Food Intolerance Primer: What I Wish I Had Known

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.

6 Reasons to Quit Gluten If You Have Chronic Illness

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.

5 Reasons Chronic Illness Symptoms Flare (And What to Do About It)

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.

#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.

What is Functional Nutrition?

by Amanda Malachesky | May 21, 2018 | Functional Medicine and Coaching, Functional Nutrition

So what are Functional Nutrition and Functional Medicine, and how can it help you if you are chronically ill? Though it’s been around for 30-some-odd years, and it’s been growing by leaps and bounds in the last few years, the average person doesn’t know what Functional Nutrition and Functional Medicine is. Even people I would expect to be in the know are confused about what it is.

Functional Nutrition and Functional Medicine are an emerging holistic health care approach that will likely become a default part of the medical system within the next 5 years.

Functional Nutrition and Functional Medicine provide the kind of care that a growing number of chronically ill people with confusing health problems need to get better. It is also valuable for everyone else.

There are three fundamental principles of Functional Nutrition

1. Work to uncover the root causes of health challenges and address them at the source

Conventional treatment, though sometimes necessary, usually doesn’t try to uncover the why behind a symptom or diagnosis. You go to the doctor to get a diagnosis and maybe a prescription or other treatment. Though diagnoses are important, and can properly frame the problem, the challenge is that they are simply a label, and standard treatments do not necessarily lead to remission.

Functional Nutrition and Medicine practitioners help you dig through your case details to help identify the probable sources of your health distress.

Once the sources are identified, your practitioner helps you create a plan to remove the root causes, so your body can heal. In Functional Nutrition, this plan may include diet changes, shifts in sleep and exercise habits, stress reduction techniques, supplements to correct deficiencies, use of functional lab tests, and referral to additional practitioners.

If this work isn’t done, the situation that created the problem in the first place is likely to continue. You may need treatments and therapies to deal with symptoms forever, while never getting any closer to resolution. Does this sound a little like a hamster wheel?

2. Use tools and frameworks to clearly identify problems and possible solutions

There are many variables at play in your life that are affecting your health, but it can be overwhelming to organize these details, and to decide what the best path forward should be.

As my own chronic illness case unfolded, I had a file full of test results, food journals, forms I had filled out at doctor’s offices, notes from conversations I had with health providers, and more. I know many of you also have “the file”.

I also tried a lot of natural treatment protocols and diets that I thought might help, based on my symptoms. I would haphazardly add and subtract things from my life on a dime.

The trouble with this shotgun approach is that though you might get lucky, you’re mostly shooting in the dark. If you don’t have a systematic way to evaluate what you’re doing, or you don’t know how your signs and symptoms fit together in the whole, you’re truly flying blind.

In Functional Nutrition, we use tools, systems, and frameworks rather than protocols to help organize all the information that is relevant to your case. The tools show us where our efforts will be most useful, and track the metrics that matter. Using this information, we continue adapting your action plan so it fits with what works for your body.

3. Honor clients and patients as truly unique and “bioindividual” people, discover what’s true for the individual, and tailor recommendations to those people.

If ten of you have heart disease, you are likely to get very similar prescriptions for treatment. Statins. A Mediterranean diet. Maybe blood pressure medication. Quit smoking. Get exercise.

The trouble is, the root causes of the heart disease is different and unique for each of the ten people. For some it might be diet related, for others stress, and for others still, it may have to do with genetics or something else entirely.

And because we know heart disease is largely driven by lifestyle factors, resolving the root causes will require lifestyle shifts. Yet what a person is capable of changing, and how fast they can change it will be unique to each individual.

In Functional Nutrition and Functional Medicine, we acknowledge, fundamentally, that each client or patient is unique, and needs a unique and tailored prescription of care. Not only this, but whatever solutions we offer must fit with the client’s lifestyle, and be able to be sustained, or no real change will be possible.

Functional Nutrition uniquely fills a gap in conventional as well as Functional Medicine care. Certainly, we need doctors and hospitals, and they are experts at diagnosing and treating life-threatening, emergency, and pathological illnesses.

Yet there is a growing population of people who are sick, and need more high-touch, one-on-one, expert support care than doctors offer to restore their health. They need more frequent help and guidance, and help linking their behaviors and habits with the results they want to see.

And the truth is that most of these people are chronically ill with complex health conditions or overlapping and multiple diagnoses. According to the CDC, current statistics are 1 in 2 Americans has a chronic disease, while 1 in 4 has multiple chronic diseases.

If you are one of these chronically ill people with confusing health challenges, and you want root-cause resolution and restored function, then Functional Nutrition and Functional Medicine may be a good fit for you.

A Functional Nutrition Practitioner can help you do the detective work on your case to uncover YOUR root causes, and create a plan to restore your health, or manage your diagnosis long-term in the best possible way with the most quality of life.

Where to Find A Functional Nutrition or Functional Medicine Practitioner

There are several places to find a Functional Nutrition Practitioner or Functional Medicine Doctor. Many Functional practitioners work online, and may be able to help you even if you don’t live near them. Try these links to practitioner directories:

Functional Nutrition Alliance

Functional Diagnostic Nutrition

Institute for Functional Medicine

Learn about how to work with Amanda as your Functional Nutrition Coach.

Have you tried to create root-cause resolution with your own chronic illness or complex health challenge? Share about your experience below!

Want to see what it would look like to apply Functional Nutrition to your own health challenge? Grab a free copy of Roadmap to Recovery: How to Get Beyond Your Symptoms and Create A Personalized Plan to Restore Your Health. It’s got easy action steps to get started, and you’ll get my favorite tool as a bonus in one of my follow up emails.

How to Avoid Health Whack-A-Mole

by Amanda Malachesky | Dec 18, 2017 | Functional Medicine and Coaching, Functional Nutrition, Symptoms

I’m referring, of course, to the carnival/arcade game where robotic moles pop up from holes all over a game board, and you get points if you can hit the moles before they hide back in their holes again.

It’s kind of hard to hit them, and no matter what you do, more of them keep popping up again until your time is up.

Is there a way to win the Whack-A-Mole game so no more moles pop up?

Nope.

Sometimes, we treat our health and symptoms like the Whack-A-Mole game. Headache? BAM! Ibuprofen. Anxiety? BAM! Alcohol or benzodiazapines, like valium. Depression? BAM! Anti-depressants like SSRI’s. How about hormone problems? BAM! Birth control pills.

It’s reflexive and pervasive. Most of us have been raised to think this way. Symptoms happen, and we do what we can to make them go away right then. If “A”, then “B”.

But what if you want to figure out WHY the headaches, anxiety, depression, or hormone trouble? Wouldn’t it be better to remove the cause for the headaches, especially if they are common and frequent? The anxiety or other symptoms?

Hitting the symptoms with temporary fixes is a lot like the Whack-A-Mole game…you might knock that symptom back into its hole, but it’s just going to explode out of its hole again. A better fix might be to unplug the game. That way, no more moles are ever going to come out!

People can be impatient with what’s required to take this different approach to their health problems. It’s nowhere near as easy as popping a pill, and hoping that the problem won’t re-emerge. And for a while, this approach can seemingly succeed in keeping symptoms at bay.

However, eventually, if the original source of the problem is still there, you’re going to continue to need that pill to keep you on your feet, which can get expensive, both in money AND with side effects. (Have you ever read the side effect warnings on medication labels?)

Root Cause Resolution: Unplug the Whack-A-Mole Game

Resolving your symptoms at the source takes a bit more time, but with the proper guidance is totally possible. Let’s take the headaches as an example.

First things first: when are they happening? How often? When did they first start? What else was happening then? Did you change jobs? Move? Experience another stress? Begin eating a new food? Is it always before your period? A thorough health history and timeline can help illuminate the original cause of the headaches. These questions give us the initial clues to figure out where to try approaching the situation.

Let’s say that you’ve noticed that they always come around when you ovulate and right before your period. You also notice several other symptoms around that time that you also struggle with, such as irritable and dark moods, tender breasts, cramps, and diarrhea. You crave chocolate, but it makes your cramps worse.

Knowing all of these facts provides us with a lot of helpful clues. Now we begin the work of sifting through your day-to-day to identify which foods and behaviors may be contributing, and remove them.

I’m sure you can infer that we’re likely seeing a hormonal challenge with this hypothetical headache case, because the symptom shows up at certain parts of the monthly hormone cycle. And you might be tempted to say, “They have PMS.”

This may be true, but PMS is truly just a label, and doesn’t tell us anything about the specific players that make things better or worse, or how to approach. The first place I want to explore when hormones are at play is blood sugar handling.

What?

Yes. Hormone imbalances often begin with blood sugar handling. So more questions: are you eating protein with your breakfast? Are you eating throughout the day? What does your food intake look like? Are you getting protein, fat, and fiber in with each meal and snack? Does your diet include a lot of high carb foods? Junk foods? Caffeine? And so on…each of these can help me understand whether you may be experiencing blood sugar ups and downs that may be impacting your hormones.

How about dairy products? If they are regularly in the diet, their hormone content can impact hormones as well, especially if they aren’t organic. Are there other inflammatory foods in the diet, such as gluten or sugar? How about missing or deficient nutrients that might help the body function better, like magnesium or vitamin B6? Are there other signs of this deficiency?

Even before we get past “diet”, there are lots of possible supports for someone who presents with “hormonal headaches”.

There are many other pieces, such as exercise, stress, and sleep, which could be involved as well. Cleaning up all these areas often results in symptom resolution, for the headaches and other things that may be there as well. We could choose to take the Motrin and call it good, knowing that we’ll need to try to hit that mole when it shows up again next month…

Or, we could be proactive, and create a playing field where the moles just don’t pop up at all. We essentially REMOVE the moles from the game, so we don’t even need the Motrin, or antidepressants, and curiously, many of the other symptoms that plague us reduce in frequency or go away altogether.

This is functional nutrition, and how we work to remove the root causes, and how we avoid health Whack-A-Mole.

This approach is how we get power over our life back from our health complaints, by understanding how our actions and choices are impacting our symptoms, and making different choices.

3 Ways Digestion Holds the Key to Health

by Amanda Malachesky | Dec 6, 2017 | Brain Health, Digestion, Functional Nutrition, Inflammation, Symptoms

What body system is at the center of any illness, symptom, diagnosis, happy moods, well-being, and vibrant health?

If you guessed the digestive system, then you nailed it! Digestive symptoms are strong clues that something isn’t right inside our bodies, and that our digestive system needs a little bit of extra attention. Things like constipation, heartburn, acid reflux, bloating, gas, and more are important message that are worthy of our attention.

Sometimes, this can seem a little bit confusing. You mean that digestion plays a key role in depression or anxiety? Or heart disease? Or Arthritis? The answer is yes. Here’s how.

Reason #1: Digestion is our Source of Needed Nutrients

A full spread of nutrients is needed for the body to do everything it does: power our muscles and brain so we can move and work, repair damage, detoxify any exposure to harmful substances, maintain appropriate levels of minerals and vitamins, and so on.

If shortages of nutrients become significant enough, function begins to break down. For example, if we don’t have enough B vitamins and antioxidants, such as vitamin A, C, and E, then we won’t be able to neutralize cell-damaging free radicals, because this clean up process require these nutrients.

Digestion is our source for these nutrients that power thousands of essential body functions every single day. If digestion is compromised, by hidden infections, inflammation from food sensitivities, previous antibiotic use or other medications, or other factors, it’s not too difficult to become deficient in important, necessary nutrients.

Interestingly, many of the nutrients we use are synthesized in our digestive tracts by the resident bacteria. If we have an imbalance of this microbiome, we may have a compromised ability to create and use certain nutrients.

Cleaning up the digestive system is super important, to make sure we are able to access all the nutrients we need from our food.

Reason #2: The Gut Has a Direct Communication Line to the Brain

The digestive system has a direct line of communication with the brain: the vagus nerve. When something goes wrong in the gut, say it gets invaded by a bacteria, the vagus nerve sends a signal to the brain that something is wrong, and this can affect our moods.

Have you ever heard the expression “I had a gut feeling”, or “I had butterflies in my stomach”? This is the gut-brain connection in action. How about the way in which nervousness can trigger diarrhea or nausea? Same thing.

There are lots of studies being published all the time showing how the composition of the gut microbiome has a profound affect of emotions and health. Balancing your microbiome is not only the key to decreasing digestive symptoms and making sure you can access and make important vitamins and other nutrients, it is also the key to promoting positive moods, and protecting your body from invading microorganisms.

The gut immune system is designed to protect us from hitchhiking bacteria, parasites, viruses, and fungus. If this system goes down, or is imbalanced, we are vulnerable to infection, imbalance, and all the downstream effects (see Reason #1).

80% of the immune system is centered in the gut, because besides our respiratory systems and reproductive systems, this is the place where we are daily exposed to outside influences. This means it is also the place where we have a lot of leverage to shift the terrain of our health.

Reason #3: Healthy Elimination Means Healthy Detox

Now we’re going to talk about the other end of digestion, which is elimination. Like I mentioned in Reason #1, our body uses lots of its nutrients to clean up and detoxify incoming pollutants.

In today’s day and age, we are constantly exposed to chemicals in the form of pesticides, herbicides, xenoestrogens, heavy metals, petrochemicals in air pollution, and many of us work in environments where we are exposed to other types of toxins.

Our liver does the heavy lifting here, using up all those antioxidants and B vitamins and amino acids to break the toxins down into water or fat-soluable parts that can then be eliminated by the kidneys in the urine, or by the bowel, in the stool.

But how many of us poop irregularly, or struggle with constipation? Ideally, we should be pooping 1-3 times per day, with ease. If you aren’t eliminating regularly, it’s likely you aren’t efficiently eliminating all those environmental toxins that your body is working so hard to break down. These toxins accumulate in the digestive system, and can affect the balance of the microbiome (see Reason #2), or are reabsorbed from the bowel, and can end up depositing into tissues in the body, and causing problems.

Making sure you are regularly eliminating is a super important part of supporting digestive health, and promoting overall health.

How do we make sure the digestive system is working well?

The first step is to remove any inflammatory foods. I always start my clients with removing gluten, diary, and sugar. If we need to identify other foods, we go deeper, but many people find that these three foods are actually contributing to digestive and deeper trouble.

The next step is to supply nutrients that may be deficient, to make sure the body can keep performing its essential functions of maintenance and detoxification.

Lifestyle habits regarding sleep, stress management, and exercise often need to be rearranged to support health, and improve and promote effective digestion.

Finally, if all these changes don’t resolve digestive or other challenges, we need to explore whether there may be hidden infections in the digestive system or elsewhere that need to be addressed.

Working through these steps provides powerful relief from many common symptoms, and even some diseases.

Who knew? Digestion holds the key to better health! What have you found that best supports your healthy digestion? Comment below!

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