Ok, so I'm the one who posted a similar question a few months ago when I was on the fence about seeing him, and I did indeed end up making the plunge. I'll try to answer this, but I've not yet settled on an opinion about his practice.

So, I started having these weird symptoms pop up post-paleo. You can read any of my other PH questions to hear me obsessively whining about it. After getting nowhere with my PCP, I turned to Kresser. We did the case review, which is essentially a comprehensive (our kind of comprehensive) blood panel, a long questionnaire, and an hour review with Kresser where he outlines a treatment plan. I live in SF, so I went to his office. Most of the bloodwork came back fine, which was actually kind of dissapointing, not that I wished anything was wrong, but something WAS wrong and I was desperate for a culprit. He was really thorough with the review, explaining to me what each test result meant and asking me questions about my symptoms. To follow up, Kresser ordered a full thyroid panel, an autoimmune panel, and an organic acids test. His supplement treatment for the interim mostly addressed my acne, along with a low-histamine/tyramine diet. He also ordered two adrenal-support supplements to normalize my sleep pattern, which was slowly getting worse along with the other symptoms.

And because I'm an ass who worries too much, the cracks started to show: The outlined diet seemed out of left field, really. He mentions it in a podcast, that helped his patients, but in ALL of the reading I've done about diet and acne, such a thing has never come up. His outlined diet was copied verbatum (including typos) from a website addressing uticaria. Then came the $600 charge for all the tests and supplements, in addition to the $550 from the actual case review. His acne herb tincture had alcohol, which I couldn't take because I'm a recovering alcoholic, something I'd mentioned almost too frequently. I wondered if it was truly OK to take a gob of the FCLO he suggested every day on such a diet because it's probably the most histamine rich substance I could imagine. I also had the morbid fear that I was simply reacting to something in my diet that I hadn't figured out yet, something that no practitioner could really find out for me. Basically, I got lost in my own head again, which isn't Kresser's fault.

The follow-up tests showed nothing but a minor irregularity in the autoimmune panel, "not really a slam dunk" he said, so he ordered a glutathione recycler, suggested whey peptides, and told me to look into LDN (which I would have to get from Thomas Cowan in SF, hundreds of more dollars). So, at this point, I was suppossed to be taking the following: FCLO, Zinc, Selenium, Glutathione Recycler 3x a day, two adrenal support supplements 4x a day, whey, the herb tincture 4x a day, vitamin D, and a probiotic powder. It was getting absurb, and my symptoms got worse, so I stopped ALL supplements besides vitamin D, and things have been getting better. So, yeah, what did I just spend $1200 dollars on? I have to build everything from scratch now, and the bookmark for Paleohacks gets worn out again.

To me, his use of supplements was excessive, and expensive. I felt like we were throwing supplements at the symptoms before having a clear framework about their causes. That was the whole point of going to Kresser, to find the cause. I just didn't buy the pitch that all of these supplements where somehow going to constelate into a solution, a mindset that I myself am guilty of, and it truly seemed more likely that any one of them could cause more reactions, diluting my assesment of what's going on, but that's another rant. However, I think all of this has way more to do with the elusive nature of whatever is happening to my body rather than Chris's practice. Most problems won't get by the blood tests and his nuanced interpretation of them. It was also helpful in definitvely ruling out a TON of stuff, thus saving me the headspace. When a doctor orders a TSH, I'm still left wondering, but when Chris Kresser orders a full thyroid panel and assures me that it's fine, then I can look elswhere, because heck, I do trust the guy's judgement concerning certain things.

Edit after pondering: You know, the only other thing that showed up on any of Chris's testing, on the organic acids test, was an anomaly he said usually correlates with over-supplementation of n3. I've never taken more than maybe gram or two of fish oil a day, and not consistently, but they are lurking there in the fridge and I've more or less supplemented with them for about a year, as it smoothed out my skin. Now, that's a pretty wild thing to discover through testing, to Chris's credit, and seeing how my abrupt elimination of all supplements has brought nothing but improvement, there's a chance that he DID in fact figure out what's going on. Then again, I have ideas like this every time the symptoms calm down, because I just match the improvement to whatever kooky scheme I tried last. In the coming days I'll test and see.

I contacted Chris Kresser when I started obsessing with diet after detecting that some joint problems I had improved when I cut gluten and processed foods. By the time of the case review, I had started on a (low-carb) autoimmune Paleo, and a lot of weird symptoms had started to show, like racing heart at night (resulting in insomnia) and during the day, puffy face, fatigue, chest pain, lack of mental focus, dizziness etc. I did not really have these problems pre-Paleo. The case review revealed some wacky patterns. Follow-up tests confirmed anti-bodies to the thyroid. Chris never questioned my diet. From what I told him, he thought it sounded just right. He recommended LDN, which I tried. He did not recommend other supplements, and asked me to wait with dessicated thyroid even though my T3 was very low (on or just below the lab range). I tried the "support your immune system" measures on his website. After 6 months of feeling like shit, including 6 months of amenorrhea (had never had menstrual problems before going low carb Paleo), I started looking elsewhere. What frustrated me the most, is that when I mentioned the big picture in consultations, namely that all my bad symptoms started after going Paleo, he did not take me seriously.

I think Chris is a decent guy. He is friendly during consultations. I think he did a pretty thorough job with the case review. The thing is, I do not buy into his "theory" of hypothyroidism at all, namely that "it is all about the immune system". I have a pretty low stress job and life. I think I had a pretty healthy "lifestyle" before I got messed up. In retrospect, I am sure low-carb Paleo crushed my T3, and consequently messed up my estrogen to progesterone balance and a lot of other stuff. I think my anti-bodies to the thyroid is related to estrogen excess, not that my immune system attacks my thyroid gland. I think Chris missed the hormone connection completely. After implementing some of Ray Peat's recommendations, I got my period back and feel way, way better.

One the positive side, I am happy with the process of getting tests done through Chris. I live outside the US, so getting the ASI and Metametrix GI panel from a local doctor, would be be way more expensive and complicated. Chris' office manager is an absolute darling. Very efficient and easy to work with.

For thyroid related symptoms and hormonal issues, I am skeptical to Chris' approach. However, maybe my case was unique. Maybe he has had good results with others. As for the other problems he specializes in, I have no idea whether his approach is really addressing the "real" underlying cause of the problem or not.

I think I might actually be able to offer some useful info based on my experience. I haven't actually had my case review appointment with him yet. It's scheduled for late next month. I started the whole process way back at the beginning of this year, but took me a while to get my tests done (still have to go get blood drawn for a final one, but need to drive to another state for it because of Massachusetts laws).

I don't make much money these days, but I had a bit of a windfall and decided to take the plunge and do a case review with Kresser. I've had horrible acne for over a decade along with some depression and anxiety issues. Paleo has been the first thing that really helped, but I'm not 100% better yet. More importantly, I don't feel that I have a clear sense of the underlying issues that I'm dealing with. Like other answerers, I turned to Chris hoping for some clarity and encouraged by his focus on testing and his expressed skepticism towards easy answers (which I've had handed to me by conventional and alternative docs alike).

Like I said, I haven't actually had my case review appointment with Chris yet, but I made the decision to do this months ago. I think my experience so far is actually worth sharing.

Even my initial 15-minute skype call with Chris took place a few weeks after I signed up for it, so I had some time to think about what I wanted to express to him and what he might ask me. Now, between Chris' podcast, website, and interviews on those of others, it wasn't hard to come up with a short list of obvious things that I might start doing to address my situation. If I'm willing to pay so much money for the guy's advice, I may as well start by acting on the advice he's giving out for free, right? I can be a pretty academic guy, so I sorta felt like I was preparing for inspection by a professor. I didn't want to seem like an idiot for not doing the obvious things.

The call went by quickly. Chris kind of explained the context in which he was going to look at my situation (gut-brain axis kinda stuff, obviously), and he told me what tests he recommends to get started. Rather than doing the standard comprehensive case review tests, we started with the more specific tests (organic acids and intestinal biota) to save time and money.

And I continued in my efforts to do as much as I could pre-case-review. On top of an already strict autoimmune paleo diet, I really became uncompromisingly committed to avoiding tyramine and histamine. I emphasized gut-healing foods like bone broth and ghee. I started taking L-glutamine, marshmallow, slippery elm, probiotics and experimented with other supplements as well. I even tried small amounts of fermented foods despite their amine content but backed off from them again. I redoubled my stress-management efforts, bought dark curtains for my bedroom, read the GAPS book, the Perfect Health Diet, and others to try to learn as much as possible.

The point is, just by making the commitment to the case review, I ended up doing a hell of a lot of work on my own that I might not otherwise have done. This alone is really worth the cost for me.

And then, I got some of my test results. Orgnanic acids and gut biota. The latter came back pretty clean, which was surprising but also a huge load off my mind. Here I was thinking that I might have a gut full of candida or something, and it seems that I'm actually in pretty good shape in that department. The organic acids results were initially mystifying, but I've done a lot of research and note-taking and am slowly starting to comprehend them. Even though I'm not sure just what to do about them, I'm starting to feel like I've caught a glimpse of those underlying mechanisms that I mentioned earlier. The worst part about having a chronic illness for me is not the illness itself but the sense of not knowing what to do about it. I at least now have some clues to go on.

And my problems? Well, they're not gone yet. At the moment, my skin is looking better than ever. My mental issues are day to day, but on the whole I think they are improving. Everything could all go to shit tomorrow, I know, but I think I'm in a better place than I've ever been with respect to my health.

At the end of the day, few other people will care as much about your health as you do, and nobody else is in a better position to really understand your health issues as you are. If you go to someone like Kresser hoping that he will lift the burden of your own health from your shoulders, I think you'll be disappointed. That's the same hope that people drag into conventional doctors' offices every day. It's the same hope that prompts people to buy processed foods covered in health claims.

In a way, Chris can't satisfy me. If he comes to my case review with a super specific answer about what's causing my problems, I will feel cheated, because I know that he can't really know for sure what's going on with me. On the other hand, if he can only offer some vague pronouncements about glutathione and methylation, I might also feel cheated, because I didn't pay all of this money just to hear him reprise one of his podcasts episodes on the phone. Now, of course, I think he will have some valuable information to offer, especially in regards to eliminating possible causes of my condition from consideration. But I know that this probably won't be the end of my travails. I'll probably continue to have these problems for some time, and my work with Kresser will be a small part of the big picture that I'm trying to assemble. I won't fault Kresser for not being able to give me the final word on my issues.

The realization and the commitment to the idea that I am the person who is going to change my own life are really the best things I've gotten out of this whole process.

And one other thing I should consider here is that I've only been paleo for 6 months or so, and I slipped up a few times in the beginning. I've had my problems pretty much my whole life, so the progress I've been making may well just have been a matter of time. And making more progress might just be a matter of patience, not the result of some epiphany that I receive from Kresser or anybody else. One way to look at working with Kresser is just as a coaching experience to keep you committed to what you're doing and to affirm that getting better is a priority for you.

I was surprised to find that I had something to say about this, and writing this has been helpful for me. I'll shut up now! :)

I have an nuanced answer as well. Chris has helped me incredibly. He's given me a better understanding of what's goine on in my body, but that said, I haven't gotten any better while seeing him and still feel horrible. I know that knowledge is power, so I'm grateful that I know what I know now and am hoping that I'll get better someday. But Chris has a terrible bedside manner. His tone is robotic, and the caring vibe he gives off in the podcasts is very different from how he behaves during a phone call with a patient. I do believe that as an individual you are in charge of your own health, but I'd like to feel like I have someone along for ride who has my back. It doesn't feel like that with Chris. Moreover, his assistant, Diane, is incredibly unfriendly and his office policies are absurdly rigid and I have had a few situations where I have been charged when I should not have been. Not trying to be bitchy, Just tellin' it like it is.

People, please, save your money.

While I am an MD, I consider myself open-minded and I'll be the first to say that western medicine does not have all the answers. But that doesn't mean that Chris Kresser does.

Reading this guy's blog is sufficient to start--then explore the literature yourself. See what works and what doesn't. But going to see him for an evaluation, blood panel and supplements is just ridiculous and exploitative.

I'd much more highly recommend Mark Sisson's site, Mark's Daily Apple.

Holy cow...

Just wanted to thank Charlie, edle, Melanie, and StrekofLean for writing such detailed accounts of your experiences with CK. I'm three months away from a master's in nutrition and will be starting up a consulting business. It's so helpful to read about your experiences so I can learn what does and does not resonate with clients. (I've been to an ND myself, for my own hormonal issues, so I've been on "the other side of the desk," as it were, but it's still very educational for me to hear about other people's experiences.)

Seems like it might be a different ballgame when it comes to me helping people who eat 100% SAD and have absolutely no clue about the connections between food, sleep, and stress on their health and mental/emotional well being, vs. people like us, who've been listening to Robb Wolf, Chris Kresser, Sean Croxton, etc., and feel like we could probably tell our conventional doctors a thing or two.

And Charlie, you're SO right -- no one will ever care about your health more than you. If taking thousands of dollars worth of supplements just doesn't sit right with someone, they shouldn't keep doing it just because someone like CK says so. (Lots of things for me to keep in mind when I start my practice. I'll likely use supplements in many cases, but I certainly understand the budget issues! And I'm all about using them to restore/replete and then dosing DOWN. Kind of like conventional medication, even "natural supplements" aren't things we should need to take for the rest of our lives. (Not if we get our diet and lifestyle in line, that is.) Also great info for me not to treat symptoms, but treat PEOPLE. Just because someone presents with x and y issues doesn't mean they'll respond exactly the same way to whatever protocol I gave the last person who came to me with x and y. In that way, sometimes natural medicine is as narrow-minded as allopathic.

Seriously, you have no idea how helpful this is. Thanks, all!

There is a peer pressure badge?

Yes, he isn't perfect

somewhat related...has anyone done something like this? http://www.wellnessfx.com/crossfitbox/potrerohill