Around the Web; Congratulations Naomi Edition

I had a great time talking to Sean Croxton on his Underground Wellness radio show Thursday night; check out the show here. I’m excited to be participating in Sean’s upcoming “Paleo Summit.” And it was nice to see that Miriam Knight of New Consciousness Review put our chat on Youtube.

Shou-Ching and I pleased to be blogging at Psychology Today. We join some great writers there, including Dr. Emily Deans and Dr. Kurt Harris, and are looking forward to introducing our ideas to a new audience.

[1] Reader Results: I’m always excited when readers report results. Here are a few from this week.

Naomi has recovered from longstanding digestive troubles:

Hi Paul, I have incredible news, my food intolerances are gone!! I just returned from a trip to India and Nepal, and while on the trip discovered I could eat anything with no reaction. If you recall from my questions in the Q&A section, I had severe histamine intolerance and fructose intolerance. After doing GAPS + buckwheat (but no ferments) for 7-8 months last year, I got worse, but after adding rice, via PHD and supplementing Vit C and D last fall, I felt a lot better, but still had the severe intolerances. I took ivermectin in early December after my stool test indicated the parasite strongyloides, but there was no noticeable change. For the trip to India, my doctor recommended artemisinin, 200 mg 2 x a day for prevention of malaria. I started it 2 weeks before the trip and had 3 days of mild die-off. It took about 2 weeks before I realized I could eat anything. Now that I am home, I cannot wait to add ferments or many of the simple things like tomatoes that I could not tolerate before.

I definitely credit PHD as well as your thinking about infection and parasites for helping me. Thank you so much.

I’m very happy for Naomi. Her case is also a capsule summary of our strategy for healing disease; disease is caused by bad diets and infections, so the strategy is to fix the diet, diagnose pathogens, and then optimize diet for that type of pathogen and take antimicrobial medicines as appropriate. Sometimes diagnosis is impossible, and it is worthwhile to just experiment with antimicrobial medicines. Artemisinin is known to work against protozoa such as plasmodium which causes malaria and trematode worms which cause schistosomiasis; perhaps it also works against the nematode worm strongyloides, or perhaps the stool test got her pathogen wrong. In any case, congratulations Naomi!

Naomi’s failure on GAPS recalls an observation I made in my Weston A Price Foundation Wise Traditions talk, which was discussed a bit on the Internet afterward. Natasha Campbell-McBride’s GAPS diet is a great approach, generally speaking, for bacterial dysbiosis of the gut, but isn’t necessarily optimal for infections with eukaryotic pathogens like fungi, protozoa, and parasitic worms. No one diet is perfect for every gut problem – as we wrote this week, “All healthy persons are alike; each unhealthy person is unhealthy in his own way.”

Helena reports:

Hi Paul, Thank you again! You helped my mom who has suffered with chronic constipation for 60 plus years. She had taken Senna for decades. I read your post about using Magnesium Citrate instead. It works like a charm and she is no longer taking toxic Senna. Thank you!

Think about this: Helena’s mom was magnesium deficient for 60 years, suffered constipation as a result, and never got the problem diagnosed or fixed. This says something about how easy it is to be magnesium deficient in today’s world, and how unaware people are about the need for key nutrients.

Finally, Ole reported his progress:

Here is a short summary of my time on the PHD: I have been on the PHD diet for over a year now. (I bought the draft version in September 2010). My health has improved a lot. I have lost about 25kg and I’m now about 87kg (i’m 185cm tall). I’m probably healthier than an average person on just about any performance metric.

On his blog Ole shared “before” (2010) and “midway through” (summer 2011) photos:

[2] Music to read by: Via Craig Newmark, here is They Might Be Giants covering “Tubthumping” by Chumbawumba at A.V. Club:


They Might Be Giants covers Chumbawamba

[3] Interesting Items This Week:

In the book and the post What Makes a Supercentenarian? (Aug 18, 2010) we discuss supercentenarian diets, and find they’re almost always Perfect Health Diet compatible. Dr. Daniel Chong, a naturopathic doctor and primary care physician in Portland Oregon who recommends our diet, reports another example: the oldest woman in the world, age 121, eats “grilled meat, monkey, fish, manioc (a root vegetable), and banana porridge. She does not eat salt, sugar, or any processed foods.”

Jamie Scott compiles evidence against omega-6 fats. All of Jamie’s posts are good, but this one is really good.

At RobbWolf.com, Roman Sasik, Ph.D., argues that chlorella may be dangerous, because it carries giant viruses and is rich in LPS to which chronic exposure is dangerous. CarbSane objects to stevia, xylitol, and erythritol.

Dan’s Plan has a nice discussion of Paula Deen’s decision to treat diabetes with drugs, not diet.

Peter Dobromylskyj of Hyperlipid comments on Stephan Guyenet’s recent paper: Peter argues that injury to the hypothalamus increases adipose insulin sensitivity leading to a free fatty acid deficiency, after which obesity is an adaptation that normalizes free fatty acid levels.

Matt Stone argues the case for ice cream: “[I]ce cream is not only healthy, but far healthier than most human breast milk.” Of course, it’s not an either-or situation.

Seth Roberts comments on Tara Parker-Pope’s “The Fat Trap”: Its defects were what it didn’t say.

Are GMO foods safe? Brian Cormack Carr quotes from our book’s discussion of why genetically modified foods can be unsafe and need to be screened for safety. Elsewhere, Emily Willingham in Slate supports GMO foods against a critique by Ari LeVaux in the Atlantic. Unfortunately, LeVaux doesn’t seem to know much biology and cites unlikely mechanisms, such as miRNA, for potential harm from GMO foods. (Monsanto responds with a nice commentary on the Zhang et al. paper we commented on earlier.) Neither article states precisely what safety testing is currently being done on GMO foods. What is needed is careful testing for the levels of all natural plant toxins. Is this being done? I don’t know.

Prof Dr Andro calls a high-fat diet “exercise in a pill.”

John J. Ray reports that men over 6 feet tall have a 24% lower risk of heart failure.

LymeMD:  “Idiopathic means the doctor is an idiot and the patient is pathological.”

A student revolt may mean the end of “healthy” food in the Los Angeles schools: “The complaints have been heard … and dishes like quinoa salads and brown rice cutlets are out.”

The Economist (hat tip: Brad) and The Scientist report on a new paper showing that exercise may improve health by inducing autophagy. Here’s the Pubmed abstract. What’s exciting about the research is that exercise induces autophagy not just in muscles and the heart, but in organs like the liver and pancreas. This gives us a mechanism by which exercise will be therapeutic for diabetes and metabolic syndrome.

Joshua Newman makes a powerful case for exercise.

Richard Fernandez ponders whether the FDA is on the side of the microbes.

Conrad’s Dairy Farm finds that it’s good business to give their cows waterbeds. Here’s a video:

[4] Some items I may do posts on: First, two critiques of our diet:

  • Travis Culp complains that we like butter too much; it’s the Pastoral Diet.
  • Danny Roddy complains that we don’t like sugar enough; it’s a Fructose-Deficient Diet.

I started writing a response but it’s too long for inclusion in this Around the Web.

Second, Dr Emily Deans has an important post: Tylenol and Autism? Paul Whiteley contributes a good comment to the post. Moms, don’t give your kids acetaminophen (paracetamol), and I wouldn’t take it during pregnancy either.

Third, Chris Kresser did an outstanding post on GERD, arguing that GERD is an inflammatory disease characterized by autoimmune attacks on the esophagus. I’ve been meaning to do a post or series on acid reflux and this fills in one of the missing pieces.

[5] Cute animal: Via Kamal Patel and reddit.com, a Galapagos Island seal:

[6] Scary animal?: Those who have read the verso page of our book may have noticed that our niece, Seo Jung, did a few illustrations. Here’s a recent drawing she made:

[6] Notable comments this week:

Dr. Ricardo de Souza Pereira left a comment telling us how to buy his Protexid supplement for acid reflux. Michael Eades once blogged about this supplement.

Lucas Tafur notes that ketogenic diets suppress leukocyte chemotaxis and phagocytosis, and increase vulnerability to tuberculosis and staph infections.

Rhonda W of the National Starch Company reflects on the benefits of resistant starch, a fiber found in starchy foods. She favors cornstarch, we favor safe starches like potatoes as a source of resistant starch.

Mehlinda provides us with a student video I found fascinating. It turns out many supermarket potatoes are sprayed with Bud Nip, a herbicide and sprout suppressant:

[7] Not the Weekly Video:

Via Yoni Freedhoff, who claims he almost got his bride to process to the Imperial Death March.

[8] Shou-Ching’s Photo Art: I disagree with this one:

[9] Weekly Video:

Via John Durant.

Leave a comment ?

44 Comments.

  1. I wonder how harmful the chlorpropham is. The organic potatoes we get sprout really quickly even in our dark pantry but the ones we get from costco never sprout.

  2. Naomi didn’t do the GAPS diet. You can’t do GAPS without fermented foods. Plus, GAPS doesn’t have to be low-carb. Let it be known, that I eat PHD and love it but just had to point that out.

  3. Here is MatLalonde on Ice cream “Ben & Jerry’s ice cream contains some nasty legume-derived stabilizers and thickeners such as guar gum, xanthan gum and locust bean gum. The carbohydrates in the gums are really problematic for some folks, especially those with irritable bowel disorders.”
    http://www.facebook.com/photo.php?fbid=155715531177120&set=a.151909551557718.38456.116169665131707&type=1&theater
    & http://www.facebook.com/photo.php?fbid=157119924370014&set=a.151909551557718.38456.116169665131707&type=1

    He’s also said “I once used to think the health of the planet would be so much better if sugar and HFCS were replaced with glucose (or dextrose or corn syrup or anything that is mostly glucose). I still think the switch would have a positive impact but it appears it would not be as positive as I anticipated given that some people would probably be consuming glucose in excess.”
    http://www.facebook.com/permalink.php?story_fbid=140321389393376&id=116169665131707

  4. Hi Paul

    Thanks for the mention and link love! Much appreciated.

    Jamie

  5. The ice cream in Lalond’s picture contains cream, milk, organic cane sugar, egg yolks, organic non fat milk, sea salt.

    http://www.facebook.com/photo.php?fbid=157119924370014&set=a.151909551557718.38456.116169665131707&type=1&theater

    http://batchicecream.com/?page_id=19

  6. Paul, thanks for mentioning my story in ATW (although I am a little embarrassed)

    Jennifer, technically you are right, I couldn’t really do GAPS, although I tried! Out of necessity for a short time I ate a lot of fruit and honey on GAPS, but then I developed a fructose intolerance. So, yeah, you don’t have to be low carb on GAPS, but I don’t think its the quantity of carbs, but rather the quality. Also, I don’t think my problems with GAPS diet are all that uncommon (for example, if you read posts on the yahoo GAPS groups, you will see a lot of other people with histamine and other intolerances who also cannot tolerate fermented foods and even cannot tolerate bone broths). I know GAPS has helped a lot of people, but not all food intolerances are due solely to leaky gut. The huge turnaround for me was after adding white rice, milk + supplements.

    • healingjourneygirl

      Naomi. I know your post was written ages ago. However, I am in a similar situation to what you were. I was having crippling / debilitating symptoms too long to list. Started eating gaps / paleo. I also got rid of a parasite with extreme antibiotics. Dairy intolerance went away, digestion improved. However, I am still experiencing symptoms. Recently connected all the dots and realized that aged foods and fermented foods (histamine foods) have been making me EXTREMELY ill and causing nausea / skin reactions. Have been reading about GAPS / paleo / PHD / Ray Peat / SCD for awhile now. As of tomorrow, I am going to eat raw carrot salad daily. Started to crave icecream (?) Started to eat icecream. Hope that is okay. Hope I can heal from this intolerance…it’s pretty inconvenient and affects my life greatly. Also this week, I will start to eat low histamine PHD (I have always loved eating white rice). Will let you know if there are any changes. : ) P.S Love the PHD. I intuitively / naturally eat this way. Such a balanced healthy way to eat. I just need to fine tune a few things. 🙂

  7. Naomi, thanks so much for sharing. You never know if someone else may find their way to health through your story.

    Jennifer, thanks. I am not putting down GAPS, it’s great in many cases, but if you have the right infections then it will be intolerable, as it was for Jennifer. What we really need is a taxonomy of all possible gut problems, to match each problem with the diet that works well for it and the diets that cause problems, and then develop a systematic procedure for experimenting with diets that will diagnose the problem and minimize its severity.

    What I’d like to have is a table in which you could look up, eg, that intolerance of fermented foods and fructose means you have a trematode worm infection, and what works best against that is a rice and milk diet and artemisinin. If we had that sort of information for all gut conditions, then we could walk patients through an experimental decision tree to find solutions fairly quickly.

  8. Hi Lance, thanks, that’s a helpful study for my obesity series.

  9. Hi Paul,

    Thanks for the mention, but it’s actually my sister’s blog. She has just finished a bachelor in nutrition and is starting a private practice here in Norway. I introduced her to PHD and have kind off been promoting PHD for some time now. For people that have known me for some time the health improvements is kind of difficult to deny.

    At least here in Norway it’s impossible to discuss PHD without also discussing the recommendation given by Norwegian Health Authorities. In 2011 they published a 365 page report titled “dietary advice for promotion public health and preventing chronic diseases”. The report was actually delayed about a year to give them time to go through “all the evidence”. Given its goal and the delay I was actually expecting its conclusions to be similar to PHD. I was wrong, their advice and assertiveness still puzzles me. The report is summarized in 13 dietary recommendations. Here are some of them:

    Tip 2: It is recommended to maintain the balance between energy intake and energy expenditure.
    Tip 4: Eat at least 4 servings of whole grain products each day.
    Tip 6: It is recommended that low-fat dairy products are included in the daily diet.
    Tip 7: It is recommended that you choose lean meat and limit
    intake of red meat and processed meat.
    Tip 8: It is recommended that you choose cooking oils, liquid margarine or soft margarine.
    Tip 11: Limit intake of salt.

    In the end health conscious people are faced with the difficult question: How can they rationally believe that they know more than all the professors creating the official guidelines? Young health practitioners are maybe facing even bigger ethical challenges.

  10. Hi Paul,

    I’d would also like to see your response to these critiques of the PHD.

    > Travis Culp complains that we like butter too much; it’s the Pastoral Diet.
    > Danny Roddy complains that we don’t like sugar enough; it’s a Fructose-Deficient Diet.

    Thank you,
    Mark

  11. Contra Dr. Lalonde, xanthan gum is not derived from legumes.

    Here’s wikipedia: “Xanthan gum is a polysaccharide, derived from the bacterial coat of Xanthomonas campestris, used as a food additive and rheology modifier,[2] commonly used as a food thickening agent (in salad dressings, for example) and a stabilizer (in cosmetic products, for example, to prevent ingredients from separating).”

    It’s interesting that the oldest woman in the world eats her meat grilled since grilling is not said to be a safe way to prepare meat.

  12. Loved the Galapagos Island seal. 🙂

  13. Hi Ole,

    Yes, it’s almost impossible to be an ethical health professional in modern bureaucraticized health care systems. You have no freedom to serve patients according to your conscience and personal knowledge; you have to follow official standards; and official standards are often wrong, or inappropriate in the case of individual patients even when they’re right for others.

  14. Gary had news this week and I immediately looked to see if you had linked. His critique in the full petition was well written and I think it goes a long way towards explaining what Tara needed to talk about.

    Your power in part comes from your remarkable generosity and lack of petty disputes. How did you respond to Emily’s pettiness? Admirably.

    Did you see this?
    http://www.ncbi.nlm.nih.gov/pubmed/22235369

    You freely admit that different people have different tolerances to carbs and the paper above tells you why that may have occurred. So why treat Gary worse than Stephan? They both put the blinders on against the group they are not part of.

    I have many loved ones that could be helped immensely by Gary’s advice but would never make progress by following young healthy Stephan’s advice.

  15. “Yes, it’s almost impossible to be an ethical health professional in modern bureaucraticized health care systems.”

    That’s why I consider Dr Annika Dahlqvist to be such a hero. I had the good fortune to spend a couple hours with Annika when she came to Prague and she’s a very down-to-earth person who simply felt compelled to do the right thing as she saw it(prescribing an LC diet to diabetics), even if it meant jeopardizing her career–which it did.

    I doubt Dr Dahlqvist has ever read Thoreau, but it was her famous stand against the system that paved the way for people like Andreas Eenfeldt and the current popularity of HFLC in Scandinavia.

  16. Hi Chuck,

    I didn’t notice Gary’s blog post until after the Around the Web went up, so I’ll mention it next week.

    I did see the Carnivore Connection paper, in fact I linked to Pal Jabekk’s discussion of it earlier (http://ramblingsofacarnivore.blogspot.com/2012/01/carnivore-connection-hypothesis.html).

    As far as my treatment of Gary and Stephan, I think in some ways I have been more generous to Gary than to Stephan. As far as science is concerned, I do have some differences with Stephan and some positive things to say about what Gary has contributed, and those should come out in my upcoming series. However, in terms of manner of argumentation and willingness to address the scientific literature, Stephan is much more praiseworthy. Gary is all too willing to engage in equivocation and straw man arguments, while neglecting to admit or address evidence contrary to his points. Also, he makes basic mistakes in biology, like treating insulin as a master/dominant hormone in fat metabolism. Biology just doesn’t work that way, there are no master/dominant hormones, not for any process that is important.

    I don’t see what differences among individuals would do to support Gary’s argument. His case is that everyone is alike.

    I agree with you that Gary’s diet prescriptions might be more helpful than Stephan’s for some people, perhaps most. When I first came in contact with Gary, that was his key characteristic in determining my regard. But having seen the same arguments repeated over and over again for 5 years, his merits start to fade and his defects become more apparent.

    Hi Sean,

    Yes, Dr Dahlqvist is indeed a hero.

  17. Your niece does beautiful drawings! Thanks for the link love! I’m hopeful a friend will cover an acetaminophen/asthma link soon…

  18. Hi Emily,

    Thanks, she’ll appreciate that!

    I’m very interested in this link. I’ll probably do a post on acetaminophen more generally, not autism only, and let others do the heavy lifting re autism mechanisms, but I find the potential autism connection fascinating.

  19. There is a LOT of stuff with regards to asthma. A friend of mine was going to do a blog on it so I refrained…

  20. “the oldest woman in the world, age 121, eats “grilled meat, monkey, fish, manioc (a root vegetable), and banana porridge. She does not eat salt, sugar, or any processed foods.”

    Wow, the woman has unbelievable skin for someone who is 121 <— if it is true!

    She seems very short — very much in line with the thought that low IGF-1 seems to promote longevity.

    I'm interested to know the fat content of her diet. Almost without exception — it seems centenarians eat diets higher in starch than higher in fat.

    I'm a little tired of people just throwing out info like the above — she could have a fat content of her diet from 10-60+% I would love to get more precise with long living individuals.

    Other than that — amazing woman to have lived so long!

  21. Naomi,

    How did you take the artemisinin?

    Empty stomach or w/ food?

    Thank you.

  22. Naomi,

    I forgot to ask…

    Could you describe your exact symptoms of food intolerance?

    Thanks again.

  23. Enrique, I take the artemisinin with food. Another thing that helped me last year was glutathione. I got IV glutathione for a short time and still take acetyl glutathione.

    Its hard to describe exactly my symptoms, as they have changed over the years. Most recently, I would have histamine episodes if I ate anything high histamine/histamine releasing, even really small amounts. These episodes included headaches, nausea, no energy, just really sick, and they would last a day or two. Also hot flashes were quite common. Small amounts of fructose would cause me to have severe morning grogginess and larger amounts would cause gas/diarrhea. Over the years, I had so many types of reactions: mood issues, headaches/migraines GI problems, nasal congestion, vertigo, acne, brain fog, weight gain……Those histamine episodes were the worst. If you read Jamie’s post on histamine intolerance, the paper he cites (by Maintz, et al) has a great graphic: http://thatpaleoguy.com/2011/04/11/histamine-intolerance/

  24. Thanks a lot Naomi.

    My symptoms are most likely from food intolerance AND/OR GI infection, like SIBO.

    I get tired (immune activity, reacting to LPS and other toxins), irritable, spacey, my eyes get heavy with a sandy gritty feeling (this is the most common symptom), minor GI problems like a little bit of bloating, mildly tarry stools, but never diarrhea.

    I think I have some malabsorption, last time I tested quite low in SIgA levels. I experimented with iodine (50 mg) and seems to resolve the symptoms for as long as I take it and stay away from garbage food while (this points to a GI infection but also iodine is an effective antihistamine, from what I’ve researched).

    It seems that I do well with fructose. I can drink almost a gallon of Orange Juice (unpasteurized) without problems. A few glasses of OJ per day, have shown to improve insulin sensitivity, lower glucose, lower inflammation, raise nutrient status, lower cardiac risks, etc, all without any weight gain. Just a tip for those worrying too much about natural sources of fructose (and other sugars).

    What I’m doing is a conservative but seems-effective, bio-film protocol. Basically using serrapeptase and iodine and then strain-specific probiotics (antiinflammatory strains) besides a very complete nutritional regimen from food (PHD) and supplements.

    Thank you very much Naomi, congratulations for what you have achieved! Keep us updated on your progress!

  25. Hi Paul — do you have any opinion on ice cream being beneficial? I am wondering this especially since the PHD is established as comparable to breast milk. It does seem like ice cream (especially vanilla) has a wonderful soothing quality.

  26. Hi Kathy,

    I think ice cream is a fine food, though I’d call it benign if made with PHD-compatible ingredients, rather than beneficial. Here’s our recipe: http://perfecthealthdiet.com/?p=2408.

    It’s definitely a dessert, not an entree. Eggs, lemon juice, blueberries, and cocoa are healthy components. The cream and rice syrup are empty calories, but very tasty!

  27. Ole,
    These recommendations are similar to the ones in the US, Denmark or France.
    They are Still based on the false assumption that animal fat is bad (causes cardiovascular illnesses and weight gain) which is NOT true.
    The original study showing that saturated animal fat caused CVD was done by a researcher actually using MARGARINE (all from hydrogenated fat at that time) and NOT animal fat.
    He thought standardized animal fat sources where impossible to find and margarine would be just as good.
    SO NO STUDY ever showed animal fat was linked to cardiovascular diseases.
    In fact as low fat became more popular, CVD incidence exploded!
    It may take another 10-20 years for governments to get it!
    Personally I am worried about new animal fats resulting from feeding animals Genetically modified corn and soy: another criminal large-scale experiment on man. Therefore, I do not eat pork fat and focus on butter (raw, from grass-fed cows).

  28. Chris D,
    The more I read the more worried I get about new and novel foods in general 🙂

    Regarding health recommendations I’m just puzzled by the fact that they got it so wrong and that they seem unable make basic changes, like the recommendation regarding margarine vs animal fat.

    I speculate that most of the recommendations are based on expert consensus made at WHO meetings/conferences and further that health authorities/experts has made unofficial agreements to follow “WHO recommendations” with the goal of standing together in the fight against “fad diets”. This all leads me to worry that most of the world health organizations are caught in a powerful groupthink.

  29. Paul,
    I have symptoms similar to Naomi. I have what may be histamine intolerance. I seem to especially react to alcohol and sugar, including fructose. Every morning I wake up with a runny nose, sneezing, and a headache. The symptoms are worse when I consume the previously mentioned foods. Sometimes I’ll wake up in the middle of the night feeling feverish, and my nose will start running and prevent me from going back to sleep. These issues began about six months ago and have been getting progressively worse. I’m also experiencing pain in my left, middle back area, possibly coming from the spleen.
    I’m concerned that I have some sort of infection, but I don’t have much confidence in my doctor’s ability to diagnose something based on my weird symptoms. I do plan on going to the doctor since my efforts at self-diagnosis and treatment don’t seem to be doing much.
    Previously, I thought I might have candida, but I’m not so sure anymore. Is there a way to distinguish between a candida infection and an infection such as Naomi’s? Do people with candida experience the sinus issues that I have?

  30. Hi Renee,

    The best thing is not to guess. Naomi got a diagnostic test – I recommend this: http://www.metametrix.com/test-menu/profiles/gastrointestinal-function/gi-effects-microbial-ecology – and it guided her toward parasite treatments.

    You’re right, it’s very hard to match symptoms to specific infections; thus testing is desirable.

    If you have a candida infection a stool test will show it. Candida, or circulating fungal toxins, can cause sinusitis/rhinitis and does tend to be flared by alcohol, so it’s possible. But many other things can cause the same symptoms, so I would try to get diagnostic testing done.

  31. Is it known why alcohol seems to cause flares of sinusitis symptoms? I’ve been very prone to sinusitis since a throat infection 4 years ago and alcohol seems to make my sinuses swollen almost immediately. Corticosteroids help to alleviate some of the symptoms, but I don’t want to depend on them. Acetylcysteine help against the thick mucus. I’m so sick of the constant sinus issues..

  32. Thank you for the quick answer! Have considered it being some kind of chronic infection, though I haven’t heard of fungal sinusitis though. What do you recommend, beyond the standard PHD? I’m contemplating anti-biotics (any certain kind you recommend?), though I know swedish doctors are really restrictive in their prescription of anti-biotics.

    • Hi David,

      PHD is a good diet, and circadian rhythm factors for immunity are important. Treatment options have to be discussed with a doctor as individual cases may call for different treatment.

    • Hi David,
      Interesting Q&A here on chronic sinusitis,
      http://chriskresser.com/the-highly-effective-but-little-known-treatment-for-chronic-sinusitis

      I’ve done salted neti pot washes before, but some of the info in this article may lead me to experiment further.
      may be by mixing one of these in to the neti as a test, not mixed, one at a time,
      – xylitol powder
      – nac powder (empty a capsule)
      – sodium ascorbate powder (vitamin C)

      the idea being that you are trying to break down biofilms in the sinuses.

      Paul, any comments…do you see any dangers of flushing any of these three though the sinuses?

      • in that q&a they mention a nasal spray or wash product by Xlear,
        http://www.xlear.com/nasal-spray.aspx
        which contains xylitol.
        hence the xylitol powder test.

        the nac idea was mine, driven by Paul’s views i’ve read regarding nac.

        & the Vit C idea, was from a user comment under the q&a.

      • Hi Darrin,

        There was the warning about brain infections caused by neti pot use: http://well.blogs.nytimes.com/2012/09/03/rare-infection-prompts-neti-pot-warning/

        Xylitol is a mixed bag, it feeds some microbes and harms others, some people it helps and some it hurts. It is mildly antifungal, and fungi are a common cause of sinusitis.

      • Thanks Paul,
        I actually learnt about the neti pot infection thing from watching an episode of ‘House’ 😆

        Apart from that caveat, any comments on using nac and sodium ascorbate powders (dissolved)?

        btw, at the time of that Feb 2012 q&a i linked, Chris Kresser was taking a slightly different stance with regards to fungi & sinusitis

        “extract of CK Answer: …I’ve read that Mayo Clinic thing,
        [Research by Mayo Clinic in 1999 found that virtually all (96%) cases of chronic sinusitis are caused not by bacteria but by fungus]
        and it turns out to be a little bit of a red herring.
        The consensus that I respect on fungus is that except for true fungal rhinosinusitis — which is what the technical term is for chronic sinus infections, chronic rhinosinusitis or CRS — true fungal CRS is easily diagnosable by the presence of eosinophilic mucin, but that’s actually pretty rare, and fungus in the nose is commensal, meaning it’s just part of the body’s natural terrain, and most cases of CRS have nothing to do with fungus being present, and furthermore, there is no good evidence that antifungal agents help in the treatment for fungal rhinosinusitis, which is relatively rare.
        So, I don’t actually buy the fungus hypothesis for that reason, and my view on it is that it’s probably more like chronic, recalcitrant, difficult-to-treat sinus infections are more related to biofilm than fungus, and particularly in those who have had surgery and those who have poor immune function.
        And there’s a bunch of studies that I’ve looked at connecting CRS to biofilm — and we can put those studies in the show notes for anybody that’s interested — but there are some pretty interesting emerging treatments for chronic sinusitis that relate to this biofilm hypothesis, and one of them is nasal irrigation with Johnson’s baby shampoo solution…
        (continued)”

        • in case you missed it hidden in my comment Paul,
          i had a follow up query,

          thanks for your comment on xylitol,
          any view on the other two (nac and sodium ascorbate) used in a nasal wash?
          (the goal being to attack any biofilms, as per the CK view).

          Thank You

  33. Hello Paul,

    i´m from germany and want you to ask to give me a view on histamine intolerance.
    thanks a lot in advance!!

    Marco

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