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Leaky gut may be a term that you've heard before. If you have an autoimmune disorder or something inflammatory or chronic illness and you've gone searching for root causes or what may have led to it, there's a good chance that leaky gut would've come up on the list. So I want to take a minute and explain what leaky gut is, what the term means, how it relates to problems like autoimmune issues, and then kind of the framework for what we do about it. Every case is a little bit different, so I can't just say specifically what to take and what to do, but I can at least lay out the framework for you so you understand what it takes to get that repaired. Alright, so let's jump right. In your digestive tract, you have cells that line that digestive tract, right? And on one side of the cell you've got what's in your digestive tract, which is either food coming out of your stomach, all the way to poop, moving through your large intestines, and then on the oth...

All right, let's discuss homocysteine. It's a test we do on all of our annual physical panels. I think it's a pretty important test. Everybody ought to have it done at least once a year. If you've got issues with it more often than that. To keep an eye on it, I'm going to go through and explain why we test it, what it is, why it matters, what the normal range is, and what we do about it when it's out of range. So you're going to kind of get an all encompassing little primer on homocysteine right here. Whether you've gotten it from one of your other doctors or whether you have a test from me and you don't remember our discussion about it when we went over it, this will be a good way for you to either revisit that or look at what you've gotten from your other doctor and interpret it on your own.

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Alright, so what is homocysteine? First of all, H-O-M-O-C-Y-S-T-E-I-N-E homocysteine. It is what we call an intermediate product in a pathway that pro...

I had a patient come in a couple of weeks ago with an interesting situation on his blood work that I wanted to share. And this is all surrounding blood sugar, type two diabetes, A1C, that kind of stuff.

So he had had blood done at his previous doctor's office and came in for some general wellness work. And in going through reviewing his labs I noticed that there were some tests that I normally like to see that were not included in his labs. And he was told by his previous doctor that he was pre-diabetic and they had put him on metformin. So in looking through his labs and getting the new ones to fill in the blanks he had already shown up with a fasting blood sugar of about 106 and his hemoglobin A1C was sitting at 6.0. That's why he was told he was pre-diabetic.

So in doing our labs I looked at a few other things. His triglycerides were 165, which indicates that there's probably some problem with blood sugar and we already knew that, but we looked at his fasting insuli...

So a question I get regularly from patients is, can they get their family practice doctor, or gynecologist, or endocrinologist, whomever, to run our lab panels instead of us running them? Which I don't mind. I tell the patients regularly, I don't care who orders it. As long as it's got the components that I need, it'll work for us. So that comes up regularly.

Well, there are several reasons why we've had very little success getting other doctors to run our lab panels. So I just want to run through this real quickly. It's, again, something I answer pretty regularly during an average week at the office.

So number one, understand that I do functional medicine, and the lab panels that we've put together are specifically geared toward finding underlying mechanisms. Looking for problems before they are so far down the road that they're diagnosable. Looking for indications that there's dysfunction even if there's not disease at this point.

That's, to a large de...