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Matthew has been on the Autoimmune Protocol (AIP) for 18 months.

17 of those have been low-FODMAP.

For the last 2 months, he's been doing the most extreme low-FODMAP AIP variation yet: a gut-healing protocol outlined by Aglaée Jacob in her book Digestive health with Real Food.

The only carbohydrates he's been eating for the past 9 weeks are carrots and spinach. And he drinks gallons of bone broth.

The Results

This is the reporting part of the Scientific Method.

  • Nausea: As I mentioned in my post Dietary Treatment for SIBO, after 9 days on this new Protocol, Matthew's unexplained and debilitating nausea went from a 7-10 on a scale of 0-10 to a 4-6. And stayed there. Two months later, his nausea is still in the 4-6 range. This reduction has enabled him to participate in life, including cooking for himself (and me), engaging in moderate exercise, and doing things around the house. But the nausea has plateaued at the 4-6 level and that is barely tolerable much of the time.
  • Brain Fog: Over the past 2 months his brain fog lifted further. He's winning at scrabble again. For the first time in years.

A New Hypothesis

Our Functional Medicine Doctor was as perplexed as everyone else about Matthew but (unlike everyone else) he didn't give up.

Dr Cline talked to several colleagues and has a new hypothesis: yeast colonies protected by biofilms in the gut.

Biofilms

Biofilms are communities of microscopic organisms, such as bacteria and yeast, that produce their own protective matrix.

Organisms inside a biofilm are highly resistant to eradication attempts and, it seems, are also capable of complex, coordinated behaviour like quorum sensing.

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Take the Assessment

The hypothesis that Matthew is colonized by biofilm-protected yeast colonies in his gut comes from a re-analysis of the results of a comprehensive stool analysis that Dr Kline ordered last year.

As Matthew had been on a low-FODMAP AIP for quite some time when that test was conducted, his results were better than any Dr Kline had ever seen.

Apparently, he should have been feeling great!

But he wasn't.

The trace amounts of yeast in each of the three tests didn't seem consequential at the time. But the specialist Dr Kline consulted with, Dr Tom O'Bryan, thought they were. Quite.

Vratislav Šťovíček, Libuše Váchová and Zdena Palková explain: "Pathogenic yeasts can colonise various surfaces within the human body, including host tissues... and form biofilms that resist otherwise effective drug therapy. Biofilms are thus very difficult to eliminate and serve as a source of serious systemic infections."

Apparently yeast can grow roots, called hypha, which can puncture the intestinal wall and thereby create intestinal permeability (leaky gut). So even though Matthew has been on increasingly restrictive gut healing protocol for a year & a half, if the yeast is armored inside biofilms and putting down roots, his gut is still leaky.

It makes sense.

A New Protocol

Dr O'Bryan has recommended a 3-month protocol designed to attack the biofilms and eradicate yeast colonization, with supplemental colostrum for gut-healing.

He has also recommended an 'Intestinal Antigenic Permeability Screen' from Cyrex Laboratories to measure Matthew's gut permeability before and after the protocol. That will enable us to get a baseline and then measure any improvement.

Dr Cline has suggested that we may want to consider a fecal microbiota transplant at the Taymount Clinic in England after that, to repopulate Matthew's micobiome. Maybe even as soon as this winter.

We might have sell our house to finance that, but hey.

If I want to go on losing at scrabble for the rest of my life, that might just be what we have to do.

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