Monday, May 20, 2019

everything good is bad for you, part 1: fiber

You may have seen a book in stores several years ago with a...similar...title to this post. This post serves as a sort of counterpoint-slash-confirmation.

Lately I've been made even more aware of how dumb and lousy critical thinkers most doctors are. Ever notice how their egos are inversely proportionate to how intelligent they are? If it's not a textbook case that can be treated with pills, most doctors don't know what to do with themselves. And specialists are almost worse because they end up treating the same things over and over again. When something new comes, their brains are scrambled. I recently went to a GI doctor and she told me my constipation was psychological and suggested an antidepressant. I felt like I was in a sitcom after that comment. Honestly!

So, in the spirit of stupid medical advice, I am here to tell you the truth about what the doctor recommends. Today I'm going to discuss the well-known "gut cure-all" that is fiber.

All about FIBER!

Fiber comes in two forms, insoluble and soluble. Both are unabsorbable by the human body and thus devoid of nutrition. These both should already be hints that we weren't meant to consume it. Not only that, fiber can actually inhibit nutrient absorption. This is why you're instructed to take fiber away from supplements. Insoluble fiber is insoluble, meaning it doesn't dissolve in water (become a solution). This makes food stick together and passes through the intestines completely unchanged. Soluble fiber is soluble (duh) and when combined with water becomes a thick gel. This is why you should NOT dump Metamucil down the drain. You will need a plumber.

The problem is that fiber is always given as the cure for constipation and diarrhea. Do you see the problem here? It's for two opposing problems. How can it soften and harden poop at the same time? It can't. Insoluble fiber passes through the body unchanged, doing nothing for diarrhea and only making constipation bulkier and harder to pass. Soluble fiber just attracts more liquid, making diarrhea no better than it was without it, and attracts more water in the intestines which, again, hardens the stool and creates blockage and constipation. Nothing like adding more cars to make the traffic go faster, am I right?

Fiber isn't just bad for your poop. Not only is it unnecessary, it's not meant to be digested for a reason. Fiber is one of many natural plants' self-defense mechanisms to prevent you from eating them. That's right, plants actually don't like being eaten, just like any living organism, and do their best to survive, thanks to a little thing we call evolution. (And if we can't agree on that concept you should probably just leave this blog right now.) Insoluble fiber actually scrapes your intestines (no, this is not good). If leaky gut is a thing this is certainly not going to do any favors for it.

Now let's discuss some other issues that fiber is known for helping.

Weight loss. High fiber diets are touted as healthy because fiber is meant to fill you up. There is some truth to that in that those who eat more produce generally consume less calories due to bulk. However, calorie for calorie, fiber isn't doing anything special to help your weight woes.

Colon health. Fiber has not been proven to prevent colon cancer and there is no reason to think that it would. It does not help with IBS symptoms (and as seen above can actually worsen them).

Gut bacteria. Vegetables and fruits are known as prebiotics, meaning they feed gut bacteria (biotics = living organisms). The problem is, they feed ALL the bacteria, good and bad. SIBO, which I've mentioned in a previous post, is the overgrowth of bacteria in the small intestine. The small intestine is meant to contain only a small number of bacteria. SIBO leads to problems with digestion, food intolerances, gas/bloating, IBS, weight gain/loss... that's right, produce can indirectly make you fat! (But it most likely won't unless you've already got SIBO). Fiber slows down digestion and makes food ferment in the gut. Fermentation = more bacteria. That's why fermented foods are recommended for gut dysbiosis, to correct the bacteria imbalance. Unfortunately for the reasons listed, this isn't necessarily a good idea.

Fiber FAQ:

But isn't fiber good for your blood sugar?
Good question. It can reduce your blood sugar... by about 10%. Which isn't bad, but it's not really worth mentioning.

What about LDL cholesterol? I read it reduces it.
Yes, it does, but only by about 5%. Again, not even worth mentioning. Not to mention the fact that traditional LDL tests aren't very indicative of health, because they don't test particle sizes. Additionally, cholesterol isn't the big bad bogey-man it's made out to be. It's actually necessary for the production of hormones, and the lower the better isn't really true at all. Better tests of metabolic health are CRP and fasting insulin.

But...but...vitamins! And minerals! They're in plants, right?
They are, yes. Don't get me wrong, you don't need to cut produce out of your diet. But you can easily exist without it. Carnivore diets are a thing and meat has plenty of iron, B vitamins, and other tasty things your body likes that will keep you healthy. Some people have had luck improving chronic illnesses, curing them or putting them into remission, switching to this diet when all else failed.

Didn't cavemen and older generations eat fiber, though?
They did, but not nearly in the same amounts as we see today, and certainly not in the highly processed forms we see today. And on a similar note, their crops weren't exposed to as many pesticides or bred to be high in sugar and low in crop diversity. So no bragging to your friends you're healthier because you eat high-fiber celery (one of the most contaminated vegetables in circulation).

Why are we being taught this? Is this some sort of fiber conspiracy?!
Well, yes and no. Some of it is due to medical misinformation (see: high-fat, low-carb diets and the like). But some of it is due to the food industry (a.k.a. "big agriculture"). Wheat is a cash crop, corn is a huge cash crop (it's in everything, really), cereal grains are all cash crops. When people see "high fiber" on a label, no matter if it's intrinsic to the food or not, they mistakenly think it's healthier because that's what's drilled into our heads. Think about it. How many times have you heard "complex carbs" are better than "simple carbs"? They are all carbs. They all turn to sugar in the body eventually. Fiber just slows down the process.

There you have it. Throw out your Metamucil and psyllium husk powder, they're doing you no favors. If you like fruits and vegetables, by all means eat them. But for goodness sakes don't go full-on Whole 30 and fill your entire plate with them. If you're not getting the "recommended" 25-30 grams of fiber a day, hell even if you're getting 0, you'll be just fine. "Forks over knives", my friends, is bullshit.

Now eat your damn steak.

Thursday, April 11, 2019

why you're getting fat for no reason

As if it weren't hard enough not having control over your own body, weight changes can be incredibly disheartening. Feeling out of control of your own health as well as how you look is a double whammy. Weight loss comes with its own set of issues (of which I'm not familiar because, to be blunt, I'd love that problem), but weight gain in this society is practically unacceptable. Along with it comes shame and a lot of unhelpful, unsolicited "advice" (and let's be honest, not all those people mean well). Once and for all, it's NOT my fucking PERIOD!!!

Weight gain has been hands down the worst symptom I have dealt with since being chronically ill. Eating right, eating less, and at times not even eating at all, and having the scale not budge or worse, go up, is the most maddening thing I have ever experienced in my LIFE. I don't know about you but I can't keep myself away from the computer during times like these. So the following is a list of everypossiblereason that could be causing your weight gain, when the extremely outdated and flawed calorie model isn't explaining anything (after all, our bodies aren't input-output machines).

[Note: If you are experiencing rapid weight gain or swelling/edema, please call your doctor immediately because this could be a sign of a serious illness like congestive heart failure, ascites, or kidney failure.]

A bit of a warning here. Everything I mention in this post warrants a whole blog post of its own. There are many resources online and I leave you to do your own research, but hopefully this can at least serve as a starting point.

Thyroid
The number one reason you're getting fat. Ever heard it before? I bet you have. "It's your thyroid!" Surprisingly, both hypo and hyperthyroidism can cause weight gain, but it's more likely you're hypo, or have a mix of both, which is called Hashimoto's. Thyroid controls metabolism. It's like a master hormone. There are many other things that contribute to metabolism but if your thyroid is out of whack you're gonna be out of whack too.

Hypothyroidism has a symptom list almost as long as Lyme Disease, with weight gain, fatigue, and low body temps being at the top (clear signs of less energy expenditure). Hypothyroidism is a lot more common than the data would suggest. This is because most general practitioners only test your TSH. TSH is what tells your body to make thyroid hormone. If you have a high TSH, in theory, that means your body is telling your thyroid to produce more damn hormones because it's not making enough. But there's something called subclinical hypothyroidism, which I have, where your TSH is normal and your body's just like, yep, this is fine, we're just gonna put out the bare minimum amount of thyroid hormone to keep you alive, nothing to see here. This is why you need to get other blood tests done. Sometimes you have to outright demand them, which is ridiculous but I can't count how many times I've had to demand blood tests. You need to check your T4, free T4 (more important), T3, free T3 (this one is pretty telltale - T3 is the active hormone which T4 converts to), and your RT3, which plugs up the T3 receptors so they can't get in. Why your body makes this a "thing" I have no fucking clue.

Anyway. If you see a regular GP who diagnoses you, they will likely put you on synthetic T4 (Synthroid). No. This stuff is garbage. Sorry. What you want is natural thyroid hormone. It is prescribed, it is regulated, and it works a hell of a lot better because it's made from actual thyroids of pigs and cows. It contains the active hormone, T3, which your body might have a problem converting from T4 and could be the very cause of your hypothyroidism. You'll likely have to find a naturopath for a prescription. Thyroid.org has some good options, or you can just search for naturopathic doctors in your area who can prescribe meds and they should be able to get it. And on the subject of hormones regulating metabolism...

Insulin and Leptin
These probably deserve two separate paragraphs but I'm trying to be as concise as possible here because this is a long-ass post. Insulin and leptin are kind of like the hunger hormones (actually, ghrelin is known as the real "hunger hormone" but that one isn't as important for the purposes of this post).

If you've ever known anyone with diabetes, you'll already know that insulin is a necessary component of the body, but you can also become resistant to it. Insulin regulates blood sugar and fat storage. The higher your blood sugar is, the more insulin is pumped out to lower it, and the more sugar is shuttled away into fat cells. Alright that is vastly over-simplified but, basically, if you're eating too much sugar/carbs, you're spiking your blood sugar all the time, your body's pumping out more and more insulin and eventually it's like dammit I'm tired of this shit and stops responding to it. That's when you get type 2 diabetes. But, you can be insulin resistant without full-blown diabetes too. And this can happen in spite of diet, simply because your hormones are fucked up (more on this later), or widespread inflammation (also see below), or any number of reasons. Spikes and drops in blood sugar cause hypoglycemia, and when this happens, you get "hangry" (such a stupid word) - hungry, angry, tired, jittery. So the result is you're constantly eating to avoid this, and well, if you keep feeling the need to eat, it's hard to not ...eat. And eating more than you expend causes weight gain. It's a little more complicated than that but I haven't studied this in school so this is a shitty abridged version.

Leptin you might not be as familiar with. Leptin is the satiety hormone. So it's kinda similar. It's also the fat-burning hormone. Just like you want to be insulin-sensitive (and not resistant), you also want to be leptin-sensitive. So you'll know when you're full. Leptin also burns fat. Well, not directly. It's part of the process though. If you're leptin resistant you're gonna have a very hard time losing weight.  Leptin is produced by fat cells so if you're overweight you probably have more than enough. It's just that your body just isn't responding to it anymore. The best way to become leptin sensitive is to stop snacking, which, if you're insulin resistant (they go hand in hand), is obviously hard for reasons above. The funny thing is though, even though leptin stimulates appetite suppression and fat burning, less leptin is better (like insulin - but you obviously need some). So injecting leptin probably won't help you. The ketogenic/carnivore diet can help with both of these hormones by mediating blood sugar and hunger signals. Speaking of food...

Food Intolerances
So you know what food allergies are. The things that require the epi-pen so the person doesn't die from their throat closing up, and lesser degrees of that. But did you know some food allergies don't show up on allergy tests? Because they aren't allergies in the traditional IgE blood test sense. They can wreak havoc over time, slowly, and cause delayed reactions.

One intolerance we're all familiar with now, thanks to the blogosphere, is gluten. Yes, we all know Celiac is the gluten allergy thing that causes all kinds of crazy symptoms. But you can have other degrees of sensitivity and gluten is among the most common. Gluten (which is actually a protein), along with grains that have a hard outer shell (brown rice is not your friend in this case), can irritate the lining of your stomach and cause leaky gut syndrome, another buzzword in the online community (though it's a real thing, medically labeled as "intestinal permeability"). Other common food sensitivities include peanuts, corn, shellfish, tree nuts, lactose, and soy (a big one, and one you should avoid anyway as it's mostly GMO and estrogenic (discussed below)).

Carb intolerance is also a thing. Those that would benefit from the ketogenic/carnivore diet are often carb intolerant. This can come from insulin resistance or hormone imbalance (such as PCOS - see below). This is a relatively simple fix - lower the amount of carbs in your diet until you figure out the threshold at which you can stop gaining/start losing weight and you don't have blood sugar swings anymore.

Finally, SIgA is something you might want to pay attention to. You can figure out how much you have if you take a stool test. This is one instance where more is more. It's important for fighting off infections and bad bugs. SIgA also "tags" food as being okay to eat. The less you have, the more food intolerances you have, in a nutshell. People with Crohn's, ulcerative colitis, and gut disorders usually have low levels of this. It can be caused for the same reasons most of these gut ailments are caused by - stress, infection, etc. It can also cause SIBO (below). Treatment for low SIgA includes cleaning up your diet (derp), S. Boulardii, probiotics, glutamine (careful with this - see next section), and colostrum. And we're not done with the subject of food yet...

Histamine, Glutamate, and the GAPS Diet
Histamines are an evil thing. Yes, they are necessary in some amount in the body, as are most things the body naturally comes equipped with. They help fight infections. But too much of them, of course, is no bueno. Overproduction of histamine and/or inability to degrade it due to lack of DAO enzymes causes widespread inflammation, leaky capillaries (leading to water retention, also discussed below), very bitchy food intolerances (above), irritable bowels, basically every gut problem you could imagine. It can be caused by a number of things including stress (what doesn't stress cause?), infection (like Lyme disease), chronic illness (physical stress, like Lyme, lupus, MS, fibromyalgia, ME/CFS, etc.), and the like. The treatment for it, naturally along with treating the root cause, is avoiding high histamine foods. Generally the longer a food sits out, and the more protein it has, the more histamine content it has. But a lot of random foods like spinach, peanuts, and tomatoes are high in histamine too so check a list to be sure. You might have to do your own elimination diet (can help with food intolerances too) because what affects one might not affect the other. Overall, you want to eat fresh food and avoid anything slow-cooked or aged (like cheese and beef, which is actually aged to obtain its flavor prior to market).

Glutamate is another sneaky one. MSG, the Magical Secret inGredient as someone spelled out to me yesterday, is something you might be familiar with thanks to (American) Chinese food. Glutamate is excitatory. In normal amounts it's fine as it gives you energy. Too much causes most of the problems histamines do - leaky gut, food intolerance, anxiety (because of its effect on GABA - see my insomnia post).

Now here's the kicker. Most people with leaky gut and other gut issues hear great things about the GAPS diet - Gut and Psychology Syndrome. They go on it and voila - every symptom they have is now on full blast. This is because GAPS, honestly, is a horrible diet to follow for the reasons it is promoted. Bone broth, one of the most "gut healing" components of it, is exceedingly high in both glutamate and histamine and can spell disaster for you. In fact, I believe a few servings of bone broth is what tipped my histamine bucket over the edge into full blown Mast Cell Activation Syndrome (basically the medical term for severe histamine intolerance). That happened months ago and still I suffer from food intolerances and inflammation that just drive me (and my weight) up the wall. L-Glutamine, an amino acid also promoted for its healing properties, just like the name sounds, is a building block for glutamate. I'm not sure if there's a connection, but histamine and glutamate excitation seem to go hand in hand. This along with the high amounts of meat in the GAPS diet could make you feel like death. This is one case where I would NOT recommend the keto/carnivore diet.

Treatment for these includes avoiding the listed foods, taking DAO enzymes to degrade histamine in food prior to meals, avoiding snacking between meals (I know it's a hard one, but every time you eat histamine is released), taking Vitamin C, quercetin, and zinc (all of which degrade histamine/promote DAO), and eat DAO promoting foods like olive oil and onion. But wait! We're STILL not done discussing food, because next up is...

SIBO/SIFO
So if you're not familiar with the gut, nutrients are all absorbed in the small intestine. This is normally a sterile environment with a limited amount of bacteria. The large intestine is where all the dookie (medical term) goes. But if you're eating the wrong kind of food, or you have an infection, or leaky gut, or have fungus (Candida or SIFO which is similar to SIBO), or your body just SUCKS, you can develop SIBO. Small Intestine Bacteria Overgrowth. The two types of this are methane-dominant which usually leads to constipation, and hydrogen-dominant which leads to diarrhea (note: methane-dominant has nothing to do with how much you fart). You can also have both. There's a theory that most IBS is just poorly/untreated SIBO.

Like Lyme Disease, the med-industrial complex throws a couple-week course of antibiotics at you for SIBO. This is usually Xifaxin (for hydrogen) and possibly Neomycin (for methane). You take a breath test for a diagnosis, then test afterward. (Note: I've heard of the breath test reactivating people's SIBO that was dormant, so if you can get a doc who gives a clinical diagnosis this would be more ideal). The more extreme, but highly effective, treatment is a two-week Elemental Diet protocol where all you drink is nasty shakes, for breakfast, lunch, and dinner. And if you're carb-intolerant, they're even nastier, because it's usually chunky pieces of coconut oil you'll have to put in there. There's also amino acids in there for your protein, so that could potentially pose a problem for histamines (histidine) or glutamate (glutamine)! AGH! It's a nightmare!

The FODMAPS diet can help you avoid fermentable foods that feed bacterial overgrowth (fermented = high bacterial load). These include different types of saccharides. Once again you'll have to look up the specific foods for this diet because they can vary. But the most common gut-busters (in a bad way) are beans, garlic and onion, unfortunately. I know, onion is good, onion is bad, what the hell CAN I eat? At this point I just eat what I can. I may or may not have SIBO still, but I still eat garlic and onion because dammit they're delicious and I'm down to less than ten foods at this point.

Finally, here are natural treatments for SIBO, and they often treat SIFO/candida. Candida is a yeast overgrowth in the gut that makes you crave carbs and sugar to feed it. Everyone has the bacteria, but when you have an overgrowth it can also contribute to weight gain, insulin resistance, everything that'll make you go nuts. Candida can be controlled with a low-carb, no-sugar diet but it's very hard to get rid of. Anyway. The natural treatments for SIBO include protocols that involve things like Allimed/Allimax (prescription-grade allicin (garlic extract)), berberine, neem, monolaurin/lauricidin (coconut extract), oil of oregano, digestive enzymes, S. Boulardii (a beneficial yeast, not a probiotic), and herbal combo products like Dysbiocide, FC Cidal, Xymogen Candicidal, Candibactin AR and Candibactin BR. Pro-kinetics are also helpful to keep the food moving along (get it - promoting motion? hah, hah), and these include OTC products like triphala, Iberogast (online) (note neither of these worked for me), or Atrantil (also treats SIBO itself) or erythromycin. Alinia has shown some promise in treating SIBO/gut issues but can be hard to tolerate so start slow. It's also expensive. On that note, let's move on from food to gut bacteria...

Gut Bacteria
Did you know that if you take two mice and inject one of them with the gut bacteria of an obese person and one with that of a thin person, the mice's body types will mimic those of their respective donors? More and more research posits that gut bacteria holds a major influence over the obesity epidemic. Obviously you are what you eat, and eating junk will not help your little creatures, but you are also what your parents gave you.

You might be familiar with probiotics. And there's prebiotics and soil-based organisms and apparently something called postbiotics which I have no idea what would consist of. I actually just bought my first batch of spore-biotics which don't need refrigeration so I'll tell you how that goes if I see results. Research shows that probiotics really do not help us. First of all, we have innumerable strains of bacteria in our guts, and naturally they differ from person to person. Probiotics typically have 8-12 strains. Second, the strains in probiotics actually might contribute to decreased biodiversity. That's right, they can start killing off some of the good guys you already have in your gut! Third, sometimes you can down probiotics day in and day out and they won't even get to colonize your gut because the current residents won't let them build communities. They will be ostracized and go in and out of you (if only they could take those fat cells with you amirite).

Two types of gut bacteria that hold some influence over obesity are firmicutes and bacteroidetes. These you probably haven't heard of. I didn't until I got a GI Map stool test (I'd recommend one just to see where you stand from a GI standpoint, though they're not definitive of course). Basically, firmicutes are bad and bacteroidetes are good. The more F's you have the more fat cells like to expand their territory, and the more B's you have the better you'll look. Firmicutes do NOT make you firm, or cute, in other words. One example of a firmicute is Enterococcus. There's not a whole lot of research on their ties to obesity at the moment, or their mechanisms of action, but word is that beans can increase the ratio in your favor. However! Beans are bad for FODMAPs and histamines (though this is debatable, too) so pick your poison. And since we're talking about stool...

Constipation, Diarrhea, and IBS
Irritable bowel syndrome. A collection of mysterious ailments involving the bowel that used to be thought to be a psychosomatic disorder (thanks, asshole modern medicine). Causes of this are unknown, though SIBO, as mentioned above, can be a major contributor. IBS can cause idiopathic constipation (IBS-C), diarrhea (IBS-D), or both interchangeably (IBS-A (alternating)).

Constipation can cause weight gain for obvious reasons (you can have up to five pounds poop in you at any time if you're backed up). Diarrhea can also cause weight gain because you might feel constantly empty/hungry and your body might not be absorbing nutrients so it'll pack your food away for later. They both can cause weight loss, diarrhea for obvious reasons, constipation because you feel full all the time, and both because you might be deterred from eating due to the effects (uncomfortable or not wanting to shit yourself in public).

The causes of IBS are unknown. As I said, SIBO is thought to be a primary suspect. Treatment usually involves stool softeners, laxatives, Miralax, Metamucil (fiber), and in very extreme cases getting part of your intestines removed or a colostomy (colon removal). Hopefully it doesn't come to that. Enemas (particularly coffee enemas) can be helpful temporarily but don't reach that high in the colon. Colonics also only provide temporary relief and don't get to the root of the problem.

Some other things that can cause bowel obstruction that are quite serious are colon polyps and diverticulitis. If you have IBS symptoms I'd urge you to schedule an appointment with the GI doctor (gastroenterologist) and, if typical prescriptions don't help, schedule a colonoscopy. If anything they'll give you something called GoLytely that will scrape your system clean of all traces of doodoo so they can stick a camera up there.

One more thing, if you're up for it: you can do a salt water flush to scare the shit out of you. Typically it involves dissolving 1 1/2 to 2 1/2 tablespoons of sea salt into 1-2 bottles of purified or distilled water, then drinking it all, and proceeding to spend the next couple hours next to a toilet. Be prepared and don't make any plans for a while because apparently, the aftermath quite the smelly horror scene (hence, scary). For me it just made me pee out my butt and not much came out. If it works for you, or not, let me know in the comments. While we're on the subject of unwanted objects in your gut...

Parasites, Mold, Pathogens, and General Dysbiosis
We all have some parasites. Hate to burst your bubble, but if you eat or drink, they're in there. (And no, they're not just in meat - raw, uncooked food is more likely to have them). The most well-known ones are Cryptosporidium and Giardia, but to be honest, I don't think science has even covered the tip of the iceberg as to the number of parasites out there. Parasites can come out in your stool sometimes, if you take antiparasitics. Even if they don't, that doesn't mean they aren't there. The theory is that parasites reproduce with the moon cycles and that's when they're most active. I'm not sure about this so I'll just leave that up to you. Parasites will eat all your nutrients and potentially give you IBS-like symptoms (often diarrhea), and since they eat your vitamins and minerals too, they can make your body deficient and hold on to food (causing weight gain). Typically a doctor will give you antiparasitic prescriptions to deal with them. These include Malarone (also effective for babesia, it's used for malaria), Albendazole, Ivermectin, Alinia, Mimosa pudica (can be bought online), and some other ones I'm forgetting. You might also want to take a binder like bentonite clay, diatomaceous earth or zeolite to help get the bastards out.

We also all have some degree of mold. It's in the food, it's in the air, some of it is in your air filters and such. The important part is what your level of mold is and how sensitive you are to it. The primary ones you'll see on a lab test are Penicillium, Cladosporium, Aspergillus, Stachybotyrus (black mold - the worst), and Candida (mentioned above). Candida can be controlled with diet and avoiding sugar/alcoholic beverages (alcohol is fermented sugar - major no-no on both fronts for gut dysbiosis). As for the other ones, well, the first thing you gotta do is get rid of the mold. Either change your living/working environment or get the mold removed professionally. (Warning: if you do this it will inevitably cause an initial stir-up in symptoms due to all the spores being revealed.) I have to be honest - I haven't treated for mold so I don't know the protocol other than you need to take binders to get it out, usually charcoal. Charcoal has some precautions of its own, namely that it attaches to food and meds so you must take it 1-2 hours between ingestion of either, and it can cause constipation (I know, damned if you do damned if you don't).

There are quite a few different pathogens that can colonize your gut. Some of the main ones are Campylobacter, C. difficile, E. coli, Salmonella, and viruses like Adenovirus, Norovirus, HHV 6 (99% of people have this - it's herpes, but not genital herpes), CMV (Cytomegalovirus), and EBV (Epstein-Barr Virus, also a herpes virus). You've probably heard about E. coli and Salmonella outbreaks in food. Each of these is its own beast. Most require antibiotics. E. coli, Norovirus and salmonella often clear up on their own. HHV6 and CMV use the same medications (anti-CMVs) as treatment, but HHV6 mostly just flares up (like herpes, naturally). EBV is the one that'll bring you down to the ground though. It can have all the same symptoms as Lyme and really just tackles your immune system. Many suspect it's a main player in other illnesses like CFS, fibromyalgia, and other incurable "syndromes" with a bunch of random symptoms, because of all the toxins it releases (and guess where toxins are stored: fat!).

Finally, there are just some generally bad bacteria you do not want living inside you. These include H. pylori, certain strains of Enterococcus, Staphylococcus (staph infection), and Streptococcus (strep throat). H. pylori is diagnosed with a breath test, like SIBO. You drink a nasty solution and then breath into a bag a while later. Unfortunately, the antibiotics for H. pylori can also cause weight gain. Agh!!! I know, I know. It's enough to make you say, dammit, I'll just keep the damn bugs. Antibiotics are used for the -coccus strains too. Antibiotics, antibiotics everywhere! And yes, I have a section that touches on that as well. Fortunately these bacteria don't directly contribute to weight gain in significant amounts, but they do alter your gut microbiome in a bad way which most certainly can lead to an unwanted muffin top. More stuff that can alter your gut? Read on...

Medications
Oh boy. Medications and weight gain, let me count the ways. So many different classes of medications can cause weight gain and sometimes the cause is unknown. These include antihistamines, antidepressants, antipsychotics, antibiotics, opiates, and here's something you might not consider: withdrawing from medications can also cause weight gain. Birth control and steroids, which are technically hormones not medication, are also a huge culprit.

Antihistamines are often for allergies, but they can be used for other things like histamine intolerance (next section). The reason these might cause weight gain is histamines are excitatory metabolism byproducts, so they can give you energy, thus contributing to metabolism. Thus, antihistamines can slow this process down. This can be a good thing short-term, but long-term antihistamines like Ketotifen and those used for sleep can cause major weight gain.

Antidepressants are often of the SSRI class. Serotonin is actually largely located in the gut. So messing with it can mess with food digestion, metabolism, and it can also spike your appetite. However, some people just tolerate meds differently than others and gain weight in spite of diet and exercise due to these jagged little pills.

Antipsychotics are notorious for weight gain. It's a major reason a lot of psychiatric patients refuse to take their medication. They make you dull, in short. They slow everything down, which can be good for mania/schizophrenia, but they also make you super sleepy (which can be good for insomnia, but I'm talking all-day zombification). So, they slow you down. And this means your metabolism. Once again everyone is affected differently and some might not gain, some might gain a lot.

Antibiotics mess with your gut. They mess with your microbiome by deleting a bunch of strains along with the ones they target. This includes the good fat-burning bacteria sometimes. Antibiotics shouldn't be used flippantly. In a way they're like throwing the baby out with the bathwater. Probiotics are suggested while you take antibiotics but due to the low level of strains, their questionable absorption, and (you might be surprised) their negative impact on gut biodiversity, they're honestly not gonna help you in this regard and are a huge waste of money.

Opiates will make you constipated, in short. It's not real weight gain per se, but you will look bigger because your gut will be full of poop. Lots of people use opiates when they have diarrhea, though they're not prescribed for that reason. There's a theory that Kurt Cobain was addicted to heroin because he had IBS-D and serious stomach pain, both of which opiates treat.

Birth control, thanks to messing with hormones, is another notorious cause of weight gain. I avoid it for that reason among others. Some doctors use it to treat PCOS patients which is...questionable. A lot is water weight but because it involves estrogen (discussed below), it can also increase the amount of fat you have.

Finally, steroids are a big cause of weight gain. No, I'm not talking about bodybuilding. If you've ever taken any form of cortisone you'll be familiar with the "moonface" that comes with it. Cortisone makes you retain water and since it messes with cortisol (below), it can also make you retain fat for complicated reasons. So on the subject of cortisol...

Adrenals
Your adrenals are a major contributor to all processes in your body. They're closely intertwined with thyroid. If one is out of balance the other is guaranteed to be as well. Adrenals give you energy. Their most well known product is adrenaline (and the lesser knowns noradrenaline, epinephrine, and norepinephrine), but they also produce cortisol. Cortisol is a tricky guy. If it's too high, you'll be stressed all the time, won't sleep, and your blood sugar will be all messed up, it'll leech pregnenolone away so your other hormones won't get produced, your insulin goes haywire...bunch of nasty stuff that all leads to weight gain.

Then, after that process goes on too long, you'll start to experience what's called "adrenal fatigue", or adrenal insufficiency I guess. I'm not quite sure if they're the same, but adrenal fatigue is when your adrenals majorly slow down production of cortisol, leading to tiredness all the time, inability to cope with stress, and unexpectedly enough, inability to sleep. You need a certain amount of cortisol to get thyroid hormone into its receptors, but not too much. If you don't make enough, sometimes you'll be given hydrocortisone (Cortef) to treat it. Sometimes this doesn't work for people and their adrenals end up producing even less and they become dependent on it. On to the other hormones now...

Sex Hormones
The sexy sex hormones. You all know two of them - testosterone, the dude hormone, and estrogen, the chick hormone. There's another - progesterone, which is kind of both, but more attributed to women because it's "pro-gestation". And there are a bunch other minor sex-related hormones that I won't get into because this post is a mile long already and they're not too important for the goal here.

If you are a female, PCOS is a common culprit of weight gain due to majorly elevated testosterone levels (which are linked to insulin resistance in females) and low progesterone (linked to water retention among other things). PCOS can be treated with spironolactone which lowers testosterone and rids some water retention; birth control (if painful periods are a symptom, though messing with hormones is risky); and metformin (Glucophage) which controls blood sugar, and lowers testosterone a bit, but can cause upset stomach.

Conversely, low testosterone can also cause weight gain in both men and women. Testosterone is known for its fat-burning abilities in addition to libido stimulation, muscle building, stamina, etc. When your testosterone is low (incidentally this happens with low progesterone too) you'll experience estrogen dominance, where your body is making too much estrogen in proportion to the other hormones. Estrogen is a fat storage hormone, because our bodies are still primal and think we need a bunch of body fat to hold a baby for some reason I guess? I don't know. Some people say bodies are smart. Bodies are stupid, I say. Estrogen will lead to aromatization and fat gain and water retention and mood issues and just toxicity all over. In fact I don't think I've ever read anything good about estrogen other than it might have some beneficial properties for clearing your skin up. Someone once said it's a happy hormone. Yeah, right. You know what else affects estrogen?...

Liver Issues
Your liver. Chinese medicine emphasizes the liver. It's a big detox organ. If you have a bunch of alcohol all the time it gets as fucked up as you do and you get cirrhosis or fatty liver. But you can also get non-alcoholic fatty liver disease. Isn't life grand? The body can fuck up for no reason.

One thing the liver detoxes is estrogen. Too much estrogen and a shoddy liver (shown by increased liver enzymes on a blood test as well as high beta-glucuronidase levels on a stool test) equals poor detox ability and increased storage of toxins, in the most convenient place to store trash - more body fat. Too many drugs can potentially back up the liver. Milk thistle is thought to fix the liver but it can mimic estrogen. Once again, damned if you do damned if you don't. Water also gets stored in fat cells, which some people aren't aware of. Water makes up about 10% of the content of fat cells. So fat cells store water-soluble toxins as well. Where the rest of this water is stored beats me. Which leads me to...

Kidney Issues
Now if you know anything about the kidneys, it's that they filter all the fluid that comes through the body. The little kidney bean shaped things in your lower back. If your kidneys suck, your detox ability is also impaired. Too much water will lead to weight gain on the scale. Your body will be hard to the touch, because it is full of water, not squishy fat. Electrolytes play a role in water retention. Sometimes salt makes you retain water. More than likely it won't unless you're drinking pickle juice. Sometimes salt will tell your body it's okay to get rid of water. Potassium is good for releasing water. Magnesium. That also helps you poop sometimes. And calcium, uh, is also an electrolyte. If all else fails try natural diuretics. Temporary solutions are still solutions amirite.

People tell you to drink more water to get rid of water weight. You know when this doesn't work? When your kidneys aren't filtering properly. Honestly this is some of the dumbest shit I've ever heard. If you have water retention problems, drinking more water will just leave your kidneys with more work to do. And they're not going to work overtime when they can't even work on time. You'll end up with more water. Ta-da. See how that works?

Now I know a lot of people think detoxing is bullshit. These people are the people with perfect detox pathways who also think starvation mode and similar phenomenons are bullshit because they have no problems losing weight and are in perfect health. Fuck these people. So, regarding the importance of detoxing...

Inflammation
Inflammation is the number one driver of weight gain. Last but not least, probably most actually. It causes all the problems of the above and some of the problems I'll mention after this (or is caused by them, one or the other). Inflammation leads to weight gain. It also leads to water retention. These are both stupid measures by your body to prevent you from getting sick. Only they make you more sick, and stressed, and angry. Inflammation is good for acute illness. Ongoing inflammation leads to chronic illness and the body fucking up in every way you wish it wouldn't. And if you don't like gaining weight, your body's gonna gain weight just to spite you. What's that called, Murphy's Law or something? If it can go wrong it will?

What causes chronic inflammation? Well, chronic illnesses, viruses, and miscellaneous syndromes can. Inflammation can also cause those. It's an infinite feedback loop. It's complicated. What isn't? Why is this post so long? Some things just suck. Including reading thousand-word blog posts to find the answer to the problems doctors couldn't give a shit about. Anyway. Other things that can cause inflammation: Too much exercise. Not enough exercise. The wrong kinds of foods. The wrong kinds of foods for your body (see: food intolerances). Lack of sleep. Medications. Drinking alcohol. Drinking tap water. Watching the news. Heavy metal burden. Hormone imbalance. Electrolyte imbalance. Any imbalance. Oh and probably stress, I dunno.

Some science-y things that cause stress are things called excitotoxins. These are basically glutamate and histamine. I mentioned these above. Additionally, cytokines, which are just little devils. Cytokines are an inflammatory response and I don't understand what their use is. They're like the reverse T3 of the inflammation system (remember that thing up there?). Why do they exist? Just, why. Well, if you're like me, and you get a Herxheimer reaction (Google it, this post is long enough as is) from any type of supplement, you get a flood of cytokines, and voila, that can make you gain weight. What the fuck?? Yeah, my response every time. I take a supplement, up a pound the next day, pound never comes off, queue infinite cycle of weight gain. One year I actually gained 40 pounds over my normal weight due to this. But of course it was what I was eating (saw a nutritionist every week and eating disorder mindset was in full force), my lack of exercise (for inflammation-related reasons), and other stupid outdated simplified reasons.

So, there you have it. Whew! Your body can fuck up in endless ways! Chronic illness is a bitch! What else is new. I hope this post helps, if only so you can show it to the preachers of the Good Word of Calories In Calories Out, so they can potentially shut the fuck up (yeah, right). (Can someone explain to me what's wrong with these people, anyway? They are the most defensive people on the internet.) (I mean really, it's like you're threatening their whole world view.) (Just saying, the laws of physics also include the [complicated] laws of the human body.) (Not everything is that simple, stupid.) (Okay I'm done.)

Alright, I'm gonna go back to silently crying and taking anger naps regarding my seven pound weight gain. See you next month, if I think of anything else worth writing.

Friday, March 15, 2019

depression is depressing

Ah, depression. The utmost in depressing topics, right up there with the stock market, America's current president (at time of writing), and oh, right, Lyme Disease.

Lyme Disease can without question cause depression. Understandably. Depression probably doesn't cause Lyme Disease. They can exist separately though, too, and you certainly don't have to be suffering from any sort of physical illness to get depression. This is one of the reasons depression is depressing: it's one of the least understood mental illnesses because of this. Famous stars who seem to have everything can even get depression. The latest star being treated for depression is Justin Bieber himself.

My experience with depression started when I was a preteen. I exhibited some symptoms beginning middle school but a fall-out with my friends instigated a full-on clinical diagnosis of Major Depressive Disorder. I don't really remember what happened at the time but I think I was just going home and going right to sleep, maybe getting up for dinner or homework, then going back to bed. I was put on antidepressants as a preteen. To this day I think they are what put into motion my bipolar diagnosis, but at the time that was the only option. Therapy wasn't cutting it. I also had to change schools.

Depression can be acute or chronic, and like I said, there doesn't have to be anything specific causing it. In a lot of cases it can be resistant to treatment. Chronic depression is usually a neurotransmitter problem and that can be corrected with medication potentially, but finding the right medication is another problem in itself and can take years of trial and error. Conjunctive therapy can help but if your brain isn't operating it's not gonna do a whole lot.

The major depression subsided but I continued to have low-key depression throughout high school, and it affected my self esteem which affected my ability to make friends, and that became a vicious cycle. I had to switch schools several times and was home-schooled for two semesters.

That's the thing about depression, it is a cycle. Your depression causes low self-esteem, loss of motivation, loss of interest in doing things, isolative behaviors. And these cause withdrawal from society and formerly enjoyable activities, and then you lose your sense of purpose because nothing makes you happy anymore and that's even more depressing. It's as much a physical illness as a mental illness. Your brain just is not functioning properly and the happy parts aren't responding, to put it in very un-scientific terms.

I went to college and again had trouble there. My roommates did not like me for whatever reason. I was still struggling with an eating disorder which worsened notably during that period. I had to drop out within a month and spent the rest of the semester at home doing nothing. I slept from 4am to 4pm for months. I eventually went to city college the following semester and made up for lost time by taking a ton of units, but the friend thing remained a chronic struggle.

School and work are two major things depression impacts. Teachers lose their patience when students are chronically late, miss assignments, and seem uninterested in the subject matter (because nothing is interesting anymore and why bother). Bosses lose their patience when employees are unmotivated, potentially unfriendly, and don't get their work done on time. Dropping out of school and quitting work are unfortunate consequences of an illness you really have no control over but for some reason are blamed and shamed for having.

I was in my last official year of college when I started smoking weed for depression. I don't recommend this for obvious reasons I'll get into right now. First, weed is not a magical cure-all for everyone. One of the most annoying groups of people are the marijuana evangelists. There is no such thing as a cure-all drug. If it sounds too good to be true, it is. Everyone knows about weed and its existence, and the reason not everyone uses it is because it's not for everyone. Well, eventually, this weed caused me to stop sleeping, which of course caused me to be delusional, and then I was put in a hospital and diagnosed with mania and bipolar disorder. That instigated a two-month long inpatient stay where I put on 30 pounds due to being drugged up so I would fall the fuck asleep. Queue relapse of eating disorder and I think I explained the rest in my first post.

This is the problem with diagnosing depression. Often other illnesses are mistaken for depression. Bipolar 1 and 2 have major depression components. Binge eating or restricting can be a symptom of depression but also an eating disorder in spite of a healthy weight (my views on eating disorder treatment warrants a whole 'nother post). PTSD is majorly rooted in depression. But even physical illnesses like hypothyroidism, chronic fatigue syndrome, any chronic illness really - the fact that the body slows itself down or is spending all its energy fighting a virus or bacteria or parasite or what have you, means it's not focusing on, well, making you happy. The bacteria invading your brain can fuck up all the wiring up there too. Hell even having shitty gut bacteria can mess up your happiness signals. Junk food diets aren't exactly known for making people happy.

In conclusion. Depression is depressing. The politics of depression is depressing. The treatment and outcome for depression are depressing. Did you know it's been established that there will never be a cure for depression? That's depressing. But that doesn't mean you shouldn't keep fighting. Not everyone is depressed, most people have had a life before depression, many have lives after depression. It's possible. It's hard. Do I have the answer? No. I'll always struggle with it and it's why I'm mistaken for an introvert which again is a whole 'nother rant. I've been told it's almost a part of my personality at this point by a therapist, and a psychiatrist said I'll need to be on benzos for the rest of my life (again, a whole 'nother topic for another time), because depression often comes with anxiety. I've tried treatment after treatment, neurofeedback, TMS, drugs, illegal drugs, no drugs at all, eating healthy, exercising, meditation, socializing. Some stuff works sometimes, some stuff doesn't work at all, it's a crapshoot. Is there a point to this post? No. But hopefully something in here has been relatable and maybe even made you feel a little better that you're not the only one suffering.

Monday, February 18, 2019

how to be supportive of someone with chronic illness

I thought this was an important post to make in light of recent events I've experienced.

A lot of people don't understand chronic illness. Your own family probably won't, which is extremely disappointing. Friends can alienate you, you feel isolated, and what makes it even worse is when people say the wrong things.

Family, friends, coworkers, acquaintances, and people who know or meet anyone with a chronic illness, here is a short post detailing some of the things you should and should not say to someone suffering.


Do say:

"I'm sorry you are dealing with that [symptom]."

"I don't understand but I sympathize."

"That sounds very frustrating/difficult."


Do NOT say:

"That doesn't sound right." (When they mention an unusual symptom)

"What does your doctor say about that?"

"Are you sure that's what's going on?"

"Have you tried [diet/exercise/lifestyle tip]?"

"Yeah, I feel tired all the time too."

"You're just getting old."


And the number one thing you should NOT say in any form to a chronically ill person...

"I don't believe you."

Monday, January 7, 2019

I CAN'T F@#$ING SLEEP (a.k.a. the insomnia mega-post)

There's nothing quite like being told obvious advice by some idiot when you've been struggling with a serious issue for years. I can't tell you how many times melatonin has been "recommended" to me by "casual professionals," for lack of better terms. The latest one I got was to avoid caffeine. Wow, really? You mean I should avoid the very thing that keeps me awake? Jesus what a revelation.

This post is about all things sleep. And boy have I become an expert. However I still have not solved my own such problem. If you're struggling, and you've yet to find the solution, here is all the data I've compiled in my half-decade-long search for sound sleep. Mostly first-hand experience, but some things avoided for reasons detailed below. Here are three categories of sleep aides, in order of potency.

Natural solutions

5-HTP: Precursor to serotonin which is necessary to instigate the sleep cycle. If you're deficient in serotonin it will help. Otherwise not so much. It can also keep you awake for the same reason (serotonin can be stimulating). Be careful taking it if you're prone to mania.

Alcohol: Alright this is NOT a sustainable solution but technically it might help you sleep. I just feel like my list has to be exhaustive y'know. I don't recommend this method of knocking yourself out. Over time it will mess up your sleep, and it won't help you stay asleep.

Ashwagandha: Hard to spell. This is what's known as an "adaptogen". I have no idea how adaptogens work. Supposedly they lower what's too high and vice versa, but how your body or the herb knows how to do this beats me. Anyway, this is meant to regulate your cortisol and raise/lower it at appropriate times. For me personally, it kept me awake. So I'm not sure adaptogens are really a thing.

Cannabis: Good old weed. Mary Jane can work like the Sandman for some but for others she can cause paranoia and anxiety at best, hallucinations at worst.  Long term this is a poor choice because it tends to disrupt deep sleep, which is the restorative kind, in favor of REM, or the dreaming kind. It could also potentially cause psychosis and bring out latent psychiatric disorders if you're predisposed. Yikes. Use with caution.

CBD: Cannabidiol, an extract of cannabis with no psychiatric properties or THC. Can be vaped, used as oil, or smoked, but the flower will have an amount of THC in it. You can buy this online when derived from hemp. Good for pain management too. It can work as an antipsychotic/anti-anxiety as well. Kind of weak for sleep though, at least in my experience.

Chamomile: Found in "Sleepytime"-type teas. Can help relax and calm your mind but probably won't put you to sleep, to say the least.

GABA: A somewhat lesser-known supplement that's used for anxiety. GABA is actually a neurotransmitter, the one that calms, as opposed to the one that, well, opposes it: glutamate. Some claim it can be addictive but there is not much evidence to support this. There is also some debate as to whether it can cross the BBB (blood-brain barrier) in supplement form. PharmaGABA is a specific type that is supposed to do this more effectively. GABA works best as an anti-anxiety supplement, and only relieves mild insomnia. It can have a bit of a rebound anxiety effect the following day.

Homeopathy: I'm gonna be honest, I think homeopathy is a hunk of junk, and it has about no science to prove it works. But it can work for some people, paradoxically. Its modus operandi is it takes an ingredient that provokes the symptom you're trying to eliminate, and waters it down to an undetectable minutiae and packages it in some water or a sugar pill. There are infinite concoctions of insomnia-related homeopathy and I don't care to list any of them for reasons stated.

Kava (kava): Like theanine, it works with GABA and acts as an anti-anxiety/relaxant. Commonly used in a tincture or drank as tea. Can have some trippy/recreational effects when taken in high doses.

Kavinace: Very strong and thus very addictive. Some people are behind this one but I compare it to benzos (see below). It will give you just as horrible a withdrawal, without the seizures. Panic attacks, possible sweating, the whole gamut. Once a week is probably the most often you wanna take this. It starts to lose effect after a while anyway.

L-Ornithine: An amino acid. I haven't tried this one so I guess it's still on my list, but I have a feeling it's not quite strong enough for my level of insomnia. It's supposed to be relaxing and eliminates ammonia in the gut (which, obviously, is inflammatory, and inflammation = insomnia). More of a stress reliever, methinks.

L-Theanine: Similar to GABA but does not have its own neurotransmitter, though it does work with GABA. Better used as a mild anxiety reliever than for sleep but can calm your thoughts down if that's what's keeping you up. However, if you have a sensitivity to GABA-ergic drugs this can produce a bit of a rebound effect the next day, like GABA itself.

L-Tryptophan: Sounds familiar because it's that ingredient in turkey that allegedly makes you tired after Thanksgiving dinner. That's actually more likely from eating massive amounts of food but anyway. It's another precursor to serotonin which is necessary for sleep. If you're not deficient in serotonin it probably won't work. If you are but can't covert tryptophan well it probably won't work.

Magnesium/CALM: CALM is a drink with magnesium in it. Magnesium is relaxing. It is an electrolyte so it's necessary anyway. Too much will give you the shits but it's not really dangerous unless you're mainlining it. It can calm your thoughts down and give you a feeling of relaxation but it won't relieve anything more than mild insomnia.

Melatonin: Yep, you got it, the number one Google solution for insomnia. More an insult than a suggestion for us hardcore insomnia sufferers. It's a natural hormone produced in your body when it gets dark out. Some people don't produce enough of it, in which case they need supplementation. No more than 3-5mg should be necessary. If you aren't lacking in it, you won't benefit from it. This is for people who need to reset their sleep cycles, mostly. Not hardcore insomniacs such as myself.

Progesterone (cream/suppository): Funnily enough this is actually a sex hormone. Yeah, I know, unusual to mention this in a sleeping post, but it is also relaxing, and if you're short on progesterone (hello PCOS) it can help calm you down when applied/taken at night. Be careful when messing with hormones. They are powerful and any alteration in one affects the rest of the hormone network too.

Rehmannia: This one is new to me, someone randomly mentioned it on a message board for Lyme disease regarding cortisol regulation. I have not tried it yet as it is not sold in stores. It's a Chinese herb that is supposed to lower cortisol, which as you will read below, can be a problem, so be sure this is your problem before treating it. It also alleges to give you more energy when you're depleted from stress/lack of sleep. So basically an adrenal supplement. No word on this one yet.

Schisandra: Like rehmannia, I'd never heard of this one either and have yet to try it or find it. It promotes calmness and relaxation, and like ashwagandha, is an adaptogen. No word from me on this one either.

Seriphos: Phosphatidyl serine, or phosphorylated serine. This, uh, chemical? Lowers your cortisol. Take it at night if you have high cortisol keeping you up. Be careful because too low cortisol is a problem too. It won't lower it to dangerous levels likely, but it can lower it enough to paradoxically raise your anxiety. If high cortisol/irregular diurnal cortisol cycles are keeping you awake this will help. Otherwise you're tampering with something that doesn't need tampering with.

Valerian root: Another GABA-ergic drug/herb. This one is a little more potent than the others. It has a strong taste and is usually taken as a tincture. It can definitely induce sleepiness and might be helpful for moderate insomnia or problems falling asleep.

Other miscellaneous relaxing supplements: Echinacea, holy basil, lemon balm, magnolia bark, passionflower, vitamin B6

OTC solutions

Benadryl: That little antihistamine you take when you have a cold is also supposed to help get you to sleep. Lots of antihistamines do this. It can however have the paradoxical effect of keeping you awake like it does for me. This one can be good if you suffer from MCAS/histamine intolerance that keeps you awake, but of course you're better off avoiding reactive foods/items in the first place.

Doxylamine: This is the "stay asleep" part of Unisom, which also includes benadryl (diphenhydramine). This is the one that helps me sleep best, after NyQuil.

NyQuil: Contains doxylamine, acetaminophen, and DXM (dextromethorphan). For some reason this one knocks me out the best, even though the actual ingredient for sleep is very low in dose - about 1/4 of the regular tablet dosage. Unfortunately can't be used long term. Acetaminophen is hard on the liver.

ZzzQuil: Don't be fooled, this is just Benadryl repackaged as a pricier sleep med.

Psychiatric/prescription solutions

Ambien: Everyone's favorite DUI drug. I've been a victim to it myself. Got my license suspended for about a year. Fun times. Personally all it does is put me in a hypnagogic state, but for some it's a lifesaver. Unfortunately long-term use is highly ill-advised due to addiction. It's considered a z-drug (see below), which is similar in mechanism to a benzo (see below again).

Antihistamines: Basically, hydroxyzine and Vistaril. Powerful antihistamines that will probably knock you out or at least make you fairly groggy. Side effects include sleep hangover and weight gain.

Antipsychotics: These are the second line of defense by psychiatrists when a patient has sleep issues, after short-term solutions.   Antipsychotics work against dopamine which is a stimulating neurotransmitter. It may knock you out, or it may just make you really slow. Often lasts into the next day. Majorly problematic side effects of weight gain and metabolic syndrome.

Belsomra: A new sleep prescription med. Not much is known about this one. For me it did nothing. Probably not addictive, but also not very strong.

Benzos: If you're reading this blog and are considering, or on, benzos, I urge you to please stop. If you aren't already, you will become physically addicted to them and will need a higher and higher dose to achieve the same effect. After that the only way is off of them. At worst your doctor could yank you off them way too quickly, and you could actually die from a seizure. They will fuck your GABA receptors up and the withdrawal, unlike what doctors will tell you, consists of much more than a return of your anxiety/insomnia symptoms. There's a wonderful site called benzobuddies that provides support and a guideline to getting off them. Common ones are Ativan, Klonopin, Valium, and Xanax. See also: Z-drugs.

Beta blockers: These drugs should be used with caution because they slow down your heart rate and lower your blood pressure. If you have low blood pressure already they can be dangerous and potentially fatal. A slower/weaker heart beat will get you to sleep but this is not the best solution for obvious reasons.

Gabapentin: More used as a pain drug than a sleep drug but it can have relaxing effects for the former reason. It's a bit of a misnomer because it doesn't work on GABA. This is one I do not have experience purely because I hear the withdrawal is a bitch and well, been there done that with benzos.

Prazosin: If nightmares and/or PTSD are keeping you awake or causing pre-sleep anxiety, this will help. Its actual use is not related to sleep at all, but it does have the side effect of mediating negative thought patterns as it relieves hypertension. It's not a beta blocker but it does treat high blood pressure so once again, use with caution.

Trazodone: Atypical antidepressant that is no longer used for that reason but for sleep. This is the one I use. Now it only prevents me from not sleeping at all. I need an adjunct with it, usually NyQuil, much to my chagrin. It can be pretty sedating and last into the next day. It can also give some people some mild anxiety for some reason.

Xyrem: A.k.a. GHB a.k.a. the date-rape drug. Sure the company will tell you differently but no one's fooling anyone where I'm concerned. This "narcotic" is actually a very useful drug for narcolepsy. It costs upwards of a thousand dollars a month, ironically enough, seeing as the street version is probably one of the cheapest drugs you could find (not that I'd know). Only used in severe cases of insomnia and even then, good luck getting a prescription. You have to take two doses a night. It works similarly to benzos (on GABA receptors) so you can become addicted to it unfortunately, meaning it will stop working. Also has a not-so-sexy side effect of bed-wetting if taken in too high a dosage (again, not that I'd know).

Z-drugs: Ambien/zolpidem (above), Lunesta (zopiclone/eszopiclone), and Sonata (zaleplon) are all collectively known as Z-drugs due to their name. They work similarly to benzos and are just as addictive. Lunesta is known for giving your mouth a nasty metallic taste in the morning. Lunesta worked best for me personally but Ambien is the most popular. Once again, avoid these except in case of emergency.

Other methods

Acupuncture: Now I know some people lump this in with homeopathy, but there are actually a number of clinical studies showing some science behind it, based on using true acupuncture points versus randomly-placed needles. Acupuncture is based on energy meridians and is part of Chinese medicine. It's often covered by insurance to boot. I've tried it, and while it did help me relax/nap during the session, the effect did not carry over into the night. And believe me, I gave it plenty of tries before I gave up on it.

Camping: There is some science behind camping and sleep. Yes, for fellow Lyme sufferers camping is possibly the last thing on your mind, but if you're safe about it, it can be quite beneficial. A week spent falling asleep and waking up to natural light in an area off the grid can reset your sleep cycle potentially. My body for whatever reason resists replenishing its neurons by sleeping, so unfortunately sleeping outside for a few weeks resulted in, well, simply not sleeping for a few weeks.

Diet changes: There are a number of diet changes you can experiment with to help you sleep. Among them are eating carbs at night time (stimulates serotonin release), abstaining from carbs altogether (to moderate blood glucose which can cause midnight awakenings/cortisol dysregulation), intermittent fasting (blood glucose again), and most obviously, avoiding caffeine/stimulants (possibly including sugar). Cutting caffeine out, of course, is usually first on everyone's sleep-improving to-do list.

Epsom salt baths: Alright, this one is a bit of a toss-up science-wise. Epsom salt baths are known for their relaxation and healing properties, supposedly due to the magnesium in the salts being absorbed transdermally. However, science does not back this up (magnesium can't be absorbed through the skin). So the actual bath might just be the thing doing all the leg-work here. Anyway, this won't cure your sleep woes, but combined with other methods, can put you in a relaxed enough state to get you there.

Essential oils: I should probably lump this in with homeopathy. Essential oils (honestly have no clue why they're deemed "essential") are used for a wide variety of purposes. Lavender oil has relaxing properties to it when inhaled, supposedly, and I believe vanilla might as well. I'm not well-versed on these because they don't do much and their effects are primarily psychological in nature.

Exercise: This can be iffy. Exercise should exhaust you to the point of falling asleep when everything is working right. But when you have chronic insomnia, it's obviously not. Exercise with chronic illness can just make you physically exhausted, slowing you down for the rest of the day at best and overstimulating you at night at worst, paradoxically keeping you awake. For this reason it's best done in the morning. Yoga is the best exercise for Lyme/chronic illness patients as it is done at your own pace and not very intense (unless you do bikram/hot yoga, which is another story entirely).

Hypnosis: Yes, hypnosis. I've tried it and I'll spare you. This should be done if you have anxiety related to falling asleep and/or in general. If your thoughts are keeping you awake at night, or if the bed(room) is a source of anxiety consciously or subconsciously, this is a good option. But if your brain/body just refuses to fall asleep on its own terms, having someone trying to convince your subconscious to do so probably ain't gonna work. This stuff's expensive too. Meditation (below) would be a better option.

Massage: Massage is the ultimate relaxation technique, though this is also a costly habit, and you sure can't get one every day if you're on a budget, though you do need to sleep every day. Touch is an underrated form of healing and we all require it as humans. Whether traditional Swedish massage or deep tissue or hot stone or whatever other kinds are out there (sidebar: reiki "massage" isn't a massage, I'll leave that up to you to research), a massage can't hurt. Well, not unless you're full of knots, in which case I'm guessing you have something else going on keeping you awake.

Meditation: Another classic armchair psychiatrist prescription. Meditation works for some at calming the mind. The point is to sit upright and practice thinking nothing. As soon as a thought comes in, you let it go. Can be done with music or without.

Relaxation/affirmation tapes: These can lull you to sleep, or like me, the talking can keep your mind awake. Basically they are CDs (or Youtube videos) that repeat many affirmations over the course of an hour or more and the monotony is meant to bore you to sleep. They can be helpful if you're prone to subconscious suggestion. Or again, like me, they could just irritate you and keep you up.

Rife machine: The Rife machine was invented a few decades ago. The idea behind it is it emits EMF frequencies on specific wavelengths to kill specific pathogens. Somehow it treats every illness known to man. Sounds too good to be true, right? Mhm. I did get one of these (a cheap-ish spooky2 version) and tried it for a bit. At first I think the waves just kept me awake. After a while though it just seemed to do nothing. And then the machine stopped working. RIP. Proceed at your own risk.

Sleep deprivation: What! Depriving someone of sleep to help them sleep? That sounds like dieting before going on vacation if you ask me. But yes, this is a tactic used by some resistant people to reset their sleep cycles, potentially in conjunction with melatonin. You skip a full night's sleep, with the hopes that you'll be tired enough the next night to fall asleep on your own and continue on from there. Unfortunately for some of us, not sleeping just gives us a hangover and we feel like garbage, only to proceed to another night of no sleep. Similarly, some have suggested if you're not asleep in 20 minutes, to get up and do something (e.g., read something boring). To me that sounds an awful lot like, you know, just being awake. I thought the idea was to tell your brain it's time to turn off? This idea seems like it's scraping the bottom of the barrel.

Warm milk: More of an old wives' tale but there may be some science to it based on anecdotes, if only due to placebo. Warm milk is relaxing and puts babies to sleep so why not you? Someone told me once about a recipe that put them to sleep called "dead soup", which combines bread with warm milk into a soup you eat. Sounds um, odd to say the least, but allegedly you "sleep like the dead". Didn't work for me but if you're down for downing that downer  to get you down and out (yes, I'm incredibly lame), have a go.

So, if you're like me, and you've tried every damn thing in the book, and read this whole list, and none of these things work...well, I dunno what to tell ya. Hopefully attending testicular cancer support groups aren't in your future. *

*I would tell you the reference but remember the first rule is we don't talk about it.

(If you have anything else to add to this list - be it successes or failures - write it down below!)

Thursday, November 15, 2018

my boring story

Ay. I have Lyme disease. Where do I even start? This blog is meant to educate others but also somewhat as a log of stuff I have learned, tried, accomplished, failed, I really don't know yet. But I guess I have to have some sort of intro post since I can't very well just start writing about how Lyme affects your kidneys or whatever.

Things started getting all fucked up in like 2012, when a bunch of events led me to basically just stop sleeping. I was put on a bunch of psych meds and put on a ton of weight in the process which led me to an eating disorder which is another story. I went into recovery the following year and that's when shit really hit the fan.

During "recovery", which was basically just weight restoration, I gained 10 pounds in a month. Which is not uncommon for people with eating disorders. But what wasn't common...I kept gaining. And gaining, and gaining. I went to a nutritionist each week. Within about three months I had gained 20 pounds over my initial "goal weight". I continued to gain weight for a year (!). All the while eating healthy, unappetizing food, which was just infuriating and exceedingly depressing. I got to my highest weight ever and never stepped out of the house. I refused to see anyone except my nutritionist. I couldn't even walk anymore I was so heavy. And I developed the paradoxical symptom of weight gain with exercise/exertion. This can happen when your body is inflamed, believe it or not. Most people did not, and told me that would help me lose weight. Even my own family. Definitely did nothing to help that eating disorder voice which never left. As if I weren't already trying every damn thing to lose it. Anyway.

During this time I was diagnosed with PCOS, and someone suggested I might have Lyme. I'd never gotten bit by a tick to my knowledge but I was at my wit's end with the lack of answers. So I went to the only LLMD in my area, and after taking two tests from Igenex, I was given the confirmed diagnosis. I tried antibiotics and they didn't seem to make a dint, so he considered me a complex case and sent me off to another (very expensive) doctor two hours away. She tried a few different things and gave me a diet to follow. Ultimately I treated myself using the Cowden protocol, and the diet cut almost all carbs out so I did end up losing most of the weight. Both of these things got me about 75% better. Timeline-wise we are in early 2015. It was around this time I stopped treating.

I started adding back in things to my diet, and over time it became somewhat unhealthy by Lyme standards (a big no-no is sugar, which feeds the bacteria). In summer of 2016 I ate an inordinate amount of sugary cereal for a few months. The end result was about 75% of my hair falling out. It continued to break off and fall out for about a year, in spite of reverting back to a (somewhat healthier) diet. Weight crept up over time but not nearly as much.

By mid 2017 I was diagnosed with legit hypothyroidism. I went on natural desiccated thyroid medication, after gaining over 10 pounds in a month. During this time I was eating out of taco trucks which I admit was not the best, but I was nowhere near eating an amount that could account for that gain. I have a theory the taco meat had parasites in it which I'll get to later. Yeah, disgusting I know.

By early 2018 I was back in a routine of exercising. I did hot yoga for a few months, got sick with the flu (probably due to over exertion to an extent), but picked it back up and went a few times a week for an hour. Flash forward to around July of this year. Somehow my digestion and metabolism took a nosedive, and my weight kept creeping up while my calories kept creeping down. I'd gained five pounds over the span of about as many months. Not a lot, but definitely too much for my taste, especially given the fact that last time this happened I became overweight.

So that's still where I'm at now. I started treating again several months ago with Buhner herbs to no avail, gave up on those, and started seeing my LLMD again in August. I've increased my thyroid hormone, decreased the variety of food I can eat (due to intolerances causing poor digestion/more weight gain), and have been treated for SIBO. Right now we are kind of at a loss as to what to do which is pretty damn discouraging. I no longer can walk very far, let alone do yoga. I cannot work for similar reasons. I have trouble with insomnia, still, and fatigue. And I've struggled with depression throughout this whole ordeal.

At the moment that's where my story ends. I'm going to use this blog to inform everyone things I've learned so far, as I said, and hopefully you'll learn something or benefit somehow or, I dunno, it won't be a complete waste of time at least. Thanks for reading this long-ass post if you made it this far.