TFCC & 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 without any known cause. Typically these cases present with bilateral symptoms.

 

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.
and 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! 

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. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074899/

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 https://www.greatplainslaboratory.com/organic-acids-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. https://www.diagnosticsolutionslab.com/tests/gi-map 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 https://cnmhealth.com/ 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!

Wendy

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