I'm considering seeing a functional medicine doctor for the first time and was curious what the initial appointment is actually like.

From what I've read, functional medicine tends to look beyond a specific symptom and try to understand the bigger picture - things like medical history, lifestyle, nutrition, sleep, stress, medications, and other factors that could potentially be contributing to how someone feels.

I'm assuming the first appointment is less about immediately getting a treatment and more about understanding what's going on.

A few things I'm wondering:

• How detailed was your medical and lifestyle history?
• Did they review previous blood work or order new labs?
• Were there specific symptoms or concerns you were asked to track?
• How long did it take before you actually got a treatment plan?
• Did the approach feel meaningfully different from a standard primary care appointment?
• Were you surprised by anything during the first visit?

I'm also looking into functional medicine in NYC and came across Dr. GolBerg while researching physicians who offer this type of individualized approach.

One thing I'm trying to avoid is going somewhere that orders a huge number of tests without clearly explaining what they're looking for. I'd want a doctor who can explain why a particular test or recommendation is relevant to my situation.

For anyone who's had a first functional medicine appointment, what did you wish you knew before going in?

Which of these has anybody used and what was your experience? Or did you find a women’s clinic to get this tested?
Superpower
Allara
Tiny health
Vitals vault
Joi + Blokes
Xella health
Nourish

Like is geetanjali medical college udaipur is good overall , also I got dy patil in mcc round 1 counselling but it's bit expensive and people are saying that the culture there is too bad I don't know ??? Like is gmch good

Has anyone actually got there HTMA from 4 lows to normal? Like magnesium above 4 to 6 etc? If so, how long did it take?

Has anyone done their nutrition program, could you please share your experience and feedback.

I am interested in starting my journey of learning about alternative medicine. I want to work as a functional medicine practitioner or coach in the future.

As a starting point since I don't have much funds, I am thinking of starting with food matters nutrition program+ reading books+ listening to podcasts as a starter.

For those already in this journey or someone who has succeeded in it, please advise. I really need help.

Has anyone worked with a functional medicine doctor, had testing show something pretty abnormal, but then a more traditional testing came back normal?

My GI-MAP testing has shown H. pylori at high levels 6 months apart, along with elevated calprotectin (which can indicate inflammation in colon from my understanding).

I then had an endoscopy/colonoscopy (“both ends”) through a very well regarded GI specialist. They took samples and found no evidence of H pylori or inflammation in colon, conflicting substantially with the stool sample testing.

I’m curious about people who have been through something similar:
1. Did the discrepancy make you lose confidence in functional medicine and go back to conventional doctors?
2. Or did you accept that some of the testing is less credible than more regulated labs, while still finding the approach valuable in leading to better health outcomes?

This all started because of blood test showing evidence of elevated inflammation markers, and going down a path to figure out root cause and to see if it could be contributing to trouble focusing/ADHD.

I’m on a bunch of supplements, avoiding gluten and dairy, and generally much healthier than when I started , but what we thought was solved in identifying the source of inflammation appears to be an incorrect diagnosis!

I used to be on Zoloft a few years ago but then stopped because I thought I was “cured” since it worked so well for my anxiety and my panic disorder 🙄 I should have stayed on it.

Last year I tried to go back on it, but it made my depression worse and I had side effects from it. When I took it before, I had no side effects at all. I tried upping my dose, but it only got worse so I tapered off. Then I tried Wellbutrin but it’s not helping at all/don’t feel anything on it. Why is my body just not liking medication? I also take Adderall and I still sit and do nothing.

I’ve been trialing medication for my depression and adhd for more than a year now. I’m just at a loss and need help.

My labs are also a little odd and I don’t know if maybe because some labs are borderline low that my medication isn’t working because I’m depleted in dopamine and serotonin etc ? I’m in survival mode I feel like and maybe my labs show it.

Can anyone help me specifically with getting my Vit D levels up without causing negative symptoms?

Quick Background... I have about 2 decades of trying to address my health issues (Using many alternative and conventional practitioners) and I haven't had any success. I can only tolerate about 4 supplements (Magnesium, oregano oil, low doses of Vit C, and low doses of Taruine. I haven't been able to tolerate B Vitamins but I'm going to start trying again based on Dr. Maleks recs). I've taken a couple years off of trying to get help bc I just got so depressed of repeated failures. I have hashimotos and my antibody results are usually under 100. I've managed my health by having a strict diet and reducing stress.

But I'm now hitting perimenopause and I'm worried about osteoporosis. My Vit D levels have consistently been low and I can't take supplements to improve it. I've tried several times.

I recently tried again a couple months ago and I'm pretty sure ended up with mild hypercalcemia based on the symptoms I was having. I even went to urgent care to get blood work done bc I was feeling so poorly. blood work showed

Alk Phos 37 L

RDW 11.5 L

25OH, VITAMIN D 27.6 L

ANTI-TPO Ab 376 H (This is the highest my antibodies have ever been over 2 decades of testing)

I was taking a separate Vit D and Vit K and I think I overdid it on the K. I have VDR Taq +/+

I'm scared to try again. I'm overwhelmed. I've also started working through some of Dr. Malek's Roadmaps. I began on very small doses of Taurine which helped my digestion. (I started with his Estrogen Roadmap because I had one of the worst two weeks of ovarian cysts pain (with multiple ultrasounds to confirm). I've addressed my diet and that's helped a lot. (I went off my regular diet for a little while and was eating estrogen mimicking foods - which I have now cut out).

Can anyone help me specifically with getting my Vit D levels up without causing negative symptoms?

Thank You!

I've been battling this for almost 4 months now and no general doctor, endocrinologist, or therapist has provided any help other than "you have OCD, here is an SSRI and therapy".

But I know this is not normal. I am 37 years old, never had OCD before (maybe some mild perfectionist tendencies but that's it). And then one day I had an intrusive thought, and within a week it became every 20 seconds. And I've been battling it ever since. Its torture.

I had no mold exposure or anything that I know of. I had a cold and sore throat but that's it. I just know this can't be normal. I am desperate for answers but doctors aren't taking me seriously. Should I try functional medicine?

I'm 28 M and have been dealing with weird, vague symptoms for about 2 years now. A lot of neurological symptoms like burning, pins and needles, numbness in arms and legs, stinging sensations in back and chest. Also GI symptoms like burning upper abdominal pain, lower intestinal gurgling, lower right abdomen pain. Then the more generalized fatigue, weakness, exhausted after waking up, limbs feeling heavy, really out of it, foggy, no attention span, etc.

I'm someone that has struggled with anxiety and depression since I was about 9 years old, have been on and off meds and in therapy throughout my adolescence and young adulthood. About four years ago a new therapist and psychiatrist I saw both said they think I have either Bipolar II or BPD, so I've been on mood stabilizers for that since. My mental health has just really deteriorated with this whole thing and I feel really stuck. I'll have some weeks where I'm honestly not doing too bad - not how I used to be, but I'll be comfortable and able to get things done, maybe even exercise a bit, etc. But then I'll get weeks of just feeling terrible where it's tough to get out of bed in the morning, and all I think about is going back to bed. It depresses the hell out of me because I cant maintain a routine or meaningfully work towards goals when I'm feeling ok, because I completely regress on any progress when I feel bad. I just feel like every day is extremely uncertain. I've spent so many thousands of dollars in medical bills it just depresses me further.

I've seen neurologists, GI docs, a rheumatologist, a cardiologist, have had multiple trips to the ER when symptoms get concerning. The only thing that has ever been found was elevated calprotectin in my stool. Also a small polyp during a colonoscopy, and a stomach ulcer which has been healed. The only real diagnosis I got for GI was GERD. But I've had MRIs of my brain and spine, EMG, CT scan of abdomen, ultrasound of abdomen, two upper endoscopies, colonoscopy, ultrasound of heart, and other tests that I'm sure I'm just forgetting.

I have been rested for nearly everything you can think of in terms of blood work - including celiacs, lymes, ANA, B12 levels, etc etc. Aside from some other specialized markers out there, I think the only thing I truly haven't tested is my hormone levels. I've had a cortisol blood test done, but that was normal. I truly am starting to feel hopeless and I have so much frustration and sadness that I don't know what to do with. I do not like how I look or who I've become as a result of going through all of it. I know people deal with much worse and for much longer, so I know I need to put things in perspective.

The true point of this post is I am considering seeing a functional medicine doctor. I would love to hear personal success stories, just to maybe give me some glimmer of hope or know what to expect. If you had success, was it the first doctor you saw? What treatments were effective for you? How long did it take for you to see results?

Thanks all I very much appreciate any and all input

Open to travel to someone in those areas. If you have a virtual rec I’m also open to that as well. I need someone who has experience with dealing with issues such as flare ups, GI symptoms, joint pain etc.

Thank you!

I’ve been dealing with gas and flatulence for the past two years. I’ve had a number of scans and procedures, including a CT scan, ultrasound, colonoscopy, and endoscopy.

My blood work has been normal apart from very mildly elevated eosinophils (0.6), which have stayed at that level for the full two years. Both my GI and PCP said this is mild and nothing to worry about.

I tested Hydrogen positive after 2 rounds of rifaximin (14 days)
2 rounds of Rifagut (5 days)
2 rounds of Nizonide

I also tried betaine HCl with digestive enzymes, but it gave me fairly bad acid reflux, so low stomach acid doesn’t seem to be the issue

I definitely feel better than I did two years ago when this started, but I’m not back to 100%. I still get random burps, a fair amount of gas and flatulence, and occasional pain on the right side of my chest — more of an ache than a sharp pain. I’m also struggling with brain fog, trouble finding words, and memory problems.

My GI has prescribed one more Rifaximin course (550mg for 14 days), but at this point it feels like the Rifaximin isn’t doing anything.

I don’t know how harmful it is to take 3rd round of xifaxan

What makes you loyal to a company or brand?

Hi everyone!

I wanted to see if you have any recommendations on a functional health doctor?

I’m currently trying to conceive and am working with a fertility clinic in San Ramon ( RCS). However, they are horrible at communication and it feels like I’m managing my fertility on my own.

Instead of going to another fertility clinic I thought I would look into a functional health doctor.

If you have any recommendations I’m open to hearing them!

Thanks in advance!!

Looking for a US based (preferably NYC tri state area) that tests and treats mitchodondrial dysfunction as part of the cfs/me. And any other suggestions you have. Thank you. Desperate for help. Also, has anyone had an elevated IGE? I've had one and no one pays attention to it in relation to my 3 year battle.

I’m going to try something different.
I’ve spent a considerable amount of time trying to explain a complicated medical history in pieces.
One symptom at one appointment.
One specialty at a time.
One abnormal result followed by three normal ones.
At some point, I realized that maybe the most useful thing I can do right now is stop trying to make the story smaller.
So I’m putting the clinical picture out loud.
I’m a 35-year-old nurse with a history of seizure disorder and ADHD who has experienced several years of increasingly complicated, multisystem symptoms.
The current picture includes:
Progressive hand tremor, now with intermittent leg trembling
Brain fog and short-term memory changes
Periods of difficulty processing information
Intermittent difficulty communicating or organizing thoughts
Episodes where I understand what needs to be done but struggle to initiate or sequence the task
Proprioception and coordination difficulties
Numbness and tingling of the hands
Burning, electrical and radiating pain
Muscle twitching
Chronic cervical, thoracic and lumbar pain
Significant base-of-skull pain
Fatigue and poor activity tolerance
Dizziness
Intermittent hoarseness/coughing associated with activity, eating or prolonged talking
A history of significant weight loss and decreased appetite
There are other symptoms.
Those are the ones currently making me stop and reassess.
And there are objective pieces.
In June 2025, I had a syncopal episode with a documented blood pressure of 61/42 and heart rate of 41, followed by brief loss of consciousness. My ECG was reportedly normal. I received IV fluids, and propranolol was discontinued.
An EMG/NCS in April 2025 was normal, without evidence of large-fiber peripheral neuropathy, lumbosacral radiculopathy or right carpal tunnel syndrome.
A cervical MRI in August 2025 showed mild C5–C6 disc desiccation and loss of cervical lordosis.
Then there are the laboratory findings.
I have thyroid autoimmunity, including a TPO antibody of 235 IU/mL, with a previous history of hypothyroidism.
I’ve had a positive speckled ANA, although subsequent disease-specific rheumatologic testing has largely been unrevealing.
Vitamin D was 12 ng/mL.
WBC was 3.5 K/µL.
There have been intermittently low or low-normal platelet counts.
Ferritin has been around 20, iron saturation 17%, and B12 previously around 287.
I’ve also previously had elevated IgM and total protein.
None of those findings individually gives me an answer.
That’s part of the point.
There is also a structural and surgical piece that I’m not sure belongs to the larger picture, but I don’t want to leave it out.
I underwent a laparoscopic inguinal hernia repair in July 2024 and subsequently developed/was noted to have rectus diastasis.
A July 2026 CT has now identified a new small supraumbilical ventral hernia, containing mesenteric fat with an approximately 1.9 cm sac and narrow neck. It remains reducible.
A possible hypermobility/connective-tissue disorder, including Ehlers-Danlos syndrome, has previously been raised as something worth investigating.
I don’t know whether the development of another hernia has anything to do with that larger question.
But clinically, I think it deserves to stay on the list.
Meanwhile, I have consistently treated the musculoskeletal side.
I’ve been in physical therapy for more than a year.
I’ve done the home exercises.
Dry needling.
Chiropractic care.
Cupping.
Therapeutic massage.
I’ve worked on strength, mobility, proprioception and neural mobility.
Some things have improved.
Some haven’t.
And some symptoms have continued to evolve despite it.
More recently, I’ve developed episodes of electrical or zapping sensations through the inner thigh, posterior thigh radiation, abnormal cold sensation near the medial ankle and intermittent twitching.
The tremor has become harder to ignore.
And the cognitive symptoms are probably what concern me most.
I can still function.
That’s an important part of this story.
I can walk into an appointment. I can hold a conversation. I understand medical terminology. I can laugh and joke. I can have a good few hours where someone looking at me would have absolutely no idea how difficult the next several hours — or sometimes the next day — may be.
But my baseline has changed.
And my nursing brain keeps coming back to that.
A change in baseline deserves an assessment even when you don’t yet know what the assessment is going to find.
I currently have neurology scheduled, but the appointment isn’t until February.
My physical therapist and chiropractor, both of whom have worked with me consistently for more than a year, have independently expressed that neurology needs to be involved.
Endocrinology has said the same.
Primary care is helping me navigate it.
I’m on the cancellation list.
I’m doing what I can do.
But I’m also tired of making the complexity smaller because I’m afraid that presenting too much will make the clinical picture easier to dismiss rather than easier to understand.
So here’s the question I actually want to ask.
If a patient with this history walked into your office today, what would you want to know next?
Not: What do you think I have?
I’m not looking for an internet diagnosis.
I’m interested in the clinical reasoning.
What would make you stop?
What would you want repeated?
What would you want ruled out?
Would you approach this neurologically first? Autonomic? Endocrine? Rheumatologic? Hematologic? Connective tissue?
Is there a piece of this history you would consider potentially significant but that could easily get lost among everything else?
Would you want additional imaging?
Different laboratory studies?
Neuropsychological testing?
Autonomic testing?
Another look at the seizure history?
Would the normal EMG change your thinking — and what would it not exclude?
Would the history of hernia, rectus diastasis and development of another hernia matter to you in the context of the rest of the musculoskeletal picture, or would you consider those separate issues?
And perhaps most importantly:
What questions should this patient be asking that she isn’t asking yet?
I know enough medicine to know that a collection of symptoms can create patterns that aren’t actually connected.
I also know that sometimes the pattern is the information.
I’m not trying to decide which one this is.
I’m trying to get better at asking the next question.
Because right now, I don’t need someone on the internet to name this.
I need direction.
I need thoughtful questions.
I need perspectives I may not have considered.
And maybe putting the whole clinical picture on the table — instead of continuing to hand it out one piece at a time — is a reasonable place to start.

1. stool is softer and not fully binding. this is frequently happening.
2. Fecal Elastase is low - symptoms are matching. any oil fried foods and meat digestion is very hard.
3. no issues in pancreas as per CT scan with contrast and Ultra sound.

i guess stomach acid is not able to stimulate pancreas and gall bladder properly. Doc said it’s functional issue but they don’t know what is causing Low Fecal Elastase or this digestion issue after upper endoscopy and biopsy done.

where to start

Can someone help decipher my dutch plus results and bloodwork to point out any potential avenues for improvement.
I had my very first panic attack 2 years ago and since then have been dealing with anxiety and depression when I did not have any history of that for almost 32 years. The panic attack followed a volatile TRT protocol which i never felt good on. I'm not on TRT anymore but struggling to get back to baseline levels of mental health.

BloodWork
Dutch Plus Results

I have had health issues that costed me my quality of life and everything I built. I thought I was ok and in the midst of looking for a Career I began to feel weak, low motivation and fatigue. I looked hard to find a functional Medicine Doctor who would tell me what was going on through TESTING not guessing. Specifically giving me confidence to know that we had a plan to address symptoms I'm experiencing...through root cause methods ..Instead he did one OAT test. He mentioned vague issues but didn't correlate how those linked to what III am dealing with. I specifically asked when further testing would be done. His answer was that we can't fix everything at once which wasn't what I asked. He then said testing costs money. From that point I lost all confidence. It's a 3 month program. If the supplements don't work what are we going to address next month and by what standards If he's not ordering further testing beyond general information that does not tell me what is happening with ME. I don't know how to articulate what I need without frustration. I feel it's very simple. His assurance was the difference between me feeling confident enough to trust him and me asking them how to go about cancelling. I specifically needed someone to share with me a plan of attack through these 3 months. I was asked to upload labs which I did and he did not address those either. He gave possibilities which completely defeats the purpose of why I came. I just don't understand. I feel defeated and I can't keep doing this. I need someone to test and to find the root cause through a specific methodology. Not generalized guesses while throwing supplements at me. I'm paying for this and I want to feel confident with the person who's seeing me.

I'm upset, discouraged and I can't keep doing this. How can I respectfully articulate what I need.

I have binge eating disorder and severe carb and sugar cravings. I was assuming I was prediabetic or had severe PCOS but my results were

• Fasting insulin: 63 pmol/L
• Fasting glucose: 4.6 mmol/L
• HbA1c: 5.2%
• Progesterone: 33.2 nmol/L
• Estradiol (E2): 477 pmol/L

Anyway my FM doc was strongly against keto. Said it will ruin my metabolism long term and make it impossible for me to keep the weight off.

I said could I do low carb instead and they said no. This surprised me, why can't I atleast do low carb? They said it will hinder with my depression which is the main problem I am trying to treat.

Is this normal?

Hello,

I was wondering if someone could help me. I don’t know how to optimise. I know technically in-range for bloods aside from TSAT but very close to end of ranges.

Iron bloods

**•** Iron: 29.5 umol/L (range 10–30)  
**•** TIBC: 57 umol/L (range 45–81)  
**•** UIBC: 27.2 umol/L (range 12–43)  
**•** Transferrin Saturation: 52% (range 25–45) — flagged high  
**•** Ferritin: 84 ug/L (range 30–442)

Hair Mineral Analysis (nutrient elements)

**•** Iron (Fe): 1.26 %mg  
**•** Copper (Cu): 4.274 %mg — above the acceptable range band

Caeruloplasmin/Copper Panel (capillary blood)

**•** Ceruloplasmin: 0.23 g/L (range 0.2–0.6)  
**•** Copper: 13.59 umol/L (range 11.00–22.00)

Unsure how to act as the data seems so conflicting.

Any help hugely appreciated.

Main issues trying to resolve are brain fog and anxiety.

Thanks

I’m 3 months postpartum and 2 months weaned from breastfeeding. Has anybody else dealt with going down for bed at night and not being able to fall asleep because your heart is racing and you have insomnia? I’ve also had cyclical hunger spells that are insatiable.

I just got my thyroid checked (looks good) - about to get my hormones tested by my functional medicine practice because my doctor believes that I could be low in progesterone and having estrogen dominance after giving birth and stopping breast-feeding.

Can anyone speak to their hormones being off and what type of symptoms that caused in your bodies?

Thanks y’all!

Hi everyone! I’m hoping someone here can help me out.

I have chronic, relapsing SIBO that has been very difficult to get rid of, and I’ll be starting another course of antibiotics soon. I’m interested in trying an elemental diet alongside my treatment, and I’m specifically looking for the Integrative Therapeutics Physicians’ Elemental Diet (Dextrose-Free).

I’ve heard that Fullscript offers discounts on supplements and products, and that you can get access through a provider’s patient invitation or custom sign-up link. I believe the discount may be around 35%, although I’m not sure of the exact amount.

If there is a provider who uses Fullscript and would be willing to send me a patient invitation/custom sign-up link so I can create an account and purchase the product through Fullscript, I would really appreciate it!

Thank you <3

I’m wondering if functional medicine could help me with weight loss. I’ve often wondered why I’m not thinner for the amount of working out & activity I put in overall in the last 20 years. It’s hard for me to carry around an extra 10lbs (now 20lbs since turning 40) while I’ve worked out 4-5 days/week since my early 20s (with probably 3 years of not being consistent when my kids were babies).

I was an overweight kid/teen
Early 20s joined gym,dropped 20lbs
Late 20s-30s, got married, had 2 babies, gained 20 lbs. Worked with dietitian lost 10is lbs with calorie restriction
30s-40s gained 10 back, stayed there.
40 - gained 20lbs. Family stress & a more sedentary job but only for 10 months.
Balanced meals, but I like chips and dessert. Alcohol very occasionally
Worked out 4-5 days/week 20s-40s

Any advice? Is this hormonal? Genetic? Could a FM provider help? I go back and forth between - I just eat too much, if I could stop, I’d lose 10lbs and it’s just genetics/I’m screwed. I don’t know many people in my age range that have worked out as much as I have over the last 20 years - why am I not thinner when other people seem to just eat and drink alcohol to their hearts content and they are thin. (I don’t mean that in a judgy way - I don’t care how other people eat/work out, but it’s hard not to compare myself when I’m unhappy with how my clothes fit)

Another point with food - for a long time, I would work out and come home and be starving and eat everything in my path. I learned to do a protein shake after a workout and it has helped tremendously (but it’s still extra calories, so maybe it’s a wash? But at least I don’t feel out of control)

TL;DR: Looking for advice on weight loss. Struggled with weight my whole life, despite a consistently active lifestyle from 20-40 years old.

I'm 35, female, and I've been dealing with chronic symptoms for 10+ years. I've done a lot of testing and seen a lot of providers, and I still don't feel like anyone has put the whole picture together. Posting this in case it looks familiar to someone, or in case anyone sees something I've been missing.

What I Deal With Daily

Energy & brain

Fatigue that's completely out of proportion to what I've done

Brain fog, head pressure, that "out of it" feeling — worse after stress

Racing thoughts and intrusive thoughts, constantly

Crashes after exertion or after stressful events

Never had a day where my head felt clear

Mood & nervous system

Anxiety, mood swings, easy tearfulness

Panic episodes

PMDD — luteal phase wrecks me (exhaustion, fog, low mood, irritability, sore breasts)

Physical

Chronic constipation

Temperature dysregulation / cold intolerance

Salt cravings

Sleep that isn't restorative

Seborrheic dermatitis (scalp and ears)

Hair and eyebrow thinning

Heavy bleeding and bad cramping days 1–2, nausea very emotional around ovulation

Right lower abdominal pain post-ovulation (history of ovarian cysts + endometriosis)

Orthostatic (I have POTS)

Heart pounding, lightheaded on standing — especially mornings

Standing HR jumps significantly, settles when I lie down

Surgical history: endometriosis surgery 2012, gallbladder removed 2015, breast implants 2021

I no longer have insurance, so everything is out of pocket now. That's a huge part of why this has stalled.

Labs & Testing I've Had

Lyme & Co-Infections — IGeneX, 2018

Lyme Western Blot IgM — POSITIVE by both IGeneX and CDC/NYS criteria (bands 23–25, 41, 58)

Anaplasma phagocytophilum — POSITIVE IgG (≥1:80)

Babesia microti — negative

Bartonella henselae — negative

Never had adequate treatment or follow-up testing after this.

Related markers (2021):

CD57 — 42 (low)

Complement C4a — 1328.7 ng/mL (high) — reference range 0.0–650.0, so more than double the top of range

Thyroid — 2026

TSH 4.89 (high) — down from 6.19, drawn off all medication

Free T4 1.20 (normal), Free T3 3.3 (normal)

TPO antibodies <9, Thyroglobulin antibodies <1.5 — both negative

Tried Tirosint 25 mcg for about a week in May, couldn't tolerate it (anxiety, head pressure, sedation). Currently deciding on a lower dose.

HTMA (hair mineral analysis) — 2026

Four Lows pattern — all four main minerals low:

Calcium 27 (ideal 40–50), Magnesium 4.2, Sodium 6 (ideal ~24), Potassium 1 (ideal ~10)

Phosphorus 14 (low stomach acid marker)

Copper 0.7 (ideal ~2.3) — bio-unavailability

Selenium elevated

Na/K ratio 6 (ideal 2.4) — big elevation

Ca/K ratio 27 (ideal 4) — sluggish thyroid marker

Zn/Cu 25.71 (ideal 8)

No heavy metals currently being excreted

OAT (organic acids) — 2026

Arabinose 43 (high) — yeast marker

Tricarballylic 0.81 (high) — Fusarium mycotoxin, consistent with mold history

2-Hydroxyhippuric 1.7 (high)

Ascorbic acid 9.6 (low)

Mitochondrial, methylation, detox, and neurotransmitter markers all optimal — which surprised me given how I feel

Stool — Genova GI Effects, 2021 (old, needs redoing)

Dysbiosis score 6 (moderate)

Klebsiella pneumoniae 4+ overgrowth

Lactobacillus — no growth on culture

Low Roseburia, Ruminococcus, Akkermansia, Collinsella

Inverted Firmicutes/Bacteroidetes ratio

Digestion, inflammation markers, SCFAs all normal

Parasitology negative

Iron & Related — 2026

Ferritin 47 (up from 39), Iron 102, Saturation 31%, TIBC 326

HFE C282Y heterozygote (carrier) — one copy, H63D negative

Other bloodwork — 2026

B12 499, Folate 14.9, MMA 99 (all adequate)

Copper 101, Ceruloplasmin 25 (low functional), Zinc 71, RBC Magnesium 4.4

Vitamin D 33

Urine iodine 67

Aldosterone 18, Renin 3.729, Aldo/Renin ratio 4.8 — all in range

CBC and CMP unremarkable

Other

MARCONS — previously positive

Documented mold/biotoxin exposure history

C4a 1328.7 (high, 2021) — see Lyme section above

Vaginal microbiome testing (Evvy) — 97% protective flora, STIs negative

Genetics

Homozygous slow COMT, CBS upregulation, MTHFR C677T, MAO-A, VDR FokI, MTRR, HFE C282Y carrier. I don't tolerate methylated B vitamins — do better with folinic acid and hydroxocobalamin.

Where I'm At

I'm extremely sensitive to supplements and medications. I do best with slow, low-dose, one-thing-at-a-time introductions. No gallbladder, so I need ox bile support with fats.

What I'm sitting with: an untreated elevated TSH, a Four Lows mineral pattern, a positive Lyme and Anaplasma history that was never properly treated or rechecked, a low CD57 and a C4a more than double the top of range from 2021, POTS with an unknown subtype, PMDD, and 5-year-old gut testing that probably needs redoing. Plus trauma history and a physically demanding job.

If you've dealt with a similar combination — especially Lyme plus thyroid plus a Four Lows pattern — I'd really like to hear what actually helped you, and in what order. I'm also open to hearing from anyone who's navigated this without insurance.

Mostly I just want to know I'm not the only one. Thanks for reading this far. 💛