listen to your bodyI just wanted to share my personal story of working through a case of systemic inflammation—because I didn’t think it could happen to me.  And perhaps you are feeling similar and it might help direct you towards some resources so you can start to feel better.

I consider myself to be healthy—a vegetarian since 1999, practice and teach yoga, a physical therapist, daily exercise and meditation.  I teach and talk about having an anti-inflammatory diet to my clients and suggest stress-relieving tools. Pretty healthy, right?

But then I started to not feel so good….just not like myself. And when you practice yoga and meditate, you can start to pick up on these things pretty quickly.

So what was I feeling?

  1. Sadness: I started feeling sad.  And I did have some reason to have feelings of sadness—two of our friends in our kitesurfing community took their lives within a year of each other.  And sometimes there is the stress and struggle of worrying about a business. But in my gut, I didn’t feel like those things were making me feel sad. I would have this pervasive sense of sadness, like I wanted to cry out of my right eye at any given moment. And if I let it go, then I would end up going into full force tears and gasps.
  2. Fatigue: On top of that, I felt this impending, towering sense of fatigue. Fatigue that feels like apathy. Like, “I don’t care.” I usually don’t mind waking up early and starting my day with the exercise bike, some yoga, followed by meditation. But all I wanted to do was a few stretches and sit in meditation, because it meant I didn’t have to “do” very much. And hey, I’m the first one to tell you that that’s ok sometimes. We all need a chance to not “do” as much each and every day. But this just didn’t feel like me. Also, I didn’t care about going kitesurfing or walking on the beach—things I love to do (and I actually have time for them now).  What the heck? I felt kind of like a failure.  Thinking, what’s wrong with me?  If I can’t manage my fatigue and sadness, how can I help others to do it?
  3. Rash: Then an all out break out occurred, literally.  I was on a conference trip to Texas for a week. About the second day there, I started to notice what I thought were bug bites on the backs of my legs. I thought, hmmm, ok, haven’t really been out in the trees, but I am walking 40 minutes daily from my residence to the conference, so perhaps I could have been bitten. And everything’s bigger in Texas, right?  So the bites start progressing each day and now they have moved to my chest, arms, back, buttocks and legs, and they are itchy. Now I’m really starting to wonder—what could this be?    And the last day as I was leaving, it really got bad.  (Insight here: the last day I had some serious stressing moments with my travel arrangements–more on this later). These could not be mosquito bites—I would have had to stepped into a swarm of them to have been bitten that much. Bed bugs?  Hmmm.

Just to note, the fatigue and sadness had been going on for about 9 months. The rash was a newer addition.

Trial Solutions

1. Primary Care Physician: I went to see my primary care physician who happens to be an allergy specialist. He reported that, no, these were likely not bites.  He really gave me no answer as to what they might be. I told him that I had taken Benadryl, mostly to see if I could sleep. The itching was keeping me awake all night! So he provided me with things to help the symptoms.–many samples of Zirtec (for allergy relief) and a prescription for some anti-itch cream (which I never filled). So, the Zirtec helped me sleep for the first few nights, but then I couldn’t continue taking it because it made me sleepy.  The doc told me that very few people feel drowsy from taking this (I guess I’m one of the few).  And the itch and rash stayed with me. Basically, wait and see.

2. Dermatologist: I then went to see my dermatologist (good thing this was a regular checkup already scheduled for less than a week from my return from Texas). We are looking at almost 2 weeks since the symptoms first started. She also confirms they are most likely not bites. But has no confirmation as to what it might be. She does suggest that perhaps it might be something new that I am eating. I mentioned to her that perhaps it was gluten—she dismissed it saying that very few people are gluten insensitive and those that she has seen, the rash did not look like mine.  She declined to do a biopsy, stating that it would only confirm what she was sure of, that it was not a bite and was of allergic nature. And she also declined to start a round of prednisone (thank you!), stating that it would have too many other affects on my system. Still, more waiting and seeing.

Ok, so what do I have so far?  Confirmed: not bites. Possible: allergic reaction. But I’m still itching. I’m still tired. And I still feel sad. Sounds like a perfect time to find a functional medicine doctor I have been hoping to find for at least a year now.

3. Functional Medicine Practitioner: Now invited in, Dr Stephanie Daniel, a functional medicine physician and doctor of osteopathic medicine (DO). I wanted someone that was more than a psychologist or a chiropractor (which some functional medicine practitioners are) and someone that could get to the source of my itchy rash, fatigue and sadness–my guess now is that there is some connection. She has a thorough questionnaire discussing my thoughts about what it going on, my daily eating habits, my daily activity habits and my spiritual beliefs. And she spends 90 minutes with me my first visit. It’s awesome, just what I’ve been wanting in a physician. Looking towards the source.  And she orders a cortisol test, lab tests (more comprehensive than a traditional doc would order) and stool testing to get down to the nitty gritty.

Findings

  1. Elevated white blood cell count (indicating that my body was fighting something)
  2. Low Vitamin D (even though I was taking a supplement)
  3. Low Vitamin B12 (even though this was in my protein powder; It is possible that either the B12 was not bioavailable or that my gut was somehow impaired and not able to make proper use of it)
  4. Low Magnesium (even though this was in my supplement; In this case it was likely because the form of magnesium in my supplement was magnesium oxide, which is the cheapest form and not at all bioavailable….so watch your sources!)
  5. Elevated cortisol levels (suggesting increased levels of stress, but in a sense it’s good that it was high and not low, because low would mean my adrenals were shot and I was under full blown adrenal fatigue. High levels suggest that some lifestyle changes will take more easily.)
  6. Low stomach acid levels (the right pH is necessary for proper digestion and absorption of vitamins and minerals. The stomach acid helps to activate the digestive enzymes. The stomach releases acid and the enzyme pepsin to start the digestion of proteins. When food isn’t properly digested by the stomach, the partially digested food makes it’s way into the intestines. These particles can lead to leaky gut syndrome and increase the risk of food sensitivities and autoimmune reactions.)
  7. Normal Thyroid levels (a good sign)
  8. Normal gut levels (confirming no inflammation or immune response (Dysbiosis) in the gut, but there still could be the presence of “leaky gut”) Learn more about Leaky Gut Syndrome here

Functional Medicine Solution

  1. Elimination Diet:  basically the anti-inflammatory diet eliminating sugar, soy, corn, dairy, gluten, alcohol—This was done initially to just see how I felt by doing this and see the effects (if any) on the rash.
  2. Supplements: Start taking good quality supplements (Click on any of these to find out the brand and where to find it—see the code and link at the bottom to receive a discount)
    1. Magnesium glycinate–x2 at night
    2. Liquid Vitamin D3—5000iu in AM
    3. Sublingual Vitamin B12—1000mcg in AM
    4. Transition to B-Complex after B12 runs out
    5. Omega 3-6-9 Emulsion formula—2 tbsp in AM (mmm, tastes like lemon meringue)
    6. Betaine HCL Pepsin—x4 prior to a high protein meal (tested to this amount, so your level may be different)
    7. Probiotic, x2 daily  (though I wouldn’t order from them again due to the outrageous packaging waste)–Added 10/29/14, I now use Udo’s Super-8 which you can find at Whole Foods or your local natural grocer.
    8. Curcumin, x2 daily
    9. Add in one egg per day (likely because I am a vegetarian and need a more complete protein in my diet)
  3. Transition from my all inclusive vitamin+ protein powder to a protein powder that is just protein minus all the non-bioavailable vitamins, Click here for the protein powder. 
  4. Reduce my stress
  5. Read the book, “The Immune System Recovery Plan,” by Susan Blum, MD (see below for reference link)

Results

  1. Within a few days to a week, I was feeling better—in fact 95% better!  The fatigue-fog lifted, as did the pervasive sadness.  And there I was several months back, writing on my blog about “Chronic Inflammation, Could it be making you depressed.  Yes, I think it might have been.
  2. And within a few days, the rash started to get better. The first weekend of the elimination diet, I did cheat a little bit because we went on a weekend getaway. But I noticed the night after we had a glutinous meal, my itching was back in full force.  Note to self.

I don’t believe I have celiac disease (though I was not tested for the anti-gliadin antibody (AGA) or deamidated gliadin antibody (DGA))—I don’t have any of the other symptoms such as bloating and gas after eating gluten. But I believe I may have a food sensitivity, of which there are no accurate tests.

Follow-up

I have slowly added things back from the elimination diet to see how they affected me. And thus far, nothing has brought the rash back, nor the sadness. I have felt fatigue after eating gluten and alcohol, but no other affects from the other things. And I am watching carefully for itchy “bites” on my legs after eating glutinous foods (trying to not become a hypochondriac about it). I will likely try to stay low on the elimination diet contents—afterall, I feel so much better not ingesting them.

Overall

I feel these occurrences are likely due to an accumulative effect. The rough idea I got from the whole experience is that eating those things might have not bothered me in the past but with an accumulated use, they just started to add up. And though I did not feel “stressed” per se, on my Texas trip, the stress of travel and of being in the unknown, may have been enough to trigger it.  The last day of my trip my flight got cancelled while I was checking in at the airport and had to pay to get a taxi to a motel for the night (just added stress of travel and expenses). Nothing, I wouldn’t have normally blown over, but for some reason this really set off my stress response. Add to that, I was also eating more gluten because the AirBnB had granola for breakfast, I had ordered a pre-made lunchbox with yet more gluten and I believe I had gluten at several of my dinners. So we had what they might call, “the perfect storm.

Lesson Learned

No matter how healthy you think you might be, things can still go haywire—it just takes a perfect combination. And knowing that the signals (sadness, fatigue, rash)—might be all connected, find the right practitioner to guide you.  Even though I consider myself an integrative practitioner, I obviously still need help and guidance. We can’t all go through this alone.

Recommendations

  1. Watch for persistent symptoms of fatigue, sadness, rash, gas, bloating, constipation, apathy, difficulty concentrating, headaches, joint pains or muscle pains.
  2. Try an elimination diet according to the book, “The Immune System Recovery Plan, by Susan Blum, MD, http://www.immuneprogram.com/.
  3. Or find a functional medicine practitioner in your area. In the Bay Area, check out, http://www.bayareafunctionalmedicine.com/.  And of course my favorite on there is Dr Stephanie Daniel, http://drstephaniedaniel.com/   (by the way, she also works with men). Whereas a primary care physician may look into your lab tests, they may see that levels are “within normal” because you are not yet in a “disease” state. A functional medicine practitioner will look at all the readings and be able to see if you are on the verge of something bigger. The idea is preventative medicine, not treating the symptoms.

It’s worth a shot and may save you lots of time wondering, “what’s wrong with me?” and going to a bunch of doctors that can’t really tell you. It’s soooo worth it!

I welcome your feedback and hope that if you find this helpful, you will share with your colleagues and your friends. Click here to Contact Tianna to see how she can assist you if you are experiencing any of the above symptoms. 

References:

1. Blum, S. S., & Bender, M. (). The immune system recovery plan: a doctor’s 4-step program to treat autoimmune disease.

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