News topic du jour:
Carnivore Identity Crisis
Hi Guys, Thank you for all you do to advance honest and introspective health discussions. I am grateful for you. I am a 41-year-old male with a history of severe mental health and skin issues dating back to early in life. I was discharged from my dream career in the military due to mental health issues. Candida diets, fasts, paleo, and other approaches helped me with my skin but never with mental health. After a mental breakdown the day of a planned wedding in 2021, I left my home in Georgia and spent a month in a cabin in Idaho to focus on a carnivore diet and tai chi to see if I could make progress mentally. I did. I made advances that I never thought possible. Since then I married the woman I fled and have come close to conquering life-long OCD and anxiety. Nonetheless, depression persists at times, especially when I try to eliminate coffee. After trying the lion diet while following one carnivore advocate, I developed a new severe cystic acne response that remains months later. To my family’s delight, I have become more open to the idea that carnivore is not the end-all-be-all. I find myself wrestling with an identity crisis related to this matter as I thought carnivore saved me. I also now find myself disappointed with carnivore fanatics, one in particular who would shame me for eating a single blueberry. Today, as I add things like fruit, nuts, and veggies back into my diet, I feel fine. Did I convince myself carnivore was doing the work or was it just what my body needed for some period of time? Is it a matter of time before mental health issues come raging back due to increased exposure to plant material? I feel more lost than ever with regards to my health despite feeling better than ever. All of the dogma is hard to understand. This is where I so appreciate you both for your willingness to approach everyone individually on the n=1 basis. Thanks! Carter
IF and blood glucose levels, Pre diabetes
I’m so glad you’re doing this show! Background: 68yrs 5’7” 157lbs. Eat very few processed carbs, have 5-7ish spirits a week Life long athlete.
I’ve been doing daily IF for about 3 years, previously with a 12hr feeding widow. Now I’ve shortened that window to 10hrs often less than 8hrs. However my blood glucose levels seem to always hover over 100. Am I
“pre-diabetic”. What other tests might I try and are there any other Lifestyle factors I can play with?
My wife’s digestion needs urgent help
Hi Robb and Nicki,
Long time listener of the podcast! I’m reaching out today in desperation for my wife. About a year ago, my wife started having SEVERE constipation and bloating. Last March we went to the E.R. for the first time because the pain from her stomach/intestinal region was a 9/10. They did some scans and said she was severely backed up, and told her to just eat a bunch of fiber and take Mira lax and sent her on her way. Super helpful, thank you sick care system.
Over the past year it’s gotten progressively worse, and we’ve tried multiple diets to try and get this under control, from low-FODMAP to strict carnivore, and nothing seems to help. Prior to all this starting, she was very fit, worked out 5 days a week and movement was her life. She ate a pretty healthy diet for the most part – fruits, veggies and meats made up most of her diet, with some protein bars and powders mixed in too. This last year, she’s lost 15 pounds on an already slim, athletic frame that didn’t have much room to lose. No matter how she eats, she gets incredibly bloated with sharp pains in her stomach/intestines and has to give herself multiple enemas each day to try and get things moving, sometimes with no luck.
Within the last week, we’ve finally had an endoscopy and colonoscopy. The endoscopy found a small hiatal hernia, and some white spots in her esophagus that they are testing for candida. Her doctor says GHD hiatal hernia is too small to be causing her symptoms and doesn’t require surgery.
In the colonoscopy, they found a small polyp, an ulcer they’re doing a biopsy on, hemorrhoids, and said she has a tortuous (redundant) colon. They ruled out cancer, which was actually was bad news to her, because she wanted something that could be treated at least. They prescribed Linzess and she just started the first day to help get the constipation under control. She doesn’t have much hope it’s going to work though and I can’t say I blame her after all she’s been through the past year.
Besides the physical pain, which is more than anyone should have to bear, it’s taking its toll on her mental health as well. She doesn’t want to be alive anymore. She can’t do the things she enjoyed previously, she can barely eat without becoming nauseated or throwing up, and she just doesn’t see the point in living anymore. We’re doing what we can on the mental health front with professionals, but I fear it won’t get any better until her body is normal again.
We really have no idea where to turn anymore. Her massage therapist thinks it could be related to a tight muscle in her low back that needs myofascial unwinding. We have an appointment this Friday to get that worked on. My wife says when she presses on that muscle in her low back, she can feel pain through her pelvic region. Is there any way a muscle could be constricting her bowels?
I’m not sure what else to say, I’m sure there’s plenty more info you need from me, so let me know what would help. We’d really appreciate any ideas you might have – if you knew a loved one in this situation, what would you tell them?
We both appreciate you and all the work you do for the Rebellion. Thanks for taking the time to read this!
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Nicki: It’s time to make your health an act of rebellion. We’re tackling personalized nutrition, metabolic flexibility, resilient aging and answering your diet and lifestyle questions. This is the only show with a bold aim to help one million people liberate themselves from the sick care system.
You’re listening to the Healthy Rebellion Radio. The contents of this show are for entertainment and educational purposes only. Nothing in this podcast should be considered medical advice. Please consult your licensed and credentialed functional medicine practitioner before embarking on any health, dietary or fitness change.
Warning, when Robb gets passionate, he’s been known to use the occasional expletive. If foul language is not your thing, if it gets your britches in a bunch, there’s always Disney Plus.
Robb: Welcome back folks.
Nicki: Good morning everyone. This is episode 141 of the Healthy Rebellion Radio. Thank you for listening yet again. Good morning.
Robb: Good morning.
Nicki: Let’s see. I know there’s one thing that you wanted to talk about up front, but first I just want to say I am so amazed at how you/we are doing with this weather.
Robb: So far so good. It’s been absolute dog shit.
Nicki: It’s gray.
Robb: Well, it’s not just gray. Since November, I want to say, we’ve maybe had seven days of sunshine.
Nicki: Seven clear days.
Robb: Seven clear days. And normally, that would be piano wire and me measuring it out [inaudible 00:01:34].
Nicki: You’d be in a really rough spot, normally. And I think we’re attributing this to the Zone 2 Cardio.
Robb: More days than not.
Nicki: And it doesn’t mean that we’re not like, “Geez, some sun would be super nice.”
Robb: Well, when the sun does come out, then I’m like, “Oh wow, I really could feel good.” I’ve maybe looked at places to live in Arizona, and then realized we’ve got it really good here. And so we’re just going to ride it out.
Nicki: Not moving. But a trip to the sun wouldn’t be a bad idea.
Robb: Wouldn’t be bad.
Nicki: We need to make sure we make that happen here. That aside, in previous episodes, we’ve talked about your essential tremor. And then we shared that Jack Ruston had shared a paper with you about high-dose thiamine for essential tremor. We actually had a woman that emailed us the actual paper that you couldn’t find.
Robb: We got dozens of people.
Nicki: We had lots of people comment.
Robb: And thank you.
Nicki: Yeah, thank you.
Robb: Thanks everybody.
Nicki: But then you found a fellow that-
Robb: Jack, being the brilliant and handsome guy that he is, he also followed up with a YouTube link, “How to start high-dose thiamine EON.”
Nicki: … EONutrition.
Robb: EONutrition. Seems like a super sharp guy. I haven’t followed him previously. But lays out the different forms of thiamine, how much to start with, some expectations around you can sometimes see symptoms worsen before they get better. And so actually, we could throw this link in the show notes as well.
So about a week ago, I started and they had a product called Thiogen, I believe, is the product. And the interesting thing is you’re supposed to start off pretty low dose and then work your way up. This thing starts off high dose, so it’d be really difficult to stair-step up. And so I just jumped in.
It’s a mix. So it has the thiamine hydrochloride and then the benfotiamine and several, basically all four of the common variants. Some of them are more neurologically active, some of them are more peripherally active. I’ve been on it for a week. Feel like maybe things are a little improved. It’s hard to tell.
Nicki: It’s hard to tell. But so far, cautiously optimistic.
Robb: At a minimum, it didn’t make things worse, which is one of the things you can expect to have. Interestingly, one of the commenters in that-
Robb: … video, mentioned you really need to make sure that you have a mixture of B vitamins also, which they mentioned in the video. And also adequate selenium, molybdenum and iodine. And so I think, generally, I’ve been okay on those points.
But this is where some of this stuff starts getting a little bit crazy because you’re just taking supplements all day long. But so far so good. I actually bumped up to a double dose today. So I’ve been on it for a week at the single capsule, and then pumped it up to a second one today. And we’ll keep folks updated.
Nicki: So we’ll keep you all updated on how this works. Hopefully it works. Fingers crossed.
Robb: Hopefully non-shaky fingers crossed.
Nicki: And for you, it normally is most obvious when you’re excited or angry.
Robb: Angry, yeah.
Nicki: Or nervous. Those types of feelings can make it more pronounced. So we’ll see. News topic today, hubs.
Robb: This one might be a bad one to share. So what it is, it’s Dr. Peter Hotez who’s an MD PhD. And apparently, he is on the short list of people to replace Dr. Fauci at the NIAID, which is super frustrating, particularly when you look at what this guy has been up to. And so he’s been this staunch vaccine advocate. And I guess that that’s okay as far as that goes.
But this is maybe a two-minute clip of him sped up to 1.5 speed and taking him from the very beginning of the pandemic and selling everybody the dream to essentially where we are now. And what’s fascinating about it is it starts off with, “If we can just get 60% of people a single dose, the pandemic will be over, it will block transmission.”
And it just goes from there until at the end, he’s saying you need to be boosted. Not just the first one. And you start losing count. You’re like, “Okay, so the first two don’t really count. It’s really the boosters that get you where you need to be. And you need three of those. And oh, by the way, you’re going to need two of them a year, every year for the rest of your life.” And what was really interesting is he’s interviewed by the same cadre of media persons.
Robb: Reporters and whatnot. You can see their face where he says, “I’ve always said that this was going to be a three-booster vaccine.” And you could see people, their brow furrow because they have had him on the show.
Nicki: And intentionally, probably. But they’re cringing.
Robb: Yeah, they’re cringing. They’re like, “Wait, you were here two months ago and said that this was a single dose and then a double dose.” And part of this is just I’m not even sure why I’m sharing this one. And I apologize, I could only find this video on Facebook.
So if you don’t do Facebook at all, which I don’t blame you for not doing Facebook at all, if that’s where you’re at, then it’s really not that big of a deal. But this guy was trotted out as a major expert on this, and he got everything wrong.
Nicki: Is this not the guy that recently has walked back some of his things? Or is that another person?
Robb: Might be a different person.
Nicki: Different person?
Nicki: I remember there was something.
Robb: I don’t think this guy has walked anything back other than completely forgetting what he has said in the past. No, I’m blanking. It is not.
Nicki: It’s a different guy.
Robb: Yeah, it’s a different guy. It’s a different guy. But God, what is my point with this? It’s just so frustrating that I was reading something from the Boriquagato, the Bad Gato the talking about there’s this huge meeting to try to get to the bottom of mis and disinformation. And it’s a hoity-toity thing in Europe, as all these things have want to be.
And it’s all it these different things about how we could use AI and we could do this and we could do that. And what’s fascinating about it is there’s not a single mention of, “Maybe we should just be honest, maybe we should just be transparent, maybe we should try to rebuild trust in people.”
And instead, what they’re doing is doubling, tripling, quadruple downing on, “We’re going to fucking force you guys to have the narrative that we want you to have or else. We’re going to jump on you with both feet and have whatever other outcomes we’re looking for.”
Nicki: I don’t know that trust and honesty are pillars that help provide for power and control over a population.
Robb: For sure not.
Nicki: So if the aims are power and control, screw trust and honesty.
Robb: And the interesting thing is the Gato is optimistic in that he feels that this constant ratcheting down is going to ultimately make them lose their footing, lose their position on this, which I tend to be a little bit more sanguine about that.
I’m like, “I’m not entirely sure because there’s still enough of the population that has disengaged their gag reflex and takes this thing all the way down to the hairy nuts each time they can that I’m not sure.”
But I get it too. You get lied to enough, enough people just start checking out whether they actively make it part of their communication like we do. Or they just slowly drift into the background and don’t pay attention anymore.
Those can all be the effects. But anyway, I’ve wasted a bunch of time talking about this Peter Hotez thing. It’s just interesting to me to watch this. And it is fascinating in the digital age that it’s like peeing in a pool. You never get it back out, and maybe be careful about what one is saying.
Nicki: Well, we could move on right now. Or you shared another thing with me this week that ties into your peeing in the pool, be careful what one is saying. We’re also in an age of technology where you don’t actually have to say it or do it for it to look like you.
Robb: Well, do you want to talk about that really quickly?
Nicki: Just briefly. Robb shared, I believe it was from the Free Press, which is Barry Weiss’s-
Robb: Yeah, Barry Weiss.
Nicki: … She retitled her Substack. And it was a gamer gal. I don’t follow gaming, but apparently she’s very, very popular.
Robb: Has a big Twitch following.
Nicki: Has a huge following of people watching her play games. And someone took the videos of her and put it into some sort of an AI that then made her a porn star in these porn videos. And when she found them, she was just destroyed and crushed. So she made a video, and she was just in tears and just completely distraught talking about what she discovered.
And it’s crazy because everybody’s seen ChatGPT and all of these things that can write better, copy and write. We’re at the spot where we have this massive technological frontier with AI and it’s a double-edged sword.
Obviously, there’s amazing things that are going to come from it just like there’s been amazing things that have come from the internet, the printing press, go all the way back with these new technologies and how they’ve changed humanity.
But it’ll be interesting to see how we navigate it. Somebody can just take… Especially, if you’re a person like Joe Rogan or somebody who has a lot of content online, there’s a lot of material there for one of these AI to create something that’s not something you did.
Robb: So 10 years of Paleo Solution podcasts and whatnot.
Nicki: Yeah, you too.
Robb: So you though have run across within… We’ve been digging around in this Web3 stuff a little bit and Crypto.
Nicki: We listened to an interesting… We’ve mentioned the show, Bankless before. I don’t listen to every episode, but the good ones will come along and it’ll perk my ears up. So we listened to one recently on Sign-in With Ethereum. And I can’t remember the name of the gentleman that was being interviewed, but it was pretty interesting the things that he was bringing forward. Currently, right now, and I know this is a big tangent of where we were going with the show, but here we are.
Robb: It’s a much better show than what I thought it was going to be.
Nicki: Here we are. So currently, right now, you want to use your Facebook account, Twitter, Instagram. Shoot, I wanted to watch a video last night that was gated behind somebody’s private platform. So you have to enter your email address.
So all of these companies hold your data. And if you are one of these people that uses sign-in with Facebook or sign-in with Amazon or whatever, I tend not to. I tend to just use my own email address and create an account.
But thankfully, and I didn’t know this was a potential downfall of using sign-in with Facebook. But Facebook then is your sign-in, or sign-in with Google is your sign-in for, maybe it’s Etsy, whatever other site that you might log into. If you lose access to that Google account, you lose access to every other platform that you’ve used to sign in with Google.
So anyway, the Sign-in With Ethereum technology, basically the theory or the goal is that you would bring your data to these platforms instead of the way it works right now where these platforms hold your data. And it’s a pretty complex show, but it’s also accessible and it’s really fascinating.
Robb: And pertaining to the deepfakes, it would, in theory, make it very difficult for somebody to do a credible deepfake because if you own-
Nicki: Because any content that you made would be stamped with your Ethereum address on it. So it would be Robb Wolf-verified, this is content I put out. So then if somebody put something else out and it doesn’t have that-
Robb: … It’s immediately questionable.
Nicki: … it’s immediately questionable. So they did talk a little bit about deepfakes and how this-
Robb: Could be a solution.
Nicki: … could be a solution. So I know that’s a tangent. If that’s at all interesting to you, I’ll put the link to that Bankless episode in here also. I think it’s easy to see the new technology coming or that’s here and get really scared and be like, “Shit, all is lost.” Like this Chicken Little, “The sky is falling, the sky is falling.” But I find that when you listen to other super smart builders in the space that have the same, they don’t want that as the-
Robb: Default mode.
Nicki: … as our future. So there are people building for a more decentralized, user-first, not corporation-first or big entity-first who own all of our data. But there are people actively building so that we, as individuals, can have that control and power over our own information. So that gives me a little bit of hope that the sky actually isn’t falling.
Nicki: So let’s move on. The Healthy Rebellion Radio is sponsored by our salty AF electrolyte company, LMNT. If you find yourself dragging during the day, in need of a little pep in your step, don’t reach for another cup of coffee. Instead, grab some electrolytes. LMNT is a perfect pick-me-up for afternoon sluggishness. LMNT also helps with recovery, muscle cramps and keto flu, to name a few.
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Robb: My goodness, that was a lot of gesticulating.
Nicki: Hey, Italians speak with their hands. And when I’m trying-
Robb: [foreign language 00:18:02].
Nicki: … Yeah. [foreign language 00:18:05]. Or I could say [foreign language 00:18:08]. But this is an honest show. And we try to keep things clean most of the time. This question is from Carter on Carnivore. He says, “Hi, guys. Thank you for all you do to advance honest and introspective health discussions. I’m grateful for you. I’m a 41-year-old male with a history of severe mental health and skin issues, dating back to early in life.
I was discharged from my dream career in the military due to mental health issues. Candida diets, fasts, Paleo and other approaches helped me with my skin, but never with mental health. After a mental breakdown, the day of a planned wedding in 2021, I left my home in Georgia and spent a month in a cabin in Idaho to focus on a Carnivore Diet and tai chi to see if I could make progress mentally. I did.
I made advances that I never thought possible. Since then, I married the woman I fled, and have come close to conquering lifelong OCD and anxiety. Nonetheless, depression persists at times, especially when I try to eliminate coffee. After trying the Lion Diet, while following one Carnivore advocate, I developed a new severe cystic acne response that remains months later.
To my family’s delight, I’ve become more open to the idea that Carnivore is not the end-all, be-all. I find myself wrestling with an identity crisis related to this matter as I thought Carnivore saved me. I also now find myself disappointed with Carnivore fanatics, one in particular, who would shame me for eating a single blueberry.
Today, as I add things like fruit, nuts and veggies back into my diet, I feel fine. Did I convince myself carnivore was doing the work? Or was it just what my body needed for some period of time? Is it a matter of time before mental health issues come raging back due to increased exposure to plant material?
I feel more lost than ever with regards to my health, despite feeling better than ever. All of the dogma is hard to understand. This is where I so appreciate you both for your willingness to approach everyone individually on the N equals one basis.”
Robb: Man. Thanks, Carter. And props to you for just hanging in there and fighting. It’d be easy to tap out and let this overwhelm a person. It’s really hard. I’ll back up and maybe get to stuff that I think is more quantifiable. One, I’ve said for ages that segments of the carnivore population are the raw vegans of ancestral health. They’re fucking lunatics.
And it’s an incredibly efficacious and beneficial methodology and technology. And it’s so beneficial that you don’t need to be an asshole about promoting it. It works to the degree it works, and being supportive and non-crazy is a good place to be with that.
But I also get it when some people have had really profound transformations. And when we generally have lives that are devoid of broader meaning, we don’t have religion in our lives much anymore, we don’t have these broader social connections, then we identify around diet.
Nicki: And other things.
Robb: And other things. And other things like that, team sports and whatnot. So I think that that’s a thing. This should always, always, always be predicated on what’s working for you. And by all means, if something’s not working for you, then shift gears and change. And I think it’s entirely possible that… What have we always advocated? A reset.
Our reset originally was low-carb Paleo diet reset. And then this has modified over time to we’ve got a bunch of different entry points that you can do as a reset. You could do a 7-Day Carb Test, you could do Carnivore. And within Carnivore, there’s so many different ways that one could do that.
Some people are ruminant meat only, other people are anything that had a face and a soul. And it goes from there. And the important thing is that people just get in and tinker and they’re really objective about. Is it working for me or is it not? Is it making my life better or making it worse? Is the juice worth the squeeze, ultimately?
And I think that Carter, that’s what you are doing in this situation. It may have been just the right thing that you needed at that time, and then your body changed. Thank God things change, things improved.
Nicki: And you’re able to tolerate a wider variety of foods.
Robb: And now it looks like you’re able to tolerate a wider variety of foods. I go through ebbs and flows with this. I feel in the summer, I’ve got a little more capacity both for carbs and for plant material. In the winter, it seems less, generally. Although, this winter, maybe because I’ve been doing the Zone 2 Cardio, things are a little bit better. But this is where the rubber hits the road, is just what is working for you?
And all that the theory should provide is a beginning point, a roadmap. And then you need to get in and tinker and fiddle from there. And I agree, there are folks out there that maybe some of them can find a goddamn shirt once in a while and then others, it’s just whatever the person needs to facilitate their life. And goddamn, somebody’s like, “I think I need to be vegan.”
As long as it’s working. This has always been my thing. If you are firing on all cylinders, you don’t need me. I’m the person that’s pretty good at, at least, spitballing some ideas about like, “Well, let’s try this. Maybe the problem is this, and we’ll try it. And if the theory is correct, then this will be the result. And if it’s not, then we’ll have to reassess and we go from there.” And I think that that’s an honest, reasonable place to approach damn near everything in our lives.
Nicki: I clearly don’t abide with shaming people for eating a blueberry or deviating from whatever the plan is that a particular influencer or whoever is promoting. But the thing that was popping into my head, I’m just going to share it. I don’t remember who it was.
But somebody was telling me that they were trying to get their dad to do Paleo and he was just like, “It’s not working for me.” But this guy was eating mac and cheese cups, like a cup of noodles. But something like that.
And so he wasn’t really doing it. And I don’t know exactly who he’s referring to here. I think when somebody’s trying something, do it for real, whether it’s Paleo or Carnivore.
Robb: That’s a fair point.
Nicki: Or vegan or whatever, do it for real for the full 30 days. You can’t be including foods that really aren’t on that plan if you’re really trying to objectively see, “How does this plan work for me?” Do it for real for 30 days, or longer if it’s working. And then you’re tinkering from there. But this person was convinced that Paleo didn’t work, but he wasn’t really doing Paleo. So I don’t know.
Robb: No, that’s a fair point.
Nicki: It kept popping into my head. So I wanted to share that.
Robb: That’s a fair point too.
Nicki: Our next question is from Alan on intermittent fasting and blood glucose levels. Alan says, “I’m so glad you’re doing this show. As background, I’m 68-years-old, 5’7, 157 pounds. I eat very few processed carbs, and I have five to seven-ish spirits a week. I’m a lifelong athlete.
I’ve been doing daily intermittent fasting for about three years, previously with a 12-hour feeding window. Now, I’ve shortened that window to 10 hours, often less than eight hours. However, my blood glucose levels seem to always hover over 100. Am I pre-diabetic? What other tests might I try? And are there any other lifestyle factors I can play with?”
Robb: One thing that we have seen is that making… It’s counterintuitive at first. Longer fasts, you would think, would bring down your blood glucose levels because we’re not eating as much, not eating as frequently. But folks forget that the liver can make glucose and release glucose. And if we’re under stress, one of the primary things that the body does is elevate glucose levels because we’re under stress. So we’re in fight or flight.
Nicki: And intermittent fasting is a stress.
Robb: And intermittent fasting is a stress. It can be a good stress, and we’ve talked about this a ton. But the poison is really in the dose. And Alan is somebody who’s 68, knocking on the door to 70-years-old. My biggest concern if the individual isn’t overweight, which you’re not overweight, is maintaining muscle mass. And I just find it evermore difficult to maintain muscle mass as we age.
The literature’s pretty clear on that. And this super constrained feeding window just seems totally antithetical to that. And I’m just not sure what other benefits we get. And I did a piece, Longevity: Are We Trying Too Hard? It was, I think, one of the best talks I’ve ever done.
And it just makes the case that if you’re thinking about autophagy and all this different stuff that’s supposed to come along with fasting and things like fasting, I’m not so sure that it’s really delivering the goods and there may be more downside than upside.
And so whether or not you’re pre-diabetic, we would need to do more screening than what you have. A blood sugar level isn’t going to tell the whole story. And I suspect that this is all an outgrowth of probably doing too much fasting. And so I would do some tinkering with relaxing the feeding window.
Nicki: Do you suggest going back to the feeding window? Because he’s been doing it daily for three years. Would you advise staying daily or pulling a few days out where he’s not doing IF?
Robb: Maybe try pulling a few days out as a beginning point. But it’s that stress again. So you could try pulling a few days out. But I would just make sure that you’re getting adequate protein, that you’re getting adequate calories. And really make that the focus and make performance a goal.
Lifting weights, doing some cardio, making sure that you can motor through all that type of stuff. And then, if you want to do some more extensive screening, the A1C fasted glucose, maybe a fructose just to get a different way to triangulate in on the glycemic load situation. That might be a way to look at this.
Nicki: Because he says lifelong athlete, but he doesn’t say what his training situation is. But clearly, we want to be able to do some strength training, we want to keep that muscle mass on and we need to feed, eat accordingly so that we can keep and maybe even put on some muscle.
Robb: Yeah, absolutely.
Nicki: This last question is from Kyle. He says, “My wife’s digestion needs urgent help. Hi, Robb and Nicki, longtime listener of the podcast. I’m reaching out today in desperation for my wife. About a year ago, she started having severe constipation and bloating. Last March, we went to the ER for the first time because the pain from her stomach and intestinal region was a nine out of 10.
They did some scans and said she was severely backed up, and told her to just eat a bunch of fiber and take MiraLAX and sent her on her way. Super helpful. Thank you, sick care system. Over the past year, it’s gotten progressively worse. And we’ve tried multiple diets to try and get this under control, from low FODMAP to strict Carnivore, and nothing seems to help. Prior to all this starting, she was very fit, worked out five days a week and movement was her life.
She had a pretty healthy diet for the most part. Fruits, veggies, and meats made up most of her diet, with some protein bars and powders mixed in too. This last year, she’s lost 15 pounds on an already slim athletic frame that didn’t have much room to lose. No matter how she eats, she gets incredibly bloated with sharp pains in her stomach and intestines and has to give herself multiple enemas each day to try to get things moving, sometimes with no luck.
Within the last week, we finally had an endoscopy and colonoscopy. The endoscopy found a small hiatal hernia and some white spots in her esophagus that they’re testing for candida. Her doctor says GHD hiatal hernia is too small to be causing her symptoms and doesn’t require surgery. In the colonoscopy, they found a small polyp, an ulcer, they’re doing a biopsy on hemorrhoids. And said she has a tortuous (redundant) colon.
They ruled out cancer, which actually was bad news to her because she wanted something that could be treated at least. They prescribed LINZESS, and she’s just started the first day to help get the constipation under control. She doesn’t have much hope it’s going to work though, and I can’t say I blame her after all she’s been through the past year.
Besides the physical pain, which is more than anyone should have to bear, it’s taking his toll on her mental health as well. She doesn’t want to be alive anymore. She can’t do the things she enjoyed previously, she can barely eat without becoming nauseated or throwing up and she just doesn’t see the point in living anymore. We’re doing what we can on the mental health front with professionals, but I fear it won’t get any better until her body is normal again. We really have no idea where to turn anymore.
Her massage therapist thinks it could be related to a tight muscle in her lower back that needs myofascial unwinding. We have an appointment this Friday to get that worked on. My wife says when she presses on that muscle in her lower back, she can feel pain through her pelvic region.
Is there any way a muscle could be constricting her bowels? I’m not sure what else to say. I’m sure there’s plenty more info you need from me. Would really appreciate any ideas you might have. If you knew a loved one in this situation, what would you tell them?”
Robb: Man, that is a lot to unpack.
Nicki: First of all, big love to you and your wife because this is a very trying situation. And it’s hard when a loved one is going through something so huge and-
Nicki: … all-encompassing. And it’s hard not just on her, but also on you. Because you are her primary support person and you love her and you don’t want to see her going through this. And so just big love to both of you.
Robb: There’s so much going on here. I’m not even sure where to start. And I had talked to Nicki a little bit before we pressed record on this thing. I’m like, “I’m not entirely sure I’ve got anything to offer these folks other than keep tinkering, keep looking.”
The thing that stands out is that this all started. There was a time when this wasn’t happening and then it started. I’m really curious, what, if any, precipitating event occurred around all this? Was there some new thing? And I’m just throwing it out there, did she catch COVID? Did she get vaccinated? Did she get injured?
Nicki: Did you guys travel somewhere and get an intestinal bug?
Robb: Yeah, did you travel?
Nicki: Did you eat, drink or eat food in a-
Robb: Street meat, at a taco-
Nicki: … street meats. Yeah.
Robb: … I feel there was some precipitating event here. I was at a farm fundraiser thing several years ago. And at the event, I think I mentioned this a show or two back. But they had kombucha just on tap. You go up to this truck and you got kombucha, and it was amazing. And I’m pretty sure that because kombucha comes from a-
Robb: … Yeah, a fungal. I think that got me. Because I came home and I was really sick, laid-out sick. I didn’t know what to do. I reacted to looking at a piece of plant fiber. And even straight-up Carnivore, it kept me alive, but it wasn’t like, “Oh, I totally shook that off.” I was really, really sick for quite some time.
We were trying to figure out if I hadn’t caught some sort of a parasite because we were on a farm. And they had a great food spread there, but farms being farms, there’s lots of flies. And if flies got on the food, to some degree, and it’s unavoidable, I don’t know. I still don’t know. Eventually, I shook this stuff off. But what was interesting is each summer, for the next two years after that event, I got sick right about the same time.
So there was this anniversary element to it. And I just kept tinkering. In some ways, my situation was maybe not as bad because I tend to be on the loose stool side versus the impacted side. I will say that my experience in the past is when people get on the merry-go-round of enemas, it’s hard to get off that. The digestive system can get entrained to needing that. And I know that that becomes a whole chicken and egg problem because when you get impacted, you got to do something to address that.
It would be awesome if you could track down somebody like a Ruscio, an Agolli, Jacobs, a Chris Kresser or somebody like that, that takes a functional medicine approach to digestive health. If you could find if there’s a gastroenterologist out there who is also functional medicine certified, I would give that person a talking to and see if you could get a consult as just a beginning place.
It sounds like you all are on a path of investigation, and a candida overgrowth could be part of the problem. Usually, it manifests in looser stools. But this is the interesting thing about irritable bowel disease and whatnot. Some people, they get constipated, some people they get loose stools. And that’s just the way that that plays out. I’m trying to think of anything else.
Nicki: So one thing that you do, whenever the girls or myself has felt a little constipated… And even he went traveling with a friend in the Bahamas before kids, and he’s one of these types that can only poop at home. And so on vacation, he was going seven days without a bowel movement, is you do some abdominal massage.
Robb: Massage. I do.
Nicki: And so that might be something, Kyle, that you could do for her. And I’m sure there’s probably YouTube videos on it.
Robb: There’s probably a YouTube video on it.
Nicki: You describe it.
Robb: You start right below the xiphoid process. And both hands are together, and you press in. And her tummy’s probably going to be tender, so you have to go light initially. And you do clockwise, circular movements, small. And then you work around the whole belly in a clockwise fashion.
Nicki: So you’re basically helping to move stuff-
Nicki: … around, through the colon.
Robb: I totally forgot about that. And I’ve-
Nicki: You’ve done it on a lot of people.
Robb: … rubbed a lot of bellies on people who were backed up. And literally, the person would be on the couch, and I’d be working on this maybe 10 minutes, and they’re, bam, off the couch into the bathroom.
Nicki: It’s just called abdominal massage?
Nicki: Okay. So Kyle, maybe there’s… And she has a massage therapist. You were trained as a massage therapist. Do all massage therapists know how to do this or no?
Robb: I don’t know.
Nicki: But it would be great. It could be something that you could help her with even at home.
Robb: And Kyle, if there’s nothing on the internet, ping us back and I will shoot a quick video and do some details on how to do it and get it off to you. I’m glad you remembered that. I had totally forgotten about that. There are other things out there. If there are autoimmune issues here, things like low-dose naltrexone to try to dial down the immune response.
But hopefully the abdominal massage helps, meditation practice. All these things just broadly speaking of supporting health. Sunlight, photoperiod, all of that. She’s having some mental health challenges around this obviously, and understandably. Supporting all the rest of that.
But let’s hope that maybe the abdominal massage helps. But there are lots of other things out there that can be done. But this is where getting hooked up with somebody who’s pretty knowledgeable and good at the differential diagnosis and just trying things. It’s like, “Hey, here’s an idea. Let’s give this a shot and then we go from there.”
Nicki: I’m trying to think if there’s anything else that was sticking out at me. Back to your original point, what caused this onset?
Robb: [inaudible 00:39:52] be helpful to try to know that.
Nicki: I feel like figuring out the root cause. Rack your brain, if there’s something that precipitated this. Because it seems unlikely that just out of the blue, this would pop up.
Robb: I’m just throwing stuff against the wall. But she did a super gnarly Spartan race and was blown out afterwards. And interestingly, even some of these adventure races, like the Spartan race stuff, oftentimes, they incorporate fields where people climb through muck. And some of the muck has-
Nicki: Might have something in it.
Robb: … something in it, like cow manure and different things like that. And so people can get sick from that, the stress of the training. And again, I am completely spitballing here, but if she keeps a digital calendar, one of the benefits of a digital calendar is you, in theory, always have it.
And it’s like, “Well, what were we doing on this date?” And you can go back and look around that time and see if you had something scheduled around that time or something occurred. But I would really do some digging around trying to figure out what was the precipitator, for sure.
Nicki: And again, sending you guys both big hugs. It’s a lot.
Robb: Anything else?
Nicki: I think that was our final question for this week. Actually, I wanted to… When Robb mentioned, he’s like, “I don’t know if I have much to offer here. There’s a lot going on. Pretty complex case.” And I was like, “You know what? Sometimes though, we read something and we might not have the answer. But somebody that’s listening has experienced the exact same thing or might have some direction.” So that’s another reason why I wanted to do this one on the show because we do have an amazing listener base, we have doctors and PhDs.
Robb: Very smart folks.
Nicki: And people who have had a whole host of experiences. So if any of you listening have any thoughts on this for Kyle, just shoot us an email on the robbwolf.com website and we’ll share them. Cool. That’s a wrap for episode 141.
Thank you all for listening. Be sure to check out our show sponsor. For all your electrolyte needs, you can grab your LMNT at drinklmnt.com/robb. Have a wonderful weekend and we’ll see you next week.
Robb: Bye everybody.
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