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Carnivore and Bile Acid Malabsorption

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@bertrand, ah, the fat deposits! Yes, I also got them in the form of xanthelasma- two fat, yellow pancakes on my eyelids. It’s taking a long time for them to disappear and after several years I still have some residue left. Never mind my cholesterol that was the highest my doctor ever saw! 
It sure takes a while for us to heal from PKD. I am older so even longer for me. 

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Bertrand

@wavygravygadzooks " If people like Shawn Baker and Anthony Chaffee can be ripped and in good health after years of hard exercise on a carnivore diet"

What? He did blood test and his testosterone is low. Btw just because you have some mucles and lower body fat doesn't mean that he is healthy. He can drop dead from heart attack in any moment.. His beef meat only diet is crazy deficient and unbalanced. I wouldn't be surprised if he dies from aneurysm for example due to copper deficiency from his diet so low in copper and so high in zinc.. Btw I don't see many healthy 70-80yo carnivore/keto people walking around. But I see plenty of plant based people.. In my opinion kids need plenty of anabolic foods like dairy, eggs, meats. But as we get older we need more plants for detox and less things that increase HGH, IGF1, less cholesterol, ideally nothing with hormones like soy, eggs, dairy etc.. I think plant based diet with lean meats is ideal diet for most adults..

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Shaun
Quote from Beata on April 6, 2022, 3:22 am

@wavygravygadzooks, I cannot believe that anyone says anything positive about the Paleomedicina! 

To be fair, the folks at Paloemedicina are halting the progression of deadly disease like cancer and autoimmune conditions with diet alone. Their data on PEG 400 tests of gut permeability also show large improvements. So they are hardly quacks. 

They do have a blindspot to the vitamin A issue, but so do 99.9% of other medical partitioners. They also advocate a low calorie approach, which is less backed up by hard evidence in my opinion. 

Quote from Nina on April 5, 2022, 11:24 pm

Do you personally take any supplements to help with the detox? Or just a muscle meat only diet. (Molybdenum, B1, Charcoal...)

I'm not currently on any supplements. I did try lactoferrin and, over several months, it made my symptoms worse. 

Quote from Nina on April 6, 2022, 1:12 am

Have eaten some salmon roe, brain and marrow in the meantime though...

I have eaten roe, brain and marrow in the past and quite enjoyed them. I have eaten marrow while I claimed to be on a vitamin A detox. 

Still, the bottom line is that there is no nutritional information about the vitamin A content of brain and marrow that we can trust. Salmon roe presumably contains vitamin A and other members of the carotenoid family, including whatever compound makes the salmon roe red. 

Now I eat only muscle meat from grain-finished cattle. If I am at a sushi restaurant for social reasons I might have a few pieces of sashimi, but this has not been frequent, particularly during the pandemic. 

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Beata

@jeremy, I would love to know the content of vitamin A in lamb’s brains and sweat breads. The nutritional data says it’s 0. I reintroduced them in my diet as the very low fat isn’t working for me. But I wonder if I am doing any harm to my low vit A diet journey. 

Quote from Beata on April 6, 2022, 7:20 am

@jeremy, I would love to know the content of vitamin A in lamb’s brains and sweat breads. The nutritional data says it’s 0. I reintroduced them in my diet as the very low fat isn’t working for me. But I wonder if I am doing any harm to my low vit A diet journey. 

I would personally only trust somewhat recent (say 21st century) academic research, not a nutritional database. It is hard to figure out what lab did a measurement and what methods were used. Some values of 0 in nutritional databases represent not performing the tests, rather than performing the tests accurately and finding no. Unfortunately, the incentive to study the vitamin A content of brains and sweet breads is probably zero for both the government and academic researchers. 

 

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Beata

@nina

Oh, I've tried all kinds of supplements!  Pretty much all the B vitamins separately and in a complex; molybdenum, manganese, copper, zinc, calcium, magnesium, potassium, chromium; lactoferrin; a variety of spore-based and non-spore-based probiotics; Vitamin C, D3, E, and K1/K2; taurine, glycine, lysine; and the list goes on.

The ones I feel I got a strong enough reaction from to speak on are:

B1 (thiamine) in basically any form available made me feel super lethargic with an inability to think or do hardly anything.  It also seemed to cause colon problems (kind of a paralysis in the descending colon, I think due to magnesium depletion).  I think B1 probably plays an important role in a variety of detox mechanisms, but taking too much throws everything out of balance.

B3 (niacin) gave me facial flushing at doses starting below 250 mg.

Most of the B vitamins seem to make me feel kind of jittery, hypoglycemic, and unable to concentrate.

Vitamin E gave me awful sensations in my sinuses and might have given me headaches.  However, I was getting a ton of those same symptoms when I first removed Vitamin A from my diet, and I'm not sure whether to interpret them as a sign of successful detox or not.  The literature suggests that Vitamin E supplementation in animals results in greater (healthier) weight gains and growth and prevents Vitamin A toxicity, but it apparently leads to higher levels of Vitamin A in the liver, so it's a bit unclear whether it is somehow sequestering excess Vitamin A in the liver (which may not necessarily be good if you are toxic in it).

Lactoferrin seems to cause bile acid dumping into the colon, which is what the research I've seen suggests it does by downregulating reabsorption in the intestines.  Smith, of course, probably thinks this is a good thing because he thinks bile ACIDS are attached to toxins and Vitamin A, but in reality I think it just depletes your body's precious pool of bile acids and gives you bile acid diarrhea (which is what I seemed to experience...wicked, burning diarrhea) without actually helping to eliminate Vitamin A or other toxins.

Taurine, even in small amounts, often led to awful hydrogen sulfide gas and diarrhea.  I suspect that eating a diet very high in lean meat for as long as I have may be problematic by enabling sulfate reducing bacteria (SRB) to flourish in the colon...then, when your liver ejects Vitamin A directly bound to taurine, that compound makes its way to the colon where the SRBs gobble up the taurine, leading to H2S gas as a byproduct and leaving now unbound Vitamin A to aggravate the colon walls and cause inflammatory diarrhea.  I also seem to get H2S gas from consuming joint connective tissues when I'm eating whole legs (lamb, rabbit, chicken) or cuts from the leg (beef arm roasts), but I never seem to get it from ground beef or most other cuts of meat, so I think the SRBs are also flourishing on undigested connective tissue and glucosaminoglycans (GAGs).  I'm not sure if eating a diet higher in fat and lower in lean meat would help or not...in the past, I've gotten fat malabsorption whenever I ramped up by fat intake, but that might also be due to oversupplementing.

MY MAIN CONCLUSION ON SUPPLEMENTS

You probably don't need them if you're eating a carnivore diet, and if you do take them they are very likely to just throw everything out of balance by speeding up one process and causing a new bottleneck/deficiency in the system.  I would mostly consider taking a bit of extra minerals here and there in case there is validity to the idea that the soils our animals graze on are really depleted as badly as some claim.  The one thing I haven't gotten myself to stop taking is magnesium, because I have constant muscle problems and it seems like some amount of additional magnesium helps alleviate it.  At times, I don't even get loose stools from taking 1000+ mg in a day, which seems to strongly suggest that my body needs it.

I would probably also recommend trying to slowly increase taurine and see what happens.  If you seem to tolerate it, I think it's probably hugely beneficial.

I am still on the fence about Vitamin E...probably better to eat ruminant fat and not supplement E derived from plants.

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RetinoiconNina

@nina

My list of symptoms is a long one.  I had oxalate problems before I went low Vitamin A, so I'm not sure which symptoms might be from oxalates and which from Vitamin A toxicity.

I'll paste the records that I've been giving to doctors below:

Diet and Health History Overview

  • Was raised on a Standard American Diet high in processed carbs/sugar, with meat consumed twice per day on average (always loved meat)
  • Have been extremely athletic my whole life
  • Was very healthy with no noteworthy medical issues until age 18
  • Began having diarrhea, gas, and intestinal disturbances during first year of college (age 18.5) that continued in some form or another until the present; diagnosed as IBS after several years of testing, with no known cause (the only possible associated health event leading up to it was a brief spell of “traveler’s diarrhea” when in Rome/Florence/Pisa, Italy about a year earlier); in retrospect, the “IBS” was most likely SIBO and dysbiosis fueled by carbohydrate consumption and low quality plant oils used in the processed carb products I was eating regularly
  • Attempted to control “IBS” by adopting different dietary strategies; continued to eat a very high processed carb diet low in fat and low in fiber (aside from supplementing with Acacia Fiber regularly), but high in animal protein
  • Despite “IBS”, continued to be very healthy and athletic until 2017 (age 33)
  • Around 2015, began to incorporate more vegetables into diet, particularly large servings of cooked spinach and lots of carrots baked in olive oil or coconut oil; also began to eat sprouted grains and experiment with “alternative” whole grains like amaranth and millet
  • “IBS” became less manageable in 2017 with terrible diarrhea; began to have anxiety problems, agoraphobia; began to experience chronic fatigue and poor exercise endurance
  • Adopted a Specific Carbohydrate Diet / GAPS diet in 2018 primarily by removing starch and sugar; diarrhea stopped within a week for the first time in almost 20 years, but chronic fatigue and poor exercise endurance continued
  • Got acute vertigo around May 2018, followed by chronic dizziness and vision disturbances (nystagmus, myokymia, blurriness)
  • Began eating more and more vegetables from 2018 to 2020 and dramatically increased fat intake (primarily olive oil, coconut oil, and butter)
  • Diarrhea eventually returned around 2019 and I slowly crashed into a state of “adrenal fatigue”, confirmed through testing as HPA axis dysfunction
  • Adopted a low-oxalate diet at the beginning of 2020 and saw marked improvements
  • Shifted towards a carnivore diet around June of 2020 and was 99% carnivore by July
  • Still had terrible fatigue, dizziness, and vision problems; suspected Vitamin A toxicity due to years of supplementing cod liver oil, desiccated liver, and more recently eating fresh liver, kidney, and lots of eggs and milk kefir, as well as having ongoing carotenemia from eating too much beta carotene (carrots, winter squash, leafy greens)
  • Removed virtually all Vitamin A from diet at end of July and suddenly went through a phase of nausea and episodic watery diarrhea interspersed with constipation and mucus-laden bowel movements that were often orange, or had a bright yellow liquid leaching out of them (looked like the color of Riboflavin in urine)
  • Explosive watery diarrhea became more and more common until it was chronic, often happening multiple times a day; began to have gas and bad intestinal gurgling every night around midnight
  • Began to have a variety of dry skin, dry mucus membrane, and fingernail/toenail problems that can all be associated with Vitamin A toxicity
  • Began to get fat malabsorption
  • Began to get cherry angiomas, thread/spider veins, and “age spots” on arms and legs (hyperpigmentation dots 1-2 mm in size)
  • Began to have severe gum recession and gingivitis
  • Have persisted on a low-Vitamin A diet for 1.5 years now, dominated by lean beef, and seem to generally have better energy when eating white rice for calories instead of fat
  • Have tried supplementing just about every Vitamin and mineral out there with mixed results

 

 

Current and recent symptoms history

 

Gastrointestinal

  • Extremely urgent, watery diarrhea began to occur very sporadically after removing Vitamin A from diet. Often burned terribly and had an orange and/or yellow color to it, as well as an oily appearance at times
  • Was virtually constipated (Bristol scale 1-3) between bouts of watery diarrhea early on, with a lot of mucus in stool, often with orange coloration in the stool and/or mucus
  • When stools were firm, often had bright yellow liquid rapidly leach out of otherwise very dark brown stool
  • Over time on a low Vitamin A diet, watery diarrhea became chronic, often happening in the middle of the night. Began to have gas around the same time every night (around midnight) despite little to no gas during the daytime.  Began to have really uncomfortable gurgling in the lower intestines (around ascending colon) in the middle of the night, associated with gas buildup; the severity of the gurgling was correlated with the degree of burning watery diarrhea that followed the next day
  • Eventually, began having difficulties passing gas at night, and would have to get up for an hour or more every night to change body positions to get it out. Often requires pressing the abdomen with a hand to force it out.  Sometimes am unable to pass gas at all between around 3AM and 9AM, with immense pressure building in descending colon.  Feels like sphincter will not relax to let gas out.  Seems to be associated with things that depress magnesium levels (thiamine supplementation, endogenous and exogenous oxalates)
  • Diarrhea and nightly GI symptoms seem to worsen with increased fat intake. Very hard to tell if the diarrhea is due to bile acid malabsorption or to Vitamin A aggravating the colon.  Fiber consumption seems to help to some extent, especially when minimizing fat intake.  I suspect that the gas is due to bacteria deconjugating Vitamin A from glucuronides and taurine, and the diarrhea and abdominal pain results from unbound Vitamin A (retinoic acid) aggravating the colon wall.  Eating heart or supplementing even tiny amounts of taurine leads to awful hydrogen sulfide gas and diarrhea, which I believe is due to the liver binding additional Vitamin A with taurine and sending it to the colon, where it gets broken down by sulfate-reducing bacteria

 

Neurological

  • Vertigo and dizziness (disappeared almost entirely after a few months of low Vitamin A)
  • Tinnitus (disappeared almost entirely after a few months of low Vitamin A; some very brief episodes lasting seconds continue to reoccur)
  • Vision problems akin to oscillopsia and/or nystagmus (see below)
  • Slight tremor or generalized feeling of shakiness

 

Eyes

  • Vibration in visual field, most noticeable along high contrast edges when starring for longer periods of time; images in peripheral vision tend to move around a lot, most noticeable around screens and digital lights in the dark. Ophthalmologists have not detected visible motion.
  • Dry eyes, particularly outer corners, more often at night; very easily irritated by the slightest amount of dust generated from things like moving hay bales or other animal feed (has mostly disappeared recently)
  • Throbbing pain, mostly at night earlier in the low Vitamin A diet
  • Floaters
  • Extra fluid/puffiness/inflammation of upper eyelids and skin fold above eyelids
  • Upper eyelids (and to lesser extent skin immediately surrounding eyes) extremely oily during the day with burning sensation; at night, when eyes closed, upper eyelids would become extremely dry and irritated and occasionally cracked and bled (disappeared almost entirely after a few months of low Vitamin A)
  • Numerous eyebrow hairs have become kinked or kind of spiraled and grow at weird angles

 

Mouth

  • Roof of mouth constantly feels ulcerated or burns even though there is essentially no visible change to palate
  • Sensation that gums are lacerated, primarily rearmost upper molars; seems to have begun happening with consumption of shredded coconut. Believe it’s a response to a combination of fiber and fat intake that causes a large amount of bile to be released, which results in more Vitamin A being released from storage sites in the head, including the mouth
  • Gum recession, dramatic at times with visible change within days
  • Gum inflammation, gingivitis
  • Gum pain, tooth sensitivity

 

Muscles

  • Chronic twitching
  • Episodic cramping, primarily in feet, or when holding certain positions (cradling something in crook of arm will cause arm to cramp)
  • Easily fatigable
  • Soreness

 

Mental

  • Impaired reading ability (primarily due to vision disturbances)
  • Difficulty concentrating when talking face to face (primarily due to vision disturbances)
  • Strange mental states during the night

 

Sinuses/Nasal Passages

  • Sensation of extreme dryness and sensitivity to cold air early on in low Vitamin A diet, less so recently. Seems to come on strong during the late hours of the night and gradually dissipate during the morning.
  • Commonly have bloody noses during the winter, much less common or non-existent in the summer

 

Skin

  • Dry skin
    • Very mild eczema on one big toe (no redness, just thickened rough patch of skin)
    • Dry flaky skin between toes
    • Dry heels and outer edges of feet
    • Bottoms of big toes peeled relatively deeply at one point (painful!)
    • Flaky skin on forehead, bridge of nose
    • Flaky scalp
    • Side folds of nose get very itchy with a visible red line forming occasionally
    • Dry, itchy elbows early in low Vitamin A diet
  • Small bumps on back of triceps and backs of upper legs
  • Cherry angiomas, popping up in 2-3 separate events
  • Other small red lines that look like burst capillaries
  • Isolated thread/spider veins
  • Sun spots, age spots
  • Unusually inflamed pimples on face, forearms, and tops of thighs
  • Occasional small rashes or patches of strangely textured skin

 

Nails

  • Nails very thin, cracked and splitting early on in low Vitamin A diet
  • Some faint longitudinal ridging
  • Beading on a couple fingernails
  • Occasional isolated white spots on nails
  • Onycholysis (separation of nail from nail bed), most noticeable on all fingernails, but also on toenails to some extent
  • Cuticles receding on fingernails, somewhat separated from nail
  • Cuticles on toenails covering much of the nail and flaking off
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RetinoiconShaun

@jiri

I've responded to most of those same comments you've made in the past.  You can make conjectures based on the shitty reductionist dietary science we've accumulated, but nothing trumps real life experiences in large numbers.  Only recently have people started trying a carnivore diet in large numbers in "civilized" societies and documenting the outcomes.

So far, when you look at the real life outcomes and compare it with our knowledge of human anatomy and evolution, it is pretty obvious that some form of the carnivore diet is the ideal human diet.  If carnivores dieters start dropping dead left and right, I will of course eat my words and admit I was wrong, but that's less and less likely to happen as the days go by.

What is abundantly clear is that plants mostly rely on chemical defenses, which are essentially impossible to completely eliminate no matter how much you process them, and the more of those you ingest over a lifetime, the more likely you are to suffer from them.  Herbivores rely on specialized anatomy, physiology, and gut microbiomes to cope with plant toxins.  Humans can largely replicate the functions of those things with fermentation, soaking, cooking, but it's still not the same...we are not designed to eat plants, although we have done a damn good job of minimizing their defenses.

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Retinoicon
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