Question about lactic acid
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Hello Dr. Woeller,
A few questions about a 17 year old male, m/c seizures.
Diet- eats only several foods; not on a managed diet. Focus- is to improve the number of foods he consumes.
Questions about OAT values
1. lactic acid is 1575 and creatinine is 375. The OAT summary suggests that a value over 1000 and creatinine over 300 may indicate an inborn error of metabolism. I’m certain the parent will ask about this. I would appreciate your experience.
2. Moderate yeast, elevated oxalates, high normal orotic. Clostridia low normal markers. Should I address the orotic with alpha-ketoglutaric?
3. Elevated quinolinic, very low 5-HIAA: tryptophan is being shunted. I will support seretonin 5-htp, barring no SSRIs involved and support oxidative stress.
4. Normal dopamine levels, high VMA (fight/flight). Is this possibly a COMT issue? First protocol: address MV/MM and basic nutrients (Vitamin C up to 500) for co-factor support.
5. Deficient glutathione, potentially low Vitamin D. Should I wait on supporting glutathione until after the diet and the infections are removed and the health of the gut is improved? (I’m reluctant to promote detoxification until much later in the protocols but want to be sure this is correct).My first phase:
1. Add in MV/MM, nutrients Cod liver oil, digestive enzymes and liver support (would you use alpha lipoic acid to support the liver as well as mitochondria?).
2. Cal/Mg supplement prior to every meal.
3. Address yeast slowly with moderate botanical protocol.
5. Support the excretion of ammonia?
6. Watch how the child responds.I hope you can weed through the questions and understand my train of thought. I appreciate your expertise.
Lynn
Lynn,
Here is my reply:1 – Not a lot of experience with this. I would approach it as a ‘Maybe’ and implement your other interventions, then retest.
2 – yes, worthwhile to do
3 – High quinolinic – I use Niacinamide 1000mg daily and add in some antioxidants as well, i.e. Resveratrol 1000mg daily, glutathione.
4 – Could be. You would have to test for it.
5 – No, I wouldn’t wait. Low glutathione should be supported as leaving it low just increases the potential for cellular damage throughout the body.I would retest the OAT in 90 days.
Dr. Woeller
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