Your First Step For Any (Any!) Chronic Symptoms

Here’s an unfortunate trend: more and more young people (at my age, everyone under 50 is young) are troubled by chronic physical and emotional symptoms. Sometimes there’s a diagnosis: rheumatoid arthritis, multiple sclerosis, Crohn’s, fibromyalgia. But just as often there are plenty of symptoms and no diagnosis. I can’t count how many times patients have told me they went to multiple doctors who told them all their tests were normal.

Many symptoms aren’t signs of a dangerous illness. Instead, they sap your joie de vivre (“I exercise regularly, limit myself to 1,200 calories a day, and am still overweight,” “My hair is getting thinner and thinner,” “I get panic attacks but hate feeling drugged up”).

In these circumstances, most doctors resort to what they know best: prescription drugs. But since correctly taken prescription drugs are the 4^th leading cause of death in the US, people are understandably resistant. (“I’m worried about having my immunity suppressed,” “My fibro pain is better, but I’ve gained 25 pounds,” “I’m less anxious, but I’ve become a zombie”).

Many doctors, perplexed by a patient’s symptoms, simply shift the blame for the symptoms to the patient herself (“He told me there was nothing wrong and gave me an antidepressant. I got so mad I tore up the prescription.”)

Underlying causes
I continue to be amazed at the resistance of conventional physicians toward nutritional therapies, including supplements and diet changes. You’d think someone who slogged through eight years of education to earn an MD could grasp the basics of hidden food sensitivities and leaky gut (also called intestinal hyperpermeability). The most recent doctor I asked about this, a rheumatologist, thought leaky gut “had something to do with chiropractors.”

To some extent, she’s right. Most students in functional medicine classes, where diagnoses like these are everyday stuff, are chiropractors, naturopaths, and clinical nutritionists.

I’m not saying you should abandon your rheumatologist if you’ve been diagnosed with rheumatoid arthritis or your neurologist if you have MS. I’m here to suggest several steps you can take immediately to see if nutritional therapy can help your unexplained symptoms. In three weeks, you may be in for a pleasant surprise.

Inflammation! Inflammation! Inflammation! (Did you catch that?)
Chronic widespread inflammation is often the real villain. A local area of inflammation, like the redness surrounding a pimple, skinned knee, or surgical incision, is part of healthy, normal healing. But if you’ve got head-to-toe internal inflammation, something’s very wrong.

If the inflammation is relatively mild, you might experience joint achiness, sinus congestion, or skin eruptions. You might be retaining weight or losing hair. If the inflammation is serious, it may be a component of MS, rheumatoid arthritis, or even Alzheimer’s. Autoimmune disorders, from Hashimoto’s thyroiditis to lupus, are all triggered by inflammation. Chronic Lyme disease, mold toxicity, pollution, an unhealthful diet, and poor dental care all can cause chronic inflammation.

 Leaky gut is by far the most overlooked cause of chronic widespread inflammation. 2500 years ago in ancient Greece Hippocrates wrote “all disease begins in the gut.” This is a bit much (it would take a few more years to discover germs), but the quote merits serious attention.

What’s leaking through your intestines and into your bloodstream are large molecules of food and bacterial breakdown products that should stay inside. When they do leak, your immune system panics and triggers inflammation. Blood test results for inflammation, like hsCRP, sedimentation rate, and C4a, start to rise.

You can waste both your time and your insurance deductible for the opportunity to observe the blank look on a specialist’s face when you ask to be tested for leaky gut. Or you can get started yourself. 

What causes leaky gut?
The most common causes of leaky gut are high-inflammation foods. That’s right. Inflammatory foods trigger leaky gut, which in turn leads to widespread body inflammation.  You’re not necessarily allergic to these foods, and while the foods will trigger some inflammation in everyone, most people aren’t bothered by them. For example, I can eat gluten without any problems, but my associate Dr. Kelley is wiped out by a muffin.

If you search “anti-inflammatory diet” on amazon, you’ll get 1,027 results. The plans in these books have a wide variety of names: autoimmune solutions, anti-aging diets, paleo and super-paleo approaches, keto eating plans. Honestly, they’re all similar. However, if you really want to test yourself to see if leaky gut is behind your chronic symptoms, bite the bullet and follow the AIP (auto immune protocol) for three weeks.

Like author Sara Gottfried, MD, I admit it’s challenging, but if you feel a turnaround in your chronic symptoms by week #3, you’re onto something very important.

And while following the AIP can initiate healing in your leaky gut, you can speed the process with the gut-healer Glutagenics (by Metagenics) and the probiotic Prescript Assist Pro.

A little help from your friends at WHC
If you’re feeling overwhelmed by the information in this Health Tip, schedule a visit with one of our functional medicine specialists (Drs. Caley Scott or Alaina Gemelas) or functional nutritionists (Marla Feingold or Seanna Tully).

There are three specific tests for leaky gut, and functional medicine practitioners are quite familiar with them. All are available at WholeHealth Chicago:

• Lactulose/Mannitol Testing (urine)
• Occludin, Zonulin, Actomyosin Protein Antibody Testing(serum-blood draw)
• Zonulin Levels(serum-blood draw)

Now for the challenge
I’m going to conclude with the list of what you need to eliminate if you’re serious about doing the self-test for chronic inflammation. If after three weeks of strictly eliminating the foods below (along with using the Glutagenics and probiotics) your symptoms are completely unchanged, and you feel exactly the same when you reintroduce the eliminated foods, then it’s likely chronic inflammation/leaky gut are not at the root of your chronic health issues.

It’s important to also note that simply by following a low-inflammatory eating plan you’ll reduce your chances of developing any chronic illness as you age. Several authors call this way of eating an anti-aging diet. Pay heed!

Foods eliminated on the autoimmune protocol (AIP) diet, via Dr Gottfried’s website:

Grains – wheat, rice, corn, and others; and pseudo-grains (millet, amaranth, teff, etc).

Legumes – all beans including peanuts, black beans, pinto beans, hummus, etc.

Dairy – all sources of dairy, even raw or fermented.

Nuts and seeds – all nuts and seeds including cashews, almonds, quinoa, sunflower seeds, sesame seeds, seed-based spices, chocolate, coffee, etc.

Eggs – especially the white part of the egg, which contains inflammatory proteins.

Nightshades – tomatoes, potatoes, peppers, tomatillos, eggplants, goji berries, and several spices.

Industrial seed oils – pretty much all liquid oils, except for olive and avocado oils.

Processed foods – basically anything that comes out of a package.

Alcohol – it is well established that alcohol induces a leaky gut.

NSAIDs – non-steroidal anti-inflammatory drugs such as ibuprofen, aspirin, and naproxen, which cause holes to form in the gut and stomach linings.

Sugar, starches, fruits, yeasts, FODMAPs – sweet, starchy, and yeast-containing foods can contribute to imbalances in the gut microflora (dysbiosis) by feeding unfavorable bacteria in the gut. They are best limited or restricted, especially at first on the AIP.

Good luck and be well,
David Edelberg, MD