One year of NSD

Posted by: Kellybells

One year of NSD - 01/20/18 06:19 PM

Where I started

I found my way here a year ago. I had just seen a rheumatologist about debilitating pain, swelling, and stiffness in the finger joints of both hands. It had started 10 months earlier, a few months after hurting my right hand in a bike accident. It got so bad my hands were unusable every morning. And it was getting worse, with stiffness and swelling lasting longer each day.

While waiting for test results, I went searching. When I learned about the NSD a light bulb went on. I had already given up dairy and grains, having linked them to my rosacea and severe knee arthritis. But I had always felt I was missing something. I would still have painful days that I was sure were food-related but I could never pick out the pattern. I don't think I would have ever figured out starch on my own.

I started NSD the next day. Within days I felt better. And 2 weeks later, my finger stiffness and swelling were almost gone. And so were a bunch of other symptoms I had thought unrelated: sharp tendon pains in my knee and groin, pain in my neck and upper back that often came with brutal headaches, throbbing pain in my left hip, and overall body stiffness, especially in my spine. My skin improved, my mood improved, my energy levels soared. It was an amazing turnaround in the dead of winter, when i usually feel my worst.

The early days: very low starch tolerance

Still, the first month was tough. Finding a truly starch free diet was hard. Apple juice, nuts,  mushrooms, carrots, collards, cabbage - these all tripped me up at first. I would think I'd had a good day, only to wake the next morning in pain. I was frustrated. I lost weight I didn't want to lose. But I eventually landed on a base diet of eggs, meat, zucchini, and leafy greens like spinach and chicory, and slowly added from there.

I used to track my daily starch intake. I quickly discovered that I could eat up to 2 grams of starch and generally be ok. But starch levels can vary, so I took iodine everywhere. 

After a really bad week of accidental starching, I tried a short water fast. I definitely felt better. But I hated every minute of it. Definitely not for me.

The protocol: 'weed and seed'

After a month or two, I got the hang of it. Pain levels hit 0-1. But I wanted lasting change, so I started a 'weed and seed' protocol: 6-8 weeks of proibiotics alternating with 1-2 weeks of herbal antibiotics (berberine, goldenseal, oregano oil, peppermint oil, etc.). I don't tolerate regular probiotics - I break out and get constipated - so I take soil-based probiotic like Prescript-Assist.

After several rounds and faithful NSD, I now find I can tolerate a little more starch. If I eat a single high starch meal, it's only a mild reaction, if that. And now I can regularly eat very low starch foods, like carrots and winter squash, which had previously been a problem. My tolerance is up to about 5 grams a day now - a modest improvement but one that gives me many, many more choices.

Sticking with it

I've read enough success stories to believe that starch tolerance can improve with strict NSD. I want to be that person. Someday.

In the meantime, my weak spot is Christmas, and this year was no exception. Cheese, crackers,  bread, cookies: these dominate my holiday landscape, especially at work. So like most years, I indulged. I was in major pain. And I have not bounced back quickly. I've been back on a strict NSD for weeks now, and while my pain is back down to a 1-2 most days, it's not gone. My finger joints still hurt to the touch. My neck pain and headaches persist. But I'm not worried. It's amazing knowing that I can control this. A few more weeks and I expect I'll be my usual 0-1, mostly pain free state.

Despite this gleeful leap off the wagon, I'm not back to where I started one year ago. My pain is a ghost of what it used to be. And my stable of starch-free recipes (which I will continue to post) is growing. I eat a healthy, balanced diet, and I'm able to exercise more, and longer, than before I started.

I continue to follow my protocol. I've been taking gelatin lately to undo the damage I did during the holidays. Otherwise, I take no meds or supplements, except for a very occasional NSAID for my worst headaches.

I'm really happy with my progress and where I'm at. NSD has been a life changer. My sincere thanks to everyone here at KickAS for making this possible. I am eternally grateful for your insight, advice and support.
Posted by: mulehound

Re: One year of NSD - 01/20/18 06:40 PM

I can totally relate to everything you said. I stray now and then thinking I am now normal and body reminds me that I am not. Way to go does my heart good to see your success. This place saved me in more ways than one.
Posted by: Robin_H

Re: One year of NSD - 01/20/18 06:53 PM


thanks for sharing. Your pain descriptions and duration sound similar to mine and so I have hope. I just lack the discipline to eliminate nuts and coffee. Yesterday I also had NY cheese cake and Hot and Dry Noodles but the effects are rather dull, which is a good sign that the gut is slowly getting stronger. I just ate the last bit of nuts in my house (again).

My gut tells me (no pun intended) that if I have the patience to stick to strict NSD for just a month then my resolve will be even stronger because of the sense of benefits. Sadly I want instant gratification from a pill.

Speaking of which, this poop/fecal organization might be of help.

We must endeavor to get a rich microflora that allows us to eat most anything without fear just for the sake of long term health. The NSD diet is probably too restricted for the long-term and not contributing to a robust neuro-immune system.

Where are you posting your recipes? Without starch I get hungry fast or just don't loose my cravings for carbs. Drenching my steamed vegetables with butter helps satisfy me.

Thanks again,
Posted by: Exacta

Re: One year of NSD - 01/22/18 03:05 PM

Appreciate the journal. Those indulgences are not worth it. It's often not as easy as you think to get back to 0 pain once you are flared.
Posted by: Anonymous

Re: One year of NSD - 01/23/18 05:33 AM

Originally Posted By Exacta

It's often not as easy as you think to get back to 0 pain once you are flared.

NSD or not it is never easy to get yourself back to 0 pain after a A.S. flare up. That is more to do with the disease than whatever diet you are on.
Posted by: Kellybells

Re: One year of NSD - 01/23/18 08:06 PM

Thanks guys. NSD is a lonely road. My partner, who also has food sensitivities (he eats low FODMAPS for IBS) is really supportive and accommodating, but everyone else in my life has trouble wrapping their head around it. Team lunches, work meetings, dinners out with friends are all really hard. I feel really lucky to have this forum.

As for Christmas, I confess I did it with eyes wide open! I knew what I was doing, what the cost would be, and did it anyways....each day off the wagon was like watching my own slow motion train wreck, except it was also delicious.

Today was a 1, so I'm optimistic I'll be through this soon. But I won't be in a hurry to do this again, at least not too soon.

I'm curious: what's the longest you've gone without falling off the wagon?

Robin: there's a recipe forum on KickAS that I've started posting to. I've only posted 2 so far but I have others in the pipeline, coming soon.
Posted by: ranger7

Re: One year of NSD - 01/23/18 09:21 PM


I’ve been on NSD for a year now and feel much better but still have gut related issues. Bloating and constipation is constant - probiotics make me even more constipated, seems like you had the same issue. I tried Natren, GutPro and bunch of other ones. Are the prescript assist probiotics better? I need to do something and those are ones I didn’t try yet. Any side effect from using them?

Thank you.
Posted by: Robin_H

Re: One year of NSD - 01/24/18 08:12 AM

Hello ranger7:

Try adding magnesium supplements. Depending on the dose size and chemical form they can loosen up stools.

I think that coffee is a barrier to my gut healing. But if I don't have two cups in the morning then I am constipated. My body has a learned ritual that keeps me hooked. Caffeine is a signaling molecule to my but (with news paper in hand). Some rituals are religions.

Proboitics is regular in my diet (no pun intended) but I have recently started trying bentonite clay to help heal the gut. The FDA requires manufacturers to put warnings on them to not eat it. However there is a "food grade" version but that might mean that there are simply additives to make it mix well with water; pure bentonite clay will not mix with water. The pros, cons and well settled facts about bentonie clay are for another thread.

Hope this helps
Posted by: Robin_H

Re: One year of NSD - 01/24/18 08:22 AM

I just want to add or ask...

Is our diet too restrictive and hence reducing the variety of species in our gut and hence reducing the robustness and tolerance of our immune system?

Could we be in a state like a new born baby that needs to sample the world to teach its gut and immune system what is good and bad?

All that being said I recall something being said about babies having stem cells that allow them to build that robustness in their immune system. As adults have we lost that stem cell ability to relearn that robustness?

Evidence shows that fasting triggers stem cells in the pancreas to produce new cells that can produce the enzymes to digest sugars. Can fasting do the same for neurological, immunological and other cells related to the gut?

Are there people out there that have found that monthly fasting increases their starch and food tolerances? Are there people out there that never miss a meal and seem to be not improving?

If you have answers to these questions then perhaps new subject threads would be best.

Posted by: Kellybells

Re: One year of NSD - 01/24/18 11:20 AM

Originally Posted By ranger7
I’ve been on NSD for a year now and feel much better but still have gut related issues. Bloating and constipation is constant - probiotics make me even more constipated, seems like you had the same issue. I tried Natren, GutPro and bunch of other ones. Are the prescript assist probiotics better? I need to do something and those are ones I didn’t try yet. Any side effect from using them?

The Prescript Assist has been really, really good for me - I'm more regular and my skin is clearer. Total opposite of how regular acidophilus probiotics make me feel. The only side effect is to my disposable income - they are pricy and I take two a day.

Apparently my reaction to acidophilus probiotics is not uncommon among people who have SIBO (small intestinal bacterial overgrowth), which is strongly linked to constipation and rosacea. I've often wondered if SIBO is also a factor in my SpA symptoms. In the end, the treatment for SIBO is similar to the 'weed and seed' protocol I'm following, so I haven't pursued it further. But I'd be curious to hear from anyone else who has.

Another approach for constipation, and especially for those who also experience bloating, is a newish supplement called Atrantil which specifically targets the methane-producing species that seem to be the culprit. I haven't tried it but I know two people who have had resolved lifelong issues after using it.

Another supplement that I haven't tried but have also heard good things about for constipation is sodium butyrate.

If you're not having any luck with probiotics, these might be options.
Posted by: Kellybells

Re: One year of NSD - 01/24/18 11:49 AM

Originally Posted By Robin_H
I just want to add or ask...

Is our diet too restrictive and hence reducing the variety of species in our gut and hence reducing the robustness and tolerance of our immune system?

I absolutely believe that the limited diet on NSD affects the diversity of our mircrobiomes. There is lots of research that shows low carb diets reduce diversity, especially when low in fermentable carbohydrate. And there are likely issues with this in the long term (e.g., possible impacts to colon health, impacts on sleep, body temperature,etc.) But I see that as something to grapple with in the longer term.

For now, I really think that the reduction in inflammation is better for my overall health and immune system than the lack of fermentable carbs. Right now I want pain relief and an extended opportunity to heal. So I will continue to use NSD to 'starve' the bad bacteria and the 'weed and seed' protocol to shift the balance. And hopefully one day I will be able to incorporate foods that will support a broader diversity.
Posted by: ranger7

Re: One year of NSD - 01/24/18 03:35 PM

Thank you Kellybells and Robin. I already take lots of magnesium but I will check out that new product. This Dr. Brown is in Plano, TX which is only like 20 minutes from me so maybe I'll go see him.

AS for the Prescript-Assist, I will probably need to try and see if they help. What is the "weed and see" protocol?
Posted by: Kellybells

Re: One year of NSD - 01/24/18 08:13 PM

Pretty cool that you live so close! Will be curious to know your results if you try the Atrantil.

'Weed and seed' means alternating probiotics for 6-8 weeks with herbal antibiotics (e.g. berberine, oil of oregano, peppermint oil, etc.) for 1-2 weeks. Idea is that the 'weeding' kills off bacteria, including the bad guys, while 'seeding' helps replenish it, taking up real estate that was occupied by the bad guys, and shifting the makeup of the microbiome
Posted by: Robin_H

Re: One year of NSD - 01/25/18 12:36 AM

Originally Posted By Kellybells
I'm curious: what's the longest you've gone without falling off the (NSD) wagon?

For me, within the past two and a half years, at most two months. That was probably only at the very beginning.

I quickly got better at that time (damage was not noticeable when there was no inflammation) and began to eat noodles in the morning everyday and coffee a couple times a day. Perhaps other rare abuses were well tolerated.

Sadly, these days I am terrible at staying on the wagon, suffer a lot and can feel the accumulating damage. Just over a year ago I did not have a problem with my sacrum but now it is chronically burning and stiff. Since October symptoms of tingling, burning, needles and a throbbing are in my but, hands, face, neck, legs and feet -- worse in the middle of the night along with head and neck pain which diminish after a couple of hours. But the leg and arm symptoms are becoming more persistent in the day. Burning and stinging sensations in the calfs, feet and both left cheeks are constant now.

For those that find relief using NSD let me be a warning to stay on the wagon.

After last night I believe that I'm loosing ground on starch tolerance and my diet is narrowing -- I went out for a LSDinner. It feels like I really need to both weed and feed concurrently. A week ago the cheese cake with coffee and cold noodles was not as intense. I need to stop sticking my finger in the fan! No sympathy please!

The way I feel the disease migrates in my body gives me the strong impression that the cause is microbes that can hide in the cells and evade antibodies in the blood. They prefer collagen but don't mind mucousal membranes either (the gut, sinuses, etc); they seem to like muscle and nerve too. I don't know if Klebsiella can sequester in the cells but I doubt that it is the only cause. I don't think a definitive marker will ever be found but as infectious agents become more accepted then doctors will have to resort to interpreting a test like the Western Bolt test used in Lyme Disease, but including the use of the human metabalome on micro-arrays combined with AI would be better. I do not know why the technology is not common in medical practice already. All the components were already in development fifteen year ago (minus massive databases). Right now, what I see are organizations trying to collect genomic, metabolomic and medical history to build massive datasets. It's just business that slows down medical advances. Ethics and trust also.

Your Cynic!
Posted by: Robin_H

Re: One year of NSD - 01/25/18 01:27 AM

Originally Posted By Kellybells
I used to track my daily starch intake.

Is cronometer able to break down carbohydrate consumption into percentage of calories from general starch and sugar types: glucose, fructose,... soluable, insoluable,resistant starch, etc? Or did you do that on your own?

Posted by: ranger7

Re: One year of NSD - 01/25/18 09:06 AM

Got it, maybe I need to weed and seed too! how do you take the berberine, oil of oregano, peppermint oil and how much of it?

Also, where do you buy Presvrip-Assist? I saw this on Enviromedica site:

PLEASE NOTE: Enviromedica no longer distributes Prescript-Assist due to
substantial changes made to the formula by the manufacturer.

Any inventory purchased directly from Enviromedica or an authorized Enviromedica reseller, is the original Prescript-Assist formula, which is backed by clinical studies, and manufactured prior to these changes. Enviromedica is currently in development of an advanced soil-based probiotic that will release in 2018.
Posted by: Kellybells

Re: One year of NSD - 01/26/18 09:14 AM

Cronometer shows breakdown by carbohydrate type and sugar type.

You can see this in your daily log (you have to change the settings to get the sugar breakdown) and also when you check individual foods. Here is an example of the latter:

The daily log is really detailed, and you can add more (like the sugar breakdown) to the default. I mainly use it for starch but the nutrient breakdown is also really good, since NSD makes it harder to eat a balanced diet. Here's an example of what the default log looks like:

I don't use it all the time, just for short periods to either get on track or to stay on track.
Posted by: Kellybells

Re: One year of NSD - 01/26/18 09:40 AM

Ranger: I buy Prescript-Assist online from whatever vendor has the best price at the time. I think last time was from Nourishing World? But I've also found it on Amazon. It's pretty easy to find, especially if you live in the US (not all vendors ship to Canada).

As for the 'weeding', I usually take 2-3 pills a day or whatever it says on the bottle. So, for example, I would take 500mg berberine 3x day. I usually stick with one kind of herbal for the duration, and usually go 10-14 days. It's not a strict plan.

What I am very rigid about during and after the weeding phase is NSD. I think this is a must. My thinking is that the herbals are killing a broad range of bacteria, both good and bad, which means freed up space for the taking. If you don't limit the bad guys' food during this time, I think you risk giving them even more room to grow. (To be clear: I have no proof of this, it's just a pet theory).
Posted by: Robin_H

Re: One year of NSD - 01/27/18 03:47 AM


I am having my last "normal" dinner tonight and then beginning a three day fast (I probably need longer). I will break it with a beef bone broth soup and maybe a boiled egg. I've been consuming antimicrobials for only 24 hours before this fast -- choosing to fast was a rash decision while I was "seeding."

I find that if I drink antimicrobials while fasting then it really hurts the gut. I will stick with pure water.

Advice anyone?
Posted by: Robin_H

Re: One year of NSD - 01/27/18 03:51 AM

For those interested in the early attempts at building a functional metagenomic database see the video
Posted by: Kellybells

Re: One year of NSD - 07/02/18 12:48 PM


It's been awhile since I posted but I wanted to share that my 'weed and seed' protocol really seems to be working!! NSD is amazing for holding the line and getting early relief, but I'm now convinced that it needs to be combined with some kind of antibiotic therapy to achieve actual lasting improvement.  By doing both I've been able to 'graduate' from strict NSD to LSD without any increase in pain and stiffness.

After last posting about my very cheaty Christmas, where I ate copious amounts of starchy food and found myself back in daily pain, I have since done two more rounds of 'weed and seed' with some really positive outcomes:
  • My finger pain is 0 most days, and a scant 1 at most. Even when I occasionally eat something starchy, I don't go above 1. I also have no lingering joint pain. I can hardly believe it. 

  • My daily starch tolerance continues to improve. I'm able to eat more low starch foods without consequence than I could just six months ago: nuts, figs, dates, apples, dark chocolate are all staples again. I also eat a small amount of cheddar everyday now, which was unthinkable this time last year.

  • When I have a massive starch cheat (this week was pizza and donuts for a work thing) the impact is minor and short-lived. Some minor stiffness and bit of puffiness the next day or two. That's it. So I no longer worry about occasional big cheats.
However I am not cured. If I push it too far, as in too many  cheats in a short stretch, then my fingers swell up and the pain starts to linger. And if i keep going, then my tendons flare and my neck stiffness and headaches come back.

'Weed and seed' protocol

I've modified the protocol a bit in the last few rounds, from what I originally posted. During the 10-14 day weeding phase I now:
  • use more than one herbal antibiotic, so along with the berberine I take peppermint oil or caprylic acid or oregano oil to increase the killing power

  • consume small amounts of starch based on my new pet theory that bacteria that are active are easier to kill than starving ones that have gone dormant. (this is a big turnaround, I used to stay strict NSD....but it's just a pet theory)

  • keep taking a probiotic pill a day when it won't overlap with the herbal antibiotic
To be clear, I still regularly eat very low starch, I'm just not as strict as I had to be early on when even carrots would cause me pain. It's really nice to freely eat figs and apples and squash and dark chocolate again and I have no doubt that's all because of the protocol.
Posted by: Ann1965

Re: One year of NSD - 07/02/18 06:43 PM

Hi, I love hearing this! I am doing a low/no starch diet the past 3 weeks and I feel amazing. I take Turmeric for the inflammation and pain. No wanting to go back on biologics after severe reactions to Humira. So glad to hear someone else is going the natural route.
Posted by: Kellybells

Re: One year of NSD - 07/07/18 09:22 AM

Hi Ann! Welcome to the forum and to the diet! It has been a life changer for me. Happy to hear you're feeling so good after just 3 weeks. I too responded quickly when I started, definitely made sticking with it sooooo much easier.

I'm now at 1.5 years of the diet. I had experienced 8 months of increasing joint and tendon pain with no insight from modern medicine when I started. To get some relief from my diet within a week without any drugs felt miraculous. How about you....what's your story?
Posted by: Ann1965

Re: One year of NSD - 07/08/18 05:56 PM

Is there a way to contact you by email?
Posted by: Kellybells

Re: One year of NSD - 07/08/18 10:05 PM

PM me anytime! It works just like email. I've had lots of side convos with people here that way and find it more convenient than email for me (my email is a business email). I will check back with the site more frequently.
Posted by: Kellybells

Re: One year of NSD - 07/16/18 11:49 AM

In keeping with the rest of my update, thought I would share the NSD survival strategies that have helped me get here:

1. Hardboiled eggs - My biggest and best discovery. I boil a dozen at a time to eat as breakfast, snacks or lunch. They are extremely portable, durable, and filling. I always, always keep these on hand. I dislike cold foods so I often warm them up in hot water.

2. Eating more fat Hitting 2000 calories every day was hard at first without starchy carbs and my weight dropped quickly. I quickly realized fat is key:
  • lots of olive oil to roast or sauté vegetables (asparagus, rutabaga, spinach, kale, zucchini, peppers, eggplant)
  • coconut milk in soups (see my Thai soup recipe in the recipe section) or pureed with  fruit and honey for smoothies
  • fatty cuts like beef blade, pork shoulder, ribs, chicken legs, lamb shanks, salmon belly, etc. - bonus: fatty cuts are usually also high in joint healing connective tissue
  • avocado
3. Quick and easy Eating no starch means preparing most meals. Having options that come together easily is essential. Here are my top quick and/or easy foods:
  • eggs, cooked any way (hardboiled, poached, scrambled with asparagus and salmon)
  • pork ribs - 7 hours on low in the slow cooker and they're perfection, the tastiest cut of pork and full of connective tissue and calories; I also save the broth for soups
  • tuna salad wrapped in romaine lettuce leaves
  • soups with broth and whatever veg and leftover meat is in the fridge (last night was pork broth, leftover ribs, kale, mushrooms and onion)
  • meat and two sides - a pork chop takes 5 minutes or less to cook, and with steamed broccoli and boiled carrots, dinner is ready in 15 minutes. Roasts take awhile but require little effort so I make them a lot in winter, with just a few minutes at the end to cook some veg. Sticking to 2 veg per meal is also a good way early on to figure out what you can/can't eat
5. Frozen fruit - many fruits can be starchy or sweet depending on how ripe they are, and it's especially tricky when they are out of season. I find frozen fruit reliably ripe, convenient, and much less expensive. I eat a lot of fruit to make up or the lack of other carbs, so this is a life saver. I mainly eat strawberries, blueberries, raspberries, sweet cherries and pineapple. I defrost ahead of time or heat on the stove in a bit of water for a quick dessert.

6. Lunches I always make enough dinner to have leftovers for lunch. It's that simple.

7. Eating out - This has been much easier than I thought it would be. I ask for more of the good veg in place of potatoes and rice. Most sandwiches and burgers and taste great without the bun. Worst case scenario I can have a salad with chicken and stick to the vinaigrette. The world is now used to low carbers so my requests don't seem strange.
Posted by: Robin_H

Re: One year of NSD - 07/31/18 10:35 PM

Kellybells, I am glad to hear that the low starch diet is working for you.

After returning to my home country of Canada at the end of June the jet lag combined with the challenge of controlling my diet when I do not have my own home sent me into a fast health decline.

Regardless of what my fundamental issue is -- autoimmunity and/or infectious disease -- I am going to get control of my diet ASAP.

Your good news keeps encouraging me to try and get better control of my starch AND sugar. I have not given it an honest, long-term effort for years.

Posted by: Kellybells

Re: One year of NSD - 08/02/18 06:49 PM

Welcome home Robin H!

Good luck with the diet. Hopefully things will calm down and you can focus on staying on the wagon. I can definitely relate to hard it is.

For what it's worth, I don't actually have any issues with sugar, only starch. If you're having trouble avoiding both you might try focusing just on the starch, at least at first. I find my sweet foods help me stick to the harder parts of the diet.
Posted by: MLR

Re: One year of NSD - 08/02/18 10:22 PM

Thanks for posting your meal plans. This helps a lot with helping my son out with his diet. I'm curious about something. I was making cinnamon and ginger tea for him but we found out both contain starch. Turmeric also and yet you are able to tolerate them. I don't know what's up with that because they are all anti-inflammatory and I've noticed many take them. I'd like to know if anyone has had a problem on the NSD.

Posted by: Kellybells

Re: One year of NSD - 08/03/18 10:46 AM

Turmeric, ginger, and cinnamon are all starchy and I avoided them very strictly - along with most spices - like black pepper, pumpkin spice, cloves, cumin, coriander - for a really, really long time. I can tolerate them now that I've been doing the 'weed and seed' protocol for over a year, though i still keep my intake low.

I'd be surprised if I included turmeric in a meal plan, unless I indicated it was low starch (not no starch). Long before I tried NSD I had tried turmeric for inflammation and found it made things worse not better. Wasn't til I learned about NSD that figured out why!

Other posters have reported success with curcumin extract, saying it doesn't test starchy with iodine.

And one poster shared a genius trick of blending ginger with water and then straining. If you let the liquid sit for a day, the starch will sink to the bottom and you can pour off the ginger extract. You can use this for tea.
Posted by: MLR

Re: One year of NSD - 08/31/18 08:26 PM

Hi Kellybells. I've posted about this book on other threads but I can't recommend it more heartily: "The Keystone Approach" by Rebecca Fett. It explains what is going on in the small and the large intestine and which probiotics are most effective for SIBO and for other autoimmune related ailments.
Posted by: Robin_H

Re: One year of NSD - 09/22/18 08:44 PM

I ordered the Keystone Approach. I am surprised that it has to be imported from the UK.

Also, I ordered "How Can I Get Better?: An Action Plan for Treating Resistant Lyme & Chronic Disease" by Richard Horowitz hoping it has some good advice on integrated medicine.