Case Study: Eosinophilic Esophagitis, Chronic Skin Outbreaks, Autoimmune Alopecia, Chronic Allergies

Case Study: Eosinophilic Esophagitis, Chronic Skin Breakouts, Autoimmune Alopecia, Chronic Allergies | June 2017

Kristy presented with a variety of autoimmune/allergic health issues. She had taken numerous drugs prescribed by her MD including steroids and ant-acids but her condition worsened over time.

Kristy reports 80-90% overall improvement in her health since coming to the Goldberg Clinic. Her skin is clear, her hair has regrown and her allergic tendencies have reduced substantially. She is drug free. 

See video interview with Kristy (left) and before/after pictures below.

Skin Deep?


A Closer Look at Dermatological Issues

Paul A. Goldberg, MPH,DC,DACBN,DCBCN

Skin issues are a common reason patients come to the Goldberg Clinic, sometimes as a primary issue, sometimes secondary to other issues they suffer with. Our patients have experienced both the disappearance of their skin issues and a most pleasant new beauty to their skin even though we never treat skin diseases. How is that possible?

The skin is the largest organ of the human body covering us from head to foot.  It is, however, much more than a mere covering…it is living tissue interacting with both the outside world and the inner world including the immune, digestive, endocrine and nervous systems. The skin is reflective of a person’s general state of health. In addition, inside the body we are compartmentalized with skin like membranes covering the genito-urinary tract, auditory canals, vagina, urethra, gall bladder, etc.

In our practice we see patients with chronic skin disorders of many varieties, yet we never “treat” skin disorders. Rather than treat the outside layer of the body (the skin) we seek out and address the causal factors responsible for the patient’s impaired health that have manifested through the skin.

Skin issues are both health issues and appearance issues. We all care about the way we look and the skin is the single most important organ in that regard. The billions of dollars spent on cosmetics, face lifts, tanning beds, facials, and millions of office visits to Dermatologists every year all speak to this.  The majority of dollars spent, however, only go “skin deep” i.e. the application of lotions, creams and pharmaceutical agents can at most have only superficial effects on the skin’s health. The skin’s good health depends on the health of the rest of the body from which it derives its blood and nerve supply... its sustenance and direction.

We applaud Dermatologists for identifying skin cancers and other pathologies and in executing surgical procedures such as the removal of warts and other growths. Dermatological Care, however, as in other areas of Medicine largely involves the treatment of symptoms as opposed to causes. There are a plethora of medical names for skin disease symptoms such as acne, dermatitis, eczema, impetigo, moles, psoriasis, rashes, ringworm, rosacea, vitligo, etc., each of which has a set of pharmaceutical treatments used to address them. Unfortunately, the treatments employed rarely  address the patient’s overall health nor do they identify the causal factors involved in the problem’s genesis. In addition, many dermatological treatments employ steroids, antibiotics and other drugs that both fail to address causal factors and carry the risk of damaging side effects.  It is notable that virtually any drug we apply to the skin will to a greater or lesser degree affect the rest of the body as well as it is absorbed.

A common diagnostic term utilized by Dermatologists is “dermatitis”. The patient enters the Dermatology office complaining of reddened and inflamed skin. The Physician hands the patient a tube of steroid cream or pills and tells them they have Dermatitis. What does dermatitis mean? Inflammation of the skin, i.e. reddened and inflamed skin. The cause has not been identified; steroids suppress the effects but not the cause. The term eczema is also widely bandied about, is of equally little specificity and often treated in the same way i.e. with steroids.

In our practice we see patients with chronic skin disorders of many varieties, yet we never “treat” skin disorders. Rather than treat the outside layer of the body (the skin) we seek out and address the causal factors responsible for the patient’s impaired health that have manifested through the skin. It is rare to find a patient with chronic skin problems who does not have other complaints as well.

Indigestion, fatigue, constipation, diarrhea, gas, bloating, depression, lack of appetite, insomnia, headaches, migraines, arthritis, muscular pains, back aches, irregular menses, allergies, are all just a few of the many complaints that may accompany skin disorders. Determining what the causes of these problems are and addressing them thoroughly serves us best in returning the skin to good health and the rest of the body along with it. It is of no surprise that patients who come to us complaining of other issues are commonly delighted at the improvement of their skin’s condition as their other health issues dissipate and their vitality increases.

Our patients know that in reversing chronic health issues the body has to often go through stages of healing that include ridding itself of toxic materials that have been stored up in the body. As this occurs, one of the eliminative channels utilized is the skin. It is not difficult to understand, therefore that in the recovery process a patient’s skin may at first go through an increase in their symptoms as wastes are discarded, prior to the restoration of the patient’s well being. This exacerbation is generally followed, however, with a great improvement in both the patients overall health and a dramatic improvement in the appearance and health of their skin. Discipline and persistence are sometimes critical to get the job done.

Those patients who have taken years of steroids, antibiotics and immunosuppressive drugs will have the greatest challenges to overcome. We have patients who have taken such drugs for five, ten or more years prior to seeing us. They will need to not only address the original reasons for their skin issues but also will also face the task of dealing with the toxic effects and dependency these pharmaceuticals bring with them.

Skin diseases are no different than other health issues in that the same basic steps must be taken:

  1. Identify the reasons for why the skin issues are being manifested. Naming a skin disease does not accomplish this. Dermatitis, eczema and psoriasis are not causes of themselves.  It is our long experience that each patient will have different reasons for having the skin problem they have even though they may have been given the same medical diagnosis.
  2. Address the causes identified by guiding the patient through the steps needed to create the conditions for the restoration of health.

Health issues, whether primarily involving the skin, the bowels, the lungs, heart, immune system or any other system of the body all require addressing causes. They all require work on the part of the doctor to identify those causes and the dedicated work of the patient in addressing those causes with the doctor’s guidance.

The rewards of not only good skin health but of a high level of overall bodily vigor and vitality, of real health, make the work well worthwhile.

Click here for video interviews and more before/after pictures of patients at the Goldberg Clinic who came to see us with a variety of chronic skin disorders.  

Reversing Rheumatoid Arthritis

May 2017 | Rheumatoid Arthritis

Andy was diagnosed medically with Rheumatoid Arthritis and prescribed numerous drugs by his Rheumatologist including steroids and methotrexate. The pain he experienced was debilitating. Approximately one and half years after beginning care at the Goldberg Clinic, Andy is pain and symptom free and off all drugs. He reports feeling healthier than he has in 25 years. 

Congratulations Andy!


1) Reversing Rheumatoid Arthritis
2) Anklyosing Spondylitis and Other Autoimmune Disorders
3) Case Studies: Rheumatoid Disorders
4) Case Studies: Autoimmune Disorders

Reversing Psoriatic Arthritis

Psoriatic Arthritis, Gout | June 2016 

Dana came to the Goldberg Clinic in early 2016 with medical diagnoses of Psoriatic Arthritis and Gout. His Rheumatologist prescribed steroids (Prednisone) but his health continued to deteriorate. In this video, Dana shares his experience with us at the Goldberg Clinic and the significant improvement he has made while under our care. He is now drug free and he reports a reduction in his overall pain by 90%. 



One Year Follow Up | April 2017

Dana returned to the clinic one year after his initial visit for a follow up evaluation. He continues to do well and his inflammatory markers are still normal and healthy (see below).

Small Intestinal Bacterial Overgrowth (SIBO)

Paul A. Goldberg, MPH,DC,DACBN,DCBCN

As a Practitioner of Clinical Nutrition and Functional Gastroenterology, I’ve discussed small intestinal bacterial overgrowth conditions (SIBO) with students and my patients for over thirty years. It has only been in the past couple years, however, that the topic has become popular and can now be found in articles and ads across the Internet.

SIBO is a relatively common condition in which the first portion of the small intestine i.e. the duodenum, normally absent of bacteria due to the periodic washing of this area with hydrochloric acid (HCL) from the stomach, becomes overgrown with bacteria. The bacteria change the environment of the duodenum leading to a host of detrimental alterations including digestive and absorptive issues, impaired immune function and often a serious decline in well-being. Patients may in turn be medically diagnosed with various digestive diseases, skin issues, autoimmune diseases, chronic fatigue syndromes and emotional disorders stemming from the SIBO and treated with drugs missing and complicating the underlying issue(s).

The massive number of antacid prescriptions written by gastroenterologists and other medical physicians has assured this problem’s (SIBO) proliferation.

The massive number of antacid prescriptions written by gastroenterologists and other medical physicians has assured this problem’s proliferation (see our video "How Ant-Acids Wreck Your Health"). In neutralizing hydrochloric acid (HCL) production, which prevents bacteria from entering the duodenum, they have opened a Pandora’s box for the creation of health havoc. The neutralization of stomach acid creates great difficulties in protein digestion leading to a reduced ability to utilize them for nutrients while increasing the entry of undigested protein molecules through the intestinal membrane into the bloodstream triggering allergic reactions. Mineral imbalances are also likely to occur, as they are dependent in part on HCL for their solubility. Digestion suffers as the pancreas no longer receives stimulation from the HCL Acid Flow (due to the taking of Antacids) which is required to release sodium bicarbonate i.e. the “alkaline tide”.

The digestion of fats and carbohydrates is also hindered with further adverse side effects. The haphazard prescription of antacids has widespread detrimental effects, which patients rarely associate. Prescription and over the counter antacids lead to complex problems for which the patient seeks help from more physicians who in turn prescribe more drugs creating more side effects.  

Antibiotics also play a role in the development of SIBO, especially when repeatedly prescribed as is often seen in the patient’s history. Overeating, lack of sleep, poor diet, surgical procedures, emotional stress and other drugs also play important roles in the creation of SIBO.


SIBO is a common functional disorder leading to potentially serious consequences. It has traditionally been tested for medically by acquiring samples of duodenal fluid and checking for the presence of bacteria. At the Goldberg Clinic, we conduct a less invasive testing procedure that has the patient utilize a home testing kit, collecting breath samples in tubes over two hours after ingesting a small amount of sugar solution. The air samples are sent to a lab to be analyzed for the presence of hydrogen and methane gases. If little or no gas is revealed, the test is negative. The presence, however, of rising amounts of hydrogen and/or methane gas after the ingestion of the solution is indicative of bacterial colonization of the upper small intestine, an abnormal condition found increasingly in the population. See sample test report to the right indicating Bacterial Overgrowth of the Small Intestine. 

Medically, antibiotics are commonly given for this condition. While this can produce short-term improvement, long term this is a slippery slope, particularly as antibiotics were often the reason the problem began.

The approach taken with the patient must not be based solely on a single test result, but determined individually as to what causal factors led to the issue. Cookie cutter protocols for a positive SIBO test are to be avoided, as the results from such a limited approach will rarely be satisfactory as legions of our patients found out prior to coming to our office.

The Internet is full of sales pitches, often touted by young doctors barely out of school (and/or by supplement companies) in the business of selling products based on trendy health interests. Products such as Bone Broth Powders, Essential Oils, Soil Based Organisms, Collagen Proteins, “Super Greens” etc., are hawked to address the latest popular condition. This practice has a long history to it, including selling products for hypoglycemia, candidiasis, food allergies, adrenal fatigue, etc. over the past several decades. Now comes SIBO for yet another round of product marketing.

SIBO is a real condition that we see commonly, but it is not the cause of itself nor is it caused by a deficiency of any product. The causes behind SIBO must be identified and specifically addressed. The test results should be viewed by the practitioner with other testing procedures combined with an extensive, carefully taken, patient history and physical examination. Each patient requires an individualized plan along with guidance for carrying the plan through in a structured manner to assure long lasting results.

No health restoration program should be based on one factor alone. Practitioners should not be mere showmen selling products; there should be evidence that the practitioner has a high degree of clinical success in working with patients on an individual basis with such issues.

SIBO does not exist in a vacuum. Every patient with this condition has specific reasons for having developed it, their own biochemistry and their own detailed history. All these factors must be considered and acted upon in bringing the patient back to health. When causes are addressed in each case, a high state of reliable health and vitality is achieved and Bacterial Overgrowth is successfully reversed as evidenced by before/after SIBO test results from our Clinic below. 

The following are before/after SIBO test results from patients at the Goldberg Clinic. The improvements seen came by addressing causal factors and without the use of drugs or other treatments/therapies. To view more before/after SIBO test results from the Goldberg Clinic archives, click here. 

Before/After: Crohn's Disease

Before/After: Severe Eczema and Digestive Issues (see case #1)

TJ after.jpg

Before/After: Rheumatoid Arthritis and Digestive Issues (see case #12)

Before/After: Diabetes, Chronic Indigestion, Chronic Muscular Pain

Before/After: Depression, Chronic Gas and Bloating

Tammy before.jpg
Tammy after.jpg

Before/After: Rheumatoid Arthritis, Chronic Indigestion

Viji Before.jpg
Viji after.jpg