Fibromyalgia and Paleo

I was diagnosed with fibromyalgia about two and a half years ago. Looking back I've had it for at least ten years. So what is it?

From the National Fibromyalgia Association website:

Fibromyalgia (pronounced fy-bro-my-AL-ja) is a common and complex chronic pain disorder that affects people physically, mentally and socially. Fibromyalgia is a syndrome rather than a disease. Unlike a disease, which is a medical condition with a specific cause or causes and recognizable signs and symptoms, a syndrome is a collection of signs, symptoms, and medical problems that tend to occur together but are not related to a specific, identifiable cause.

Fibromyalgia, which has also been referred to as fibromyalgia syndrome, fibromyositis and fibrositis, is characterized by chronic widespread pain, multiple tender points, abnormal pain processing, sleep disturbances, fatigue and often psychological distress. For those with severe symptoms, fibromyalgia can be extremely debilitating and interfere with basic daily activities.

The most common way to diagnose someone with FB is check for tender points. There are up to 18 of them. You need to have at least 11 to be diagnosed. I have 16 I think.

That's very general. I want to focus on what FB looked like in my case. And I must admit, I have a very moderate level of symptoms, nothing like some other persons.

PAIN
All over. Everywhere, but you can't pin point it. Spreads through legs, belly, arms. Sometimes sits in one limb only, sometimes hits everything at once. You try changing positions, lift the legs, not move, move... nothing helps. You can just try to sit as comfortable as possible and wait till the worst is over. Then there is this "I have a flu with no fever" feeling. As if you were bruised on every inch of your body, every touch hurts. Putting on underwear hurts. Using bathroom hurts. Touching hair hurts, because your skin hurts. That usually holds for three days. Then there are joint pains. Sometimes random, sometimes as an outcome of long walk, standing for too long, wrong shoes, too hard surfaces or I don't eve know what.
When I finally started to do some workout over the summer (I am a teacher, so I had more time then), my knees would scream, not only during the workout but even in between. After a few days they were hurting all the time. My doctor told me that it is what it is, gotta get used to it.

FATIGUE
Not just tired... but the absolute physical and mental exhaustion. Too tired to prepare a meal, to clean the house, to make the bed. Too tired to visit friends or invited anyone over. Too tired to do shopping, check out a nice place or keep up with a hobby. Too tired to even begin about working out. Too tired to finish up some documents from work or even answer emails to friends.
I used to come back from work, and was sitting from around 5pm to 10pm in front of my laptop, not being able to do anything. I ate whatever I could find when I was so hungry it overcome the fatigue. I was so tired it was difficult to get up and get prepared for bed. Too tired to understand what I was reading on the internet, so I usually was surfing through home decor blogs - pictures only, easy. I was too tired to focus on a book or even watch a movie. I was vegetating.

SLEEP
I could sleep for ten hours and wake up tired. I wake up multiple times during the night for a split second. My body cannot fall deep enough to get into the most important, restorative phase of the sleep. Sometimes I fall asleep without any problems, sometimes I have a hard time with that. On free days I may also take a nap during a day. I aim for 7.5-8h during a weekday, 9h on weekends. If I sleep less than 6h I feel sick, have bad headache and simply remind a zombie.

OTHER
I did have problems with my bowels, and I am getting bad headaches, with occasional really severe ones. I have had problems with concentration, clear thinking and memory. I still struggle with depression and really bad anxiety.


TREATMENT
My rheumatologist has tried various meds and supplements. Nothing worked. No CoQ10, no lyrica, no other. He suggested stretching, exercising (promising that it was supposed to get better after a while of bad pain), and "healthy diet". To be honest, the only advice he gave me that worked, was getting a body pillow!

So why am I writing most of the symptoms in past tense? Well, because they are things of the past for me. Enter Paleo.

I've been eating low-carb since about January, almost-paleo since March-April. Completely gluten-free since July. Even without cutting all gluten the majority of FM symptoms either lessen or disappeared.

PAIN
I have very rarely the "random" muscle or joint pain. I do still have aches, especially after running long errands and/or having to stand for a longer time. The recovery still takes a while.
I am working out, strength, sprints etc., with no joint pain whatsoever! I do lunges, squats and my knees sing the songs of praise.
I still wake up stiff in the morning sometimes, but it takes less time to get moving.

FATIGUE
Gone. Can you believe it? I am a new woman! I come back from work and I have still energy and will to do stuff. I do workout or cook dinner and/or lunches for work, I clean around the house and whatever else I feel like doing. I am able to read and understand what I am reading even after 6pm. I have my life back. It's unbelievable. I think this part of the recover is the most beneficial. I do cook more on Paleo - but now I have time to do it!

SLEEP
Still working to get it better.

OTHER
Can't remember when was the last time I had any GI issues. My focus, ability to concentrate on a task and general mental ability improved dramatically. Anxiety and depression got better, but they need more time for full recovery. I take medicine for both of them.

All of it only thanks to cutting grain, sugar, processed foods, vegetable oils and other crap of that kind. I eat a lot of animal protein of many varieties, fish, good fats like coconut oil and butter, a little bit of cream or cheese, some green veggies and occasional fruit or chocolate. That's it. That's all the medicine I needed!

This post is part of "Paleo Rodeo" @ Modern Paleo!

Fasting and paleo

When I was on my old way of eating (high-carb), I had extremely difficult time with any kind of fasting. When I tried to fast a whole day (for religious reasons, like Yom Kippur), it was a nightmare. Very soon after waking up I would already start to feel bad. A few hours later I would have no energy, had problems with moving my legs fast, my head would feel as if made of lead with pounding pain. Toward the end of the day I would be lightheaded, dizzy and sometimes close to fainting. I thought it was just my nature...

On Monday we had "Back to School Night" about which I completely forgot. It meant that instead of going home before 5pm I made it at 9pm. With no extra food, on some eggs, coffee with cream and protein shake. Hardly any hunger, no headache, energy and full mental attention.
I used to say how I simply couldn't not eat a breakfast. I would be sick and nauseated with this deep, painful need to eat at that right moment. Nothing like that anymore - when I am hungry, it's a normal signal, no attack from inside. It's fascinating to me how all of that has changed.

Yesterday I did my "refeed" dinner. And I had too much. I see on other blogs how people make these humongous meals, sometimes calling them variations of "refeeds". How do they do it? I tried three beef sausages, three eggs with two extra yolks and a bit of veggies (broccoli, green beans, mushrooms). I felt full one third in. I wasn't sure if I should just stop or try and force to eat more. I decided to try and it more, because I don't want my body to think I am starving it, so it would go into starvation mode or something.

Each day this week I came back late from work, so no workout yet. And tomorrow I will be even later... Friday it will be, then. And maybe Saturday as well. I have to do a good strength workout and practice more on pull up bar. I am beginning to being able to do pull up! I have big problems with that... I try with support, and it gets better. chin ups get better as well, now I can do 3-4, and same with parallel chin ups.

"healthy" knish

In the faculty lounge during lunch we often comment on each other's choices of food, exchanging ideas and sharing struggles (a few people try to lose weight). Today the hero of the hour (well, 20min) was home made knish. It looked very good, had no crust and according to the maker was also delicious. The person got the recipe from cardiologist which in the opinion of all present gave it a stamp of approval. Everyone assumed it must be healthy... I said nothing when I started to hear the ingredients... Apart from spinach and spices I wouldn't touch anything else in it. Egg beaters? Tofu? fat free mozzarella? Sad. I didn't say anything because I knew it was pointless. Between weight watcher, newborn conventional (fat is evil) healthy eater, cancer survivor on low-fat "healthy" diet and a couple others SADers* there was no point. It would only upset everyone, especially that most of them really think they know best. Obviously I also think I know best :) The only reason I feel better is that I have been researching nutrition and evolutionary science for quite a while now and don't take my health advice from color magazines.

I have decided to give PSMF** a try. Even though I didn't get into paleo in order to lose weight, I do want to shed the waist and legs/buttocks fat that I put on about a year ago. I switched then to a new anti-anxiety medicine and it caused enormous carbs cravings, no control in eating sweets and cakes, and made me 30Ibs heavier a month and a half later. I would like to get back to my wardrobe from the days before that.

I let myself eat too much of healthy and  paleo foods. I forgot that paleo means also eating according to the body's needs. Which means I should eat when I am hungry and enough to be satiated, not because I feel like it would be fun to eat a bowl of sour cream with coconut and banana. I think it is clear what I am talking about ;-)
So for a few days I am trying to keep on the low carbs but also cut on fat, with the minimum protein that is needed per day. This way the body is not starved, receives enough necessary nutrients but also is prompted to kick in serious fat burning. I will let you know how it goes - it's only day two.

*SAD - Standard American Diet.
**PSMF - Protein Sparing Modified Fast

Some good medical/diet/health links

Over at Evolutionary Psychiatry a good and simple explanation on why our brains need Omega-3. I have started to take supplements (Krill Oil) a while ago realizing that I just dont' eat enough fish. I don't have the access to fresh fish, I don't cook much out of frozen, and I don't want to rely on cans only. I wan't to make sure I get enough essential fatty acids.

Interesting discussion on the need of calorie counting if someone wants to lose weight.

Since going paleo I stopped counting anything other than paying attention to carbs. I found that I let myself eat too much of the good. I love cream too much, and I think I really eat too much of protein and fat sometimes. I am not in paleo to loose weight, I want to be healthy and strong. BUT I do want to look good naked. I always loved athletic bodies, I find female athletes much more sexy than some skinny celebrities. Give me strong arms and a six pack and I am drooling all right ;-) So yeah, I would like to lose a bit of the fat around my waist, esp. that it's the risky fat as it's often a sing of fattening of inner organs. I am exercising and do strength training, and I feel that I do have muscles.. but I would like them to be properly seen :) So I want to uncover them from the cushion of fat. I won't suddenly change much, but I will cut on fat a bit and stop overeating. I am interested in doing PSMF just to start the system. And I still want to make my muscles stronger and bigger (esp. arms). We will see.

Here is one of many articles criticizing the China Study and why it is not scientifically sound. This one comes from dr. Mercola.

Got my lab results finally

I did the lab two months ago, but only yesterday received a copy. Yep, it took them that long.

Anyway, I was very nervous to find out any changes in my blood work after switching to new way of eating. I started to change it around January (I think), but for the first three months or so it was back and forth between different ideas, eating generally low-carb, but with a lot of processed foods. I knew it was the right way to eat after reading Gary Taubes "Good Calories Bad Calories" book, but it took me a while to figure out where I wanted to be. Slowly I was cooking more, I stopped trying to create low-carb versions of old foods, wanted to eat more and more "real" foods. I started to read about Paleo/primal/evolutionary lifestyle and the more I read the more sense it made. I have been interested in pre-historical times, I loved learning about anthropology and evolution - so this approach is just perfect for me.

I can't remember exactly, but I think I made the switch to paleo around April? Around that time. I stopped eating processed foods whatsoever, and I was cooking by myself. Now I am still dairy eating paleo. I cut off gluten only after the tests. I kept on eating gluten (low-carb versions) b/c I wanted to have some in my body to make celiac testing. But after it took them so long to get my lab back, I decided to just go gluten-free no matter the results.

So, the results are after about a half a year of low-carb and three months of real food, paleo eating. I was comparing them to my results from roughly two years before that.

The good:

- Potassium, Calcium, Chloride and Sodium are all in the correct ranges, went up from under-ranges (esp. Potassium & Calcium) since last time.

- my lipid panel: even though my total cholesterol went up slightly (it's 210 now, which is considered "high"), my HDL levels went up even more and are now 78, when anything above 59 is considered beneficial and negative risk factor for CHD. My triglycerides are in healthy range as well.

- my vit. D is much higher, I had deficiency before. I am not scared of sun anymore!

The bad:

- It looks like I still have anemia. I've had anemia all my life, so I am used to it. Even though with eating all that meat you would think I should have enough iron.

I will still wait for my doctor to actually contact me and tell me her opinion about the labs, but I know for sure I am not changing the way I eat! I feel great, my lab results I think are pretty good as well.

Ode to an egg. Or rather to a yolk.

Eggs get recently a really bad rep. Too bad, as they are some of the best what nature has. Nowadays, with the ridiculous fear of saturated fat the yolk is seen as the worst offender, and we can see "egg white only" products popping up everywhere. The result? throwing away a nutritious treasury and leave the least useful part. Whites bring some protein and very little benefit beyond that. Many people who are sensitive or allergic to eggs are only sensitive to whites, not yolks. We know also that eating too much protein is not that great, and on paleo diet we get plenty of protein all right.

I love eggs. Sometimes I will use two full eggs and then add just yolks, throwing away the whites.

My expertise in nutrition is far from strong, so it's much better to refer to people who do know their stuff - this time it's an article on Paleo Diet Lifestyle with a lot scientific details for inquiring minds.

They contain 100% of the fat soluble vitamins A, D, E and K as well as carotenoids lutein and zeaxanthin found in the egg. They also contain more than 90% of the calcium, iron, phosphorus, zinc, thiamin, folate, vitamin B6 and vitamin B12. Compared to the yolk, the white doesn’t bring much to the table in terms of nutrients. The gg white contains more protein than the yolk, but it’s only because the yolk is smaller.

food, budgeting and benefits of paleo eating

Posted in Fight Back Friday:

Just finished eating late lunch (I love the Mexican frying cheese! I added fried eggs to it). I cooked ground beef with a lot of garlic, onion, allspice, bay leaf and some ketchup. I added a small can of diced tomatoes. I added also extra fat from cooking beef stew pieces and spare ribs (slow cooker is my friend), so it's extra "creamy". All of that should give me base for quite a number of meals. I will try and not do any grocery shopping for a while, I need to save up a bit. It's hard to keep a balance between buying food that I know is good for my health and knowing the limitations of my budget. As for now I am doing pretty ok, I think. I try to buy the cheap cuts of meat and chicken. I got grass-fed offal and beef sausages online, which I am using almost like a spice, a touch of luxury. Even when I am talking about liverwurst or bologna! ;-) I don't eat much vegetables, so I try to rely on frozen only as they don't go bad the way raw do. Too often I had to throw away things I just didn't have time or wish for using. But I do buy real cream, organic grass-fed butter, organic coconut oil... I haven't checked, but I think when I would count all the crap and non-paleo I used to buy that I don't eat now, in the end I might actually come on "plus" with paleo diet.

I do spend more time cooking, that's for sure. A year, two years ago, I used to come back from work and veg in front of my laptop till it was time to go to bed. I hardly had energy to do anything. Very often my body was aching and my head felt as if it were made of lead. I didn't feel like cooking and when I finally was so hungry I couldn't wait any longer, I had to eat something at that moment, fast. And it never was a healthy choice. I was hungry often, was craving carbs like crazy. And I was hungry it was very nauseating, horrible hunger.

Now? I come back home and I have energy to do things. I might begin to cook something, clean kitchen, do workout, read, check internet for couple hours and then move to do something else... Sometimes I still have worse days when I am more tired. But it's unbelievable how my flu-like daily pains and tiredness simply disappeared. I have fibromyalgia, which supposedly has no cure. I tried CoQ10, a few different meds, stretching and nothing helped. When I tried exercising and my joints (esp. knees) cried out in pain the doctor basically told me to suck it up, b/c that's what fibro is.

Now? I have my life back. It's still not perfect, but it's so much better. So yeah, I do spend more time on cooking... but all of it is during the block of time that normally was stolen from me by fibro and chronic fatigue. Now I cook and I still have extra time left to do other things.

I eat almost 100% processed-free food. The only processed foods I use is protein powder (only once in a while), supplements, no-chemicals no-sugar or preservatives ketchup. Can't think of anything else... All other food is natural, in raw, frozen or canned form, or slightly processed by reliable meat plant (but with no hormones, chemicals, nitrites or preservatives).

A few years ago I would never believe myself being so food-conscious, reading tons on nutrition, evolution, genetics... I was the kind of person who would openly and with pride say that I didn't care about food, nutrients, health... I thought nutrition and carbs or protein talk was for some crazy organic-obsessed hippies. now I am one of them ;-)

oh, and shortly will add other benefits I've notices since going low-carb, and then completely paleo (no grains, no sugar, no beans, no processed foods. only meat, fish, animal products, vegetables, some fruits and nuts): my skin cleared, I haven't had cold in a long time, my nails are stronger, I have better stamina in general, I have bigger and stronger muscles, I can fast without nausea and can even workout hard while fasted feeling great and energetic, chronic muscle and joint pain almost completely disappeared (I still have heightened sensitivity to touch, trigger points and occasional stiffness in joints and muscle pains, esp. after longer activity), no bowel pains or painful bloating, less headaches, lighter periods.

Might be more, but that's what I can think of now.

the killer grains

Over at Fathead (Tom Naughton) the author brings dr. Cordain's paper Cereal Grains: Humanity’s Double-Edged Sword. I saved the article to read later, and at the moment I am using Fathead's choice of quotes (just because I am lazy, and it's soon time to go to work). Restating the evolutionary arguments for the beginning:

For the vast majority of mankind’s presence on this planet, he rarely if ever consumed cereal grains. With the exception of the last 10,000 years following the agricultural ‘revolution’, humans have existed as non-cereal-eating hunter-gatherers since the emergence of Homo erectus 1.7 million years ago.

It is apparent that there is little or no evolutionary precedent in our species for grass seed consumption. Consequently, we have had little time (less than 500 generations) since the inception of the agricultural revolution 10,000 years ago to adapt to a food type which now represents humanity’s major source of both calories and protein. The sum of evidence indicates that the human genetic constitution has changed little in the past 40,000 years. The foods which were commonly available to pre-agricultural man were the foods which shaped modern man’s genetic nutritional requirements.

Generally, in most parts of the world, whenever cereal-based diets were first adopted as a staple food replacing the primarily animal-based diets of hunter-gatherers, there was a characteristic reduction in stature, an increase in infant mortality, a reduction in lifespan, an increased incidence of infectious diseases, an increase in iron deficiency anemia, an increased incidence of osteomalacia, porotic hyperostosis and other bone mineral disorders and an increase in the number of dental caries and enamel defects.

Consumption of high levels of whole grain cereal products impairs bone metabolism not only by limiting calcium intake, but by indirectly altering vitamin D metabolism. In animal studies it has been long recognized that excessive consumption of cereal grains can induce vitamin D deficiencies in a wide variety of animals including primates.

Consistent with populations from the fossil record showing a characteristic reduction in stature with the adoption of cereal-based agriculture, is the observation that present-day populations depending upon cereal grains for the bulk of their energy and protein also tend to be of short stature. Further, vegan and vegetarian children often fail to grow as well as their omnivorous cohorts despite apparently adequate intakes of amino acids and nitrogen.

Because primates evolved in the tropical forest, all of their potential plant food was derived from dicotyledonous species; therefore, the primate gut was initially adapted to both the nutritive and defensive components of dicotyledons rather than the nutritive and defense components of monocotyledonous cereal grains.

Consumption of monocotyledonous plant foods, particularly cereal grains, is a notable departure from the traditional plant foods consumed by the majority of primates. Consequently, humans, like all other primates, have had little evolutionary experience in developing resistance to secondary and anti-nutritional compounds which normally occur in cereal grains.

Lectins are proteins that are widespread in the plant kingdom with the unique property of binding to carbohydrate-containing molecules, particularly toward the sugar component. They were originally identified by their ability to agglutinate (clump) erythrocytes which occurs because of the interaction of multiple binding sites on the lectin molecule with specific glycoconjugate receptors on the surface of the erythrocyte cell membranes. Because of this binding property, lectins can interact with a variety of other cells in the body and are recognized as the major anti-nutrient of food.

Of the eight commonly consumed cereal grains, lectin activity has been demonstrated in wheat, rye, barley, oats, corn, and rice but not in sorghum or millet. The biological activity of lectins found in cereal grains are similar because they are closely related to one another both structurally and immunologically. The best studied of the cereal grain lectins is wheat germ agglutinin (WGA), and the in vitro biological effects of WGA upon tissues and organs are astonishingly widespread. In his comprehensive review, Freed has shown that WGA can bind (in vitro) the following tissues and organs: alimentary tract (mouth, stomach, intestines), pancreas, musculoskeletal system, kidney, skin, nervous and myelin tissues, reproductive organs, and platelets and plasma proteins.

Most food proteins entering the small intestine are fully degraded into their amino acid components and therefore do not pass intact into systemic circulation. However, it is increasingly being recognized that small quantities of dietary protein which escape digestive proteolytic breakdown can be systemically absorbed and presented by macrophages to competent lymphocytes of the immune system. Under normal circumstances, when the luminal concentrations of intact dietary proteins is low, absorbed proteins generally elicit a minimal allergic response because of the limiting influence of T-suppressor cells.

Because of their resistance to digestive, proteolytic breakdown, the luminal concentrations of lectins can be quite high, consequently their transport through the gut wall can exceed that of other dietary antigens by several orders of magnitude. Additionally, WGA and other lectins may facilitate the passage of undegraded dietary antigens into the systemic circulation by their ability to increase the permeability of the intestine. Consequently, dietary lectins represent powerful oral immunogens capable of eliciting specific and high antibody responses.

[Fathead comments: In other words, lectins can lead to leaky-gut syndrome. They poke holes in your intestines, seep into your bloodstream and are carried throughout your body, which then must produce antibodies to attack them. If that were the end of the story, it would be bad enough. But that’s not the end of the story. The amino-acid profile of lectins is similar to the amino-acid profile of many of your own tissues. The result of what Cordain calls “molecular mimicry” isn’t pretty.]

Autoimmune diseases occur when the body loses the ability to discriminate self proteins from nonself proteins. This loss of tolerance ultimately results in destruction of self tissues by the immune system.

So why are we told, over and over, that humans need grains to survive and reach optimal health? If for 99.6% of our existence as species we thrived without them, why suddenly they became the core of our health and well being?

fasted training

Once in a while I workout when I am hungry, or on really empty stomach (but not feeling any hunger at the moment). Since going paleo I can fast hours and feel ok, with a lot of energy and no touch of the old nausea as I used to have on old carb-focused diet. Most of the time I don't even plan on fasting (even though a lot of paleo do it for health reasons), it just happens - I forget to take lunch with me, or don't eat breakfast etc. There are many studies that show benefits of hunger and fasted state for human organism. Some hormones work better, the body has a chance to cleanse a bit, get a breath, strike a balance. If you workout when hungry, which was very common for paleolithic peoples (workout = hunting/gathering/escaping/building), your growth hormone is released, insulin sensitivity improves , and it's even more easy for you body to use fat as your fuel.

In this blog entry there is even more explanation on the benefits, with links to some new studies. Here is just a small excerpt:

As you can see, the fasted training group beat the fed training group on almost all relevant parameters. More importantly for some perhaps, the fasted training group saw significant improvements in all parameters relevant to improving body composition and health, where as the fed training group saw comparatively lackluster results here.

This study strengthens the notions I covered here, which is that fasted training may provide some unique benefits to those training in the fasted state, whether it be endurance training, conditioning or bodybuilding. However, this study may be somewhat more relevant considering the higher exercise intensity used, which is closer to, albeit not exactly similar, to CrossFit, kettlebell training and weight training. That is, activities which rely on glucose utilization to a greater degree than fat oxidation.

Paleo grocery list

Here is a good list of paleo foods to stack up on. It's simple and without too many complicated details.

I am a huge, huge fan of paleo lifestyle, and with each day I am even stronger. I read a lot, educate myself and dont' just blindly follow someone else's fad ideas... this is a solid, science and evidence based, way of living. not to loose weight (even if that can happen if your body needs it), not to look good naked (even if it's nice and probably will happen) but simply to be healthy and in sync with own genes and our species evolution.

And eve if it's anecdotal - my own amazing health improvement (esp related to fibromyalgia and GI issues) is enough for me to know I am on the right track.

paleo and healthy eating

A good explanation and the general overview on how people get fat, the role of insulin, why fat is not your enemy, and other things connected to paleo diet. Worth reading!

Check it out!