Update from visit with Dr. Gersten in San Diego

Discussion in 'Fibromyalgia Main Forum' started by annade, Jun 29, 2008.

  1. annade

    annade New Member

    I had my follow-up visit last week with Dr. Gersten (CFIDS doc in Encinitas, CA) to go over my very lengthy lab workup. Last time I reported my initial visit with Dr. G and the labs he requested (Stool sample, hair analysis, urine, blood, saliva). He was looking at my viral load, candida,GI tract, amino acid profile, fatty acid chemistry, heavy metal profile, metabolic profile, brian chemsistry and adrenal stress.

    The following are the results of these tests:

    (1) Very high levels of candida (yeast overgrowth).

    (2) Active EBV (Epstein Barr Virus)

    (3) Previous HHV-6 activity, unclear about current activity due to how test was performed. Will have to check back in 6 months.

    (4) Mild colitis and dysbiosis (overgrowth of bacteria in colon)

    (5) Food Intolerances: soy, egg, gluten and possibly cow's milk,

    (6) Leaky Gut Syndrome (amino acid testing) along with protein deficiency and low levels of tyrosine and norepinephrine. SAMe is also low,

    (7) Fatty Acid Profile showed good levels of Omega 3's with deficiency in Omega 6's (apparently they need to be in balance for sex hormones to come back into balance),

    (8) Blood test for heavy metals showed no heavy metals in red blood cells (yeah!), however, in hair analysis it showed borderline levels of lead and high levels of Uranium. Apparently high levels of Uranium can cause fatigue. May nhave to do chelation in 6 months if the proposed treatment regime does not fix it,

    (9)Metabolic urine test showed deficeincy in folic acid,

    (10) Brain chemistry revealed good levels of serotonin and dopamine, but low levels in tryptophan and norepinephrine,

    (11) Adrenal Stress Test showed normal cortisol in morning, low normal at noon, deficient in midafternoon and low normal at night (which is probably why I feel the worst around 4-5pm). DHEA is also low.

    (12) Sex Hormones: progesterone is low normal and testosterone is normal. Melatonin is a little low.

    So those are the results of the labs. He explained everything very carefully and even tape recorded it for me in case I forget (which of course I will).

    He recommended several supplements (23 in all) and one prescription med. (Niroral) for the candida and well as putting me on a strict candida diet for three months, then we will re-test. I will also have a liver panel done every month to make sure my liver in handling the Nizoral.

    The supplements he has recommended are as follows, ranked according to importance:

    (1) Vitaminz Plus(company that makes it is Montiff)
    (2) TriPhos B (Montiff)
    (3) B-Complete (Montiff)
    (4) All Basic (Montiff)
    (5) Whey Protein Shake Jay Robb(health food store)
    (6) NeuroBalence(Montiff)
    (7) Pure L-Glutamine (Montiff)
    (8) Ultra Flora Plus DF (Metagenics)
    (9) Metazyme (Metagenics)
    (10) Molybdenum (internet - vitaminshoppe.com)
    (11) Pure Tryptphan (Montiff)
    (12) Intrinsi B12/Folate
    (13) Hempseed Oil (health food store)
    (14) UltraInflamX (Metagenics)
    (15) GLA Forte (Metagenics)
    (16) Transfer Factor 100 (prohealth store)
    (17) Immunocil (forgot the name of the company, but will look it up if anyone is interested)
    (18) Mag Glycinate (Metagenics)
    (19) Super C Plus (health food store or Montiff)
    (20) Super AntiOxidant (Montiff)
    (21) Mineral Complex (Montiff)
    (22)SAMe (health food store)
    (23) Pure Lysine (Montiff)

    Yes, this is a lot but I am committed to try it for six months which is how long Dr. Gersten thinks it will take before I notice a significant improvement. If you are wondering about the cost, well, the supplements are about $500 (some will last a month, some three months). Yes, very expensive, but apparently I won't have to take all of this forever (not sure how long).

    Dr. G also requested that I keep a daily journal of how I feel and any questions that I have so that when I see him in a month he has some data points. I will start all of this when I get my supplements, probably in a week or so.

    Hope this info. was helpful. I will periodically give updates.

  2. brainfoggy

    brainfoggy New Member

    Sounds like a GREAT cocktail of supplements! I will check them out. I have never heard of Nizoral for yeast. Did he say this was more effective for candida than diflucan or nystatin? I'm eager to have this new LLMD (I quit Holtorf... yippee!!!) recommend some Metagenics products. He seems to suspect lyme based on the co-infections I have. Transfer facter has really helped, also Virastop and Candidase together I've been using with good improvements. This is what you really need! I just started taking doxycycline and zithromax for co-infections and am feeling better every day so don't know if you've tested for those already but may be worth checking.

    Good luck!

  3. annade

    annade New Member


    Nizoral is very similar to Diflucan, but since I have been on Diflucan in the past (with Holtorf) he decided to switch the med. He also says he pesonally prefers this one, but really they are very similar.

    I am looking forward to starting with the supplements and changing my diet (Candida Diet) so I can hopefully start feeling better. Not sure how to start the supplements, if I should do it gradually or all at once. I left my doc an email, because I don't really know how to get started. Probably should have asked at the end of our 2 hour appointment, but I was so overwhelmed with all the info. that I forgot. He let's me email him though, so that is helpful. Thanks for the info.

  4. brainfoggy

    brainfoggy New Member

    All at once meaning just split them up like 3 x day. Some like transfer factor and probiotic and the enzymes need to be taken on an empty stomach. I've found that in the beginning I'm more sensitive to stuff but your body will adjust. Yeah, hopefully he will give you some instruction. I think you mentioned the same Heparin nose bleed problem I started to experience too...it's kinda an emergency and if you aren't paying these docs they are MIA. Hopefully, he will give you a schedule to be on.
  5. annade

    annade New Member

    I was reading your profile and boy it seems like we have a lot in common. In fact, when I looked at your picture, I could have sworn that I saw you once at the Holtorf Clinic last year (maybe April/May). Anyway, small world.

    By the way, I did get an email back from my doc who said he usually does have his patients start it all at once but because I have such a senstitive system, he is starting my on three things together and then we will work up from there.

  6. marti_zavala

    marti_zavala Member

    Thanks for a great post. This is very helpful. Thanks for taking the time to type it out. It will be helpful for you in case you forget.

    I would think #18-#21 to be the more important. I disagree with the Glutamine. But sounds like a great list.

    I would start one thing at a time. At least a week in between. You could lose months trying to figure out what is causing you to detox too fast. Then you would have to stop everything and start over.

    It would take you longer than 6 months but save you time in the long run.

    Just my opinion.

  7. annade

    annade New Member

    No, unfortunately my insurance, and probably most, don't cover the tests. I spent about $1000.00 in total, but I am glad I was able to afford it because it gave us a direction to follow. I have spent six years with various doctors who really didn't know what was going on and just prescribed meds based on symptoms, so I am thankful to have a direction.

    Thanks for the advice about slowly starting the supplements. My doctor did email me back and told me to only start three and see how I did for a week before adding anything else.

    I will keep you posted on how I am doing.
  8. brainfoggy

    brainfoggy New Member

    Hey Deanna

    Starting slow and low is probably a safe bet, when I started the intrinsi b12/floapro I had a huge detox reaction which went way too fast but I tend to overdo it...aggresive treatments are not always safe. I think it was more from the folapro though.

    The only time I was ever at Holtorf was last Oct the rest have been phone consults, but I've often been told I look like someone familiar! I sent the co-ag clear and heparin back as this new doc says both are not effective. He said protease not lumbrokinase or heparin is what you need for hypercoagulation. Maybe one of these supps has this in it.

    Also read an article in the Vitamin Shoppe newsletter called The Best Time For Supplements. He says take all vitamins, minerals, antioxidants, EFA's with meals as digestion is most active and will maximize absorption. There is also more stomach acid during and after which will enhance performance, especially calcium and minerals. He suggests the minerals be taken with later meals, lunch and dinner. I do this too because of my thyroid med. Probiotics and herbals on an empty stomach, or inbetween meals. He says bedtime and first thing in the morning are best times for probiotics.

    Hope this helps.

  9. annade

    annade New Member

    Dr. Gersten is a board certified MD in both psychiatry and neurology. He specializes in Nutritional Medicine and Integrative Psychiatry.

    His contact info:

    1020 Second St., Suite C
    Encinitas, CA 92024
    fax: 760-633-3393

    Hope this is helpful.
  10. annade

    annade New Member

    Cannot believe I am posting already, it's only my first day of starting the first 4 (of 23) supplements, but I feel sick to my stomach, have mild intestinal cramps and on/off diarrhea all day (only 4pm). Maybe it's just my body cleaning out.

    The four things I started with today are All-Basic (has 22 different amino acids), B-Complete(has several B vitamins plus taurine, Para Amino Benzoic Acid, Inositol, Alpha Lipoic Acid, Pine Bark Extract, Grape Seed Extract, Lycopene), Neuro-Balance (P5P, L-Tyrosine, N-Acetyl-L-Tyrosine) and Tri-Phos-B (B6, Thaimine and Riboflavin). Granted, most of these products have high levels of the vitamin(above 100% of daily value).

    Hope that it doesn't get much worse, but I do know there is a detox effect, just didn't realize it would happen within a few hours of taking my first supplement.
  11. annade

    annade New Member

  12. brainfoggy

    brainfoggy New Member

    When I started taking whey I felt really bad. You have to get worse before you get better. When you feel signs of detox your body is ridding itself of toxins, this is good. The whey helps raise glutathione levels and I think helps keep the toxins from recirculating. Your body will eventually adjust. Since you are doing the eliminiation diet and killing off candida you will definitely feel die off from this but it wil go away, along with the bloating, gas, diarrhea. Are you on the nizorol yet?

    I take activated charcoal and bentonite clay to mop up toxins in the gut and ease stomach pain. It helps. Start taking loads of probiotics to compensate!
  13. annade

    annade New Member

    Thanks so much for your response. I am now day 3 into the supplements and feel tons better, no more of the symptoms I reported on the first day. I also reduced the amount of amino acids I am taking and that seem to have helped.

    I have not yet started the Nizoral yet and want to emil my doc before I start it. I have done some research on Nizoral and while rare, it can cause a fatal liver disease. I know all drugs have side effects and that I probably wouldn't get liver disease (liver panel a few months ago looked good), but it scares me to think a drug used to treat candida could cause such damage. I am going to ask him again if he I should take Diflucan instead. I know he prefers this drug and feels it works better, but not sure I want to take the risk.

    I have not started on the probiotics but planned on adding that tomorrow. Only adding one thing at a time now and waiting a few days before introducing new stuff as I obviously have a very sensitive system.

    Thanks again for your response.
  14. annade

    annade New Member

  15. marti_zavala

    marti_zavala Member

    Since you have a sensitive system (most of us do), then may I suggest that you have the supplements on hand to stop or slow down detox.

    Charcoal capsules, pectin, fibers - all of these are used to soak up all the toxins that were released.

    GABA, l-theanine, valerian root - all of these calm down the nervous system which sometimes gets activated during detox.

    Also there are various mechanical ways to help recover from detox - caffeine cleanses, dry skin scrubbing, epsom salt baths.

    When you have time or energy, you could start to do searches and learn how to stop the detox.