1. Project. Effectiveness.

What is the “Natural Way to Remission” project?

It’s a comprehensive project that educates patients on how to achieve remission through natural methods, focusing on identifying and eliminating the root causes of psoriatic disease, primarily through individualized diets, lifestyle changes, and specific treatment courses.

What is the main goal of this project?

The primary goal is to achieve long-term and sustainable remission of psoriatic disease by identifying and eliminating the root causes, which are linked to an increased level of specific bacterial products (kPAMP) in the blood.

What information will I learn during my participation in the project?

You will learn about basic and individual diets, fasting diets, gastrointestinal cleansing procedures, how to estimate your psoriasis severity using PASI, necessary tests. You will learn about influencing factors like bacterial oral cavity diseases, upper respiratory tract bacterial issues etc. You will learn about two key factors Small Intestinal Hyperpermeability (SP1) and Small Intestinal Bacterial Overgrowth (SIBO) with specific PsB-bacteria.

Has this approach been proven to work?

Yes. The Project was developed and improved over several years with the participation of medical specialists and the Antipsoriatic Association. Between 2013 and 2021, many patients who followed this project achieved long-term and sustainable remission.

Is achieving “long-term and sustainable remission” a guaranteed outcome?

Success depends on the patient and the ability to identify and address influencing factors on the two main factors SP1 and SP2. It depends on the patient’s persistence in following the tests and treatment recommendations, diet, cleansing procedures, lifestyle, etc.

2. Two main factors. Pathogenesis model and terminology.

What is the scientific basis for this approach?

The approach is based on a pathogenesis model where two main factors sustain psoriatic disease: Small Intestinal Hyperpermeability (SP1) and Small Intestinal Bacterial Overgrowth (SIBO) with specific PsB-bacteria.

What are SP1 and SP2?

SP1 is Small Intestinal Hyperpermeability (“leaky gut”), which allows bacterial products (kPAMP) to pass into the bloodstream.
SP2 is Small Intestinal Bacterial Overgrowth (SIBO) with specific “PsB-bacteria.”
The presence of either SP1 or SP2 is enough to maintain the psoriatic disease.

What are kPAMPs?

kPAMPs are specific bacterial products that drive and support psoriatic disease according to pathigenesis model. They include LPS (lipopolysaccharide), PG (peptidoglycan), and bacterial DNA.

Why is the focus on the small intestine specifically?

The pathogenesis model states that the small intestine is the organ where the two main factors originate: hyperpermeability (SP1) and bacterial overgrowth (SP2). They allow bacterial products to enter the bloodstream and drive the systemic inflammation seen in psoriasis.

What are “PsB-bacteria” mentioned in the SP2 factor?

PsB bacteria have a peptide glycan similar to that of pathogenic Streptococcus pyogenes. PsB bacteria are potentially involved in small intestinal bacterial overgrowth (SIBO).

Where can I find psoriasis pathogenesis model and explanations of abbreviations and terms?

You can view these by following link

The pathogenesis model appears to downplay the role of genetics. Why?

Pathogenesis model doesn’t downplay the role of genetics; it reinterprets it. Psoriasis is a disease with a hereditary predisposition: the concordance rate in identical twins is 70%. If one parent has psoriasis, the disease is diagnosed in children in 15–25% of cases; if both parents have psoriasis, the rate is more than 40–60%. The patient’s genotype determines the phenotype and severity of psoriasis manifestations (skin and/or joint). However, psoriasis cannot develop solely in the presence of genetic abnormalities. This conclusion is based on a series of genome-wide association studies (GWAS) in patients with psoriasis. These genomic studies did not identify any single nucleotide polymorphisms (SNPs) or combinations thereof that consistently (regardless of other factors) lead to the development and maintenance of psoriatic disease. Conclusion: additional non-genomic factors are required for the development and maintenance of psoriatic disease. Our pathogenesis model suggests that these main factors (SP1 and SP2) are located in the small intestine and, as a result, kPAMP high levels production are observed in bloodstream.

3. Patient in process and health coach role. Roadmap.

What is the role of the health coach?

The health coach analyzes your completed Guide, test results, and other provided data (on diet, sleep, exercise, etc.) to give you personalized recommendations on your individual diet, necessary additional tests, treatment courses, exercise, and lifestyle changes.

What happens after I submit my completed Guide?

After submitting, you will receive personalized recommendations regarding the optimal set of tests and procedures you should undergo. This is an important step before developing your personalized diet, lifestyle recommendations, and a customized treatment plan.

What does an “Individual Roadmap” practically consist of?

It’s an action plan based on your information. This plan is developed in collaboration with a health coach. The plan consists of several stages, during which you undergo additional tests, follow dietary tests, or address influencing factor (such as chronic URT) on one of key factors SP1 or SP2. The sequence and content of the stages are determined individually.

What kind of treatment courses might be recommended?

Influencing factors on SP1 or on SP2 determine the content of treatment courses. Courses may be aimed at weight loss, elimination of chronic infections (oral, URT, Helicobacter), deworming, or therapy aimed at improving intestinal motility.

How will my progress be monitored?

You will monitor your psoriasis using the PASI (Psoriasis Area and Severity Index), as well as track your sleep quality, diet and gastrointestinal health, exercise, and overall well-being. Your health coach will use this data to formulate subsequent recommendations.
The PASI is a standardized, quantitative tool used in clinical trials and dermatology. Using it allows for objective tracking of your progress, making it easier for both you and the health coach to see if the interventions are working.

Why is it so important to provide detailed answers and medical history?

The effectiveness of the entire process relies on the health coach having a complete picture. Your past and present illnesses, treatments, and their outcomes provide crucial clues for identifying your unique “influencing factors”.

How exactly does the health coach use my filled-out Guide to create recommendations?

The coach acts like a detective. By reviewing your detailed medical history, described symptoms, and test results, they look for patterns that define your specific combination of influencing factors. They then determine the specific causes of small intestinal permeability (SP1) and specific SIBO (SP2). This allows the health coach to create your “personal roadmap” to normalizing the two main factors and ultimately achieving remission of psoriatic disease.

How long after switching to a individual diet and completing treatment courses can I expect improvements?

Time may vary. Some patients may notice positive changes within a few weeks. Others may require more time—up to several months. First, small intestinal permeability and microbiome must normalize. Only then will positive changes in skin gradually occur. Patience and consistency are keys to success.

Is the health coach the only person I will be interacting with?

The project mentions development involved “leading medical specialists.” While the coach is your primary guide, the approach is collaborative. For specific issues, you will be referred to and need to work with the appropriate medical specialist.

4. Influencing factors and their elimination (treatment)

What are influencing factors?

These are all the abnormalities in your body, diet, and lifestyle that trigger or exacerbate the two primary factors (SP1 and SP2). Influencing factors are excess weight, chronic oral and upper respiratory infections, Helicobacter pylori, helminths, impaired peristalsis, and much more.

How does eliminating influencing factors, such as chronic oral infections or upper respiratory tract infections, improve skin condition?

Chronic oral infections or upper respiratory tract infections promote a constant flow of pathogenic bacteria into the small intestine. This contributes to SIBO. This flow is limited by the barrier function of gastric acid (with normal or increased acidity). Eliminating chronic oral infections and upper respiratory tract infections can promote spontaneous resolution of SIBO and, of course, facilitate SIBO treatment. Conquer SIBO and psoriasis will go away on its own!

What should I do if I’ve been diagnosed with Helicobacter pylori, for example, but my doctor believes it doesn’t affect my psoriasis?

This is a common problem. The pathogenesis model suggests that one of the key factors is a specific type of SIBO. Carrying Helicobacter pylori typically leads to decreased gastric acidity. As a result, the stomach’s barrier function is weakened against bacteria entering the gastrointestinal tract from the mouth and upper respiratory tract, as well as with food. This leads to persistent SIBO. Several studies also show that psoriatic patients with Helicobacter pylori have more severe psoriasis.

What is the role of “impaired peristalsis” as an influencing factor?

Peristalsis is the wave-like muscle contractions that move digested food (chyme) through the intestines. Impaired peristalsis leads to stagnation in the small intestine, promoting bacterial overgrowth (SP2) and increasing the likelihood of developing hyperpermeability (SP1).

What does “normalizing the levels of the two main factors SP1 and SP2” mean?

This is a multifaceted approach based on identifying all influencing factors and then eliminating (or normalizing) them, in particular:
* SP1 (hyperpermeability): restoring normal permeability by eliminating (reducing consumption) problematic (specifically for you) foods from the diet, etc.
* SP2 (SIBO): using targeted antimicrobials, restoring gastrointestinal motility, etc.
It should also be noted that factor SP2 typically negatively impacts factor SP1.

5. Individual diet and nutrition.

What are basic diets?

Basic diets are general eating patterns that the author has personally tried over many years (vegetarianism, veganism, and the John Pagano diet). But there are also others listed in the article.
Your base diet may be different from those listed in the article. You’ve been following it for a long time, and it may be good for your overall health (except for psoriasis). Start creating your new personalized diet with your base diet.

What is the role of an “individual diet” compared to a “basic diet”?

A “basic diet” provides general principles, while an “individual diet” is tailored to your specific food sensitivities and factors influencing on SP1 and SP2 . This “individual diet” is key to effectively reducing kPAMP levels in bloodstream exactly for you.

How complex will a individual diet be? Will I have to give up many foods?

The diet can be highly individualized. Developing a diet doesn’t involve arbitrary restrictions, but rather identifying your personal food triggers that can increase intestinal permeability or contribute to the development of SIBO. For some, this may be gluten and/or lactose, for others, foods high in FODMAPs. The goal is to create a complete diet based on eliminating (or limiting) your personal food triggers. Learn more here.

The Guide mentions “fasting diets.” What is their purpose in this context?

A fasting diet is a short-term diet (up to 10 days) with strict restrictions (for example, only fruit is allowed). A fasting diet is not starvation! A fasting diet can help reduce small intestinal bacterial overgrowth (SIBO) and intestinal permeability, which can lower blood kPAMP levels. During a fasting diet, cleansing procedures and SIBO treatment with antibacterial agents are also performed.

What are PPS?

PPS (Potentially Problematic Substances) are substances in foods that can negatively affect small intestinal permeability or contribute to SIBO. These include gluten, glycoalkaloids (from nightshades), lactose, and some FODMAP carbohydrates.

What are the official dietary guidelines of the National Psoriasis Foundation (NPF) in the US?

The NPF strongly recommends a gluten-free diet (GFD) for patients with celiac disease, as well as a 3-month trial of a GFD for those with latent celiac disease. The Foundation also recommends weight loss for those with a BMI greater than 25 and a Mediterranean diet.

Why can gluten be harmful for psoriasis?

According to research, some patients with psoriasis (approximately 16%) have a genetic predisposition (celiac disease or latent celiac disease). Gluten damages enterocytes in these patients, causing villous atrophy and increasing small intestinal permeability (SP1), which worsens psoriasis.

What are glycoalkaloids and what foods contain them?

Glycoalkaloids are natural substances found in plants of the nightshade family: tomatoes, potatoes, eggplants, and peppers. With a genetic predisposition, they can increase small intestinal permeability

What methods are there for diagnosing lactose intolerance, and which is the most reliable?

There are genetic diagnostics, a hydrogen breath test (not helpful for SIBO), a rapid biopsy test, and blood glucose testing after lactose ingestion. The most reliable test used in the US is repeated blood glucose testing for 1-3 hours after ingestion of 50 g of lactose.

What does the acronym FODMAP stand for?

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. This group of short-chain carbohydrates is poorly absorbed in the small intestine and can be fermented by bacteria, aggravating SIBO.

What is a “low-microbial diet” and why is it needed?

This is a diet that limits the consumption of foods containing live bacteria and fungi. It is designed to prevent SIBO.

What are the different methods for following a low-microbial diet?

There are three methods: “sterile” (all foods containing live bacteria/fungi and probiotics are excluded), “selective” (only foods containing PsB bacteria are excluded), and “normal” (the author’s choice, general adherence to the principles of a low-microbial diet).

How does one begin developing indiet ( individual diet)?

Indiet is developed based on the selected base diet, which is then adjusted based on: a) allergies, b) the chosen low-microbial diet method, c) body mass index (BMI), and d) individual sensitivity to PPS.

What is the recommended sequence for testing PPS sensitivity?

The recommended sequence is: 1. Gluten. 2. Lactose. 3. Glycoalkaloids (nightshades). 4. FODMAP carbohydrates (except lactose).

What is the simple PPS sensitivity testing regimen?

This involves completely eliminating foods containing certain PPS (such as gluten or nightshades) for up to 3 months and assessing their impact on psoriasis.

What is the complex PPS sensitivity testing regimen and when is it used?

This is a longer regimen (12-36 weeks) that includes a phase of elimination followed by a gradual reintroduction of the food in increasing portions. This allows us to determine not only the actual sensitivity but also the tolerable portions and frequency of consumption.

What are the general dietary recommendations?

Avoid overeating, increase the number of meals to 4-6 per day, reducing portion sizes. Dinner should be the lightest and finished 2-3 hours before bedtime. Maintain a regular meal schedule (±30 minutes). Drink 6-8 glasses of clean water per day and maintain regular bowel movements.

How does developing a standard low-FODMAP diet (LFD) differ from developing a version for patients with psoriasis (LFDP)?

The main difference is the timeframe. Because the skin reacts to dietary changes more slowly than the gastrointestinal tract, all stages of the LFDP (elimination, challenge, integration) take significantly longer.

How long does the “Challenge” phase of the single FODMAP carbohydrate in the LFDP last?

The maximum time for challenging a single carbohydrate is 3 weeks: Week 1 – half a serving, Week 2 – a standard serving, Week 3 – a double serving. There should be at least a week between testing different carbohydrates.

Why is it important to keep a food diary?

This is the only way to accurately track the relationship between the consumption of certain foods, gastrointestinal health, and the dynamics of psoriasis (according to the PASI scale).

How often should skin assessment be performed when developing an indiet?

It is recommended to perform PASI skin assessment and photograph characteristic areas at the end of each week

What should be done if an external factor (e.g., a cold or sunburn) impacts the patient during the PPS assessment?

This PPS assessment should be discontinued. It should not be resumed until at least 2-4 weeks after the external factor has ceased to be active.

Why is it important to monitor the nutritional composition of the diet when developing an indiet?

Excluding entire food groups (e.g., those containing gluten or lactose) increases the risk of vitamin and micronutrient deficiencies. It is essential that the indiet be complete.

What is the key takeaway regarding the role of diet?

Diet is not just an adjunct, but a powerful tool for managing the two main pathogenic factors of psoriasis (SP1 and SP2). Following the indiet may be sufficient to achieve long-term and sustainable remission.

6. Cleansing procedures.

The Guide mentions gastrointestinal cleansing procedure. What are these?

These are specialized protocols designed to cleanse the gastrointestinal tract, reduce bacterial load, promote healing of the intestinal mucosa, and create a healthier microbial environment. One such procedure is intestine lavage.

What is Intestine Lavage?

Intestine Lavage is a medical procedure for cleansing the entire gastrointestinal tract (GIT) by having the patient drink a special Saline Enteral Solution (SES). It works in the natural direction of digestion to remove toxins from the body.

How is intestine lavage different from colonics or laxatives?

Unlike colonics (which only clean the colon) and laxatives, Intestine Lavage cleans both the small and large intestine. It is more physiological, helps normalize gut microflora, improves blood and metabolic indicators, and requires no equipment.

What is the SES solution?

SES is a patented, balanced saline enteral solution. Its mineral content (including Sodium, Potassium, Calcium, Magnesium, and Chloride) is similar to that found in the empty intestine, making it physiologically compatible.

How is the procedure intestine lavage performed?

The patient drinks 150 ml of SES every 5-10 minutes. Within 0.5-1.5 hours, the bowel begins to empty itself softly and without pain. The procedure continues until the intestinal washings become clear yellowish, typically taking 2-3 hours in total.

How many procedures intestine lavage are needed?

A full course consists of no fewer than 4 procedures, conducted with intervals of 2 to 7 days. The exact treatment program is determined individually.

What are the main preventive benefits of intestine lavage?

Preventive benefits include an influx of energy, improved skin and hair quality, sleep normalization, enhanced immunity, increased libido, and better preparation for surgeries or endoscopic examinations.

What are the main medical indications for intestine lavage?

It is indicated for conditions like intestinal dysbacteriosis, obesity, type 2 diabetes, chronic skin diseases (psoriasis, eczema, acne), allergic diseases, constipation, hangover syndrome, and for recovery after antibiotics, food poisoning, or stress.

What are the absolute contraindications for intestine lavage?

Absolute contraindications include gastrointestinal or other internal bleeding, the second half of pregnancy, and any condition requiring urgent surgery or intensive care.

What are the relative contraindications for intestine lavage?

Relative contraindications (requiring doctor’s caution) include erosive gastritis, the first half of pregnancy, gallbladder/kidney stones, type 1 diabetes, hypertensive crisis, and hemorrhoids exacerbation.

Why is body detoxification necessary?

The body accumulates toxins from food, cellular metabolism, and gut microbes. When the natural detoxification organs (liver, kidneys, etc.) are overwhelmed, self-poisoning occurs, leading to fatigue, skin problems, and chronic diseases.

How does intestine lavage help with detoxification?

The procedure intestine lavage provides deep, physiological purification. It removes toxins from the GIT, which interrupts their circulation between the intestine and liver (enterohepatic) and between the blood and the GIT (enterohematic), reducing the toxic load on the entire body.

Is medical supervision required?

Yes. The first procedure should be performed under a doctor’s supervision. Subsequent procedures in the course can be performed independently.

How does it enhance the effect of other medications?

The procedure significantly increases the absorption and effectiveness of medications taken right after the lavage or with one of the last portions of SES. This is particularly beneficial for drugs aimed at normalizing small intestinal permeability and microbiome.

7. Phagotherapy as an optimal method for treating SIBO.

What is the main advantage of phagotherapy’s narrow spectrum of action?

It allows for the targeted elimination of pathogenic bacteria while preserving the beneficial normal flora. This is a significant advantage over broad-spectrum antibiotics, which can wipe out good bacteria and cause severe side effects.

How does phage “self-replication” benefit the treatment?

Phages multiply at the site of infection as they infect and kill bacteria. This means a initially small dose can achieve a high concentration precisely where it is needed, unlike antibiotics whose concentration decreases over time.

Is bacterial resistance to phages linked to antibiotic resistance?

No. Resistance to antibiotics and resistance to phages are, to a significant degree, unrelated phenomena. This makes phage therapy a potent option for treating infections caused by multi-drug resistant bacteria.

Is the science behind phagotherapy well-understood?

Yes. The clinical mechanism of action and the biology of phages are well-studied, providing a solid scientific foundation for their therapeutic application.

How can the narrow spectrum of a single phage be overcome?

This limitation can be compensated for by using phage cocktails —mixtures of different phages that target a broader range of bacterial strains or species.

In summary, what makes phagotherapy a compelling alternative?

Phagotherapy offers a targeted, self-amplifying treatment that is effective against antibiotic-resistant bacteria and spares the beneficial microbiome, all based on a well-studied biological principle.

What is the primary goal of 10-day treatment course?

The goal is to eliminate (lower the level as much as possible) SIBO with psoriagenic bacteria.

How is the specific phage choice determined?

The choice is based on a culture of a smear or aspirate taken from the Treitz ligament area during a duodenogastroscopy, followed by determining psoriagenic and pathogenic bacteria and their sensitivity to specific phages.

What dietary regimen is followed during the treatment?

The patient follows an “apple fast,” which includes natural apple juice (unlimited), raw apples (2-3 per meal), and stewed apples (preferably in the evening). Water intake must be over 1.5 liters per day.

How often is procedure intestine lavage performed?

It is performed 3-5 times of the 10-day course.

What happens to meals on intestine lavage days?

Breakfast is canceled on lavage days because the procedure itself takes 3-4 hours to complete in the morning.

Why is a soda solution recommended before phages?

A soda solution is taken before the phages to temporarily neutralize stomach acidity. This helps preserve the phages as they pass through the stomach, ensuring they reach the intestines intact.

What is the rationale behind combining these therapies?

The combination is designed for a synergistic effect: the apple fast and lavage cleanse the GI tract and reduce bacterial load, while the phages specifically target and kill the remaining psoriagenic and pathogenic bacteria.

What are the sleep recommendations?

Total sleep should be no less than 8-9 hours. If feeling unwell, an additional 1.5-2 hours of daytime sleep between lunch and dinner is recommended.

8. Difficult questions.

How does your approach differ from standard dermatological treatment?

Standard treatment is aimed at suppressing skin symptoms (e.g., with topical agents or biologics). Our approach is aimed at identifying and addressing the causes of two key factors: SP1 (increased small intestinal permeability) and SP2 (specific SIBO). This can achieve long-term and sustainable remission, reducing or eliminating the need for drug therapy with topical agents or biologics.

I don’t have any obvious gut problems. Is this appoach still relevant for me?

Yes. The pathogenesis model explains that one of two main factors (SP1 or SP2) is sufficient to maintain the systemic psoriatic process. You may have subclinical small intestinal hyperpermeability, or SIBO, without overt symptoms, but it can still contribute to the development of psoriatic disease.

I am already on biologic medication. Can I participate in your project?

No. The project aims to eliminate the suspected root causes, while biologics relieve the symptoms of psoriatic disease. While developing an individualized diet and eliminating the causes of factors SP1 and SP2, it’s important to monitor your psoriatic disease to identify any patterns. And ultimately, after following all of the health coach’s recommendations, evaluate the effectiveness of the “Natural way to Remission” project for your specific psoriatic disease. Identifying patterns and evaluating effectiveness are both impossible when taking biologics. Please contact us after completing your course of biologics (at least 2-3 months).

How do you define remission in psoriatic disease?

It is a long-term, stable skin condition without psoriasis or with very mild psoriasis (PASI no more than 3) with no tendency to relapse. This condition is maintained by a healthy lifestyle, a personalized diet, a balanced gastrointestinal tract, and moderate physical activity. It ensures an energetic and balanced state of health and does not require medications that suppress the immune system.

This seems like a lot of work. What is the ultimate motivation for going through this process?

The main motivation is to become an active creator of your own health. You’ll gain new knowledge and achieve stable, long-term remission without the use of potent drugs with serious side effects. This knowledge and experience will allow you to maintain remission completely independently in the future.

9. Guide (Questionnaire). Completion and access.

What is the “Psoriatic Patient Guide (Individual Roadmap)”?

It is a comprehensive questionnaire and guide designed for psoriatic patients. It is part of the “Natural Way to Remission” project and serves as a foundational tool to help identify the personal factors influencing your psoriatic disease and create a tailored path toward remission.

Who is this Guide for?

This Guide is intended for psoriatic patients who believe that their disease is a consequence of an increased level of kPAMP (LPS, peptidoglycan, and bacterial DNA) in their blood.

What is the first step I need to take?

The first step is to download the guide (questionnaire) and fill it out thoroughly (skipping any sections or items for which you don’t have information). Then, send this guide (questionnaire), along with your test results and medical reports, to your health coach via email or Google Drive.

Where can I download the Guide?

You can download the Word file in English or Russian using the links at the top (or bottom) of this page.

How should I fill out Guide (Questionnaire)?

How do I fill out the guide (questionnaire)? You must answer all questions in detail by filling in the blanks. You can add additional lines if necessary. It is especially important to describe any past and current illnesses, their treatment, and their results. If you don’t understand a question, please clarify it with your health coach (via chat or email). If you cannot answer a question due to missing information, leave the line blank.

What should I do with my medical test results and reports?

You need to attach scanned copies or photos of these documents. You can either include them in a Google Drive folder along with your Guide or send them as email attachments.

The Guide asks to “attach files with scanned copies.” What if my results are in an online patient portal?

The instruction provides for this: “provide read access to your account in a relevant application.” You can take screenshots of your results or, ideally, download the PDFs from the portal and save them in your designated Google Drive folder. The key is to ensure the health coach can easily view them.

How should I name my file?

Please include your name or nickname in the file name like this: `Guide_NNN.docx` (e.g., `Guide_JohnDoe.docx`).

What are the options for submitting my completed Guide with attachments?

You have three options:
1. Save and fill out the Guide on Google Docs in a dedicated folder and share that folder with healh coach’s email. 2. Store everything on your computer, then upload the entire folder to Google Drive and share it link with healh coach’s email.
3. Send the completed Guide and all additional files as email attachments directly.

What is the email address for submission?

All documents should be sent to or shared with: psorias.info@gmail.com.

Can I use cloud services other than Google Drive?

The document specifies Google Drive as the preferred method. You should follow this instruction to ensure compatibility and a smooth process with the health coach.

I filled out a previous version of this Guide. What should I do?

You need to transfer all your information from the old version to this new one and update it with any new data.

What if I cannot perform some of the recommended tests or procedures?

You should discuss this directly with your health coach. They can likely adjust your roadmap based on what is feasible for you, prioritizing the most critical tests and interventions.

How long does it take to initially complete the Guide (Questionnaire)?

It will require a significant investment of time, as it involves gathering medical records, recalling your health history, and providing detailed answers. You should set aside several hours to complete it thoroughly.

What if I cannot answer some of the questions in the Guide because I don’t have the information or don’t remember?

Be transparent. Write “Unknown” or “Do not remember” instead of leaving it blank. This shows the coach that you saw the question but lack the data. They can then advise if it’s a critical piece of information that needs to be investigated.

What is the single most important piece of advice for filling out the Guide successfully?

Brutal honesty and thoroughness. Do not omit information you think is irrelevant. Seemingly minor issues like occasional bloating, a history of frequent antibiotic use, or chronic stress are all critical pieces of the puzzle for the health coach.