Tuesday, May 24, 2016

10 Causes of Autoimmunity

If you need to get caught up on the latest, start here :)

Once I was officially diagnosed with autoimmune disease I dove into how to heal like it was my job. I refused to accept that my condition would gradually worsen and that prescription drugs were the only option. Healing from the inside out is no easy feat, though, and it started with getting down and real with myself on what really led to this condition. I knew genetics played a role, but only a third or so, which meant two-thirds were things that have happened in my life--whether in my direct control, in my environment, or something that happened to me by chance.

If you really start digging into it, you will find that there seem to be a million and a half reasons why one gets an autoimmune disease and it can be overwhelming. Autoimmune conditions are fairly common. I've read stats such as autoimmune conditions affecting 80 million Americans and 5% of the population in Western countries--and those are the diagnosed cases. Many conditions go undiagnosed. So how do you figure out your unique situation? How do you figure out how to get your body to stop attacking itself? Hack away at it one variable at a time. I sought help from experts, played investigator, did some heavy self-introspection. I feel like I have boiled down my main reasons, which I'll list below.

But first, I also have a theory on what ultimately caused the autoimmunity (AI) to trigger when it did despite living relatively healthy as can be these days. I heard some stories from others on there being one "traumatic" event in which their body was never really the same and AI set in. For me, I am fairly convinced the final trigger that caused everything to blow up happened in December '15. I got a really bad case of the flu where I was sick for 14 days at a level that was worse than I had ever experienced in my life. It simply wrecked me, and ever since that I never really felt the same to be honest. For example, I was weak working out into January--I figured I'd just have to patient yet tough to build back--and I also had a gut setback in which I was sensitive to everything yet again (ugh) among other noticeable symptoms. Now I'm thinking that flu and its bugs threw things off just enough in an already-vulnerable environment. Combine that with go-getter me who was trying to workout thinking about marathons and ultras, and it was a perfect storm that blew up on me.

I did a stool test in January (the GI MAP) to assess the current state of my gut and it came back showing elevated levels of salmonella, staph, enterococcus, and pseudomonas. Say what?! I was shocked. I also tested positive for moderate candida and some small intestinal bacterial overgrowth (SIBO), both of which were nothing new and had been taking a toll for a long time. Interestingly fungal infections (eg candida) are present in most autoimmune cases.

So there's that, but I would never blame just the flu. I know it's more.

My Top-10 Reasons For Developing Autoimmunity
  1. Gut dysbiosis -- chronic infections, overgrowths and an imbalance between beneficial and harmful gut bacteria.
  2. Leaky gut -- little particles of food getting into the bloodstream and triggering an immune response, this one is all too common and dangerous. Read more here.
  3. Other hidden infections -- in my case, those two root canals one of which I got when I was 16 years old.
  4. Nutritional deficiencies -- not because of a poor diet, but rather malabsorption due to gut issues.
  5. Stress(!) -- This is where I get real and admit I have a deep history of chronic stress, high-stress living, and spending too much of my life in a sympathetic state. 
  6. Impaired detox and poor methylation -- all my resources were tapped and body not able to do its job to be resilient and full-functioning. The deficiencies can be detected in blood testing and even some hormone tests. Methylation what? For more on what it is and its role especially with inflammation and immunity read here.
  7. History of adrenal insufficiency and mild hypothyroidism -- mostly in my 20s. Thyroid interestingly tanked even more right before AI triggered.
  8. History of HPA Axis dysfunction and other hormonal imbalances -- I've made this no secret.
  9. Environmental toxins, mold exposure -- living in small beach apartments for the past 5 years.
  10. Genetic susceptibility -- up to one-third of one's risk factors for developing an AI disease.
Other factors branch off from these 10, like why the gnarly gut dysbiosis? It's not because I've had a diet rich in refined carbs and sugars, that's for sure. So this is where you have to play investigator and often it's not that hard to nail down the reasons. 1) I was a C-section baby which put me at a gut deficit on Day 1 due to not being exposed to all the beneficial bacteria in the vaginal canal. I am not crazy here; there is plenty of evidence to support this link. 2) Having an eating disorder (ED) and the stress/diet issues related to that were a huge factor in worsening my poor gut, there's literature supporting this connection as well. 3) Replace ED stress with endurance training/ triathlon stress and this is when my gut issues got really bad. Oh I could tell stories but I don't want to lose my readers ;) 4) And then other things like being a wine drinker.... and heck, let's be honest: I've enjoyed drinking alcohol for many years of my life... a little in high school, a lot in college, and on and off in my adult life since. I think alcohol can be fine (in moderation), until it's not. I reached the point of even moderation being too much for my body and I'm sure it ties into the aforementioned reasons.

All those 10 things, and some, and at the end of the day it was a big body burden... 

And What Else in the Present?

I also pondered deeply and honestly, what else besides the flu was I doing in the present time and mostly in my control that could have also triggered this thing? I wanted to uncover anything that I could change....
  1. Stress -- while I love my life, love the present, and the direction it's going, I was still addicted to that stressed out way of living--letting little dumb things set me off or becoming overwhelmed when it's easily preventable. It was time to change once and for all. Adopt new habits and no bullshitting it. Even though I've eased up on training/racing in recent years, I think I was still stressed about my role as an athlete and races like Boston, so on.
  2. Diet -- yes, of course I eat healthy and avoid junk, but there are certain healthy foods that can still be gut irritants to the sensitive person such as nuts, eggs, chocolate, nightshades, dairy, gluten and alcohol, as well as foods implicated in SIBO and candida such as FODMAPs. I was having all these except gluten. None of these things had to be eliminated forever; rather, just long enough to heal the gut, make progress, then reintroduce slowly.
  3. Alcohol -- I already described a bit of my history with alcohol. Last year I really cut back. But then over the holidays it crept back in and I was back to regular wine consumption. Not a ton, but it was too much for my current state. In March I went cold turkey and it helped a ton. In a future post I'll discuss my reintroduction and how I've found what I believe to be my ideal balance.
  4. Mold/toxin exposure -- I didn't pay thousands of dollars to test this so it is more speculation on my part, but I trust my senses. I'm fairly convinced the beach apartment we lived in from early 2012 until February 2016 had mold/mildew in the bathrooms--I could smell that smell, you know what it is. Plus I often woke up felt groggy, congested and shitty no matter what I ate, drank or did the day(s) before. I think our old bed/sheets/comforter played into that as well--it was like 10 years old--and the more of a deficit I got into, the more sensitive to everything I became. We moved in February and most of my morning issues of feeling crappy disappeared instantly!
  5. Exercise -- Without a doubt my exercise habits have changed in the recent few years trying to promote health above all, but I still had an exercise addiction, and with a race on the calendar (Boston) plus toying around with more race ideas (ultra) I am just used to doing a lot and pushing my body--but that doesn't mean it's right in this context. It's so funny talking to my functional doctors who think the amount of running/training I do is absurd, yet to me it's just normal lol! Looking back at 2015 into this year I have to admit i was still going relatively full-speed (marathoning, backpacking trips, hours-long trail hike/runs, a 30k race in November, this year back to weekly running in the 20-40mpw range for Boston, strength training, etc). And that's just exercise; doesn't even touch on my workload and all the other stuff we do.

'But You're So Healthy!'

Everyone always tells me, "You're so healthy, you are the healthiest person I know! How could YOU be dealing with this?!" I agree, I do pride myself on a healthy lifestyle and I feel like I have all the tools to do it right. So this was a wakeup call for sure, and quite humbling, but at the end of the day it does make sense and I've totally made peace with it. I'm actually finding an immense amount of personal growth and deeper happiness because of it! Go figure.

Hopefully this post explains that even "healthy people" may be at risk. A lot of the normal things we do and are exposed to can build up over time and create an unhealthy body burden. You can see in my case that there were just many variables in and out of my control that added up over time and were too much on a sensitive body. Sometimes our healthy habits aren't even enough to offset the negatives, and things happen. Not to mention those of us who are Type A'ers and who don't easily slow down. I'm a go-getter by nature and not one to take a back seat and observe, but this wake-up call has forced me reevaluate a lot. I realized I can still be a go-getter but take a different approach, slow down a bit, find better balance and foster a better environment for my body.

As I have opened up more about my AI condition, I've received an outpouring from others who tell me about their condition--varying levels of some kind of autoimmunity--and the tools they use to work through it. I'm coming to find it's really common, and I know i'm not the only one. Folks like Dr. Mark Hyman and others mentioned on my last post are doing a great job to create awareness on appropriate healing methods.

In my next post I'll go more into my healing protocol that allowed me to achieve a ton of progress in a relatively short amount of time. 

Monday, April 25, 2016

Being Boston Strong

I had some folks reaching out to ask me if I'm ok after seeing my Boston Marathon result, and I so much appreciate the thoughtful messages. I can imagine how my time looked odd to those who know me. After all, I was an hour slower than my BQ time 11 months ago. I'm usually a pretty consistent athlete, so this was certainly an atypical performance for me.

I am ok—kind of! No injuries, no race-day disasters, no bonks, no nutrition woes. And in fact, this race went way better than I expected it would! I am very pleased with my 4:28 finishing time, and pleased that I was able to run most of it, probably 90 percent, not walk. I had been mentally preparing for a 5-7 hour day with mostly all walking...

That said, there is certainly a reason why I was slower and couldn't run to my potential this year. I wanted to wait until after Boston to talk about what's been going on. I'm ready now. "Project Open-ness" continues :)

The Symptoms & Diagnosis
It's been a tough year so far and I've had to put health and healing at the forefront again. Late February/early March I started investigating and testing because something was off and it had been off since the new year. I had some unusual symptoms, unlike anything I'd every experienced. The most disturbing were my hands—they'd become chronically swollen/puffy (I couldn't even wear my rings), and had weird red spots surfacing on them (but not a rash). There were other things too like unexplainable fatigue, brain fog, weight fluctuations, odd aches and pains plus sore joints especially in my hands, increased sensitivity to foods that were once no biggie, and a greater intolerance to any toxin like wine. I was congested daily, and my gut and digestion were all over the place again, definitely some kind of setback. I just seemed so sensitive to every little thing! All these new symptoms; yet, nothing I did had changed, at least that I know of. Diet, training, work, life—all the usual. I'm not a complainer so I tried not to make a big thing out of it. But I was getting concerned. My gut feeling told me something was up and I was compelled to find out more.

After consulting with a couple doctors and practitioners, researching, zeroing in on possible issues and doing mega blood testing, I got my answer on March 2:

I was diagnosed with autoimmune disease. 

Autoimmune (AI) disease is when the immune system attacks healthy tissues by mistake. Symptoms and severity manifest in many different ways. There are more than 100 kinds of AI diseases, with more than 700 million affected around the world. AI diseases are connected by one central biochemical process: An rogue immune response caused by systemic inflammation.

To put it another way: “Autoimmune diseases are born when your body is working hard to defend itself against something potentially dangerous, such as an allergen, a toxin, an infection, or even a food, and it fails to differentiate between the intruder and parts of your own body. Mistaking certain types of tissues for harmful substances, your body turns these antibodies against itself, wreaking havoc on your organs.” - PaleoGrubs.com

My official diagnosis was early-stage lupus and rheumatoid arthritis (RA), which the rheumatologist called "rupus" being that it was a blend of the two but not extreme in one or the other; more leaning toward lupus. For example, I am certain I was not in as much pain as you would expect with a typical RA case, and I also tested negative for rheumatoid factor. I got second and third opinions just to be sure—all in all I reached out to functional health practitioners, my MD friends in addition to the local rheumatologist (who also gave a physical exam to further validate her diagnosis). No one doubted the diagnosis.

Why Me: Seeking Answers & Solutions
The news came as a total shock as you can imagine. But wait, I'm healthy! Being healthy is my thing! What is happening in my body and why? Was this my fault? Was it genetic? Was it both? Why now? Why me? These are things to which I did not yet have answers. I didn't even fully know what lupus was until I was told I had it! Once I wiped away the tears and accepted the reality I got straight to work trying to answer the biggest question of them all: WHY ME?? If I could find out why, then there's a good chance I could fix that and fix the condition.

I knew enough of conventional medicine's approach to AI disease that this was not the route I wanted to go for treatment. Conventional medicine says that basically we don't know why people get autoimmune diseases, and that there is no cure; at best you can manage symptoms usually by using drugs to fight inflammation and suppress the immune system. Often hardcore drugs are prescribed like prednisone and pain killers, and even regular use of NSAIDs, all of which have negative side effects.

On the other hand, functional medicine will answer the question of "why me?" and provides hope for healing. With this medical model we can hunt down root causes and thus find solutions, rather than just manage symptoms. Functional medicine evaluates a person's whole history to determine why an autoimmune disease occurs. What is the source of inflammation in the body? Why did the immune system get overworked to the point of getting confused and waging war? There is a plethora of information out there—case studies, research, books, articles, etc—that outlines common underlying causes to autoimmunity and healing success stories. There's hope! I am not saying these things are a cure. There still is no cure, but with the right tweaks you can put your autoimmunity into remission and live a normal life. Just don't slip back to old ways that led to the AI to come about in the first place. I can do that! Functional medicine FTW again!

I read books like The Thyroid Cure by Michelle Corey (great resource for all AI issues not just thyroid) and Dr. Amy Meyers' Autoimmune Solution—I felt so connected to each woman's story, nodding and agreeing with how their stories paralleled mine. For example:

"I was shocked... Because I was doing what I thought were all the right things already, being diagnosed with an autoimmune disease was shocking and frightening /// [It] was a real wake-up call for me. I discovered you can be doing all the right things—or what you believe to be the right things—and still get terribly ill." - Dr. Meyers
... That's what I'm sayin! Reading those words by Amy made me feel so much better. Furthermore, Amy is an amazingly brilliant doctor, which helped me come to terms with the fact that even the "best" and "smartest" who seem to have it all figured out may be at risk, and it's nothing to be ashamed about. This helped me because, to be honest, at first I was feeling guilty, responsible and most of all like a failure—I had invested so much into gaining good health, and this is what happens? Was this some cruel punishment for my past sh*t? But that was not the right way to approach it, and thankfully I was able to step outside that silly mindset. At the end of the day, I realized this is just one of life's many challenges and it will make me smarter, wiser, more compassionate to myself and to others, and an even better coach to my clients.

I read other books, conducted endless research online, listened to very specific podcasts on the matter and reached out to my amazing network of health professionals, including my main practitioner Brie Wieselman who thankfully is an expert on these conditions.

Brie especially drilled in the point that I simply couldn't be so hard on myself and couldn't look at this as if it were all my fault. This didn't happen overnight and it didn't even happen over a few months; this disease was a lifetime in the making, and a very intricate combination of variables—many of which were out of my control!

On Track To Healing
I started to truly see and understand the patterns that lead to autoimmunity, and the light bulb went on. My whole life—a combination of variables in and out of my control—combined with the genetic susceptibility played into triggering my AI disease. (Many experts cite that genetics are one- to two-thirds responsible for one's risk to developing an AI disease.) The say leaky gut and gut dysbiosis are a huge factors and I know those have plagued me for years, not to mention chronic stress. It was starting to make sense. As such, I gained hope and got excited. Hope that I could and would heal. It would take a mountain of work—I've been calling it my new full-time job—but it'd be worth it!

This post is intended just to share the news of what's been going on and in this blog post I dive more heavily into specific causes of autoimmune disease. I will discuss the main causes of why I developed an autoimmune diseases, specific details of my healing protocol (it's been eight awesome weeks so far), and everything else I'm learning along the way including preventative information. What an education it's been! It's actually increasing my passion for functional medicine; if I could only figure out how to go back to school to become a practitioner—without too much stress ;) I digress. 

Anyway,  I started keeping a daily log on me—everything that could be significant. It took a few weeks on my healing protocol to start seeing and feeling the results, but it was undeniable that what I was doing was already working! I know I'm on the right track; the real results I'm getting are mind-boggling. I also think I caught this very early so that helps too. For example, my hands are no longer swollen and affected, I can literally feel that my detox & methylation have been rebooted, and my gut is very much back in order.

A huge help was doing four weeks of a strict Autoimmune Paleo Diet (AIP) protocol to eliminate any trigger foods and/or gut irritants, which wasn't "fun" at first due to some pretty gnarly restrictions. No eggs, chocolate, nuts, seeds, nightshades, caffeine!? The horror! Meanwhile, I was totally fine eliminating alcohol, gluten, dairy and non-nutritive sweeteners. It was an adjustment, but in the end it was so empowering and eye-opening, not that hard to follow, and it even allowed me to get out of the rut of eating the same old things day in, day out. I can't say enough good things about the benefits of a (temporary) elimination diet, disease or not.

During my reintroduction phase I was very lucky to have success with most the foods and even a bit of red wine. I will say, though, I think I've lost most desire to drink at this point—it's just too risky to justify going back to my glass-a-night kind of habit. I'll also keep nuts and seeds to a minimum because even though I've been ok with little bits, I still believe they are a gut irritant. I haven't and won't return to gluten anytime soon, nor dairy—minus one exception: After the Boston marathon, there were Italian pastries and cannolis that showed up at our place, and I decided to enjoy. It was a first, and I have no regrets.

All the reintroduction was complete before our Boston trip, and my plan was to use Boston as a test. It would entail a lot of eating out, and I was excited for that, excited to see how my body held up and if I would get a setback or be fine.

On Running with Autoimmunity
With all the improvements I've seen so far, the one area that was and is still suffering is my running. There's no doubt that by April I felt in a much better spot health-wise and like I was getting the AI condition under control, but running was still a bust. I know why: My body was/is putting all energy into healing and there's not one ounce of energy leftover for athletic performance at this point. I had to respect that.

I mostly shut down marathon training as of March. My body simply was not responding to the running I wanted to do so badly for Boston training, and even short easy runs took a monster effort and left me more fatigued than usual. As such, my long runs got shorter instead of longer, and became less frequent. I gritted out a couple more long sessions in the final six weeks before Boston, but they were more akin to a death march rather than quality running. I cried. It hurt physically and mentally to feel this reality. Meanwhile, any intensity I had been doing was out; a bummer as it had been so fun! My aerobic/MAF runs also slowed incredibly, and I was walking a ton more on every run. I quit all strength training because it hurt and made me too sore. It was not your normal marathon training; it was not normal Tawnee training ;) It was sad to see my fitness slip away, but I got used to the new norm eventually and gave myself a little more self-love and respect, which had been lacking. Instead of fighting the inability to train I gave myself a pat on the back for any exercise outing. Likewise, I gave myself a pat on the back for knowing when not to exercise or push it, and to rest instead.

I had everyone telling me to just shut it down and don't run Boston. But I couldn't quit. I wasn't ready to give up. I couldn't let it go that easily. I needed to do it for me, just this last one. And then after Boston I would shut it down and not train/race until it was time again.

Before Boston, I "participated" in the Ragnar Relay with my amazing Endurance Planet team and that was a very emotional reality check that even if I wanted to race hard my body was saying no. I missed my old athlete self. Thankfully my EP team consisted of kind, understanding people who were my rocks, and not to mention they all happened to be great runners so we still were 5th or 6th overall out of nearly 700 teams!

Ragnar verified that I could not do anything stupid in the marathon (i.e. I could not try to race like my old self but rather run appropriate to my current condition). I honestly thought this could mean a 5-7 hour day in Boston. I really didn't know. I was willing to do whatever it took to cross the finish line and I was ok with a really long walk.

And Then There Was Boston
Sadly, to add to the hard times, the night before the marathon our amazing dog of 12 years had to be put down. She was diagnosed with cancer, and her condition declined so incredibly fast. I said my goodbyes to Sydney Arrow before we left for Boston, bawling over this dog who meant so much to me. I was hoping she'd hang in until after I got back, but she was suffering so badly, it was obvious, and my parents couldn't bear to let her continue in that state. So on Sunday marathon eve I sat on Face Time with my family as they laid our Sydney Arrow to rest. It was beyond difficult to go through this; I'm just thankful for modern technology that allowed me to be in the room with my family even though I was 3,000 miles away. Thankfully I had John by my side the whole time.

Monday morning came. I surprisingly woke up with a really strong mindset and attitude. It would have been easy to stay tucked in my bed and avoid reality (who would blame me at this point?), but no way. I decided to rise to the occasion and use this marathon as a test of strength. Do it for Sydney, do it to show that this AI disease won't ruin my life. Persevere.

Still, I wasn't sure if I could do it. I was nervous in a different way than usual. I used to get nervous about how I'd perform and what others would think of my times; but at Boston those were the least of my worries and not even thoughts in my head.

Eventually at 11 am (so late lol!) the gun went off and the rest was magical. I'm certain I was in a state of flow. I was able to just be. It was hard, there was pain, but it was not impossible and I felt at peace. I was respecting my limitations and in return my body allowed me to run. I was running, and actually faster than I expected!! I was 100 percent grateful for each step I took that led me to Boylston Street. I've never been so proud of a "slow" race before and my 4:28 finishing time felt like a gift. The whole day I knew I had my Sydney Arrow running next to me in spirit, along with all my friends and family who knew of my condition and were rooting for me. So much emotion went into crossing that finish line. It was a moment I'll cherish forever.

A lot of people make excuses why they don't perform well in their races. Heck, I've made tons of those excuses in my time (I'm sure some you can find on old blog posts right here lol). I'm sick of that shit. Own it. Own the situation. Whether you had a good, bad or mediocre day, it is what it is. You'll be so much happier and better off if you just let it go, take it from me. In doing so, you'll find the silver lining in all your performances.

I'm reminded of pro triathlete Amy Marsh who recently kicked cancer's ass (GO Amy!). She posted a tweet not too long ago that said, "Ran 20 minutes today. No walk breaks :) #10monthstoday." Now that is what I'm talking about! Twenty minutes of running is nothing to most of us, but in her situation it probably felt as gratifying and special as winning the world championships—and rightly so! What an incredible woman she is to fight such a battle, win, and now be making her way back. I just can't say enough awesome things...... I'm not trying to compare my AI disease with cancer, but I think I can now better relate to what it feels like to receive some really shitty news, fight to overcome and deeply appreciate the baby steps made on the path to healing. Being diagnosed with a disease affects everything; it changes you. It changed me as an athlete and a person, and I have to believe these changes are for the better. No matter how fast or slow, I won on Marathon Monday.

At the end it was all smiles! Thanks to Vespa for fueling my run. I was slow thus in total fat-burning mode,
and Vespa got me through the day. 
Get a 20% discount on Vespa when you use the code #EPRagnar2016Expires 4/30/16.

Thanks for reading.

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Sunday, March 27, 2016

Root Canals Are Silently Ruining Your Health—Get Them Out!

Editor's Note: I want to clarify that each person should consider his or her unique situation and health to decide if avoiding, removing or keeping your root canals is the right decision for YOU. Everyone is entitled to their own opinion, and you may believe root canals are perfectly safe with data to back up your opinion—I respect that. The blog below presents a case for avoiding and/or removing root canals. I'll admit when I wrote this post I was angry and even the title of this post is very definitive without leaving room for multiple points of views. I was angry because no one ever informed me of the risks associated with root canals, and my doctors believe my root canals played a role in my autoimmune disease. (Of course I could have taken better care of my teeth back in high school to avoid them in the first place but hindsight is 20/20.) That said, when originally writing this post I should have made sure to emphasize the need for individuality. That is: Research and do what's best for you! As with anything, I am certainly open to exploring multiple sides of the argument, and I have explored multiple POV's on the root canal debate as well. If you wish to comment and let me know why you think root canals are perfectly safe, I am all ears and I love to learn more especially when it's presented in a constructive way. But please, don't be a jerk about it and don't have a bad attitude; I don't prefer to get sucked into hostile debates. 


 I Last Monday, March 21, I had two root canal extractions and cavitations cleaned up. This was a long time coming, and I only wish I had done it sooner. I'm on the verge of anger that these root canals were not only allowed in the first place, but have lasted this long now understanding how harmful they are:

"Research has demonstrated that 100 percent of all root canals result in residual infection due to the imperfect seal that allows bacteria to penetrate. The toxins given off by these bacteria are more toxic than mercury. These toxins can cause systemic diseases of the heart, kidney, uterus, and nervous and endocrine systems." ~Dr. Edward Arana, D.D.S. 

I had one root canal when I was 18, and the other I got in my mid-20s I believe. Additionally, I've had wisdom teeth removed and this procedure wasn't done properly so there were unhealed holes in the jawbone, known as cavitations, and these can become (and did become) rampant with infection.

"Dentists are taught in dental school that once they pull a tooth, the patient's body heals the resulting hole in the jawbone. However, approximately 95 percent of all tooth extractions result in a pathologic defect called a cavitation... Cavitations occur when bone is deprived of its blood supply and dies. When the bone dies a hole in the bone develops, literally a cavity and into this hole migrate anaerobic bacteria"~Photos and more here.

This is a descriptive definition and explanation of cavitations; the concept of cavitations was confusing to me at first but now I get it.

In fact, all of this was confusing—you mean conventional dentists remove wisdom teeth and don't clean up properly, AND they allow dead organs in the form of a root canal to remain in the mouth knowing full well that over time these could harm our health and cause disease!? WTF! This seems ludicrous and unethical.

Put it this way—if you get an organ transplant you generally wouldn't leave the old, dead organ that failed in the body, would you? (Although, I guess a failed kidney is usually left behind after a transplant due to complications of removing it.) Teeth seem to be an exception—we kill them off, and leave the debris. Teeth are organs with "pulp" in their center made of living connective tissue and cells, with blood supply, nerves, and all. During a root canal all this living pulp is removed and what's left is a dead organ in the form of bone. Then a crown is put on the tooth, but the seal between tooth and gum is imperfect so junk seeps in over time, meanwhile the dead tooth becomes chronically infected no matter what. You can see how over time this can be a problem!


In addition to the localized infection in the mouth, our teeth also have strong connections with other parts of the body. Each tooth is associated with which one of more organs, body parts, joints, endocrine glands, sinuses and more. Look at the Meridian Tooth Chart, and you can see the relationships:

If you can't figure out which number is which tooth in your mouth, this is a cool interactive chart with even more depth on the tooth-organ relationships.


Little did I know my root canals and cavitations have been putting me in a deficit of health for 10+ years—and no matter how hard I work to live healthfully, eat clean, mitigate stress, avoid overtraining, avoid environmental toxins, perform better, recover faster, or whatever it is, these infections have not only been holding me back from full health, they've also cause my health to deteriorate. The lurking infections don't hurt and you can't feel them—they're a silent attacker—but years and years of this compromises the immune system and affects certain organs, functions and systems a la the Meridian Tooth Chart.

My root canals were teeth numbers 2 and 31—associated with pancreas, stomach, breast, bladder (2); and lung, large intestine, illeocecal (31). If you count the wisdom teeth cavitations, numbers 1 and 32, these are associated with small intestine, duodenum and heart.

You can buy into the Meridian Chart or not, but here's the thing: Gut issues have plagued me for years and no matter how disciplined I am with diet, supplementing and healing protocols, things just won't totally heal. I make incredible progress followed by an incredible setback, and/or we make discovery of "new" bugs or old ones that never fully healed (bacteria and fungal infections). Multiple practitioners have told me, "You're just a really tough, stubborn case." Then I look at the organs associated with my infected teeth, and I'm no expert on this matter, but and there's an undeniable connection.

Back in 2013, Dr. David Minkoff was the first to tell me that old dental work and the state of my mouth could be at the root of my problems. He even helped me find a holistic biological dentist in my area. I did an initial appointment and $300+ later was told it was probably a good idea to get the teeth removed, but that it was going to cost more than $3,000—money I couldn't really cough up at that point. I also wasn't fully convinced then that the dental issues could be so incredibly destructive, so I let it go.

Fast forward to now. Recently, I had some health stuff going on that was odd and made zero sense based on how I am living my life these days, so I reopened the case on the old dental work, going back to the same dentist. This time I worked directly with Dr. Marvin at the Center For Natural Dentistry (before it was one of his assistant dentists), and he highly advised that I clean up this "mess," and that yes indeed it could be at the root of most if not all my issues, and/or only get worse with time.

Time to dig into the savings. I didn't want to go another day with this crap in my mouth.

I scheduled the procedure a couple weeks after my initial appointment, trying to fit it in best I could knowing we have a lot scheduled, i.e. we had plans to get SCUBA certified—so it had to be after that—and coming up is Ragnar SoCal and Boston Marathon, followed by some travel and our wedding—so I decided it would be best not to wait and do it before the races and travel. Granted, doing this procedure prior to Ragnar/Boston puts a huge damper on my training, but I don't give a shit. My health is a million gagillion times more important. There will be more years ahead to train and race, but knowing this issue was going on was something I couldn't live with ignoring any longer.


The procedure wasn't enjoyable, but Dr. Marvin is brilliant. He spent a long time with me describing the process and the meticulous attention to careful cleaning of the infected areas and making sure nothing infected was left behind. This entails a combo of tooth removal, drilling/scraping (or whatever they do, it sounds horrible), sanitizing with Ozone, and the coolest thing: injecting my own platelet-rich fibrin into the holes for accelerated healing and tissue regeneration. This meant I had a blood draw prior to the procedure, in which they took seven vials, spun those, handed the batch of tubes over to me, and I transported them to Dr. Marvin's office to be used during the procedure.

During the procedure, Dr. Marvin was practically cursing as he extracted the infected teeth, bone and tissue, discovering how bad it really way—he's pretty passionate about what he does. Then he said, "Your body is going to love not having these in your mouth!" I have pictures of the teeth and infected tissue/bone that was removed, and you don't need to be a rocket scientist to see the deterioration and infection. It's pretty gross though so I won't post it on this blog (if you want to see LMK in comments, and I'll email you).


The procedure was on a Monday, so for a couple days I was on the mush/liquid diet, and even had to cancel a podcast and client calls because I honestly couldn't talk well at all, the gauze didn't help... The first 12 hours or so, or until the bleeding stops, you have to keep a wad of gauze over the holes to help a clot form. Besides being uncomfortable, I wasn't in a lot of pain from this and I've always been impressed at how fast I heal. I only woke up in pain the first night, after that slept like a baby and never had an issue. I also do NOT take pain killers, but I did use arnica and ice.

Eating was fun at first ;) The first night for dinner (the day of the procedure) I cooked up a bunch of broccoli, mushrooms and veggies in bone broth, then put that in the vitamix for a broccoli-mushroom soup, adding collagen powder. It was delicious, and something I'd cook anyway. I also made some mean breakfast bowls of kabocha squash-avocado-coconut milk-collagen-cinnamon-nutmeg-vanilla, which came out tasting like pumpkin pie filling. Plus green juices, more bone broth, soups, etc.... I was just fine with the diet. That said, within a day I was able to upgrade to more soft-solid foods like chicken, fish, roasted carrots, avocado mash and sweet potatoes. By mid-week I was feeling like I could eat nearly anything.

Meanwhile, NO running for a week or two. Shoot. Over the weekend I did make it out walking and tested a slow jog--no go, I could tell it was not a wise idea and made the healing areas feel too throbby. I've had to accept that this is just my situation right now and not get too down that I haven't had better training. And in all actuality, I'm totally ok with it. Health first!

Did I feel better right away? Hard to tell. Dr. Marvin said healing time varies. Some people feel better instantly, some people it takes several weeks. I can't say I feel like a new person, but my gut has been incredibly strong and normal feeling since, and I've had a few other positive signs. I had a couple instants of testing some foods that normally upset my system and they were fine.

Maybe this was the final piece of the puzzle that was missing?


Your turn.

If you have one or more root canals, metal/amalgam fillings, or have had wisdom teeth removed by a "conventional" dentist, I'd highly suggest finding a holistic biological dentist who can do an exam to see if you're at risk, or a functional practitioner to take a look at your health from a holistic standpoint, i.e. test for immune function, infections, mercury toxicity, etc. If you have root canals I'd say without a doubt find a way to get them out asap! But only by a qualified holistic biological dentist who will do this procedure safely (some conventional dentists may remove the old tooth but not sanitize and clean up the infected area, then they seal it back up and the infection remains. Ugh.)

If you're in SoCal, check out Dr. Marvin at the Center For Natural Dentistry in Encinitas. I can get referrals for the LA area too if anyone inquires.

Bottom line is if you want to get closer to optimal living you have to look at all aspects, especially the condition of your mouth and past dental work you've had done.


More resources:

Why You Should Avoid Root Canals Like the Plague 

Root Canals and Jawbone Cavitations

Dr. Westin Price: Holistic Healthcare & Dental Cavitation Surgery 

Dr. Westin Price: Root Canal Dangers

If you want more info on the evils of root canals read this:

Monday, March 21, 2016

In-Depth Hormone Testing and The Value of Monitoring BBT Every Day

I’m more than two years into a dedicated shift to build back health that was lacking in my 20s, and continuing on this mission to promote more overall wellness in my life and in your life too! 

Every day on this journey still amazes me in a couple specific ways: 1) How dedicated, hard work can go such a long way to repair one's health and get back to healthy, normal functioning; 2) but at the very same time I’m realizing that no matter how hard I’ve worked in recent years to live optimally, I can’t simply erase a history in which a lot of havoc was happening in my body—it would have been nice to erase the past and start with a clean slate but the body don't work like that. If you are feeling like things aren't well in your life don't wait another day to act and make positive changes

What I’m saying about my case specifically is that I have really good news and not-so-good news brewing in my life, and today we’ll start with the good... 


Honing in on Hormones! 
It's one thing to get back to a normal period, it's another to get a deeper look inside to see assess hormone levels and the progression of a menstrual cycle. In January I decided it was time to some deeper hormonal investigation to see where I’m at, especially with pregnancy goals in the horizon. I’ve had my period again for a while now—it came back January 2014 and was spotty for a while until August 2014 when it returned for good on a monthly basis, minus that few-month hiccup last fall from which I quickly recovered and learned my lesson that I’m still very sensitive to “extreme” living and stress. 

So anyways, the month-long hormonal panel is called the BioHealth 208, and it tracks 17 days worth of progesterone and estradiol, and two measures of testosterone levels throughout an entire menstrual cycle. I highly recommend getting this test from your practitioner if you’re on a similar path as me in regaining and/or balancing out hormones. If you haven't regained a period yet, however, wait off on this test and there are others that are more helpful (inquire in comments).

How the test works: Starting on Day 2 of a new cycle every other day you spit saliva into a tube first thing in the morning before food or drink. This process continues until the start of the next period. I’m so used to the saliva tests by now, having done my first back in 2013. They’re awkward, but saliva is a much better way to monitor hormones than blood, and obviously the saliva is very DIY efficient. Some new tests like the DUTCH Test to measure hormones might even be a better way to gauge production and metabolism of hormonesand more bang for your buckbut that’s another topic for another day. 

Basal Body Temperature (BBT) 
As part of the test’s requirements and also for my own data collection, in conjunction to the saliva collections I measured basal body temperature (BBT) daily. BBT is your core temperature at complete rest, and it can tell you a lot about your fertility, hormones, health status, or any underlying issues like thyroid problems. Like HRV, our BBT is a direct window into our body, and it is a super easy and low-cost mechanism to assess your current state, health and overall well-being—and also figure when to make changes if needed. Also like HRV, measuring BBT in itself will do nothing to affect health, it's on you to go the next step to support what you need if indeed additional support is needed. It’s important to take BBT immediately upon rising before going pee, before hanging out in bed having a chat, before anything, for accuracy. Eyes open = thermometer in. 

You can use apps to record BBT instead of old-fashioned pen and paper. I use Kindara and love it.

It’s surprising to me how many women aren’t really familiar with BBT, what the numbers mean, why it’s important to measure it, or even ovulation and the menstrual cycle for that matter. So I’ll explain a bit and why I think it’s so valuable to understand these things if you want to own your health—as you should. And even if you think nothing is wrong right now, it's also good to measure BBT anyway so in case you have an issue in the future you have data from when things were "normal" with you.

BBT: Normal vs. Abnormal Readings 
 Waking temperature should be pretty static, ideally not below 97 degrees nor too high, i.e. not over over 98.9 degrees. A temp of roughly 97.0 to 98.5 degrees upon waking—depending where you’re at in a cycle, which we’ll get to—is considered normal. A low BBT in the 96s, 95s is not normal and associated with some problematic issues like hypothyroid, increased risk of fungal infection, etc. If your BBT is chronically low, i.e. below 97 degrees for 5-10 days or more then it’s definitely worth looking into to find out why. 

BBT and the Menstrual Cycle 
Basal body temp and the menstrual cycle are directly related so you can learn a lot about your female situation simply by taking your temperature upon waking. In the follicular phase, the first half of the cycle, BBT ranges from 97.0 to 97.7 degrees. Upon ovulation and into the luteal phase, the second half of the cycle, BBT increases to roughly 97.8 to 98.3 degrees or more. At the end of a cycle your BBT on a chart should look something like this: 

This is my BBT chart from the Kindara app. You see the overall trend in BBT readings, which pretty much line up with what you want to see in normal functioning. You may take note that my cycle is a tad long still, we're hoping it will normalize over time as cycles of 32 days or less are ideal for conception.

Notice lower temps in the first half, a very clear spike in temp (ovulation) and higher temps in the second half before the start of another period in which temperature drops back down and the cycle continues. 

For a woman, there’s really no excuse to not get in the habit of monitoring BBT as much as possible, ideally every day. I know it’s hard to form new habits, but set yourself up for success by having your thermometer and phone app to record BBT right next to your bed, and just get into the routine—as mentioned, you must measure BBT before you sit up or get up and especially measure before your first morning pee, even laying in bed and chatting or rolling around will increase temperature and it’s crucial to get that core resting temp for accurate information. It took me a few days to remember to measure BBT, but once I got in the habit it was an automatic response as soon as my eyes opened. Even since the month-long hormone test, I’m still measuring BBT daily. 

BioHealth Test Results
So my BioHealth 208 panel showed amazingly rad results that seriously had me fist-pumping and feeling very proud like hard work is paying off. I have normal and near-perfect levels of progesterone and estradiol—and the progression of each throughout my cycle look spot-on for a healthy female who has a healthy normal menstrual cycle. In fact my functional doc said my hormone levels and the curves they form when charted out (i.e. the spikes and drops over the course of a month) look better than 90 percent of patients she sees! No longer is low/no progesterone a problem of mine, oh ya!

In terms of the progression of my cycle, my chart showed a clear spike in estrogen, a very clear and strong ovulation midway, and a clear spike in progesterone—each hormone forming a "beautiful curve" as my doc put it. See the graphic below for a visual of this. Of course, ovulation is also key to getting pregnant. 

The menstrual cycle. Note how the BBT readings line up.

Comparing Present and Past
These results are a far stretch from where I was at in 2013. A saliva test I did in June 2013 showed no signs of a menstrual cycle (no surprise) and pretty much no signs of sex hormones either. My progesterone levels were literally measured at 1 (the range on this test was 80-270 pg/ml)—and that might as well have been none. Estradiol, DHEA, testosterone were also scarily low for female norms, as was my PG/E2 ratio (i.e. progesterone to estradiol ratio), which was reflective of what you’d see in perimenopause and postmenopausal womenat age 28. 

Everything was bottomed out, except for cortisol—not surprising at all actually. My cortisol wasn’t off the charts, but it was on the high end in the morning and afternoon, and I’m sure I was in some phase of adrenal fatigue. As this relates to sex hormones, it’s very likely that I was deep into the pregnenalone steal—more cortisol production was taking priority over production of all other hormones to support my high-stress go-go-go lifestyle, and my body saw no need to push for sex hormone production given the environment I created… and as the story goes this can only go on for so long before you tank, which I did later that fall in ’13. 

Since then, as I’ve shared openly, I’ve worked incredibly hard to adopt a lifestyle that supports a healthy period and healthy hormones—and doing so while not having to totally give up my love for endurance sports and an active lifestyle. It hasn’t been easy, and there have been slip-ups, but I think I’m getting used to what I need for steady rockin' hormones. Supplements have certainly been involved along the way, but really it's more about lifestyle and your mental state that fosters the best results.

Finding A Normal BBT Over Time, and Tie-In With Thyroid
Going back to the BBT, interestingly, in 2013 I tracked BBT for a while in July and August of that year (after the hormone test showing I was bottomed out), and my numbers were consistently 96.5 to 97.1 degrees, never over that. A red flag for sure, and this lined up with the other health issues I was exhibiting and lifestyle choices I was making—training for 70.3 worlds and a tough-ass Ironman.

BBT got back to being more normal in 2014 and 2015, but I’ll be honest I rarely measured it—just hadn’t adopted the habit. 

Then, when I was going through a bit of a hiccup lat fall I started measuring my BBT again and saw it dropping into the 96’s several times. Uh oh. At that point, we also saw that my thyroid was acting up—or should I say down—I was definitely exhibiting some hypothyroid issues. (I now have a clue as to why thyroid function decreased; more on that to come.)

I got back on track quickly in December '15 by taking a few simple steps to re-balance out my life, rest, etc, and put a halt to being in that chronic high-stress state. My BBT, hormones and period followed suite. As of this year my BBT is solidly in the 97’s to 98’s every day and never once below 97 degrees. Most days in the first phase of my cycle it’s high 97’s, and into the second phase it stays in the 98 range. 

Interestingly, in January/February my thyroid was still wonky, including symptoms of fatigue and quick weight gain, which I didn't freak out about but I was still a bit shocked since I hadn't changed anything in my diet or exercising habits. We tested with a full thyroid panel and got answers, at which point I started thyroid support including lifestyle and nutrition “hacks” and taking an all-natural non-synthetic supplement for thyroid—just one!—called GTA Forte II. By late February a third blood test showed my thyroid numbers—TSH, T3, T4—were all back to normal. And my weight also returned to normal, in the 133-135lb range.

Pretty cool what you can do to by taking charge of your health and understanding what’s really going, then implementing the right lifestyle and nutrition/supplemental support for healthy living. 

Take Action
Go buy a thermometer now if you don't have one. And get Kindara too. And if you really are curious to know more or figure out that reason why you're not functioning optimally right now (i.e. can't lose weight, tired, amenorrhea, etc) it might be time for not only new blood labs but some more detailed hormone testing too. Don't put it off, invest in YOU!

Tuesday, January 12, 2016

Part 2: Risks of Keto and Very Low Carb

Read Part 1 first in clearing up the difference between keto and moderate low carb diets, and my experience with each.

Next. If you are an Endurance planet podcast fan, you know we've discussed the benefits of very low carb (VLC) and ketogenic diets. There is not doubt that these diets can do a lot of good for certain folks and improve health--the research supports this--and it can even aid in athletic performance for those dedicated to the stringent protocol, but these diet extremes are not for everyone.

Thus on EP, it's our duty to share the pros and cons of certain diets to allow you, the listener, to make an informed decision hopefully along side your doctor/coach/health practitioner. The last thing I want is for "the wrong person" to start a keto or VLC diet because they heard it was sooo great, but not have all the facts and tools, and end up worsening their situation or health. Who is the "wrong person?" Generally: someone who's not in the right state of health, not metabolically fit, and/or a lot of women; you have to listen to the podcast with Tamsin for the full lowdown.

I did this podcast with Dr. Tamsin Lewis is to give the female POV without male bias. There are a lot of great guys out there who are able to look at the science and not just talk from a male-biased perspective (Peter Defty and Dr. Jeff Volek come to mind). But usually those who promote keto are male. And let's face it, us ladies shouldn't always have to take advice from the dudes ;) I personally am getting more emails and/or reading stories from female athletes who've messed up their health by poor dietary practices including keto. Women who heard advice about low-carb being awesome, so they tried it, had initial success (toned up, better energy, some performance gains, etc) then it backfired. Weight loss plateaued and/or they gained weight, energy crashed, performance crashed, hormones crashed, periods disappeared. And that's why I wanted to do this show.....

Furthermore, if you listen to other podcasts who praise keto (Tim Ferris, Jimmy Moore, etc) it's important to note many of these folks aren't endurance athletes either. That matters because they can probably handle keto extremes that endurance athletes can't, thus they give advice that doesn't apply to the triathlete and runner folk.

Hence, it was time to get 1) a female voice on the show to balance it out and 2) to talk straight to endurance athletes female or male, to show that keto is not always what it's cracked up to be.

So far with the outpouring of emails and comments I've gotten since releasing the show, it seems like we did what we set out to achieve in creating more awareness and depth to this topic. Women (and men) have mostly been stoked and appreciative of the show.

Why Bother Discussing VLC and Keto?
This actually brings me to an important point. If keto is risky why the hell even bother? You also may already assume or have heard that low-carb is "dumb" for athletes. Mainstream sports, especially the triathlon and running worlds, still largely promote the traditional high-carb diets, sugar-based fueling and carb-loading. Pizza and pasta parties are still a big thing. Sigh. However, the content you get on Endurance Planet in regards to diet and nutrition won't be what you've traditionally learned about sports nutrition nor what the USDA food pyramid recommends.

Why? Because we take sports performance to the next level and integrate concepts for better health, metabolic efficiency, and optimal living.

Most people will not optimize their health and performance as a high-carb sugar burner. It may work for a while, but eventually catches up in some way, shape or form.

So moderate low carb, high fat (LCHF) is usually a safe, healthy route, which I talked about in Part 1. However, a lot of people don't settle for "safe" and they want extremes! Those risk-takers lead us to new discoveries. Thus, we're seeing that lowering the carbs to a state of nutritional ketosis is effective, depending on the goal, and it's catching on. Keto is intriguing and "sexy" right now, and also easier to sell vs. the moderate safe approach. Keto has its pros: It can create a ripped lean body without training your ass off, control appetite, maximize metabolism, boost brain power and function, increase energy, increase clarity and productivity, prevent disease, balance health, and the list goes on.... In a clinical application, keto can also be life-saving and is shown to be effective in treating certain cancers, epilepsy, obesity, Type-2 diabetes, reversing insulin resistance and so on.

But what about for an endurance athlete? For the athlete who's healthy and fit enough to begin with, he or she may thrive off getting into nutritional ketosis (with appropriate carb cycling). It gets nitty gritty, but the evidence is there. Look to the low-carb guys in the FASTER study, for example, including Ben Greenfield and Zach Bitter. These guys are finding a level of fat-burning capabilities that we never thought possible. The more we can efficiently burn fat during endurance events, the more we can sustain and achieve--and not wreck our bodies with chronic sugar dosing. Seems like a win-win for the athlete who also deeply cares about health and longevity.

Zach, for example, just broke the American 100-mile record going 11:40, a 7:00/mile average. Ben trained for and raced Kona well on a keto diet in 2013. And even female athletes like pro ultrarunner Nikki Kimball are thriving off keto not only for endurance performance but mental and cognitive benefits (it's alleviated her depression). Dr. Maffetone has been promoting low-carb high-fat for decades and even has his current athletes like Dr. Amanda Stevens able to cycle in and out of ketosis--interestingly Amanda in 2015 had one of her best seasons to date after going this route, which we discuss on this EP episode. Vinnie Tortorich is a good example of someone for whom keot makes sense; he's a cancer survivor and endurance athlete who's seen real benefits of no-sugar, no-grain, keto-style diets.... how can you argue with how good he's doing vs. what could have been?

Keto can be healthy, beneficial, and a smart approach....

But YOU Matter
That said, for as many people for whom keto works or could work, there are plenty of people for whom it doesn't work or won't at all--to the point of risking a harmful backfire. That's why careful consideration is needed when approaching any diet extremes and we must take into account the individual.

Perfect example: In this article, Chris Kresser writes on prescribing individual diets for two different females with two different stories. One woman had Metabolic Syndrome, insulin resistance, and obesity; the other had Adrenal Fatigue Syndrome and Hypothyroid (interestingly, the latter woman's conditions were partially caused by a very low carb diet!). For the obese woman, Chris prescribed a keto-ish diet (15% carbs) and an intermittent fasting (IF) protocol. The woman with adrenal fatigue and hypothyroid received diet prescription that included moderate carbs (20-25%) and more frequent eating, no IF. That makes absolute perfect sense, and in the article Chris explains why.

What's right for you may not be right for me, and vice versa. What's right for a 40-year-old sturdy male athlete may not be right for a 20-something female runner with body-image issues. Hence the podcast with Tam...

The Podcast
Tamsin brings a lot of experience and expertise to the topic of diet and health for athletes as an Ironman champion, practicing medical doctor and psychiatrist, someone who's dabbled with LC diets, and also someone who's overcome an eating disorder. Her patients include female athletes who've suffered from dietary extremes like keto. So does she have the experience and authority? You bet.

We set up this show to be more geared toward women because they have the most "to lose" with keto. While males are not void of potential issues, they do tend to be more robust and suffer less hormonal disruptions when they do diet extremes. That said, it's certainly not impossible for a guy's health to tank with keto extremes.

The podcast highlighted potential risks of keto diets, especially risks for athletes. Furthermore, we wanted to help educate people on whether they are the right candidate for a keto diet or not, as some are more susceptible to the risks than others. It wasn't a keto-bashing podcast nor fear-mongering; although, I'm sure some will take it that way.

That link will also take you to the show notes, which has a full outline of keto's risks, which we discuss in detail; thus, no need to be repetitive on this post.

Did we discuss risks and side-effects that aren't necessarily backed by research, but rather anecdotal evidence? Yes. Not everything can be answered by "what the research says" and just because it isn't in the research doesn't mean it can't be true. Keto for endurance athletes (especially females, and even non-athletes) the way it's being done in modern times is relatively new and the research just hasn't caught up yet and/or it can't be done due to IRB issues. And even the research that has been done has had its hurdles....

"I remember all the flak we got for the Western States Study by the UCONN IRB...they were against athletes trying to run 100 miles on Low Carb and did not realize the athletes were running anyway and in this state....we finally got it through, but took a few months...." says Peter Defty, of Vespa.

If research is lacking, especially on females, then we can look at what's going on in the real world. There is a growing amount of anecdotal evidence on females--athletes or not--who've suffered poor consequences of keto diets. In my professional network, I talk about this with my colleagues quite often. It's real. It's not just opinions that were conjured up out of nowhere. And even digging around online you can find tons of stories of keto gone bad. Tamsin and I even shared some of our personal experiences from an educated POV. I hope it was clear that we were not trying to generalize the situation and diet-bash, but rather "bring life" to the topic.

Meanwhile, there is plenty of research showing the very real issues associated with female-athlete triad cases, and I can make an educated guess that there are plenty of triad cases that involve diets that are too low carb... this even gets into the psychology of the matter. Very important.

Tamsin said near the end that she would never recommend keto for any female athletes. A bold statement, and her opinion. Do I agree? No. But I respect her opinion, just like I respect the opinion of other guests who've been on EP whose opinions don't always align with mine. And besides that statement of Tamsin's, I pretty much agreed with everything else she suggested and learned more from her.

Even Defty, who's a nutrition genius and advocate of keto-style optimized-fat-metabolism diets, says that keto won't work unless health is there:

"Many females in today's modern world probably should not be in straight up NK [nutritional ketosis] .....they just are not metabolically fit enough to make it work. If you have an underlying condition its tough to get into ketosis and you will struggle to maintain it....as you mention and know there are a lot of really badly broken people out there including a lot of females....people who through trying to be healthy actually got very sick and compromised.....so until the underlying issues are solved NK is not going to work well and even backfire.....if you are pregnant doubly so. I see a lot of people who are wrecked by Low Carb because either they or the person who is coaching them thinks they get it but really don't. There cannot be underlying conditions," he says.

We have to understand everyone is an individual and brings a unique situation to the table. As such, let's work with individual needs not try to broadly recommend diets as being right or wrong.

We will have more podcasts on the diet matter. It doesn't end here...

For More Resources on Keto Risks

Ben's top-10 mistakes of keto and his article on keto dangers.

Is low-carb ruining your health by Kresser, and more on VLC.

Adverse reactions to keto by the Paleo Mom.

Friday, January 8, 2016

Healthy Female Athletes and Babies

A few posts back I went into a rather deep analysis on a MAF Test I did, what the results "really meant" and how I was planning to get faster. But ya know what? My heart's just not in that right now. I'm still running, hiking and "training" regularly(ish), but not like I thought I'd be doing when I wrote that post. And that's ok...

I'm on this path to rebuilding health, and the results I'm getting in that department are far more valuable than MAF Test results at this point in time. I know the MAF Test is also there to show if you're a "healthy athlete" but that also assumes one is consistently training at/around MAF heart rate in order to maintain or improve the MAF Test. I'm all over the board to be honest. So who knows: I could be faster if I went and did another test, or maybe not. But I just don't really feel that feedback is needed right now.

This is not to say MAF Tests are old news though! I can still give you 101 reasons why nine out of 10 endurance athletes--like those I coach, lol--should be doing regular MAF tests every 4-8 weeks. It's just, for me, my "MAF Journey," is taking a turn........

So, I will tell you where my heart IS at. Two big things that are bigger and more important than me:


A Resource on Health

The more I open up about my personal journey in a candid way--in particular regaining "female" health after once being a broken athlete--the more I am so thrilled to be doing what I am because it's clearly needed.

I am learning how many women--especially those who are endurance athletes--are also struggling with their health and simply not functioning as a woman should. At least a couple times a week, sometimes more, I receive new stories of health and/or performance tanking. Going slower and fatigue to begin then in gets worse: injury, amenorrhea, acne, hormone issues, hypothyroid, adrenal fatigue, weight issues, gut issues, insomnia, erratic moods, and so on. Usual culprits often include overtraining, over-racing, stress, under-eating, unhealthy relationships with food and exercise, body dysmorphia, straight-up eating disorders, etc. Often they are lost. There's plenty of great functional health practitioners out there who can help these women but (correct me if I'm wrong) there's not a lot of female endurance athletes who are bridging the gap between women in endurance sports and the functional health world. I want to be that person.

I need to be because countless female athletes are hurting their bodies and health at an astronomical rate. Some want help and deserve the right kind of help; some need to realize their symptoms and issues aren't "normal" and they're not alone. Some women will turn to western medical doctors but get zero answers--or worse shit-poor advice like, "It's ok not to get your period" or "just go on the pill." I'm sorry but, FUCK! This is BS, and I've been fed that story too--by a female doctor nonetheless. So often the health problems just continue, unaddressed, for 5.... 10.... 15+ years.

I am obviously not a doctor, nor here to dish out individual medical advice, but what I can do is just share my journey in detail and dish out tons of resources, and hope that provides inspiration to those silently suffering on how they can get help and take charge of their health naturally with a practitioner (or team of them) like I have. Be a detective. Don't be afraid! Don't accept BS answers from doctors who only give you 3 minutes before moving onto the next patient. If you feel like something is wrong and you're not getting answers you want--go with your intuition and seek the answers.

For example if you're a woman listen to this podcast now and by Sara's book too.

Let me change gears slightly...


Family Planning (ah!)

Another reason MAF Tests don't really matter to me right now is because of what I'm about to share.

This year I am getting married to the man of my dreams, and we have plans. We want to start a family! We're not starting tonight (lol) but it's coming. Which makes me sooooo grateful I switched things up in late 2013 to build back health because I've needed these past couple years to take the time to do it right.

It's incredibly important for a woman to be in a good state of health if she expects to get pregnant and build a healthy baby to completion.... I don't take this task for granted and I'm also not living in la-la land like I've had a perfect bill of health all my life. Two years ago my hormonal status was basically at rock bottom, and I know there would've been no baby-making happening had we bothered to try.

Meanwhile, I know plenty of women get pregnant all the time with sub-par health in some way shape or form. So please don't misunderstand, I'm not saying I need to be "superwoman" and obsess over a perfect body and perfect pregnancy. It's not like that at all. I'm just being real with the situation, and I know I have to get my body over some final hurdles to make a healthy pregnancy possible. Thus, I am taking the time to read books, study, and figure out how it applies to me. Do the right things for my body--like not overtrain in a way that could setback my hormones and things like thyroid. For a somewhat technical example of what I mean check out this podcast or this book.

So anyway, wow, right? Did you see that coming?


What's Next for TriTawn?

This story, this blog, this journey is taking new turns all the time as you can probably tell lately given the subject of my posts--not really the triathlon race reports of the old days, and I should probably do a redesign on this outdated blog or at least change that header photo (fact: I was amenorrheic when that photo was taken and definitely too skinny). But it's all good; it's all related and all important here on tritawn.com.

So what about training and racing? I can say with confidence I'm not quitting anything. I'm 30 and have plenty of years ahead. I am an athlete for life. After 20-plus years of being an athlete I don't think that's going to change. And it certainly won't change just because we start a family. Perhaps I'll have to revise the plan and my race schedule temporarily to make sure certain things happen, but I'm not worrying about a thing...

We got Ragnar SoCal and I got the Boston Marathon coming up--I will be there! I know I've talked a lot about ultra-ing too. This year? Maybe, maybe not. It's not off the table, but I'm also 100-million-percent willing to pull the plug on anything right now if my body gives me the signal that it's just too much. We're just taking it one day at a time. I'm monitoring myself well. We will see..........

I'm curious to see what my body is up for in 2016. The unknown doesn't scare me. I'm so ready for this crazy ride........


Wednesday, January 6, 2016

Part 1: Keto vs. LCHF, and My Experience

Last week we published an Endurance Planet podcast on the potential risks of very low carb (VLC) and ketogenic diets for endurance athletesThis was especially geared toward female endurance athletes, and even non-athletes for that matter.

Keto/VLC is defined as roughly 50 grams of carbs a day or fewer, on most days. Furthermore, it's a very high-fat diet, often 50-70 percent of calories coming from fat! That's a lot of fat. It's also not a low-calorie diet, which should be clear if you know a bit about macros: 1 gram of fat has 9 calories, whereas 1 gram of carb or protein has 4 calories... if you have 50-70 percent of calories from fat, and you're eating enough, that's going to be a lot of calories. That said, it's not always pounding a ton of calories because keto-adapted people can go long periods with less or no food because they're so efficient at burning fat for fuel. Often the keto folk do intermittent fasting. And other times they're taking down "fat bombs." Endurance athletes are finding more interest in this diet lately because you can be a mega fat-burning machine and go forever on very little fueling needs--efficiency like none other.

To read more on what keto even means and its role for athletes, check this out. You'll see, it's extreme diet with extreme considerations. It doesn't just cut you off from cookies and junk, it goes way deeper. As do potential risky side effects if not executed carefully.


Keto Does Not = A Moderate Low-Carb High-Fat Diet

I had some folks email me and thanking me for the podcast, which makes me happy. And in Part 2 I'm going to talk more about why I thought that podcast was needed, along with more that we'll be doing.

But first, I think some people might have mistaken that the potential risks/side effects of keto also apply to a more moderate low-carb high-fat diet. It's important to point out that keto and VLC is not synonymous with a moderate low-carb high-fat diet. The moderate approach is something one would generally take on to promote better fat oxidation (fat adaptation), metabolic efficiency, "cleaner" eating, and overall better health (i.e. avoiding refined carbs, refined sugars and junk). Moderate low-carb diets are much more flexible, "friendly" and doable in most lifestyles, and have many many benefits. And for the record, if you see me hashtag #LCHF, in my world I use this acronym for a moderate low-carb high fat diet, NOT keto or VLC. Maybe it should become MLCHF lol.

Tailored LCHF kick ass diets for health and sports performance, and I truly feel like most people should go this route instead of traditional high-carb fueling. I don't promote high-carb diets for males or females, nor even females needing better hormonal health. I won't say never, though, because I also believe our diet needs are unique to our situations and I can think of a few cases where I can see high-carb diets working really well. For me? High-carb/low-fat makes me batty, erratic, foggy, flat and sluggish, gut in shambles, and I feel like crap. On the flip side, I cannot sustain keto (at this point in my journey). I do well somewhere in between, moderate low-carb, high fat, adequate calories. I've learned through trial and error; scroll down for more of my story.

For females who who need to regain hormonal health, there may be a bit higher need for carbs--but you don't have to go off the deep end--while allowing tons of good fat and calories in general. In regaining hormonal health and a menstrual cycle, I allowed more carbs when my body craved them*, but I did not need to binge on tons of carbs in an unhealthy way--it was more about ensuring adequate and nourishing energy was present in my regular diet (including the fat that had been missing!), that stress remained low, and that body fat/body composition remained in a good spot. It's as simple as that. Ok, I know it's not that simple, but it also doesn't have to be overly complicated if you're dedicated to the cause as I was/am.

*If you are currently a carb-addicted human you will always be craving carbs all the time, so first you must break this addiction--it's a mental exercise. Sugar and carbs are a drug, and you have to break the addiction. There's also usually an emotional and psychological component at play here too. And, no, you are not that special exception, sorry. I know what it's like to crave refined and processed carbs/sugar, and I know what it's like to get off that cycle. So when I say above that my body craved carbs these cravings were genuine--my body was asking for things it needed to rebuild. You have to respect that. Likewise, I also crave fat now--fatty meats, avocados, butter--and always crave the greens and veggies and so on. 

More reading on sugar addiction.

And ya, I'll say it again: I love LCHF and I'm willing to align myself with a diet style at risk of being called out for joining a LCHF cult, or whatever. But I don't mind because I really truly believe this carb- and sugar-addicted world in which we live is making us obese, the root of so many diseases, killing us, and hurting athletes' performances and health. (It's not the dietary fat that's to blame). Managing carbs and sugar so that it doesn't spiral out of control and lead to bad outcomes just makes sense--and it doesn't doom you to a life without carbs either.

Should You Cut Back the Carbs, Add the Fat?

How do you know if you should give this moderate LCHF stuff a try? If you can't go more than 2-3 hours without food in general, if your energy is constantly fluctuating (when you're empty you're a jerk/b*tch), and if you can't do a workout without fuel--even a 60-minute session--this is bad. I'd suggest weaning of the carb and sugar dependence and introducing more healthy fats into your routine. End that vicious cycle, end the carb and sugar addiction/dependence, and you will go far as athlete and human. The carbs, while enjoyable, can wreak havoc in you.

"Thanks to generations of people over-consuming sugar and other refined carbohydrates, many people suffer from a condition known as carbohydrate intolerance, or (CI). This is perhaps the most well-hidden epidemic of our time... CI then progresses to a functional disorder producing symptoms that negatively affect quality of life, such as fatigue. Gradually, this process generates serious illnesses such as diabetes and heart disease." --Dr. Phil Maffetone

That said, if you find you are having trouble getting off the carbs and shit is going haywire in the process, a few things:

1) First I would make sure your carbs haven't dipped below 100g/day--i.e. don't start with extremes like keto. Even though I personally hate counting and calculating calories and macros, sometimes it is needed, and even I've done it to check in.

2) Ensure you're getting enough calories and fat. Too low calorie is a common mistake when making diet switches and eliminating things--if you eliminate foods, you gotta replace the calories with something else nourishing. It could be as simple as adding more cooking fat (oils) to your meals; an extra handful or raw nuts, some avocado, or sipping on bone broth daily. Or google "fat bomb recipes" and take a stab. Again, food logging can help.

3) If it's still a problem and say you're 100-200ish grams of carbs a day and still struggling for whatever reason then I would look at the bigger picture: Are there other underlying problems that need solving first? Are you severely addicted to sugar/carbs and it needs time to break the addiction? Are you "fit but unhealthy" i.e. maybe overtrained and burnout. Is your lifestyle so high-strung and stressful that you can't survive without carbs? Or could it be another issue ranging from adrenal fatigue to gut disorders, and so on. Not that you need to be LCHF forever, or else, but a healthy person should be able to handle a moderate LCHF diet without it crashing their world.

We as humans simply don't need to be carbed up to survive and quite frankly it's really healthy to develop "fat-burning" with LCHF-ness whether you're an athlete or not. Like Maffetone's Two-Week Test, a test to see how you handle moderate LCHF (not keto) can be telling. It's good to be able to slip into LCHF with ease, and slip out if you feel like it. This concept is also closely related to what my friend Peter Defty is doing with OFM.


How I'm Dialing It In

As much as I now love LCHF, at first it was my enemy. LCHF did not work for me until I stepped back and fixed my health first--it was too much stress at the time. I also made the mistake of starting out too low carb, and too restrictive too often. In fact I remember blaming LCHF saying, "It ruined me."

But really, LCHF in itself was not the only problem. I was.

First off, I was likely doing something closer to keto and possibly too low-cal while 70.3 & Ironman training, so that did me no good. Yup, I made the mistake of mixing up keto and LCHF and it was mainly because I didn't carefully monitor what I was doing. Meanwhile, I was too deep into being "fit but unhealthy" at the time, overtrained, gut wrecked, and in need of lifestyle changes. I needed to get my training and stress under control. I needed rest. I needed nourishment of all kinds.

I still actually did achieve and maintain a level of fat-adaptation though. The fat-adaptedness was clear in my training, a few races, and even a metabolic efficiency test. But that didn't even matter at the time because my hormonal status and overall health needed mending if I wanted that fat-adaptation thing to do me any real good.

On my road to regaining health and recovering, I was able to still keep a healthy lowered carb/high fat/Paleo-ish approach as a general theme, and did so because I know at the end of the day this is a healthy way to live and thrive (and also knowing that high-carb diet hadn't done me any good either). But I also did not define how I ate by a specific diet and became open to anything that would charge my body back up. So I tweaked my approach to carbs, allowing more but not going off the deep end. I also got comfortable with eating a lot more dietary fat that had been missing for so long, and overall dug into more calories too--which really wasn't scary for me if you can believe it. It wasn't scary because when I put my mind to something--in this case the goal of regaining health--nothing can stop me. Overall, this combo/approach was when I found my sweet spot. It wasn't just carbs for female health.

But it's so important to underscore that I had bigger fish to fry than just a diet protocol. I had to create an environment--mind and body--that allowed for hormonal balance, a regular menstrual cycle, among other things. This made me reevaluate my training, racing and how I executed my days. Diligently making the necessary lifestyle changes was the ticket to start moving up the ladder toward optimization.

When it synced up finally--a healthy thriving body, good mindset, my macro's working for me not against me--man did that feel awesome!

And that's also when I could start playing around with LCHF how it's supposed to be--slip into lower carb times for fat-burning endurance sport purposes, and then cycle in the higher carb times for refueling, female health, and whatnot. Again, not to the extremes of keto but rather building a diet that would promote health, performance, and relief from gut woes--another benefit of LCHF.


Intuitive LCHF

My ticket to maintaining health and LCHF these days entails intuitive eating and living (so MAF!). I know "intuitive" is hard to define, but for me being intuitive means some days that are quite frankly very low carb/high fat, and that feels fine and I'm not depriving myself whatsoever. Then there are other days where I eat as many carbs as I want because my body says so: including but not limited to sourdough bread, sweet potatoes, gluten-free crackers/stuff, honey, oatmeal, rice, kabocha squash, healthy cereals, bars when on the go, even quality sweet treats (yes, I like to bake things like banana bread, healthy-ish cookies; yes, I love chocolate). And then days that are somewhere in between. It fluctuates with the training/adventures I'm doing, life demands and also my female cycle.

I've learned to really deeply listen to what my body's asking for, and answer its wishes. As such I don't find myself mindlessly snacking or chowing down at all hours of the day. Ya, maybe sometimes I eat beyond satiation when I cook a good meal, but that's because I also love food. And if you're good at balance and/or 80-20 you can be flexible.

But there's a catch:

Intuition only works when you don't overrule it with your brain by doing something other than what your body is asking for. 

...That said, there have been times when I've overruled my intuition--because I still get stubborn--and that's when I get in trouble. This usually happens when I let my old tendencies get the best of me--overly stressful kinda stuff--and there are times when I get this crazy idea that I can go even lower carb and keep it going even with more training added on... As such, my body may look great and I may even feel revved up (sympathetic state overload), but it's not healthy for me. I think that's what happened this last time--I was doing things that didn't align with what my body needed to thrive. So I stepped in and fixed it--fast. I'm totally back on track. Dodged a bullet. Learned more lessons. I think now I have even a better feeling of when my body is teetering on the fine line of wanting to "shut down" and go haywire vs. when it's wanting to thrive. It is literally is a feeling, and when I am thriving I just feel strong and sturdy like I can take on the world; when I'm about to shut down I feel weak, fragile, and emotional.


Ok let me tie this up.

I'd try not to lump keto and LCHF into one. They're not synonymous. There are many reasons why I'd recommend avoiding and/or being very cautious with keto (like the podcast covers) but LCHF tweaked to your needs can be a secret weapon. If you're trying and having trouble getting off the high-carb life there's a reason. Get to the bottom of it. We need to be in control of what we're eating instead of it controlling us. Climb that ladder of optimization.