13

votes

Post-paleo: Will I adjust back to grains?

Answered on August 19, 2014
Created February 05, 2013 at 8:56 AM

Hi all,

First, some personal history to flesh this question out with some context:

26 year old male, around about 90kg (13-15% bf), ex-weight-lifter (currently recovering from tonnes of niggly injurys in back, knees, ankles, wrists and shoulders...yeah, I know...). I have eaten in a paleo style to varying degrees for around 2 years now, initially beginning my quest to improve well-being generally and improve body composition. I have tried quite a few slants at different points for different reasons, including whole30, primal (80/2), low-carb, high-carb, Robb Wolf-esque, Pefect Health Diet-esque. Throughout this time I have read much in the community and are at least partially aware of the many hypotheses, both evolutionary and biological, that are attached to this way of eating. In all my time with paleo, I have never found a solid answer to my question below.

Most recently, for New Years, I began a strict auto-immune protocol (no grains, no dairy, no legumes, no nightshades, no nuts, no eggs, no coffee/caffeine, no alcohol) in order to see if I could improve some psoriasis that has maintained its infliction throughout my paleolithic experiments. I had some concerns that my psoriasis was turning into psoriatic arthritis (read injurys above) and thought that if one could be manipulated through dietary means, likely so could the other. I read some (tentative) hypotheses (on 'paleomum') that immune system dysfunction could take up to 3 years to fully heal, particularly in the brain, where immune dysfunction can contribute to psychiatric disorders. Since I have also suffered with anxiety and depression (rapid cycling periods of both, to various levels of intensity, generally baselining between non-existent to mild/moderate symptoms) since my middle teens, experienced a bout of stress-induced psychosis after a particularly intense meditation retreat, and are aware of the possible connections between gut and brain dysfunction....I thought what the heck. My cyclical optimism got excited that this really may be the answer.

In short, I was strict for 3 weeks. During that time my psoriasis healed by around 70%, with healing occurring rapidly. There was no change in joint/tendon difficulties, although I remember my back feeling 'cooler' at times (self-suggestion? not sure). Psychiatric difficulties worsened if anything, primarily mediated by the severe lack of fun and pleasure that such a regeime brings, not to mention the larger percentage of the little free-time I do have going over to cooking and preparing food. By the end of the three weeks I was beginning to doubt whether it was worth the trouble (particularly as I might not see psychiatric improvement for a long time), and are well aware of concurrent negative side-effects to such restriction (increased anxiety about food, frustration, endless hypothesising....).

I am also trying to get out of debt and the auto-immune protocol was setting me and my partner back around ??550 per month ($865 USD). This is as cheap as we could make it, strangely cheaper than our normal habits (less alcohol etc). In short, I got fed up with the taxation on my free time, my wallet and a significant amount of food/health anxiety and frustration. I had a blood test one week after starting the diet - no inflammatory markers were raised (I would exepct CRP to drop quickly after removing dietary aggravation, but ESR was also in the normal range). Doc said my injuries were likely bio-mechanical and my psoriasis was changed by modulation of the immune system.

There is a sure-fire why to save money on food - eat carbs. If possible, eat grains. I have been eating moderate quantities of oats and white rice the past week or so. The first time I ate rice, I ate a large quantity and had a tight chest for around 6 hours. I had loose stools the first morning, although these have returned to normal, leaving mild gut pain at various parts of the day and my gut feels more dystended and bloated than usual, particularly in the mornings. In days past, I would have acknowledged the normal paleo wisdom on such matters and 'listened to my body. But, my question now is:

If I continue to eat rice/oats, will this 'intolerance' adjust back to pre-paleo levels (i.e. no apparent difficulties/symptoms with ANY food - excepting the presence of psoriasis and something happening there).

Since going paleo, I have become apparently more and more sensitive to more and more foods. Is this just a psycho-somatic suggestion? Is there a period of adjustment when re-introducing almost any food?

Because if there is, 'listening to our bodies' may not always be in out best interest.

Apologies for such a long post. My thanks in advance to anyone who answers - any suggestions are welcome. I welcome scientific references if they exist!

Regards,

Rick

EDIT (12/02/2013) - Update: After 1.5 weeks of re-introducing oats and white rice (Guinness, beers and potatoes at the weekend), my psoriasis changed after the 3 consecutive days of around about 1 potato per day. This is the only time I can be confident of some kind of psoriatic reaction since finishing the autoimmune protocol, despite exposure to gluten (beer). Whilst my re-introduction has been messier than ideal (more than one food at a time etc), it seems that nightshades cause the most consistent effect. This also correlates with a previous attempt at eliminating nightshades, which also caused psoriasis improvement. It is worth noting I am still getting mild gastrointestinal pain and bloating. I seem to experience chest 'tightness', behind the sternum area, at some point during each day.

New Question: Can nightshades aggravate psoriasis if there are no gut permeability issues? (If they cannot, I must assume that either the gluten or alcohol exposure created a situation of leaky gut, and that my entire 2 years on various levels of paleo have no resolved a leaky-gut situation!)

Bounty offered due to complexity and length of question! :)

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:55 PM

As for my own n=1, the bloating, gut pain and chest tightness has almost completely disappeared after 2 weeks of reintroduction of oats and rice. I am 100% I am not becoming more used to, and therefore less aware, of these symptoms. My stomach is quite literally less bloated, and even meditative awareness does not reveal l the gut pain that was previously so obvious. My body is either adapting (gut biome, enzymes etc), or it is 'hiding' the problem, for some ridiculous reason that has heretofore been unexplained by evolutionary biology.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:53 PM

...mainstream is likely to find much at fault with the paleo gig at large. There is a huge potential for healthy people to become over-watchful of their body, causing them to make their lives unnecessarily stressful and complicated, which, ironically, by itself is enough to create problematic symptoms.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:50 PM

Combine these following beliefs: "most people are unaware of the harm their food does to them", "many foods can disrupt healthy functioning, even in apparently healthy people", "you will only know if a food is harmful by elimination and reintroduction", "any abnormal symptom in the body must be paid attention to", "you must modify your diet until you find the appropriate balance for you". Every one of these has a sound basis, but everyone is also a recipe for disaster when it comes to rigid and potentially problematic thinking. If these concerns are not adequately addressed, the scientific

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:47 PM

I actually also find the argument extremely patronising, as I have been a meditation and mindfulness practitioner for the past 7 years. I am exquisitely aware of extremely small changes in my physiological, emotional and cognitive state, perhaps overly so! This does not go away with the 'noise' of a more regular diet - I either am aware of symptoms, or I am not. We already know that the mind can cause an incredible array of psychosomatic responses - the emotionally-charged paleo memosphere is easily sophisticated enough to trigger these types of reactions in unsuspecting customers.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:43 PM

Thanks for responding, Matuyama. I believe that your concerns are very valid ones. Yourself, my partner and me have all had symptoms on reintroducing a number of foods that were previously not a known problem. At this stage, the paleo-sphere normally comments by claiming that SAD diets create too much 'noise' to allow for symptomatic clarity. Whilst there is a truth to this, as people notice unpredicted changes when first going paleo, I feel it is used as a 'cover-all', and is potentially harmful advice, especially if symptomatic reintroduction is without harmful physiological cause.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 15, 2013
at 01:07 PM

Points awarded for addressing the question with the power of balanced science.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 12, 2013
at 06:31 PM

So a lack of flare up can indicate both less reaction AND increased systemic inflammation? I appreciate this may be an either/or, but from a n=1 diagnostic standpoint it is hard to know what to do with that information? I must be missing something...

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 12, 2013
at 06:27 PM

An honest and scientific answer to a multi-factorial problem - bravo! Thanks for the advice - I guess much of the problem lies in my confusion about whether leaky gut has ever been an issue for me or not. Based on limited data and the financial difficulty, I think your answer has highlighted for me how I need to mess with the system as little as possible for a good while. So far, oats and white rice have not reversed the improvement with my psoriasis, so from that perspective it seems reasonable they can stay.

Eed7dabde3d61910685845e04605267f

(2934)

on February 12, 2013
at 02:19 PM

People can only be aware of things according to the knowledge/experiences that they have. That doesn't take away teh benefits that can be garnered from 'tuning in'/being aware, particularly as people (through being on this website eg) learn things...

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 12, 2013
at 01:16 PM

Not a huge fan of the 'body awareness' BS that some folks like to get excited about. Most folks don't know what they're listening for unless it's very obvious (i.e. stabbing abdominal pain!) They'll simply read the wrong cues and come up with wacky conclusions.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 12, 2013
at 01:14 PM

I'm of the opinion that dysfunction had be corrected. Most folks reduce baseline inflammation when they switch to paleo and then are able to observe the inflammation caused by problematic foods much easier. If you're not flaring up after food, you're reducing your reaction (or you've inadvertently increased systemic inflammation).

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 08, 2013
at 01:18 PM

I'd say your mile may vary. But it took my body 3 weeks to get used to *not* eating grains, I'd assume it would be similar time frame to reintroduce.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 08, 2013
at 01:00 PM

Let's say this was an enzyme adaption issue - do you have any idea how long that might take? Even a ball-park?

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 05, 2013
at 09:07 PM

I think you can be healthy while not strict paleo. In fact I added dairy back and found that I do better with dairy than I did without. However, I think the approach of going whole foods and eliminating potential problems in general is the best approach. After that you have to find your way. Right now my body works in ways it never had previously, so it it not worth trying to find a new way

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 05, 2013
at 09:05 PM

No, I agree with you. If I were healthy I probably would never have come to Paleo. But I struggled with weight, even in a restricted caloirc state and running 55+ miles and constipation (I was on medication to treat), asthma (imagine running 55+ miles with astham), and allergies (I was getting weekly allergy shots and treating with medication). I was not healthy, paleo has helped me. My wife, very healthy very fit. She never went paleo. We don't eat a lot of sugar and she dislikes beans -- so really the only thing non-paleo for her are grains and the occasional bag of chips...

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:30 PM

As a side, I'm also not sure that, as I have developed considerable body awareness in my time with paleo, it would be easy for me to 'miss' any gut pain amongst the noise of a standard diet. There would have to be constant gut pain for me to do so, which is not the same as the gut pain itself reducing (the only outcome I am interested in achieving).

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:27 PM

Thank you for your help, Lazza. I suppose the differences in our n=1 is that you had obvious IBS symptoms, whereas I only have them on reintroducing grains (rice, oats etc). If my symptoms resolve, whilst continuing to eat some grains, whilst maintaining a level of self-awareness, I guess I'll have to assume that I can in fact tolerate these foods when they are a regular part of my diet. I should also mention that my psoriasis doesn't seem to have gotten worse whilst eating rice/oats again. It could just be nightshades after all...?

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:25 PM

I guess what I don't know right now is that I've ever had leaky gut for sure - even after only one week on an autoimmune protocol, I had no elevated blood markers of inflammation. Could my gut dysfunction be so mild as to leave no trace within 1 week? The discomfort I have right now could just be a lack of enzymes, if your initial suggestion is true. A lack of enzymes wouldn't indicate removal of something from the diet, quite the contrary?

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:23 PM

It's a good point and I agree with the premise. To side track from the larger issues to my particular case again, prior to paleo, the only chronic issues I can think of were weight management (probably just calorie excess, resulting in a stocky frame) and the psoriasis. Of course I had the psychiatric difficulties but I've never actually seen any convincing evidence that would suggest my particular issues (i.e. psychiatric disturbance without obvious gut dysfunction) are related to diet, as much as I would like them to be in some ways (a simpler solution, potentially...)

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:16 PM

In your particular case, do you think that, on re-introducing foods, your sensitivity reduced or the dysfunction itself reduced? I understand there could be some confusion there, but the two seem to be very different physiological changes with equally different long term effects. Changes in sensitivity could be a problem, as this is ignoring the damage.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 05, 2013
at 07:55 PM

A standard diet creates so much noise that you'll be unable to detect what problems wheat might be causing you (if any). Elimination diet decreases the noise which helps you find any problems. If over time (meaning months to years timescale), you do not regain tolerance to X food, you've probably got irreversible damage and you'll have to live with that. You could just turn up the noise and suffer a little bit until you get used to that again, but it might just be better to avoid it.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 05, 2013
at 06:02 PM

Just to be "Devil's Advocate". Are people really symptom-free? low level, chronic inflammation doesn't show up the first time you eat bread it is very possible that grains are not healthy. I know that it took 4-5 months of strict paleo before I was completely healed of many chronic issues -- constipation, asthma, allergies, etc. I truly believe that reducing my systemic inflammation is what was so effective. Many people with "leaky guts" do not get that way tactically, it takes years. Maybe introducing grains are ok in the short run, but in the long run you are doing damage.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 04:47 PM

Even more problematic, is that this then fuels the "grains/legumes/dairy" are evil meme, or that population intolerance is more prevalent than it actually is.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 04:46 PM

Very interesting. It seems possible to me then that, given the large numbers of symptom-free people trying paleo, they may then re-introduce a food, acquire symptoms and then believe themselves to be 'intolerant', when really they just temporarily lack the ability to process the stressor!

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 04:43 PM

Thanks for your response. It does seem that you are suggesting the gut healed despite the initial warnings it sent you, which I have to admit is what I am hoping for, alongside the relative financial and social ease that comes with it. It does rather beg an answer though; if these foods were causing you an issue, *why* did the issue heal without removing it from the diet? So much of paleo-land is 'absence ' focused, i.e, the problematic food must be removed before healing can occur. This does not seem to be the case with many of its adherents. I will report back my n=1 as the weeks continue!

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 04:39 PM

Thanks for your thoughts, Mash. I agree that suggestion plays a role, although my new fears of white rice have only really developed on this occasion (I haven't confidently established a problem with it before this re-introduction). A previously 'safe' food, seems to now not be so well tolerated after a month of an auto-immune protocol. It makes me wonder if something has changed in my gut biome, and that is causing the dysfunction, rather than often-vaguely used terms such as 'irritation' or 'inflammation'.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:57 AM

I forgot to mention - I have been able to reduce our food budget by 50% - so at least THAT part of this is working!

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7 Answers

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4
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 12, 2013
at 01:57 PM

Answer to question #2:

Can nightshades aggravate psoriasis if there are no gut permeability issues?

First let me say I accept that some people are not going to like this answer.

The autoimmune protocol has shown some benefit to some people. It has not been definitively linked to reducing issues we believe are caused by leaky gut. But it is not the answer for everyone. The science is very shaky and based entirely on anecdotal evidence and a few small N studies. It is good science, but honestly, from a applicability in people standpoint, it is in its infancy.

So to get at the root of your question, we first need to make the assumption that gut permeability issues are real. Ok, check. And then assume that you do not have gut permeability issues. check.

Ok, given those two assumptions, is it still possible to get psoriasis?

First, we do not have a true "cause" of psoriasis. What we do know are things that increase the occurrence of psoriasis.

What could increase the occurrence of nightshade-induced-psoriasis? Allergies

Unfortunately, currently there is not a definitive link between the two: http://www.mayoclinic.org/medical-edge-newspaper-2011/may-27b.html. However, there is anecdotal evidence that the link exists and if you have a food-based allergy that could cause psoriasis without a leaky gut.

Other, non-nightshade-induced causes of psoriasis:

  • Ethanol
  • Dry Weather
  • Hormonal imbalances

These could also be contributory to your proiasis.

So what next.

I understand how difficult this is, and how hard you are looking for a solution. I do not believe there will be any one 100% solution. Also I do not believe that a quick fix exists. You mentioned that you saw a 70% improvement in three weeks. That is an amazingly fast turn around. To have then stopped and moved into a different direction, or assumed that you see a change within 3 days... I don't think you are giving yourself enough time. The body wants to maintain homeostasis. And will likely push back against any change.

Personally, I would go back to what worked and rather than give it 3 weeks I'd try to give it three months. I know the cost was an issue for you, and that is a very personal decision. Good luck

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 12, 2013
at 06:27 PM

An honest and scientific answer to a multi-factorial problem - bravo! Thanks for the advice - I guess much of the problem lies in my confusion about whether leaky gut has ever been an issue for me or not. Based on limited data and the financial difficulty, I think your answer has highlighted for me how I need to mess with the system as little as possible for a good while. So far, oats and white rice have not reversed the improvement with my psoriasis, so from that perspective it seems reasonable they can stay.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 15, 2013
at 01:07 PM

Points awarded for addressing the question with the power of balanced science.

7
Ca2c940a1947e6200883908592956680

(8574)

on February 05, 2013
at 10:18 AM

Rick,

First of all thanks for posting this, it is a rare good question here on PaleoHacks. Hopefully people will vote it up for future reference.

From what I understand about food sensitivities, there appears to be some mechanism by which the healthier the gut, the more sensitive it becomes to the normal offenders. If anything it means that you are reacting how you should, or perhaps more acutely.

Personally I think 'listening to our bodies' is about as useful as 'everything in moderation'. I would rather aim for perfection and reap the benefits of almost getting there.

On your comment of 'psycho-somatic suggestion', honestly I think there is something to this which I think can be seen in the carb-phobia that manifests itself in all manner of symptoms not actually produced by the carbohydrate itself. I.e. Someone franticly worries about their last 'binge' only to find out later that 500g of starchy vegetable is still less than 150g of carbohydrate. Funny how a lot of previous healthy low-fat individuals used to say eating fat made them sick and now they are bathing in the ecstasy of butter.

Anyway I think more focus specifically on restoring healthy gut flora (http://bit.ly/WNMbk9), would be the way forward and if you are still unsure about white rice (http://bit.ly/WjdG8B).

I think there is little reason to use wheat when there are equally cheap and less toxic 'staples' such as white rice. Sorry I haven't really answered your question, if I find any better information I will update this.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 04:39 PM

Thanks for your thoughts, Mash. I agree that suggestion plays a role, although my new fears of white rice have only really developed on this occasion (I haven't confidently established a problem with it before this re-introduction). A previously 'safe' food, seems to now not be so well tolerated after a month of an auto-immune protocol. It makes me wonder if something has changed in my gut biome, and that is causing the dysfunction, rather than often-vaguely used terms such as 'irritation' or 'inflammation'.

4
32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 05, 2013
at 12:57 PM

In my mind, food intolerances all come to leaky gut and gut health. They are a symptom rather than a cause of health issues. There's a reason that most people can consume wheat and other grains without issue (this does fly in the face of paleo wisdom). Grains are, in and of themselves, not harmful. Goes for just about all foodstuffs.

Now, whether you'll adjust back to grain consumption and what effect that will have on you. That depends on the state of your gut. But after 2 years, if your gut was going to be healed, it should be healed. There are many people who have irreversibly damaged their gut, and simply cannot fix the damage enough to tolerate some foods. Speaking from personal experience, I never had overt intolerances. I only ever experienced minor malaise adding grains back after being paleo for some time, and eventually even that stopped. I take that as meaning I had a slightly leaky gut, with reversible damage/inflammatiaon, which over time was healed and proper gut/immune function was restored.

Of course, I could be misinterpreting what my body is telling me. Listening to your body is not an exact science. My whole theory could be junk.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:16 PM

In your particular case, do you think that, on re-introducing foods, your sensitivity reduced or the dysfunction itself reduced? I understand there could be some confusion there, but the two seem to be very different physiological changes with equally different long term effects. Changes in sensitivity could be a problem, as this is ignoring the damage.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:30 PM

As a side, I'm also not sure that, as I have developed considerable body awareness in my time with paleo, it would be easy for me to 'miss' any gut pain amongst the noise of a standard diet. There would have to be constant gut pain for me to do so, which is not the same as the gut pain itself reducing (the only outcome I am interested in achieving).

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 04:43 PM

Thanks for your response. It does seem that you are suggesting the gut healed despite the initial warnings it sent you, which I have to admit is what I am hoping for, alongside the relative financial and social ease that comes with it. It does rather beg an answer though; if these foods were causing you an issue, *why* did the issue heal without removing it from the diet? So much of paleo-land is 'absence ' focused, i.e, the problematic food must be removed before healing can occur. This does not seem to be the case with many of its adherents. I will report back my n=1 as the weeks continue!

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 05, 2013
at 07:55 PM

A standard diet creates so much noise that you'll be unable to detect what problems wheat might be causing you (if any). Elimination diet decreases the noise which helps you find any problems. If over time (meaning months to years timescale), you do not regain tolerance to X food, you've probably got irreversible damage and you'll have to live with that. You could just turn up the noise and suffer a little bit until you get used to that again, but it might just be better to avoid it.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 12, 2013
at 01:16 PM

Not a huge fan of the 'body awareness' BS that some folks like to get excited about. Most folks don't know what they're listening for unless it's very obvious (i.e. stabbing abdominal pain!) They'll simply read the wrong cues and come up with wacky conclusions.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 12, 2013
at 01:14 PM

I'm of the opinion that dysfunction had be corrected. Most folks reduce baseline inflammation when they switch to paleo and then are able to observe the inflammation caused by problematic foods much easier. If you're not flaring up after food, you're reducing your reaction (or you've inadvertently increased systemic inflammation).

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 12, 2013
at 06:31 PM

So a lack of flare up can indicate both less reaction AND increased systemic inflammation? I appreciate this may be an either/or, but from a n=1 diagnostic standpoint it is hard to know what to do with that information? I must be missing something...

Eed7dabde3d61910685845e04605267f

(2934)

on February 12, 2013
at 02:19 PM

People can only be aware of things according to the knowledge/experiences that they have. That doesn't take away teh benefits that can be garnered from 'tuning in'/being aware, particularly as people (through being on this website eg) learn things...

2
75d65450b6ff0be7b969fb321f1200ac

(2506)

on February 05, 2013
at 07:36 PM

ZenFire, 70% psoriasis clearance in three weeks is quite extraordinary. You've hit upon something important. It would be unfortunate to back track after this success, albeit financial constraints is very understandable.

Like you, I have psoriasis and I have used diet as a means to tackle it. Just by going gluten free and dairy free cleared up my symptoms tremendously within a few months. But I also suffered from IBS, and so it was pretty obviously my gut was a mess ... and a contributor to psoriasis flares. Going grain/starch free really did a great job in healing my gut, and my psoriasis improved further ... at glacial speed. Going low carb, getting H. pylori eradicated, and taking the supplements recommended in Perfect Health Diet has helped further (..my IBS is just about gone). Like you, I want to reintroduce forbidden food at some point. Rice and/or potato is my first choice. But I want to wait at least a full year of being on Paleo before pushing the envelope, and I have a couple of months to go.

Finally, the effectiveness of a Paleo diet on an autoimmune disease is highly variable. I think in > 50% of the cases Paleo can help significantly. But there will be a large number of folks who will remain frustrated.

Best of luck to you.

_Lazza

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:27 PM

Thank you for your help, Lazza. I suppose the differences in our n=1 is that you had obvious IBS symptoms, whereas I only have them on reintroducing grains (rice, oats etc). If my symptoms resolve, whilst continuing to eat some grains, whilst maintaining a level of self-awareness, I guess I'll have to assume that I can in fact tolerate these foods when they are a regular part of my diet. I should also mention that my psoriasis doesn't seem to have gotten worse whilst eating rice/oats again. It could just be nightshades after all...?

1
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 05, 2013
at 01:18 PM

One thing you may want to research is whether taking some enzyme supplements could help jump start your body during re-introduction. My understanding is that enzymes are not particularly long lived (I've seen estimates in the 6 month - 2 year range -- probably based on the enzyme, and your gut health). If you stop eating a certain food type (like wheat) your body's supply of enzymes will eventually die out, and the body will see no reason to work to repopulate them (which makes sense from an evolutionary stand point). In addition you are not receive any enzymes from the food (since you are not eating that food type).

For re-introduction of wheat you might benefit from: Beta-glucanase; Peptidase; Malt diastase; Glucoamylase; Cellulase; Amylase; and/or Alpha-galactosidase.

Hope that helps.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 05, 2013
at 09:07 PM

I think you can be healthy while not strict paleo. In fact I added dairy back and found that I do better with dairy than I did without. However, I think the approach of going whole foods and eliminating potential problems in general is the best approach. After that you have to find your way. Right now my body works in ways it never had previously, so it it not worth trying to find a new way

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:23 PM

It's a good point and I agree with the premise. To side track from the larger issues to my particular case again, prior to paleo, the only chronic issues I can think of were weight management (probably just calorie excess, resulting in a stocky frame) and the psoriasis. Of course I had the psychiatric difficulties but I've never actually seen any convincing evidence that would suggest my particular issues (i.e. psychiatric disturbance without obvious gut dysfunction) are related to diet, as much as I would like them to be in some ways (a simpler solution, potentially...)

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 04:47 PM

Even more problematic, is that this then fuels the "grains/legumes/dairy" are evil meme, or that population intolerance is more prevalent than it actually is.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 08, 2013
at 01:18 PM

I'd say your mile may vary. But it took my body 3 weeks to get used to *not* eating grains, I'd assume it would be similar time frame to reintroduce.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 04:46 PM

Very interesting. It seems possible to me then that, given the large numbers of symptom-free people trying paleo, they may then re-introduce a food, acquire symptoms and then believe themselves to be 'intolerant', when really they just temporarily lack the ability to process the stressor!

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 08, 2013
at 01:00 PM

Let's say this was an enzyme adaption issue - do you have any idea how long that might take? Even a ball-park?

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 05, 2013
at 08:25 PM

I guess what I don't know right now is that I've ever had leaky gut for sure - even after only one week on an autoimmune protocol, I had no elevated blood markers of inflammation. Could my gut dysfunction be so mild as to leave no trace within 1 week? The discomfort I have right now could just be a lack of enzymes, if your initial suggestion is true. A lack of enzymes wouldn't indicate removal of something from the diet, quite the contrary?

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 05, 2013
at 09:05 PM

No, I agree with you. If I were healthy I probably would never have come to Paleo. But I struggled with weight, even in a restricted caloirc state and running 55+ miles and constipation (I was on medication to treat), asthma (imagine running 55+ miles with astham), and allergies (I was getting weekly allergy shots and treating with medication). I was not healthy, paleo has helped me. My wife, very healthy very fit. She never went paleo. We don't eat a lot of sugar and she dislikes beans -- so really the only thing non-paleo for her are grains and the occasional bag of chips...

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 05, 2013
at 06:02 PM

Just to be "Devil's Advocate". Are people really symptom-free? low level, chronic inflammation doesn't show up the first time you eat bread it is very possible that grains are not healthy. I know that it took 4-5 months of strict paleo before I was completely healed of many chronic issues -- constipation, asthma, allergies, etc. I truly believe that reducing my systemic inflammation is what was so effective. Many people with "leaky guts" do not get that way tactically, it takes years. Maybe introducing grains are ok in the short run, but in the long run you are doing damage.

0
5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 07:03 PM

It would seem, the re-formulated question, boils down to this:

"If reintroduction of foods previously eliminated foods can cause symptoms that were not historically experienced, and fade with consistent reintroduction of said foods, without obvious pathology, how does one distinguish between problematic and 'normal' symptoms?"

Of course, we can answer this by saying that symptoms must be associated with some other measure of pathology (blood work, diagnosis of syndromes etc), but this is somewhat a mute point considering the vast majority of people trying paleolithic approaches to nutrition are doing so from a non-clinical and subjective observational perspective. Not to mention that any concerning syndromal presentation is likely to persist with time, not disappear in two weeks! If it were to do so, it is by definition a non-issue.

I believe the jury is still very much out on this. It is very tempting and comforting to smother these concerns by lip-servicing the most common brands of paleo ideology, but that is simply not rigorous enough for real world application.

So, paleohacks, what do we think?

0
783275f7d7d5fd8de47977d42fc5f97d

on February 20, 2013
at 03:58 PM

Great question, I've actually been wondering the same thing. I'm currently on the autoimmune protocol and am now attempting to reintroduce a number of foods (eggs/nightshades/nuts/dairy) that I eliminated well over 2 months now. I've only strayed once or twice during that period, on minor things like black pepper and other seed-based spices. Curiously enough I had an immediate reaction to everything I've tried to reintroduce so far. No reaction has been really severe but all of them have been sufficient to make me concerned about eating that particular food (I'm talking tense pain in the neck, headaches, stuffed nose, gas, joint pains, etc.).

Now, I've never been diagnosed with an autoimmune disease but have suffered from IBS-like symptoms, depression and generally feeling like crap for years. This improved significantly after cutting out gluten, dairy and all processed foods (including all sugar) about 3 years ago, but I had some remaining issues that motivated me to try Paleo. The change in my health has been significant, so I'm not doubting I did something right, but I find it very hard to believe that I am sensitive to ALL the things that I cut out of my diet. A bit of anecdotal evidence seems to confirm my skepticism:

1) I had a friend joining me on the elimination diet for a very brief period (even though she had no overt health issues) and on reintroducing wheat etc. she had symptoms akin to mine for about a week. She did not revert to the elimination diet and kept on eating SAD and her symptoms disappeared completely after about a week.

2) I've read a lot of reports from raw food dieters (who have no particular autoimmune diseases) who get similar flu-like symptoms when accidentally eating cooked food.

All of this makes me wonder: To what extent is the reaction that we are getting from reintroducing food actually just a 'normal' readjustment to a food that has been avoided for a long time? There's hardly any information on this that I've seen, but if any such readjustment reaction exists then it seems hardly unreasonable to expect it to be particularly outspoken when cutting out an entire food class (like, all seeds).

I guess this is not an answer to your question, more a reiteration of it, but it seems this is a question that needs to be seriously considered. I'ld love to know how your reactions to the oats/rice are at the moment? Have they abated?

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:53 PM

...mainstream is likely to find much at fault with the paleo gig at large. There is a huge potential for healthy people to become over-watchful of their body, causing them to make their lives unnecessarily stressful and complicated, which, ironically, by itself is enough to create problematic symptoms.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:43 PM

Thanks for responding, Matuyama. I believe that your concerns are very valid ones. Yourself, my partner and me have all had symptoms on reintroducing a number of foods that were previously not a known problem. At this stage, the paleo-sphere normally comments by claiming that SAD diets create too much 'noise' to allow for symptomatic clarity. Whilst there is a truth to this, as people notice unpredicted changes when first going paleo, I feel it is used as a 'cover-all', and is potentially harmful advice, especially if symptomatic reintroduction is without harmful physiological cause.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:50 PM

Combine these following beliefs: "most people are unaware of the harm their food does to them", "many foods can disrupt healthy functioning, even in apparently healthy people", "you will only know if a food is harmful by elimination and reintroduction", "any abnormal symptom in the body must be paid attention to", "you must modify your diet until you find the appropriate balance for you". Every one of these has a sound basis, but everyone is also a recipe for disaster when it comes to rigid and potentially problematic thinking. If these concerns are not adequately addressed, the scientific

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:47 PM

I actually also find the argument extremely patronising, as I have been a meditation and mindfulness practitioner for the past 7 years. I am exquisitely aware of extremely small changes in my physiological, emotional and cognitive state, perhaps overly so! This does not go away with the 'noise' of a more regular diet - I either am aware of symptoms, or I am not. We already know that the mind can cause an incredible array of psychosomatic responses - the emotionally-charged paleo memosphere is easily sophisticated enough to trigger these types of reactions in unsuspecting customers.

5740b342b3b4ca4af7625f9505f7eb5d

(281)

on February 21, 2013
at 06:55 PM

As for my own n=1, the bloating, gut pain and chest tightness has almost completely disappeared after 2 weeks of reintroduction of oats and rice. I am 100% I am not becoming more used to, and therefore less aware, of these symptoms. My stomach is quite literally less bloated, and even meditative awareness does not reveal l the gut pain that was previously so obvious. My body is either adapting (gut biome, enzymes etc), or it is 'hiding' the problem, for some ridiculous reason that has heretofore been unexplained by evolutionary biology.

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