I recently received an e-mail from a young woman who has been through the diet ringer as so many who have gravitated to 180DegreeHealth have. From raw-foodie to low-carb Paleo, Sarah went through it all and got repeatedly punched in the face. Just reading her story felt like I was on the receiving end of Mike Tyson or Rocky Balboa’s boxing gloves. Extreme diets can definitely be formidible opponents, especially for a young kid with a well-intentioned but hopelessly lost mother as you are about to read.
I take great pride in 180 having become a sanctuary for those who have tried all kinds of radical diets. I’m sure many of you have had similar experiences. “Screw ’em!” says Anthony Hopkins in Legend of the Fall. Ferris Bueller’s sister said that as well I believe. Anyway, here’s Sarah’s story. I highlighted the craziest parts…
Hi, I’m Sarah, 26, mama to 2 little people, wife, bookstore owner, health obsessed, food obsessed, and adrenal fatigued beyond all understanding.
I was raised by a single mama, 7th child born (she was 44) – which already sets me up for disaster, I know. She raised me eating a diet based on her readings of Bernard Jensen, Dr. Christopher (and his Mucusless Diet), and Ann Wigmore. She did a lot of nutty things that in retrospect I recognize as very dangerous for a growing child (though her intentions were very well meaning). For instance, in high school, for a year she would force me to take apple cider vinegar, cayenne, and honey. And that was breakfast (and no more). I can’t tell you how bad those stomach burns were in first period Theater class. Or how horrible those hypoglycemic attacks were a couple unnourished hours later. Augh.
I started binging on junk food at a very young age, but it jumped a notch when I started living primarily with my mom at age 6. Vegan, low fat, high carbs, mostly salads. I was starving (in fact, at church functions I would head right for the cheese, butter, bread and meat). When I started making babysitting money at age 14, almost every day I would eat donuts, chips and ice cream for lunch. I soon after got awful acne, gained a couple pounds (for the first time ever), and started getting really tired.
The second year into this, my vision went from 20/15 to 20/30 overnight. A month later I was stuck in bed for two weeks with pneumonia. Try throwing up non-stop, drinking 3 gallons of water a day to keep from coughing, eating nothing, and laying in bed with 104 fever that won’t go away. Why, oh why my mom didn’t take me to the ER, I don’t know. Finally the fever left, and after 2-3 days I was better. But not really. I didn’t know it at the time, but I was left with an adrenal mess. I joined the track team the next year, and it was at that time that I realized something was wrong. Running at all felt like trying to walk through thigh-deep mud. It was awful, and after 3 months I finally quit. I was so, so tired all the time.
At 18, I became a raw foodist. I was obsessed entirely and completely. I was pregnant 3 months into it, and therefore became obsessed with purity. So fruitarian made perfect sense (rolling eyes here). I tried and I tried. I failed and I failed. At age 14 months old, my daughter suddenly showed signs of severe tooth decay (aka bottle mouth). I was devastated. What did I do wrong? She had never had sugar, meat, dairy, chemicals, processed foods, etc. How was it possible? I was at a loss, but decided it was because I hadn’t been able to attain a pure, 100% raw diet (those dang potatoes!), so I just tried harder.
(Sounds like Rami…)
Then a year later, I had baby number two. By the time he was a year old, my daughter’s teeth were so bad and I was just heartbroken (and just couldn’t bring myself to anesthetizing her so they could “fix” them all). Luckily at this time, I started reading about how a raw vegan diet was incomplete because primates eat bugs, therefore some animal matter was biologically correct. A mother had added raw goat dairy to her and her kiddo’s diet and found health to be a whole lot better. So I started justifying my occasional raw dairy binges. A year or so before, my sister had showed me Weston Price’s book, but I thought it was weird, outdated, and boring. I was 19 and thoroughly convinced that raw veganism would save the world. But now, I found references to him all over the place (even David Wolfe’s store sold the book! although, I think it has since been removed). So, I bit the hook and bought the book.
Thankfully, it snowballed into becoming fascinated with scientific reason. Unfortunately, all those years of thinking everything except fruits and vegetables was bad caused one massive 3 year long binge. Yes, I know. So brilliant. And when I say binge, I also mean sugar and processed crap. Each binge would last anywhere from 2 weeks to 6 months (the biggest, the longest, and one of the last caused me to gain 30 pounds…yikes!). During that time I started running (and got super skinny, and then proceeded to spend the entire day laying on the couch exhausted), did multiple juice/herbal fasts of every variety (in which I would actually gain weight), and read like crazy. Reading didn’t mean that I could stop myself from damaging my body though. 22 years of malnutrition and my body was toast and craving everything under the sun. No, I didn’t have antibiotic damage (thank the gods), or crazy partying damage, or the usual complaints. But my body was so, so starving.
A year ago, I went to the local ND to try and figure out why the heck I felt so exhausted 24/7, why I couldn’t lose any of my weight (even when juice fasting), and why I couldn’t think straight EVER. I was irritable, clumsy, frustrated by everything, and just wanted to take an eternal nap. I also had pretty bad cystic acne, and had been dealing with pinched nerves in my arms for a couple of years (relieved by chiropractic/massage care, but not fixed – still have these issues). He had me do the adrenal saliva test. Results came back that I produce almost no cortisol ever. Like almost zero. DHEA was borderline bad, insulin doesn’t rise after eating food (so it’s the same whether I’m fasting or full), and my immune system wasn’t even working (which I thought was strange because I never, ever get sick).
I tried doing his recommendations and supplements, but it caused PCOS symptoms to show up. Great. So, I quit. I had quit doing cardio exercises, and was doing strength training. I was trying really hard to sleep more (since my cortisol levels fell in the normal range at night – even though production is next to nothing – I was/am wide awake and can’t fall asleep to save my life before midnight). I became obsessed with Anthropology (fantasizing about getting a PhD and saving the world Paleo style) and the Paleo diet. I stopped eating grains for long periods of times (including all starches), and for the most part didn’t eat carbs much at all (excepting for those binges – anything chocolate was in trouble then!). Honestly, I was starving. My hunger itself diminished, but there was just some gnawing feeling that I was really, really starving. About August, I started eating 1200 or less calories a day – I would skip dinner. I lost 17 pounds over a period of 5 months. It was easy (after the hunger dimished), felt great, instantly satisfied me, and I was happy. Then the holidays came and I decided I deserved a treat. Then it became more like 200 treats. And 10 pounds.
So fast forward to today. I’m still flat-out tired all the time (and have the horrible acne and pinched nerves). I’m trying really hard to make myself go to bed at 8pm (and hopefully fall asleep between 9-10) for that extra-needed rest. I’m suspicious of my ND’s hormone recommendations after doing research online – a friend who did the same protocol (and recovered from severe adrenal fatigue) just relapsed and is exhausted again. Dr. Schwarzbein makes it seem like I need to hook up with an endocrinologist NOW and get on HRTs. The day I found your blog -> website -> ebooks, I was researching lectins, plant toxins and anything else I could find that would explain why I felt so shitty.
Then I read this: http://cogweb.ucla.edu/Abstracts/Pennisi_99.html. And I read some comment somewhere about how one can observe evolution happening instantly in a petree dish. It hit me – duh, why can’t humans adapt to starch over a period of thousands of years? We do make an enzyme to digest starch specifically. So why not? Then I started reading your website, ordered your books, inhaled your Metabolism book in 2 hours flat, and felt more relief than I’ve felt in a decade. Of course, that doesn’t fix my exhaustion, but you might comprehend the level of food obsession I endured. The hunger. It sucked. I don’t know how many calories I’m consuming at the moment, but I know that my great-great-great grandma would be proud. I didn’t realize how little I was eating. And you know, even though I’ve banned myself from the scale, I don’t think I’m gaining weight, and I might even be losing just a little bit. And you know what? I don’t care. Because I know that I am now committed to fixing this for the long haul. No more quick “fixes” (aka damages). I’m ready to truly care about my health instead of my weight.
But what to do about the adrenal fatigue? I’m resting, not exercising, eating as much fat as I can handle (I’ve already been on board with the high fat diet, so that was easy), actually eating carbs and loving it (gasp), and cutting down on the fruit (down to grapefruit – oh, and that occasional chocolate, though the cravings are greatly dimished). In your research, have you found that someone with severe adrenal fatigue should go down to the local doc and get a prescription for bio-identical hormones? Or what should I read/learn about here? I’ve spent so many hours of research and gotten all the opinions leaning one way or another. I’m still sorely confused.
Any help would be greatly appreciated!
Thanks for your awesome information and quirky sense of humor!
-Sarah Braun
Roots and Branches Photography
I of course told her to try eating well for once in her life. HRT is a life-sentence and a last resort, and something few fertile 26-year old women need to improve their health.
Sarah, thanks for letting Matt share this challenging dietary journey with us; So glad you find this site and info. Wishing you and your two kids total metabolic healing over the coming months and years :)
It's amazing how free it feels to finally give up obsessing over food. Even on paleo/low-carb I obsessed over what I was eating, though I wasn't counting calories. Now I just focus my diet on real foods of all kinds, and don't stress over exact numbers (and I don't stress if I want to slurge a little, either).
I've been reading Adrenal Fatigue by James Wilson, and have been really enjoying his different suggestions for recovering. One was taking about 1/2 teaspoon of sea salt in the morning with a glass of water. Lots of other helpful suggestions in there, too.
Sarah, I didn't roll my eyes when you said fruitarian… I was there too, and pregnant, and trying to head toward breatharianism. Luckily my body craved chicken so bad I had to eat some… but in my infinite wisdom went back to vegan later on. We all make mistakes with the best intentions for our off spring in mind. Glad you found the right path. I too was glad to find Matt's stuff as I was getting into low carb, which of course had never actually felt good to me, but I was going to force myself… I've learnt.. I hope!
"In your research, have you found that someone with severe adrenal fatigue should go down to the local doc and get a prescription for bio-identical hormones?"
I'm anything but an expert on this, but I've got at least some experience with adrenal fatigue (although not that severe). And before trying to get some hormonal treatment, I would at least try herbal + nutritional supplements. I would say that B vitamins + some kind of herbal extracts (there's a Rhodiolae Rosae/Ashwagandha mixture out there from Higher Nature which is supposed to be pretty good)+ the salt thing Elizabeth mentioned is very much worth a try in my opinion. At least if you haven't tried it yet.
I think this is quite a decent article about the whole subject:
http://www.drlam.com/articles/Adrenal_Fatigue_Glandular_and_Herbal_Therapy.asp
I am a male, but my story was almost exactly the same. I had SEVERE adrenal fatigue that has been documented by multiple lab tests, by several doctors. The only thing that helped was getting a prescription of hydrocortisone and self medicating with caffeine. I am now off the hydrocortisone after taking it for a year, and find that oral pregnenelone first thing in the morning really helps, try this before jumping onto prescription meds.
It is also imprortant to eat Schwarzbein style, especially with enough protein in the morning. I also find that eating starches instead of fruit has helped. Now that I have healed my adrenals I can eat fruit alone, but would crash before.
If you really do have adrenal fatigue then your other hormones will probably be low too because the adrenal glands make much more than just cortisol. But, if you go to a typical endocrinologist and tell them that you have adrenal fatigue they will not take you seriously, and they probably wont give you HRT either.They mostly just know how to treat thyroid and diabetes. You will have to see a doctor that specializes in anti-aging medicine probably, or one that specializes in female hormone problems.
I also had an Ayurvedic doctor that helped me alot as well. But it is difficult to find a real one in the USA.
I totally agree with her. When eating grain/starch free, I don't feel hungry, but it is a false feeling, cause there is that huge feeling that something is missing and no matter how much steak and bacon you eat, you are never truly satisfied. Also true that in that state, when you do have one little high carb or high sugar sweet you end up eating out of control, sometimes even for weeks. Doing HED I can no longer binge. I tried to yesterday. I went to the grocery store and wanted to buy something so I could have an all out naughty day. I went up and down the aisles looking for something, but nothing sounded good. I finally bought a bag of all natural potato chips, ate like 5 of them, and still have the whole bag in my pantry. Now when I crave something, it is not something sweet and destructive, it is something simple like rice with broccoli and melted cheese or buttery mashed potatoes with sauteed chicken.
Very different than eating starch free where I would crave doughnuts, chocolate, and cake.
Saw this at a raw vegan site:
http://www.shazzie.com/life/articles/raw_vegan_children.shtml
"The truth is, though I'd love to see it, I have never once seen a 100% raw 100% vegan 100% unsupplemented child past breastfeeding age who has no tooth decay and is the correct weight and height for their age. Not one. Ever.
On the other hand, I have, since 2001 seen countless raw vegan unsupplemented children spanning several countries with growth, teeth and mental disorders. Now, don't ask, because I will not name names, ever. I have cried at the child who was so retarded he barely moved (he since recovered on a cooked vegetarian diet, perhaps with some fish in the early stages). My heart has sank at the tiny girl on YouTube who has hardly any top teeth due to visible decay. My heart has wept when I've received letters from mothers who "just couldn't raise their children raw vegan", no matter how much they wanted to, even though they followed the advice of "experts" to the letter. And I've been puzzled as to why the raw food community covers these issues up time and time again. "Is it just me"? I've often wondered?"
The sad thing is when people bring this up, raw vegan gurus will say "well I've been RV for 30 years without a problem." yeah, it's truly amazing what an adult human can survive on, but a growing child needs more.
If you are hungry and not getting enough calories, you aren't on a paleo diet, you are on a faleo diet. Pick a diet that nourishes.
Hungry? Ur doing it wrong. That's my PSO for the day.
Now I will go back to my delicious lunch of pork belly mashed potatoes MMMMMM
Not related to this topic, but how many time it took you guys to feel ?normal? again after eliminating caffeine while eating 180?
This is my first day of zero tea -I have always been a heavy tea drinker, never coffee, and I have been feeling sleepy from the morning (it’s the afternoon now).
I don’t want to make this too long, but I understand you completely, since I am one of those persons that used to cut calories drastically to finally sucumb to a binge of weeks.
Thanks,
Max
i never had as severe adrenal burnout as sarah, but i did have a test done by my chiro when i was 3 months post partum, i think, and i was pretty messed up. she started me on the salt thing mentioned already–put a pinch of salt on your tongue in the morning followed by a glass of water. put sea salt in all of your water. i took large amounts of cod liver oil, B-vitamins and coconut oil. i did my own research and came to my own conclusions as to what i should take and took all kinds of supplements from http://www.qnlabs.com
that combined with a near perfect Nourishing Traditions diet including massive amounts of raw dairy, butter and meats helped me tremendously.
Sarah,
That is quite a story. It sounds like you are on your way. I will be interested in hearing about your progress.
The sad thing is when people bring this up, raw vegan gurus will say "well I've been RV for 30 years without a problem." yeah, it's truly amazing what an adult human can survive on, but a growing child needs more.
Don't believe that nonsense for one moment. They cheat. They downplay it. They still call themselves "raw vegan" but that "cheating" can make all the difference in the world.
The anecdotal first hand stories of raw vegan gurus "cheating" going back many many decades are legion. "Cheating" once a week or once a month by eating animal products and then proclaiming you have done okay as a RV for 30 years is delusional. The animal food makes a significant qualitative difference and removes them from the class of "raw vegan."
Dr. Poppy here. Matt, I have to disagree with your skip the hormones advice. First of all, as a cycling female, albeit abnormal one right now, it will be near impossible for her to heal her adrenals without hormonal support. There is no such thing as a "life sentence" if you use hormones, that all stems from the idiocy of synthetic hormones/birth control pills for everything approach. Support of her sex hormones will not only help her feel better (of course bioidentical are a must), but it will accelerate her ability to heal her adrenals as will as all the other things needed nutritionally and supplement-wise. Since cortisol is a sex hormone that is intimately related to the other sex hormones, you cannot treat one hormone imbalance without addressing the rest. And life will suck a lot more if you don't.
Dr. Poppy,
There is no such thing as a "life sentence" if you use hormones, that all stems from the idiocy of synthetic hormones/birth control pills for everything approach.
So is hormone therapy of this type temporary until the person is well?
Max,
I was badly addicted to coffee when I started on HED (a sign of adrenal fatigue). Takin Scwarzbein's advice I did NOT just quit taking it. It's a crutch, and do you know how helpful it is to throw away your crutches before you're fully healed? "Un-helpful" is the right answer.
And by the way, I did try quitting coffee at several points prior to HED. Never worked. I was tired, just like you described.
Instead, what I did was started drinking hot water to cover my physical habit (like someone trying to quit smoking chews gum) and drank coffee whenever I got tired. Over time I drank less. Then I switched to decaf. Later tea, then green tea. It took six months but I have been off all caffeine since New Years now and I'm never tired for lack of coffee.
That's what I suggest you do. If you're tired, drink some tea. In the mean time, eat well and get lots of rest. Your need for tea will diminish over time.
Regards,
Brock
I've got severe adrenal fatigue and have been taking low-dose hydrocortisone for about 3 years. When I'm in better shape, I can lower the dose, but I haven't gotten off it all the way. Yet. But life would be pretty much unlivable without it.
When you've had a saliva test done and it proves your adrenals are a mess, take the meds so you can get out of bed and have some kind of life. As someone above said, you likely need to check your sex hormones and especially thyroid as well.
Of course you can do all the other stuff too that helps your adrenals, like avoid stress and eat HED and supportive herbs, at the same time.
Dr Poppy,
I totally agree with you. This has been my experience.
Michael,
My doctor specializes in hormones and treats many people with adrenal burnout and he said he has seen people get well and restart their production. But, it may take a while to get to that point, and you may need hormonal support to get there. The sex hormones like testosterone are necessary to rebuild, if you are low it will be difficult. So, yes it can be temporary until the person is well, or it might be that the people who get burned out in the first place are the types who may need support to live in this unnatural world.
Brock,
Regarding caffeine, if you have REAL adrenal insufficiency, then it can be extremely helpful to use while you are getting better, as it extends the half life of adrenaline in the body. Just because you are addicted to coffee doesn't mean you have adrenal fatigue. Too many people say they have it, when they haven't done the proper tests to know for sure.
I look at hormones as restorative, with bioidenticals we can use very low doses with great clinical response. If there is good recovery, then you don't need to stay on them indefinitely. Each person is different. I use hydrocortisone in only very select cases because when you address hormone imbalance, vitamin/nutrient deficiencies, nutritional therapy, the adrenals will repair and start producing their own cortisol. I disagree with the caffeine dogmatics. Usually I have people come off completely if they are diagnosed with moderate to severe adrenal fatigue, then I gradually allow them to reintroduce it as long as: it is a natural source like organic coffee or green tea, nothing with artificial sweeteners and only if it does not interefere with their sleep. Caffeine is a great anti-oxidant, but if its overuse is blocking your adrenals from healing, then temporarily it may need to be discontinued.
Caffeine
My wife weaned the slow way. We literally counted the number of regular beans that we mixed with decaf. Started at 60, and took away 5 to 10 regular beans per week, until it was pure decaf. At that rate it is practically not noticeable. Even decaf still his a minuscule amount of caffeine, but I think not enough to be an issue.
Scott
What's wrong with the guy in the video? He looks and sounds (not his advice, but his voice) like a vegan.
Scott
I took about three weeks to get off caffeine, moving from half-decaf eventually to tea. That was in November and I still miss it — but who wouldn't, it made me feel energetic and just having a few hours of fake energy was enough to bring on the happiness.
I do like waking up and not feeling all fuzzy until I've had coffee. And I'm hanging on to the hope that eventually I'll have that energy and happiness without coffee.
Sadly, I found a tasty brand of decaf but it definitely has too much caffeine in it. After being CF for this long, when I had a cup it was like coke.
I think it's licorice that extends the life of cortisol, not caffeine…
Great commentary amigos. Thanks Dr. Poppy for your assessment, and pointing out confidently that BHRT is not a life sentence. I'm glad that you feel that is the case, although I would still be the last person that would tell a 26-year old who has never eaten well for one day to run to the doctor before seeing what eating well can do. That is still the appropriate sequence, and only after a couple months would I suggest someone look to additonal means to treat a non-life threatening illness like fatigue.
Swede-
Rami definitely used to be a vegan. But then he found those teeth rotting out in himself and his kids and pulled a serious 180 on that. But his advice is a little too weighted towards Weston A. Price and not weighted towards Melvin Page enough IMO.
Indeed, a food-related trait can evolved in as little as 396 years, or even less:
http://healthcorrelator.blogspot.com/2010/01/how-long-does-it-take-for-food-related.html
This does not mean that a population's entire metabolism or digestive system will change in that period.
Genetic mutations that have a positive effect on reproductive success do take a long time to appear in a population, but, in the case of an isolated population, evolution uses the genetic diversity that is already present in the population.
What is the big problem with caffeine? Does anyone have proof that using small amounts is bad for you?
Ray Peat thinks it should be given vitamin like status. Schwarzbein says it is OK to use as a crutch if you have adrenal fatigue.
If you are going to use it as a crutch when you have adrenal insufficiency then the key is to use small amounts at a time. Drinking a whole cup of coffee at once can be too much. I used pills and cut them up in to 25 mg pieces. I used this along with hydrocortisone as a crutch allowed me to function normally even though I had severe adrenal fatigue.
Very interesting. I haven't been drinking any coffee or tea for months! Even though I really, really like coffee. Still feeling kinda tired every now and then but until now I thought caffeine should be completely avoided.
Hmm, maybe I'll give Yerba Mate a try. It's supposed to be way better than most coffee/tea because the risk for a "crash" isn't supposed so high and some people even recommend it for adrenal fatigue. Anyone got any experiences with Mate tea?
Nell,
Licorice root is also very helpful for someone with adrenal fatigue because it has cortisol like effects. It can increase the cortisol half life in your body by quite a bit. If you are taking the real stuff, then you can feel it very strongly. I have used it, but stopped because it can have strong estrogen effects in males. I dont think it should be used for a long period of time if self medicating. And it might be better for women than men because of the estrogen. I would use a qualified specialist if I was going to use the herb for long because it is so strong.
Regarding caffeine, yes it does increase the half life of adrenaline (epinephrine) in the body.
madmuhh,
Just ask the people who "know" caffeine is evil for proof that it is bad for everyone.
I have a lot of experience with Yerba Mate as I used to live in South America and drink it all the time. A lot of people there are totally addicted. It doesn't really stimulate as strongly as coffee, but I didn't like it as much and seemed to have a slight allergy to it. You should try it yourself and see if it is good for YOU. The reason people crash with coffee is because they take too much at one time.
Sorry, for being off-topic, but I thought, I'd just share a quick status update.
So I stepped on the scale today, and while it may not be totally accurate, since that scale is darn old, it looks like I gained 5kg! However, it still doesn't show very much, which only further confirms how goddamn skinny I was before. Wonder how my weight would change if I upped carbs and ate less fat, but that's not what amtters now. Overfeeding still has top priority.
I just ate a huge amount of food and my stomach is close to exploding, but I'm still hungry! That just shows how much low-carb has messed me up, even though it seems to have started even before that that huge meals just make me hungrier. Kinda hard to eat beyond satiety that way.
However, body temp has gone up a bit already and I'm doing much better, so I guess my body is starting to get out of starvation mode, even though my hunger still is not in control – or at least I hope so.
this story is almost identical to mine… now im just fatigued all the time it sucks. i am never hungry either whereas before this whole diet mess came about i always had the biggest appetite/metabolism… why is that? i want to be hungry…makes me depressed cause i love food and am a chef at heart
"Doing HED I can no longer binge. I tried to yesterday. I went to the grocery store and wanted to buy something so I could have an all out naughty day. I went up and down the aisles looking for something, but nothing sounded good."
Yeah, after a few months on HED, food simply doesn't interest me. I don't particularly enjoy eating now and I'd rather eat less – the problem is just I still get hungry whenever I try to. Before the HED I had the exact opposite problem on my binge days – I filled up very quickly even though I wanted to eat more, cursing my stomach for not having room for everything I wanted to gulp down.
I think this is very strange – that the hunger is persisting even after the appetite has died completely and the thought of food doesn't entice me in the least. I guess the absence of food cravings is a sign of a well-nourished body that doesn't lack for anything – but I can't figure out why the extreme hunger should persist in that state, maybe just a matter of having sped up gastric emptying too much through months of overfeeding?
In other news, I've gained a few pounds, and probably some fat too, the past few weeks and am now up to 196 pounds (from 141 initially). My fasting glucose has not changed in the past month, I got a 90 this morning, but have been getting closer to 95-100 the rest of the week. I seem to get more and more bloated now and overall haven't been feeling too good these past few weeks – the outright headache is gone, but still tired and feeling sort of drugged and hazy. Sleep has been ok so I don't think that is the problem.
Elizabeth,
I have Dr. Wilson's Adrenal Fatigue book too, and liked it a lot, but I ignored his diet advice because I didn't think I could handle that many carbs. Now I'm working more toward his (and Schwarzbein's) recommendations of some unrefined starches and vegetables at every meal.
I was pretty happy last night when I had mashed potatoes with butter and sausage, and my BG only went to 137 after one hour and was down to 100 after two hours. I can definitely live with that. Next step looks to be an adrenal hormone test, because I know my adrenals have been a problem for years, but I don't know whether they're at the burned-out point or still overproducing cortisol. The latter seems to fit my symptoms better.
Dr. Schwarzbein's take on HRT seems to be that you should use it as a last resort if the other four parts of her program don't do the job. It's always supposed to be temporary, and never a crutch to keep you going while you continue to eat poorly, overexercise, or whatever screwed you up in the first place.
I look at hormones as restorative, with bioidenticals we can use very low doses with great clinical response. If there is good recovery, then you don't need to stay on them indefinitely. Each person is different.
Thanks that was helpful, although I still look at them as a last resort approach, especially for someone who is relatively young.
Aaron, I agree: Wilson's dietary advice is basically good but it should be taken with a grain of salt. I tend to do Schwarzbein with WAPF principles and some HED influence. I think Wilson's is too low in fat for most people, and although he stresses eating often I don't think he put much emphasis on eating *enough*.
Funny thought on caffeine: since quitting caffeine a while back, I can now get a buzz from drinking decaf. A mild one, of course, but I can't tolerate caffeinated beverages at all any more, so decaf gives me just enough if I'm wanting some coffee.
Any suggestions from the crowd on how to go about finding a Doctor who understands all this and is willing to work with it? Dr. Poppy sounds ideal but she's not anywhere near where I live (and maybe she only works with women anyway?). I want to get some levels tested and work with an expert on that, but haven't had any luck in finding one in my area.
damn… i haven't drunk coffee in 3 months… i forgot all about it…
hope you get well sarah.
troy
Dr. Poppy here. With the above woman's story, I guarantee you she is progesterone deficient at the very least, probably DHEA is low due to adrenal burn-out. There is simply no good reason not to treat her with bio-identical progesterone which has no cardiovascular risk, helps a woman cycle regularly/helps her become ovulatory which she is likely not with this disaster story, treats PMS/PMDD/sleep disorders, etc. I am a bit frustrated that younger women are prevented from getting the proper attention and therapy to their hormone imbalance because someone thinks their age should be what dictates when such therapy starts. If you are testing hormones and they are abnormal, it is crazy not to address them…you can't say, hey change your diet and we'll recheck it in a few months. Schwarzbein's approach to HRT is something with which I disagree (most endocrinologists really are not well-versed in sex hormones surprisingly, they usually leave that to the fertility doctors). Her approach was to use primarily oral hormones, albeit bioidentical, which causes its own set of problems. High doses of oral bioidentical estrogens likely played a role in Suzanne Somer's breast cancer and pre-cancerous endometrial hyperplasia which necessitated her hysterectomy. For some reason, Schwarzbein has been opposed/unwilling to use transdermals much. As a gynecologist, perhaps I have a different patient base than she did. I think most people are still in fear of hormones from the synthetic/WHI era, but I see hormone deficiencies in young women (and testosterone deficiencies in young men) that I am most certainly going to treat. Let's face it, we live in a polluted planet with endocrine disruptors everywhere that we cannot control, even if we eat a great diet, get good sleep, don't smoke, etc. Hormone balance is a MUST!
I've found that I feel absolutely fine (even better than before!) if I add enough white sugar to my coffee. I guess I'm doing the opposite of what most here are doing: I'm trying to drink at least 5 cups a day–with sugar and cream, of course. Quite honestly, I feel fine in the morning. Actually I feel better in the mornings (before the coffee) than when I avoided it. Of course I've changed all sorts of things, so don't use this as a guide. I sort of have to remind myself to drink my morning coffee. I figure that it's not so much that the coffee makes people feel shitty when they wake up, but that some food intolerances/low metabolism make people feel shitty and they naturally medicate with coffee. And it looks like alcoholics who drink 5 or more cups a day are 80% less likely to have cirrhosis of the liver. 5-cup-a-day'ers are also more likely to hallucinate (the small kind). I (probably incorrectly) attribute the hallucinates to coffee's supposed anti-serotonin properties.
Hey Dr. Poppy,
What city do you practice out of?
troy
Sarah thank you for sharing your story, please keep us posted on your progress and what avenues you end up choosing.
Dr. Poppy thank you for sharing a professional opinion. Do you think the body is capable of healing it's self, in Sarah's situation? If so, do you think that proper hormone treatments only afford a much speedier recovery?
Were you arguing what hormones Schwarzbein is using in her practice or just the mean of administration, oral vs. transdermal?
@Half Navajo, my practice is in Poplar Bluff, MO. I see men and women for hormone imbalance. http://www.drpoppy.com, blog: http://www.drpoppy.com/wordpress, twitter: @drpoppyBHRT
@Nathan: Yes, the body is able to recover hormonal function, but a lot of it is age-related. For example, a women's progesterone is directly related to ovulation, egg supply, this starts to drop significantly after age 30 so that is why most women after this age tend to need progesterone support. Often they can continue to produce estrogen (esp. if overweight, well into menopause). If their DHEA is low due to adrenal fatigue, it may be a long time for the adrenals to recover enough to produce adequate amounts so they would benefit from hormonal support. All my patients are tested first, given the very lowest dose necessary to control symptoms, using transdermal bioidenticals and are montiored very closely. I heard Schwarzbein is writing a menopause book, so maybe her thoughts have changed (from what I understand, she doesn't see patients clinically anymore). She stated that she had a bad experience with progesterone cream early on and that kind of colored her approach, so primarily she was using oral estradiol and oral progesterone, both of which have their problems. I use a lot of different forms, topical creams, vaginal cream, suppositories, troches/sublinguals, patchs, sprays and I do use oral progesterone, it just has some side effects and absorption issues you don't see with transdermals.
I use a sublingual progesterone drop by Clark's in Seattle. The lab my MD uses, Diagnos-Techs, recommends them bc they can run an accurate saliva test on them.
The bio-identical P drops are making a big difference for
my middle-aged body.
I'm new to Schwarzbein, and new to HED. I'm trying not to get distressed by my initial weight gain!
I following the blog below due to the legal issues with raw milk here in Ontario, Canada.
Nice surprise posting today:
http://thebovine.wordpress.com/2010/02/22/the-story-of-layla-and-her-perfect-teeth-some-cultural-learnings-from-africa/
Layla added some comments and a nice thanks to Matt!
I just want to add, about adrenal fatigue — if it's severe enough, it's not just a matter of dragging around and being too tired. It's scary. You start getting a lot of anxiety because your body is telling you that if something super stressful happened, your adrenals would not be able to pull you through.
And if they do fail, it can be life-threatening.
For me the problem with caffeine was that in my mind it was linked in with sugar. I used to drink sweetened tea, a lot of it, (between 5-10 cups a day). I also used to always have something sweet with my caffeine. I gradually weened myself down from black tea, to green, to white, to herbal, now to none. It has helped my sugar cravings a lot. It is a drug and it is physically addictive. Lot of alcohol recovery programs won't let you have caffeine because many drinkers have a caffeine in the morning/booze at night loop. Breaking the caffeine part of the loop makes shaking the booze easier too.
This is all hilarious. Weening yourself off bean by bean. Haven't any of you ever quit smoking? I still read the paleo blogs for good laugh, but these comments are starting to shape up nicely as well.
Oh D man. Just earlier today I had to write to a man explaining how his panic attacks were being caused by caffeine. He told me that was the case after paying close attention. He had checked into the hospital over it thinking that he was having a heart attack.
After investigating it, he found that it was actually the caffeine doing it to him. I told him that it was a common response, something reported by Stephen Cherniske and written about as early as the 1940's with the work of Seale Harris and E.M. Abrahamson – who recommended cutting out sugar, alcohol, and caffeine to treat various psychological problems with an unprecedented success rate.
It's a profound stressor of the nervous system and an adrenal whipper that provides short-term relief from low adrenal output with presumed consequence. It ain't for everybody, and I maintain that caffeine is one of the most underrated ills in the typical modern dietary.
Collden-
The only other author that recommends a true overfeeding version of the HED is Aajonus Vonderplanitz. For him, gaining weight by overfeeding is a healing regimen, but even he follows it up with a protocol to remove all the excess fat in a short period of time. This may be a sound approach, regardless of why AV thinks it is therapeutic (he believes the excess fat magically chelates harmful toxins).
I came across something in The Biology of Starvation that is of particular interest. Some old-schoolers appear to have created a fat loss program that maintains nitrogen balance (no lean tissue loss) and results in normal basal metabolism even after weight losses in excess of 100 pounds. These guys were pure researchers, not diet book hucksters. It has captivated my interest for sure and I have high hopes for it.
It may just be the phase II that restores ideal body composition after going through the process of "metabolic healing." The perfect icing on the HED cake.
Keep you posted as to what I think of its rebound potential as I explore it further. I'm still uber skeptical about it right now, but like I said, it does have promise.
Matt, you bastard! How do you drop a bombshell like that and not elaborate and just casually move on?
Maintains nitrogen balance and basal metabolism?
Like that isn't going to peak everyone's interest in here, and you brush it off like it's something we read or discover every day.
And that book is like 700 pages and very expensive and that's just the first volume. I hope you are finding it informative and worth the price and the time it's taking to get through it. And I hope you will summarize the good parts for us in a blog post.
Hope you don't leave us hanging. Thanks.
I am a bit frustrated that younger women are prevented from getting the proper attention and therapy to their hormone imbalance because someone thinks their age should be what dictates when such therapy starts.
I understand your frustration, but while I can't speak for Matt, to be clear I wasn't suggesting that therapy should be delayed because of her age, but rather hormonal therapy, since younger men/women generally speaking have much greater regenerative powers than their older counterparts.
There is more than one way to skin a cat and if your approach does great job without becoming a life-long crutch you won't hear any nay-saying from me.
Thanks for your insight. If possible it would be great if you had a list of practitioners around the country who share your approach to this issue.
Michael. Thanks for that. That was my point as well.
Moleman-
I'll be doing a good summary in the March eZine if I can finish the damn thing in time. It's 1300 pages, not 700!
Everyone stop making comments for Matt to respond to so he can finish the damn 1300 pages and give us a summary of this intriguing nitrogen balance/restoring ideal body composition thing!
I hope Sarah can get her heath under control and continue to recover. All this talk of hormones leads me to ask a few questions. I'm a post-menopausal woman (60) who is on very toxic medication for AIDS which I can't seem to get off of and maintain my health. I am much better than I was, but I still have very little stamina, I sweat with almost no provocation (including some hot flashes), my hair was falling out but seems to have stabilized, my fingernails are very brittle and ridged.
I guess I'm asking Dr. Poppy how likely this all is to be hormonal. I was on Prometrium, but my new gynecologist, who is very good and very thorough, took me off it and put me on Remifemin and Estrace cream. I recently started a 25mg dose of DHEA. A while back, a saliva test indicated my cortisol was low, but a blood test taken before a cortisone shot and again ah hour after indicated that my cortisol was responsive. I welcome any thoughts on what's going on and what can be done to help.
I do all I can to maximize my glutathione and take CoQ10 to hopefully mitigate effects of the drugs (which can be very bad for mitochondria) as well as a bunch of other supplements. I have recently increased the fat in my diet, which is helping with hunger, and am roughly following a Nourishing Traditions-Eat Fat/Lose Fat diet where I don't go crazy with carbs. I take DGL before meals to help my digestive system, and would be happy if it's also good for the adrenals.
Also, I was wondering if anyone was familiar with the work of Kathleen DesMaisons. She has done a lot of work with addiction and has a site called Radiant Recovery, where she deals mainly with a plan to detox from sugar and recover health. Her books include Potatoes Not Prozac, The Sugar Addict's Recovery Program and Your Last Diet. She deals a great deal with brain chemistry and the effects of beta endorphins and serotonin and such. Many people have had a great deal of success on it. Might be worth checking out.
Thanks for any insight anyone can provide.
Thanks Gazelle! Totally!
Linda-
Love me some Kathleen DesMaisons.
You might want to try getting a hold of Dr. Janet Lang. A friend of mine recently contacted her and was very impressed. Seems like she's got a good head on her shoulders for dealing with complex hormonal issues.
Matt, I don't want to tell you what to do an' all … wait, yeah I do!
More on losing weight + no lean tissue loss + normal basal metabolism NOW!!!!
I'm kidding. Except I'm not. You know what I mean. :)
Thanks, Matt. Glad you like Kathleen, though she does put more emphasis on protein than you seem to. I'm trying to work out its importance to me relative to fat.
I'll check out Dr. Lang. I also think there are some very good local people, maybe even at Duke Integrative Medicine, where I've been going recently for some of my healthcare.
Kathleen and others with similar views such as Julia Ross are into protein because it ameliorates the symptom of hypoglycemia (whether it's true hyoglycemia or a low beta-endrophin state).
But that's not the almight answer. I like Broda Barnes's thoughts on it:
?To date, when the symptoms of hypothyroidism are relieved, hypoglycemia, like the others, disappears. The diagnosis of hypothyroidism can be made from a careful history and physical examination better than it can from laboratory procedures. I routinely use the Basal Temperature test to confirm suspicions of hypothyroidism.
??it has been clearly established that a high protein diet lowers the metabolic rate, [therefore] symptoms of hypothyroidism will be aggravated? Hypoglycemia may be controlled on the high protein diet, but the other symptoms of thyroid deficiency which usually accompany hypoglycemia are aggravated.
That's another reason why low-carb feels good at first, but may, as I have proposed, be counterproductive long-term.
I had adrenal fatigue last year. it had gotten so bad that I could barely function. My doctor put me on an elimination duet to help me get rid of my eczema and that seemed to help my adrenal fatigue a little. i went from that to a low carb diet and eating raw dairy, butter, cream, meat, etc, and that seemed to solve the issue for me.
Vicky-
Since this post Sarah has pursued overfeeding for restoring adrenal health. Her basal body temp. is up over 99 degrees F. It's only been a couple of months. Problem solved.
I loved loved loved reading this testimonial. I was just about to press "pay now" for purchasing the 80 10 10 diet book after going back and forth b/w raw and low carb (rich. bernstein).
Here is my question: i am a type 1 diabetic, have been for 14 years. i do horrible on 'restriction' diets because the thing i am restricting is what i will crave, hands down. i also want to keep my blood glucose in check…matt, or anyone else…what does one do? my bg's will never be at a 4% HbA1c level since every type of carb will raise my sugars until eventually going to a normal level 2 hours later. any suggestions?
love your work!
Pylgram-
Someone asked me this a couple weeks ago and it's tough to come up with an answer. I guess if I were a type 1 I would eat a mixed and satisfying diet and do my best to dose my insulin just right. But there are plenty of people with A1C's in the 6-7% range that still live well into their 70's. There's more to life than obsessing over A1C tests. I'd much rather eat an unrestricted diet and deal with health consequences in my 60's and 70's while feeling great than eat 80-10-10 or Bernstein-style and live to 80 without health problems (although I think either of those approaches would yield plenty of both) while miserable.