Case Study: Experimental Antibiotic Tx Gone Wrong

Justine Thorner
Case Study: Experimental Antibiotic Tx Gone Wrong

Functional Lab Work Case Study

Presented By: Dr. Zachary, DC AFMCP 

Dr. Zachary, D.C.

Licensed chiropractic physician in CA (D.C.) with 18 years experience

  • Extensive functional medicine training (AFMCP/IFMCP)
  • Founded Body Love Cafe (Holistic Health Clinic)
  • Lead Instructor: Functional Medicine Academy
  • Created software to analyze FM labs for practitioners

Patient Presentation

  • 64 y.o. Female, “Amy”, active, healthy BMI, employed 
  • Severe lack of hunger, HTN, Graves dx 
  • Floating stools, loose/frequent BM, mild heartburn 
  • Hx: “experimental tx with Ab” as a teen for acne including 3 years of antibiotics, steroids and BCP 
  • Hx: yeast infections, acne, irregular menses, thyroid radiation, tonsillectomy, sickly & ear infections as a child 

Dr. Zachary utilized the GI MAP DNA-qPCR stool test for this patient. Lab results are below, followed by Dr. Zachary's interpretation of the labs.

Lab Results

Interpretation of Labs:

  • Dysbiosis - likely play a role in overgrowth of several opportunistic bacterial markers which are now playing a contributing role in her loose stools.
  • High Firmicutes/Bacteroidetes ratio may contribute to patients weight gain and insulin resistance.
  • Autoimmune markers present and elevated which are known to "initiate and sustain the autoimmune process" and may have played a role in her Graves dx.
  • High Candida markers may be secondary to past antibiotic use and likely contribute to hx of yeast infections, acne, hormone and immune dysregulation.
  • Additionally, her Elastase was very low, as was her primary immune response (SIgA) and signs of inflammation present.

Treatment Plan

  • Customized to patient’s willingness & tolerance
  • Anti-candida diet, no gluten
  • Meal spacing, vagal tone exercises, stress management + sleep support
  • Supplementation with digestive enzymes, antimicrobials, antifungals, saccharomyces boulardii, high dose probiotic with phages and biofilm enzyme with EDTA
  • Belly breathing, efforts to normalize BM
  • Phase 2 included gut barrier support and T-panel

Patient Follow-up after 5 Weeks:

  • Return of appetite, protein smells good again, no heartburn
  • Lost 2 lbs, changes in BM during the month, now normalized, dailyBM 1-2x, well-formed, sinks
  • Reported anxiety and challenges at week 2, now “mood is great”
  • Had a “yeasty rash” mid-month that resolved with red leaf horopito topical cream, no other yeast infections currently
  • Reports better sleep except when “ate gluten” and felt “horrible” for several days, plans to stay gluten-free
  • Discussed expanding diet, switched antifungals, added gut mucosal support


  • Quantitative for specific microbes (bacteria, yeast, protozoa, worms)
  • Intestinal health section invaluable for seeing impact for particular patient
  • Patient can complete test at home
  • High value clinical relevance with multiple markers for low cost

Dr. Zachary utilizes this test often in her practice for patients of hers with symptoms of constipation or diarrhea that have not been easily remedied. She also orders this test for patients with autoimmune, hormone and immune issues, if digestive issues are also present.

To learn more about Diagnostic Solutions Laboratory and the tests they offer, visit the Rupa Health Lab Test Catalog and select Diagnostic Solutions as the Lab Company. From here you can see the specimen type and more details on each test. If you're a Rupa Practitioner, you can also view the cost of each test.

Not yet a Rupa Practitioner? It’s free to sign up here.

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Justine Thorner
Head of Marketing and Sales at Rupa Health, Holistic Health Coach, Doula, and Birth Coach
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