by Amanda Malachesky | Aug 13, 2018 | Chronic Illness, Digestion, Food Intolerance, Functional Nutrition, Testing
Though there is often confusion about what actually constitutes constipation, I’m sure you know it when you have it! I can’t think of one good thing to say about it.
Constipation has been a significant part of my chronic health problems, but feeling bad when I have it is only one of the reasons it’s a pain in the butt (pun intended!). Making sure we can poop easily and regularly is a main pillar of a healthy life, and can improve all manner of health challenges.
The bloating, pain, foggy head, gas, straining, and worse might be no big deal every once in a while. But when you face constipation frequently on an ongoing basis, it’s time to dig down and start unraveling the puzzle.
In my own case, I had to dig for answers. Adhesions from endometriosis, which caused gut dysbiosis (including methane-dominant SIBO), inactivity due to fatigue, and food sensitivities all played a role.
Constipation is not only uncomfortable and a challenge in its own right. It can also compound other health problems in our chronic illness picture.
Clearing up constipation is of utmost importance.
There are likely many possible causes for your constipation. The key to solving your personal constipation puzzle is discovering your personal reason(s). Once you figure out the cause, you are much more likely to be able to create a reliable relief action plan.
What Is Constipation?
Technically, constipation is defined as irregular and infrequent or difficult bowel movements.
Though your normal may vary from the next person, we should be pooping at least once per day, and passing stool should be easy. I consider a person constipated when they have less than one bowel movement per day OR they have difficulty eliminating stool, even if they go once or more per day.
Our body only has a few ways to clean itself out, and pooping is one of them. (The others include urinating, sweating, and breathing.) It’s essential for this normal detox function to work well to keep us healthy, happy, and strong.
Pooping regularly is important because our body releases toxins in the stool. If we retain stool longer than necessary, we not only can re-absorb toxins, but the bacteria in the stool can begin to ferment. Hello gas and farts.
I have noticed that if I go longer than 24 hours between movements, my brain function declines. I become crabby and snappy with my kids and husband. I’m more tired. And my belly becomes swollen and painful, which never helps my patience, self-esteem, or confidence.
Some of these suggestions may resonate, others may not, and that’s ok. Everyone’s body is different. Follow up on the ones that seem to make the most sense for you. Start with simple interventions, and only try the more complicated or expensive options if the easier options don’t work.
One thing I find true again and again is that there often isn’t ONE magic pill, but that several things in combination together CAN make a difference. Experiment and see which tips move the needle, no matter how small.
Here are my top 9 tips for getting to the bottom of your constipation, so you can create a solid plan.
#1: Remove Inflammatory Foods to Relieve Constipation
Eating the specific foods that your body is sensitive to can cause constipation. Many people experience constipation when they eat dairy products, eggs, and gluten. But ANY food can be causing a problem. For example, I discovered that every time I ate broccoli, I became constipated for TWO days!
If you know that your body becomes constipated by eating a certain food, avoiding that food will obviously help. But how do you figure out which foods are causing the problem?
An elimination diet is the gold-standard for identifying problem foods. By eliminating suspected foods for a period of 3-4 weeks, and the reintroducing them one by one and observing the effects, you can create a diet that is customized for you to reduce symptoms.
The key tool to go along with this process is a Food-Symptom Diary, where you track your food intake alongside your symptoms.
IgG food sensitivity testing or Mediator Release Testing may also be helpful in this situation, but it is usually more useful for checking for an immune response to certain foods (though constipation could be an immune response as well).
#2: Add Nutrients to help Constipation
These three nutrients fall more into the relief-care realm. But while you are sorting out your root causes of constipation, it can be helpful to have support to encourage your body to poop.
Magnesium citrate, vitamin C, and ginger can all help stimulate the bowels to move. You will want to experiment with a dose to find the one that produces a bowel movement. Start low and go slow, until you find the appropriate dose for your body.
Additionally, psyllium husk, soaked in some water, can help bulk up the stool. But too much can cause bloating, so go slow!
#3: Increase Dietary Fat (With Caution)
Fat helps lubricate the digestive tract and move things along. If you aren’t consuming enough dietary fat, it can be difficult for your intestines to function properly.
The challenge here is that many people have compromised fat digestion. Some natural health coaches encourage people to eat spoonfuls of coconut oil or ghee at bedtime as a remedy for constipation.
Though this may help relieve symptoms in the short term, it could cause other problems downstream. If you plan to increase your fat consumption to remedy constipation, it is important to support fat digestion as well with enzymes, bitters, and other liver/gall bladder support. Start low and go slow!
#4: Increase Dietary Fiber to Relieve Constipation
Fiber has long been promoted as way to keep the bowels moving and to reduce long-term risk of colon cancer. Eating a low-fiber diet can be a significant contributor to constipation.
The key element to understand about fiber is that it is the insoluble fiber that helps keep the bowels moving. It absorbs water, increases stool bulk, and swipes the walls of the colon clean.
Sources of insoluble fiber include:
- Bran
- Whole grains, like brown rice, millet, quinoa, and buckwheat
- Seeds
- The skins of fruits and vegetables, including tomatoes, peppers, apples, etc.
If you eat a diet low in fruits, vegetables, whole grains, and seeds, see if you can gain some relief by incorporating an increase in whole fiber foods. Start low and go slow! Too much change in your fiber budget can lead to bloating and gas.
If you find that increasing high fiber foods seems to worsen your constipation, you may have sensitivity to certain high FODMAP foods. FODMAPS are Fermentable Oligo-, Di-, Mono- And Polyols. They are types of starches present in certain foods.
#5: Assess Your Microbiome
We can’t talk about the gut without considering the state of your microbiome. The community of bacteria and other microorganisms has a significant effect on how things move through your intestines. We want to investigate how your microbiome is doing, and how it may have changed recently.
Many people find that their constipation began with a shift in their microbiome terrain. This can happen from things like a course of antibiotics, a new medication, or a major stress event, like a death in the family, change of jobs, moving, or marital troubles.
Consider what else was happening at the time your constipation started. Did you experience a major stressor around the same time?
If it seems that the microbiome piece of the story is important in your case, evaluating yours is a helpful step. Completing a GI-MAP stool test (or similar stool test, like Doctor’s Data, Genova, or BioHealth 401H) to check for parasites, bacteria, and yeasts, can help you understand what specific bugs you are dealing with and can inform your approach.
Another very common microbiome cause of constipation is methane-dominant SIBO, or Small Intestine Bacterial Overgrowth. If you have an overgrowth of methane-producing bacteria in your small intestine, the methane exerts a powerful paralyzing effect on your small intestine.
Properly addressing dysbiosis, whether from parasites or SIBO or yeasts, is a very powerful way to resolve chronic constipation.
Some people find constipation relief with the addition of probiotic foods or supplements (or both), while others find that probiotic foods and supplements make their constipation worse. You will have to experiment for yourself to figure out what works right for you.
If you find that you react to the commonly available varieties on the shelves at your local health foods store, you may want to try spore-based probiotics, like MegaSpore Biotic, soil based probiotics, like Prescript Assist. You may also have better luck with a blend that does not include histamine-producing probiotics. I like Klaire Labs Ther-Biotic Metabolic Formula.
If you can’t find a probiotic that seems to work, this is a sign that you have some cleaning work to do before you are ready to repopulate your gut microflora. Dig for answers to understand your gut flora picture, and work a plan to reset your flora.
#6: Break Down Adhesions with Physical Therapy
Adhesions are internal scar tissue that can bind up tissue and organs inside the body. They can occur anywhere, and can cause problems no matter where they show up. This is nowhere more true than in the gut.
Possible reasons for adhesions include:
- Abdominal surgery
- Inflammatory disease, like endometriosis, gastroenteritis, diverticulosis, hepatitis, or colitis.
- Injury or blunt trauma (think car accident, sports injury, etc.)
- SIBO
- Appendicitis
- Gall bladder trouble
- Pelvic inflammatory disease
If adhesions are impeding the function of your gut organs, no amount of other help you throw at the problem will last indefinitely. Specialized abdominal massage, like that offered by the Clear Passage clinics, or physical therapy can help a lot with constipation.
When I had my wide-excision endometriosis surgery two years ago, one thing we discovered was that my colon was adhered to the wall of my abdomen. No wonder I suffered from constipation! The surgery likely created more adhesions as well, just in different places. For this reason, avoiding surgery unless absolutely necessary is important, to avoid creating more adhesions!
#7: Support Vagus Nerve Function
The vagus nerve is the largest nerve bundle in the body and controls automatic body functions like digestion, respiration, stress response, etc.
Because our digestion is highly regulated by the vagus nerve, and the vagus nerve function can be affected by the microbiome, sluggish vagus nerve function can be an underlying reason for constipation or slow motility (movement of food through the digestive system.)
The vagus nerve can be damaged by food poisoning, which can lead to chronic SIBO.
Fortunately, there are many easy and fun things to do to support the vagal function! They include:
- Singing loudly (shower or car time, anyone?)
- Jumping on a trampoline or rebounder
- Gargling
- Exercising
- Belly massage
- Yawning
See if incorporating any of these ideas regularly helps relieve your constipation, in addition to your work supporting a healthy microbiome.
#8 Assess Thyroid Function
One of the most common underlying causes of chronic constipation is poor thyroid function. The digestive tract, like all other body tissues, requires thyroid hormone to function properly.
Especially if your constipation occurs with other common thyroid symptoms, such as weight gain, depression, cold hands and feet, heart palpitations, dry skin, consider having your health provider evaluate your thyroid function.
Because of insurance payment standards, many doctors will only check your Thyroid Stimulating Hormone (TSH) levels. But to truly look at how the thyroid gland is doing, it’s important to look at a complete thyroid panel, including:
- TSH
- Free T3
- Free T4
- Reverse T3
- Thryoid Peroxidase Antibodies (TPO)
- Thyroglobulin Antibodies (TG)
If your doctor won’t order these, or your insurance won’t pay for them, you can order them directly from a direct-to-consumer service like Life Extensions or DirectLabs.
#9 Assess Your Current Medications
Many medications have either a direct or indirect effect on intestinal motility. Be sure to check your product inserts, or check with your pharmacist if you have concerns about a particular medication.
If you think a medication is contributing to your constipation, have a conversation with your doctor to explore possible alternatives. It’s important that you keep pooping!
I hope by now you can see that solving the root causes of your constipation is unlikely to come from just one source, but many. Finding the pathway to resolution requires some questioning, some digging, sometimes some deeper investigating, and experimenting to find the proper combination of solutions.
But even if it takes a little while, finding your particular solution means less long-term loss of quality of life, less symptoms, less lost work time, less lost pleasure time, less medications, and a whole lot more comfort.
When you’re ready for help to make sense of your constipation, I invite you download your free copy of Roadmap to Recovery. Inside, I detail the steps you can take to unravel your health challenges, so you can find the RIGHT solution for YOUR body.
When you know you are ready for some more robust support, I encourage you to schedule a free 30-minute Assessment Session with me.
by Amanda Malachesky | Jul 30, 2018 | Chronic Illness, Functional Nutrition, Inflammation, Nutrition, Stress
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Blood sugar imbalance is one of the biggest American public health epidemics of our time. According to the CDC, approximately 10 % of Americans have Type 2, or adult onset diabetes. Even worse, 33% have pre-diabetes, and most of them aren’t aware that they are pre-diabetic.
Diabetes is caused by excess sugars or glucose in your blood. Normally, when our blood sugar is too high, our pancreas produces more insulin, which helps the sugars enter body cells.
When the body can’t produce enough insulin, or can’t use insulin as well as it should, this is called diabetes and insulin resistance. A diabetes diagnosis is made when your body can no longer control blood sugar in a normal range without intervention.
But blood sugar handling occurs on a spectrum. There is a range of normal blood sugar levels. Pre-diabetes means that your circulating blood sugar is a little higher than normal, and that your blood sugar is trending higher than normal, but that it hasn’t yet reached diabetes levels.
The excess circulating blood sugar in pre-diabetes and diabetes leads to a suite of health problems including cardiovascular disease, obesity, vision problems, peripheral nerve pain and degeneration, and kidney disease. There is also a growing correlation between blood sugar imbalance and Alzheimer’s Disease and cognitive decline.
But although Type 2 Diabetes is one of the most common chronic illnesses, it’s also one of the most possible-to-treat chronic illnesses with diet and lifestyle modifications. Though the changes can feel challenging if you’re used to eating and living a certain way, you CAN often reverse Type 2 diabetes with diet and lifestyle changes.
And even if you don’t have diabetes or pre-diabetes, it’s important for you to keep reading, too. Even if your body is handling your sugars just fine for the time being, excess sugars in the body promote more generalized inflammation. This inflammation has a role in many chronic diseases, not just diabetes.
Here is what you need to know to bring your blood sugar into balance, without medication.
How to Balance Blood Sugar
Balancing sugars is one of the first steps of getting a handle on chronic illness, no matter your diagnosis. And even if your health challenge isn’t a diagnosis, balancing your blood sugar is a foundational practice. Keeping your sugars balanced helps support the health of your adrenal glands, manages your weight, keeps your brain clear, and helps keep your moods stable.
Excess circulating blood sugar that can’t get into your cells leads to inflammation. It increases inflammatory cytokines, and also causes oxidized fats to damage your arteries. In plain speak, that means you may gain body fat (especially around your middle), and experience increased pain, declining brain function, and increased risk of cardiovascular disease.
There is no debate: keeping blood sugar balanced throughout the day using diet is both doable and is an effective way to promote health.
From a Functional Nutrition perspective, the first question to explore and answer is: What foods are elevating your blood sugar too high?
The common American diet is full of foods that can aggravate blood sugars. Added sugars in all manner of packaged foods are a problem, but processed carbs, starchy vegetables, and fruits can also be culprits. Even a healthy, therapeutic diet can have foods that elevate sugars inappropriately.
The key is discovering which specific foods are problematic for YOUR unique body. Tracking food intake alongside blood sugar readings taken with an at-home glucometer is the best, most specific way to identify your blood sugar triggers.
How to Track Blood Sugar
Tracking your blood sugar requires using a glucometer, or sugar meter. You can buy one online or at your local drugstore. Make sure to buy test strips along with your meter. If you are a diagnosed diabetic, insurance will usually pay for your meter and test strips, but the cost isn’t too prohibitive to buy out of pocket.
Grab a sheet of paper or an online tracking app, and take note of what you ate and when during the day.
You’ll want to take your blood sugar at several intervals through the day. Add these values onto your food log.
- Immediately after waking, first thing in the morning (functional range: 78-88 mg/dL)
- 40 minutes after breakfast (functional range: <135 mg/dL)
- 40 minutes after lunch (functional range: <135 mg/dL)
- 20 minutes before dinner (functional range, if >2 hours since last food: 78-88 mg/dL)
- Just before bed (functional range, if > 2 hours since last food: 78-88 mg/dL)
If you find values above these ranges, it’s time to evaluate what you had for your previous meal. Were there ingredients or products with added sugar? Were there foods with a high glycemic index, like breads, tortillas, pasta, crackers, or baked goods? Even white or sweet, white rice, winter squash, legumes, grains, or beets and carrots could be triggers.
Certain fruits or fruit juices could also be a problem, but will likely cause a delayed elevation of blood sugars, because the fructose must first processed in the liver before being broken down into glucose. Dried fruit can be a particularly strong trigger, as it is a concentrated food and it’s easy to overdo it.
Alcohol and caffeine can also be blood sugar destabilizers. Drinking alcohol in the afternoon and evening may contribute to elevated waking sugars. Caffeine may lead to blood sugar problems near lunchtime if you drink coffee first thing in the morning.
The triggers will likely be different for everyone. To manage your sugars well, you need to get curious and become a detective. If you feel like you’ve identified a blood sugar trigger, remove it for a week and keep tracking your sugars.
Do your numbers stabilize? Or are they still elevated? If they’re still elevated, get curious about what OTHER foods might be triggers. Do removal trials until you identify the culprit(s).
Common blood sugar triggers include:
- Bread, pasta, or tortillas
- Chips, pretzels, and other snack foods
- Baked goods, like cake, cookies, pastries, pie, etc.
- Boxed cereal
- Potatoes (plain, or French fries, potato chips, etc.)
- Fruit juice
- Dried fruit
- Even healthy foods like grains, legumes, or starchy veggies could cause a problem for some people.
Lifestyle Can Affect Blood Sugar
Lifestyle choices, including when we eat, how much we sleep, and how we manage our stress can affect our blood sugar.
Two hormones, leptin and grehlin, are responsible for signaling our appetite and turning it off. Grehlin is produced in the stomach, intestines, and kidneys, and tells us we’re hungry.
When we don’t get enough sleep, our grehlin output increases, which increases our appetite. Fructose (fruit sugar) consumption will also increase grehlin, and therefore appetite. So you can see a self-reinforcing pattern developing here: don’t sleep enough —> increased grehlin —> increased appetite —> eat not great food choices, including sweets or drinks with high fructose corn syrup —> increased grehlin —> repeat… you get the idea. This pattern increases the likelihood of overeating, reaching for quick energy foods like sodas, caffeine, and treats that elevate blood sugar.
Conversely, when our body determines we’ve eaten enough, it releases leptin, which tells us to stop eating. But your cells can become leptin resistant and stop responding to the signals.
Guess what encourages leptin resistance? Fructose, including fruit juice, corn syrup, and agave syrup.
In this indirect way, lack of quality sleep can drive us to have an increased appetite, and can encourage poor food choices. Do you ever notice you have a bottomless pit of hunger when you didn’t sleep well the night before?
One simple way to help prevent this pattern from starting is to get to bed earlier, ideally well before midnight.
Stress and Blood Sugar
When we experience stress, our body mobilizes resources to meet that threat to our well-being. The “fight or flight” response tells the body, “it’s time for action”. To allow this response, the body releases stored energy, and elevates blood sugar.
We want this to happen if we are being chased by a mountain lion. This is the reason average sized people are able to lift a car off of their trapped child, or do seemingly superhuman feats when their life is threatened.
But when our body is experiencing this pattern many times daily, in response to stressors both big and small, this can have a significant effect on blood sugar. It can lead to highs and then lows.
Successfully managing stress, whether it’s from your boss, your kids, your commute, or your financial situation, is absolutely essential for balancing blood sugar. Inviting stress relief practices, such as meditation, mindfulness, walking in nature, spending time with friends, or doing things we enjoy can help us not only feel better, but improve our actual health data and statistics.
No matter your health challenge or diagnosis, making sure your blood sugar is in balance is a key part to healing or maintaining your good health.
When you are ready for help understanding which foods are blood sugar triggers, what to do with your blood sugar readings, or how to successfully manage your blood sugar with diet and lifestyle changes, please schedule a free Assessment Session with me to find out how I can help. You can also grab your free copy of Roadmap to Recovery: How to Move Beyond Your Symptoms and Create a Personalized Plan to Restore Your Health to learn more about how I would support you. I look forward to meeting you…
by Amanda Malachesky | Jul 16, 2018 | Chronic Illness, Digestion, Food Intolerance, Functional Nutrition, Genetics
I’ve walked a long and ugly road with food intolerance, and sadly, it’s not over. I first found that I had a an intolerance to gluten, dairy, and sugar when I was trying to resolve my ovarian cysts, 9 years ago. But I didn’t stay off them, despite the improvement I felt. Wheat crept back in. My husband is a serious dairy fan. It was too hard to adapt my whole family’s diet.
When my son was born, and was very fussy, I removed gluten again, to see if he had a gluten intolerance through my breastmilk. This helped him enough that I quit for a while. But once he was more stable, gluten slipped back in. It’s everywhere and hard to avoid.
But when my health unraveled further in 2013, and I faced daily anxiety attacks and crippling fatigue, I recommitted to observe my food intolerances again. I fully kicked gluten, dairy, and sugar to the curb. I removed these foods and did nothing else to correct my intolerances, and thought I was doing the right thing.
But when I finally got around to running a food sensitivity test, I found that I was reactive to many of the foods I had substituted, and had to remove a whole bunch more! No fair! I had tantrums, for sure. I further found there were whole categories of food that were problematic, and I had to deal with those too.
By the time I was done with this process of discovery, I could no longer eat in a restaurant or at a friend’s home. In addition to the gluten, dairy, and sugar, included on my no list were beef, pork, potatoes, corn, chocolate, coconut, eggs, and almonds.
Good luck eating out for breakfast with this list!
Though removing foods you are sensitive to is an important healing technique, continually removing more and more foods isn’t really a long-term success strategy. With all my self-diagnosing on Dr. Google before I was trained, I missed the mark, and my mistakes cost me the freedom to eat what I want. I’m still fighting this battle.
Allow me to save you some heartache and belly ache: having long-term success with food intolerances requires that we understand WHY they are happening, and that we work on repairing our digestive and immune function so we can live a normal life again.
The unfortunate truth about food intolerances is that many people, and even practitioners who deal with them, it get all wrong. There is so much confusion and misinformation about them. The “avoid forever” strategy works great if you have one or two sensitivities, but not once you have many.
Like always in the Functional health space, we want to understand WHY something is happening so we can fix the problem at the source. So I’d like to clear up the food intolerance landscape, so that you can understand: what are food intolerances? How do food intolerances develop? How can you assess whether you have food intolerances? And will they ever go away?
What is food intolerance?
There are many types of food intolerance. Put simply, a food intolerance is when your body reacts negatively to a food that you eat. What’s not as clear to most people is that there are different types of food intolerances. And properly dealing with your food intolerances demands that you understand exactly which type of sensitivity you have.
Food intolerances are a significant contributor and trigger for uncomfortable and unwanted symptoms. Discovering food intolerances is key to moving your case forward.
In my practice, I see five categories of food intolerance:
- Outright allergy
- IgG food intolerance
- Intolerance due to lack of needed enzymes or other nutrients
- Intolerance due to genetic shortfalls
- Intolerance due to microbiome imbalance.
These different types may co-occur, but understanding which ones are at play is key information to create your strategy.
Outright Allergy (IgE Intolerance)
The food intolerance most people are familiar with are IgE (ImmunoGlobulin E) allergies, which is when you have a very strong, potentially deadly anaphylactic or hives-and-itching type reaction.
Immunoglobulins are immune antibodies that get triggered if you eat or are exposed to something you are reactive to. If you have an IgE intolerance to peanuts or shellfish, you likely found out the hard way that you can’t eat these foods and need to carry an epi-pen in case of accidental ingestion.
This is the type of food intolerance that most allergists check for. Clients often come to me saying, “My allergist tested me for wheat and dairy allergy, and nothing showed up, so I can keep eating them.” Unfortunately, this isn’t really the case. IgE allergy or intolerance is only ONE kind of food intolerance.
IgG Food Intolerance
To explain IgG food intolerance, I need to share a little more about immunoglobulin antibodies. Immunoglobulin antibodies are part of what’s called the adaptive immune system. This part of the immune system is designed to adapt and respond to the environment that we live in, and protect us from incoming pathogens or irritants, like pollen.
Imagine that your immune system tags something unfamiliar with a little post-it note. This post-it note is an immunoglobulin (Ig) antibody. Now the body knows that every time it encounters that non-self material, called an antigen, it needs to create an immune response to destroy and clean up the invader.
An IgG antibody immune response emerges more slowly than the IgE antibody response, and the effects may not be visible for several days. For this reason, identifying IgG food intolerances can be challenging.
The gold standard for understanding this type of intolerance is an elimination diet followed by single reintroductions to watch for reactions. Tracking foods and symptoms using a Food-Symptom diary is the best way to track for delayed food reactions.
Additionally, using IgG Food Sensitivity testing from labs like Oxford Biomedical, Cyrex, or USBiotek can help speed the process of identifying the culprits.
But beyond our symptoms and reactions, we need to understand that IgG food intolerances are an important clue that we need to address and support digestive function.
The main cause of IgG food intolerance is partially undigested proteins sneaking through the gut lining and getting into the bloodstream. These proteins are then tagged as an immune threat. These proteins shouldn’t be in the bloodstream because they should be completely broken down into unrecognizable peptides or amino acids before they get there.
Removing your IgG sensitive foods is important, temporarily. But more importantly, you need to make sure your body is completely digesting its protein, and seal the gut barrier. Otherwise, you will continue to develop worsening IgG intolerance and the immune or autoimmune symptoms that go with it. This process is the seed for autoimmunity.
Intolerance Due to Lack of Needed Enzymes or Other Nutrients
Sometimes, your body just doesn’t have the tools to digest or otherwise break down a component of foods. The most familiar example of this is lactose intolerance. Many people are born sensitive to lactose, while some develop this sensitivity as they age or become adults.
People with lactose intolerance don’t make enough of the enzyme lactase, and so they can’t break down the lactose, which leads to gas and bloating. People in this boat can choose to consume lactose-free dairy products, or try using enzyme supplements with lactase to improve their digestive experience.
Another important type of intolerance in this category is sensitivity to particular chemical components in foods. This can include compounds like salicylates or oxalates, which are normally-occurring, natural chemical components of food.
Vitamin or mineral deficiency can be the reason for this type of intolerance. For example, salicylates require adequate sulfate, magnesium, vitamin B6, vitamin B12, vitamin D, and molybdenum to be processed through the liver. Excess oxalates bind onto minerals like magnesium and calcium. In the absence of adequate magnesium or calcium, the excess can end up being stored in body tissues and cause pain.
This type of food intolerance is often dose dependent. Because many of the foods that contain these compounds are healthy, nutrient-rich foods, we don’t want to throw the baby out with the bathwater!
To understand how to work with dose-dependent food intolerances, imagine a bucket. You can consume up to the amount of food that doesn’t trigger a response, or up to the amount our body has the resources to manage. When you eat too much, your bucket overflows and you experience symptoms.
You want to reduce the amount you eat to below your threshold so you don’t overflow your bucket. You should only remove the particular foods that are most reactive, while simultaneously supporting the body’s natural ability to process them properly.
Intolerance Due to Genetics
Some people have genetic SNPs that cause their body to be less efficient at processing certain compounds for detoxification or elimination. Salicylate intolerance may be evidence of this type of intolerance.
Salicylates require sulfates to break down via the liver. The SUOX gene converts sulfites to sulfates, and this reaction requires certain nutrients as co-factors. If you have certain copies of this gene, you may be less efficient at generating the sulfate you need to break down and excrete salicylates.
Understanding how to work with this kind of a defect often comes slowly, if you have struck out with other types of interventions. Genetic results from a company like 23andme or Ancestry can be run through an interpretation software like StrateGene and then reviewed with someone knowledgeable about genetics.
Intolerance Due to Microbiome Imbalance
Finally, food intolerance can be driven by a microbiome imbalance. Infections with parasites, overgrowth of normal or pathogenic bacteria, or yeasts and fungus can wreak havoc on digestive function.
These infections can dramatically increase leaky gut, which can increase IgG food sensitivities. Overgrowth of the wrong type of bacteria, or of bacteria in the wrong place can compromise the body’s ability to tolerate certain classes of carbohydrates. This is often the reason for a FODMAP sensitivity, and a low FODMAP or Specific Carbohydrate Diet may help. (FODMAPs are foods with particular types of starches).
Not having the right kind of bacteria can impair your body’s ability to break down oxalates.
Having overgrowth of bacteria that are histamine producers can be part of a histamine intolerance.
Food intolerance isn’t always because of microbiome imbalance, but it is often connected. If dysbiosis is part of the equation, this needs to be addressed alongside food removals, reintroductions, and rebuilding or restoring a proper gastrointestinal.
Don’t Forget About Sensitivities to Food Additives
I can forget to bring this category up, because I have eaten a preservative- and chemical-additive-free diet for my entire adult life (20+ years and counting), but many people are intolerant to food additives. Things like artificial colors, flavors, preservatives, hydrogenated fats, processed ingredients, and chemical ingredients you can’t pronounce are anti-nutrients and best left off your plate for good.
If you are currently eating a “Standard American Diet,” and eat a lot of pre-packaged, processed, canned, frozen, and pre-made foods, you are likely ingesting many substances your body doesn’t know what to do with. If this is you, you may want to begin by removing processed foods, and eat a real food diet.
The simple way to avoid food additives is to eat real food: actual vegetables, fruits, grains, legumes, nuts, seeds, meat, fowl, fish, and real dairy. Organic food is uncontaminated with pesticides and herbicides. When we stick to these foods, we remove many of the irritants that our body may be reacting to. This step should happen before any further elimination or special diets.
Managing and Healing Food Intolerance
I hope you can see now that understanding food intolerance is actually quite complex. It’s essential to understand what type of intolerance you are dealing with before you begin removing wide categories of food.
Elimination diets are one of our biggest and most important tools to use when trying to understand food sensitivities. But elimination diets can backfire, especially drastic and lengthy ones, like the keto-adapted or autoimmune paleo diets. Maintaining a very restrictive elimination diet for the long term can lead to nutrient deficiencies, and can also negatively affect our microbiome.
An important first step is to use a Food-Symptom diary to track what you’re eating and your symptoms to see if you can identify any obvious culprits. For most people, I recommend eliminating common allergens to see if they are culprits in your symptoms, and this is the part that everyone understands.
But even more important is understanding what to do next. Healing from food intolerances depends on which type of intolerance you have, but generally, you need to:
- Support robust digestive function
- Do the proper elimination diet to remove offending foods ( you will reintroduce them in the future to test tolerance if not a severe allergy.)
- Restore good intestinal barrier function
- Improve nutrient status
- And restore a healthy microbiome
Restoring proper digestive function is absolutely essential. Otherwise, the conditions that allowed for intolerances will continue to be a factor, and the intolerances are likely to get worse.
An elimination diet follows this basic support work. In my practice I have everyone eliminate gluten, dairy, and sugar, and sometimes I have them eliminate soy, corn, and eggs. Specific eliminations become much more individualized after that. Refer to the handouts I mentioned earlier to try and assess what type of sensitivity you may be experiencing.
Beyond these top six foods, any other food can be a culprit, but I don’t necessarily want to ask people to drastically change their diet, at least not at first. Why?
Our microbiome, or the community ecology of bacteria and yeasts that live in our digestive tract are accustomed to what we are eating now. Making a sudden, 180-degree dietary shift selects for a different microbiome.
This may be what you need to happen if part of your health challenge is due to dysbiosis, or an imbalance in your microbiome. The idea is that making a big change makes space for the good guys, kind of like rototilling your garden in the spring to make room for your veggies.
But after all my years of experience, as a food intolerance patient, and now as a practitioner, I am questioning the wisdom of these dramatic shifts. We want to preserve the good guys we have, while making the terrain inhospitable to the not-so-friendly bacteria.
Rebuilding a healthy gut ecosystem from scratch is a lot harder than supporting and working with what you’ve got. Your undisturbed gut ecosystem is a bit like an old-growth forest. If you clear cut, the second growth is going to take a LONG time to even remotely resemble the diversity and beneficial complexity of an old-growth forest. I think it’s best to work with what you have and not be too aggressive.
Also, when you go down the road of eliminating things left and right, you may just keep going, until you paint yourself into a corner with just a few foods. I had a client that was down to just two foods. And I myself was down to about 20-30 foods at one point.
Therapeutic elimination diets, like the Autoimmune Paleo, Specific Carbohydrate Diet (SCD), low FODMAP diet, or low histamine diet are important, but these diets are never meant to be long-term solutions, and it’s best to ease into them gradually, while simultaneously supporting your positive gut flora.
Therapeutic diets are designed to help lower your immune burden temporarily while you implement a longer-term strategy of repair and restoration on your gut and microbiome, so that you can re-invite a wide variety of nutrient-dense foods. That is, with the exception of gluten and sugar, for most people!
Determine Your Intolerances
The tried and true way to get clear on your intolerances is by doing an elimination diet, followed up with one-by-one reintroductions of foods while using a Food-Symptom Diary, to test for reactions.
Not only does this method give you concrete data based on your own n=1 science experiment, you become quite the expert in understanding what you need to do, and what will happen if you invite your trouble foods into your life.
The other way to assess for food sensitivities is with blood testing. There are a couple of different options:
Mediator Release Test (MRT)
The MRT test uses your blood sample to measure your blood volume before exposure and after exposure to a potential food trigger. It doesn’t test for a specific antibody, but a change in blood volume on exposure indicates that there is some kind of mediator release at the cellular level to that food.
Foods that react above a threshold should be removed for a period of months while working on gut and microbiome healing.
IgG Food Sensitivity Testing
IgG testing tests for IgG antibody reaction to a number of foods. Three common labs for running this kind of testing are Cyrex Labs, Great Plains Laboratories, and US Biotek. These labs screen for IgG reactions to 150 or so foods, and Cyrex also has several specialized screens for gluten and gluten-cross-reactive foods.
It’s easy enough to see what you’re reacting to, but the understandable question is, what do I do with this information? As with the MRT, the IgG panels provide a starting place to direct your efforts to remove foods, while you focus on restoring and repairing your gut, microbiome, and calming your immune overreaction.
Will I Ever Recover from Food Intolerance?
I had a young client whose allergist told them that they would grow out of their intolerances. Some people do report being able to reintroduce foods they previously reacted to without any problems.
For most of us, the road to successful reintroduction and tolerance is a much longer road. We remove the foods that aren’t working, but then we need to consider WHY the terrain isn’t suitable. We need to do the restoration work to create a functional digestive and detoxification system that works, and THEN we can work on reintroducing foods, and maybe even be successful.
Whether you can recover depends on the severity of your gut damage. If it’s in deep distress, it could take years to repair to the point where you can tolerate some foods again. I have only been able to reintroduce a few of the foods I removed, and I keep working toward recovery.
So the short answer is, it depends. But in my opinion, it’s not likely to happen just by taking a break and then trying to reintroduce the food. OR growing out of it. There is more proactive work needed on your part to create remission and healing.
Tools to Heal and Seal the Gut to Reduce Food Intolerances
There are certain nutrients that the gut needs to do its job effectively. Here is a general list to play with, in addition to removing offending foods.
Visit my FullScript online dispensary to shop for these and other supplements.
Probiotics: Most people with food intolerances also have an imbalance in their microbiome. Encouraging a proper microbiome is an important step and including probiotic supplements or foods may help. However, if you find that probiotics make you feel worse, you may have other issues to address first, such as SIBO.
Stomach Acid: IgG food intolerances are partly created by proteins sneaking through a leaky gut. Ensuring adequate stomach acid makes sure proteins are thoroughly and complete broken down to their constituent parts (amino acids and peptides) before they make it through the gut wall. In these forms, they are not recognizable as anything dangerous by the immune system.
Stomach acid also has many important functions, including preventing infection with pathogens, enabling the absorption of iron and vitamin B12, helping digestive secretions release, and helping food move through the intestines.
Supporting stomach acid can be as simple as including a small amount (1/4-1/2 tsp) of apple cider vinegar or lemon juice in a small amount of water before meals, or by using a Betaine Hydrochloric Acid supplement.
Digestive enzymes: Enzymes help break food down and transport it into the cells. As with the stomach acid, providing enzymes can help ensure complete digestion to prevent food intolerances. Incorporate enzyme capsules, chewables, or liquid with each meal and snack.
L-Glutamine: An amino acid that is used extensively by gut tissue for repair. Titrate up to a dose that feels comfortable, starting at 1 g, and up to 9 grams per day.
Zinc: Especially zinc picolinate helps repair the lining of the gut. Zinc is best consumed with food.
Vitamin A and D or fermented cod liver oil: These two nutrients are key antioxidants and repair enhancers for the gut mucosa.
Colostrum: When we are born, our guts are normally and naturally permeable. Colostrum is the first mother’s milk a baby receives after birth, and its function is to seal the gut, and to provide immune protection. If you’re not dairy sensitive, colostrum can be a game-changer for gut barrier function.
Chew food thoroughly, and relax while eating: Not all digestive supports are foods or supplements. Good digestive function relies on a feeling of relaxation. Digestive function declines or stops working if we eat when stressed.
Bone broth, gelatin, or collagen: All of these help repair the lining of the gut. Tolerance may vary, so test carefully.
Aloe vera juice, deglycyrrhized licorice (DGL), slippery elm, and marshmallow root: Soothing and healing for the gut lining.
Things to Avoid
Unnecessary medications, including OTC meds (NSAIDs, and birth control pills, e.g.): Many medications have a negative impact on the gut microbiome and intestinal permeability. Stick to medications that have a high level of clinical and personal benefit with low risks.
Gluten: Gluten increases intestinal permeability for everyone, no matter whether you are gluten sensitive or not. Avoiding gluten is a huge priority for resolving food intolerances.
Dairy & sugar: These commonly inflammatory foods are best avoided while repairing and restoring digestive and immune function. They can be retested for sensitivity after good work has been done, and maybe reintroduced.
Antacids: Antacids reduce stomach acid, which we need to protect us from food intolerances.
Antibiotics, if at all possible to avoid: Antibiotics drastically affect the microbiome in the gut. Some microbiome shifts can lead to food intolerances, or make existing ones worse. Of course, don’t avoid necessary treatment, but avoid them if possible.
Immunizations during the repair period: Metals increase intestinal permeability, and there are usually metals, especially aluminum, as adjuvants (immune stimulators) in vaccines.
Stress: Stress increases intestinal permeability, and should be actively managed and reduced while you are working to repair food intolerances.
When you’re ready for some support and help sorting out your food intolerances, Schedule a free Assessment Session with me to hear my assessment of where you are and what kind of improvement may be possible for you.
When you’re ready to hear more about the 7-Step process I use to help clients get beyond their symptoms once and for all, download your free copy of Roadmap to Recovery: How to Move Beyond Your Symptoms and Create a Personalized Plan to Restore Your Health.
by Amanda Malachesky | Jul 2, 2018 | Brain Health, Chronic Illness, Digestion, Functional Nutrition, Inflammation, Symptoms
I first gave up gluten when I was 33 years old. I was suffering from recurring ovarian pain, and I eliminated gluten, dairy, and sugar to see if it would help. I felt remarkably better.
But gluten slid back into my diet, little by little. By my second pregnancy, two years later, it was open season. My main craving was a comfort food from my childhood: toasted crispy Thomas’s English Muffins. I ate scores of these gluten-filled snacks, with lots of butter. And pasta.
What I didn’t know at the time was that since gluten was problematic for me once, it was likely to be problematic for me on an ongoing basis. I wish I had known…
I’m not going to win any friends by saying this. But as a health professional, I need to say it: gluten is a problem for just about everyone. And it’s especially a problem if you are suffering from any kind of chronic illness or health complaint. It’s one of the first dietary shifts I ask my clients to make.
But people are understandably confused and a little defensive. You mean to tell me I can’t eat my pizza? My noodles? My bagels?
The answer is “Yes”.
Let’s bring some information to the table so we can at least answer the question: Why is gluten so bad?
What is Gluten?
Gluten is a collection of proteins that are found in certain grains: wheat, barley, rye, triticale, spelt, and kamut. Each of these grains has varying amounts of the many gluten proteins.
The most commonly-known gluten protein is gliadin, but there are many more gluten proteins in gluten foods.
There are several ways people can be sensitive to gluten.
So why is gluten and it’s protein such a problem for people with health challenges?
#1: Gluten Increases Intestinal Permeability (Leaky Gut)
Our health largely depends on a strong, resilient immune system. 80% of this immune system is located in the digestive tract. It’s responsible for protecting us from pathogens and toxins in our food.
When we have good gut function and a non-permeable gut, any incoming pathogens remain in the intestines and are disabled by the immune system and excreted.
But if our gut is “leaky” or permeable, those invaders can get past the defense systems and end up in our bloodstream. Invaders can be pathogens, like bacteria, viruses, or parasites. But they can also be proteins and peptides that didn’t get fully broken down in the stomach.
When the invaders and proteins enter the bloodstream, they are tagged by the immune system as a threat, and a more systemic immune response is mounted. (Read more about what happens next in #2 below).
A study published in the journal Nutrients showed that exposure to gluten increases intestinal permeability, no matter whether you are sensitive to gluten or not.
Though there are several reasons why your gut may become leaky, including stress, certain medications, and gut infections, frequently consuming gluten leaves your gut at constant risk of permeability.
Maintaining and repairing your gut barrier function is of primary importance for improving your chronic health challenges, no matter what form they take.
#2: Gluten-Induced Gut Permeability Contributes to Autoimmune Disease
There is increasing evidence that gluten-induced intestinal permeability is a major contributor to the manifestation of autoimmune disease. Partially digested proteins that sneak through a “leaky” gut barrier are tagged by the immune system as a problem.
The challenge is that those tagged proteins may resemble our own tissues. Once they are tagged, our own similar tissues are identified as a threat as well. This is thought to be one mechanism of the development of autoimmune disease.
If proteins that resemble thyroid tissue sneak through your leaky gut, your body may create thyroid autoantibodies, and you may develop Hashimoto’s thyroiditis.
If proteins that resemble nerve tissues sneak through your leaky gut, your body may create nerve autoantibodies, and you may develop fibromyalgia, or parkinson’s, or multiple sclerosis.
Especially for people facing one or more autoimmune diagnoses of any type, creating a gluten-free lifestyle and supporting proper intestinal function is an absolute must.
#3: Non-Organic Gluten-Grain Crops are Sprayed with Glyphosate
Glyphosate is the chemical herbicide and defoliant known by the trade name RoundUp. Glyphosate use in agriculture has skyrocketed during the last several decades.
Commercially-grown wheat (as well as GMO corn and soybeans) is routinely sprayed with glyphosate as a dessicant to speed drying in preparation for harvest.
Glyphosate has been shown to negatively affect the gut microbiome and to increase intestinal permeability. A paper in the journal Interdisciplinary Toxicology claims that people and animals exposed to glyphosate have less beneficial bacteria, and an increased incidence of infectious organisms. It also demonstrates that glyphosate has also been linked to esophageal damage, liver, gall bladder, and pancreas damage or disruption, and depletion of key nutrients, such as Vitamin A, Vitamin B12, Vitamin B9 (folate), iron, molybdenum, and sulfates.
Avoiding gluten foods helps you avoid exposure to glyphosate, which compounds the negative affects of gluten.
#4: Gluten is a high FODMAP food
Many people with chronic illness have a lot of digestive troubles, including painful bloating and gas, constipation, diarrhea, and cramping.
FODMAPs are a group of starches that some people have difficulty digesting. FODMAPs stands for Fermentable Oligo-, Di-, Mono- Saccharides And Polyols. When people with a FODMAP sensitivity eat high FODMAP foods, they often experience bloating and pressure in the gut, as well as diarrhea, constipation, or both.
If you experience any of these symptoms after eating gluten, it’s possible that you have a sensitivity to FODMAPs, and may benefit from removing gluten.
#5: Gluten can cause brain problems
Besides the increase in intestinal permeability, and all the possible downstream affects of that, gluten can increase inflammation. This can wreak havoc on the brain, and can cause neurological symptoms similar to psychological disorders and neurodegenerative diseases like Alzheimer’s and dementia.
Dr. David Perlmutter, in his NYT bestseller Grain Brain: The Truth About Wheat, Carbs, Sugar—Your Brain’s Silent Killers states:
“Gluten sensitivity—with or without the presence of celiac—increases the production of inflammatory cytokines, and these inflammatory cytokines are pivotal players in neurodegenerative conditions. Moreover, no organ is more susceptible to the deleterious effects of inflammation than the brain.”
There is even a strong link in the literature, from research going back 60 years, between schizophrenia and gluten intolerance. In a 1976 study published in Science, patients with schizophrenia on a gluten-free diet were challenged with gluten and experienced setbacks in their therapeutic progress.
For anyone suffering from brain fog, memory loss, mood challenges such as anxiety, depression, or more severe diagnoses, or dementia and Alzheimer’s, gluten should be avoided.
#6: There are many Great alternatives to Gluten!
Change is challenging, no matter who you are. Most of us are accustomed to eating gluten-foods, because that’s what we’re used to and it’s what’s available. But eating without gluten doesn’t mean you have to miss out on yummy food.
Many gluten foods, whether they are organic or not, are highly processed foods, made with white flour. Examples include your noodles, tortillas, breads, cereals, crackers, pretzels, cakes, and cookies.
Most of us eat too much of these foods, and could benefit from shifting our diet away from them, and towards a more whole-food plate. Instead of bread and pasta, choose whole grains (if those work for you).
Instead of bread, swap a lettuce or kale wrap.
Why not try a nut-based, high fiber bread?
And, of course, there are many gluten-free versions of these foods as well. Though I generally don’t recommend them due to their glycemic load, as a transition food to help wean you away from gluten, I find them quite useful.
Conclusion
Even if we are not suffering from a chronic or autoimmune disease, or complex health challenge, there are still reasons to avoid gluten. Removing gluten helps limit carbs and processed foods, and proactively reduces blood sugar problems, inflammation, and intestinal permeability to preserve your hard-earned health.
There are lab tests to test for gluten sensitivity, but the best and cheapest way to find out if gluten is a problem for you is to remove it for a few weeks, and then eat some and watch for 4 days. If you experience symptoms with this trial, you will want to keep gluten out of your diet.
While many of us with chronic illness and autoimmune disease may need to make many individualized dietary changes to best support our health, gluten is one food that hands down must be avoided. If we weigh the risks and benefits, we have a lot to lose by continuing to eat gluten, and very little to gain, other than symptoms of brain fog, weight gain, blood sugar problems, and intestinal permeability.
Getting gluten out of your life can be a challenging experience, and requires some finesse, compassion, and patience! When you are ready for support in removing gluten from your life, I invite you to schedule a free Assessment Session to find out how I could help you with this process.
And when you’re ready to understand the big picture of how removing gluten fits into the whole process of restoring your health, grab your free copy of Roadmap to Recovery: How to Move Beyond Your Symptoms and Create a Personalized Plan to Restore Your Health here.
by Amanda Malachesky | Jun 12, 2018 | Chronic Illness, Nutrition
The internet is alive with discussions and opinions about how to eat a healthy diet. Message boards, Facebook groups, and social media are full of recommendations for many “healthy” diets, from the Autoimmune Paleo diet to completely plant-based diets. And there are success stories for all of them.
But there are also people who have given their all to try and eat a healthy diet, and still aren’t seeing the results they hoped for. And if this is you, nothing is more frustrating. What gives?
It’s bad enough to be aware of all the yummy foods that could be problem. But when you’re never sure if you’re going to feel ok or have the worst day ever, and feel anxious about everything you eat, how do you figure out how to eat healthy?
Healthy Diet Basics
Despite all the competing claims, the basics of a healthy diet aren’t really in dispute across all these different communities (with the exception of the carnivores vs. the vegetarians!).
We know that a healthy diet generally includes lots of organic fruits and vegetables, nuts and seeds, pasture-fed meats and poultry, wild-caught fish and seafood, healthy fats, legumes and whole grains, and spices, herbs, and seasonings.
We know that processed foods, refined grains, gluten, sugar, alcohol, dairy (for many people), artificial anything, and hydrogenated fats are generally not a good idea to consume. These items feed the inflammation that promotes disease.
The devil is in the details, as you no doubt know. For some of you, grains flare your symptoms and you can’t touch them. For others, too many vegetables make you bloated and gassy. For others still, too much meat will leave you feeling sluggish and tired.
There is no one right diet for everyone, just one right diet for YOU.
So even though we know that these general principles work, why are we still SO confused? The answer is because very few people understand that they need to learn how to combine these foods properly for their particular body.
The Magic Pill Pitfall: Rearrange your Expectations of What it Means to Eat Healthy
For many of us, muddling through chronic illness, we’re willing to try anything that might bring us relief. It’s easy to be wooed by the promise of a simple fix when you feel crappy. Like me, I suspect many of you have been guilty of assuming that the “right” diet would cure everything.
The unfortunate truth is that if you’re chronically ill, or your health challenges are complex, you aren’t likely to completely reverse your problems with a diet shift alone (though this DOES happen sometimes).
While therapeutic diets are wonderful and important, and are a cornerstone of my work with clients, they are always a template to start with, and MUST be customized. For you. Just because the Paleo diet recommends plantains or meat at every meal doesn’t mean your body can tolerate this. You should always be looking to your body to tell you what is a healthy diet.
Eating a healthy diet starts first and foremost with understanding that your diet (along with digestive function) is your FOUNDATION for health. What we’re aiming for with a good diet is providing our bodies with what it needs to do its work.
The Healthy Diet Key to Success
The true key to success when trying to figure out your healthy diet isn’t contained in the food lists, recipes, or cookbooks. What creates success is learning HOW to determine whether your diet is working for YOUR body or not.
You may not have been given the tools to figure this out before. To truly practice Functional Nutrition, and help you get to root-cause resolution, we need to get ultra curious, and observe, observe, observe.
In practice, I use a Food-Symptom Diary tool to help my clients track what they’re eating along side of their physical, mental, and emotional symptoms. By bringing awareness to these connections, I can help them learn which foods help their bodies thrive, and which do the opposite.
Using this tool is essential when changing your diet or trialing a therapeutic diet because you need a way to notice the changes. Effects of diet changes, and symptoms from foods can appear up to four days after consumption!
You can do this, too. It’s not as easy-sounding as following a diet template. But if you invest in doing the work, you will have the information you need to eat a healthy diet for YOU.
Remember, the goal isn’t to figure out the magic pill, because there likely isn’t one. The goal is to establish a trusting relationship between food and your body, so you can know how to best support yourself while you work on other layers of your puzzle.
What Should You Eat?
If you have tried special diets and haven’t had success, and feel even more discouraged than when you started, never fear. It’s time to get curious. You can figure out which foods are safe, and which ones need to be avoided to prevent symptoms.
The first thing I suggest people do in this situation is to get back to the basics. Zoom out and tinker with your macronutrients, which are your carbohydrates, your proteins, your fats, and fiber. Find the right fuel mixture for your body by doing an exercise like the breakfast experiment. In this experiment, eat something with different ratios of macronutrients for several days in a row for breakfast, and observe the effect on your energy, mood, and other physical symptoms.
When you eat mostly simple carbs for breakfast, like a piece of toast and coffee, how do you feel? How about when you add an egg to that mixture? What about when you add steamed greens or other vegetables to those eggs and toast? See if you can get this mixture right, so that you feel satiated and energized until lunchtime.
Your needs for the mixture may be different at different times of day. Experiment to see what works best for you.
Once you feel like you have a good handle on how much protein, fat, fiber, and carbs you need to eat, THEN zoom in and get curious about more specific things: particular foods that aggravate symptoms, or help symptoms.
Using my Food-Symptom Diary, begin tracking what you eat alongside your symptoms. Really get curious. Consider many layers of detail. Look at all the ingredients in your products. Do removal and reintroduction experiments..
Though my Food-Symptom Diary has only 7 days-worth of pages, with more complicated symptoms, it can take more time than that to figure out the source. If you find yourself in this situation, don’t give up. It took me 5 or 6 weeks of tracking to finally figure out that broccoli was contributing to my constipation.
If you still can’t make heads or tails of what you find in your Food-Symptom Diary, it’s time to get connected with me (www.confluencenutrition.com/contact) or another practitioner who is trained to see patterns in a food diary. There may be layers you haven’t considered, or be aware of that could be impacting your symptoms.
Happy tracking!
Have you discovered something useful about your chronic illness by tracking your food and learning about your body’s specific needs? Leave a comment down below!
Sometimes, simply tracking your food and symptoms isn’t enough. You may need deeper layers of investigation. When you’re ready for some support figuring out why your “healthy” diet isn’t working for you, schedule a free Assessment Session with me, and I’ll help you explore how you could find YOUR answers.
To get the bigger picture view of what you can do to restore your whole health, grab your free copy of Roadmap to Recovery: How to Move Beyond Your Symptoms and Create a Personalized Plan to Restore Your Health here.
by Amanda Malachesky | Jun 8, 2018 | Chronic Illness, Functional Nutrition, Inflammation, Symptoms
When you’re chronically ill or have chronic symptoms, whether you have a diagnosis or not, you are all too painfully aware of the waxing and waning of your symptoms. Headaches. Belly aches and bloating. Insomnia. Rashes. Fatigue. Pain.
When you’re swimming in the sea of chronic symptoms, it can be hard to make heads or tails of them. But understanding what is causing symptom flares when you have a chronic illness, like lupus, fibromyalgia, chronic Lyme, Hashimoto’s, or any other ongoing health challenge can improve your quality of life. If you know what is causing them, you can work to remove those triggers.
WHAT CAUSES CHRONIC ILLNESS FLARES?
The short answer to this question is generally an immune system response, or inflammation.
Some amount of inflammation is normal and necessary, but if we have more inflammation than our body can clean up at one time, or chronic inflammation, we may experience symptoms.
The question becomes, what is triggering that immune inflammation response?
I’ve compiled the 5 most common chronic illness symptom triggers I see in my practice. These can serve as a starting place for you to begin studying your symptoms so you can make proactive changes. (When you’re ready to explore how all these aspects fit into your whole Roadmap to Recovery, you can grab your free copy here.)
#1: FOODS YOU ARE SENSITIVE TO
The number one chronic illness symptom trigger to consider is food. 70% of our immune system is located in our digestive system.
Makes sense, right? We bring in potentially contaminated material from the outside world three or more times per day!
You may already be aware that certain foods cause problems for you. If you’re not yet sure if this is a problem for you, decoding the problem foods is of utmost importance.
The challenge is that the problematic foods are often the ones we eat all the time, and figuring out friend from foe can be confusing.
The first place to start is with the three most common inflammatory foods: gluten, dairy, and sugar. Unless you’ve already delved deep into an elimination protocol to evaluate these foods, you are likely eating at least one of these foods, if not all three.
Read more about elimination diets here.
Even though these are the most common problem foods, any food can cause symptoms. This is highly individualized for everyone, and depends on what your immune system has tagged as a threat.
This is nowhere more frustrating than when you try to eat what you’ve determined to be a “healthy” diet, but you end up feeling worse!
A few weeks ago, a woman told me she increased vegetables in her diet because she had read they were important for good health. Unfortunately, the increased vegetables created increased bloating and stomachaches. Not even the healthiest of foods works for everyone.
To figure out which foods are contributing to your chronic illness symptom flare-ups, the tool you don’t want to be without is a food-symptom diary. I find that for people with chronic illness, tracking food intake and symptoms over a 2-week period is a good baseline.
Once you have some data, look back over your record. Can you notice any correlations? Do certain symptoms always occur after eating a particular food?
#2: HORMONE SHIFTS
Another common trigger of chronic illness symptoms are variations in hormones, especially during a woman’s menstrual cycle. Estrogen and progesterone levels, as well as other hormones, impact the way the immune system and other body systems inter-relate.
For example, progesterone raises our baseline body temperature by a few tenths of a degree. This can impact the effectiveness of our immune response against outside pathogens.
As another example, the hormone cortisol normally fluctuates throughout the day. It peaks mid-to-late morning, and gradually descends from there until the middle of the night. If your body has too much or too little cortisol, it can really impact your energy level, immune function, and many other body systems. We tend to feel our worst when our cortisol levels are low.
Hormone levels also affect our moods, our energy level, our clarity of thought, and our motivation.
Though women have wider monthly fluctuations than men, men also experience variations in hormone levels that can affect how they feel.
To see whether hormone levels are affecting your hormone flares, you can:
- Track information about your menstrual cycle on your Food-Symptom Diary. Do your symptom flares correlate with a certain phase of your cycle?
- Note whether your symptoms always happen at a similar time of day. This could be another clue pointing to hormones
- Consider mapping your cortisol and sex hormones with a DUTCH test or comparable test (at-home urine test. Contact me for more information).
The best medicine for balancing hormones is maintaining balanced blood sugar. Be sure to start your day with protein in your breakfast, include protein, fat, and fiber in each and every meal or snack, and eat slow-burning carbs like whole grains, fruits, and vegetables.
#3: PARASITE OR PATHOGEN HATCHES
This isn’t the prettiest of subjects, but many of the practitioners skilled in treating people with chronic illness, like Lyme, chronic fatigue syndrome, and so on find that their clients are infected with parasites and other pathogens.
As everything else alive, parasites have life cycles and hatch cycles. These cycles can be as short as a few weeks, or as long as a whole year.
When parasites hatch, they can quickly overwhelm the immune system, and irritate the tissues where they live, cause insomnia, itching, shortness of breath, asthma symptoms, and many more.
One clue that you may be facing pathogens is if your symptoms flare at the full or new moon. Another is if your symptoms always flare at the same season or time of year (barring seasonal allergies).
To evaluate this situation, be sure to note when your symptoms flare, on a calendar. See if it correlates with the full moon, or with a certain season.
Though no test is 100% accurate, and macro-parasites are difficult to find in standard or even functional stool testing, stool or blood pathogen screening can be helpful to understand what is happening in your body and whether further action is warranted.
#4: CHANGES IN SELF CARE HABITS
This may seem self-evident, but how we care for ourselves with our chronic illness can have a significant impact on our quality of life and our flares.
Greater than 80% of our day-to-day health is determined by our diet and lifestyle habits, so how we work with this pays big dividends. It’s also one area where we have the power to make a change.
The three most important areas to pay attention to, besides making good food choices, are sleep, exercise, and stress. At the beginning of my healing journey, I started tracking my sleep, exercise, and stress reduction activities.
I aimed to be in bed by 10, with no screen time in the previous 2 hours, do a minimum daily walk for exercise, and make time to do something I love everyday.
I found that when I fell off the wagon and started letting those habits slide, I had more symptoms, and had a harder time with everything. I would get grumpy, have more pain, get more snappy with my kids, and everything looked like it was falling apart. If I was consistent with my self-care routines, I was happier, more balanced, and better able to control my symptoms.
Using your Food-Symptom Diary to keep track of lifestyle practices, can you notice whether your symptoms correlate with a change in your habits?
#5: TOO MUCH EXERCISE
Though everyone knows that exercise is important, the bottom line is that for many people with autoimmune and other chronic illness, exercise can cause symptom flares. I know I just said that exercise is an important part of keeping symptoms in control. And it’s true, but we have to be careful not to overdo it.
The reason this happens is because the body perceives exercise as a stress. If you think of the biological reason for heavy-duty body movement, it’s to escape from a threat: a tiger chasing us, for example.
If our exercise amount exceeds our body’s ability to recover and repair, our body can be overwhelmed with this. Have you noticed that after a workout or run (if you’re able to do this) that it takes an inordinate amount of time for the achy muscles to go away? Or you’re extra crabby and fatigued for several days afterwards? If this sounds like you, you may want to consider reducing the amount or intensity, or both, of your exercise.
If you’re not sure whether exercise is causing negative impacts for you, note your exercise on your Food-Symptom Diary. See if you can connect it with any symptom flares.
Though it can feel like everything is chaos when you’re swimming in the sea of chronic illness symptoms, there are often parts of this scene you have control over. The single most powerful thing you can do to understand the ups and downs so you can feel better is to GET TRACKING.
No one else can do this part for you. Only you live inside your body, and can note the timing and severity of the symptoms, and note the activities in your life that may be affecting them.
So I encourage you all to get tracking with your Food-Symptom Tracking Tool here.
Despite your best efforts, simply tracking may not get you where you’d like to be. If you’re still confused about why your symptoms are flaring, I invite you to schedule a free Assessment Session with me here. I’ll share my thoughts about what you might be missing, and how you could investigate.
