Fasting vs. Elemental Diet

These are two very different things even though both involve no chewing.

Fasting is no calories, just water (and salt or trace minerals) for hours/days.  You can ease into fasting by drinking bone broth, which is what I tried but need to be somewhat careful as consuming too many calories can turn fasting into a low calorie diet of sorts.  Why does this matter?  When you fast, your body will burn through the energy stores in your liver in 2-3 days, with no other calorie options present it will turn to burning body fat for energy.  If/when you get into this magic zone, leptin, your hunger hormone decreases and your metabolism revs up because energy is required to convert body fat to energy.  That's the very, very simple way of explaining what I understand from listening to Jason Fung and reading The Complete Guide to Fasting.  If you are over 300 calories then your body will not switch into this magic zone, you will remain hungry and your metabolism will not rev up and go into body fat burning mode. It will just slow down because you are consuming both too many and not enough calories. This is the zone many dieters end up in after years of calorie counting, exercise and yo yo dieting.  According to the hosts of Fasting Talk this is also what happens to some people who only eat one meal a day.  Your body adapts to the low levels of calories and you do not lose weight.

The elemental diet on the other hand, if done correctly, keeps your calorie consumption up to your normal levels.  If you do the homemade version and keep the fats high and carbs low you will go into ketosis and much of the initial weight that comes off will be water.  It shouldn't slow your metabolism.  The problem comes in that many people with SIBO end up not digesting fat well so they rely more on carbs, which with the elemental means sugars. This is also the problem with many packaged elemental diet formulas, heavy on sugars and nutrients, not much fat.  Thankfully so far I am not one of these people, protein and carbs give me difficulty, fat not so much.  I sucked a tiny bit of honey out of my son's honey stick at the farmer's market today and have had a headache ever since.  I didn't used to be this sensitive but cutting sugars out has reduced my tolerance. It probably doesn't help that I seem to have some lingering insulin resistance issues as well.  Turns out my BS monitor is wildly inaccurate and needs to be replaced so I don't know this for sure.

Given that my body is not digesting well and I have a lot of lingering methane I am considering the homemade elemental.  First I need to finish eating the perishable food in the house that only I will eat, then I'll decide.

In a holding/healing pattern

Instead of being impulsive and diving right into the next killing spree since my small intestine is still overrun with methane, I'm trying a little patience.  Not my strong suit and if you've read any of my earlier posts you know I was more likely to go stronger, longer which has not been to my benefit.  I tried fasting, lasted two days, which makes sense since SIBO can have such a damaging effect on your ability to digest and assimilate.  So I was talking this through with my coach on Wednesday.  She's more of a business/lifestyle coach, not a health coach but she's so darned good at reading me and getting me to really think things through on my own that I broached the subject with her.  You tell me what to do and I'm likely to push back but lead me there and let me think it's my idea and I'm all in :) . Such is the way of my crazy brain!  

So, a year and a half ago after my last major "I'm going to rotate through ever last antimicrobial in the cupboard in a last ditch effort to get rid of every last archaea" episode, I gained 10 lbs, like BOOM!  This has annoyed the hell out of me for a multitude of reasons, one being I can't get my wedding band on, the other being I feel like a stuffed sausage in my clothes.  So while I say that I want to fast to let my digestion rest what I really want to do is lose these stubborn 10 lbs.  So this was the conversation with my coach, am I really fasting for the right reasons??  Maybe I just need to read The Complete Guide to Fasting again, I said.  She responded, stop reading, you are just giving yourself analysis paralysis, what does your body tell you?  I started to respond again from the head.  No, she said, take some time, lay on the floor, hand on heart and belly and really listen.  I don't have to.  My body is soooo hungry for nutrition, which means fasting will continue to be torture and I should really contemplate elemental if I do in fact want to give my digestion a rest.

I have a bag of the Integrative Therapeutics Physicians Elemental Diet but it's so sugary (dextrose and tapioca maltodextrin are the first two ingredients) that I am too chicken to try it.  I'm afraid it's just going to make me itch like crazy since I react so easily to sugars.  Not to mention that I would have to take antifungals as it can feed yeast overgrowth bigtime.  I'm sensitive to both potato and tapioca so there's that too.  I believe the dextrose is from potato since the formula is corn and wheat free. Those are the major sources of dextrose (potato, corn, wheat).  So back to contemplating the homemade elemental....  so nasty.  Still not sure that I want to go that route but really feel like my body could use the love.  In the meantime I'm stuffing my face with mexican food and contemplating beer :P.

Knock, knock?

Is anyone still out there??  

So, yes, it's been forever.  I felt pretty good for about a year, working on motility, gut healing and rebuilding my gut microbiome.  Then the election happened and I won't get political but I just tanked from all the stress.  First, my thyroid took a nose dive and I started pushing into Reverse T3.  Worked to get that sorted out, eventually just throwing in the towel and switching from NDT (natural dessicated thyroid) back to Cytomel.  The muscle cramping didn't go away and the itching came back, which are my body's major SIBO signs.  I'm on so many prokinetics that I have the digestion stuff down so it's the only way my body can cry wolf. On New Year's Day I broke down and did a breath test.  Hello Methane!  

Baseline was so much higher than it's ever been.  Super discouraging and I knew I had to know for sure.  Was my IBS due to the two bouts of food poisoning I had in 2010??  I printed out the lab requisition for the IBSChek and presented it to my ND.  Results came back positive on both measures meaning yes, I have had food poisoning and yes, this SIBO is autoimmune in nature.  Even though the events were nearly 7 years ago I still have antibodies well over the cutoff.  Drat!

We know that when SIBO is autoimmune there's not a heck of a lot you can do until the antibodies clear but I added Lion's Mane and Acetyl L-Carnitine back in to support nerve regeneration.

I opted to do Chris Kresser's SIBO protocol because I've tried many of the others.  90 days of GI-Synergy, biofilm disruptors (lauricidin and Interfase plus), probiotics (Megaspore, PrescriptAssist and Ideal Bowel Support) and hydrolyzed guar gum.

Retest last week...

A big ole...  let down.  Are things better?  Yes!  Have my symptoms reduced?  Yes!  Did I expect more from 90 days of protocol?  Hell YES!

So for now I'm trying Atrantil as I hear for some it can really help with methane.  I'm also playing around with fasting.  Not elemental diet, plain old broth only fasting a couple of days here and there.  I feel pretty darn good.  I have a bag of the ITI ED (Integrative Therapeutics Elemental Diet) sitting in my cupboard but I've heard so many stories of "now I have SIFO" or "now I have a horrible yeast problem and it's worse than SIBO", that I'm seriously scared of the stuff.  I do not tolerate carbs or sugars very well at all so there's that too.  Not sure I could stomach going the homemade elemental diet again and that seems to be the only way you can control the amount of carbs.

Oh and can I just say Biohealth rocks for breath testing - Quintron machine, 3 hr lactulose, I did my test on Monday and had the results by Thursday morning.  I NEVER have to go through NCNM/NUNM again.  Woot! Woot!

I eat dead food...

according to Ayurveda, the sister science to yoga.  Ayruveda says food should be prepared fresh and eaten right away. Leftovers, items that have been frozen or canned are apparently dead and do not feed the body.  I can only seem to chew veggies if I cook the bejeezus out of them so I'm sure there is not much nutrition left to them at all.  Is it worth eating them at all??  A friend posted this on her fb group a while back but I promptly ignored it.  There's   I'm eating too much, not taking my time and chewing enough (hard with all the orthodontia) and just feeling overly full most of the day.  I am off all ox bile and HCL while I treat the H. Pylori and that's not helping at all.  I read today that the itch can come from H. Pylori (my friend always suggests histamines, which I DO NOT want to hear!).  I'm banking on the pylori (and lactase) for now since it's primarily after meals and all freaking night after my Resolor. Need to do something about that.

And I was reminded of this today which has a lot of similarities but with actual science behind it.

As I mentioned before if I eat the same thing every day my digestion stays spot on but I am really feeling the need to shake up my diet.  I feel swollen and kind of gross.  I'm eating waaaaaay too much chocolate.  I keep threatening elemental (which would not be good for my adrenals or thyroid) or just scrapping the whole lot which wouldn't been good for my SIBO.  I need to come up with a reasonable middle ground.  I just can't imagine not reaching for my frozen jars of (dead) soup.  I did drag out the dehydrator today and dehydrated some kale.  I pulled out a raw bread recipe book in hopes of making some raw wraps out of greens and herbs.  We'll see how well I tolerate them.  I really don't want to pull out my juicer, it's just a beast and I hate cleaning it.

I do know I need to make the time to do my daily yoga practice, meditate 12 minutes a day (that's the minimum necessary for positive brain benefits) and take time to read.

Alright, enough bitching and moaning for now :)  Everyone have a Happy Thanksgiving!

Love and Be Kind to Yourself

Most all of us take our body for granted.  It struggles and we just keep eating what we want even though it sends us signals, quiet and loud, not to.  I say this as I drink a cup of Jasmine tea which is making me nauseous.  It only does this sometimes so I keep drinking it.  It has even made me puke once, at a child's birthday party.  Embarrassing!  Why do I keep drinking it?  I love it.  I wasn't reactive on the Array 10 (some excuse).  The only other thing I really drink is water.  How boring!  But clearly, CLEARLY I shouldn't be drinking jasmine tea. My body has been kindly asking me not to and I'm a bitch and ignore it.  

I've been thinking a lot about this today as I have been so itchy and yucky feeling in general, knowing I have flagellated bacteria burrowing into the lining of my digestive tract does not help (have you SEEN the pictures???).  I need to listen to my body.  I'm not digesting protein well (haven't for eons and duh keep eating it) and I can't really chew it properly in the first place so I need to work on decreasing my consumption while increasing amino acid support insert *gag* here.  I need to be eating more soups, green juices and I need to try smoothies again with perhaps ginger or cinnamon to make them "hotter".  In Ayurveda they said cold foods dampen digestive fire and I really don't need my ability to digest dampened at all. I've been afraid to try hemp but I've got to do better about giving my body an opportunity to heal.

No plan yet but you can be sure it will include drinking cabbage juice.  Which Katie swears is delicious.  Okay, not so much.  I've got several digestive health books on request at the library.  I've perused them all before but need to take another look.  Hoping to formulate a plan and start slowing incorporating some things over the next week.  I probably should do it before my weird outrageously expensive African tea gets here.  That supposedly can cause some mucho bad reactions for a short period of time.  I am just so done.  I was contemplating going elemental and just climbing into bed.  Instead I will get my butt outside and walk the dogs.  Just keep moving forward!

My notes from SIBO Symposium

I should preface this by saying that on Thursday I received my son's results for the Cyrex Array 3 & 4.  Turns out he was off the charts sensitive to both wheat (interestingly enough the lectins way more than the gluten) and dairy (casein but not whey).  My family loves their bread products and dairy products and they are a staple in our home (I don't eat them of course due to SIBO and dairy sensitivity).  We talked on Thursday evening and Friday morning after they guys left I cleaned all the dairy and wheat out of the house, jumped in the shower and left for the symposium.  Needless to say all this was heavy on my mind during the weekend since I didn't know what the results actually meant in terms of autoimmunity. Our ND can't see us until July.  Thankfully I ran into the Cyrex Rep at the Symposium and she talked me through the results.  Not specific to him or diagnostic but what each value measures, translates to (eg - wheat germ agglutanin is a lectin), and how symptoms may manifest in the body for people.  After talking with her I was able to breathe because I think that Celiacs and IBD are likely off the table. Phew!

Dr. Pimental spoke first about the Underlying Causes of SIBO.  He has teamed up with the military to study IBS because the majority of soldiers get food poisoning on deployment, as if they don't have enough stress!!!  In these studies they have found that 10% of soldiers returning have IBS from one deployment. You can imagine the rates for soldiers going through multiple deployments! They ruled out stress as a cause by asking question such as - did you fire a weapon, did you shoot another human, were you injured, etc. Through these studies he has determined that IBS is not caused by stress (and therefore is NOT all in your head).  His belief is that the majority of SIBO is caused by food poisoning.  Based on a study, 60%+ cases of IBS are caused by SIBO.  They determined this using both duodenal sample and the breath test.  This number is likely low because if the breath test was positive and the sample negative they said negative for SIBO.  Dr. Pimental mentioned that the duodenum is just a small sample of the upper small intestine and often the bacteria is lower down so this percentage is likely low.

Dr. Pimental has done A LOT of work looking at how food poisoning causes SIBO.  He found that when you get food poisoning often from Campylobacter Jejuni, E. Coli, Salmonella or Shigella they can all cause SIBO.  The bacteria produce CDT (Cytolethal Distending Toxin).  The toxin attaches to the wall of the small intestine and the our immune system creates antibodies (Anti-CdtB and Anti-Vinculin), these antibodies go to attack the CDT and in the process destroy the vinculin which in turn damages the Interstitial Cells of Cajal (ICC).  These ICC cells are responsible for motility.  Dr. Pimental found that if you remove CDT from bacteria before injecting it into the mice they still got gastroenteritis but did not get lasting intestinal damage or SIBO.  This is where Dr. Pimental's new test comes in that measures these antibodies. It's his first step in finding a way to cure SIBO. These antibodies - cause SIBO, the greater the antibody the greater the SIBO so can predict treatment length and if we measure antibodies perhaps we can learn how to decrease them and heal the ICC/motility.  Dr. Pimental stated that if you remove the antibodies the body will heal in 3 weeks.  He also said it is imperative for people with SIBO to NEVER get food poisoning again.  He advises some type of antibacterial while traveling with every meal (of course he said Rifaximin but that's only because it's his weapon of choice and he's rumored to get kickbacks, personally I will stick to Biocidin).

Other takeaways from his talk:

• 10 times more people with IBS have an abnormal breath test than normal people.
• Methane slows transit time in the small intestine 69%.
• You are 5 times more likely to get IBS if you have had food poisoning.
• Also, the breath test is not good at measuring methane under 3 so if your hydrogen is elevated and you still have constipation assume it's positive for methane and keep treating.
• If the breath test shows methane in the colon it's still a positive because you shouldn't have methane produced anywhere!
• Stomach acid (and Betaine HCL) slows motility but kills bacteria so take it if you need it!!
• PPIs increase motility but they are NOT recommended because the decrease acid (which kills bacteria)

Dr. Pimental and Dr. Siebecker then presented Elemental Diet Treatment for SIBO.  Dr. Pimental noted that he only has a 50% success rate with methane producers using Vivonex.  Sometimes people don't feel better until 10 days after they stop the elemental diet.  It's important to reintroduce foods SLOWLY, starting out with soups.  Antibiotics don't work during the elemental diet because the bacteria can hibernate.  The elemental diet is effective in 80% of people in 2 weeks, 85% of people in 3 weeks, there is no benefit in going longer.  Thrush can be a side effect of Vivonex due to "all the nutrition being swished in the mouth".  There have been no studies yet on Peptamen but it appears to have the same effectiveness.  Dr. Siebecker has done no formal studies on the homemade formula but she has found virtually the same effectiveness as Vivonex and says she has found it is effective with Methane.  You can find the recipe here.  Can I just say she is so tiny and absolutely adorable?!?!

I skipped Dr. Pimental's presentation on Rifaximin.  Been there, done that, wouldn't do it again, wouldn't recommend it.  I've found herbals much more effective.

Prokinetic Prevention of SIBO presented by Drs. Pimental, Weinstock, Siebecker, Keller.  I didn't take any notes on the prokinetic discussion because I've used most of them :)  The only one I haven't tried is Resolor because it's expensive and you have to get it from Canada.  Dr. Siebecker does a good job outlining prescription options here.  Dr. Pimental likes Resolor the best.  Dr. Weinstock talked about LDN. Dr. Siebecker seems partial to Iberogast (even for kids).  Dr. Keller presented on Motilpro.

Herbals include:

• Iberogast 20 drops with meals and/or at bedtime
• Motilpro - no instructions provided
• Ginger - 1000-1500mg daily

They all seemed to feel that there may not be a benefit to starting prokinetics early.  Often the methane overrides the benefit of the prokinetic and you are just wasting your money.

Steven Sandberg Lewis and Dr. Shaver presented on Beyond the Breath Test: Other tests for SIBO patients.  My takeaway from this was that a provider should never assume it's just IBD, or Celiacs that if the patient doesn't get better they should always check for SIBO (and in some cases vise versa).  Dr. Shaver indicated she likes to r/o celiacs, non-celiac gluten sensitivity, do food sensitivity testing and a stool test.  Celiacs and SIBO often seem to go hand in hand.  Food sensitivity testing helps you identify and remove foods causing symptoms and/or inflammation, stool testing can help identify parasites/pathogenic bacteria/fungus, bacterial imbalance, inflammation, and sIgA ("a key marker of humoral immune status").

Larry Wurn presented on Physical Treatment for SI Obstruction and all I have to say about this is if you feel like surgical scarring/adhesions are an issue for you, you need to check them out.  I have a friend that has been to their clinic and had treatment and it changed her life.  There technique has been well studied and it's no bull!

Sunday was a bit more of a blur.  The conference started at 8am and the presentation was done via video (for an hour and 15 minutes).  It was hard to follow along.  My friend Tim will do a much better job of summing up Dr. Mullin's presentation and I will link it when he does.  Dr. Mullin spoke on a wide variety of topics, one was using D-Limonene 1000g daily as a prokinetic. I don't recall timing but prokinetics are usually at bedtime.  He also talked about use of the Smart Pill to measure PH in various parts of the digestive tract, in addition to measuring motility, pressure and the ICV.  Sound intriguing!  I also wrote down S. Boulardii increases SigA (which is a good thing!).  I think I tossed mine out long ago however so can't add it in now and again.  He spoke about adding in fermented food but I glazed over :(. His uses the garden metaphor, first kill all the weeds (SIBO), support the soil (gut) so good plants can grow, then reseed (pre- and probiotics).  I'm on the probiotics, the prebiotics still scare me a bit!!  Oligosacchararides promote bifido and lacto, discourage growth of clostridia, prevent constipation, etc.  Sounds kind of important.  Oligo's are found in artichoke, asparagus, broccoli, brussel sprouts, fennel, garlic, leek, onion and cabbage. It was interesting, Dr. Mullin seems to be willing to try anything and if I am remembering right he talked about patients ending up in the hospital (one due to use of biofilm buster EDTA) and said "we discontinued use of that treatment" a handful of times. Which is both awesome and frightening.  We need strong SIBO fighters but I'd hate to end up in the hospital!  He has a new book tomorrow!

Dr. Weinstock spoke again about leaky gut and SIBO.  The feeling is that pretty much everyone with SIBO has leaky gut and if your intestinal permeability test comes back negative it's only because the SIBO has eaten all the lactulose/mannitol before it leaked through to the blood and could be measured.  I believe he said they use 10g of lactulose for the breath test and only 5g of lactulose/mannitol for the intestinal permeability test.  Other ways you can look at intestinal permeability is butyrate, lower levels imply impaired barrier, the other ways, measuring LPS (lipopolysaccharide) is difficult, Anti-LPS only shows in acute phases and the endotoxin test requires measurement in the portal vein.  Bottom line, assume intestinal permeability and support repair using the following supplements:

• Serum Bovine Immunoglobin (SBI) - binds and removes microbial components
• Zinc (I use Endozin) - supports tight junctions between cells
• Glutamine - nutrition to support mucosal integrity
• Curcumin - reduces inflammation
• Probiotics - increases zonulin

The Lactulose Breath Test Interpretation was fascinating and we all pulled out our breath tests to follow along.  It went really fast though.  The only takeaway I had was that you want to see a double peak, the dip between peaks indicates that you have moved from the small intestine to the large intestine.  

That pretty much sums it up.  Phew!  Let me know if you have any questions!

Podcast by Dr. Ruscio

You really should like to Dr. Ruscio's 2 part podcast on SIBO. Here is the link to iTunes. I wonder now if I've just extended my treatment by trying to starve the bacteria with a low FODMAP diet during treatment. And the information on methane dominant SIBO and related weight issues was fascinating. And here is a link to his website and blog. Your welcome :) enjoy!

Accountability vs. Victimhood

I did a 10 hour yoga workshop this weekend.  Not the brightest idea but these teachers only come to town once a year.  As we all know exercise is stress and given the recent diagnosis of Hashi's and the ongoing battle with SIBO, I should be keeping stress to a minimum. What can I say, I couldn't help myself!

My teachers talked a lot about alignment (of course) but also what that alignment does to your mental health and overall wellbeing.  Slouch and you feel physically, emotionally, mentally like crap, not to mention what it does to your digestion, rounding in and compressing everything. When you raise your head, expand and raise your chest you are more likely to feel strong and empowered, you give your stomach, intestines, gall bladder, liver, etc. more room to do their thing.  Think about the animals you see, the only time they slouch or tuck their tail is when they are scared, unsure.  Most of the time their tail is up their head held high, ready for anything.

It got me to thinking about all of us.  For many of us we didn't do anything wrong to create our SIBO so we have the "woe is me" feeling (someone can't remember who called this the Eeyore).  We can't find a good doctor, we can't (or won't) stick with the diet, we don't know what supplements to take to make ourselves feel better.  We can live in this victim mentality or we can take accountability for our actions, do our own research, get support via groups on FB or whatever social media outlet we choose, carve out time (even just 5 minutes a day) for mindfulness/belly breathing/whatever and make a plan for getting well.  Great places for finding information?

http://www.siboinfo.com/

http://chriskresser.com/sibo-what-causes-it-and-why-its-so-hard-to-treat

https://www.facebook.com/DrRuscio (He's in the process of updating his website, I had not heard of him but his herbal protocol from the Digestive Sessions covers all bases - more about this later)

http://www.amazon.com/IBS-Irritable-Bowel-Syndrome-Antibiotics-ebook/dp/B00CBP2S1Q/ref=sr_1_2?s=digital-text&ie=UTF8&qid=1423452835&sr=1-2&keywords=fast+track+digestion

http://www.amazon.com/New-IBS-Solution-Bacteria--Irritable-ebook/dp/B007Z5SVRC/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1423452939&sr=1-1&keywords=new+ibs+solution

There are numerous podcasts that deal with SIBO.  Not to mention it seems like every few months there is some sort of weeklong free online Summit related to health (this week it's Healthy Gut Summit).  Check out Underground Wellness, Revolution Health Radio.  There are also several podcasts, articles and videos on SIBOinfo.com under learning more.

The bottom line is no cares about your health as much as you do and sometimes you just have to take matters into your own hands.  I have walked into the doctor's office several times and said, "what about this?", and given him information about labs or probiotics or herbal protocols or conventional treatments.  I'm lucky that I have a provider who is open to this and willing to try anything.  I also skype with Dr. Keller at the SIBO Center at NCNM to help clarify things I am unsure about.

And more important than anything (and trust me hindsight really sucks on this one for me) keep a food journal, better yet a food journal and an everyday journal so you can track what is working for you and what isn't.  I've started measuring my belly just below my belly button too because I can't always tell by looking if I'm bloated at all.  My high fat, low carb, low-mod protein diet is doing wonders for me (that doesn't mean it will work for you).  But it took me a full year to figure it out because I wasn't willing to change my diet that much and hey, it was low FODMAP so I didn't think I had to.  If you feel like things aren't working, change it.

If you don't have the money to do labs and supplements and don't have a good doctor, start with the SIBO specific diet or better yet, a low FODMAP AIP diet to help reduce some of the inflammation in your digestive tract.  Tip - you can do this by printing out the SIBO specific diet and then crossing off anything not allowed on the AIP (great resources for this are Practical Paleo, The Paleo Approach or The Paleo Mom blog.  Don't have money for books, check them out at the library (if they don't have them, you can request they order them or loan them from another library).  Just give it 30 days to see if it makes a difference. And seriously if a food on the list makes you feel bad, stop consuming it!  Start a practice of some kind to help you reduce stress.  Research which of the supplements recommended to treat SIBO are the least expensive.  There are several places to order them online and most do not charge tax or shipping.  If you can scrape together $$ for one test, consider a good 3 day stool test which can show how well your body is digesting food, if there are parasites present and whether candida is a problem.  The stool test will also show which botanicals and meds the nasty organisms are resistant to and which will kill them.

For a quick, inexpensive (no fun) fix you can also spend your food budget on amino acids, multivitamins, coconut oil and honey and do the elemental diet.  Siboinfo.com says it has an 80-84% rate of erradicating SIBO.  

I'll say it again, no one cares about your health as much as you, so keep your head up, do your research and take charge because in the end wouldn't you rather be a Tigger than an Eeyore???

Dr. Siebecker video for limited time!!!

Sorry!  I just discovered this in my facebook feed.  Looks likes weeks of really interesting videos!

I that link doesn't get you there, this should.

With Good Sometimes Comes Bad

I met with my ND and got the results from the last stool test.  The blastocystis hominis of which there was many is now gone, HURRAY!  Thank goodness for Heron Botanical's formula Purge the Whorl.  But with good comes bad and it looks like my dysbiosis is even worse.  The only thing I did differently over the summer was add the Purge the Whorl and do a couple of rounds of the elemental diet.  Could the elemental diet have made it worse???

We decided to switch everything up to see if we could get some better results.  I am now on a combination of Heron Botanical's Herbal Biotic, Heron Botanical's Bitters (to aid digestion), Berberine Complex, Neem Plus, Interface Plus, Metagest (digestion), Spectrazyme (digestion) and PrescriptAssist, the probiotic Chris Kresser recommends.  Oh, and my low dose Erythromycin at night to keep things moving and the couple of drops of iodine that I continually forget to take.  I take other supplements but they are related to general health and not SIBO.  He doesn't want me to do any tests again for 6 months.  He knows how much I love numbers but says with the lack of positive movement I need to let that go and focus on how I feel instead.  Poo!  I have the results from my breath test coming next week to see if the Rifaximin/Neomycin with biofilm buster Lipophos EDTA did any better than the abx with Interface Plus.

Stick a fork in me

I hate throwing in the towel, but I saw my ND today and my digestion was locked up tight.  All the sphincters in my intestines were tightly shut allowing bacteria to fester and the blood supply to my intestines was really restricted.  He got everything open and hopefully moving. He says I need to focus on stimulating my digestion not starving out the bacteria.  All the supplements and biofilm busters won't do any good if everything is shut down.  

Last time I did the elemental diet my energy stayed good and my strength strong.  This time I just bonked, low energy and just mental exhaustion.  Not really sure why, could have been the protein, could have been the timing (too close to the last time).  My ND says next time I want to do it I can schedule some time with him for some intravenous amino acids.

So I came home and made myself some hot chocolate and downed some herbal muscle relaxers for my back and all my supplements.  I ate a few steamed green beans.  Now I'm relaxing with heat on my back.

Day 11, Round 2, Elemental Diet

Weight:  118.2 lbs

I had scrambled eggs for dinner.  Hard to believe that made me gain a full pound but this diet and my body's reaction to it is crazy.

I'm really, really close to throwing in the towel.  My back has been spasming all week and it hurts.  Not sure if my magnesium is too low or if it just needs time to heal.  My massage therapist has been sick or on vacation since I've been back so I haven't been able to see him.  It's really hard not to eat when I'm hurting all the time.  I know you shouldn't use food (or wine :) for comfort but it what I really want.  You can probably guess that when my back flares up I usually gain weight.

I'll see my Naturopath today and hopefully my Massage Therapist tomorrow.  At that point I will be at day 12 and might as well keep this up until day 14.  Still haven't decided if I'm going to test at the end to see if the different biofilm buster (Lipophos EDTA) or the MCT oil made a difference.

Day 10, Round 2, Elemental Deit

Weight:  117.6 lbs

I am just not hitting my groove this time.  By the time I hit day 10 last time I was feeling great, working out, not minding not eating.  Now I still struggle.  I still feel indecisive.  Should I quit, should I keep going?  Should I test when I'm done or not spend the $$?  What's the point of doing it if I'm not going to get results to see if it was effective.  Should I start a round of Rifaximin/Neomycin when I'm done to kill all the remaining bacteria who start to eat again?  Hoping my ND can help me answer some of these questions tomorrow.

Day 9, Round 2, Elemental Diet

Weight:  118.0 lbs

No more protein.  It just stops up my digestion and at some point the bacteria will just adapt and start eating it.  All the magnesium citrate finally did the trick.  That made for a pleasant day ;)

I'm past my feelings of nausea.  It felt like that took longer to resolve this time.  Although I can't really say for sure how long it's been gone.

Can't believe I'm almost to the halfway point.  Wow!  What didn't seem doable a couple of days ago is all good now.  I'm sure that will change.  Evening has been the hardest in terms of feelings of wanting to give up.

Day 8, Round 2, Elemental Diet

Weight: 119.4 (another gain!)

Don't ever let yourself quit part way through the day.  I really wanted to throw in the towel last night.  This would have been my excuse.

This is our harvest from yesterday alone (with a bunch of crap in the background).  Our house is a war zone on the weekends.  We just don't spend time cleaning up after ourselves.
What I did do was told myself if I still felt the same way tomorrow than sure I would consider it.  But I didn't allow myself to eat last night.  Why?  Because I knew what I was feeling would probably pass and that I would really regret messing up 7 days of fasting if I woke up feeling like I could continue.  If I woke up feeling like I didn't want to do it anymore than maybe this would be an entirely different post.

I did take a boatload of mag citrate yesterday.  1000mg with breakfast and 600mg with lunch and 600mg again at dinner.  I need to stop eating meat.  I'm afraid with starving the bacteria and meat sitting in my gut the bugs will just learn to eat it, then where will I be??

There was a person who posted several comments on the recent Chris Kresser article about the elemental diet.  She says she used Iodine to cure her SIBO and was really upset that people weren't listening to her.  I did a search last night and couldn't find anything about using Iodine to kill SIBO.  Has anyone heard anything about this?? 

Day 7, Round 2, Elemental Diet

Weight:  119.2

Ha!  I managed to gain weight on this crazy diet :)  We processed our meat chickens on Friday and I cooked one up yesterday.  I didn't think I ate THAT much!  I'm not moving waste out which is typical both on the elemental diet without meat and when I do the meat fast for the breath test.  I'm going to down a handful of magnesium citrate with breakfast to see if I can get things moving today.

Day 6, Round 2, Elemental Diet

Weight: 119.0

I did fairly okay through the day yesterday but then evening came and I started in with the, "I hate this", "I don't want to do this", "I'm just not into this" stuff.  I need to get over myself.  I'm 6 days in for goodness sake, pretty much 1/3 of the way done.  I did get a bit nauseous in the evening.  Lunch has been late just about everyday, 2:00 instead of my usual between 12 and 1.  I'm sure that's not helping.  

Day 5, Round 2, Elemental Diet

Weight: 120.2 (Yahoo! No weight loss)

I stopped taking the magnesium citrate.  So perhaps I'm not losing water.  I'm not losing any solids either so that could be a problem if I keep eating.

This is from last night:
"Ugh!  I am so not into this diet this go around.  I have been so tired.  Our garden is overflowing with fresh veggies and I just want to give up and do in the winter when there isn't such an abundance of food.  My husband thinks I just need to stop eating protein.  I do too and I need to tap.  I wonder about the amount of honey I am eating as well, 2 T per meal.  That's about 32 grams of carbohydrate and it's all sugar.  The 3 T of coconut oil works out to about 42 g of fat.  My elemental meals are around 550 calories.  I don't remember experiencing such exhaustion the first time around."

I did my tapping and I do feel better today.  Took our chickens out to a local farm for processing and hit the local mountain bike park for a quick ride with my son.  Felt good to be out and active.  We'll see how the rest of the day goes!

My favorite blogger/cookbook author posted a sandwich bun recipe today from her new cookbook.  This is similar to the hamburger bun recipe I use. I generally swap macadamia nuts for cashews or a combination of almond flour, sunflower seeds and mac nuts.  I also usually make much smaller portions to keep FODMAPs in check.  For her burger bun recipe, it says it makes 4 buns and I think I make at least 8-10 thinner buns.  Her bun recipe does not use arrowroot which means they tend to crumble a bit more.  Can't wait to give this new recipe a try. Only 16 or so more days.

Day 4, Round 2, Elemental Diet

Weight: 120.2 lbs

I planned on doing the just elemental meals yesterday (and today) but my son didn't finish his scrambled eggs yesterday or this morning so I ate them so they didn't go to waste.  We raise our own chickens and barely get enough eggs as is.  

We have 2 CornishX meat chickens going in for processing tomorrow.  Can't wait to roast one up this weekend!

I stopped taking all my herbal abx. I'm still taking probiotics (Lactoprime Plus and Align) and my biofilm busters (just finished Interfase Plus, now switching to Lipophos EDTA).  I like the idea of switching back and forth for some reason.  I also think the Lipophos EDTA might work better but that's only because it tastes horrible :)

Still feeling fine.  No nausea, headaches or anything.  I might be a bit more tired than usual but I just got back from vacation so that's to be expected.

Day 3, Round 2, Elemental Diet

Weight: 121.0 lbs

So it seems even if you keep the carbs up you still shed a significant amount of water weight in the beginning.  I think it's helpful to understand this is not real weight loss otherwise you start to panic.  By real weight loss I mean the weight comes back on within a few days of resuming a normal diet.  I've been taking magnesium citrate every night as well and this could be contributing to water loss since it pulls water into the intestines.

Yesterday because I had a 2 hour appointment at 11:30 I ended up packing scrambled eggs in a thermos and eating them for lunch, only about 320 calories.  I had an early elemental dinner before work, then a snack of salmon when I got home from work (around 8:30pm).  I normally do not snack and work to keep all my food consumption 3-4 hours apart to give my digestive tract time to do it's thing.  Today I will do all elemental, eating an actual protein meal isn't doing anything to prevent me from losing weight and is just contributing to constipation, so what's the point!  My body doesn't process protein easily probably because my open bite prevents me from chewing and breaking down food adequately.  Which is why I had the 2 hour appt, braces! The things we do to get healthy :)

Research by Dr. Pimental has shown that bacteria does not eat when being starved so I'm contemplating stopping my herbal antibiotics.  They are expensive and if they are not doing anything or there's no proof that they work during the elemental diet then what's the point.  From what I have read Dr. Pimental doesn't have his patients alter their diet until after they kill off the bacteria.  I have an appt with my ND next week so I may stop until then.  Have a nice little pill break.