I needed to disable self sign-ups because I’ve been getting too many spam-type accounts. Thanks.
Sunbathing, UV, IR and agitation
@rachel-2 @jaj Do either of you have comments on my suggestion that fiber/charcoal could be inhibiting detox by binding fats and bile acids needed to eliminate Vitamin A from the liver?
If you need fiber to get Vitamin A out and avoid cholestasis, I should have had cholestasis for the past 9 months of eating saturated fat and zero fiber, but instead the only time I think I may have experienced cholestasis was before I eliminated fiber from my diet.
Consider that when someone is healthy, fiber is binding to fat that the body wants and bile acids that the body needs to process fats, which means that it is depleting the body of critical resources. Fiber represents a nutrient and energy sink. In the case of Vitamin A toxicity, you might view fiber as a medicine. But medicine always represents a tradeoff, and usually the benefits of a medicine quickly become more harmful than what it's treating, which is why medication has historically been used to treat acute illness, not chronic illness (also because chronic illness is a relatively recent phenomenon). I could see fiber or charcoal being used for maybe a week to overcome some roadbloack in the system, but I think its longterm use is problematic, especially in the absence of much fat in the diet.
Have either of you tried higher fat and lower fiber simultaneously to see if it relieves what you believe to cholestasis symptoms? You may wind up with diarrhea (like I have) depending on how much fat you eat, but I would be curious if it resolved some of your systemic symptoms.
Quote from Jenny on April 27, 2021, 2:48 pmGlad you are improving your cholestasis symptoms. I wasn’t quite sure if you were blaming psyllium and charcoal for your cholestasis or the UV treatment ramping up detox that then exposed a previous problem? I ask because I’ve found the reverse - with the soluble fibre & charcoal helping cholestasis. I know that too much soluble fibre doesn’t suit everyone and that charcoal can cause constipation but I’ve not thought they are causative for cholestasis.
Ergh... Sorry again. I read the question again and feel the need to be more clear. I'm not blaming the UV OR the psyllium OR the charcoal for creating cholestasis. Cholestasis was a prior, unknown condition that wasn't giving me obvious symptoms, until I started the Low A diet / detox. All of those things can be agitators in different ways.
Dr. Smith has been saying that he believes all/most of us who came to his circle have cholestasis. (I don't want to misquote him, so take it with a grain of salt. Also, I'm not in the inner circle and I'm trying hard to keep up. ) Enterohepatic (re)circulation is a result of cholestasis (they go together).
Now, "cholestatis of pregnancy" is the itching of the whole body, and that's the SYMPTOMS I had and that ramped up during my "detox setback cycle."
But, the underlying CAUSE is cholestastis which to me means "liver motionless" which means the bile isn't moving, i.e. stuck. Why is it stuck? Because the bile ducts are destroyed, like how you can't see the shape of a river once the whole area gets flooded. Now instead of a river, there is a pool. Why are those ducts destroyed? Because the liver cells are destroyed and no longer form ducts. Dr. Smith said something about it being a "structural damage" and that we will have to re-build the structures, I think. So, of course the bile being stuck in the liver might not even be exactly the ONLY cause of the symptoms.
The secondary bile acids going into the blood are what's causing the systemic itching/symptoms/destruction of other parts of the body. That's also what might end up being called "cholestasis" which is a wrong term from allopathic medicine which recognizes the liver/bile is motionless. I'd say it's a misnomer. So, I will try to, in future, use the term "systemic itching" or something.
By the way, the itching I get starts in my calves or feet in the morning when I go vertical. I'm sure this is due to gravity pulling the blood down. I hate to think about the vascular damage that is being done. (I'm now quite certain that my father who passed away in April 2020 due to "cardiovascular disease" was very cholestatic. He had psoriasis since teen years, arthritis, at times had high cholesterol, He was never obese--always a thin guy and liked to lift weights, General Anxiety Disorder (misdiagnosed several times, once as bipolar) and then this cardiovascular disease toward the end, a rash/infection in his groin, problems with sinuses off and on, and maybe something with his kidneys (I'm trying to find out). He tried to be positive and seek spiritual enlightenment. He was pragmatic in the end, always telling me that "We just have to have a good attitude." However, he had so much trouble sleeping and battling anxiety and depression that he took to alcohol and that was the final nail in his literal coffin.) I have a lot of hope for the work of Grant and Garrett... we need people with truly open minds, creative thinking, curiosity, and communication skills. And, by the way, I found THIS website because I searched for "oxalates." My joints are doing much better since I started this Low A diet.
Quote from wavygravygadzooks on April 27, 2021, 4:10 pm@rachel-2 @jaj Do either of you have comments on my suggestion that fiber/charcoal could be inhibiting detox by binding fats and bile acids needed to eliminate Vitamin A from the liver?
If you need fiber to get Vitamin A out and avoid cholestasis, I should have had cholestasis for the past 9 months of eating saturated fat and zero fiber, but instead the only time I think I may have experienced cholestasis was before I eliminated fiber from my diet.
Consider that when someone is healthy, fiber is binding to fat that the body wants and bile acids that the body needs to process fats, which means that it is depleting the body of critical resources. Fiber represents a nutrient and energy sink. In the case of Vitamin A toxicity, you might view fiber as a medicine. But medicine always represents a tradeoff, and usually the benefits of a medicine quickly become more harmful than what it's treating, which is why medication has historically been used to treat acute illness, not chronic illness (also because chronic illness is a relatively recent phenomenon). I could see fiber or charcoal being used for maybe a week to overcome some roadbloack in the system, but I think its longterm use is problematic, especially in the absence of much fat in the diet.
Have either of you tried higher fat and lower fiber simultaneously to see if it relieves what you believe to cholestasis symptoms? You may wind up with diarrhea (like I have) depending on how much fat you eat, but I would be curious if it resolved some of your systemic symptoms.
I'm not sure I'm the person to comment on this. However, I have a couple of thoughts so I will add them. I'm not a scientist, doctor or chemist. I'm operating as a patient under the premises that are taught by Garrett Smith.
1. fiber/charcoal could be inhibiting detox by binding fats and bile acids needed to eliminate Vitamin A from the liver?
I don't know about the fat part. As for bile acids, Smith has established that the body makes a lot of bile acids. They also get "recycled" but it's not helpful if they are "dirty". The "dirty" ones are secondary bile acids and these are made in the gut by "bad" bacteria which use the primary bile acids (created by the liver) and transform them into the bad/dirty/secondary bile acids.
So, YES, we want the SOLUBLE fiber to bind to secondary bile acids and pull them out of the gut. Do these pull also primary bile acids? I don't know but let's guess that they do. However, we don't get a choice of what happens there with the fiber (or charcoal). It's just going to bind to whatever it's near to which it has an affinity. Also, could we provide the body with more of what it needs to make new clean bile to replace the dirty bile that we are working to pull out/eliminate?
As for the fats, Smith has also established that fats help to re-store Vitamin A (or I'm guessing other toxins).
In my case, eating more fat did NOT seem to help. Let's speak hypothetically, again, for a moment. If the dietary fat was in fact my culprit, what it seems to me happened was that excess fat intake had to be processed. Since my liver was already in a state of cholestasis, for whatever reason it couldn't process that extra dietary fat--certainly NOT while I'm eating a low VA diet and causing VA to be released out of storage. But, the proof that the fat didn't help is that more secondary bile acids circulated in my body (and caused a much higher level of itching). However, now we need to look at the COMBINATION of the fat and the higher fiber--because I was doing both at the same time. So, I don't know where that leaves us and maybe doesn't answer your question...
because you want to know if I tried high fat with low fiber.
You said a healthy body needs fats. Is that true? I'm not sure how that works. I think that when we eat sugars (or proteins that break down into sugar) any excess is stored in fat cells and the fat cell makes the sugar into fat.
I don't know how primary bile acids are made. They are normally recycled up to 16 times, but maybe the more toxic the environment (including diet) is, then we don't want to recycle them. Even in a healthy person... maybe they are not recycling bile acids in the first place and that is why they are healthy. ???
Dr. Smith has presented some evidence on charcoal and the various things for which it does and does not have an affinity. He believes that it does not bind to stuff that we want to keep/absorb. I don't recall whether it binds to fat, but it does bind to Vitamin A.
Recently, Dr. Smith has been finding research about probiotics, gut flora and dysbiosis and how it functions in cholestasis. Again, bad bacteria convert primary bile acids into secondary bile acids that we don't want. I think he also said something about the bad bacteria doing their thing more when there is fat for them to work on... maybe they make secondary bile acids out of fat, too? Sorry, I cannot remember.
I had already become concerned about the possibility of damaging the gut microbiome by eating a high fat diet / keto. This was mentioned by Kiran Krishnan of Microbiome Labs (FYI Dr. Smith does not like that product because those strains produce carotenoids).
I will not be trying a high fat diet with low fiber any time soon.
I'm not trying to argue any particular case. I'm only trying to put the pieces together. I know we all want answers and we must all be open to the truth. I'm just sharing what I know, so feel free to tear it to pieces for the benefit of all.
I too use a sperti lamp. I've only been measuring the typical storage forms of vit D but mine have gone from severely low to only just under the normal range from using the lamp over winter.
I feel the same as lil-chick that sunlight is optimal but having had life long issues with sun exposure and living in the UK which has erratic weather I can never build up my tolerance of sunlight sufficiently to keep my vit D levels in range and I no longer feel comfortable supplementing vit D.
I've built up v slowly with the lamp but am able to use it consistently which I can't do with sun light.
My intention is to continue to use it over the summer but cut back the number and duration of sessions. I just want to keep my tolerance going and to keep my levels ticking over.
The reason I'm commenting is not really to promote the vit D lamp but to add my experience with artificial light. I typically react to sunlight with an itchy rash (it's definitely sunlight causing it and not a heat rash). I have not had problems or aggravations with the lamp. At one point my skin was getting warning prickling and I was not sure if I was reacting to the lamp or not so I took a break from it for a couple of weeks and restarted at a shorter exposure time.
I have used sun beds in the past and react to those as I do with sunlight. I have to go very very slowly with them which is at least possible with a sun bed vs the sun. It would not have been possible for me to do this in a commercial setting since I have to keep my exposure so minimal and build up so slowly.
Hi @rachel-2 thanks for your extra explanation. I’m sorry to hear about your father’s health issues. I too have reflected on my parents health and developed an understanding of what may have happened to speed their demise - this feels sad to me as nothing can now be done.
I think that being women gives us a head start with cholestasis (oestrogen increases) and also a likely history of more meds e.g. contraceptive pill. Looking back at my history I feel like everything I’ve done has inadvertently pushed me towards this pattern. Cholestasis is very abnormal whereas enterohepatic circulation is a completely normal process, however, if too much toxicity (such as certain secondary bile acids) is being recirculated, then this is not good and can feed into the abnormal pattern. I think I had significant medication cholestasis and this ‘helped’ me become vA toxic. The vA toxicity then increased the cholestasis. Vicious cycle.
Hi @wavygravygadzooks I don’t have a fully formed opinion of fats and fibre yet but I can share a few of my current thoughts. Firstly and most importantly I think that a diet that suits one person is not the diet that suits another. If someone already has significant cholestasis then a high fat diet, that causes increased bile dumping, could be a disaster as the bile would not be going to the right place - it could be going out the ‘back door’ into the blood and exiting via skin, kidneys and affecting brain. Not good. However, if someone has good liver function and bile production then a high fat diet could increase the amount of bile exiting the body. There is some evidence that high fat increases storage of vA so I don’t know how that would pan out for the vA detox but with good liver health it could be worth examining, as you are doing. Many people have found that high fat increases detox setback cycle symptoms, these are probably people who can’t cope with increasing bile dumping as their bile flow to the intestines is not working well. No point increasing bile flow if it is re-toxing not de-toxing.
I’m pulled two ways with fibre. I like Karen Hurd’s work. It makes a lot of sense to me and she has had 30 years of success stories I believe. Therefore the importance of fibre for health can’t be ignored. There is also a lot of research studies correlating fibre intake with health - reduced diabetes (Jason Fung) and improved microbiome diversity (Tim Spector). Not saying that they are necessarily correct but there is a body of evidence. However, if fibre like fat is increasing bile dumping then it could be an unhelpful thing if introduced too quickly for people with poor bile flow (cholestasis). Also some of the high fibre foods have other issues unrelated to fibre such as hard to digest protein. I ran into issues with the beans. They were helping in one way but not in another. I’m currently undecided on what to do about this as the x6 bean protocol seemed to help cholestasis but cause me other problems. I’m experimenting at the moment.
Back in my days of having "food attacks" it seems to me that some were brought about by too much fiber. I definitely had chick peas on my "never eat" list, for instance.
I look to tradition, and think low and steady amounts of fiber is what is probably trad. Not zero, not lots, and not a big variation daily. Nana had prune sauce, apple sauce, jam, pickles and kraut, some oatmeal, some beans.
I think fats were also lowish and steady. Meat and white carb were the mainstays of the diet.
@rachel-2 Thanks for the thorough response despite being a busy mom! @jaj Thanks for your thoughts as well!
My understanding is that the primary route of excretion for Vitamin A is the intestines, and the secondary route is the kidneys. To excrete it through the intestines, it is typically conjugated with glucuronic acid, which makes it water soluble instead of lipid soluble, which ensures that it passes into the colon without being reabsorbed in the small intestine. Once it's been conjugated and released in the bile, the main thing preventing its excretion from the colon is the breakdown of the conjugated product by bacterial enzymes in the small intestine. The bacteria that degrade these conjugates appear to be commonly associated with dysbiosis, which in turn appears to primarily exist in the presence of plant/carb intake.
Glucuronic acid is a derivative of glucose, and as far as I know the bacteria that are most likely to degrade the Vitamin A conjugates are those that preferentially feed on carbohydrates. I would wager that a diet heavy in carbs and fiber is going to propagate a lot more bacteria that specialize in eating carbs and fiber, and those bacteria are going to be the fastest to degrade the Vitamin A conjugates. On the other hand, I would wager that a diet high in fat and meat is going to minimize intestinal bacteria by minimizing their food supply, enabling more of the Vitamin A conjugates to reach the colon intact. I could very well be wrong, but my experience seems to say otherwise. The only studies of intestinal beta glucuronidase activity I've seen so far are in animal models, which may not have much application to humans when it comes to diet, and they are even more worthless when the animals are being fed unnatural diets.
The connection between all this and cholestasis is that, the more beta-glucuronidase activity there is, the less ANY waste or toxin is going to be successfully excreted, and the more likely your liver is to get backed up with all those recirculating waste/toxins, leading to cholestasis. It sounds like you and Smith probably agree with that. Where I think I differ in opinion is that the underlying cause is the presence of carbs/fiber/plant compounds in the diet, fueling bacterial overgrowth and dysbiosis. In addition, if your fat and protein intake is low, you will have less bile flow, increasing the odds of toxic stagnation and cholestasis.
As far as I know, Smith references a lot of dietary studies that used animal models (questionable application to humans), and I don't believe he's established much at all. I think he's generated a lot of hypotheses and is testing them on his clients. He's been wrong plenty of times before... I'm glad he is generating hypotheses and trying to sort this all out, and a lot of his program does make sense, but I think he's often drawing much too strong conclusions from far too little evidence.
so, what I’m hoping will happen is that Smith and others will figure out which bacteria are doing what, and answer this question for us!
certainly, what diet is necessary to maintain a healthy liver may be very different from the diet needed to detox the liver. I would like to know which diet will not permanently damage the liver more or cause other irrevocable changes throughout the body.
do you think that having gut bacteria is necessary for immune system signaling or other jobs? How could we know what the healthiest Gut bacteria profile is? Would we be able to get it back? (I’ve wondered if biofilms have a way to be changed. Maybe fasting or carnivore—or something else—can change biofilms??
@rachel-2 Ha, that would be nice if somebody figured out which bacteria were the culprits and how to get rid of them with probiotics, but the scientific community has been researching the gut for a long time and we still don't know that much. I wouldn't hold my breath...
I tried a variety of probiotics, prebiotics, and fermented foods to cure my IBS-D. I tried the GAPS/SCD, Fast Tract/Low Residue, and Low FODMAPs diets. The probiotics seemed to help a little, and every step I took towards a higher fat, lower carb diet helped. But the biggest changes by far happened (1) when I took out oxalates (after which I basically was eating small amounts of berries, rutabaga, and turnip as my only plant foods), and then (2) when I went full carnivore.
Coincidentally, I started getting all the diarrhea I've had on a low vA diet around the time I stopped eating plant foods. Some people would say that's because the plants were helping, but I think it's because I finally kicked my dysbiosis to the curb and all of a sudden all of the conjugated Vitamin A and other toxins were finally making it to the colon. I'm still not entirely clear on how that results in diarrhea, but it's the best explanation I've come up with so far.
I think the diet that is optimal for liver health is the same for treating an ailing liver...why would it be any different?
We will always have bacteria in our guts, there's no way to make them sterile, and I'm sure some bacteria are integral to our well-being. I think the biggest role the "good" bacteria play in our health is by outcompeting "bad" bacteria. The "good" commensal bacteria tend to be more resilient to fasting, so intermittent fasting is an excellent way to clean up the gut - yet another reason that carnivore diets offer huge benefits (it keeps you satiated for so long that it naturally encourages extended fasted states). I don't know too much about biofilms, but I tend to think that they can't last forever if they're being simultaneously starved and outcompeted by other microbes.
I find the carnivore diet interesting as it’s so far removed from my style of eating. I’ve been a vegetarian for 30 years but now include meat for protein, although I don’t enjoy eating meat. I just wonder how it fits with all the research on plant foods improving microbiome diversity. I’m fully on board with some plant foods being a problem for some people but removing all just doesn’t sit well with my nutritional therapy routes. I’m not in any way criticising people who have found symptom relief with this diet and fair dos for doing a diet I could never do, however, it is an extreme diet and I do wonder what it is doing to the body long term. I would personally be very concerned with a diet that gave me diarrhoea as that doesn’t seem healthy to me.