Your Complete Guide to Autoimmunity and Allergy Testing

This article originally appeared on Healevate.

Why do you get hay fever every spring, while others are totally unaffected? Why can one person cuddle up with their dog, while you break out in hives from merely petting the furry little guy? Allergies and autoimmunity are complicated conditions that exist on a spectrum, and have a few things in common.

  1. The underlying cause of both is inflammation.
  2. Having the right genetics predisposes you to developing them.
  3. The epigenetic factors responsible for manifesting the symptoms are probably more important than the genes themselves, since the environmental influences on the genes are what cause them to be turned on or off.

Epigenetics are all of the environmental factors that control your genes, so if you’re stressed out, not sleeping, eating an inflammatory diet, not exercising, and are surrounded by toxins in your home and on your body, there’s a good chance you’ll have some kind of inflammatory symptoms. These could be itchy, watery eyes from allergies or fatigue, brain fog, and constipation from an autoimmune condition.

These factors cause your immune system to kick up and start overreacting to normal stimuli, which ultimately produces systemic inflammation. Identifying the symptoms can help you get to the bottom of what’s causing your autoimmunity or allergies.

Symptoms of Autoimmunity and Allergies

Autoimmune and allergy symptoms are all on the inflammatory spectrum, so they can literally affect your entire body and cause many symptoms simultaneously.

Immune/inflammation: Asthma, wheezing, coughing, runny nose, post nasal drip, itchy or watery eyes, sneezing, unresolved infections, autoimmunity, swelling, anaphylaxis, and throat closing.

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity, hair loss, nail pitting, dry eyes, skin, and mouth.

Gastrointestinal: Stomach pain, acid reflux, IBS, gas, bloating, nausea, diarrhea, constipation, gastroparesis (delayed stomach emptying), cankers, and food sensitivity.

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, and insomnia.

Nerves: Tingling, pins and needles, numbness, and paresthesia.

Hormones: High or low blood sugar, weight gain or loss, excessive sweating, imbalance in thyroid, adrenal, and sex hormones.

Musculoskeletal: Joint and muscle pain, muscle weakness, and fibromyalgia.

Liver: Elevated liver enzymes, poor detoxification, and chemical sensitivity.

Cardiovascular: High or low blood pressure, rapid heart rate, and palpitations.

Which Test Should You Choose for Autoimmunity or Allergies?

Lab testing for allergies and autoimmunity can be exhausting, since the symptoms are vast and systemic.

Allergies are more easily tested, as you can do IgE antibody testing or skin prick testing to identify environmental allergens.

If your symptoms are outside the realm of typical allergies, then further investigation is warranted. Start with general testing to confirm that you have an inflammatory or autoimmune-based condition.

The serum labs for nonspecific markers of inflammation will let you know if you have an inflammatory or autoimmune process going on inside your body. If your symptoms coincide with a specific illness—for example, stomach pain, brain fog, and depression would possibly correlate to celiac disease—then specific testing should be initiated as well.

An important feature of reversing inflammatory, allergic, and autoimmune processes is finding the root causes. GI infections, food sensitivities/intolerances, toxicity, and hormone imbalances are all causes that could be contributing to your condition, and should be identified.

Autoimmunity and Allergy Testing

Allergy tests:

  • IgE antibody testing
  • Skin prick (scratch) testing

General inflammation and Autoimmunity tests:

  • CRP (C-reactive protein)
  • ESR (erythrocyte sedimentation rate)
  • ANA (anti-nuclear antibody)
  • APA (anti-phospholipid antibodies)
  • RF (rheumatoid factor)
  • Lactoferrin
  • Calprotectin

Testing for specific conditions is the next logical step if general testing suggests an autoimmune or inflammatory process, or if your symptoms correlate to a specific condition. For example, TPO (thyroperoxidase antibody) and TGA (thyroglobulin antibody) should be tested for autoimmune hypothyroidism (Hashimoto’s).

Allergy Tests

Environmental allergies to pollen, trees, weeds, dust, mold, and animals are fairly common, affecting over 40 million Americans annually.

Allergies are a hypersensitivity reaction to a substance that normally doesn’t cause a problem in most people. Once the substance is encountered and your immune system identifies it as foreign, it creates specific antibodies against the substance’s antigens (proteins).

IgE antibodies are one of several types of antibodies. They’re created when your body has a true allergic response to a substance and is considered a fixed allergy in that it will almost always provoke an immune response when the allergen is encountered. This type of testing analyzes your blood for the presence of IgE antibodies.

The skin prick or scratch test is often used as a quick screen, as it can be completed during an office visit. This test is administered on your back or arm, and anywhere between 20 to 40 substances can be tested, from dust, dander, and pollen to mold and foods.

A drop of the allergen is placed on your skin, and then a lancet is used to prick the skin, allowing the allergen to penetrate. Fifteen minutes later the results will be interpreted. A positive reaction will form a raised red bump that may itch (called a wheal). This type of test is usually performed in your doctor’s office.

General Inflammation and Autoimmunity Tests

CRP (C-reactive protein) is a protein made largely in the liver, immune, and fat cells in response to various inflammatory processes, such as tissue damage, infection, and disease states.

It’s released into the blood within a few hours of the inflammatory event; thus, it’s called an acute phase reactant. It’s a general marker of inflammation and isn’t specific to any particular condition. It can be used to track inflammatory and autoimmune conditions, as well as monitor flares. It’s often ordered with an ESR.

ESR (erythrocyte sedimentation rate) describes the inflammatory process in which red blood cells (erythrocytes) clump or aggregate together, causing sedimentation. The ESR measures the rate at which the erythrocytes settle in one hour in a vertical tube. It’s useful for assessing tissue destruction and levels of inflammation. Similar to CRP, the ESR is also a non-specific marker.

ANA (anti-nuclear antibody) is measured to assess levels of antibodies produced against the nucleus of a cell. It can be useful for identifying autoimmune conditions that affect multiple tissues throughout the body, such as lupus (SLE). ANA is a general indicator and isn’t specific to one particular condition.

APA (anti-phospholipid antibodies) reflect antibody production against phospholipids, which are required for blood clotting. APA is useful in blood clotting disorders, some of which are autoimmune, and for diagnosing lupus.

RF (rheumatoid factor) is an antibody that’s detectable in up to 80% of rheumatoid arthritis (RA) cases, but it can also be present in other autoimmune conditions such as lupus, scleroderma, and Sjogren’s. It can be helpful in distinguishing RA from other arthritic disorders.

Lactoferrin is a protein produced to combat inflammation. Lactoferrin can be measured in a stool sample and reflects inflammatory processes. It’s useful in diagnosing ulcerative colitis (UC) and Crohn’s versus non-inflammatory IBS. Since it isn’t specific, other causes of inflammation must be investigated such as dysbiosis, GI infection, and food intolerance.

Calprotectin is another protein measured in the stool that’s produced by a white blood cell called a neutrophil. Since neutrophils aggregate at the site of inflammation, calprotectin is more useful for diagnosing UC and Crohn’s against non-inflammatory IBS, as well as monitoring their progression. Other sources of inflammation should still be ruled out with other tests.

Testing for Specific Conditions

These are some of the common antibody (Ab) and gene tests associated with specific conditions. They may be helpful in diagnosis, along with other advanced tests and procedures such as biopsy or imaging.

Hashimoto’s: Thyroperoxidase Ab (TPO) and Thyroglobulin Ab (TGA)

Graves’: TPO, Thyroid Stimulating Hormone Receptor Ab (TSHR Ab), Thyroid Stimulating Immunoglobulin (TSI)

Diabetes (Type 1): Islet Cell Ab (ICA), Insulin Autoantibody (IAA), Glutamic Acid Decarboxylase Ab (GADA)

Autoimmune Hepatitis: Smooth Muscle Ab (SMA), Liver Kidney Microsomal Type 1 (Anti-LKM-1)

Ulcerative Colitis: Perinuclear Anti-Neutrophil Cytoplasmic Ab (pANCA)

Crohn’s: Anti-Saccharomyces Cerevisiae Ab (ASCA), Anti-CBir1, Anti-Omp C

Rheumatoid Arthritis: RF, Myeloperoxidase Ab (MPO), Cyclic Citrullinated Peptide Ab (CCP)

Lupus (SLE): MPO, APA, Anti Double Strand DNA (Anti dsDNA)

Myasthenia Gravis: Acetylcholine Receptor Ab (AChR)

Ankylosing Spondylitis, Juvenile Rheumatoid Arthritis (JRA), Reactive Arthritis (such as Reiter’s Syndrome): HLA-B27 gene test

Celiac: HLA-DQ2 and HLA-DQ8 gene tests, Anti-Tissue Transglutaminase Ab (tTG), Deamidated Gliadin Peptide (DGP), Endomysial Ab (EMA)

There are also specialty lab tests for celiac that involve testing IgG and IgA antibodies against gliadin, glutenins, gluteomorphins (made during the digestion of gliadin), and tissue transglutaminase. Cyrex Laboratories offers this panel, which is called the Array 3: Wheat/Gluten Proteome Reactivity & Autoimmunity.

Cyrex also offers the Array 5: Multiple Autoimmune Reactivity screen that measures IgG and IgA antibodies against 24 tissues and organs in the body. It includes many of the specific antibody tests, including ASCA, ANCA, TPO, TGA, GAD 65, and APA (discussed previously).

This test is very useful because it screens most of your body at once for AI, and when you have one known autoimmune condition, there’s an increased risk for autoimmune activity against other tissues. The tests in this panel can also be obtained in smaller panels according to condition or tissue type, including diabetes, neurological, and joint autoimmune reactivity screens.

Most of these tests can be obtained and completed by going through Direct Labs, which is a centralized location to buy and organize tests from labs such as LabCorp or Quest, as well as specialty lab companies who do mold and inhalant allergy testing.

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How to Test for Hidden Food Allergies or Sensitivities

This article originally appeared on Healevate.

If you’re experiencing a variety of health symptoms and have no known food allergies or sensitivities, you might wonder why you’d need to test yourself for them. You may believe that simply cleaning up your diet and eliminating soda, baked goods, sugar, and processed foods is enough. And while that’s certainly a good start, it’s not nearly enough to eliminate the immune and inflammatory processes that food reactions can cause.

Since eating is such an automatic process for most of us, we never stop to consider whether the symptoms we’re experiencing are related to food unless the reaction occurs while we’re actually eating or very soon thereafter.

If you have brain fog, fatigue, congestion, rashes, joint pain, or headaches, there’s a pretty good chance that your body is reacting to something you’re eating.

For many people, food is the most inflammatory substance they encounter on a daily basis. Because we eat multiple times a day, and because we’re creatures of habit, we tend to consume the same things, giving the immune system the opportunity to react.

Food sensitivities and allergies cause many symptoms, especially if you have a leaky gut. Any symptoms of inflammation or autoimmunity can point to food intolerances, so the list is vast.

Symptoms of Food Allergies and Sensitivities

The symptoms of food intolerance can manifest quickly, as with a swollen tongue or anaphylaxis, but quite often the symptoms are delayed. This makes them hard to pick up on, as well as attribute to a certain food.

Immune/inflammation: Allergies, asthma, runny nose, post nasal drip, unresolved infections, autoimmunity, swelling, wheezing, coughing, anaphylaxis, throat closing.

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity (sun sensitivity), hair loss, nail pitting, dry eyes, skin, and mouth.

Gastrointestinal: Stomach pain, GERD (acid reflux), IBS, gas, bloating, nausea, diarrhea, constipation, gastroparesis (delayed stomach emptying), canker sores.

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, insomnia.

Nerves: Tingling, pins and needles, numbness, paresthesia.

Hormones: High or low blood sugar, weight gain or loss, excessive sweating.

Musculoskeletal: Joint and muscle pain, muscle weakness, fibromyalgia.

Liver: Poor detoxification, chemical sensitivity.

Cardiovascular: Low blood pressure, rapid heart rate, palpitations.

The First Food Allergy or Sensitivity Test To Perform

The first method of screening isn’t a lab test at all. It’s an elimination diet. Eliminating the most common sources of food intolerances is a great way to find out if you have an issue.

Removing gluten, dairy, corn, soy, eggs, and nuts from your diet for 4 weeks, then adding them back one single food (not food group) at a time over a period of 3 days should tell you whether your body is reacting to something.

If you have a known autoimmune condition, you may also want to include the nightshade vegetables, such as tomatoes, potatoes, sweet and hot peppers, eggplant, and spices made from these, as well as gluten cross-reactive foods like coffee, chocolate, and the gluten-free grains.

If any of the previously mentioned symptoms appear during that 72-hour window, you should avoid that food for at least 6 months to give your immune system a break and let the inflammation go down.

This method can you help you to identify the source of your food troubles, but for some, reactions can occur to even the healthiest foods, such as blueberries or spinach, especially if they have a leaky gut. To further complicate matters, not only do the foods themselves cause a response, but the additives, colorings and gum resins (binders used in gluten-free foods) do as well. This is where testing can be valuable.

Food Allergies vs Food Sensitivities

Food allergies and sensitivities are very different issues. A food allergy occurs when the immune system identifies a food as a foreign substance and attacks it. This response occurs on a spectrum and can be anything from a swollen tongue to anaphylaxis, which is a potentially life-threatening reaction.

Food allergies are tested by measuring antibodies in the blood against particular foods. IgE and IgG are commonly measured. If you have an obvious response to a food, you can confirm it with this type of testing.

Food sensitivities are the more common and elusive form of food intolerance. They’re more vague than allergies and are considered to be any toxic or inflammatory response to food. Quite often they’re mediated by a lack of enzymes, stomach acid, and/or a leaky gut. Celiac disease is a perfect example, where a severe intolerance to gluten causes the destruction of the surface of the small intestine.

Testing for food sensitivities offers a variety of options; antibody and mediator release testing (MRT) are two of the better ones available. No matter what test you choose, be aware that if you have a leaky gut, there’s a good chance you’ll be reacting to many of the foods you eat.

Food Allergy and Sensitivity Tests

There are several types of testing available for identifying food allergies and sensitivities. IgE testing represents the true food allergy test. IgG testing can also identify allergies, but more commonly, it shows delayed sensitivity reactions. The rest of the testing options are for intolerances or sensitivities only.

  • IgE antibody test
  • IgG and IgA antibody test
  • Gluten and gluten cross-reactivity tests
  • MRT test

IgE Antibody Testing for Food Allergies

Antibodies are produced when your body mounts an immune attack on a substance it has identified as foreign, which in this case is food. It creates antibodies against specific proteins (antigens) in that food. Antibody tests measure your body’s immune response to a particular substance or organism.

There are several categories of antibodies. IgE antibodies are created when your body has a true allergic response to a substance, which is why traditional food allergy testing analyzes antibody levels in the blood. An IgE allergy is considered a fixed allergy in that it will almost always provoke an immune response when the food is consumed. This type of food allergy elicits an immediate response.

This test can be completed by traditional labs such as LabCorp or Quest, as well as the specialty lab companies Alletess Medical Laboratory and Great Plains Laboratory. IgE testing can easily be ordered online through Direct Labs.

IgG and IgA Antibody Testing for Food Allergies and Sensitivities

In spite of having an allergy, you can still yield a negative IgE test result. This is why it’s important to test IgG levels as well. IgG antibodies measure a delayed hypersensitivity reaction, which can take up to 72 hours to occur. These are the more difficult reactions to link to a particular food, so testing can be helpful here. IgG antibodies are the most prevalent antibodies in systemic circulation and are the most common form of immune-mediated food responses.

While some IgG responses represent true allergies, most are hypersensitivities or intolerances. Similarly, IgA antibodies also represent delayed hypersensitivities. They can take many hours or days to occur and operate in a low-and-slow manner.

Traditional labs such as LabCorp or Quest will offer this test. Genova Diagnostics offers an IgG test. Alletess Medical Laboratory offers stand-alone IgG testing, combined IgG and IgE testing, and IgA testing. Cyrex Laboratories offers the Array 10: Multiple Food Reactivity Screen that measures IgG and IgA levels. The Array 10 tests raw and cooked foods, additives, gum resins, and brewed beverages.

All of these IgG and IgA tests can be ordered online through Direct Labs.

Gluten and Gluten Cross-Reactivity Tests

If you suspect that you’re sensitive to gluten, or even have full-blown celiac disease, testing is an important piece of the puzzle. Gluten testing involves analyzing the IgG and IgA response to various components of the gluten molecule, including several gliadins, glutenins, gluteomorphins (made during the digestion of gliadin), and the intestinal enzyme transglutaminase. It’s important to note that you must consume gluten for this test to be as accurate as possible.

Once you confirm gluten intolerance or celiac disease, completing gluten cross-reactivity testing is helpful, since these foods elicit the same response from the immune system as gluten does. This means that they contain similar protein sequences as the gluten molecule (molecular mimicry). Milk, whey, chocolate, coffee, soy, potatoes, corn, eggs, and most gluten-free grains (including rice) are considered cross-reactive.

Conventional lab companies offer gluten testing and the Array 4: Gluten Associated Cross-Reactive Foods test. This test can be ordered online through Direct Labs.

Mediator Response Test (MRT)

The MRT utilizes different technology than antibody testing. It quantifies the inflammatory response to specific foods and additives. Mediator release refers to the inflammatory chemicals that are liberated from your cells in response to a sensitizing food.

Instead of measuring antibody production, this test measures your white blood cells’ chemical response to a food. It gauges the cells’ change in volume, which comes from the release of inflammatory chemicals such as histamine and cytokines. A non-reactive food will produce no change, while a reactive food will produce an increase or decrease in cell volume.

This is a blood test and is only offered by Oxford BioMedical Technologies.

The Bottom Line on Food Allergy and Sensitivity Tests

Start with the basics and conduct an elimination diet. That alone will give you new information to work with. From there, spend money only on the testing that could reveal new information that would alter your approach to food. If you’re already 100% gluten-free and are avoiding all cross-reactive foods as well, then gluten testing would be a waste of time and money.

So be smart and be proactive. Discovering hidden food allergies or sensitivities could make a huge difference in your day to day health.

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Eczema: The Autoimmune Disease Everyone Seems To Be Overlooking

The No Cause, No Cure Paradigm for Eczema is Wrong

I’ve always been a questioner. This is why I believe eczema can be healed and reversed (and new science backs this). When I was a little kid, I asked lots of questions because I wanted to know how and why things worked. Conversations I’d frequently have with my parents would go something like this:

Me: “Why does my tummy hurt?””

Parent: “Probably because you just swallowed your gum.”

Me: “Why would gum make my tummy hurt?”

Parent: “When you swallow your gum it can stick to your insides.”

Me: “Why would it stick to my insides?”

Parent (frustrated): “Oh, I don’t know, it just does!”

At this point I usually stopped the dialogue because I was clearly annoying my parents and I was frustrated that I didn’t get the answers I desired. Even as little kid I couldn’t understand why gum wouldn’t be digested like the rest of my food?? It also didn’t make sense to me that it would stick to my insides. There is always a reason why (even if not everyone know the answer).

Those same feelings of frustration and disbelief came to the surface for me when I was told I had Eczema. I was instantly transported back to my childhood when I heard the words “there is no known cause or cure.” It was so infuriating and disheartening.

No cause. No cure. Yet, you’re still miserable, with a very real rash that makes you crazy because you want to keep scratching it incessantly and your doctor hasn’t provided you with any help at all. This is exactly how I felt.

The majority of conventional medicine still clings to the old idea that eczema, also known as atopic dermatitis, is purely a topical rash that makes your skin red and itchy, causes lesions, and is related to allergies.

And if you’ve ever had an eczema breakout you know that this isn’t just something to brush off, or something you should have to live with-  it’s a problem that affects the way you look and feel too.

I’ve never accepted the no cause, no cure paradigm- there’s always a reason why something is happening. Your body just doesn’t start to malfunction- it’s way too smart for that. There are complex physiological processes that occur over time that culminate in conditions like eczema. We’ll get into the details of that later.

Those of us in the functional medicine community, as well as many researchers, are redefining what eczema actually is. In December 2014, this groundbreaking study published in The Journal of Allergy and Clinical Immunology confirmed what many of us suspected all along- that eczema is indeed an autoimmune condition. The study showed that by blocking 2 key proteins involved in the body’s ability to fight off bacteria and viruses, the eczema was reversed. In the process of eczema, these proteins mistakenly target the body’s own tissues, causing an autoimmune reaction which can result in the body attacking the skin. That sounds like a cause to me!

But before we get into the details of how eczema develops as as autoimmune (AI) condition, let’s review what eczema is and briefly discuss the types.

What is Eczema?

As an inquisitive and frustrated kid, I’d reach for the encyclopedia when I got one of those “it just is” answers from an adult. Encyclopedias helped, but were still limited in information on many topics.

Now we have an overabundance of information coming at us 24/7 thanks to the internet, but it’s hard to digest and make sense of it all. So, let’s break eczema down.

Eczema is more commonly referred to as Atopic Dermatitis (AD) clinically. That term is very telling since atopy or atopic is Greek for “being out of place” and dermatitis is “inflammation of the skin”. What’s interesting is that in my graduate training (which was conventional medical clinical pathology) we learned that atopy refers to an allergic reaction or hypersensitivity occurring in a part of the body NOT in contact with the allergen. Based on this definition you’d think that conventional medicine would’ve realized the cause of eczema isn’t occurring on the skin level, but that hasn’t been the case.

Eczema or Atopic Dermatitis (AD) is defined by the Mayo Clinic as “a condition that makes your skin red and itchy. AD is long lasting (chronic) and tends to flare periodically and then subside.” It’s the most common type of eczema and research suggests that a family history of atopic conditions such as eczema, allergies, asthma, and hay fever is a predisposing factor in developing it. The data compiled from my research analyzing over 7,000 patients shows that 1 in 5 people with a family history of eczema have eczema. 20% is significant.

Eczema: The Autoimmune Disease Everyone Seems To Be Overlooking

Typical symptoms include:

  • Itching, which may be mild to severe, especially at night
  • Raw, sensitive, swollen skin from scratching
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Weeping wounds
  • Thickened, cracked, dry, scaly skin
  • Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees

Eczema symptoms and appearance differs from person to person. A mild form might look like red, irritated, and slightly speckled skin, to more severe forms where the skin is significantly inflamed, with lesions that are bloody and weeping. Discolorations often occur during the outbreaks and as the skin heals.

7 Types of Eczema (Yes, …there’s actually more than one)

There are many different types of eczema according to various sources. You could go a little crazy researching them all on Dr. Google, so we’ll cover the most common ones here.

Most varieties of eczema are named for where they occur or because they look slightly different than your typical atopic dermatitis. Regardless of where it located or how it looks, it’s still eczema.

  • Contact Dermatitis occurs when an irritant or allergen contacts the skin causing redness, burning, swelling and sometimes blisters. It can be caused by things such as frequent hand washing, solvents, chemicals, foods, metals, animals, pollen, and plants like poison ivy. For the record, I don’t believe contact dermatitis should be classified with these other forms of eczema as the cause is external contact and can happen to anyone regardless of health conditions and family history. It doesn’t appear to be AI in nature.
  • Dishydrotic Eczema occurs on the palm side of fingers, palms of hands, bottom of toes, and soles of feet. It presents as red spots, bumps, or blisters. Scaly patches, flaking, and deep cracks can form from damage to the skin. This type is 2 times more common in women. I can vouch for that since this one type that I had in a very classic presentation which makes it easier to distinguish from some of the other types.
  • Hand Eczema is different from dishydrotic in that it occurs on the back of your hand and fingers, as well as the webbing between fingers. It visually looks more like typical atopic dermatitis.
  • Neurodermatitis, also called Lichen Simplex Chronicus, which is similar to AD in that there’s significant itching but differs in that the surrounding skin is healthy. It occurs in isolated patches that look thick, discolored, dry, scaly or flaky and can be mistaken for psoriasis. There can be underlying dysfunction of the nerves in this area.
  • Nummular Eczema, also known as Discoid Eczema is characterized by coin or circular shaped lesions that can be raised. Inflammatory reactions occurring in the body and dry skin are thought to play roles in developing this type of eczema. It can look like ringworm which is a fungal infection so it’s worth ruling that out.   
  • Seborrheic Dermatitis, Scalp Eczema, or Cradle Cap typically occurs in areas where there are high concentrations of oil producing sweat glands including the scalp, face, neck, upper back, shoulders, and chest. Individuals with immune system dysfunction are at increased risk for seborrheic dermatitis. It can have an oily or greasy appearance, unlike the other types of eczema, with white to yellow flakes.
  • Stasis Eczema/Dermatitis, also called venous stasis dermatitis, is a special type of eczema that occurs in areas where there’s decreased venous blood flow resulting in pressure build up causing fluid leakage from veins. Red, swollen, flaky, itchy skin occurs initially and if not taken care of can progress to ulceration, infection, and/or permanent thickening or scarring of the skin.

What Causes Eczema

If you type in ‘causes of eczema’ in Google, you’ll get a variety of answers like:

  • No true known cause
  • Dry or irritable skin
  • Genetic variant that affects the skin’s barrier function
  • Stress
  • Immune system dysfunction
  • Hormone Fluctuations
  • Bacterial or viral infections or imbalances
  • Environmental conditions such as cold, dry weather or humid, hot weather
  • Allergens

Unfortunately, while many of the above are absolutely true, most conventional doctors still treat it like it’s a condition that only occurs on the surface and don’t address most of that list. They’re likely to suggest topical treatments and possibly tell you to avoid a couple of foods, allergens, and hot or cold weather. They neglect the impact of the true root causes beneath the surface.

The worst fact of all is that some doctors are still of the old school thinking that there is no cause or cure for eczema.

Thankfully, research is evolving and know we know otherwise.

Given that eczema is now considered an autoimmune condition, we know the conditions need to be ‘just right’ for one to manifest.

These are the 3 key factors that come together to initiate autoimmunity:

  1. A genetic predisposition/family history
  2. Intestinal permeability (leaky gut)
  3. Environmental triggers such as stress, infection, gut or skin dysbiosis (imbalance between the good and bad bugs), food sensitivities or allergies, trauma, hormone imbalances, toxins, and nutrient imbalances.

With autoimmunity, the immune system mistakenly targets a body tissue and tries to attack it like it’s a foreign invader. If you have eczema, this means that the autoimmune process is attacking your skin. And to get rid of eczema, you need to address each of your root causes, which are covered in numbers 2 and 3 above.

For me, the perfect storm for eczema flares was high stress levels, hormone imbalances, GI infections and dysbiosis, leaky gut, and food sensitivities. Histamine containing foods, exercise, and hot showers made it even worse. This scenario is very similar for most of my clients as well.

A New Paradigm for Eczema

Just like when I was a kid, I wasn’t satisfied with the explanation of what causes eczema, so I developed my own process to explain the cycle of how it occurs.

Stage 1: Flare Up

You know when a flare up is coming because your body send you little signals in the form of tingle, slight itchiness or a burning sensation. On the inside the panic begins to set in and you’re thinking, “Oh no, not again!” These are the subtle hints that you’re body is unhappy and it’s trying to tell you. The flames have been stoked and a fire is beginning to burn inside.

From a physiological standpoint, your immune system is activated from one or more triggers like foods, chemicals, toxins, or microorganisms (bacteria, fungi, parasites, viruses) and has begun attacking your body tissues. Having a genetic predisposition toward eczema or autoimmunity, and a leaky gut make this the perfect storm.

At this point, trying to stop or slow the flare is a good idea as it will help begin to reverse the inflammatory process. Start with your diet as many significant triggers for eczema are food related. At a minimum go gluten and dairy free, but likely you’ll find other foods that need to be avoided while you heal.

Getting stress under control right now is key as it’s often what pushes you over the edge into a flare. It’s hard to eliminate it, but try to manage stressors by maintaining boundaries, saying no, or asking for help. If you can completely eliminate a stressor (like avoiding a toxic person or situation) even better! Also, finding an outlet like journaling, deep breathing, meditation, or walks in nature can profoundly reduce the stress response.

Stage 2: Outbreak

Your flare up transitions to a full blown outbreak when the tingle, burn or minor itch escalates to constant itching causing red, inflamed skin with welts, wounds, and/or blisters. At this point it can appear to be treatment resistant since all of the root causes likely haven’t been addressed.

The outbreak occurs when the inflammatory process mediated by the immune system goes unchecked. The inflammatory chemicals have kicked up and are peaking resulting in your extreme discomfort and many symptoms. During this phase eczema can interfere with life, making social gatherings, work, sleep, and sanity difficult due to the incessant itching. There’s a full blown inflammatory fire raging inside.

Getting to the bottom of all of your triggers and root causes is essential now so you can heal.  Addressing diet and stress may do the trick for some, but others may require deeper digging or testing which is easiest with assistance of a trained professional. Even though I do this for a living, I call upon my friends and colleagues to make sure I’m not missing anything. We can all use some help now and then!

If you haven’t begun dialing in your diet- there isn’t a better time. You need to focus on taming the fire burning within. Anti-inflammatory supplements and foods are super important now. This blog article I wrote provides a recipe, as well as 6 healing foods and supplements to help put out the flames.

Topically, some people may benefit simply from coconut oil, but I personally didn’t and many of my patients echo that sentiment. The same can be said of shea butter. However, by combining these an easy and wonderful healing salve can be made.

Eczema Healing Salve Recipe

  • ½ cup unrefined, organic coconut oil
  • ½ cup unrefined, organic shea butter
  • 10 drops calendula essential oil
  • 10 drops yarrow essential oil
  • 10 drops rosemary essential oil
  • 5-10 drops frankincense essential oil

Mix these together in a bowl by hand or with a mixer. It will be hard and clumpy at first, but eventually will soften and everything will come together. Note: you can play with the essential oils as some people respond better to certain ones than others. If you can’t some of these, that’s fine too. These all have healing, calming or anti-inflammatory properties.

The most important thing to remember in the outbreak phase is the root causes. If you don’t identify and address them all, your eczema is likely to return at some point.

Stage 3: Healing

Relief is in sight!  This is when you start to feel better and symptoms are less severe, but still present. You may or may not be itchy. Your skin still shows signs of irritation, but no open wounds and blisters. It may also appear thick, leathery, scaly, dark, or ashy now. The fire within is now just smoldering embers.

Your immune system is now ramping down and under control, but in physiological time things go slow which is why there are still visible signs (think of how long it takes to completely heal a cut or broken bone).

Steering clear of dietary triggers or any other triggers you’ve identified through self investigation or testing is still a must to maintain healing. Continue use of natural topicals to protect the skin and help rebuild integrity. Nutrients like vitamins A,C, D, and E, biotin, zinc, selenium, and collagen support healing and skin structure.

Stage 4: Clear Skin

Hooray!! When you’re suffering through an eczema flare you often don’t think this day will come, but it is possible to completely reverse eczema and have clear skin again. You’re skin is fully healed and looks great again. No more hiding in long sleeves or gloves!

Think of this stage as maintenance or dormancy. You immune system is finally calmed down and balanced so the attack on skin is over. The fire is out completely!

Maintaining a healthy diet, stress levels, and getting adequate sleep will help keep you here in your happy place.

Common Treatments for Eczema

Again, if you look eczema treatments up in Google, you’ll get a list that looks like this:

  • Over-the-counter medications such cortisone cream, Benadryl cream, or antihistamines (Benadryl, Claritin, and Allegra)
  • Prescription medications topical corticosteroids, oral steroids, and oral antihistamines.  
  • Moisturizers that contain petroleum jelly, mineral oil, or synthetic emollients like lanolin or glycerin
  • Special baths with bleach, salt (sea salt or table salt), baking soda, epsoms salts, oatmeal, or apple cider vinegar.  
  • UV Light/Phototherapy
  • Wet Dressings
  • Stress Reduction

While the medications may be helpful at first for managing symptoms, they don’t address the root causes and the eczema returns. Long term, the topical creams can damage the integrity of the skin and the topical steroids and oral medications shut off the body’s natural inflammatory response which is counterproductive to healing the body.

The moisturizers typically suggested sometimes work and other times cause more irritation due to the ingredients. Unfortunately, if they do work it’s only addressing issues at the skin level and not what’s beneath the surface.

Special baths can definitely be helpful in managing symptoms, but some need to be use with caution. I am personally not a fan of the bleach baths, ever. Sea salt, table salt and apple cider vinegar can be great, however should be tested first since they could irritate open wounds. Oatmeal baths are also very soothing as long as you know you don’t have Celiac or it’s skin variant called Dermatitis Herpetiformis. If you do, you should probably avoid oatmeal completely as it’s often contaminated with gluten.

Phototherapy from the sun is my preferred use. While using phototherapy lamps that emit UV light definitely have benefit, there are a few more risks associated with them due to broader spectrum of the light rays, such a burning, blistering, accelerated aging/breakdown of the skin, and skin cancer. More recently narrow band UVB therapy, which uses a smaller spectrum and thus less radiation, is a better option for artificial light therapy.

Wet dressings can be very helpful in healing eczema when used with natural moisturizers. However, topical corticosteroids are often used and I believe they’re a bad long term strategy for the reasons given above.

My Methodology for Healing Eczema

While some of the commonly used treatments listed above can be helpful at soothing or even resolving some symptoms, they’re all missing the most important factor: addressing the ROOT CAUSES.

Even if you’re in remission and asymptomatic, you’re still at risk for a flare up because you haven’t addressed the important factors lingering beneath the surface. You’re trigger might be work, family, or financial stress, a stomach virus or infection, passing of a loved one or pet, a divorce or separation, moving to a new town or job, or even injuring yourself exercising.

My major trigger was always work related stress (or not addressing it) as it is for so many that suffer from eczema.

The good news is that I healed my eczema and we, together, can heal yours too.

My process starts with a detailed history, from birth until now, that identifies all of the contributing factors to your eczema and what potential root causes need to be investigated.

Next we order the appropriate tests to identify your specific and individual underlying causes.

From there, I design a comprehensive program based on your results and history that addresses all of your root causes in a systematic way. We don’t throw the kitchen sink at you all at once and hope it works. Instead, the plan is outlined in a step-by-step manner that makes it easy for you to follow and allows your body to heal.

If you’re tired of living in the eczema cycle of remissions and flare ups, or have an active, raging outbreak that itches so bad and looks so horrible it’s affecting every aspect of your life and you don’t think it will ever end, I invite you to work with me and my team to heal your eczema for good.

We’ll work together to put the pieces of your health puzzle in place. We’ll guide you at every step with a plan of action to get your body healing and skin happy again.

If you’d like 1-on-1 support troubleshooting which root causes are contributing to your Eczema, and get a specific plan to reverse it, the first step is to book a 1-hour “Eczema Root Cause Troubleshooting Session”.

 

 

 

Strict Elimination Diets are Possible- Part 4 of 4 (High Points, Personalization, & The Next Phase)

My 28 day Autoimmune Paleo Rotation diet is complete! This was a great learning experience for me since I haven’t done an elimination this long in 2 years, and even more, never one this strict.  This diet was more stringent than a typical rotation diet since it didn’t give any variability within each day as you’d normally get in a rotation. This makes it easier to plan and execute, in my opinion. You don’t have to think too much, kind of like wearing a uniform to school or work!

I feel great! I estimate my symptom reduction in the ballpark of 90-95%.

Itchy red bumps on my skin, random itching all over my body, light acne (associated with hormone fluctuations), and occasional headaches were my primary symptoms. I also tend to get ringing in my ears and a sore tongue or cankers with certain foods. The skin and tongue issues had been getting progressively worse, and if you recall from the beginning of my journey, I actually got a true hive. That was what I was afraid of all along! As often is the case in the healing process, sometimes things get worse before get better which I expected.

Now I only get the occasional itchy spot, not even every day. There’s no redness associated with it either. I haven’t had a headache (other than the virus) during the entire process.  My tongue is much less reactive, and I realized might be my canary in the coal mine. It seems to be one of the first symptoms to show up when I have a reaction to a food. Similarly, my soft palate may also burn. Any symptoms related to hormones have significantly reduced too. I have more energy and better sleep too. I’d say this was a successful experiment!!

The High Points

New Baseline Established. This is a really important point. Now that I’ve had a significant reduction in symptoms, I have established a new baseline. When I reintroduce new foods and observe for symptoms, I’ll use this as my new set point to gauge any reactions.

The big take-away here is that your baseline can and will fluctuate with therapeutic interventions. At the beginning of the rotation, I’d say mine was a 7 (with 10 begin horrible symptoms), and now it’s a 1.5. It’s always important to have an idea where you’re at so you and any practitioner you work with can measure progress.

Simple Food Tastes Really Good. I’ve always been a fan of bold flavors, but I realized that eating food prepared in a simple manner can be amazing too. A “hash” of ground buffalo, kale, and sweet potatoes with a little sea salt and oregano is really tasty, as are many other combinations. Eating this way gives the opportunity for high quality ingredients to sing.     

I Never Felt Deprived. This was probably the biggest revelation of all for me. I thought I’d miss having elaborately seasoned dishes with lots of ingredients, but even more, I thought I’d be starving. Neither were the case. I was surprisingly satiated the entire time. I made adjusts for increased physical demands on workout days, but I was never, ever starving. Nor did I ever feel like I was missing out by not being able to eat certain foods.

Symptoms Can be Confusing to Navigate Even for a Trained Professional. When you have lots of symptoms that fluctuate on a daily basis, especially at the beginning, it can be difficult to figure out what’s causing them. During those times, I relied heavily on my diary to track what I thought the likely culprits were. When I ate those foods again I knew to look out for reactions. I also knew not to combine them with the other suspect foods. I still don’t know with 100% certainty about a few foods. I’ll consider testing for them when I’m through the entire process if I think they’re still a possible issue.

The Healing Capacity of the Body is Amazing. I’d been experiencing my symptoms on and off for almost a year and a half. I’d take a couple foods out of my diet or try certain supplements, but nothing seemed to make them completely go away because I wasn’t doing the right things. I knew the first step was to do an elimination diet to get the food situation under control.

I’m shocked at how rapidly my symptoms declined. At the 2.5-3 week mark I largely felt as good as I do now. That’s pretty darn fast.

The Process Really Wasn’t Difficult.  One of the biggest ways we tend to psych ourselves out is to think that doing something different will be hard, which often delays or prevents us from starting new things.

Once I wrapped my brain around what I needed to do and got into the groove, I was set. The first 2-3 days were a little rough, but I made it through and then it became my new routine. I plan on maintaining these new routines as they are since it was so easy to follow.

The Hard Truth…You Are The Only Thing Standing in Your Way. We are in control of ourselves- period. We often sabotage our goals with negative self-talk or excuses. We can come up with all sorts of reasons why it isn’t a good time to do an elimination diet, lose weight, or quit sugar, gluten, or smoking, but they are purely justifications to make ourselves feel better about not doing what we know we need to do.

We all have lives. There will always be work, events, holidays, finances, stress, etc.- that won’t change. What can change is how we think about things. That is what will allow you to achieve any goal you have.

During my month long elimination I had St. Patrick’s Day, Easter, and my birthday, as well as everyday life and a day long road trip. I decided not to let that stop me. I planned so that I could successfully make it through the process.

The Next Phase

Since I’m feeling so good I’m staying on the rotation in an expanded way for 2 more months. My plan is to add more foods back in systematically. I’ll test them on day one, and won’t add anything else new in for 2-3 more days. If I react to a food, I’ll keep it out of my diet for 3-6 months. If I don’t react, it will become part of my rotation.

In general, when adding foods back in, I usually start with things I like that I don’t seem to react to. I usually save possible problem foods for later.

I’m starting with eggs because I don’t think I react to them and REALLY miss them. So far, so good. No immediate reactions, so I’ll eat them again today two more times. I’ll watch for delayed responses to the eggs over the next 2-3 days. After that I’ll probably test walnuts, then pumpkin seeds. I’m not sure after that?? I’ll also continue to record everything.

I know in the past I may have had some type of reaction to tomatoes- usually cooked in combination with a high protein meal. That will probably be one of the last things I test since I know I’ve had issues in the past. I will also test raw tomatoes in a salad and see if I handle those in a different way since the preparation can be a factor as to if you’re going to have a reaction as well. For certain foods, it’s a good idea to test raw and cooked variations.

It’s never a good idea to jump back into your old habits or patterns that you had when you weren’t feeling well. Some people are just “dying” for certain foods and an alcoholic beverage. If that’s the case, you really need to check in with yourself and figure out where you’re feeling deprived or unfulfilled in your life because there’s a good chance you’re filling a void. No, you don’t need bread or cheese or ice cream, or beer, or whatever…. you want them. There’s a big difference.

Personalization

I believe another key to success and enjoying a diet of any kind, but especially a rotation diet, is to eat foods you like that are allowed on the program. There is always room for personalizing the menus to suit your tastes. Don’t be afraid to try new things either. I realized I liked lamb and collard greens, but don’t like dandelion greens.

Adjusting quantities to meet your caloric demands is also important. A 125 pound woman that does yoga and walks will need substantially less than a 125 pound woman that lifts heavy weights or trains for triathlons, or 225 pound guy that competes in strongman competitions.

Supplementation is another opportunity for personalizing. As discussed in the previous post, digestive enzymes and betaine HCL are good support supplements for a program like this, but many other types of supplements would work well here to support healing.

Once you’ve gone through the process of a 30 or 60 day elimination and still have some symptoms, testing may be the next logical step. GI infections are often the root cause of leaky gut and food intolerances, so identifying and treating them will often provide the last piece of the puzzle you need to heal and feel amazing.

I previously worked on Candida and some dysbiosis, so I’m focusing on rebuilding and supporting my flora as an ongoing part of my program.

Final Thoughts

This was an awesome experience that was long overdue because of my own procrastination. Once I get through the next month or two of the expanded rotation and testing foods, I’ll take what I’ve learned and apply it to my normal diet. I’ll keep the rotation feature in because I think it’s a bad idea to get into the habit of eating the same food daily. I’ll also expand my diet as wide as possible since I believe in varied nutrition- somewhere in the realm of Paleo-AIP plus. I add the “plus” because I know I handle certain foods well that aren’t considered Paleo or AIP. For example, I tolerate certain legumes and quinoa when prepared properly. While I don’t think it’s a great idea for me to eat them daily, I will eat them on rare occasion with no issues.

The take home message is to tune into your body and listen to what it tells you. Make adjustments as you need to. There’s a whole lot of wisdom and guidance at your fingertips every single day- you just need to be open to hearing it.

 

Strict Elimination Diets are Possible- Part 3 of 4 (Supplementation and Keys to Success)

Completing 3 full weeks of this elimination diet has definitely enlightened me. This process is getting more and more interesting as I go through it! This week I tried ground lamb, collard greens, and sunchokes (Jerusalem artichokes) and loved them! I also had dandelion greens and hated them- so much so, that I tossed the whole batch after a couple of bites.  Some experiments work, some don’t. Below are some more diet observations and thoughts about supplementation while on this rotation diet.

Diet Observations and Progress

Days 15 and 16 were not the best. First, my 3 year old got a virus on Easter that peaked on Monday (Day 15). The poor little guy was miserable and I was a little itchier than the previous day or two. My itching subsided after breakfast and I made it through the rest of the day relatively itch free. The following day however, the itching increased a bit, even after breakfast. To make matters worse, I got the virus too. I was congested, sore, and had a headache. I took a homeopathic blend, maitake mushroom extract, and upped my vitamin D, antioxidants, and probiotics to see if I could decrease the severity and duration of this lovely virus.

On Day 17 when I woke up something interesting happened. I was way less itchy (like 95% less) and it remained that way for the entire day. Not even a minor hint of irritation anywhere. I was also feeling better than the previous day. Still congested, but less fatigue and achiness. Nothing changed in my diet, so I assume the cocktail of supplements I took helped my immune system with the virus and my itching, so I decided to keep the regimen going.

Day 18 and 19 brought very minimal morning itching upon waking that left about 30 minutes later. I also felt much better concerning the virus. Symptoms were a down about 85%. I felt so good on Day 19, I went back to the gym. I didn’t push too hard and felt pretty good. I definitely got fatigued faster than usual, but listened to my body and backed off when I needed to.

I had another interesting finding on Day 19. I weighed myself and was 6 pounds lighter than Day 1. This diet is not calorie restrictive in any way. You can eat what is necessary to maintain your activity level. I believe a combination of factors contributed to the weight loss- decreased total calories, decreased total carbs, improved blood sugar handling, and decreasing inflammation.  I eat 3, sometimes 4, whole meals per day and I feel completely satiated most of the time. This was really intriguing to me. I realized that even though I ate a 90% Paleo diet, I was still not regulating my blood sugar well since I’d often be ravenous 2-3 hours after a meal or shortly after a snack. Not good.

I also recognized that I am very sensitive to protein amounts and form. If I don’t eat enough whole food protein with my meal I’m prone to being hungry sooner. Before, I was eating too many “pre-digested” foods such as protein shakes and bars that didn’t help satiate me.  Getting enough whole food based protein with fiber and fat= satiety and improved blood sugar regulation.

Increased energy and almost zero itching defined Days 20 and 21. Things are definitely moving in the right direction!!

At the end of 3 weeks, I have about a 95% reduction in the symptoms that prompted me to do this diet in the first place. I haven’t had any red bumps, welts, or hives in over a week, and the itching has significantly diminished.

I couldn’t be happier with my progress! I’m also learning more fine details since I’m paying so much attention to my body.  I realized early in week three that if I have too much betaine HCl it makes me feel fatigued after a meal. I had upped my dose to 4. I didn’t feel much in the way of other symptoms, just profound fatigue. I backed the dose down to 2 (3 when eating certain meats) and feel fine again.

Supplementation

Taking supplements is always a very individualized experience. We usually don’t all need the same things, however, if you’re doing a program that is designed to decrease inflammation and heal the gut, then there are some things you can try to improve the program.

My top two for increasing nutrient absorption and taking stress off of the digestive system are Betaine HCl with Pepsin and Digestive Enzymes. Lacking enough of these can result in amino acids, vitamin, and mineral deficiencies, as well as an increased chance of GI infection from decreased barrier function and protection.

Probiotics also give you give good bang for your buck. During this program I’m taking both S. boulardii (10 billion cfu) and a 100 billion cfu Lactobacillus and Bifidobacterium blend. S. boulardii has many benefits, but I chose it since it improves host immune defense, decreases inflammation, and helps combat harmful microorganisms. I selected the blend because Lactobacillus and Bifidobacterium species support a balanced intestinal ecology and microbiota, enhance the immune response, and support bowel regularity and transit time (how long it takes your meal to get broken down, absorbed, and exit your body).

Beyond the above suggestions, I recommend adding most nutrients based on known depletions or imbalances, or for a specific reason such as getting sick. I added in the stack of a homeopathic, maitake mushrooms, with increased levels of vitamin D, an antioxidant blend, and probiotics since I knew I had a virus. I plan on doing this as long as I don’t feel well, but I’ll stop once I feel better.

Other supplements that are common for reducing inflammation are curcumin, boswellia, and higher dose fish oil. GI support and healing supplements include glutamine, n-acetyl glucosamine, colostrum or proline rich peptides (PRP).

I’m a fan a cycling supplements or using them when needed. There are very few things most of us need to take forever. Paying attention to your body can also help guide you. You may realize that something that once helped may now be an issue for you. Stop taking it or decrease the dose.

Keys to Success

Success in any lifestyle change, including diet, involves a few key steps that set the stage.

Planning. Plan your meals out one week at a time. Sit down on the weekend and outline what the next week will look like for every meal and snack. Each time you go to the store or farmer’s market (and you’ll definitely be going more than once per week if you’re eating fresh, whole foods) have your list. If they don’t have what you planned on, feel free to adjust on the fly. Just make a substitution!.

Also plan on how you’re going to prepare the food to accommodate your schedule. I started cooking earlier in the morning, or sometimes with a slow cooker overnight.

If you’re going out to eat, look for places ahead of time that can accommodate your needs. Don’t be afraid to call. So many restaurants now are willing to accommodate dietary needs- you just need to ask.

Planning takes away guessing and stress!

Record everything. I have a spreadsheet that has columns for my protein, fat, carb, and seasoning sources (also doubles as my grocery list). I also record any symptoms, improvements, general observations, and changes I make (such as adding or eliminating supplements or foods). This makes it easier to make necessary adjustments and have an accurate record of what actually happened rather than guessing.

Be mindful. Tune into your body and pay attention to everything. How do you feel mentally and physically during the diet? Do certain foods give you reactions? Do you feel more energy? There is endless input that your body provides as feedback. Take note and respond accordingly.

Also be grateful for each meal. Everything on your plate was once a living organism that was harvested to provide you with life giving energy. That’s something to be tremendously appreciative of.

Reduce your stress. Your body will heal faster the more you reduce your stress. If you feel stressed, take a step back and do some deep breathing or sit and meditate for a few minutes. Journal, exercise, talk, dance…. Do whatever it is that makes you feel good.

Minimizing your sources of stress is helpful too. Reduce your responsibilities, ask for help, and say “no”. These are empowering tools if you use them.

Be adventurous. I mentioned at the beginning of this post that I tried several new foods. I loved some and hated some, but the point is that I tried. You’ll never know if you actually like something or not unless you step out of your comfort zone and try it. Some of the ugliest and scariest sounding foods are quite tasty.

Practice self-forgiveness. If you slip up it’s not the end of the world. Get back on track and keep moving forward. We’re all human.

Enlist support. Having a buddy to go through this with is always helpful, but if you don’t have one, let your friends or family know what you’re doing and why it’s important. There are also online forums that can provide support too.

I’m excited to see what’s in store for the final week. I hope the positive trend continues! Next week I’ll discuss food as medicine and big picture take-aways.

Strict Elimination Diets are Possible- Part 2 of 4 (Working Out and Adjusting Your Program)

Week number two is in the books! There was definitely less drama on the skin side (no hives or red bumps= win), but there were definite peaks and valleys. Overall I’m feeling great for the most part.

Diet Observations

Monday was Day 8 and I felt amazing 90% of the time. I had lots of energy and significantly less itching than Saturday and Sunday. My workout was great and my brain was firing on all cylinders. The only bump in the road on this day was a little gas with my acorn squash at dinner. I plan on testing that again soon to see if it was random, or if I have issues with acorn squash.

I added in progesterone (only cycle days 15-28), DHEA, licorice root extract, an adaptogenic herb blend, and vitamin C to help support my hormones and adrenals again. Curious to see if it makes a significant difference in my symptoms.  I’ve been recovering from adrenal fatigue and major hormone depletion since the birth of my son 3 years ago. It’s considerably better, but far from 100%.

Days 9 and 10 were positive as well, with high energy all day, however, the itchy skin and runny nose seemed to be making a bit of a comeback. By the evening on Day 10, I considered the itching moderate. It’s strange too since there’s a completely random distribution- palm of hand, scalp, belly, or arm- really anywhere. There aren’t any red spots or welts of anymore, just itchy skin that isn’t even pink or red most of the time. I’m still trying to make the connection between certain foods and the itching flares, but there’s no obvious link yet. I have a few other theories on my itching too, but I’d like to see if I can eliminate the GI causes first.

Another Day 10 observation was that I have a harder time breaking down shredded beef than ground beef. I felt as if it was sitting in my stomach for a long time despite having taken my usual amounts of HCl and digestive enzymes. Seems odd, however, the ground beef is already in smaller pieces and easier to chew. I noticed by the end of the day my jaw hurt from so much chewing. I suspect I got a little lazy and wasn’t chewing enough by the end of the day which contributed to the poor digestion.

Day 11 was similar to the previous 2 days, except that I had a little more fatigue in the morning that I suspect was from a killer workout the day before. I knew I’d need to take it easy and do light recovery movements so I wouldn’t over stress my adrenals and nervous system. A positive was that my skin was looking clear and radiant. No sign of any acne or redness. Win!

Anyone that’s done an elimination diet knows eating out can be traumatic, so I was excited and nervous for Day 12. I went out to lunch with my sister which meant extra planning. Luckily, we are blessed to have some local, truly Paleo restaurants here which made my day much easier. Agra Culture Kitchen and Press is an amazing choice if you want healthy food in the Twin Cities. They cater to many diet variations- Paleo, gluten free, vegan, vegetarian, fresh pressed juices and Bulletproof coffee (which I really miss). They made my meal out of the house very easy and stress free. Anyhow…this day was short of miraculous. I was symptom free 90% of the day! No itching (my worst symptom), no runny nose, no NOTHING!!

My nirvana didn’t last on Day 13, sadly.  The itching resumed at a low level in the morning, but after breakfast it was gone again. The main issue today was that I was hangry (hungry and angry). This is usually a result of low blood sugar. I set myself up for disaster since I ate breakfast 2 hours late, which lead to a day of grouchiness (my husband didn’t appreciate it… sorry dear). Clearly my adrenals and blood sugar are still not 100% which I already assumed.

Meal timing and content are important when you have adrenal fatigue. If your calories or carbs are too low, you will feel fatigued and sluggish mentally. Eating at least every 4 hours is a good idea to keep blood sugar and energy levels even throughout the day. That’ll keep the people around you happier too!

Days 13 and 14 also brought perfect, Bristol #4 bowel movements. That’s another big win in my book.

Day 14 was similar to the previous day in that I started out itchy, but it went away fairly early in the day.

Week two was definitely better than week one with several wins and a decrease in symptoms. So far, so good.

Adjusting Your Program on the Fly

I never operate in a “set in stone” manner, nor do I expect my clients to either. Humans have a complex physiology with a seemingly infinite number of variables (many of which we don’t know much about yet). We need to pay attention and tune in to what is happening when we change the inputs (diet, supplements, exercise, stress, sleep, etc.) and adjust accordingly to our own individual needs.

Here are some of the modifications I’m making:

  1. Sticking to lower histamine foods given my reactions in week 1. The histamine issue may be worse than I thought, so I’m trying not to eat leftovers either (which sucks a bit since I’d mostly been making my meals for the day in the morning). Freshly cooked is best with histamine. I’ve also axed fish and shellfish for now which saddens me because I love them. I also realized I may need to test methylation, Candida, and my gut microflora as those can be causes of histamine issues.
  2. Adding in supplements when necessary. I realized I need to use more HCl and enzymes with certain proteins that I don’t seem to breakdown as efficiently. I add in one extra cap of each. I also added in a DAO enzyme supplement to help clear histamine when necessary.
  3. In order to maintain my energy and facilitate recovery post-workouts I added in an amino acid powder with no additives immediately after my workout, plus an extra meal later that day.

There will probably be more to come. The point is that you need to be alert to what your body is telling you and listen.

Hard Workouts are Possible on a Strict Elimination Diet

One of my biggest fears, and why I put this elimination off for so long, was that I thought it would kill my workouts and recovery. You can’t use protein powders like whey, beef or pea, and many supplements you’d replace those with are off the table as well.

This elimination is about as strict as they come, however, it doesn’t limit quantity which is helpful. I also wasn’t used to eating so many purely whole food meals in a day. I have a shake for breakfast half the time and always have one after workouts.

Surprisingly, my experience has been exactly the opposite of what I expected. I generally have more energy and feel more satiated during the day.

My workouts are 80% weight lifting and 20% metabolic conditioning. Certain days are definitely more taxing than others.  I do this 3 times per week and fill in the other days with hiking, sprinting, mobility work, or riding my mountain bike. As a rule though, I always have rest days and listen to my body. If I’m feeling really fatigued I don’t push as hard or I skip a day. I’ve suffered severe adrenal fatigue and really don’t want to go there again.

I eat my breakfast 60 minutes before my workouts to give enough time to digest. I adjust the portion down sometimes if I feel I won’t be digested enough. I’m also taking vitamins and supplements that support energy metabolism (which I also did before).

The second workout during week one was when I noticed a little more fatigue which could’ve just been part of the adjustment period, but I made some changes to be safe. As soon as my workout is done, I have my straight amino acid powder and try to eat within 30-45 minutes to replenish my muscles and prevent excessive soreness. To further aid in recovery, I often add in a fourth meal if I’m feeling a little hungrier.

Strength and endurance haven’t decreased 2 weeks in which I’m ecstatic about. I’m hoping I can maintain this throughout the duration.  So far, lots of energy and normal levels of post-workout soreness and fatigue.

Next week I’ll discuss supplementation and keys to success, as well as my progress update!

4 Simple Ways to Kickstart the Battle Against Inflammation

Inflammation may be the most common term used in all arenas of health now, and deservedly so since we know that it’s the underlying cause of almost every chronic disease on earth. Inflammation is your body’s response to danger signals, sounding the alarms to trigger biochemical processes to keep you alive in times of infection, injury, and trauma. This acute response is a healthy, normal process that is necessary for life. The key is that it begins and ends.

Chronic inflammation differs from the acute response in that it persists without end in response to foods, hidden infections, toxins, nutrient or hormone imbalances, or inefficient physiological mechanisms that would normally counteract inflammation. It’s the type of inflammation associated with disease. The most significant problem associated with chronic inflammation is that it’s largely silent, often causing destruction for many before it’s detected. During the time it is under the radar, the seeds of chronic disease have been planted and one day you wake up with achy joints and muscles, a headache, and digestive issues. You think to yourself, “Did I eat something bad or catch a bug?” All the while, this process has been building for years unbeknownst to you.

When these symptoms hang around for longer than a week or two, that’s the first clue this isn’t an acute infection or food poisoning. What do you do next?

The key to reversing chronic inflammation is identifying all possible causes and healing them, which often can be a long process. Working with an experienced practitioner can help you decide what treatments and lifestyle interventions are necessary after a thorough history and appropriate labs have been completed. In the meantime, there are several simple things you can do to begin tipping the inflammation scale in your favor.

Start on a basic anti-inflammatory diet. At a minimum, eliminate all gluten, dairy, soy, and sugar for at least 4 weeks. An organic, whole foods based diet consisting of healthy proteins, fats and high levels of plant foods is inherently anti-inflammatory. If you find that you still have some level of inflammation or other symptoms, you may need to eliminate some of the other common allergens such as corn, nuts, eggs, or fish. Also consider eliminating foods you eat frequently because even though they may not be common allergens or sensitizers, they could be causing an immune response in you.

Vitamin D3 is often deficient in people with autoimmune or chronic conditions. Vitamin D is a strong immune system modulator, especially with regard to its anti-inflammatory capacity. It also supports healthy gut flora, promotes gut barrier integrity, and activates adaptive immunity in the GI tract which all fortify a healthy inflammatory balance. Supplementing with high doses (10,000 IU per day) for a month to start. Be sure to monitor your 25(OH) Vitamin D serum levels aiming for a range of 50-80 ng/mL.

Essential fatty acids (EFAs) as fish oil, cod liver oil, or krill oil are important to the inflammatory response since humans don’t make them efficiently on their own. EFAs support the immune system by regulating the intensity and duration of the inflammatory response and decreasing the production of inflammation promoting compounds. Short term dosing at 3-6 g per day can help ramp up these effects, however caution should be taken when dosing above 3g daily if you take blood thinners or have a bleeding disorder.

Curcumin, green tea extract, and resveratrol all activate a potent anti-inflammatory pathway called Nrf2. They are far more effective at increasing antioxidant production than typical antioxidants, like Vitamin C or E, in their supplemental form. You can use these as individual supplements or in a combination product.

There are many other good supplements and foods that also decrease chronic inflammation, but the options listed above give you a relatively simple starting place. If you visit Dr. Google, the vast amount of information on treating chronic conditions and inflammation can be overwhelming, so spare yourself the confusion and stress.

Completing four weeks of an elimination/anti-inflammatory diet plus some support supplementation will give you a good idea of how advanced your situation is. If you are making good progress, keep doing what you’re doing, but drop the supplements down to maintenance doses. If you don’t feel better or only marginal improvement, then enlisting some help to dig into the causes may be necessary.