Hi @Tatjana – welcome to the community! I will reply to you here, but please note that for more complex case questions and replies, I’d highly recommend posting in the “Ask a Question” discussion forum so that it’s easier for you to refer back to later. https://bbv2.genesisengine.io/groups/private-members/forum/ask-your-questions-2/

All of your discussions, documents, photos, etc get saved in your profile so you can easily access them in the future (from Profile or your Home page), whereas posting here directly in the activity feed can easily get lost between all of the messages (plus we can’t hyperlink words in comments).

Nonetheless, I’d like to offer some guidance given the labs and symptom of random shakes you’ve shared. Please keep in mind that your lab results are more than a year old, so there could be many changes since that time, especially if you’ve worked on the issues during this time.

The lab tests confirmed bacterial overgrowth (SIBO) as well as lactose intolerance so there is a strong need to work on gut health if you haven’t already. We actually have a SIBO/IBS Relief program that can help you figure out root causes, and offers rapid relief solutions, dietary guidance, as well as root cause resolution support. You can find that in Take Action > Programs: https://bbv2.genesisengine.io/courses/sibo-ibs-relief-2/

The blood tests also showed clinically high levels of direct bilirubin which may point to bile flow issues, liver detox overload, or gut-liver axis dysfunction. Lack of bile flow is a common factor in the development of SIBO so addressing the congestion and addressing what lead to biliary tract congestion is priority. This will also impact a person’s ability to digest and absorb fats, including fat soluble vitamins A, D, E and K.

My go-to for biliary tract congestion is D-limonene (1,000mg 1-2 x per day with food). You can learn more about that as well as other liver/gallbladder support in the Gut Health Masterclass lesson here: https://bbv2.genesisengine.io/courses/gut-health-masterclass-2/lessons/liver-gallbladder-support/

Along the same lines, MCV is suboptimally elevated which can point to a need for B vitamins. With a clinically low MCHC, vitamin B6 and iron are often required. If a person is not consuming enough animal proteins (or digesting/absorbing them properly), supplementing with a methylated B complex supplement is a good idea. This also helps with phase 1 liver detoxification.

Now going back to why you may get random shakes, there could be a few possibilities:

1. With SIBO and lactose intolerance, there is likely a lot of wear and tear on the gut lining which can lead to malabsorption of nutrients, loss of enzyme production (like lactase to breakdown lactose, and DAO to breakdown histamine). Pizza can be a perfect storm of triggers: refined carbs, gluten, cheese (lactose), and possibly fermentable fibers — all of which can worsen SIBO symptoms. This could cause post-meal bloating, pressure on the vagus nerve, and trigger autonomic symptoms (like shaking, dizziness, and feeling “off”).

2. Pizza contains histamine-rich foods (cheese, tomato, processed meat perhaps?). If your gut bugs aren’t breaking histamine down properly (common with SIBO), or your liver is overburdened, you may react with nervous system symptoms like shaking, anxiety, nausea, and feeling “unwell”.

3. Possible reactive hypoglycemia? Your fasting glucose seemed “normal” at the time, but fasting insulin wasn’t measured. If it’s elevated, this could decrease glucose levels and make it appear “normal”. You didn’t mention your typical diet or stress levels, but if this is something that resonates with you, you might want to retest a blood sugar panel which includes fasting glucose, fasting insulin, HbA1c for starters. Alternatively, you can look at getting a glucometer or CGM (glucose monitor) which have become quite trendy amongst biohackers. 🙂

4. Food intolerances/sensitivities may also lead to shakes. If the pizza had cheese which you’re intolerant to, not only will it cause GI distress, but it can also cause a nervous system response leading to shakes. Does this only happen when you consume dairy? Or does it also happen with other foods? Have you ever kept a journal or done a food sensitivity test?

In terms of action steps, here are things to consider:

1. Support the 3 digestive players “GPS” (gallbladder/bile, pancreas/enzymes, stomach/stomach acid). Consider digestive enzymes, ox bile support, betaine HCl (if no H Pylori overgrowth).

2. Reduce histamine overload by trying a low-histamine diet for a few weeks to see if symptoms improve/go away. If it’s only once in a while, it might be hard to tell, but if you have any other symptoms, it could help us be more targeted with our suggestions. https://bbv2.genesisengine.io/resource-library/diet/histamine-elimination-diet/

3. Support liver/gallbladder bile flow: dandelion, artichoke, phosphatidylcholine, castor oil packs, and D-limonene are all helpful. Please watch the video I shared above for more suggestions.

4. LOTS of gut healing to help support the intestinal lining and brush border: https://bbv2.genesisengine.io/courses/gut-health-masterclass-2/lessons/gut-healing-therapies/

5. Checkout the SIBO/IBS Relief program to walk you through it step by step.

If you have any other questions in the meantime, please feel free to let us know!