Transition

Before I forget all about this, I wanted to talk for a minute about the transition my body has been going through since being able to eat different foods again.

Remember back when I put it all together that histamine intolerance was a significant issue for me?  Looks like that was a little less than 2 months ago.  Soon after that – on 12/29/16 – I stopped eating foods high in histamine.  Then a few days later – on 1/3/17 – I started taking Culturelle Probiotics.  By 1/6/17 my hot flashes were almost gone.

Then I had a week of die-off, after which I could eat anything without becoming depressed.

Since then my mood has remained great, my weight has slowly been dropping (not without effort, I admit – I’m consciously adding about 10 servings of fruit/vegetables a day – none of which I could eat 2 months ago). Between now and then though, there were some weird things going on.

When I first started eating starches and fiber my tongue would swell and my throat was sore every day.  It would start after eating something starchy/containing fiber and continue for hours, and then fade, to be repeated again next time I ate something like that.  I would also get pressure in my lower-left ribcage area, which I think was a swelling of my spleen.  I started taking an ibuprofen when all of this got to be too uncomfortable.  These symptoms – the sore throat, the swollen tongue and spleen – have gradually gone away over the last few weeks, and I haven’t needed ibuprofen for at least 2 weeks now.

Another strange thing has been sharp stabby pains in weird places around my body that have come and gone.  I’ve felt them in my individual toes, left side of abdomen, and pelvis.  These pains were severe enough that it made me wince and gasp, and then it would disappear for a few minutes or a few hours…and then come back.  These have also disappeared over the past few weeks.  It felt like an electrical short circuit or something.  I imagine the gut bugs were tap dancing on individual nerves.

My hot flashes have returned, as I mentioned earlier, since I stopped paying attention to eating a low-histamine diet.  They’re starting to bother me now, so I’m going to eliminate tomatoes, bananas, and leftover meats again.  I hate eliminating anything at this point – really tired of eating weird diets – but as the weather gets warmer these hot flashes are going to get annoying.

Losing It

Excess body fat, that is.

Down 10.5 pounds as of this morning, since I started following Weight Watchers (WW) online program 3 weeks ago.  Truth be told, I have signed up for WW in the past but was unable to stick with the plan because I couldn’t tolerate any fruits and vegetables…and without produce this plan is near impossible.  What I like about it is that it’s really 100% positive – there’s no shaming or punishment for missteps.  There’s also no need to count calories or grams – I just put the food eaten into the online tracker and everything is assigned a points value based on nutrient composition. You can eat anything at all and still be “on plan” as long as you can work it into your points.  I have 30 points a day to “spend” however I want.  Fruits and vegetables are nearly all 0 points, so there’s never a need to be hungry.  Just eat.  There are also an extra 45 points per week to spend on anything at any time – so if I eat something that isn’t awesome there’s a forgiving points cushion there to catch me.

To give me more incentive to exercise I have also joined StepBet.  From their website:

StepBet is a fitness game that motivates you to be more active. Players “bet” on themselves to meet their personalized step goals during every week of the game, and win money if they do. The cash prize, accountability, and community support help you become more active while having fun!

If you hit your personalized step goals for the entire game, you split the pot with the other winners. That means you get your bet back plus a profit.

So I have 6 weeks of walking ahead of me with $40 on the line.  My Fitbit will report back to StepBet folks.

I also signed up for a DietBet (same company).  I’ve bet $100 that I’ll be down to 199.6 pounds by March 4th.  I’m within 2 pounds of that now, so I’m pretty sure I’ll make it.

Here’s what I ate yesterday:

today

I’d like to be clear once again that until I started taking Culturelle Probiotics, which dramatically altered my gut flora, I was unable to eat whole fruits or vegetables, starches, or fibers without becoming incapacitated with depression.  Now that my gut is working normally (maybe even optimally) I can eat these things and stick to a diet plan like WW.  Weight loss may come down to a certain macronutrient balance or even Calories-In-Calories-Out (CICO) – I don’t know for sure – but I do know that if you can’t tolerate healthy foods it’s much more difficult to make a long term change.

I think the probiotics also reduced systemic inflammation, causing hormonal changes (e.g., reduced cortisol) that are now allowing body fat to be released.  I spent months and months eating low-carb (even no-carb at times) and not understanding why other people I knew were able to lose eating that way while I didn’t.  I think my body was inflamed due to gut dysbiosis, putting me in a constant state of stress and making weight loss impossible.  It’s also possible I was just eating too much, but I was listening to hunger cues and never eating past that.

So…bottom line…maybe weight loss is as simple as CICO – but until my body was able to tolerate healthy low-calorie foods, a CICO approach wasn’t possible for me.  If you’re having trouble losing weight, I strongly recommend taking a good look at what may be going on in the gut.

Fasting Insulin and Current Diet

I had a fasting insulin run a couple days ago, as a measure of insulin (in)sensitivity.  Let’s compare:

12/15 – 20.9 (while eating high-carb, low-fat)

2/9/16 – 20.7 (while eating low-carb, high-fat)

8/31/16 – 24.6 (while eating moderate carb and high-fat)

2/13/17 – 20.0 (while eating high-carb, low-fat)

The reference range is 2.6-24.9 uIU/mL, so I’ve been at the top of this unfortunate range for quite a while.  It appears that what makes things much worse is when both carbs and fat are high.  It also appears nothing diet-related gets me below 20.0….yet.  I’m going to test again in a few months and see if my current plan and/or probiotic has a longer-term effect.  In the meantime, blood sugars are coming down following a low fat plan, currently around 110-120 each morning.

Here’s what I ate yesterday (and this is typical right now):

typical

(Edited to add…I also had an apple I forgot to include above.)

Oh – also I’m down around 9 pounds now, on this diet.  Not much exercise.  I’ve started wearing a pedometer and I walk 3000-4000 steps per day, just as part of my normal routine.

Grateful

I’m so grateful for the relief of being able to eat a normal healthy diet and still feel happy.  I feel happy every day, all day now.  Even when something happens that shouldn’t make me feel happy, I still feel happy. I wonder if feeling happy gets boring after a while?  I doubt it.

I spend my days now feeling a combination of relaxed, aware, creative, and at peace.  All of the searching I did during my DECADES of depression gave me the tools I need to feel great – all I needed was my biology to cooperate.  In my 20s I would make lists of things I accomplished so I would stop hating myself.  It didn’t work, but I felt more accomplished.  In my 30s I read tons of spiritual books on creating one’s own life and on having gratitude for what I have.  I knew in my head that I was grateful for all the privilege I know as a white woman in America with eyes, ears and legs that all work well.  I still couldn’t overcome the sadness and anger I felt most days.  I remember going to a therapist when I was 32, saying, “I just feel sad.  I want to stop feeling sad.”  Therapy didn’t help my mood, but it made me better at communicating and helped me to understand myself.

But all that reading, all that therapy, all that list-making and self-esteem building and affirmation chanting and appreciation-list-writing – all of that was actually doing something for me.  I just couldn’t tell because my brain was being poisoned by something in my gut.  Now that the poison is gone (at least as long as I take Culturelle – I may never give up this precious supplement), I’m left being able to actually experience the structure that was being built all those years.  I hear people around me complain about their jobs or their kids….and I’m just so grateful I get to be here at all.  And completely confident in my ability now to create whatever life I want.

I think of all that meat I ate over the last few years…meat and cheese were some of the only foods I could reliably eat without losing my mind.  I’m now 2 weeks into Weight Watchers and down 8 pounds.  I eat fruit and vegetables, rice, potatoes, bread, meat, eggs – anything and everything I really want, I just work it in.  I have no cravings for sugar so I’m not eating that.  I’m not counting calories but I’d guess I’m eating around 1500 a day.  High fiber, low fat.  My fasting blood sugar is now around 112 every day – down from 160s in December.  Blood pressure is ok – I’m starting the gradual taper of one of the 3 prescription meds I’m taking to control it.

I don’t know if this will last forever.  I’m appreciating it all while I can.

Update

Here’s what’s been happening:

  • I’ve been eating lots of high-fiber foods and continue to feel great unless I eat too much bread or don’t get enough sleep.  So far those are the only things that seem to interfere with the awesomeness of my mood and energy level.
  • I’ve lost 6 pounds in the last 8 days doing Weight Watchers. It’s been so long since I’ve been able to eat any kind of variety in my diet, I sort of forgot how to eat.  So I’m re-learning.  WW encourages the consumption of low-sugar, low-fat, high-nutrient-dense, high-fiber foods.  I’m sure the pace will slow – in fact, 3 of those pounds were in the first day.
  • I don’t really follow a low-histamine diet anymore, and my hot flashes have come back.  They’re not as bad – no sweating, pretty short in duration, and less frequent- but back.  Right now I’m ok with it. At some point I’ll eliminate whatever is causing them.
  • I’m eating no sugar and lots of fiber and starch now, and pretty low fat.  My fasting blood sugar is now in the 120s – down from 140s a couple weeks ago.

Change

Things are going well – I can eat just about anything now.  Over the last 2-3 weeks I’ve been increasing the amount of fiber in my diet gradually.  At first I was getting sore throats and my mood was a little unsteady, but now that seems to be gone – or almost gone.  Still taking Culturelle Probiotic.  I tried taking 2 capsules twice a day and one capsule 3x a day, and it wasn’t any better than taking one capsule twice a day.  I’m not totally sure it even needs to be twice a day – maybe I’ll experiment with once a day.

This probiotic has caused a massive shift in my day-to-day health and (in my opinion) my prognosis. Since I’ve started taking it I can tolerate fiber so I can eat fruits and vegetables again.  I’m not so hungry anymore, and I’ve been able to reduce the fat and caloric density of my diet.  I’m optimistic now that I’ll be able to shed the extra pounds and get off some of my prescription medications over time.

I stopped taking the R-Lipoic Acid.  I became irritable after a full day of taking it, so I stopped, not sure if it was the supplement that caused the problem or if it was something else.  I’ll probably try again at some point.

 

One Step Back

I had to retreat a little bit on my “look ma! no hands!” diet.  Turns out bread and starches still make me feel a little…like crap!  I had a few days away with the family, eating out in restaurants the whole time, and I discovered that when I stop monitoring my histamine intake and eat whatever I want I still get irritable and tired…even with my new probiotic friends.  No crying though.  Used to be I’d dissolve into a puddle of tears, and only waiting it out a couple days would fix it.  So things are better.  Still not perfect, but better.

Now that I’m home again I’m happy to get back to eating food I’ve prepared myself, so I can get back to feeling awesome again.

Next Up

I have taken a couple days to enjoy eating starches and fiber without worrying too much about my blood sugar.  Yesterday I (gleefully and with abandon) ate a banana, an apple, bread, pasta, and broccoli.  Today my weight is up 2 pounds to match my all-time highest weight of 211 pounds. It’s the most carbs I’ve eaten in a long time so I’m hoping it’s just water.  Time to refocus on my next goal…whatever that is…

I think my next goal will be getting my blood sugar under control.

I’ve decided to start taking R-Lipoic Acid again, which my NBT coaches said was important for blood sugar control, doing sort of the same thing Metformin does but without the possible negative side effects.  No way around it – this stuff is expensive, which is what has stopped me from using it much.  I’m going to give it a try again though.   I have enough right now for 2-3 months, so I’ll get started and see how it’s going in 60 days or so.

Exercise.  I have shied away from exercise for a long time because it made me feel worse – more tired, less relaxed, and frustrated by my lack of fitness.  I need to start somewhere though, so I’ll be starting with yoga and biking (stationary) using my spin bike at home.  If things are going well I may add some kettle bell exercises.

Eating.  I’m thinking maybe the Perfect Health Diet…paleo with starches.  Not sure. I think for now I’m just going to focus on adding more fruits and veggies.

By the way…mood is still great.  Hot flashes still gone.  Histamine symptoms are greatly reduced – some minor itching is all that’s left.  I’m not sure if the Culturelle effect is transient or if the little L. Rhamnosus dudes are setting up camp.  One day I’ll get bold and see if the effect sticks around without the supplement.  I wrote to Culturelle and thanked them for their awesome product.  They wrote back and told me they don’t claim to cure hot flashes or fix depression.

Haha….ok.  Well, a nice side effect then.

Recovery

I feel like I’ve taken a giant leap toward recovery.  My depression is gone.  I ate an apple yesterday with no negative mood consequences!  A month ago I ate a small slice of an apple and was irritable and tired 3 hours later.  Yesterday I felt great all day.

I feel like it’s important to nurture my new L. Rhamnosus GG bacteria by giving them something to eat, so I’m adding fiber right away.  I’ve been dying for this!  I can actually eat healthy food now.  I’m so tired of eating meat all day long, and my body isn’t happy about it either.  I think meat can be a PART of a healthy diet, but a standalone – substituting for everything else?  I don’t think so.  Yesterday I had eggs and gluten-free toast for breakfast (first slice of toast in about a year), and then soup and an apple for lunch…and then I didn’t eat again for 4 hours.  4 glorious hours….I couldn’t believe I could go so long without my blood sugar crashing and making me desperate to eat.   Then I realized…that’s the power of fiber!  It actually keeps you from having to eat every 2 hours.  Maybe my perpetual hunger will drop now.

As much as I’d like to sit around and celebrate right now, I do have other work to do.   Recent issues:

  • I had to go on a third blood pressure medication last week….and still my b/p isn’t awesome.  It went up when I gained weight, and I haven’t managed to lose the weight again yet.
  • Went to the dentist a week ago.  No cavities, thankfully, but my gums were in worse shape than the previous visit.  I asked what the hell happened.  The dentist said, “Well, you’re likely to see more of this when you have Diabetes.”  Really?
  • Had an eye infection last week…went to the optometrist, who gave me antibiotic drops.  He said, “This kind of thing becomes more common when you have Diabetes.”  Huh.

My fasting blood sugar has been in the 160s a lot lately.   Too high, but I haven’t had a lot of options lately.  Because I couldn’t eat starches or fiber, it was eat meat all day long and suffer blood sugar crashes every 2 hours, or add sugar to my diet (which I did).  I’m not sure what I’m going to do now that I can eat fiber….maybe a Terry Wahls-type diet?  Is my gut ready for 9 servings of colorful fruits and vegetables?  Or how about the potato diet?  If I can get my weight down at least one of the above problems will improve – maybe more.  Exercise is a possibility now too, without the fatigue that came with the depression.

So many options.  I couldn’t be more grateful.

A Theory of (almost) Everything

It’s all starting to make sense.

Starting Culturelle probiotics has caused a major shift for me.  Initially it made me feel amazing – euphoric, even – and I was taking it 3x a day.  Then I began feeling like my guts were all swollen, my mood became uneven, and my sore throat flared up, as it tends to do when my body is under some kind of stress.  I couldn’t tell if I was sick with a cold or virus or if something else was going on.  After a couple days of this it occurred to me this might be a Herxheimer reaction so I cut the probiotics back to 2x/day.  The symptoms continued.  I felt very tired, went to bed early, slogged my way through work, and then I developed a bacterial infection in my eyes.  Probably unrelated, except to the extent that my immune system was too busy to kill it off in the early stages.

Two days later I suddenly felt better.  Like, all better. I started eating things that would normally cause me to become depressed – things containing starch or small amounts of fiber.  No depression.  My throat would become a little sore, but no depression.

Then I put it all together.  I think my biggest problem – my inability to tolerate starches and fibers, which has prevented me from eating fruits and vegetables for years now – has been caused by an overgrowth of a so-called “beneficial” bacteria that produces histamine in the large intestine.  So when I would eat things that ferment in the large intestine like soluble fiber or resistant starch, those bacterial colonies would have a feast and put out a ton of histamine.  My body would react with negative cognitive and emotional effects because histamine acts as a neurotransmitter, mucking up my brain.  (<–Not too clear yet on the actual biochemistry…but this is close.)

So when I started taking Culturelle probiotics with L. Rhamnosus GG in it (apparently the “GG” is the strain and is pretty important here) the GG starting kicking the ass of the bacterial overgrowth.  I don’t know how this happens exactly, but I will say (without too much offending detail) that the first week after starting Culturelle my stools changed – there was evidence that biofilms might be breaking up (?).  And now suddenly my moods are solid and I can eat regular-people food including bread, potatoes, pretzels, crackers – without bloating, discomfort, or mood changes.  (I haven’t tried anything REALLY fiberous yet, but will soon.)

A little background – there are several reasons histamine may be high in the body.  It can be high because:

  • The gut is damaged and doesn’t make enough DAO (histamine degrading enzyme).
  • There is a genetic mutation causing the body to produce insufficient amounts of DAO.
  • The mast cells (producers of endogenous histamine) are unstable and producing too much histamine.
  • There are too many mast cells.
  • The diet is just too damn high in histamine-containing foods.
  • There are too many histamine-producing bacteria in the gut.

I think my problem is the last one.  WAS the last one.  And I think the Culturelle is cleaning up that mess.  I’m so friggen excited about this!

I mentioned in a previous post that there are some bacterial strains to AVOID because they DO produce lots of histamine.  Not everyone agrees about which ones these are.  Mark Sisson says:

Among the histamine-producing, foremost are Lactobacillus casei, Lactobacillus delbrueckii, and Lactobacillus bulgaricus, all of which are found in most yogurts. Avoid those. That’s why fermented dairy is a no-go for most people with histamine intolerance.

Joe Cohen from SelfHacked says to be wary of the following histamine-producing bacteria (supporting research is linked in the parentheses):

  • L casei (R)
  • L reuteri (R)
  • L bulgaricus (R)

Alison Vickery – a holistic health coach from Australia who seems to know a LOT about histamine has written an ebook on The Therapeutic Use of Probiotics for Histamine Intolerance, which she sells for $10.  I bought it and it’s very much worth the money, just in the hassle it’ll save you experimenting with different probiotics.  She says some strains of L. casei and L. reuteri ARE helpful for some conditions (and her book is specific about which ones), so it may not be as cut and dry as some of the other sources would have you believe.  This study agrees with her, and indicates (emphasis mine):

Lactobacillus casei (TISTR 389) and Lactobacillus delbrueckii subsp. bulgaricus (TISTR 895) were found to produce [biogenic amines]. The highest levels of histamine (1820.9 ± 3.5 mg L−1) and tyramine (5486.99 ± 47.6 mg L−1) formation were observed for the TISTR 389 strain, while TISTR 895 produced only histamine (459.1 ± 0.63 mg L−1) in the decarboxylase broth. Biogenic amine potential was not observed for the Lactobacillus acidophilus, Lactobacillus lactis subsp. lactis, Lactococcus lactis subsp. lactis, and Lactobacillus plantarum strains studied. This study confirmed that BA formation is strain dependent and not related to the species.

Here’s what I’ve learned though – and this is important – L. casei (unspecified strain) was in almost all of the probiotics I’ve used over the last few years, and it’s widely considered to be a species that produces histamine. It’s also in a lot of commercial yogurts and other fermented dairy products.  THAT CRAP MIGHT BE WHAT WAS MAKING ME MISERABLE ALL THIS TIME. I don’t know for sure that that was the overgrowth I was dealing with, but it might have been.

Bottom line…I now believe my depression was caused by a “good” gut bacteria, in the right place.  This wasn’t SIBO.  And it wasn’t a pathogen.  It was a “good” guy.

Bacteria are truly running the show.

I’m so grateful science has advanced to this point, that we can identify specific species and strains of bacteria to treat specific conditions….and they actually work.

My next step is to eat some fiber and see how it goes.  If I can successfully eat fiber for a few days in a row I’m confident I can start eating a more healthful diet and get the rest of my health back on track.

Oh, and by the way….hot flashes are still gone.