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 daughters 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 daughters 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--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 Brewers Yeast (B-vitamin support).

Results with post-test:

Susans 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.