Still Looking For My “Missing Link”

September 29, 2012 in 2012, Sarah's Personal AI Struggles

This post is about frustration.  My frustration.  With my [expletive deleted] autoimmune disease that seemed to be improving dramatically in the late spring, then flared after eating tomatoes in July.  And three months later, it’s still not getting any better (although thankfully, I seem to have stabilized and am not getting any worse).  I get that nightshades are a problem for me, but what happened?  Not what happened to cause the flare (clearly tomatoes and stress), but why is it taking so long to heal?  What am I doing wrong?  Or maybe more importantly, what was I doing right before?!

The reason why my blog has so much autoimmune disease content on it is because I personally suffer from an autoimmune disease called lichen planus, a skin condition similar to psoriasis where itchy, painful, scaly purple lesions cover my ankles and shins (I have had lesions on my wrists and forearms in the past, but these have fortunately not reappeared with the current flare except for a couple very small spots).  Understanding which diet and lifestyle changes can mitigate autoimmune disease is something I am personally vested in and care deeply about.  I am constantly trying to understand the various facets of the paleo diet autoimmune protocol, research nutritional and herbal supplements that may help, and tweak as many different aspects of my diet, lifestyle and environment as I can to get a grip on my disease.

So, what was I doing right in May and June that saw such dramatic improvement?  I was following the autoimmune protocol (with the notable exception of occasional bites of nut- or egg-containing foods).  This was before I gave up coffee (yes, for those of you keeping track, I am still too chicken to try reintroducing it).  I spent a good amount of time outside (but I was still outside a good amount after the flare too).  I went on an amazing weekend trip to the beach with my family (stress relief?) and got a sunburn (vitamin D?).  I got sick immediately upon returning home (did I take any immune support supplements like zinc, Vitamin C or Echinacea?  I can’t remember, but it’s likely.).  I didn’t wear any makeup for a few days between the vacation and being sick (I know my make-up is gluten free, but maybe there’s a chemical sensitivity piece to this puzzle?).  I was eating similarly to how I eat now (maybe more coconut oil because I was drinking it in my coffee?).  I was getting about the same amount of sleep as I am now (and I’m sleeping way more soundly these days which should help!).  My activity level was about the same.  Am I more stressed now?  Even though I am sleeping well, I do feel quite tired, but that may just be a symptom of the flare.  Do I need to go back to the strictest version of the Autoimmune Protocol for a while and the reintroduce the foods that I seem okay with?  There’s just nothing obvious and it’s so frustrating!

Being frustrated makes it harder to comply with a very restrictive diet.  For me, the hardest part is sticking with the low sugar aspect of the autoimmune protocol.  I’m hanging in there, but I find it’s more of a battle and much more willpower and discipline is needed these days than usual.  I have added some supplements in the last couple of months (notably Fermented Cod Liver Oil and L-Glutamine), and these do seem to be helping and I think are a large contributor to the fact that my lesions are no longer growing.  I am working to switch up any supplements I was on that had potentially irritating fillers (mostly trying to steer clear of magnesium stearate).  I am also in the process of going chemical-free in my house.  I gave up shampoo in late April.  I am in the process of giving up my skin care products (and this one is tough for me because I’ve always liked them!) and moving to just using Tropical Traditions Gold Label Coconut Oil on my skin (actually, my skin is looking pretty great so far!).  I am giving up makeup on a trial basis (this one is hard!).  I didn’t like the Tropical Traditions deodorant so I’m still trying to find a chemical free solution for that (next thing to try will be making my own).  I have switched to Tropical Traditions liquid hand soap (which I LOVE!  I’m even using it to shave my legs and it’s awesome).  I have stopped buying our old cleaners and we are switching to a combination of different chemical-free cleaners and using vinegar too.  I am giving our tap water a very critical eye and am making an effort to only drink filtered water (I already did this for straight water, but I’m also trying to use filtered water to make tea and steam veggies etc.).  I feel like I’m constantly tweaking, constantly trying to find my missing link.  And the more I research and learn, the more possible culprits there seems to be.

When we recorded this week’s episode of The Paleo View, we had Diane Sanfilippo of Balanced Bites and author of my absolute favorite paleo resource book Practical Paleo (seriously, I cannot recommend this book highly enough.  You can read my review here).  Diane is one smart woman plus super nice (is there any better combination?!).  She was kind enough to chat with me a bit about my disease and what I’ve tried so far after we finished recording.  Very reassuringly, Diane confirmed that I’m on the right track.  She had some good supplement ideas, which I am going to try (changing up my vitamin D3 supplement, adding more fermented cod liver oil, trying a gamma linolenic acid supplement, using the Green Pasture Beauty Balm on my lesions, going to a tanning bed, and continuing with my efforts to reduce chemical exposure by changing beauty products and household cleaners).  I will be doing my best to change only one thing at a time, so this may take a while.  But, it helps me to have a plan.

Diane also had something really important to say that I needed to hear.  Sometimes these things just happen.  For people with autoimmune disease, there is no cure.  The disease can be in remission for years, maybe our entire lives, and it feels like it’s gone, but it isn’t really.  You can do everything right and still have a flare (the converse is true too; some lucky people can do everything wrong and still reduce symptoms).  Lichen planus is known for flaring up for 3-5 years and then mysteriously subsiding.  I hope I don’t have to wait years.  I hope I can figure out my missing link.  There is much more that is not understood about autoimmunity than understood.  And there is so much that is individual.  It’s about much more than just diet.  And time is such an important factor.  I might be doing everything right and all I need to do now is be more patient.  That’s not easy.

So, what do I do when I’m frustrated?  I take some deep breaths and try to focus on the positive.  I have a plan for the near future thanks to the brilliant mind of Diane Sanfilippo.  I have an amazing paleo support network developing around me because of my blog (that means you!).  My lesions are no longer getting worse (big sigh of relief) and I do not have to slather my skin with steroid creams to make it through the day.  Actually, that’s pretty positive, isn’t it?  Maybe all I really need to do is redefine success?

Gut Health for Kids

July 31, 2012 in For Babies, For Older Kids, For Younger Kids, Gut Health

(Created as a guest post for The Paleo Parents)

Gut health is essential for overall health.  A healthy digestive tract is efficient at absorbing nutrients from your food, protecting the body from foreign invaders including mounting appropriate immune responses when required, and at regulating a wide variety of hormones.  A growing number of health conditions are being linked to poor intestinal health.  As you already know, the foods you eat can have a powerful influence on your gut health (for more information on how grains, legumes and dairy contribute to a ‘leaky gut’, read this post, this post, and this post).  So, what about kids?  A paleo diet is a fantastically healthy diet for kids, as we consume only the most nutritionally-dense foods (I am very fond of the nutritional analysis presented in The Paleo Diet).  It is also a great starting place if your child requires a focus on healing the gut. 

Many of the recommendations for optimizing adult gut health (as outlined in here and here) are appropriate for babies and younger children.  However, getting a child to eat what you know is good for them can be a challenge!  Also, many of the supplements recommended to promote healthy digestion are inappropriate for children (such as digestive enzyme, hydrochloric acid, and apple cider vinegar supplementation; other supplements such as L-glutamine and quercitin should only be given to your child under the supervision of a medical professional).  So what can you do to help them?  Whether you are looking for strategies to heal your child’s confirmed or suspected leaky gut or are looking for ways to protect your healthy child from developing a leaky gut, here are some ideas for promoting a healthy gut for your child (including some practical tips for pulling it off!).

1. Start Them Off Right:  Breastfeeding your baby is the best way to ensure that their digestive tracts develop a healthy diversity of beneficial bacteria.  However, if you face insurmountable obstacles to breastfeeding or have gut dysbiosis yourself (or if your child requires antibiotic treatment), you may want to supplement with a source probiotics to help their digestive tracts establish this essential probiotic diversity.  I chose to supplement with a small amount of acidophilus for a couple of months before starting my youngest on solid foods (I didn’t know any better for my oldest and I still regret it).  I bought acidophilus/bifidus supplements in capsule form, broke open the capsules and put a tiny pinch of the powder in her mouth before nursing a couple of times a day, starting at about 3 months old.  I bought the highest diversity/quality probiotic supplement I could find and changed brands every time I bought a new bottle (I was taking it for myself at the time, so I went through a small bottle fairly frequently).  Other people achieve the same using fermented foods (for a baby or toddler who can’t chew raw sauerkraut, a little of the “juice” around the sauerkraut can be given on a spoon or mixed in with other foods).  It also helps not to start solid foods too early (typically, the digestive tract isn’t really ready for solids until about 6 months old).  I am a big fan of “baby-led weaning” which essentially means that you don’t start your baby on solids until they are ready to self-feed.  For both of my girls, that was around 7 months old (they could pick up small pieces of cooked vegetable or soft fruit, put it in their own mouths, chew and swallow), but many babies aren’t ready until older than this, and that’s okay!  If you are wondering what foods to introduce first, check out my post on paleo baby foods (this post is written for traditional introduction of solid foods, but the information is also relevant to baby-led weaning).  Don’t worry if your child is older and you missed your chance, because you can still…

2. Sneak Some Probiotics Into Their Diet:  Even after your child is eating solids, a continuous supply of good bacteria and yeast in their diet is good for them, especially if you are trying to restore gut microflora diversity after illness.  You can introduce these in the form of kombucha, yogurt and kefir (I’m a big fan of homemade coconut milk yogurt and kefir), fermented vegetables like raw sauerkraut and homemade pickles, and/or acidophilus supplements (you can continue to break open acidophilus capsules or switch to chewable tablets once your child is old enough).  Frequent small doses are more effective than one large dose, so 1 Tbsp of homemade kombucha or coconut milk kefir mixed in with your child’s food or beverage daily is a great way to go (do keep in mind that regular kombucha does have a small amount caffeine).  This is especially important after any infection requiring antibiotics or steroids and after stomach bugs.  Is this important to do if your child is healthy and you are just looking to prevent problems?  The answer is yes and no.  If your child is healthy now, they almost certainly have a healthy diversity of bacteria growing inside them now.  There is no added benefit to including a probiotic supplement in their diet.  Fermented foods however, are still beneficial as these help feed the good bacteria growing in their guts in addition to adding a much greater variety of beneficial bacteria than typically found in supplements.

3. Include some healing foods in their dietHomemade bone broth is rich in glycine, which is very important for healing the lining of the gut and reducing inflammation (for more information, see this post).  My 2.5-year old loves to drink plain bone broth, but it can also be added to mashed vegetables, smoothies and even homemade popsicles! Organ meats like liver (especially if grass-fed) contain Vitamin D, tons of vitamin and minerals, and more glycine than muscle meat.  Just because you don’t love liver, doesn’t mean your child won’t.  It’s a soft meat and many young kids find the texture more enjoyable than muscle meats.  If your child isn’t a big fan, check out my recipes for hidden-liver meatloaf and hidden-liver Turkish meatballs.  Oily cold-water fish is not only rich in omega-3 fatty acids (the highest omega-3 fish are salmon, mackerel, sardines, herring, kipper, anchovies, trout, fresh tuna, and carp) which helps resolve inflammation, but is also high in vitamin D and selenium.  My 2.5-year old loves brisling sardines and both my kids love poached or baked salmon.  There are dozens of neat seafood recipes out there, from salmon cakes to fish sticks (which could be made with haddock, cod, hake, halibut, sole, flounder, bass or perch which are all moderately high in omega-3), which may entice your child to eat them.  The medium chain triglycerides (MCTs) in coconut oil are known to have anti-microbial and anti-inflammatory properties.  Extra virgin coconut oil also contains a large amount of Vitamin E and other anti-oxidants and is wonderful for cooking just about anything, from paleo baking to scrambled eggs (or even just eating off a spoon!).  Coconut butter can be eaten by the spoonful or added to soups and curry dishes.  Full-fat coconut milk (which can be easily made at home) can be added to smoothies or used to make homemade kefir or yogurtGrass-fed meat (and butter and ghee from grass-fed diary) is rich in conjugated linoleic acid (CLA), a fat known to promote healing, as well as providing plenty of vitamins, minerals and having a balanced omega-3 to omega-6 ratio.  My kids love anything made with ground beef, from Swedish meatballs to tacos!

4. Avoid gut irritating foods, including foods you child has a sensitivity to:  Avoiding grains, legumes, dairy, processed foods and refined sugar will go a long way to improving your child’s gut health.  However, if your child is facing an uphill battle with health, there are some other culprit foods worth eliminating as well.  If your child has signs of Small Intestinal Bacterial Overgrowth (SIBO), you’ll want to limit starchy vegetables (see this post for a guide on which vegetables are okay for SIBO and which are better to avoid).  Another class of vegetables that can cause issues for some people are those high in types of sugar that qualify as FODMAPs (Fermentable, Oligo-, Di-, Mono-saccharides and Polyols).  Continued digestive symptoms after following a paleo diet may indicate SIBO or FODMAP-sensitivity (also known as fructose malabsorption).  There is a high degree of overlap between vegetables that are avoided to address SIBO and those that contain FODMAPs.  If you aren’t sure, try an elimination diet approach where you avoid all vegetables which may be problematic for 3-4 weeks and then slowly try reintroducing them one at a time to see if they cause digestive symptoms.  In addition to these vegetables, other foods may be problematic due to development of food sensitivities (this is common in children and adults with severely leaky guts).  You can evaluate whether or not these foods are problematic for your child using an elimination diet approach (where you leave the suspected foods out of your child’s diet for 3-4 weeks and then add them back in one at a time).  Sensitivities to eggs, nuts, seeds, and vegetables from the nightshade family (tomatoes, eggplants and peppers) are common.  Alternatively, you can find a naturopathic physician or chiropractor who can order a food sensitivity blood test (IgG and IgA).  Any foods that your child tests positive for in a food sensitivity test should be avoided completely for at least 6 months, after which you can reintroduce small amounts to see if the sensitivity persists (many sensitivities will disappear after the gut has fully healed).

5. Play and Have Fun:  Kids need both structured and unstructured play time, both active play and quite, focused play time, and both independent and social play time (with other kids and/or with adults).  Having this mix of different types of play is important for the developing brain, but also helps regulate hormones (like stress hormones, which are particularly important to gut health) and helps tire kids out for a good nap and a good night’s sleep (also critical for healing and staying healthy).  And making sure to take time to have fun with your kids is good for your stress levels too! 

6. Get them outside:  If you read my post on the importance of sunlight, you’ll remember just how important it is to be outside for a good amount of time every day.  For kids, it also provides space to run around and a stimulating environment for their developing brains to explore (you get to play and get sun exposure! Yay for efficiency!).  I aim to have my kids outside for at least 1-3 hours every day, weather permitting (I am a big supporter of playing outside in just about any weather as long as you’re dressed for it!).  Beyond the benefits of fresh air and exercise, sun exposure on their skin is essential for the formation of Vitamin D (you don’t want to let them get sunburned, of course).  Vitamin D is very important for healing and reducing inflammation.  If getting outside is not possible for you and/or your child or if you feel that your child may deficient in Vitamin D, it is worth talking to your doctor about a Vitamin D3 supplement.

7. Provide an environment conducive to sleep:  Sleep can be more or less of a challenge depending on your child.  One book that I really like for gentle sleep strategies for babies is The No-Cry Sleep Solution (also available in a toddler through preschooler edition).  The tips that have been most helpful for me and both of my non-sleepers are:  have a rock-solid routine (not just at bedtime but consistent structure throughout the day), put your kids to bed earlier rather than later (they will often sleep longer if they go to bed earlier), and have kids sleep in a cool, very dark room.  A white noise machine may also be helpful. 

8. Don’t make food a battle:  However you chose to introduce food to your child, whether or not you chose to give your child options or only give them what everyone else is eating, don’t make meals a battle.  This means having a realistic expectation of what and how much your child might eat, of how long they might sit up at the table, and of age-appropriate table manners.  Even if you are taking a firm stance, don’t argue or raise your voice.  Stress and food just don’t mix.  And stress can hinder healing.  Keep in mind that, when given a variety of healthy foods, the vast majority of children will naturally eat what their bodies need.  The two most important things that you can do to help your child learn how to eat healthily is do so yourself and present them only with healthy options. 

As a final thought, I believe you are already doing the most important thing you can to help your child get/stay healthy by learning about how food affects the human body.  If you are unsure how to apply any of these recommendations or whether they are appropriate for your child, please discuss them with your child’s doctor or alternative healthcare provider.

TPM Tidbit: My Experiment with L-Glutamine

July 27, 2012 in Supplements, TPM Tidbits

A number of followers have pointed me toward L-glutamine supplementation as a way to reduce sugar cravings, which I experience when stressed or fatigues.  As I started researching the merits of L-glutamine supplementation, I found evidence that it can also speed up healing the gut and reduce systemic inflammation, including inflammation in the brain.  I have started to thoroughly research this topic for an upcoming post, as there seems to be some fairly well understood mechanisms for why a deficiency in glutamine may contribute to a leaky gut.  I started supplementing with L-glutamine two weeks ago, taking 1-2g on an empty stomach between meals 2-3 times a day (I have to admit, I have not been that regular with when I take it because my life has been so hectic lately).  I actually started with a lower dose, but increased to this level after reading the recommendations in Practical Paleo (how cool to read about the benefits of L-glutamine supplementation from such a reliable source just one week after I started!  And as a quick aside, if you haven’t ordered this book yet, I highly recommend that you do!). 

What have I noticed so far?  My sleep has been fabulous.  Even when my kids get me up at night, I seem to slip back into a deep sleep very easily.  I have had far less muscle soreness after particularly challenging yoga classes.  It does seem to help sugar cravings if I take a dose right when I’m starting to look around the house for something sweet to eat that won’t irritate my digestion too much (tough on the Autoimmune Protocol!).  And, I have had higher carbohydrate meals in the last week (stress plus displacement from my home), which normally causes horrible bloating and constipation, and was absolutely fine afterward, no ill effects to my digestion whatsoever.  Now, I have to admit that this experiment overlaps with my no coffee experiment.  So, now I have to evaluate if any of the benefits I am seeing is actually due to my avoidance of coffee (and this is why I always advise changing one thing at a time!).  My plan is to reintroduce coffee while keeping up with the L-glutamine supplements and see how I do (late next week some time I think).