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?

Next week: my options for better health, and why I don't take them up.

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Progress report: diet, dogs and trying to meditate

I’ve been meaning to write something about the changes I’ve noticed since going on an incredibly strict food intolerance diet, and thought I'd combine a progress report with a couple of other ‘developments’.

I’m on a strict version of the Failsafe diet, which rules out all food additives as well as two groups of chemicals that occur naturally in foods: salicylates and amines. My diet is also gluten-free, dairy-free, yeast-free, fruit-free, and sugar-free (the first four of these additional restrictions are necessary for some Failsafers, but not all).

I’d been on a diet that had these four restrictions as their basis for many years (though with plenty of ‘lapses’) but never tried to avoid salicylates and amines (in no way am I suggesting that others should follow this diet, especially the extreme version I’m on!).

Researchers have found that not only does the Failsafe diet improve the symptoms of ADHD but it also improves behaviour and mood including depression. Food intolerance has also been linked with a number of other mental disorders.

So, even though an outbreak of hives drove me to this extreme rather than my mental ups and downs, I was curious as to what effect the diet would have on my overall mental and cognitive state now that I’ve been on it a couple of months.

So what changes have I noticed? My memory is definitely better. I’m retaining more of what I read. My thinking is sharper. My mood is also better, except on overcast days. I still get sad a lot, but it passes. I generally feel more positive.

I’m less angry. I noticed this when catching up with a friend recently. She’s a lovely person but a bit chaotic, and sometimes I’d get annoyed when she complained about her life. Last time I met up with her I was amazed at how calm I felt.

My concentration isn’t all that much better, though, mainly because my mind is less tired and quite ‘busy’. In fact, if anything I feel more concerned about particular activities that feel vitally important (for example, writing comments on political opinion sites!).

This feeling is quite compulsive – it’s been there for years in anything related to work or effort; but I think I’m just noticing it more because my thinking’s clearer, and it’s strengthened the sense that I may have a form of OCD, albeit not focused on things like germs and counting. The obsessiveness is also centred on what’s wrong with my body and mind – yet I’ve been less focused on my bodily imperfections lately, though winter could be the cause of this rather than the Failsafe diet.

I still have social phobia. However, there has been a small decrease in my physical anxiety.

The Failsafe diet dismisses sugar as a contributor to children’s behavioural and mood problems. Instead, it links hypoglycemic symptoms with salicylate intolerance. Failsafe also dismisses the scientifically controversial phenomenon of leaky gut, which some believe can cause and worsen food intolerances and an overgrowth of Candida, a type of yeast.

I still have low blood sugar, although I have to admit it seems to be less severe. I don’t know whether or not I have leaky gut but I still feel more tired, vaguer and quite depressed on overcast days, and I still get PMT during which my hypoglycemia is significantly worse. And, sad to say, I still have rosacea – being on an amazingly restricted diet hasn’t stopped me having red, rashy cheeks.

All the changes I’ve experienced are subtle – I don’t feel transformed, just a bit stronger, and I wouldn’t have the confidence to make a major change like applying for an in-house job.

My family and other animals

Sorry about the hackneyed heading, but it was just too relevant not to use! I have ongoing ‘difficulties’ with my family of origin, and these have deepened in recent years because two of my sisters acquired dogs and I wasn’t happy with the treatment of these unfortunate canines. I’m still not, but I wanted to report some progress on that front (I’ve changed everyone’s names).

There are two dogs in this saga. Jordan is a lively, mischievous, ginger-coloured, mostly-cocker-spaniel owned by my older sister, Andrea, and her husband Richard. There’s been ongoing disagreement between me and Andrea and Richard over the treatment of Jordan, who I used to walk regularly.

Sarah is a quiet, chocolate-brown, rather resigned retriever–wolfhound(?) cross who nevertheless transforms into superdog when someone throws a ball in her direction. She’s owned by one of my younger sisters, Therese, and her husband, Tony.

A particular incident around Easter sparked the latest dog fight. Sarah was left alone in Therese’s backyard for the four-day break, with my father visiting and feeding (and playing with her briefly) twice a day. On one of those days she came to my parents’ backyard for most of the day (they live down the road from Therese) and I walked her, and along with my parents gave her some attention.

Sarah is a challenging dog. Loving and calm around children, she hates most other dogs, and anyone who walks her must carry a bottle of water to spray into her face if she becomes aggressive towards a passing dog.

I had never seen this side of her and, thinking it couldn’t really be that bad, didn’t bother with the water on the Easter walk I took her on. But then we passed two dogs and a cat, luckily safely behind the neighbour’s front fence. Sarah suddenly lunged towards them, barking furiously while I pulled desperately at the leash to maintain control – she’s very strong and whimpered angrily when I finally managed to restrain her.

Clearly Sarah suffers from a lack of socialisation – this had soon become apparent after my sister found her through a rehousing service (she was already at least five years old). She had also become quite overweight since I’d seen her last, and was constantly panting even when lying down. All this, combined with my sister leaving her in the backyard over Easter, gave me a sense of despair about her situation that left me wanting to distance myself from Therese.

Since the arrangements to stop walking Jordan ended just after Christmas my relationship with Andrea and Richard hadn’t really improved much (this is beginning to sound like Days of our Lives crossed with Animal Rescue).

Anyway, last weekend I finally caught up with the family, after not seeing some of them for almost two months, at Therese’s place for a Mothers Day gathering. And there were some tiny but significant miracles.

The first one was that after delivering the family to Therese’s place, Richard went back to his place and brought Jordan back with him. Smelling Sarah even before he got to the front door, Jordan skidded frantically through the house to the backyard. He spent the afternoon there with Sarah and occasionally some of the children, trying to steal Sarah’s ball (by some quirk of fate, Sarah actually doesn’t mind Jordan, although she got a bit aggro at one point when he grabbed the ball).

The second miracle was that Sarah herself was looking much better than when I’d seen her last – leaner and healthier. This was because my oldest niece, who’s 16, had been taking her along with her on her runs, and Sarah apparently is too distracted when she’s running to bother about other dogs.

Jordan hadn’t forgotten me. As soon as I went outside he dashed towards me and, as I stroked his head and scratched his chin, stayed by me with a look of relief on his face. Our reunion, after almost five months, was much less gruelling than I’d rather melodramatically anticipated, but I still felt a level of guilt at having abandoned him.

It was good to see him as his same old self, and he was happy and active. Also, I knew that since I’d stopped walking him, Andrea had been taking more responsibility for him. I know he doesn’t get walked enough, and she doesn’t like the whole social scene at the park and so avoids taking him there, as she’s told me. But he seems better integrated into the family. He also spends a fair bit of time inside, I’m told.

Sure, I wasn’t happy as it began to get dark and the two canine pals forlornly stood sentry at the back door, soulful eyes watching the fun inside, cold and lonely and wanting to be part of their human packs, with me going outside to pat and soothe every now and then. But I’m happy about the progress that’s been made, and I just hope it can continue.

Good morning, meditation

I also wanted to report on my recent experience of trying to meditate. When I look back over my adult life, it could be viewed as one long failed attempt to meditate. It seems that when I do start meditating regularly, every time something out of the ordinary happens – I get a cold, or a really difficult job comes up, or a major event looms – I give up meditating. I’m talking about 5 or 10 minutes a day here, not anything heroic like half an hour.

But in all my attempts I’ve come to realise some important things.

There is absolutely no point in me waiting to meditate till 6 pm, which I’ve tried to do in the last year or so. It’s not that I can’t find the time then; my brain just isn’t in the right state for it.

The only thing that works for me is to meditate just after I get up in the morning and before I leave the bedroom. As I’m a morning person this is the best time for my brain; I’m definitely at my freshest, even if I haven’t slept that well. But the other reason is that, because I know if I don’t meditate immediately I won’t be doing it later in the day, it’s much harder to put it off and make excuses. I also know that it’s good for me to start the day that way before I compulsively go to my office and turn my computer on.

Another thing I’ve realised is I don’t have to wait for meditation benefits. I get them right away. Yes they’re subtle, but meditation is like daily medicine.

And the best thing? All the times I’ve stopped and started mean that when I start to meditate again, my brain already has some skill that it’s retained from the last time. So all the stopping and starting hasn’t been a total waste of time.

So far, I’ve managed to meditate first thing in my bedroom, for 10 minutes at a time, for five days in a row. I know that sooner or later there’ll be some crisis that may threaten this, but now at least I can’t fool myself and say ‘I’ll do it later in the day’. It’s first thing or not at all.

(BTW, the picture above isn’t of Sarah, but it was too appropriate to resist.)

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Heroes and villains: food intolerance, hypoglycemia, candida and the Failsafe diet – Part 3 of 3

Please note: the following shouldn’t be taken as medical advice. It’s simply what I’ve gleaned, and in other cases am guessing because of a lack of accessible information concerning health issues I’m currently facing. If anyone has any relevant information that they think would be useful, please send it to me.

In my last entry I described the Failsafe diet, which was developed for children with physical and behavioural problems caused by intolerances to human-made and natural food chemicals. While I’m a great fan of the diet and Sue Dengate’s website, with my own long history of hypoglycemia I was disturbed that the possible role of sugar in contributing to behavioural problems was being dismissed out of hand. I was also concerned that a controversial medical diagnosis, the so-called ‘leaky gut’ and its associations with yeast overgrowth, was also being dismissed.

With cane sugar (sucrose) no longer a culprit for most Failsafers, what seems like an unhealthy degree of tolerance for sugary foods has developed in the food companies that have sprung up to respond to the needs of children with allergies and food intolerances, as well as more specifically Failsafers and their families. So, as well as using my own experience as an argument for the existence of hypoglycemia, I decided to look at what else was ‘wrong’ with sugar, even if it wasn’t the main culprit in conditions like ADD.

Is sugar good for anybody, especially kids?

Sucrose does occur naturally in fruits along with fructose, but table sugar isn’t really a natural food. Although it comes from sugar cane or sugar beet, it’s extremely concentrated and processed. Our bodies were built to ingest sugars in the form of complex carbohydrates, such as those occurring in fruit and vegetables.

In the small amount of research I did on sugar, I discovered a few interesting things. The main one was that processed sugars rather than fat are now said to be the cause of obesity; the latter has increased in the US during a period when carbohydrate consumption has been going up and the consumption of fat has been going down. Thus, low-fat diets are not necessarily the answer. Sugar has also been shown to be a physically addictive substance that has chemical effects on the brain.

In addition, processed sugar, and, importantly, other forms of concentrated sweetness, have been linked with coronary heart disease; dietary sugar and salt have been linked with the development of cataracts; and one study has found that a diet with a high amount of sugars and carbohydrate ‘may increase the risk of pancreatic cancer in women who already have an underlying degree of insulin resistance’.

But, rather than be a total killjoy and recommend that everyone give up sugar, it does seem, from my very limited knowledge, that there’s some truth to what Dengate says about it: both children and adults are better eating sugar as a dessert than in the form of fizzy soft drinks.

I’d go further and say that homemade desserts and sweet foods are the best way of eating it, and that junk food containing cane sugar or fructose should be avoided.

Fructose, a different form of concentrated sugar made from fruit, seems to be particularly problematic in processed food, even for those without a genetic intolerance. It seems that much of the junk food that is causing obesity in America is sweetened not with sucrose but with corn syrup, a highly processed form of fructose that is cheaper to produce than sucrose, much sweeter and even more harmful; some scientists believe that the body processes it differently from cane sugar and that it’s more likely to cause obesity. ‘Crystallised fructose’ is, apparently, just as bad.

In fact, ‘sugar-sweetened beverages’, which commonly include corn syrup (ie fructose), have been linked with ‘an increased risk of gout, hypertension, and diabetes’, although it’s not clear whether the fructose is directly causing these conditions.

I do think that kids who are benefiting from the Failsafe diet but still aren’t totally well should be taken off all forms of concentrated sugar for a few weeks to see if they improve further. And, partly because of its addictive qualities, I think all kids should only have sugar in their diet in a very restricted way. (In my family, of course, that ain’t going to happen in a million centuries!) As I’ve said, this isn’t medical advice, but just my opinion.

The food intolerance industry

There are a number of websites offering allergy-friendly foods for beleaguered parents; in fact there seems to be a whole industry encouraging children with food allergies and intolerances to eat as normatively as possible. Unfortunately some of the products on offer seem remarkably close to standard junk food.

This website offers coconut ice, chocolate pudding mix and ‘blackberry crunch’ complete with tapioca flour and cane sugar. Meanwhile, this website offers allergy-friendly two-minute noodles. Admittedly these foods are for children with relatively limited allergies and food intolerances, but the Failsafers still get colourless lollies, carob sticks with cane sugar and ‘maggots’ made from puffed brown rice, cane sugar and canola oil. What happened to Failsafers only eating unprocessed food? And why do these companies encourage sick kids to eat heaps of sugar?

The unsavoury fact is that all processing changes the composition of food. As a hypoglycemic (for the moment, anyway!) I react to plain rice crackers made from brown rice without a trace of sugar.

I’m being very cynical here, but it’s obviously easier for the food industry to deal with low-amine and low-salicylate foods (the Failsafe diet) than it is for them to deal with a hypoglycemia or candida diet. In the latter diet especially, you really do have to eat mainly whole foods. But on a diet low in natural food chemicals you can eat plenty of sugar, thus boosting the food industry’s profits.

Of course, all children need treats, and it’s easy for me to pontificate – I’ve observed my sisters using food treats to bribe their kids to be good, and I can’t say that if I was in the same situation I would never do that. Any parent struggling with trying to get an ill child to eat a restricted diet probably welcomes these foods, and I’d assume they’d be a godsend for special occasions.

But common sense tells me that if a kid is reacting to many food chemicals, then unprocessed food with a minimum of concentrated sweetness would be the way to go, at least until the child’s system had had a chance to start healing.

Links between hypoglycemia and food intolerance – a shaky hypothesis based partly on my experience

Let’s assume that hypoglycemia can exist as a separate issue, at least in adults with food intolerances, although perhaps not in the majority of cases. What is the relationship between the two? Where does the whole thing begin?

It was very difficult to find useful information on the web regarding this question. This website by a parent of child with reactive hypoglycemia provides lots of worthwhile information and is keen to promote hypoglycemia as a distinct health issue, but makes no reference that I could find to food intolerance. The Australian-based Hypoglycemia Association does acknowledge food allergies and intolerances, but its information is fairly out of date.

The adrenal connection

Because of my own issues I’m most interested in adrenal fatigue and leaky gut as causes of hypoglycemia. It was extremely difficult to find worthwhile info on the web that linked food intolerance and allergy with adrenal fatigue and leaky gut. I’m convinced there are connections, and some websites seemed to acknowledge that there are, but they weren’t all that authoritative.

When your adrenals are fatigued, you don’t produce enough cortisol. Cortisol is a hormone that has balancing effects on blood sugar, which is why adrenal fatigue can be linked with hypoglycemia. But it’s also involved in helping the body deal with allergies, regulating ‘immune response’ and ‘anti-inflammatory actions’.

This suggests that if you’re under stress for a long time you may be more susceptible to allergies. Some people are genetically unable to cope with food proteins such as gluten and/or casein (a protein in milk). However, food intolerances can also develop.

In leaky gut syndrome the lining of the intestine supposedly becomes damaged, making it possible for tiny pieces of undigested food, toxins, parasites and waste to penetrate the lining, causing the immune system to respond by creating antibodies. This then results in symptoms of food intolerance.

This website says that, according to Dr Sherry Rogers MD, ‘The leaky gut can cause food allergy, and food allergy can cause the leaky gut’. In the case of gluten, ‘gluten sensitivity inflames the gut to the degree that the body will make antibodies to intestinal bacteria and chemical additives in food’. [This is confusing: possibly Rogers is talking about food intolerance when she says ‘the leaky gut can cause food allergy’.]

This medical doctor concurs, claiming that adrenals themselves can be affected by food allergies.

One interpretation of this is: you start off with a fixed allergy with a genetic component (say to gluten or casein) and, perhaps by consuming the allergen, end up with a leaky gut, which then results in all sorts of food intolerances you didn’t have before (eg to food chemicals such as amines and salicylates).

Perhaps at the same time you may be stressing out your adrenals as they struggle to deal with the gluten or other allergen you’re ingesting. And then the adrenals will be less able to cope with the food intolerances you’re developing (if it’s not actually directly contributing to their development). You may also develop reactive hypoglycemia. Perhaps you’ve also got some exterior stresses as well, which are putting even more pressure on your adrenals.

This scientific article suggests that pollen allergy can induce anxiety (which would then presumably have an unwelcome effect on the adrenal system).

This source, not a very scientific one admittedly, seems to suggest that the exterior stress can actually cause a leaky gut via the adrenals, without the further complication of a genetic allergy:

When we are under physical, emotional, or environmental stress it triggers cortisol, a stress hormone to be released. Cortisol raises blood sugar which feeds bad gut bacteria, yeast and other pathogens causing an overgrowth. When the intestinal flora gets out of balance it causes symptoms of gas, bloating, constipation, diarrhoea, and indigestion.

And this scientific article suggests that children are susceptible to stress just as adults are. It finds that environmental stresses in children can contribute to their developing allergies, but that the children who do so may have a particular allergy-inducing response to stress in the first place. (Again I’m not absolutely sure whether the author is talking about genuine allergies here or food intolerances, which seem to be much more variable.)

One possible reading of the Failsafe diet is that once you give up food chemicals, this takes the pressure off the adrenals and they can perform properly, therefore eliminating hypoglycemia.

But if the leaky gut theory were correct, surely you would need to eliminate concentrated sugar for a while (and perhaps fermented foods?) to allow the lining of the intestine to recover.

Children and sugar

The study, cited in my last entry, that seemed to prove that cane sugar played no role in behavioural problems was done on children. Perhaps, for most children, taking pressure off the adrenals by removing intolerances is enough. Yet excessive sugar, inadequate nutrition and use of antibiotics are all considered to be contributing factors in leaky gut. Children’s immune systems also have to deal with the effects of pollution, dust, pollens, pesticides etc. Perhaps a few children do develop a ‘leaky gut’, and need a rest from sugar until the condition resolves.

I grew up with an undiagnosed lactose (or casein) intolerance and a possible undiagnosed gluten intolerance. This could have contributed to a leaky gut. Once you feed sugar into a leaky gut you may be contributing to a yeast overgrowth and causing hypoglycemia.

Perhaps the leaky gut led to the sensitivities to amines and salicylates that I seem to have developed. And maybe that was one reason why I never got better on the candida diet: I was ignoring the amine/salicylate problem.

I’ve finally snagged an appointment with an allergist, and will ask them if it’s possible to take a test for adrenal function – if not, they may be able to refer me to someone. But in the meantime I’ve researched some ways I can support my adrenals. They’re incredibly simple really:

Exercise
Daily meditation
Vitamin C
Vitamin B
Magnesium

Other options are supplements of cortisol and a hormone called DHEA, both of which have been used experimentally to treat adrenal fatigue. But I reluctantly let go of the idea of taking them as they seemed to be unsafe.

I’m not blaming Dengate. I’m incredibly grateful for her website, which has allowed me to get rid of my hives, given me extra clarity about my food issues and encouraged me to go to a conventional allergist for the first time in my life.

It just annoys me that the issue of hypoglycemia is being blindsided, by the food intolerance ‘industry’ as a whole, when there is already so much ignorance about it. There needs to be more research about the links between adrenal fatigue, food intolerance, reactive hypoglycemia, and food addiction; or the research that has been done needs to be explained so that it’s understandable to the average person.

So, as so often occurs in my blog entries, I’m left with a series of questions rather than answers:

What role does fructose intolerance pay in reactive hypoglycemia? Does the role vary depending on whether the fructose intolerance is hereditary?

What role does leaky gut play in reactive hypoglycemia?

Can food intolerance co-exist with a reactive hypoglycemia problem?

Is there a connection between fructose intolerance and leaky gut?

To what extent is food addiction a symptom of hypoglycemia?

If food intolerance can mimic hypoglycemia rather than causing it, as Dengate suggests, can that mimicking itself cause sugar addiction?

Are processed foods inherently more physically addictive than non-processed foods, targetting the reward centres in the brain? Can concentrated sweetness have this effect too, regardless of the chemical make-up of the sweetness (eg Diet Coke)?

What connections are there between the development of food intolerance and the overeating of processed foods?

And when will Blogger enable users to easily insert bullet points? Surely it can't be that hard? (Sorry, may be slightly off topic!)

And, for good measure, here are some useful links on food intolerance and related issues:

SalicylateSensitivity.com

Plant Poisons and Rotten Stuff Community

Environmental Illness Resource

(but this website doesn’t seem to have any info on Failsafe and amine/salicylate intolerance)

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Heroes and villains: food intolerance, hypoglycemia, candida and the Failsafe diet – Part 2 of 3

In my last entry I gave a rundown of my food intolerance problem. In this entry I’ll talk about the Failsafe diet, designed primarily for children with food allergies and sensitivities, and the unexpected discovery about hypoglycemia that my search for information about food intolerance on the internet led to. (This entry is way too long anyway so I’ve steered clear of discussing the role of food in causing or worsening psychiatric problems, a highly relevant issue given the usual flavour of my blog.)

It’s very common now for conditions that affect children such as autism, ADD and asthma to be attributed to food intolerance and allergies. That much I expected. What I wasn’t expecting was the extent to which reactions to refined sugar have been discredited as a contributing factor in these conditions. The hypoglycemic and anti-candida diets are out, and the Failsafe diet is in.

The Failsafe diet is based on the finding that many children suffer from intolerances to particular chemicals in food. These chemicals may be artificial or natural and include additives, in particular food colourings, flavourings, and flavour enhancers, as well as chemicals that occur naturally in foods, such as amines and salicylates (these aren’t the only natural chemicals that can cause grief, but they seem to be the most common).

The diet also acknowledges that children and adults may suffer a range of allergies along with their food intolerances, such as allergies to soy, egg, gluten, dairy, and peanuts. (The difference between food allergy and food intolerance is explained here).

The Failsafe diet avoids all harmful food chemicals. To say it’s a welcome development is an understatement. It was actually devised in Australia, at the Royal Prince Alfred Hospital in Sydney, as a more up-to-date version of the US-devised Feingold diet, and has great scientific credibility.

The website of Sue Dengate, an advocate for the Failsafe diet who has researched and authored books on food intolerance and the diet, seems to have by far the most comprehensive information on Failsafe on the web.

The website has a wealth of useful free information about the diet. It is full of testimonies by relieved parents whose previously ill, inattentive, insomniac and appallingly behaved children (often it’s a case of more than one problem) are now themselves again.

However, the website includes an assertion that could be controversial if the problem it refers to were better known. It appears to dispute the existence of ideopathic reactive hypoglycemia as a cause of behavioural problems in children (ideopathic is a fancy word doctors use when they haven’t a clue what causes something).

What is hypoglycemia?

Symptoms of reactive hypoglycemia include irritability, headaches, and mental confusion, and it’s also been linked with panic attacks, depression and anxiety.

It's a condition whose actual process doesn’t seem to be entirely clear, or perhaps it has differing causes. The amount of glucose in the blood becomes low for everybody several hours after eating. Hypoglycemia is related to the hormones adrenaline and cortisol, which the body produces at this time to prevent the blood sugar becoming dangerously low.

Hypoglycemics may produce too little cortisol, which is associated with underactive adrenal glands. Apparently, the symptoms of shakiness, poor memory and so on are a reaction to the adrenaline that is produced as a back up. Poorly functioning adrenals have been associated with food sensitivities. But the central question is: what is the ultimate culprit – the adrenals or the food sensitivities?

Stress has been shown to be a major cause of hypoglycemia. This also suggests that it's relates to adrenal functioning, as long-term stress puts pressure on the adrenals.

Earlier descriptions of hypoglycemia focused on the pancreas and claimed that in hypoglycemics it produced too much insulin as a response to the glucose in the blood, shifting the glucose into the cells and causing a sudden drop in blood sugar. It’s been said that the level of sugar in the blood is not necessarily the problem, but the speed at which the level gets lower.

However, I deliberately haven’t called this condition ‘low blood sugar’ ( a common term) because it wasn’t clear to me after a very basic internet research that the blood sugar of hypoglycemics becomes lower than that of non-hypoglycemics; certainly the blood glucose test has been discredited as a diagnostic tool.

Reactive hypoglycemia should not be confused with hypoglycemic reactions from diabetes, or hypoglycemia caused by serious conditions such as Graves disease and pancreatitis.

Early diets to combat hypoglycemia focused on removing concentrated sugar from the diet and emphasised complex carbohydrates (eg using brown instead of white rice). Following a brief ascension as a fad diagnosis, this condition is all too often routinely ignored by doctors. It seems that research is being done on it, particularly in the case of children, but in my experience that research hasn’t trickled down to GPs.

It’s unfortunate that a condition linked to food intolerance in some way is in fact the province not of allergists but of endocrinologists. The failure to find a cure for another condition that straddles more than one specialty – rosacea – indicates the neglect that can occur when more than one branch of medicine is involved.

What is candida?

More recently, hypoglycemia has been linked with candidiasis, the overgrowth of candida, a fungus, in the digestive system. While yeast overgrowth in areas such as the genitals (thrush) is recognised and treatable, the existence of candida overgrowth in the digestive system as a condition has remained controversial.

Also scientifically unproven are the supposedly associated symptoms of this overgrowth, such as fatigue, and the anti-candida diet to combat these symptoms. Like the hypoglycemia diet, the anti-candida diet removes sugar and emphasises whole foods but it goes much further, also excluding all foods that might contain mould, including fermented foods and drinks (eg conventional bread, beer) as well as aged foods such as cheese and processed meats. The theory is that you literally starve the yeast overgrowth in the gut. Like the Failsafe and hypoglycemic diets, the anti-candida diet acknowledges that some sufferers might also have allergies and intolerances, for example to gluten and dairy.

Candidiasis is linked to so-called leaky gut syndrome, in which damage to the bowel lining is seen as both a cause and effect of hypoglycemia and ever-worsening food intolerance. Wikipedia puts the status of this diagnosis beautifully:

While many practitioners maintain that leaky gut syndrome is a bona fide medical condition, the area of ‘gut problems’ lies between conventional and alternative medicine, and includes other diagnoses such as small bowel bacterial overgrowth syndrome or small intestine bacterial overgrowth (SIBO), and yeast syndrome or systemic candidiasis, and remains controversial and scientifically unsettled.

Disputing the role of sugar

Dengate (and perhaps the developers of the Failsafe diet) disputes both low blood sugar and candida as causes of unexplained symptoms. The website makes the unequivocal assertion that ‘Contrary to popular belief, sugar does not cause children's behaviour problems’.

It goes on to say:

When mothers swear their children are ‘sugar addicts’ whose behaviour is affected by sugar, they are generally surprised on going failsafe to find that their children are actually reacting to salicylates. Sugar craving can be a salicylate-induced reaction.

Similarly, feeling tired, weak and shaky can be a delayed reaction to food chemicals such as salicylates, rather than hypoglycemia.

This is a breathtaking claim. Dengate seems to be saying that food intolerances only mimic hypoglycemic symptoms rather than causing them.

Yet hypoglycemia itself is certainly a distinct phenomenon, even if it is caused or worsened by food intolerance.

Indeed, the website itself admits this elsewhere, seeming to suggest that sugar can play some role in behaviour if ingested on an empty stomach:

It is best to eat sugar as part of a balanced meal (e.g. in a dessert) rather than in drinks or treats on an empty stomach when it can affect blood sugar levels.

Even if we admit that it may not be blood sugar levels that are the problem but the body’s reaction to low blood sugar, why do some people exhibit these symptoms and not others? All this suggests to me the possibility that some children react to their food intolerances with hypoglycemic symptoms and some don’t (ie they have other symptoms). If that’s the case, surely those children with hypoglycemic symptoms should be taken off sugar for a while because it might put extra stress on an already oversensitised system, even if the sugar wasn’t the original culprit?

And does this mean that that if I continue on my low-salicylate, low-amine diet, eventually my system will right itself? (At this point in my diet it’s impossible to say whether I am ‘losing’ what Dengate believes is faux hypoglycemia, but at the moment I would not experiment with cane sugar in, as they say, a ‘pink fit’.)

The claim that sugar is not the villain it has been assumed to be does seem to be borne out by some evidence.

According to the website, a study that successively fed children three different types of sweeteners without their knowledge – sucrose (cane sugar), aspartame (an artifical sweetener) and and saccharin (as a placebo) – found that regardless of the type of sweetener, the children’s behaviour was unchanged.

The study took place over a nine-week period in which the children were fed a diet that changed each week, with the sweetener used in the food being changed every three weeks. Half the children in the study were chosen because they were believed by their parents to have problems with sugar.

However, the emotional language used to describe this study (‘definitive multimillion dollar study’) belies the reality. It used only 48 children, and no children were fed no sweetener at all. The anti-candida diet, unproven as it is, says that all forms of refined sugar exacerbate candida, including sorbitol.

What would have happened if the researchers had withdrawn concentrated sweetness completely from the diets of a control group? Perhaps nothing, but such an addition would have enhanced the efficacy of the study.

One reason why the website supports cane sugar may be that the Failsafe diet warns against artificial sweeteners, which have not been proven safe; in fact some of these sweeteners seem to act like poisons.

And to be fair, the website emphasises that the Failsafe diet should consist of unprocessed foods. Dengate has researched food additives and Australian labelling laws, and it seems that few processed foods are actually safe.

The website also provides information about a form of intolerance affecting some Failsafers: fructose malabsorption. Fructose is a natural sugar derived from fruit, and it’s now added to processed foods instead of cane sugar, for example in the form of corn syrup. Fructose malabsorption can occur alone or in conjunction with other food intolerances.

Too much fructose can affect the most hardy, but it causes all sorts of digestive problems for the intolerant. Fructose occurs in some vegetables as well as fruit, and the solution is to eat only fruits and vegetables with low fructose, and no processed foods containing fructose.

Finally, if Dengate is correct, it’s feasible that some people with food intolerances would show some improvement if they followed the anti-candida diet even if that diet were a crock, because it removes all processed foods. It does allow fresh fruit, however.

My experience

Reactive hypoglycemia is said to have many possible causes. One of these is adrenal exhaustion. My hypoglycemia became worse after I had a ‘breakdown’ (an unfashionable word now) at the age of 21, when my adrenals would have been under an enormous amount of stress. Quite possibly intolerance to amines and salicylates and reactive hypoglycemia exacerbated each other.

When I look back at my food history, giving up most cane sugar at the age of 21 or so had a marked effect, although at the time I was ignorant, like most people, about amines and salicylates. During the period of withdrawing from concentrated sugar I could hardly get out of bed. Sugar acted for me like a drug; but whether everyone giving up sugar would have had a similar reaction, or only people with reactive hypoglycemia, is something I can’t be sure about. However, for reasons unclear at the time I never completely ‘stabilised’, that is, felt normally clear-headed and energetic. And I haven’t since. So Dengate’s assertion is, to say the least, interesting to me.

However, before the diagnosis and before I drastically reduced cane sugar in my diet (I didn’t fully succeed in giving it up for at least three years), I do remember experiencing these occasional, awful feelings of a kind of cognitive emptiness, a sense of vacancy, and I’ve never felt that degree of vagueness and disorientation since giving up cane sugar. My sugar problem still seems a separate issue to me, even if it is at least partially caused by food sensitivities.

To complicate things further, I went to Europe at the age of 23 for five months, developed a full-blown eating disorder and shivered in freezing, mouldy rooms. This period saw a worsening of both my sugar and food sensitivities, and I’ve always associated it with the development or worsening of some kind of candida problem, or at least a sensitivity to mould.

So, despite my interest in Dengate’s assertion, my completely uneducated guess would be that a proportion, perhaps only a tiny proportion, of children with food intolerance might also have hypoglycemia or candidiasis as a separate problem; and if even these were related to food sensitivities, giving up all kinds of concentrated sugar mightn’t be a bad idea for these children, at least for a while until their systems had time to recover from their food intolerances.

There’s a common sense element here: some of the symptoms of ADD, such as vagueness and poor concentration, are also classic hypoglycemic symptoms. If the Failsafe diet doesn’t completely cure the problem, mightn’t it be worth finding out if the child has a separate sugar or candida problem? (You would need a few weeks to check this because the body becomes physically addicted to sugar, and there would be a period of withdrawal.)

But in this case, computer definitely says no. Dengate again: ‘It is counterproductive to try to combine failsafe eating with a candida diet’. Elsewhere on the site, she asserts that a thrush problem ‘does not mean you need to eliminate sugar and yeast. The so-called candida diet is not scientifically proven’.

That puts me between a rock and a hard place. At the moment my diet is extremely strict, and I’m now doing what the website warns against, which is combining Failsafe with anti-candida (this is making finding a suitable calcium supplement, um, interesting). But I’ve done nothing to remove salicylates from non-food products. The website warns:

As perfumed toiletries, cosmetics, airfresheners, scent sprayers and household cleaners mostly used by women have become increasingly pervasive and over-fragranced, they can push you over your salicylate limit.

I can’t help wondering if removing non-dietary sources of salicylates would help my hypoglycemia.

What worries me is that ideopathic hypoglycemia is already ignored by so much of the medical profession – the Failsafe diet will just make this worse.

Whew! In my final entry on this topic I’ll ask whether sugar is good for anybody, take a horrified look at the allergy food industry and present a very shaky, unscientific hypo-hypothesis about the links between reactive hypoglycemia and food intolerance.

See also Heroes and Villains Part 1 and Heroes and Villains Part 3.

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Heroes and villains: food intolerance, hypoglycemia, candida and the Failsafe diet – Part 1 of 3

The following, first in a series of four blog entries, goes into a fair bit of detail about my food consumption and intolerances, and therefore may be boring for all but the most allergy-ridden. I’m on a restricted diet, and once I had mentioned particular foods I wasn’t eating, it seemed necessary to mention all the foods in my diet, otherwise it wouldn’t be clear what I was giving up.

Usually the sudden appearance of itchy welts on the legs, stomach and arms would be a matter of some concern. For me, with my body image issues, it was a disaster of mammoth proportions. After taking a few days to stare in horror at the welts – some of which were admittedly quite creepy, starting off red then turning into bruises – I finally faced the fact I’d been avoiding for the past five years: I was probably intolerant of a number of food chemicals.

My dietary life at the moment appears to be grimmer than ever before. Not only can’t I eat dairy, gluten, yeast and anything sweet, but I’m also probably sensitive to amines and salicylates, two natural chemicals that occur in many, many, foods (ironically, these chemicals add flavour to the food!). My immune system has turned against me, and I’m in extreme dietary blandsville. Also lost to me is the simple pleasure of eating a meal out with friends.

Why did I come to this grim conclusion?

There really weren’t any other culprits to blame. I’d been more or less avoiding gluten, lactose, yeast and alcohol for over a decade, and been religiously off sugar for about two decades as a result of reactive hypoglycemia (low blood sugar), a condition in which the pancreas can’t deal with concentrated sugar.

Hypoglycemia has been linked with the overgrowth of candida, a natural fungus, in the digestive system. I’ve therefore spent at least the last decade on a half-hearted anti-candida diet, which entails avoidance of any foods that could produce yeast in the gut. However, I couldn’t give up real coffee, which was disastrous for my blood sugar.

I finally managed to give coffee up completely in 2002, but the anti-candida diet’s remained a tad half-hearted, mainly because, in order for me to stay sane, it included tofu, tinned fish, shelled nuts and store-bought hummus. To this day, I can’t tell you if the diet’s half-hearted because it never made me better and I got discouraged; or whether its half-heartedness was why I never got better. Perhaps a bit of both.

At one point I did attack my presumed candida with a course of an anti-fungal drug, Nystatin, and I took vitamin supplements for years, but I never embarked on that full-on assault with probiotics and massive doses of garlic that you’re supposed to. I still feel vague and out of sorts on cold, cloudy days, and I’m reactive to any hint of carbohydrate, even the complex carbohydrates that occur in grains and vegetables, both of which suggest some kind of lingering yeast problem.

Apart from the exceptions outlined above, I had already made some additional food sacrifices. I got rosacea five years ago, and that’s when I stopped eating the flavoursome foods I loved – most of the time, anyway. Most herbs and spices were out, as well as garlic, onion, red meat, treats like tinned tomatoes, and eventually even fresh fish. But there were also perfectly harmless-seeming vegetables that inexplicably gave me a red face, like zucchini. However, I still ate these forbidden foods occasionally when I was willing to put up with redness. Coffee and alcohol are common causes of rosacea, but I was already off those.

My rosacea and candida food lapses (practitioners sometimes call these ‘dietary indiscretions’) had been getting worse in recent months. I’d started eating roasted cashews a few times a week, as well as tomatoes. I was also eating out once a month or so, picking the safer options at vegetarian and Asian restaurants. Store-bought hummus was becoming a weekly treat, and once in a blue moon I would eat a whole 250 g block of cheddar cheese for lunch. When I look back, my diet was becoming steadily higher in amines, natural chemicals that tend to be in aged and preserved foods.

I could ignore occasional red cheeks, but not these horror hives. So when they sprang up, almost two months ago now, I was forced to research foods that were low in amines and salicylates, and sure enough, the treats I’d been allowing myself were full of them. So I gave up anything that wasn’t low in amines and salicylates. And the hives have mostly gone, suggesting that the food chemicals were to blame.

Interestingly, though, the rosacea hasn’t gone, so the picture is probably even more complex. I still believe that there is a connection between rosacea and food chemicals, however, because I inadvertently gave up some salicylates when I first got rosacea and stopped eating herbs and spices, and I’ve got no doubt my rosacea would be worse if I hadn’t.

At the moment I’m trying to get an appointment at an allergy clinic at the Alfred Hospital (a whole other story – the hospital has so far not even been able to confirm that it received my referral, now faxed to them four times). I need to know for sure whether I am intolerant of these chemicals, and whether or not there’s a way of making me less intolerant, for example an underlying digestive weakness that could be fixed, or even a thyroid problem, said to be a cause of food intolerance.

At the moment the only foods I’m officially eating are chicken, brown rice, tofu, eggs, cold-pressed safflower oil, chickpeas, quinoa (a gluten-free grain), celery, raw cashews and cabbage! (Fruits that are low in amines and salicylates are out because of my blood sugar problem.)

Boring!

Learning to tolerate food intolerance
Food intolerance differs from food allergy in a number of ways. True allergies are the body’s immediate immune response and occur as a reaction to proteins in foods. With food intolerance the digestive system is involved, the intolerance is to particular chemicals in the food, and there is a longer onset between ingesting the food and a reaction appearing. It is harder to diagnose food intolerance for the latter reason, but there may be an advantage too: some say that if you go without the foods containing the offending chemicals for long enough, the body will no longer produce the antibodies against the chemicals, and you will be able to tolerate small amounts of those foods.

Apparently food intolerance produces an addiction to the food and a craving when it is removed from the diet. While withdrawing from amines and salicylates, I not only felt exhausted but craved amines like never before. It’s a very different craving from the desire for sugar or yeast. The yearning seemed to be for the taste of the food rather than the sugar content, which is what amines are all about I guess.

During this period I wanted, more than anything else, rich tangy hummus with falafel. (This probably sounds like a bland craving to have, but to me these foods are tasty treats!). My whole body wanted not concentrated sugar but concentrated flavour. The cravings have now diminished but, like a dysfunctional relationship that still beckons, I’d go back to amines in a second if I thought I could get away with it.

Having said that, I’m thinking more clearly than before I gave up the amines and salicylates – when alone especially, I notice my brain seems to be working better. I know that sounds weird but it’s the only way I can describe it.

And I do wonder whether this sensitivity could have been the main game all along rather than a side issue. In other words, perhaps it’s contributed to my low blood sugar problems, not to mention my lack of energy. On the other hand, low blood sugar could still be the main culprit, because it supposedly leads to too much insulin washing around in the system; insulin is a hormone, and too much of it can supposedly have adverse effects on other bodily processes.

Stop press: I gave in last night and ate some store-bought hummus, and there were a couple of hives on my knee this morning.

In my next post I’ll look at the Failsafe diet, which is low in food chemicals.

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