by Amanda Malachesky | Nov 24, 2018 | Chronic Illness, Diet, Digestion, Food Intolerance
It can feel difficult to choose healthy foods during the winter holidays when you are facing food sensitivities or other digestive troubles.
Maybe you’ve successfully eliminated some of the big six foods (gluten, dairy, sugar, soy, eggs, and corn) or other foods that trigger symptoms for you, and you’re doing great! Or you’re even rocking a more involved elimination diet, like Autoimmune Paleo. Congratulations!
Or maybe you’re just working on maintaining your weight.
But enter the WINTER HOLIDAYS.
Thanksgiving, the holiday centered around overeating.
And then comes the Christmas season, with it’s parade of company parties, school events, advent calendars, community events, and candy bowls. Solstice, Hanukkah, Christmas, Kwanzaa, and New Year’s (not to mention this author’s birthday!)
Each holiday comes with a lot of opportunities to feel tempted to eat foods you are choosing to avoid for health reasons because, you know, “tradition!” Or, “I don’t want to miss out!” Plus, you might be feeling stressed, overwhelmed, or tired, which always makes it harder to stay the course.
Most of us have been programmed from a very young age to associate celebration with eating with others to celebrate. It can feel empty and lonely to abstain from the treat your grandma makes every year, or eggnog that makes your company Christmas party feel tolerable. These are some of the things that help the season feel special.
So this week, I wanted to share a few tips and tricks I’ve picked up through my years with food sensitivities and digestive challenges to help keep you on track through your winter holidays. So you can come through without symptom flares, weight gain, or any other loss and hit the ground running in the new year.
#1. Reframe Your Holiday Eating Perspective
It’s tempting to descend into sadness or a fear of missing out, or even have a downright tantrum about not getting to have foods you have always loved. During special occasions, you might feel especially sensitive about having to go without what everyone else is enjoying.
In these situations, I coach my clients to return to their why. Why are you making the food and lifestyle choices you’ve made? Maybe it’s because your symptoms are disrupting your job, or your ability to parent, or simply your ability to enjoy something you love.
Remind yourself of what you are working to achieve with your food choices, and especially ask yourself the question, “So I can do WHAT?”
For example, I avoid the foods that don’t work for me because the consequences of eating them result in more uncomfortable time in the bathroom, severe back pain, and a grumpy mood. When I feel this way, I am a grumpy mom, and can’t keep up with everything in my life that needs doing. I choose this way of eating so I can be a competent mom to my beautiful kids, and so I can enjoy time outdoors working in my garden or hiking.
Getting crystal clear on this for yourself, and reminding yourself frequently, can help you stay committed, in spite of feeling the sadness and grief about missing out on sharing certain foods.
#2. Get a Holiday Eating Buddy or Accountability Partner
If you really struggle to stay on track with your food plan, you may have an easier time if you enlist a buddy to go to events with you, or to check in with daily during the holiday season. Together, you can preemptively think about what situations might trigger you to go off plan and think ahead of time about how you would deal with them, and then create a codeword, or alternative action to take when you feel like you want to cheat.
#3. Low-Carb Holiday Eating
So many of the delicious holiday foods you want to eat are high carb: baked goods with included sugar and alcoholic drinks. And the traditional holiday meals are also relatively high-carb. Think of the stuffing, mashed potatoes, cranberry dressing, along with the desserts and drinks.
Many people groan about the high fat holiday treats, or think they are blowing their diets by overeating. But ultimately, the extra weight gain that shows up by the end of the holidays likely has to do with all the extra carb helpings and sweets. You know, the cookies, cakes, pies, candy, and so on. And don’t forget the drinks.
If you can simply focus on keeping each meal and snack low-carb, and making sure you get protein, fat, and fiber at each meal, you’ll likely feel more satiated, and you won’t have gained much if anything by the turn of the year. You’ll also keep your blood sugar stable, which will reduce the possibility of bloating, a flare of bacterial overgrowth, or an autoimmune flare.
#4. Minimize Holiday Drinking
Alcohol, though delicious, is nothing more than empty calories that destabilize your blood sugar. This can lead to sudden blood sugar drops, which leads to craving and overeating.
If you really like sipping a beverage with your friends and family, make your own delicious mocktails with bitters, bubbly water, herbs, and 100% fruit juice, or bring sparkling apple cider, like Martinelli’s. Or give these more fancy mocktails a try.
If you can’t don’t want to avoid ALL alcohol, consider following these rules to minimize the effects of alcohol:
- Never drink on an empty stomach
- Drink a glass of water or other non-alcoholic beverage between your drinks
- Limit yourself to 1-2 drinks.
#5. Bring Your Own Healthy Holiday Eating Dessert
If the party is a potluck, offer to bring a dessert, and make something on plan: a gluten free, low sugar, treat, like these Nakayummies, for example, or these Cardamon Thumbprint Cookies, or this Dairy Free Coconut Chocolate Fudge. Then you can both enjoy dessert and not feel left out, but also let people see how delightful it can be to take good care of yourself while you’re at it.
#6. Minimize Holiday Late-Nights
All the holiday parties really can eat into your needed rest time. If you are struggling with digestive or autoimmune health problems, it’s always important to get a good 7-8 hours of sleep.
One reason this is important is because not getting enough sleep reduces the hormone that helps us control our appetite. Have you ever noticed that when you don’t sleep well, you experience more cravings and appetite the next day? In this way, not getting enough sleep can lead to overeating, especially if we use this moment to binge on foods we would be better off avoiding.
Not only that , but in the depth of winter, our bodies naturally want to snuggle in and get more sleep. The days are short, and it can start to feel like a push to keep burning the candle at both ends.
Honor your body by making sleep a non-negotiable. Your immune system and brain will thank you.
#7. Continue Your Normal Stress Reduction Plan
More and more, stress has become a normal part of the holidays. There are a lot of extra events to attend, shopping to complete, planning for family visits, or THE family visit itself.
If you have a regular stress reduction routine, like getting a massage, going to yoga or exercise class, or meditation, DON’T stop during the holidays. It’s at this time that you need it more than ever!
If you don’t already have a stress reduction routine, now might be a good time to invite this practice into your life!
#8. Plan Ahead for Healthy Holiday Eating
If you’ll be hosting holiday meals, make sure to plan ahead. Especially if you are new to your diet plan, you may need extra time to adapt your favorite holiday recipes, or to find suitable replacements. You may also need to test out those recipes.
One year, I wanted to adapt the pumpkin pie so I could eat it. I made one a week before Thanksgiving, and boy was I glad I did. The filling came out totally rubbery, and wouldn’t have been very attractive on Thanksgiving day. I was able to adjust the recipe to have it tasting and feeling good in the mouth by the time my aunt, who is a phenomenal cook, tried it.
Planning ahead doesn’t just need to be for food. It’s proactive and empowered to imagine the moments that might be a problem for you, and to create an alternative plan. For example, if you know your mother-in-law doesn’t “get” how gluten can impact your and will offer you Christmas cookies that you will want to eat, it’s often easier to follow through with your intention if you’ve visualized it ahead of time. What will you say? Do yourself the favor of thinking about it ahead of time.
#9. Do Your Holiday Eating at Home (Eat Before You Go), or Bring Your Own
If you know that you’re going to a party where there will lots of tempting foods, eat a full meal before you go, so that you’ll be less hungry and less likely to stand by the cheese and cracker plate or the dessert spread all night.
I often find that I literally can’t eat anything at a party, except maybe some sliced bell peppers or carrot sticks. If I showed up at a party hungry for a meal, I’d likely be in trouble, both mood and energy wise in a hurry. Not all of you will have diets as limited as mine, but I just bring my own food. I pack a dinner, like a lunch, and eat it with all the guests. It’s a little weird, and I do sometimes feel a little awkward letting the host know that I brought my own food.
But I’m far more willing to do this than to suffer with painful digestion, back pain, joint pain, or bloating and gas because I was afraid of feeling awkward, or was feeling shy about my diet choices.
Wear it proud! You deserve to be well cared for.
These tips are great for navigating the holiday in the short term, but I would like to see you not need to make these adaptations in the future. How are you working to resolve your symptoms so that these modifications aren’t necessary?
Sometimes, you need a little professional support crafting your plan for being out in the world and facing these kinds of challenges. If you’ve had a hard time making meaningful progress with your symptoms, it might be time to get a little help. Download your Roadmap to Recovery, a guide to the 7-step process that can help you create your plan to get to remission or an effective long-term management plan. Or, Schedule your FREE Assessment Session here, and I’ll help you see your next best steps to feel better.
by Amanda Malachesky | Oct 26, 2018 | Chronic Illness, Digestion, Food Intolerance, Functional Nutrition, Nutrition, Symptoms
If you’ve been exploring an elimination diet for your persistent symptoms, you may be overwhelmed with all the conflicting advice. Some advocate for removing the top 6 allergens. Others say you should give up grains, legumes, and the big six. Some say it’s certain kinds of starches that are the problem.
I’ve heard from many of you who ask, “Which one is the right one?”, or “What do you think about the carnivore diet, is that a good one to try?”
It’s wonderful that so many people are becoming aware that their food choices have a huge impact on how they’re feeling. But many of you are falling into one of the traps I see a lot: the magic pill trap. It seems like if you can just figure out which elimination diet is the RIGHT one, then all your health problems will magically fade away.
The truth is, an elimination diet is only only ONE tool in a large box of many needed to resolve your symptoms. To get the best benefit from elimination diets, you have to choose the right one, AND use it properly to see the benefits.
What is an Elimination Diet, and Why Should You Use One?
An elimination diet is simply a diet where you remove certain foods to evaluate their effect on your body. If your symptoms improve while you have removed those foods, you can now tell that you have a sensitivity to them, and you can choose to remove them for a longer term while you work on finding your upstream causes of your sensitivity.
So often, your chronic symptoms are partly a result of eating foods you may not realize you are sensitive to. Trying a methodical elimination diet can help make sense out of all those symptoms, and help show you what is a problem for you.
But I so often see people make mistakes when they try to do elimination diets. And one of the frequent mistakes I see is choosing the wrong elimination diet for the situation.
Not only that, but diet templates are always a starting place, and must be customized. Because in Functional Nutrition and Medicine, what matters is not what has worked for everyone else, but what works for YOU.
How to Choose the Right Elimination Diet and How to Use It
The best way to choose the right elimination diet for you and your body is to begin with considering what kinds of symptoms you are experiencing. Are your symptoms primarily digestive in nature, are they more related to your immune health, or maybe you have a lot of hormone or neurotransmitter symptoms. (If you need help mapping these symptoms out, please read How to Use These 2 Functional Medicine Tools to Clarify Your Path to Healing).
There are literally hundreds of diets and dietary theories out there, but many of them fall into 6 main categories of elimination diets. Choosing the right one is important, because you don’t want to introduce too many drastic changes to your diet at once, or become deficient in important nutrients.
So choosing partly depends on symptoms. What follows is a summary of the different types of elimination diets, and when you might use them.
The basic elimination diet method is to remove (or reduce in some cases) the suspected foods for 3-4 weeks. During this time, your body has a chance to take a rest from these foods, and calm down and heal any inflammation that might be related to them.
Once the elimination period is over, you introduce the foods you removed (if desired) to test whether they have an affect, and what those affects are. This is the part that many people don’t take advantage of, but it’s one of the most important benefits of the elimination they just went through. The key is to ONLY introduce ONE food at a time and carefully observe any change in symptoms by using a tracking method. Next, you wait for 3-4 days until the next test.
If there is no change at all, then that food is not a problem. If symptoms show up, then that food may need to be eliminated for a while longer, while you work to resolve the sensitivity.
As a general rule, if you are someone struggling with persistent symptoms, I recommend removing gluten, dairy, and sugar. (You can read 6 Reasons to Quit Gluten if you Have a Chronic Illness here). These three foods are highly likely to be involved in your symptoms.
And also as a general rule, you will want to eat a real-food diet, full of fruits, vegetables, whole grains, legumes, and pastured, organic meat, free of hydrogenated fats, industrial seed oils (canola, soy, cottonseed, and safflower oils), and artificial ingredients you can’t pronounce. Avoid conventional produce to reduce your exposure to pesticides and herbicides.
The Basic Elimination Diet:
The basic elimination diet, recommended widely by Functional and Integrative practitioners everywhere, is to remove gluten, dairy, sugar (including alcohol). These three foods are the top triggers of food-related symptoms. The three right behind are corn, soy, and eggs. So the basic elimination diet involves removing these potential food allergens, to assess their affects.
The basic elimination diet is best used if your symptoms are mild but persistent. Symptoms like fatigue, sleep problems, mild digestive trouble, mild anxiety or depression, or skin symptoms would be a good indicator to try removing these 3-6 basic foods.
You should of course also continue to avoid any foods that you KNOW are a problem for you.
If you are struggling with arthritis, you may want to include nightshades in your basic elimination program. These include:
- tomatoes
- potatoes
- peppers
- eggplant
- okra
- tomatillos
- cayenne pepper
- paprika
If your symptoms or health condition is more specific, for example, to the digestive system, or you have an autoimmune diagnosis, you may need a more specific elimination diet.
Specific Carbohydrate Diets (SCD)
A Specific Carbohydrate elimination diet is primarily useful if you seem to react to lots of vegetables and fruits, or have a lot of digestive symptoms or diagnoses such as Small Intestinal Bacterial Overgrowth (SIBO), IBS, or IBD. There are 5 types of starches in plant-based foods, and some people are sensitive to some or all of them. They are collectively referred to as FODMAPs, which stands for Fructo-, Oligo-, Di-, Mono-Saccharides, and Polyols.
If you experience a lot of bloating, pain, distention, gas, and discomfort from eating what you might think are “healthy” foods, high FODMAP foods may be the culprits.
There are two different variations on specific carbohydrate diets. One is a low-FODMAP diet, and another is the Specific Carbohydrate Diet (SCD). They are similar, but they differ by which specific carbohydrates they eliminate. A low-FODMAP diet is designed to help IBS-sufferers identify trigger foods, while SCD is a more long-term strategy of avoidance of certain kinds of carbs.
As elimination diets go, low FODMAP is probably the way to help you distinguish which types of carbohydrates trigger your symptoms. You can find resources about how to give this elimination diet a try here.
Paleo and Ancestral Elimination Diet
You have probably been living under a rock if you haven’t heard of the Paleo diet. The concept of the Paleo elimination diet is to only eat foods that were available to humans before the advent of grain and dairy farming.
The Paleo diet relies heavily on animal protein, healthy fats, and lots of fresh vegetables. It eliminates not only grains, and dairy products, but sugar, industrial seed oils, alcohol, and legumes as well. Because of these omissions, this diet is also much lower in simple carbohydrates than most Americans eat.
The Paleo diet has been popularized by Chris Kresser, in his book The Paleo Cure, and the Melissa Hartwig’s Whole 30.
Many people have found significant relief from their symptoms by adopting a Paleo diet, especially those with heart disease, diabetes, metabolic syndrome, and autoimmune conditions. Because it combines the basic elimination diet with elimination of grains, it’s a good template to try if you don’t have drastic health problems, but know aren’t in your best shape.
There are some caveats for the Paleo diet. Many people worry about the high fat advocated in the Paleo diet. The science is in on this topic, and it clearly shows that there isn’t an association between cardiovascular events and dietary fat intake. But if you increase your fat intake without making sure that your gall bladder and bowel can tolerate it, you may make digestive or other symptoms worse.
Also, the Paleo diet includes many high-oxalate foods (see Specialty Elimination Diets below), such as spinach, chard, sweet potatoes, almonds (especially as almond flour), chia, peanuts, and chocolate. Some people react to oxalates with increased body pain, or urinary tract problems, such as kidney stones.
If you’re a lot sicker, with one or more autoimmune diagnoses, you may want to consider the more specific autoimmune paleo template. (See below).
Autoimmune Paleo Elimination Diet (AIP)
The Autoimmune Paleo elimination has a lot of the same basic template factors as regular Paleo, but it removes many more potential autoimmune and symptom triggers in the initial removal phase. It is one of the most strict elimination diets. In addition to removing foods on the Paleo diet, foods to remove includes:
- eggs
- legumes
- grains
- many spices and herbs
- nuts and seeds
- nightshades
The AIP should generally only be considered for serious, autoimmune health problems, and ideally should be taken on with at least some guidance. And though it can take some time to work through the elimination and reintroductions, AIP isn’t meant to be a long-term diet solution, because the lack of diversity can lead to nutrient deficiencies of zinc, selenium, B vitamins, and the omega 3:6 balance. Not only this, but it can be very hard to adhere to, because eating outside of your home becomes very difficult.
But if you have food sensitivities or autoimmune issues that have been unresolved with a basic elimination diet, AIP may be the way to go for you.
If you want more support with the Autoimmune Paleo protocol, I recommend checking out Mickey Trescott and Angie Alt’s website Autoimmune Wellness.
Ketogenic Elimination Diet
A ketogenic diet is an very low carb, moderate protein, and high fat diet designed to bring the body into nutritional ketosis. This means that your body relies on burning fats for fuel, instead of the usual carbs and sugars.
The ketogenic elimination diet is similar to the Paleo template, but it also removes or reduces starchy vegetables, like potatoes, beets, carrots, and winter squash, and most fruit.
A ketogenic diet is most beneficial for people with metabolic problems like obesity, syndrome X, and diabetes, who are wanting to reset their metabolism for weight loss and maintenance. It’s also valuable for people who have severe brain issues, like epilepsy, brain injuries, certain types of cancer, autism, or neurological disorders like Alzheimer’s, Multiple sclerosis, Parkinsons, and ALS. This is because sugar is inflammatory for the brain and cancer cells, and the high fat, low sugar template can help reduce inflammation.
People on a ketogenic diet may become deficient in potassium, and will need to adjust the carbohydrate content of their diet to their unique tolerance.
Because keto diets are very high in fat, it’s important to assess the strength of your fat digestion before diving in. You aren’t necessarily what you eat, but what you can do with what you eat. Especially exercise caution if you have had your gall bladder removed, or already know that your fat digestion is compromised.
Specialty Elimination Diets: Glutamates, Oxalates, Salicylates, and Amines, Oh My!
Sometimes, the problem is a category of foods. These include foods high in glutamates, oxalates, salicylates, and amines, like histamine.
These eliminations typically are something to look into if you haven’t gotten relief with the more basic elimination trials. For some of you, certain chemical elements of different kinds of foods may overwhelm your body’s ability to break them down.
You’ve likely heard of people reacting to MSG (monosodium glutamate). MSG is a high-glutamate food. Glutamate is a brain-stimulating chemical that naturally occurs in cured meats and cheeses, MSG, soy sauce, fish sauce, corn starch, corn syrup, seaweed, bone broths, L-glutamine supplements, gelatin, and protein isolates.
Glutamate is broken down in the liver. If you happen to be deficient in nutrients your liver uses to break down glutamates, or if you have a genetic variation that inhibits your ability to successfully break them down, you may experience symptoms when you ingest too much of them. If you eat more than your body can handle in one meal, hello symptoms.
With Specialty eliminations diets, it’s generally not possible to completely remove them from your diet. The food chemicals are often present in many common plant foods. The goal is to identify which ones are the worst offenders for YOU, and then work to eliminate those ones in particular, or to find your level of tolerance. But don’t throw the baby out with the bathwater.
Specialty eliminations are best done with the support of a nutrition professional who can help you determine where to look, and how to track the eliminations and trials.
A Food-Symptom tracking diary or app can help.
Conclusion
Food is such an important piece of how we feel, but we need to be smart about how we work to understand what we need to change to feel our best. We don’t want to open up our bodies to nutrient deficiencies, or take on undue hardship with restrictions.
Getting to the heart of YOUR unique sensitivities, so you can remove that stress from your body’s energy field is important, but you want to do it right, with the least amount of upheaval for the greatest benefit.
When you’re ready for some support in digging through the weeds, I would be happy to sit down with you and map out an elimination diet plan in the context of all your signs and symptoms. Schedule your Free Assessment Session right here, and I’ll let you know where I think you might best focus your efforts.
With any complex health issue, food is only one part of the strategy that will bring you relief. To find out more about the strategy I use to help my clients find remission or a successful long-term management plan for their symptoms, download your copy of Roadmap to Recovery: How to Move Beyond Your Symptoms and Create a Personalized Plan to Restore Your Health.
by Amanda Malachesky | Oct 12, 2018 | Digestion, Food Intolerance, Functional Nutrition, Symptoms
Digestion. It’s that kind of icky thing that is supposed to go on without notice. We don’t really want to think about it, but it comes back to talk to us when it’s not working right.
Nausea. Bloating. Heartburn. Gas. Reflux. Diarrhea. Constipation. Even vomiting. Who wants to think about that?
But nearly three quarters of you normally have at least one of these digestion problems regularly. And if you’re trying to heal from a more complex health challenge, it’s highly likely digestive troubles are part of your picture. Not only are they uncomfortable, but they are an important signal that something in your body needs attention.
Because digestion is so important for health, I want to make sure that you have the information you need to create your good digestion foundation.
What are Digestion Problems?
Though they range from mild to severe, digestion problems can be symptoms, like heartburn, reflux, indigestion, nausea, bloating, or diarrhea. But digestion problems can also be a diagnosis, like Irritable Bowel Syndrome (IBS), Colitis, Crohn’s disease, and Celiac Disease. They can also be functional problems, like when your motility is too slow (constipation) or too fast (diarrhea). And don’t forget things like food sensitivities that can cause some or all of these symptoms.
All of these are signs or symptoms that signal that your gut isn’t working properly and needs to be supported. And no matter what health challenge you are facing, whether it is digestive in nature or not, we need to get your digestion working efficiently so your body can access the raw materials it needs for healing and maintenance.
Why Good Digestion is Key to Health
Of course, your body needs lots of high quality nutrients to perform its duties. You know, all those seen and unseen things it does every single day to keep you breathing, moving, and living.
If you think about the mechanics and chemistry of it, you chew your food up. Then little broken down molecules, like sugars, fats, and proteins or amino acids are absorbed into your bloodstream for use in your cells, tissues, organs, and systems.
Without this working right, you essentially starve to death, or at least work at a deficit.
If your carbohydrate digestion isn’t working well, your muscles may not have enough ATP to produce energy, and you feel fatigued.
If your fat digestion isn’t working well, you may not have the raw materials your body needs to create hormones or nerve cells, and you may feel moody, or experience pain, or memory loss.
If you can’t digest your proteins properly, your brain may not have the raw materials it needs to make your neurotransmitters, and you may feel depressed, or anxious, or irritable.
If you are low in particular vitamins or minerals, like B vitamins, for example, your liver may not be able to detoxify your waste as well as it should.
In this way, poor digestion can lead to just about any sign or symptom you can think of, though it might be difficult to track it back directly. And this is why, to give your body a fighting chance to maintain itself in full health, we want to make sure that your digestion is working at the top of its game.
A well-functioning digestive system also protects your body from outside invaders or pathogens that come in with your food, no matter how clean it is. If this function breaks down, for any number of reasons, you become susceptible to infections that can create more complex symptoms.
Beyond the fact that poor digestion can compromise your body’s ability to do it’s important work, there is an increasing amount of research that hypothesizes that one of the major sources of autoimmune disease is a permeable gut membrane.
So you can see how very important it is for us to evaluate and support our digestive systems at the highest level of health we can.
How to Assess Your Digestion
To assess your digestion, you want to look at the whole system from top to bottom.
Because digestion starts in your mouth, take a minute to consider how well you chew your food. Do you wolf your food down, or do you give yourself time to mix your food with your saliva?
Next down the line is the stomach. Your stomach produces a super important piece of the digestion puzzle: stomach acid. Without enough stomach acid, you can’t fully break down your protein, you are more vulnerable to infections because it’s supposed to kill them, and you are also susceptible to B12 and iron deficiency.
And though people often mistakenly believe the opposite, reflux and heartburn are actually a sign of not having enough stomach acid. This is because the acid helps maintain the sphincter that keeps stomach acid out of the esophagus.
Your stomach acid is ALSO responsible for causing you to release bile and pancreatic enzymes, for fat, protein, and carbohydrate digestion. It also helps move things along in your intestines.
So, to assess your stomach acid, consider: do you experience heartburn or reflux? How about poor fat digestion? Or constipation? A heavy feeling in your stomach long after you ate? Do you have a lot of food sensitivities? Mental health complaints?
If so, you may not have enough stomach acid to help move your digestion process along, release your needed co-factors for digestion, or the acid necessary to fully break down your proteins into amino acids and peptides.
Next in line is the small and large intestine. For many of you out there, the small intestine is not your friend when you eat the wrong foods. You experience such intense bloating that you may look 6 months pregnant. Or you experience brain fog with the wrong foods. Or maybe gas that smells so bad you’re afraid to go out in public.
The small intestine should have relatively low levels of bacteria, while the large intestine is designed to be teeming with beneficial bacteria. If you have trouble with diarrhea, constipation, bloating, brain fog, it may be a sign that your microbiome is out of balance. Stool testing or Small Intestinal Bacterial Overgrowth (SIBO) breath testing may help you determine if dysbiosis is part of your digestive challenge.
Finally, at the far end of digestion is your poop, which is an awesome assessment tool. Your stool should be a number 3 or 4 on the Bristol Stool chart, slightly “S” shaped, soft, and well formed. And it should sink.
If this isn’t true for you or your poop, it can tell you that you may need to evaluate your digestive health and track down what is irritating it. Too mushy, and you likely have inflammation in your gut, possibly from food or medication sensitivities or infections. Too hard and dry, you may also be dealing with food sensitivities, infections, too little water, or poor motility.
One of the biggest controls you have over your digestion is understanding how the foods you eat are affecting you. Becoming a skilled food-symptom tracker can help you determine where you can improve your symptoms simply by making some dietary changes. Learning about the right therapeutic diet template as a starting place can help. In many cases, this is all you need to do to feel much better. And even if you have deeper layers to investigate, this buys you some symptom relief while you work on figuring out the underlying issues.
How to Support Your Digestion Foundation
Step 2 in my Roadmap to Recovery (you can grab your free copy here) is to Lay A Solid Health Foundation. As I hope you can gather by now, this is nowhere more important than with your digestive health.
Here are a few of the digestive foundation supports I recommend for most of my clients as they walk their road to recovery. Not all of these will be right for you. As with everything in Functional Nutrition, you will want to evaluate how right they are FOR YOU. If your body gives you negative feedback, listen to that closely, and see what else you can learn from it.
#1 Stomach acid: A little apple cider vinegar, lemon juice, or Betaine Hydrochloride supplement before meals can support your stomach acid, and make sure your proteins are fully breaking down, your secretions are flowing well, you are absorbing your B12 and iron, and your sphincters remain closed. Avoid this support if you have ulcers, or are currently infected with H. pylori, a bacterium.
#2 Enzymes/phytonutrients: If stomach acid has been low fore some time, you may need additional enzyme support for digestion. One way to get more natural enzymes is from colorful plant foods. Another option is chewable tablets or capsules. If you don’t have a gallbladder, taking ox bile as a supplement may be important to help your body properly digest the fats it needs for hormonal and brain health.
#3 Probiotics: An essential part of your healthy digestive tract is a vibrant, healthy community of beneficial bacteria. Adding a probiotic supplement can be a helpful addition for most gut problems. However, some people have a difficult time with some or all types of probiotics. If this is you, listen to your body, and maybe look into gut testing to see why. It’s often related to bacterial overgrowth or infections. If standard collections of Acidophilus and Bifido bacteria seem to cause trouble, you may do better on a soil-based, or a spore-based formula. (Email me about how to access MegaSpore Biotic probiotic supplement). Experiment to see what works.
#4 Essential Fatty Acids: Certain essential fatty acids are necessary for gut repair and maintenance. Some of these EFAs are made by beneficial bacteria in your gut (hence the benefit of using probiotics). Adding fish oil supplement and cod liver oil can help provide these needed nutrients.
#5 Vagus Nerve Support: Certain behaviors encourage the vagus nerve, the largest connection between the brain and your involutary organs. Things like gargling, singing loudly, bouncing on a trampoline, deep breathing, meditation, laughing, or yoga help promote digestive motility, and can be especially helpful for constipation or gastropareisis.
#6 Habits That Encourage Good Motility: Stopping eating by 6 or 7 pm, and avoiding food until your breakfast in the morning, as well as waiting beyond 12 hours between dinner and breakfast, can help restore your digestion by giving the system a break. This also goes for snacking between meals, if you don’t already struggle with low blood sugar issues.
#7 Chewing: Fully chewing your food, until you can taste the sweetness of it, not only helps promote the proper “rest and digest” nervous system state, it also mixes your food really well with digestive enzymes and secretions that help it absorb better.
#8 Bitters: Digestive bitters promote secretion of saliva, bile, and pancreatic enzymes, which all support good digestion, breakdown, and absorption of the foods you eat.
#9 Avoid Food Sensitivities: Foods that you know cause trouble for your digestion should be avoided. This can be a blind spot for many people, because many of you are sensitive to common foods, like gluten and dairy, but because you never take a full break from eating them, you can’t tell. Avoid your known sensitivities. If you’re not sure, but suspect you may be sensitive to foods, you can do an elimination diet to explore this possibility.
Conclusion:
Because poor digestion is linked to so many health problems, including autoimmune diseases, and because digestion is the fundamental center of health, you owe it to yourself to create a solid digestion foundation as a major part of your road to recovery.
And contrary to popular belief, there is no one solution for everyone, but only specific and targeted solutions for YOU. I encourage you to experiment with some of the supports I mentioned here to work on reducing symptoms and to lay your digestion foundation. This may give you the breathing room you need to investigate deeper. Or perhaps you will uncover the one or two things that will help you resolve your challenge at the roots.
When digestive symptoms continue over weeks, months, or years, it’s time to get serious about searching for root causes and resolving them. When you are ready for some support identifying and resolving your digestion troubles, schedule a free Assessment Session with me to get my opinion on how you may need to move forward. Or to learn more about what YOUR Roadmap to Recovery might look like, download your Roadmap here.
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 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.