Tuesday, December 13, 2016

Three years? Time flies

It's been three years since my last colonoscopy, and three years since my last post. Reading that post feels like reading a note in a time capsule; so much has changed since then. My wife and I bought and fixed up a house, had a baby, both had work changes (she moved schools, I got promoted) and have had some wonderful and trying times. Stress out the wazoo.

But one thing hasn't changed: I'm still symptom free. More on that in a bit.

Diet-wise the only hard rule left is "no gluten", which in pragmatic terms translates into "no regular, large starch piles". However, I do eat potatoes with regularity, and have ventured into the dark lands of gluten free pizza a few times (with predictable results). Overall, my diet remains centered around meat, eggs and cheese, with fruit (mostly "gross" bananas), vegetables and starchy tubers rounding it out.

One negative health event was scoring high cholesterol for a physical two years ago. 290 total, I forget the exact splits. At the time, I was chugging milk and yogurt, so I stopped. A year later I was down to 204 and had an extremely positive Boston Heart panel. High HDL, the right LDL pattern, etc. The cardiologist was a little stunned by the turnaround and mentioned that it takes most people years to pull that off. Most people probably aren't drinking that much milk. I guess my phenotype doesn't respond well to a sustained dairy onslaught. Oh well. I've been making up the calories with a shake made from protein powder, super-ripe bananas and peanut butter, with no negative side effects.

On to the colonoscopy.

I switched gastros to one who had a facility a little closer to my new house. The prep they gave me was astonishingly inoffensive (suprep). I recall gagging and being almost unable to finish a similar prep (fleet phosphosoda or something like that), but this one was so mild it was no big deal. Only complaint about the procedure itself was that instead of giving me the relaxant a few minutes ahead of time, they just knocked me out - come on guys, I crapped my brains out for twelve hours, I think I deserve a little legal high time.

Woke up and the doctor told me everything looked fine. No polyps, no inflammation, no visual signs of disease. Come back in two weeks for follow up.

When I went to my follow up appointment, he said that I didn't look like I had Crohn's. He had me go through my history just to make sure that my diagnosis seemed sound, and I don't think there's any doubt that I do in fact have the disease. He said that it's so thoroughly in remission it's hard to tell. All of my biopsies were unremarkable except one which showed some signs of old inflammation, which wouldn't be enough to diagnose the disease if I was a brand new patient.

He grilled me about my diet for a bit and said that he's seen a few people like me, all with their own random diet stories. It's not possible to say if I actually induced remission with my year on meat, or just had a random remission start at the same time, but he said that given the individual nature of the disease and our lack of understanding of the microbiome, anything's possible. Maybe in ten or twenty years, we'll be able to sample your gut and say, "Eat like this and you'll be fine." The science just isn't there yet.

He said that given my results I probably shouldn't bother coming in for another colonoscopy unless I had symptoms, but he's obligated to recommend a follow up given that I have a history. Keep doing what I'm doing, and call him if anything changes, but otherwise my colon looks like any other 32 year old colon. Not bad.

So, maybe in another three years I'll go get scoped again. We'll see. For now, though, I'm fine.

Eight years ago I decided to eat nothing but meat for a year. Now I have a perfectly normal colon. If those two events are indeed correlated, and someone could figure out exactly how, a whole lot of people would be able to find relief from a terrible disease. I hope that in twenty years, I'll be able to shutter this blog with a post saying, "They figured it out, go eat X and Y." But for now, it's all up to you to find the diet that works best. My approach might not work for you, but I'm betting there is an approach that will. Don't give up!

23 comments:

  1. "The cardiologist was a little stunned by the turnaround and mentioned that it takes most people years to pull that off." You might find this of particular interest: https://proteinpower.com/drmike/2017/07/25/how-to-lower-your-cholesterol/

    Cheers, Amber

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  2. Great blog. I only just discovered it via someone's post. I've also been ZC for about a year now, and it was a life saver from UC. Thanks for sharing your experience.

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  3. Like your story. made aware of your post from Principiacarnivora Web site. I am presently on Humira for Crohn's and AS. So far 6 months ZC (or almost)... Thanks for sharing

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  4. Thank you for sharing your story. I've been suffering with daily IBS-D symptoms for 20 years (though I never had a colonoscopy to confirm it wasn't something worse).

    I've been doing SCD (which you showed some interest in) for 1 year and it has helped a lot. I now only have diarrhea about once a week instead of multiple times daily. My diet has tended to get most of my calories from fatty meat. It is difficult to correlate symptoms to food, but it seems to be various plant material that leads to horrible gas and sometimes diarrhea.

    I don't know if the overall improvement has been because of microbiome changes (as per SCD theory) or just certain food triggers.

    In any case, your experience is very inspiring - especially that you were able to reintroduce plant foods after a year. Reading through your experience was very inspiring. I guess a year isn't really that long (out of a lifetime) to experiment with a major life-improving change.

    I plan to attempt a 3-month to 1-year experiment to see if it works, though I don't have a theory as solid as yours (other than hoping maybe it could give sufficient space to heal 20 years of gut damage and reduce unknown bad bacteria). I hope to successfully reintroduce plant foods at the end, though I see no reason not to eat a predominately meat diet forever.

    Thanks for sharing your experience.

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  5. It sounds like, with your gut healed, you're able to eat whole healthy foods (meat, fruits, veggies, even potatoes) but still have to avoid most processed foods. That's pretty awesome it was enough to maintain remission and that even the occasional "cheat" didn't damage your gut/biome enough to cause major issues.

    You're not too dissimilar from the Specific Carbohydrate Diet, and I believe Elaine permitted one to start doing "non SCD" foods after a year or two of healing. Technically a "meat only diet" is within the SCD framework too.

    I've been reading a lot about the damage caused by glysophate (highly present in the "evil" gluten/wheat foods) and it almost sounds possible the glysophate damages the gut to permit gluten to enter and set off the auto-immune response. Maybe meat-only allowed your gut the space to have nothing to react negatively too and close up to allow a permanent change. So awesome you kept this blog up all these years.

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  6. I’m just starting and have tried everything for my UC for 6 years. Really hopeful!

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  7. This is simply brilliant, and it should be read side by side with a post by someone who went into remission with a vegan diet. The simple lesson being that everyone is different and Crohn's is complicated. We are in the infancy of our knowledge of the possibly multiple causal and risk factors, the nature of the gut biome, and the inflammatory process. Thanks for sharing your experience.

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  9. Hi! You've been inspiration for me. Such diet helped me tremendously. But I've noticed if I don't cook my meat enough leaving raw blood in it symptoms come back.
    The question: how do you cook meat and how did you cook it when you started?

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    1. I cooked it rare or medium rare. Not blood-rare usually, although I did try to eat a few raw steaks over the course of the year, just to see what happened. I didn't notice any symptoms relating to how cooked the meat is, so I'm not much help there, sorry!

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  10. Hi! I've some new questions if you don't mind)
    Do/did you use any probiotics? Do you salt food? Do you take any supplements like vitamin D?
    Do you try to get more fat/measure ketones?
    I am sorry for so many questions and thank you.

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    1. 1. I tried probiotics in 2003/2004, but saw no difference in symptoms. Makes sense, because I didn't change my diet. The gut microbiome is very resilient.

      2. Salt, yep! Just to taste, and probably not all that much.

      3. Yes. Over the past 5 or so years I've taken vitamin D and over the past year or so I've experimented with K2. No noticeable differences in health.

      4. I don't measure ketones since ketosis isn't a goal of mine. If I want to lose weight, I make sure to stay low carb and measure my overall calorie intake until I can dial in portion sizes.

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  11. Randomly came across your blog from a reddit link about leaky guy ;-)

    My story is similar to yours, but without the Crohns and digestion issues. I tested negative for Crohns using DNA testing. Not sure if that is valid though. I have no belly aches or poop issues ;-) Only some bloating from plant based food.

    Suffered from severe chronic fatigue syndrome for 14 years. Went on a diet of red meat and 3 bananas a day for a month, and started to get better. I just could not do 100% meat (and I love meat), so I chose one carb to avoid ketosis. After several more weeks all my symptoms were gone.

    Slowly tried introducing one food item at a time back into my diet after 6 months, and paid the price. Extreme fatigue, body aches, arthritis, old injuries would suddenly hurt again, etc.

    I can only eat red meat, bananas, avocado, coffee and coconut oil it seems. Im trying some potatoes now. Trying to expand my plate, but it seems everything fails. Cant eat any grains, eggs or dairy at all. Oatmeal kills me in just a few hours.

    The whole N=1 makes its so incredibly hard to decipher what is happening. But there is no doubt this is triggered by food. Ive gone from feeling super human on 100% meat+bananas, to in bed and debilitated, so many times now, its statistically significant.

    Now im starting to wonder if trying to force myself to be an omnivore is a good idea at all. Are we really sick?? Or are we simply humans near the tail end of the bell curve? There is no doubt in my mind that the human bell curve is incredibly wide.

    Maybe having issues with grains, veggies, and non-meat items is perfectly normal?? Maybe we are like the Fox, technically an omnivore, but only in a pinch as an evolutionary advantage? But we're optimized to eat mostly meat???

    This new isotope analysis method has recently shown (2019 reports) that neandrathals and early homo sapiens we're nearly carnivores.

    Maybe we should stop trying to force other food items and simply listen to our bodies? Could being 90-100% carnivore actually be perfectly normal for a human? Or even optimal??? My blood tests have never been better. My colonoscopy was so pristine, they told me not to come back for a decade. I feel super human when running on 90-95%+ meat.

    Just one article on this subject. I have read most of them that go into details about early homo sapiens. They scored as more carnivorous than the neadrthals! Food for thought.


    https://www.sciencedaily.com/releases/2019/02/190219111704.htm

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  12. Hi I was wondering about your experience with milk and acne. Does it apply to cheese as well? And has it resolved? I want to go low starch but want to gain weight.
    Thanks so much

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  14. Just checking in to see how you're doing now and hope you don't mind my asking a few questions.

    Did you eventually not have diarrhea after your initial start, and is the diarrhea inevitable do you think? This is one of the reasons I'm reluctant to try it.

    Did you get any bloodwork done during your carnivore year and were any markers out of range, particularly cholesterol or triglycerides? I'm on a medication that can raise trigylcerides and I'm wondering how eating this way may affect that.

    Lastly, I know this is just conjecture on your part, but do you think you would've had the same beneficial results if you would have just done the Life Without Bread 72 grams of carbs per day? I can't really envision myself only eating meat, but may be able to do mostly meat with a few veggies and maybe minimal fruits. But then I wonder if the main reason you were able to start eating normally again was because you did only meat for that whole year.

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  15. Sorry, one last question, did you have any extra intestinal manifestations of Crohn’s?

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    1. Answering both comments here. I should probably write another update post, but time is not my friend :)

      I no longer had diarrhea by ~October/November if I recall correctly. So basically +3-4 months from start of diet. It's hard to say if it was inevitable, or a general-case side effect. I know normal people who have gone on all-meat diets certainly did not report "diarrhea for 3 months". So maybe I just had a flare up around the same time, or the diet caused a flare up, or I'm just unlucky. I would put a small amount of money down on a bet saying that you will suffer SOME digestive disruption, but my experience could be outlying.

      I did not get any bloodwork done during the year itself. A few years later I had very high cholesterol (270) and that dropped to ~204 when I stopped drinking milk, with a Boston Heart Panel showing a very low risk profile of HDL/LDL and triglycerides, particle size, etc. My bet is that the diet did elevate my total cholesterol, and it would probably be worth monitoring if you gave the diet a shot. If you get a Boston Heart Panel and it comes back with a low risk profile after ~6 months, then you can feel better. If it comes back bad, you can adjust. For me, dairy was the problem, not meat.

      I did have a fistula when I was first diagnosed in 2002. But nothing since then.

      Saving the best for last: did I have to go all meat for a full year? That's the bazillion dollar question :)

      All I can say for certain is that after 12 months of diet, I had zero inflammation in my bowel. It's probable that there was a point before that where I could have stopped the diet and retained the benefit. My hunch (ie, my guess that is only weakly supported by evidence and is definitely not medical advice) is that I did need to be strict for the period of time where I had diarrhea. So 3-4 months in, with maybe a month or two more for safety. After that, I bet I could have stopped the diet with most if not all of the benefits. That would bring me nicely to the 6 month mark indicated in Life Without Bread - fun coincidence.

      If you put a gun to my head, I'd predict that you'd get at least some of the benefit, albeit possibly more slowly. The underlying hypothesis here remains starving out gut bacteria, so if whatever not-meat you leave in the diet continues to sustain the bacterial population causing you trouble, then it might take longer to work or not work at all. The good news is that your proposed diet almost certainly won't hurt you, so you might as well give it a rigorous try for 6 months.

      I was kind of hoping by now (10 years since I did this! wow) we'd have a better model for Crohn's, and I'd know if I was right or wrong, but it remains uncertain. Ugh!

      Best of luck!

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    2. Thank you so much for your prompt and detailed response. I hope you don’t mind my asking you a few more questions.

      1. How severe would you classify your Crohn’s and did it respond well to medication?

      2. Was your Crohn’s in remission when you started carnivore? (I believe you said it was)
      which leads y to I my next questions

      3. Did you have any objective inflammatory markers taken before or during? I know you her a colonoscopy after but did you have one fairly recently when you started your diet and/or get inflammatory measures like CRP or sed rate taken. Just wondering if you had objective improvement or if the diet kept you in remission as opposed to improved it,not that it by itself isn’t amazing.

      4. Did you ever take any peppermint it oregano oil? I may be confusing your blog with someone else’s.

      5. Do you have any suspicions on what caused your Crohn’s? Mine started after I took antibiotics for a sinus infection, so I feel very much there is a microbial link

      Anyways, I suppose none of it matters that much because results will vary depending on the individual. It’s just nice to have an idea of what to compare to. I’m currently doing a round of EEN and if it doesn’t work, I’m debating on carnivore vs 72g carb limit with SCD.

      I really appreciate your blog and your time. I remember stumbling on your blog after I was diagnosed and thought there was no way anyone else would do that. Now carnivore is so trendy. You’re like the OG carnivore blog. Thanks for sharing your experiences! Glad you are still well. 😀

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    3. Happy to help! And wow do I need to update the theme on this blog. Painful to type comments :)

      1. I was first diagnosed in 2002 after what in retrospect was several years of active Crohn's. I would say it was a moderate case - I was 6'3", 135-140lbs, hadn't had a normal bowel movement in years and was exhausted all the time - but I've read about the truly bad cases and mine wasn't like that. No blood in my stool or resections or hospital stays. I took prednisone to get into initial remission,and then asacol/pentasa for maintenance after that. Outwardly that did the trick, but see #2.

      2. Yes, technically. However, every yearly colonscopy I was getting polyps removed and showing Crohn's inflammation on my biopsies. That was pretty good for my gastro at the time, but never sat right with me. In 2009 my gastro started talking about doing a resection to remove a large polyp, which is part of what motivated me to try a radical diet - I really did not want to get a resection.

      3. I did have blood tests, but I can't find them now. I don't recall them being very interesting before/after snapshots, no big movers anywhere. The only objective evidence was the biopsies from the colonscopies going from all inflamed before the diet to no inflammation after the diet. My last colonscopy showed zero disease activity, something which never happend pre-diet.

      4. No, just meat. I did try cod liver oil a few times, but gave it up after a massive fish-smelling diarrhea episode that made me want to die. I'm generally skeptical of supplements beyond basics like vitamins for deficiency. My guess/bet is that removing the trigger food(s) is all that matters. No supplment (besides actual medication) will outweigh the trigger. But just a guess.

      5. No clue. I was a pretty sick as a kid all the time until they took my tonsils out at ~9, and my parents assure me that I was getting liquid stool ever since I started eating solid food. I was a c-section kid, so maybe that mattered, but then so was my brother, and he didn't get Crohn's. I ate unbelievably poorly in high school, which can't have helped and may have been the trigger in a final straw sense. But I remember horrible stomach cramps going back my whole life, so I might have had a mild case since forever.

      Odd timing for this comment thread - I'm doing a brief all meat reset right now. I periodically do a week or two after an extended period of poor eating, just to reset back to baseline. Like you said, carnivore is trendy nowadays, and I have to admit I'm bemused by how many blogs and gurus have sprung up around the diet. It's not a difficult concept, and watching everyone make hay off it makes me shake my head. Maybe I should have been selling $100/hour life coaching all this time. Oh well. Could have bought bitcoin back then too, but them's the breaks :)

      Best of luck with whatever diet you choose. I hope you find the right mix and get to a lasting remission!

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    4. Sorry I took so long to reply, but I just want to thank you so much for getting back to me and sharing your experiences.

      Your story is very interesting. I'm a female and at 5'8" if I get down to 135lbs I start to look pretty emaciated, so I can't imagine how that was on you at your height and as a male. It sounds like you had digestive issues your whole life, so who knows if you maybe had the beginnings of Crohn's that was undetected way back in the day.

      I'm kind of the opposite, I had a stomach of steel, was a swimmer for most of my life and the stories of what Michael Phelps ate as a swimmer aren't really off base for most swimmers, so I pretty much ate anything and everything and never had any issues until I took antibiotics for a sinus infection when I was 30 and that seemed to be the catalyst, but I also had a bunch of other possible predisposing factors including taking antibiotics a lot as a child and my dad having UC, but neither of my sisters got Crohn's, as you mentioned your brother didn't, so it seems that there are definitely environmental factors going on as well.

      Also, I did want to mention that I don't think just being gluten-free was all you may have needed to do as you had mentioned back in one of your posts. I've been gluten-free for almost a decade and it doesn't seem to affect my disease enough to notice at least. I've done pretty much every diet out there except carnivore, so maybe that's the key for me. SCD unfortunately didn't seem to work despite being religious about it for years, but I have talked to someone on Facebook who SCD works for her son only after he went through 8 weeks of exclusive enteral nutrition, and then he was med free only on SCD but then flared again when he tried to add back in illegals. So maybe you really do have to starve out everything for a long period of time in order to fully heal like you have.

      I have been reading up on EEN studies since it's the only dietary measure that has seemed to help me, and I just read a study that had adult Crohn's patients on EEN for several months and had them use it until there was endoscopic remission, not just clinical or biochemical remission, and the average time that it took them was around 6-7 months, I can't remember, but I'd have to find the research paper again. Anyways, that goes along with your experience and the Lutz data that around 6 months seems like the length of time for things to work. It would've been nice to see if Lutz's patients had endoscopic remission.

      Anyways, I'm babbling now, I just want to thank you for your time and keeping your blog up and running. And I'm glad you have updates since some people may be more likely to try something like this if they know they may eventually get to loosen up on their diet after a year or so. Your blog is just the right amount of data and humor, and I like that you posted just usually monthly, because it gives your audience a good way to somewhat quickly see how things progressed.

      Glad you're doing well. Hope the meat reset went well too. You should feel good that you're a pioneer in this area, and I'm sorry you didn't get to cash in on it, but I'm happy you're willing to share just to help others. 😀

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