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

Posted On April 11, 2016 By Dr. Stephanie Davis In AIP, Autoimmunity, Diet, Healing, Inflammation, Rotation Diet /

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 2 of 4 (Working Out and Adjusting Your Program)

Posted On March 28, 2016 By Dr. Stephanie Davis In Adrenal Fatigue, AIP, Autoimmunity, Diet, Healing, Histamine, Inflammation, Rotation Diet /

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:

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.
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.
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!

Strict Elimination Diets Are Possible- Part 1 of 4

Posted On March 21, 2016 By Dr. Stephanie Davis In AIP, Autoimmunity, Diet, Healing, Inflammation, Rotation Diet /

As a rule I try to practice what I preach. I also like to try everything that I can before I recommend it to a client, because if I can?t do it, I?m surely not going to recommend it to my clients. Following my own advice, I decided it was time to embark on the Autoimmune Paleo (AIP) rotation diet I?d been procrastinating on. I?ve been having odd symptoms such as single itchy, red, bumps that look like bug bites that show up on the flexor surfaces of my body (think areas with creases like arms, hands, legs, etc.), mild acne, occasional sleep issues, and an irritated tongue with certain foods.

I put it off like most people because there wasn?t a good time- family events, my birthday, travel? the list was long. Timing is just a ridiculous excuse. No time is ever a really good time- you just need to do it. With the gentle nudging from a good friend that is a hard core advocate of the diet, I jumped in.

It required much preparation and planning, but now that I?m one full week into it there?s no problem. I?ll admit I was hesitant because my mornings are busy with a toddler I have to get ready for school, getting myself ready, and work. I had to add food prep to this, but now it?s a cinch since I pre-planned my menu for the week and will sometimes cook things the night before. I?ve developed a rhythm and it?s working, which truly is one of the keys to success of any protocol or habit change.

I thought it would be interesting to share the details of my experience with you since I often ask people to rotate their diet on an SCD, GAPS, Paleo, AIP, FODMAP, or low histamine diet. So here it goes!

The first 2 days sucked! I was tired, brain was foggy, and I was still really itchy. Day 2 was actually worse because I got a headache to boot. This isn?t unusual and I expected it, because anytime you change inputs to the body you often get push back. I suspect my symptoms were largely due to no coffee, less carbs, less total calories, and possible detoxification shifts. A bonus was that I felt completely satiated all day long both days and this NEVER happens for me.

Days 3 and 4 I felt much better- clear brain, more energy, and my itching had decreased. Yay! The only negatives were a little bit of a runny nose with meals and I was extra sore from workouts since I wasn?t having my regular post workout shake. I decide to add in a smaller 4^th daily meal right after the workout which helped.

Day 5 was similar to days 3 and 4, but I didn?t have a bowel movement. Red flag! That?s not what I want to see happening and I wasn?t sure why? yet.

I went downhill fast on day 6 and the lack of bowel movements continued. That morning after I ate my breakfast I was super itchy, got an actual hive for the first time, my runny nose was out of control, my tongue was irritated, and I slept horribly. The light bulb went off in my head and I realized I had eaten foods that I had long suspected I had issues with (plantains and avocado) or those with higher histamines (shellfish) over the previous few days. This was enough to trigger a fairly significant inflammatory reaction in my body. I took some anti-inflammatory enzymes, DAO, high dose vitamin C and fish oil which got the reaction to calm down in less than 12 hours. This illustrates a huge point I always tell my clients: even though a diet says you can eat a food, it may not be tolerated by your body!! We all need to individualize our diets for our own needs.

Day 7 was definitely better. The hive was gone, the itching and runny nose significantly decreased, sleep was better, and the BMs returned! I?m still feeling completely satiated on 3-4 simple, whole food based meals per day and I?m back on track. Next week I?ll report back on my progress and talk about how to deal with workouts and performance on diets like this.

10 Tips to Minimize Healing Frustrations and Time

Posted On February 2, 2016 By Dr. Stephanie Davis In Functional Medicine, Healing, Lifestyle, Working with a Practitioner /

The truth about healing is that it?s hard and often very frustrating for those going through it. I get questions from my patients on a daily basis about the progress of their healing journey. I refer to it as a journey and not a process because it truly is something that dramatically impacts your life and becomes a part of who you are. ?It encompasses serious self-analysis, lifestyle and habit changes, and often therapeutic interventions to change physiology and gene expression. People don?t understand why a certain protocol, lifestyle or dietary change is making them feel worse or isn?t working. That?s when I launch into the discussion about individuality, as well as the difficult truth: healing is hard.

There are a few things that many practitioners don?t like to talk about and a big one is the difficulty of the healing journey. This does patients a disservice because they need to understand that healing takes time, effort, and often a good amount of detective work because finding the root causes can be challenging when they?re buried under years of symptoms and physiological adaptations that have occurred as your body works hard to right the ship to keep it afloat. The body often does a good job of this unbeknownst to you since there are many built in back up processes always aiming to keep you alive and as healthy as possible. However, when the insults become too numerous, changes start to happen. It generally isn?t until the boat has ?sprung a leak? that you feel bad enough to do something about it. This process can take years or even decades to develop, so reversing it is hard and often takes years as well. Don?t worry though, healing can and will take place- it just takes time, effort, and perseverance.

There are ways to make the journey easier, saving time, energy, and money. Some of the work regarding diet and lifestyle can be started on your own, but if you have a complex or chronic case, working with someone else will likely save you lots of frustration.

Work with a trained practitioner that understands your case. There is abundant information available on the internet that allows you to research who is the right fit for you, which is very important. Additionally, if the practitioners you?re looking at do free consults or Q&A sessions to see if you?re a good match, take advantage of that.
Doing a complete functional medicine assessment illuminates the journey for the practitioner and the patient. Going back in time starting with pre-birth and pertinent parental history, then walking through birth, childhood, and adulthood in detail allows a timeline to develop that shows major illnesses, exposures, traumas, habits and life events that eventually snowballed into how you feel today. Always tell your practitioner the entire story and truth so you have a complete timeline and don?t need to waste time backtracking once you?re on your healing journey. What may seem insignificant to you, may be of massive importance to your practitioner in uncovering potential causes.
Complete necessary testing to avoid frustration and guessing. Many well intentioned practitioners treat without testing. This isn?t a good idea in chronic cases where the symptoms of conditions are very similar. A good example is with digestive symptoms- diarrhea, gas, and bloating can be cause by many things including SIBO, yeast, parasites, food allergies or intolerances, exposures to toxins, altered microbiome, autoimmunity, etc. Often several of these are occurring simultaneously. Testing allows you to have a more targeted therapeutic plan.
Develop a game plan that works for you and your practitioner. If you don?t think you can handle certain aspects of the treatment plan, let your practitioner know. Most will accommodate your wishes whenever possible- but be honest with yourself. Do you want to alter treatment because you don?t want to do it (such as eliminate foods from your diet) or truly can?t. These are some of the hard truths we have to face when healing. Eliminating foods from your diet and changing your stress response, exercise, and sleeping habits may be challenging at first, but eventually they?ll become habit? it does get easier.
Stick to your guns when temptation strikes. When other people try to sway you away from your healing path, don?t let them. You probably look much better on the outside than you feel on the inside, and they just won?t understand because they?ve never been through it. Sometimes people just flat out ignore what you tell them. Don?t let them ruin what you?ve worked hard for.
Develop strategies for social situations. Hopefully your family understands your journey, but outside the home can be more difficult. If you are going to a social event, preplan and research as much as possible to avoid speedbumps that slow healing. For example, offer to bring some appetizers to the Super Bowl party you?ll be attending so you have something you know is safe for your diet. Additionally, you can make the host aware of your situation and he/she will likely consider you when planning.
Avoid doctor Google. While the internet is an amazing tool for research and empowering yourself, too often people compare themselves to others that were ?miraculously cured? by taking a supplement or going on a special protocol. This occurs much less often than you think, and some of these people are leaving out serious details or just plain lying. The truth is that you and every single other person on this planet on genetically and epigenetically different which means you won?t have the same response to supplements, diet, and lifestyle changes. Eliminate your frustration by not comparing yourself to them since you don?t know the details of their history. Also important to note is that on certain sites some of these seemingly honest testimonials come from people that are paid by companies with motives and agendas. The key to healing is doing what is best for YOU (the insert-your-name-here protocol).
Be honest with your practitioner when they ask if you?ve followed the treatment plan. Avoiding the truth will make it more difficult for you and your practitioner to figure out what isn?t working when problems arise (and they will).
Understand that there will be bumps in the road along the path to healing. There is a reason the terms ?healing arts? and ?practicing medicine? exist- there is no magic pill or protocol that will fix you so as practitioners we must analyze the information and make our best effort to design a treatment plan for you. Since everyone is a unique individual and there?s still so much we don?t know about the human body, it may take some time and effort to find and address all root causes.?Additionally, it takes time to change physiology which is imperative to healing. There is often pushback in the form of reactions and additional or increased symptoms while the body adjusts. This is normal and expected, so unfortunately you have to push through it most of the time. If the symptoms last for an extended period or are severe then treatment should be adjusted.
Be kind to yourself during the journey. We are often our worst critics. Don?t beat yourself up over missing a dose of supplements or not getting to bed on time one night. Life happens! Acknowledge the mishap, forgive yourself, forget it and get back on your plan. Stressing will only make the situation worse and prolong your healing.

Following the above can help make your healing journey smoother and also give you an understanding that healing doesn?t occur overnight. The analogy I often use is the healing is a marathon and not a sprint. There are hills and valleys, but in time the road becomes smooth, you hit your stride and things get easier. Eventually you round a corner where you feel good more often than not, which is a good sign that the finish line is near. For some it takes months, but for others it can take years. There is no way to predict how long, but if you?ve felt poorly for years, it may take years to heal. But take heart in knowing that it?s possible since so many before you have.