Podcast Episode #63: Dizziness, Adrenal Fatigue, Tourette Syndrome, HCG Diet

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Opening chat:
Updates on projects, events, and a few words on nut butter consumption and acne.

Topics:
1. Dizzy since a Paleo Challenge? [9:00] 2. Dizzy, could it be adrenal fatigue? [19:30] 3. Tourette Syndrome [30:45] 4. HCG Diet [36:05] 5. Gut healing [47:20]

Show Links:
Mary Vance’s post on HCG
How to Eat, Move, and Be Healthy – Paul Chek
Some of Liz’s supplement picks: Probiotic, Bile salts, Enzymes, General healing

Click here to download this episode as an MP3.

The episodes are currently available in iTunes, Stitcher & Blog Talk Radio.

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LIZ WOLFE: Hey everyone, I'm Liz Wolfe, nutritional therapy practitioner, and I'm here with Diane Sanfilippo, a certified holistic nutrition consultant and the woman behind Balanced Bites and the new book, Practical Paleo. Remember our disclaimer that the materials and content contained in this podcast are intended as general information only, and must not be considered a substitute for professional medical advice, diagnosis, or treatment.
Welcome to episode 63 of the Balanced Bites podcast! We were gone for a week. We missed you guys. Hope everyone had a great Thanksgiving for people who celebrate Thanksgiving. I hope you ate your faces off. Diane, how was your THX? How was it?

DIANE SANFILIPPO: It was awesome. Family, friends over the weekend, had a couple of friends in town from San Diego. Pete's Paleo, Pete and his wife Sarah, so that was really fun. They came to the gym, and then we had a nice brunch after the gym, so that was really fun to pow-wow with them. And yeah, so it was awesome, and I'm back…back working. Back home, which is nice.

LIZ WOLFE: Finally.

DIANE SANFILIPPO: I have to say thank you to the people who not only showed up in…where were we? We were north of Seattle, so a couple of weeks ago, for those of you who may or may not have heard, I signed books in the dark. I don't think we recorded a podcast since then.

LIZ WOLFE: Nope.

DIANE SANFILIPPO: Yeah, I was signing books by like flashlight. I pulled up to this amazing bookstore, and was like, oh, this place looks awesome. It's huge, tons of space. And then no joke, like 20 seconds later, like I was Instagramming a picture of the store with all their cute Christmas lights, the entire strip mall, the power goes out.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: I was sitting there, like..

LIZ WOLFE: You broke it!

DIANE SANFILIPPO: That's exactly…so that was…that was interesting. And so I just wanted to say thank you for the folks that showed up and I'm really sorry for the ones that showed up and got turned away because we did end up, you know, having a small event by flashlight in the back of the store. There were about 20 of us or so, kind of like huddled up and I was just talking, answering questions in the dark, and telling ghost stories and whatnot, so…

LIZ WOLFE: Sweet!

DIANE SANFILIPPO: So anyway.

LIZ WOLFE: Goosebumps? Ghost stories?

DIANE SANFILIPPO: Totally.

LIZ WOLFE: I'll tell ya a ghost story. Actually, no, I won't. So what other events do you have coming up?

DIANE SANFILIPPO: This weekend I'll be in Summit, New Jersey at Lululemon, just a free book signing. And that will be from 11AM to 1PM, so that's December 1st. And I don't know what's more fun than being surrounded by like piles and piles of super cute, comfy workout clothes, so definitely come…come check that out. What else? I think we're finalizing our 2013 schedule for workshops, so that should posted up pretty soon within the next, I guess, like week or two. And I think the first events are most likely going to be January 19th and 20th in Southern California. We are looking at Los Angeles and San Diego, so definitely stay tuned for more info on those events and on the other events we have coming up.
What about you? Any projects? Updates?

LIZ WOLFE: Well, you know, I'm working on figuring out Facebook. I just like…I don't get it. And I've never really gotten it, and it makes me sad because it's such a great place to have a conversation. I feel like you have mastered Facebook, but it won't pull in pictures from my blog posts. This is such a dumb thing to complain about on the podcast, but it won't pull in pictures from my blog posts, so I feel like I need some kind of computer genius to volunteer to help me and figure out how to make it pull in and look pretty because I just wrote finally my review of Stefani Ruper's PCOS Unlocked guide, which is unbelievable. I mean, really, she's…I don't even need to take clients anymore with PCOS problems because it's done so, so much for people just in and of itself, and I really pull that into Facebook and make it look good so people will check it out. But I can't figure it out, so somebody help me. [laughs] Help me with that.
In other news, the skincare guide that I've been talking about and teasing is just a few weeks out. Just finishing up designs, plugging in everything, all the recommendations. I'm so excited about it. And I'm so proud of it. I cover nutrition, digestive support, and the entire section on actual body care, on topical stuff, on hair, skin, nails, and teeth is going to be further enhanced by Trina from Primal Life Organics, who is just a genius with oils and it's just going to be amazing. So I'm really excited about it. And so that's coming up pretty soon. And I guess that's about it. Just thanking everybody for the book support. I mean, the beans have been spilled. I actually put a link up on my blog to the listing to my book on Amazon, and people have been so cool. So supportive and amazing. I'm excited to get it out there. And that's about it.
Oh! Here's one. I wanted to share with everybody a very brilliant tip that I came up with all by myself about nut butter. So I…for a lot of clients that I take that contact me for acne and skin issues and whatnot, I've really encouraged those people to pull back on nuts as much as possible. Like the nut flour crusts and the nut flour baked goods and you know, the 3 scoops of sunflower seed butter at 10 o'clock at night, that type of stuff. For whatever reason, nuts just tend to aggravate people’s skin problems. It's just something I've observed. And so I came up with this idea, Diane, and it's to blend coconut butter with a little bit of almond butter or sunflower seed butter. You mash it up and you spread it and you can eat it, you know. Put it on an apple. Eat a spoonful of it. Just like you would do with normal nut butter and it totally, you get that flavor of the nuts, and you get the consistency of the nut butter, but you get a hit of really healthy fats, really skin healthy fats and a little bit less of that concentrated, you know, hit of nuts. Am I genius or what?

DIANE SANFILIPPO: Yeah, I have a jar in the back of my fridge of something just like that.

LIZ WOLFE: Oh. I hate you. Is that the Meenut butter? I knew it.

DIANE SANFILIPPO: No, I actually…it's not the best idea to do it, like ahead of time where I did it, where I had one of my Tropical Traditions, like coconut cream concentrate, it's basically the same thing as coconut butter from other brands. But it was all like softened because I was going to use it for something and I needed to soften it to mix it. And I had half a jar left, so I just dumped it, you know, half almond butter and half coconut butter and just kind of like stirred it up. But then it went back in the fridge, which is just a bad idea. Like you do not want coconut butter in the fridge.

LIZ WOLFE: Ew.

DIANE SANFILIPPO: It's a good idea to do it, just kind of ad hoc, like as you need it. But yeah, I like that, and you know, it's kind of a CHEK practitioner thing, too. Like Paul Chek definitely has a ton of folks who are having issues with acne. He always tells them to get rid of nuts and seeds, too.

LIZ WOLFE: Yup.

DIANE SANFILIPPO: That’s been kind of a thing that I've been hearing swirled around a bit, but I think that idea of mixing that little bit, that will kind of help people with their overdose on the nut butters.

LIZ WOLFE: You know, I love that for kids, too, because I feel like kids just get such a constant hit of, you know, peanut butter, almond butter, nut butter, all of these things that are kind of kid-friendly. But, you know, if we're messing with, you know, if my theory is correct and some of these kind of heavy hits of nut butter are messing with the gut bacteria a little bit, we’re starting kids out on these things super early, and I think it can definitely, potentially set the stage for some problems. So I encourage folks to try that out and report back and see what you do with it.

DIANE SANFILIPPO: It might also help with some of the allergens that are going on in the nut butters.

LIZ WOLFE: Yup.

DIANE SANFILIPPO: I think I made myself allergic to walnuts by overdosing on walnut butter for about a year.

LIZ WOLFE: You know, we had a question on that about coconut, too, in the past, about are we going to make ourselves allergic to coconut eating it all the time, so I guess I just kind of opened a whole new can of nut butter with that. But anyway, there’s our, you know, urinal talk. All right, anything else before we get to questions?

DIANE SANFILIPPO: No, I think that's it for today.

LIZ WOLFE: Cool. All right, so we’ll start out. We have two questions that are both, to start out here, about blood pressure changes, so a lot of times these two kinds of issues are…well, just issues of, you know, in general, that are kind of lumped together, but people's experiences a lot of times have different precipitating factors. So there may be some crossover between these two questions, but Diane and I kind of teased out a few different perspectives as we prepared for this podcast and to answer these questions, and I just have to say, I love that. I love attacking client questions and podcast questions with the wisdom of another practitioner because we really do kind of bounce off one another to tackle every angle of this stuff. So we're going to present a few different ideas for each question.
So here's the first one. This is from June: “In the past month I have had mild bouts of dizziness. It’s on and off…I notice it when I wake up and go from supine to vertical or sometimes vice versa, or during the day when I do the same…I’m a Pilates trainer so am often demonstrating exercises to clients. It’s not all the time and there doesn’t seem to be any particular pattern. I had this about 3-4 weeks ago. My chiropractor said I had a virus. He gave me herbal supplements, and it went away. Now it’s back. I feel like maybe I COULD have a virus….I don’t feel fabulous….I’m tired and my head feels like it’s in the clouds, though I’m not dizzy at the moment, but I was last night. The dizziness is fleeting and it’s not debilitating….but noticeable and annoying because it’s not supposed to be there. Could this be a deficiency? Have you heard of this with Paleo?
I have been strictly Paleo for 6 weeks. My CrossFit gym is doing a 6 week Paleo Challenge which really helped me fine tune and get off sugar….before that, mostly Paleo for about 6 to 8 months. I’ve never felt better. I’m going to be 60 in January and am told I look 40 (thanks partly to my hair guy, partly to genes, partly to healthy diet and lifestyle). I’ve been gluten free for 7 years. I went gluten free to help my son who needed to try it. I found it was so beneficial for me and I never went back. I cut out most grains last September and dairy in January 2012. Sugar has been my nemesis, but now am sugar free as well.
I am currently strictly Paleo. Breakfast might be some kind of egg dish, fried eggs, w/ bacon or sausage, avocado, fermented carrots (I’m mostly following your fat loss meal plan…not verbatim but trying to eliminate nuts, too much avocado, yams, etc for now. I could lose about 10 to 15 pounds. No snacks, breakfast holds me for 5 or more hours. Lunch would be some kind of meat and veggies….maybe salad w/ steak or chicken, or maybe leftover dinner…yesterday lunch was chicken curry and an apple streusel muffin. Dinner was stuffed cabbage and sautéed greens. Apple for dessert. I’ve cut way back on fruit since sugar is an issue for me.
Last week I decided to have a bowl of pumpkin ice cream. MAN DID I PAY FOR THAT!!
BAD idea. I’ve also found that chocolate gives me a stomach ache…sweetened or not.
I occasionally use honey in my coffee. I drink a cup of decaf less than once a day…probably 4-5 times per week, w/ coconut milk.
Supplements- Designs for Health twice daily multi, 2 Omega 3, Vitamin D3 (my levels are normal). I take my supplements AM w/ breakfast and PM before bed. Synthroid for hypothyroidism. Just had my TSH checked and it’s normal. I’ve never had dizziness around thyroid issues and feel pretty normal in all other thyroid areas. (I took Armour thyroid for years and a few years ago it “stopped working”…so my doc (who never asks what I’m eating) suggested I go back to Synthroid.
For exercise, I do CrossFit 3 times per week. I teach 2 Pilates mat classes during the week(where I am doing many of the exercises with the class) and take one class from another trainer. I also am demoing Pilates exercises throughout the day to clients (I own a studio in El Cerrito).
I walk my dogs for 20-30 minutes once, sometimes twice a day, at a “strolling” kind of pace. I don’t enjoy running though sometimes we do at CrossFit. The cardio I get is at CrossFit. I’m comfortable with the amount of exercise I get.
I really try to get at least 7 or more hours of sleep, but it’s often 6-7. It’s hard to function w/ 6, but sometimes I just can’t get to bed early enough. I know I can do better in the sleep department. ”
So that's June's question, and I'll just, you know, jump in on this. Hypotension is what we're talking about, and that can be a consequence of undereating. And if we're being totally honest, I see little too often for my liking these gym challenges that really just end up being an undereating challenge. Like I'm sorry, but that's what ends up happening. Folks eat chicken breast and vegetables and bacon, and they go really hard at CrossFit, and they starve their bodies of nutrients and electrolytes against the backdrop of increased activity, which depletes the body even more than what they may have been doing before. And I'm not saying that's the case with June, but I think it's worth point out, and as we come closer to the new year, I know there will be a lot of gym challenges, and I really want to stress that folks watch out for that because it's just a bad deal, and it sets the stage for different problems, if only just rebound weight gain. So watch out for undereating. Watch out for low electrolyte consumption, which Diane will talk about more in the next question. Don't just eliminate foods and narrow your food choices or choose things you knew about before, but just never used to eat, you know. You knew that steak was a thing that you never used to eat it, but now that you can't have, you know, bread or a turkey sandwich, you're going to start eating steak, I don’t know. Just expand your choices to things you'd never thought you'd try. That was me with bone broth. That was me with sardines. That was me with cod liver oil. That was me with liver. You get the idea.
So that out of the way, one thing that did come to mind with June is pretty freaking simple. She has a really high activity level. She may not think it's high because she's used to it, but I do think that her lifestyle, even on a fat loss type plan could use a little extra carb and some extra fat. A lot of folks think of like carrot and sweet potato as equally starchy, and that’s absolutely not the case. Carrot, beet, turnip, even acorn and butternut and spaghetti squash are…they're astonishingly low in carbohydrate for what folks normally consider them to be. So, you know, it's possible that there's a virus there. You know, who knows? We've all got viruses, you know, living inside us. It's also possible that she's just fatigued at the end of a gym challenge, or that she's been fatigued since the beginning of that gym challenge. Or since those first two weeks, looking at the timeline. She says in one part that she's never felt better, but she also says that she also doesn't feel fabulous. So that's just my read. There are some connections between hypotension, hypothyroid, and caloric restriction, so it may be just a perfect storm there. We could be looking at the effect of prolonged hypothyroid on adrenal function, which is kind of the governor of normal blood pressure. Diane will address the adrenal support stuff, I think, as well for the next question.
The last thing I'd say, because June is 60, and she works out frequently, I do want to say that as we age, we do lose some of our stomach acid production. That means less B-12 is released from protein for absorption. There's a possibility that this could be a B-12 deficiency mediated situation of food bound malabsorption issue. So getting B-12 levels checked might be a decent idea if she's going anyway to get some stuff checked out. But we did learn, Diane, at the Weston A. Price conference that B-12 testing, even, you know, the “gold standard” tests, they're not necessarily reliable, and it's probably best to go by functional markers, so, you know, maybe just try a little B-12 supplementation. Maybe some stomach acid supplementation and see how you do with that. That's what I've got. What do you think? Any-anything to add?

DIANE SANFILIPPO: The only other thing I was just going to mention is that I think your note about the undereating is a really huge one. It's so funny because when I have any increase in activity level, like after the last month of basically being on the road and maybe training like 5 times in that whole month, and then coming back home and training, you know, very regularly, it's like the floodgates open in terms of my consumption. Like I'm just eating whatever because I feel like I'm a lot more hungry because working out, you know, we know that exercise just makes people hungrier. And I think that the point about, you know, challenges and getting the sense that like they're trying to lose weight or lose body fat or win a challenge or what have you, not paying attention to the fact that like, the reality is we just…we want that body to be as healthy as possible, and if somebody is undereating at all…I say this all the time, but it's like they're not getting enough nutrition. Like any time you skip out on food, you're missing nutrition, and if you're working out, and especially if she's not absorbing things as much because of possibly the lower stomach acid, you know, your body just doesn't have the chance to replenish what you've just depleted. So, you know, this is one of the things that we actually cover even in the guide that we give gyms to running their own Paleo challenge, and the first thing that I talked about, Week 1, with my own gym, with the members that were doing our challenge. Week 1, I was going to talk about something else, and I ended up like watching them, you know, I think I talked about this before once on the podcast where I saw one of the guys in the challenge posting a picture of his lunch, and it was like…it looked like diet food for a small female. And I was like, you can NOT be eating that on this challenge. Your performance at the gym is going to suffer. Your whole body's going to suffer, and this is not about, you know, cutting back on anything. This is just about changing the food that you're eating. So a lot of times people just don't know what to eat. So if you're having any trouble with that, you know, reach out to the people who are in the challenge. See what else people are eating. Get the carbs in. Don't forget about them. And just kind of remember to keep it, you know, keep that nutrition coming in, and look at it that way. Don't look at it just as like, you know, not, you know, not overeating. Like okay, I really need to fuel my body for these efforts.

LIZ WOLFE: All righty. Okay, next question. “Hi Diane and Liz, I love your podcast! Thank you so much for not only giving out such solid information, but doing so in an incredibly down-to-earth manner. I really enjoy listening.
I guess I should start with my question, and then get into the details: I generally feel pretty good throughout the day, but I often get spells of lightheadedness, slightly blurred and unable to focus vision, and even vertigo-like imbalance (mild, not severe). This mostly happens either when I am sitting and concentrating for long periods of time (working at my desk, long drives) or even when I am out running. I also get occasional chest tightness/mild pain. I do not feel so dizzy or have fainting spells that I feel unsafe, but I am still concerned. This has also been going on for years. About 3 years ago I felt similarly and went to the doctor. They took my pulse when I was lying down (I have a slightly below average resting heart rate) and then when I stood up my pulse SKYROCKETED. They said this was because I was “severely dehydrated” and put me on an IV. Ever since then I have worked to make sure I drink enough water, cut down my coffee consumption (8-16 ounces per day vs. sometimes 4 to 5 cups) but I still get these sensations almost daily. Until now, I have learned to live with them and have remained unconcerned (figured maybe it was due to stress?).
That is until I began learning about Paleo and some of the symptoms the diet can help with. I began learning about Paleo for lifelong health reasons, but after reading about Adrenal Fatigue I began to question whether that is what I have been experiencing. While I do not showcase all of the symptoms, the ones I do have seem to fit, and I was especially struck when I read about the differences in blood pressure when standing vs. sitting vs. lying down in relation to adrenal function.
So my questions are: does this seem like adrenal fatigue? Could it be purely dehydration as my doctor suggested? If it is adrenal, how should I go about FINALLY feeling better? Thanks for all you do, Sophie.”
Diane, you had a lot to say on this one.

DIANE SANFILIPPO: Yeah, one thing that I do want to point out is that before I even kind of get into her specific issue, though sometimes it seems like people go Paleo and then we start hearing about adrenal fatigue, and I think, this is just kind of occurred to me as you were reading it over again, and I think we get a little bit of like a selection bias on this group of people who are either doing CrossFit or who are, you know, just interested in improving their health, and I mean, you may have a huge majority of people out there who are dealing with a lot of fatigue, but just never tune into it, and so I think that's really what we're getting here, is that people are tuning into feeling better. They're addressing all kinds of issues that would normally make them feel a lot better. Cleaning up their diets, sleeping more, etc. And then still not seeing amazing results, and I think some of the stuff I'm going to talk about here is hopefully what's going to help people, but I just wanted to mention that because I feel like that’s kind of a, I don't know, just kind of crops up that we get these questions so much, and I feel like somebody might think, oh, we're attributing this dietary change to as a factor as a reason for this fatigue, and I don't think it really works that way in most cases.
But for Sophie, yes, I absolutely think this sounds like an adrenal issue. What we do know is what may be done in the short term to work on remedying the issue, but what we don't know is the underlying cause in this case. So addressing the issue in the short term means that from a nutrition perspective, she wants to make sure that beyond hydration, she's getting the following bases covered. So first things, as we mentioned in the last question is carbohydrate intake. You want it to match your activity levels. So we don't know how much exercise Sophie's doing, but if she's working out and not getting in some carbs, and this is how she's feeling, chances are, you know, she's not getting enough. And so, you know, this can also promote some of the dehydration issue. if you're eating really low-carb, lowering carb intake also causes us to lose more water. Carbohydrates are chemically like carbon plus water, so that's the carbohydrate, and people who've ever done like a low carb approach, you know that the first thing you end up losing is water weight, and that's really because your body just isn't holding onto it without the carbohydrates in the diet. So that's kind of one thing that goes a little bit hand in hand with something she's already seen and experienced from the doctor.
So the second thing is the electrolytes. Sometimes hydration is an issue, but sometimes it's just the electrolyte imbalance more so than the actual, you know, hydration or lack thereof. And if you're overhydrating and not getting enough electrolyte substrate in there, you could be worsening the problem. You're just diluting what's available in the body. So the solution I'd offer up here would be that she replaces a good portion of the plain water she's drinking with homemade bone broth.

LIZ WOLFE: Woo hoo!

DIANE SANFILIPPO: And so I would definitely use a recipe, you know, I have a recipe that's got plenty of good sea salt in there, along with the minerals that you're getting from the bones, and I think that could really help, too. That could help for a lot of other reasons as well. She could just be lacking magnesium. Like magnesium is the one mineral that we know almost everybody could use more of, and it's almost like, if you just start getting more magnesium, you might find a lot of different things change. I’m definitely finding that I'm sleeping a lot better taking Epsom’s salts baths, like regularly. Part of that's just a relaxing ritual, but part of it's that transdermal magnesium that's coming in through the bath, so that's another thing that she could actually do is some Epsom’s salts baths. But that's just specifically for some magnesium.
And then the third thing, specifically on adrenal support, nutrition would be vitamin C. So we know that adrenal glands should be rich in vitamin C. We know that from adrenal glands that we might eat from other animals. That's one way to get vitamin C if we're not potentially eating plant foods, which most of us are. This means if you're not only, you know, not only looking to get more of it in the diet when we want to support adrenals, but the vitamin C is being seriously depleted when any time our adrenals are overtaxed. So if we're exercising a bunch or we're stressed or whatever’s going on, we're just constantly sort of like burning through or emptying out those vitamin C reserves, and so we really need to consider repleting them as much as possible. Vitamin C is water soluble, so it really doesn't stick around for too long in the body stores. So it's something we do need to replenish on a regular, like daily basis, and I think this is one of those cases where if you've got some insufficiency, or if you’re feeling like, you know, you have some issues with your adrenals, it could be a good case for vitamin C supplementation. One that I've been recommending pretty often recently is just a fizzy drink mix from Designs for Health. I've seen some pretty good, just immune support and adrenal response from folks taking that. It's a practitioner line item, but I think you can find it on Amazon these days, and I'll see if we can throw a link in. It’s just a…I think it's called BioFizz, and that could be pretty useful. I also, you know, even and especially when doing any kind of lower carb, just for folks who might be doing that, I just want to throw out there that if you're eating lower carb, and you're not eating adrenal glands, which I'm going to guess most people aren't, getting some sort of form of vitamin C, richly like lemon juice, just freshly squeezed into water or onto your salad is really important, especially for this reason.
So anyway, what we don't know about Sophie here is the underlying cause of this fatigue and so, I think when people are dealing with serious issues like this one, it really means an honest evaluation of lifestyle factors is in order for them. So sleep, stress, and stress means so many things other than, you know, the ones that we normally consider. It can be environmental toxins. It can even be things like negative thought patterns. I know people who absolutely put their bodies through so much stress simply because of the thoughts that they have and the way they perceive every situation in their lives, exercise, etc. So if Sophie's life is depleting her nutrient stores, or her brain chemistry is sort of pushing to the side of too much stress or an imbalance, then that can really drive the adrenal output down. The adrenals have no sort of brain or command center with them…within them. They take marching orders from your brain. So whatever your brain is sort of putting out and saying okay, this is what's happening right now. That's what they're working with. So figuring out the stressors and perhaps, sort of systemically reducing them is the best approach to resolving the issue. This is where I consistently recommend Paul Chek's book, How to Eat, Move, and Be Healthy. It gives you sort of an assessment checklist of different lifestyle factors, and she may find that diet is not her biggest issue any more. Maybe she's already changed the diet. It's time to look somewhere else. It's time to look at sleep, toxins, movement, etc. So that's kind of where I would go with that.

LIZ WOLFE: Just a couple practical strategies for…I love the Epsom’s salt baths, but I don't know…I don't have an access to a bathtub, you know, at all times during travels or whatnot, so I don't know how you feel about the magnesium spray or that…some people call it magnesium oil, but you basically just spray it on, rub it on your skin, leave it for a little bit, and then you can shower it off. I've been doing that lately, and I really do like it. I was a little skeptical at first, but I like that a lot.

DIANE SANFILIPPO: I don't have any opinion either way.

LIZ WOLFE: No?

DIANE SANFILIPPO: I think if you feel like it works for you, whether it’s working for real or working for placebo reasons, it's still working, so, yeah.

LIZ WOLFE: Yeah, whatever it is…I'm liking it.

DIANE SANFILIPPO: Good.

LIZ WOLFE: But let's see. What was the other thing I wanted to say? Oh, you reminded me. I do tend to start my day with just some…a glass of water and lemon, some muddled ginger with hot water and lemon. So I love that idea of just making sure you get some of that lemon, and maybe even first thing in the morning. And I think you told me to use it right after you cut it because I believe the vitamin C content degrades pretty rapidly once you cut a lemon or whatever, so…what were you going to say?

DIANE SANFILIPPO: Oh, you know, the other thing I was thinking of when you said that, you starting the day with like water with lemon or something, the first thing I usually drink these days is like my kombucha. It's often been the home brew, and I know that kombucha is pretty rich in B vitamins. I don't-I guess it's just a sort of a by-product of the bacterial…the bacterial reaction or, you know, the…I don't even know whatever comes off of the bacteria as it's eating the sugar, but getting some extra B vitamins is always useful as well for adrenal support, and again, those are more water soluble vitamins. We're talking about like B and C vitamins as water soluble, so we do need to, like really what that means in terms of the diet is the stuff that we need to get in very regularly vs. you know, vitamin A, D, E, and K. We still need them. We need everything all the time. But since they're fat soluble, they tend to just stick around a little bit longer in terms of reserve. So pretty critical to make sure we're getting those B vitamins. So anyway. Yeah.

LIZ WOLFE: Cool. All right, next question. “Tourette's Syndrome.”
This is from Michelle: “For the past six weeks I’ve become obsessed with learning as much as possible about the reasoning and research behind the Paleo diet, and also unlearning the “conventional wisdom”. My husband and three kids ages 9, 12, and 13 eagerly followed along as I transformed our kitchen (but only because I told them they didn’t have to–reverse psychology never hurt anyone)” Hehe, that's funny. “and we all look and feel better as a result. I picked up my first two copies of Practical Paleo” Do you like that? My FIRST two copies of Practical Paleo…they're going to get…they're going to buy more, probably to give to their friends and family.”

DIANE SANFILIPPO: [laughs] Yeah.

LIZ WOLFE: Pretty cool. “I've since purchased three more” There you go. “to give away. It is such a terrific resource and makes it easy to help my friends clean up their own lives. Thank you.
My question is about Tourette’s Syndrome. I have heard bits and pieces about helping Tourette’s through diet, but nothing really substantial. So my question is: Do you have any resources for helping a child with Tourette’s? I can only imagine there must be a huge correlation between diet and this neurological issue, but can’t find more than bits of data. I convinced my sister-in-law and her family to give Paleo a try for thirty days because my 12 year old nephew has Tourette’s (since about age 7) and some ADHD issues. They have resisted medication so far, but their doctor is useless.” Change doctors. Okay. “His only suggestion is to wait it out–that he might grow out of it. While that might be true, it doesn’t really help them right now. Switching his diet seems the most logical first step, and he’s been doing great for almost two weeks now (I bribe him!) The rest of their family knows they will not go back to their old habits because they see huge benefits in only a few days, but my nephew has a really strong sugar addiction and is really concerned about Halloween, and can’t wait until the 30 days is over. They notice that many of his ADHD symptoms are better and that he is more calm and focused, but his tics are still the same. I know that if his tics start to subside even minimally he will be motivated to continue, so any tips you can give us would be super helpful. He has eggs and sausage or bacon for breakfast, rolled lunchmeat, fruit, and carrots and maybe some nuts for lunch, and snacks and dinner is usually a recipe from Practical Paleo (they LOVE the book!) He’ll smell the doughnuts the Sunday School teacher brings in, but eats an apple instead, but only because he thinks he’ll be able to eat doughnuts again when the 30 days are up. No supplements yet.”
Well, I feel kind of bad, Diane, that we missed the Halloween deadline for this question, but I'm glad it came across the table this week because I just had a conversation with a mom who's having incredible success with her Tourette's child with the GAPS protocol. So GAPS, it stands for Gut and Psychology Syndrome, has just been a godsend for so many issues like this. Neurological issues, ADHD, behavioral issues, and even Tourette's. Doctor Natasha Campbell-McBride, in my opinion, is a total genius, and she's not afraid to kind of be out on a limb and to do so with great confidence. So I would definitely go that way. I do trust that protocol. It can be intense, and it can take awhile, and the pace is really set by what the child can tolerate. So there's no one size fits all, but really, you know, in the end what can be more rewarding than seeing some resolution. And what GAPS does that kind of out of the box Paleo doesn't do is it doesn't just eliminate irritating foods, you know, and work in some more, you know, generally nutrient dense foods. It actually works to restore proper gut bacteria and detoxify the individual, which can absolutely turn neurological symptoms around. People with neurological issues are almost always also suffering from unbelievably disrupted gut bacteria, and it's not unusual to have those sugar issues, being addicted to sugar because that bacteria is just demanding it. But as soon as you heal that through GAPS, which, as I said, it can take awhile, but it is possible, you'll not only detoxify, but that can down the line change how neurotransmitters are utilized and that's really the key. It really can change absolutely everything if you do what's called for and you stick with it. So, you know, go for the highest quality food humanly possible, but I know that, if you can't afford all organic or all grass-fed all the time, you can still do GAPS. There are some neurotransmitter-effective supplements that can be helpful, I think, as well, in conjunction with GAPS. I believe 5-htp is one of them, but I don't know enough to say anything definite about that. Just look into GAPS, read everything they provide because there are few anomalies I think with stressed individuals where fatty acid metabolism may not be totally normal, so something like the cod liver oil that we like for almost everybody may not be indicated. I think-I'm trying to think what the two official sites are. I think www.gapsdiet.com and www.gaps.me would be where to start. Look into that, and definitely keep in touch.
That's what I got.

DIANE SANFILIPPO: Cool.

LIZ WOLFE: Cool. All right, next up. “HCG Diet.”
Suzanne says: “I recently ran into a friend who went on the ‘HCG diet’ last year. She confided in me that she hasn’t had a period in six months and feels that there may be a connection to the HCG ‘supplement’.” Supplement is in quotes. “It’s been over 12 months since she was on this program and has since regained a little weight back. (I’d say she’s within a healthy/ideal body composition. Perhaps slightly higher body fat percentage then ideal). As far as I know, she consumes a nutrient dense, whole foods diet with limited consumption of potential damaging foods. She does yoga as her main form of movement, no chronic cardio.
As a nutritional consultant, I cannot wrap my head around this ‘diet’. Just another quick fix? How did we get so disconnected? Where’s the intuition here? I digress…
I am shocked, actually with my peers and other health practitioners that have embraced and promoted this diet. Of course you’re going to lose weight on 500 calories a day, But at what cost? What are the potential long term ramifications of this diet? on our metabolism? endocrine health? Any derangement going on here? I apologize if you’ve already covered this. I could not find it in a search. But if you would, I’d love to hear your thoughts on this one. As always ladies, keep up your amazing work and spreading the good word. You are inspiring more than you know!
Thanks, Suzanne
PS. Diane, Practical Paleo has become an invaluable tool for me and my clients
Liz- I look forward to your upcoming book too!” Thank you, Suzanne.
All right, Diane, what are your thoughts?

DIANE SANFILIPPO: Hunh, okay, so I don't have tons of experience with HCG as some people might guess. Not something that I work with regularly, and I've had a couple of clients who've done it, so I've got a little bit of sort of my clinical experience and views on it for that reason, but I'll just give you my two cents for what it's worth here. The first thing to know is that HCG stands for Human…I'm always like afraid I'm going to mess this up. chori-chorionic-chorionic, yeah, that looks good. Human chorionic gonadotropin, and it's a hormone produced during pregnancy. It's made by the developing embryo after conception, and it's what you're detecting in a urine test in a home pregnancy evaluation. So the hormone injections as, you know, as a dietary and weight loss intervention can be quite effective for some people in just shaking up what's going on with their hormonal signaling. Now I'm not saying that's a positive thing for everyone, but I'll get to my sort of gut reactions on the very small population for whom I think it might be a reasonable consideration in a minute.
So for the average person looking to drop anywhere from, say, like 10 to even 50 or 70 or so pounds, I can't really get behind it. Realistically, you know, we know that we need to reset hormonal status to get our bodies to let go of fat that we don't need. And I say that let go of vs. lose because it's not really just about burning it via exercise or cutting calories, it's about getting the body's hormonal set of checks and balances to even out and start working as they're supposed to. Now that said, we've seen far too many times that people who are dealing with serious ramifications of extreme dieting, calorie restriction of this kind of magnitude, which that presents a whole, you know, set of other hormonal disruptions, just in the sheer lack of nutrients coming into the system. Even without the introduction of exogenous hormones like HCG, we see lots of periods as a huge, huge side effect to so many of these diets, and you know, even to something as seemingly innocent as taking oral contraceptives.
The other issue and I'm going to kind of touch on this in a bit is the emotional component of what's happening with these extremely caloric restrictive diets, and I think that that's almost even worse than the very short term caloric restriction. I think that the effects on the body can be pretty severe, but I think the emotional effects are almost worse in the longer term. So for those who are in the like 100 pound plus weight loss sort of needs range, and you know, obviously that will be for medical reasons at that point. Maybe they're on the road to something like a gastric bypass or a lap band type of surgery. I do think it's an interesting idea perhaps to look into this approach, and it's for a very short intervention before taking it so far as to involve an irreversible surgery. We've had a lot of questions about surgeries like that, and you know, I'm not trying to throw my…any sort of judgment on the decision that people make about those surgeries, but you know, maybe this is an intervention that is useful for that type of person before they take it to that next level where then they just, you know, you can't go back from that. And, you know, this could send some new signals to that person's brain and body about food and nutrients. It could just sort of shake up the hormone signaling for them, and those people do have a lot stored. The HCG could perhaps help to reset the brain in the uptake signaling, get them started on a better path.
Now, that said, we know that there are huge ramifications emotionally that come with any diet, so even something as seemingly innocent as like a 30 day Paleo challenge as Liz mentioned before, or like the 21 Day Sugar Detox, for some people, these very limited ways of eating cause a lot of emotional and mental damage. And it's pretty impossible to predict how each person will respond to that set of circumstances. For some, it may be entirely positive, and for others, the opposite. So at the end of the day, HCG has presented itself as sort of a medical intervention that folks can use and/or abuse just like any other. I don't think that there's…I don't think that there's any way I could say, you know what? It's a terrible idea for every single person because I don't know. And if it can help some people, and it can help them in a way that is using some new dietary interventions. We know it's like lean protein and vegetables are what they’re eating, and some of my clients who've come to me have said, you know, this introduced them to Paleo. And if that means it introduces them to this other way of eating that, you know, they do this and their digestion feels a lot better, you know, maybe it's not only negative things that come of it. But of course, I don't think that anybody eating 500 calories a day indefinitely is going to be healthier for it. I think that it needs to be a very acute intervention if used at all, and I don't think it's something that I would say makes any sense whatsoever for somebody who doesn't have a lot of weight to lose. I really don't think that that's the approach that those people should be taking.
I have a link to my colleague Mary Vance's article on HCG that, you know, her views are pretty similar to mine. I’m not sure that she's addressed this idea of who may benefit from it, and it may not be the worst idea, but if anybody wants to read a little bit more about what's it doing, specifically like how the HCG works in the body, she's addressing some of that, and I'll put a link in here to the show notes. Her website is www.maryvancenc.com, and you could probably just search it for HCG if you wanted to see additional thoughts on that. But I don't know. Do you have any other…any other thoughts on that, Liz?

LIZ WOLFE: No, I like your angle. It's just kind of the shifting focus, you know. Just ways of looking at this issue that maybe, you know, I haven't really thought of that before. So that's cool. I like it. The idea that it may be appropriate for some people in some circumstances and if it brings them around to something that’s better and more sustainable and it's…that may be a good thing. You know? in that way?

DIANE SANFILIPPO: Yeah, and you know what I think too? And I think this is pretty common with most of these sort of, you know, medical sort of diet interventions is that they're developed for generally, you know, pretty obese people, and then they get funneled down to women who want to lose, and I say women because it's the majority of who’s asking us about it, but, you know, women and men who are in that much lower range of how much weight they want to lose, and I just think it's irresponsible of people to assign these types of diets to those people. I just do. I think it's really irresponsible of the professionals for kind of addressing it this way, and not addressing the diet and lifestyle concerns in a more appropriate fashion.

LIZ WOLFE: Agreed. I mean, it's just exacerbating neuroses.

DIANE SANFILIPPO: Yeah, creating neuroses and I think that it should be examples like this where it's been over 12 months since she's been on the program, regained a little bit of weight, but hasn't had a period in 6 months? Like, we talk about this all the time, you and I, but you know, amenorrhea and any sort of disruption in fertility or you know, female health and hormones, like that's a sign that something wasn't going well. And a lot of times the relapse from that or sort of the ramifications can hit a little bit later with anything that's like a major stressor on the body, and I would just take that seriously. And for anybody's who's ever thought about it or is listening to this, and it's like, oh, well, I have this friend or I was thinking about it, like just know that it's pretty serious. You know, whenever you put yourself in…this is a starvation diet, and starvation is no joke. Like you are keeping your body from getting a ton of nutrients when you're only eating 500 calories a day. You know that it's 1200 calories a day at a minimum to just be alive and have enough nutrients to run normal body processes. So if you're not eating at least that, you know, you are doing a starvation…you're on a starvation type of diet, and I just don't, you know, I don't think that for most folks, that's the way to go. But, you know, I was trying to think about it as like well, is there a place for this anywhere? And trying to just drop the pre-conceived notion that it's ridiculous. You know what I mean? And I do think that maybe that would be useful for some of those people in that case, so…

LIZ WOLFE: But for most people like me, you know, 6 years ago, when I was convinced and just thrilled by this idea that because of the BMI, you know, how they calculate BMI, I was technically on the edge of overweight or obese, and at the time, I was so disordered in the way I thought about food and the way I was nourishing myself that I was like, well, then I need to, you know, eat so much less food, and it was just this ridiculous way of just indulging these terribly disordered patterns and, you know, for 90% of the population, that's probably what this amounts to. But there may be people that it’s useful for. So I have a complicated history with food and I'm sharing a lot of it in my book, Modern Cave Girl. It's just kind of a cleansing of all of that history. Very rewarding to leave behind. Anyway.
Last question then?

DIANE SANFILIPPO: Yeah, sounds good. One more.

LIZ WOLFE: All right, this one is from Madison. “Can't eat the foods I really enjoy.”
“Hello! I have a question for you today about 3 things regarding the paleo diet, but I’ll make each one of them as short as possible!
Okay, here are my questions:
1. I want to try paleo because I feel like grains like quinoa are still bothering my stomach. I’m worried about getting enough to eat though, because many paleo foods are off limits for me. I can’t eat eggs, vegetables like broccoli, cauliflower, peppers, sweet potatoes bother my stomach (beans also hurt it, but that’s okay because paleo doesn’t include those anyways)… and I can’t digest fat. Seriously. Whenever I eat any type of nut, avocado, coconut, oil, or even tuna (with a small amount of fat– like 1 gram!) my stomach starts getting bubbly and rumbling. I usually get stomach pains shortly after and have terrible gas for days. I know that fat is very important, and I take flaxseed oil (about 3 grams of fat worth daily) and digestive enzymes (because I have a lipase deficiency) with every meal to help me cope. Still no fat. Will my fat digestion improve after going Paleo? What are some things that I can do to help me digest these foods properly?
Question 2. My naturopath said that I have candida, which I’m sure you get a lot of questions about. She wants me to go on a basic Atkins diet, which I think would be even tougher for me than paleo because of the high levels of fat. Have you heard of anyone having success with candida and a paleo diet? Any tips?
Third question. My dream would be to one day be able to eat some of the foods that I was allergic to again. Do you have any inspirational stories of people reversing, or improving their food allergies from going paleo.
Thanks for taking the time to answer my questions!”
A little on Madison's back-story:”I took antibiotics for my acne for 4 years and severely messed up my stomach. Now I’m allergic to wheat, eggs, milk, peanuts, tomato, celery, rye, pork, yeast (in yogurt) and probably something else, but I can’t remember right now! I was suffering from severe stomach cramps, pain, bloating, weight gain, fatigue, nausea. It all started suddenly last December and after finally finding a naturopath who could help, I’m feeling better. I am currently taking probiotics, adrenal caps, magnesium, buffered vitamin c, choline, digest (a digestive enzyme) and allergy drops. The only things that I eat that are non-paleo are quinoa flakes, stevia, and brown rice protein powder.
Exercise wise, I walk a lot and do some toning exercises a few times a week. The last time that I tried to run and do heavy-cardio work I actually gained weight and was craving carbs all of the time. I gain weight really easily!
I sleep normally. I don’t have a problem with sleeping, but as a college student (aged 18) I could probably go to bed a little earlier!
Basic day of food… I know it includes grains. That’s why I am thinking of shifting!
Breakfast: Banana, protein powder, quinoa, pure stevia (digestive enzyme, vitamin c, adrenals, magnesium, choline, flaxseed)
Lunch: tuna, lettuce, cucumbers, grapes, green beans, supplements
Apple, quinoa, pure stevia for a snack
Dinner: grilled chicken, steamed zucchini, lettuce, grapes, cucumbers, supplements
Snack: quinoa and pure stevia.” Is that a thing? Quinoa and stevia?

DIANE SANFILIPPO: It tastes like nothing.

LIZ WOLFE: Hunh. Fruit, digestive enzymes, vitamin C, probiotics. Okay.

DIANE SANFILIPPO: It's like eating plain oatmeal, but worse.

LIZ WOLFE: [laughs] You're like quinoa? The worst thing ever.

DIANE SANFILIPPO: I used to make it all the time for the meal delivery business, so I know all about the fact that quinoa needs a lot to make it taste good.

LIZ WOLFE: Ay yi yi. Well, people love quinoa because it's a good source of B vitamins. It's technically an ancestral grain. It goes, you know, it dates back quite a long time, but really I have never developed a taste for it. Not even because it's not Paleo.

DIANE SANFILIPPO: I used to really like it. I made a really good quinoa salad back in the day, but yeah.

LIZ WOLFE: Oy yoi yoi. Okay, so I think if Madison is ready to do exactly what needs to be done to correct a few things, namely digestive status, digestive capacity, and probably bacterial disruption, then this is, you know, 100% something that can be tackled within the parameters of a healthy Paleo-ish diet. I mean, I understand the Atkins suggestion. I mean, I get where it comes from. But in my opinion, it's really just not good enough. So here’s what my inclination would be if Madison were my client. Rein in the diet to a few basic, but extremely nourishing options for several weeks. This is not prescriptive. I’m just saying, if she was my client. All extremely well cooked, gently cooked as in Crockpot, slow cooker, a ton of homemade broth, possibly some extra gelatin. Working up to a higher content of healthy fats with the help of increasing gall bladder support supplementation and enzymes. I have a few brands I recommend in particular. We can link to those in the show notes. Add some healing supplements, not just supportive supplements, which seems to be what Madison is on. But some healing supplements that will actually work to restore the gut lining, mediate this out of control immune response, and unfortunately, most commercial probiotics, I don't know what probiotics she's on, but even most practitioner line probiotics honestly are just not that helpful. They're half dead and ineffective, and they…I've just gotten away from recommending them these days because the results I've seen have been so much better with these other ones I've been using lately. The ones that are recommended on the GAPS diet protocol that you can get through that website. You can get them on Amazon as well. We’ll put some links to that in the show notes.
So with the candida issues, and all the healing that's needed here, this really may be the time to seek a good practitioner. That's a given really with candida anyway. Obviously she has a naturopath, but I don't know. It might be time to just kind of get some extra opinions on this or help implementing this type of eating plan. A Paleo diet can be a total revelation for people whose issues are caused by food and food only. But when the issue is caused or at least partially caused by antibiotic use, prolonged antibiotic use, and the consequences of just total digestive disruption and destruction, even the best foods won't interact properly with the digestive terrain. That's why…that's why I don't think, you know, it starts with food with everyone. I just don't think it does. I think it starts with the terrain, and that's about digestive healing, so good food can actually be used properly. And this takes time, and it takes patience, but, you know, she didn't get here overnight, so you can't expect to resolve everything overnight. But again, you know, focus on that reward, like I said with the Tourette's question.
And just if I could offer any, you know, really basic practical advice throughout this process, no matter what you're eating, chew extremely, incredibly well. You've got to give your body stuff that it can deal with. That's pretty much my take on this one. Do you have anything to add?

DIANE SANFILIPPO: I do not. I think you covered it.

LIZ WOLFE: Cool. All right. So I guess that's it for this week. We're rounding out our time together today, Diane. If you're enjoying the show, everybody, please stop by iTunes and leave us a review. If you're not enjoying the show, forget that I said that. [laughs] Oh, I entertain myself. We will be back next week with more questions as usual. Until then, you can find Diane at www.blog.balancedbites.com, and you can find me at www.cavegirleats.com. Thanks for listening, and we'll be back next week.

Cheers!
Diane & Liz