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

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, so I was thrilled when she gave me a copy of the cookbook to review.

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. She gave me her new e-book, 28 Days of AIP, to review. The book 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/.

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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. Along with the medication my doctor prescribed, I’ve been eating a strict healing diet for nine months now and 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.

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!

On Strength

Image Being physically strong has always been an important part of my identity. I take after my father in build – inherited his muscular frame rather than the petite stature of my mom. In elementary school, I was the best football player in the neighborhood, always picked first for the team. In middle school and even high school, I wasn’t afraid to challenge – and beat – the boys in my class at arm wrestling.

After college, I let my strength take me to the haggard North Shore of Lake Superior, where I worked on a Conservation Corps crew for a year. I spent entire days tearing up old stairs on hiking trails and lugging the waterlogged lumber up the side of a steep ridge. I hiked eight miles in one day, over a Minnesota-sized “mountain,” carrying a days worth of water, gasoline, and a bulky weed whip strapped to my body for trail maintenance. I shoveled gravel, wielded a chainsaw, put out hotspots to contain forest fires, broke ground with pulaskis and sledgehammers. I was at the pinnacle of my physical strength.

And then I woke up one morning with pinkies that clicked when I tried to open them and feet that burned as if there were tiny planets on fire between my toes. Rheumatoid arthritis—and the medicines used to manage it—came and leached away that strength so that some days I couldn’t even hook my bra behind my back or grab a door handle and twist. In the past few years, there have been times I felt physically strong despite RA –thanks to prednisone – and other times where I felt very sick. At the times I was my sickest, I would look in the mirror and be unable to find that strength I’d always defined myself by.

I’m learning that I need to work through, and heal, the parts of me that are psychologically wounded by RA as I work hard to heal myself physically. As part of my healing process, I’ve made space to think about and meditate on these things. To wonder, if the thing I always valued about myself was my strength, and I now have a disease that wants to take that from me … who am I?

Recently I spoke to a good friend about this faltering self-image and the struggle rethink the way I perceive myself. She told me that as she’s seen me undergo this transformation – particularly since I’ve made an effort to manage my disease as holistically as possible – she’s witnessed the unfolding of a remarkable inner strength. That as I invest in healing, my discipline and self-awareness set me apart and give me that unique strength I’d always sought even as a little girl.

Her words moved and encouraged me. As a result of this friend’s wisdom, I am consciously practicing seeing myself differently. Not as sick or weak, but as resilient and strong. Strong enough to face each day without knowing what the pain will be like. Strong enough to eschew aggressive medications, trusting that healing the source of the problem will be better in the long run than masking symptoms. Strong enough to live without knowing what my physical capabilities will be in a year, or five years, from now. I might not be arm wrestling any guys anytime soon, but I have a new capacity for strength that reaches well beyond the power in my biceps. I invite anyone else struggling with a chronic illness to take the words of my friend as your own and be encouraged by them.

To all of you suffering from chronic disease, to all who take this challenging, sometimes scary road to healing, know that you, too, are incredibly strong.

On the Ten Ways AIP has Changed My Life

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November marks four months on the Paleo Autoimmune Protocol.  I’m going to be honest – AIP changed everything for me, in both really good and really difficult ways.

– I saw improvement in my symptoms. Change happened gradually – for me, I didn’t notice instant improvements. Also, it hasn’t been a linear path – there have been ups and downs in my joint pain, energy, and digestive health. When I started AIP, it was difficult to grab a door handle due to the pain in my fingers and wrists. After about two months, my pain had subsided to the point that only one finger occasionally gave me problems. Multiple medication changes have caused a series of ups and downs in the latest month or so, but my inflammation is leveling out again.

– I became empowered to accept my diagnosis and to have a say in what happens to my body because of it. Getting diagnosed with an autoimmune disease is one of the most disempowering things I’ve ever experienced. My doctor said, “There is no cure for this, and you will likely experience a lifetime of chronic pain and joint deformation.” After which she launched into a list of the possible medications I could start taking, followed by a list of scary side effects. I left that appointment feeling helpless, and proceeded to live in a state of denial about my RA – until I found Paleo, and then AIP. Eating this way has empowered me to learn about my disease, what may have caused it, and all of the ways I can nurture and heal my body with food.

– I got out of a stressful relationship. To be fair, when we started dating I was still in denial about having rheumatoid arthritis. We’d only been dating a month or two when I decided to start AIP. He was supportive in theory, but his own lifestyle was difficult to reconcile with my new one. As I became more focused on my health, I felt the need to focus inward. I had trouble committing fully to AIP and also keeping up with a new relationship that was somewhat stressful for multiple reasons. I just knew that I had to choose what was best for my health. Did that make it easy? Not at all, but I believe it was the right decision.

– I got off of THREE medications! And am still taking one. When I started AIP, I had been on four medications for my RA.  Now I am down to one. This is a HUGE accomplishment. I believe AIP eased my transition off of one of the disease modifying anti-rheumatic drugs (DMARDs) that I had to stop taking due to side effects. I found a rheumatologist who is knowledgeable about functional medicine, and she supports my use of food and supplements along with meds. I will be working with her as this process continues.

– I embraced an earlier bed time. I try to crawl into bed at 9 and usually read until about 9:30. It takes me around a half an hour to fall asleep – leaving me with a solid 8 ½ hours of sleep every night. Now I can’t imagine what I used to do past 9 pm every night besides sleep!

– My exercise routine completely changed. Before starting AIP, I loved lifting weights and biking long distances. I still love those things. I believe it is actually prednisone that both enabled me to do them for so long, and now has taken them away from me due to the adrenal fatigue I am experiencing from stopping it. Now on good days I go for a brisk walk, do yoga and stretching, and lift some free weights at home. I hope to continue to heal my adrenal fatigue and hop on my bike again next summer.

– My budget is completely transformed. I used to have money allotted each month for meals at restaurants, alcoholic beverages at the bar, and my membership at the gym. Now pretty much all that money goes toward quality food and supplements. This transition happened slowly over the few months that I’ve been on AIP. I had to embrace the fact that good food is a priority for me. Now I invite my friends to go for walks or grab a cup of tea, or to join me at the Farmer’s Market. The shift in my social life hasn’t been a detriment to it, and I find it fits my overall AIP lifestyle much more than going to a bar.

– I lost weight, but that isn’t the point. I did lose weight by eating this way, but have tried not to make my focus. As someone who has struggled with weight and body image issues for my whole life, being able to look past the weight loss is not always easy. It’s almost like I have to practice looking at food as medicine and sustenance, not as a tool to feel control over the way I look.

I learned to cook. Not that I didn’t know how before, but I’ve delved further into allowing my creativity to translate into the food I make. I make do with my tiny kitchen and experiment with recipes.

– I let go of the “It’s only 30 days!” mentality. I thought I would only do AIP for one month, and now I see it is a lifetime commitment. I’ve decided to hold off on reintroducing foods, since my symptoms and digestion are still not stabilized. Since they seem to change on a daily basis, I don’t think that I could pinpoint a change in symptoms on any food I tried to reintroduce. It’s important to me to wait until I feel completely ready before experimenting with reintroduction. Thankfully, I feel well adapted to eating AIP and am willing to continue it until I make the right tweaks to get me where I want to be.

I entered into this lifestyle with some resistance, some fear, and a lot of hope. Looking back now, I see how AIP slowly changed not only my diet but my capacity to give my body what it needs to heal – whether that be more sleep or time alone. Change is not easy to accept, but I grow increasingly sure that these changes are all a part of my healing process.