In this case study we look at two individuals who present with comparable gastro-intestinal symptoms. Without looking at their genetics, a practitioner might consider using similar acute and long-term treatment protocols. However, their genetic coding reveals how one is truly food sensitivity while the other is not. Each therefore requires unique therapeutic management.
Susan – a 38-year-old female.
- Susan has had digestive issues for a number of years; what she calls a “sensitive system”.
- She has a great deal of gas and distension after meals, worse after lunch and dinner and getting more severe each year.
- She reports high stress levels and always wakes feeling “bloated”.
- Stool analysis and blood work have always been normal.
- Recently she started coughing more and felt as if her sinuses were congested. However, there was never any mucus discharge or sneezing.
- She started taking an anti-histamine medication on the advice of her GP with no success.
- She cut gluten, dairy, most meat and some nuts from her diet with little to no effect.
Susan’s Genotype (Gene: Allele Coding)
- GIPR: TT Inhibition of gastric acid and gastrin production with simple carbohydrate consumption. Increased GI inflammation and bloating.
- HLADQB1: TT Normal major histocompatibility and allergenic response.
- FUT2: AA High B12 absorption but decreased probiotic growth and vitality.
- FKBP5: AA Significantly increased loss of negative feedback in the HPA axis.
- MCM6: AA Normal response to dairy.
- IL6: GG Increased inflammation in mucous membranes. Over stimulated mast cells.
- TNF-α: GA Increased inflammation; additional mast cell stimulation and IL6 production.
INTERPRETATION:Susan’s allergy-like symptoms are not true allergic reactions. (Note the normal HLADQB1 coding). It is her GIPR gene coding that results in an increased inflammatory response in the GI tract from carbohydrate ingestion. This is augmented by her variant FKBP5 gene coding, which also increases inflammation and impairs digestive enzyme production. Her FUT2 gene leads to lower levels of probiotics, which would normally offer some protection. These genes, combined with the variant IL6 and TNF-αcoding leads to over-stimulation of the inflammatory cascade, triggering mast cell activation in the GI tract and sinuses.
Susan’s Plan
- Reduce the intake of all grains, starches, sweets, fruits and alcohol to 1 meal per day. For that 1 meal the carbohydrate can be a maximum 1/3 the size of the protein portion. After 1 month increase to 2 meals per day. Note that vegetables/salad are unrestricted.
- HMF Intensive 500: 1 sachet per day with food to replenish and maintain an optimal microbiome.
- Ultrazyme: 1 capsule per meal for 1 bottle. Her stress levels inhibit the production of digestive enzymes by up to 88%, resulting in an immune reaction to undigested food molecules.
- Gi Revive: 1.5 tbsp. in a glass of water, BID on an empty stomach for 1 tub to repair the lining of the bowel.
- Sereniten Plus: 2 capsules BID empty stomach for 6 weeks to restore normal HPA function. Reduce to 1 capsule BID after 1 month but increase as needed for stress.
Susan’s Outcome
- Within 48 hours she reported far less gas and bloating after meals, but still felt “swollen”.
- 2 weeks later she her bloating, swelling and GI discomfort was “70-75%” better.
- 3 weeks later she did not notice any sinus heaviness or congestion.
- 2 months later she had little to no GI symptoms.
- 3 months later she tried to increase simple carbs to equal portion size to her protein and became bloated again.
- She reduced her carb intake back to 1/3rdthe size of the protein and remains symptom free 3 years later.
Jane – a 42-year-old female.
- Jane has always suffered from seasonal allergies and small bouts of eczema that she controlled with antihistamines and topical steroids.
- Over the past few years she started experiencing a great deal of odorous gas, abdominal distention and bloating after eating.
- Symptoms became much worse when she was stressed, but resolved once the stressor had been removed.
- Her bowel movements started to loosen, and she noticed mucous more frequently than in the past.
- Along with the bloating her “seasonal allergies” had become “year-round” and her eczema was flaring more frequently despite medication.
Jane’s Genotype (Gene: Allele Coding)
- GIPR: CC Normal gastric acid and gastrin production with simple carbohydrate consumption.
- HLADQB1: CC Abnormal major histocompatibility complex and increased allergenic response.
- FUT2: GG Low B12 absorption but normalprobiotic growth and vitality.
- FKBP5: CA Increased loss of negative feedback in the HPA axis.
- MCM6: AG Loss of lactose tolerance; worse with age.
- IL6: CC Normal inflammation in mucous membranes. No increased stimulation of mast cells and TNF-α.
- TNF-α: GA Increased inflammation; stimulates mast cells and IL6.
INTERPRETATION:Jane has true food allergies and a heightened allergenic response through her HLADQB1 and MCM6 genes. Her stress response was only slightly elevated. This would aggravate her symptoms when under stress, but once the stressor was resolved her nervous system would normalize, allowing for full digestive enzyme production and less inflammatory cytokine production through TNF-α. Her IL6 gene was also normal, indicating that her symptoms were due to a true allergenic response rather than a hyper-inflammatory or stress-induced response.
Jane’s Plan
- Elimination diet to determine foods she was reacting to. These turned out to be gluten, high lactose dairy products, tomatoes, eggplant and peanuts.
- Adenosyl/hydroxy B12 – 1000 mcg per day with food. (Her blood B12 levels were slightly low as a result of her FUT2 gene).
- Gi Revive – 1.5 tbsp. in water twice a day on an empty stomach for 1 tub to repair the lining of the bowel.
- Quercetin-Bromelain – 2 capsules BID empty stomach for 9 months then reduce to 2 per day.
- Sereniten Plus: 1 capsule BID on an empty stomach when under stress.
Jane’s Outcome
- Her GI bloating and gas were reduced by 40% in 2 weeks, but her seasonal allergy congestion and skin remained the same.
- 3 weeks later her congestion began to clear allowing her to stop taking anti-histamines.
- It took 3 months to fully complete the elimination diet, but after identifying and removing the offending foods, she reported that her bowel was “90% better”.
- The following Spring, her seasonal allergies did not flare for the first time, nor did her eczema.
This case study illustrates how valuable integrated genetic analysis is when interpreting your patient’s symptoms. It is key to understanding why your management may work well for some patients but not for others and is a crucial component when providing ideal personalized treatment protocols.