Next steps for dealing with methane while not actively killing....

While I wait for my antibodies to clear so my nerves can heal and restore function to my migratory motor complex in the small intestine I need to do something to keep the methane at bay.  I tried a 90 day protocol and that clearly didn't do much at all.  So what to do??  I don't want to dive into more killing so I may go back to the (possible) methane inhibitors.

Methane inhibitors
Red Yeast Rice - we know that Dr. Pimental is testing a lovastatin type drug to see if it inhibits methane production.  See here for information, scroll to bottom.  Red Yeast Rice does contain a natural form of lovastatin. I've used it in the past and was able to keep my methane numbers mostly in the single digits.  Once I got them to a certain level they wouldn't go lower but with Primary SIBO (aka the food poisoning induced autoimmune variety), getting the numbers down and maintaining them seems better than having them go up and down. And, it made goats fart less so why not us :) 

"At the genus level, the predominant archaea in the rumen of goats was Methanobrevibacter, 

which was significantly inhibited with the supplementation of red yeast rice. 

In conclusion, red yeast rice is a potential feed ingredient for mitigation of 

enteric methane emissions of goats." 
https://www.ncbi.nlm.nih.gov/pubmed/27467559

The link above is to a brand I used in the past. I might try a different brand this go 'round.

Ideal Bowel Support - this is a probiotic containing only 

Lactobacillus Plantarum which according to Chris Kresser can degrade methane.  I quite literally have a shelf of this stuff in my refrigerator.  Can't hurt!

Atrantil - This seemed so gimmicky when it first came out.  And there were so many "worked like a charm" and "didn't do squat" type comments on message boards that I really was skeptical. But I listened to Dr. Brown on a few recent podcasts and given my current situation (anti-vinculin antibodies negatively impacting motility) I thought I should at least try it.  It made me feel better, lighter.  I don't know how else to explain it.  I should say that I did use it after fasting so I was already feeling lighter and I do have most my digestive symptoms under control but wouldn't it be nice to be able to expand my diet without the usual repercussions. I think yes!  So I'm going to add it in while I focus on boosting motility and supporting healing.

Prokinetics
Cause if things aren't moving you are just generally screwed.  In hindsight I would have started taking these the second I learned I had SIBO.  Keeping things moving through the GI tract is the easiest way to prevent more overgrowth (in my opinion).  And note, not all of these are actual prokinetics, some have a more laxative effect, I realize that.  Slowing anywhere in the GI is just not good, makes you feel toxic, sluggish and ornery.
  
LDN - Low dose Naltrexone, although it really doesn't seem to actually have a prokinetic effect much if at all.  For those with Primary SIBO, LDE (low dose Erythromycin 50mg at bedtime) or Resolor (Prucalopride) seem to be the prescription of choice.  I don't tolerate Resolor because it has a teeny tiny amount of lactose.  Maybe you are luckier than I and tolerate dairy. Resolor is available through Canadian pharmacies.  I may ask for a script for LDE the next time I'm in office but I just hate the idea of more antibiotics even though it is a minidose. So for now I continue on LDN since it's beneficial for autoimmune issues.

Motilpro - Taken at bedtime, helps stimulate the cleansing waves of the small intestine at night.  In the beginning of my treatment it was recommended to take between breakfast and lunch as well but I don't really eat before lunch so I just wait until bedtime. Sometimes I take Ginger capsules in between breakfast and lunch.  The stuff is mega ginger burntastic so make sure to swallow it down with a LOT of water about a 1/2 hour before you actually go to bed.  

Vagal Tone - This shows some promise.  It was recommended by my ND but sadly I am reactive to the chamomile and it gives me a headache within seconds of application. Ugh! Similar to Iberogast in that you use it with meals and at bedtime, only it's external, apply a tiny dab on your occiput.

Magnesium - Most people recommend Magnesium citrate because it's not absorbed well into the system so does the trick. But it's acidic and can burn on the way out. Yikes!  Oxide is also not absorbed well and is not acidic, but I like a blend, that way your body can use some of the more absorbable forms and the rest can do it's job of pulling water into the colon and flushing the system.  I take it at dinner and bedtime so it can go to work in the evening and overnight.

Triphala - My new love.  LOL!  I used to swear this stuff did nothing but made me super constipated (and frustrated).  Turns out you just need to keep increasing to find your optimal dose.  I take 4 capsules at bedtime unless I've indulged and then I take a couple extra. Carbs and nuts do nothing but stop me up but oh how I love the taste of them!

I used Iberogast for a while but it started to not sit well.  It was the chamomile. Now the company has been sold to Bayer and is either being reformulated or completely taken off the market.  Either way pretty sad since I know it's used by many. I also try to use bitters before meals but got out of the habit and now forget a lot of the time.  These things can have a positive impact on motility as well.

Most of us have heard of the physical things we can do to stimulate the vagus nerve.  The vagus nerve stimulates the migratory motor complex so it's important that it's strong and active.  According to Dr. Kharrazian there is (vigorous) gargling, gagging and singing.  I also know from yoga that breathing stimulates the vagus nerve, most notably deep belly breaths followed by restricting and extending the exhale. It's your exhale that stimulate the parasympathic response. It's easiest to do this lying down.

Gut and Liver Support
Zinc Carnosine and L-Glutamine.  That's really all I have found that isn't mucilaginous and doesn't feeds the darned bugs.  I capsule up my own Glutamine because it's cheaper and I can avoid the fillers.  A lot of people drink it in water and it supposedly helps with sugar cravings, I just never liked doing it that way.  I recently added in a small dose of copper when I take extra zinc, apparently you are supposed to keep them balanced and not take zinc longterm on it's own.  Don't ask me where I read this, I cannot recall.

I always taking some sort of liver support because your liver takes the brunt of filtering whatever leaks through the intestinal wall.  If we are permeable and/or killing, your liver could use some assistance cleaning all that garbage out of the blood stream.  I've taken everything from plain Milk Thistle to ayurvedic formulas to herbal combinations.  I rotate formulas. 

Soil based probiotics remain my protocol (I would call it "my stack" but that seems really weird for some reason!).  I still take both PrescriptAssist and MegaSpore. I've done so much killing since my initial diagnosis that I feel it's necessary to support the microbiome in whatever way I can.  

Nerve Support
For those with Primary (autoimmune) SIBO, taking supplements that benefit nerve healing may be helpful.  It may not, who really knows.  I add Lion's Mane and Sunflower Lecithin to my hot chocolate and take Acetyl L-Carnitine in the morning. They talked about using Lion's Mane and Acetyl L-Carnitine at the SIBO Symposium a couple of years ago. 

The other thing I take that may or may not be of any help at all is Fibrenza.  My ND feels it may help remove antibodies in some way.  I have no idea how that would work but the idea of having something that scavenges the body seems good to me.



Please note - I do not make anything off these links I just included them for ease and examples.  All the links are products that I have used and companies I have purchased from.  Make your own decisions with your healthcare provider and buy from someone you trust.  Personally I don't like to buy supplements off Amazon unless I know it's coming straight from the company itself.  There are many rumors of counterfeit supplements out there.

New Protocol - Repair

Just to remind all of you, I am not a healthcare provider of any kind.  I just do a little research and add what I feel works for me.  SIBO is such a strange animal so you have to figure out (hopefully with a qualified provider) what works for you.

I've decided to work on gut repair and motility since my reactions to foods are mostly in the form of belly itchiness which I contribute more to permeability and not SIBO per se.

I should also note that there is a bit of a brouhaha right now about FCO (fermented cod liver oil).  You can read about it here (and in many other places).  I am opting to continue with my bottle but not sure I will buy it again.  It's fairly difficult to keep fish oils from becoming rancid and they are expensive.  It's better to include some fatty fish in your diet a couple of times a week.  If you've been following along you might remember that on my Array 10 I am reacting to salmon, tilapia, trout, tuna, squid, and shrimp.  I did not react to sardines but for some reason they are making me nauseaus when I eat them.  My guess is it's a placebo thing.

Pre-meals     
Bitters (2 droppers)

Iberogast (2 droppers)

Red Yeast Rice       

LiverCare

Serrapeptase

Breakfast    
Multivitamin (2)

All-zyme

Magnesium Glycinate

Betaine HCL (1-2)

Fermented Cod Liver Oil

Vit C

Vit D 4000 iu (2 drops)

Vit K-2

Thyrosol

Adrenomend (2 capsules)

OrthoBiotic (every other day)

                  

9-10AM
T3 – 22.5mcg

Primal Defense (on days when no OrthoBiotic)

L-Glutamine (1)

GastricSoothe (2)

                  
Lunch           
Multivitamin (2)

All-zyme (1)
Magnesium Glycinate

Betaine HCL (1-2)

Vit C

PrescriptAssist (1)

Adrenomend (2 capsules)

Adrenaplex (2 capsules)

Dinner         
Multivitamin (2)

All-zyme (1)

Betaine HCL (1-2)

Magnesium Glycinate

Fermented Cod Liver Oil

Thyrosol (1 tablet)

Turmeric

9pm             
LDN – 5mg

Motilpro (3)

GastricSoothe (2)

L-Glutamine

Lion’s Mane (2)*

Magnesium Citrate (PRN)

*I haven't added the Lion's Mane in.  I added in the Motilpro last night and will add the GastricSoothe in tonight.  I've been taking Endozin for a while so shouldn't have a problem with the L-Glutamine and GastricSoothe since it's the same ingredients.  In a few days if all goes well I will add in the Lion's Mane.

Counting down to school

School starts here on Sept 2nd.  I am really excited to get back into a regular yoga practice. It benefits my mind and my gut, not to mention my neck.  Summer is hard with the kid and activities and travel.  I'm not great at doing a home practice.  I usually end up tweaking something when I do because I skimp on the warmup.

Triphala

In John Herron's book The Gut Health Protocol he sings the praises of Triphala.  I had used it way back when but it was no match for the methane.  I decided to give it another try.  I'd heard rumors that it hindered T4 to T3 conversion but I couldn't find any research of any kind to back it up.  Well, my temperatures TANKED.  Even with my medication I could barely keep it above 98.0.  And worse than that it made me constipated.  WTF!  It's supposed to have the OPPOSITE effect.  No such luck with me.  So, if anyone wants to try some Triphala, let me know.  It's in my supplement graveyard.

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!

MTHFR?

Skyped with Dr. Keller today.  Very funny, she popped up and said, "I feel totally unprepared, I don't have any lab results".  We are waiting for results on my ASI which should be in any day.  I knew they probably weren't going to be ready but wanted to talk anyway because I always have so many questions about what I should or shouldn't be doing.  The herbal protocols are somewhat easier to figure out and I feel like I can experiment with that on my own (to some extent) but there are other pieces I just can't wrap my head around.

Concerns I have: dysbiosis in my large intestine and my inability to support that given the fact that I cannot eat starch without getting C.  My last stool test showed my Butyrate was borderline low and my SCFA's were low.  Both of these things are necessary for a healthy large intestine.  She had concerns about this as well and said she thinks of me often because we have tried so many things without much result.  I find this oddly reassuring and disturbing.  I don't want to be the kind of case that a doctor has to ruminate about.  I want to be the easy fix, the success story, the happily ever after.  She's wondering about MTHFR and thinks we should test (you can do this specifically with a saliva test or through a more comprehensive 23andme.com and then have the results translated for you through a service such as Genetic Genie).  23andme is actually less expensive and you can a wealth of information (that I probably don't need! Who needs more to worry about?).  

She also wants me to consider a barium study to look for any anatomical abnormalities and/or adhesions from my c-section.  That sounds expensive!  My insurance will probably just apply it toward my astronomical deductible.  Which makes me wonder why I'm paying through the nose every month for coverage!

White rice and white potatoes are recommended to help introduce some starch but keep the fermentation potential low.  She thought I may need to add back in the LDE in addition to the LDN while my body gets used to the starch.  My digestion is feeling so good right now that I am a bit reluctant.

She asked about my Vit D levels because Dr. Weinstock has been researching LDN and found that it doesn't work optimally as a prokinetic unless you have enough Vitamin D on board.  Thankfully I just had mine tested and it's in the 50's so were were able to rule that out without more labs.

Another way to support my large intestine bacterial health would be probiotic enemas.  She recommended once every 3 days to see how it goes.  I have both PrescriptAssist and Lactoprime Plus on hand and she thought the PrescriptAssist would be best.  Sounds like fun!  I still think I should add a little resistant starch or some other prebiotic to feed them as well :)

I also had thyroid specific questions.  Why do I need to be on T3 when the issue I am having is not with lack of hormone but with my body's inability to convert from T4 to T3?  She says we need to get my temperatures regulated (they are all over the place) and then we can work to support conversion.  Okay, but ugh, I hate taking these little white pills.  She didn't have any concerns with occasional seaweed or iodine in my multi's which is a relief.  She also doesn't think I need to worry about TH1 and TH@ dominance.  If I react to one of the triggers then we'll figure it out. 

I asked about Glutamine powder and Liposomal Glutathione but she wants me to wait before adding anything else in.  She is also researching Glutathione to figure out which one she trusts the most.

Oh, and she said I could experiment with fermented foods again.  I've eaten them in past and didn't notice any issue so I'll try again.

30 minutes goes so quick but I always find it so helpful.

Vagus Nerve Stimulation

Vagus Nerve Stimulation is all the rage right now on the SIBO group I follow on Facebook.  Everyone has been watching the Digestion Sessions with Dr. Kharrazian so they are all gagging, gargling and singing.  I'm not saying this is a bad thing.  It's free, fairly easy (if you remember to do it) and worth a shot to help improve your motility.  For me, I don't think the vagus nerve is the cause of my slow motility.  I've been doing yoga for years and the breathing that we do in class stimulates the vagus nerve.  I've also been trying to do belly breathing daily which apparently also stimulates the vagus nerve.  

These are all pretty interesting if you are interested in learning more about the vagus nerve or you can always pick up Dr. Kharrazian's book!

http://www.newhealthguide.org/Vagus-Nerve.html
http://eiriu-eolas.org/2013/06/29/its-very-easy-to-deal-with-your-anxiety-using-your-vagus-nerve/
http://life.gaiam.com/article/depressed-just-stimulate-your-vagus-nerve
http://www.newsmaxhealth.com/Headline/anxiety-vegus-nerve-stimulation-brainstem/2014/09/15/id/594746/

There's always more to learn!

Went and saw my ND on Wednesday.  He dove right into treatment (visceral manipulation).  All my abdominal pulses were really sluggish.  My body is trying to starve out the infection/inflammation in my small intestine by reducing blood flow.  Not the most effective method.  My blood pressure has been really low in general.  I'm probably remembering wrong but when I was at the Chiropractor on Friday they measured it as 90 something over 50 something.  No wonder I've been feeling so bloody tired, rundown and stiff and sore.  My bloods not pumping!

Anyway, he made no mention of my recent labs.  Free T3 measured in at a whopping 1.5.  When I had it tested 18 months ago it was at 2.8.  My microsomal AB (antithyroid antibodies) came in high at 36.5.  Not way above the acceptable 35, but still of concern to me.  When I said, Hey wait, what about my thyroid tests, he said there was nothing to worry about.  He was more concerned that my Vit D was at 52, I usually keep it in the 80's.  He said not to worry about the thyroid, things would get better when my SIBO was gone.  He gave me NADH to help with my muscle stiffness and soreness.  Not sure I like that.  I want to know why I am crashing.  So I did some research when I got home and found this on Chris Kresser's site.  Gut issues lead to thyroid issues and the gut cannot heal when there are thyroid issues.  Great!  And then there's this all about low T3 and how it's caused by inflammation (check!), not eating enough carbs (check! that actually may have been from a separate article), and physiological distress (check!). "In emotional, psychological or physiological stress, the body will convert excess T4 to reverse T3 (rT3) as a means of conserving energy for healing and repair." - from the Low T3 article.  And of course, I have lots of reverse T3.  Ugh!  Supplementing with T3 doesn't seem to be a solution but he did mention LDN (low dose Naltrexone) would be beneficial.  2 birds, one stone - a prokinetic and thyroid support all in one.  So I emailed my ND and he called me in a script.  I had been taking LDE (low dose Erythromycin) but never really liked the idea of a low dose antibiotic.  Can't remember why I was taking LDE and not LDN but it really seems like I screwed myself there!

Oh, AND when I was rooting through my labs I came across my Urine Organix test that recommend I take more selenium, which I overlooked somehow, probably because I have had umpteen millions tests.  Selenium is necessary for the body to convert T4 into T3. See here.

I also scheduled an appointment with Dr. Keller on Tuesday to skype from NCNM SIBO Center.  I have lots of questions that my ND doesn't seem able to answer.

Then today I went in to get the results of my chiropractic reexam.  My heart rate variability score was pathetic and my chiropractor is worried about my adrenals.  A low HRV indicates dominance of the sympathetic response, the fight or flight side of the nervous system associated with stress, overtraining, and inflammation. - From Mark's Daily Apple.  She said it's an indication that cortisol is just coursing through my system.  Again, good explanation for not recovering from my workouts and feeling generally rundown.  She wants me to talk to my ND about getting this test.  It's all so overwhelming and I feel like I need to study in order to put it all together.

In the end I really have no complaints.  When my family talked about what we were grateful for at dinner the first thing I always say is "my health".  Because even though I have all this nasty crap in my gut, I am still a productive functioning human who can pretty much do anything I want.  It seems like so many people who have SIBO don't have access to good doctors who understand the proper treatment protocols, struggle with how they are going to pay for the doctors who don't take insurance, the herbals which aren't covered by insurance,  they have many symptoms most of which are far worse than mine and they also have other autoimmune or yeast or whatever issues that make the treatment of their SIBO even more difficult.  I'm a lucky girl, that's for sure.

Oh and I had Brazilian Fish Stew from The Zenbelly Cookbook for dinner.  Yep, life is good :)

Paleo AIP Day 6 - pancakes

Okay, so these are not going to be sold in IHOP anytime soon but they were pancake-like enough to satisfy my hankering for something sorta baked that wasn't anything like a smoothie.  For protein I added in a hamburger patty.  My husband suggested eggs.  I think he wants a divorce :)  Seriously though, try at he might, it's impossible to keep up with what I am and am not eating now.

My intention for the morning was to get up and have a non-AIP nut butter energy bar (that I make) and head off to yoga.  But I am going to a yoga workshop at 2pm and I'm not really sleeping all that well.  Not sure if it's the adjustment back to the school schedule or if it's related to diet change.  Sometimes diet can impact hormone levels and disrupt sleep.

I'm still mildly nauseous after I eat.  I've been this way since that first cannabis massage.  Wonder when my body will bounce back and my digestion will return to normal.

This AIP thing is tough to stick to when you are not having any real problems that are being fixed.  I feel pretty much the same except a bit more stressed around meals at times as I try to figure what I can eat.  I ended up eating the first 1 1/2 of 3 pancakes standing in the kitchen while cooking the last pancake and the beef patty.  Not ideal. 

Connecting the dots

Isn't that the hardest part sometimes?  So I had a massage with cannabis cream just before Thanksgiving.  I ended up getting constipated but with Thanksgiving and eating more carbs again I wasn't sure it was connected.  I cut the carbs back out and moved on.  Throughout the month I experienced increased stomach (like actual stomach, not lower abdomen) bloating, gas with belching, popping out through my diastasis recti, constipation and resulting crankiness and feeling like crap.  I couldn't figure out what was going on. I'm really bad at recognizing patterns and connecting things.  A week ago I was chatting with my massage therapist during my weekly massage (I know a luxury, but he's awesome and uber inexpensive) and we are talking about digestion stuff and he says he's been using cannabis cream on me weekly since just before Thanksgiving.  Ugh and eureka! I love that my therapist was trying to help relieve my muscle tension in the best way he knew how and don't hold him at fault.  I talked to him about how permeable the skin is and how the cannabis can relax all muscles including the ones involved in moving food through the system.

I spent the next 3 days suffering and then things slowly improved.  Now I know what the heck has been going on.  It's not a new food sensitivity and it's not a hiatal hernia.  My ND says that my diastasis recti is narrow enough that I may be able to knit it back together using the exercise he showed me years ago that I never followed through on.  He wanted me to try an elimination diet but that was before the cannabis discovery and we didn't know what was going on.  Now I'm not sure I really want to.

Tests for Hashimoto's are unclear at this point.  Still waiting for one more number to come back and a follow up appt to go over the results.  My guess is it's positive and mild and that my diet over the past year has really brought things under control.

I cheated a bit on Christmas (a cinnamon roll made with coconut flour, almond flour and a bit of coconut sugar) and did okay.  The thought of doing an elimination diet has caused me to go off the rails a bit.  I don't do well with diets.  Lifestyle changes yes, temporary change, no.  I drank beer a couple of nights ago and have been eating a few sweet potato chips here and there and more chocolate in sort of a last hurray (although I generally don't even eat those things).  I laid in bed last night and itched all over, back to the good ole days :)  I need to get my shit together, in other words, either start the diet or decide not to do it and just move on.

Protocol as of Dec 1

First thing in the morning I take:

1/2 tsp Lipophos EDTA (but will be discontinuing when it's gone because in the Digestion Sessions Dr. Siebecker said she hasn't seem anything that indicates it actually helps in treatment.  Bummer!)

20 minutes before meals:

4 tablets Spectrazyme

1/2 - 1 tsp of Bitters

20 drops of Iberogast

With meals:

1-2 Metagest (depending on the type of protein I am eating)

1 tsp Herbal Biotic

1 Allimed

1 Berberine

1 Neem Plus

1 Resveratrol (after listening to the gut-brain axis talk)

1 Huperzine A (after listening to the gut-brain axis talk)

Bedtime:

1/2 tsp Lipophos EDTA

I take other supplements as indication by labs but these are nutrients specific to my needs.

I need to work in the whole gagging and gargling thing to see if it actually helps motility as discussed by Dr. Datis Kharrazian.  Still waiting to get his book from the library.  I am definitely not delving into the whole coffee enema until I've read more!

Digestion Sessions Encore

Dr. Siebecker is back in the encore of the Digestion Sessions, as is Dr. Kharrazian.  There is also a link where you can print the transcripts which I am definitely going to do as there is a ton of information that I will never remember and my notes just aren't as good.

The bottom line with Dr. Siebecker is that everyone is different and your treatment and especially your diet must be individualized.  And when it comes to diet the only person who can really figure that out is you (with or without the help of your provider).  Soooo helpful :) Wouldn't it be nice if there were a one size fits all treatment and diet??

Dr. Kharrazian's book "Why Isn't My Brain Working" on hold at the library.  I may decide I can't wait and just download it from Amazon, since it's only $10.

As a side note, my aunt has been very ill and her doctor's can not figure out what's wrong with her. Turns out she has these bouts of nausea, exhaustion, etc when she is with my grandmother or talks to my grandmother who isn't the nicest to her.  I tell you this why? Because if you don't deal with your stress and set limits with people, you will never be well. And again, you need to figure out what works best for you in terms of relieving your stress. I've mentioned before that I tap, do yoga and take daily walks.  What I still need to work on is being more present because it's so easy to get wrapped up in things I want to do rather than what I am doing.

Digestion Sessions

If you have not clicked this you should!  There was an excellent video today with Dr. Datis Kharrazian all about the brain - gut connection, how it impacts your motility and simple exercises you can do to fix it.  I'm all about trying things that cost NOTHING!  I'm going to get this all wrong because there was so much information but it has to do with your vagus nerve not functioning properly and how you can exercise this nerve by gargling to the point of tearing up several times a day (like everytime you go to the bathroom) and using tongue depressors to stimulate the gag reflex.  He also said coffee enemas help too although I didn't really catch or understand all the science behind it.  It wasn't about detoxing, it was about a chemical reaction.  Anyway, you need to listen for yourself!

In other news in addition to braces I now have 8 shiny screws in my jaw in an attempt to move my teeth up and allow my jaw to sit differently so my teeth actually touch enough that I can chew.  It's been fun I tell you.  It's made it even more difficult to chew my food and I end up with enough stuck in the bands in my cheeks to tide me over until my next meal.  Fingers crossed it works and I don't have to have my jaw broken and realigned.  The things we do for digestive health I tell you!!!

I've ditched the iodine for now since I am having enough trouble taking everything else my ND has me on.