Posts Tagged ‘I <3 my Yahoo Group’

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SIBO is not Candida

February 25, 2010

I am seriously always butting in where I am not invited. At least I have learned to give disclaimers, and I don’t shove Atkins down everyone’s throats anymore (although its pretty obvious from your symptoms if you are most people!) and now I’m also not such a candida-denialist. (Thanks to my group and thanks to having been on Nystatin and Diflucan for more than a month now RX’ed by holistic doctor.)

In summary, a woman from California (I mention this only because the entire board is for residents of the Central Coast, not girls in Queens!) asks how to get rid of SIBO “naturally.” Of course the first answer is from someone telling her that she has an “idea” that her SIBO is not actually SIBO but really it is Candida.

It’s really hard for me to sit by and watch people deny that SIBO exists. Sometimes, like in this case,  they are well-meaning people, with a background (either as a patient or a practitioner) in natural medicine.  But often they are just selling something, like Dr. Jeff with his McCombs Plan.

Anyway, I jumped in and here is my response:

The only natural treatment for SIBO with any research to back up claims is enteric coated peppermint oil

I moderate a support group for SIBO with 80 members and therefore speak based on the experience of myself and these folks – I am NOT a medical professional. With that said, I have found that you must take peppermint oil for a long time, (6 months or more) alongside other treatments (antibiotic/probiotic) and you must rotate it with other natural anti-microbials (garlic oil, etc.) if you want it to work.

Candida is very real and can co-exist with SIBO. However, the two are not the same. Just because most people have never heard of SIBO or don’t know a lot about it; they dismiss it and call it candida. Yes the diets are similar but they are not the same thing. SIBO is colonic bacteria inhabiting the small intestine. It is not a yeast, friendly or pathogenic. Even the Environmental Illness Resource differentiates the two.

With a SIBO you have to avoid fructose, and fiber. You need something with anti-microbial properties in order to kill the bacteria that exists in the wrong location. Probiotics can assist in ameliorating symptoms, but if the housekeeping wave isn’t working correctly to move things out of the small intestine and into the large, you might be compounding the problem in the long run by loading up on more bacteria.

I have been researching SIBO for years now and I have not run across a natural treatment. Yet it is an important part of the entire treatment regime because Holistic or natural medicine can work to correct imbalances in the body that create an environment that is SIBO-friendly. For example, SIBO can be caused by an underactive thyroid. A holistic MD who treats thyroid based on symptoms and body temperature may detect low thyroid in an individual who would be told by a conventional endocrynologist that they are “normal.” He or she can then treat the patient’s thyroid, adrenal, testicular and ovarian hormones and bring the patient to hormonal equillibrium, helping to create an environment less friendly to developing SIBO. However, if you take a look at the study linked above, you will see that even after treating for hypothyroidism, SIBO patients still needed antibiotics to kill the bacteria.

Other natural things you can do: Eat whole foods, (you are probably already doing this!) Avoid things that you know bother you, whether they are “healthy” or not. It is also very important to take HcL with meals because stomach acid kills off most infections that try to get into the gut, contributing to most bacteria being in the later part of the intestines (colon or large intestine) where they belong.

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A battery of tests

January 5, 2010

So back to the story of the new doctor. After getting next to nowhere with my health center doc (or her replacement) I went ahead and found a new doctor. I looked around for an M.D. with a holistic practice, willing to prescribe natural thyroid meds (if thyroid turned out to be my problem then I didn’t want yet another fight on my hands) and a demonstrated understanding of SIBO/IBS. And since I would be paying out of pocket, the new doc also had to be in my price range.

A few emails and phone calls later I had found my guy. He didn’t diagnose me over the phone, but he said I sounded sick (obviously he was attempting to curry my favor right away! – imagine listening to me describe my symptoms and then flattering me by saying that I sound ill!) He mentioned a few things that he would look into were I to become his patient, such as low thyroid function and hormonal imbalances as well as fibromyalgia. He recommended me to look over his preferred treatment protocol and told me to call back and schedule an appointment if I liked what I saw. Which I did, so then I did.

Schlepping all the way from Queens to his Brooklyn office in the snow wasn’t easy (regardless of what you see on the map, the two boroughs are not that convenient to each other!) He asked about my symptoms and within a few sentences he was naming them all for me. Salt cravings, weight gain, inability to get warm, low blood pressure, lots of colds, PMS and painful periods. He definitely listened to me when I talked but he did tell me pretty quickly that he had my diagnosis all ready based on just a few answers – adrenal fatigue and hypothyroidism. He gave me a saliva test for cortisol to take home and perform. And a laundry list of bloodwork to get wherever I could and bring back to him for analysis to test for not only thyroid, but blood sugar problems and wacky hormone levels suggestive of Poly-cystic Ovarian Syndrome (PCOS.) He also gave me a prescription for Nystatin to clear up any yeast that I might have.

Walking to the train in the snow with my husband, I didn’t know exactly how to feel. I was exhilarated that someone with medical authority had finally declared me truly ill. I was terrified that I wouldn’t be able to get the tests done at the health center and worried that I could never pay for them on my own. I was a little skeptical and here is why. In a perfect world, where I would name off all of the things that I would suspect might be causing my symptoms, between a lifetime of a sluggish metabolism, suddenly getting ill four years ago, and then crashing into a brick wall this summer with my energy levels, weight control and digestion, he named every last one of my suspicions. Including a few things you really only hear from holistic doctors, things I used to “not believe in.” Thankfully, I’ve recently learned a lot about yeast from a really well-researched Yahoo group member; were it not for her I may have mistrusted any doctor willing to give me an antifungal. I had also just begun to research adrenal fatigue before I saw my new doctor, and between some reputable sources recently coming out about having or suspecting this condition, and every last one of the symptoms fitting me, I think I’m willing to accept it.

So back I went to the health center. Replacement Doctor had put me in for a transvaginal ultrasound to check for fibroids or ovarian cysts. And a chest x-ray for who knows what, my only guess, thanks to a helpful Yahoo group member, (do I talk about these guys a lot lately or what?) would be sarcoidosis. Both were entirely uneventful outside of having to drink about eight million gallons of water in prep for the ultrasound, which was miserable because I visibly and painfully bloat when I have to pee. Additionally, the technician was fantastic; we discussed girl diseases, gluten-free living and dismissive doctors while she probed me!

Then I saw my (old, regular) doc. I told her of her replacement’s dismissive attitude. I told her that nothing had gotten any better. I told her what had happened with the new doctor (I lied and said he was recommended to me by a friend of the family.) I made some purposely muddy statements about family medical history (being adopted, there is a lot that I do not know and in the past this has been held against me.) I sheepishly handed her the list of tests. All while the nurse was getting my BP and other vitals. Then she put me on the scale. “Wow, you have gained a lot of weight.” The words never sounded so lovely to me. She started ordering the tests. One by one, she put in almost every single lab that my new awesome holistic doctor had ordered for me.

I went in again a few days after Christmas to let them draw blood. It took two days of trying to get up early enough to go before work to actually get there. I went over all the labs with the technicians to make sure they would not do the hormone tests; as the doctor had asked me to do those on the 21st day of my cycle. Blood was drawn for a Vitamin D test, (Replacement doc denied me this test since my calcium levels months ago had been fine,) AM Cortisol, DHEA, Iron, B12 (even though I just tested terribly high two months ago) Hemoglobin A1C, and a comprehensive thyroid panel. I had terrible diarrhea after drinking the dextrose solution for the fasting insulin test. I ate lots of carbs that day thanks to getting all freaked out by 75 grams of sugar at 8 AM. I have eaten very clean ever since that day, as my bloating and abdominal aching have been quite bad due to my period. I’m going to go in on the 21st (because my cycle has it like that this month) and have more blood drawn for hormonal testing.

I will get the results of the tests tomorrow. Normally this would be a really harrowing experience and I would be getting a little anxious about going to the center just to get handed a bunch of normal results and told that I really just need to relax and exercise. Instead, I am just not that tense about it now, knowing that whatever the tests say, I will just smile and nod and take the labs to the new doc at the end of the month and let him make the decisions. I am  probably most interested in the results of the ultrasound,  since I had one a while back and never got the results but yet many a gynecologist (I have gone through a few but not by choice) has told me that my lady parts are riddled with cysts and fibroids. And I am a little worried that the health center’s idea of “comprehensive” just isn’t. I was put in for a thyroid panel back in 2007 and it didn’t include the very important free T3 test that my new doc wants. However, these things must be dealt with as we get to them; no more stressing out over future worries. Just a few weeks ago I thought I was staring at thousands of dollars worth of labs and I didn’t think I’d get any cooperation from my health center. Now they’ve done the lion’s share of them already. And I just found out that a program through my job will reimburse part of any of my out-of-pocket medical costs for tests. So anything can happen, and worrying about the future won’t get us anywhere. Bleeding a lot, into several small tubes, however, will.

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white carbs

January 4, 2010

I know with a title like that you are expecting a masterpiece really, a complex tirade bordering on manifesto, containing both opinion and fact, insanely well-researched but perhaps a little preachy….but honestly I think there are plenty of those out there. We all know how bad white carbs are for us, how good they taste, and how bad they are (I’m putting that point here twice for emphasis!) Making the switch as I did from vegan to veg to low carb was difficult emotionally; one thing that made it possible, despite the near immediate symptom minimization, was tons of patient research on my part. Reading blogs, books, articles, etc. about high fat/low carb made it really clear that it was not only going to help me manage my symptoms, but it would probably extend my lifespan and really improve my health!

Sadly, however, there was something differentiating me from all those super hardcore low carbers; something even more obvious than my tepid taste for meat – it was my desire to beat the SIBO and whatever else is ailing me so that I can once again return to eating carbs. I know. Its disgusting. High fat/low carb has done wonders for my health. My cholesterol has gone down from the 180’s (as a vegan) to 169. Go figure! My HDL continues to soar upwards and is currently at 85.  I could never lose weight as a vegetarian; but eating low carb I was able to lose over 30 lbs. I maintained my loss too, until this summer when I began to come down with symptoms of something I suspect I’ve been fighting off all my life – overt hypothyroidism (more on this later.)

So this is my dirty little secret. I dream about carbs. I wish for carbs. I desire carbs. Not just any carbs; white carbs.  Fluffy rolls, steaming baked potatoes, discs of sticky white rice.  And it is in the interest of full disclosure that I tell you this before I talk about the retraction I need to make.

A few posts back I wrote:

First of all, when you have SIBO, fiber becomes fairly indigestible. If you can easily digest fiber, I’ve got news for you – you probably don’t have SIBO. Secondly, most sugars aren’t digestible either, so if you have no sugar, and you have no fiber, all you’re left with is starch. And guess what? While Dr. Pimentel says you can eat all the potatoes, pasta, rice, and bread that you want, (and I hope for your sake he’s right) you may be like me, and those foods may bother you about as much as low GI carbs do.

Well, I noted earlier this year that I am really a social scientist, not a scientist, and readily admitted that sometimes I would be wrong about things. Who would have thought I would be wrong about something I could easily go to my bookshelf and confirm? But I suppose that is the nature of brain fog.  I am lucky that a  really astute poster in my Yahoo group recently pointed out to me the error of this last statement, the one about the starches, and I’m so glad that he did!  In A New IBS Solution, Dr. Pimentel does not actually say “Hey you can have all the white carbs that you want.”  He does allow potatoes, pasta, rice and breads, but his very specific dietary guidelines are actually self-limiting when it comes to these foods;  not only is all food restricted (to a certain degree) by allowing the patient only three meals per day, but portion sizes for these foods are explicitly listed; they are kept on the small side and the patient is allowed one per meal.

Personally I find it difficult to keep portion sizes small when eating white carbs, particularly starches. I don’t think that would get me any votes for “Most Unique.” I don’t want to speak for the original poster, and I especially don’t want to take his great theory and get all the credit for it. Maybe I’ll ask him to guest blog sometime soon. If a person actually notices symptom improvement with small portions of these foods that one doesn’t see when eating zero carb, then the question is this: given that one could actually control their portions….and this is the most important given…is it better or worse to eat these foods? A small side of rice with our brisket? Our boneless, skinless chicken breast between two slices of…white bread?

What do you think? Can you control your carb portions? I haven’t really ever tried. I usually just eat white carbs when I’m “cheating.” I’ve been thinking about a life without anymore “cheating.” I realize its not easy but maybe its worth it. Or maybe its a good resolution for the New Year to control my portion sizes (starches only – no gluten) Or maybe I don’t need white carbs at all. I’m just not sure which life is better – one with mastery over my surroundings or one where all temptation is ultimately removed.