Friday, June 11, 2010

May Weights and Measures

Tenth monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity. Also added average frequency.

The "Weight Chart Daily Graph" worksheet shows the daily morning weight.

The "BM Score Daily Graph" worksheet shows the daily combined BM score and quantity.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

So may got interesting!

The pain from my mystery steak buffet illness subsided until it was time for the endoscopy. Of course, at that point I was something of a hypochondriac and I was aware of every burp or stomach rumble, but by that point nothing hurt anymore. As I walked into the center I thought, “Great, do I really need this?” Nothing like wasting money on a medical test you don’t need. But I was there and I hadn’t had an endoscopy in years, and ignoring medical conditions has bitten me in the ass repeatedly, so in I went.

The nurse prepping me asked what I was in for. Eventually he found out that I had Crohn’s and said, “Oh I have that too. How do you manage it?” That put me in the awkward situation of trying to explain this great diet that’s working really great except for that whole two day crippling pain episode. I think he was just trying to kill time though, so I didn’t get much of a reaction.

My gastro arrived and started reviewing the results of my blood tests while I was lying on the gurney. My fasting blood glucose was pretty low (73) and he joked that I should eat a piece of bread. Har har. I am somewhat intrigued by the low reading and I’ll probably get around to doing a glucose meter experiment one of these days.

Then they knocked me out. I woke up and the doctor said, “Doesn’t look like anything significant. We took some biopsies, we’ll let you know how they turn out.” Great! Nothing significant. I had just wasted everyone’s time – outstanding.

I went about my life as usual for the next week or so. I started lifting weights again at the end of April, just squatting. I wanted to see if I could break my previous record and didn’t really care about the rest of the lifts. Of course, that’s “not doing the program”, and I wasn’t eating enough, so all in all it was a moderate to severely stupid plan. More on that later.

I got a voicemail from a nurse at the endoscopy center saying, in total, “We got the results of your biopsy and you definitely have GERD. You really need to be on Nexium. Call us if you need a prescription or if you’ve run out.” Since it was a voicemail I couldn’t respond with, “Wait, the doctor said it wasn’t anything serious. What the heck?”

I did a quick research blitz, which lead me to Jonathan Wright, who claims that low stomach acid is the cause of 90% of heartburn cases. I dutifully tried the acid treatment recommendations: take one betaine HCl pill with a meal, see if you “feel a burn”. Keep adding a pill until you either feel a burn or something bad happens, and then back off one pill. As near as I can tell after three tries, the result of taking a stomach acid supplement was nausea and diarrhea. Since I didn’t have visible heartburn symptoms to begin with, I had no way of evaluating its reflux fighting power. Ok, back to square one.

I scheduled an appointment and talked to the gastro. He showed me the biopsy report, which did indeed claim that I had “moderate chronic reflux”. The “chronic” part was surprising, since I hadn’t noticed any reflux or heartburn symptoms at all until that one event. The doc mentioned that some people don’t feel the reflux, and that perhaps I was one of them. He rattled off a few meds I could try, none of which were appealing. He was unimpressed with the acid hypothesis and said that I was too young to have to worry about that. End result: I walked out with a prescription for some drug “if I wanted to try it” and a recommendation for another endoscopy in a year to see how I was doing.

More research. This time I ran across Ricardo de Souza Pereira, a doctor from Brazil who had compared a supplement with a Nexium precursor drug to see which was better at controlling heartburn symptoms. The supplement won hands down. That caught my attention. Dr. Michael Eades (see blog) had apparently come across this before and tried to market it in the US with no success. He’s got a very interesting blog post about that whole process. He also hosts a summary of the study, which helpfully gives the supplement ingredients.

After doing some more research, I discovered that melatonin appears to be the critical ingredient. There’s an anecdote about a woman who was able to control her heartburn with 6mg of melatonin before bedtime. The therapy is founded on the fact that melatonin, often associated only with the pineal gland and sleep, is also secreted by your gastrointestinal tract for unknown reasons. The way it works on hearburn is, in theory:

However, others concluded that the esophagoprotective activity of melatonin against GERD might be related to the inhibitory effect of this indole on gastric acid secretion and due to stimulation of gastrin release, which might attenuate the gastro-esophageal reflux by stimulation of the contractile activity of the lower esophageal sphincter”

A more recent study (quote above) comparing melatonin with omeprazole had some very interesting results. (Sidenote: omeprazole is basically Prilosec, which, when its patent expired, was trivially altered into Nexium, which was then patented again. Gotta keep those patents. So Prilosec is widely used in research as a stand in for prescription heartburn medications.)

The most interesting, and I think important, dichotomy here is the fact that melatonin generated significant increases in LES tone while the omeprazole only created “non-significant” increases. Since reflux is fundamentally a disorder of acid entering the esophagus, melatonin does a better job of treating the fundamentals of the disorder.

In any event, after reading up on that I went to the store and started taking 6mg of melatonin before bed. Again, since I have no obvious heartburn symptoms, this experiment is very difficult to judge. As far as I can tell, the only result has been MUCH deeper sleep. That was a welcome side-effect, since I’m usually the sort of sleeper who will wake up if a mouse farts in the house next door. I’m still looking for studies on the long term effects of melatonin supplementation, but so far I’m happy. We’ll see how it goes.

Since GERD is a clear indication of dietary failure, I went back and reviewed my food choices up until now. My clear reliance on dairy might be a significant contributing factor, but it’s really damn hard to get enough fat without dairy. So I’m not sure if I can give that up as of yet.

I had always been intrigued by the specific carbohydrate diet, which I suppose I am now doing a rather extreme version of, and thought, “Well they eat yogurt. I should see how.” The end result of that line of inquiry was me making homemade yogurt for the first time. It came out pretty watery, but after letting is strain through a cheesecloth for a couple hours it thickened up into some pretty decent (super sour) greek yogurt. I bought a tub of full fat Fage yogurt at the grocery store and my stuff tasted about the same, just a bit more sour. I suspect this was because I fermented mine, or at least tried to ferment mine, for 24 hours, whereas the commercial operations probably only do it for half as long.

If the Klebsiella Pneumoniae connection is true, I really don’t want lactose getting into my large intestine, so I might have to start fermenting my own yogurt from here on out. I need to make some modifications to my system before that’s really a sustainable activity, but it’s actually a pretty simple thing to do.

A final note on weight lifting. It turns out that only working one exercise and not eating a lot of food still results in you stalling. I can’t seem to get 170lbs for 3 sets of 5 on my squat. Since this is a pathetically weak squat for an adult male, I suspect that it just happens to be the weight at which underlying form issues are exposed to the point where I can’t force my way through it. So I guess I’ll be working on form for a while, eating a lot more and doing the damn program.

Ten months down, two to go (holy crap!)

2 comments:

  1. Congrats on having the endoscopy behind you!

    Have you tried only ghee or tested for casein intolerance?

    Would coconut milk yogurt be compatible with your plan?

    Do you supplement with magnesium and D?

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  2. I have not tried ghee or tested for casein intolerance, though I suspect I might have a mild allergy to some dairy protein. Whatever it is it's not that strong so it's very hard to distinguish between a reaction to milk/yogurt and some other environmental factor. And of course I can't draw a 1-1 correlation between my eating dairy and getting an allergic reaction, so I'm just not sure at this point.

    I never thought about coconut milk yogurt. Huh. That might be an interesting substitute. I'll hold out on not eating plants until August then give that a shot.

    I do not supplement with magnesium though I do supplement with D on days where I don't get a lot of sun.

    ReplyDelete