Alopecia Areata A 13 year old patient by the name of Susan initially consulted with me back in 2013. She was suffering with Alopecia Areata since the age of 5. She was seen by a primary physician and a dermatologist. Treatment consisted of topical corticosteroids resulting in a “slight” measureable improvement. The mother was referred to my office and was deeply concerned about the emotional toll the alopecia was taking on her daughter’s life. In addition, she was dissatisfied with the topical medication and concerned about the long term side effects not to exclude the fact that the results were poor. The mother wanted answers to the possible causes of her daughter’s alopecia and was told by the dermatologist that most auto-immune diseases have no specific cause. After a thorough history and examination, I decided to order a Secretory IgA test, stool test, organic acids, Vitamin D and IgG Food Sensitivity test. The following are the results:

Stool Analysis Results Triglycerides (3.4) Elevated/>3.3 mg/g Incomplete fat hydrolysis Consider Bile insufficiency, Reduced pancreatic function, High fat diet, Hypochlorhydria Fatty Acids (41.0) Elevated >23.7 mg/g Consider Malabsorption, Increased mucosal cell turnover, Bacterial overgrowth of the small intestine, Bile insufficiency Cholesterol (5.7) Elevated >3.5 mg/g Consider Malabsorption, Increased mucosal cell turnover, Bacterial overgrowth of the small intestine Fecal Fat (58.9) Elevated >32.4 mg/g Consider Malabsorption, increased mucosal cell turnover, bacterial overgrowth of the small intestine Beneficial Bacteria Lactobacillus- 0 Bifidobacteria: +1 Consider Dysbiosis

Vitamin D Results:

Here is the medical paper for your review: http://omicsgroup.org/journals/2167-0390/2167-0390-1-105.pdf

Secretory IgA Results

Mucosal surfaces are the first lines of defense against invasion and colonization by pathogenic microorganisms. The principal molecule of mucosal immune responses is Secretory IgA (sIgA), which is produced by activated B-cells. Upon activation, B-cells in the mucosa form immune complexes with the pathogens and antigens encountered, thereby preventing antigen attachment to the intestinal wall, which may result in antigen penetration of the intestinal lining. IgA is the only immunoglobulin isotype that can be selectively passed across mucosal walls to reach the lumens of organs lined with mucosal cells. An imbalance of protective SIgA can result in a compromised mucosal immunity and eventual gastrointestinal, immunological and neurological disorders.

IgG4 Food Antibodies

Organic Acids

a-Ketoisovalerate, a-Ketoisocaproate and a-Keto-ß-methylvalerate Commentary: Functional markers of thiamine (B1) insufficiency.

Clinical Comments: Based on the results of Susan's labs, it was my opinion her alopecia was likely a result of a combination of intestinal mucosal hyperpermeability contributing to malabsorption, digestive insufficiency, gut dysbiosis and vitamin D deficiency. In addition, I felt the positive IgG4 food antibody results were the likely culprits causing the elevated SigA. My treatment focused on decreasing the mucosal inflammation via strict adherence to refraining from consumption of the positive foods, proteolytic enzymes (Inflazyme Forte) and prescribing a product called Support Mucosa from BioMatrix http://biomatrixone.com/support-mucosa.html I rounded the treatment with probiotics, 5000 IUs of Vitamin D3 and Brewer’s Yeast (B-vitamin support).

Results with post-test: Susan’s response to the above treatment was remarkable. She now has a full head of hair and as you can see from her post test dated 9/18/13 her Secretory IgA has returned to normal.

This is the power of functional medicine.