Betsy Hendricks MD at the AR Center

07/06/2026

Another Gut-Brain Connection?

“Shall we play a game?”
Can you name the movie from 1983?

“Wouldn’t you prefer a good game of chess?” is another line from this movie.

Let’s talk chess and checkers. And we’ll talk about a Gut-Brain Connection you may not hear much about.
But first, let’s talk about why looking at human physiology and biochemistry is not like playing checkers. Checkers is a 2 dimensional game. Each time a person makes their move, there may be several possible moves for the opponent. But the number of possible moves is limited to the available spaces on the board and the number of pieces in play. Each player has 12 identical pieces that can only move diagonally on the board.
Chess, in its classical form, is also a 2 dimensional game and is played on a 8 x 8 grid, just like checkers. But each player has 8 identical pawns, 1 king, 1 queen, 2 bishops, 2 knights and 2 rooks. Each of these pieces has its own set of rules for moving on the board. The possible moves throughout the game are considerably more than in checkers.

I think of human physiology, the chemical reactions that drive the function of cellular organelles, as being more like 3-dimensional chess. We often think of one chemical doing ONE thing but the reality is that any given chemical can participate in multiple different chemical reactions in the body. How a chemical functions will depend on where it is and what else is occurring chemically in that location.

Take Butyrate for example.
That is, after all, what this essay is about.

Butyrate.
Butyrate is a short chain fatty acid that is found in mother’s milk - cow, human or other mammal. So we have a clue that this is an important nutrient. Later in life, the young mammal will have the Butyrate provided from another source. One source is some of the bacteria that live in the gut microbiome. But if that microbiome is not yet developed, or has been disrupted by antibiotics or toxins, Butyrate production can be compromised.
If Butyrate functions were like a game of checkers, the one thing it would do is provide fuel to the cells that line the intestine. That’s it.

If Butyrate functions were like a game of chess, Butyrate would provide fuel to the cells that line the intestine, and also act as an HDAC inhibitor which up-regulates some of our genes - allows the genes to be translated for the purpose of making proteins that have multiple functions in cells. In immune cells, this can favor genes that code for anti-inflammatory cytokines.

Butyrate may support a reduction in inflammation.
Siddiqui MT, Cresci GAM. The Immunomodulatory Functions of Butyrate. J Inflamm Res. 2021 Nov 18;14:6025-6041. doi: 10.2147/JIR.S300989. PMID: 34819742; PMCID: PMC8608412.

Butyrate is involved in Immune System regulation, including an effect on Mast Cells.
Corrêa RO, Castro PR, Moser R, Ferreira CM, Quesniaux VFJ, Vinolo MAR, Ryffel B. Butyrate: Connecting the gut-lung axis to the management of pulmonary disorders. Front Nutr. 2022 Oct 20;9:1011732. doi: 10.3389/fnut.2022.1011732. PMID: 36337621; PMCID: PMC9631819.

If Butyrate functions were like a game of 3-dimensional chess, it would provide fuel to the cells that line the intestine; also act as an HDAC inhibitor which up-regulates some of our genes; and as an HDAC inhibitor, up-regulates the CFTR gene which in turn, regulates the expression of additional genes. Butyrate can up-regulate production of CFTR cell membrane protein.
In cells that have CFTR in the cell membrane (this includes multiple types of cells, not just endothelial cells), the up-regulated production of CFTR cellular membrane protein can favor an increase in release of Glutathione into the extracellular fluids. The CFTR cell membrane protein also regulates other membrane proteins like the Epithelial Sodium Channel as well as regulating the expression of some mitochondrial genes.
(I write about this in the second book, Broken Body. References for these statements are in the book.)

What else can Butyrate do? Butyrate can be involved in nerve health. Remember that you have a big bundle of nerves in your head!

Chakraborty, Prapti; Laird, Angela S.*. Understanding activity of butyrate at a cellular level. Neural Regeneration Research 20(8):p 2323-2324, August 2025. | DOI: 10.4103/NRR.NRR-D-24-00468

But going back to how Butyrate is a fuel for the cells that line the intestines. Adequate fuel leads to healthier cells and healthier “tight junctions” that hold the sides of the cells together and helps prevent proteins from foods and from bacteria, “leaking” through the cellular barrier into the blood stream. A healthier gut lining can lead to less immune reactions to foods.

Adequate Butyrate can influence GI tract health (and support a healthier microbiome).
Adequate Butyrate can influence immune system balance.
Adequate Butyrate can have an effect on Mast Cells.
Adequate Butyrate can influence Glutathione availability.
Adequate Butyrate can influence nerve health.

So, let’s play Physiology Chess or 3-Dimensional Chess.

If we want to improve the health of the cells that line the GI tract, what is one option for this?
If we want to support a shift from pro-inflammatory immune response to anti-inflammatory immune response, what is one option for this?
I we want to help stabilize Mast Cells, what is one option for this?
If we want to improve availability of Glutathione, what is one option for this?
If we want to improve nerve (and brain - that big bundle of nerves in your head) health, what is one option for this?

The answer to each of those questions, at least one possible answer, is to improve availability of Butyrate.

Improving the health of the gut microbiome is a good step, but you may actually benefit from using supplemental Butyrate (from foods or supplements) to improve the health of the gut so that you can improve the health of the gut microbiome. A gut microbiome is not quickly restored by a pack of probiotics or a carton of yogurt. The environment of the gut microbiome must be prepared and tended for the microbes to flourish.

Butyrate is something that may benefit people who have chronic, inflammatory conditions.

I am not at an academic center or employed by a major medical center. I’m just a small town doc trying to do the best that I can for my patients.

You can learn more about the work that I do on my Patreon page (many posts are free to read) and from the books that I wrote for my patients.

I recommend reading the books in order. Books 1 and 2 are in the bookstore. Book 3 is still in the editing phase. Get started with Broken Brain and Broken Body and then you will be ready for Book 3, Breaking Free.

The links for the bookstore page and for my Patreon page are on my website.

betsyhendricksmd DOT com

I’ll put the link to my website in a comment.

NOTE: The information presented in this post (and all of my posts) is for informational use only. This information is not intended to diagnose or treat any condition and should not be taken as medical advice. If you have medical concerns, please discuss these with your healthcare provider.

06/15/2026

Trickster TSH in ME/CFS

I put this information in the books instead of in many disjointed articles. But if you don’t know that the information is in the books, you don’t know that you can find it by reading the books. It’s a bit of a paradox.
An article came out on Medscape this week which made me think, “Okay, I need to talk about this.” People need to know about this aspect of TSH if they have ME/CFS or one of the other multi-system Chronic Complex Diseases (msCCD). These may include but are probably not limited to: ME/CFS, Fibromyalgia, Dysautonomia (including POTS), Long Covid, Post-Viral Syndrome, hEDS, Chronic Lyme, Autism, PANS/PANDAS, Gulf War Syndrome/Illness. These are many names for conditions that have overlapping symptoms.
To understand how TSH can be misleading in ME/CFS and/or other msCCD, it is important to understand that the evidence is pointing to Neuroinflammation as a central theme. In the Mayo article (Grach SL, Seltzer J, Chon TY, Ganesh R. Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Mayo Clin Proc. 2023 Oct;98(10):1544-1551. doi: 10.1016/j.mayocp.2023.07.032. PMID: 37793728.), the opening line is, “Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic neurological disease often preceded by infection.”
One of the points I make in the books is that we are looking at Neuroinflammation and how this affects the body. And how Neuroinflammation, from a biochemical, pathology point of view, looks a lot like Traumatic Brain Injury.
Why is this important? In the first book, Broken Brain, I describe how inflammation can affect the brain and lead to many different symptoms. Trauma that affects the brain can be from: physical trauma; emotional trauma; head trauma/TBI (traumatic brain injury); prolonged stress; sleep deprivation; oxidative stress; inflammatory (to the brain) trauma from pathogens and/or systemic inflammation. (NOTE: The pathogens do NOT have be in the brain.) Trauma that affects the brain can initiate Neuroinflammation in the Central Nervous System. A person may not even be aware of this process happening in the brain.
In the second book, Broken Body, I write about (with citations) how the Neuroinflammation can affect every organ and every system of the body, but can also affect the structures in the brain including the hypothalamus and the pituitary. I explain why this can mean that TSH may not be a reliable indicator of thyroid function in ME/CFS and related conditions. Other endocrine functions may also be affected.
But back to TSH. There was an article in Medscape (Secondary Hypothyroidism: Why TSH is Misleading - Medscape - Jun 10, 2026). The article is a transcript of a podcast from two Endocrinologists who were having a discussion about Secondary Hypothyroidism and TSH. This is from the Thyroid Stimulating Podcast, which was created in partnership with the American Thyroid Association to discuss up-to-date diagnosis and management of a wide array of thyroid diseases.
The two Endocrinologists, Kaniksha Desai, MD and Sara Lubitz, MD, discuss how Secondary, or Central, Hypothyroidism differs from Primary Hypothyroidism and why this makes a difference in how TSH is interpreted.
They mention that the prevalence of Central Hypothyroidism is fairly low, about 1 in 20,000 to 80,000 people, but that it is consistently under diagnosed.
But what I think they may not realize is that many people with ME/CFS and related illnesses may have Central Hypothyroidism as part of their illness.
Dr Lubitz: “The most important thing is when there’s a low free T4 and a non-elevated TSH. Also, you should be thinking about it with known or possible pituitary disease, pituitary surgery, radiation, pituitary hormone abnormalities, or unexplained hyponatremia. One of the things we’re seeing now is TRAUMATIC BRAIN INJURY CAUSING CENTRAL HORMONE DEFICIENCIES. That’s another time to think of it.”
Now what did I say earlier about Neuroinflammation and Traumatic Brain Injury?
There are a lot of patient charts were I state that “even though the TSH is consistently low, the T4 (thyroxine) is in range with current treatment and if we adjust the thyroid dose to get the TSH in range, the T4 will be too low.
Central Hypothyroidism is a real thing and inflammation in the brain can be one reason that it is occurring.
The endocrine involvement is part of this illness, this constellation of illnesses.
Read the Medscape article.
Read the Mayo article.
Read my books. I walk you through how this Neuroinflammation can occur - Broken Brain - and how it affects every organ, every system in the body - Broken Body - and then in the third book (in editing) how to use this knowledge to improve symptoms and function

I am not at an academic center or employed by a major medical center. I’m just a small town doc trying to do the best that I can for my patients.

If you want to learn more about what I am talking about, you are welcome to get the books and also review the information on my Patreon page. (There are some things in Book 2, Broken Body, that never made it to my Patreon page. This includes some research information on the relationship between trauma and PTSD. Also information on Vasopressin (antidiuretic hormone), neuroinflammation and Orthostatic Intolerance (and ME/CFS).

I recommend reading the books in order. Books 1 and 2 are in the bookstore. Book 3 is still in the editing phase. Get started with Broken Brain and Broken Body and then you will be ready for Book 3, Breaking Free.

The links for the bookstore page and for my Patreon page are on my website.

My website is:
betsyhendricksmd DOT com

I’ll put the link to my website in a comment.

Comments are turned off. If you have a question or need to contact me, you are welcome to send a message.

NOTE: The information presented in this post (and all of my posts) is for informational use only. This information is not intended to diagnose or treat any condition and should not be taken as medical advice. If you have medical concerns, please discuss these with your healthcare provider.

06/09/2026

Something More to Say

I told you in March that I had been quiet on facebook for a while. I let you know that I was still seeing patients and that I had been writing,

I have been writing a 3-book series. The first book in the series, Broken Brain, was up on my bookstore page in March. I just finished reviewing the proof of the second book, Broken Body, and this is also now available.

The second book takes a deeper dive into what I think is a very important aspect of Glutathione. If you have studied Glutathione, or if you have considered it as a supplement, then you probably already know that we need Glutathione as an antioxidant and also for detox support. We all make Glutathione but there are factors that affect how much Glutathione we have available.

In the first book we learned about Neuroinflammation and why understanding the relationship between Glutathione and Glutamate is important. We learned about the effect that Neuroinflammation can have on the body, leading to many of the symptoms that we see in the multi-system Chronic Complex Diseases (msCCD). These may include but are probably not limited to: ME/CFS, Fibromyalgia, Dysautonomia (including POTS), Long Covid, Post-Viral Syndrome, hEDS, Chronic Lyme, Autism, PANS/PANDAS, Gulf War Syndrome/Illness. These are many names for conditions that have overlapping symptoms.

Broken Body takes a deeper look at the evidence suggesting a link between Neuroinflammation and these conditions.

Broken Body takes a deeper look at the regulation and control of Glutathione.

We have learned a lot about the importance of Glutathione in the past 20 years. You probably know that Glutathione is a very important intracellular (inside the cell) antioxidant and is also a very important extracellular (outside the cell) antioxidant.

What you may not know is that Glutathione has a “Gate Keeper”.

Available Glutathione is limited by precursor (cysteine, glycine) availability and biochemical pathway function. A variety of vitamins and minerals are required for the biochemical reactions to occur.

Glutathione functions within the cell as an important antioxidant. Glutathione also has functions outside of the cell.

The availability of Glutathione outside of the cell is limited by a Gate Keeper. The Gate Keeper has to do with the ability of Glutathione to move from inside the cell where it is formed, to outside the cell. The Gate Keeper that I am referring to is a gated cell membrane channel. There are several cell membrane channels that facilitate Glutathione movement across the cell membrane, but there is one in particular that I find very interesting. The availability of this channel is modulated by certain hormones and chemicals. This channel can be down-regulated by Oxidative Stress and toxins. This channel can be up-regulated by Estrogen and down-regulated by Progesterone. This channel can be up-regulated by Butyrate which is an HDAC inhibitor.

This membrane channel also influences mitochondria function and cell membrane potential. Mitochondria function and cell membrane potential are directly tied to cellular energy, to your energy.

As I mentioned in March, I am not at an academic center or employed by a major medical center. I’m just a small town doc trying to do the best that I can for my patients.

I have been using this information while working with my patients and I put this information in my books.

I put this information into books to help my patients understand what I am talking about and to help them understand why I use the methods that I do in my evaluation and in my treatment plans.

Patients can buy these books. By following the “Books” link on my website, you can buy these books too.

If nothing here resonates with you, just keep scrolling.

If you want to learn more about what I am talking about, you are welcome to get the books and also review the information on my Patreon page. (There are some things in Book 2, Broken Body, that never made it to my Patreon page. This includes some research information on the relationship between trauma and PTSD. Also information on Vasopressin (antidiuretic hormone), neuroinflammation and Orthostatic Intolerance (and ME/CFS).

I recommend reading the books in order. Books 1 and 2 are in the bookstore. Book 3 is still in the editing phase. Get started with Broken Brain and Broken Body and then you will be ready for Book 3, Breaking Free.

The links for the bookstore page and for my Patreon page are on my website.

My website is:
betsyhendricksmd DOT com

I’ll put the link to my website in a comment.

Comments are turned off. If you have a question or need to contact me, you are welcome to send a message.

NOTE: The information presented in this post (and all of my posts) is for informational use only. This information is not intended to diagnose or treat any condition and should not be taken as medical advice. If you have medical concerns, please discuss these with your healthcare provider.

03/22/2026

I’ve been quiet.

I’ve been quiet here on facebook but have been active with communicating directly with my patients.
I’m just dropping in to say that I am still seeing patients and I have been writing.

I’ve been writing on my Patreon page. You can see the posts there and see that I periodically write about what I have been learning, figuring out. But I don’t think the information that I have been writing there is easy to navigate.

So most of my recent writing time has gone into a series of 3 books. I’m organizing the information from the Patreon page to make it more user friendly.

I’m old enough to remember the show where one character said to the other, “you got some ‘splainin’ to do!”.

These books are my ‘splainin’ books. I use these books to help explain why I use the methods that I do in evaluating and treating my patients.

Chronic inflammatory illnesses aren’t just about the symptoms you feel. To address the symptoms, we work on addressing what is causing the symptoms. Whether it is Fibromyalgia or Allergies, ME/CFS or Dysautonomia, Hypermobility Syndromes (that are not gene-linked) or MCAS, Long Covid or Chronic Lyme - it appears that all roads lead back to Neuroinflammation and the systemic manifestations of this.

We learn about Neuroinflammation and why understanding about Glutathione and Glutamate is important. We learn where Glutathione comes from, what might influence how much you have available, and why that matters.

I am not at an academic center or employed by a major medical center. I’m just a small town doc who has been working with people with chronic illnesses for more than 20 years and I’ve learned a few things along the way.

I have some “not conventional” ideas about the initiators and drivers of the Neuroinflammation. I’m sure that I don’t have all of the answers, maybe not any of them! But we are seeing a positive impact with this approach.

To truly understand this root illness with these multiple different manifestations, I think we will need to step back from our specialists boxes in medicine, from Rheumatology, Cardiology, Neurology, Immunology - and look at the root driver. Our specialists can be vital for helping to manage the illness, but the illness does not exist only in each of their boxes. At least one aspect of this root driver may be in the fields of Pulmonology and Gastroenterology.

If nothing here resonates with you, just keep scrolling.

If you want to learn more about what I am talking about, you are welcome to look at my Patreon page.

You can go to my website and find a link to my bookstore page where you can order the first book.

My website is:
betsyhendricksmd DOT com

You can also find the link to my Patreon page on my website.

I’ll put the link to my website in a comment.

Comments may be turned off. If you have a question or need to contact me, you are welcome to send a message.

11/22/2025

Glutamate and migraines. Glutamate and brain changes.

News Release 15-Nov-2025

Low-glutamate diet linked to brain changes and migraine relief in veterans with Gulf War Illness
https://www.eurekalert.org/news-releases/1105155

"raises the question of whether a low-glutamate diet could also benefit the wider population of migraine sufferers"

"Glutamate, which is found in high levels in processed foods and also occurs naturally in some foods like tomatoes and mushrooms, is the most abundant excitatory neurotransmitter in the nervous system, where it is known to play a role in mediating pain."

I've heard people before say they react to MSG.

07/28/2025

06/08/2025

Glutamate. Many of my patients can tell you about Glutamate and why I talk about it so much. It's not just about the chronic pain, it has to do with neuroinflammation and many of the symptoms we see in ME/CFS, fibromyalgia and other chronic inflammatory conditions.

"University makes 'ground-breaking' discovery offering hope for chronic pain sufferers"

https://news.stv.tv/north/aberdeen-university-ground-breaking-discovery-brings-hope-for-chronic-pain-sufferers

2-minute video clip plus article from Scottish TV news features woman with &

See my earlier Facebook post linking to the press release here:
https://www.facebook.com/TomKindlonMECFS/posts/pfbid0BKPhZDzaeWvvv5aGGk9hRS1t3t5cZvUwpeeDojJ41uLNtWLaDo8zTCdmVuihb61gl

05/19/2025

The world-renowned autism expert shares her thoughts with NBC News after Robert F. Kennedy Jr. delivered controversial remarks about autistic people.