Kickas.org Forums Treatments, Drugs and Alternatives NSD and diet-related; Frustrating relapse - any advice?

I have only been suffering from AS for about 4 months. I found this site, immediately got on NSD and ACV and had an incredible improvement to zero pain within a few weeks. I am also taking turmeric, B vitamin, Boswellia, oregano oil, and fish oil. I also am on Humira, but I cannot say that it makes any noticeable difference.

Of course, I then decided to press my luck and went on a stretch where I ate some starchy foods and drank to excess (alcohol in excess seems to be a trigger for me). I flared back up, and I have not been able to get back to where I was. I have also been fighting a sinus infection (not sure if this is associated with a flare up).

I have been very disciplined for several weeks, so it has been a bit frustrating. Should I consider Sulfasalazine or some other supplements? Anything else to watch out for?

Also, when I was pain free, I was eating pecans and continue to eat them. I know they have a little bit of starch.

Hello, Exacta:

I think the turmeric is a bit starchy but there are extracta which are safe. Pecans are only a little starchy. It is probably not good to stay on oregano too long, but mostly during cleansing regimen.

I would suggest one day of fasting followed by taking fresh wheatgrass juice (6-8oz on empty stomach) and also take 6-8 borage seed oil capsules just before retiring. During the day, and especially just before meals, take EVOliveOil by the teaspoonful, perhaps 8 times.

Then supplement with zinc, copper, magnesium, calcium, vitD, vitE, niacinamide, and lysine. Eat okra, lychee fruit, and small amount (2oz) probiotic yoghurt (Brown Cow or Stonyfield Farms).

You should be able to avoid changing medications and make what You are taking much more effective this way.

HEALTH,
John

Got my wheatgrass seeds on order..

So just what exactly do you think that is going to do for you?

Hi Exacta - Excellent advice from John. Yes, a bit of a drag all those pills and potions, but...way to go to get there.

As for the SFZ...IF you have gut problems then would suggest giving a miss. Side effects of SFZ can leave one 'house bound' and also, can cause tinnitus ! Am still suffering from the tinnitus some years later. Not as bad as it was originally - church bells and radios at 2.00 a.m. are not conducive to sleep - Ho-Hum.

Wish you well, take care -

Molly C - Keeping on, Keeping on (as we all do, innit )

I have no exact expectation of what it is going to do for me. It is a very nutritious food product, so I don't think that I have anything to lose.

Wheatgrass ? Good stuff. Mercola also recommends it. Here's some info on wheatgrass -

50 Reasons To Drink The Benefits of Wheatgrass - The Chalkboard Mag
thechalkboardmag.com/50-reasons-to-drink-wheatgrass-everyday
May 13, 2013 - Wheatgrass juice is an effective healer because it contains all minerals known to man, and vitamins A, B-complex, C, E, l and K. It is extremely rich in protein, and contains 17 amino acids, the building blocks of protein. 3. Wheatgrass juice contains up to 70% chlorophyll, which is an important blood builder.
Benefits of Wheatgrass - Hippocrates Health Institute
hippocratesinst.org/benefits-of-wheatgrass-2
It contains the full spectrum of B vitamins, as well as calcium, phosphorus, magnesium, sodium and potassium in a balanced ratio. Wheatgrass is a complete source of protein, supplying all of the essential amino acids, and more.
35 Amazing Wheatgrass Benefits (Backed by Science!)
www.organicauthority.com/benefits-of-wheatgrass.html
Many people swear by a shot of wheatgrass first thing in the morning, and it's no wonder! Learn how to reap the benefits of this superfood.

------------------------ ##

Here's a note from the Mayo Clinic - Mayo tends to know what they are about... All good stuff :-

http://www.mayoclinic.org/healthy-lifest...ss/faq-20058018

I react to really small amounts of starch and turmeric is an absolute no go for me.

Even a half tsp of ground turmeric, which has less than a gram of starch, will cause pain and stiffness the next day. Ginger and black pepper are also off limits.

Might be worth a try.

A few days after posting this, I felt 100% better. Then I had another flare up which has lasted about 5 days so far. I know for sure that this one is not alcohol related.

I have narrowed it down to either the 2 day binge I had eating a lot of pimento and cheddar cheese or overdoing it with honey+greek yogurt.

Exacta - I have NO sympathies- binging - indeed !! Flares follow binges sure as lighting a fire will keep you warm <LOL>
Take care over there -

Is there any prevailing theory about why cheese causes flares?

From what I read, dairy isn't good because it contains lactose and lactose feeds klebsiela. Not sure if that's acurate so hopefully someone can provide more info on this.

Hi, Exacta:

Cheeses which are soft contain a lot of lactic and galactic acid; Carol's dodgy disaccharides. Klebsiella can do quite well on these and it is a milk fermenter, so basically everything derived from it is a fringe food. When I first began NSD, I had a terrible flare from too much mozzarella. Lesson learned: Cheese is a condiment and not the whole meal!

HEALTH,
John

Is this true of something like Stoneyfield organic greek yogurt? Should this be eaten in moderation as well?

Hello, Exacta:

Yoghurt is one of the offenders and should be eaten to help heal the gut, but not very much should be eaten. I used to consume half a serving (2 ounces) in a day, maximum. That seemed to help avoid the flare, and along with supplements I was able to repair my tract. Stonyfield Farms is the best brand I have found.

HEALTH,
John

I had a rough week between going out of town for vacation and then visiting relatives. I avoided grains, but gave into social norms with borderline foods like squash, ginger, etc.

I ended up doing a 36 hour fast which helped quite a bit. Because I was diagnosed so early (within months of symptoms) with AS, I was very hopeful that I could alter my diet for a few months, and return to somewhat normalcy. It has now been 5 months of a pretty strict NSD, and I am definitely not symptom free.

I am going to keep at it, because the diet certainly improves my symptoms. I am also going to consider trying a different biologic as the Humira seems to do nothing for me.

I should note I am seeing my rheumy on Monday 4/17, so let me know if there is anything I should consider asking or discussing.

Exacta - being with chums is so tempting. But y're back on track now. Good.

Have you tried the curcumin / turmeric protocol ? Fresh grated rhizome or buy in powder form. Add to pretty much any dish you are making, with fresh ground black pepper and a saturated fat of some description. Great on fried eggs - fry in organic virgin coconut oil (butter). Great in soups, any meat dish. Vegetable, any dish really.

Also, LDN. Low dose Naltrexone. Lots of information here on the alternatives forum. I learnt of LDN here on KA, that was some 12 years ago, and haven't looked back. Good website for LDN is the yahoo group, Low dose Naltrexone Research Trust. Much information. A place to ask all your questions.

Give everything a chance to kick in. Nothing is an overnight magic wand.

Have a good consult on the 17. Take care.

Alcohol is one of the worst triggers for me, i get AS and Gout like symptoms and it absolutely reverses the hard NSD management that has given me great results. To much protein seems to be a trigger for me as well.

IF by 'too much protein' you mean red meat...then, yes. Red meat is an inflammatory food - see this, just in:-
http://thehealtheducation.com/scientist-finally-discover-eating-red-meat-causes-cancer/

Humans are the only animals that have a higher risk of cancer when it comes to eating red meat, as other carnivores eat red meat naturally with no ill side effects. The study, which was published December 29 in the “Proceedings of the National Academy of Sciences,” discovered that a unique sugar named Neu5Gc, found in most mammals but not in humans, triggers an immune response that in turn causes inflammation

As for alcohol, beer is starchy. A glass of cold beer on a hot day is pretty good, but just not worth the after effects !

I have kicked off some fasting to try to get back to a baseline of zero pain. Going on 48 hours, and I did have a spinach salad with olive oil about 24 hours in.

Strange thing is that I probably had my most intense pain of the past 6 months last night. Possible healing crisis? I hope so.

Just take some painkillers do you more good than all the spinach salad and olive oil in the world Well possibly that is

I started eating again yesterday. Feel a lot better for whatever reason.

I am definitely far from giving up on experimentation with diet and lifestyle as a way to better manage the disease. I do not want to start the NSAIDs because I am concerned that it will make it more difficult to determine the cause/effect of diet & lifestyle (if it exists), and long term damage to my digestive system.

I am on Enbrel, so I am certainly not adverse to taking pharmaceuticals.

Hi Exacta - sounds like the fast was helpful? How long did you make it in the end?

I've been reading up on fasting and have seen many report that after a few days their aches and pains seem to get worse or even old injury sites flare up. This is interpreted as the body repairing those sites. I wonder if this was what was happening to you.

I fasted about 55 hours (minus the spinach salad). I actually feel great right now. I have been eating normally for 48 hours and went mountain biking yesterday.

I also started eating Natto on Monday based on another thread.

I got my lab results back from when I was flaring up a few weeks ago.

My sed rate was a 2. I understand that this is normal and pretty low. Anything that I can conclude from this? Like I said, I know I was suffering back and neck pain at the time the blood was drawn.

I think that less notice is taken of Blood Sedimentation Rate these days. Whether high or low you can still have flare ups. As it is normal best just ignore it.

Hi, Exacta:


ESR is a reliable test for disease activity in about 60% of AS patients; regret many patients cannot learn anything useful from this test.

I am glad You are doing so much better now, and it looks like You are narrowing in on the culprit(s)!

HEALTH,
John

Regret that I am now flared back up. I have some natural anti-bacteria stuff on its way: Tanalbit, Biofilm defense, Berberine, & Uva Ursi.

If I cannot get some relief by my next Dr. appt in July, I am going to request a round of Cipro.

Anyone have an opinion on pork skins aka chicharrones as a no starch snack food? They are fried, but w/o starch, and they show up negative on my iodine test.

Sorry to hear it Exacta.

I'm feeling pretty frustrated myself. After a glorious week and a half of pain at the 0-1 level (my best stretch since I started NSD 4 months ago!) I clearly ate something to set me off. Was it the blanched almonds? The okra? Some under ripe cantaloupe? A small mouthful of deli roast beef that I foolishly didn't test first but stopped eating when I realized it was processed?

Can't say for sure but I was back in the pain zone and went straight into a 36 hour water fast (you and another poster really inspired me!), felt much better, then ate a minimal amount of what I thought was non-starchy carb and had issues again. The stiffness was quite minor, but after getting to experience almost-pain free a worsening of any kind is discouraging.

I also started up another round of goldenseal, peppermint oil and oil of oregano, which I wasn't due to start again for a few more weeks. (I haven't heard of tanalbit or biofilm defense so I will look those up).

I now find myself reluctant to eat any carbs at all. Before I found this site I came across the blog of a person with Crohn's who wrote about his year on a meat-only diet. He successfully resolved all of his symptoms but I remember thinking: whoa that's crazy. Have to say, it's not sounding so crazy anymore...

Well, I am now back to feeling great for the past 3 days. This time feels less 'random' and more like I have been making actual progress. I think my supplement regimen might really be helping to control the Kleb.

I will keep track, and if I make continued progress, I will update this thread with my regimen.

Going back to the sed rate referenced on page 3, I was curious. Is a "normal" non-inflammation number your age divided by 2?

Hello, jackson:


Because ESR should peak at age 40 then decrease, I would not expect the divide by 2 idea to be very realistic. I know for a fact that if my ESR were >32.5, I would be in excruciating PAIN! Fortunately, it has been 9 or below for many years now, but >100 at height of activity.

HEALTH,
John

That's great! Would be good to know your regimen either way, if you're inclined to share. If it's successful it may be useful to others. And if it isn't, then we'll know what not to try :-)

Hi Exacta,

Curious to know about your supplement regimen for the benefit of the members, including me.

Jay

I didn't have an opinion but thanks to you I tried them! They appear to have a tiny amount of carbohydrate but I seem to tolerate them just fine. I'm not much for junk food but I have missed treats like popcorn and dark chocolate, which are both a no go on NSD. Pork rinds are definitely helping fill that void, so many thanks for the post.

My next snack test will be roasted seaweed. Nori seems to be free of starch but I actually haven't tried it yet to see how I react.

On the sweet side of things, I've been experimenting with homemade jello and gummies. I seem to tolerate them but I'm still working on my gelatin ratios and flavours. Does anyone have any fruit juices that they have been ok with? So far apple juice and tart cherry juice have turned out starchy though pomegranate was fine.

Awesome! Thanks for the idea! I love pork rinds. Go for it especially if you know exactly what is in it or is homemade and you know what is in it.

My naturopath advized me to try a new food item for at least three meals in a row to see if there is a reaction during or within three days after the last serving.

Might there be a difference in ESR or CRP values when a patient is either on or of the NSD/LSD?

Hello, Robin_H:

About 40% of AS patients do not have elevated ESR/CRP tracking disease activity. However, in the majority of cases, these are useful to determine disease activity. When I first started NSD, I was able to check my ESR on demand (I was in Philippines and laboratory close), and could absolutely demonstrate the effect of dietary starch on this--long before my actual perception of pain increase, which did not happen as I got much more strict.

In his "Etiopahtogenesis" paper, published in the AS and RA Papers section, Ebringer tracked 36 patients' ESR for a 9 month period. The instructions to the patients were to just try and reduce eating all the obvious starches as much as they were comfortable with and try eating more meats and leafy vegetables. There was one unchanged, but one of the two wrong-way results was later revealed by his son (also a patient): "Dad eats a potato every dinner; says 'it is not really a meal without it.'"

HEALTH,
John

Thanks for the insight DragonSlayer.

One of the reasons I remain undiagnosed is that my CRP and ESR levels were normal when finally tested last December. This was before I started NSD but I had already been eating a grain and dairy free diet for many years. While not completely starch-free, I was eating substantially less starch than the average person. While I still had a fair amount of pain, I suspect my diet limited my inflammation and was the reason my ESR/CRP were normal.

I have seen other posters note that after subduing their AS with NSD that their ESR/CRP levels don't necessarily elevate when they experience a flare, so pain level doesn't seem to correlate directly with ESR/CRP. I have begun to wonder if those tests are sensitive enough for the lower levels of disease activity that come with NSD. And whether they are most useful for longer term, full blown active disease among full-starch eaters. What is your sense of this?

On a personal note, the blind reliance on these tests for diagnosis has been frustrating for me. I was experiencing daily, persistent pain when I was tested, and my symptoms were real. However, all was dismissed when my test results came back negative. My PCP even suggested I might try eating full starch to see if my CRP/ESR would be affected, in order to support a diagnosis. Obviously I refused.

Spondylitis pain started in the thoracic are when I was in my early 20s. I think my GP was on the ball but I didn't know what he was looking for. He did ESR at that time and all was well. I was getting rare IBS symptoms then too. Doc concluded I had fibromyalgia.

I have always been a big vegetable and meat eater out of instinct due to the discomfort I felt by age 35 when I ate starchy foods. I had no idea why I felt bad.

All those years I believed the fatigue and discomfort was FM.

Over 20 years later (age 47) pain and inflammation finally got to the neck and lower spine. CRP and ESR were still fine but before those tests I was already on a LSD .

I too have wondered if I went off the LSD/NSD for a few weeks and then saw the rheumatologist what the CRP/ESR would be like but I am too afraid because when the inflammation goes up the damage accumulates and doesn't seem to heal.

Right now I am doing the three day apple fast but I feel horrible: lower back is fine but the neck and head is a different story.

That's a question I want to post, "anyone have chronic inflammation in the mucous membranes of the head, tightness and pain in the temples, pain behind the eyes, and a lot of pain, crunching and inflammation at the base of the skull?" I developed those head symptoms after a scuba accident in 2013 in which I got sea water in my head and then the full blooming of AS symptoms developed over a period of two years with the help of heavy NSAID use futilely attempting to kill the skull. pain.

I'm ending the fast with a pot of beef bone broth soup!

Hi Robin,

I have neck issues and frequent headaches but not quite like yours. But other aspects of your story really resonate.

I had persistent SI joint pain from age 18 but just muddled through with NSAIDs and occasional visits to the chiropractor. And like you, I gravitated to low starch eating without fully realizing the significance.

That might have been that except a year and a half ago, I also suffered an injury: badly bruised my right hand in a cycling accident. A few months later I developed crippling joint pain in the fingers of both hands, which is what eventually led me to a rheumatologist and then here. Rheumatologist was useless but NSD has changed everything.

I think the injury was the trigger. Leads me to wonder if there is something about the body's response to injury that can trigger AS in different sites, especiallly in sites beyond the typical SI joints, heels, and eyes.

I too wonder what kind of injuries and other things can trigger AS. I feel a large, well designed database would be needed for researchers and doctors, assisted with AI, to tease out such effects.

https://www.kickas.org/ubbthreads/ubbthreads.php?ubb=newreply&Board=7&Number=517109

These days my body overreacts to injury and just adds insult to injury -- the inflammation process is our of control

Keep on trucking!
Kevin

I wanted to check back in. Oh boy.. I had a great run of 2-3 weeks with basically a 0-1 pain level. I went off the wagon again, this time drinking bourbon over the course of 2-3 days straight. I am back in the midst of a nasty flare, where I am going to go ahead and fast again to try to relieve the pain.

We talk so much about diet. A random variable that we may not be paying attention to at all is daily, heart pounding, blood circulating EXERCISE! Diet, exercise, good laughs, rest and no worries is almost everything. Missing one of those and life is a bigger challenge.

Hey everyone. I am happy to report that I am doing GREAT since 6/15. I have cut out all dairy, starch, and alcohol, started exercising 3x/wk, and I can honestly say that I have never felt better. This includes the time predating my AS symptoms.

If I cheat a tad bit, I still feel some of the ache wanting to come back, so I certainly do not believe I have beaten it.

That's great to hear exacta. Way to stay on it. I find that nothing inspires sticking with it like success.

I also find that small strays set me off. Hope the day comes when we can tolerate more foods. In the meantime, having a med-free way to manage all this is pretty amazing.

Hey KickASers - I wanted to provide an update.

I have had my share of ups and downs since July. I am in a good place right now, where I feel like I have continually increased my knowledge of what drives my inflammation.

Here are some of the borderline food/drink that do not seem to affect me:
Red meat, pecans, most dried fruit, honey, eggs

And those that do:
Alcohol of any kind, figs

I'm also on LDN, which I am fairly certain is helping. I am currently at zero pain, but very sensitive to any starch, alcohol, or excessive sugars.

I too can not touch alcohol.

I have been suspecting that eggs and coffee are an obstacle to remission, but I just wont quit!! Eggs have inflammatory properties and acidic coffee destroys the microvilli in the gut which reduces nutrient absorption, increases permeability and knocks out the healthy biofilm that aids nutrient absorption and protects us from pathogens. The microbes hold on to the microvilli. If there are no microvilli then a protective layer can not form.

I am also a pecan and walnut addict. Nuts in general are another barrier for my remission.
Honey will make me suffer too.

It feels like we are having a Starch Anonymous meeting. What are our 12 steps?

Speaking of Chron's disease. Some sufferers are treating themselves with parasites. http://www.sciencemag.org/news/2016/04/p...cterial-balance

I suggest that AS sufferers my have actually lost a microbe that suppresses part of their immune system. Not all synergies may be detrimental; obviously there are beneficial synergies between microbes in the microbiome.

Just as Dragonslayer notes that his ESR goes up when eating starch I had the same experience -- one time when I knew I was going to have ESR/CRP testing done I began to eat starch every day for at least a week before the test. It drove my ESR up by nine points. My CRP remained almost zero.

Thanks for the update!

Any pitfalls to using coconut milk smoothies for extra calories? I've been doing an entire full fat can (1200 calories) with some frozen berries and honey. The milk has no additives.

Haven't been feeling great lately.. going to fast again.

Hi Exacta:

I have no obvious reaction to coconut oil. I sometimes eat it with a spoon out of the jar. Good stuff! It's a good cooking oil too. Sadly I don't bake with it. Homes here typically have no oven or dryer so I don't bake and most foods that I know of that contain coconut are baked goods.

Cow's butter too. I had not eaten cow's butter for about seven years only because it is rare to see in the store and for all that time I've been rarely eating the foods (buns, breads,...) that it would be put on since breads are not popular foods in central Asia. When I decided to make the journey to get butter my body screamed "where have you been all my life!?!?" I literally ate it with a spoon. No reaction.

It feels like the NSD diet is making me age since it is just vegetables and lean meats (mostly chicken). Of course the disease eats collagen too. Since NSD is so narrow I feel that nutritional supplements are a must but some kind of starch is a common filler. Why must manufactures put in fillers like that?

We must make efforts to keep calories up and that is probably best done with healthy fats.

A few days ago I tried bacon (very fatty). I cooked my eggs (literally deep fried in a wok) in the fat and then the veggies for the pseudo-omelette. I had a major REACTION!! Was in the fat type???? Any suggestions?

Last night I went out and ate a dinner that wasn't a problem many months ago. It was donkey meat with cilantro, shaved cucumbers, shaved carrot and hot peppers. Then a big dish of bok choy and garlic. It gave me a bad flare peak in the skull and neck. If I was still for a while then my hands would go numb. An aching but isn't so bad but this diseases has my head and neck, really sensitive areas. Lumbar and sacrum are trivial annoyances in comparison.

I'm struggling to diversify my foods because I feel this narrow diet is harming the microbiota and me. Also, I'm loosing my appetite for cucumber, chicken, cumber and chicken. And cucumber too.

Oh, and there are differences in fat/carbohydrate ratio and nutrients between:

1) coconut water
2) coconut milk
3) coconut oil

What a great idea! I have a hard time finding a) enough calories from non-animal sources, and b) good sweet treats to take the place of everything that's now off limits.

I regularly eat coconut milk and have had no issues. I haven't tried with fruit but will let you know if I have any issues.

Sorry to hear you're not feeling well lately....good luck with your fast.

Does anyone know of starch-free Iodine or Vitamin K2 supplements? I have purchased two bottles of each and all four have tested positive with the Iodine test despite only listing 'plant cellulose' as an extra ingredient.

I use Thorne Research K2 drops. Totally starch free. Each drop is 1 mg, so it lasts a really long time.

What's the other supplement? (I'm guessing you wrote iodine by mistake)

Iodine was indeed the supplement. I will check out the drops, thanks!

Feel great after my fast.

Got back to zero pain on Friday following my fast. Now it's Monday, and I have back pain again despite eating nothing but chicken, red meat, fresh greens, berries, coconut milk and coconut homemade yogurt.

Has anyone found a food journal to be integral to their success? I have not been keeping one.

In looking back through this thread, I was doing my best last summer when I was taking a lot of botanical anti-microbials. I am going to start another round of that.

Also, I certainly have anxiety over my weight. In my past, I did competitive strength training, and this time two years ago I weighed approximately 190 lb. When I step on the scale in now starts with a 16x. I love the way fasting makes me feel, but I feel like I am having to choose between not being in pain and not wasting away..

Hi Exacta - try cutting out the red meat. For many red meat is inflammatory - includes myself !

But well done the fast -

Hi Exata:

* WATER FAST WITH SUPPLEMENTS

I am in the third day of my fast. I at first tried going with only water but I also was adding biofilm disruptors (EDTA, NAC,...) detox supplements (GSH, alpha-lipoic acid, milk thistle,...) and binders (charcoal).

* REACTION TO SUPPLEMENTS OR JUST HUNGER???

I was feeling a little better during the fast but there was a lot of room for improvement. At almost the 24 hour point I took a couple of grams of L-glutamine, obviously on an empty stomach. My hole body began to increase in odd sensations and pain mostly in the neck. Muscles tightened, my neck was tight and burning and I was developing head pain similar to trigeminal neuralgia.

* REACTION REMEDY AND BONE BROTH FAST

I quickly but reluctantly took two paracetamol followed by a carbonated, fizzy anti-acid and then proceeded to make a pot of spinach soup broth and threw in a couple of small Taiwan sausages and sea salt. After one bowl I was feeling better than I have in the past year. So I decided to keep the fast to a bone broth fast.

As an aside I heard a doctor say that an anti-acid like Pepto-bismol is good to counter a Herx reaction.

* FOOD REINTRODUCTION

After the bone broth fast I will reintroduce one food every few days into a spinach or bok choy soup. Each introduction will have me eat it at least three meals in a row to watch for a reaction.

About 2.5 years ago I suspected that broccoli was a barrier to further gut healing. I took it out and noticed an improvement.

So recently have been trying to learn about soluble and insoluble starches, and their relation to resistant starches, FODMAPS, etc. I realize now that cooked broccoli is classified as a soluble starch when cooked. I see that as a great food source for microbes in the small intestine which will sustain SIBO.

I also noticed that nuts and other foods high in inflammatory omega-6 fats made me feel very bad yet those fats are in healthy foods. This may partly explain why going from stir-frying in olive oil to steaming was also a gut healing aid (I think that stir-frying in coconut oil is the best). I wondered what the big deal was about omega-3 and the EPA/DHA ratio in fish oil.

I went to Wikipedia and found a page that listed the omega-3 and omega-6 ratios of many foods and was somewhat surprised to see that the two vegetables that make me feel best were spinach and bok choy and that they had the lowest omega 6 to 3 ratio.

So I will try to stick to green vegetables for now and keep the omega-6 oil very low and the omega-3 very high, and supplement with fish oil.

* KEEP THE MICROBE POPULATION LOW

I feel that all meals should incorporate some form of natural antimicrobial which are typically seasoning. However many are starchy. It might be better to use fresh herbs grown in your windows instead of store bought dried ones. They would be more potent and less starchy.

Onion and garlic also are anti-microbial however they contain oligosacharides which feed microbes; probably good and bad.

I did read an interesting article that said that the "good" bacteria can only metabolize simple sugars when complex sugars and starches are present. In contrast the bad bugs can metabolize simple sugars at any time. The details of the article evade me. So if the diet contains more simple sugars than complex carbs then the growth of bad bugs will be promoted more then the good bugs. This can explain why the more cellulose I eat the better I feel; or in other words, the less starch the better.

This makes me wonder where FODMAPS and soluble starches fit in. They are important in maintaining a healthy gut mucousa but when AS sufferers attempt to include foods high in those compounds then they suffer. So, how can AS sufferers nurture a healthy mucousa that will protect us from compounds we don't want in our body and digest foods for us? I don't know!!! It seems like a barrier we need to figure out how to pass.

* CHRONIC INFECTIONS ARE A BARRIER

I am still taking biofilm disruptors to aid the antimicrobials. I am always changing from one side of the fence to the other regarding using big guns like pharmaceutical antibiotics. I feel that when some infections get embedded into our gut lining that they are almost impossible to get out with natural antimicrobials. The longer they live there the more our immune system will change making remission less likely.

FOOD DIARY

Two and a half years ago I used a food diary. It didn't help. These days I am more willing to go on an elimination diet then slowly reintroduce foods. My mistake often is to reintroduce too many different foods too fast.

Red cabbage might be a good choice of vegetable to make a salad from

I used an online food journal when I started and found it incredibly helpful: www.cronometer.com

It's great as a guideline for starch content since it draws from the USDA database. You can check for each food and it keeps a running tally. You can also add notes, which I used to track my pain levels. Pretty quickly I discovered I could tolerate a max of 2 grams of starch daily.

It's not perfect, since starch can vary by individual item. Kale, for example, is listed as very low starch, but I definitely had issues with it. So you still need to iodine.

It was a great way to get started on NSD. It also helped me through the nutritional side of things, which i was worried about in making such a big shift in my diet, as it tracks calories and nutrients. I would routinely plan hypothetical meals to figure out what I could/couldn't eat and how much I needed to eat well and not lose more weight.

I posted about it here, including a few screenshots:
https://www.kickas.org/ubbthreads/ubbthreads.php?ubb=showflat&Number=518133#Post518133

And another one, that shows the log part:

Cabbage always tests a bit starchy for me with iodine. I recommend staying away from it if starch tolerance is low.

I recall you mentioning that cabbage tests positive for starch. Have you tested red cabbage?

Also, you mentioned kale. I read that for some reason it is not good to eat raw kale. Did you eat it raw or cooked?

Yes, I'm sorry to say, red cabbage also tests starchy. It never goes fully dark purple, but definitely has starchy streaks of varying degrees. Some cabbages are worse than others. I eat it now anyways, now that I can tolerate a bit more starch. But it was a no go early on.

I haven't read that eating raw kale is bad for you, but there is research that shows some veg nutrients are better absorbed when cooked. That wouldn't surprise me for kale. I have also come across research that cholesterol lowering effects are better when kale is steamed.

Do we think that overeating (regardless of starch content) can feed Kleb and create disease activity? I ask because at some point I am interested in trying to pack some weight back on.

Is it inadvisable to force feed myself copious amounts of meats, fats, etc?

If how I feel during a fast in comparison to eating is any guide then I would think that over-eating will make me feel worse. I will try to be observant about that but I think it is true.

Also, a chemist that knows a lot of biology told me that eating too much protein can contribute to higher sugar levels because the body will want to convert the protein to sugar. But I suspect that is in the blood and organs, not the gut. Just my guess. Or perhaps once our body is satisfied with the level of available amino acids it sends signals to the gut which alter the functioning of the microbiota and they increase breakdown of protein to sugar and have a big feast!!!???

* SNACKING!!

Just to add, I suspect that snaking will promote microbial overgrowth. Perhaps mother's advice was best to not snack between meals? Perhaps fruit or dessert at least half an hour before a meal is best, not after. That is the current advice; I don't know why.

I have never found that overeating non-starchy foods makes anything worse. For me, all that matters is starch and dairy - if I stay away from those, I'm fine.

Last year when I started I had a really hard time getting it right - I had lots of bad days and I lost weight. It was really hard to find truly non-starch veg and fruit and still eat enough calories. I tried fasting out of frustration but I hated it. I already have low blood pressure and not eating made it so much worse. So my pain went away but it wasn't worth it.

After fasting failed, I tried feasting - I turned to high-fat cuts of meat like pork ribs, pork shoulder sausages, chuck roast, chicken thighs, salmon steaks, etc. to get non-starch calories. And it was enough food that I could get away with eating totally NSD veg like spinach and zucchini, even though they have few calories. Most people around me were horrified, but I finally started to feel better - that's when I started having 0-1 pain days. I regained the weight I lost and have been stable every since.

Except for an irresponsible holiday season, I still eat this way and have no issues (though I haven't had my cholesterol tested since I changed diets). I've now started adding more vegetarian fats (e.g., olive oil, butter, coconut milk) to have a little more variety. I'm also able to eat veg and fruit with slightly more starch now, but still, it's hard to hit my calorie needs without the high fat content (I am a cycle commuter - I burn a lot of calories every day). I have lots of energy, my weight is stable, and I will probably stay with this diet until my starch tolerance improves (if it ever does).

Sounds like you don't eat much in the way of sugars (honey, dried fruits, etc) ?

I didn't eat much fruit early on - it was too unpredictably starchy and I was too sensitive. It was often problematic and part of my early frustration.

But I eat fruit almost every day now. I find blueberries, cranberries, raspberries and cherries are almost always ok. Pineapple, strawberries and kiwi mostly ok. Grapes are often ok but they can be really starchy, so when they are bad they are really bad! I haven't tried many dried fruits - just dates and figs which are starchy. I've started drying my own pineapple and cherries.

I use honey as my go to sweetener but I don't really like it enough to have it just for the calories but it's not a bad idea. I also use maple syrup.

So I do eat lots of fruits and sugar - it really helps me hit my calorie targets, especially on workout days (when I aim for about 2500 calories). But it's the first to go when I flare since it's just too unpredictable. I also drop it during my 'weeding' phase, which I try to keep strictly no starch to make it more effective.

When I look at the high omega-3 to omega-6 ratios of spinach, red cabbage and bok choy, and their relatively high quantities of those oils in comparison to other vegetables, then I conclude that they will be good sources of anti-inflammatory vegetable broth (throw away the actual vegetable after boiling the nutrients out).