HouseCall: B Vitamins & Overstimulation, MCAS & Breastfeeding, Chronic Reflux & Hiatal Hernia, Autoimmune Gastritis, Mold & Migraines

Welcome back to our weekend Cabral HouseCall shows!

This is where we answer our community’s wellness, weight loss, and anti-aging questions to help people get back on track!

Check out today’s questions:

Spencer: Hello Dr. Cabral Working my way out of burn out, and gut issues. Trying to work in b vitamins, but getting some overstimulation. I already shifted to methyl free b9,12 as they were giving me issues likely because of gut health. Should I try to work them in first, or work on lowering stress first? I wanted to have b vitamins in my rotation before attempting the CBO protocol, but not sure if I’m able to. I know excessive oxidative stress etc in the gut can cause methylation issues, but you still need b vitamins for optimal gut health right, so it seems like a chicken and egg scenario. If you could nudge me in the right direction, I’d appreciate it. Thanks for all you do. Almost done with level 1 IHP and looking forward to meeting you at the Reimagining Health Summit in November.

Shirra: I have symptoms of MCAS I am breastfeeding where to I begin to heal it what tests to order?

Sai: Hello Dr. Cabral, thank you for all your work! 38M, healthy lifestyle, but chronic GERD with a minimal hiatal hernia since 33. On/off PPIs for 5+ years. Had 4 endoscopies in 6 years—just told to take meds. Biopsies/labs confirmed negative for H. pylori and Candida.Off PPIs for months and OK if I eat perfectly. But just one wrong food triggers an intense vicious cycle, requiring weeks of medications to reset. No bloating, constipation, diarrhea, or indigestion. Why won’t this tissue heal, and why am I so hyper-sensitive?Recently, a tiny bit of decaf coffee caused severe pain, sudden bowel movements, and a strong sensation of food stuck in my upper abdomen (must walk to move it). Back on meds now. Is chronic reflux inevitable with a minor hernia, or am I missing a root cause? Thank

Anonymous: Here’s what’s happened: 2023: Abdominal ultrasound showed a 7 mm gallbladder polyp; I had no symptoms. 2024: Endoscopy/biopsies found chronic atrophic gastritis, intestinal metaplasia mainly in the stomach body, and ECL/neuroendocrine cell hyperplasia. The pattern suggested autoimmune gastritis/pernicious anemia. No H. pylori, dysplasia, or cancer was found. Follow-up was planned every 2–3 years. July 2026: Repeat endoscopy looked reassuring with no obvious concerning area. Mapping biopsies found a tiny 1 mm, Grade 1, well-differentiated gastric neuroendocrine tumor. The doctor said the visible bump was fully removed. No dysplasia or usual stomach carcinoma was found. Plan: conservative monitoring and repeat endoscopy in 6–12 months. My question: Can this/ autoimmune gastritis be reverse.

Nicole: Hi Stephen, A bit of background: I suffer with migraines, which started in 2021 around the time I was living in a mold-exposed environment (I also received the COVID shot that same year). I’m based in Australia. I had urine mycotoxin testing that came back elevated for ochratoxin A, aflatoxins, trichothecenes, and zearalenone. Based on those results, I purchased your Mold Protocol. I’ve also put on significant weight since the mold exposure. I also recently had a stool microbiome test done, which showed low levels of several beneficial bacteria (including Akkermansia muciniphila and various Lactobacillus and Bifidobacterium species), along with an elevated Phocaeico

Thank you for tuning into today’s Cabral HouseCall and be sure to check back tomorrow where we answer more of our community’s questions!