Podcast Episode #56: Gall Bladder, Tongue Toxicity, Gastric Bypass, Hula Hoops & Hormones

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Topics:
1: How to balance fat and protein with no gallbladder. [8:53] 2: What is my function? Broken appetite signaling? [16:45] 3. Tongue affected by overall toxicity of the body? [26:21] 4. I feel like the Willie Wonka blueberry girl/Dolly Parton mutant… Help! [38:08] 5. Following Paleo I am STARVING post Gastric Bypass [47:44]

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LIZ WOLFE: Hey everyone, I'm Liz Wolfe. I'm a nutritional therapy practitioner, and I'm here with Diane Sanfilippo, who is a certified holistic nutrition consultant and the woman behind Balanced Bites and the new book Practical Paleo. Remember our disclaimer: the materials and content contained in this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment.
However, I can say with confidence that this is a better use of your time than debating the relative merits of the two most important people on the United States cultural radar today, Wednesday, October 3rd, and by this I mean, Ian Somerhalder and Ryan Gosling, and who will play the main character in the film adaptation of 50 Shades of Gray. So…[laughs]

DIANE SANFILIPPO: [laughs]

LIZ WOLFE: Welcome to episode 56 of the Balanced Bites podcast. Diane, the question of the day is not who are you voting for, but have you read 50 Shades of Gray?

DIANE SANFILIPPO: I have not.

LIZ WOLFE: Yeah, me neither.

DIANE SANFILIPPO: And the fact that we're recording this podcast Wednesday evening goes to prove that neither of us are watching the Presidential debates.

LIZ WOLFE: [laughs] All I know is that Schmitt had played a magnificent Tag Romney on New Girl. What was that, yesterday? Man, that show just is killing it. I love it. He's hilarious.

DIANE SANFILIPPO: He makes the show, I mean. His character's the best. I just watched it this afternoon, so yeah, it was awesome.

LIZ WOLFE: So funny. I think he CrossFits. That's the rumor.

DIANE SANFILIPPO: Tug..Tug Romney.

LIZ WOLFE: or, what is Tug? Tag? There were some, you know, innuendos in there with the whole Tug thing. It was pretty funny. It took me like 20 minutes after the show, I was like, ohhhh. That's gross. All right. Anywho. So it's like…

DIANE SANFILIPPO: So what's up?

LIZ WOLFE: Yeah. Not a lot's up. It's like 10:15. I'm super. I feel like it's…I'm an 89 year old woman. No offense to 80 year old women podcast listeners. But I'm like, I should have been in bed yesterday.

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: Probably 4 hours ago.

DIANE SANFILIPPO: Yeah, this is definitely late for us. We don't normally get on the horn this late to record, but…

LIZ WOLFE: You've got your hood on and like your visor on and you're just [laughs]

DIANE SANFILIPPO: It's not a visor. It's a regular cap.

LIZ WOLFE: Once again, we can see each other.

DIANE SANFILIPPO: Actually I taught…we're doing our Paleo challenge at my gym, so we're doing…it's pretty cool actually. We have…we did a kickoff meeting, and then there's a meeting every week for an hour, and it's kind of funny. I feel like I'm leading some kind of AA meeting or something like that. It feels like every week people come in and have their like food stories and like people asking them questions, stories, and all that. It's pretty cool. But yeah, so we did that, and I worked out. So I'm sweaty. Like these braids are not like post-shower. They are post-workout braids, and got my homebrew kombucha that I'm sipping on, or as you like to say, kombucha.

LIZ WOLFE: How is that any different from the way you just said it?

DIANE SANFILIPPO: I don't know. I just seem to enunciate more letters that are in there, which is very strange because I don't usually do that.

LIZ WOLFE: My husband calls it “kambucha.”

DIANE SANFILIPPO: “Kambucha.” It's really yummy. It's not quite as strong as it should be, but my next batch will hopefully be better. So fingers crossed. And people keep asking me to post a recipe, and I'm like, you know what? I'm certainly not going to be the most experienced person at this.

LIZ WOLFE: [xxx]

DIANE SANFILIPPO: Can you hear me? Whoa.

LIZ WOLFE: I got you.

DIANE SANFILIPPO: Yeah, so I don't know. At some point, I'll post about this whole experiment has gone, but I figure there's like probably, I don't know, at least a million other people posting about how to make kombucha.

LIZ WOLFE: At least.

DIANE SANFILIPPO: At least a million. No?

LIZ WOLFE: Approximately one million five hundred and fifty-three thousand by my latest estimation.

DIANE SANFILIPPO: Okay, good.

LIZ WOLFE: Yeah.

DIANE SANFILIPPO: So, and then I've been pointing people over to Jill from First Comes Health. She's one of our friends down in Pittsburgh, a friend of the Food Lovers.

LIZ WOLFE: Ha-ha.

DIANE SANFILIPPO: I think that should be an abbreviation. [laughs]

LIZ WOLFE: FOTFL?

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: Fotful? She's a FOFTL. [laughs]

DIANE SANFILIPPO: So she's awesome. She tried actually-she ate a lot of the food when I was cooking for the book. She and her husband came over a bunch of times, and got to eat a bunch of the food.

LIZ WOLFE: The Dude? Is that what she calls him?

DIANE SANFILIPPO: Jill and the Dude, yup.

LIZ WOLFE: Jill and the Dude. Bad ass.

DIANE SANFILIPPO: So yeah, I'm actually really excited. She's going to talk about some new projects she's working on, and I keep sending people over to her for information on how to make their own kombucha. She's got a couple of posts on her blog, so maybe we'll put a link to that in the show notes.

LIZ WOLFE: She's the coolest.

DIANE SANFILIPPO: Yeah, I really like them. So what else? I have to open our
notes up here because I'm just looking at yer face.

LIZ WOLFE: Yeah, you know where to put that.

DIANE SANFILIPPO: So we're podcasting with video chat for the second time. I actually think it kind of helps things out a little bit and we can see each other. Know when we're done talking and whatnot.

LIZ WOLFE: Not that that makes any difference. [laughs]

DIANE SANFILIPPO: [laughs]

LIZ WOLFE: Just whoever talks louder.

DIANE SANFILIPPO: Really I just miss your face.

LIZ WOLFE: Awww.

DIANE SANFILIPPO: Awww.

LIZ WOLFE: [snorts & laughs] I'll have to edit that one out. All right, so I'm feeling a little, a little, I don't know, what's the word for when you're a little saucy? I'm not sure if I have any announcements other than we're smack dab in the middle of our Fall workshop series. It's been super fun so far. Easton, Massachusetts was a blast. We got to hang out with Diana from Radiance Nutrition, who's also got a nifty Paleo recipe book coming out here, I believe, by 2013? You with the mouthful of kombucha there. [laughs]

DIANE SANFILIPPO: I'm sort of choking on it now.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: Woo! It's sour.

LIZ WOLFE: Anywho. We got to hang out at Clark Farm in Carlisle, and it was so much fun. I finally started my YouTube channel. People have been telling me to start a YouTube channel, and I put up a video of some chickens trying to attack my galoshes.

DIANE SANFILIPPO: Is that the inaugural Cave Girl Eats…? Is it Cave Girl Eats, the channel?

LIZ WOLFE: Yeah, yeah.

DIANE SANFILIPPO: The inaugural video is chickens pecking at your boots? Awesome.

LIZ WOLFE: Chickens pecking at my boots, about 16 seconds worth, and I was like, I was cracking up.

DIANE SANFILIPPO: Oh my God.

LIZ WOLFE: It was-you have to be like a real foodie of some kind or wannabe farmer, probably, to share my sentiments, but I thought it was the most hilarious thing that had ever happened to me. My boots had white polka dots on them, and they're from like the Christmas Tree Shops or something like that. I've had them for a couple of years. And the chickens thought the bugs were some kind of, or the dots were some kind of bug, and I got quite a kick out of it.

DIANE SANFILIPPO: It was very cute.

LIZ WOLFE: So there you go. Thanks.

DIANE SANFILIPPO: It was.

LIZ WOLFE: So that was fun.

DIANE SANFILIPPO: Yeah, I don't have any more to say. I already have the farm
tour-I posted on that. A couple months ago, we were at AHS.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: And yeah, had some duck eggs. I think it was the first time I ate duck eggs. And my only real feedback was that the shells were hard to crack. I didn't really like, they didn't really taste any different to me than chicken eggs, but I would say they didn't taste different from like the nice farm chicken eggs I'm used to eating.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: I mean, they definitely looked different from if you were to crack a standard, a standard egg [laughs] Standard, standard salami. [laughs]

LIZ WOLFE: We're just wasting everybody's time right now.

DIANE SANFILIPPO: Okay. [laughs] Maybe we should answer questions.

LIZ WOLFE: Refer back to three episodes ago, the charcuterie facial, if you want to know what we're talking about.

DIANE SANFILIPPO: Inside jokes and you're on the inside, if you've been listening for the past three weeks. We've had-we actually have a lot of new listeners. I know Liz doesn't usually look at stats of all this stuff very often…

LIZ WOLFE: No.

DIANE SANFILIPPO: But I will say hello and welcome to all of our new listeners because it looks like we've had…

LIZ WOLFE: Hey everyone.

DIANE SANFILIPPO: The past few weeks…Hey everyone. In the past few weeks, we've had a significant bump up in listenership, so like…it looks like double the listeners in the last few weeks, so I will say hello and welcome, and please don't let this one episode [laughs] derail you. Please listen back to many of the others where we were recording much earlier in the day. Anywho.

LIZ WOLFE: And we have a lot of good stuff in this one coming up, so hopefully…or in this podcast, so hopefully we do it justice.

DIANE SANFILIPPO: All right, let's roll right into it.

LIZ WOLFE: Let's do it.

DIANE SANFILIPPO: My computer's got about 40 minutes of battery life.

LIZ WOLFE: Whomp whomp. All right, first question from Alyssa: How to balance fat and protein with no gallbladder. Alyssa says: “Hi ladies! After listening to every episode and reading the book, I finally have a question after listening to episode 54, your top ten questions, which made me feel like I might be a unique snowflake. I don’t want your medical advice, because I know you can’t give that, but I’m just curious about your opinions. You spoke about people with compromised kidney function being perhaps unable to eat standard amounts of protein, and I realized that might be the cause of my elevated creatinine and BUN results on my 4 recent blood tests (yeah, I got tested and then re-tested 3 times). I’m on lithium, which affects the kidneys. Levels were normal pre-paleo. Okay, keto diet, I don’t want to go low-carb, but….I can totally up the fat and lower the protein.

A few questions later, you got to the other exciting question: the gallbladder-free zone. I had my gallbladder out a few years ago. My awesome naturopath has me on a couple of forms of digestive support–HCL, pancreatic enzymes–but not ox bile. I am not afraid of fat by any means, but I’m not sure what would happen if I were to try to raise it, especially depending on variety. My body cannot handle the fat from more than 1-2 servings of nuts, for example. Is there a way to balance (see what I did there?)”[ laughs] Balance. “fat and protein for a person with an overall finicky system?

Things are not typical right now as I am wrapping up work on my first book,” That's awesome! “but when I shortly get back to normal. This is what it will look like:
Sleep: 9.5 hours in a completely dark room. I try to wake without an alarm at least a couple days a week.

Food: Autoimmune paleo . I have celiac disease and am working on figuring out cross-reactants. No eggs for sure. Not sure about nightshades so I play with them. No dairy. No chocolate or coffee. I don’t eat out. I brew kombucha and ferment pickles, eat a lot of salmon, grass fed beef, bone broth stew, tons and tons of carrots. Some seasonal fruit. Some sweet potatoes, some tubers. I like vegetables, was never a huge meat fan (maybe my low HCL issues) but I’m getting there and like to cook.

Pills etc: psych meds are lithium, Lexapro, Seroquel, Topamax (bipolar cocktail); naturopath has me on Thorne prenatals and 5-mthf” And just a note-that's
methyltetrahydrofolate, which is actually a good call when it comes to folate supplementation. Back to the question. ” (I am not pregnant but because of my celiac she wants me to load up on vitamins), betaine HCL, pancreatic enzymes, Barlean's 3-6-9 liquid fish oil, Probiomax probiotics (30 billion), Vitamin D 5000

Exercise: I walk home from work, through the Arboretum in Seattle, about 4.5 miles, a few days a week. It’s amazing. No weight training , but I want to.”

What do you think?

DIANE SANFILIPPO: Am I muted?

LIZ WOLFE: No.

DIANE SANFILIPPO: Okay.

LIZ WOLFE: Not that I'm aware of.

DIANE SANFILIPPO: I couldn't tell with this fancy microphone if I had done it right. So you know, she's given us a ton of information, but her real basic question here is about fat processing without the gallbladder, and she did ask a little bit about the kidney function. And I wouldn't say…I don't really know. I think if she wants to play with lowering her protein intake and upping the fat, and seeing what happens to her bloodwork, I say go for it. I mean, if you're not having optimal kidney function with some of these meds, then definitely try it. It definitely can't hurt to try lower protein and upping the fat.

So if she does do that, though, without the gallbladder, obviously, the best way to do it is really just track what you're eating, how you're feeling. You know, keep notes. It sounds like she has pretty regimented food, so you know, it shouldn't be too tough to do that. Write down kind of how much, what the servings are like, and what types of fats they were. So if it was, you know, butter or lard vs. olive oil or nuts, and you know, generally, we think that some of the shorter chain fats and the more saturated fats might be actually easier to digest than some of the longer chain fats like the unsaturated, monounsaturated and poly, so nuts may be even tougher than something like butter or coconut oil. And watch what's happening in the toilet. You can refer to page 75 of my book. But just see if your, you know, if your stools are well-formed, if they're, you know, kind of softer or if they're green in color or white in color, that could indicate that you're not digesting fat that well. So just see what's happening there.

And then I might recommend that thereafter that you ask your naturopath for an organic acids panel, so this is a urine test from a lab called Metrametrix. It pretty much measures everything under the sun that you wouldn't measure in blood. So what I'd want to see in an organic acids panel is for whether or not you're severely nutrient deficient, which, if so, could be a case for really getting the bile salts or ox bile in, so that you're absorbing what you're eating because the real issue with not having enough bile coming in is not just digesting the fats, but it's also about digesting the fat soluble vitamins that you're trying to digest with the help of the fat.
What else here? I might also recommend some other like gut healing digestive support, things that we've mentioned before, like l-glutamine and, you know, she's obviously doing some bone broth. Perhaps some herbal teas like ginger or licorice root, and a tincture of marshmallow root extract is pretty good. Even licorice root can be helpful to get the mucosal lining of your stomach really repaired up and kind of working better so that all of digestion kind of works a little bit better. And I think that's pretty much all I have for her.

LIZ WOLFE: Dr. Ron's has a stomach support, gastric support supplement that I really like, and I think it's called Smooth Operator. Dr Ron's. D-R-R-O-N-S.com.

DIANE SANFILIPPO: Smooth Operator.

LIZ WOLFE: Smooth Operator. It's not cheap, but it's one of the best I've referred people to.

DIANE SANFILIPPO: The best in terms of the compilation of what's in the supplement?

LIZ WOLFE: Yup. The compilation of what's in the supplement and just the reports that I've gotten from it vs. some of the other stuff that I've used with folks who didn't want to spend the money right out of the gate.

DIANE SANFILIPPO: Mm-hmm.

LIZ WOLFE: It really does seem to be worth the money, but I've found that with everything at Dr. Ron's, so…

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: I'm not affiliated with them in any way.

DIANE SANFILIPPO: Yeah, I just ordered a bunch of stuff, so I basically cannot wait for the mailman to get here with my desiccated organs.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: [laughs]

LIZ WOLFE: Only in this community. My desiccated organs are coming! Yes!

DIANE SANFILIPPO: Well, I've taken desiccated adrenals for a really long time on and off, so I'm kind of excited to try some other stuff more regularly.

LIZ WOLFE: Yeah, you know, I think at least a couple years ago, before I was really into the whole holistic nutrition and supplementation deal, I really was not aware of how many really excellent systemically supportive supplements actually contain parts of actual organs that you're working on supporting, so adrenals…

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: you take adrenals. Liver, you take liver. Interesting stuff.

DIANE SANFILIPPO: Yeah, it's pretty…it is pretty common and I generally don't go first to recommending supplements…we're totally on a tangent.

LIZ WOLFE: Lesson learned. Don't record at this time.

DIANE SANFILIPPO: What?

LIZ WOLFE: Lesson learned. Don't record at whatever o'clock at night it is. Want to just move on?

DIANE SANFILIPPO: Yeah, let's go on to Andie's question.

LIZ WOLFE: Andie's question. What is my function? [sings] Conjunction Junction, what's your function? All right, Andie says: “Hi all. Love the podcast. Love Practical Paleo . Love everything ya’ll do. Rock on. Here’s my thing. I have little to no appetite, accept in the later part of the day. I can go a full 12 hours in the am and not eat and be fine, but around 8pm or so I feel hungry. What is my function? I normally do not have time (i.e. I like to sleep) in the morning for a good paleo breakfast so I skip it (maybe have an hardboiled egg or two) and then go until lunch/dinner. I eat before bed, sometimes more than I want to. I see this as kind of a comforting reward too. I usually have my carbs at the end of the day. So what can I do to regulate my body back to a normal eating pattern. I have eaten 3 meals a day normally before (honestly I do better with 2) but still. I kinda want to feel hunger like all the rest of the world. Could this be maybe a thyroid problem? I eat paleo, try to get organic when can, grass fed beef, tons of canned fish, and eggs. Veggies and fruit. Little nuts. Butter and olive oil and avocado.
Cheats include sugar or chocolate, sometimes yogurt. And a Corona with friends over Mexican food. I sleep about 7 hours a night. Take Ambien, magnesium, birth control, and fish oil. Exercise 3 times a week moderate and Pilates and cycling.”

And I'll just throw in there, Andie, if you're doing tons of canned fish, I honestly think that the fish oil may be a little bit excessive, just knowing kind of how these omega-6/omega-3 elongation pathways work and balance each other out. If you are my client and if you had signed a disclaimer with me, I would probably tell you you're doing fine just with the canned fish and not needing that extra fish oil. I like to take that out as a potential degraded or oxidized fatty acid, just kind of removing that potential variable in any situation, so just throwing that out there.

I also… Diane, I'm going to go ahead and just tackle this one, if you're cool with that.

DIANE SANFILIPPO: Sure.

LIZ WOLFE: All right. There may be a few things at work here, but I do want to comment on the non-nutritional, non-appetite related aspects of this type of situation. I am speaking from experience when I say this, and I actually write about my personal dirty history with food in my upcoming book, Modern Cave Girl, a little product placement there. I have been in that place where I can hold out, both appetite-wise and intake-wise almost the entire day. Then, I want to eat the world around 7, 8, 9 PM and usually all the way until I get myself into bed with a full, full, full, super-full belly. You wake up in the morning, and again, I'm not hungry because of the whole excessive food intake towards that latter part of the day and towards bedtime. So there's this feeling, and it's not always a conscious, front of the mind feeling, but it's absolutely there that with that type of eating window, even if I over eat or eat at suboptimal times, it's still…it can't possibly be an amount of calories that overwhelm some kind of perceived daily necessity, so it's that voice in my head that's saying, if I conduct myself in that manner throughout the day, not eating, not eating, not eating, and then eating all of the things, I still won't overwhelm however many calories are actually appropriate at that time. And I've actually eaten that way and dropped body weight, but it was such a bad disordered place for me. And I knew intellectually and I now know, by virtue of my education, that appetite regulation starts with choosing breakfast, and then choosing lunch, and then choosing dinner. Well-rounded, appropriate energy content, nutrient dense breakfast, lunch, and dinner. And at the beginning, when your appetite is dysregulated, and you generally know it's dysregulated when you're not hungry until that late in the day, that's how you move in the right direction. It's just choosing to eat those meals, even if it doesn't feel right.

But, you know, despite knowing that, it's like, well, what if I do that, what if I do what I'm supposed to do and eat a healthy appropriate breakfast, and then I eat a healthy, appropriate lunch, and I'm hormonally balanced, and I'm not necessarily hungry…yet, I still have that compulsion to eat my face off at night…you know, and then I've taken in all those extra calories throughout the day, trying to do the right thing, yet this emotional compulsion kicks in and I load up on even more calories, and it's this awful cycle of just self-immolation that to me is just driven by a sordid food history. A history of disordered eating. And that can only be overcome by emotional and mental triage. Whether or not you go through those healthy eating motions, that's where it starts. So yes, food powers emotional health from a neurotransmission standpoint, a raw materials standpoint, but anyone that's been there as I have knows that taking your cod liver oil and having poached eggs over sweet potato for breakfast doesn't automatically erase decades of baggage about food. So again, not saying this is what's going on with Andie, but I think it's worth saying since I don't think I'm the only one who's been through this. That we all have to forgive ourselves our fears and our history and just say, come what may, I'm going to do the right thing, in the moment, to the best of my ability. I'm not going to look any further than this moment, and I'm going to offer myself forgiveness and just have the guts and the gumption to choose something different instant by instant.

I don't know. That's really just…just my take on this because I've been there, and I've felt like…I felt like a lot of this emotional baggage that I used to have was brought to bear on a lot of the good decisions I was trying to make for a very long time. Does that all make sense?

DIANE SANFILIPPO: It does. I think we've talked about emotional stuff around food at least one full episode before when we had Stefani Ruper on, and I think…I think it's definitely worth exploring with, who is this, Andie?

LIZ WOLFE: Yeah.

DIANE SANFILIPPO: With Andie, because I think that's…it's just a huge part of appetite dysregulation is sort of this like, okay, I don't feel hungry and then what do I think about that? And then, choosing not to eat, like continuing that cycle based on “well, I think if I'm not hungry, that seems like a good thing, and then I don't have to eat and take in more calories, like you said. So I think that's part of it. I think-whoa, my microphone. I think the other part is at least on the emotional front, and then I'll just mention something quickly on the non-emotional front, but I think the other thing on the emotional front is just the idea of feeding vs. eating, and if it is emotional, it's like what emotions are you trying to feed when you do eventually eat? And I know that, and when this happens in my life, that it's really a sign is something else is completely out of balance. Something else in your life is completely out of balance when you're just not…you're just not kind of eating on a normal schedule. So I think, and when you're, you know, when you're ending up kind of having that excess in the evening especially tends to be a little bit more of like a solo, lonely time when the rest of the day other people are around and that tends to happen at night.

So yeah, the other issue here when it comes to suppressed appetite pretty much all day long is really just about stress, and a lot of times, it's appropriate that we're not hungry when we are stressed because we're in fight or flight, you know, dominant mode. So our digestive function would be really, really low if we were to be eating, and this is pretty common, you know, just any kind of stress, whether it's like school work or you're just extremely focused on something, and I know I've had some days where I feel like my appetite's really low because I'm stressed for a “good reason.” Like I'm really focused on something I'm working on, and I feel like really, I don't want to stop, and I'm not even feeling hunger, but as you said, kind of the backlash of that is not a positive one, so you know, I think like that cortisol response, I think if that's happening to somebody where all day long they're really not hungry, then they're probably doing something all day that's a little more stressful than it should be. Maybe it's just work or whatnot. Maybe it's just like a mental cycle, but taking time out to kind of step away and eating some food and a lot of times when you do just kind of start eating on a regular schedule, you do kind of provoke that natural hunger, appetite signaling response after, you know, even just a few days, so that's what I would say for Andie.

LIZ WOLFE: Cool. All right, next question. Tongue affected by overall toxicity of the body. This is from Nicole. She says: “Hello Diane and Liz, First off I am completely obsessed with your podcasts” Just a hint to everybody, if you want to get your questions on, say nice things to us. Totally works.

DIANE SANFILIPPO: Chocolate to the seminars…

LIZ WOLFE: Chocolate to the workshops, the seminars. It's actually, okay, so back to the question. “It’s actually been helping me through a pretty rough time in my life and your humor, frankness and clarity have helped keep me afloat and focus on myself. My question is strange and moderately gross, so here goes…. For the past couple years I’ve been noticing some strange things going on with my tongue: Weird white coating and enlarged bumps toward the base. I think the bumps have increased in number and size over the past year or two and the white coating waxes and wanes in terms of amount and severity (like the coating increases when I up my sugar intake), sometimes I even feel a strange sensation on my tongue, like a tingling or burning, and it’s gotten to the point in the past where I felt like it severely interfered with my taste buds. From what I’ve read and know, I’m sure the white coating is some sort of detox situation, but I’m not sure about the bumps, there are probably 6-10 back there. They’re not totally painful, perhaps a little tender upon brushing them with my tooth brush. I use a tongue scraper almost daily and have a rather natural self care routine (DIY deodorant, natural toothpaste, and junk-free shampoo and Dr. Bronner's soap). I think this issue has something to do with the overall toxicity of my body, but was wondering if you had any knowledge or input on this, especially in regards to the bumps. Speaking of toxicity, I suffer from leanings. Take probiotics and Vitamin C supplements but struggle with becoming regular.

I’ve got a pretty rocky health back story. I have a history with IBS and acid reflux off and on acid blockers and habitual use of Tums from age 14-20. The doctors just put me on Zoloft at 14 after they couldn’t figure out the root cause of my stomach pain. Off and on birth control from 15-20 too. Smoked cigarettes and was a wild child partier, but oh my how times have changed…. I am pretty sure all this madness has lead to some MAJOR hormonal and brain chemistry imbalances that I’m currently struggling with to whip back in shape (It’s been over 2 years since my menstrual cycle, major mood swings, irritability, seriously intense sugar cravings and bouts of depression). Combine that with a year of vegan/raw foodism that eventually led to severe hormonal acne, leaky gut, probable candida, adrenal fatigue and some major emotional food issues. Ugh…What a mess…But the reintroduction of meat has been a godsend. I am not %100 paleo, as I am wary not to be too restrictive, my eating disordered past + crazy hormones= Binge Central. I cook paleo foods only for myself but sometimes eat non-paleo foods when eating out. Over the past year my eating habits have been pretty inconsistent, very much on and off the wagon (perfectionism + self destructive tendencies= inconsistency). Also a stress addict, worry wart, self deprecator (I’m working on it!). Apologies that I just basically cried you a river, I think I just wanted to complain to you about my health problems and hear your hilarious input on my bodily functions.

So exercise includes casual walks in the mornings, bike rides, light yoga and weighted hula hooping (I’m obsessed-you should totally try it).

Current eats: Eggs, onions, and fruit for breakfast . Tuna, turkey or chicken for lunch with greens, and veggies. chicken, fish or sausage, beef, lamb for dinner with green beans, artichokes, butternut squash, kale, mushrooms.” Pretty much everything we would tell people to eat. “Chia puddings and coconut flour mug muffins.” I don't know what that is, but it sounds super fun. Mug muffins. “Addicted to raw sauerkraut and kombucha. Morning glasses of apple cider vinegar or lemon water.”

I totally want to be her friend, Diane, because weighted hula hooping? Yes, yes, yes, yes, yes, yes. I would put on my dancing dingus and revert back to second grade, like glasses, heavy bangs, scrunched socks and slap bracelets all day long.

DIANE SANFILIPPO: Wait, I pretty much look like that now.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: Glasses, heavy bangs, scrunched socks, maybe knee socks.

LIZ WOLFE: Slap bracelets!

DIANE SANFILIPPO: I am a really good hula hooper, so I think we should call her up and have a party.

LIZ WOLFE: Noooo. Have you seen The Hudsucker Proxy?

DIANE SANFILIPPO: No, I have not.

LIZ WOLFE: Oh my gosh. We've got to watch it or at least watch a couple clips. [laughs] There's this whole, oh my gosh, the belly go round! The wacky circumference! [laughs]

DIANE SANFILIPPO: I have no idea.

LIZ WOLFE: We're going to have to watch it. I hope somebody out there knows what I'm talking about because it's pretty hilarious.

So I just have a couple things to say on this, and [laughs] so awesome. We need to do hula hooping. Nicole's approach to this whole mental game is good, I think, because I can tell she's gotten to this point where she knows herself, she knows her own mental landscape and she is functioning as is appropriate too. It seems like push growth, but not, you know, throw herself off the cliff of obsessive, rigid requirements because that doesn't work for everyone. Everybody's path is different and Nicole is totally game planning with self-awareness, and I love that. So moving on to the tongue situation, I don't think she's talking about full-blown like thrush, although there may be some candida going on, which ultimately is what causes thrush. So I think this white coating could certainly indicate some yeast activity as she said, probable candida. But unfortunately that would actually require a somewhat dedicated, a more strict regimen, but that has to happen whenever she's ready.

Now the bumps themselves, which I believe are called lingual papilla or something like that, I don't think there's really a conclusive Western medicine explanation for it, other than a kind of loose association with GI upset. And I actually have had those at different periods in my life, although it's been years. So I imagine it had something to do with food or detox of some kind. Interestingly, though, I know a little bit about how this is conceptualized in Chinese medicine, and I do believe the base of the tongue, the back of the tongue is associated with the intestines, intestinal dysfunction. So dealing with getting the best food possible, leaning into the most productive lifestyle she can, you know, not a big expense of her sanity, but something that's going to support that, just to get the greatest degree of healing possible. Gut care is really the way to go. And I also probably suggest trying some oil pulling a few times a week with sesame oil or even coconut oil and see what kind of mileage she gets out of that. I think Bruce Fife may have written a book on oil pulling. If not, I think a Google search would probably work just fine. It's just a way of you're swishing oil in your mouth, and it's supposed to pull toxins from wherever it's pulling toxins from. But people swear by it, so I definitely have her look that up.
Thoughts for you?

DIANE SANFILIPPO: Yeah, I think we're going to talk a little bit about this with the next question as well, but just if it is something that's rooted in dysbiosis, meaning gut flora imbalance and/or a candida overgrowth, and I say that because we all have some candida, so to say, like “I have candida,” I mean, she's not saying that, but just if somebody were to say that, it's like well, we all have candida. It's a matter of whether or not it's overgrown, but, you know, really pulling back on sugar and overall carbohydrate intake could be helpful. And I know, you know, we both don't have issues with people eating carbs. It's not like carbs are bad, but the reality is if you're dealing with something that is largely fed by sugar and carbohydrates, pulling that all back might be helpful. I know, I forget, I think her name's Donna Gates, who wrote the Body Ecology Diet. She writes a lot of stuff about like a candida or a fungal type of diet, a fungal overgrowth type of diet, and it really is pulling back on all that stuff. I think, you know, she's mentioning that she's eating some fruit with her breakfast and you know, we ask people for a lot of details because the reality is, sometimes the devil's in the details. So fruit for breakfast, I just would not be eating fruit for breakfast. You know, the rest of this stuff, I think, you know, I might even consider pulling out some of the starchy veggies, even the sweet potatoes and butternut squash. You know, I'd be careful and just see what's happening with your digestion, maybe keep some carrots in, so you're getting some starch without like an overload, but I would also pull back on things like the fruit for snacks, and even the nut butters which can also contribute a little bit to some fungal overgrowth if there's any sort of issue with the nuts as they've been stored and things growing on them. Same thing with the chia, like I just would stay away from that stuff. And I might even say to stay away from things like coconut flour muffins. So basically just being like the total Debbie Downer on your food and taking away all the really fun stuff.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: But I think you should treat this as, you know, a gut imbalance and really do like a digestive health protocol, you know. The one that's in my book is going to be pretty low in sugar. You could do a blood sugar regulation plan. You could do a digestive health plan, but I would get rid of the nuts and seeds and the fruit, and just pull it back to meat, veggies, and fat. I mean…

LIZ WOLFE: What else is there in the world?

DIANE SANFILIPPO: What?

LIZ WOLFE: Fill your diet with veggies, not veggies, but fat and protein.

DIANE SANFILIPPO: We kind of joked in the beginning of the day at our workshops, like we could tell you to eat meat, fat, and some veggies, and like that would be it, but obviously that's not it. So anyway, I just wouldn't…I wouldn't plan in any fruit. I would actually try and avoid it. And some of this other stuff, I would just put yourself on a plan for a month. I mean, it seems like you'll probably see results within that time on this because if you've got some kind of overgrowth that wants sugar, it will get starved out really quickly. And you know, one way that you'll find out if it could be that kind of overgrowth is if it's really painful to get rid of the fruit. Like, if you're getting some really serious detox symptoms, that was the right thing to do. Unfortunately.

LIZ WOLFE: So the more it hurts, the better it is.

DIANE SANFILIPPO: Yeah, I mean, this is so common with the sugar detox. It's like I know not everybody coming into that plan is eating a Paleo diet, so it's really painful for a lot of them just from the carb flu standpoint, but for some folks, you know, they are dealing with a dysbiosis, candida overgrowth, that kind of thing, and it can just be a little bit more painful. But I think she could probably address it with that and see what happens, and kind of let us know, and then also tell us where you live, and send us a hula hoop, and we will come join you. [laughs]

LIZ WOLFE: We'll come over. Come knock on your door.

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: All right.

DIANE SANFILIPPO: Hopefully, that was helpful. And really we like the gross questions, so please don't hesitate with your gross questions. We find them alluring.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: Maybe I speak for myself.

LIZ WOLFE: [laughs] No, I definitely find them alluring.

DIANE SANFILIPPO: I like the gross ones! It's just like, I don't know, it's interesting.

LIZ WOLFE: I find them strangely attractive.

DIANE SANFILIPPO: Yeah, we get punchy.

LIZ WOLFE: We are very punchy.

DIANE SANFILIPPO: And tired. Okay.

LIZ WOLFE: Next question, which is only going to make us more punchy with the subject line. From Kym. I feel like the Willy Wonka Blueberry Girl/Dolly Parton Mutant. [laughs]

DIANE SANFILIPPO: Oh my goodness.

LIZ WOLFE: Oh, it cracks me up. All right, Kym says: “I have been listening to your podcasts during my commute to and from work. I had to buy a note pad to begin writing things down as I listen! It seems that I heard something about estrogen in one of the episodes and can’t find it now. My cycles are regular but about 1-2 weeks before my period begins (closer to two weeks), I begin feeling like I had over night implants put in my breasts. I also get very gassy and looser stools. My period starts and suddenly the balloons in my bra deflate and go back to their normal size. I absolutely hate this. Is this just because I’m 47? I eat strict Paleo, rarely any nuts or fruit, am addicted to the Green Pastures fermented cod liver oil, take Progon B as prescribed by my naturopath. I have one Americano a day and that’s in the morning. I’m so excited when my period starts because I know for a short period of time my body will feel normal. I dread the two weeks that I feel like the Willie Wonka blueberry girl/Dolly Parton mutant. I also take a small dose of Armour for my thyroid which I know has corn in it but the symptoms are better on that than when I was on levothyroxine. I tested positive for gluten sensitivity and read every label, eat only whole foods. No dairy, no grain, no paleofied foods and no legumes. I eat sauerkraut several times a week (because you said so! lol.)”

Okay, did you catch all that, Diane?

DIANE SANFILIPPO: Yeah, do you want me to jump in on this one first?

LIZ WOLFE: Yeah, do it.

DIANE SANFILIPPO: Okay, so just for folks listening. Progon B as she mentioned is a plant-derived progesterone replacement. So I kind of alluded to this just a minute ago, but what I've seen work the best, in terms of nutritional strategy for dealing with dysregulated hormones is pretty stick sugar and caffeine free approach, meaning no fruit and no coffee. Not even the one Americano, so I know this is like, seems like Diane's no coffee soapbox, but it's really not. Like I would have said this before I quit coffee.

LIZ WOLFE: So mean!

DIANE SANFILIPPO:Because I've seen it happen many times over, and especially I've seen it happen with women who are dealing with some thyroid issues. Specifically, I do know of one person even recently who was like, yeah, my period's way better when I'm not taking in anything sweet or any caffeine, and she definitely has hypothyroidism. So just another one person, but there's also a lot of others that I've kind of worked with, who not necessarily been dealing with the hypothyroidism at the same time, but who've reported back that you know really cutting the sugar and eliminating caffeine has done it for them. So it sounds like this won't make a big difference when I just kind of say, oh just cut these things down, but it really does because insulin control is critical for female hormone imbalance issues. So we say this a lot when people are asking questions about like PCOS and other hormone imbalances. But I would say you have to give this at least a full 30 days to get through the one cycle, but then even more like 90 days to see how it fares over 3 cycles or so. Because really just kind of waiting it out over that next one probably won't tell you the whole story.

So I don't really know about the Progon B. I wouldn't personally be too quick to pop anything like it myself. I'd rather see Kym maybe ask her naturopath about like pregnenolone or even DHEA, which are the hormone precursors. They have some adaptogenic qualities to them, meaning they'll funnel down hormone production synthesis chains as the body wants them to, rather than taking in the end resulting hormones. So for me, this seems like a bit of a safer bet. It's sort of like the way I recommend a 5-htp supplement vs. melatonin directly, so you know, people know that melatonin will help them sleep. It's a counter-regulatory hormone to cortisol and it helps you, you know, relax and be sleeping at night, but your body can convert 5-htp to melatonin if it needs it, but if it doesn't need melatonin, if that's not really the issue, it won't go that far. So it's a little bit safer, like a less intense supplementation, which I always think that when it comes to supplementing with hormones, it should really be done with caution. So obviously she's working with her ND, and her ND thought that that would be a good idea, but you know, maybe do some research, kind of see how you're feeling and see if some of these other options might be worth asking about.

I might also recommend some GLA in the form of either evening primrose or borage oil. And Liz, I don't know if you kind of had a take on one of those. You're like my oil geek expert.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: I've taken…I've taken evening primrose oil before, and I've also had some other clients who do it basically for about a week, the week before your cycle. So a low dose, like one to two grams a day for that week. Often our inflammatory pathways are a bit imbalanced, so that's an omega-6 fatty acid, and people usually think that, you know, omega-6 is bad, and we don't want it, but the reality is, we're not always getting in that end-usable form of omega-6 and we might need it to help the inflammatory process and just whatever's going on with hormonal imbalances kind of happen, and then heal, and just be done properly. So I don't know if you had any thoughts on that too?

LIZ WOLFE: Borage seed oil, borage oil, I believe has a higher concentration of GLA, gamma linolinic acid…it's linolinic, right? Linoleic? Eh, I always get them mixed up, but I believe borage oil has a higher concentration of GLA, but I've had better luck with evening primrose oil. Totally anecdotal, that's just throwing it out there. But I like it topically too, by the way, for skincare. It can be helpful with acne and whatnot.
So, okay, is that your answer? Is it my turn now?

DIANE SANFILIPPO: Yeah, it's your turn.

LIZ WOLFE: Okay. So ovulation occurs at day 14 of the cycle, so meaning at about 2 weeks after the first day of your period. And then those two weeks preceding your period is where first, estrogen peaks with luteinizing hormone followed by an estrogen-progesterone peak in that week preceding your period. So that span of time that Kym is referring to where her balloons inflate and her bowels deflate is called the luteal phase. I think. I always get these things all mixed up. So it sounds like this is happening when she's really got those hormones peaking. And I do know that the peak in estrogen could potentially blunt a thyroid function just a little bit. But I really don't…I have not developed that…I haven't looked into that too much other than to just…I just know I've heard tittering about that. But that could explain some of the positive effects of the Armour. You're better versed in some of this thyroid stuff than I am, though, Diane.

I also know that a high level of estrogen relative to progesterone can cause some aldosterone elevation, and that can lead to water retention. But that can also be modulated by prolactin excess or prolactin sensitivity, and that can drive the breast tenderness as well. So all that said, what comes to mind to me is probably some B vitamin support, some magnesium. We like magnesium glycinate. Some potassium glycinate to deal with that sodium/water retention issue. Maybe some liver detox. Unfortunately while I do know that there are herbs and things like that out there that can kind of naturally support progesterone production and help balance the hormones through the luteal phase, I am no way qualified to make recommendations. Although, you know, I'm not sure how I feel about the Progon B. I think that's got some estrogenic compounds as well, like from yam. But again, not 100% sure. I think chaste berry may help with the prolactin excess. I'm remembering some-something called, some C vegetable I think, bladderwort or bladderwrack. Maca might be interesting. It's got adaptogenic qualities, specifically with regards to helping with thyroid function, but again I'd definitely seek out an herbalist or do some more digging because I'm totally speaking out of turn here. Just talking out of my booty.

So really I'm just going to go back and delete that whole rant there, Diane. [laughs]

DIANE SANFILIPPO: Awesome.

LIZ WOLFE: Awesome. No, I'm not. Next question?

DIANE SANFILIPPO: Yeah, how are we for time?

LIZ WOLFE: We are about there. I think this last question we should probably shut it down.

DIANE SANFILIPPO: Do you want to do…we've got this one or the one that's written up right after it from Andrea or…

LIZ WOLFE: Andrea…let's do Andrea's question.

DIANE SANFILIPPO: Okay, this other one, we'll keep for…we'll keep this one for next week. I think this is…the other's one pretty similar to stuff we've been talking about, so it may be good to kind of change it up a little.

LIZ WOLFE: Bounce around.

DIANE SANFILIPPO: I'm going to save that.

LIZ WOLFE: Okay, cool. Okay. Following Paleo, I am starving post-gastric bypass. Andrea says: “1. If everything”…She's got a couple questions here. Question number one. “If everything alive has anti-nutrients then where are the anti-nutrients in veggies? And why aren’t they bothersome?”

And I'm just going to offer a quick answer to this. There are anti-nutrients in veggies. They're called lectins. Every living thing has lectins, and there's also oxalic acid and phytic acid, which is actually found in the skins of foods like sweet potatoes, so we don't eat the skin. So this is all that ,you know, that coincidence of history and the whole Paleo concept with actual nutritional chemistry and what we know about vegetables. And a quick note: Diane and I are much more geeked out on healthy meats and fats than on the wide world of hybridized and selectively bred vegetable matter. Just a note. Just to be controversial there towards the end of the podcast.

DIANE SANFILIPPO: Agreed.

LIZ WOLFE: Agreed. Prioritize those good meats and fats. All right, continuing with Andrea's question. Part 2. “Tell me everything you know about post-op” I'm going to say it wrong. “Roux-en” Is it “rou-any? Roux-en-y? Not a clue. Gastric bypass nutrition. Specifically, how often to be eating, how much, do I need to cook my veggies more, etc.

I have always been told that I have to use supplemental protein powders because of my inability to consume large amounts of protein because of my gastric bypass. How much protein do you recommend for a post-op gastric bypass patient, and if I cannot eat enough of these, do you recommend supplementing with a protein powder, and if so, which kind? Why does whey protein not cause allergies? What about brown rice protein? I’m told that the anti-nutrients are gone when it is just the brown rice protein… is this true?”

The next part is Andrea's story. “Following Paleo I am STARVING — see information below My story: 8 years ago I was 5’9″ tall and weighed 335. I was 29 years old and overweight my entire life. I had the gastric bypass operation and quickly lost 175lbs. I stayed at 185 for about a year. Got married, gained 20lbs. Then got pregnant, beginning weight 205, end pregnancy weight 270. Lost back down to 215, then pregnant again and end pregnancy weight was 260. I overdid cardio and extreme calorie restriction to get back down to 220lbs, and then got ill from malnutrition (both from the almost vegan eating and the gastric bypass combined), and adrenal fatigue. I had a series of tests done that showed I have way too low cholesterol (125), not enough progesterone, low cortisol in the am and afternoon and rising a tiny bit at 10pm, absolutely zero vitamins and minerals in my blood. My wonderful naturopath suggested weekly iv vitamin therapy, and a change to a paleo diet. I have now eliminated soy, grains, dairy, almost all sugar (tiny bit of cane sugar in m y 1TB coconut coffee creamer), and I am feeling better, but I am STARVING. Hungry all the time. My ND suggested adding in a bit of fruits (1/4 of a peach with a meal), to bring my blood sugar up a bit, to turn off the hunger feeling. That or adding in a very small amount of brown rice, quinoa, etc to help in the transition. I feel full after I eat, but within an hour I am hungry again. Not sure if this is just my body learning to regulate, and I need to be patient, or if I’m doing something wrong. I am not exercising at this time, as I am just too tired. I have 2 little kids 3&5, and I own my own massage business (part time) and teach A&P at a local massage college. I am doing meditation 3-5 times a week, and am working hard on the self care. I sleep from about 10pm-7am daily, although I must wake 3-4times a night to pee, put a kid back to bed, roll over, etc.

I’d say I’m 100% Paleo for the last 2 weeks.
Breakfast: 3 scrambled eggs, 1 Applegate turkey sausage link, 1 pumpkin pancake (from Diane’s book, thank you Diane!).
Snack: 2 hrs later – Apple with almond butter Lunch – salad with 4-6oz meat and oil/vinegar mix – 1/4 – 1/2 of a peach or nectarine.
Snack 2 hours later: Coconut wrap with 1/2 can tuna mixed with coconut oil and pickles.
Dinner – 4-6 oz roasted chicken with small sweet potato and small green salad.

Then I’m starving at night, trying to keep myself from eating everything in the house. I’ve lost 10 lbs in the last 2 weeks, which is great, but I’m having a hard time keeping up being this hungry. I just cannot eat anymore at meal times, as I feel stuffed and I don’t want to feel sick from eating too much. And I can’t see eating anymore than every 2 hours. I have to stop drinking liquid 1/2 hour before I begin eating, then eat, then wait 1/2 hour to begin liquids again, and so basically I have 1/2 hour to get down as much liquid as I can to only then stop, because in a 1/2 hour I’m going to need to eat again. Apparently we post-ops cannot drink with our meals because it washes the food out of our pouch too quickly. What a mess. I’m discouraged and scared. Where to start?”

Diane, what are your thoughts?

LIZ WOLFE: Whew. So I'm just going to kind of read people a basic definition of the surgery that she's gone through because I think it's worth understanding. So this bariatric procedure known as Roux-en-y. I think that's how we say it. This type of gastric bypass procedure, which combines restrictive and malabsorption techniques, meaning it reduces the amount of food a patient can comfortably eat, the restriction part. It also reduces the amount of calories that can be digested in the small intestine. Malabsorbtion. That's the malabsorbtion part. So this combination of bariatric methods leads to greater weight loss, and this procedure is seen as one of the best ways to treat clinically severe obesity. So that's just a definition. That's not our recommendation or anything other than that. Just kind of a definition.

So for this post-op situation, you know, part of the advice I would give you on food is the same advice we'd give anyone having issues digesting and absorbing food. But obviously it needs to be smaller meals. The meals you're eating don't sound that small to me. I mean, they don't sound huge, but what you're describing sounds like pretty normal sized meals, if you were to look at what some other people are eating as well. So, you know, I would just kind of…I don't know. Liz, did you kind of think the same thing? I mean, 3 eggs and a turkey sausage, is…I mean, that's not like…I would say 1 egg and like a few bites of a turkey sausage would have been a really small meal.

LIZ WOLFE: Agreed.

DIANE SANFILIPPO:But anyway, it doesn't look like a super small amount of food to me. So I would say to really just continue to eat meals of that size if she feels okay eating those, but I would really go for, you know, as she's already guessed, the well cooked foods, soups and stews, only well cooked veggies for sure. I think one of the issues might be just, you know, the nutrient density that she's getting from the food. So if it's passing through the stomach and the small intestine too quickly, who knows how much is really happening in terms of actual absorption of nutrients, so I would focus on things like the homemade bone broth, grass-fed pastured meats in stews and braises, and maybe try for a few days like a little bit lower carb, meaning not fruit or sweet potato. Just see how that feels. Focus on the other foods. You know, like I said, because you are eating what seems to be, you know, fairly normal sized portions, maybe the carbs are driving your appetite a little bit. Who knows?

Like it's really hard to count on what I think is a delicate thing, you know, being in this post-op situation, but the fact remains that our stomach and small intestines are a certain size by design, by nature, for a reason. We need food to be in each of these organs for a specific amount of time, you know, for our bodies to be able to digest and absorb the nutrients that we need for satiety. So satiety is not really just about, you know, the volume of food that we eat, or even just the number of calories, but it's really about that nutrient density and how well we are absorbing the nutrients. So at a cellular level, are you taking in the micronutrients that your body needs to run energy production, for the Krebs cycle, and make ATP and all those things. Like, are you taking in the vitamins and minerals that you need and if your body has gone through a procedure where basically you're forcing this process to move quickly, you know, I mean, it's almost the same as any other person who's dealing with malabsorbtion, like a celiac who, you know, isn't going to be able to absorb nutrients and put any weight on or hold weight because they're just not absorbing anything. So, you know, maybe this is an effect of the surgery that isn't often talked about that it doesn't…it sounds like she knew that not drinking a lot would happen and smaller meals would happen, but this idea that like your body's ability to feel normal satiety, I don't know if that can come back, you know. I wouldn't be like this is a totally lost cause, but I would have some patience with it, and just kind of see what happens with changing the type of food that you're eating to stuff that's sort of quasi-pre-digested in that well cooked, you know, soups and stews, well cooked veggies because the cooking is what does that sort of, you know, I'm saying this in finger quotes, like “pre-digesting” for you. So maybe your body can take more from the food because it's already gone through that process, and hopefully, that's going to help a whole bunch. And I would really just start to make that shift away from, you know, what you're typically doing now to even something that looks kind of like GAPS diet because it's more the broth and the stews and you know, the braised meats, that kind of stuff.

I don't know, more thoughts on this, Liz?

LIZ WOLFE: No, I think you covered everything I would have said. You go, Glen Coco.

DIANE SANFILIPPO: [laughs]

LIZ WOLFE: It's a tough situation.

DIANE SANFILIPPO: Oh, obscure.

LIZ WOLFE: Yeah, that one's not too obscure.

DIANE SANFILIPPO: It's not.

LIZ WOLFE: Not too bad. I think it's officially You Go, Glen Coco Day. Something about October 3rd. But this is a really tough one, and let's crowdsource it a little bit. If there's anybody out there that's had this same…this same situation, there's got to be somebody out there that's listening, pop over to the BalancedBites.com blog post on this podcast, and leave a comment. See if we can't throw it there to folks that have actually…that have been there.

DIANE SANFILIPPO: Yeah, I would love to hear what other people are kind of dealing with on that one and hopefully, you know, hopefully, Andrea will come back and kind of let us know if some of these things are helping because you know, we don't…we kind of always say we don't have answers. We just have recommendations or suggestions. Because every human system is a combination of like science and art at play, so you know, we can know some basics of how the science and biochemistry and you know, just nutritional breakdown is going to work, but we can't know how every person's body will respond to different things, so come tell us.

LIZ WOLFE: That was beautiful, D. That was a beautiful statement.

DIANE SANFILIPPO: That's a wrap?

LIZ WOLFE: That's a wrap. That's that. We'll be back next week with more of your questions. Until then, you can find Diane at BalancedBites.com. You can find me, Liz, at CaveGirlEats.com or LizWolfeNTP.com. Thanks for listening everybody. We'll be back next week.

Cheers!
Diane & Liz

Comments 9

  1. Liz, the wacky circumference is awesome!And, Nicole sounds like me, so thank you and Diane for the advice and thanks to Nicole for asking. By the way, I’m one of those new listeners and I’m loving it. Thanks to you both!

  2. I too am a post gastric bypasser… I’m coming on the 5 year mark and my issue/concerns are more related to whether I’m getting enough calories in a day when eating Paleo (working very well on a ketogenic diet now). Is it possible Andrea is in the midst of ‘carb flu'(read that she was at the 2wk mark)? I remember feeling ravenous some days around that time, too… followed by extreme fatigue as my body adjusted to running on fat. I also wonder if I am more prone to carbs and their effects… could she be, too?

    1. And BTW… I’ve already kitchen-dirtied my Practical Paleo book right up… coconut oil stains and the like. I’ve made it thru five or six of the recipes (not bad in two weeks!) and everyone has enjoyed them all. Thanks!

  3. I am yet another gastric bypasser (gallbladder removed), five years this December. I have never felt better in all my years since being more “Paleo” but the path has had its challenges. Two weeks, as note above suggests, is only a drop of time. I had the surgery to lose the weight, now I eat as healthy as I possibly can to maintain and keep myself nourished! Recent bloodwork indicated low iron (nothing new on that one), but everything pretty good. I eat a TON of butter, full fat coconut milk, bacon, avocado, and olive oil. I have yet to experience any problems without a gall bladder. My stools are interesting, tho. With each meal I eat 2-3 ounces of lean red meat (not grass fed tho), lots of salmon, organic chicken, pork, etc. and then almost always some leafy greens. Breakfast can be one egg and some greens, and I feel stuffed after that. Recently I did have struggles with what I think is a peptic ulcer. I immediately started on finding a happy balance in gut with acid level. I think I’m on the right course. I still struggle with sugar addictions (I eat spoonfuls of honey right out of the jar), but I get better with each passing day! I have no idea how many calories I eat, I NEVER count anymore, I just follow a Paleo template and my clothes fit great, I feel good, I have the occassional cookie (or two) and I’m doing great. I exercise very little/sit at a desk all day. I don’t take supplements other than iron and complex B vitamins (when I remember). I wish I knew about Paleo prior to surgery…. it would have solved a lot. When seeing the doc about why my gut was burning, he commented I’m one of the healthiest post surgery patients he’s ever seen. I educated him on Paleo. This is a lifestyle every post by pass person should follow.

  4. Ladies of the Podcast,
    You mentioned a Dr. Ron (?) where you order adrenal support through holistic supplements. Would you mind posting a site for this?
    Many thanks!
    Danielle

  5. YOU.GUYS.

    I am over the moon that you featured my question. Your comments, advice and encouragement are precisely what I need at this moment and the push I need to commit to my health, both mentally and physically. I’m slowly inching my way to “nutrient seek” with my diet and “crowding out” the not so amazing stuff. I’m nourishing my body and soul rather than, my anxious mind or cravings and boy oh boy you guys are not messing around with your advice.

    I’m taking daily raw liver “shots” (the more frozen, the better, it’s like a liver popsicle!) I’ve made my first bath of bone broth (could only find pork bones) and made some delicious herbal tea jello.

    Amazingly enough by a stroke of fate my whole foods FINALLY has Diane’s book in stock (I bought it the same day as this podcast was published) and am easing my way into the meal plans. Woohoo!

    You guys flipping rock, I was basically your biggest fan before, but now apparently OBVIOUSLY we’re best friends.

    Also. for your viewing pleasure an ab hula hooping demonstration:

    http://www.youtube.com/watch?v=VZLI8FwateE

    This is not me, but I kinda wish it was……..

  6. Thanks for addressing the gall bladder issues! I too am one of the gall bladder-less masses. Sadly, I had it out at 24 (three years ago almost to the day) before learning about paleo and how changing my diet might have prevented the need for surgery. But since I can’t go back and “reinstall” my gallbladder at this point, but want to be able to eat plenty of healthy fats, I was concerned about how to do that without the extra bile support. Thanks again!

  7. I am post gastric bypass 9 years in August with no gallbladder. All of my blood work is the best it has ever been. I follow all the ‘rules’ about drinking before and after meals and not during. I don’t really snack during the day, but maybe a little at night. This is a recent change in the last two years since I started trying my hand at being an athlete. I discovered the Paleo lifestyle through the Whole Life Challenge through my CrossFit box. I ate pretty clean before, but cutting more processed food out hasn’t been as hard as I thought it would. What is hard is the dairy element. I do notice my ‘eliminations’ are much different eating this way though. I’m pretty sure after listening to your podcast now that it has to do with not having a gallbladder. My main concern is maintaining my sugar/carb levels to not have a hot sweat/fainting episode. This happened at my half marathon last weekend. I had carbs during the run and no protein. I about passed about afterwards. This has been a concern for me for several years to keep that balance just right. Maybe I’ll submit my own question:)
    I’m glad I discovered your blog/book/podcast to help me on my on going health journey.

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