To read my update after 2 months on the AIP, click here. Final update (healed!) is here.
I have a confession: my bloodwork from Cyrex Labs Array 2 came back last week and I tested positive for a leaky, infected gut. If you've read my story, you know that I have dealt with digestive problems for a long time. Going paleo allowed me to stop taking all my prescription and over-the-counter medications to manage chronic, severe digestive problems (IBS-like, but never diagnosed as such). Starting daily Qigong practice nearly 2 years ago allowed me to enjoy tremendous improvements in my digestive health, but I still never felt like I was back to "normal" (if I can even remember a time when my digestion was that way!)
How Did I Get Here?
For the first 2 years of my journey, I felt like I was making continuous progress with improving my gut health. However, after my mother suddenly and unexpectedly passed away, my digestive health noticeably started to decline. Stress alone can cause a leaky gut, and I experienced some pretty profound stress related to my mom's death. Coupled with additional extreme stress (that I'd rather not get into the details of) related to my day job and family, and I was a real wreck for the first 7 months after she passed. During that time I was also drinking alcohol more often in the evenings and weekends, letting my 80/20 slip down to 60/40, not sleeping well, and not getting nearly enough physical activity -- all of which are NOT good for gut health.
I also learned about a year ago that I'm no longer gluten intolerant, and have since allowed myself to indulge about once every 1-2 months in something wheaty and tasty. Almost always, that's been Weston A. Price Foundation approved pizza, made from a Sicilian mother culture that's 300 years old and fed with unbleached, unbromated flour and combined with olive oil, salt, and water to make the most amazing sourdough pizza EVER. (That's Blocks Pizza Deli, if you are ever in Miami Beach and can eat wheat you NEED to go there!)
While I have no overt or noticeable side effects from consuming gluten now, I realize that my purposeful consumption of it could have been contributing to developing a leaky gut. This study by Alessio Fasano used small intestine biopsies and cell cultures and found that gluten (gliadin) increases intestinal permeability even in non-Celiac individuals.
A Long History of Antibiotic Use
Antibiotics are another major contributor to developing leaky gut. While I have not taken a round of antibiotics in more than 3.5 years, ever since early childhood I would take a minimum of 4 per year -- I would get sick each season like clockwork (sometimes more frequently) and I was ALWAYS prescribed 1, if not 2, rounds of antibiotics because I used to get so sick and I had a very difficult time getting well (note: I haven't been truly sick with a respiratory infection in 3 years. I've had sniffles and a scratchy throat, but I haven't been sick the way I used to get).
I was even put on chronic antibiotics by a dermatologist to manage hidradenitis suppurativa (now in remission, thanks to paleo). I'd take them for about 2-4 weeks, take a week or two off, then start them back up again.
I didn't know any better; I just wanted relief from the boils. And this doctor never recommended probiotics. I totally decimated my gut flora in the year leading up to my switch to paleo. I've made my own ferments and taken probiotics off and on over the years, but I know I haven't done nearly enough to repair the damage to my microbiome.
I can't help but be somewhat disappointed with this diagnosis, but I am excited to embark on what I hope will be the final leg of my digestive healing journey. Let's talk about the blood test that I had done and what my doctor has prescribed to address my leaky, infected gut. Please, do NOT misconstrue this as medical advice; I am just sharing my own story. Get tested if you suspect that you have leaky gut and work with a doctor to heal it.
What is Array 2 by Cyrex Labs?
Cyrex Labs offers a number of tests (called arrays) for things like leaky gut, food sensitivities, gluten sensitivity, and autoimmunity.The full name of the test I had done, Array 2, is "Intestinal Antigenic Permeability Screen" and it tests for antibodies against actomyosin, occludin/zonulin, and lipopolysaccharides (LPS). Actomyosin is a a complex of the two proteins actin and myosin which works in conjuction with occludin and zonulin to properly regulate intestinal permeability and ensure that tight junctions actually remain tight. If you want to learn more about these molecules and intestinal permeability, I recommend this excellent review article: Multiple facets of intestinal permeability and epithelial handling of dietary antigens. For a nice illustration of tight junctions, check out Figure 1. I also highly recommend this article to learn more about leaky gut, probiotics, and diet: Regulation of Tight Junction Permeability by Intestinal Bacteria and Dietary Components.
Lipopolysaccharides (LPS) are potent endotoxins found on the cell membranes of gram-negative bacteria. Having blood antibodies against LPS indicates a gut leaky enough to allow large (macro) molecules into the body where they certainly don't belong.
My results: positive for leaky, infected gut
How Am I Going to Heal My Leaky Gut?
I am seeing a Doctor of Oriental Medicine who utilizes the latest in functional medicine treatments in addition to the ancestral wisdom of Chinese Medicine to treat her patients. She has prescribed an 8 week protocol to address the infection in my gut with a product called GI Synergy. It is full of anti-parasitic, anti-bacterial, and anti-fungal herbs (like wormwood and black walnut hull) to clear out whatever is in there that isn't supposed to be there. In conjunction with that, I'll be taking RepairVite, which provides a big dose of L-glutamine plus lots of great herbs, like slippery elm bark, to soothe and heal my intestines. I'm also going to be taking large doses of probiotics (80+ billion per day with these and these) and increasing my fermented food intake (I've got dilly carrots going on my 3L Pickl-It right now!) The diet my doctor prescribed is strict paleo plus homemade bone broth every day (I have to say it is awesome to have a doctor who prescribes the paleo diet to patients on a regular basis!)
Regarding diet, while I was researching the supplements I will be taking I came across the RepairVite Diet. Basically, it is autoimmune paleo (AIP) meets the 21-Day Sugar Detox. I've also read as much of Michael Maes' research on leaky gut as I can, and his "leaky gut diet" is dairy-free, gluten-free, and low-carb but does not specifically avoid the additional things that the AIP does. Since my University doesn't have a subscription to the journal in which he published his initial paper detailing his "leaky gut diet" I don't know exactly what he means by "low carb". Is that 50g a day? 100g? I'm going to listen to my body and just try not to be excessive.
Based on my research and the investment in time and money that I am going to put into healing, I've decided to follow the RepairVite diet -- which means I am going to be low-carb autoimmune paleo for 2 months. The foods that are avoided on AIP have been shown in the scientific literature to potentially contribute to increased intestinal permeability in some people. It's simply impossible for me to know whether or not they will hinder my healing, so I'd rather err on the side of caution and do everything I can to heal in these 2 months than risk unnecessarily prolonging the process.
Autoimmune Paleo Recipes
I've already been working on some new autoimmune paleo recipes, and many recipes on my blog are already AIP compliant. I did come up with an AIP version of my plantain flour pancake recipe and plan on making up an AIP version of my very popular slow cooker Cuban ropa vieja. I do have several recipes lined up to post in the next two months that are NOT AIP compliant -- oh well. I'm adding a new recipe category for AIP (in addition to the existing Whole30 and 21-Day Sugar Detox categories) and will be focusing on sharing AIP recipes via my social media. I'm also going to finally fill up my AIP Pinterest board.
I will check in with healing update posts along the way -- probably once a month.
Are you on the autoimmune protocol? Have you tested positive for a leaky gut? Have you healed a leaky gut? I'd love to hear your stories!
UPDATE #1: 2 months on the AIP
UPDATE #2: Healed!
DISCLAIMER: I am not a medical professional, I am a scientist, and I am sharing what I am doing to address my own medical condition. This post is intended as informational only and should not be construed as medical advice. If you suspect that you have a leaky gut, please see a doctor and get tested! I recommend finding a doctor who uses the Cyrex Labs tests, and you will most likely be able to find one if they are a Doctor of Oriental Medicine (aka acupuncturist/Chinese Medicine doctor), Naturopathic Doctor (ND), or a functional medicine MD (and sometimes a DO, but not always).
