried Urine Test for Comprehensive Hormones known as as & useful for?
DUTCH
Covers many hormones & their metabolites
Reproductive hormone imbalances & stress
Can include adrenals & nutritional markers
What are the 3 oestrogens, their pathways & their risks?
E1 - Estrone
E2 - Estradiol
E3 - Estriol
Which pathway Oestrogen is going down indicative of women’s health. Body treats it as a toxin:
2-OH pathway- Best, safest & anti-cancer, after phase 1 oestrogens can be deactivated & eliminated
4 -OH - creates reactive products that damage DNA, >PCOS risk, after phase 1 oestrogens can be deactivated & eliminated
16-OH - most metabolites & least elimination - recirculating > cancer & PCOS risk
