Diagnosis update – Not C-diff

Not sure if this is a good thing or bad thing. Got test results today. No C-diff.

On the plus side, this is one less thing we have to battle.

On the minus side, we now don’t have an easy explanation for the IBS-D. Well, we’ll continue on with another plan.

Tonight Kayla is off to the colonic clinic for another hydrotherapy session. Theory is that if there’s something reactive in her intestine, this will wash at least most of it out. Maybe if we wash out a bunch of it then the probiotic supplementation will be enough to create more good bacteria than whatever bad thing is there.

If we can restore normal function following this colonic, then great. If not, then maybe we do it again and increase the probiotic supplementation.

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Soluble Fiber Sources

At the naturopath’s office yesterday, we discussed the plan to add more soluble fiber to kayla’s diet. We were increasing intake of chia seed, bananas, avocados, and oranges along with psyllium husk. Doctor agreed with all of these except for chia seeds. Doc believes that chia seed can cause diarrhea. I’m not in agreement with this as I have never had such an experience and everything I read online says the opposite. However, his recommendation was to switch the chia with flax and continue to increase soluble fiber intake.

Theory is that if we have enough soluble fiber intake, it may bind with the c-diff or whatever bad bacteria may be present and carry it out. It may be enough to overcome and regulate.

Note, we also added another kind of fiber supplement to the mix. We now have dextrin (Benefiber).

The psyllium husk (Metamucil) is a sugar free orange. I personally think it tastes like Tang and reminds me of my childhood. I didn’t even know they still made that stuff!

The dextrin dissolves clear and has no taste or texture. I suggested that Kayla just add this to her water and drink throughout the day.

I have no thoughts yet on efficacy of the dextrin, but have never had a bad experience from the psyllium. The dextrin should be easier to mix into smoothies and drinks and may result in being able to increase intake without effort.

clostridium difficile – C-diff

Went to doctor yesterday. New theory is that IBS-D could be resultant from a lingering C-diff infection. Over a year ago, Kayla had a kidney infection. It was during the ultrasound examinations that the hospital discovered splenic cysts as well. She has now had two operations for partial splenectomy in order to de-roof the cysts. All three came back one time and one has come back a second time. We do not yet have any theories about a connection between cysts on the spleen and the current problem of Hashimoto’s. We also don’t yet have any theories about a connection between the kidney infection and the Hashimoto’s.

But, there may be some merit to the connection from the treatment of the kidney infection. At that time, Kayla was put on antibiotics. It looks like this is a very common occurance Antibiotic-associated diarrhea caused by Clostridium difficile. When Kayla had this course of antibiotics, there was no protocol prescribed for probiotics afterwards. I believe this was a large oversight.

So, the question is how best to treat this. This coming weekend, we’re going to get a test kit from Quest Diagnostics to test for C-diff presence. If confirmed, there will be a protocol of other antibiotics. I think that if we dose with probiotics appropriately after the treatment, then we have a good shot at managing the infection.

Another note is that several months ago Kayla went to a clinic for a colonic. It was a good experience at Colon Care. Now, we don’t necessarily agree with claims of magic occuring after colonics or agree with the idea that this is something that everyone should be doing all the time, but Kayla has indicated that she had regular bowel movements for over a week following the colonic. Theory is that the colonic washed out enough of the c-diff to reduce inflammation and allow proper digestive action until the c-diff once again multiplied and took over.

Following the screening test for c-diff, plan is to have another colonic and maintain current protocol of high soluble fiber with probiotic treatment until test results come back confirming c-diff. At that time, we can either see if colonic followed by probiotics can handle it alone or if we need to continue with a new antibiotic treatment round.

Fiber Source – Chia vs Psyllium Husk

We’ve been trying to increase soluble fiber intake via Metamucil psyllium husk supplement. The goal is to get up to the recommended daily allowance of 30g or up to whatever it takes to regulate Kayla’s digestive tract. The problem is that the single serving of Metamucil is 1 tsp and only provides 4g of total fiber. 2g of insoluble and 2g of soluble. Consider that the psyllium husk supplement doesn’t come with any other nutritional value.

Compare this to chia seed or flax seed. In either of these, you get the fiber as well as protein, vitamins, and healthy fats. Going to try to measure out something like 6 TBSP per day of chia + flax in order to get around 30g fiber and see how that goes.

Elimination diet

In order to try to address Kayla’s IBS-D symptoms, we’ve been trying to eliminate insoluble fiber foods, gluten, dairy, and soy. We’ve been adding more soluble fiber foods and psyllium husk metamucil twice a day. So far, very little success over the last week.

However, she did have a solid stool on Friday around lunch time. So, what we need to do is identify the foods eaten leading up to this and try to repeat the success.

Thursday breakfast – paleo pancakes by Birch Benders (ingredients: Cassava flour, organic coconut flour, almond flour, eggs, monocalcium phosphate, sodium bicarbonate, salt, monk fruit, spice). Coffee. Took Metamucil (1TBSP)

Thursday lunch – leftover baked chicken tenderloin, zucchini pan fried with avocado oil. Some chia pudding (chia seed soaked in cashew milk overnight).

Thursday dinner – Chipotle rice bowl with white rice, steak, fajita vegetables, sour cream, hot salsa, mild salsa, black beans, guacamole and half a bag of chips. Took metamucil (1TBSP)

Friday breakfast – smoothie with avocado, banana, vanilla Vega protein powder, chia seed, unsweetened vanilla cashew milk. Coffee. No Metamucil before breakfast.

Friday lunch – same Chipotle rice bowl again.

Then – successful movement.

Now, I’m still not so sure if coffee is problematic as we haven’t been able to ween her off of it, but maybe the fact that we got some positive result is good. I wonder if there is significant lag time (greater than 72 hours) between removing something from the diet and getting a positive result. Or if there might be lingering materials in the gut that will take weeks to flush out completely?

After the friday lunch movement, we had korean food for dinner – rice and kimchi soup.

Saturday breakfast – paleo pancakes

Saturday lunch – mexican food. street tacos with rice and beans.

Saturday dinner – no-bun cheeseburger and a side salad. Metamucil prior to dinner.

Saturday night movement – not well formed. Had globs of fiber, but no cylinders.

Sunday breakfast – no Metamucil because she doesn’t want the fiber prior to a workout. Had fried eggs, sausage (TWR – Teton Waters Ranch – 100% grass-fed beef cooked uncured beef polish sausage from Costco), and Mikey’s muffin.

Chia is my secret

Every once in a while I go on a kick where I like to constantly drink from a 64oz hydro flask water bottle into which I crush a whole lemon and pour a couple tablespoons of my seed mix. I have a container in the cupboard that is a mix of hemp seeds, flax seeds, and chia seeds.

A lot of other people, including Kayla, have watched me drink this mix and think it’s weird. They also don’t seem to like the texture of little floating things in their water. I find it more interesting, and actually enjoy the experience.

I started with the seed drink after reading Born To Run – Christoper McDougall. After finding about chia from the book, I eventually found hemp hearts and flax and just came to appreciate that they’re all essentially superfoods.

Now with the current effort of trying to increase soluble fiber and regularity in Kayla, I can better appreciate that perhaps my habit of drinking this seed concoction may have really helped me stay regular. Kayla never liked it, so she didn’t partake in the same. Maybe now I can convince her to.

The problem with a ketogenic diet

Years ago I started loosely following a ketogenic diet plan, trying to avoid carbs as much as possible. Before keto, my standard breakfast of choice was toast covered by a can of chili beans and a couple of fried eggs, all smothered in hot sauce. I ate this every day for years and never had a problem.

On keto, the beans were a no-no and the toast had to go. So, what we ended up with was a standard breakfast of kale or spinach sauteed or wilted in a pan, then mixed up with some eggs and bacon or sausage. Again, I was able to eat this for an extended period of time with no problem.

Kayla and I used to eat sandwiches, pizza, and normal bar foods on a regular basis. After keto, we tended to choose more salads, whole fruits and vegetables, and generally more plain foods. This drastically increased our intake of lettuce, kale, broccoli, cauliflower and miscellaneous frozen vegetable medleys. Again, no problem for my digestion.

All the stuff we were eating is “healthy” food. However, what didn’t become apparent to me until recently was that Kayla has been dealing with improper digestion of our new diet for at least a year! This should have been a red flag within a few days, but she has just been dealing with it and accepting the condition as a new normal for such a long time now. Now that I’ve been paying closer attention to her reaction to our meals, it appears that she’s got IBS-D.

There seems to be a lot of talk on the internet about getting more fiber on keto, but the talk doesn’t distinguish between insoluble fiber and soluble fiber. Like this: Reddit.com – Fiber on Keto. The comments simply talk about eating more leafy greens, broccoli, and cauliflower. We were doing just that! We were eating greens every meal. It was normal to cook 16 oz of broccoli to split between the two of us every night. We were eating cauliflower rice. We cooked the Trader Joes – Healthy 8 Veggie Mix in a pan, then added eggs to it for a standard breakfast. We didn’t eat bread. We rarely ate potatoes. We ate only a few bananas in order to avoid the sugar. All of this matched up with the keto plan.

When Kayla’s stool was loose, the thought was just to add more fiber. So we kept increasing the salads, increasing the broccoli, adding cauliflower. It didn’t work, but we felt like that was what we were supposed to do. After the Hashimoto’s diagnosis, we were having green smoothies every morning with loads of spinach and kale. Now that I’ve investigated further, I’ve re-learned the difference between soluble fiber and insoluble fiber. Maybe now we can attribute at least some of her digestive issues on a lack of soluble fiber.

Soluble vs Insoluble Fiber

Look at that list. Insoluble fiber is found in vegetables. Vegetables like broccoli, cauliflower and leafy greens! All of these foods, while considered essential eating and healthy contained loads of insoluble fiber. Each of these foods contributed to “help food pass more quickly through the stomach and intestines.” That is exactly the opposite of what we were trying to achieve.

There’s also a conflict if you look at the list of foods with soluble fiber. Again, this is only available from plants, but the only one that is allowed on keto is seeds. We weren’t eating a lot of seeds, bananas, apples, oranges, or other sweet fruits, so we weren’t getting much soluble fiber at all!

Now I’m seeing different sites giving the advice not to eat any insoluble fiber alone or on an empty stomach. Totally makes sense. If you eat a bunch of leafy salad with broccoli and other fibrous veggies with nothing to balance it, then the only reaction is acceleration through the digestive tract. Not what anyone with IBS-D is looking for. Now, if you’re dealing with IBS-C this might be exactly what you need in order to clear out. But that’s probably because your diet didn’t have any fiber at all to begin with.

The explanation of soluble fiber given on this site was an eye-opener for me. Soluble Fiber for IBS

This is now a list of stuff to pick from, but with exclusions of some necessary due to the Hashimoto’s.

Rice
Pasta and noodles – Avoid due to gluten
Oatmeal
Barley

Fresh white breads such as French or sourdough (NOT whole wheat or whole grain)*  – Avoid due to gluten
Rice cereals
Flour tortillas  – Avoid due to gluten
Soy
Quinoa
Corn meal
Potatoes
Carrots
Yams
Sweet potatoes
Turnips
Rutabagas
Parsnips
Beets
Squash and pumpkins
Mushrooms
Chestnuts
Avocados (though they do have some fat)
Bananas
Applesauce
Mangoes
Papayas 

So the adjustment away from all the insoluble fiber started on the morning of 8/18/2017 with a plan to cut out all the leafy greens and increase soluble fiber until we could establish a more regular cycle. We started with less than a teaspoon of psyllium fiber supplement in the morning and evening. Unfortunately Kayla went to a work event during the day and wound up eating a green salad. That’s ok, just pushes the results of this experiment out another half day. So, with the plan to add more soluble fiber from the list above, we went for sushi for dinner. Including the white rice. We had tamari instead of regular soy sauce in order to avoid the gluten that is in most soy sauces.

Throughout the day on Saturday, 8/19/2017, we continued to supplement a little bit more of the psyllium throughout the day. We ate “junk food” all day and it was glorious. Now, for Hashimoto’s sufferers, it still makes sense to avoid gluten, dairy, and soy. We still did that. We had breakfast and lunch tacos from some catering leftovers that I brought home from work. This had beans, potatoes, eggs, bacon, and sausage in corn tortillas.

As of this morning, Sunday, 8/20/2017, still haven’t seen the first sign of the fiber supplements from Friday. Everything’s still liquid on the way out. I think this is perfectly normal, but it’s odd to her since everything has been flying through her body so rapidly for so long.

Later I’ll write about how I believe the increase in vegetable intake has resulted in vitamin deficiencies and maybe even contributed to the occurrence of Hashimoto’s in the first place.