Eating for Balanced Blood Sugar
Every year, various diet theories make their way into popular view on the internet. “Everyone should eat less fat”…. “Everyone should eat low carb”…. “Everyone should go Keto”….. it’s enough to make your head spin! The truth is that we are all biologically and genetically unique, and there is no One Diet that is an ideal match for everyone. That said there are some general principles that hold true across various diet types, and one of those is the importance of maintaining balanced blood sugar
Keeping blood sugar levels stable is critical for hormone balance, lowering inflammation, and optimizing energy levels throughout the day.
Why Balanced Blood Sugar Matters
When we eat carbohydrates, the body breaks them down into simple sugars called glucose. Glucose crosses from the small intestine into the bloodstream where it can be taken up by the mitochondria - the “powerhouses”of our cells - and converted into energy. This energy is called adenosine triphosphate (ATP). However, mitochondria have a limited capacity to convert glucose into ATP: they can only convert as much glucose into ATP as they can use. When more glucose is present than can be used by the mitochondria, it causes “glucose spikes” - also known as elevated blood sugar. To prevent glucose spikes, one of two things happens to extra glucose circulating in the bloodstream: it is either converted by the hormone insulin into fat for storage, or into free radicals.
Free radicals are small, unstable molecules that set off a chain reaction of oxidative stress, inflammation, and aging. Free radicals have the potential to create mutations in our DNA, “turning on” harmful genes and even leading to cancerous cell changes. Oxidative stress caused by free radicals is the main trigger for all types of chronic disease, such as heart disease, dementia and cognitive decline, type 2 diabetes, and accelerated aging of all tissues, including your skin. Free radical damage to mitochondria leads to a loss of endurance for exercise and handling situational stress. A diet that prevents free-radical-creating glucose spikes lowers oxidative stress and the resulting inflammation, thereby reducing the risk of any of these inflammation- based diseases.
Insulin is the hormone that stashes away glucose that our mitochondria can’t make use of at the moment. Insulin is released when blood sugar levels rise. First, insulin pushes extra glucose into the cells of our muscles and liver to be stored as glycogen. But then, when it runs out of “closet space,” it turns excess glucose into fat and stores it in our fat reserves. When the muscles and liver run out of glycogen, they should be able to tap into fat stores to replenish themselves, causing weight loss. However, if insulin is present, our body is prevented from tapping into these reserves. If levels of glucose are kept stable, insulin levels stay steady, allowing the body to burn fat for energy, thereby decreasing weight.
Excess levels of insulin contribute to adrenal stress, including hypoglycemia, by clearing glucose out of circulation and into fat cells to be stored for later use, causing blood glucose levels to drop. In order to normalize blood sugar, the adrenals have to produce increased levels of cortisol and epinephrine. This often leads to long-term cortisol depletion and ultimately adrenal hormone dysfunction.
The decline of a glucose spike back to normal levels also triggers cravings. Studies show that a decrease in glucose levels, even just a decrease of 1.1 mmol/L, leads to increased cravings for high calorie foods. This can lead to overeating.
Short & Long-term Effects of Glucose Spikes
- Cravings
- Fatigue/chronic fatigue
- Poor sleep (waking during the night)
- Suppressed immune response/more vulnerability to viruses and bacterial infections
- Exacerbation of hormonal hot flashes and night sweats (worse flashes = high levels of glucose and insulin in studies)
- Increased likelihood of migraines
- Memory and cognitive issues
- Increased risk of Alzheimer’s and dementia
- Acne and other inflammatory skin conditions
- Arthritis and other inflammatory diseases
- Increased cancer risk
- Heart disease
- Infertility and PCOS
- Insulin resistance and Type 2 diabetes
- Non-Alcoholic Fatty Liver Disease
- More depressive episodes
- Digestive symptoms like leaky gut, heartburn, acid reflux
- Accelerated aging and more rapid formation of wrinkles
Normal Blood Sugar Levels
According to the American Diabetes Association (ADA), normal fasting blood sugar is below 100 mg/dL. Levels between 100-125 indicate pre-diabetes, and anything over 126 when fasting is considered diabetic. After eating (postprandial), the ADA considers 70-140 mg/dL to be normal.
But, what’s “normal” isn’t necessarily optimal. Fasting glucose can be “normal,” but you may still experience glucose spikes over 140 mg/dL throughout the day. Instead, I prefer to look for these signs of optimal blood glucose levels:
- Fasting: 70-90 mg/dL
- Postprandial: Below 120 with a return to pre-meal glucose levels within 2 hours (ideally below 100)
However, a single blood sugar reading taken alone is not the best way to gauge overall blood sugar health. Instead, I suggest continuous glucose monitoring.
Continuous Glucose Monitoring
A Continuous Glucose Monitor (CGM) is a small device that you wear on the back of your arm for two weeks. They are painless to insert, and once placed, monitor the amount of glucose in your tissues 24 hours a day, sending the data to an app on your smartphone. Though they were originally developed for people with diabetes who need multiple blood glucose readings a day, almost anyone can benefit from the convenience and multiple data points a CGM can provide. A CGM is the best way to understand how specific foods affect your body, and the impact that glucose shifts have on your mood, energy, sleep, inflammation, and more.
Those interested in continuous glucose monitoring may be able to obtain one by prescription from your general practitioner, especially if you’ve had a history of elevated HBA1c, fasting glucose levels, or labs that suggest diabetes, gestational diabetes, or pre-diabetes. Alternatively, you can request a prescription to be filled at a pharmacy of your choosing through the concierge service at www.pushhealth.com. Request the Abbott Freestyle Libre unless you have an actual diagnosis of Diabetes, in which case you should qualify for insurance coverage of the Dexcom G6 CGM, which is more accurate, but more expensive out of pocket.
There are many subscription platforms using CGM, as well. These services come with app interfaces with more bells and whistles, food tracking built in, and generally some type of interactive coaching service available through in-app messaging. January.ai, Nutrisense, and Levels are a few of the better known platforms offering this service.
For more information on how CGMs work and directions on how to calibrate yours, read here.
Are Carbs Bad for Blood Sugar levels?
Since carbohydrates become the glucose that elevates blood sugar levels, it’s only natural to wonder if carbohydrates are something that should be avoided. But in actuality, it’s much more complicated than just “good” or “bad.”
Glucose is essential to life. In fact, in the absence of any glucose in the diet, the liver converts fat into usable glucose via a process called gluconeogenesis. We are also biologically programmed to love sweet tastes. In hunter-gatherer times, sweet flavor meant food was both safe and was rich in energy. Sweet tastes release dopamine in the brain, which registers as pleasurable, prompting us to seek more of it. We are literally designed to consume carbohydrates.
But, not all carbohydrates are created equally. Carbohydrates are made by plants during photosynthesis and consist of starches, fibers, and sugars, including glucose, fructose, and sucrose. These exist in different proportions in different plants: kale has lots of fiber and some starch, while cherries contain mostly sugars, and some fiber. The fiber in plants slows the absorption of the glucose. This is what nature intended. In modern times, we have learned first to breed plants for higher sugar content and sweetness, and then to extract sugar from the fiber in plants and use it to sweeten… everything! It is this that has led to chronic health problems and modern degenerative diseases, not carbohydrates themselves.
How Much Carbohydrate Should I Be Eating?
One of the most effective ways to prevent or reverse the excess production of insulin and cortisol is to balance the amount of carbohydrates and proteins that are eaten with each meal. The amount of carbohydrates that each person needs is highly individual, and is based on several factors: size, activity level, being physiologically male vs female, and biochemical individuality/genetics. For example, an average sized woman who is moderately active, and not trying to lose weight, might need 75-150 grams. If she’s training intensively, she might need closer to 200 grams, or more. An average sized man might need 150-200 grams, or up to 400 grams daily if highly active.
Proper macronutrient ratios (percentage of carb/fat/protein in the diet) vary by health goals as well, for example weight loss vs mood stabilization vs maintaining a healthy pregnancy. Weight loss is generally supported by lowering carbohydrate consumption, whereas some people with insomnia, anxiety, or depression may be better served by slightly increasing carb consumption. If you are only eating 50 grams daily, and not sleeping well, or suffering from energy or mood dips, consider increasing by increments of 25 grams daily up to 100 or 150 grams and noticing what happens.
The only way to know what is right for you is to experiment and observe how you feel. Additionally, wearing a Continuous Glucose Monitor (CGM - discussed above), can provide a sense of your carbohydrate tolerance at various times of day.
Beyond just the amount of carbs eaten, the type and way in which you eat carbs can also have a profound effect on blood sugar stability.
A few simple guidelines:
Include small amounts (1/2 – 1 cup) of starchy veggies (such as root vegetables, squash, or tubers), 1-3 times daily, depending on your personal carbohydrate need. Eliminate or minimize grains. If you do include grains, emphasize whole form, not flours, as flours have a higher glycemic load and will raise blood sugar more rapidly, and to a greater extent than their unprocessed counter-parts.
Include proteins with each meal in a weighted ratio of at least 2:1 of carbohydrate to protein.
Eat 15-20 grams/protein at each meal, unless directed otherwise by your healthcare provider based on specific health goals. This is approximately a palm-sized serving of fish, chicken, or red meat, or 2-3 eggs. You can also get some protein in the form of nuts, seeds, and legumes, just be aware of the carbohydrate load that beans naturally include. While this amount may be fine for some people, for people with blood sugar control issues, beans may be better as a condiment or salad topping.
Eat as many green, and then multi-colored (red, yellow, orange and purple) veggies as possible each day. Strive for 5-10 cups of veggies daily.
Use extra virgin olive oil, coconut oil/coconut butter/coconut milk, ghee, flaxseed oil (do not heat), macadamia nut oil, or avocado. Avoid canola oil and use seed oils sparingly.
Eat 1-2 servings maximum of fruit daily. Always consume fruit with a protein or fat: nuts, nut butter, or other fat/protein source.
If you struggle with elevated blood sugar levels, do not snack between meals, and instead eat at 3 specific times of day, or as your practitioner has recommended for you.
How to Flatten Glucose Spikes
#1 Deconstruct your meal
Instead of grabbing a bite of this and a bite of that, try this: eat veggies first (especially above-ground veggies and anything leafy). The fiber in veggies slows the breakdown and absorption of glucose. After you finish your veggies, eat protein and fat next, as fat slows the absorption of sugar. Save the starchy component of your meal for last.
#2 Add greens to the beginning of every meal
In addition to eating your veggies first, add a small salad or veggie appetizer before the meal, such as spinach leaves with a few artichoke hearts and vinegar and olive oil. Alternately, roast some low carb veggies like cauliflower and broccoli in the oven and store in the fridge to have on hand. Or, try grabbing a few bites of fermented veggies like sauerkraut or kimchi: eating even just a few bites of these prior to your meal lowers glucose spikes.
#3 Stop counting calories
Not all calories are equal. Weight management and health have much more to do with keeping glucose stable (using these techniques) than with sticking to an arbitrary calorie goal.Conventional wisdom says adding oil and vinegar to your salad only adds calories, but in reality those extra calories will keep you full longer, rev up fat burning, blunt the absorption of starches in the rest of the meal, and ultimately contribute to weight loss!
#4 Prioritize a high protein, lower carbohydrate breakfast with plenty of healthy fats
Extra points for fiber from veggies!This will set you up for better glucose control and energy through the day, as we are more sensitive to sugars first thing in the morning after fasting. Plus destabilizing glucose first thing with a high-sugar breakfast makes it very hard to regain glucose stability later in the day. (One note: Avoid smoothies containing lots of blended fruit, as this breaks up the fiber, making the sugar in the fruit more available, yielding bigger glucose swings. Some smoothies easily spike blood glucose as high as drinking a can of soda!
#5 Consume vinegar before a meal
To blunt glucose spikes, dilute 1 teaspoon to 2 tablespoons of any unsweetened vinegar– most people enjoy Apple Cider Vinegar the most– in water and drink before eating. Adding vinegar can reduce glucose spikes as much as 20%. Not a vinegar fan? This blog lists many delicious drink recipes based around apple cider vinegar.
#6 Move your body after you eat
With every movement we make, we burn glucose. If we stay still after a meal, glucose enters the bloodstream and then floods our cells and overwhelms our mitochondria. But, if we use our muscles as the glucose moves from the intestines into the blood, our mitochondria have a higher burning capacity and will use that glucose to make more ATP. This makes a huge difference when tracked using a glucometer or CGM: just adding exercise after a meal significantly lowers glucose levels. For best results, move anytime in the hour after you finish a meal - but it doesn’t have to be a hardcore workout. Just 10 minutes of walking is helpful, and if you can’t go for a walk, doing squats, planks, or lifting something heavy works just as well.
Sweet Foods & Dessert
If you’re going to eat dessert, the best time to eat it is at the end of a meal - meaning green starter, vinegar, then veggie, protein/fat, starches…..and then dessert. When snacking, opt for savory snacks whenever possible. Don’t eat carbs by themselves– always eat them with protein or fat beforehand. This includes fruit.
Replace sweeteners with monk fruit, allulose, or stevia (if you tolerate and enjoy stevia) where possible. Better yet, go sweetener free for a period of time to “reset” your taste buds. Avoid sweeteners like sucralose, xylitol, aspartame, maltitol, and erythritol.
Sample Blood Sugar Balancing Menu
Day 1:
- 8am breakfast: 2-3 egg scramble with 2-4 oz ground chicken or chicken sausage, chopped spinach, onion, garlic, herbs, cooked in 1-2 TBS of grass-fed butter or ghee or coconut oil. Ideally with a few bites of roasted broccoli from the fridge, beforehand.
- 11am snack if needed: 10 nuts or 1 TBS nut butter and 1 cup berries
- 1pm: leafy green salad with 2 cups of chopped veggies, hard-boiled egg, turkey or chicken breast, and salad dressing of fresh lemon juice and EVOO
- 4pm snack if needed: turkey roll-up (2-3 turkey slices rolled around avocado and hummus)
- 6-7pm: oven roasted fish (coconut crusted salmon: rub salmon with olive oil, sea salt and pepper and pat with flaked coconut. Bake at 375 for 20 minutes),1 cup of roasted butternut squash cubes, and 1-2 cups of sautéed leafy greens with garlic. Eat the greens first.
Day 2:
- 8am: Clean protein smoothie w/ 2 cups super greens, 2 TBS tahini, cinnamon, and 1 cup of berries blended in almond milk. Bonus: add 1 TBS of Paleo Fiber
- 11am: raw veggie sticks and guacamole
- 1pm: Lettuce wrapped lamb burger, leftover greens, 1/2 sweet potato with coconut butter
- 6-7 pm: shrimp fajitas (with 1-2 cassava coconut Siete Foods Tortillas) OR ground turkey lettuce tacos with organic pressure-cooked black beans . Eat the beans last!
Day 3:
- 8am: chicken sausage, grated parsnip hash cooked in avocado oil, with spinach and avocado 11am: protein powder smoothie with 1 cup berries and almond milk.
- 1pm: coconut milk soup with chicken, side salad
- 4pm: handful of almonds
- 6-7pm: pesto chicken breast, braised red cabbage (slice cabbage and sauté in olive oil + chicken broth), roasted beets in olive oil with rosemary.
- dessert/snack: dark chocolate (1-2 squares) with whipped coconut cream
Get Your Own Customized Plan
You have the power to take back control and help your body (and blood sugar) get back into balance.
For a customized plan, step-by-step support, and expert guidance, the first step is to book a free, no-obligation discovery call with my health team.
Learn about how we work with clients to achieve their unique health goals and help them step back into radiant health, so they can stop worrying about how they feel and start living a purposeful life.
> Book your free discovery call here
Check Out These Books for Further Reading
- The Glucose Revolution by Jessie Inchauspe
- Drop Acid by David Perlmutter
- Unlocking the Keto Code: The Revolutionary New Science of Keto That Offers More Benefits Without Deprivation by Steven Gundry.
Insulin Sensitivity and Gut Health—A Dynamic Duo
Do you want your skin to look smooth and youthful for as long as possible?
Do you want your brain to be sharp?
What about losing weight and maintaining a slender, sleek body?
These are just some of the reasons to care about keeping your insulin and blood sugar levels balanced—even if you don’t have prediabetes or diabetes. Yet, when many people hear about insulin sensitivity they think it’s only relevant to diabetics.
That couldn’t be more wrong.
There are good reasons for everyone to care about how their body is handling insulin. And surprisingly, it’s your gut that plays a major role in keeping this blood-sugar-balancing hormone in control.
If your gut is unhealthy, your body won’t handle insulin well, which means your blood sugar will get out of whack.
What Is Insulin Sensitivity?
Insulin is a hormone that’s made when our blood sugar (glucose) levels rise. It pushes extra glucose into the cells of our muscles and liver, where it’s stored as glycogen. But when our muscles or liver run out of closet space to store the glucose, the excess is converted into fat and stored in our fat reserves.
When muscles and the liver run out of glycogen they should be able to tap into fat stores to replenish themselves, causing weight loss.
However, if insulin is present in excess amounts, it blocks your body from tapping into those reserves.
What causes high insulin levels? Usually the culprit is high blood glucose in the form of glucose spikes that often happen even in people without diabetes.
Insulin sensitivity refers to the body’s ability to respond to the blood-sugar-lowering signals that insulin is broadcasting. If the body can’t respond to those signals, it starts making more and more insulin to try to “hear” what insulin is saying. Kind of like talking louder when someone can’t hear you. Reduced insulin sensitivity is known as insulin resistance. In other words, your body isn’t as sensitive to insulin anymore so it needs to make more and more.
Why You Should Care About Insulin Sensitivity
Poor insulin sensitivity and glucose spikes are to blame for a number of health problems, not just diabetes. For example, they’re linked to:
- Accelerated skin aging and more rapid development of wrinkles
- Acne and other inflammatory skin conditions
- Adrenal stress
- Arthritis and other inflammatory diseases
- Cravings
- Depressive episodes
- Digestive symptoms like leaky gut, heartburn, acid reflux
- Fatigue/chronic fatigue
- Heart disease
- Increased cancer risk
- Increased risk of Alzheimer’s disease and dementia
- Infertility and polycystic ovary syndrome (PCOS)
- Memory problems
- Migraines
- Non-alcoholic fatty liver disease (NAFLD)
- Poor sleep (waking during the night)
- Suppressed immune response
- Type 2 diabetes
- Worsening of hormonal hot flashes and night sweats
How The Gut Controls Insulin Sensitivity
Problems in the gut lead to problems with blood sugar and the way your body uses insulin. Usually people don’t connect the gut with insulin problems, but there is a HUGE connection between the two.
Here’s the deal: The gut affects insulin sensitivity in five ways. Some of these might sound kind of technical, but bear with me for a moment as I’ll explain them all in a minute.
- Leaky gut
- Endotoxemia
- Production of short-chain fatty acids like butyrate
- Alterations in bile acid metabolism
- Effects on the secretion of gut hormones
The common denominator in all five of these factors is an imbalance in the gut microbiota. The gut microbiota are the little organisms that live in your intestines, both good and bad bacteria, viruses, and fungi. Scientists call an imbalance in the gut microbiota dysbiosis. Dysbiosis is common in diabetes, suggesting the gut microbiota and blood sugar problems are connected. In diabetes, levels of beneficial bacteria are decreased, whereas many harmful bacteria are increased. Small intestinal bacterial overgrowth is also common in diabetes.
Leaky Gut
Gut microbiota dysbiosis can lead to leaky gut, otherwise known as increased intestinal permeability. Leaky gut is the name for what happens when a person’s intestinal lining is weakened. This weakened lining allows toxins and bacteria to slip through into the bloodstream, causing problems throughout the body. Leaky gut creates inflammation and reduces insulin sensitivity. There’s also a link between leaky gut and diabetes.
Low-Grade Endotoxemia
Bacteria in the body produce a type of toxin known as an endotoxin, primarily a bad guy known as LPS. It’s a component of bacterial cell walls found mostly in gram-negative bacteria. When LPS escapes the colon during leaky gut and becomes a fugitive on the run throughout the body, it triggers an inflammatory response known as endotoxemia.
LPS also does a number on the way your body uses insulin. LPS triggers an inflammatory cascade in every type of tissue it comes into contact with in the body. In insulin receptors, this inflammation leads to reduced sensitivity to insulin—or—insulin resistance.
Endotoxemia and leaky gut go hand in hand. Since the intestinal lining is weaker, it allows these toxins to escape into the bloodstream, causing problems that at first glance don’t seem as if they’re linked to the gut.
Butyrate and Short-Chain Fatty Acids
Short-chain fatty acids like butyrate are important for gut health and insulin sensitivity. Bacteria in the gut, especially those that belong to the phylum Firmicutes, make butyrate. If your gut isn’t making enough butyrate it spells trouble for the way your body uses insulin.
In studies of obese mice, butyrate supplementation increased insulin sensitivity and improved weight loss. Fasting blood glucose, fasting insulin, and insulin tolerance remained normal in mice given butyrate.
In humans, if there aren’t enough butyrate-producing bacteria, it boosts the risk of metabolic disorders like diabetes.
Butyrate repairs the intestinal lining and reduces inflammation, helping to get rid of leaky gut, which in turn promotes healthy blood sugar levels.
Bile Acid Metabolism
Another way in which the gut controls insulin sensitivity is by regulating the way the body produces bile acids, which stimulate insulin secretion. People with leaky gut don’t recirculate bile acids efficiently. So they wind up with bile acid deficiency over time, which leads to inefficient detoxification as well as changes in how your body regulates fat and carb digestion.
Secretion of Gut Hormones
A healthy gut equals healthy amounts of gut-derived metabolic hormones called glucagon-like peptides (GLP-1), which are linked to blood sugar balance. GLP-1 boosts insulin levels when there’s glucose in the blood, helping to push glucose into your cells to improve blood sugar levels.
GLP-1 also keeps you feeling full and satisfied after eating so that you can stay away from desserts and other unhealthy foods.
How To Know If You Have Blood Sugar Issues
One of the best ways to monitor your insulin and blood sugar levels is to work with a functional medicine provider, who will order lab tests. The lab tests to measure insulin sensitivity and blood glucose include:
- Fasting glucose, optimal range 70 to 85
- Fasting insulin, optimal below 5
- Fasting uric acid, optimal less than 5.5
- HBA1c (a measure of blood sugar control over time), optimal range 4.8 to 5.2
Also important: Finding out if your gut is healthy by using a stool test. I like the BiomeFX panel.
The second way to see how your body is coping with blood sugar is to monitor glucose spikes. Everybody has glucose spikes to a certain extent. But when insulin sensitivity is low, blood sugar spikes are often too high since insulin is unable to control your blood glucose.
The best way to monitor glucose spikes is by using a glucose monitor for two to four weeks. Monitor readings should be 70 to 120 the majority of the time, but even more ideal is 70 to 100. Lots of people spike above 140, even if they’re not diabetic, but most of us shouldn’t be going over 120 most of the time.
What To Do About Glucose Spikes and Reduce Insulin Sensitivity
Eat Foods That Support Butyrate and Probiotic Bacteria
The main goals of balancing blood sugar and insulin are to raise butyrate levels and to get rid of any gut microbiota imbalances.
From a dietary perspective, there are certain foods you can eat to increase butyrate levels.
Butyrate foods include:
- Apples
- Leeks
- Onions
To support a healthy gut microbiota, eating high-fiber foods rich in prebiotics is a good first step. These types of foods can also help butyrate-producing bacteria flourish. Research has shown that eating fermentable fiber was linked to an increase in the beneficial bacteria Bifidobacteria. This type of fiber also normalized LPS and improved glucose tolerance and insulin secretion, while reducing inflammation.
Prebiotic foods include:
- Apples
- Beans
- Bran
- Chicory root
- Garlic
- Jerusalem artichoke
- Oat bran
- Onions
- Psyllium husk
- Tomatoes
It’s also a good idea to limit sugar and saturated fat, since these can cause butyrate levels to tank.
Butyrate Supplements and Other Solutions
Another way to increase butyrate levels is through using certain dietary supplements. In animal studies, giving mice butyrate supplements blocked the development of insulin resistance caused by eating a high-fat diet.
Probiotics containing Bacillus bacteria endospores such as MegaSporeBiotic can increase butyrate-producing bacteria in the gut.
Certain supplements can also boost butyrate production directly. These include:
- Alanine
- Citrus polyphenols
- Cystine
- Glutamate
- Glycine
- Lysine
- Oligosaccharides (FOS, GOS, XOS)
- Proline
- Sulforaphane
- Threonine
- Tributyrin X by Healthy Gut Company
I have found that it’s possible to boost butyrate by 140% in four weeks using a combo of MegaSporeBiotic and MegaPre—which only feed selectively the keystone bacteria species, not the bad guys—along with MegaMucosa to heal and repair leaky gut with essential nutrients as building blocks.
Balancing Blood Sugar By Improving Gut Health
I have seen so many patients experience an improvement in their health after addressing gut issues, restoring butyrate levels, and balancing insulin and blood sugar levels. They’ll often have improved energy, clearer skin, better sleep, less hot flashes, and many of their other health complaints go away.
You’re going to have the greatest success working with a functional medicine provider who can tackle all the bases. That’s why I invite you to reach out to me for a free 15-minute call to find out the best course of action for you.
If after the call you come on board as a patient, I’ll order the right tests for you. Based on the results and your symptoms, I’ll start you on a protocol to balance blood sugar, improve your gut health, and help you look and feel your best.
How to Heal Ulcerative Colitis: A Case Study
If you have ulcerative colitis, this is a case study you’re going to want to read. It’s about a woman—I’ll call her Sherrie—who suffered from this condition for years—until we were able to make some real breakthroughs in her health.
Ulcerative colitis is a type of inflammatory bowel disease (IBD), a disorder that also includes Crohn’s disease. People who have ulcerative colitis have an inflamed colon and rectum and ulcers on the intestinal lining. Living with IBD can be a roller coaster. Their symptoms worsen during flare-ups and their symptoms go away during periods of remission.
Doesn’t sound like much fun, does it?
Ulcerative colitis is often hard to put into remission. It can take time to pin down and treat the root cause. But I’ve found that ulcerative colitis responds well to functional medicine. Often, we can send its bags packing—or at least put it into a long-term remission.
Such was the case for Sherrie.
Sherrie’s Long-Term Battle With Ulcerative Colitis
When Sherrie first came to see me in January 2018, she had been diagnosed with ulcerative colitis nine years prior at the age of 25. Before developing symptoms, she’d had a stressful few years. She bought a house, got married, was finishing her bachelor’s degree, and became pregnant for the first time.
After her initial diagnosis her symptoms were manageable for years. She responded well to the drugs offered her. Conventional doctors gave her prednisone and Lialda (mesalamine) to lower inflammation. Most of her ups and downs were during pregnancy when she had to get off her meds, and she’d get better when she went back on the drugs.
After her third child was born in 2013, she went into remission and didn’t need to take any UC medications for two to three years. Then she caught a cold while traveling and this turned into an ear infection. She took antibiotics, which led to a UC flare. In the two years before she contacted me, she never came out of the flare, which motivated her to seek my help.
Sherrie suffered from bloody stool and watery, urgent diarrhea six to ten times per day. She couldn’t leave her house for fear of not being near a bathroom when she had to go.
She’d never been hospitalized, but the poor dear had only been in remission for a brief period since giving birth, she told me. Pregnancy and birth can cause an immune shift and had made her ulcerative colitis even more difficult to control.
The lab work ordered by other doctors found:
- Low iron and ferritin
- Low vitamin D
- Low potassium
- Low hemoglobin (she was anemic from blood loss)
- Monocytes and eosinophils very high (suggests a parasitic or other type of infection.)
When she first came to my clinic, she was already on a strict paleo diet. That by itself didn’t do any good.
Treating Stress Hormone Imbalances
The first step? Treating Sherrie’s stress-response system. The hypothalamic-pituitary-adrenal axis (or HPA axis) regulates our circadian rhythm and our stress response. Chronic stress can really throw the HPA axis out of balance, which leads to hormone imbalances. It can cause the adrenal glands to pump out too much of the stress hormone cortisol. Some people call this “adrenal fatigue,” but it’s really a problem with the entire HPA axis.
As Sherrie tapered off the prednisone, I gave her a higher than normal dose of dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands. Because she had been under stress, her adrenal glands were likely worn out and weren’t making enough DHEA.
In fact, every ulcerative colitis patient I’ve treated has had HPA axis dysregulation. So I typically always address this in my UC patients.
And guess what? Her ulcerative colitis flare regressed for the first time in two years. She now had only minimal rectal bleeding and not every day.
Candida and Intestinal Bugs
While dealing with Sherrie’s adrenals, I ordered a stool test that revealed she had high levels of the following bacteria and fungus:
- Candida
- Klebsiella
- Prevotella
- Proteus
- Pseudomonas
- Salmonella
- Staphylococcus
- Streptococcus
It didn’t surprise me that she had Candida overgrowth. The fact she had gotten worse after taking antibiotics for her ear infection was a BIG clue that fungal overgrowth played a role. Candida is a type of yeast that under the wrong conditions can turn into an invasive fungus in your body.
Plus, we know from studies that almost all cases of ulcerative colitis involve the marriage between a fungal imbalance and a bacteria that either trigger immune dysfunction or worsen it.
In mouse studies, Candida albicans can worsen inflammatory colitis. What’s more, the yeast Candida tropicalis teams up with certain bacteria like E. coli to form a monstrous biofilm larger than any created by just one or two of the species alone. A biofilm is a type of shield that bacteria and fungi can form to protect them from things like antibiotics.
The stool test also detected the presence of an amoeba parasite known as Entamoeba coli. Although many people with this parasite don’t have any symptoms, high amounts are linked to loose stools, gas, and other GI complaints. Amoeba infections in general are also linked to IBD.
Sherrie’s stool test also showed high levels of calprotectin, which is a marker of inflammation in the gut lining. A high calprotectin is a red flag for IBD. Her levels of secretory IgA (SIgA) were also high. SIgA lines your intestines and acts as a gatekeeper, keeping bacteria, parasites, and allergens out of your circulation.
Fancy Footwork and Ulcerative Colitis
I began treating the parasitic infection, balancing the microbes in the intestines, and starting round one of Candida treatment. However, we had to put the brakes on treating the Candida for a little while because before starting treatment for this fungus, Sherrie went into flare mode.
There’s often a lot of fancy footwork needed to treat ulcerative colitis patients. Flares can happen due to stress, seasonal changes, and other reasons. We need to time treatments so that we’re not putting too much stress on the body during flares.
Other issues that showed up in testing also needed attention. For example, her mitochondria—the powerhouses of the cells—were in trouble. This is likely because the Candida produced ammonia and acetaldehyde, both toxins to the mitochondria. She also had high levels of a damaging process known as oxidative stress due to the autoimmune process that had created a years-long raging fire in her body.
Her glutathione levels had also tanked, so her body wasn’t making enough of this antioxidant to fight the oxidative stress. I included liposomal glutathione into her regimen.
Here are some other strategies that worked:
- Adding low-dose naltrexone, an anti-inflammatory drug shown to reduce symptom severity in IBD
- Eating an anti-inflammatory diet and adding in foods like rice and some dairy
- Gut-focused hypnotherapy for her post-traumatic stress disorder (PTSD) response when getting into her car. This was triggered by the fear of needing to poop and not being near a bathroom. This therapy and the progress we were making allowed her to travel far from home.
Big Improvements in Ulcerative Colitis Symptoms, But More to Go
By August 2018, Sherrie was the best she’d been in two years!
In September 2018, I ordered another stool test and some other lab work. Some of her beneficial gut bacteria were low and her calprotectin levels were still high. At the same time, I ordered a food reactivity test. Based on that, I had her avoid eggs, wheat, lentils, peas, cashews, peanuts, tuna, and a few other foods.
Her worst flares tended to happen between Thanksgiving and Christmas. My theory? Holiday stress combined with lack of sun and vitamin D contributed to these flares. I learned to give her proactive support heading into that time of year.
Finally, for the first time, she was able to go through the holidays with only a minor flare. I gave her a Chinese herbal formula known as Yunnan Paiyao, which stopped the flare in three days. The Chinese herbs also firmed up her stool.
In addition, I gave her pre- and probiotics and improved her detoxification and antioxidant levels.
Ultimately, after a period of three steps forward and two steps back, she was able to endure the holidays with zero flares.
By January through May 2019, she was better overall and her stool consistency improved, but she was still bleeding mildly.
So much progress, but there was still a root cause that had not been addressed. At this point, I ordered more testing, including a stool test that found the amoeba parasite Blastocystis. The testing also revealed problems digesting and using fats, so I had her take ox bile and a few other supplements.
What’s more, her zinc levels were low. Zinc is critical for bowel repair and lowering inflammation. Selenium—a mineral critical for autoimmune health and the production of glutathione—was also low.
The testing showed her oxidative stress levels were high and her detox abilities were overwhelmed. Levels of the antioxidant glutathione were better, but still low. She still had some Candida.
How To Stop An Ulcerative Colitis Flare-up
In July 2019, after a stressful event, Sherrie went into another flare. I put her on the Specific Carbohydrate Diet (SCD), a diet that’s free of sugar, grains, starch, and processed foods, which really helped. Butyrate enemas were also helpful. Butyrate is a short-chain fatty acid formed from the fermentation of dietary fiber in the colon. It is the main fuel the cells of our intestinal lining use for repair, and it is known to reduce ulcerative colitis symptoms.
Even before our next appointment, as soon as Sherrie could feel a flare coming on, she immediately followed my advice for reducing a flare. It was a BIG win! She was learning how to manage and stop flares on her own. The flare stopped by August and by the fall she was the best she’d been in four years.
She had another flare at the end of summer triggered by poison ivy while camping, but she was able to stop it within two to three days.
By fall she was feeling amazing. She was having regular, twice daily bowel movements. There was no urgency and the stool was well-formed. At the same time, Sherrie was finishing round two of the Candida program.
From fall of 2019 to January 2020, Sherrie stayed in remission. Right after the holidays were over she had another flare, but she was able to stop the flare almost entirely on her own before our next appointment. Yay!
We tested again. As you can see, this is a process of continually testing, treating, and modifying the protocol until we can get ahead of the disease process. Since her vitamin D levels were very low, I gave her a higher dose supplement. Her gut microbiome was also imbalanced with low levels of a type of bacteria known as Akkermansia. I focused on restoring levels of this important bacteria using specific prebiotics (pomegranate seed husk, matcha, greens powders, red powders for polyphenols, and acacia fiber) in order to repair her gut lining.
She had only a mild flare in the winter of 2019-2020. This happened in February 2020 and drew out with occasional small amounts of blood until April.
Can Mold Toxicity Cause Ulcerative Colitis?
After the flare in February 2020, we discussed some reasons why she kept having flares—and we had a breakthrough.
I knew that there is a link between mycotoxins—toxins produced by mold—and ulcerative colitis. When no obvious lifestyle or nutrition factors could explain Sherrie’s UC flares, I started digging deeper into what might be bothering her in her environment- her house to be exact. The fact she got worse in winter when the environment was more moist also pointed toward mycotoxins as a possible cause.
Even though her home was a new build she knew for certain there was periodically mold in her home. She and her husband often tried to clean it up.
We tested Sherrie for mold and mycotoxins in April 2020. Many markers for mycotoxins were high. An inflammatory marker known as TNF-alpha was also elevated.
Aha! Mold could definitely be the culprit.
She had her home inspected by a professional company that uses indoor mold testing and found the home was contaminated.
I started Sherrie on a treatment regimen for mycotoxins in July 2020 to proactively get her through her vulnerable period in late fall/winter.
At first that strategy paid off. She felt great. Her stool was firm and she had no flares.
She took a break from the mycotoxin program and had a flare between Christmas and New Year’s 2021. She mostly recovered within a month. But since she was still having flares, I decided to retest her for mycotoxin markers in February 2021.
That testing revealed she still had very high levels of the mycotoxin known as ochratoxin. Although these tests aren’t always 100% accurate, Sherrie’s lack of complete progress, her symptoms, and other markers suggested mold could be to blame.
I put her on another round of the mold protocol, and she stayed well through August 2021.
I ordered another mycotoxin test and it was much lower, although still high. This suggested she might be getting re-exposed.
Her husband had done some mold remediation on their home. But another round of indoor mold testing still showed the mold was off-the-charts positive. A mold-testing company found more mold in the utility room behind the water heater, in the shower caulking, and in the air.
They had their home professionally remediated.
I then put Sherrie on another round of mold treatment.
She had COVID-19 in November 2021 but did not experience a UC flare even though her body was under stress from the virus. This showed her intestines were getting stronger.
Stopping Ulcerative Colitis in Its Tracks: Success at Last!
Sherrie had no UC flares through the winter of 2021—the first winter with no flares in nine years. Over the course of treatment, Sherrie would have long periods up to a year with no bleeding, but she might develop loose stools with blood for a few weeks and then go back into remission. But by 2022, she had gone a very long time with no visible blood in her stools. Now we were getting somewhere!
Her mold test came out clear. She felt great—high energy, no anxiety, and able to travel a lot in the winter and spring without fear.
At this point, I put her on a long-term program featuring antioxidants and pre- and probiotics. She’s taking minimal supplements and doing well.
Sherrie’s case shows that ulcerative colitis and inflammatory bowel disease respond well to a functional medicine approach. In IBD, there are many overlapping root causes that must be identified, treated, and modified, all the while working around a person’s flare-ups. Over time, Sherrie and I figured out her triggers and she learned the tools to stop her flares before they started. It may take some time, but ultimately a functional medicine practitioner can dig down to the root problem in order to heal ulcerative colitis.
Heal Ulcerative Colitis with Functional Medicine
Like Sherrie, you can heal ulcerative colitis by working with a functional medicine practitioner. That’s why I invite you to reach out to me for a free 15-minute troubleshooting call to find out the best course of action for you.
If after the call you come on board as a patient, I’ll order the right tests for you and start you on an anti-inflammatory protocol. The goal is to pinpoint your individual triggers and put ulcerative colitis in remission or cure ulcerative colitis altogether.