Are Aphthous Ulcers caused by Cereal Grains?

This I have ventured into the unexplored lands of nutrition and disease, I have had almost no more aphthous ulcers. I the last year I had maybe three times:

• In December 2012, when I ate cookies containing grains and egg
• In April 2013, after eating dairy and bread
• Now (August 2013) after eating bread

So the common theme seems to be cereal grains causing my mouth ulcers – not eggs, and not dairy. Finding out what causes my ulcers is more difficult than the cause of my acne: In the case of acne, I get an reaction within 6 to 12 hours, and this happened almost every time. But with ulcers, it is a bit different: when I ate bread and dairy daily, I would go one month, two month, maybe three month between an ulcer outbreak. I have seen a clear reduction after going to eat "low carb" Atkins, but nutrition is so much than just "carbs", so much more I did not know to look out.

Et tu, Mutton?

So in addition to cow products (especially dairy and veal), it seems that lamb does at well cause Acne/Behçet's like symptoms for me.

Tough look.

Interesting was that veal caused much more problems than beef, and that lamb is on the same order as veal. Something is different in the meat from those young animals.

If other bovid animals are the same for me? Seems like the entire family of Bovidae might be bad for me – must be some shared protein or something…

Mucus !

And here I write about a "YUCK!" topic - be warned.

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I promise to make it short not with no intention to revisit it any time soon.


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So here we go, you have been warned.

Dairy and Somnolence

OK: I eat some dairy at 10am, drink some milk at 11am, and get drowsy some two to three hours later, at 1pm.

WTF? Beef and Somnolence?

The things you learn with an elimination diet, and then re-challenging with that food. My somnolence seems to have been caused by beef. Hmm.

I need more data to confirm or refute that. Hmpf.

More SNAFU – Coconut Milk gives me The Runs

So I tried out coconut milk (over some time now), and every time I ate it, I got "The Runs" (aka diarrhea).

Don't know what causes this (and don't particularly care at the moment), but according to the information I have, per 100 gram coconut (except coconut oil) there are several grams of "Pentosans" and "Hexosans", which are pentose/hexose-sugar-polymers (aka carbohydrates) and AFAIK can be classified as "fibers". And in addition coconuts contains a couple of of hundred milligrams of "poly uronic acids" per 100 gram.

Both pentosans/hexosans and poly uronic acids, so I would speculate, have the potential to interfere with the normal state of gastro-internal affairs – but nothing concrete is known, I'm afraid.

So more SNAFU, and one more food that I know does not agree with me… Oh well.

A pity, as it makes cooking more varied. But then again I never was a big fan of coconuts…

Eggs – The Other Cause Of Acne?

While I am pretty certain that my acne was caused by dairy (from pasteurized milk), I had some small acne flares from time to time despite not eating any dairy – now I think I narrowed the other cause of acne down to eggs.

And it would make sense, as both milk and eggs contain immunoglobulins. And both pasteurized milk and eggs are heat treated.

One small observation (which I need to confirm yet) is that the acne from eggs is slightly different:

• Eggs seem to cause mainly pustules ("pimples") with round white purulent material, and mainly at what seems to be follicles (e.g. at the arms)
• Dairy from pasteurized milk on the other hand seems to cause mainly inflamed papules/nodules at what seems to be (sweat? sebaceous?) glands (e.g. around the nose)

But same as with acne from milk, it is a "winner takes it all" situtation, with two to three spots and the rest of the skin looking fine.

Situation Normal, All Fucked Up – I guess.

Skin, Nails, Tongue – Health Surrogate Markers

So I noticed today that the appearance of my tongue has improved. My tongue used to be covered with some (very slight) white patches, and it looked a bit like it would rot away and fall apart in some time – gross, I know, so I did look to often at my tongue… :-) But now my tongue looks pale red and uniformly so, with a little bit more white in the back.

Hmm, it is only a optical improvement, yet I take that as a positive health thing.

Again, I blame it on my paleo diet.

While we are at the topic of "skin" in the mouth, what has gone for good are aphthous ulcers / canker sores in the mouth (which I had from time to time).

And this in addition that my skin no longer suffers acne. From the various skin improvements, acne is the only one I have clearly linked to (pasteurized) milk and dairy as a cause.

And two years ago I noticed for the first time something my skin doctor called "hemangiomas" (might as well be "vascular lesions"), very small, about 1 to 2 mm, give or take (about 1/20 to 1/10 of an inch), red dots on the skin, from blood vessels. She said they would get slowly worse over the years, but they improved a tad bit over the last two years – but it is too early to call.

And the skin around the "front corners" of fingernails used to peel off easily, so the top layers of skin around my finger nails had a tendency to be missing in action – and that has improved much as well with a paleo diet.

And while we are at nails, the appearance of my nails has improved a little bit over the last two years – almost no more "mountain ridges" across from side to side (beau's lines?) – but the grooves on the length of the nail plates (in growth direction) are still here, but maybe a tad bit weaker. And the problems with hangnails have improved much as well. Cuticles and white spots are no longer noticable, but were not a huge problem in the first place.

Then, I had about once or twice a year an armpit rush, which seems to have gone by eliminating dairy and eggs from my nutrition.

So related to only skin there are more than half a dozen surrogate health markers for me, some moving slowly (e.g. hemangiomas), some moving fast (mainly acne), some were seldom (e.g. canker sores), some a constant bane (again mainly acne).

While I traced down only one skin problem clearly to an identified cause (with acne and dairy), I suspect that the other skin problems might have been caused by dairy too (maybe with cereal grains being a problem in one or the other instead of dairy, or maybe in addition to dairy).

So if you have health problems and want to start a paleo diet, you should make an inventory of your little health problems, and then you can see if they improve – things like improvement in areas such as mood are important to notice too, but acne and canker sores are so much more objective. Then you can do a challenge with dairy, or with cereal grains, or whatever you removed from your diet, to see if the things get worse again.

Is Acne caused by the Hormones in Milk and Dairy?

So, do the hormones in milk cause acne? I isolated pasteurized cow milk (and dairy) as the cause my acne.

• If I eat cheese made from raw milk, I get no acne
• If I eat cheese made from pasteurized milk, I get acne

I think the hormone levels in both raw and pasteurized products should be comparable. Of course it is possible that some producers of raw milk use different production methods, and the raw milk might contain less hormones – but then again I tried three different brands of raw milk cheese, and ate each time a large amount of raw milk cheese in one go, without getting acne. So, I don't think it's the hormones.

Another thing that makes me think it is not the hormones in milk, is that if I eat some dairy, I get about three distinct points of acne (pimples/papules/nodules) for about 100 to 150 grams of dairy from pasteurized milk. If it were hormones, I would expect slightly increased inflammation everywhere. But instead I see "the winner takes it all" with a mainly "all or nothing" inflammation.

Now this is pure speculation, but I suspect that "something" from milk (bovine IgA immunoglobulins?), that was changed during pasteurization, traverses intact from the gut to the blood. Then human immunoglobulins attach to this "something" and start forming immune complexes. Some of these immune complexes either dock to the relevant skin tissue, or they form there in the first place – and these would be the distinct points were then inflammation arises, because now leukocytes rush in and start a giant gang-bang at the expense of my no longer acne-free skin.

Still much to learn…

Mark Sisson on Self-Experiments

Mark Sisson on Self-Experiments:

…

• Start with a sensible premise drawn from reliable sources.
  
  Like your own experience, another’s, or results from clinical studies.
  
  An example: you forget to eat breakfast and feel stronger during the afternoon lifting session. Was it the lack of breakfast? Maybe; test it.
• Eliminate outlandish premises.
  
  I wouldn’t advise testing whether the trans-fats in Crisco are actually harmful by eating a tablespoon every morning,
  
  and breatharianism [life without food] almost assuredly won’t work; the literature is quite consistent.
• Be prepared to discard a hypothesis.
  
  Things won’t always work.
  
  And things that seemed to work for a while might suddenly stop working.
  
  Or, things that seem to work won’t actually work, or they’ll be working for entirely different reasons than you supposed.
  
  In other words, you’re probably never going to know with absolute certainty that something is working for the reason you thought it was.
  
  Just be ready to ditch failed hypotheses and change them on the fly.
• Don’t extrapolate to others.
  
  Just as your experiences didn’t jibe with results from randomized controlled trials, the solutions you discovered from your own experiments may not always work for other people.
  
  They’ll have to test it on themselves.

…

No dairy? "But you NEEEEED the calcium!"

An interesting encounter today at the medical specialist, when I mentioned that I avoid dairy as dairy gives me acne and I was getting worse until I stopped eating dairy and grains:

If you don't eat dairy, then you must take calcium supplements. Otherwise you don't get enough calcium from nutrition.

Yeah, right.

Somehow the information that I tried to convey to her, that "Milk makes me ill", somehow that did not register for her. I know, it's only an anecdote to her, but still.

"If I eat this it makes me ill, if I stop eating it I get better" should be an easy to understand concept.

But I guess I am some sort of freak of nature and the only person in the world that has adverse health effects by dairy? And after all, don't all adult animals need calcium, well, because.

Yeah, right.

Maybe in 10 or 20 years we know much more about the adverse health effects of (pasteurized) dairy, and then she'll look back on what she told me about milk – or maybe not.

I wasn't in the mood to argue, so I just said "I am trying raw-milk dairy and it does not give me acne so far."

I guess she hears all kind of BS, so she'll file it under "Another Nutter", oh well. Whatever happened to being your own experiment, of being your own n-1?

Dairy and that Sore Mouth Feeling

So, having not eating dairy for quite some time now, I recently started trying out cheese again. And trying only cheeses made from raw-milk. My focus was if I get ill health effects, especially acne. And what can I say, raw-milk cheese does not cause acne for me – unlike cheese from pasteurized milk, which does cause acne for me. (And just for the record: I had no repeat of an hypoglycemia episode.)

But now I noticed another effect of dairy: An slightly sore mouth immediately while I eat cheese, and especially in the palate. And I remember I had this feeling many time before, while I was eating certain cheeses. But I never really took much notice of it.

(And furthermore, now some eight hours later, I feel even one "canker sore" or "aphthous ulcer" appear, something I had in my pre-Paleo days)

I wouldn't go so far and describe my mouth sensation as a "burning" (so I guess it is not "burning mouth syndrome" or Glossodynia), but it sure does feel a slight bit "scalded".

Wikipedia (as an reflection of what is "known" in medical sciences) is funny:

Possible causes include nutritional deficiencies, chronic anxiety or depression, type 2 diabetes, menopause, oral disorders such as thrush or dry mouth, or damaged nerves (specifically, cranial nerves associated with taste).

So there seems to be a correlation between glossodynia and chronic anxiety, and between glossodynia  and depression. I would say: Is it possible that all three are caused by an as of now undetermined third factor? I would throw in milk as an educated guess. But wikipedia instead suggests that there is a causative relationship. What bollocks, IMHO, to think that depression could cause glossodynia. Oh well.

By now, if I read such a hodgepodge of associations and no clear etiology, I would always suggest trying out an Paleo style elimination diet (no cereal grains, no dairy, no vegetable oil, no "crap in a box" and no soy), to see if the condition improves. Then, if one can't live without the crap, one can reintroduce it slowly, one by one, to see who is the culprit. Or one could simply stay on a Paleo diet.

Diets: Atkins, Lutz, Low-Carb, Paleo, Ketogenic…

Attention conservation notice: I will focus in this post on the ketogenic diet, and whether it helped me (spoiler: it did not help me). I will try to focus on the other diets in some future posts, when I find the energy.

During some time early in summer 2010 I started to feel like I was going to die. Maybe not the next day. Maybe not the next month. But maybe in some of the next years, not too far away, I felt I would become an ex-parrot not too far in the future. And if my illness wouldn't put me down, I would have done so myself.

Health problems of mine, that weren't good since my youth, took a turn for the worse. My energy level took a steady dive. Caffeine was the only thing that kept me going through day after day, and only barely. I needed two hours to get out of bed.

Then new symptoms started to appear.

First there was a "pressurized feeling" in the back, whenever I got stressed. This pressure was on both sides, localized, not broad, where I would suspect the kidneys are. After a month or two, this "kidney pressure" during stress" turned into "kidney pain" during stress. Very focal pain. Not too strong, but very nasty pain. Might have been the adrenals.

Now I know that I have primary adrenal insufficiency, the real kind, confirmed through two salvia tests and an ACTH stimulation test – not too "strong", mind you, my luck I can't even get a full blown primary adrenal insufficiency. So the "kidney pain" back then might have been adrenal pain. And adrenal insufficiency explains some of my symptoms, but not all.

Anyway, back to summer 2010. The adrenal pain wasn't the only new thing. Strange feelings on the skin. Very unpleasant skin sensations, that made it difficult to touch e.g. a trackpad.

I initially took a "psychosomatic" view of my ailments. I am not motivated to get out of bed in the morning. I am stressing myself too much. The pain is psychosomatic response to pain. All that bullshit.

I really tried hard to battle my problems from an idealistic position. Aided by the people I were with at that time, who had an explicit idealistic position when it came to health.

As if pain wasn't a real warning sign for bodily problems, as if it could be "willed away".

Anyhow, while I managed to manage some details, most of my symptoms got worse. Steadily. Downwards. Something else had to be done.

Little did I know about humans and illnesses back then. But I knew a little bit about type 1 Diabetes, have heard of type 2 Diabetes, of obesity, of "metabolic syndrome". So I looked into nutrition. Stumbled across Wolfgang Lutz and his book "Life Without Bread" ("Leben Ohne Brot"), and stumbled across Robert Atkins and his diet. Both are about reducing carbs, and as the regulation of carbs/insulin is broken in Diabetes, reducing carbs might be a good idea, I thought. (Today I know that an optimal diet is probably closer to an Paleo diet, and that carbs are not bad in general, but rather some foods containing carbs – like grains and dairy – are probably to blame for health problems)

As I felt I was going to die some time sooner that later anyway, I ignored all the well-meaning warnings about these diets ("You need grains! Blah blah!") and gave it a shot.

And what can I say, my health improve. Improved fast. Improved markedly. Symptoms waned and faded away. I got energy in the morning, to get out of bed soon after waking up. I started to feel like a human being for the first time in my life, not a sack of flesh dragging myself through life.

One of the predictions Atkins made was that his diet would be ketogenic, and that is what this ketogenic property that helped the body heal. And sure enough, when I meassured the so called ketones with ketosticks, sure enough the diet was ketogenic.

But the ketogenic property of the diet faded away, as Atkins predicted – the ketosticks confirmed it. And with the ketones faded the energy.

The good thing that with a Paleo diet a considerable share of the health problems stayed away for good – but my energy levels were in the gutter again.

So for some time I had the idea that I need to get back into a ketogenic state to get my energy back. It took me some time until I tried an shot at an proper ketogenic diet. Ketogenic diets are a bit demanding, as you need to reduce carbs and increase fat consumption, increase fat consumption massively.

So I tried a ketogenic diet, to get back to an ketogenic state. And lo and behold, with some considerable effort I was able to get my ketones up. Measurable up.

Unfortunately, the positive health effects, that I had the first time my ketones were up, that positive  health effects did not return with the ketones.

So I have to report a negative result with regards an effect of an ketogenic diet to my illness (whatever that illness is).

As a note, I have heard that the ketogenic diet might be useful for other illness (like epilepsy and migraines). Good information on ketogenic diet can be found at the Perfect Health Diet blog – don't expect too much though: Your milage may vary; A Paleo diet helped me to some considerable degree, but a ketogenic diet did not improve above that.

What I can recommend is to experiment with an Paleo diet, and to be careful not to attribute health problems to one certain product too fast ("my X is caused by Y!").

As an example: To test the influence of e.g. dairy on your health, you need to get rid of all dairy for at least a month (even milk-chocolate!), then reintroduce dairy (make a "challenge"), see the effects (if any), then go dairy free again for at least two weeks, to repeat the challenge once more. Only if after two or three challenges you see consistent results, then you can say that the problems are caused by dairy. You could (and should!) repeat this with other foods, like grains (bread, cereal), or with potatoes.

Raw milk, acne and blood sugar – An update

As I wrote before, my acne is caused by milk. While I sometimes get very very very small furuncles (which i haven't been able to track down to a cause yet), I just need to east a bit of dairy to get several nasty furuncles and sometimes even nasty pimples. No doubt, milk caused my acne, which I can say with certainty after being dairy-free for quite some time now.

Now I wanted to see if raw dairy (from non-pasteurized milk) makes a difference, as I read something to that effect. I got some really nice raw-milk "Bergkäse" cheese, and ate a nice piece of it.

And what can I say about raw-milk dairy, after a sample size of 1?

The good: 
No acne. None whatsoever. And the Bergkäse was really nice.

The bad and ugly:
I ate the cheese at 10 in the morning and about half an hour later I got a rather low blood sugar: All the symptoms like "that jittery feeling", and the confirmation by several measurements of blood sugar (blood glucose) during the day. Eating some glucose, and then some more didn't help much. And then some potatoes, and then some more. I was jittery to some degree all day. And had (slighter) problems with blood sugar for some days.

Hmmm.

I need to try this experiment again, in some weeks, to see if this is not some random fluke.

At least for now, and for me, it seems that (pasteurized) milk is able to provoke an immune reaction (in the form of acne) in my body – this could provide an plausible mechanism for some autoimmune conditions.

And it seems possible (for now) that milk fucks up the insulin/blood sugar regulation of my body – something I need to confirm† or rule out‡. Next time

Update: Just one short update, a second try with raw-milk cheese, and I did not get any noticeable bad health results. Let's see.

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† Confirmation that milk fucks up insulin/glucose regulation would be really really cool, as it would provide an mechanism for some of the diseases we see – say: obesity, "metabolic syndrome", T1DM and T2DM (type 1/2 diabetes mellitus)

‡ Ruling out negative health effects (for me) of raw milk would be really really cool, as I could eat cheese again, in the form of raw milk cheese.

My eyesight has improved

It's been a while since I had an eye exam: 2009. Now some time ago I started to realize that my eyesight has changed, so I went to the optician today to get new glasses. And lo and behold, my eyesight has improved. Only slightly on the left, from 2.25 to 2.00. But much more on the right from -2.00 to -1.25 *. In November 2010 I started eating something resembling a Paleo-diet, and I blame my improved eyesight on the diet – YMMV.

* And yes, this is not a typo, I am far-sighted on the left and near-sighted on the right.

My Acne is caused by Milk and Dairy

I can now say, with rather high confidence, that my acne was caused by the consumption of (cow-)milk. I used to drink a lot of milk – and had a lot of acne. One and a half years ago I massively reduced my consumption of milk and milk-products, and my acne almost went away. I ceased to eat dairy and my acne went completely away. I reintroduced dairy, and my acne came back, pimples within 6 to 12 hours. It does not rise to the level to be considered proof, but for me, in my case, it is pretty clear.

Over the next months I will try Ghee ("clarified butter", which is almost free of both cow proteins and lactose, and contains almost only fatty acids) to see if this still contributes to my acne or not.

iPOP (integrative personal omics profile) – tracking proteins, metabolites, metabolism, microRNAs, cytokines, antibodies, and gene transcripts in one person

Michael Snyder tracks his health status with iPOP and finds a virus causing his Type 2 Diabetes (T2DM)?

Snyder had a cold at the first blood draw, which allowed the researchers to track how a rhinovirus infection alters the human body in perhaps more detail than ever before. The initial sequencing of his genome had also showed that he had an increased risk for type 2 diabetes, but he initially paid that little heed because he did not know anyone in his family who had had the disease and he himself was not overweight. Still he and his team decided to closely monitor biomarkers associated with the diabetes, including insulin and glucose pathways. The scientist later became infected with respiratory syncytial virus, and his group saw that a sharp rise in glucose levels followed almost immediately. "We weren't expecting that," Snyder says. "I went to get a very fancy glucose metabolism test at Stanford and the woman looked at me and said, 'There's no way you have diabetes.' I said, 'I know that's true, but my genome says something funny here.' "

So much for "These people eat too much."

Topol writes in an e-mail, "this type of 'pan-ar-omic' study of individuals is now not only feasible but in select individuals with medical conditions, particularly useful clinically."

We'll have to wait until this will be used more often in research, and then it will take some considerable time, but it will reach clinical use some time, maybe in the next decade.

Read it all.

[Update] Here's another blog post about this.

Be your n-1

So, about 3 and a half weeks ago, I made up my mind to stop the caffeine, and the beloved coffee. I tapered things down for about 2 and half weeks, endured daily headaches, but then finally, I quit about a week ago.

Since quitting, I haven’t had a single headache, visual aura, or palpitation. I’m cured.

It’s curious, isn’t it? I’m a doctor right? I should have known better. I should have identified the obvious instigator and simply stopped it.

But I’m also a real person, with a real life, real loves, and real routines. I’m surely not stupid. And we’ve all seen morbidly obese doctors and unfaithful preachers. So what happened?