Have you ever felt bad about your digestion problem progress after reading heroic stories of health recovery on your Facebook feed? Or felt like there’s something wrong with you because you aren’t better yet?
I most certainly have faced this, and it feels double-strong for me, because I’m a coach who is supposed to have figured this all out.
But the truth is this: I still have digestive problems, and I still need digestion remedies!
The other truth: for some of you, there is no complete “cure”.
But this doesn’t mean that you are S.O.L. (that’s “sh*t out of luck”!)
Au contraire.
The solution instead is learning how to take care of yourself in a way that fits in your life.
If you’re like most of my clients, you’ve already been on this journey to restore your health for quite some time. But where I see a lot of people getting stuck is in the try-everything-and-see-what-sticks phase.
You deserve a more strategic approach that helps you build an arsenal of tools that you know work specifically with your unique physiology AND works with your life.
There’s a bit of a myth in the wellness space that says that you have to do a lot of complicated dietary and lifestyle gymnastics to see real results. And while some people are able to do this, others really struggle with it. Sometimes, life is just too full for a complete overhaul.
So I think you might find my video this week refreshing…in it, I share my current digestion remedies, which I continue to use daily. Hint: It’s not hugely complicated. Give it a watch, and let me know if you learning anything surprising.
Note: This article contains affiliate links, which give me a small commission on items you purchase by clicking these links, with no additional cost to you.
At the beginning of my healing journey, instead of doing a basic elimination diet to go gluten and diary free, I chose to use the keto diet as my template. During my keto time, I relied heavily on dairy products to provide my needed fats. I didn’t know that this was going to be recipe for disaster…
Many of my hormonal and endometriosis symptoms flared over the first 9 months, and got drastically worse. And I didn’t notice right away that my fat digestion wasn’t up to snuff when it came to dairy (I wish I had already studied nutrition before I committed this act of unintentional self-harm!)
It’s easy to eat dairy many times a day. We might have milk or half-and-half in our coffee, milk in our cereal or pancakes for breakfast, cheese for a snack or with our lunch sandwich, and cheese as a topping on our dinner. Salads often are topped with cheese garnish or creamy dressings. And desserts and treats are another common source of dairy products.
Though dairy foods can be important and nutritious parts of a whole foods diet, the constant flow of dairy products can mask their true effects: many of us are sensitive to dairy and need to go dairy free.
In fact, dairy products are one of the top three food intolerances, and for this reason, I usually recommend that my clients do a trial period without dairy products when we begin working together. Once we complete this elimination, we can test the various forms of dairy to see which ones you react to.
It’s important to understand how and why dairy can be inflammatory, and to figure out if YOU are dairy-sensitive if you are working on improving your digestive or other health challenges. Many of you may need to go dairy free to get a handle on your health.
Let’s explore why you might try going dairy free.
What is Dairy and Dairy Free?
Dairy refers to products that come from or are made from animal milk. This includes:
Butter and ghee
Milk and milk powder
Cheese
Yogurt
Kefir
Cream and Half and Half
Ice Cream
Sour Cream
Dairy can also include ingredients that are sourced from milk, such as whey protein powder, casein, lactose, hydrolyzed casein, calcium caseinate, caseinate, iron caseinate, lactalbumin, lactoglobulin, lactulose, magnesium caseinate, potassium caseinate, rennet casein, sodium caseinate, whey protein hydrolysate, and zinc caseinate.
Dairy free refers to eating a diet without any dairy or dairy-derived products.
Why Go Dairy Free? Effects of Dairy on Your Body
There are several types of sensitivities to dairy. Your strategy for moving forward will depend on which type of intolerance you have.
Dairy Allergy
A dairy allergy would be characterized by a severe allergic reaction to dairy consumption, including swelling of the mouth, tongue, and throat, difficulty breathing, unconsciousness, and dilated pupils. This type of reaction, sometimes called anaphylaxis, is caused by a sudden and acute response of IgE antibodies and the release of histamine on a massive scale to an allergen.
If you are sensitive to dairy in this way, you likely already know it and avoid it. This is actually a pretty rare type of dairy reaction, though it does happen.
Lactose Intolerance
Lactose intolerance is a dairy sensitivity where the body does not have the enzyme lactase to adequately break down lactose, or milk sugar. Lactose intolerance can be quite uncomfortable, causing:
Intestinal cramping
Diarrhea, bloating
Gas and flatulence
Gurgling sounds in the belly
Vomiting
Most of you who suffer from lactose intolerance likely also know this about yourselves, as the symptoms are usually quite uncomfortable. It’s estimated that approximately 30-50 million Americans are lactose intolerant.
Casein Sensitivity
Casein is the protein in milk. Some people are sensitive to this protein, either because their leaky gut has allowed casein to be tagged by the immune system for destruction, or because of an innate sensitivity. Possible symptoms are:
Bloating and gas
Swelling and pain in joints or muscles
Nausea or vomiting
Diarrhea
Constipation
Skin itching or inflammation, such as eczema
Fatigue
Sinus and breathing issues, such as asthma, wheezing, coughing
Headaches
These latter two sensitivities can cause inflammation in the digestive tract, which can contribute to wide-ranging symptoms throughout the body. Inflammation from dairy in the large intestine can impede the absorption of minerals.
Many people who are gluten sensitive, especially those who have celiac disease, are “cross-reactive” to casein, the milk protein, because the casein protein is chemically similar to gluten.
A1 vs A2 Casein Sensitivity
Milk protein from northern European cow breeds, including Holstein, Friesian, Ayrshire, and British Shorthorn cows, contains mostly A1 casein, while milk proteins from the southern European breeds including the Guernsey, Jersey, Charolais, and Limousin cows mostly contains the A2-type.
Because milk is blended from many dairies and breeds, most regular milk contains both types of casein, but A2 milk, available in some stores, only contains the A2 casein (milk protein.) Some people are sensitive to one but not the other, and find they can tolerate the A2 milk just fine. This is also the reason why some people tolerate goat milk but not cow milk. Goat milk never has A1 casein.
So if you find that you react to milk but not other dairy products, it might be worth a trying an A2-type milk to see if you fare any better.
Other Sensitivity Issues with Dairy
Besides these sensitivities, dairy can also impact your hormones. This is because milk, no matter the quality or source, comes from either lactating and/or pregnant animals, and therefore contains estrogens and other hormones. These hormones can disrupt the balance of hormones in our own bodies, and contribute to menstrual changes, acne, PMS, infertility, mood swings, pain, inflammation, and more.
Non-organic milk may also contain additional growth hormones, or lactation-stimulating hormones, as well as antibiotics, and residues of glyphosate and other chemicals in the feed the cows ate. Because toxins bio-accumulate in fat, milk is a reservoir for such chemicals. This chemical intake can damage our sensitive digestive tracts, just like glyphosate and gluten.
Dairy can also in some people be responsible for creating mucous in the digestive tract, if it’s not digested well, which can negatively affect your digestion and create irritation in the wall of your gut.
Should I Go Dairy Free?
The best way to evaluate whether or not dairy is contributing to your symptoms is to try eliminating it for several weeks, and then to carefully reintroduce it to see if you notice any symptoms.
I generally recommend eliminating gluten, dairy, and sugar (including alcohol) for 30 days as a basic elimination diet, as these are the top three inflammatory foods that may be contributing to your symptoms.
After you’ve eliminated these foods for 30 days, you can begin testing each one in turn, and using a Food-Symptom Diary (you can grab mine here) to track your body’s response. The key thing here is to only test ONE food at a time, and to wait 4 days until trying something new.
When reintroducing dairy products, it’s helpful to test each one that you regularly eat one at a time. So in other words, you might test butter first, but then wait four days, then test yogurt, and wait a few more days, and then test cheese. Each dairy product is unique, and you may find that you tolerate some better than others.
If your body shows symptoms within 3-4 days of eating the item, it’s probably best to continue to leave it out while you work on understanding what else is happening to create that sensitivity.
OK, so you can’t have dairy, and you’re panicking a little about what you’ll do without cheese? Let’s talk about some ways to crowd out dairy products, so you don’t feel deprived.
Milks There are many milk substitutes out there on the market. Try almond, hemp, rice, macadamia, or cashew. I don’t recommend soymilk, because most soy is GMO and likely contaminated with glyphosate, and is often also a reactive food for many people. It can also have some undesirable effects on hormones. Homemade is better than store bought, if you can find the time to make it.
Healthy Fats Try coconut oil, extra virgin olive oil, and avocado oil instead of butter. Coconut oil with a little salt is delicious on toast. If you choose a non-dairy butter substitute, make sure it is free of hydrogenated oils.
Creamy foods Satisfy your craving for creamy foods with spreads such as guacamole, tahini sauce, nut butters (almond, peanut, sunflower, cashew), coconut cream, coconut milk, coconut or cashew yogurt. And don’t forget about mayonnaise/veganaise, or hummus.
High Calcium Foods Many people are concerned about the lack of calcium when giving up dairy. There are many foods that can provide adequate calcium such as sardines with bones, sunflower and sesame seeds, almonds, broccoli, collard greens, bok choi, oranges, white beans, black-eyed peas, and kelp.
What to Expect When You Go Dairy Free
As with any elimination diet, expect some cleansing reactions, and possibly uncomfortable symptoms while your body clears a backlog of inflammation and your gut flora readjusts to life without dairy.
Fatigue
Bowel Changes Many of the symptoms of dairy sensitivity are related to the digestive system. You may become less constipated, or your bowels may clean out as they are able to deal with the backlog of inflammation. Stay well-hydrated and trust the process. This should clear within a few days.
Cravings As with gluten, dairy contains caso-morphins, morphine-like compounds that mimic the effect of morphine in the brain. You can be quite addicted to our dairy products, and can experience a withdrawal when you stop eating them. Observe what this tells you about your relationship with dairy, and consider how you would like it to change. Be ready to crowd out your craving with healthy substitutes. You can also try using the amino acids L-glutamine or DPA (d-phenylalanine) with a glass of water on the tongue when the cravings are active. (For more on this subject, check out Trudy Scott’s blog about how to use individual amino acids for craving relief.)
Mood swings Related to the cravings and withdrawal symptoms, you may find you feel a little emotionally tender. Remember to warn your loved ones and coworkers that you may be a little off during the first week you go dairy free. Know that the mood effects will pass, and you will likely feel more balanced and in control than you have in a long time.
Flu-like Symptoms, like aches, chills, sweats, and nausea.
Weight Loss Often, dairy sensitivities can lead to bloating and water retention. When the dairy disappears, the body can release that water, and begin to heal the intestines. Weight loss can be a side effect. Make sure to weigh yourself at the beginning of your elimination diet so you can celebrate your wins at the end.
Improved Skin As with weight, skin issues are common symptoms with dairy sensitivities. Observe your skin during the month as your body adapts to life without dairy.
Improved Digestion Many of the common symptoms related to dairy sensitivity are digestive. Keep a close eye on your digestion, and note any positive changes, such as less bloating, less constipation or diarrhea, and less gas
Caveats with Going Dairy Free
Pre-Made Nutmilks: Many pre-made nutmilks in the store have added sugars, and other ingredients that don’t have a place in a whole foods diet. Read your labels carefully. If you can’t find one with the right ingredients, buy a nutmilk bag (this one is 100% organic cotton) and try the Nut Milk Recipe (at the end of this article).
Avoid Soy-Based and Processed Dairy Substitutes: There are many dairy-free mock cheeses and other dairy products out there, but many of them are full of processed ingredients. Many are based on soy. As I mentioned earlier, it’s best to avoid soy-based products, due to the likely GMO content, as well as non-real-food ingredients. Stick to healthy, real-food substitutes instead.
If you find that you don’t react negatively to dairy, there’s nothing wrong with including dairy products in your diet. The main thing to focus on is to buy grass-fed, organic dairy products to minimize your exposure to the toxic chemicals and hormones present in conventional milk and milk products.
Dairy Free Wrap Up
It’s really quite common for dairy products to cause or contribute to inflammation and symptoms, and for this reason I recommend to all of my clients to at least go dairy free for a short while to see if it is causing problems.
Of course, going dairy free is one small piece of a larger puzzle of discovering your unique food-symptom triggers, and investigating any other underlying causes of your symptoms.
If you’ve been struggling with how to make sense of all the special diets and recommended supplements you’ve read about, I’m here to help. As an expert in helping people understand their unique food triggers, I invite you to download your free copy of Roadmap to Gut Recovery, which will help you see your big picture road to feeling better.
When you’re ready for some one-on-one help, schedule a free 30-minute assessment session with me. I’ll help you start walking that road to gut recovery. Together, we can get you feeling well again.
Here’s that Homemade Nutmilk Recipe I promised:
HOMEMADE NUT MILK Makes approximately 4 cups
2 cups raw almonds, cashews, macadamia nuts, or similar
½ cup dates
½ tsp. sea salt
4 cups water
Place nuts in a bowl and soak overnight. Pour nuts into a colander and rinse. Place the soaked nuts into your blender or food processor. Add the remaining ingredients and blend well. Be careful not to over blend. You don’t want to completely pulverize the nuts.
Pour this blended mixture into a nut milk bag (here’s the one I use), or sieve, set over a bowl. Squeeze the liquid through the nut milk bag, or press with hands or a tool in the sieve. Store in a glass jar in the refrigerator. Nut milk will keep for a few days.
It seems like everyone today is aware of food intolerances. It’s likely that you have tried at least one elimination diet in an attempt to improve your digestive or other symptoms. And with good reason: our daily food intake has a lot of effect on how we feel. Food is the main foundation of our health and how we feel—along with our habits around self-care, exercise, stress reduction, and sleep.
But along with the widespread use of special diets and restrictions I see being used by those with food intolerances, I also see a lot of very confused people. The Facebook Groups I frequent, related to autoimmune disease, digestive disorders like SIBO or IBS, and chronic fatigue, are full of people asking questions like:
“I have been eating a Paleo diet for a while, but I recently read about the low histamine diet, and I think histamine might be part of my problem. But half of what I eat on the paleo diet is high histamine, I’m so confused. What should I do?”
“I have been told to go AIP, Keto, low histamine, no dairy, no Eggs by my Functional Medicine Practitioner following the results of my elimination diet. I know I can do it, but I’m getting cold feet. Any tips and tricks to make this a little easier?”
“I’ve read about several diets that are “good” for SIBO—low FODMAP, SCD, GAPS, Cedars Sinai diet. But there are foods that some diets restrict that other diets say you can eat. Does anyone have an explanation for these discrepancies?
Or: “Diet. Do I need a dietician? I’ll stick to one diet, then hear of another and veer that way. Then I find myself cheating, feeling guilty, and picking another diet. My Naturopathic Doctor just said to do the SIBO-specific [diet] 80% of the time. It’s hard when you are surrounded by family who can eat whatever, whenever.”
Sound familiar?
As a bonafide do-it-yourself-er, if I want to do something like a specialized diet, I spend time online, or buy a book or two about it, and dive in. But even with a very detailed book as a guide, many of our health situations are very nuanced and complex, and need a more nuanced approach.
Though a handout or a book is a great starting place, successfully applying a specialized, therapeutic diet requires a methodical approach. To use this approach makes sure that you are appropriately using the diet as a tool to learn more about your unique body, so you can continue to make better and better choices.
The alternative is blindly grabbing for the next right thing, anxiety about whether you’re doing it right, and hopping from one diet to the next , without really understanding what you’re seeing and what’s best. For example, how do you know if the diet is really working for you? Should you be concerned about deficiencies? How restrictive is too much?
So I’m going to spell out the method and approach I use to help my clients with digestive symptoms and food intolerances adapt the principles of using therapeutic diets so they can be successful with their food-as-medicine approach. You can use these tips to improve your success, too.
Food Intolerances Key #1: A Basic Elimination Diet, to Remove the Most Common Inflammatory Foods, Should Be Completed First.
The thing most therapeutic diets have in common is that they typically eliminate the top 3 most common inflammatory foods and focus on whole, real food. In my practice, I consider this to be gluten, dairy, sugar, and alcohol at a basic level, followed by the next top three, corn, soy, and eggs. A significant number of symptoms improve with this approach alone.
So, if you haven’t already gone down the elimination-diet rabbit hole, I recommend starting with a basic elimination diet that removes these top 3‑6 foods, and focuses on removing anything processed and eating nothing but real food for 30 days.
Many people find that this basic level of clean up provides a lot of relief from food-sensitivity symptoms. Most of us can benefit from this template at least once or twice a year.
A friend and colleague of mine, who doesn’t have any significant health issues, has recently decided to do this cleanse, using the Whole 30 template, twice a year for a month at a time, and always notices that his sleep and stress management improves, digestion improves, and he generally feels great.
When my clients use this approach, they usually find they sleep better, have less digestive upset, better skin, more balanced mood, and they often lose unwanted weight as a side benefit.
A significant number of problems clear up when you eliminate gluten, dairy, sugar, alcohol, and focus on eating whole, unprocessed food. This is the food our bodies were designed to eat, and is a valuable investment in our health, no matter your health issues.
Food Intolerances Key #2: Choose the Right Template and Customize
OK, so you did the 30-day elimination diet, but you are still seeing food intolerances and symptoms, and are confused about what foods are contributing to the problem. Now what?
The next step is to choose another elimination-diet template to work with, to see if you can isolate the food-related causes of your symptoms.
Diet templates like the Autoimmune Paleo, Keto-Adapted diet, or Low FODMAP diet are examples of templates that might help you figure out what is causing trouble. They are important and essential tools, and should absolutely be used. But as tools, they are really just the place for you to start.
The most important step here is to choose the right template for your situation. Imagine that your best, personalized diet is a small apartment in the middle of a huge city—you want to begin your search by looking in the right neighborhood to start.
So for example, if you have been diagnosed with IBS, or have symptoms that suggest IBS, you probably shouldn’t give the keto-adapted diet a try. (See my video Is Keto Good or Bad? Keto for IBS). It’s generally acknowledged that the Low FODMAP or Specific Carbohydrate Diet is a useful place to start thinking about which foods might be triggering your IBS symptoms.
In contrast, if you are have Type II Diabetes and Metabolic syndrome, the Low FODMAP diet probably isn’t a useful template, whereas the Keto diet might be right for you. For more about how to choose the right diet template, check out my earlier blog post Choose the Right Elimination Diet for your Persistent Symptoms.
Next, to get the best mileage out of diet template, you must take it and make it truly your own. The way to do this is to:
Work with the suggested elimination lists to choose small groups of foods to eliminate for a few weeks. The most likely culprits are the ones you eat frequently, especially daily.
After your elimination period, test them one at a time to see if they really do cause symptoms. You can use a Food-Symptom Diary (like this one) to track your results.
Remove the foods that truly cause a change in your symptoms or mental state while you work on healing the underlying causes of food intolerances (usually things like gut dysbiosis or leaky gut).
Food Intolerances Key #3: Only Test Specialty Elimination Diets for a Set Amount of Time, and Customize, Customize, Customize:
Specialty elimination diets, like Autoimmune Paleo, Low FODMAP, low histamine, low oxalate, low salicylate diets, should be a) trialed for about a month, and re-evaluated at the end of the period; and b) should be customized.
One thing I’ve found personally, with my food intolerances, and more widely with clients is that they are rarely sensitive to everything on that list. Our bodies are complex systems, with many overlapping influences, and our food tolerances are as unique as our fingerprints.
The key here is that the template tells you where to look. You have to look at that list and identify the likely culprits, but the wider goal that we shouldn’t lose sight of is that we want to have the widest-variety diet we can have.
We don’t want to eliminate foods that are actually working for us, and we don’t want to inadvertently create nutrient deficiencies by quitting foods that are actually OK for us. Eliminating foods that we DO tolerate for long enough can lead to reduced oral tolerance and actually increase food intolerances!
Specialty eliminations, with lengthy lists of things to exclude, should be taken on for a trial period, about a month, and then evaluated.
If you haven’t seen any improvement in that time, then that diet is likely not the right template for you, or there are bigger issues that need addressing. A supportive diet is always an important piece of the healing puzzle, but it sometimes isn’t enough.
Food Intolerances Key #4: If Symptoms Persist Beyond an Elimination Diet, You Need to Start Thinking About WHY Those Symptoms are Persisting.
The problem is likely bigger than just food. And regardless, I always want you to be thinking about why the sensitivities are there in the first place.
Some top possibilities include:
Gut dysbiosis or SIBO
Leaky gut
Adrenal or thyroid problems
Gut adhesions/scars
Environmental illness from mold, pollen, dust, household toxins, workplace toxins, etc.
At this stage in your game, it’s important to find a qualified Functional Medicine or Functional Nutrition Practitioner, or Naturopathic Doctor, or similar holistic health care provider to help you investigate your root causes.
Each of these providers has a methodical way of figuring out where to support your body in your quest to regain function and quality of life.
Food Intolerances Key #5: It’s Vitally Important to Work Methodically.
It’s easy to skip around, get confused, and just get no clarity while diet hopping. But the true value of the elimination diet work is to test a series of theories about what is causing your problem, and to slowly cross off the ones that have nothing to do it.
In this way, you build on your experience and create a highly personalized diet template. And not only this, but this work empowers YOU to intimately understand what your body is doing why.
If we return to a question from the top of this article, I can now answer it:
“I’ve read about several diets that are “good” for SIBO—low FODMAP, SCD, GAPS, Cedars Sinai diet. But there are foods that some diets restrict that other diets say you can eat. Does anyone have an explanation for these discrepancies?”
The reason for these discrepancies is because there is no one, right diet for everyone. Food intolerances are caused by many different possible causes, and without doing some methodical investigation, it will be difficult to tell why this template helps and this other one hurts.
There is a right template to begin with, and this will depend on the specific symptoms or problems you are trying to address. Once you’ve chosen that diet template, it must be customized specifically for YOU! You may not need to remove everything or even a lot of the foods on the list.
This person asked specifically about SIBO, and why all these diets are supposed to work for SIBO. The answer is because each person’s SIBO is unique, and has unique causes. For many SIBO patients, the low FODMAP diet is very helpful. But “FODMAPs” are five different types of fermentable starches. The particular bacteria causing your SIBO bloating, diarrhea, or constipation may only be interested in one or two of them. But to figure this out, you must do the methodical work of getting clear about which specific foods are triggering your symptoms.
Doing this work is definitely a little bit time consuming, compared to popping a pill, or using a “stock” diet template, but it provides drastically better results in the end.
Conclusion:
Cutting through the confusion of which diet to eat for your health can be easy: simply choose the right place to start, and do your homework about which foods are specifically a problem for you. Working through this method will provide you with the most useful food information you could imagine: a perfect, tailor-made diet, uniquely suited to your personality and circumstances.
If after reading through all this, you’re still confused, or not sure how to move your situation forward, please reach out to me to get some support. This is the exact method I use to help my clients, who struggle with everything from anxiety to SIBO, figure out what to eat to thrive, while minimizing symptoms.
If you struggle with IBS or IBS-like symptoms, you may have found your way to the low FODMAP diet or another therapeutic diet. In this blog post, I will help you understand how the low FODMAP diet fits into the context of your full IBS diet plan.
Making sure your IBS diet is low on aggravating foods is a key part of healing, and will dramatically improve your quality of life. But dietary intervention is rarely enough to help you resolve your IBS from the root cause level.
Because IBS is so frequently caused by dysbiosis, what you are really aiming to do with all of your interventions, is to support your body in shifting its gut microbiome.
So if you’re trying to resolve your IBS or IBS-like symptoms at their roots, what does this plan look like? And where does your IBS diet plan fit in?
Getting to the Right IBS Diet Plan
The first step in any plan is doing a proper assessment and finding which areas are ripe for easy action. These areas usually fall into a few different categories:
choosing the right diet for your unique body.
creating a foundation of health practices that supports you (sleep, stress management, exercise, balancing blood sugar, hydration, and supportive community).
recharging nutrient deficiencies with proper food and supplementation.
So many people think that the diet part is all they need to do. But this is only one small piece of the journey.
Though tempting to skip these steps, finding your way to the right combination for you can often remove some of the root causes that are contributing to your current health challenges. This makes your bigger healing project easier and more efficient and effective.
By cleaning up these foundational pieces, you set yourself up for much greater success.
How to Create the Wrong IBS Diet Plan: Potential Pitfalls
I made a lot of mistakes using therapeutic diets before I was trained as nutrition coach, and I’ve seen countless others make the same mistakes.
Here is how my story went:
Like many of you, I had intermittent, but challenging digestive symptoms. They at times, but not always, had me staying close to a toilet, and feeling very puzzled. Sometimes my symptoms struck in the morning, sometimes it was the middle of the night. Either way, it was always unwelcome.
I have been a DIY health person since I was in college, when I succeeded in curing my recurrent bladder infections using herbs and homeopathy. So I started researching.
I learned about therapeutic and elimination diets, and tried them out. I stared with simple gluten, dairy, and sugar free. This one actually made a lot of difference, but I didn’t know I should stay on it for a while. I gradually slipped off after the initial month.
A few years later, still struggling, I learned about the ketogenic diet, and based on the testimonials of people who had been wildly successful with it, I dove in whole hog.
I felt a little better, but didn’t seem to access the profound energy that many keto advocates describe. Then, after several months, my digestion, hormone, and skin issues all started to get WAY worse.
I shifted back toward a more paleo template, and added more carbs back in, but cut dairy out. This helped, but by now, the issue had exploded, and was bothering me more days per month than not.
When adopting a diet template for digestive problems, I was missing a few very key pieces of information:
Your Diet Highly Contributes to Your Microbiome: Extremely low carb diets like keto can dramatically shift the composition of the microbiome, and this isn’t always a positive thing. Our good bacteria survive by consuming the natural fiber in plant based foods, such as fruits, vegetables, whole grains, legumes, nuts, and seeds.
In my case, the keto diet removed most fruit, some high fiber vegetables such as beets, carrots, potatoes, and winter squash due to their carb content, legumes, and whole grains. Essentially, I starved my beneficial bacteria, which contributed to a lot of worsening mood and hormone symptoms. When choosing a therapeutic diet, it’s important to be mindful of the varied effects it is likely to have on your microbiome, and to be sure to support it.
Diet Templates Must Be Customized: Any diet template, for any health condition, needs to be customized to you to minimize the potential negative affects that widespread eliminations can produce. You want to remove the foods that are causing a lot of inflammation or other problems, but minimize the number of removals so you don’t destabilize the microbiome, create nutrient deficiencies, and minimize the disruption your experience of eating.
In my case, eating a much higher fat and lower carb diet overburdened my already struggling digestion and elimination, and contributed to increased acne, anxiety, diarrhea, constipation, and hormone havoc. Had I been paying closer attention with diet tracking, I would have noticed that these changes were worsening my symptoms.
Diet is ONLY ONE piece of a complex puzzle that may require multiple steps. I feel the diet shift is beneficial to do at first, to focus on providing symptomatic relief, as well as underlying inflammatory relief. Once you have diet sorted out, then and only THEN should you focus in on resolving the other pieces of your puzzle, such as nutrient deficiencies, detox support, and hidden infections or pathology.
I think a lot of experts and authors sell a lot of people short here. Many people promote their therapeutic diet as the magic bullet or likely cure for an illness. For some people this is the case, but I believe it is the slim minority. Most people require not only diet changes, but also habit realignment, customized supplementation, and sometimes, more significant protocols to shift the microbiome or even prescription medications. It’s a great disservice to tell people that diet will fix them when it’s not really the case.
Your IBS Diet Plan: Customized and In Context
The Low FODMAP diet is currently the only peer-reviewed diet proven to support IBS. The Specific Carbohydrate Diet is similar, but has not yet been proven scientifically to be effective. But since diet templates are simply a place to begin, this doesn’t really matter. You start where you need to start, and work from there.
In the basic FODMAP diet, you focus on removing high FODMAP foods, which are foods high in certain fermentable carbohydrates. These carbs and fibers feed bacteria in the gut and can contribute to gas and bloating, as well as the diarrhea or constipation that are hallmarks of IBS.
But the high FODMAPS list is really broad. It includes a lot of generally healthy foods, including (this list is not complete):
asparagus
artichokes
garlic, onions, and leeks
apples
cherries
figs
mango
agave
high fructose corn syrup
honey
peas
soybeans, black, fava, kidney, navy beans
dates
persimmon
plums
cauliflower
mushrooms
apricots
blackberries
carob
chicory
and more…
But here’s what you need to know about this list: it would be difficult to remove ALL those foods entirely, and you don’t need to. You likely have sensitivity to one or two TYPES of FODMAPS, but not necessarily ALL of them.
You might mostly have a problem with Fructo-saccharides, or fructose. By using detailed FODMAP lists of foods (check this really detailed one out) along with your Food-Symptom Diary (you can download yours here) properly to assess this, you may find that you don’t need to eliminate the segments of the list that pertain to other types of sugars.
And even within one sub-segment of the FODMAP list, you may find that some of the foods on that list bother you, while others are just fine and don’t contribute to your symptoms.
So while anyone can read a list, and decide to remove everything on it, the true benefit of the list is to use it as a tool to know WHERE TO LOOK for your unique sensitivities. Then you do the elimination work to discover what specifically is true for you.
Once you have THAT information, you can move ahead with confidence, knowing that you won’t be triggering your symptoms while you address whatever other underlying causes are contributing. Ideally, you’ll be able to discover the specific dysbiosis or other mechanisms that are creating the conditions that make your IBS happen, and you can work through the process of resolving them. (To read more about how to use Gut Microbiome Testing to resolve IBS, read Gut Microbiome Testing for IBS).
Conclusion
Healing from a chronic illness like IBS is really a transformative experience, and requires context. Transforming your practices and habits sets you up for a lifetime of not only improved health, but the ability to deal with and successfully face any future health challenge that comes our way because you will have learned how to work WITH your body. What you learn about your body never deserts you. It becomes something you build on as you move forward.
Now you know how to use the Low FODMAP Diet in the proper context to create your IBS diet plan, but what about the other steps along your Roadmap to Recovery? Grab your free copy here.
And if you’re feeling confused about how to wade through all those FODMAP food lists, and you’re ready for some support with diet and supplement customization in your pursuit of your personal remission, schedule a free 30 minute Assessment session with me right here.
During my late teens and early 20s, mental and gut health challenges slowly became daily burdens in my life. The first time I experienced anxiety, I startled awake in my dorm room with my heart racing in the middle of the night, wondering if I was having a heart attack. Other times, I would sometimes experience a deep sense of foreboding, like something really bad was about to happen, and I would frantically ask my friends or partner to change plans.
By my 30s, I had frequent diarrhea and cramping attacks, which were inconvenient when I wasn’t near a bathroom. I would go through periods where I was nauseated a lot. And I couldn’t sort out why it was happening. And my worry compounded my digestive symptoms. I could see some overlap between my mental and gut health symptoms, but I didn’t really realize until later how my mental and gut health were deeply connected.
As I studied functional nutrition, it suddenly all fell into place: the health of our gut is totally connected to our mental health status.
Here are some aspects of the mental and gut health connection you may not know about that may help you understand what you are up against, and to create a plan.
1. The Gut and Mental Health -Microbiome Connection
Your gut is home to a community ecosystem of microorganisms, made up of bacteria, yeasts, and even some types of parasites. When in balance, this ecosystem helps you maintain your digestive function, create and absorb nutrients, and maintain an effective barrier against pathogens, or bad guys. These microorganisms communicate by chemical signaling messages, which can be actually transmitted from gut to brain. In this way, your gut tells your brain if you’re feeling well, or if you’re feeling stressed. This is the source of a “gut feeling”.
Healthy microbiome residents, like certain kinds of Bacillus bacteria, are responsible for creating certain essential nutrients via fermentation in the colon, such as B vitamins, vitamin K2, vitamin A, and antioxidants. Some of these nutrients help maintain good gut barrier function, and prevent toxins from unwelcome microorganisms from getting to and affecting your brain.
If you have populations of unwelcome, pathogenic bacteria, their chemical messages and waste exhaust communicate with your brain via the vagus nerve and can contribute to anxiety and depression symptoms. Collections of digestive symptoms are often a sign that gut infections may be present. Because the gut microbiome is so important to brain health, it’s important to address any hidden infections as a part of your plan to resolve your mental health challenges at its roots.
2. Regular Bowel Movements are Essential to Gut and Mental Health
If you aren’t pooping regularly, toxins and exhaust from bacteria can increase and affect your mood and mental health. For example, elevated methane gas from bacterial overgrowth in the small intestine can create severe brain fog, anxiety, depression, headaches, irritability, and fatigue. Moving the bowels if constipated may help reduce mental health symptoms. (See 9 Ways to Get to the Bottom of Chronic Constipation for additional help and resources).
3. The Thyroid- Gut and Mental Health Connection
Thyroid imbalances are closely related to your gut health and mental health. A majority of T4 hormone (made in the thyroid gland) is converted to T3 (the usable hormone) in the gut. In this way, emergent thyroid problems may be a digestive disturbance at the root, and can often be cleaned up with an elimination diet and adrenal support.
If your body notices too little thyroid hormone, your brain and thyroid gland may try to make up the difference by releasing more Thyroid Stimulating Hormone (TSH), leading to too much hormone. Too much thyroid hormone, and you may experience anxiety. Too little thyroid hormone, or low levels of T3 and T4, and you will likely feel depressed. Supporting your thyroid function by supporting your gut function can be a really important part of balancing any mental health concerns.
4. The Gluten- Gut and Mental Health Connection
Many authors have noted the presence of mental health symptoms with the consumption of gluten. Grain Brain by Dr. David Perlmutter, Why Isn’t My Brain Working by Dr. Datis Kharrazian, The Autoimmune Fix by Dr. Tom O’Bryan, The Paleo Diet Cure by Chris Kresser, L.Ac., Healthy Gut, Healthy You by Dr. Michael Ruscio, and many more explain how consuming gluten foods breaks down gut barrier function which allows toxins to reach your brain and affect your moods and mental well-being.
As partially digested gluten (and other) proteins make it to the brain through a leaky gut, they can cause inflammation in the brain and contribute to mental health symptoms, including anxiety, depression, brain fog, poor memory, and even schizophrenic episodes. There was some very interesting research done in state hospitals in the 1960s removing gluten from the diets of schizophrenics. The patients experienced noticeably improved symptoms, and symptoms got worse with the reintroduction of gluten. If you are experiencing gut and mental health challenges, you might consider a gluten elimination diet. You can read more in 6 Reasons to Quit Gluten If You Have a Chronic Illness.
5. The Importance of Good Digestive Function for Gut and Mental Health
Many of our mood-supporting and regulating amino acids and neurotransmitters, like GABA or 5-HTP, or serotonin are in part made from protein foods in our diet. For your body to have access to the amino acids that build neurotransmitters, they must be chemically broken down from protein with hydrochloric acid in your stomach. If your body is low on stomach acid, then you can become deficient in aminos important for your mood regulation. Further, even if you can break down the proteins, if your gut function is compromised by bacterial overgrowth, yeasts or parasites, you may not be adequately absorbing the aminos you need either. Supporting your belly for robust digestive function is important for your mental health. You can read more in Have You Skipped These 9 Digestion Tips in Your Quest to Heal?
6. The Stress- Gut and Mental Health Connection
I hope by now you can begin to understand how important good digestive function is to support gut and mental health. High stress levels work against this process, and not only decrease our mood, but deplete our ability to maintain a positive mood. Stress also decreases our digestive efficiency, by slowing down digestion. To make matters worse, staying stressed out burns through large quantities of amino acids, which can further deplete your stores. Coupled with a compromised digestive system, you can see a self-reinforcing feedback loop worsening your mental health state. To make sure your stress isn’t wrecking your gut and mental health, it’s imperative to focus on effective stress relief practices, such as breathing, yoga, meditation, or simply doing something you love.
7. The Importance of Fat for Gut and Mental Health
In a world that has mistakenly villianized dietary fat, our mental health has suffered. Not only does too much carbohydrate-rich food feed the bacteria and other microorganisms that can destabilize your gut and therefore your mood, your body need fats to make your hormones. Your hormones help keep your moods in check, help you feel motivated, confident, and relaxed. As women begin to experience perimenopause, for example, levels of progesterone decrease, which can increase feelings of anxiety and stress. This process often collides with increased family and career demands, leading to a confluence of events that can precipitate a mental health crisis. If this woman also happens to be eating a low-fat diet, she will feel far worse than a woman who is consuming healthy fats. Make sure that you are including healthy fats (olive, avocado, coconut, ghee, or butter) and are avoiding industrial seed oils (cottonseed, soy, canola, safflower oils) in your diet, and are supporting healthy fat digestion with stomach acid and enzyme support.
Conclusion: What does all this amount to?
To work on resolving anxiety or depression at its root cause, it’s important to consider what exactly is going on in the gut, the interface between your gut and your food, and to work to balance and correct it. In most cases, the gut is a significant contributor to mental health symptoms, and must be balanced. This work is done by managing stress, adjusting the diet to reduce inflammation, removing infections, and repairing the gut barrier function and leaky gut. It can take some time, but the mental health improvements, without medication, are worth the effort for those that want to avoid medication.
If you are experiencing gut and mental health symptoms, know that you are not alone and that there is a lot you can do to heal yourself from the inside out! When you’re ready for a some support and action in crafting a plan to investigate your root causes and heal, schedule a free 30-minute phone call with me here. Together, we’ll assess where you are, and what your next best steps would be. I look forward to talking with you.
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.
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.
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.
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!
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.
