4d2939fec2398793f778331640d42d41
0

Elemental diet for SIBO and leaky gut

by (0)
Updated about 19 hours ago
Created May 02, 2014 at 9:27 PM

I am about to try an elemental diet to treat severe SIBO, leaky gut and slow-transit constipation. It will consist of:

~125g Hydrolyzed whey protein (a product called Dymatize ISO-100)

~25g Hydrolyzed collagen

~100-150g Dextrose powder

~70g MCT oil

-multivitamin, sea salt and electrolytes

My main concern is the insulinogenic properties of these ingredients, as dextrose always makes me crash and crave carbohydrates soon after. I can't follow a ketogenic diet because of adrenal and thyroid issues, so I'll probably use 100-150g dextrose per day. I tolerate carbohydates better in the evening, so I was thinking that I'll drink all of the dextrose at night. However, this will cause an even bigger insulin spike if I drink it all at once, so I'm not sure what to do.

1. Should I drink all of the dextrose at night, or should I try to spread it throughout the day? Also, are there any supplements that might prevent the blood sugar crash from dextrose? I might add alpha-lipoic acid, but I'm not sure if that would help or make it worse.

2. Will the sucralose and artificial flavorings in the whey protein have any impact on gut bacteria? I'll be consuming ~125g per day, and I wasn't able to find a lactose-free unsweetened hydrolyzed protein powder. Normally I avoid all sweeteners, but this was my only option.

3. Are there any potential problems from following an elemental diet for 1-2 months?

Thanks.

E24390f6d880f9144cdf7ab13220a84a
15 · May 04, 2014 at 10:04 PM

I read that people with insulin resistance and high insulin levels retain excess sodium. Low carb lowers insulin levels, which then causes much of the excess fluid and sodium to start excreting.

I am NOT insulin resistant (e.g., I do not have any of the symptoms such as being overweight), so unlikely that is the reason I would excrete sodium.

E24390f6d880f9144cdf7ab13220a84a
15 · May 04, 2014 at 10:02 PM

Whenever the intracellular potassium is excreted, it is drawn out of the intracellular areas into extracellular serum. That makes the serum read higher than it would otherwise.

The cardiac rhythm issues would be most likely caused by low intracellular potassium.

In any case, I haven't measured my own intracellular potassium, and at this point I'm having problems even finding a doctor who understands low carb diets and electrolyte issues enough to help me figure it all out.

4d2939fec2398793f778331640d42d41
0 · May 04, 2014 at 9:19 PM

As far as I know, serum potassium levels are the most widely used and understood. It's an interesting theory that intracellular potassium might be abnormal while extracellular potassium is normal on a ketogenic diet, but I don't know if there's evidence to back that up yet. Either way, I don't currently have any reason to believe that my intracellular potassium is low even though my serum levels are normal.

E24390f6d880f9144cdf7ab13220a84a
15 · May 04, 2014 at 8:58 PM

I did not know that ketogenic diets increase cortisol, and that does make me wonder could cortisol be what is driving excretion of potassium. See this old study I found from 1955:

http://press.endocrine.org/doi/abs/10.1210/jcem-15-2-176

Excretion of intracellular potassium would explain cardiac rhythm issues.

E24390f6d880f9144cdf7ab13220a84a
15 · May 04, 2014 at 8:50 PM

I don't know how to resolve it by electrolytes alone.

Just a note: serum potassium measurements commonly done in blood panels measure the extracellular potassium, NOT the intracellular. 98% of potassium in the body migrates inside cells. The test for intracellular potassium it is not commonly done and is expensive.

I do wonder if somehow the same mechanism in a low carb diet that causes shedding of extracellular sodium might also be causing depletion of intracellular potassium, while masking that because the potassium leaks out into serum and reads normal or high in serum tests.

4d2939fec2398793f778331640d42d41
0 · May 04, 2014 at 8:27 PM

Then how else could I resolve these issues without going off the diet, if nutrient intake wasn't the problem?

4d2939fec2398793f778331640d42d41
0 · May 04, 2014 at 8:22 PM

Adrenal problems like excess epinephrine can also cause heart pounding, and I experienced these same symptoms whenever I tried various treatments that affected my adrenal or thyroid function. I think that any electrolyte imbalance is probably secondary to these hormone problems, and doesn't have to do with mineral intake. I wish that the ketogenic diet didn't increase cortisol and decrease T3, because I would like to continue it for its neurological benefits.

E24390f6d880f9144cdf7ab13220a84a
15 · May 04, 2014 at 8:22 PM

My point was that for some people it may be more complicated than just taking extra salt and potassium. Taking extra salt and potassium does not resolve all of my own symptoms on low carb.

4d2939fec2398793f778331640d42d41
0 · May 04, 2014 at 8:20 PM

I agree with the logic of most of your points, and I appreciate that you're trying to help. Electrolyte imbalance is very common in ketogenic diets, and electrolyte imbalance can also definitely cause heart rhythm issues like the ones I had. However, I am 100% sure that I used more than enough sodium and adequate potassium, because I followed published guidelines for ketogenic diets (from Lyle McDonald's book), and I tracked my nutrition intake meticulously.

4d2939fec2398793f778331640d42d41
0 · May 04, 2014 at 1:48 AM

By "high amounts of sea salt," I mean more than 5g per day. Again, I am aware of the diuretic effects of a ketogenic diet, and you're right that electrolyte imbalance is the first thing you should consider when experiencing these symptoms on a low-carb diet. I was aware of this before I started the diet, and made the necessary adjustments to sodium, potassium and magnesium intake. I have experienced "adrenal symptoms" on many other occasions, and I recognized those same symptoms on a ketogenic diet, which is why I did not continue it in the long-term despite the neurological benefits.

4d2939fec2398793f778331640d42d41
0 · May 03, 2014 at 9:13 PM

I should have mentioned that I was using high amounts of sea salt on the ketogenic diet, along with adequate potassium. I get a CMP done pretty frequently, and the only electrolyte abnormality it ever shows is low chloride. I am aware the sodium and potassium loss is common on low-carb diets, but that would have been unlikely in my case

I attributed these symptoms to adrenal and thyroid issues because they are the same symptoms I get when I take a cortisol-lowering supplement like phosphatidylserine, or when I adjust doses of a thyroid medication. My body temperature also dropped.

4d2939fec2398793f778331640d42d41
0 · May 03, 2014 at 7:12 PM

According to my blood tests, I have high AM cortisol, low T3, and borderline low T4. When I follow a zero-carb ketogenic diet, my energy levels improve a lot initially, but I then start getting heart pounding and palpitations. This is why I don't continue a ketogenic diet in the long-term.

  • Total Views
    1.3K
  • Recent Activity
    E24390f6d880f9144cdf7ab13220a84a
  • Last Activity
    227D AGO
  • Followers
    3

Get Free Paleo Recipes Instantly

4 Answers

E24390f6d880f9144cdf7ab13220a84a
0
15 · May 04, 2014 at 6:53 PM

Alex0, so the interesting thing is your heart rhythm issues, particularly after going very low carb. The four main electrolytes play the critical role in each heartbeat. Calcium starts the closing process of each heartbeat, and sodium finishes the closing process. Magnesium starts the relaxation process that causes expansion of the heart muscle, and potassium finishes the relaxation process.

So - I am no expert - but it is not a stretch to say that you have some kind of electrolyte issue involved. When I developed rapid pulses on low carb, these were quickly resolved by sodium. But my muscle cramping, lack of muscular energy, and general sense of fatigue did not resolve with sodium alone.

Something about these very low carb diets messes with electrolytes, and for some us, getting them into balance again while still remaining in a low carb mode is not a trivial thing.

4d2939fec2398793f778331640d42d41
0 · May 04, 2014 at 8:22 PM

Adrenal problems like excess epinephrine can also cause heart pounding, and I experienced these same symptoms whenever I tried various treatments that affected my adrenal or thyroid function. I think that any electrolyte imbalance is probably secondary to these hormone problems, and doesn't have to do with mineral intake. I wish that the ketogenic diet didn't increase cortisol and decrease T3, because I would like to continue it for its neurological benefits.

4d2939fec2398793f778331640d42d41
0 · May 04, 2014 at 8:20 PM

I agree with the logic of most of your points, and I appreciate that you're trying to help. Electrolyte imbalance is very common in ketogenic diets, and electrolyte imbalance can also definitely cause heart rhythm issues like the ones I had. However, I am 100% sure that I used more than enough sodium and adequate potassium, because I followed published guidelines for ketogenic diets (from Lyle McDonald's book), and I tracked my nutrition intake meticulously.

E24390f6d880f9144cdf7ab13220a84a
0
15 · May 04, 2014 at 12:54 AM

Define "high amounts of sea salt".

Get the electrolytes measured during one of these heart pounding episodes.

I'm not denying that cortisol may have a role to play in your symptoms, but it is extremely important that you observe these symptoms after you start a low carb diet. Low carb diets are diuretic and force the body to lose a lot of sodium. Sodium imbalance causes the intracellular potassium to be excreted, and then you get muscle cramping and cardiac rhythm issues. Ultimately fluid volumes diminish and you get incredible fatigue.

You might get these symptoms worse than others because of your cortisol problems, but unlikely you are escaping the basic implications of diuresis caused by low carb.

4d2939fec2398793f778331640d42d41
0 · May 04, 2014 at 1:48 AM

By "high amounts of sea salt," I mean more than 5g per day. Again, I am aware of the diuretic effects of a ketogenic diet, and you're right that electrolyte imbalance is the first thing you should consider when experiencing these symptoms on a low-carb diet. I was aware of this before I started the diet, and made the necessary adjustments to sodium, potassium and magnesium intake. I have experienced "adrenal symptoms" on many other occasions, and I recognized those same symptoms on a ketogenic diet, which is why I did not continue it in the long-term despite the neurological benefits.

E24390f6d880f9144cdf7ab13220a84a
0
15 · May 03, 2014 at 8:39 PM

Alex0 the heart pounding and palpitations are a classic symptom of an electrolyte imbalance, and high probability that on a CHEM8 panel you would test low on sodium levels during one of these episodes. Get your doctor to hand you a lab form for a basic metabolic panel that includes all electrolytes, and save that for the next time the symptom repeats.

These electrolyte issues are a HUGE problem for low carb diets, but only for those people who are NOT overweight and fluid-bound. If you are holding a lot of extra fluid, the diuretic effect of the diet is a fantastic benefit. If you are skinny, the diuretic effects of these diets will just destroy you, unless you manage your electrolytes. This is a completely under-discussed aspect of these diets. Doctors will fail you in making the low sodium diagnosis, and even if they find it I guarantee you that less than 1% of doctors out there have read enough about low carb diet research to understand the sodium issues.

Some researchers suggest that low carb diets (<60 grams a day) can require up to to five grams of sodium supplementation per day. That's about 2.5 teaspoons of celtic sea salt, and that is a LOT of sodium. That ended up being too much for my case.

I am going to start a thread on this issue soon, so watch for that.

4d2939fec2398793f778331640d42d41
0 · May 03, 2014 at 9:13 PM

I should have mentioned that I was using high amounts of sea salt on the ketogenic diet, along with adequate potassium. I get a CMP done pretty frequently, and the only electrolyte abnormality it ever shows is low chloride. I am aware the sodium and potassium loss is common on low-carb diets, but that would have been unlikely in my case

I attributed these symptoms to adrenal and thyroid issues because they are the same symptoms I get when I take a cortisol-lowering supplement like phosphatidylserine, or when I adjust doses of a thyroid medication. My body temperature also dropped.

E24390f6d880f9144cdf7ab13220a84a
0
15 · May 03, 2014 at 7:08 PM

What are your adrenal and thryroid issues, and why do those prohibit you from doing either ketogenic or low carb?

4d2939fec2398793f778331640d42d41
0 · May 03, 2014 at 7:12 PM

According to my blood tests, I have high AM cortisol, low T3, and borderline low T4. When I follow a zero-carb ketogenic diet, my energy levels improve a lot initially, but I then start getting heart pounding and palpitations. This is why I don't continue a ketogenic diet in the long-term.

Answer Question

Sign in to Your PaleoHacks Account

Get Free Paleo Recipes