Paleo Diet and Paleolithic Diet Questions & Answers

Question

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Hey all. Been paleo for a few years, strict for the past 8 months. I have ankylosing spondylitis and have been working with Cordain's (and others') autoimmune protocol. I feel like paleo + my awesome strength and conditioning coach have helped reduce pain and inflammation over the past year. I've been able to cut my AS meds (Celebrex) by 75% and am more comfortable and active than I've been in years.

Last week I had a few tests run through my cardiologist and found out that my CRP (c-reactive protein) levels are normal (yay!), but my ESR (erythrocyte sedimentation rate) was off the charts (boo...). I was very surprised. The upshot from my doctor's POV is that, regardless of lower superficial pain in my joints, this high level of systemic inflammation will burn out my heart, kidneys, lungs, eyes, etc, and needs to be treated aggressively in the short term to be put into remission. Although I'm fully on board with paleo and its anti-inflammatory powers, I have to admit that I'm a little worried by the test results.

How do you reconcile a seeming reduction in the outward expression of inflammation (pain, stiffness), with increasing internal markers?

flag	asked Jul 25 2011 at 13:43 Riveted 3,707●1●5●20

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what is it your doc wants to do- steroids? oral or infusion? for how long? – being Jul 25 2011 at 14:09

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Biologics - adalimumab. Not sure yet. He says we need to "hit it hard", put it hopefully in remission, then back off the biologics and maintain as usual (for him that means NSAIDS, for me paleo + exercise). – Riveted Jul 25 2011 at 14:13

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ESR. Is very non specific.......hs crp comes from acute phase reactants from liver and shows gut mediated inflammation. Your inflammation may not be gut mediated. I bet your TNF alpha is up too and your thyroid is down too.......get a salivary cortisol too. It will be altered I bet as well – The Quilt Jul 25 2011 at 14:26

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Riveted, please do some serious research on the biologics before committing. Doctor's throw these drugs at us without telling us that they supress your entire immune system and can make you more susceptible to cancers such as leukemia. The percentage of increased risk is low, but real. – Annie Jul 25 2011 at 14:51

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Annie - thanks for that. I've been looking into them for the past few months and am (of course) very reluctant. I gave myself 6 mos of strict paleo to see what I could do on my own, and I feel I've done well (which is why I was shocked at the ESR). It ultimately comes down to weighing the drug risk against the damage chronic systemic inflammation can cause. Still not sure what I'll do, just know I can't stay inflamed given my super risky family history of heart disease. – Riveted Jul 25 2011 at 14:57

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grace · Answer 1 · 2011-07-25 15:34:29Z UTC

R--

Congrats with all the progress so far!

ALL health and health demise starts in the gut. You were on Celebrex and that drug like similar NSAIDs/COX2-I are disruptors of gut permeability and the microbiota. Have you had antibiotics? Any acid blockers to 'protect NSAID/celebrex induced risk' of peptic ulcers? These all cause gut dysbiosis allowing Klebsiella, a gut inhabitant, to cross into the blood stream and initiate an immune response and antibodies which are similiar to the proteins in spinal and joint proteins. Read: google 'Ebringer and HLA B27'.

Is your food digesting? Are you a hard gainer? Is the doc gonna repeat the ESR or rx based on an asymptomatic profile and just one lab test??

I would consider w/your doc 3 things first: (1) a focus on the gut, (2) removing immune complexes in circulation (takes 6-18 months -- using some enzymes e.g. seraptidase hastens) and (3) even consider evaluation of a heavy metal burden because even low levels of metals cause autoimmune disease and gut dysbiosis. Metals behave as metalloestrogens and the pathogenic bacteria and yeasts have estrogen receptors which can induce their growth.

I concur with Quilt -- the adrenals take a hit for multiple reasons. Get the adrenals in line.

These Amazonian miners have elevated inflammatory markers incl ANA and cytokines (no ESR measured) due to low level exposure of metal from seafood and mining exposures. If metals are positive for you, then for optimal health and 100% remission of AS, the consideration for oral, gentle and safe chelation cannot be exempted. http://iah.iec.pa.gov.br/iah/fulltext/pc/artigos/2010/environres2010v110n4p345-354.pdf http://www.sc.edu/news/newsarticle.php?nid=1470 http://www.sciencedirect.com/science/article/pii/S0041008X05003248

G

julianne · Answer 2 · 2011-07-25 20:46:20Z UTC

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Are you doing the starch free version of auto-immune paleo for AS?

I've had great success with one client http://paleozonenutrition.wordpress.com/2011/02/12/auto-immune-disease-hla-b27-pain-free-on-no-starch-paleo-diet/

answered Jul 25 2011 at 20:46

julianne
2,377●3●9

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I agree fully with this.....anything that upregualtes insulin pathways increase issues with the joints – The Quilt Jul 25 2011 at 21:31

Absolutely!!! Ebringer is no-starch. Right now I am going through metal toxicity (positive hair analysis post8wks chelation by oral) and gut still digests little food. When the microvilli are blunted, pancreas non-functional (from dysbiosis, strain, metals), and brush border enzymes are defunct/non-existent, supps (proteases, lipases, etc) help til lawn of villi grow back... WEED, SEED, WATER!! chemistry.gravitywaves.com/CHE452/… [digestion 101] Pottenger's work on digestive enzymes: regenerativenutrition.com/printer.asp?cId=54 – grace Jul 25 2011 at 22:17

Thanks for this info. I am curious as to the role of straight sugars as the author names starches as the main culprit here. – Annie Jul 25 2011 at 22:19

If one has difficulty digesting, it doesn't really matter the type of starch and chain bending/length. The duodenom only absorbs mono-saccharides (so straight ribose and glucose are ok) but FODMAPs are not and will ferment. If protein doesn't digest, then they'll putrify. Here are some signs/symptoms to look for (if one is in tune w/their body) (look at the answer box -- whoops too BIG) – grace Jul 25 2011 at 22:25

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isn't Cordain's autoimmune protocol already non-starch? – Bread-Eating Beelzebub Jul 25 2011 at 22:29

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grace · Answer 3 · 2011-07-25 22:26:55Z UTC

From the Pottenger link:

Symptoms of mineral and vitamin deficiencies occur relatively quickly. They are recognised to cause specific illness. Enzyme deficiencies, outside of genetic or birth defects, take longer periods to be noticed and have only begun to be recognised in some circles of the medical community. What, then, are typical signs and symptoms of the more common enzyme deficiencies?

. If you have problems digesting carbohydrates, you may experience airborne sourced allergies, diarrhoea, fibromyalgia or attention deficit disorder (ADD or ADHD).

. If you cannot digest fats, you may experience constipation, gallbladder problems, heart disease or hormone imbalances.

. If you cannot adequately digest protein, you may experience constipation, arthritis or other inflammatory conditions, anxiety or panic attacks, premenstrual syndrome or immune system disorders.

. If you are unable to break down plant fibre, you may experience constipation, eczema or other skin-related problems, recurrent yeast/fungal infestations or excessive weight gain.

Super High ESR, Normal CRP - WTF?

3 Answers