AAAAAND, WE’RE BACK! (episode 3: kim’s deal)

quick disclaimer: all the stuff i write about in my adrenal blog posts are relative to my own personal experience and recommendations.  what was recommended to and worked for me may not work for you, so please proceed with caution and enlist the help of a naturopathic doctor in your area for the best + safest results!

10/26/15
ok sorry guys for dropping off and lagging on this post.  we had some employee turnover that i had to handle, which left me little time, energy or motivation to completing and posting this post.  i am working on the mantra ‘done is better than perfect’!  here goes:

7/2015
warning: this one is kind of long and boring (if you’re not into this stuff, and especially since it’s not about you! :)).  you can scroll to the bottom if you just want to skip the explanations of each test, and see a quick review of what my blood, spit and poop said, and dr. fig’s recommended plan of action for me.

so a month had gone by, and until i got my test results (which was around july 10, 2015)  been able to live like normal, more or less.  the impending doom of all the gluten i can’t eat and who knows what else is weighing on my mind, but i’m not that upset about it.  i just remember how shitty i feel and how awesome it’s going to be when i have more energy to be active, the much better mood i’ll be in, and how i’ll get to wear all my ‘skinny’ clothes again after losing 30 pounds – and i’m motivated.  when i see happy, healthy and fit and buff people out and about, it reminds me how these changes i’m making now will positively impact my longterm health and happiness, and that i can do it!

how does this not look amazing?!growing up chinese american, i never really ate much wheat.  we had bread in the house for my mom and grandparents (they’d have it soaked in their morning instant coffee) but i just never really got into it.  i suppose my body intuitively knew gluten wasn’t the best for me.  i was a rice girl.  my favorite comfort meals were (and still are) most always involve white rice at some capacity.  as i got older and started growing ‘healthier’, i switched to brown rice and quinoa – but relished eating white rice anytime i had it; what a treat.  rice bowls!  rice porridge! sushi rice and ribeye steak!  nigiri and sushi rolls!  rice crackers and rice noodles!  and of course, sake, which is distilled from rice.*

any leftovers got a fried egg on top; over easy so that yolk could sauce everything up.  especially with ones i get from local farmer to deliver free-range, organic eggs to me every other weekend**.   pastured eggs are one of our favorite, quick and nutritious forms of protein.  yum yum yum!

sure, i’d get bloated sometimes after eating rice, but it didn’t seem to happen so much (or cause pain) that it was a problem.  wheat and gluten, were on the same boat – but not only bloating, fatigue came along too.  sometimes i’d eat it and feel ok, and sometimes i’d eat it and yawn all day.  but upon discovering della fattoria’s delicious seeded wheat bread, i ate it more (and noticed feeling even more tired).  so i did my best to lay off the gluten – after all, after hearing so many tales of going gluten-free had changed lives, i suspected this would be a culprit for my body’s behavior right now.

TEST RESULTS
sitting in dr. fig’s office, we go over the test results one by one.  she first started off with the adrenal test, which would have some questions the stool test could answer, which would have some questions the food allergy test could answer.  (happy to share the full reports to anyone that’s interested in seeing them, just ask! email frontdesk@skinsalvationsf.com).

adrenal test resultsDIAGNOS-TECHS, INC. – ADRENAL STRESS INDEX

‘energy graph’
looking at the cortisol test, the first page had a graph.  the graph has a ‘normal range’ lime green stripe, which shows the average cortisol output of a healthy human.  my line, a dark blue solid line, showed that my levels were on the low, if not lower than normal, end of the norm.  it seemed that as soon as i woke up, my cortisol was already at the low end of normal, which persisted, until about 4pm when my energy was it’s lowest – pretty much at the rock bottom of the chart.  then, i had a tiny energy boost right around midnight before going to sleep.  (this totally made sense, as i often complained of being tired upon arising, getting REALLY tired around 4-5, but then somehow getting a bit of energy at night before sleep; i had always attributed this to just being distracted at home with ‘home stuff’ – cooking, cleaning, socializing or being on the computer’).

along with this ‘energy’ graph, a few other hormones were detected and their roles explained.

dhea
my DHEA was on the high end of what’s normal (10 out of a range of 3-10).  DHEA is a “hormone made in the adrenal glands and in the brain, and leads to the production of male and female sex hormones..  typically, those with high DHEA can have oily skin, acne, among other more serious side effects.”

insulin
diabetes runs on the paternal side of my family, and after a borderline high blood sugar test a few years ago, i had been conscious of consuming sugar (both ‘sweet’ and refined grains kind of sugar) and making sure to have veggies with every meal.  exercising was on my mind, but lately i hadn’t had the energy to even go for a walk, let alone flat out work out.

i had tested just below borderline elevated (5 out of the borderline 6-25) so that was good; but not great.  the results explained that “insulin is tested because insulin activity is affected by the stress response.  chronic stress with cortisol elevation may counteract the effects of insulin, and may lead to functional insulin resistance.”

nothing to freak out about (right now), but something to keep watch of, and to be aware that my stress was a factor in this category.

total salivary SIgA
what is this thing?  the test says that “it’s the predominant antibody found on the mucosal membranes throughout the body.  one of it’s main functions is to bind to antigens and prevent their adherence/admittance into the body.  typically it moderates the mucosal inflammatory response…” and that it “may be associated with some autoimmune conditions, diabetes, gingivitis, ulcers, and inflammatory conditions.  in addition, acute physical or emotional stress can transiently raise values.”

and since i didn’t have any ofl the aforementioned autoimmune conditions,  here was another marker that my stress was an issue – so much that i tested abnormally high on this one – 39 mg/dl out of a normal 10-20, and borderline high of 21-25.

gliadin
ok.  so “gladins are proteins found in wheat, rye, barley and other grains which may trigger an immune reaction in some individuals.  a positive response to gliadin may warrant further diagnostic workup and/or dietary elimination trial in some patients. lab results should be used in context of the entire clinical picture.”  (which is why the stool and food allergy testing was such a good idea – thanks dr. fig!).

in this test, i had scored again, very high.  i got myself a 32 out of a borderline 13-15, and positive result of 15+.

———


DOCTOR’S DATA INC. – COMPREHENSIVE STOOL ANALYSIS
interested to see what else my guts were doing with the really high gliadin response, we now moved on to the stool test.  this test was divided up into sections for each enzyme, each with its own job.

bacteria
i had some good bacteria (but lacked lactobacillus, interestingly enough.  maybe because i don’t consume fermented dairy, and my probiotic doesn’t have this in it?  could also be because my gut’s environment couldn’t sustain it) and had some not so good (but not really bad) bacteria.  dr. figoski explained that this ‘not great’ bacteria could have been from any source – be it from trips involving drinking water or iced drinks in foreign countries, to eating ‘regular’ domestic food at home.  no real way to tell, but just to work towards cleaning it out and replenishing good bacteria.  luckily though, no really bad (dysbiotic) bacteria or yeast was to be found.

digestion + absorption, and all my short chain fatty acids
were all good!  woo!

inflammation
lysozymes are enzymes that are excreted at sites of inflammation in the GI tract.

under 600 is normal; i had 1140 (!).

immunology
another enzyme that has to do with mucosal tissues, “secretory IgA” is the “first line of defense of the GI mucosa and is central to the normal function of the GI tract as an immune barrier.  elevated levels have been associated with an unregulated immune response.”  this meant that my body’s immune system was working extra hard, all the time, to fight off ‘invaders’, which could explain my terrible seasonal allergies (as well as responses to things like dust and molds).

the normal range of this enzyme is 51-204, and i had tested 1240.

intestinal health markers
lastly, the pH of my poop would tell us about how the fermentation of fiber by the beneficial flora of the gut was doing.  it was a little low (5.6, normal range was 6-7.8).  but dr. fig wasn’t too worried about this – we had other bigger problems to deal with.

so, what foods are physically irritating my guts, and causing so much inflammation?!  now the finale – the food allergy test.
——

us biotek's general food panel
US BIOTEK LABORATORIES – GENERAL FOOD PANEL 
the quick and easy test dr. fig administered in my office the day of my testing consult a month ago is based on a scale of 0-6.  ideally, of course, the foods we eat have little to no reaction in our blood.  the idea is that if you are constantly exposing your body to allergens that rate 4-6, it’s natural that things 3 and below are probably going to be really irritating too.   when this happens, the body treats the offending foods like allergens, and manifests in the body in different ways: rashes, headaches, fatigue, even acne, in some.

so, dr. fig’s got me on a conservative plan – not only because these foods show up as irritants, but are also inflammatory (because they are irritating my guts, but also – like for example, sugar and corn – inherently are) – but also maybe she sees it in me to be 100% compliant?

on a scale of 0-6:
0 – no reaction
1 – very low
2 – low
3 – moderate
4 – high
5 – very high
6 – extremely high.

the basic food test i took has a panel of 100 foods, and these are the only ones that showed up as irritating, and therefore are the foods i am to avoid for at least 2 months:

DAIRY
casein (3)
cottage cheese (3)
mozzarella cheese
milk (3)
whey (4.5)
yogurt

MEAT
chicken egg whites (5.5)
chicken egg yolks (5)
duck whole eggs (3)

FRUIT
banana (2.5)
cranberry (2)
pineapple (3)

MISC
sugar cane (3.5)

FISH/SEAFOOD
none!

GRAINS/LEGUMES/NUTS
corn (4)
wheat gliadin (3)
wheat gluten (3)
oat (3)
write rice (3)
spelt (3)
whole wheat (3.5)

VEGGIES
none!

these restrictions sort of make up a diet close to the candida cleanse, except that i can’t have eggs.  and it’s also sort of like a gluten-free diet, but i can’t have rice or corn.  my beloved eggs and rice!  and no tortilla chips!  this makes it pretty challenging, since a lot of paleo recipes use a lot of eggs, and gluten-free alternatives are often based on rice or corn.

all the more diligent i must be, to 1. cook my own food, 2. and source responsibly.  i’ve got to read my labels even more, and have an even more watchful eye on not only cane sugar but also brown rice sugar/syrup – which is in almost everything that’s packaged.

with a bit of pinterest-ing, i found that this diet more or less makes up what’s called an “auto-immune paleo” diet – one that’s meant to be eaten for a short while (1-3 months) to allow the body to “reset and heal”, before reintroducing foods one at a time to see how my body reacts (if at all).

in many ways, it’s a mirror image journey of the clearing process at sS – allowing the 3-6 months of acne purging, while abstaining from the potentially acne-causing aggravators, before getting to a clean slate (clear skin!) and reintroducing possible triggers to see what substance causes acne-formation, if any.

on the bright side, it’s very cool that we are in this together 🙂

NUTSHELL SUMMARY OF TEST RESULTS 
my adrenal test said that i indeed was low on energy, and had certain hormones that get excreted when the body is (in my case) under a lot of chronic stress-related inflammation (i tested 39, when normal is 10-20), and exposed to gliadins (proteins found in gluten – i tested 32 and 15+ is considered reactive).  my blood sugar was also borderline high, but is probably attributed to the chronic stress.

my stool test revealed that enzymes excreted when inflammation in the GI is present and when the immune system is working at capacity at long intervals were abnormally high (one was double and other was 6 times the norm) – again probably due to the chronic stress and foods that were irritating my guts.

finally, the food allergy test showed the foods that my blood reacted negatively to; which probably were directly responsible for inflaming my gut so bad, and causing my immune system to work triple-time, which stresses the body out (and inflames it).

all in all, it’s a cycle of stress (mental and physical) causing irritation that’s causing inflammation, and it’s manifesting in my body via fatigue, depression, and frequent headaches, along with allergies.

PLAN OF ACTION
basically, i need to take a ton of supplements to restore much needed nutrients that my body needs to run efficiently and heal itself, avoid the foods that are aggravating my guts (literally), and manage my stress (probably the hardest part of the plan).

pills pills and more pillz

this picture shows the different pills dr. fig has me taking, but doesn’t include the inflammation controlling glutamine powder, or adrenal support tinctures that are also part of the mix.  my daily supplement schedule is as follows:

AM (breakfast)
2 – active vitamin b pills
1 – vitamin c capsule
1 – omega 3 capsule
1 – hydrochloric acid (stomach acid to help digest food and prevent bloating, gas, etc)
1 – squirt of adrenal support tincture
1 – scoop of inflammation controlling glutamine powder, in water

LUNCH
1 – hydrochloric acid pill
1 – vitamin c capsule
1 – omega 3 capsule
1 – squirt of adrenal support tincture

AWAY FROM FOOD
2 – zyflamend (taken away from food so it can work better at managing inflammation vs. digesting your food)

PM (dinner)
1 – hydrochloric acid pill
1 – omega 3 pill
1 – vitamin c pill
2 – neurocalm (or relaxed sleep herbs) – this is so that i can get restful sleep, because i have had active, stress- and dream-filled dreams for weeks which makes for even more fatigue in the morning.

8/3/2015 – 3 weeks in
i definitely felt some detoxing in the immediate 2 weeks after starting the diet (headaches, muscle tension, light-headedness after eating, and changes in bodily fluids).  after an hour or two of serious road rage while in the ovulating days of my hormonal cycle, i could slowly feel i had a mild boost of energy and a generally more positive outlook.  managing stress though, is still a struggle – and i think it will continue to be.  but in the days following, i was in high enough spirits to buy a new bicycle, and motivated enough to ride it around on errands (ok, maybe one so far).

a couple of hours’ of shopping at sf’s beloved rainbow grocery co-op and carefully reading labels, coupled with lots of pinterest-ing and google-ing, motivated me further to keep on the food part of the plan.  food has always been a big part of my life, and it sucks that i can’t go out and eat sushi, have chips and salsa, eat chinese or just a burger so easily (for now), i look at these diet restrictions as a new way to get creative with eating even more healthily.  and luckily, i’ve found some delicious recipes along the way!  in the coming weeks i’ll be posting what i’ve been cooking and eating on our blog, facebook, pinterest and instagram.

adrenal fatigue part one: running a business, is catching up with kim and wearing her down

quick disclaimer: all the stuff i write about in my adrenal blog posts are relative to my own personal experience and recommendations.  what was recommended to and worked for me may not work for you, so please proceed with caution and enlist the help of a naturopathic doctor in your area for the best + safest results!

empty on gas

i think it’s safe to say that everyone knows that running your own business takes a lot of blood, sweat and tears..  and time, patience and hard work – among many other things.  being raised by a single mom, i always knew that hard work was going to be part of the game of life.  yes, juggling all the tasks of owning a business alone is tough, but it’s even harder when you feel like poop.  all.  the.  time.

for the last two years, sS has gone through some major growth – and growing pains.  a major buildout and relocation.  running a busy clinic.  employee management (hiring, training, firing, repeat).  (trying to) write and finish the acne book.  reformulating and rebranding products, and getting them ready for distribution.  doing most (if not all) the company’s blogging, instagramming, facebooking, marketing, bookkeeping, buying, receptioning, networking.  working with a business coach.  etc etc etc.  lots to keep me busy.  the best part of all this though, is that over these last two years, we’ve been able to help over 500 clients get and stay clear.  if we go all the way back to when i opened sS in 2008, the total numbers would likely reach close to 1500.

it was only at this past new years’ dinner at bar agricole did i realize, after talking with an entrepreneur who was sat next to me at the bar, all that really was on my plate.  he asked, “how was your year?”  “to be honest,” i said, “2014 was the year of ‘what did i get myself into’.  i’m working really hard, and not only my mind but my body, is stressed out – it’s very hard to keep motivated, managing this all alone, and i kind of really wish i could just run away.”  i described all the projects i had been working on for sS and he simply said: “it makes total sense that you are overwhelmed.  you aren’t running just one business.  you are actually running four.  the clinic.  formulating and retailing products.  writing a book, and distribution of products, let alone trying to open new locations.”  that was a total a-ha moment.  this epiphany helped to alleviate a lot of my mental stress, for sure.  i still had to DO the work, but knowing that as a single person, i could only do so much, really helped me get through the winter of 2014/2015.

physically though, i was not doing great.  especially for having given up a lot of the recreational wining and dining (which was my vice) that was the ‘play hard’ to my ‘work hard.’  i felt way too tired ALL THE TIME, for someone my age (32), who was eating high quality + healthy food and living a relatively healthy, yet busy, lifestyle.  i actually felt like i had more energy when i was eating dinner late into the night, with friends and cocktails.  but now, i felt that my nervous system was very sensitive, and that my adrenals were taxed.  something benign like a loud motorcycle running past me would literally rattle my nerves, leaving me feeling like i was crashing hard after a (very long) adrenaline rush that one might get after almost getting into a car accident, or some other situation where my life was in danger.  i felt weak, and had no energy to be active.  the lack of exercise, coupled with my daily driving commute, helped me gain 30 pounds in the last year.  after a full night’s of solid, uninterrupted sleep, i’d wake up exhausted.  i had learned to just push through it, and tried seeing a functional chiropractor, got weekly acupuncture for over a year, worked with a nutritionist, got regular massages, meditated, etc etc and after all that – i was still tired, both physically and mentally.

finally, after being fed up with being both fat and tired, regular headaches and a long-term dose of low-level depression, i finally decided to step my game up and see dr. laura figoski to get control of my life back.

dr fig!

to be honest, i had seen laura over a year ago and at the time, was not 100% dedicated to her treatment plan.  in retrospect, i think i was just not ready.  this probably was because i had just gone through a similar process with a nutritionist, while at the same time relocating sS to mission and 21st.  though i was under an incredible amount of physical and mental stress, i was really strict with her protocol and actually felt much much worse on it.  this nutritionist had me do some bloodwork (which, to her credit, definitely revealed some important things) which she tried to interpret for me – she’d identified some adrenal imbalances (it was a little low), abnormally high iron levels in my blood and borderline type 2 diabetes blood sugar levels.  after a solid 6+ weeks of compliance, i was still feeling much worse on her protocol than before it, so i consulted laura for a second opinion.  dr. fig was able to give me a bigger picture of what the bloodwork was saying (that perhaps this was all due to a poorly functioning liver), and had me take a blood test which ruled out hemachromotosis (a genetic defect in which the blood stores abnormally high amounts of iron, which can cause lethargy, and also be lethal).  laura put me on a liver supplement and, with regular psychotherapy and bodywork, i started feeling a bit better.  i was still tired, but i just continued to push through.  i wasn’t as exhausted as i was during that month of the move, so i was content with where i was at.  i had much work to do, and felt ok-ish enough to keep pushing through.  at this point, kate (a former office manager) had quit, so there was no one else to run the show but i, and i felt i didn’t have the time for self-care.

so a year passed by, and then june 2015 rolls around.  i’m still exhausted, and, after realizing i only had 2 pairs of stretch pants i could comfortably wear because of the extra 30 pounds i’d gained in the last year, i finally decided to see dr. laura again.  i knew i had to exercise, but i was too tired to do it.  plus, i just felt like something was wrong – but i didn’t know what.  an email to kaiser about adrenal fatigue yielded a response of “adrenal fatigue is being thrown around a lot these days.”  at a women’s entrepreneur brunch, i met a colleague who lost weight, had vastly improved her digestion, and gained a ton of energy from taking the alcat food allergy test.  she said that by avoiding gluten and oregano, she felt a million times better.  i knew dr. fig administered this test, so i booked an appointment with her to get this done.

when i got to see dr. fig, we talked about my symptoms, and i was hopeful that figuring out the maybe 1-3 foods i was reactive to, would solve all my problems.  (yeah right!  so silly.  geez.).  she explained that taking a more holistic snapshot of what my body’s systems were doing would be more informative than just zeroing in on food sensitivities.  so, she suggested i take 3 different types of tests, instead of the 1 mondo food allergy test – for about the same cost.   the tests i ended up taking were: adrenal (saliva), gut/intestinal (stool), and food allergy (blood).  taking just the food test alone would have been only 1 part of the puzzle (like switching to acne-safe products but still drinking milk by the gallon) – and as we know, all the body systems work together, and also affect each other if one system is imbalanced.  (fyi: the tests, all combined, cost about $600 out of pocket; though an HSA or FSA would likely cover it).

it would take several weeks for all the test results to come back, and i figured, the time would pass anyway.  i would be busy with work, training our newest esthetician, liesse.  i had a couple of trips planned, and could eat and drink everything with abandon before i got the test results back that said i couldn’t.  🙂

so july 6, 2015, came doomsday.  this was the day laura revealed to me the results of the tests i had taken a month prior, and what our plan of action would be.

dun dun DUN!!!!

stay tuned for the next episode of my journey, working through my adrenal fatigue, with a naturopath.  next up: the testing process, reveal of my test results, and my action plan + dietary guidelines/restrictions!