Gastritis

[Tina Vu]

Hello,
Have a 70 yof patient with long hx of gastritis.

PMHx: hypercholesterolemia (on statin), diabetes (on metformin), hypertension, GERD (on PPI), depression/anxiety (was recently put on anti-depressant about 2 months ago)

Takes no supplements

Has had a hx of fibroids and hysterectomy in 1986

With her gastritis, she gets what she describes as “anxiety in her stomach”, loss of appetite, when she eats anything, after a couple bites she will throw it back up (not all the time)

Other symptoms include: being hot/cold, depression, “shaky”, trouble falling asleep…

Here is what I am trying to understand…she says the ONLY thing that helps her is Megestrol Acetate that they prescribed for her gastritis. She said she can eat again, the anxiety in her stomach goes away, she feels great.

However, her PCP will not prescribe it anymore due to its side effects.

My understanding is that Megestrol is a progestin.

Do you have any reason why Megestrol is helping her so much?

I did thyroid panel (normal), H. pylori was negative.

I don’t know if she would benefit from Organic acids test? Or test her sex hormones? ANY feedback would be greatly appreciated!

[DrWoeller]

Tina,
Their are benzodiazepine receptors in the digestive system. Many people get anxiety-related stomach and gut problems. There are certain serotonin receptors in the gut too that are involved in this situation. Progesterone is known to increase GABA which can have a calming effect in the nervous system. It is likely the Megestrol is augmenting progesterone effects which is having an anti-anxiety effect and eliminating stomach discomfort.

The OAT may be helpful, but ultimately it sounds like hormone testing is important.

Dr. Woeller

[Tina Vu]

If hormone testing indicates low progesterone, would supplementing with progesterone cream instead of oral progesterone help her or would it have to be oral to have an effect on the “gut-anxiety”? I am also wondering if trying something like GABA supplementation would benefit her (I am familiar with Trudy Scott’s work on amino acid therapy) and she explains that “gut-anxiety” could be due to low GABA.

PS Your hormone course needs to be sooner than later (can’t wait to take it)

Thank you,
Tina

[DrWoeller]

Tina,
Either oral or transdermal would help to raise progesterone levels.

The GABA is a great idea.

Looking forward to the hormone course too.

Sincerely,
Dr. Woeller

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