SOLVING THE GUT’S MYSTERIES
Patients, doctors turn to diet for relief
Michelle Gindl was an energetic, outgoing communications professional who went from being an avid runner, mountain climber and swimmer to someone who took daily naps and couldn’t walk without pain.
“I was a shadow of the person I used to be and I hated it,” says 43-year-old Gindl. “I hated that I would be in so much pain after pushing the baby stroller and that I would have to take these massive pain killers ... I hated that I didn’t have the energy not only for my kids but also for my husband who was so supportive. It was a very low and long period of my life.”
Gindl spent eight years making weekly trips to the chiropractor, massage therapist, acupuncturist and physiotherapist to manage her pain. She became anemic and took iron pills that made her feel worse. Her family doctor dismissed the fatigue as par for the course for a young mother of two and prescribed her an antidepressant.
“But it got to the point where it was more than that,” says Gindl. “I knew it was something else … I realized if I wanted to get well I had to start taking my health into my own hands. I became a research junkie.”
She tried bioidentical hormone replacement therapy, iron infusions, pain-reduction injections, and vitamin therapy. But they all felt like Band-Aid solutions.
It was a naturopathic doctor who introduced her to gut health and showed her the direct connection between the food she was eating and how she was feeling.
“That was interesting and eyeopening for me,” says Gindl, who then picked up a book called Gut and Psychology Syndrome (GAPS), written in 2004 in the U.K. by neurologist and nutritionist Dr. Natasha Campbell-McBride, who claims that “all diseases begin in the gut.”
“The more I read, the more I realized there was a connection between the gut, the brain and the food we eat,” says Gindl.
On New Year’s Day 2014, Gindl threw out everything in her kitchen that wasn’t GAPS-friendly, went off all her medications and stopped all her treatments. The next day, she started her whole family on the no-grains, no-refined sugar, no-dairy, no-processed foods diet.
“We started with lots of bone broths,” says Gindl. “It was really extreme.”
Three weeks later, all her pain was gone.
“It was miraculous,” says Gindl. “It was life changing. It just invigorated me. ‘Oh my God, this is working. There is something to this.’ Literally all my pain was gone. In fact, my physio called, my massage therapist called and they were like, ‘ Where are you?’ because I had been a regular customer of theirs for years. Now I didn’t need them anymore.”
Beverly Huang, president of the College of Naturopathic Doctors of Alberta, says Gindl’s outcome isn’t surprising.
“Often a person may not realize how their diet can affect their health,” says Huang. “Once they can sort out which foods are the most appropriate for their body, optimal health can be achieved and many of these chronic symptoms get resolved.”
Dr. Maitreyi Raman isn’t familiar with the GAPS diet, but she also believes that diet can make a dif- ference in fighting more than the obvious diet-linked diseases such as diabetes and heart disease.
“Diet has been hugely underappreciated in the prevention, treatment and management of diseases,” says Raman, a gastroenterologist specializing in GI nutrition, an author, and the medical director for Calgary Nutrition Services. “We are doing fairly cutting-edge research with regards to dietary manipulations to help promote healthy microbiomes to treat inflammation of the gut.”
But this approach is still relatively new.
“Gut dietary research has really only emerged in the last five years,” says Raman. “In the GI world, there is a natural assumption that diet has a role, but there is very ( little) high quality research done on dietary intervention when it comes to treating inflammation.”
Raman hopes to change that with the new GI Nutrition Centre of Excellence, set to open next month at the University of Calgary with a focus on patients who have GI diseases.
Unlike Gindl, Jennifer Shin didn’t have exceptional results when she tried the GAPS diet or the popular Paleo diet.
Slim and trim like Gindl, Shin considered herself a fairly healthy person who exercised and practised yoga regularly, ate right and avoided fast food and sugar. But at 32, she began experiencing chronic fatigue seven months after the birth of her daughter. She was diagnosed with Hashimoto’s disease — an autoimmune disease that attacks the thyroid. Her family doctor put her on a drug called Synthroid but it made her feel worse.
She told one internist that she had noticed there was some connection between what she was eating and what she was feeling and asked if there might be an alternative to taking Synthroid.
“He actually told me I should go enjoy my life, eat whatever I was eating and I’ll be just fine,” says Shin. “He wasn’t listening.”
Dr. Leah Gramlich says many doctors aren’t equipped to address complex health issues related to nutrition. “They don’t have the training,” says Gramlich, a gastroenterologist and the provincial medical adviser for Nutrition Ser- vices with Alberta Health Services. “Beyond the common lactose intolerance or celiac disease, (doctors) don’t have the knowledge and skills to assess all these special diets. Doctors work with evidence-based research and provide support and information and there isn’t evidence to support all these different diets.”
But on top of continual fatigue and feeling cold, Shin experienced swelling and rashes all over her body. She stopped taking Synthroid on a doctor’s recommendation. A year and a half later, she began experiencing severe, fiery pain in her joints and along her spine leaving her sleepless for months.
Her symptoms puzzled specialists. Rheumatoid arthritis and lupus were ruled out but nothing was ruled in. “The internal medicine doctor and the rheumatologist said there was nothing they could do for me and they both actually wished me good luck,” says Shin.
According to longtime rheumatologist Dr. Chris Penney diagnosing disease isn’t as simple as the public would like to believe.
“The layman thinks it’s straightforward but it’s not always straightforward,” says Penney, director of the Early Inflammatory Arthritis Clinic, who has treated Calgarians for 35 years. “The problem is there are people with some features of one disease and some features of another disease that you can’t put into one category.”
Gindl realized that she was one of those complicated cases. Her diet helped rid of her pain, but it didn’t erase the inexplicable fatigue, despite taking additional measures to treat various parasites and undergo heavy metal detoxification.
But upon further research, she discovered a condition called SIBO — small intestinal bacterial overgrowth — and knew the symptoms sounded all too familiar. It appeared to be the last piece of the puzzle because after being treated for SIBO with an herbal protocol, Gindl says she feels energy like she hasn’t felt in 20 years.
Her successful journey propelled her to become a certified nutrition health coach. She just graduated last month from the Institute of Integrative Nutrition in New York where the focus is on diet and lifestyle “education not medication.”
Often a person may not realize how their diet can affect their health. Once they can sort out which foods are the most appropriate for their body, optimal health can be achieved and many of these chronic symptoms get resolved.
“I really wanted to do this so I could help people,” says Gindl. “So they don’t have to spend years of their life and thousands of dollars figuring this out like I did.”
As a biochemist, Shin was skeptical when it came to treatments outside the western scientific realm.
But after meeting with eight different doctors, countless blood tests and trips to the ER, watching food documentaries such as Forks Over Knives, and “researching ( her) butt off,” she considered changing her diet after one internist, a naturopath and an integrative doctor all suggested diet modification as a means to address her symptoms.
Shin began to journal everything she ate and made an extensive list of what agreed and didn’t agree with her. Then she stumbled upon an obscure, alternative Korean practice called Eight Constitution Medicine that combines specific diets with non-traditional acupuncture treatment.
Assessed with a weak liver profile, Shin was prescribed a pescatarian diet with a limited list of specific fruits, vegetables and grains.
“It’s helped me get to where I am today,” says Shin. “My energy level is up. I don’t have any more of those fiery heat induced flares. My joint inflammation is down 80 to 90 per cent ... and I’m not losing as much hair as I used to.”
The experience has shifted Shin’s perspective on health care.
Although she says she’s felt ignored and judged by some physicians, she says she doesn’t take it personally. Her own sister is a pulmonary specialist in the United States.
“I know when they went to medical school they’ve been taught a certain set of skills and they’ve been trained to think and do things a certain way,” says Shin. “I don’t think it’s entirely their fault.
“But I don’t believe in symptom management anymore based on the way my body was able to recover so much. I know that addressing the root of the problem will get you so much further than just taking measures to take the symptoms away.”
Penney says that until there’s a cure, sometimes medication is all there is to offer, especially in the field of arthritis — one of the most common chronic health conditions afflicting Canadians.
“That’s the bad news,” says Penney. “But the good news is you won’t be laid up at home unable to work and impoverished because of your arthritis. We don’t have any magical cures but we are going to do our best to get you functional and comfortable.”
But no, diet doesn’t play a role in treating rheumatoid arthritis, says Penney.
“Everyone always ask us (that),” says Penney. “And the simple answer is no, because if there was a diet, I’d have you on it.”
But Penney doesn’t want to give up on his patients.
“We don’t give up on people,” says Penney. “We continue following them because they need emotional support and who knows, there could be a new drug or new research out tomorrow that’s going to make a difference for those patients.
“Another important point is listening to people, talking to them, examining them and looking again to make sure you haven’t missed anything…. Sometimes you wake up in the middle of the night and you have an idea. I don’t give up.” Neither will Shin.
“You have to advocate for yourself,” says Shin. “Your healing journey is your own. You can’t trust others’ journeys will work for you.”
She is in the queue to see another specialist.
“I want to know what happened to me the last five years,” says Shin. “If the endocrinologist can’t help me then I’ll have to continue searching for answers.
“In the meantime, I plan to do everything I can do help my body heal. I refuse to give up.” Gindl echoes the sentiment. “You can live a pain-free, fatigue-free life and I believe that wholeheartedly,” says Gindl.
“If I can do it, anyone can do it. There is hope.”