Histamine Well Podcast: Exploring Histamine, Methylation & Holistic Health

Practitioner's Perspective - Managing Complex Cases of SIBO, Histamine, Oxalates & Mould

• Joanne Kennedy • Episode 10

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In this episode of the Histamine Well Podcast, Joanne is joined by Naturopath Mariela Gebhardt from Austria to discuss a fascinating and complex case. Initially thought to be related to SIBO, Mariela shares how, despite seeing early improvement in her patient's gut health, she remained in a heightened anxious state and developed an unusual symptom: toe pain.

Mariela identified this as an oxalate issue, which was later confirmed through Organic Acids testing. This discovery prompted Mariela to inquire further about mould exposure, which quickly became clear as a significant factor.

Mariela humbly acknowledges that the mould and oxalate issue should have been identified during the initial consultation, but, due to her lack of training in this area at the time, it wasn’t immediately apparent. However, after mentoring with Joanne and her colleague Melanie Peers, her perspective shifted, and she now approaches these cases with greater insight.

This episode is a must-listen for anyone dealing with chronic histamine issues, as well as practitioners and students interested in more complex cases.

Connect with Joanne:

Joanne Kennedy:

Hi, it's Joanne. If you are someone dealing with a myriad of histamine related symptoms and have only been focusing on gut microbiome issues like sibo, but you are still suffering, this episode is for you. We'll, shed light on how mold and oxalates can be underlying drivers of histamine intolerance. You'll learn key symptoms to look out for and discover some important tests that can indicate potential mold exposure. For practitioners and students, this case study offers insight into how to prioritize treatment and get to the root cause more efficiently. Welcome to the Histamine Well Podcast. Designed for practitioners and patients alike. This is your trusted source for insights on histamine intolerance, methylation, gut health, women's hormones, and much more. I'm Joanne Kennedy, your host, naturopath, author, and educator. Passionate about breaking down complex science into clear, accessible knowledge. Whether you are a health professional or navigating your personal wellness journey, the Histamine Well Podcast bridges the gap between cutting edge research and practical understanding to empower you with the tools to thrive. Hi everyone. Welcome back to the show. Today I'm joined by Naturopath Mariela Gebhardt, all the way from Austria. Mariella contacted me several years ago now as she found me on Instagram. I think it was talking about histamine. And over there in Austria it was starting to pick up traction and in Germany as well. And Mariela could sort of start seeing that what I was talking about the symptoms were showing up a lot in her patients. So she started to become interested and she contacted me and we had a few mentoring sessions several years ago. And Mariela then did my histamine methylation online group coaching course. So we got to know each other a lot better. We've become friends. We met up in Barcelona at the naturopathic conference over there. Mariela is an absolute world of knowledge when it comes to all things histamine. And we've just been chatting about a case that Mariella had several years ago now before she did my course. And we really wanted to talk to you all about this case because it clearly shows the interconnected relationship of all the different causes of high histamine. And we're gonna run through the case. I'm just gonna interject and give my sort of two bombs worth on a few things. And really try and work out the priorities of things that need to be addressed. So Mariela welcome.

Mariella Gebdhardt:

Thank you very much, Joanne.

Joanne Kennedy:

You're welcome. So Mariella, don't you wanna tell our listeners a bit about this lady that you treated several years ago now and what she presented with and sort of the first steps you took towards helping her.

Mariella Gebdhardt:

Sure. Well, this patient of mine came to see me in Vienna. She's an expert, so she's actually born in the States. Lived in England and then she moved to Vienna. And back then she came to see me because there were several digestive issues. She had diarrhea. She had nausea. She had a belly bloated all, let's say her adult life. And basically in the case taking I already knew that mold might play a role. So I asked her about mold and she confirmed me. Yes, actually I lived like two and a half years in an apartment in London and we had mold behind the walls. And we had mold everywhere. I didn't know that much about mold back then. You've mentioned it to me that mold can play a real issue with histamine related issues. So I've always had it kind of like in the back of my mind. So we started. We got some SIBO testing. It came back positive for hydrogen sibo. We did some digestive stool analysis testing. And basically we started her on a SIBO protocol. And it was extremely interesting because within a week on the I had her on the biophysic diet. So just on the first phase, within a week, all her GI symptoms disappeared. Her belly bloating was gone. It was for her incredible because she was used to not being able to have a very comfortable. You know, putting the pants on or things like that. So having a flat belly just really changed her life in that moment. Anyways, we cleared SIBO and then certain symptoms remained. And that's when everything started to where we looked into the deep dive.

Joanne Kennedy:

What were her histamine symptoms?

Mariella Gebdhardt:

She actually had this popping up anxiety. that was a real issue. And she changed also, that's not quite typically histamine, but she changed from diarrhea to constipation. Which is a mold issue. I didn't quite know back then that mold can cause that. But very clearly it turned out that way. She had headaches. And she had horrible PMS symptoms especially just before her period. So those were the remaining symptoms.

Joanne Kennedy:

Okay. Interesting. What did you use to treat sibo?

Mariella Gebdhardt:

It was like a very. Like back then, standard protocol. She was one of my very first civil clients three years ago. I had her on oregano. I had her on Berberine. I had her on activated charcoal. And those were like the basic ones that have rotated her around.

Joanne Kennedy:

Yeah. Yeah. Just standard for hydrogen sibo and so she had no motility issues. It all kind of cleared out really well. Yeah, interesting.

Mariella Gebdhardt:

It kind of popped up now and then, and we used magnesium oxide.

Joanne Kennedy:

Okay. To get her bowels moving.

Mariella Gebdhardt:

Exactly. And that worked for her fantastic. She had her dose that she knew exactly how much, how many capsules needed to take to really have a bowel movement the next day. Like that was number one priority. Her bowels need to be moving.

Joanne Kennedy:

Okay. And so interesting. So she's on board with you now'cause you've helped with a lot of her symptoms including the bloating. Bloating's worse than it sounds. it is the distension and the complete discomfort that people feel like all the time. So it's real And you know, You know that there's something not quite right with your gut. So you've got her on board now. So how did you approach the mold issue with her?

Mariella Gebdhardt:

Well, there was an in-between step because she started to have those pains in her toes or in particular in one toe. So it was red inflamed and to me it was like, I mean, that's oxalates written all over it. Yeah. And of course she went to the doctor and the doctor gave her anti-inflammatories and creams and nothing helped. And I told her, look, you know, with your whole history. I really suspect that there are some oxalate issues. And the only way how to really test for it is an organic acid test. So it has taken a couple of steps of explanation why and what for, and, you know, the whole investment of the money because it's not a very cheap test and it shipped from Europe to the states. And she trusted me. Even though there were a lot of critical opinions in her family and in her friend circle, because a lot of medical professionals. And in the organ acid test there was very high. They were very high oxalates. And also quite high candida. So a couple of things that made me aware that, all right, there's certainly an oxalate issue, but there might also be a mold issue hiding within that.

Joanne Kennedy:

Yeah. Interesting. Okay. Interesting. So it came back high oxalates and you started removing oxalates from her diet. Did you see an improvement in her pain symptoms Pretty quickly?

Mariella Gebdhardt:

They did, and then it kind of all happened really fast where I explained to her that there is an interconnected relationship that we need to explore the mold issues. And back then I just, I was new to the field of mold. And lucky I knew you. And we booked in an appointment with your colleague, with Melanie. And I sat in and it was just the best bridge, and it was such a fantastic work together because I could sit in. I could learn. I actually sat in with a couple of clients that I've sent to Melanie. That's how I really got firsthand education about mold. And Melanie picked up everything. She asked certain questions that I wouldn't have even known to ask for. And without testing, she could tell, yes, we have mold. So for that particular client, it was very difficult to understand that mold mycotoxins and oxalates can cause all her symptoms. So she was very hesitant towards the treatment, but she said, look, we've gotten so far and you're the only one so far who has really helped me with so many improvements of my symptoms. I trust you. Let's do this. But still her question about is there really mold? Is it really there? Yeah. Made me understand she's the type of person we need a test to really have a proven yes there is, or no there isn't. So as time has changed in Europe, luckily there's now a lab in Germany that also does mycotoxin testing. Which is a lot, cheaper and a lot easier with the whole process, so we don't have to send it to the states. It came back positive. So that was gaining her trust again for Melanie also for my work that everything we are doing is right and it's actually for the right reason.

Joanne Kennedy:

Yeah. Wonderful. And tell me what was the things that you used to bind up mold and how did you deal with that oxalate issue?

Mariella Gebdhardt:

We incorporated certain foods. A lot of polyphenolic foods and also sulfur containing foods to support the whole detoxification. And we got the bio seed and GI binder. So that was like the first one however, she reacted really strongly with that one. Like she went into straight constipation. So then we started to use sprinkles. And that kind of, it was also for her a psychological issue because for her, constipation psychologically was fear of getting again her hemorrhoids inflamed. And that kind of left her be traumatized after pregnancy. So basically with the sprinkler slowly she could readapt and she could see that, okay, it's the safe doses and it works well. So we worked with microdosing. Fibers in the diet. Supporting all the detox drainage pathways and she actually also reacted really strongly to anti candida drops. So her system started to react treating mold very fast. So we had to back off and go into like one drop instead of eight or 10 drops.

Joanne Kennedy:

That's common with mold patients.

Mariella Gebdhardt:

Exactly.

Joanne Kennedy:

Was she out of the mold when she did this treatment? Do you know?

Mariella Gebdhardt:

Yes. However, she took certain furniture with her from that apartment. So that was the big issue. And that's where Melanie also explained certain furniture needs to go. And she just moved back to England and it was a heartbreaking process to really let go of certain materials that she has taken from the flat to Vienna, and now she had to leave it here.

Joanne Kennedy:

Yeah, it's hard. Mariella, do you recall what Melanie said, the questions that she asked your patient regarding trying to identify mold? Do you remember any of those things? Like are some key things that she asked? Do you remember?

Mariella Gebdhardt:

I remember that she asked particular questions about the room and where and where the mold was and if it was visible molds and about certain materials or furniture types that she kind of took with her and the plants that were in the apartment that also traveled with her. And she asked also about.. I can't recall them all, but there were certain questions where I was like, wow. I wouldn't even have considered asking them. So there were of course specific about the nervous system. And yeah, I can't recall them all that.

Joanne Kennedy:

That's okay. Mariella. It's interesting. Yeah. It's just living especially in the bedroom with the mold and how mold disrupts the nervous system. It's very fascinating. So it damages the nervous system. People with mold illness have massive anxiety and depression.

Mariella Gebdhardt:

And that's exactly those two remaining symptoms. Yeah, she had very intense anxiety and depression, so she actually had to look back on an antidepressant. Also it's important to mention this woman didn't have any support with her two toddlers in Vienna. She was by herself in a foreign country, so her nervous system already was at high alert. And then on top of that, all the other, you know, it's, it's, it's like an atomic bomb in her body causing constant irritation, constant inflammation, and that altogether just really feels tops the whole glass to all the flows.

Joanne Kennedy:

Yeah. No, I, I um, people don't believe in mold illness, but it is real. I have friends of mine saying, oh, so and so says they've got mold. They're mental. I'm like, no, they're, they're not mental. Don't gaslight them. It's a real thing and it disrupts a nervous system. It's a really challenging condition'cause people don't believe in it. I have so many patients with mold all around the world and they're so unwell. It is a real thing. We can test it, we can treat it. So yeah. So thanks for bringing that up because you know, we, people live in London or they go to Asia. Southeast Asia and just live in moldy places. Dorm rooms in colleges throughout the us. So much mold there. There's mold everywhere in Sydney. We've had a lot of patients, um, from cold, you know, Northern Cold Europe. Damp. And do you know where else it is? Is in Dubai with all the air conditioning? So it's in hot places with Air Con. It's in moist places. It's in damp, wet places.

Mariella Gebdhardt:

You know, but it's, you mentioned the air condition. I've just been on a holiday and I went into a room and I had the air conditioner on and on. Said to my friends, I'm really sorry, but this air condition is full of mold.

Joanne Kennedy:

Could you smell it?

Mariella Gebdhardt:

I can smell it.

Joanne Kennedy:

Yeah, you can smell it. Yeah.

Mariella Gebdhardt:

I can smell the mold. And once you start working with mold, you see it, you smell it, and it's just, you enter a friend's house and you're like, oh my goodness, I can smell mold. What should I do? Should I mention it or not mention it?

Joanne Kennedy:

Yeah, that's so, you know, mold. We're gonna learn a lot about mold on this show. I'm gonna have Melanie on and other mold practitioners. Christiana, our German friend, I'll get her on. Mould specialist. So Mold very simply disrupts a microbiome, doesn't it? It causes havoc with a microbiome. It disrupts bile flow, which is a really big problem that can cause an oxalate issue. And the interesting thing this lady had high oxalic acid. So oxalic acid is the, it's more gut microbiome diet related. The microbiome was could not break down the oxalate.'cause we rely on our microbiome to break down oxalate. We don't have the enzymes to do so. You can see it now, can't you, Mariella? A lot like definite mold exposure, SIBO bowel problems. And then in retrospective like I should have even picked it up on the stool analysis. Yeah, like back then we could already see certain markers and we just spoke about that before we went, uh, live. Yeah. Um, did you consider mold, uh, oxalate issues back then? And I'm like, I, I couldn't, yeah. I just didn't, I was just not trained well enough to pick it up. Before we go any further, I want to speak directly to the practitioners and students listening. If you're intrigued by histamine and methylation and eager to expand your knowledge in this fascinating area, we offer the Histamine and Methylation online group coaching course. The only program of its kind, it covers everything you need to know about histamine and methylation, providing both the theory and guidance you need to treat these issues effectively in clinical practice. We cover sibo, hormonal imbalances, oxalates, M-T-H-F-R, the four pathways of methylation, including the folate pathway, methionine pathway, tetrabiopterin pathway, and the all important transation pathway and much more. The program is delivered by detailed online webinars and handouts for you to keep. And for eight weeks you'll meet with me for live coaching calls in a private community space with other practitioners from all over the world dealing with histamine and methylation issues in their patients every day. Together we learn so much. To learn more and apply, visit joanne kennedy naturopathy.com. So listeners. This lady, when she did a SIBO test at the beginning, also did a stool test, and it was really interesting. She came up with low oxalobacter formigenes. That's one of the bacteria, a prevalent bacteria that breaks down oxalate. This definitely does on its own. Doesn't mean that there's an oxalate problem, but it's just you check that with a red flag. But what was a massive red flag in this lady is that she had high calprotectin. Calprotectin is an inflammatory marker used for the diagnosis and treatment and assessment of irritable bowel disease. Crohn's disease and ulcerative colitis, which are autoimmune and highly inflammatory. But these people don't have Crohn's or ulcerative colitis, and I've seen this when I see high calprotectin, it's mold and oxalate usually. So she had high calprotectin,. She had also had high mucin degradation, which can also be caused from mold and oxalate. So it is just those, when we see markers like that, these is your body's immune system essentially, isn't it? It's different to the bacteria and it's highly inflamed. SIBO doesn't do that? It's just dysbiosis doesn't do that. It's usually mold and oxalate. So fascinating. I talk a lot about this when it comes to histamine issues. I rarely see just dysbiosis in a large bowel, high bad bacteria. Some of them are histamine producing and low beneficial bacteria as a cause of high histamine in the body of someone with histamine intolerance and chronic health issues is usually something more. Wouldn't you agree, Mariella? Definitely, yeah. Yeah. You need to dig deeper. It's gonna be oxalates, mold or SIBO or combination of that. This is why these complete microbiome mapping tests are so useful is not necessarily looking at the dysbiosis. It's all of these additional markers. Which is why you pay a little bit more to get those tests done because it's looking at calprotectin level, mucin level, fecal secretory, IGA, these are a complex part of the gut's immune system. And when they're out of balance, it's, this is an issue. When we need to fix, we need to be focusing on that.

Mariella Gebdhardt:

Yeah, absolutely. And we also ruled out parasites, so we, I also check parasites with dis stool analysis. Yeah. Yeah.'cause she's been to India and she had, um, food poisoning and that's where all her digestive issues started. So that's what, why I also considered first treating SIBO because it was very evident that, that there is a SIBO issue. And, uh, I also wasn't sure if there's any parasitic issue still.

Joanne Kennedy:

Yeah. Interesting. Do you know if she increased her oxalate foods on that SIBO diet or you're not sure?

Mariella Gebdhardt:

Yes, she did. Yeah, she did. And um, she first felt extremely good. And then towards the end of the SIBO treatment, actually with her, it literally only took six weeks. So it was for me, like a very fast elimination of SIBO. Um, usually get more complex, uh, patient cases where it can take up to three months. However. All the symptoms afterwards that they kept me wondering, all right, SIBO is eliminated, what is, what else is going on in the body? Mm-hmm. And yeah, that's where it all came together.

Joanne Kennedy:

Yeah. Yeah. No, it's amazing job Mariella. It's really great. So, um, yeah, we learn, we all have to learn and we don't get taught this at college.

Mariella Gebdhardt:

Not at all, unfortunately. And I think now with the whole SIBO hype, because everyone is treating sibo, si, si, si. It's not about just eliminating sibo, it's actually what you're left with after you've treated SIBO to see what's really going on.

Joanne Kennedy:

Totally. I look at SIBO as a whole gut issue. Exactly. You know, know, like it's, it's just di, especially digestive enzymes, motility bowel disruption. So that can just be due to bad liver, estrogen dominance. It can be due to mold. And stress driving sibo. So if you are, you know, some people can just get SIBO from an acute stress situation or food poisoning. But if you're resistant to treatment with sibo, if it's not working for you or if you relapse a lot, there's something deeper going on. And when it comes to gut, it's gonna be digestive enzyme, insufficiency, oxalates, mold as big culprits. Yeah, exactly. For why you can't get on top of your sibo. Interesting. So tell me what was going on with her hormones at the time? A woman like this, a bucket of histamine is not having fun with her hormones.

Mariella Gebdhardt:

Yeah. It's an issue. she went to the gynecologist because, basically her PMS got really bad at certain point in time. And that's with, let's say half a year, almost a year after sibo. I've seen this client for a certain period of like I think altogether like two years or something now. Just because things take time to understand and to implement and you know, especially if there are lots of critical voices that question the treatment plan and where you need to explain and you need extra testing. So everything prolongs a little bit. Anyhow, so with the testing of the doctor, there is a little bit of a progesterone decline. But that didn't really do anything about her PMS. And she's a lot more stable. But I still see we're not at the end yet.

Joanne Kennedy:

What PMS symptoms is she getting? You're still working on the mold? Oh, you're still still working on the mold?

Mariella Gebdhardt:

We haven't finished that yet. Exactly.

Joanne Kennedy:

Well, okay.'cause she's just was, she can't take a lot of binders'cause she gets constipation.

Mariella Gebdhardt:

And she reacts to the supplements. Yeah. Very strongly.

Joanne Kennedy:

She's highly reactive. Exactly. Oh, you know what? I think Mariela, what about nervous system support? What's she doing for that?

Mariella Gebdhardt:

Yeah, we've, that's an interesting one. I first. Actually from the first consultation I put her, I think it was Ashwaganda or Radiola at first, but I had her on Ashwaganda. I had her on Radiola because the whole anxiety picture thought radiola would be more appropriate. I've heard her, I've had her on B vitamins. We've always checked also her B vitamin status and her mineral status in the blood. A lot that we figured out that was linked to her emotional state was actually when visitors came from overseas.

Joanne Kennedy:

Oh, okay. So she gets stressed from visitors. What I wanna say, I understand this girl is living in a foreign country and she's got two young children and she's got some health issues. Mariella, I used to be like, I used to always just think, oh God, that would be terrible. I'd be, so I'd want everyone to leave and I just wanted like, get into bed and watch Netflix and you know, that's what I would say to my patients. Give them to my Uganda and Magnesium. But now that I understand nervous system more, she can't cope because she's in chronic fight and flight. Exactly. And she needs the limbrick retraining. Either Gupta Program or Primal Trust, or she needs to also do somatic work from someone like Irene Lyon or Workout Witch. Listeners, I'll put these people's programs and links to their website in the show notes on my website. So anyone that's had mold, it's the limbrick retraining from Gupta or Primal Trust is really helpful In conjunction with somatic work. This is like very gentle nervous system healing. Irene Lyon or the workout witch. And this stuff is fundamental for these people. Fundamental. I actually asked Melanie on a podcast Mariella. It's episode three on Oxalates. We started talking, asked her why are people so reactive to foods and supplements. And she went straight into nervous system and we spoke about it for like half an hour. The nervous, when the nervous system is dysregulated, the immune system becomes dysregulated. And vice versa. When the immune system is dysregulated, it is a threat to the body. And when it's chronic, the nervous system's like, it becomes scared of food and it can become scared of supplements. So it's a very chicken and egg.

Mariella Gebdhardt:

so you started the SIBO treatment. I had her on Nerva, like that meditation program for IBS. Yeah. Yeah. That's good. It actually worked really, really well for her but I totally agree. I got to understand the Gupta, through you and through Melanie, and I think it's, it's fantastic and it's also available in a lot of languages, which makes it a lot easier because not everyone is that my clients speaks English.

Joanne Kennedy:

Oh, that's great. Yeah. So do, can you, do you know much more about the Gupta program to tell people Mariella? Because I don't know much, too much else about it.

Mariella Gebdhardt:

I looked into it. So it has different sections and um, different exercises. And it really helps you to, to retrain so you get, become able, to develop a total new resistance or resilience. That's the right word. Yeah. And, um, it takes you step by step. So you have like an online program. And there are lives I think as well. It depends what kind of program you choose. I haven't had anyone yet who stand alive. But I know the ones who've done like all the, the recordings and they have, have had good results.

Joanne Kennedy:

Yeah. I've had a lot of patients do it. Um, so anyone that has had mold. Um, it's fundamental to get that, to do that, those programs.

Mariella Gebdhardt:

And I totally agree with somatic, um, work. I think there's so much trauma also involved quite often in those clients. And I find that this is one of the most powerful techniques to implement.

Joanne Kennedy:

It definitely is. I've, I'm telling all my patients they need to do it. You know, having a chronic health issue alone is traumatic to the body. And so they get stuck in this chicken and egg situation of immune system dysregulation, nervous system dysregulation. There's a lot that we can do to help sort of with, you know, with the fall out of that. But it needs to be, recalibrated from the autonomic subconscious nervous system. So you can't talk yourself out of it'cause it's subconscious. Yeah,

Mariella Gebdhardt:

I totally agree on that. It's the most fundamental aspect of getting well.

Joanne Kennedy:

Yeah. Yeah. Fantastic. Great. So anything else that's interesting about this case? We haven't gone through her bloods. They're all in German. Mariella. Oh gosh. She's got chronically low hemoglobin.

Mariella Gebdhardt:

Actually. One thing that was interesting about her bloods is her homocysteine. I started testing homocysteine when I first got to know you a couple of years ago. Just out of curiosity, I just tested it with everyone. Mm-hmm. And she brought a blood test that she had done like a year or two before she seen me where she had high homocysteine. And then when I tested her, she had low homocysteine. High I mean, it was not super high, but it was like 13.

Joanne Kennedy:

I saw it's like 11 and then it was 11 and it dropped down to 4.5. I mean, was it fasting and non-fasting, because it's a big drop.

Mariella Gebdhardt:

The blood sample she took in Vienna was fasting. Yeah. The first one, I can't tell because it was a couple of years before she's seen me.

Joanne Kennedy:

Okay. So correct. It's correct to do fasting so, exactly. And as you've learned, if you knew about the low homocysteine and the high calprotectin in the stool test. And low oxalobacter formigenes. You'd be like mold, mold, oxalate.

Mariella Gebdhardt:

Absolutely. I've learned so much with this case. It's been an enrichment and yeah, I feel like I went into a speed capsule and deep dive into the world of mold.

Joanne Kennedy:

She should be very grateful to have you. So, listeners, just briefly, home assisting is such an interesting test to look at because when it's low, it can indicate an oxalate issue. And mold, but it's very specific to oxalate because homocysteine is a storage molecule for sulfur. And oxalates can deplete the body of sulfur. And sulfur's the second most abundant element in the body and we really need it for many things. Including phase two liver detoxification pathway of sulfation. Helps make the protective mucosal lining in the gut. It helps make your digestive enzymes. And it makes glutathione your body's major antioxidant. So it's super important. So if oxalates are depleting your sulfur, one place it can get it from is from homocysteine'cause homocysteine's a storage molecule for sulfur. A few other reasons you can have low homocysteine, including if you don't eat enough sulfur foods, including red meats, et cetera. However, in conjunction to signs and symptoms, chronic health issues, pain, gut issues, mold exposure, you know, high calprotectin and stool tests, it's very, very red flag oxalate. Yeah. Yeah, it's wonderful. So you know guys, in summary, some, when someone comes in, like Mariella gets this now is Yeah, for sure. She's got sibo, but someone with a case history like that and the nervous system dysregulation and the pain symptoms. And then seeing when you run the bloods and she's got low homocysteine. And then her stool test it's rare to see high calprotectin in a stool test. And so when you see it, you stop. Because allopathic medicine will pick that up for irritable bowel disease diagnosis. They'll go into the medical system for diagnosis for that, but when they don't have that, and we see it on a stool test. It's a big red flag that there's something really inflammatory in the gut. And oxalates, a sharp little shards, little crystals, and they'll deposit in the gut. They get into the bloodstream, they get into the thyroid, the joints, the bladder, and they'll cause chronic inflammation. They'll drive up histamine and cause a lot of inflammation in the gut, which is I think why the calprotectin is so high.

Mariella Gebdhardt:

Every time I do a stool testing, I also speak to the support from the lab and I go through it and I did ask uh, them do we need to do any further medical testing. You know, with the calprotectin like that, and they were like, no, it's still within a range where you would retest and see what happens. Because I, every time I see high calprotectin, it's for me, like a real red flag, but not a red flag for oxalate. It was just a red flag for, for any major, other digestive

Joanne Kennedy:

Absolutely. Problems that can Oh, I would always be asked, yeah. You would always ask your patients if they've been investigated for irritable bowel disease. Exactly. And also ask them to take this, give them their doctor a copy. Exactly. Yes. Very interesting. So she's got really low iron in her bloods.

Mariella Gebdhardt:

Yes. Um, she's got thalassemia. So her blood needs to be read differently, but she's with a thalassemia expert who really monitors her iron level and basically he said there is no need to supplement at all.

Joanne Kennedy:

Okay. Interesting. What's her ferritin? Does it not affect her energy though?

Mariella Gebdhardt:

What she kind of tells me, the only thing how she notice thalassemia, sometimes she gets shortness of breath when she walks upstairs occasionally. Okay. That's it. But it's not something cotton. Okay. It's not anything in her life that keeps on, that reduces her life quality at all.

Joanne Kennedy:

Okay. Okay. And she had really low vitamin D. Yeah. So did you get her vitamin D up?

Mariella Gebdhardt:

We got that up really fast.

Joanne Kennedy:

Did she find a lift in mood from taking that?

Mariella Gebdhardt:

It did. It, uh, supported her mood and I also believe it started to regulate a little bit more her hormones.

Joanne Kennedy:

Yeah, her progesterone. Yeah. It increases progesterone. Exactly. Yeah. Interesting. They're all in German guys. It's hard. I can read some of them. All right. Mariela. So I, it's so wonderful you that you take on all these cases over there in Vienna with not much support. So it's really great. Is naturopathic medicine sort of getting a bit more mainstream support over there?

Mariella Gebdhardt:

It's a tricky one because naturopaths need to be doctors in Austria, so I do work very closely with doctors in complex cases, so I'm backed up. Otherwise, I wouldn't be able to legally do what I do.

Joanne Kennedy:

Yeah, they must love you.

Mariella Gebdhardt:

I do love working in, in a network and in a group and with, with doctors. I do have to say it's, it's the network is sometimes just what really makes people improve fast.

Joanne Kennedy:

Yeah. Yeah. The combination of allopathic and then having an amazing naturopath like yourself on board. Yeah, it's wonderful. So Mariela, is there anything else that was really interesting about this case for you?

Mariella Gebdhardt:

For me, it was very interesting that we went from this classical SIBO treatment and what we were left with were actually like mold and oxalate issues. Yeah. And if I wouldn't have had the training or let's say at back at the very beginning, it was your mentoring that made me aware of all those issues, I wouldn't have been able to actually really support and help this client efficiently.

Joanne Kennedy:

Yeah. Thanks for saying that. Mariela, I think. Practitioners and students. This is so common what we are dealing with, and we are getting more complex cases. I'm getting more and more complex cases Gone are the days of the simple SIBO case.

Mariella Gebdhardt:

Definitely.

Joanne Kennedy:

What's going on? I'm not sure. I mean, are they just going to take the rifaximin and getting on with it or I wonder? I'm not sure, but I, I'm getting more and more complex cases. The SIBO cases are never straightforward like they used to be. People are getting sicker and sicker. Um, but, or maybe it's just the awareness about of this stuff. Maybe it's'cause we say we do histamine. I potentially, but it's we seem to be getting more chronic conditions. Have you found that?

Mariella Gebdhardt:

Certainly. And I think also once you're known for complex cases, you attract complex cases as well.

Joanne Kennedy:

It's very true. You do. You do attract. They come in waves. Definitely. Cool. Alright, Mariella, thank you so much for your time.

Mariella Gebdhardt:

Thank you. It's been a real pleasure.

Joanne Kennedy:

Yeah, thank you so much.

Mariella Gebdhardt:

Thank you, Joanne.

Joanne Kennedy:

So thank you for joining me. I hope you found this episode beneficial. Be sure to subscribe to the histamine well so you don't miss an episode. Leave a review and you can also share this episode with someone who could benefit if you have any questions you'd like answered. Or have a topic you'd like me to discuss, please go to my website, joanne kennedy naturopathy.com, where you can provide us with that information. Until next time, take care and be well.