L3 - Assessments & Diagnostics

Question 1

What’s the ‘Rule of 3’

Answer 1

Symptoms

Indicative Test findings

Other indicative test finding that the same system is under stress

Question 2

What are microbes?
1 - Commensals
2 - Pathogens
3 - Pathobiont
4 - Gram Negative Bacteria
5 - LPS

Answer 2

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

Question 3

What do Comprehensive Stool tests measure & what do we look for?

Answer 3

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

Question 4

Host Markers
INFLAMMATION x 2

Answer 4

Calprotectin- leukocytes active in gut wall

Eosinophil Protein X - raised with leaky gut

Question 5

METABOLIC Host marker : Beta-glucuronidase, what is it?

Answer 5

humans & bacteria make - basically DYSBIOSIS

Think Gluca = sugar in gut

Question 6

What are 2 markers related to digestion? & how to support?

Answer 6

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

Question 7

Name 2 IMMUNE host markers & what they indicate

Answer 7

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

Question 8

What is Zonulin?

Answer 8

A peptide host marker produced by epithelial cells when GI junctions open

INTESTINAL PERMIABILITY

Question 9

4 signs of healthy Commensals?

Answer 9

Diversity!!

Lots of SCFA producers

Good levels of BIFDOBACTERIUM (crowding out ecoli)

Good levels of LACTOBACILLI (50% space of Bifo!

Question 10

What are Shirt Chain Fatty Acids (SCFAs) & what’s the most common?

Answer 10

Bacteria gets hold of ingested fibre, digests it and produces SCFAs

Basically FIBRE FERMENTATION

BUTYRATE - main fuel source for epithelial cells in intestines/colon

Question 11

Good & bad of Mucin-degrading bacteria & common examples?

Answer 11

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

Question 12

Name 4 Natural anti-micro ale for the GIT

Answer 12

Oregano oil
Garlic
Berberine
Thyme
Sage

Question 13

What is SIBO & how do we test for it?

Answer 13

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

Question 14

What creates a healthy vaginal microbiome?

Answer 14

Acidic ph (3.8-4.5) from Lactic Acid

Low diversity

LACTOBACILLI dominance - produce Lactice acid!

Question 15

Why is a healthy oral microbiome important?

Answer 15

Prevent tooth decay, oral cancer, inflammation

Some oral bacteria assoc; CVD, autoimmune & Alzheimer’s (some release LPS into blood)

Question 16

How to support oral microbiome?

Answer 16

• Optimise probiotic foods
• Minimise crap
• 4 hours between meals so ph can recover
• brush, floss, salt water
• scrape tongue
• avoid fillings

Question 17

What is ‘Metabolic Endotaxemia’?

Answer 17

Immune response
Low grade inflammation
Leaky gut
> risk autoimmune & chronic disease

Question 18

How to reduce ZONULIN & support leaky gut?

Answer 18

> Glutamine
O:3
Vit D
Zn

Question 19

What are Organic Acids?

Answer 19

Metabolites of enzymatic pathways in body including MITOCHONDRIA activity

Question 20

Why is Organic Acid Testing (OAT) useful?

Answer 20

• 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

Question 21

Watch outs with OAT?

Answer 21

• Hard to interpret
• Diet eaten st time impacts results (point in time)
• Snapshot in time
• Not measuring nutrient directly - an assumption based on function

Question 22

Examples of what can OAT measure?

Answer 22

Markers assoc with nutritional function:

• Kerbs cycle metabolites
• Neurotransmitter metabolites
• Ketone & fatty acid oxidation
• AA metabolites
• Bacteria metabolites (dysbiosis)
• Environmental toxins

Question 23

Common serum tests & pros/cons

Answer 23

Flag deficiencies but not how tissue is utilising the nutrient

B12
Folate
Ferritin
D3
Mg
Ca

Question 24

B12 & Folate testing

Answer 24

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

Question 25

Serum Ferritin & Iron testing

Answer 25

Ferritin = Fe storage capacity (more accurate)

Optimal range 30-100 if/L

Question 26

What is the Dried Urine Test for Comprehensive Hormones known as as & useful for?

Answer 26

DUTCH

Covers many hormones & their metabolites

Reproductive hormone imbalances & stress

Can include adrenals & nutritional markers

Question 27

What are the 3 oestrogens, their pathways & their risks?

Answer 27

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