A 45 y/o female client with history of tick borne diseases, mold exposure and chronic thigh pain and long term brain fog. She complains that she doesn't sense much improvement from TBD treatment, nor does she feel much in general. She is on low dose SSRI for many years and has a history of little T childhood trauma for which she has not yet received much support. She has been on a "healthy" high oxalate diet for many years, with high serum ox, and recently abruptly changed to a lower oxalate diet. Her steatocrit 30, and zonulin 260, are both extremely high on a recent stool culture. Her beneficial bacteria were all very low except a few bifidos. She is homozygous on ABCC4 and some weakness on ABCC11. Her recent gall bladder sonogram is negative, but the pancreas is showing "mildly heterogeneous echogenicity" for which she will seek medical advice. Do you have any thoughts on this? If related to the high steatocrit, then how? With the pancreas involvement, might the plan to bring in suppository probiotics, bile production and transport support, PC, flax, psyllium, and castor oil, still be in line?