Blood test results

Prior to review of her blood test results, based on her history and NAQ, I would be inclined to think that her long term symptoms are mostly a result of an insufficient vegan diet with blood loss and her short term symptoms may be related to stress. Since her menorrhagia improved with exercise I would be inclined to think that her menorrhagia symptoms are related to thyroid dysfunction with a possible iodine deficiency.

Chronic blood loss with an already possibly low iron diet is the more obvious cause of anemia but I would suspect her B6, B12, folate, zinc, and magnesium may be low as well because of her diet and MTHFR variation. Initial low iron is associated with the cause of heavy bleeding in some cases as well. We will run tests to see a general idea of what is happening and order more testing if necessary.

The functional blood test result findings all have a general theme of deficiency with elevated TSH, adrenal dysfunction, elevated vitamin, mineral, and protein needs. Addressing the immediate needs first is of primary concern in order to increase energy and appetite so that diet recommendations are more likely to be compliant and sustainable. Thereafter, further testing may evaluate improvement and other factors that may not be related to diet.

The elevated TSH levels and low Free T4 indicate thyroid dysfunction with a tendency toward hypothyroidism. It can also be an iodine deficiency, which is consistent with her general mineral needs as a result of all assessments. I would recommend a complete mineral supplement that contains some iodine and more thyroid supporting ingredients, being careful not to supplement too much iodine. Follow-up tests should be done to test for a more detailed look at other thyroid-related bio-markers including the iodine level and thyroid antibodies. Will order a full thyroid panel, anti-thyroid globulin antibody, thyroid receptor antibody, and thyroid peroxide antibody tests.

Adrenal dysfunction findings are likely caused by 3 forms of stress present. These would include external stress with being overworked, endogenous stress with nutritional deficiencies, lack of sleep, periodic back pain, not exercising and, mental stress with worry about her child. I would recommend a B complex to give adrenal support and provide supplementation for the need exhibited by existing and former blood tests. Her Low ALT result is associated with B6 deficiency which is required for stomach acid production and absorption of B12. Adequate stomach acid is also required to absorb her needed iron.

Her MTHFR gene variation indicates that she may utilize only half of her B12 and folate intake. Coupled with her blood test results and family history of stroke, B12, folate, and B6 would need to be supplemented. Special care would need to be taken to obtain sources of these nutrients on her restricted diet type.

Her mineral needs are multifaceted. Although she has an elevated ferritin result, it most apparently is due to her recent iron infusion. The hemoglobin level is expected to increase slightly following the recent infusion and the ferritin level is expected to inevitably fall. Consistent iron supplementation is highly recommended to achieve more steady levels of hemoglobin, platelets, and ferritin. I recommend 25mg capsules of gentle iron with Vitamin C increasing to 75mg/day if tolerable.

She also has a need for zinc supplementation as her WBC level is less than 5, ALP is less than 70, and zinc taste test all indicate zinc is insufficient. Zinc has a myriad of functions in the body including being necessary for thyroid hormone synthesis, increasing stomach acid, and increasing appetite to sustain a nutrient-rich diet.

Rbc magnesium was not tested but her muscle spasm symptoms and diet suggest the overall mineral intake is low. She also does not appear to eat sources of magnesium-rich foods. Since magnesium is essential for protein synthesis and fatty acid metabolism and acute stress can also further deplete magnesium and zinc, a supplement containing these minerals is beneficial and recommended.

The low calcium level indicates that calcium regulation is out of balance and possibly low, given the limited diet. The primary indicator of calcium imbalance is her insufficient Vitamin D. Vitamin D supplementation is needed along with magnesium, Vitamin A, and K  to regulate calcium.

Multiple markers indicate the protein levels are insufficient. Proteins repair and build tissue, providing a structural framework, and are essential to maintain proper body function. Studies have also shown that inadequate protein intake has been associated with conditions including reduced bone and calcium homeostasis, electrolyte imbalance, enzyme production, and delayed recovery from injuries. Given her test results and history of lasting injuries, I

Recommend amino acid supplementation until diet sufficiently consistent in protein intake.  Increase protein intake along with healthy essential fatty acids to optimize cholesterol. Cholesterol is needed to produce Vitamin D which is insufficient. It is also needed for the production of steroid hormones and in the process of digestion of fats and fat-soluble nutrients. Although fatty acids were not tested specifically, the low- fat diet and low vitamin D cause concern for optimal function.

Further study and testing could also explore her coagulation factors and how they are working.

It is also notable to assess why certain substances have worsened her condition for a thorough investigation. An Nsaid was recommended by her gynecologist as NSAIDs block prostaglandins to help control the inflammatory factors that may be responsible for heavy menstrual bleeding in some women. However, studies show this recommendation may make menorrhagia worse in women with coagulation issues because NSAIDs are blood thinners.

Other blood-thinning substances that may not have been recognized are herbs and spices that may be used excessively that contain blood thinning salicylates. Some contain tannins that interfere with non-heme iron absorption as well. Given her history of cycling consumption and corresponding negative effects, the limitation of these foods is highly recommended.

Further testing can look at platelet aggregation tests, fibrinogen, PT/INR, PTT, factor VIII clotting activity, Von Willebrand factor antigen, and ristocetin cofactor or other vwf activity to measure how well the vwf works.

We can also review her basal metabolic temperature graph to assess baseline and improvement with consistent supplementation, improved diet, sun, and relaxation prior to further testing.