Side Effect Cascade

I think I figured out why I was having such a hard time over the last couple of weeks.  On June 17th I added Nystatin back in…cuz, you know, why not.  “Low side effect profile,” my doctor said.  “Maybe it’s yeast,” my doctor said.  Well as I’ve mentioned on here before these yeast medications have made me very constipated.  So I’ve been gradually increasing the magnesium I’ve been taking at night, from 200mg to 400mg a couple weeks ago, and then to 600mg about a week ago.  It wasn’t until I got to 600mg that the constipation let up.

I didn’t realize it explicitly, but I’ve been feeling more sleepy during the day.  Didn’t correlate it with the increased magnesium, because I take that at night so I figured it wouldn’t affect me during the day.  So increased sleepiness recently, which became more pronounced when I increased the magnesium from 400mg to 600.  When I get sleepy I start craving carbohydrates – sugar especially – for quick energy.  None of this was thought out consciously.  I wasn’t thinking “I”m so sleepy from my magnesium – I think I’ll have some candy to wake up!”  I just wanted candy or whatever, and ate it.  That sent my blood sugar all over the place – cuz, diabetes – and then I was eating all kinds of things in an effort to regulate.  More protein, but then blood sugar is too low.  More carbs, then blood sugar too high.  More caffeine.  More food.  More whatever.

So bottom line:

  • 4/26/16 – Added Diflucan for suspected yeast.
  • 5/15/16 – Started elimination diet (“The Plan”)
  • 5/26/16 – Finished Diflucan, started Nystatin.
  • 6/1/16 – Quit Nystatin.  Constipated (and annoyed)
  • 6/16/16 – Quit “The Plan”.  Plan deemed unreliable.
  • 6/17/16 – Added Nystatin back in.  Increased Magnesium to 400mg.  Eating became much harder to control.
  • 6/22/16 – Constipated cuz of Nystatin.  Increased Magnesium to 600mg
  • 6/27/16 – Back to 200mg Magnesium
  • 6/27/16 – Quit Nystatin

So I’ve been on a side effect roller coaster for a couple weeks. Nystatin = more magnesium = more sleepy = more sugar = more blood sugar swings = more crap eating.  Viola!

Sometimes this science experiment I’m doing with my body is a pain in the butt.  The longer I do this the more I realize that man made medications and supplements all have side effects – some good, some bad.  The fewer the better.

Anyway, I cut back the magnesium to 200mg two nights ago (and quit the Nystatin again) and yesterday I felt alert, no  food cravings.  All better.

Ok, Make that 12

Having a very hard time psychologically and physically with stepping back into a very restrictive diet.  My guts ache from eating the wrong foods but I can’t stand eating just chicken and kale soup anymore.  I just don’t think I’ll be able to do it.  I know myself to be very determined and not particularly swayed by psychological cravings, so I suspect maybe a nutrient imbalance has occurred, or something is causing irritation.

I could strip back to only prescription medications and trusted supplements – maybe one of my new “kitchen sink” additions is causing me problems.  Science 101 says that when your experiment starts to go in the ditch, undo the last thing you did.  The things that are not clearly making any difference at all are Allithiamine, Nystatin, and Chromium, all of which I introduced or reintroduced in within the last 2 weeks or so.  Also I increased magnesium to cope with the constipation caused by Nystatin.  OK, that’s it, back to basics with the supplements and meds and we’ll continue trying to strip away the problem foods again. Which is most of them.

11 Days

It’s been 11 days of eating stuff that inflames my body, makes me gain weight, and makes me tired.

I’m not binge eating, overeating, or consuming past full.  But I am eating whatever looks good.  Like an average person. And I feel pretty not great.  So I’ll stop it now.

When I was younger I binge ate, so I know a little about this.  I no longer feel like binge eating, but I do have trouble sticking with very restrictive diets – those that involve cutting out necessary macronutrients (protein or fat) or micronutrients for long periods of time, or when my diet is completely devoid of flavor.  The last part applied to my time on The Plan.

I wrote a few days ago about my plan to start an Autoimmune Paleo (AIP) diet, even though I’m not yet autoimmune.  the rationale behind this was that such a diet would be absent things that tend to cause inflammation in people who are very sensitive.  However, as I was looking over the things that would be available to me on such a plan (example here) I became discouraged because I can’t even eat all of those things without problems.  I can’t have the wide range of vegetables, fermented foods, and resistant starch-containing foods that appear to be recommended. Sarah Ballentyne says about insoluble fiber, “I can’t find a single reason why insoluble fiber should be limited.”  I’ll give you one – it makes me desperately depressed.

I’ve decided to go back to a version of The Plan.  I felt great on it and although I didn’t trust the process completely, I felt like I was getting most of my nutritional needs met.  This time I’m going to stop adding salt to food to see if I can better control the scale for the purpose of measuring daily reactions to food.  It’s going to be difficult because salt is sort of the last flavor I was allowing myself.  Yes, this is a restrictive process – especially when it seems I react to almost everything.  At least I know it led to feeling good so there’s something to look forward to.

There were a few foods added at the end that I was not confident were actually “friendly foods”, including macadamia nuts and mozzarella cheese with vinegar as an ingredient, so at some point I’ll retest those but will not be including those to start off.

Regarding exercise, I have not done any.  I keep forgetting.  Actually my 11 days made me tired and unwilling to put forth the effort.  I’ll be interested to see how long it takes to feel better again.  I’ll hold off on exercise for now anyway, until I have a greater base of foods from which to choose on a daily basis.  At that point – maybe a couple weeks? – I’ll be feeling better and can add it in.  I know diet alone isn’t enough to reduce insulin and therefore hunger.

Perioral Dermatitis: Fixing My Daughter’s Face

I want to share a health issue that I find really interesting, but involves my daughter.  Over the last 2 years she has been developing this rash whenever she eats gluten.  Here she is:

gluten lips

It would start with just dry lips, and then she would develop the rash under her lower lip.  If she kept eating gluten on multiple consecutive days she would develop the rash over her upper lip too.

I had her tested for gluten intolerance when she was 2 years old using stool testing from Enterolab. The results showed that she was intolerant to gluten as well as to many other things.  Some coaching I got at the time suggested that gluten sensitivity may have led to a leaky gut, causing intolerance to all of the other foods.  So, as a family we stopped eating gluten at home altogether, and tried to prevent all exposure to gluten.  That worked fine until she got a little older and started trading food with kids at daycare and at school.  She got really sneaky about it and I was unable to control this behavior. So over the last 2 years she has been eating small amounts of gluten most days of the week during the school year.  I could tell when she got home if she ate gluten or not by how the rash looked.  The rash would clear up over school breaks, and then get bad again when she was eating lunch with other kids.

Last year sometime I took her to an allergist. The [mainstream] doctor refused to test her for gluten sensitivity, but was willing to give her skin prick tests for environmental and wheat allergies.  She tested negative to everything, but that meant very little to me.  I knew she didn’t have an IgE allergy to wheat, because she wasn’t breaking out in hives or having anaphylactic episodes, and that’s what skin prick testing evaluates for. I finally found a functional medicine doctor who would do IgA/IgG testing to look for an immune system reaction to gluten. In other words, I wanted her tested for gluten sensitivity, not gluten allergy – a concept lost on mainstream medicine.

Anyway, in April 2016 he tested her for gluten sensitivity with a routine antibody test.  She tested negative.  So then I spent $350 for the doctor to order her a more elaborate gluten/autoimmunity panel from Cyrex labs, which tested about 20 different markers of gluten sensitivity.  I fed her a lot of glutenous foods during the week prior to the test so her body would have a little time to react, though it’s possible that wasn’t enough time.

All markers tested negative.  The doc wrote at the bottom of the results, “Lab results show 0 evidence of gluten sensitivity.”  The zero was underlined twice.

So why the rash whenever she ate gluten?  I don’t know for sure…but I have recently learned that feeding her homemade (unpasteurized) sauerkraut makes it go away.  If she has a bite of sauerkraut daily the rash goes away and stays away.  If she goes 4-5 days without sauerkraut and has some form of gluten during those days it comes back.  Isn’t that interesting?

My working theory about this is the rash is caused by yeast.  The gluten causes intestinal permeability and gives the yeast access to the bloodstream where it shows up as a rash on her face.

Good thing she likes sauerkraut.

We’re still not eating gluten at home but I’ve stopped berating her for trading with other kids.  I just don’t have scientific evidence to support a diagnosis of gluten sensitivity anymore.

So interesting thing #1 – Stool testing at the age of 2 showed lots of antibodies in relation to eating gluten.  Now at the age of 6 – no antibodies.  Cured?  Or a more mature digestive system?  Maybe one of the tests is wrong?

Interesting thing #2 – Sauerkraut fixes perioral dermatitis.  At least in this case, it’s a gut problem.

Insight for the day: Nothing involving health is simple or occurs in a vacuum.

Kitchen Sink Approach

I’ve decided to throw a bunch of shit at the problem and see what happens.  I don’t have time anymore for this well-controlled one-variable-at-a-time stuff.  And honestly, maybe that’s not the best approach anyway.  Maybe there’s more than one thing going on and it takes changing several things at a time to make a difference.  For instance, a study came out this week in which 10 people were given multiple interventions and ALL were able to reverse their memory loss due to Alzheimer’s.  But they didn’t try one thing at a time and carefully measure baseline and single condition changes.  They used a “36-point therapeutic programme.”  So let’s throw the kitchen sink at this bitch! Science says it’s ok!

Anyway, I figure once I’m fixed and perfect I can always peel things off one at a time.

So I’ve decided to do the following things:

Will the diet be restrictive?  Yes, but less restrictive than what I was eating most days on The Plan. Welcome back avocados!  Bye bye mozzarella.

What should I call this plan?  How about New Plan. Ingenious!  Or maybe something else.

Labs

I had a couple of blood markers tested last week.  Here are the results:

  • Fasting insulin: 20.9 (range 2.0-19.6) HIGH

My last fasting insulin was in February, and it was 20.7.  Essentially unchanged. During that 4 months I’ve consumed a low carb high fat diet on all but about 4 days.  Apparently this is not going to be fixed by changing my macronutrient ratio.  Fasting and exercise are the best bets at this point, and fasting is not something I’m able to tolerate.  So exercise.

  • hs-CRP: 8.0 (range 0-3.0) HIGH

Here’s my history with my hs-CRP:

lab

High inflammation for four years (probably longer but that’s when I started testing)…and not better now after lots of time spent avoiding inflammatory foods in the last 6 weeks.

Will think about my next steps today.

Nystatin Not Enough

I restarted Nystatin on 6/17, and since then – for the last 4 days – I’ve been eating whatever I want, within reason.  Like, I’m not eating fast food or anything, but I am eating the same stuff my family eats – homemade foods with high quality ingredients but not necessarily limited in any other way.  Well, my weight has been trending up for 4 days.  So has my blood sugar.  I guess my Nystatin-Saves-The-World theory isn’t panning out.

I’ll go back to low-carb Paleo today, and stop eating salad dressing made with vinegar again.  For real this time.