For me this year is a big one! I've been suffering from a chronic condition called SIBO
(small intestinal bacterial overgrowth) for the last 6 years, and the progression of this dysbiosis of the little bug-ers that inhabit my guts has now effected my life so severely that I can't predict what my energy levels will be from day to day. It can range from being able to get up and go out to do the shopping on my bike (I don't own a car), to struggling to be able to complete simple tasks like washing the dishes.
What is SIBO?
A large majority of the bacteria that make up the population of your gut microbiome live in the large intestine (colon). There are millions of bacteria throughout the length of the guts but the type and proportion vary based on the environment. In the case of SIBO, everything has become unbalanced and a large amount of bacteria, both good and bad have migrated into the small intestine.
Source: My SIBO Story
Throughout this battle with SIBO other imbalances have been diagnosed by the gastroenterologist. A few years ago I was diagnosed with NAFLD (none alcohol related fatty liver disease) which is a condition that has caused scaring on my liver. Symptoms manifests in me as an inability to process toxins properly. For example, hangovers come a day late as I am basically still drunk all of the following day. The hangover is extreme and will last for 3-4 days, leaving me unable to function for the best part of a week.
I am a freelance writer and the profound fatigue I suffer sometimes manifests in severe brain fog. This leaves me unable to write effectively and hit my deadlines, which has lost me clients. I'm becoming very worried that this condition will result in me becoming homeless with the increasingly Dickensian political powers in the UK persecuting those with illness who need help with social security.
With the greatest respect to anyone reading, before suggesting treatments - fermented foods etc - for my SIBO, kindly read the article I wrote over a year ago My SIBO Story. That article details the vast array of treatments, drugs and healing modalities I have followed. It can become exhausting explaining this condition, and all the treatments I've undergone, over and over again.
How I hope to Heal Holistically
I've spent a lot of time thinking about all of this over the holiday period. Partly inspired by the 21 day abundance meditation challenge that @riverflows ran in the natural medicine discord, I have set the intention to heal... and now is the time to manifest these intentions!
When I really looked at my habits and behaviors I realized that I was self sabotaging. Driven by the failure of so many treatments, fundamentally depressed at the frustration of it all, I had given up. My food choices and level of alcohol consumption were actively working against my body in its struggle to find balance again.
Everything I have tried in the past has revolved around the (traditional medical) idea of addressing what is going on in my gut by killing the bacteria. After completing the elemental diet (an extreme liquid diet designed to starve the bacteria in your small intestine) in 2019, I received a negative breath test for SIBO. However none of the symptoms have changed or gone away in the 9 months since that test, if anything they have got worse. It's for all of these reasons that I've decided to look at the problem from a different angle.
What if my liver is the main problem?
If I can heal the liver might this help bring things into balance?
It's worth a try at this point... I've nothing to lose and everything to gain!
The Keto Diet + No Sugar, Alcohol or Caffeine
This may sound extreme, but there is method to this madness of food exclusion. Excluding both alcohol and caffine are a no brainer to be honest. In a digestive system that has become so compromised as mine it is counter-intuitive to add unnecessary toxins. Add to this that cutting both of these substances out gives my liver a massive break, and it was always going to be on the cards.
How the keto diet could help.
Firstly, it could return some equilibrium to my gut microbiome. The main food group that is known to feed a (SIBO) bacterial overgrowth are carbohydrates. More specifically, starchy carbs such as grains, rice, potatoes etc. Things like bread and pasta are massive culprits - funnily enough some of my favorite foods. As I remove these problem carbs from my diet, the change in the food that is going into my system and feeding my gut bacteria, may actually promote some of the good bacteria to proliferate while starving the bad bacteria.
The variability among people and the adaptability of gut microbiota to substantial changes have permitted the manipulation of various external factors, restoring both the biological functions and richness of microbiota.
It has been shown in medical studies that the ketogenic diet does alter microbiome, however the long term effect and interaction on specific strains of bacteria is less conclusive. I'm at the point now where experimentation is my only option. Both the head dietitian and consultant gastroenterologist in the Liverpool royal hospital have told me they have no further treatments to suggest.
Secondly, the physiological process of ketosis causes weight loss and puts the body into a similar state as a fast. This is where the medical research goes out of the window... because it is inconclusive or nonexistent. My reasoning for trialing the Keto diet is based partly on instinct and logical progression. I am sure that my gut issues are causing some nutrient deficiency, the intense fatigue I experience attests to this fact. Therefor my logical progression is that if ketosis does place the body into an anti-inflammatory healing state, the damage (and inflammation) that has occurred on the wall of my small intestine due to SIBO might be improved/healed. The other main reason to trial the keto diet, is that one of the major ways to reverse NAFLD is by losing weight, while increasing exercise.
“Medical interventions incorporating ketogenic diets appear effective for improving NAFLD and therefore may be an effective approach for reversing the natural history of NAFLD progression, although further studies are needed to confirm potential beneficial effect in patients with biopsy-confirmed NASH.” – by Talitha Bennett
This whole process is going to be an ongoing assessment for me, and I'm easing myself into it with a gradual reduction in carbohydrates rather than jumping straight in at the deep end. Every human being reacts different when such an extreme dietary regime is undertaken. I will be listening to my body and being honest with myself on how the diet is effecting major symptoms, beyond the expected initial Keto-flu.
My Plan for Ketosis
I haven't done a tone of research into the different types of ketogenic diets, so I'm not 100% sure what you would call the type I have chosen. I have gone for one that is low carb (keeps my carb intake to 5% or less of total calories) and relatively balanced between protein/fat.
I used the calculator at perfectketo.com to work out my daily macronutrient goals with a weight loss target of 2.01kg/month. As I am currently 12 Kg over my perfect healthy weight I've a long way to go 😉
Milk Thistle - An Added Bonus
To supplement, and hopefully boost, the healing of my liver I will also be taking milk thistle daily with a diet rich in vitamin E.
Milk thistle has a long history in herbal lore to help with digestive issues as well as liver function. Recently there have been many medical studies that confirm some of these long known facts about this amaziing herb's power o heal.
Some studies have found that milk thistle, alone or in combination with vitamin E, may help reduce insulin resistance, inflammation and liver damage in people with NAFLD.
Source: Silymarin in non alcoholic fatty liver disease
As I have been eating lots of fresh spinach, lettuce and other leafy greens, I will be getting plenty of vitamin E from my diet. In fact, the vast bulk of what I am eating is low carb fresh veg including broccoli, bell peppers, avocado, cauliflower and various salads like radish. Even though I wont be going full keto for a few more days, I'm already feeling the effect of this reduced carb, zero processed food dietary change.
Finally, as I see improvements in energy and other symptoms I plan on increasing my exercise to at least 3 times per week. This will include both swimming and cycling.
Many moons ago, in the summer of 2010, I completed my first and only Olympic length triathlon. I would love to be able to complete a second again some day.
Wish me luck!