Wednesday, December 3, 2014

Allergies, FODMAPs and Food Confusion – Part 1

Sometimes my whole karma seems to be about having conditions that are obscure, invisible, not recognised by mainstream medicine and difficult if not impossible to treat. I’ve never felt I fitted into the patient paradigm for any of my ills, and when I’ve tried to squeeze myself in, it hasn’t always worked – which isn’t to say I haven’t received some valuable advice over the years.

(It strikes me that one day I’ll die, and presumably of something recognisable by medical science! Now I have the image of a confused doctor trying to work out how I kicked the bucket.)

I have written in this blog before about my low blood sugar and food intolerance problem, and how it doesn’t fit into any of the definitions or recognised treatments. Actually these days that’s not quite true but treatment remains complicated. Let me walk you through it ...

I have functional hypoglycaemia, a condition that most doctors know little about despite the fact that it’s a precursor to diabetes. I’m so sensitive to carbohydrates that even brown rice makes me tired. Low blood sugar is often sheeted home to the overgrowth of a bacteria that lives in the gut, Candida albicans, leading to a syndrome known as ‘leaky gut’.

Mainstream medicine has never recognised Candida overgrowth or leaky gut as legitimate medical conditions. Another possible reason for hypoglycaemia is adrenal exhaustion, but mainstream medicine doesn’t recognise this either.

However, there are people who do – and they are mainly, in Melbourne at least, naturopaths. And one of the things they sell for adrenal exhaustion is bioidentical hormones. Some pharmacists sell them also. The one actual doctor I could find who flogs them in Melbourne had some truly appalling comments written about her standards of service on a doctor review website.

Apparently it is a loophole in the law that allows the unregulated sale of these hormones, which can actually raise levels of the hormone in the blood to dangerous heights – this article was enough to put me off (it's eight years old but the situation appears to be unchanged). So I crossed that possible treatment off my list.

It’s a bit rich for mainstream medicine to complain about underqualified practitioners flogging unregulated substances when it has shown itself thoroughly uninterested in conditions such as LBS and glandular problems that don’t appear on standard blood tests.

A swag of fairly recent diets – all very distinctive and contradicting each other – do provide some help.

The Failsafe diet is designed for those with sensitivities to common chemicals found in foods, especially salicylates and amines. It’s been particularly useful for conditions such as ADD and poor behaviour and school performance in children. It recognises that additional intolerances, such as sensitivity to gluten, fructose and lactose, may also exist. 

Unfortunately this diet refuses to believe that Candida and related sugar sensitivity exist – so if a kid reacts to soft drink, it’s always just the dodgy food colouring and never the sugar. I just don’t believe that’s true for every single kid (and certainly not for me). I’ve written about this elsewhere.

Then there’s the notorious paleo diet. Truth to tell I hadn’t been thinking about that much lately until I watched a program that talked about how harmful high-carb diets were for those with diabetes – even if they were supposedly ‘good carbs’. Protein is good for low blood sugar also, and I do need to eat more – just not from cows or sheep.

Finally there is the FODMAPs diet. This is a mainstream diet that has scientific legitimacy, designed for those with irritable bowel syndrome. The premise is that some foods contain a collection of molecules (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) – no wonder they abbreviated it to FODMAPs – that some people can’t digest. They ferment in the bowel after being guzzled by the resident bacteria.

it basically boils down to fructose and fructans, galactans, lactose, and sugar alcohols like sorbitol. These carbs are found in a large number of fruits, vegetables, legumes, grains and other foods. The actual diet is highly tailored to each individual and should be devised in consultation with a dietician. It starts with a strict elimination diet followed by slowly introducing food types into the diet to test them out.

Interestingly, this may solve a mystery that has hovered around allergy medicine for years – why some folk claim to be intolerant of gluten even though they don’t have coeliac disease. Wheat and rye products contain fructans, one of the FODMAPs carbohydrates.

At first blush FODMAPs looks similar to the anti-Candida diet. In fact it’s anything but. You can apparently eat sucrose – white sugar – on FODMAPs, an absolute no-no for low blood sugar and Candida. Traditional sour dough is okay on FODMAPs too as long as the grain is allowed, while any sort of fermentation is out in the Candida diet. And hard cheeses are better than soft cheeses on FODMAPs because the former contain less lactose – the only allowed cheese in the Candida diet is cottage.

FODMAPs also contradicts the Failsafe diet with its list of allowed vegetables – there is some overlap but also many differences between it and the list of low-salicylate vegetables.

Confusing huh?

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