Archive for September, 2009

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Nourishing Traditions, cultured dairy and to VSL or not to VSL?

September 25, 2009

So I wanted at some point to update this blog to document my foray into both the traditional diet via Nourishing Traditions and Weston Price, as well as my kitchen adventures with culturing my own dairy, in the way of making yogurt and kefir. I guess I have been so busy making yogurt and kefir and eating a traditional diet that I haven’t gotten around to it.

I think in my head the entry began something like “Radical diet changes often cure superficial problems. Low carb diets cure a lot of less superficial issues. SIBO specifically can be very successfully managed with a diet low in carbs; but isn’t there more out there than managing symptoms?” I need to get ahead of myself already, though, and answer that after months of slaving away in the kitchen I still do not know the answer, and I also have to ask if any of it is worth my time?

Sometime last winter I started making yogurt in a Euro-Cuisine that we picked up at Williams-Sonoma and making 24-hour yogurt (like the SCD yogurt) with my VSL#3DS. It is not very difficult to do, mostly bringing the milk to boil, letting it cool down again and washing out the pot are the hardest parts, and with the yogurt maker (which isn’t necessary equipment but seems to make things simple for someone not so detail-oriented like myself) I don’t have to worry much about timing or temperature at all. Over the months, its really difficult to say anything but the following blanket statement: I felt a small change. Honestly, I can’t say much more than that. I still reacted poorly to eating the wrong foods, sugars, starches, etc. but I felt that there was a small negative correlation between the amount of yogurt that I ate and the length of time I would suffer bad reactions such as bloating and distention, meaning that if I ate more yogurt then I suffered less.This is a small, but very good thing. I did find, however, that I would have to eat around 21 oz a day of the yogurt to get these results on a consistent basis. So I bought another 8 jars so that I could have 2 batches lagging each other.

I started doing more research on probiotics and I decided that it wasn’t such a bad idea to try experimenting with some other strains. If I had two batches going then I could have one VSL batch and another of a different kind, and I could eat one kind in the morning and one in the evening. I was already paying a staggering amount for the VSL so I didn’t want my experiment to turn into a money sinkhole. I used what was in my house already; Digestive Advantage IBS. I took it by mouth first and I felt that it was beneficial. For starters, I had more bowel regularity. That is not usually a big problem for me; if anything I have the occasional diarrhea. But I do get backed up for a day or two from time to time and in my experience these are dangerous times that can be the tipping point for getting my SIBO symptoms back. So Digestive Advantage was a big win. Then I bought some Culturelle, due to the studies I read on it. I even got a nice little book on probiotics for free from the labs that create the Lactobacillus GG strain. My first yogurt experiments were interesting; I made one batch with VSL only. I made a 2nd with Digestive Advantage and VSL. When the first one was done I made a 3rd batch with VSL and Culturelle. This 3rd batch was a little constipating. Then I realized that with all this probiotic mixing I might have competing strains and could be losing some of them even. So I stopped mixing VSL with the others. The result = kind of crappy tasting yogurt that didn’t seem to do much for me.

Back in time for a moment, I should also bring the reader up to speed on my antibiotic treatments. During this time, I had to go through two more rounds of Xifaxan; one in December of 2008 (this one gave me around four months of  relief) and one in June of 2009 (didn’t work at all.) Both of these were the standard 1200 mg per day for ten days. I took a third round in August – 1600 mg per day for 7 days. This round knocked my socks off. I lost 9 lbs and felt better than I’d felt since I’d first gotten sick. As always is my best intention, I kept a super strict low carb diet during and after the meds. I did not take probiotics during the antiboitic course and I was cautious to add them back in after. I flew to Chicago for a business trip not two weeks out from finishing the course and got bloated on the plane. The first night in the city I was so tired I went to sleep at 9:30 PM. I got up very early the next morning and I have to say that is the last time I remember feeling thoroughly refreshed from a night’s sleep. I went to the gym and then went off to training where I started feeling like I had a cold or allergies. I ate yogurt (from Starbucks or Fage from the grocer) the first two days rather than eat the food that was available to me at work, which was not safe. But by the end of the trip I had had a few food mishaps (in the form of pizza and candy.) By the time I came back to New York I was bloated and tired and I almost immediately started having skeleto-muscular pains. I went back to my regular regime of making yogurt. I also started taking natural anti-microbials like garlic oil, peppermint oil, and wild oregano oil.  And I started looking into the Weston Price Foundation and, as I mentioned in my last entry, bought the Nourishing Tradtions book.

I could go into great detail about adjusting to NT, but as I was already eating low carb, and as I was obviously not able to do everything that the book suggested (read: grains,) it wasn’t a difficult transition. We learned how to make bone broths and we started using a lot more coconut oil. I soaked my nuts before I ate them or made nut butter or flour out of them and I have to say that this had a big effect; I no longer felt like nuts were a “in moderation” food, but they seemed to be pretty safe as long as they were soaked.  (If nothing else comes out of this effort, I have delicious almond crackers that I make with my own soaked almonds, from this recipe.) I tried soaking my oatmeal in kefir but it still cramped me up and made me run to the bathroom. I didn’t start lacto-fermenting my own veggies, because I trialed the super expensive stuff at Whole Foods and it seemed to bloat me. Kefir, on the other hand, seemed like a great idea. I was already buying it in the store (I had recently found out that not all brands were made with FOS/inulin, and it seemed fine, and I felt myself a little addicted to it…dreaming about creamy, yummy kefir all the time.) I got my  kefir “grains” from someone on etsy.com and I started making my own.

Ok first of all, homemade kefir does not taste like storebought kefir. Its yeasty….it smells yeasty, it tastes yeasty and it fizzes a little. I can drink gallons of the storebought stuff in the plain flavor; goat kefir, cow kefir, I love it. This is probably because its made from some type of powdered starter culture, much like yogurt can be, but my suff is made with “grains,” or clumps of beneficial yeasts and bacterias. But my homemade kefir needs a lot of salt and sweet n’low/stevia, coconut milk, cocoa powder, whatever I can find to make it palatable to me. I just don’t really like yeasty drinks; I never have been a big beer-drinker.

So I’m drinking my kefir and I’m making my yogurt, and we’re eating bone broths and we’re making pot roasts in our own broth that we’re making from home. Let me just say here that calorie counting has flown out the window. I have always eaten way more whole unprocessed foods than packaged ones, so calorie counting has always been sort of a bitch but I have made myself do it. But at this point I don’t even feel like its an option anymore. The weight issues that I’m dealing with could be their own entry at this point; so I won’t go into them, but I have put on around 14 lbs. Not just from NT eating and drinking kefir – the weight gain has been going on even longer than that, but NT and all this homemade stuff just isn’t making things any easier.

In late August I read Dr. Alan Logan’s thoughts on VSL#3 and its connection to possible D-Lactate build-up in CFS patients. I can’t say I knew who this Dr. was or was familiar with his work but the he impressed me somewhat with his theoretical framework for D-Lactate buildup and his knowledge on the connection between the gut and chronic fatigue. I thought it was worthwhile to try doing without the VSL.

So that’s kind of where I am now. I’m left with only my unpalatable yogurt so I don’t make it as much anymore . I recently got access to raw milk and even though I followed the instructions on the WPF’s website, I couldn’t get the yogurt to set so I don’t even have any yogurt right now. I do have my unpalatable kefir and I don’t eat a lot of real foods anymore because there are so many calories in the kefir (since I try and drink about 2 to 3 cups for breakfast.) I will admit the kefir tastes a little better now with raw milk.

So that’s where I am – how am I feeling? I am a bit lethargic; its hard to get to sleep at night and even harder to wake up. Therefore I am barely exercising. I have always been a stickler about exercise but between the lethargy and the time spent in the kitchen I just don’t do it lately. I am weepy and sad and angry a lot. I fight with my husband a ton. I don’t drink often but when I do I don’t feel drunk at all and I drink far too much and I wake up very sick, unable to do anything the entire day. When I do cheat or eat off-diet, I have immediate postprandial hypotension in addition to the regular bloating and gas and distention. I’m beginning to get the muscle pains again. I feel most of the time like only part of my brain is working, like I can only do or be good at one thing at a time. If I have a good idea at work or I catch and fix a mistake in our unit’s analysis before a big presentation, then I cannot think of anything funny to say to a friend on his birthday. If I am leaving my friends witty facebook comentary or actually completing a blog entry or yahoo group post, then I cannot figure out where I left my keys.

Last night I went dancing and I expected to not make it for very long considering how lazy I’ve let myself become. But I managed around 2 hours of solid dancing, if not a little more. I came home at the normal time for a late night out Thursday; I am always very tired on Friday morning but honestly once I get through lunch I feel pretty refreshed and I always think of a book I read years ago on natural depression treatments. Sleep deprivation can be a great tonic for depression, but apparently only when the patient is woken early from their slumber, as opposed to taking to bed very late. Today I feel like there must be a gas leak in the house. I woke up to my alarm but not until it had been going off for 35 minutes. I got up and went into the bathroom, where I promptly fell back asleep. At this point I realized I wasn’t going anywhere; so I went back to bed. At 2 I could no longer sleep but I felt far from refreshed. I have been in the kitchen much of the day because our dishwasher recently broke and the place looks like a war zone; there are so many dishes from the kefir alone – the strainer, the smaller strainer, the kefiring jar, the other jar that it goes in when its done, the pitcher, the blender to make the kefir into something I can manage to choke down, and the glass I drink it out of. I have been crying off and on all day; I feel hopeless and depressed. I am very bloated. I feel very guilty for not going to work. Sometime I wish cats weren’t such lethargic animals. Because they have also been sleeping fairly deeply for the better part of the day, I am wondering if something really is wrong with the apartment, but then I remember that they are cats.

And ultimately I know there are about ten different reasons why I could be feeling the way that I am feeling. And I do not know if have the energy to trial them all. I’m frankly quite sick of this. I want to be functional and normal again. I want all of my efforts to pay off. I suppose the immediate courses of action will be to reinstate VSL and natural anti-microbials, and after that I will have to reevaluate the kefir, and after that I will have to reevaluate the NT way of eating, given that thanks to Plant Poisons and Rotten Stuff, I’m aware that its very high in food chemicals (although I have never suspected FCIS for myself, I suppose eventually you have to try everything.) After that, there’s always another round of Xifaxan but I’m frankly longing for the days when it would give months of relief and sick of the current week-long stay of execution.

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Templates for Diet…

September 11, 2009

Diet can start to feel like religion. Especially when its tied up in ethical or political ideals. And even more so when you eat for health and healing.  And why not? What enforces habitual behavior better than ritual?  And what is ritual in food if not daily meditation on the benefits of habits that bring shades of well-being but aren’t necessarily easy to keep?

I don’t know how others might or do feel in my place; I’ve really had to fight the tendency to grasp on to one diet tightly and cling on for dear life, pouring all my hopes and dreams of health into a glass of kefir, a rare steak, or a capsule full of fish oil. I know that my house recently welcomed its first copy of Nourishing Traditions, which now sits on our kitchen counter, already dog-earred in certain spots, and which we only half jokingly refer to as “the bible.”

But it isn’t the bible. Not for everyone. And certainly not for me. I didn’t start this post to talk about why specifically the WAPF way of eating isn’t 100% ideal for someone with SIBO. It isn’t ideal, but neither is Atkins, nor Paleo/Primal, nor the Optimal Diet or the SCD. But these diets do provide something to the typical SIBO sufferer that many dietary paths do not, and that is a template, or a starting place, for a successful diet.  I’m super glad that a small British study recently found that soluble fiber helps a lot of people with IBS, but this frankly just isn’t true for me or a lot of other people with SIBO. 

So look to the sidebar in the next few days for links to great diet templates; starting points for those of us with small intestinal bacterial overgrowth. I’d especially like to invite people with low carb, whole food blogs to submit their picks for sound dietary advice.

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fasting!

September 4, 2009

Oh man, pretty sure I’ve told someone somewhere before that fasting doesn’t help much. But now I’m doing it! I sure do hate fasting. I’m 13.5 hours into it and I haven’t really complained a lot but I sure want to! 

Probably only doing this for 24/48 hours because man I am way too big of a baby to keep this up. Bone broth and gelatin fast. More details to come.

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RLS/SIBO/celiac connection article

September 4, 2009

The Restless Leg Syndrome, SIBO, Celiac Connection

Interesting yet not completely new idea. Be sure and follow the link to the specialists’ site as well.  

I am waiting for the chronic multi-illness/SIBO connection research to catch up with the digestive-distress caused by SIBO reocurrance research (there isn’t much.) I wonder what happens when antibiotics are administered, say the 3rd or 4th time, but do not fully eradicate the bacteria. Do the non-digestive symptoms return and continue the way that the digestive ones do? And what role can probiotics play in preventing these types of symptoms?

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excerpt

September 3, 2009

From an email I just sent to my husband:

I f*ing love food so much. this never gets easier. i see the humor in it a little more each day but it never gets easier.

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The antimicrobial properties of kefir, Gulf War Syndrome and gut bacteria, and the effects of high-fat nutrition on gut flora

September 2, 2009

Some interesting and unexpected research finds today:

On kefir, which I am beginning to make in my home

Resoution of Recurrent Clostridium difficile-associated Diarrhea Using Staggered Antibiotic Withdrawal and Kefir

Antimicrobial and healing activity of kefir and kefiran extract

And a few interesting studies recruiting now…

Bacterial Overgrowth Associated With Chronic Multisymptom Illness Complex
Taking the super obvious connection between SIBO and CFS past the obvious and examining the symptoms occurring specifically in Gulf War Syndrome (GWS) patients! Phenomenal!
And…

A controlled feeding experiment

“The purpose of this study is to determine the effect of dietary fat, in standard formulation, on the composition of the human microbiome in a prospective study of normal volunteers. Participants will be randomly assigned to either a high fat or low fat diet for 10 days. The gut microbiome will be phylotyped in fecal samples as well as in bacteria adherent to the colonic mucosa prior to, and during the course of the dietary interventions.”

I’m definitely going to want to follow these two for outcomes.

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I have spent my whole life in ruins because of people who are nice…

September 1, 2009

At present I’m taking a course of Neomycin. This is my first time on an antibiotic that isn’t Xifaxan, and I’m not liking what’s going on with my body. Lots of bloating, popping out of my clothes, abdominal pain and no appetite whatsoever.

The nicest thing anyone could ever say to me when I tell them how bloated and distended I am is “Wow, I see. I’m sorry.” Barring actually agreeing with me, just a simple “That sucks, I’m sorry you’re going through this” would suffice.

Things that aren’t so cool to hear:

No one can tell.

You feel it, but no one can see.

It probably feels worse than it is.

These are all well-meant as the person is trying to assist me in moving past the discomfort and getting on with my life. That’s great. But it just hurts my feelings. IF I’m complaining to you about my bloating and distention, we’re not just acquaintances – we know each other pretty well! so feel free to acknowledge that you sort of know what I look like! I mean, walking around with my gut hanging over my waistline is not really my normal thing; I tend to buy clothes that fit me. This thing takes over my body and blows me a little bit out of proportion. I don’t think I’m gaining the 6 inches each day that I used to before the diagnosis, but it still gets hard to breathe, hard to wear my clothes, and therefore hard to feel comfortable in my own skin. There’s nothing worse than walking around distended and thinking that even your friends think you always look this way. What’s the point of anything? I think I’ll just wear a potato sack to work! Although first I’ll need someone else to clear all these potatoes out of the way…