Written by Christopher Kelly
July 24, 2015
Christopher: Hello and welcome to the Nourish Balance Thrive Podcast. My name is Christopher Kelly. Today I'm joined by Amir. Hi, Amir.
Amir: Hi, Chris.
Christopher: Amir is someone I've been working with coming up on a year now. We got some test results to talk about which I'm quite excited about. The reason I'm quite excited is the organic acids test that he's just done shows massive improvement over the result I have from last July. The problem with that is I don't actually know how Amir really feels. I think I read this in a recent book by Ben Goldacre which was if the test result shows that the problem has gone away, good luck explaining that to the patient that is still complaining about whatever problem. Really, it's about how you feel and not just about the test result.
Why don't we start, if we would just turn the clock back. I don't know if you can cast your mind back to, say, last summer, last July. Can you remember what your main complaints were at that time?
Amir: Yeah. It's been a process for the past two, three years, actually. So even before I started working with you I felt like I was physically pretty broken. I couldn't eat a piece of food without feeling sluggish afterwards right away, to the point where it would really interfere heavily with my job and the work that I was doing. I have to perform at work. It's quite challenging not to be able to think clearly throughout the day. It was really to the point where I was sort of really dreading foods.
As part of the problems, so to say, I had chronic sinusitis and I had reoccurring bronchitis coming over and over again. The year before I started my first probiotics treatment I was on antibiotics about six times in one year. That was a conventional medicine trying to understand what was really going on with me. In reality, as we found out later, I was just heavily SIBO. That probably led to lots of bacteria, producing histamine on that side, and just really messing with everything, basically.
So when I started working with you last year, I do still remember how it was, I felt like my body -- there was some serious inflammation going on. This is really how it felt. Again, any sort of food that I would take in, I would bloat a lot. I would feel sluggish. I would feel tired and fatigue. My nose would start getting stuffy right away. Sometimes my lungs would close up. I would feel tight as far as breath goes. Just tons of these elements where you just feel like my body was nowhere near performing the way it should be.
Even to the point where I would say -- I mean, depression sounds like a hard word but it's just lacking the energy to produce optimism in that sort of way.
Christopher: Right. Yes. I understand completely. The depression, I agree, is such a harsh sounding word, isn't it?
Amir: Yeah, but it's true.
Christopher: Yeah. Nobody wants to describe himself as being depressed. With hindsight when you look back, it is obviously many shades of gray. It's not yes or no answer. I think I was the same way that I was just mildly depressed but maybe not even aware of it.
Amir: Yeah. You feel like somewhat stuck in this hole where you're like "Wow. I have to dig myself out of it." Up until what I did with you, I didn't have a lot of actual hard fact data around what was really wrong, so remedy was far.
I remember we started out the treatments. The improvements that I felt from the antimicrobial treatment and from starting the probiotics, from that, especially on top of everything else we did, I feel that was quite severe. The first step up, I think we talked about it, I've already felt a lot, lot better. So within a few weeks I felt how I've just gotten more stability. So we carried on.
I remember just being on the road a lot made it difficult for me but I just hung on to the treatment. So I didn't really interrupt them. I kept on doing the antimicrobial treatment and the probiotics treatment as well as the adrenal rebuilding program. I kept doing it for probably six to nine months. I think the probiotics I stopped taking probably two months ago or something like that.
I had a really good stretch over the last two months where I was really strictly Paleo, AIP. Actually the autoimmune protocol, I found out later, made a huge difference. So even looking at it now, it makes a big, big difference in my diet.
Christopher: Right. I was going to ask you about that. You already knew about the Paleo diet. You have known the Robb Wolf Podcast. I think it was the Robb Wolf Podcast. So you already knew about the Paleo diet. It wasn't like I introduced you to that. You've already gotten some good results with the Paleo diet. Did you notice a difference then when you switched over to AIP that helped?
Amir: Yeah. Absolutely. It helped a lot especially with regards to probably spices is where I would see a big difference, but also nightshades in general, eating eggplant and aubergine and then these elements. I still can't tell the difference. Not as much as it used to be but I still avoid them, and I fair a lot better just skipping them. Eggs is probably also one of the things that I tend to avoid more than to bring it back in because it's sort of hit and miss. It's a definitely a big step up.
The overall theme is always sort of inflammation and irritation. It's like a glass of water, the less you pour into it, the less likely it's going to overflow. I think that's the overarching theme. If it all adds up and goes together, maybe eggs by themselves is not the issue. If I'm loose on the nightshades and the spices too, it keeps adding up again.
Christopher: Right. Exactly. I noticed the big variable in my equation is exercise. So if I go to a bike race or a hard training ride, then, guess what, I can't eat a ton of nightshades and eggs and stuff like that. You have to be more careful. It makes total sense when you think about it.
Have you been able to reintroduce any foods? Are you eating eggs and nightshades and stuff now? Do you just sort of like the sense where you are at that time and then sort of eat accordingly?
Amir: I have an easier time not doing them but I feel that when I do, the impact isn't as bad or not really there. I don't make a rule of letting them back into my regular progress. The way it is with Paleo, you know how it is, if you aim for 100% you land at 80%. If you aim at 80% you land at 20%. So I try to stay really AIP compliant. When I go back eating things that might have been problematic in the past, I do feel that the impact is a lot less or not even present but I don't push it. That was big.
The last two months I've been very strict on my diet, I mean, very, very clean living, no booze, no nothing. I think that also makes a big difference. For the past two months, I would say I've been doing exceptionally well. This is also, I guess, also part of what's showing. So the sluggishness and the fatigue is, I wouldn't say completely gone but almost gone. It really depends, as you say, on a lot of factors coming together like sports and stress at work, maybe a day of bad food. I have a day where I feel it.
On good days, I feel outstanding. I see it in my physical performance and when I look in the mirror too. A lot of the drawbacks that I had before are pretty much gone. I feel really energetic. I picked up lots of new hobbies, actually, which is an indicator of feeling like you have more energy to tend to the things that you really want to do. I think that was the goal overall, just making sure that I can do the things again that I really like.
Christopher: That's awesome. So I should say something about the test that you did. You did the Adrenal Stress Profile saliva test which shows what it always show which is low cortisol. I think that's just the type of person that comes to me. It's nothing about the test itself. It's just really, really common to see low cortisol, and then with it, low DHA.
In this instance yours was high. Not high. It's normal, 7 points. Eight, 9, 10 is kind of ideal. So it's a titchy bit low but it's not what I normally see. This might be something specific like some genetic trait or it might be something else I don't know about. Your testosterone was also normal as well which is what I normally see. So it seems like you're just that guy that under the face of stress, just like sex hormones just hold up really well. Maybe [0:10:04] [Indiscernible] into you.
You can see your cortisol, it's super duper low. When you look at the chart, the afternoon cortisol of 0.5 points when it should be, say, 7 points at that time. So that's a huge difference, 0.5 to 7. That's kind of tightness in the afternoon really personified right there. I see the cortisol thing now is more of a symptom than an underlying cause, and so it makes sense to continue the investigation.
You did the stool test. That didn't really show much, actually. The BioHealth 401H GI Pathogen Screen is really good at detecting parasites. In this instance there was nothing for nothing, so nothing to see there. The organics, I think, was very telling.
So this is the Genova Diagnostics Organix Comprehensive Profile is a urine test, super simple to do. You just collect the urine sample at home, send it into the lab, the results come back to me electronically. The way it works is it measures these organic acids in the urine sample. It tells me something about the way that your metabolism is working.
There's a page 2 on this test. They just summarize the number of things which they think are a problem or the lab thinks are a problem. If you just count those, it's seven things. I think there are 46 marks on this test. It's not really horrible. It's not the worst I've ever seen by a long stretch. It's not great. You've just done the test again, and now I see 2. So that's kind of like the simplest where I can think to quantify this. So that makes me very happy.
Christopher: I'm wondering. Are you still taking 5-HTP?
Amir: I've not taken it in a long time.
Christopher: Okay. Interesting. Because there's one marker, it's called 5-hydroxyindoleacetic. It's a breakdown product of serotonin. One of the supplements that I recommend for people that don't sleep [Phonetic] very well, especially when I see an indication on the organic acids test, is 5-HTP. When you take it as a supplement and then do the test, it's really common to see people with high turnover as the result of taking that supplement. So I wondered if that was that.
Amir: It could actually be that for that time. It was shortly after I came back, actually. So it could have been that I had taken it for a short sprint of time again. It might have been that, yeah.
Christopher: The original test that you did, it showed B vitamin deficiency, and in particular it showed folate deficiency which I think is really quite serious because folate is such an important nutrient for so many functions in the body. What have you been taking in terms of folate now? Did you just stop your intake of leafy vegetables or did you take a supplement? How did you fix this?
Amir: So I did the take the vitamin complex that you gave me, the one for day and night.
Christopher: Right. The EXOS.
Amir: Yeah. Those, I feel, covered me pretty well on that side. I did start eating lots of endives. I'm not sure how much that is related to this. Belgian endives for me turned out to be this super food. I would eat them in the morning and for lunch and in the evening, just lots of them. They would fix tons of stuff. It made my symptoms gone down. They're full of water so they rehydrate. I feel like, in my theory at least, because you're eating all this fiber too, it just makes your toilet business go a lot faster. It's just less time.
It's also out in the discussions a lot. A lot of the SIBO stuff, the bacterial overgrowth and so on, comes from us having too little fiber. It's just taking too long for your food to pass through your gut. So there's tons of time for the bad bacteria to basically feast on whatever you give them. I feel like that has helped a lot to stabilize my situation, just getting basically the toilet business into [0:14:33] [Indiscernible]. That's been helping a lot.
From what I read, it looks like when we look at the NewOrganics, and this is more astonishing for me, is that the bacterial overgrowth seems to be gone. That was my main concern. That seems to be gone. The bad bacteria, as far as I under, takes lots of B vitamins to basically keep up with it and to deal with it. That is, in return, also messing with the energy, and then your thought clarity and all these things.
This is what I probably feel the most is that basically the pathways that I have have cleared up. I have the energy back and I have more clarity and thoughts back and all these things. This is probably what you see in the organic stuff.
Christopher: Yeah. Absolutely. I just did a quick Google search of, I want to say endives. My pronunciation of many things is very broken. I've learned so many new words since moving to America 10 years ago. Now I don't know where I'm coming or going. Endives, they are a great source of folate, most of the leafy vegetables are. Just like one little head of endive is 728 µg of folate. That's 192% of the RDA. That's an awesome fix right there if you know that you don't have enough folate.
Folate is required to make red blood cells and it's required for many of the detox pathways, assisting your liver, and then also proper expression of the genomes. You can't copy and create cells properly without enough folate which is why it's such an important nutrient for pregnant women. It's important for everyone. To fix it with real food is freaking awesome although it does sound like you might have done a bit of cheating with the EXOS. Yeah, you're absolutely right.
So the SIBO marker went away on the subsequent test. Maybe that's what it is. Most of the nutrients are absorbed in that part of the small intestine. Maybe that's what's going on here. You've killed off the small intestine bacterial overgrowth, this overgrowth of bacteria that's living in the small intestine. Now you're just doing a better job of absorbing the nutrients that are coming from what is an extremely nutrient-dense diet. So that's absolutely fantastic.
Amir: Yeah. I really feel it too in the sense of the chronic bloating, especially after foods, lots of that is gone. I'd say largely due to, I feel like the SIBO being gone. I can really feel it in a lot of different ways. The endives on top of really any other super foods that people talk about like bone broth and anything that would be out there, that is really the thing that I wouldn't want to miss ever again. It's very, very helpful.
Christopher: Yeah. I start having a nervous panic attack when I think we're running out of bone broth because it's quite difficult to kind of juice them up quickly, kind of just whip it out the fridge.
I wonder what's going on with your cyanuric though. So cyanuric acid is metabolite of inflammation, basically. There's this alternative path for the amino acid tryptophan. So you eat some protein, include this amino acid tryptophan. Tryptophan is used to make serotonin. There's an alternate pathway that leads to inflammatory cytokine and cyanuric. That's what we're measuring on the organic acids test.
Yours is mildly elevated on the new test. It wasn't before. I think it's stress, actually. It's one of the main driving forces and inflammation that causes this buildup of this cyanuric acid. So it would be really interesting to know what exactly went on there. You always have to do a bit of detective work with this test. It's never enough just to look at the result and say, "Okay. This is what's going on here."
Amir: There are still lots to do. It's good to get one thing. I mean my sleep still isn't really, really good. It might be cause, it might be symptom. That is definitely something that still needs fixing. We're not done yet. We've made a big step but we're definitely not done.
Christopher: There are two other markers, markers number 28 and 29, which are p-Hydroxyphenyl acetate and 8-hydroxy-2-deoxyguanosine. These are markers of oxidative stress. So when the membrane that surrounds a cell is broken down and the cell splits, then you start to see this Participant-Hydroxyphenyl acetate buildup in the urine. 8-hydroxy-2-deoxyguanosine, that's a breakdown product of the guanosine of DNA. So this is like your DNA. They're like the genetic material being destroyed by inflammation and oxidative stress.
Both of those have come down quite significantly after the later test. That marker of inflammation has definitely gone down which, I think, is awesome. Really good. So what's left then for you? You mentioned you're not quite out the woods yet. So what are you still working on?
Amir: I think just repopulating is the next big thing that we're doing. I mean we've just started adding two more probiotics, and we're about start the prebiotics treatment, actually. I do feel like I also respond well to the inulin and the endives, actually. So just the prebiotic part, building up the positive gut bacteria, I think that's the next big step, just rebuilding and populating and outgrowing anything that's still left that's bad in there.
Christopher: Right. So that's my fear with these antimicrobial treatments. So you go in, you take some botanical herbs, get rid of the small intestine bacterial overgrowth. Of course, there is some collateral damage which means that some of the good microbes are also killed in the process. You feel much better initially. The thing that concerns me is you're then kind of a ticking time bomb, that you're just going to pick up something else later on because there's nothing left to kind of push out the pathogens.
So I think repopulating with the probiotics, and then the prebiotic powders, I think, can be useful for encouraging the growth of the good bacteria. I know, especially for people that have a history of bloating and SIBO, introducing this power can be a bit of a minefields and quite difficult to do. You haven't tried that yet. You've just is been on the probiotics, not any prebiotics.
Amir: Yeah. That's right.
Christopher: Okay. What have you got? You got inulin, [0:21:39] [Indiscernible] and Glucomannan, right?
Christopher: Okay. Yeah. So go super slow with those, super duper slow. I've been finding out the hard way myself that you can go too fast with these things. It creeps up on you slowly. It's not like you take it quarter of a teaspoon and then two hours later you feel like hell. It's two or three days later that you start noticing it.
The tools I found to be really useful for seeing this creep up on you before you actually feel it is heart rate variability. I've got everything so constant that I know that if I see any change in my heart rate variability, then I'm pretty sure about what's caused it. Usually it's my training because that's the only thing that really varies from day to day. If I start messing around with inulin, for example, then I'll start to see an increase in my resting heart rate, and then also an activation of the sympathetic nervous system, and then also my fasting blood glucose comes up a little bit too.
I know sort of these things long before I feel bad. It's just stuff I'm measuring. Sure enough, I back off on the prebiotics and the problem according to the numbers goes away. That's really interesting. I've been using that as my guide. Whenever I see a problem, I back right off. Using that approach and going super duper slow, I've been able to introduce a couple of these powders now. I'm noticing my fasting blood glucose is low than ever which is something I've always had problem with.
It's good stuff. If you should remember one thing from this interview, it's go slow with those.
Amir: Yeah. I absolutely see that. What would really help are also the three kinds of probiotics that we're working with. I think those are going to be instrumental in just seeding the right things.
I've actually been to Paleo f(x). It's been super, super interesting seeing a lot of the different people talk about the way they see gut help, and just the repopulating of positive gut bacteria. For example, Dr. Grace, she talked about that a lot, and it resonated a lot with me. I think it makes a lot of things. She's got some decent protocols going on. She's all about measuring the variety of gut bacteria that you have in there before and after treatments.
So I think that's really what struck me, what she said with a couple of her patients or people that she works with. They brought a number of different strains that they have as far as gut bacteria goes up to 150. If you look at the regular probiotic, it's just a handful, maybe 29 or 30 in the Prescript Assist, for example. Still, you need the variety. So to rebuild that, I feel like you need time and really invest in doing it.
Christopher: Right. Yeah. Grace had been in my podcast. We've been talking a lot. The prebiotic powder program was inspired by her. I can't take full credit for those protocols as I cannot take full credit for many of the protocols. They weren't designed by me. They were designed by another doctor.
Before, there was only a single source. Now it's becoming less clear who designed which part of the protocol. Yeah, absolutely, I agree. I'm expecting all this to change as well. As the testing becomes easier and cheaper, more people are going to doing it, and we'll gather more data. I think the recommendations are going to change. So I'm a bit wary of the prebiotic powders for that reason.
I mean if you talk to Grace or go to her blog and read any of the post there, you'll see that I think we've been burnt once before by the raw potato starch which doesn't make a lot of sense when you think about it with hindsight. Why would you be eating the powerized form of a raw tuber? When have we ever eaten raw tubers? It doesn't make any sense. I'm worried that we're going to get stung again with these prebiotic powders.
The one thing I've taken more than anything else from Grace is to eat a wide variety of the vegetables. So go to the farmer's market and buy something you've never seen before, and then just Google it when you get home, and find out how you cook it. I assure you, it won't complicated.
Amir: I'm getting my CSA box every weekend.
Amir: So that's a very good incentive.
Christopher: Yeah. Exactly. That's a fantastic way of doing it. Yeah. This stuff turns up all the time. You're like "What the hell is that?"
Christopher: That's really good, I think, because we know that the more variety is better. That's a really good strategy.
Amir: You need the variety in there. In general, I've got to say, I've taken up my veg consumption also through that CSA box but also through the way I eat food. I just try to get as much greens in to me as possible. There's usually a big bowl of salad that I just chomp down. It just has to go down. It's one of the things that I don't compromise on anymore just because I know how it impacts, not just for the contents but hot it impacts the whole processing of the food within me.
On that note, actually, the other thing that's been really instrumental for me, I feel, is enzymes, digestive enzymes. So I've been doing incredibly well on those. Taking those is killing, basically, all the bloating that was left. I see that as a sign of, basically, stripping the bacteria of the remaining sugars that just take too long to digest. So that has been working really well.
Christopher: That's great. Sometimes you can see signs of this in the blood chemistry that you're not digesting protein very well which was the case before. I'm just looking at your blood chemistry now. It's not the case now. That's not what I normally see.
Amir: Yeah. I remember my recovery from sports was horrible. I mean I would take three, four days to just get rid bit of sore muscles. Just over the past two months I've added, I would say 100 pounds to my squat.
Amir: So I've been doing some serious working out. I can go every second day no problem, and still get better.
Christopher: That's great. That's huge, isn't it?
Amir: Yeah. Absolutely.
Christopher: I'm just looking at your blood chemistry now. Man, if I had your hematocrit -- your hematocrit is 48.1 points -- I would be like a Tour de France cyclist if I had that much hemoglobin.
Amir: That's right. I remember from the past. I was a soccer player. That's where that comes from probably.
Christopher: Yeah. I don't know where it comes from but it's got to be a genetic component surely. You're not dehydrated either. So normally I look at the BUN to creatinine ratio. It's elevated because the person is kind of dehydrated first thing in the morning. That's not the case here.
The only thing you've got to watch for is your iron status. This serum iron is a horrible marker for tracking iron status, iron as a nutrient, so it's worth doing. It's only $25 from Life Extension to do the full iron panel. Then you get ferritin and the percent saturation and the total iron binding capacity and all that good stuff so then you can diagnose a bit better.
You're not above the reference range. 149 mcg/dl is not outside of the standard reference range but it is above what the software considers to be optimal. Just watch this because iron overload, it causes oxidative stress. It makes you kind of rust from the inside out. You can definitely afford to give blood. It's a pretty low-risk intervention and a very worthwhile cause.
I can't do it because I'm a foreigner. In fact I can't do it for many reasons, I think. I've been a serious motorbike accident and had a lot of blood donated to me. I don't know if they'll have me for that reason either. You're probably not in that situation. So if the truck ever rolls up at Google, then I would recommend that.
Amir: We didn't dive into my blood, actually, it's true. I'm just looking at it. Triglycerides are way up and the cholesterol too. Is that something you're alarmed about or not really?
Christopher: Yeah. Your triglycerides are a bit higher than I would expect for someone eating quite a low carbohydrate diet. I mean this is cheap blood chemistry. So we've not measured LDL particle number or anything sophisticated like that. I think the triglycerides HDL ratio is interesting. The cholesterol to HDL ratio is also interesting. The vectors are the most important thing.
So I've seen how your numbers change from result to result before you get into a panic about just one result. This chemistry cost $26, and then you pay me another $75 and I'll run it through the software for you, and spend 30 minutes on the phone explaining what it all means. This is not something that you can do every quarter. It's not that expensive. Most runners spend that amount on their running shoes so you can't really argue that.
It looks like you might have been sick as well. So the low neutrophils and elevation of the lymphocytes, monocytes and eosinophils, it looks like you might have had a cold or something. I definitely would want to see how that tracks over time.
Amir: It's true. I did.
Christopher: Okay. Yeah. So sometimes I see those elevated in somebody that's got a chronic gut infection. It could just be that the person had a cold. You don't really know until you've been tracking it for a little while. Your liver enzymes are fantastic, so that's great. They always get elevated in people -- no, that's not true, that it always, but they frequently become elevated in people with nonalcoholic fatty liver disease and history of carbohydrate abuse and insulin resistance and watching it.
Amir: That's very interesting. In the past, before I started my first treatment, it might have been also related to just the toxins related with the SIBO. I've been tested several times with poor liver function.
Christopher: Yeah. I mean this is not the most sophisticated test. I'm just looking at the transaminase enzymes on this blood chemistry. It's not a sophisticated test but it still tells you something. I could get a lot of information from this for so little money.
Amir: Yeah. My liver value have always been up and down but really related to the way I eat and the way I feel overall. So this could really be in line with just me getting better. That's a good thing.
Christopher: Awesome. I'm excited for you. I'm mostly excited for myself as you can probably tell by the tone of my voice. Whenever I see NewOrganics's profiles with this much improvement I always get really excited. I mean it's down to you, really. I see the diet and the lifestyle changes as being the main driving factors behind these results. So it's all you. Congratulations!
Amir: Awesome. Thank you. Sleep is still a thing. I managed to grab Dr. Parsley at the Paleo f(x). He's outstanding. He's going to help me a bit dive deeper into what's going on.
Christopher: Wow. So we'll have to get you back on and talk about that stuff. The Paleo f(x) presentations are available on Vimeo now. I sat there watching last year thinking, "Wow. This is kind of a bit dated." I remember people talking about this a year ago. It took me a long time to realize I was watching last year's and they just did not update the link. They're like "You just go to Paleo f(x)." There's a link that's saying watch the videos. I'm like "Yeah, that's what I want to do," and I clicked on it and paid. So I was watching them and then realized it was last year's.
Amir: You felt very sophisticated because you're like "This is all old to me."
Christopher: Right. Yeah. This year's are up now. It's not all of them but some of the really good ones. I've really been enjoying that. It's only $17. I know that Dr. Kirk Parsley is in that list, and I haven't got to it yet. So I look forward to that.
Amir: Yeah. I'm also looking forward to getting my dad started. So I'm taking off to Germany today. I got my bag full of his supplements. We're getting him going. Everybody is super excited.
Christopher: That's really great. So you think it's worth it then, obviously, the testing. Kind of a lot of money and it's a lot hassle but you think it's worth it.
Amir: I keep telling it to everybody. This is life changing stuff. It's something really, really necessary, and something that's not offered by the regular school medicine. I haven't been to a doctor in three years because I don't need to. This is what I need to fix. This is it and nothing else.
Christopher: That kind of scares me though because I'm not a doctor. Sometimes when someone come to me and I'll book a free consultation I'm thinking, "The last thing I want to do for you is stop you from seeing someone that's qualified to help you."
Amir: That's true. Some people are super sick and needs nobody else. Gut health is something that they can take control of and do a lot of the work that needs to be done, get a lot of the data that you need to have. Everybody should have this data about themselves. There's no question about that. Everybody should have this piece of data about themselves just see what kind of general shape they're in.
There is a lot of, sort of say, easy fixes before you have to get serious about medicine. So a lot of chronic conditions and this is what I feel for myself. You can find a remedy in this. Once you've done this and you're still not better in a lot of cases, you can go see a specialist and doctors for other things, I feel.
Christopher: Exactly. Yeah. I would agree completely. Excellent. Thank you so much for taking the time to record this with me today. I really appreciate it.
Amir: Thanks for your time.
Christopher: Thank you.
Amir: Awesome, Chris.
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