Bacteriotherapy Journal #7

Why I run so hard.

I’m so impatient. This is the one area of my life where I am, definitely, a typical american. Waiting is hard for me to do.

The last few days have been a waiting game. Wait for the sample. Wait for the infusion to settle. Wait for the next BM to see if it changed anything. Repeat.

Yesterday was my best day: 3 semi-solid, non-urgent BMs. Then I got cocky. I ate some rice with dinner last night. Don’t ask me why. I think I was 1 part anxious to be healthy and 1 part curious to see if my gut could handle it. It can’t. Not yet. Today by 1p, 3 loose movements. Oops. I’ve learned my lesson. Strict SCD from here forward.

I look forward to tonight’s infusion. Yesterday was the first infusion (of 3) that I was able to administer myself. I think I have the system down now: Pick up sample. Prepare sample. Administer sample. Read and roll horizontally for an hour until I’m confident I can hold it indefinitely.

I’ve been eating SCD yogurt, and taking a small amount of probiotic orally to account for the antibiotic effects on the rest of my system. I’ve even used my wife’s toothbrush (before she rinsed it; yes, she was disgusted)–all in the name of quickly and effectively replacing my flora with a normal one, all the way from the north to the south.

So, not much more to report. I still have good energy, and my bowels, despite three loose D movements today, are quiet, so hopefully I’m still on the upward climb to wellness.

I ran a hilly 5.3 mile time trial today through the woods, on local hiking trails. I broke 40 min for the first time ever. That’s something to cheer about indeed. 39:15. That’s a 7:29 mile pace, which is awesome for me on a hilly trail run. This will be the basis for my 10 and 20 mile efforts. Multiply my 5.3 mile pace by 1.2 and get my 10.6 mile goal pace.

The run was wonderful, and I felt strong. I’m thankful for that. I’m thankful for my donor, who is willing to be inconvenienced for me, on the chance that his waste could be my cure–his trash, my treasure.

Onward to Health.

Bacteriotherapy Journal #3

Day 4.

I Itch.

My body started to itch when I first started taking probiotics in 2009. I started too fast and ended up with hives all over. I quit them and the itching and hives subsided–but the probiotics made a real difference in my UC symptoms, so…I built up more slowly and could tolerate them, but I still itched. They improved my colitis, so I kept taking them.

Fast forward…

I’ve been off probiotics for a couple of months, yet I still itch. Maddening, blood-drawing itching. When I first took them, got hives and quit, the itching quit. Now, even the SCD yogurt gives me itching and erythema. I experimented, of course, to see if it was indeed the yogurt. Quit the yogurt, and my erythema went away. Meanwhile, the itching lessened, but never left. Now that I’ve started antibiotics, it has returned.

Maybe it’s the die-off that makes me itch, that makes my skin break out. If anyone out there has or has heard of a similar experience, I’d love to hear what you’ve learned.

I have suspicions (still unconfirmed) that my thyroid isn’t working right. I’m cold (all the time, new thing for me), moody, tired, I have dry eyes, and my basal temperature for the last couple of mornings (I’ve only just begun measuring it) has been 95 degrees.

Hmmm?

Can Aloe Help Treat IBD?

Nice Teeth! Bet you're a softy on the inside...

The purpose of this post is to explore aloe as it relates to IBD. In that sense, this post is somewhat of a heresy; it focuses on those aspects of aloe that are important to IBD, to the exclusion of others (such as arthritis, lupus, burns, etc.). I tried to keep it to the essentials, but it turned out long and geeky anyway. For that I apologize. Digest it in pieces (pun intended) if you need. I have included references at the end of this post, for those who want to dive more deeply into the aloe research.

Here are a few books about aloe and it’s healing properties:

Aloe Vera has been prized for its medicinal properties for over 5000 years. We have record of its use by Egyptian, Indian, Chinese, and European cultures. When we talk about Aloe Vera in terms of IBD, we are talking about aloe Vera gel—the mucilaginous polysaccharide, aqueous extract of the leaf pulp of Aloe barbadenisis Miller.

Aloe Vera gel contains more than 70 biologically active compounds. The active ingredient we will focus upon here is a β-(1-4)-linked mannan (trade name Acemannan, but collectively known as polymannans), the mucilaginous polysaccharide I alluded to above. Simply put, this is a very special, non-toxic[i] carbohydrate which has been shown to have anti-inflammatory (important for IBD), anti-oxidant (also important for IBD), immune modulating (important for IBD), anti-cancer (important for IBD), anti-diabetic, and general wound healing properties (also important for IBD).[ii]

First, All Aloe is not Created Equal

Aloe refers to the aqueous extract, the gel portion of the inside of the aloe leaf. Aloes refers to a mix or extract that includes parts of the leaf. The aloe leaf portion is a potent laxative. If you’re like me (with IBD), you don’t need a laxative. So, there are two principles to keep in mind when searching for aloe:

  • First, if you buy aloe juice (I recommend George’s Always Active Aloe Juice), or an aloe extract, make sure it doesn’t have the leaf portions of the plant in it.
  • Second, aloe begins to oxidize quickly (within four hours of harvest). This means it needs to be stabilized. Improper harvesting and stabilization methods can render the product essentially useless. There is an international governing body for aloe, the International Aloe Science Council, which sets standards for aloe and independently certifies aloe products. The IASC was founded to help standardize quality. If you buy an IASC certified product or a product from a certified producer, you’re more likely to get a good product.

Now to the fun stuff, the how and why of aloe’s potential benefit in IBD.

Polymannans in the Body

Polymannans, interestingly, bind to specific receptor sites on cell membranes which activate or stimulate macrophage activity (macrophages are scavengers, disposing of cell debris, monitoring for tissue damage, infection, injury, malignant changes, etc. They are very important little cells.). When macrophages find something, they call for help using cell messenger chemicals called cytokines. In a normal system, these cytokines are released in the precise amount needed to combat whatever is going on in the body. Even more interestingly, cytokine activity is stimulated by polymannans and seems to be disease appropriate, no matter the dose of polymannans. This is one reason that Aloe Vera is considered non-toxic; it helps the body produce an appropriate immune response, but for some unknown reason, never goes overboard[iii]. Cool.

The reason that polymannans are considered helpful for such a wide range of conditions is that they seem to activate the body’s normal mechanisms of healing, when it’s needed, where it’s needed, and in the proper amount needed.

For us as IBD sufferers, however, probably the most initially interesting property of polymannans is that they are not broken down by the digestive system. They are absorbed through the brush border directly into the blood, whole and unchanged. As if our bodies have known them since the beginning, we just leave the door open for polymannans to come on in; no need to knock, no need to remove your shoes. Just like glucose, the essential energy of life and long-term friend of all living things, our bodies seem to know we need polymannans. Hmm… Interested yet? I am.

Aloe Vera and Wound Healing

Macrophages are essential first responders in healing of wounds, they are the orchestrators of wound healing, if you will. Since we already know that aloe increases or stimulates macrophage activity the jump to decreased wound healing time isn’t hard to make; however, aloe has also been shown to stimulate fibroblasts to increase collagen and proteoglycans (never mind the names here—they are just two essential substances your body makes to heal wounds.) In 1989, Johnson, et al[iv]. demonstrated that aloe Vera gel was effective at stimulating the cell replication necessary for wound healing.

There have been many studies on the healing properties of Aloe Vera (think sunburn). I’ll give just one example here. In 1992, Swaim, et al.[v] conducted a study of fifteen dogs with paw tissue injuries. Twelve received triple antibiotic treatment on one paw and a polymannan gel on the other. Three dogs received no treatment. While all dogs healed, the polymannan wounds healed significantly better by day seven than did either the triple antibiotic or the untreated wounds. The aloe treated wounds healed faster. It has also been shown that aloe treated wounds heal with less scaring (if this is as true on the inside of our body as on the outside, then aloe is useful for at least that—reducing scar tissue as we heal from IBD. This could mean fewer problems with strictures and less colonic pain from scar tissue). The wound healing properties of aloe should be particularly interesting for those with ulcers as well as inflammation.

Aloe Vera as an Anti-inflammatory Agent

Inflammation is the body’s normal response to tissue damage. The trouble in IBD is that chronic inflammation leads to tissue breakdown which causes all sorts of problems. Inflammation is caused (generally) by chemical mediators in the body. In IBD, there are a host of inflammatory cytokines (cell signaling chemicals) that scientists discuss. Some of the more common are TNF-alpha, Interlukin-8, Interleukin 1-β.

Two of the inflammatory mediators released at a wound site are histamine and bradykinin. Histamine, most of us have heard of, but bradykinin is not a part of our normal vocabulary. It is one of the most potent pain producing agents the body produces. Reduce bradykinin and you reduce pain. Aloe has been shown to block both bradykinin and histamine production.[vi]

Aloe has been shown to increase anti-inflammatory response proportionately over time. This, combined with aloe’s non-toxic nature makes it an attractive alternative to NSAID and corticosteroids. Or, alternatively, perhaps aloe, when used as an adjuvant could decrease the dose of NSAID or corticosteroids needed.

Indeed, aloe has been shown to be effective in the treatment of peptic ulcers, in the prevention of peptic ulcers, in increasing colon health of gut-normal people, and as a treatment for ulcerative colitis (See below).

Aloe as an Anti-Cancer Agent

Aloe has anti-oxidant properties, and has actually been studied quite a bit with respect to cancer. When the colonic mucosa is damaged, there is an overproduction of reactive oxygen metabolites (a free radical). Increased presence of free radicals has been linked to increased cancer risk. Anti-oxidants, like aloe, protect the body by neutralizing free radicals. This action reduces cancer risk.

Aloe has also been shown to have cytotoxic effects on tumors (kills tumor cells), and has been shown to have other anti-tumor activity.[vii] Mannans and polymannans have also been shown to increase natural interferon production (interferon treatment can reduce tumors), and increase T-Cell production.

Aloe Vera in Ulcerative Colitis

Aloe Vera has shown promise in treating ulcerative colitis. We know that it has anti-inflammatory properties, anti-cancer properties, anti-microbial action, wound healing properties, and immune enhancing functions. In one study, Aloe Vera was shown to induce a clinical response (i.e., decrease in colonic inflammation) in patients with moderate UC more often than placebo. In fact, in this study the magnitude of the clinical effect of aloe resembled that of mesalazine.[viii] The patients improved both clinically and symptomatically.

With that said, the results of the testing of aloe have been mixed. Many trials have been too small, or not replicated. Many were conducted with different aloe extracts, making a cogent argument for the benefits of aloe difficult. Nevertheless, there is ample evidence of the benefits of aloe for those with the will to search and find it.

Should I Take Aloe? Will it Work as a Treatment for Me?

This is a decision you will have to make for yourself, but I can give you some principles and take away points to ponder.

  • Aloe is a powerful anti-oxidant, wound healer, anti-cancer agent, and anti-inflammatory agent.
  • Aloe has been shown to aid in moderating yeast and bacteria.
  • Aloe has been shown to enhance immune function and modulate certain cell communication mechanisms.
  • Aloe is non-toxic and natural.
  • Aloe treatment is expensive. The initial therapeutic dose of ~4-5,000 mg/day (for about 90 days) that most companies suggest could run you $6-700 dollars. But if it works, is it worth it?

My Story with Aloe:

I’ve been taking aloe in powder form (5,000 mg/day) for 65 days now, even though I’m a die-hard SCDer (Aloe is a mucilaginous polysaccharide; these are illegal on the SCD). My body is my laboratory, and I don’t encourage people to divert from the SCD, if it is working for them. This divergence was my choice, a difficult choice after 13 months on the SCD.

However, I felt that given all that I had learned about the benefits of aloe, the risk was worth the potential benefit—further healing. Since I started aloe, I have seen improvements in my energy levels, decreased gut healing times (if I eat something that irritates me, it irritates me less, and I rebound faster), recovery times after workouts have decreased, and I need less sleep (this one surprised me). I have seen my bowel movements solidify significantly compared to before I started aloe, and mucus levels in my stool have decreased over time (by visual inspection). As of this writing, I have had almost three weeks with no mucus, and fully formed stools (for the first time in two years). Things are continuing to improve, and I attribute some of the recent improvements to aloe.

Aloe is the first non-SCD-friendly supplement I’ve tried that hasn’t ended in major diarrhea and pain. I only take two other supplements right now: SCD-friendly vitamins, and SCD-friendly digestive enzymes. I get my probiotics largely from the yogurt and from fermented cabbage juice (I have some probiotics in my fridge that I take some from time to time, but I don’t take therapeutic doses of these anymore—they make my skin itch like crazy.).

My experience has been extremely positive with aloe, and don’t regret my choice. I think aloe has helped me.

What to Look for in an Aloe Juice or Supplement

Do a quick search for ‘aloe supplement’ and you’ll quickly get overwhelmed. There is tension for me in recommending a specific product or brand—there is so much behind-the-scenes brand endorsement going on out there, it’s hard to know who (or what) is for real.

With that said, I will highlight a few different products, but you should know that do not get anything for recommending them. I would feel more comfortable if you did your own research, called the company, and chose a product that you are comfortable with. You can use my recommendations as a springboard into your own aloe research.

Aloe Juice:

George’s Always Active Aloe products have no additives and are safe for IBD (remember that aloe is not SCD-friendly—it is a mucilaginous polysaccharide.).

Powdered Aloe Supplement:

June 22, 2011 Update: Thanks to one of my readers for pointing this out. Digestaqure has been named on ripoffreport.com, and has had 3 BBB complaints against it, where customers didn’t receive their refunds as promised. While I didn’t experience any problems with them (I got a full refund), caveat emptor is in effect here–Buyer beware. This goes for all of the aloe products below, really.

I also want to re-emphasize that I don’t get any compensation for mentioning or linking to the products in this post, other than those that go to Amazon.com, where Amazon, not the company, pays NDH a small commission for each sale. These commissions go directly back into maintaining this site.

Digestaqure makes a pill with 500 mg polymannans (this is what I’ve been taking). Their website is so disorganized and the inflammatory language against “Big Pharma” is so pervasive, that it can feel like the company is a sham (in reality, I think they’re just small). They reject the BBB as an empty shell whose accreditation doesn’t really speak to the quality of the business, and are eager to tell you why their product is real, and the best. It took me some significant time and research to become comfortable with this one.

They need a website designer and a copy editor/marketing person badly, but with that said, they offer an unconditional money back guarantee that is, so far as I can tell, totally legitimate. No other company offers this kind of guarantee. No need to return the product. If it didn’t work, they’ll give you your money back.

They claim to have the highest concentration of active, long-chain polymannans on the market, and they own their own supply chain from field to bottle (that’s important). Their customer service is outstanding. Their product is lab tested, but I had trouble getting a copy of the lab test results.

Aloe Elite makes a pill with 325 mg polymannans and 125 mg of L-glutamine. BBB certified, IASC Certified, outstanding customer service. A bit cheaper than Digestaqure, but you get fewer polymannans, and a pill with L-glutamine. So far as I can tell, Aloe Elite does not own their supply chain. They must buy their aloe from a third party. I couldn’t tell if this product was independently tested.

Serovera is another company that sells a polymannan extract. BBB accredited, independently lab certified, about the same price as the others. This one mixes the aloe with L-glutamine also; 325mg polymannans: 125mg L-glutamine.

And thus ends my treatise on aloe. Wheew.

Onward to Health.


[i] Tizard, et al. “The biological activities of mannans and related complex carbohydrates.” Molecular Biology. 1989; 1(6): 290-6.

 

[ii] Grindlay D. Reynolds T. “The aloe vera phenomenon: a review of the properties and modern uses of leaf parenchyma gel. J. Ethnopharmacology. 1986; 16: 117-51.

[iii] Ray Dirks Research. “The acemannan report.” Health Consciousness. 13(1): 43-46

[iv] Johnson, Alice R., Anita C. White, and Bill McAnalley. “Comparison of Common Topical Agents of Wound Treatment: Cytotoxicity of Numan Fibroblasts in Culture.” Wounds. Vol. 1, 1989, 186-192.

[v] Swaim, StevenF., Kay P. Riddell, John A. McGuire. “Effects of topical medications on the healing of open pad wounds in dogs.” J. American Animal Hospital Association. 1992. 28: 499-506

[vi] Davis, et al. “Isolation of a stimulatory system in an aloe extract.” J. American Podiatric Medical Assoc. 1991.81(9): 473-478.

[vii] Winters, W.D., R. Benavides, and W.J. Clouse. “Effects of aloe extract on human normal and tumor cells in vitro.” Economic Biology. 1981. 35(1): 89-95.

[viii] Sutherland L.R., et al. “Sulfasalazine revisited: a meta-analysis of 5-aminosalisylic acid in the treatment of ulcerative colitis.” Ann. Intern. Med. 1993; 118(7): 540-9.

SCD Recipe: Stuffed Pumpkin

Saturday, NPR did quick story on Dorie Greenspan and her new cookbook, Around my French Table. The recipe they chose, Pumpkin Stuffed with Everything Good, sounded so amazing, that we just had to try it–SCD style.

So yesterday we gave it a shot. We took Mrs. Greenspan’s recipe (linked above) and modified it to fit the SCD. Wow! It was so good, I just had to share it here with you. Try it! It’s great fall, cold weather, SCD-friendly, comfort food. Check out the pictures below and see how it turned out.

First, the recipe:

SCD-stuffed Pumpkin

Makes 2 generous servings (even I, with a hollow leg, couldn’t eat it all)

  • 1 small pie pumpkin, about 3 pounds
  • Salt and freshly ground pepper to taste
  • ¼ pound Almond Bread (1/3-1/2 loaf), thinly sliced, toasted and cut into 1/2-inch chunks
  • ¼ pound cheese, such as Gruyère, cheddar, or a combination (you can add whatever cheese you like here), cut into 1/2-inch chunks
  • 2–4 garlic cloves coarsely chopped and sautéed* in olive oil
  • 4 strips SCD-friendly bacon, cooked until very crisp, crumbled
  • 2 large handfuls of fresh spinach
  • ¼ of a small onion or ¼ cup snipped fresh chives or sliced scallions
  • 1 tablespoon minced fresh thyme
  • About 1/3 cup SCD cream (I used just a little bit more)
  • Pinch of freshly grated nutmeg

Directions:

Preheat your oven to 350. Wash the pumpkin. Cut an opening in the top of the pumpkin, just like you would for a jack-o-lantern. Scoop out the guts and seeds. Mix together all the above ingredients in a bowl. Stuff the pumpkin with the stuffing mix (pack it full!). Place the cap back on the pumpkin and bake on a parchment covered cookie sheet in the center rack of your oven at 350 for 2 hours.

Mrs. Greenspan recommends removing the pumpkin cap for the last 15-20 min of baking. This cooks off some of the moisture and browns the top of the stuffing. We did this and it was wonderful.

Carefully move the pumpkin to a serving plate. Be careful! The hot pumpkin will be flimsy and fragile. To serve, split the pumpkin with a long knife. We liked opening it like a flower; the presentation was wonderful that way. Scoop out the stuffing and pumpkin flesh together when serving.

Almond Bread: Use your favorite almond or cashew bread here. The one we like is a published recipe from another author, so I don’t have permission to re-publish it here. Just toast, grill, or broil it thoroughly (careful not to burn it) before you throw it in the mix.

To make the SCD Cream: Ferment 2 cups heavy cream with ¼ cup yogurt for 24-28 hours, being sure to keep the mixture warm (90-105 degrees). You make this cream just like you would make SCD yogurt. Check out the yogurt directions for more detail. This cream is great for other things too. Make ice cream; use it in cheesecakes, and other deserts.

* Sauté the garlic to tame it. You can do this with the onions too. It makes them much more palatable to our damaged guts. For example, I can’t eat any raw garlic, but I can eat all the sautéed garlic I want.

Onward to (Yummy) Health.

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Podcast: Surviving the SCD Intro Diet

This is the second in a series of joint podcasts with Jordan and Steve from SCD Lifestyle. We discuss our experiences on the SCD intro diet, and give tips for surviving it with style.

Highlights from our conversation are below. As always, I welcome all suggestions and comments, especially ideas for future podcast topics. Enjoy!

:56 How did you go about executing the intro diet?  What did you eat?

11:05 How to get past the “what to eat for breakfast problem…”

12:40 What about doing the yogurt during the intro diet?

16:00 How do you deal with the emotional challenge of needing variety during the intro diet?

27:00 Psychology is 80% of the SCD Intro Diet…

29:10 What was die off like and how did you deal with it?

31:00 How do you deal with the fear that you aren’t getting enough calories to survive?

40:00 Knowing what you know now, how would you go back and do the intro diet over again to make it a better experience?

Onward to Health.

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