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Tackling the Detox setback by Grant Genereux
So...I'm Meri Arthur (Meredith Arthur, MS, RD, LD). I'm a rebellious dietitian. I don't follow typical Academy of Nutrition recommendations because honestly, those lead to my clients becoming sick. One of the big ones is avoiding egg yolks and mostly eating whites.
My most recent client has been referred for weight loss, gallstones, and new onset ulcerative colitis. I don't have current labs on him, but he is a good example for what happens when we avoid eggs and are vitamin A toxic. I know he is vitamin A toxic because he is on valproic acid and has been so for years for schizophrenia (he also has autism). His caregiver doesn't give him egg yolks for free of raising cholesterol levels. This has caused him to have toxic bile because we need phosphatidyl choline to make bile acid safe in our intestines. On top of this she only gives all of her group home clients water flavored with lime or lemon juice all day - this is a CYP3A4 inhibitor which impairs bile acid biotransformation. He isn't likely even biotransforming bile acid well. All of this led to gallstones and ulcerative colitis.
I have a friend, Mindy, who just messaged me to tell me that all of my posts are making her realize her issues are probably vitamin A toxicity. She doesn't eat eggs due to an allergy and doesn't get enough meat in to meet her choline needs. She has triglycerides in the 700s and also is gaining weight quickly. I have a post on why I think choline deficiency causes weight gain ( https://www.facebook.com/meri.arthur/posts/pfbid03QWrnidHgdPmYFRANnqBxCgVUvtjuX3qus4Q9egA12aFCutSqPhKKRiXF8bXwMf2l ) . Mindy is only 40 year old and has macular degeneration. We are starting sunflower lecithin now (or maybe betaine but she wants to do sunflower lecithin) because choline deficiency and vitamin A toxicity go hand and hand.
This is because our major source of choline in our body if we don't eat it, is phosphatidylethanolamine (PE). Retinaldehyde in excess will bind to PE and make A2E irreversible schiff base. This leads to macular degeneration. I believe this schiff base happens all over the body and not just in the eyes.
I think the first sign of things going south, slow gut motility, is caused by the stealing of endogenous choline production by retinaldehyde. (here is a video on that...https://www.youtube.com/watch?v=ZhtlWg_bShM)
So...from a clinician standpoint...I can get permission to share changes in lab work and I can post them. Here are a few successes without labs..
- Olivia, age 11, vA toxic from Nourish tube feeding. Has intracranial hypertension. Started eggs one month ago. Liver enzymes finally trending down.
- Jr G. 23 years old. Came to me for fatty liver disease. Has autism. Mom was told to not use more than 1 egg yolk per day because of his high cholesterol. I told up to three per day. His enzymes dropped to normal in three months. Mom is ecstatic. Jr is happy because he likes whole eggs. Hahaha!
- My boss's husband. High liver enzymes. Told him to have three eggs daily. Completely normalized liver enzymes in 3 months. He still has to lose the fatty liver, but the eggs saved him from continuing to liver failure.
I'll keep sharing about this, but eggs truly do help. This is because without adequate PC, and retinaldehyde stealing our ability to make PC from PE, we become severely choline deficient.
Woot! Woot! Woot! Welcome to Grant's list!
That is interesting, I also know a woman who always ate just the egg whites each morning and she had gall stones for which she received surgery.
@jessica2 do you have a progress report thread or is your essential fatty acid post kind of functioning as that? Anyways, I guess I'll just put it here that I had pain radiating down my legs (bad enough to keep me awake) when I dropped coffee. It really is surprising what detox can do. (which I guess isn't really a digression too far from the topic). I was lucky enough to find out online that dropping coffee can cause such a thing. But it doesn't happen for everyone. I wonder if it has something to do with VA or maybe oxalates or ?
I wish I had more time to edit this down, but I have something to contribute which may be relevant to at least some individuals dealing with chronic hypervitaminosis A and the Detox Setback.
I didn’t experience the Detox Setback (aside from a period of thiamine deficiency, now corrected), and I noticed significant benefits from staying under 3% of the RDA for vitamin A right from the start.
Even now, after becoming officially deficient in vitamin A, the “slow approach” strongly disagrees with me. When I consume animal-based vitamin A it is like pouring gasoline on smoldering embers.
Eggs are not for me right now (three months on eggs severely lowered my gut motility, which was perfectly fine prior—my log details one hypothesis insofar as why this might’ve happened). But I’ve never had fatty liver disease.
Like Grant, high fiber consumption early on was never an issue for me... But I’d already gone through a “replenishment phase” before lowering my vitamin A intake. I’ll get back to that in a minute.
Here’s my guess insofar as what could be one overlooked factor contributing to the Detox Setback for some individuals: prolonged low-caloric intake due to an active restrictive eating disorder.
Without some sort of “replenishment phase” beforehand, I expect such individuals will go through pure torture if they try to trigger a strong detox. Even a “replenishment phase” is brutal enough on it’s own for someone in such a weakened state (it was horrible for me).
All restrictive diets bring with them the inherent risk of triggering anorexia or orthorexia in susceptible individuals. I believe I became anorexic as an 18-year-old woman primarily due to hypervitaminosis A (low appetite is one of the symptoms) combined with a deficiency of zinc, thiamine, and EFA, so it follows that I’m not the only vitamin A toxic individual who has struggled with low-appetite.
Providing you’re eating enough, meeting the RDA for choline using a combination of low-vitamin A plant and animal foods isn’t difficult.
It’s even possible to meet the RDA for choline from whole plant foods alone. Four cups of cooked lentils, half a dozen bananas, and a honeydew melon gets you there.
To reach the RDA for choline from just meat, you’d have to eat roughly one-and-a-half pounds of ground beef.
So I think the choline deficiency issue is moreso a problem when an individual...
a) ...is not absorbing choline properly
b) ...is (either intentionally or unknowingly) restricting their caloric intake such as to make it impossible to consume enough choline from any source (other than eggs)
c) ...has a higher-than-average need for choline
It would be easy to exceed the RDA for choline eating eggs alone, whilst still restricting caloric intake. All other choline sources are way higher in calories. Four eggs are a mere 310 calories. So if one wanted to restrict his or her caloric intake severely, whilst still meeting his or her needs for choline...anorexic or orthorexic restriction could stay active.
Imo, it is impossible to recover from the health consequences of a restrictive eating disorder and a chronic poisoning while continuing to starve oneself.
I want to spell it out in case someone reading needs to hear this: if you are an active adult who is dealing with chronic health issues and only consuming 1200 calories daily, you are starving yourself. Read “The Minnesota Starvation Experiment” by Ancel Keys. Starvation causes significant mental health problems (I should know—I had severe clinical depression, suicidal ideation, manic episodes, paranoid ideation, panic attacks, OCD, social anxiety disorder, nightmares, severe auditory overload sensitivity, and chronic insomnia all of which I have recovered from)!
Andrew’s suggested 800 mg choline daily is significantly higher than the RDA. It is the amount he needed to heal. You’re not going to get to 800 mg without eggs. At least, not affordably or without eating even more calories than I do currently (3,500 daily).
I’ve been wondering if there’s a way to lower one’s need for choline.
There’s some evidence (rat studies) that a high saturated fat intake, at least on a protein restricted diet, increases the need for choline. Could this be relevant for those with fatty liver disease, whose ability to tolerate protein has been impaired?
Personally, added saturated fat (coconut oil) doesn’t agree with me as well as whole-foods-based EFAs do, and the article AlexM posted for me to read in support of consuming saturated fats whilst eschewing omega 6 was unconvincing to me personally.
I’m no longer interested in doing anything that makes me feel significantly worse over the long-term based upon a hypothesis which contradicts other big-picture evidence (for example: added dietary saturated fat may negatively affect the gut microbiome, and supposedly there’s some indication individuals with CFS, which I still have, struggle to effectively utilize and break down very long chain saturated fatty acids).
Those who are anti-PUFA believe in it for equally valid reasons, though.
We are all pioneers, here!
This whole experiment is based upon a hypothesis.
It’s exciting to blaze a trail, but also...there be wild creatures, and unexpected twists and turns...
We all should remain humble about the exploratory nature of what we are doing.
Some of us avoiding PUFA might run into an EFA deficiency. I doubt I’ll run into a saturated fat deficiency, but I could be completely wrong about the possible benefits of avoiding saturated fats. Maybe they’re a tremendous source of low-oxalate caloric energy, and I’ll switch back to them after realizing I need to cut back on plant foods due to the oxalate issue. I don’t know yet...
I’m not a scientist or medical professional, and everything I am saying here is biased speculation based upon my subjective anecdotal experience.
No one should blindly copy me, or anyone else.
My initial reaction to stopping added saturated fats has been positive. I feel less “sluggish” after a meal.
I’m not sure if saturated fat avoidance is worth considering for individuals already in a severely depleted state, especially once already stuck in this “re-tox” loop, though. Restriction of a high-calorie food could be disastrous in that case. I don’t have the expertise to weigh in on that... I’m just sharing my observation.
Others have made the opposite observation! Good.
I do feel strongly that the eggsperiment is of crucial importance to the future of Grant’s dietary intervention, even if as part of a temporary “replenishment phase,” before reducing vitamin A intake to whatever seems appropriate (picking an intake number is arbitrary, but 60% of the RDA is “too much” retinol for me still).
I’m unconvinced that just because I do not seem to tolerate retinol, that others can’t detoxify it while consuming an amount closer to the RDA. Who knows? We’re all different.
Carnivore is another possible form the “replenishment phase” could take, however it wouldn’t have worked for me because I was already too depleted in manganese and magnesium, and because low-carbohydrate diets kill my appetite like nothing else. Others will trigger an “oxalate dump” on carnivore, which could be way too much for them to handle in a weakened state.
Individual differences matter a great deal. I doubt we will find a one-size-fits-all approach.
So there may be other forms this “replenishment phase” could take, depending upon individual needs and the state of the gut microbiome. Those who have never restricted caloric intake would likely be fine to skip a “replenishment phase” entirely.
Andrew is finding that his “replenishment phase” emphasizing eggs and limiting fiber intake worked for him and is benefiting his clients. That’s awesome!
My replenishment phase involved recovery from anorexia via 4000+ calories per day of high quality ice cream (a.k.a. high in egg yolks), butter, oatmeal, beans, and junk food (going from underweight and severely mentally ill to obese and mentally stable in the process—progress as far as I’m concerned). I didn’t need to avoid fiber myself, but I was 24-years-old at the time. Age is a factor to consider.
In Ancel Keys “Starvation Experiment,” all of the young men in starvation recovery experienced overshoot weight gain. So my question: if you have restricted caloric intake, is it necessary to “overshoot” in order to heal?
I have no idea if I needed to overshoot as much as I did in order to recover from anorexia, but I do know that once I lowered my vitamin A intake to under 3% of the RDA, I was eating 3500 to 4500 calories per day and effortlessly—zero exercise—lost all of that overshoot, slowly and steadily over the next 3 years or so, without relapsing back into anorexia or mental illness (eggs on the other hand, triggered an alarming, though mild, reminder of mental health problems).
All of that to say, it is my belief that caloric restriction is the most counterproductive mistake for anyone with a history of lowered-appetite, because big-picture, it lowers metabolism, reduces body temperature (you need warmth for a healthy gut microbiome), and shifts the body into survival mode instead of rest and repair mode...
I'm glad we finally can put the eggs behind us, when the legend himself argues so clearly. So funny seeing the wannabe messiahs having a hard time swallowing this. Guess it is time to make a separate egg forum where you can discuss whether hard boiled eggs or omelette is the best for avoiding to be killed by the detox symptoms. What rhetoric!
Quote from sand on June 6, 2023, 9:21 amI'm glad we finally can put the eggs behind us, when the legend himself argues so clearly. So funny seeing the wannabe messiahs having a hard time swallowing this. Guess it is time to make a separate egg forum where you can discuss whether hard boiled eggs or omelette is the best for avoiding to be killed by the detox symptoms. What rhetoric!
It's weird that we can be reading the same thread and yet come away with totally different conclusions.
I conquered migraines and chronic vomiting with eggs on my slow boat of VA reduction. I'm actually surprised when Grant says he doesn't trust eggs. But Grant only eats three foods. So maybe not a surprise at all.
I can totally see that they might not be for everyone. It's very sad that eggs are used in vaccine production, so I wouldn't be surprised if some people might have become allergic to them.
An egg can make a whole chick, from beak to tail. Heart, liver, brain, digestive system... That's some amazing portfolio of building blocks right there.
The day that I see that eggs can't make healthy chicks, well that might be the day I stop eating them.
It isnt an RDA for choline. It's an adequate intake and it's based on 2 studies on avoiding fatty liver disease. So it's a very low bar. I went way up to 900-950 mgs for 9 months to replenish after being on the low vA diet for 2.5 years. I've been about the Adequate intake for the last 6 months and I'm slightly higher again at about 700 mgs now. Younger women might not need so much choline as adequate intake of 425 mgs as they can make it themselves as long as no genetic SNPs. With fatty liver disease that endogenous production might be affected for everyone. In pregnant women they went up to 900 mgs of choline and they still didnt eliminate much so pregnancy places a high demand on choline. I'm fairly sure many of us doing this due to vA toxicity could benefit from more choline and there isnt much downside until you get to 3.5 grams a day. But I dont suggest above 1 gram unless you've got nutritional guidance. If you put on weight with this strong detox then as Meredith pointed out it relates to choline being low.
How is your diet @puddleduck?
I'm really having a problem with metabolism of animal protein, since I been having a high protein diet(600,800 grams of chicken breast and 5-7 eggs a day) for like 7 years I think throughout theses years my organism was slowly fermentating this protein until I became chronic constipated 3 years ago, and I'm still dealing with constipation even lowering intake of animal protein and different sources. it made me feel a little better but I'm still not having bowel movements( even with tweaks on the fiber intake), I'm doing low vit A diet for 17 months now, but probably not detoxing at all because I'm not pooping in a regular basis. one interesting symptom that I have is that always at night after a day that I eat some kind of meat or even eggs, my hair smells kinda burnt(it may be bad iron metabolism as well) and I did a correlation thought that this could possibly be sub products of protein fermentation, I did a stool test some time ago that actually showed intact and degraded albumin and protein, and trypsin insufficiency that means an enzyme that directly acts in the protein to absorb it. My main objective now is to get bowel movements again to start detoxing, but in this current time I don't think my body tolerates animal protein anymore, I tried a lot of approaches and it seems to get worse. I tried b1( all forms) and magnesium but doesn't seem to be a solution.