Catching Up with Dr. Elizabeth Large, N.D.

By Carolyn B. Welcome, PA-C

Dr. Elizabeth Large divides her time between GMA’s main office in Santa Rosa and its new waterfront location in San Rafael. Among the many tools in her toolbox, this naturopathic physician offers expertise in Methyl Genetic Nutrition Analysis (MGNA), a program that provides in-depth interpretation of data from 23andMe genetic testing. This method has allowed her to home in on her patients’ individual needs.  Dr. Large’s toolbox also includes Chinese and Western plant-based treatments, Low Dose Immunotherapy (LDI),* oral and intravenous antibiotics, IV therapy and hormones.

“Natural medicine is not one size fits all,” she notes.

Eric Gordon, MD and Elizabeth Large, ND at GMA - Maggie Perkins 2017

Eric Gordon, MD and Elizabeth Large, ND at GMA – Maggie Perkins 2017

Thanks to the information given by MGNA, Dr. Large is seeing fast and quite amazing results in patients who have had health problems for most of their lives.

“When you see a lot of variants in one area – histamines, for example,” she explains, “it might help to explain unresolved issues.” Because histamine is an excitatory neurotransmitter, a patient with genetic variants might have more anxiety, insomnia, skin issues, or allergic upregulation from chronically elevated histamines. Difficulty in clearing histamines can also be expressed as food sensitivities, Small Intestine Bacterial Overgrowth (SIBO), and/or environmental allergies. Dr. Large is also interested in histamine’s association with Mast Cell Activation Disorder (MCAD). Identifying the genetic aspect that goes beyond various triggers can lead to more effective treatment, and in some cases resolution of symptoms after years of suffering and frustration.

Dietary modification and nutrient support can enhance histamine clearance. Allergy tests may not show which foods are not optimal. “A patient might be eating fermented foods like cheese, sauerkraut, and kombucha because they think it’s healthy,” she says, and unknowingly perpetuating their symptoms. In that case, a different diet might be part of the treatment Dr. Large would recommend.

To clear histamine from the body we also need methyl groups. If a patient’s genetic makeup includes methylation defects, more support in the form of Methyl B12, sam-E or folinic acid might be part of the treatment plan.

Methyl Genetic Nutrition Analysis (MGNA) Program with Elizabeth Large, ND

Learn More

“Once you know the interaction of the methylation pathways, you can start to help,” says Dr. Large. Even patients with more complicated clinical presentations have noted improvement in their health.

For example, methylation defects can suppress the urea cycle. These genetic variants make it harder to clear ammonia, as Dr. Large explains.  “People who have a lot of ammonia in the urea cycle may have problems with mood or chronic inflammation. They pull BH4 (tetrahydrobiopterin) which is needed to clear ammonia and so they can’t make enough serotonin and dopamine, contributing to mood issues. People may be taking amino acids when that is not what they should be focusing on.”

Another example is choline, a precursor to the neurotransmitter acetylcholine, important in both the peripheral and central nervous systems. “People with choline issues are much more susceptible to cognitive decline,” states Dr. Large. If genetic variants cause difficulty in producing acetylcholine, brain function can be impaired.

One more piece of the puzzle is that choline genes require estrogen, so the body’s ability to make choline declines with age.

Choline is also important for patients dealing with mold toxicity. Variants in the PEMT genes for producing choline can make it harder for patients to recover. “If you don’t produce enough choline, you may not get sufficient choline in your diet to make enough bile, which is necessary for emulsification and absorption of dietary fats. Healthy fats are needed for healthy membranes, very important in mold treatment. You can have sludge in the gallbladder and congestion in the liver that compromises liver function.”

Dr. Large’s toolbox also includes Chinese herbs and Low Dose Immunotherapy (LDI). “Natural medicine is not one size fits all,” she notes.

Low Dose Immunotherapy (LDI) at Gordon Medical

Learn More

Low Dose Immunotherapy (LDI) is used to treat Lyme disease and other tick-borne infections like Bartonellosis and Rocky Mountain Spotted Fever (RMSF), along with yeast overgrowth and viral infections such as Epstein-Barr Virus (EBV) and Herpes Zoster, the cause of shingles. Patients who have had extended antibiotic therapy without making a full recovery sometimes respond to LDI.  For sensitive patients who have trouble tolerating aggressive therapy, a very dilute preparation can be used. “LDI works very well for many Lyme patients,” Dr. Large observes, “and that can be exciting, seeing patients get better after they’ve tried a variety of other treatments. Sometimes the LDI can bring them closer to recovery.”

Lyme Disease Affects People of All Ages

Lyme Disease Affects People of All Ages

Lyme Disease Treatment with Elizabeth Large, ND

Learn More

Because she herself has had Bartonella infection and RMSF, Dr. Large knows some of the remedies first-hand. For example, she has used Chinese and Western herbs, IV antibiotics, IV detoxification, LDI, and genetic nutrient therapy with excellent results.

Coffee enemas are another way to support the liver and boost glutathione (which is produced in the liver). “Bartonella gets into the endothelial cells and sinusoids of the liver. Coffee enemas can be really helpful for those patients.”

So many of our patients at GMA suffer from complex chronic illnesses, and the sickest patients often have multiple infections. “CFS and Lyme are still a mystery,” notes Dr. Large. “We don’t have a compass.”

She is still putting patterns together and starting to experiment with treatments as new information emerges. “Genetics is exploding right now with new research,” she observes, citing glutamate as an example. Glutamate is a crucial neurotransmitter for normal brain function but can become very problematic when elevated.

One area she looks forward to exploring further is the association of inflammatory cytokines and emotional health. In the future Dr. Large will be looking at mental health issues from a secondary perspective as an immune response, and will utilize natural substances to modulate inflammatory cytokines as part of treating these issues.

Dr. Large would also like to see GMA put together some type of program for people before they start treatment, as part of the initial evaluation. For people who have genetic susceptibility but may not be sick, such as family members of symptomatic patients, preventive medicine employing nutrient support, diet, and additional testing might be offered.

Always seeking to expand her knowledge, Dr. Large keeps an open mind about new therapies. “Try to make too many rules and the next patient will come along and break them!”

For more information about her practice.


Carolyn B. Welcome PA-CPrior to her career as a Certified Physician Assistant (PA-C) Carolyn B. Welcome had a career in the arts. A graduate of Northwestern University, Carolyn has an arts background as an actress and writer. She was a founding member of The Bloomsburg Theatre Ensemble in Pennsylvania and worked in regional repertory theatre for a decade. As a freelance journalist, she has written about actors and playwrights, food and travel. Gordon Medical is fortunate to have her working in our practice, and contributing her writing skills to help educate patients about the services offered at GMA