Expert: Eric Brandt - 10/14/2006

Question
Dear Eric ,thanks for your response.Further ultrasound(since my first email) revealed that size of nodule has not changed,but picked up another two small nodules on right lobe(6mm&3mm).Doc believes multinodular thyroid with normal blood TSH AND Free T4 does not warrant any further testing.What are your thoughts?
I'll look into the calms forte and see if its available in Australia.Do you wean off the xanax first or do you take it in conjunction with the wean off? Thanks John.
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Followup To

Question -
Dear Eric, I have just received back my results from an intestinal permeability test and are as follows:-
lactulose recovery    0.56*H %   <0.30  REF RANGE
mannitol recovery     19.3%     9.5-25.0    "
lactulose-mannitol ratio 0.029    <0.035    "
6 hour collection        0.400 litres

How would you interpret these results -  LGS ?


A recent IgG 93 FOOD SENSITIVITY PANEL showed 17  mild to very stong positive results to different foods some of which I  had been eating eg wheat,rye,almonds,walnuts to name a few.

A recent gastroscopy discovered gastritis and duodentis but all the mainstream gastro wants to do is prescibe  losec whereas I  think I probably have low acid(how could I test for low or high)) and that food sensitivities and allergies are probably causing inflamation not the high acid that he thinks.
What are your thoughts and how would you takle this?

Also recent ultrasound of neck has picked up 1.3 cm nodule which I am to have a nuclear medice thyroid test --is this the usual next step of evaluation?

Also recent runs of ectopics (PAC'S &PVC'S holter showed 1500 in 24 hour period)) have increased my anxiety levels yet echo and thallium cardio stress test come back fairly normal.I think a "chicken or egg" first problem-delayed food intolerance create gastric disturbance and/or pac's,pvc's create anxiety create further pac's,pvc's more anxiety adrenaline release all creating vicious circle?

I'm sick of being told it is all in the mind(been prescibed xanax for the anxiety) even though I have  many health issues which I believe probably have a root cause(I'm thinking mainly gut related).I take .5gm xanax 3 times a day but worried about dependence,but doc told me this is extremely low dose and will be easily weaned off.Any thoughts here?

Would dearly appreciate your thoughts( not medical advice) and what you might ,possibly do if you were in a similar situation

Yours thankfully JohnMartin Melbourne Australia


Answer -
Hi John,
I do not have the expertise to interpret your gut permeability results.
I would suggest to go along with the gastro's recommendation. It is the simplest way to assess if you have too much acid. If the drugs works then the doctor was right. It is the simpplest test.
The other alternative is to get some stomach juice through an invasive procedure and test the gastric content.
THe nuclear test is usual for testing the nodules. How is your thyroid function? I am assuming that you had a TSH test with your routine blood work and it was not within normal range. The nodules and an abnormal TSH would lead to requiring the nuclear test.
Xanax is not east to wean off of. With your doctor's guidance you can try to slowly reduce the dose.
There is an alternative product available at healthfood stores which can help with anxiety. It is called Calms Forte and is worth trying. I have had people with anxiety who were able to calm down  and get normal sleep with this product.
Thank you for using Allexperts
Sincerely,
Eric Brandt, B.Sc. Pharm  

Answer
Hi John,
Souns as though the nodules are benign and of little consequence at this time. They might warrant watching over time.
Wean off the Xanax first. You may need to use the`calms forte for breakthrough anxiety.
Thank you for using Allexperts
Sincerely,
Eric Brandt, B.Sc. Pharm