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Carnivore and Bile Acid Malabsorption
Hi all. I am new to this forum but have been doing low Vitamin A for over 8 months now in order to correct a Vitamin A toxicity acquired through food and whole food supplements. My diet has been 99% carnivore (muscle meat and fat, roughly 80-85% lean) during that time period. While I have made some significant improvements, there are a number of issues I'm still dealing with. The one I want to discuss here is Bile Acid Malabsorption/Diarrhea.
Has anyone else experienced this and related it to Vitamin A toxicity?
My first encounter with BAM roughly coincided with when I removed most Vitamin A from my diet. I had adopted a low oxalate diet for about 6 months and was gradually transitioning onto a carnivore diet. At the time when I first had BAM, I was still eating lots of eggs and liver but had removed most plant foods (and sources of fiber). As soon as I removed liver and eggs from my diet, I started getting BAM more and more frequently.
I keep a food and symptoms log electronically and it's been surprisingly hard to correlate the BAM diarrhea with particular dietary components. It seems to be most strongly associated with fat intake, and secondarily with B vitamin intake (lightly cooked steak, heart, Benfotiamine supplements, B Complex supplements). And it also seems somewhat aggravated by magnesium supplementation, although the magnesium itself does not seem to cause diarrhea.
My current hypothesis is that my body is using BAM as a method to move Vitamin A toxic bile out. I have tried using various binders in between meals (bentonite clay, charcoal, Acacia fiber, Psyllium husk, GI Detox product) with little success in mitigating the BAM. In fact, it seems like the binders ultimately lead to more BAM after an initial period of slowing but not stopping the BAM.
It would be great to hear from anyone with insights or similar experiences. I'm wondering if I'm just destroying myself through this process, or if I'm efficiently excreting Vitamin A alongside the nasty GI symptoms.
-Wavy-
Hi @wavygravygadzooks, I've written here before that perhaps many of us here have a poorly functioning biliary system going on. It could be as simple as all-systems-not-working-so-great, and that a rising tide will lift all boats. Or it could be we need something to help it along. Over time on the diet I've cut back on fats to try to live within the bounds of what hubs and my systems are capable of. When hubs has a lot of meat fat (especially pork fat) he can be quite miserable.
I've often found that deep fry oils are especially toxic. Just over-eating in general can lead to problems.
On another thread today I talked about my thoughts on amines, which also might be involved when it comes to getting "the runs". https://ggenereux.blog/discussion/topic/first-5-months/?part=5#postid-12088. I've also written about times when I wondered if I was getting too many aldehydes. Perhaps these things come down the same detox channels as VA.
Restaurant meals are tricky because a lot of the above can be at play.
@lil-chick I'm now pretty sure that when I eat more lean meat and less fat, my BAM gets worse. Bile is released from the gallbladder for two primary reasons: (1) to assist in the digestion of fats, and (2) to neutralize stomach acid entering the duodenum. If I eat a bunch of meat with relatively little fat, theoretically I am getting a pulse of bile (containing bile acids) in order to neutralize the stomach acid, but the bile acids in that bile have virtually no fat with which to bind. If these bile acids are conjugated (with glycine or taurine) and are not binding to fat in the intestines, they are likely to get shunted into the colon rather than reabsorbed in the ileum for enterohepatic circulation. This would theoretically lead to BAM.
The amines thing is interesting to consider. I think I went down that rabbit hole a long time ago.
Pork fat, especially from commercial pork, is high in unsaturated fat, as are most oils used for deep frying these days. When you heat unsaturated fat, it turns rancid and produces amines. The more unsaturated the fat, the worse it is. This same pattern is reflected in the smoke point of different fats: the more unsaturated, the lower the smoke point, and the more likely it is to become toxic with heating. This is the reason why saturated fat (i.e. ruminant fat and tallow) is preferable to unsaturated fat. From least bad to worst would be coconut oil, partially unsaturated animal fat (pork, poultry), palm oil, olive oil and avocado oil, then oil from any other plant source.
@wavygravygadzooks, I guess I'm the opposite and feel that my runs are often due to more fats than I can handle. I've read that floating BM's can show if a person is taking more fat than can be processed. I probably should study the bowl contents more often, LOL.
It seems that people go carnivore and it's great for a time, but then stuff happens. I suppose it could just be the VA detox. Or they came with a disease and it hasn't gone away yet. Or it could be that healing hurts sometimes.
BUT, I sometimes wonder if carnivores are concentrated too much on muscle and might need something else from the animal that wasn't in the muscle. And maybe? I wouldn't be surprised? if that something can be gotten direct from vegetative foods that have been dropped? I dunno.
Back when I was doing all my WAPF readings there were stories about the early explorers and their carnivorousness. These stories talked about the cups and quarts of animal fluids taken. Not just the fats, but also the juices. Maybe their cooks made bone broths too? I'm sure they were eating nose-to-tail as well, eating the entire animal, they wouldn't waste anything. I bet they doled out things like liver in small amounts to everyone ...rather than a big slab just for one guy. Just my guesses.
I have predators come through and eat things. They actually don't eat the entire thing. They leave intestines, and some fur. But they do eat the rest including the bones. I suppose an egg is a very complete sort of thing, because it can make an entire chick. Milk is too as it can make an entire cow. Those could be studied and compared to muscle meat to see what might be missing.
I've got a friend who grew up in a trad culture and despite the fact that they were almost vegetarian, he is a pretty well-formed individual. He did tell me that at his (sleep away) school each child got an egg a day. And lots of beans and rice.
It's challenging to know when you are eating "right" ...sigh. You might be eating right and still suffering from what you ate (or didn't eat) 10 years ago, LOL.
One nutrient that comes to mind is potassium. That would be something that vegetative things have. I also have the intuition that I have an increased need for it now that I'm trying to get replete with B12. I'm betting that carnivorousness often helps overhaul B12.
@lil-chick Based on my experience, floating stool is either due to fat in the stool or gas trapped in the stool. If it's floating but well-formed, a normal shade of brown, and you see no signs of greasiness, it's probably from gas. If it's pale in color, soft looking, and greasy, it's from fat in the stool. However, that fat can be from bile acid (which is largely cholesterol) as opposed to undigested dietary fat. I seem to digest dietary fat well, but I still get greasy stool all the time, which I'm pretty sure is bile acids because the stool is usually very dark rather than pale. In fact, I think the more fat I eat, the darker the stool gets because my liver is cranking out bile. Very dark stool seems to be common among carnivore dieters for that reason.
I've got a strong hunch that many people doing low vA are going overboard on the fiber and eating too little fat, and they're running into bile acid insufficiency. This is showing up in the form of pale yellowish stools. If you get diarrhea from eating more fat, it may be because your bile production is too low from eating too little fat for too long and/or eating too much fiber (which binds all the bile acids that would normally be recirculated to be used again in the liver).
After reading up on carnivore principles for a year and trying it for 8 months, here's my current conclusion: Humans can thrive on just muscle meat and fat for a very long time, probably indefinitely. I don't think they are missing any nutrients by doing that. The reason that nobody has eaten that way until now is largely because nobody had that quantity of muscle meat and fat available to them year-round. Food consumption in the wild is a game of efficiency. The more nutrients you get for a given amount of effort, the more you're winning the game of natural selection. If a hunter-gatherer takes down an animal, they are going to eat as much as they can possibly get from it unless there's another animal just standing there waiting to be killed. Similarly, carnivorous animals will eat as much of their prey as their digestive systems will allow, unless it's really easy to kill another one, in which case they will only eat the most easily accessible nutrients (usually the organs and visceral fat). I'm a biologist who has studied snowshoe hares, and when there are a ton of hares around, the lynx that specialize in catching them will only eat half or a third of the hare; during times of scarcity, they eat every last piece except the feet!
So, it's quite possible to be healthy eating just muscle meat and fat, but you CAN get even more nutrients by eating the organs. The main problem with eating the organs is potentially getting too much Vitamin A, and also being exposed to parasites and pathogens. But humans have arguably evolved to use the animals they kill with high efficiency, which probably means they can handle the Vitamin A in the organs so long as they are only consumed in proportion to the rest of the animal...but this also assumes you're living an ancestral lifestyle outdoors, moving all the time, and being exposed to things that challenge your immune system regularly.
On paper, plants sometimes appear to contain more of some nutrients than animals, but the problem is that what they do contain is not very bioavailable. It is either physically inaccessible behind fibrous cell walls, or it is chemically bound tightly to plant compounds. Humans have adopted all kinds of processing methods that improve the bioavailability, but it still pales in comparison to meat and organs in most cases, and you have to expend a bunch of energy to make the plant nutrients available when the animal nutrients are almost 100% available with little-to-no cooking or other processing needed.
Wild eggs and milk are probably the most nutritious foods around, indeed. However, domesticated versions of these come with all kinds of potential problems due to the unnatural feed a lot of the animals receive, the strange breeds of animals we've created, and the growth hormones and ratios of minerals in milk that are intended to grow the young of a different species of animal than ourselves.
Maybe it's fine! I guess you are going to find out!
@lil-chick I take back what I said about lean meat causing more bile acid diarrhea than fat... I recently tried upping my fat intake again and the diarrhea got worse. The research I've seen on gall bladder emptying found that fat consumption led to the greatest amount of bile release, but protein also led to a fair amount of bile release. I think the muscle meat and fat diet I'm on is ejecting a lot of vA that's coming out as bile acid diarrhea...not pleasant, but very effective!
Very interesting @wavygravygadzooks!
Have you ever heard the theory (these are all just theories, right?) that millia is about not handling fats properly? Millia is a thing for hubs and I. I'm into little symptoms like this, LOL. Here is a quote that is typical of what alternative sites say about millia, I haven't evaluated this internet post in it's entirety, but it could be interesting. "A sign that fats are not being absorbed is a skin condition known as ‘millia’ or ‘keratosis’ which are little ‘bumps’ on the face or arms. Even adult acne can be a sign of fat mal-absorption." https://www.heartandbody.com/the-liver-and-gallbladder/
Anyways, I try very hard to be traditional (ie eat like my grandmother), this is where I've landed after a lifetime of trying odd diets. My diet when arriving here was on the high side of trad for fats. Over time here, I've moved us to being on the low side of trad for fats. It just seems like things are easier. However, the easy route isn't always the right one, LOL. You could say to me, hey, lil chick, eating low-VA fats helps moves fat-soluble toxins along. And I would nod and say, could be!
@lil-chick I hadn't heard the term millia, but I'm familiar with keratosis because I'm pretty sure I've had that for a while on the backs of my upper legs and on the backs of my upper arms (tricep area near elbow).
Keratosis is supposedly a common symptom of chronic Vitamin A toxicity. I think it's reportedly associated with zinc deficiency as well, which would align with Vitamin A toxicity. This matches my experience. The keratosis on my arms has almost completely disappeared on my low Vitamin A diet, but I've still got some on the backs of my legs.
Relating keratosis to fat malabsorption is new to me. The article doesn't draw a clear connection between the two, but based on my experience I wonder if it is not actually fat malabsorption but instead bile acid malabsorption that is associated with keratosis due to the body trying to dump toxins like excess Vitamin A in the bile. As I've mentioned before, I think fat malabsorption and BAM could be confused for one another without doing a stool test to see how much bile acid it contains.
Considering that I've only been eating meat and fat for the past 9 months, and I don't eat that much fat, and my weight has been totally stable, and I'm able to exercise on a daily basis, there's no doubt I'm absorbing most or all of my dietary fat (otherwise I would've keeled over by now), yet I still get fatty diarrhea all the time...that's one reason I've decided it's bile acid malabsorption.