9/9/2021 – Dr. Nicole

Today I sent Dr. Nicole and email:

—- On Thu, 09 Sep 2021 07:10:02 AM -0700 <Sarah Pansegrau > wrote —

Hi Dr. Nicole,

A little update on Sarah.  We had out 1st appointment at Stanford Children Center August 24th.  Sarah had her 3rd Grand-Man on August 23rd.  But as I write this today we have not had a fourth.  But anxiety for parents getting high because it was 15 and 19 days in between the first two events and we are getting to that point again.  As suspected, not much discussion about root cause with Dr,  although I understand the need to try and stop the events first. 

We are currently giving 1TBSP MCT oil, the B Complex and probiotics you prescribed last time, 100 MG of Magnesium Threonate, 5000iu D3+K2, fish oil… all twice a day.

If we make an assumption that Sarah’s Candida never got under control and potentially caused leaky gut, what can we do while we are waiting for Sarah to complete her poop tests and our appointment with you?

She responded with a foods list basically to help eliminate candida and leaky gut which I will put here.


anti-inflammatory and healing foods to incorporate more of 

Bone broth: 1 cup per day for the next 2-4 weeks. I recommend Epic brand bone broth which you can buy at whole foods. You can also order Kettle and Fire bone broth online or make it yourself. This is very soothing and healing
Turmeric fresh root or ground spice: 1/8-1/4 tsp per day. You can cook with this, add it to your bone broth or make a tea with the fresh root simply by stealing the sliced root in hot water. This tastes great with fresh ginger and a cinnamon stick. 

Ginger fresh root or group spice: 1/8-12/ tsp per day. See above for recommendations to incorporate. Organic aloe vera juice (inner fillet only): 1 ounce twice per day. 

Foods to eat freely: 

Meat and poultry: Organic and free-range is always preferable Organ meat: Organic is preferredBone-broth soup: The broth is rich in amino acids that maintain a healthy gut lining
Fish: Especially fatty fish like salmon, sardines, mackerel, anchovies, and herring. Wild is preferable.
Starchy Plants: Such as root vegetables, plantains, yucca, beets, etc. 

Non-starchy vegetables: dark leafy greens, cruciferous veggies,
Fermented fruits and vegetables: Sauerkraut, kimchi, beet kvass, coconut kefir, etc.
Healthy oils: coconut oil, ghee, avocado, macadamia, olive
Sea salt and spices: Vinegar such as apple cider is great for salad dressing. Avoid sugar and artificial flavoring Eggs: pasture-raised. May need to be avoided for psoriasis or other autoimmune conditions. 

Eat in moderation: 

Whole fruit: up to 2 servings per day. Raw is okay. Berries are best.
Nuts and seeds: a small handful per day. Soaking nuts and seeds makes them easier to digest Coffee and tea: one cup per day black or with non dairy milk 

Avoid Completely: 

Dairy: except for ghee. Goat milk kefir is okay
Grains: rice, wheat, cereal, oats, quinoa, etc.
Sweeteners: sugar, high-fructose corn syrup, artificial sweetener, sugar, Chocolate: milk contains sugar and dairy. You can have 75% cocoa Processed and refined foods: if it comes in a bag or box don’t eat it Soda
Processed meat: sausage, bacon, etc 

I had been making soups with bone broth but had stopped because I learned it was high in glutamate so I repsponed to Dr. Nicole:

—- On Thu, 09 Sep 2021 12:45:17 PM -0700 <Sarah Pansegrau > wrote —

Hi Dr. Nicole,

Thank you for this!  We have been doing some of this but avoiding certain things like fruit while we were on keto.  However, we are more of a paleo diet now so we will get some berries and such back into her diet.  And we have been avoiding your “avoid list”.  

We were using kettle & fire bone broth for soups but just learned it is very high in glutamate.  The proverbial rock and a hard place I suppose.  Perhaps i can make soups 25% bone broth and 75% water as i was using all bone broth perviously  Or just have her drink one cup per day.  I’m sure you can imagine we are so very paranoid now.

Is a Turmeric supplement ok?

fyi, we have shipped back the heavy metal test stool sample which only required one sample.

I love how now a days we can email our doctors directly for simple questions.  Dr. Nicole responded same day and her response in conjunction with the above article was very exciting.

Her response:

Ah good point on the bone broth and glutamate. It’s probably best to avoid it for now. 

And yes, a turmeric supplements is okay. 

I reached out to my colleagues to see if anyone has expertise in this area and I heard back from Dr. Camile

“Yes, I’ve had good success with grand mal. Acupuncture and especially herbs. Needles are done briefly and I stay the room as we don’t want a grand mal with needles in. Another option is supplements to support her neurochemistry. I recommend the Labrix neurotransmitter test. They also need to adjust diet to eliminate neurochemical triggers. Another possibility is 23andme genetic testing to see what’s going on with neurotransmitters. A GAD enzyme deficiency is common”

I can order the Labrix test she mentions if you’d like or do you want to wait and see what the stool testing says? I’m sure it’s been a little overwhelming with all the testing and doctors visits. 



I highlighted what was so exciting to me.  Finally, a doctor willing to talk about neurochemistry and telling me about the GAD enzyme as a possibility.  As you can see in my emails I did not say anything about GAD!  

And of course I requested he Labrix test.  It looks like this test measures all the things I’ve been reading about as it relates to neurochemistry which is a new word for me.

While very excited and optimistic again I’m now very tempered with expressing so as to not create any false hope or expectations.  I have now started down a rabbit hole on Candida because it was confirmed on October 2020 Sarah had an overgrowth.

I’m tempered because I have learned how difficult it can be to get rid of a candida overgrowth and how it takes very strict dietary changes and no cheating.  People go years trying to heal their gut from Candida.  But now we have something really focus on whether it is the cause or not.

But the facts are facts:

  • Candida overgrowth is bad.  
  • Candida overgrowth can impede nutritional absorption causing deficiency’s no matter how well you eat.  
  • Candida releases the toxin acetaldehyde which impedes the methylation process that inhibits enzyme production including the GAD enzyme which is REQUIRED to convert excess glutamate into GABA.
  • Vitamin B critical in the methylation process of which Sarah was low on back in October 2020 as show in her bloodwork.
  • Candida can create a Vitamin B6 deficiency which is critical for the GAD enzyme to convert excess glutamate into GABA
  • Sarah had/has a Candida overgrowth

If it looks like a duck, quacks like a duck, walks like duck, it must be a $%^^& duck!

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I’m a dedicated father of two; a son (Ricky) and a daughter (Sarah). They are both in their final years of high school. As a young man I always knew I wanted to have children; it’s so hard to imagine not having children. Once you have children you then know the meaning of the willingness to die without hesitation for them. I’m a type A personality with a bit of OCD built in making the perfect mind to go down any rabbit hole needed to solve a problem. I’ve always told my kids life is nothing more than solving life’s day-to-day problems. I guess that is why I ended up in the IT world. I work on facts and data and then make the best decision at the time and never look back. I get satisfaction from taking the confusion of chaos and turning it into something understandable and beautiful.

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