Two Reviews: The Autoimmune Paleo Cookbook and 28 Days of AIP e-book

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The Autoimmune Paleo Cookbook by Mickey Trescott

This book has been around for a while, so I’m a little late to the party but hey! I’m happy to be showing up now. The Autoimmune Paleo Cookbook is written by Mickey Trescott, who blogs at www.autoimmune-paleo.com. She was one of the first resources I found about AIP, and her incredible blog helped me so much in making the decision to try the AIP.

There is no doubt that this book is gorgeous to look at. The photography, layout, and font all bring to mind an idyllic, rustic scene of natural goodness. Each page is simple, uncluttered, and clear. The recipes are straightforward, without unnecessary wording crowding up the page.

But the book goes far beyond being pretty: it is a fabulous resource for anyone following an allergen-free diet, at any stage of their journey. For those new to following the AIP, the book opens with the mainstays of the autoimmune protocol diet, including a brief explanation of the AIP, lists of foods to include and exclude, and the food reintroduction process. There are even two, four-week meal plans with shopping lists to help you get started. For those who have been following the AIP for a while, and feeling bored or stuck in a rut (like me, lately), this book provides a way out through delicious, colorful, nutrient-dense recipes guaranteed to inspire.

The book covers basics like bone broth and kombucha, twists on old favorites that are easily missed on the AIP  (like Mayo and Cherry BBQ Sauce, which was a huge hit with my family), and creative ways to keep entree dishes exciting (I made the Garlic Beef and Broccoli this weekend- yum!). There are meals to impress dinner guests (Herb-Stuffed Trout, anyone?) and staples to get you through the week (like Tuna Salad and a variety of ground meat patties).

No matter what stage of the AIP process you are in, The Autoimmune Paleo Cookbook will meet you where you are and make your journey more creative, more tasty, and more nutrient-dense.

You can order the cookbook at http://www.amazon.com/The-Autoimmune-Paleo-Cookbook-Allergen-Free/dp/0578135213.

28 Days of AIP

28 Days of AIP by Christina Feindel

Anyone who follows a lifestyle like the autoimmune protocol knows that food can keep you constantly preoccupied with meal planning, grocery shopping, recipe hunting, and food prep. Christina Feindel of www.ACleanPlate.com has harnessed her no-nonsense approach to a healing diet by creating a great resource to help you get out of the kitchen and back to doing what you love.

Her new e-book, 28 Days of AIP, provides four weeks of meal plans, grocery lists, and links to her recipes at www.acleanplate.com. At the beginning of the book are some helpful suggestions for adapting the meal plans according to your needs.  The e-book incorporates old favorite recipes from the archives at A Clean Plate (many of which I’ve tried before and loved) and also introduces 8 brand new recipes to add to your repertoire.

One of the things I struggle with is getting enough variety into my diet. I find what’s easy and stick to it, sometimes slacking off on focusing on varying my food and nutrients. These meal plans ensure that you’ll get a variety of nutrient-dense foods recommended in The Paleo Approach, including plenty of veggies and organ meats (I am planning to try the liverwurst recipe when I can get my hands on some good grass-fed liver).

For anyone feeling overwhelmed by following the AIP or looking for great suggestions for changing up a repetitive routine, 28 Days of AIP is the way to go!

Download the e-book at http://www.acleanplate.com/28-days-of-aip/.

Pesto Pasta Salad (AIP)

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Big news, folks! As of last week, my blog has been awarded “The Paleo Approach Approved” badge (see sidebar)! The badge indicates that this blog is a resource which aligns with the recommendations in Sarah Ballantyne’s book, The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body. I feel so honored to be a part of the growing Paleo Approach community with a number of other talented bloggers. To view all the TPA Approved resources and blogs (all of which I highly recommend!), visit http://www.thepaleomom.com/tpa-approved

On to the latest recipe! Now that the farmers market is just bursting with fresh produce, I found myself overwhelmed with the amount of zucchini in my fridge. Zoodles  (“zucchini” + “noodles”. Get it?) are a fabulous way to eat it up!

Pesto Pasta Salad
Serves 4

Ingredients

For Pesto:

1 bunch basil
1 clove garlic, minced
1/3 cup olive oil
½ tsp salt

For “Pasta” and Veggies:

3 zucchini
1 carton mushrooms (8 oz), sliced
2 baked chicken breasts, shredded
2 Tbsp coconut oil

Directions

First, make your zoodles. If you have fancy tools for doing this, like a spiralizer, great! Use those. If you do not have fancy tools (like me) just use a potato/vegetable peeler. Peel off the skin and discard, then just keep right on peeling the flesh into long strips, straight into a colander. This makes fettuccini-like noodles. Peel until you get to the seeded, inner part of the zucchini. Set seeded part aside. Sprinkle zoodles with salt and set colander in the sink for 20 minutes.

Make pesto. Remove basil leaves from stem. Add basil, garlic, olive oil, and salt to food processor. Process until well-chopped and mixed.

Slice up remainder of zucchini. Heat coconut oil in a deep frying pan over medium heat. Add mushrooms and zucchini. Cook for 10-15 minutes until cooked to your liking. I like mine to start getting a little brown and crispy.

While shrooms and zukes are cooking, squeeze excess moisture from the zoodles (the salt helps draw it out). Once the mushrooms and zucchini are cooked to your liking, add zoodles and cooked chicken to pan and cook for 3-5 more minutes until zoodles are slightly cooked and chicken is warm.

Remove from heat and stir in the pesto. Enjoy hot or cold!

On Swallowing 57 Pills a Day

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Or, “What to Expect When You Visit a Functional Medicine Doctor.”

Well, I did it. I finally made an appointment with a local Functional Medicine Doctor (www.funcionalmedicine.org) to help me work out my persistent issues with inflammation despite almost a year on the Autoimmune Protocol.

For a long time, I’ve had a sort of fairy tale fantasy of what visiting a functional medicine doctor would be like. In my mind, the doctor would sit and listen for hours about every pain I’d ever experienced, every round of antibiotics, every digestive anomaly. They would pat me on the back for all the work I’ve been doing to heal with diet and who would provide a clear answer as to the reason I am still struggling with rheumatoid arthritis symptoms. The reality was a little different.

The Initial Appointment
I met with Dr. M to discuss my current symptoms, medical history, and lifestyle factors. He did indeed want to talk in detail about my medical history. He was quiet, yet knowledgeable and decisive about where to go from there. 

Test Results
Dr. M suggested I order two tests – one blood test for zonulin (which would tell us if I have leaky gut – read more about that here) and an organic acids test that looks for yeast/bacteria in an effort to solve my digestive mystery (which involved FedExing my pee to Kansas!). It was so helpful to be given a narrow list of tests to get, since I’ve often gotten lost down the Google rabbit-hole researching the multitude of tests I should get.

I tested positive for zonulin, indicating that I, after 9 months on a gut healing diet, STILL have a leaky gut, and I had elevated yeast presence as well. While frustrated that my gut hadn’t healed after all this time on my diet, I reasoned that I was still on hormonal birth control for 7 of those 11 months. Before that, I was on daily NSAIDS for 2 years and several rounds of Prednisone. As those medications likely contribute to leaky gut, then I can understand why it might be a problem. I can’t help but wonder if my current remaining medication, Plaquenil, is contributing as well but there is no research on it that I can find.

Diet
His recommended diet was basically exactly what I’ve been doing: healthy fats such as olive and coconut oil, pasture-raised meats and fish, and 9-12 cups of vegetables per day, with an emphasis on eating a variety of colors to ensure a variety of micronutrients. He recommended keeping carbs at 100 grams per day (to help fight yeast overgrowth), which I naturally tend to fall right around. He recommended adding back nuts and seeds (which I’ve successfully reintroduced some varieties of), and he is a big proponent of juicing and smoothies, which I incorporate occasionally. 

Supplements
Doctors prescribe medicine, functional medicine doctors prescribe further testing and LOTS of supplements. I was somewhat prepared for this, but nothing could be prepare me for being told to take 57 pills a day, plus a powder and two liquid supplements. These supplements include: herbal anti-fungals to kill off the yeast overgrowth in my gut; digestive support in the form of probiotics and digestive enzymes; gut healing supplements like L-Glutamine, MSM, and others; and key vitamins and anti-oxidants to help support my body’s ability to detoxify. The financial cost is enormous, and I can’t yet tell you how far into the future it will be financially sustainable for me. However, it helped to have someone knowledgeable about supplement quality recommend certain brands and look at my specific health history to recommend dosage. It took the guesswork out of buying and taking supplements helter-skelter.

Next Steps
The beauty of functional medicine is that you dig deep in search of the root cause of your illness. However, there seems to be no end to the depths which to dig to. One round of tests provides some answers that call for another round of tests. You can test for this gene defect (MTHFR) and these food sensitivities (IgG test) … but oh, if you have toxic levels of these heavy metals, then you’ll likely not improve even if you address those other factors. It’s really frustrating to start on the path for answers, learn which way you could take to get them, and then have to choose from a list of tests because you can’t afford all of them. Also, it’s hard to get good information about which tests are truly effective. I am still trying to research and prioritize what (if any) further testing I would like to do.

Results So Far
Though the doctor said it might take months to see real progress, since starting this supplement regimen three weeks ago, I have seen a number of improvements. My digestion has been the best it’s been since starting the AIP last August (though I have been experiencing some nausea and lack of appetite after taking my pills in the AM) and I’ve felt a surge of energy and a lightening of my mood.  My acne has calmed down.  My joint pain and inflammation has decreased quite a bit since my recent flare, and pain/stiffness is much improved.

The improvements so far are encouraging – especially that of my emotional wellbeing, which makes such a difference in the way life looks. So, though the reality of following this functional medicine plan means swallowing my weight in supplements, I’ll continue to pursue it and look forward to further improvement.

Feel free to ask me anything about this experience in the comments!

On Fire

Vermilion Lake Fire

When I worked for the MN Conservation Corps, my crew was trained to fight wildfires. One day in May, when we were staffing for fire in the northern MN town of Tower, were assigned to our first fire. All the training, all the waiting, and finally we were driving toward a small fire in a group of red pines near a new development. The fire was less than an acre, but we didn’t  care. We were just proud to be getting some soot on our clean, rookie fireproof shirts. Our job was to head in with hoses and tools and spray out remaining flames and douse any hotspots. This is called “mop-up,” and it can be a tedious process.

I quickly learned that there is so much more to fire than open flame. Even after all visible flames were out, the fire burned deep in the roots of trees and reached hot fingers into the earth.

Our crew was being mentored by a seasoned local firefighter named Ron. After two full days mopping up the fire, he took us back to the site again. The forest floor was charred and black, torn up by our thorough work digging at stumps and roots, looking for heat. All appeared to be quiet, but Ron knew better. He told us scatter around the area and kneel down. He said to engage all our senses and just wait. We were looking for smoke: little puffers that might tell of a hidden hotspot underground or tangled in the roots of some tree.

Sitting in the still forest, trying to be fully aware and present, we fell into a meditative silence. It didn’t seem possible that after scouring the area for two days that any fire could still remain. And yet after a few minutes of quiet, I caught the scent of something besides the smell of wet ash: smoke. The different smells were barely distinguishable from each other, and if I hadn’t been focused and still, I might’ve missed it. It took me several moments of staring at the ground and sniffing around me to spot the little puff of white smoke curling up from a black stump about ten feet away.

I feel like my struggle with my autoimmune disease has begun to mirror this story. I’ve been eating a strict healing diet for nine months now. I’ve used the big foundations of diet, sleep, and stress management to quash the open flames of rheumatoid arthritis. There have been some great improvements and some setbacks, the most recent being a discouraging flare up of inflammation in my joints.  I feel as though I am walking through the blackened pine stand again, looking for the missing piece. It might not be an obvious flame, but instead is like a puff of smoke or a pocket of hidden heat deep in the moss. I need to get quiet, kneel down, and engage all my senses to find where and why the fire still smolders.

There are numerous clues and possible answers, so I’ve engaged the help of a functional medicine doctor. This is something I’ve wanted to do for a while now. I finally found the doctor I wanted to see and worked out my finances to allow me to go. I am anxiously awaiting test results and am hoping they provide some clear direction of what to do next.

 

Notes on AIP Business Trips

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Restaurants. Conference lunches. Continental Breakfasts. Those words are enough to strike terror in the hearts of anyone on a restricted diet, let alone the autoimmune protocol (AIP).

In the past six months I’ve traveled twice for work to conferences/trainings – the first to Disney and the second to St. Louis. I managed to remain 100% committed to the AIP on both occasions. Here are a few tips and tricks I learned along the way:

- Be assertive. With my first trip, I felt a little ridiculous sending the list of my food restrictions to the organizers at Disney, which is where the conference was held. Little did I know that Disney prides itself on accommodating food restrictions. They assured me that it was not a problem, and even had the chef who would be working our conference call me ahead of time. I ended up getting steak and some amazing sweet potato fries every day for breakfast. So despite my fear of sounding like a high-maintenance food snob, simply asserting my needs paid off and most importantly, no one made me feel bad for doing so. So when the second conference rolled around, I didn’t feel the same fear of expressing my needs. I contacted who I needed to, and the catering staff was happy to make me a “special” lunch each day.

- Plan ahead. By asking through various email channels, I was able to see the menu for the meals included in the price of the conference. Right away, I saw that the conference venue’s breakfast was not going to cut it – pastries and fruit every day. I checked the breakfast menu of the hotel we’d be staying at, and found a source of non-egg protein I could eat – bacon. So every day I got up a little earlier and ordered breakfast up to my hotel room.

- Just Ask. Speaking of that room service breakfast, I got creative and asked for a bowl of avocado, which was not on the menu. The kitchen was happy to comply, making up a price and bringing me a full bowl of avocado every day. I broke up the bacon and mixed it in with the avocado and bon appetit!

- Pack snacks. I brought along Trader Joe’s plantain chips, two cans of salmon, and a bag of my Paleo Cheezits. I never had to use the salmon, and used the other two for mid-afternoon snacks.

- Embrace fruit. Normally I try not to eat a bunch of fruit (even though I might want to, too much fructose is not recommended on AIP), but at the two conferences, both offered fruit in the mid-morning and mid-afternoon, along with pastries. So for a week I embraced bananas, waxy looking apples, and sliced melons. You can also usually find bananas and apples in the airport once past security, so this was a good way to keep up my energy during travel.

- Look at menus ahead of time. Before even boarding the plane to Disney, I wrote down one or two restaurants near the resort where we were staying that I knew would fit my restrictions (with a few modifications to the menu items, of course!) and then casually suggested them while walking around Epcot with my coworkers. At the French restaurant, the French chef even came out of the kitchen in his tall white hat to discuss my meal with me. He made me duck confit and a special side of sweet potato. It was delicious!

- Be adaptable, but stick to your guns. In St. Louis, every night a huge group of colleagues would walk down the street near our hotel and choose somewhere that looked good. I didn’t want to miss out on being part of the group, so I went along even though the spontaneity freaked me out a little. One night, they chose a Spanish tapas restaurant. The menu was divine, but there were unlisted tomatoes hiding everywhere. I got an order of saffron roasted cauliflower that ended up having little tomato chunks all over it. I was tempted just to eat it to avoid a fuss, but when the server came back, I asked for a replacement with no tomatoes. They were happy to do so. While eating out, I understood it was likely that I consumed oils I normally wouldn’t, but I decided not to stress about it. I did the absolute best I could.

-Learn how to paraphrase. This ended up being the most important lesson I learned. In a busy restaurant setting, at first I felt completely self conscious about disrupting the flow by asking the server to ask a bunch of questions and listing off what I couldn’t have. After a little practice, I had it down pat. This is what worked for me:

  • I asked for a gluten free menu. Many places had one. If not, no biggie.
  • I picked out a few possibilities on the menu that I could modify to fit my restrictions. That often ended up being an entrée of fish or steak. I’d look for a veggie side to sub for white potatoes, and be ready when the server got to me.
  • When they did, I’d say, “I have some food restrictions. First of all, I need to be completely gluten and dairy free. I’m looking at the (insert entrée title here) – would this be safe for those restrictions?” After we got that determined, I would add “No spices except salt, sub the potatoes for a side of green beans, and add a lemon wedge”  (because let’s be honest plain restaurant white fish is not the most flavorful of all).

- Embrace questions. This final point is necessary because it is inevitable that if you’re traveling with people, they’re going to notice that you eat differently. Imagine no one noticing that I was eating a plate of steak every morning at Disney while they were having pastries! When asked, I found simply saying, “I eat a special diet for health reasons,” usually did the trick. Those who were interested would press further and then I’d tell them a little more. By being open to those who asked, I connected with another conference goer with Crohn’s Disease who was interested in the Paleo diet. Another time, I got into a great conversation with a colleague in which I learned that her husband has myasthena gravis, an autoimmune neuromuscular disease. So, even though it was at times disconcerting to have unwanted attention due to my dietary choices, it also allowed me to make these connections.

Those are my experiences so far. What have been yours traveling while on a special diet? Do you have any tips and tricks?

On Reclaiming My Energy

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Last summer, I lost my energy to prednisone—that tiny white pill that works like magic to diminish RA symptoms but causes a whole host of other issues, such as a depressed immune system, weight gain, and insomnia, among other things. Personally, I felt great on prednisone – it took care of my joint pain and didn’t bother me otherwise. This allowed me to enjoy a risky, blissful ignorance: I didn’t realize the power of the pill until I tried to stop taking it.

About Prednisone
Prednisone acts similar to cortisol, a hormone naturally produced by our adrenal glands. Cortisol completes many functions, including keeping inflammation at bay – which is why prednisone is used in treating symptoms of inflammatory conditions like rheumatoid arthritis and other autoimmune diseases.

While taking prednisone, the adrenal glands don’t have to work as hard to produce cortisol since prednisone is doing all the work. If the prednisone is suddenly taken away, the adrenal glands have trouble learning how to function again. For this reason, prednisone must be weaned off of very slowly so that the adrenal glands can re-learn how to produce cortisol on their own.

The Crash
At the recommendation of my rheumatologist, I began weaning off prednisone, stepping down 2.5 mg per week, from 10 mg which I had been taking for about 6 months. At that point in time, my symptoms were well managed using a combination of prednisone, plaquenil and sulfasalazine (which are Disease Modifying Anti-Rheumatic Drugs – DMARDs). I felt fine until about a week after my final dose. I went to work in the morning and started to feel clammy and lightheaded sitting at my desk, so headed home to rest.

The next day, I couldn’t get out of bed. Every time I sat up, I got a horrible head rush and my heart started racing. I knew I should get up and get something to eat, so I laid there and thought about it for 3 hours before actually being able to. I tried sitting in a chair to eat some strawberries, but ended up taking them back to bed because sitting up was too exhausting.

I called my rheumatologist, whose nurse told me that I was experiencing prednisone withdrawal and I could a) power through it or b) go back on a smaller dose and wean more slowly. She gave no real explanation as to what was happening in my body. Being somewhat stubborn, I decided to push through. I spent about a week in bed, too weak to do much. The simple act of folding a shirt necessitated a few hours napping. My boyfriend didn’t understand why trying to sit up and play a game of Boggle was nearly impossible. I slept for 11-12 hours a day.

After about a week, I slowly recovered my strength. I could stand and walk normally so that I was able to go back to work. At this time, I finally connected with some more helpful information and was able to give a name to what I was going through – adrenal fatigue (I highly recommend this post for more details on adrenal fatigue). With my racing heart, exhaustion, low blood pressure, dizziness upon standing, and emotional rollercoaster, I was your classic case of adrenal fatigue.

Getting Back on My Feet
The really severe symptoms lasted about a week, but over the next several months, I never regained my energy. Exercise was out of the picture, and I had lost a significant amount of weight from not eating well while I was sick. My blood pressure was consistently on the low side. I had a deep craving for salt – another sign of adrenal fatigue. I canceled my gym membership and left my bike locked up until summer was over. For a previously very active person, this felt like a defeat.

So what did I do? I researched and learned as much as I could. I knew I had to commit to healing if I wanted to get my energy back and feel like myself again. I started the autoimmune protocol. Sleep became my highest priority, and I gave myself 9 or 10 hours a night. I supplemented with B-vitamins and bought high quality Celtic Sea Salt to help with the sodium balance in my body. I looked at sources of stress in my life, the biggest being my (fairly new) relationship. I made the impossible decision to let him go so that I could seek health more fully.

It took about six months for things to turn around. A few weeks before Thanksgiving (4 months post-Prednisone), I sighed to my mom, “I just want my energy back.” It was around New Years before I felt that it was coming back to me. At that time, I was able to go for longer walks again. In January, I dusted off my hand weights. I started waking up after 9 hours of sleep actually feeling rested. Healing didn’t come all at once, or proceed in a linear fashion – at times it was very frustrating, with the triumphs seeming few and far between.

Looking back on those months, I am able to see where I could’ve done a few things differently to speed up my recovery. I was probably eating far too few carbohydrates, throwing my hormones even more out of whack.  If I could go back now I’d be sure to eat plenty of starchy vegetables. Also, I never forked over the cash to get a cortisol saliva test to confirm my diagnosis. It was pretty obvious what I was dealing with, as prednisone withdrawal is directly connected to  adrenal crisis, but would have been a good idea to know for sure.

I’m happy to say that after months of sticking to an AIP diet and managing sleep and stress faithfully, I’ve reclaimed my energy once more. I am back at the gym, lifting weights and feeling strong. I bought a new bike and took a long ride with a friend on Sunday, enjoying the first spring-like day in Minnesota. Feeling fatigued for months on end affected how I felt about everything. The healing process is far from over, but with my energy back, I am able to focus more on the good things happening in my life and feel capable of continuing the challenging road to recovery.

 

Easy Fermenting: Beet Kvass

Getting into fermenting foods can be intimidating. I’d read about how important it was to regularly consume fermented foods as a way to improve the flora in your gut. I thought about it and waffled on it for months before finally taking the Big Leap. Only to find that the Leap wasn’t that big at all – fermenting stuff is easy! It’s fun! And it’s tasty!

My favorite ferment so far is beet kvass. It takes minimal preparation, a week or so on the shelf, and the result is an earthy, salty, slightly sweet fizzy drink that’s great with a squeeze of lime. If you’re waffling on taking the Leap, try kvass as a first step.

Beets

Beet Kvass

2-3 Beets
1 Tbsp Sea Salt
Filtered Water

Instructions:

Scrub (but don’t peel) beets and chop into inch-sized cubes.

Drop into a jar. I use an empty Bubbies jar, which is about 25 fl. oz. If you use a bigger jar, add a second Tbsp of sea salt.

Add sea salt and filtered water over the beets. Leave about an inch of space at the top of the jar and seal it tightly.

Put it on a shelf in a warm room and forget about it for a week. After a week, it should be ready to be put in the fridge and enjoyed.

*Economical Tip: Re-use the same beets for another batch!*

 

Field Notes on A Typical Week

The title of this post is a little misleading, because in my experience, a healing diet and lifestyle doesn’t usually follow a “typical” course. Each new week comes with its new hurdles, new food reactions, new questions, and new triumphs. But after doing this for a while, I’ve fallen into a pattern of food prep that makes being on a healing diet simpler.

Lately, I’ve figured out a good routine that involves making two dishes on the weekend, which will serve as my breakfasts and lunches for the entire week. Yes. I eat the same thing every day for five days in a row. As someone who cooks for myself and works a full time job, that’s what works for me. Each evening meal is usually baked fish with a roasted vegetable. 

Hash with words

I make this all the time for breakfasts and lunches. Two pounds of grass-fed ground beef plus what ever kind of spices and vegetables I feel like adding. I use this to get my sulfurous veggies in – broccoli, cauliflower, and Brussels Sprouts are the usual suspects. I add garlic, ginger, and turmeric. This is where I might hide some liver to get my dose of organ meats.

Soup

Chicken soup has become a regular feature this winter. I make it with homemade bone broth and add whatever veggies and herbs sound good. I will eat this for any meal. Always with a side of greens!

Salad

I have gotten to the point where I can digest raw vegetables again. Lately my go-to lunch is a cabbage-based salad with broccoli slaw, green onion, cilantro, and a generous pour each of olive oil, apple cider vinegar, and coconut aminos. So simple, and so good. I wash and mix up the vegetables and herbs at the beginning of the week and add my protein and dressing in the morning before work.

 

Cakes

Blurry picture of nori, roasted carrot fries and fennel, spinach, and my salmon cakes.

fish

Tilapia with a drizzle of olive oil and roasted cabbage.

Finding into this routine took me months of practice.  It took a while to figure out how much food I really needed each week and when I should do my cooking.  I also eat a piece of fruit every day, usually an orange with lunch. I am newly working on incorporating more starch – like yucca, taro root, and plantain – into my diet since I’ve started working out again (yay!).

What does your typical week on a healing diet look like?

Book Review: The Autoimmune Epidemic

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The Autoimmune Epidemic by Donna Jackson Nakazawa
Bodies gone haywire in a world out of balance and the cutting-edge science that promises hope

An autoimmune diagnosis comes hand-in-hand with a cascade of questions. How did this happen to me? Why me, and why now? And what am I supposed to do next? When I was diagnosed with RA at the age of 23, these questions haunted me and were not answered adequately by my doctor. Instead, I had to set out to piece together the puzzle of my autoimmune disease on my own.

The Autoimmune Epidemic by Donna Jackson Nakazawa has been immensely informative in my quest for answers, and I believe it can be for anyone struggling to understand an AI diagnosis. This book explores the environmental factors implicated in the onset of autoimmune disease. The author posits that as the use of chemicals has increased in the past 40 years, so has the incidence of autoimmune disease. In fact, autoimmune disease has tripled over the past few decades.

The statistics quoted in the book are astounding. One in 12 Americans – one in nine women – will develop an autoimmune disease in their lifetime. Due to misdiagnosis, which often accompanies autoimmune conditions, this number is likely higher – it is quite normal for AI patients to see 6 doctors before they receive a correct diagnosis. In comparison, one in 20 Americans will have heart disease and one in 14 will have cancer. Yet, though the proportion of those who will be affected by AI disease is greater than that of cancer, cancer research receives ten times as much annual research funding. For how common AI diseases are, many people cannot name a single one.

Much of the book’s content surrounds a number of illustrative “case studies” (my phrase, not the author’s), involving both specific patients as well as specific researchers and doctors pursuing answers to the many questions autoimmunity poses. The studies and situations highlighted in the book underscore how exposure to toxins in our environment can cause our immune systems to confuse “self” and “non-self.”

There are over 80,000 chemicals registered in the US, many of which have received little research into the effects they have on the people that come into contact with them. Nakazawa proposes that just as companies are required to disclose known cancer causing agents in their products – “carcinogens” – we must also name and recognize those substances that could possibly cause autoimmune disease. She proposes “autogens.” These autogens range from heavy metals like lead and mercury to possible endocrine disruptors like BPA.

Autogens are everywhere – in our mattresses, in the air we breathe, in the water we drink. If so many people are exposed to them, then why do only some people get an autoimmune disease? Nakawaza offers a metaphor called “the barrel effect-” in the same way one drop of water can cause a barrel to suddenly overflow, so can one trigger cause an autoimmune reaction that has been building from exposure to toxins, stress, and other factors. Genetic susceptibility to AI diseases would make one person’s barrel start out much fuller than the next.

It is impossible to completely avoid all toxins and chemicals. So what is a person to do, especially those who already have autoimmune disease or know that it runs in their family? I was happy to see that the first defense against autoimmunity that the author talks about is diet and using food as medicine. She  emphasizes a whole foods, gut healing protocol. She also talks about ways to avoid exposure to known autogens. I’ve read most of the advice before from other sources – using natural cleaning and beauty products, avoiding plastic and BPA-lined cans, and purchasing organic foods if at all possible.

For me, The Autoimmune Epidemic created almost as many new questions as it did answers, begging further research and sleuthing into what may have caused my “barrel” to overflow two years ago. This book was instrumental in expanding my knowledge of how our environment affects our immune systems and it can be a helpful tool for anyone seeking to gain a deeper understanding of autoimmunity.

Six Month Update

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It’s time for another update, because mid-January marks my six month anniversary of doing the Paleo Autoimmune Protocol (AIP)!

 A Quick Recap

I was taking four medications for my RA just before starting AIP. I had been mostly Paleo for two months prior. My doctor recommended I wean off prednisone due to the side effects associated with using it for too long. I had a post-prednisone flare that made my whole body achy and weak, and my fingers and wrists sore and swollen. The resulting adrenal fatigue left me exhausted and unable to get out of bed.  I think that flare helped me come to the decision to start AIP full force – I started AIP the week after. For my four month update, click here.

Current Pain and RA activity

My pain and swelling are finally getting to a point where I feel they are managed well. I say “finally” because I did not experience steady improvement over the past months on AIP – there were ups and downs, including a particularly painful few weeks in late November. That flare faded and I continue to improve, feeling the best I have since starting AIP. I use a single medication (Plaquenil). Last year (before dietary changes) I tried to use Plaquenil alone for managing my RA and it was not sufficient, so I am thrilled that AIP + Plaquenil is managing my RA well, now with consistent improvement. I take curcumin (turmeric) supplements in the morning and night, and this seems to help with overall inflammation as I continue to heal my gut. Morning stiffness is still a reality, but it’s quite manageable and fades as I get up and move around.

Energy Level

My energy is slowly coming back to me! During my post-prednisone days, my adrenal glands struggled to get back on their feet, and for months I felt fatigued and exhausted. I had low blood pressure, and would often feel light-headed and short of breath in the mornings. I didn’t feel like exercising – every once in a while I could manage a walk.

Now after six months of being dedicated to 8-10 hours of sleep per night and eating very well, I finally feel my energy coming back to me. I am able to handle activity without feeling so drained. I even started light weight lifting again, something I’ve always enjoyed. In a fit of optimism, I’ve been perusing new bikes on Craigslist in excitement for summer activities.  Having my energy back has completely revitalized my outlook toward healing – I’m so grateful to have it back!

Digestion

Digestion has always been a problem for me. Unfortunately during the first few months of AIP, my digestion seemed to get worse. I quickly lost weight and felt like despite all the amazing, nutritious food I was eating, I wasn’t getting nourished. I experimented with cutting out foods high in FODMAPs for a few weeks and experienced no change. I alternately gave up coconut and starchy veggies, trying to find the key.

This fall, I began supplementing with Betaine HCL  and pancreatic digestive enzymes, as my rheumatologist suggested. She thought that low stomach acid might be a problem for me, and indeed it was. My digestion has slowly improved, though it still has a ways to go. I’ve stopped losing weight and feel like the wonderful nutrients I am eating are being absorbed.

What’s Next

If my RA symptoms and digestion stay on the road to recovery, I will likely try reintroductions in the coming months. I have no reason to rush these – I have adapted well to the restrictions –and so will take reintroductions slowly. As my energy continues to improve, I plan to invest more time in exercise and will continue to prioritize sleep. I am incorporating detox baths into my weekly routine – it’s amazing that something so simple can prove so effective.

Another future possible step for me is to meet with a Naturopath and get some functional medicine tests done to take the guesswork out of my ongoing digestive issues. I’m working on crunching the numbers to see if this can fit into my budget.

Do I want to get off my final medication? Of course! But I am not going to rush this. I want to allow my body this healing period and avoid spiraling into a withdrawal-flare by going too quickly. I meet with my rheumatologist in a few weeks and will discuss my next steps with her.

It’s crazy that I’ve gone six months without a sip of wine or a drink of coffee or a piece of chocolate – all those things that I thought I couldn’t live without. At the beginning, I never thought I would be able to commit to a month, let alone six. And I am ready to commit to much more. Onwards!