Case Study.

Female (20s): Overcoming POTS, fibromyalgia, and more with holistic care.

Tackled POTS, Fibromyalgia, and Chronic Fatigue, improving focus, reducing medications, and enhancing exercise tolerance.

Results After 8 Months.

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Medical Data.

Medication
Dosage
Time to outcome

Pepcid + Midodrine

Discontinued

Days

Amitriptyline + 5-HTP + Venlafaxine

Discontinued + Dose Halved

7 Weeks

OCPs + Venlafaxine + Pregabalin​

Discontinued + Weaning

~3.5 Months​

Pyridostigmine + Corlanor + Pregabalin​

Discontinued + Doses Halved

5 Months

Welchol + Corlanor

Doses halved

8 Months

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Results Summary.

  • Slow and steady reduction in multiple medications.
  • Improved focus and reduced fatigue
  • Resolution of dysautonomic symptoms
  • Improved exercise tolerance. Acheived goal to run one mile without stopping.

Initial Diagnosis.

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Diagnosis.

  • POTS
  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • GERD
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Meds & Supplements.

  • Meds: Adderall, Midodrine, Amitriptyline, Pregabalin, Pepcid, Escitalopram, Pyridostigmine, Promethazine, OCPs
  • Supplements: Fibro Formula, Digestive Enzymes, Adrenal Cortex, Salt tabs5-HTPMelatonin
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Health Goals.

  • Health optimization
  • Improve energy
  • Deprescribe medications

Treatment & Personalized Plan.

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Lab Results.

  • Nutritional insufficiencies: Folate + RBC Zinc*, CoQ10 + Vitamin D*, Iron (low ferritin 31)
  • Very high B12 and SHBG
  • GI-Effects: high sIgA, low SCFAs, borderline EPI, low Akkermansia spp.
  • Mycotoxin panels (GPL+RTL): Ochratoxin + Enniatin B, Gliotoxin + Zearalenones
  • Gut Health testing shows low elastase, high sIgA, presence of heavy growth of a potential pathogen (Klebsiella oxytoca), also lesser growth of Citrobacter and Klebsiella pneumoniae
  • Genomics insights: VDR +/+, PAI-1 +/+ (4G/4G), Absent GSTM-1, CYP1A1 +/- (hyperinduction, caution PAHs/HCAs)
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Meds & Supplement Changes.

  • Methyl folate
  • GABAergic natural agent for anxiety
  • Paleofiber + RestorFlora
  • Mycotoxin regimen: Glutathione, Medi-Clay, Floramyces, Welchol (Rx)
  • Added alternative antiemetic: low-dose haloperidol
  • Psych changed her SSRI to Venlafaxine
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Lifestyle Changes.

  • Minimal intensity with exercise.
  • Akkermansia-promoting diet strategies.
  • Stopping OCPs as tolerated.
  • Vagus Nerve Stimulation (TENS)
  • Limbic retraining (Unlearn Your Pain)
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Nutrition Plan.

  • Addition of apple cider vinegar pre-meals
  • Akkermansia-promoting foods: deep red fruits, bitter greens, walnuts, and fatty fish​
  • Resistant starches (larch arabinogalactans, plantains, etc) and soluble fiber (to increase SCFAs)
  • Seed cycling for promoting hormone balance
  • Mitochondrial-focused nutrition plan
  • Food focus: sources of zinc, vitamin D, iron, folate

Read our in-depth case studies.

Our comprehensive case studies cover the patient’s initial results when they joined Index Health, results after a certain time frame, as well as treatments used, including supplements, lifestyle changes, medication, peptide treatments, and more.

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