Many of us have issues that we’ve been dealing with for a long time, and we’ve gotten used to them, to the extent that we don’t even notice them or pay attention to them on a regular basis.  As a practicing physician I see many patients who tell me they are fine and healthy, but when questioned admit to having headaches and migraines, joint or back pain, heartburn, skin rashes, or diarrhea among other things.  These things are not healthy, we’ve just gotten used to having them, and often take them for granted as “normal”.

Therefore it’s important to back up and take an inventory of your health and disease before you begin the ECD, so you can truly get a sense of how much benefit you’ve received from doing it.

I recommend creating an inventory of your health and disease.  Below I have provided you with a template that lets you rate your general health and well-being.  Answer each of the following categories from 1-10, with 1 being lowest/worst and 10 being highest/best, and answer yes or no to the sub-questions.  If you have specific issues you can add descriptions or notes afterward.

1. Sleep 1 – 10
2. Are you waking up feeling rested?
3. Energy 1 – 10
4. Do you have any energy crashes throughout the day?
5. Digestion 1 – 10
6. How often are you having a bowel movement? (1 per day, 1 per week, etc.)
7. Are you constipated?
8. Do you have diarrhea?
9. Gas or bloating?
10. Flatulence?
11. Mood 1 – 10
12. Anxiety?
13. Depression?
14. Menses (your period; for women only) 1 – 10
15. PMS?
16. Painful period?
17. Musculo-Skeletal 1 – 10
18. Joint pain?
19. Muscle pain?
20. Back pain?
21. Skin 1 – 10
22. Rashes?
23. Overall sense of well-being 1 – 10

After having taken an inventory, set it aside in a safe place.  Once you finish the elimination portion of the diet, you’ll fill out a second copy of the above questions which you’ll compare to the first to help solidify the benefit you’ve seen from the ECD.

What are your thoughts?  Feel free to share them with us in the comments section below.

Because it seems to cause the most negative reactions of any type of food and because it is hidden in EVERYTHING.

What is Wheat/Gluten intolerance?

Wheat or gluten intolerance is a broad category of NON-autoimmune problems brought on by the consumption of wheat or gluten.  People with wheat intolerance experience a variety of health conditions/symptoms from eating wheat but do NOT test positive for celiac disease.

What is Celiac Disease (CD)?

Celiac disease is an autoimmune disease (where the body attacks itself) that is triggered by the consumption of gluten (a protein that is contained in wheat).  This results in damage to the intestines (where food is absorbed) and also to other areas of the body such as the nerves, skin, bones, and thyroid.  People with CD test positive on blood and genetic testing for the disease.

Tests for Wheat/Gluten Intolerance

1. Elimination and Challenge Diet – Remove gluten STRICTLY from the diet for 3-4 weeks and note any change or improvement.  Then challenge yourself by having gluten and note any changes or worsening/return of symptoms.
2. IgG Food “Allergy” testing – this testing is done by drawing blood and is NOT done by conventional doctors.  It measures antibody reactions to various foods and can show a reaction to wheat (as well as other foods)

Tests for Celiac Disease

1. Antibody testing – this is the most common form of testing and is done by drawing blood.  The tests that you can ask your doctor for are:
   1. Total IgA
   2. IgA and IgG anti-gliadin antibodies
   3. IgA and IgG anti-endomysial antibodies
   4. IgA and IgG anti-tissue transglutaminase antibodies
2. Genetic testing – While anyone can have wheat intolerance, Celiac disease only seems to affect people with a genetic predisposition towards it.  Genetic testing can tell you if you have the potential to get Celiac disease (you have the genes) but NOT whether you actually have celiac disease or not.
3. Biopsy – reserved as a follow up to antibody testing where a colonoscopy is performed and a biopsy of the damaged tissue is taken to confirm the diagnosis of CD

Who should be tested for Celiac Disease (CD)?

What foods contain gluten?

When in doubt, ALL processed foods contain gluten unless they are labeled certified gluten free.

The short, short list

1.  Wheat, flour (bleached, unbleached, bread, bran), bulghur, wheat germ

2.  Barley, barley grass, barley malt

3.  Spelt

4.  Beer

5.  Cakes

6.  Cereals

7.  Cookies, cookie dough

8.  Crackers

9.  Einkorn

10.  Emmer

11.  Hydrolyzed wheat gluten, protein, or starch

12.  Kamut

13.  Soy Sauce

14.  Malted barley flour, milk, extract, syrup, or flavoring

15.  Malt vinegar

16.  Pasta

17.  Rye

18.  Semolina

Gluten is often but not always in products containing:

Artificial colorings, artificial flavorings, natural flavors, natural flavorings, vegetable broth, vegetable gum, vegetable protein, and vegetable starches

Gluten IS in vitamins (unless they are labeled gluten free) and can also be found in prescription medications!

For a more comprehensive list of where gluten can be found, go here.

What are your thoughts?  Share them with us in the comments section below.

This is not a pretty story, prepare yourself…

Excluding gluten from your diet unfortunately is much easier said than done however.

Here is how you go about it:

1. Remove bread, pasta, and baked goods.  Most people think this means they’ve gone gluten-free, sadly it doesn’t.
2. Then you must also a label reader.  Many prepared foods (in boxes, bags, or cans) contain gluten in them.  A list like this will help you keep an eye out for gluten containing ingredients.
3. Sadly, you’re still not done.  Next you must check your medications and supplements as many contain gluten as a filler ingredient.  If your supplements do not say they are free from gluten you must assume they contain it.
4. Do NOT buy from the bulk aisle of grocery stores (bummer).  They keep wheat flour at one end, and by pouring it into the bucket, and people scooping it out, it gets all over the other bins and food in the other bins.  You must assume these foods are contaminated with gluten.
5. Rice is often contaminated with gluten, so just switching to rice is often not sufficient.

Even more.  Depending on your sensitivity to gluten you must go further.

1. Unless the product says CERTIFIED gluten free, you cannot assume that it is gluten free.  McCann’s steel cut oats for example, a staple many health conscious folks buy, was shown to be contaminated with wheat.  This is not unusual, MANY foods either contain or are contaminated with wheat.  It is everywhere in our society!
2. If wheat and gluten are used in your household you should have a separate set of pans, plates, bowels, and utensils that are kept strictly gluten free.  Does this sound utterly ridiculous?  Yes it does.  It sounds obsessive, and it is, but it can be necessary.  Even the tiny bit of contamination on a cutting board used to cut bread, wiped off and then used to prepare a gluten-free meal has been shown to activate immune reactions to gluten.  It is THAT significant.

Here are a few cases given at the conference.

1. A young woman had been vomiting for two weeks anytime she ate food.  She was diagnosed with an eating disorder before seeking alternative care.  After an extensive workup it was found that the gluten in her chewing gum (the white powder that is used to keep the gum sticking to its wrapper) was causing the reaction.  She went completely gluten free and the vomiting stopped.
2. A young boy with autism was put on a gluten free, dairy free diet and had a remarkably positive reaction.  Three months later the boy put on lip balm and had a strong return of symptoms.  It was found the lip balm contained gluten (not listed anywhere on the label) and when he licked his lips the tiny bit he ingested was enough to trigger a return of symptoms.  After going back to the gluten free, dairy free diet his symptoms disappeared.
3. An older man with ulcerative colitis had the disease in remission using a gluten free diet.  Suddenly he started having 16 bowel movements per day.  After a workup it was found that he had started eating non-breaded roasted chicken at Kentucky Fried Chicken.  Some research found that although the chicken was unbreaded, it was marinated with soy sauce.  Soy sauces are made with wheat and do contain gluten.  When he discontinued the food and went back to a gluten free diet his symptoms disappeared.

Unfortunately, no good news for wheat and gluten.  Gluten, yes, it’s that bad.

More posts will be upcoming on gluten in the future.

What are your thoughts?  Have you tried a gluten free diet?  Share your thoughts in the comments section below.

If you don’t feel like you have strong willpower be sure you have eaten before going anywhere there is going to be food, and try to cancel out of all the obligations you can for the 3-4 weeks you are on the ECD.  When you’re on the ECD is not a good time to have business lunches, dinners, parties or other celebrations.  DON’T plan on doing the ECD around birthdays or the holidays.

More on the ECD coming soon.

What are your thoughts?  We’d love to hear them.  Please post them in the comments section below.

Let me give you an example.  A woman had severe seasonal allergies, she dreaded pollen season with a passion.  She was on the maximum doses of all the allergy medications and was still barely keeping her allergies under control.  Blood allergy testing showed that she was very reactive to wheat, dairy, and eggs (the big 3).  She cried a little bit at hearing this because it meant that virtually everything she ate on a regular basis was out.  But she took to the challenge with relish, and decided that this was going to be her chance to get back into the kitchen and experiment, finding tasty foods that she could eat and enjoy.  Within a few weeks her allergies were gone completely.  She stopped all of her allergy medication and has had no sign of her allergies, unless she eats some dairy, wheat, or eggs.  She is thrilled with her results and couldn’t be happier she took the plunge and did an elimination diet.  And for those who worry about giving up groups of foods forever, I expect over time as her gut heals and her immune system normalizes she will be able to reintroduce most of those foods back into her diet.

Before undertaking an ECD it’s important to determine your motivation.  What is going to give you the drive to persist through the early cravings?  What is going to allow you to say no when you get in situations where it would be so much easier to simply say yes?  Unless you plan to be a hermit for the 3-4 week duration of the elimination part of the diet, you need to have motivation.  One strong source of motivation is others.  Most of us don’t tell anyone about any diet or lifestyle changes we’re trying to make, that way if we fail, no one knows.  Turn that around, and tell all your friends, tell your co-workers.  Enlist their help and let them hold you accountable.  That way when you are tempted to reach for that food you know you others are going to know.

For me, I have three sources of motivation.  The first is simply curiosity.  As mentioned in my previous post when we saw the changes a change in diet caused in our pets, I became curious.  What changes would I see in myself if I did the same?  So this is an experiment to see what happens.  The second source of motivation is my desire to have experienced the therapies I ask my patients to go through.  It is a belief of mine to, whenever possible, try the therapies out on myself that I recommend to my patients.  That way I know what the therapies feel like, and it helps me understand what my patients are going through.  The ECD is one that I have held out on, because without any major health problems I simply did not want to give up the foods that I enjoy.  The third source of motivation is others, when my wife and I first came up with the idea, the first thing I did was quickly post the idea to my blog and to my mailing list.  That way, many people know about this, and are going to hold me accountable for completing it.

If possible, get your friends or family to join you on the ECD (often easier said than done).  It’s especially important to have the help of people you are living with.  If you can all go on the diet together it creates a shared camaraderie and helps to keep the foods that have been removed out of the house.

Stay tuned as this series on the ECD will continue.

Do you have any thoughts on the ECD?  Have you tried one?  We’d love to hear your comments, please post them in the comments section below.

We had been told by our vet that one of our dogs would need bilateral hip replacement (due to hip dysplasia) at around age 6 and who was very unlikely to survive past 9.  She is now 11 years old with both natural hips intact.  One of our cats who was on the road to having teeth removed due to periodontal (gum) disease has all his teeth and his gums are in great shape (and truth be told we have never brushed his teeth).  The vet was absolutely shocked at the change.  Our other cat lost his behavior problems and has become a much more mellow, friendly cat since stopping the junk food.  And here’s perhaps the least and most important change: their poop does not smell.  The difference in the odor of their feces from kibble to raw meat is night and day.  Most noticeably our 2 litter boxes used by our 2 indoor cats only begin to stink after a week or so (versus 2 or 3 days when they are on kibble).

That’s the good news, a dramatic improvement in physical and mental well-being for our four pets.  The bad news, like any therapeutic eating plan, a raw meat diet is a pain in the butt.  We order 50 lbs boxes of turkey and chicken necks special order from our butcher, usually ordering 2-3 months worth at a time.  Then we defrost the boxes and re-bag the necks into gallon freezer bags and refreeze them in a garage freezer we keep for the purpose, transferring them to the fridge for daily feeding.  It’s a lot of work, and every once in a while my wife and I look at each other and really question whether it’s worth it.

Recently we ran out of raw meat and our butcher was backordered so we transitioned back to kibble.  Within a few days the litter boxes stunk, the dogs themselves began to smell noticeably ‘doggy’, both the dogs and cats fur began to lose its shine, and one of our cats began manifesting behavior problems again.  Even for a Naturopathic doctor, someone who knows the tremendous difference food can make, the change was shocking.

Over dinner a week ago my wife and I were talking about the huge changes we saw in our pets.  If a change from a junk food to a high-quality diet could make such a tremendous change in our pets, what changes would we see in ourselves if we did the same thing?  We both are in a good health, and eat a pretty good diet.  But we were curious,  and so we decided to do just that.

In the month of March I will be transitioning to a diet free of sugar, gluten, dairy, eggs, soy, and citrus foods (the five most common reactive foods I see in my practice are: gluten, dairy, eggs, soy and citrus).  In future posts I will be talking about making the transition, and detailing my experiences on this therapeutic eating plan.  I invite you to follow along to any extent you wish.  If you would like to join me through cyberspace, I invite you to post your experiences in the comments section through the month of March.

For those of you in the Seattle area who are interested and would like more intensive support, I will be offering a series of support classes over the month of March.  This is a prototype in design, and is currently 4-5 thirty to sixty minute group classes where we meet weekly to share information and support one another.  Because this is the first class and we will be working the bugs out, we are discounting the cost to $100 for the series.  A minimum of 5 participants are required for the series to go forward, so if you are interested or would like more information please email us right away at info@aspirenaturalhealth.com.

Stay tuned for future posts in the next 10 days as I lay out my planning for the month of March.

Do you have any thoughts or opinions?  We’d love to hear them.  Please post them in the comments section below?

Celiac has been getting a lot more attention lately, but I find in my practice there is still a lot of confusion about what celiac actually is.

What is celiac (briefly)?

Celiac is an autoimmune disease triggered when a susceptible person eats gluten.  Celiac is not a “wheat allergy”; it is possible to have an allergy or reactivity to wheat or other grains and not have celiac disease.  What makes celiac different from other problems with wheat, grains and gluten is autoimmunity, in celiac disease the body is attacking itself.

What is gluten?

Gluten is a family of proteins found in wheat (gliaden & glutenin) and wheat relatives such as spelt and kamut, triticale, barley (hordein), and rye (secalin).  There is conflicting information on whether oats contain gluten (avenin).  Most of the gluten in oats appears to come from contamination with wheat during harvesting, storage, and processing.  Certified gluten-free oats seem to be tolerated by many people with celiac disease.

What happens in celiac disease (briefly)?

Gluten is an irritating and mildly inflammatory substance to all humans.  In susceptible individuals (with celiac disease) inadequate digestion of gluten leads to inflammation and damage of the cells of the small intestine.  This allows gluten proteins to enter the damaged cells where they are exposed to enzymes (tissue transglutaminases) which modify them and make them more inflammatory.  This sets up a vicious circle of inflammation leading to the formation of autoantibodies (antibodies against the body) which leads to the characteristic destruction of the intestines in celiac disease.

This damage to the small intestines can severely damage the body’s ability to absorb nutrients leading to significant nutrient deficiencies.

Celiac & Osteoporosis – Nutrient deficiencies

In order to form healthy bone the body needs calcium, magnesium, vitamin D, vitamin K, sufficient protein and a host of other vitamins and trace minerals.  In celiac disease  the damage to the intestines can prevent the body from absorbing enough of these nutrients.  Over time the body is not able to build bone and this can lead to early and severe osteoporosis.

Celiac & Osteoporosis – Autoimmunity

A recent study by scientists at the University of Edinburgh found that in 20% of celiac patients tested, they found antibodies to a protein called osteoprotegerin which is important in maintaining bone strength.  The antibodies prevented osteoprotegerin from functioning effectively and are thought to be an additional reason for osteoporosis in at least some patients with celiac disease.

How to prevent osteoporosis?

While the study authors were quick to propose a drug to block the antibodies interfering with osteoprotegerin as an answer to celiac induced osteoporosis, there are far more effective therapies that you can do now.

1. The most important is the avoidance of all gluten.  This is much easier said than done as gluten is widely used both as a food in the form of breads, pastas, pastries and other flour containing foods.  More difficult to detect is the fact that gluten is widely used as a flavoring, stabilizing or thickening agent in virtually all processed foods.  The celiac patient must become an expert at label reading and understand all of the names that gluten goes by.  Here is a good place to begin educating yourself on safe and unsafe gluten containing foods.  Gluten can also be found in dietary supplements, pharmaceutical drugs, and health and beauty aids.
2. The person must ensure adequate nutrients to build healthy bones.  The levels of these nutrients such as calcium, magnesium and vitamin D may need to be substantially higher than for a normal person without celiac disease.
3. The person should engage in regular weight-bearing exercise.  Putting stress on our bones is the single greatest stimulus to make and keep them strong.
4. From the perspective of a Naturopathic doctor, I also incorporate the following additional strategies in the treatment of celiac disease
   1. Modulation and normalization of the autoimmune response.  By reducing the inflammatory load on the body and using broad-spectrum anti-inflammatory and immune modulating herbs and nutrients, we are often able to reduce or normalize the autoimmune process.  This may help in the newly discovered autoimmune process in celiac disease with osteoprotegrin noted above.
   2. Gut repair.  Using a variety of nutrients and other substances such as glutamine and probiotics we are able to restore normal gut function and structure.  This can help those with celiac disease absorb nutrients from their diet more effectively.

What are your thoughts? We’d love to hear them. Feel free to post them below.

Allergies

Allergies are caused when the immune system reacts to a harmless substance (most commonly dairy, wheat, citrus, soy, or eggs) as if it were harmful.  These reactions range from mild to very severe, such as peanut allergies that can cause anaphylactic reactions (where the airway closes up).

We have begun to measure allergic reactions using IgA, IgE, and IgG (proteins produced by the immune system), but the technology is still developing and is not always accurate.  Our experience with the skin prick testing commonly used by allergists is that it is inaccurate.  Things that your skin registers as allergic do not necessarily match up with things that your digestive system is allergic to.  We also suspect that there are a whole class of immune-caused reactions (allergies) known as delayed-hypersensitivity (type IV) reactions, in which other immune cells cause reactions hours or even days later which are not recognized by current allergy testing.

Wheat allergy vs. Celiac disease

We are finding more and more people specifically having issues with wheat and other gluten grains.  Many people have allergies or other reactions, and we are finding a growing number with Celiac disease.  Wheat allergy and Celiac disease are different, however.  In someone with a wheat allergy, their immune system has identified wheat as a harmful substance and is reacting against the wheat.  In someone with Celiac disease, this immune response to gluten has crossed over into an auto-immune condition where the body is attacking itself.  This results in damage to the small intestines and a decreased ability to absorb nutrients, along with a variety of other issues.

Intolerances

Intolerances are caused by a lack of enzymes.  For instance, in lactose intolerance the person does not have enough lactase (enzyme) to break down the lactose (milk sugar) in dairy products.  This undigested lactose is then eaten by our gut bacteria resulting in gas, bloating, cramping, and diarrhea.  Intolerances are not well categorized beyond lactose intolerance.  NDs have come to see more fructose intolerance emerging, and it is likely there are others.

In a similar way, hypochlorhydria (too little stomach acid) and achlorhydria (no stomach acid) result in a general malfunction of digestion.  Without enough acid in the stomach, protein digestion does not occur properly and the next steps in digestion, like the release of bile and pancreatic enzymes to continue the digestion of food, do not occur correctly.

Reactions

We use the word reactions for all the other responses people have to food that we do not understand yet.  We see that eating a food causes a bad reaction for that person, but it doesn’t seem to be an allergy or an intolerance.  Hopefully science will continue to unravel the mysteries of people’s reactions to foods, but in the meantime we continue to treat that person and help them recover their health.

One other type of reaction that we are beginning to understand more about involves our gut bacteria.  We know now that there are more bacteria in our digestive tract than there are cells in our body.  We are gaining a greater understanding that these bacteria, known as gut flora, play a critical role in our digestion and health.  When these bacteria are out of balance or when bad bacteria have taken over our digestive system, both conditions called dysbiosis, we have problems with both our digestion and our health.

The Good News

While there are many ways foods can hurt us, the good news is that NDs and other nutritionally oriented health practitioners can do a great deal to help.  I commonly see problems with food resolve and the person go on to live a happier, healthier life.  If you suspect your food might be impacting your health, please get the support you need.

What are your thoughts?  Have you had reactions to foods?  We’d love to hear your thoughts.  Please feel welcome to post a comment below.