Tag: food intolerances

Developing a schedule for a healthier pregnancy

Pregnancy can be very difficult, especially if you already have chronic health problems. Personally, I felt very sick starting week three, and until around week 12 – 13. The sickness presented itself in terms of nausea, extreme fatigue, and increased anxiety. Only once I started to feel less nauseous, I was able to go back to my regular diet which limits refined carbs and continue with intermittent fasting again. I did then also start feeling worse in the third trimester, around after week 34. From my experience, these are the actions which have helped me to feel better:

  • Start taking folic acid as soon as possible, preferably before conception. Folic acid supplementation has been found to reduce neural tube defects, as well as congenital heart defects. Taking folic acid supplement every day can provide a positive feeling that you are doing the right thing for your baby’s health.
    From Health Canada: “Folic acid is vital to the normal growth of your baby’s spine, brain and skull. Taking a daily vitamin supplement that has folic acid can reduce the risk of your baby having a neural tube defect. The benefits of taking folic acid to reduce the risk of NTDs are highest in the very early weeks of pregnancy. At this stage, most women do not know they are pregnant. For this reason, taking folic acid before you become pregnant and in the early weeks of pregnancy is very important.”
    https://www.canada.ca/en/public-health/services/pregnancy/folic-acid.html
    Recent studies have shown that high folate intake is associated with a reduced risk of birth defects other than NTDs. Higher maternal folate or periconceptional use of folic acid is associated with a lower risk of congenital heart defects (20-23) and oral clefts (24). A recent meta-analysis of 1 randomized controlled trial, 1 cohort study, and 16 case-control studies has shown that maternal folate supplementation is associated with a lowered CHD risk (RR =0.72, 95% CI: 0.63–0.82) (25). However, the results showed considerable heterogeneity, but after excluding the outliers the risk estimate was almost unchanged: the corresponding pooled RRs were not materially altered (RR =0.78, 95% CI: 0.69–0.89) (25).
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837928/#:~:text=Recent%20studies%20have%20shown%20that,and%20oral%20clefts%20(24).
  • Iron supplements – Iron deficiency is the most common nutritional deficiency during pregnancy. It happens most often during the third trimester. The iron in meat, fish and poultry is the easiest for our bodies to absorb and use. Foods rich in vitamin C help you absorb more iron. You can start taking an iron supplement during pregnancy in order to make sure you get enough and to prevent anemia. Low iron can lead to more fatigue, shortness of breath, weakness, headache, dizziness. All these symptoms in turn can make you more depressed. If low iron will lead to anemia, there will not be enough hemoglobin, and less oxygen will get to your cells. Cells won’t be functioning properly, and this can also contribute to depression and anxiety.
  • Prenatal vitamins – you can easily buy prenatal vitamins in a pharmacy or online. Nutritional yeast flakes also contain multiple vitamins. I’ve experienced more and more lethargy in the third trimester, and I started adding small doses of nutritional yeast flakes to smoothies. I have the Bob’s Red Mill brand, it is fortified inactive yeast, contains high doses of B vitamins – thiamine, riboflavin, niacin, B6, folate, and B12. It’s very cheap, given that the whole pack was around $8, and I consume less than a teaspoon a day, as the vitamin concentration is very high. I don’t see the need to take more than the needed daily value of B vitamins. I found that actually taking overly high doses of B vitamins for me can lead to panic attacks. Small doses of nutritional yeast do help me with energy during the third trimester, it can get me out of a very lethargic vegetative state to at least being able to wash the dishes, write in my blog, etc.
  • Sleep more – pregnancy can cause extreme fatigue. I found that instead of 7 – 8 hours, I currently need to sleep 9 hours. It helped me to start going to bed earlier, before 12am, then I am able to wake up for work before 9am. I also found that staying asleep became more difficult, I would wake up at around 4:30am, unable to fall back asleep. What helped me is eating the last meal four hours before bed, and the meal consisting mostly of non-refined starch, and not a lot of protein. The best sleep occurs for me if I eat short grain brown rice or potatoes (not fries) with something for dinner. Some studies mention that it is the prebiotic foods which can help sleep. “More commonly eaten foods that contain prebiotics include asparagus, onions, garlic, cashews, pistachios, and cooked and cooled grains and potatoes.” On the other hand, I found that eating cheese or red meat in the evening causes nightmares for me during the night, therefore I only eat those foods earlier on in the day.
    https://www.sbs.com.au/food/article/2020/03/13/science-suggests-prebiotic-foods-might-help-you-sleep
  • Foods for anxiety – even though there is no recommendation to completely avoid coffee during pregnancy, I had to stop drinking any coffee as it would increase my anxiety more than before pregnancy. I also had to figure out which foods exacerbate acid reflux, which got worse. Ongoing acid reflux would make it uncomfortable for me to sit, lie down, sleep, and relax. It’s hard to calm down and do any breathing exercises, or just read a book, if your throat is burning, and you feel acid going up. I had to stop eating chocolate, spicy foods, coffee, black tea, lemon, soups, and meals containing a lot of tomatoes. I found oolong tea to be a good option. I also found helpful choosing complex carbs over refined carbs – making my own oat whole wheat pancakes, eating brown rice, potatoes, lentil pasta, plantains. Eat some protein with each meal.
    From the Mayo Clinic: “Carbohydrates are thought to increase the amount of serotonin in your brain, which has a calming effect. Eat foods rich in complex carbohydrates, such as whole grains — for example, oatmeal, quinoa, whole-grain breads and whole-grain cereals. Steer clear of foods that contain simple carbohydrates, such as sugary foods and drinks.“
    I also had to stop consuming all dairy products, I noticed they were making my anxiety worse, as well as increasing brain fog. Again, from the Mayo Clinic:
    “Pay attention to food sensitivities. In some people, certain foods or food additives can cause unpleasant physical reactions. In certain people, these physical reactions may lead to shifts in mood, including irritability or anxiety.“
  • Food sensitivities – if you are avoiding any foods due to food sensitivities, make sure you get enough nutrients from other foods. I used to eat dark chocolate, which contains a lot of magnesium, but had to stop due to acid reflux. I made sure to eat other magnesium containing foods such as peanuts, bananas, and flax seeds. I also had to stop consuming any dairy, as I noticed that it was increasing my anxiety, rumination, and brain fog. I had to start consuming fortified soy milk, tofu, dairy-free yogurts, etc., in order to get calcium. I also took calcium supplements, and made my own supplement from egg shells.
  • Exercise – an important step with exercise, as with all pregnancy symptoms/issues in general, for me was acceptance. Acceptance that I could no longer do what I used to do several weeks ago. I used to dance for my mental health, because I enjoy reggaetón, and moving freely, and aerobic exercise is supposed to reduce depressive symptoms. I had to accept that I could no longer do that on most of the days due to nausea, fatigue, migraines. But still when I could, I tried to move – going for a walk near my house, going up and down the stairs (the house where I live has a staircase), doing a physical chose – washing the floor, vacuuming. Some movement is better than no movement at all, and I accepted that is it the situation right now, but it is also temporary.
  • Mindfulness – sometimes you cannot solve a problem. I have been feeling pretty lethargic throughout the whole pregnancy, especially in the third trimester. I was also not able to resolve the acid reflux issue and the stuffy nose, only reduce the symptoms somewhat. Mindfulness helps to observe your experiences from the side and accept that these are the current sensations/emotions/symptoms. I think observation can help realize how negative symptoms come in waves, so that you don’t end up generalizing or catastrophizing – “every day is terrible”, “I always feel awful”. I’m also mindful of the fact that I chose to be pregnant, as my goal is to have my own family, therefore this is something I have to go though in order to achieve my goal. I also remind myself that pregnancy is definitely a temporary condition, no one has stayed permanently pregnant.

Autoimmune Encephalitis and Diet

This post will be mostly based on anecdotal evidence , but I believe this information is still useful and there is not much harm in the suggested diets. In the worst case, the diet won’t help with autoimmune symptoms,  and you’ll just end up eating more vegetables. I don’t think that’s a terrible outcome.

The most popular diet for autoimmune diseases is the Autoimmune Protocol Diet (AIP). Most popular doesn’t mean it has the most evidence to back it up, but for whatever reason, it got around the internet. The AIP diet excludes many foods that are considered to be inflammatory and claims to reduce levels of thyroid antibodies. I cannot claim that his mechanism is true as there are almost no scientific papers on this, only anecdotal evidence. On the other hand, this diet is not unhealthy, so I doubt someone would be worse off by trying it. Usually bloggers/naturopaths recommending the diet suggest to try it for at least thirty days. Food groups that are excluded are gluten, all grains, pseudo-grains, dairy, legumes, beans, nuts, seeds, nightshades, eggs, vegetable oils, processed foods, and sugar. I might be forgetting something because there are so many items that get excluded, but if you are interested, you can read about the diet below.

Autoimmune Protocol Diet

What evidence is there? Well when I googled “AIP diet evidence”, I found one paper. You can try the same Google search. This particular study found that following the AIP diet, 6 weeks elimination phase and 5 weeks maintenance phase, improved endoscopic inflammation in patients with IBD (irritable bowel disease). Only 18 patients were enrolled in the study, so that is a very small sample size. Also such a study does not tell us whether it was necessary for all these food groups to be eliminated, maybe the results would be the same if only gluten and processed foods were eliminated. So it is some evidence that the diet helps but it is only one study and it doesn’t tell us about the mechanism of action of this dietary intervention.

Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease

Personally I did follow the AIP diet for about a year. When I found out in June 2016 that I had high levels of thyroid antibodies, I finally started to have some hope that maybe I have an autoimmune disease that can be treated instead of treatment resistant schizophrenia and psychotic depression. My mom googled a lot at that time, I didn’t have the energy or motivation to do it, and she convinced me to start trying dietary changes. I started by excluding gluten and dairy and later on went on the AIP diet and stayed on it until December 2017. In June 2016 my Anti-Tg antibodies were over 1000, Anti-TPO was 40 something. Comparing to spring/summer 2016, I did improve by fall 2017, and my Anti-Tg antibodies reduced to about 500. Anti-TPO stayed the same. Was this improvement directly related to the AIP diet and was it necessary for me to eliminate all the food groups? I don’t know the answer to that question. I did go to a gastroenterologist who diagnosed me with chronic gastrointestinal inflammation and advised me to go on a low FODMAP diet. AIP diet overlaps with low FODMAP diet, therefore it could be that it was the elimination of high FODMAP foods that helped me.

The low FODMAP diet is based on the idea that certain foods contain compounds that contribute to gastrointestinal disorders such as IBS. FODMAPS are short chain carbohydrates and sugar alcohols, such as fructose, fructans, galacto-oligosaccharides, lactose, and polyols. Research indicates that some people might not be able to digest these compounds well and this could lead to inflammation in the intestines and gas produced by bacteria as they break down undigested carbohydrates.

Below is a list of high and low FODMAP foods (for those that are FODMAP intolerant it is advised to avoid high FODMAP foods, this can be discussed with a gastrointerologist).

High and Low FODMAP Foods

Could a bad diet cause brain inflammation and psychotic depression? Could a change in diet reduce symptoms if there is inflammation? I don’t think at this point we have a concrete answer, there have been studies though which indicate that a specific diet could improve your mood and physical health. Autoimmune encephalitis is quite rare and I haven’t seen studies on AE patients and diet changes, but I still encourage you to consider whether you are eating healthy and to consider making changes. In general, from what I’ve read, many doctors consider the Mediterranean Diet. This diet includes whole grains, a lot of vegetables,  yogurt , nuts and seeds, and more fish instead of meat (increasing Omega 3 content). There has been a study with positive results, indicating that Mediterranean diet can help patients with depression.

Mediterranean Diet Depression Article

So which diet is best, should you try a specific diet, which one? There is no medical test for this at the moment, only trial and error. As I mentioned, I was on the Autoimmune Protocol Diet for about a year and I did see an improvement in symptoms and reduction in Anti-Tg antibodies . My gastroenterologist also advised me to stick to a low FODMAP diet due to my abdominal issues and I have been following this advice. After I received the IV steroids treatment in December 2017, I relaxed my AIP dietary restrictions and tested several items. I stick to eating gluten-free free and cow dairy free, also I felt that I had skin/abdominal issues become aggravated by potatoes, peanuts, and hot peppers. I avoid processed foods and vegetable oils.

It sounds restrictive but I found this diet to be working for me and I feel that I have enough variety. I eat a lot of goat/sheep/buffalo plain yogurt with nuts and seeds, tea with goat milk, quail eggs, poultry , seafood. In terms of vegetables – zucchini, carrots, squash, plantains, sweet potatoes, kale, spinach, bell peppers, etc. Grains – black rice,  quinoa, buckwheat, oatmeal. For bread I eat sourdough version and sometimes I make cassava flour tortillas. I don’t eat beans and legumes much because they are high FODMAP, sometimes I add canned chickpeas or sprouted mung beans. For cooking I use olive, avocado , and coconut oils.