The Great Plains Laboratory has been educating practitioners for over 15 years on how to help patients heal through cutting-edge testing, research and protocols. In our recent 3-Day Master Practitioner Workshop, speakers shared detailed information on how the MycoTOX Profile, IgG Food MAP and Glyphosate Test can work for you. As well as gave additional information about markers in the OAT and GPL-TOX.
The following Q+A is a response to remaining questions Dr. Woeller was unable to answer during his presentations.
The material contained within this article is not intended to replace the services and/or medical advice of a licensed healthcare practitioner, nor is it meant to encourage diagnosis and treatment of disease. It is for educational purposes only. Any application of suggestions set forth in the following portions of this article is at the reader’s discretion and sole risk. Implementation or experimentation with any supplements, herbs, dietary changes, medications, and/or lifestyle changes, etc., is done so at your sole risk and responsibility.
Kurt N. Woeller, D.O. has been an integrative and functional medicine physician and a biomedical autism specialist for over two decades. He is an author, lecturer and clinical practitioner offering specialized diagnostic testing and health interventions for individuals with complex medical conditions such as autism, autoimmune conditions, gastrointestinal and neurological disorders.
Q: How does viral genome interfere with this intracellular mechanisms – EBV for example?
A: Viral infections would likely trigger oxidative stress in the cell leading to mitochondrial damage. One of the reasons for high quinolinic acid is interferon production secondary to viral infection.
Q: What’s the difference between blood spot and blood serum vitamin d test?
A: Best to ask Great Plains directly From my understanding there is no difference when looking at 25(OH)D.
Q: Which stool test do you recommend?
A: The CDSA that Great Plains Laboratory has is very good. I also do the Doctors Data GI 360 Profile too.
Q: What markers could correlate with ALS and what other tests would be recommended?
A: No specific pattern for ALS. In anyone with a chronic degenerative condition like ALS I would personally be running the OAT, GPL-TOX, Glyphosate, MycoTOX and Hair Metals Test.
Q: If a patient comes to you with medications, antibiotics, etc. And you recommend doing the OATs. Do you suspend the medications to take the sample?
A: No. I do not have them stop their medications.
Q: Do you use botanicals for yeast overgrow instead of nystatin for some individuals who cannot tolerate Nystatin?
A: Yes, all the time.
Q: This is off the yeast/mold topic but now that Dr. Shoemaker believes that most of CIRS is due to Actinomycetes, is there a test you use that is specific to this bacteria?
A: Not that I know of.
Q: Do you compound this, or do you feel that pharmaceutically available is fine?
A: Usually, the regular pharmacy is okay, but I will compound for sensitive patients.
Q: What is wrong with higher doses, e.g. 100,000 BID?
A: Only the potential for die-off.
Q: Will these also bind helpful nutrients?
A: Yes. They can and should be taken away from supplements and medications by at least a few hours.
Q: To clarify will the zeolite etc.. also bind nutrients, how to avoid this?
A: Likely, it will. Separate by at least a few hours from other medications and supplements.
Q: Is isocitrate lyase a Candida enzyme that disrupts the Krebs Cycle?
A: It’s a enzyme within its own kreb cycle that produces oxalate. So, if you have candida in the gut it has the ability to produce oxalate in the digestive system.
Q: Can you give core biotics to young children? Age 2
A: I have, but conservatively like one capsule.
Q: I’m sure you have heard speculation that there may be correlation between glyphosate use in agriculture in our country starting in the 1950’s (I believe) and increasing since that time. I understand that glyphosate is very inflammatory and is a microbiome disruptor.
A: It is a major toxin to the gut microbiome from my research.
Q: Can saccharomyces boulardi impact the arabinose marker?
A: It won’t cause the Arabinose or produce it. But, instead go after Candida that produces it.
Q: Do you test the glyphosate level in your patients with a lot of abnormalities on the OAT?
A: I combine that with the GPL-TOX Profile. I am always concerned about Glyphosate with recurrent clostridia.
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Q: What’s the significance of 5 hydroxybenzoic?
A: Could come from Paraben exposure.
Q: What was the name of the site for practitioners ?
A: Functional Medicine Clinical Rounds – https://functionalmedicineclinicalrounds.com.
Q: Can you speak about SIFO in relation to OATS test?
A: Could cause a lot of markers seen on page #1. But, in my experience the OAT only suggests SIBO/SIFO and is not absolutely diagnostic for it.
Q: I have used Geova neutraval for several years. Can you please comment on why OAT is “better” test?
A: The GPL OAT has the HPHPA and 4-cresol which are really important to obtain because of their significant toxicity. Also, it has the oxalate information which is also important to obtain.
Q: Can supporting these deficiencies (B-6 etc) cause dumping of oxalates into tissues, how to avoid?
A: It is not going to drive dumping, but instead help to divert substrate away from being converted into oxalic acid.
Q: Are there specific metals that may have a higher affinity to oxalates than others? Nickel for example?
A: I do not know of all metal specificities, but Lead and Mercury are certainly high.
Q: Can collagen 20 gram increase oxalates? What about High dose vitamin c at 25 GMs? All of this is possible.
A: The prevalence with regards to this happening I do not know specifically.
Q: So is this SNPs testing to know? Or is this on the OATS Test?
A: The OAT does not have the SNPS. The genetics for oxalates would have to tested through genetic testing.
Q: Any headaches associated with oxalate?
A: Yes. They could be.
Q: Does someone need to stay on a lifelong low oxalate diet or temporarily?
A: It depends on what is causing the oxalates to be high. If it is primarily genetic based then a low oxalate diet is going to be necessary. If the oxalates are from poor nutrients, e.g. B1, B6 and/or mold or yeast produced, then the diet is likely just temporary.
Q: Can you explain your take on fat malabsorption and oxalates? I believe it is important to aid fat digestion when dealing with high oxalates.
A: Fat maldigestion will cause increase oxalate absorption.
Q: What if a patient has high arabinose and oxalic acid, but is unable to tolerate B6 and B1 supplementation?
A: Then you have to work on reducing high oxalate foods in their diet and treat the yeast as best as possible. Hopefully, in time they become more tolerant of these B-vitamins.
Q: When you do the Epsom salts baths how long do you sit in it to be effective?
A: Could be done nightly or at least 3 to 4 times per week. 15 to 20 minutes is a bath is often sufficient.
Q: What kind of diet is suggested before taking OATS test? How many days previous?
A: There are no specific diets needed prior to testing.
Q: Also, I believe there is a Epsom salt cream. Is that effective?
A: It can be, but I think the baths work better.
Q: Do you recommend avoiding high oxalate foods in the days before collecting the oat?
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Q: Do you know how phosphatidylcholine compares to CDP-choline? Is there a reason you prefer one over the other for PLA2 inhibition? Any thoughts on Choline Bitartrate?
A: The CDP-Choline combination is what lowers PLA2. Just choline with bitrate will not do it.
Q: If you have nigh arabinose, would you avoid taking extra Vitamin C?
Q: What does HVA/VMA ratio means?
A: it is related to the ratio between HVA (dopamine) and VMA (norepinephrine). If the ratio is high than not enough dopamine is getting converted to norepinephrine.
Q: And HVA/DOPAC indicate?
A: Ratio between HVA and DOPAC.
Q: What do it mean when all markers of Beta-Oxidation are high?
A: Problem in fatty acid metabolism with the cell.
Q: Where is lithium listed on OATS, under which heading?
A: It is not in the OAT. It is measured in a Hair Analysis.
Q: What if you’ve been taking NAC (600 mg 2 times a day) and it is not showing up on the OAT test. Why would that be? Will taking glutathione be the next step?
A: That it likely is getting converted over to Cysteine. If the glutathione is still deficient than giving glutathione directly is the next best option.
Q: Oxo-4-methiolbutyric what would cause this to be high?
A: That is a rare genetic disorder linked to Maple Syrup Kidney Disease. Low levels could occur from consuming beets, blueberries and cashews.
Q: Any thoughts come to mind with consistent eye pupil dilation in a 23-year old with AU?
A: I would first start looking at heavy metal toxicity.
Q: Is serotonin syndrome clinically significant in patient on SSRI who wants and try L-tryptophan or 5-http?
A: I personally have never seen serotonin syndrome. It is always possible if too much tryptophan or 5-HTP were taken, but not common in my experience. There may be other doctors who have more experience with this.
Q: Can you say how long you need to treat candida with botanicals, Treatment duration?
A: At least two months. It may require longer.
Q: Do you find twice daily dosing work with Biocidin?
A: Not as great compared to three times daily, but for a low level infection that is not overly bothersome for someone twice a day can work. I have some people where twice daily did the trick.
Q: Do you have to get rid of mold in the environment before you do the antimicrobial treatment for clostridia?
A: No. It is always best to work on the mold, but I have people where I am treating them while they are doing remediation.
Q: What are you favorite soil-based probiotics brands?
A: I use a lot of CoreBiotic from Researched Nutritionals and Proflora 4R from BioBotanical Research.
Q: NADB since the west coast fires have been burning so much? Or is it elevated from rubber mostly? What happened to the RA when clostridia treated?
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Q: What was the dose of Biocidin you used in the RA patient for 3 months?
A: From what I recall it was two capsules three times daily.
Q: Why test when additional testing with expected positive results will not change your treatment? Or how would you change the treatment if mycotoxins, chemicals were elevated.
A: Because if the person has high Mycotoxins they are going to need to figure out where the mold is coming from. Also, I have seen patients where all the mold markers are normal on the OAT, but they have very high levels of mycotoxins.
Q: What else to look at when #56 NAC is elevated, and Indicators of Detoxification are in the normal range?
A: It could be a deficiency of the enzyme that deacetylates the NAC. I do not know of a specific test for this though.
Q: How do you dose GI Detox, when and how many?
A: For adults I have them start at one capsule twice daily between meals with a range of 1 to 3 capsules as tolerated. If a person can handle three times daily that may be preferred in real bad mycotoxin scenarios. It is all based on tolerance and person must watch out for constipation. I would suggest contacting BioBotanical Research directly for more insight and their recommendations on dosing of their products.
Q: Regarding Small Intestinal Fungal Overgrowth, is there any OAT Info that would equate to diagnosing SIFO? Perhaps Arabinose marker, plus other marker?
A: In my experience, most people with SIBO and SIFO have underlying yeast and fungal problems. Sometimes, they have clostridia too. I always run the OAT on anyone with SIFO or SIBO or who is suspected of having these issues.
Q: If a patient cannot tolerate even one drop of Biocidin do to die off, who has problems with clostridium, candida, and mold, what do you do?
A: This would require a much larger discussion about the various things going on with the patient, their environment, history, etc. In some of these cases there are not easy answers. We developed a website called Functional Medicine Clinical Rounds – https://functionalmedicineclinicalrounds.com to help practitioners work through some of these details. Research the Cell Danger Response. This is likely what is happening with your patient.