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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My diagnostic disaster – part three

The story so far:

In an attempt to save my sanity. I had decided to apply for a part payment of a government allowance. To do this I needed a doctor’s report, and to obtain one I returned to a psychiatrist I had seen eight years earlier. At the time he had diagnosed me with bipolar and unsuccessfully tried to put me on an epilepsy drug. I had left in disgust. Upon returning in the hope of getting a doctor’s report, Dr Field (not his real name) had diagnosed me with ADD.

As I sat in Dr Field’s office trying to absorb the news, he was already back to his old diagnostic tricks. ‘Do you feel stuck in the present?’ he asked. Stuck in the present? I wished I was. I was stuck in the past, stuck in the future – the present was in some ways elusive. But even a preliminary perusal of the literature he’d given me to read on ADD suggested that the picture was far less simple than his question suggested.

‘I want you to go on dexamphetamine’, he said. ‘It’s a stimulant, but it has the opposite effect on people with ADD. It’ll calm you down’.

I was shocked but also stunned at my own naivete. Dr Field loved drugs: why would I think he wouldn’t have found one to treat his latest diagnostic interest?

I tried to explain my reluctance to take a stimulant drug but my efforts were wasted. It was all contrariness and non-compliance as far as he was concerned.

He smiled at me. ‘If you don’t take this drug you won’t get anywhere in life. Are you willing to throw away your entire future?’

In the end we reached an agreement. I would try the drug, and come back and see him again; and he would fill out the report form.

Despite our agreement, I knew I would never take the drug for any length of time; my system was just too sensitive for something so strong. But I was desperate for the report, so decided to try one dose and see how things went. In the unlikely event that the drug didn’t act as a stimulant, I’d take sufficient doses to please Dr Field so he’d fill in the report.

That Saturday, I picked up the prescription. Twelve tablets. How much would this be worth on the black market, I wondered. I joked to myself that perhaps I could go to Fitzroy Street (a street in Melbourne popular with drug dealers) and see if I could sell them.

I took one tablet. Just as I’d thought it would, it made me speedy (did this mean I didn’t have ADD? Who knew?) I rang Simon, a friend who lived close by, and asked him to come over and ‘babysit’ me. We decided to walk through the quaint, gentrified estate near where I live to the haven of Central Park. I was ‘with it’, but very talkative, chatting volubly about some of the meticulously renovated Edwardian houses we passed. Simon later confirmed that I had seemed a bit ‘high’.

I slept very lightly that night, just as if I’d taken a huge dose of caffeine. I wanted my brain back; dexamphetamine and I were fated to part for all time.

By this time I was feeling sheepish and quite manipulative. Why had I gone through this ridiculous farce? What was I trying to prove?

The following week I faced Dr Field once more. If I was manipulative and conniving, I was also honest. ‘I took one tablet’, I told him, ‘and it made me feel very speedy and a bit out of control. So I didn’t take any more. I did try.’

‘Well unfortunately I can’t help you. Counselling without medication won’t work.’

‘But what about the doctor’s report?’ He seemed to have forgotten all about it.

‘The report?’

‘Yes – that’s why I came to see you. I’m hoping to be able to get this government payment. But I’ll only be able to get it if the report’s filled out. We spoke about this last time.’

I handed him the form. He scribbled away as I sat in my chair feeling relieved and gladdened. I had looked after myself, gone through the hoops, done everything I needed to do, and now this surreal episode was drawing to a close.

‘There you go.’ He handed me back the form – like so many doctors he had almost illegible writing.

I stood up as I took it from him, gave him my most charming smile. ‘Thanks Dr Field.’

‘Good luck’, he said.

Once on the tram I eagerly pulled out the report from my bag. My heart sank.

‘Oppositional personality features and paranoid attitudes’, I read, ‘given prescription of dexamphetamine but too scared to take it’, and ‘needs medication and counselling but refuses’ (I would have gladly gone for the counselling without the medication, indeed would have done so eight years earlier).

‘Pleasant person but throwing her life away’, was his passing shot.

The report was useless; as a non-compliant patient I didn’t stand a chance of getting the payment.

The story doesn’t end there. I finally saw sense and went to a local GP I had seen intermittently over the years who headed a large clinic. She knew I had anxiety and had at one point prescribed sleeping tablets. She listened to my request and filled out the doctor’s report for me, and needless to say it read quite differently from Dr Field’s version. After many months and much stress, I finally received the part government payment I’d been seeking.

I can’t see myself as a total victim in this story; it was plain dumb of me to go back to Dr Field, to think I could see him on my own terms rather than his. I didn’t enjoy the feeling of trying to manipulate him into filling out the report. But the experience did make me think about psychiatry and the power it brings with it. I now believe that this power has its own inherent psychic dangers – in order to maintain their registration, psychiatrists should be required to undergo some kind of periodic co-counselling with colleagues to ensure they have not succumbed to, say, narcissistic delusions of grandeur or a tendency to over-pathologise.

Dr Field, in his own funny way, could see the damaged part of me better than some other psyches and for this reason I was attracted to him; but he could not see all of me, me in my complexity and entirety. His considerable talents were stymied by his inability to learn anything from his patients, to listen to their narratives, to open his heart to them as well as his mind.

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My diagnostic disaster: part two

In my last post I began relating the story of my odd encounter with a rogue psychiatrist, Dr Field (not his real name). Below is the second instalment.

When I left Doctor Field I never intended to go back. But eight years later, my brilliant career as an editor was floundering in a sea of uncertainty and self-doubt. I was at a crossroads: publishers were paying less, and wanting work done that was often beyond my expertise. I was weary of the chronic exhaustion and anxiety, not to mention loneliness and isolation, that large jobs forced on me. I wanted a style of work that was sustainable. Refusing the big jobs for the sake of my sanity, my savings were getting run down.

I needed some government help. I wasn’t going to stop working but find a niche that suited me, with a safety net underneath – a net flexible enough to allow me to work part time, as the particular payment I sought would do.

I was finally ready to admit that I had a serious, complex condition and that I couldn’t make it on my own. I was going to put my hand out.

But first I had to get the necessary documentation. This included a complicated form that had to be filled in by a doctor, stating the seriousness of the patient’s condition and that it was either stable or being treated.

This presented a dilemma; I had seen two psychiatrists consecutively for long periods of time, and I didn’t want to ask either of them to complete the report. Neither had ever presented me with a diagnosis, probably because they did not want to encourage what amounted to an obsession with self-analysis. But nor was either of them a specialist in anxiety disorders, and they had shown little or no interest in imparting skills to help me manage my anxiety. Despite this, all three of us had assumed that the goal for me was more or less normal functioning where work and love were concerned. I could not go back to either one of them and admit my ‘failure’.

Then I thought of Dr Field, and the results of his test. I rummaged around in my filing cabinet and found it: it was all there in black and white, the extent of my pathology. This could furnish some supporting evidence, but I would need to get it from the horse’s mouth. I would arrange to see Dr Field purely for the purposes of getting a doctor’s report on my condition. And, as our approaches to drugs and psychiatry were at such variance, I would make it clear that I did not want to see him on an ongoing basis.

The determination to foreclose ongoing treatment was my first mistake. There would be a few more before Dr Field and I were through for good.

I rang up his office and his receptionist answered. I bluntly asked her if I could make an appointment to see Dr Field on a short term basis. I made it clear, probably sounding over-determined, that I did not want to see him for long term treatment.

That’s the point at which the pathologising began. The receptionist passed on this message to Dr Field, and once we were in session he mentioned this reluctance as an instance of my pathology. Already there was more than a whiff of the 1950s approach to psychiatry in Dr Field’s attitude towards me. What next, a lobotomy?

The first minutes after I sat down in front of him, however, were quite okay. The room was small with an untidy shuffle of papers and a television in one corner, the walls painted a pale apricot beige, but the vinyl armchair that I sat in opposite him was low and comfortable. I had completely forgotten the look of him, and now recalled the unexpected cuteness, the expensive suit. Perhaps it would all be alright. I told him about my editing dilemma and he tipped his head to one side, quickly, in that rather appealing way – could it be he was really listening? ‘You’ve thrown in the towel’, he said. I nodded and had to stop the tears from welling up. Was he offering sympathy? understanding?

Half an hour later he had diagnosed me with attention deficit disorder (ADD) and told me the only hope for treatment was regular doses of dexamphetamine (otherwise known as speed). He had also apologised for diagnosing me with bipolar eight years earlier. Since our last encounter, he explained, he had discovered that many patients with what he’d thought were the symptoms of bipolar actually had ADD or ADHD.

So much was going on in my head as I smiled back at him. What was the point of trying to explain my chronic low blood sugar, the brain fog I already experienced from food intolerance, my battles with caffeine and the fact that my body reacted badly to any kind of drug? How could I possibly try and crack open that wall of medical certainty and blind faith he had in the efficacy of drugs to cure all mental ills? This combination of the old-fashioned and the maverick in him was bewildering. A psychiatrist like him, willing to be on the diagnostic cutting edge, should have been as focused on the body as he was on the mind – wasn’t that the point of psychiatrists being medical doctors as well as specialists in mental disorders?

At that moment I started to become what he had set out to portray me as – calculating and false.

But at the same time I was also knocked sideways by the actual diagnosis. Somehow it made sense. The literature he gave me to read later brought it home even more sharply.

According to the literature, there are a number of forms of ADD. The commonly known ADHD, characterised by hyperactivity and low academic achievement, is only one of them. There is also inattentive ADD, associated with girls and far harder to spot, as well as hyperfocused ADD, but also a couple of others even lesser known. If anything, I had inattentive ADD. I was considered a ‘brain’ at school, but was for the most part a lazy student until I pulled my finger out for the final year of secondary school and got pretty good marks, including a standardised perfect score in English. But I floundered at uni as an undergrad, failing some subjects and obtaining only mediocre or poor marks in most others.

At the age of nine, before I knew anything about mental illness, I’d suddenly come to the conclusion that there was something deeply wrong with me. Later I had assumed that this was just the first stirrings of my neurosis. But perhaps on some level I was aware of some more basic shortcoming in my neural architecture.

On the other hand, my ADD symptoms might have been environment related (as I’d always assumed), an attempt to respond to and escape from the conflicting emotional demands of parents who were respectively resentful, depressed and emotionally distant (my mother) and needy, obsessive and controlling (my father).

Regardless, Dr Field’s methods of diagnosis were lazy and reductive. One Australian ADD site has a list of other conditions that may present as ADD and should be eliminated before any diagnosis. Dr Field did not bother to eliminate any of these. What about my chronic low blood sugar, for example? Couldn’t that have been a culprit? (In my case, I believe it’s a separate condition, but who knows how it contributed to my adolescent difficulties?) When I asked Dr Field about whether I could get a brain scan to confirm the diagnosis he said a SPECT scan was available, but waved dismissively as he said it. (I decided not to – a confirmation of ADD would encourage my self-obsession).

A few more things about ADD before I leave the subject – I’ve done a bit of reading on brain plasticity, and I believe there are many types of brains, as well as many ways people can improve brain functioning. The fact that I’m an editor suggests that my brain has changed quite considerably already simply by the work I’ve done, and practices such as meditation and mindfulness, as well as life skills training, can help further.

Even if I had no physical health problems, I don’t believe the kinds of drugs that are prescribed for this condition – basically stimulants – should be the standard alternative in most cases, but rather a last resort.

Standard treatments for ADD that already exist and should be tried before drugs include behaviour modification, cognitive therapy, anger management, social training and family counselling.

To some extent these treatments seem to support the concept of brain plasticity (the brain's ability to alter itself to develop new capabilities), but more cutting edge treatments that further acknowledge plasticity, such as software that literally retrains the brain, are already available for disorders such as dyslexia -- why not for ADD?

It scares me to think of the number of children being diagnosed with this condition who may simply be suffering from food intolerance or low blood sugar. However, that doesn’t mean the condition doesn’t exist.

Anyway, just as the literature suggested was typical for an ADD person (the extent to which I fitted some of the ups and downs and brain states described was chilling) I caught the tram home thoroughly discombobulated. Dusk had fallen and as I stood in the swaying, brightly lit tram among the suited commuters clutching their mobiles, my mind was busily rewriting my entire life story – my difficulties, social and otherwise, made more sense than they ever had.

But in my bag was a prescription for dexamphetamine.

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