TFCC tears & the Gut - what's the connection?

Since 2006, I have noticed a select group of cases that present with an onset of ulnar sided wrist pain simultaneously in both wrists, without any known cause. 
The curiousness of this group's symptoms led me to ask more questions. In a small study, I asked 20 patients who presented with bilateral, significant loss of weight-bearing tolerance, and no known injury, to have a CBC, stool and urine test. It was a flawed study in 2009 because the lab and testing were not controlled.
Nonetheless, of the 20 cases, 18 had significant disturbances in their gut:
 6 with bacterial infections 
 5 with parasites
 7 with Candida albicans.
 2 with STD's


What was even more interesting in this study was the resolution of ulnar sided wrist pain when their intestinal imbalances were treated. It certainly captured my attention!


Wendy had a very informative discussion about the TFCC and Gut health on a recent Instagram episode.  Here is the link and topic list. 

Episode 10 The Gut-tfcc connection
0:56-2:30 Stool test study
2:30-3:36 What does gut health mean?
3:36-4:00 Parasites and protozoa
4:00-4:20 Bacteria
4:25-4:49 Other stomach problems
5:01-5:33 Tennis player case
5:49-6:10 tfcc and small intestine
6:10-7:42 Symptoms
7:42-8:43 What do I do about gut symptoms?
8:43-11:04 - comprehensive gut analysis
11:12-13:40 What can I do at home?
13:40-14:09 Ulnar sided wrist pain related to gut
14:09-14:25 12 hour break from digestion
14:25-14:49 Celery juice
14:54-15:18 Indigestion/heat in gut
15:18-15:45 Lack of enzymes/lack of heat
15:45-16:27 Different gut issues effect different parts of the wrist
16:46-17:17 Long term gut issues and nerve problems
17:17-17:55 Supplements based on issue
17:59-18:49 Nerve problems
19:45-20:20 How comprehensive gut test works
20:20-21:31 Naturopathic doctor
21:45-22:20 Long term indigestion case
23:02-23:35 Chronic heartburn
24:08-24:19 Psyllium

In a second talk, Wendy met with Dr. Dean to discuss the importance of Magnesium and mineral supplementation for ulnar wrist pain, gut issues, and overall health. 

Episode 15: Dr. Dean Mg & supplements for wrist, gut, health.
3:50 Introduction
6:00 How do you test for mineral and magnesium deficiency
8:00 Magnesium deficiency in different groups
9:37 Range of magnesium
10:47 Why it's important to be in the top percentile
11:00 When to re test baseline levels
11:42 Symptoms related to Mg deficiency
13:53 ReMag for deficiency
15:52 Non laxative magnesium
16:42 Why your body can't get saturated in Mg
18:15 How long does it take to saturate?
18:32 ReMyte mineral supplement for other mineral deficiencies
19:07 ReMyte for Thyroid issues
19:41 Thyroid displayed in upper extremity, rotator cuff, and tendons of thumb
19:52 Systemic mineral disfunction in flexor tendons
19:57 TFCC - broad loss of minerals
21:41 Which supplement do you start with?
21:49 Hydrate with sea salt
23:16 Muscle spasms
24:30 IBS and relation to yeast overgrowth
27:00 Candida


Since 2010, the knowledge of the gut has gone through a scientific revolution. The ability to test the gut and understand the ranges of normal have largely been due to the "Gut Project" and advancements in testing.

In Chinese Medicine, the TFCC is related to the small intestine health via the heart meridian. The small intestine functions to absorb 90% of nutrients.

This is important. Any disturbance in the small intestine will affect our ability to absorb important minerals and nutrients.


  • Iron is absorbed in the duodenum.
  • Folate (Vitamin B9) is absorbed in the duodenum and jejunum.
  • Vitamin B12 and bile salts are absorbed in the terminal ileum.
  • Water is absorbed by osmosis and lipids by passive diffusion throughout the small intestine.
  • Sodium bicarbonate is absorbed by active transport and glucose and amino acid co-transport
  • Fructose is absorbed by facilitated diffusion.
  • The small intestine also has a responsibility for your immune system. 

I started investigating labs and new tests for my patients and found two that have proven to be very important and informative. The Great Plains Laboratory has an organic acid urine test Your doctor can order the test which is sent to your home. 

The Organic Acids Test (OAT) offers a comprehensive metabolic snapshot of a patient’s overall health with 76 markers.  It provides an accurate evaluation of intestinal yeast and bacteria.  Abnormally high levels of these microorganisms can cause or worsen behavior disorders, hyperactivity, movement disorders, fatigue, and immune function. Many people with chronic illnesses and neurological disorders often excrete several abnormal organic acids in their urine. The cause of these high levels could include oral antibiotic use, high sugar diets, immune deficiencies, acquired infections, as well as genetic factors.

A stool test is equally important. Diagnostic Solutions offers a GI Microbial Assay Plus (MAP) test. This test is priceless.  The GI-MAP was designed to detect microbes that may be disturbing normal microbial balance or contributing to illness as well as indicators of digestion, absorption, inflammation, and immune function.

Once the data is collected, I have found few that can interpret and offer solutions. Dr. Bryan Skinner at Cypress Natural Medicine His team is able to meet with you online and come up with a plan of care.

It's important to share that I have no affiliation with any of these organizations.  Through research and due diligence, I have found and used them with my patients and trust the tests and interpretations. 

If you have ulnar sided wrist pain that arose from no known injury, I hope this information can lead to a better understanding of your unique self. If you do decide to take the tests, please share your case with me. I am hopeful we can better document the connection between the gut and the wrist.

Happy Healing!