Paleo Diet Challenges & Solutions IV: Is Sluggish Detox Sabotaging Your Paleo Diet?

By on January 11, 2013 in Food & Nutrition, Paleo Diet | 91 comments

woman feeling sickPlease read part I, part II and part III of this series if you haven’t already.

The final challenge to adopting a Paleo diet is impaired detox capacity. If you can’t detox properly, even the healthiest Paleo diet won’t be enough to resolve your symptoms.

If you can’t detox properly, even the healthiest Paleo diet won’t be enough to resolve your symptoms. Tweet This

The liver is the main organ of detoxification. It’s primary job is to convert toxins — most of which are fat-soluble — into water soluble compounds that can then be excreted. But there’s so much more to detoxification than the liver.

The list of symptoms caused by impaired detox capacity is nearly endless, but in my work with patients I’ve observed the following common patterns:

  • Hormone imbalances (especially in women). Defects in detoxification cause hormones to become partially metabolized, blocking the action of active hormones and throwing off natural feedback mechanisms.
  • Skin breakouts and rashes. The skin is the largest organ in the body, and the most likely to be affected by detox issues.
  • Energy problems. One important aspect of detoxification, called methylation, plays a key role in cellular energy production.
  • Depression and mood disorders. Methylation is also crucial for proper neurotransmitter synthesis.
  • Brain fog and cognitive decline. Proper methylation is required for the production of acetylcholine, a neurotransmitter that profoundly affects mental clarity.

As you can see, there’s not much that goes on in the body that doesn’t depend on healthy detoxification. That’s why it’s so important to ensure that your liver is functioning as efficiently as possible.

Are You Boosting All 3 Phases of Detoxification?

Detoxification can be broken roughly into three stages:

  1. Phase I: conversion of fat-soluble toxins (hormones, bacteria, neurotransmitters, endotoxins, medications, chemicals, etc.) into water-soluble toxins.
  2. Phase II: neutralizes the free radicals generated in Phase I, and acts on some toxins that aren’t processed by Phase I enzymes.
  3. Phase III: excretion of toxins from Phase I and Phase II in feces and urine.

Detoxification is a complex process, involving hundreds of enzymes and multiple genes. But don’t worry — I’m going to make it easier to understand by using an analogy (borrowed from Charles Poliquin).

Phase I is like taking the garbage from the various cans in your house to your big trash can in the backyard or side yard. Phase II is like taking the large garbage can out to the curb. And Phase III is like the garbage truck coming and removing the contents of your garbage can. As you can imagine, if any one of these steps doesn’t happen, there’s going to be a build-up of garbage (toxins) in your house (body).

Let’s look at the three main causes of impaired detox capacity.

Increased toxic burden

The liver is naturally designed to rid the body of excess toxins. But the environment we (and thus our livers!) evolved in did not have even remotely the level of toxins we’re exposed to now, nor were we faced with the numerous aspects of the modern lifestyle that decrease detox capacity (i.e. stress, sleep deprivation, chronic disease, etc.). This means that in many cases our exposure to toxins has exceeded our body’s ability to safely process them.

Let’s face it: we live in a toxic world. Each year the toxic burden in our air, food and water – and thus our bodies – grows higher than ever before. Companies manufacture 6.5 trillion pounds of 9,000 different chemicals each year. That’s about 3.25 billion tons – enough to fill an ocean supertanker. And the same companies release over 7 billion pounds of 650+ different pollutants into the atmosphere and water.

A recent study by the Environmental Working Group (EWG) found the average person has over 91 toxic chemicals in their body. Some people had as many as 165, including 76 known to cause cancer, 94 known to be toxic to the brain and nervous system, and 79 known to cause birth defects and abnormal fetal development. (1)

As if that wasn’t enough, the Standard American Diet itself is highly toxic. Processed and refined foods, industrial seed oils, high fructose corn syrup, and even so-called healthy foods like whole grains and soy all have a toxic effect on the body.

Methylation defects

Methylation plays a crucial role in detoxification, and it’s a vital metabolic process that happens in every cell and organ of the body. It’s so important that it takes place more than a billion times a second in the body, and human life would not exist without it. Methylation is involved in everything from tissue growth and repair, to cellular communication, to turning genes on and off, to cellular energy production to the production and regulation of neurotransmitters like dopamine and acetylcholine.

Proper methylation is dependent upon adequate levels of B12 and folate, among other nutrients. B12 helps to convert the potentially toxic compound homocysteine into the much safer compound methionine, and also helps feed fuel into the Krebs cycle to produce ATP, the fundamental energy “currency” of the cell. B12 deficiency is common with vegetarian and vegan diets, as many of you know. (2) What you may not know is that low stomach acid and other digestive issues can impair the absorption of B12 and cause deficiency even in those that are eating meat and other B12 containing foods. What’s more, some people may have sufficient levels of the inactive form of B12 (cyanocobalamin), but due to impaired liver function they have sub-optimal levels of the active forms of B12 (methylcobalamin and adenosylcobalamin). Regardless of the cause, low levels of active B12 will lead to poor methylation. (See my article on B12 for more on identifying and treating B12 deficiency.)

Folate deficiency can also cause poor methylation. Inadequate dietary intake is rarely the cause. Instead, genetic defects in the enzyme (MTHFR) that convert less active forms of folate into more active forms of folate are more commonly to blame. Statistics suggest that roughly 40% of Americans are carriers of MTHFR mutations, while 10% have the condition. (Some clinicians, myself included, have observed that even carriers — who are supposedly not affected — have impaired methylation capacity.) Some ethnic groups may be affected more than others; for example, up to 12% of Caucasian Americans and 15% of Hispanic Americans have MTHFR deficiency, while only 2% of African Americans and 3% of Asian Americans have it.

Modern lifestyle and chronic disease

One of the foundational principles of the ancestral health movement is that humans are not genetically and biologically adapted to our current lifestyle. This “mismatch” has numerous consequences, but in the context of our discussion on detoxification the most important one is glutathione depletion. Glutathione is the master antioxidant,  a tripeptide composed of three amino acids (cysteine, glutamate and glycine) that’s found in all cells. It conjugates several different types of toxins in Phase I, and in Phase II it quenches free radicals produced in Phase I. Glutathione also  protects us from oxidative damage. I like to think of it as a bullet-proof vest: if we have enough glutathione, we’re relatively well-protected against oxidation. If we don’t, we’re much more vulnerable to the harmful effects of oxidation. This is significant since most, if not all modern, chronic diseases involve oxidative damage.

The good news is that our bodies are capable of producing glutathione. The bad news is that glutathione is easily depleted by stress, environmental toxins, medications, trauma, aging, illness and micronutrient deficiencies. Studies have repeatedly found the highest glutathione levels in the young and fit, and the lowest in the elderly, infirm and inactive. (3) Moreover, according to Dr. Mark Hyman, approximately 1/3 of Americans are missing an important gene needed to create and recycle glutathione. (4) Taken together, this means that nearly everyone is subject to some degree of glutathione depletion, which in turn means that most people are not detoxing or protecting themselves from oxidative damage at full capacity.

How to supercharge your detox capacity

As I’ve explained above, impaired detox function can be caused by either an increase in the toxic burden, a decrease in detox capacity, or both. It follows, then, that to optimize your detox capacity you should address the issue from both sides.

Reduce your toxic burden

The most obvious first step is to remove all food toxins from your diet. This means ditching processed foods, industrial seed oils, and refined sugar, as well as improperly prepared grains, legumes and other foods with toxic effects on the body. Fortunately, the Paleo diet is inherently low in food toxins (which of course is one of the reasons it works so well), so if you’re already following a Paleo template you’ll be in good shape here.

The second step is to take steps to reduce your exposure to chemicals at home. This means choosing non-toxic household cleaning, bath, beauty and hygiene products. Mark Sisson wrote a great article about this a while back. Check it out here if you need some tips in this area.

Improve your detox capacity

The next step is to improve your detox capacity. This means ensuring that all three phases (I, II & III) are functioning optimally. One of the biggest problems with many commercial detox products is that they only contain nutrients that upregulate Phase I detox. This is dangerous, because for every toxin that is converted in Phase I a free radical is generated. (Free radicals damage cells and contribute to oxidative damage.) These free radicals are neutralized in Phase II, but if you boost Phase I detox without addressing defects in Phase II, you’ll increase the amount of free radicals produced without improving the body’s ability to deal with them. That’s making a bad situation worse.

For most people, focusing on improving methylation and boosting glutathione levels is the best approach to restoring optimal detoxification.

  • Methylation: the key to improving methylation is ensuring adequate levels of active B12 and folate and methylation co-factors like B6 and betaine (a.k.a. trimethylglycine). For best results look for a blend that contains all of these nutrients in synergistic amounts.
  • Glutathione: glutathione levels can be naturally increased by consuming raw dairy products, sulfur-rich foods (garlic, onions and cruciferous veggies); by exercising regularly; and by avoiding things that deplete glutathione when possible (mentioned above). There are several nutrients that are required for glutathione synthesis and/or can help boost gluathione levels, including N-acetyl cysteine (NAC), alpha lipoic acid, selenium, B12, folate, B6, and glycine. In addition to these nutrients, several botanicals have been shown to increase the intracellular recycling of glutathione, including milk thistle, cordyceps, gotu kola, and brocooli seed (which has a particularly beneficial effect on Phase II detox). I think it’s best to take a wide range of these nutrients and botanicals in moderate doses rather than very high doses of any one of them.

If you’ve been following this series, you’ll notice a theme developing:

  • In my work with patients, I started to notice three main challenges to adopting and feeling great on a Paleo diet: digestive issues,, impaired fat burning, and impaired detox capacity.
  • In many cases, dietary tweaks alone were not enough to resolve the issues these patients were experiencing (which is why they came to see me in the first place).
  • When I looked for supplements that could address these issues, there weren’t any that were a perfect fit. There were a lot that came fairly close, but they all had at least one fatal flaw or they were missing some key ingredients.
  • So I decided to create them myself, with the help of one of the smartest guys (with a background in microbiology) in the Paleo world: Robb Wolf.
  • Thus the Paleologix line was born.

The detox formula is no exception. When I looked around at what was available, I wasn’t satisfied. Too many products didn’t address Phase II detox. Or they didn’t include substances that improve intracellular recycling of glutathione, which is just as (if not more) important than boosting glutathione levels. Or they contained folic acid instead of folate (read this article to find out why that’s bad), or inactive B12 (cyanocobalamin) instead of active B12 (methylcobalamin). Or they didn’t include anything for Phase III detox. (This is one reason we recommend taking all four Paleologix formulas together; it made more sense to put the cholagogues that improve Phase III in the digestive formula.) And being the perfectionist that I am, I couldn’t deal with those compromises. I wanted the perfect blend — so I made it.

Look out for the final article in this series on Tuesday, and the official launch of Paleologix by the end of next week.

Now I’d like to hear from you: do you suspect you might have detox issues? Are you experiencing skin breakouts, hormone imbalances, depression, anxiety or mood disorders, or any of the other problems I’ve mentioned in this article? What have you found to be helpful?

Chris Kresser

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{ 84 comments… read them below or add one }

Mindy January 11, 2013 at 8:38 am

This is so timely! It’s like you are explaining my Primal Journey. I thank you once again for pointing me to Mark Sisson over two years ago. I came into this with PCOS, Endometriosis, digestive distress, arthritis, acne and 40lbs over weight. While the initial phase I felt some digestive relief from taking out grains and legumes, most of my weight came off, and arthritis is gone. Yet it wasn’t magic for everything as you’ve said. I’ve just in the last month realized I’ve had low stomach acid and not enough enzymes. This has helped tremendously. I have hope for healing my gut. I’ve had to learn it is a slow process. And just a few days ago I added milk thistle capsules and dandelion root tea. I am still on birth control pills to help manage my cycles to reduce the pain from endometriosis. I hope that I am on the road to being free of it. Thankfully I am no longer on Metformin. Question: is there a timeframe that I should notice a difference after starting the milk thistle?

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Chris Kresser January 11, 2013 at 9:03 am

It depends on several factors, but usually a few weeks.

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pd January 11, 2013 at 10:56 am

I have always felt that not being able to properly digest and detoxify has been my primary issue.
My diet has always been healthy but work stress and financial responsibility landed me with illness.
Currently battling Hyperthyroid and lost a lot of weight. I was slender to start with.
Started drinking Milk to gain weight and it added more stress to by body as well.
Question: How do you know for sure that it’s low stomach acid and not enough enzymes (i have always thought that to be my case but i could be completely wrong)? How do I know exactly where my problem is? And with an auto-immune disease I am now thoroughly confused. I want to work on getting back to full total health but the more I look, the more i get confused.

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Gabriele January 11, 2013 at 8:52 am

When Paleologix international shipment is going to be available? Thanks.

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Chris Kresser January 11, 2013 at 9:02 am

Hi Gabrielle: we don’t have a firm date yet, but if you’d like you can sign up to be notified when it becomes available here: http://paleologix.com/international-orders.php

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Gabriele January 11, 2013 at 11:16 am

Thanks Chris. Just signed up to be notified.

[OT] Just saw you don’t accept anymore online/telephone new medical consultations. I also saw you recommend someone else. Do you think you will ever go back to consult new clients? If yes, when? Thanks. [/OT]

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Chris Kresser January 11, 2013 at 12:08 pm

Unfortunately, not in the foreseeable future. I still have about 50 people on my wait list. When I get through that, I’ll probably re-open temporarily — but only on a wait list basis.

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EL January 11, 2013 at 9:09 am

I love the information here Chris escpecially how proper levels of B12 in relation to homocysteine conversion. I’ve been paleo for over two years now and still struggle with high systolic BP. Do you think there may be a correlation between sluggish detox and the affects on homocysteine levels, thus increasing systolic pressure?

I refer to this pubmed: http://www.ncbi.nlm.nih.gov/pubmed/14656018 that states a link between homocysteine and systolic pressure and wanted your opinion on the matter since it wasn’t really discussed in the post. Thanks.

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Chris Kresser January 11, 2013 at 9:12 am

Yes, that’s certainly possible. It’s one of the many potentially harmful effects of homocysteine.

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EL January 11, 2013 at 9:20 am

Thanks Chris- I’ll look forward to the release next week.

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pat January 11, 2013 at 9:22 am

Thanks for this article, Chris. I was taking sublingual vitamin B12 a while back and stopped, thinking I didn’t need it. But my memory still stinks, I still feel sluggish, and it could be a missing link? I ought to start taking it again.

I’d love to purchase your new line of supplements, but you’ve used a few ingredients I’ve been found to be intolerant to: ginger and kale. This is frustrating when you’re so close to possible help in the form of a supp, and then find out you can’t take it.

What do you recommend instead, Chris? Thank you.

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Jessica K January 11, 2013 at 9:27 am

The biggest thing I noticed when going on a strict Paleo regime was a sudden and dramatic hair loss. It was so extreme and I had never experienced anything like it. I did a little research online and didn’t find too much that was helpful. Most said it was just the body’s reaction to a sudden change in diet and possibly to weight loss. I can’t help but think I had missed something in my dietary changes. This article has me wondering again. I still do not have as much hair as I used to, even though I’m not quite as strict as I used to be. I am thinking of starting the GAPS diet and I’m terrified of the sudden hair loss again.

Another thing I noticed that the “I feel absolutely amazing” feeling last for the first several months. Then I noticed some of the issues I used to experience creep back in but not nearly at the level I used to experience. Things like: occasional headaches, back aches, low energy days, etc.

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Sandra Brigham January 11, 2013 at 5:21 pm

Jessica, wow! I had the same problem – extreme hair loss – clumps coming out in the shower; the hair brush full daily; the bathroom rug loaded with it and we have to clean the tub drain weekly. Thyroid and other stats are fine except for extremely low body temps (92-96.8) but feeling hot all the time. Adrenals are probably messed up. Gaia’s Adrenal Health has slowed the hair loss by about 25% but still fatigued and extreme exercise intolerance. I added B6 and (ugg) folic acid (need to find folate) initially as Dr. Kresser had mentioned elsewhere but that didn’t seem to help. Great article Dr. Kresser. May have to spring for Paleologix…

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pat January 11, 2013 at 9:37 am

I experienced skin breakouts in the form of angular chelitis and perioral dermatitis (spelling on both are incorrect, I apologize) over a year ago. Through serious trial and error, frustration, treating it externally, and spending too much money on “holistic allergists” who use funny machines, and naturopaths who prescribe way too many supps, I rid myself of both after completely removing all food toxins (wheat being the worst offender), sugar, starch, anything with yeast, and fruit. But…I still wasn’t 100% improved. My continued, relentless research led me to l-glutamine. Hurray! After taking high doses (slowly, up to 20 grams a day), my skin cleared up in ONE MONTH. It was a miracle!

Since then, I’ve been tested for food intolerances and have found I’m intolerant to many Paleo friendly food, such as eggs, spices like turmeric, vegetables like kale, and many others. Thankfully, I wasn’t found to be intolerant to any form of meat. Thank god! I’m still working on my help, mostly my adrenals, but I still feel like I need a bit more work. I’d like to look into acupuncture to resolve what I feel are hormonal issues.

This past fall, I took an 8 week course in mindfulness based meditation. It honestly changed my life. For anyone struggling with depression or anxiety, and you feel you’re at the end of your rope (and I did), please look for a psychologist/therapist who teaches Jon Kabat Zinn’s mindfulness program, and DO IT! It has helped me immensely, and trained me to stop obsessing over my health, which I’m confident only aggravates it. Think mind/gut connection.

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grayson January 11, 2013 at 1:48 pm

Iodine!

Some googling should get you off on the right foot. I supplement with “liqui-Kelp”.

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grayson January 11, 2013 at 1:51 pm

Sorry — the iodine comment is meant for the hair loss comment above yours (woops)

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Marie January 11, 2013 at 9:40 am

You had me until the part where you wanted to sell ‘just another supplement’. It is possible to live a healthy life on a PURE, organic paleo diet along with an exercise regimen, plus eliminating toxins from your environment. Real food, not from a bottle. Period.

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andi January 11, 2013 at 8:39 pm

Now I dislike being bombarded with sales pitches as well, BUT on a daily basis Chris shares unbelievable amounts valuable information and ideas for others. Free. Free. Free. He’s developed a product he feels will help some folks and in the process can provide for his family. If I were to decide to buy such products I would rather buy them straight from an individual who gives so freely to the community. Nothing wrong with making an honest buck.

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pandaanne January 11, 2013 at 9:56 am

Yes I am detox problems!! Acne, and according to Lauren Noel, constipation are my symptoms. What do you think of the lemon detox and salt water cleanse?

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Vicki Carpenter January 11, 2013 at 9:58 am

Not sure if it’s a detox issue or insulin but I am hungry a lot so I snack on raw cheese (for the K2 for my osteoporosis, too). Snacks are my dilemma. Am thinking more carbs needed but which ones. I follow AI Paleo for osteoarthritis.

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Julia January 11, 2013 at 10:04 am

Is testing for the MTHFR enzyme defect recommended if you have impaired detox? What is the best way to test for this? I recently had a blood test showing high levels of serum folate, could it be that the folate I eat isn’t being converted into active forms?
Cheers for the articles they have been really interesting!

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anne January 11, 2013 at 11:00 am

23andme.com offers a test for various different methylation-related genes. MTHFR is a key player but others can also be causing problems. MTHFR alone can be tested by LabCorp or SpectraCell for about 150 bucks. 23andme is normally 300, but it’s on sale for 99. Alternatively, Dr. Amy Yasko offers a test for 500 bucks that tests a more complete list of methylation-related genes. It’s important to know your whole picture because if you treat MTHFR but have other methylation defects (especially CBS), you can find yourself in worse shape! As GI Joe said, “knowing is half the battle”.

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Julia January 13, 2013 at 12:28 pm

Thanks Anne for the testing info, that’s really helpful!

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Beth January 11, 2013 at 10:08 am

I agree with Mindy. Your posts lately have been right in line with my healing journey.
What do you think about colostrum for helping to increase glutathione production? I recently started taking it for leaky gut, and only stumbled upon the glutathione connection afterwards.

I need all the help w/detox that I can get right now, as the colostrum has been causing some significant die-off reactions, which I’ve never gotten from anything else. It didn’t matter how much coconut oil, grapefruit seed extract, or combination of candida killing anti fungals I took! So as much as the migraines and flu-like symptoms have sucked (I’ve since lowered the dosage and will SLOWLY increase it as my symptoms subside), I’m thrilled that the colostrum seems to be having a positive effect!

I tested deficient in B12, so have recently started supplementing with that (the methylcobalamin form, as recommended by my holistic MD), and also take selenium and NAC, and I think I will add in some milk thistle. What do you think about using activated charcoal to help with detox? It’s definitely come in handy the last few days when the Herx-nausea hit. But I was thinking about incorporating it on a daily basis to help sop up the toxins that are being released.

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Elizabeth January 11, 2013 at 10:22 am

I didn’t get acne for the first year of my paleo journey, but then college life started to set in – studying, alcohol, and a little more studying – and I broke out really bad and it still hasn’t gone away. What do you think of a salt cleanse and/or lemon detox while I await getting vitamin supplements?

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Matt January 11, 2013 at 10:38 am

Is there any reliable functional testing for liver detox issues? It can be a minefield to negotiate which nutrients are required without overstimulating or worsening issues, especially with environmental sensitivities.

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Chris Kresser January 11, 2013 at 12:11 pm

Genova has a liver detox panel that I sometimes use. It involves a challenge with caffeine and aspirin.

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Spar January 11, 2013 at 10:50 am

Hi Chris, Why do you not write about Trimethylglycine (TMG) to boost Glutathione? Methionine is a precursor for glutathione.

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Chris Kresser January 11, 2013 at 12:11 pm

I did mention TMG/betaine in the article, I just didn’t go into detail. Only so much space!

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Tosha January 11, 2013 at 10:58 am

I feel like I really need to be on B vitamins, no I know I need to. Everything you listed as symptoms in not being able to detox properly totally describes me. But I have noticed whenever I take B vit. I get sick to my stomach. i always take them with food so i know that’s not my problem. when i take my other supplements and eliminate the B’s i dont get the sick feeling. Could I be allergic to B vitamins? What are my options if that is the case? Thanks for another great article.

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pd January 11, 2013 at 11:02 am

Yes, I agree with Matt.

Is there a reliable testing to know what’s going on and re-test to confirm that something is working?

For example, my B12 levels are normal. So supplementing on it will not be necessary.

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Chris Kresser January 11, 2013 at 12:09 pm

Your serum B12 levels are normal, but unfortunately that’s not always an accurate indicator of functional B12 status. Check out my article on B12 (I linked to it in this article) for more info, and stay tuned for an update on B12 soon.

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Sima January 11, 2013 at 11:24 am

I was one of the paleo success stories – no “flu”, no difficulties with carb cravings, and almost immediate weight loss, improved energy, and general mood improvement. I was fairly strict (90/10 most of the time) for 9 months and then I got pregnant, and continued to follow a paleo blueprint although due to very strong cravings and good tolerance, I added whole milk dairy back into my diet (chickened out of raw though). I had a dreamy pregnancy and delivery and healthy, instantly alert, baby. The problems started post partum. I’ve pretty much gotten back onto the waggon now, 4 months later, and I cut dairy back out. I’ve lost most of the weight I gained, but I’m now experiencing the issues Chris details for the first time. I do think lack of sleep is probably a factor, but I can’t help that for now. However, I’m wondering about detoxing, etc. while breastfeeding. It sounds great, but I’m worried that it may be harmful to my little one? Would I be able to safely take the supplements? Does anyone have any thoughts on what I should do for now? If anything? Or is lack of sleep probably the culprit? (I rarely get more than 3 hours uninterrupted). Thanks for your ideas and sorry for the super long post!

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Chris Kresser January 11, 2013 at 12:07 pm

I don’t recommend detoxing while pregnant or breastfeeding. Lack of sleep could definitely cause the issues you’re experiencing on its own. Some herbs can be safely taken during nursing. Maybe find a skilled herbalist to work with?

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Lisa Lineberg January 11, 2013 at 11:43 am

Hi Chris,

Where would be the best place to find more information on MTHFR? My mother-in-law and sister-in-law just recently learned that they are carriers. My mother-in-law has had a multitude of health issues over the past 5 years and was finally tested for this.

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Chris Kresser January 11, 2013 at 12:05 pm

Mthfr.net is a good resource. I will write about this more in the future, too.

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Kristie January 11, 2013 at 12:48 pm

I would love to know how your products compare to Chris Shade’s products for detox. He seems to be an expert about detox especially mercury detox. I would love to know your thoughts.

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Chris Kresser January 11, 2013 at 2:38 pm

Heavy metal detox is an entirely different ball of wax. The Paleologix line is not specifically formulated for that, but it would provide some basic support. I think anyone trying to detox from metal toxicity should do it under supervision, because it’s potentially harmful if not done properly.

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Kay January 11, 2013 at 12:52 pm

I’m personally not “on board” with pills, extended fasts and what not to “detox”. I believe our bodies know how to let go of what they don’t need. However since I never got an answer here to my question about digestion/fatigue since being on the Paleo template from this site, I’ve searched elsewhere and have found some articles about a treatment approach for a methylation cycle block, which leads to glutathione depletion. Several online articles written a pretty incredible man who, sadly passed away in November.
He was Rich Von Konynenburg Ph.D. There is a blood panel that can be ordered by a MD or DC from Health Diagnostics and Research Institute to see if you have this “block”. If you do, no amount of clean food or supplements are going to help. There is a supplement protocol for “lifting” the block if you do have it.

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Chris Kresser January 11, 2013 at 2:36 pm

I run methylation panels on my patients (when appropriate), and I use Rich’s methylation protocol — which involves a number of pills, so I don’t quite understand your bias against pills. It’s true that if someone has significant glutathione depletion and a methylation block, they will require a specific protocol, and that should be done under the supervision of an experienced practitioner. But many others do not need this level of support; they simply need some basic help improving their detox capacity. That’s the focus of the recommendations I’ve made here, and the Paleologix line.

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David M January 12, 2013 at 4:03 pm

Chris,
According to Dr. Tim Jackson, “approximately 30% of the population has what is referred to as a mutation of the MTHFR gene.” Dr. Kendal Stewart says this methylation deficiency involves abnormal conversion of B12 and folic acid, which have to be converted to their methyl forms to penetrate the immune systems– methyl folate and methyl B12.

Do you agree with the summary above and with Kendal Stewart’s work, and are you familiar with or have an opinion about his supplements, especially the Neuro-Immune Stabilizer lotion – a transdermal application, because he says we cannot absorb methyl folate very well from an oral route? The product has methyl B12, hydroxyl B12, methyl folate in the form of folinic acid, a little bit of B6, and also vitamin D.

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analisa madron January 17, 2013 at 3:16 pm

dear chris,

I am one of those people who is a candidate for a methylation panel, as I am pretty certain I have disfunction in methylation and glutathione production (as per rich konynenburg’s work). I haven’t had the resources to tackle this problem properly, so am saving up and in the meantime researching and learning as much as I can. since your recent introduction of the paleologix supplements I am curious whether the adaptaclear is a worthwhile investment in the meantime, or if it is more appropriate to get the proper testing and follow a supplementation protocol with supervision. to that end, I’m curious who you are referring people to now that your practice is closed to new clients. I live in the east bay and would love to work with someone locally, if possible.

thank you so much for all that you do.

analisa

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elena January 11, 2013 at 1:00 pm

Ithink I have detox problem but no one knows what! It goes like this I drunk green tea little in the morning 2 mouthfuls at night , 2 again next morning by lunch time I was high. Thought the FBI were trying to kill me ( we do not have the FBI in my country ) He put me to bed I slept for 5/6 hours. Also went on a rebounder been on them before for hour no problems. However I did a 15minute exercise plan from a PH Diet book.Within 2 hours I was delirious, passed out and slept then I was fine. If I come in contact with gluten or gluten free flour, or certain supplements ,chemicals I get high, I then get sleepy ,drop things,passout. Get up in my sleep ( high/drunk state) microwave teddy bears, set library books on fire,shout at people. Then lie down. When parents try to wake me up I will have a hangover,no one has a clue what is happening to me. It seems something builds up effects my brain and then I need to sleep, then I exercise and feel way better. But obviously it means I live with my parents and like a hermit no job,friends,or life really. I just keep coming on here hoping I will find the answer and get better .

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Kristie January 11, 2013 at 1:47 pm

Have you ever researched the GAPS diet. It might benefit you.

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elena January 11, 2013 at 3:29 pm

Hi kristie thank you for the suggestion I really appreciate you taking the time to help me. I have looked at GAPS however I cannot digest meat or fats so tend to be more vegan at this moment in time, where as GAPS is very meat driven. But Thank you so much :0)

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Kristie January 12, 2013 at 11:40 am

I also have a friend who struggles digesting protein. I feel like there are definitely ways to help heal the digestion, so that you could digest protein and fats, but I haven’t figured out exactly how to do that!

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The Calm Canary January 11, 2013 at 1:29 pm

Hi Chris,

As for raising glutathione with sulfur-rich foods, is it better to use raw garlic and onions, cooked garlic and onions, or a combination of both? For raw garlic and onions, what is a good administration method? Juicing? And what about crucifers?

I ask because I remember reading this anecdotal report of a dog owner shrinking their dog’s tumors by feeding the dog blended raw garlic and onions:

http://markmccandlish.com/Default.aspx?tabid=143

Thanks,

John (The Calm Canary of http://thecalmcanaryblog.blogspot.com/)

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Chris Kresser January 11, 2013 at 2:32 pm

Yes, and raw veggies and fruits contain glutathione itself in some cases.

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Stuart January 11, 2013 at 1:41 pm

Hey Chris, Great article, but I didn’t get a clear understanding of which supplements address which Phases. Is AdaptaClear just Phase I and AdaptaGest for the other phases? Or if they are all mixed between the different ones, which ingredients in them address which phases? This would be great to help me understand more about what I will be taking. Thanks!

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Chris Kresser January 11, 2013 at 2:31 pm

AdaptaClear is phase I & II and AdaptaGest is more Phase III.

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grayson January 11, 2013 at 2:04 pm

Hi Chris,

My experience with liver health may be beneficial to add to the discussion. Specifically, what a large toxic load some NSAIDS and other OTCs put on the liver. As an IBD patient, I often suffer(ed) from fevers accompanying an intestinal flare. The advice from IBD doctors is ‘only tylenol’ to treat any extra-intestinal fever or arthritis, though it is usually not pointed out to the patient what a burden acetaminophen places on the liver. Thus one is left in a vicious cycle of already-horrible digestion, and very-taxed detox capacity which prevents the liver from performing other important functions. Add a glass of wine (many people are never warned of this) and it’s 10x magnified.

It’s been my experience after beginning to see success on a gaps-style program that the liver needs to be coddled just as much as the primary digestive system to really make progress on achieving better health.

Thanks for an AMAZING and timely series of posts!!

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Julia January 11, 2013 at 4:31 pm

Hi Chris,

First of all I want to thank you for your blog and the information and support you offer here!
Unfortunately this article is quite frustrating for me. I started eating Paleo quite a while back. Since then nothing really has changed for me. My energylevel has become more stable but the prior reasons why I wanted to go Paleo are listed in this article and none of them have changed neither for the better nor for the worse. I’m so desperately wanting to heal my face from acne and equally wish for a more stable mood. You can imagine how excited I’ve been as you started this series and this article especially was striking for me. But I’m afraid to say that this article doesn’t really help me. I’m from Germany and like that I cannot use the advantage of the supplements you created.
Could you give me some advice for supplementing that might not be optimal but at least provide some help? Would it for example be helpful to sprout broccoli seeds or use broccoli seed oil for Phase II?
I would really appreciate any advice! Thank you!

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Chris Kresser January 12, 2013 at 6:17 am

Start with milk thistle extract and some basic glutathione support, such as a raw milk if you can obtain it in Germany, or a non-denatured, bioactive whey protein powder. That should help.

We will be shipping internationally soon, if that makes a difference. You can sign up to be notified here: http://paleologix.com/international-orders.php

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Julia January 12, 2013 at 7:03 am

Thank you very much!

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Dan January 11, 2013 at 7:48 pm

I recently uploaded my wife’s and my 23andme raw data to geneticgenie.org, for a methylation pathway analysis. I kind of wish I didn’t. It says my wife and I both have homozygous risk alleles for MTHFR C677T and CBS C699T. This implies that our son also has these risk alleles.

We have been eating an ancestral Paleo/WAPF diet for the past 7 months and have felt very good — though, my wife seems to have some hormone clearance/detox issue due that have remained since a short-lived stint of birth control usage seven years ago.

Unfortunately, everything I’ve read about the CBS defect says you need to go on a low sulfur diet when you have CBS — something about the upregulation of the CBS enzyme creating too much sulfur and ammonia in the body during detox. Some people say it’s bunk. Some say it depends if it’s switched on or not. Others say it depends on whether you need to detox or not. It’s so confusing and who knows if any doctors really know how to deal with these things.

I want to assume that the many “healthy” people with CBS in this world (like our ancestors) probably don’t need to worry about CBS if they feel good on an ancestral diet. Is CBS only something you need to worry about during detox?

Does anyone know if a CBS defect in your genes automatically means you have to become a plant-eating vegetarian? I can’t imagine giving up eggs and pastured meats for the rest of our lives!

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Sam January 13, 2013 at 5:49 am

Hi Dan,

My understanding of CBS issues is that it might warrant treating first (of the SNPs you have) if it’s causing problems for you. When it’s under control you can introduce more sulfur containing foods. Most of the treatments only seem to involve restriction of meat rather than elimination as well. Read Amy Yasko’s work if you haven’t.

Something else to consider, is that Rich Von Konynenburg observed that treating the methionine synthase block caused by MTHFR eventually resulted in CBS normalising over a period of 6 months I think it was. That’s without any special attention given to CBS. That’s not to say you wouldn’t experience faster improvement dealing with CBS first or in conjunction with MTHFR, but it’s something to think about.

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Holly January 11, 2013 at 8:24 pm

Thanks, Chris, for this latest addition to what has become an important online resource for those of us who are struggling to regain our health. (I refer my doctors to your site…!) You allude to heavy metal detox above. Under the care of a functional nutritionist, I’ve been on a very restricted diet (a Paleo variation) for over a year now in a last-ditch effort to combat a raging case of psoriasis and eczema that came on in the hospital after surgery, and my skin issues have gone into complete remission–a result I attribute to the gradual healing of my gut, as you have written in other posts about the connection between healthy gut bacteria and autoimmune disorders of the skin. However, a test for heavy metals a month ago revealed high levels of cesium, thallium and tin. Went to your website in the hope of becoming a patient but saw that you’re not taking on anyone new. Quick question for the benefit of those of us out who find ourselves in this predicament: do you by chance know of anyone who specializes in heavy metals detox? My nutritionist is now recommending chelation with citrus or apple pectin, which I will certainly supplement with Palologix products. Would glutathione also help? (I have a friend whose doctor injects it.) I also need to identify the sources of these metals in my diet/environment, in order to stop ingesting them. Have you ever dealt with a lab that would test food and water samples for these metals? Many thanks for any suggestions you and anyone else on this conversation can offer.

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Chris Kresser January 12, 2013 at 6:13 am

Citrus and apple pectin are great choices, because they’re effective yet mild. Injected glutathione can be effective, but it’s expensive and rather inconvenient. Sorry, I don’t have much experience testing food and water for mercury.

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Susan January 11, 2013 at 9:28 pm

I have been Primal since May 2012 with no weight loss so now I have been maintaining under 40gms a day of carbs for 5 weeks from veges. I do everything suggested including the non food requirements and cannot shift the 5 kgs from around my waist and legs and now my butt is getting bigger! The only “cheat” I have is a 200ml of red wine a night. Would that be why I cannot shift it?

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Chris Kresser January 12, 2013 at 6:14 am

Recalcitrant weight around the middle is often due to adrenal/cortisol issues. Managing stress, improving sleep, adaptogenic herbs, vitamin C, pantothenic acid, and possibly adrenal glandulars and sublingual pregnenolone & DHEA depending on the severity of the problem. Best to get a BioHealth #201 cortisol and DHEA profile to determine where you’re at.

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Susan January 12, 2013 at 8:06 pm

Wow! Thanks so much for replying!
I know all about adrenal/cortisol issues as I suffer from anxiety depression and won’t medicate, especially after reading your articles previously read on depression.
Now I am about to find out about your other advice as I have no idea what DHEA or adaptogenic herbs and all the other guff is.
Thanks for another alternative, very much appreciated

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Jared January 11, 2013 at 9:51 pm

I found out not too long ago that I have a the double mutation A1298CC, but still having issues, im still fixing my digestion and detox issues as well. I was on Mediclear but thought I could do better and cheaper by taking other supplements, and greens. I’ve heard addressing other SNPs as well can help, as I took the 23andme test recently but taking high thiols/sulfur foods can make things worse, and even taking glutathione until things get better may make things worse.

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Piper Harris January 12, 2013 at 4:33 am

I’ve really enjoyed this series! Our CF box will be embarking on a challenge in a few weeks and this will help the coaches and athletes. I was one of the fortunate ones, Paleo was a fairly easy transition (no issues etc) however I’ve seen other that have struggled, great information to get them through the hump-looking forward to you and Robb’s supplements!

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Debra January 12, 2013 at 5:19 am

Chris, when would it NOT be a good idea for someone to try your new supplements? In your material, you state: “It is for a certain person, at a very specific time, and for a finite period.” Are there certain conditions that could be aggravated or worsened by the use of these supplements? Also, how long is this “finite period”?

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Chris Kresser January 12, 2013 at 6:10 am

Hi Debra,
They’re not for someone who is feeling great on the Paleo diet and has no complaints. They’re not for pregnant or nursing women, or young children. The AdaptaGest Flex (HCL) isn’t for people with ulcers or those that have been taking NSAIDs or anti-inflammatory medications that could damage the gut lining for a significant amount of time.

The finite period will depend on the person; the analogy I’ve used is that these supplements are like a raft that helps you get from one side of the river to the other. I recommend that people take them for as long as they need to during the transition period. Once they start feeling really good, they can try stopping the supplements.

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Liane Jackson January 12, 2013 at 10:09 am

Hi Chris
I have an autoimmune condition affecting my connective tissue. I have also recently developed neurological symptoms in my feet and have been found to have Vitamin B12 levels at the low end of the normal range. Fortunately I have been treated with a loading dose of IM cyanocobalamin injections in December and the plan is for me to have injections 3 monthly.
I only started the Paleo diet 2weeks ago. Would you suggest I take your supplement containing Methylcobalamin in addition to my injections? Or would it be better to take a supplement that doesn’t include this?

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Nancy January 12, 2013 at 3:43 pm

Chris, I’m interested in your detox supplement, but I have hep c. Gotu Kola is not recommended for people with hep c. I take good care of myself, don’t drink, and stay in good health. My hep c is chronic, not acute. My liver enzymes were normal at my last check up. I would only take the supement short term. What are your thoughts.

PS: I love your podcast and deeply appreciate all your contributions. I think you’re terrific. Thank you for everything.

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Bonnie January 13, 2013 at 1:21 pm

Chris, thanks for this series, very informative and enlightening.
Let’s just start by saying I am addicted to white stuff (bread, potatoes, rice, sugar). I was recently dianogsed with moderate to severe psoraisis. Just had breakouts on mostly my lower legs that are awfully unsightly.
So, a friend suggested I start this Paleo journey. So last Sunday I began my purge, detox whatever you want to call it. well, sort of. Monday I was struck with the new flu strain. Needless to say I could not start the diet effectively (mostlay a clear liquid diet all week), but on a great note, I purged myself of all white stuff in my diet. I thought that would be my biggest challenge and so far it was been. Now, with no white stuff in my diet for over a week, I feel great (since I got over the flu). All weekend have beeing eating Paleo and it is awesome! do not have sugar cravings, no carbs cravings, only healthy good food.
Now I need to know when will I feel like I have detoxed my body? I am using probiotics (12 strain), magnesium and Vit D-3 and K12 to aid in the detox process. I have lost 8 pounds since last Sunday and think that is mostly water weight.
Anymore info you can provided would be greatly appreciated.

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Jennifer January 14, 2013 at 7:22 am

So why do I feel so awful when I take silymarin? Sluggish, fatigued, foggy, “toxic” feeling?

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allison January 17, 2013 at 4:01 pm

You may not tolerate sulfur groups. The CBS gene C699T specifically may be a problem for you.
I have to avoid all sulfur supplements which makes things difficult when trying to help my liver.

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Hannah January 14, 2013 at 12:46 pm

Hello, great article. I’m constantly researching and haven’t found the “magic” formula yet, but perhaps this could help. I am 3.5 yrs post-hysterectomy and 1.5 years post thyroidectomy (currently taking 3gr/day Armour). I am 32, avid Crossfitter and Paleo-eater for over a year. The trouble is, I have the haaaardest time losing body fat. In the one+ year of Crossfit and Paleo, I have been able to lose just under 5% of my bodyfat, which skyrocketed after my thyroidectomy. My fellow Crossfitters can do that times 5 in 4 weeks in a Whole 30 challenge. I’ve done so much research I could get an honorary doctorate, but still have yet to figure out how to lose the fat. I have so many fitness goals, both outwardly and just for health, but still haven’t found the thing that will really help. Could it be a detox issue?

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carmen January 14, 2013 at 3:14 pm

What are your thoughts on coffee enemas and saunas (Near infrared) for speeding detox?

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Kellyann January 15, 2013 at 4:56 am

Hey Chris….Dr. Kellyann here. Looking forward to your supplement line. Question: For practitioners with a license, are you going to give a professional discount so we can sell them to our patients?

Glad you developed these, Im sure they will be quality coming from you and Robb!

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Chris Kresser January 15, 2013 at 8:47 am

Hi Dr. Kellyann,

Yes, we will have a wholesale program for practitioners. Please stay tuned for an announcement about that in the coming months. Thanks!

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Ferdie January 15, 2013 at 8:39 am

My body’s been screaming for detox for a while now and I’ve decided to give it to it! There is lots of advices on detox diets and programs online. I’ve found few quite interesting ones but oh so cruel! Nevertheless, my body deserves it. Here’s an interesting one to read –
http://itsnotonlytea.co.uk/wordpress/?p=216
Take care, be safe and enjoy yourselves!

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Lindsay January 15, 2013 at 9:06 am

Hi There! Great series of articles.
I’ve been Primal/Paleo for over a year and a half- the first 6 months was with great success! SO much energy, great sleep, no weird mood swings, lost 30 lbs of fat, found a love for cooking, etc. Then about a year ago something very strange happened. Nearly overnight I lost most of the soaring energy levels I was having, started to gain weight, was getting so tired in the afternoon again, and my sleep wasn’t as restful. Since then I’ve gained about 22lbs and still don’t have lots of energy and am dealing with slight depression.
I have maintained my Primal/Paleo lifestyle the entire time.
I got bloodwork done a couple months ago and one of my thyroid hormones is “normal-low” and I have low levels of protein in my blood. But other than that I, according to my doctor, am healthy.
But I KNOW something isn’t right. Could it be that my body isn’t detoxing properly??
Any info would be so helpful!

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Constance January 15, 2013 at 10:18 am

I live in Portland, OR and would like to find someone like you, Chris, who can help me develop a program to deal with a plethora of health issues including three autoimmune diseases, arthritis, etc. I’d prefer to see someone in person but won’t rule out email or Skype consults. Someone with your level of expertise and shared philosophy. Any ideas?

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Emï January 16, 2013 at 8:16 am

I think I may have trouble detoxing. I have been experiencing on and off hair loss for the past 2 months now. It will stop for a few days or a week and then continue for a while only to stop again *repeat*…
It is starting to really show and I have a hard time coping. I have always had problems related to digestion, hormones, inflammation, auto-immune.
Switching to Paleo has helped my health problems a lot. Cervical cancerand HPV are fully gone, my pituitary tumor shrank and the prolactin went back to normal. My Hashimoto’s has bettered, I don’t really have Hashimoto’s anymore according to my doctor, but still slightly raised antibodies.
I hope I will detox properly and my hair loss will stop too.

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JMH January 19, 2013 at 2:02 pm

Hey Chris,
I have a couple more esoteric questions for when you figure out all the paperwork necessary to ship across the border.
I have Crohn’s disease that’s got me down half a colon. Are the Paleologix supplements solid pills? Or in gel-caps? How digestible are they? Would it be better if I grind them up, like I usually do if I can’t find a liquid medication?
Thanks if you see this! I know this entry is old. :-)

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Robin H January 20, 2013 at 11:47 am

Great article Chris. Thank you. One area I’m still unclear on is grooming and personal hygiene products. I read Marc Sisson’s article, and he didn’t address that much either. I hear so many bad things about parabens, sodium laurel sulfate, etc. Do you think it’s generally a good idea to avoid applying anything unnatural to the body? This would require ditching just about all commercial grooming products (even most of the so-called “natural” ones). And even many natural plant extracts can be toxic or highly irritating. I would love to hear your take on this.

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Robert Kurtz January 21, 2013 at 3:36 pm

I am going shopping this week to start the diet. Im just under 400 lbs and I am six feet tall. I had blood work done and everything was great except my testosterone levels were very low. I was told it was most likely due to my weight and that it should go up to normal levels (for a 42 year old) as the weight comes off. It still makes me nervous. The doc didn’t mention anything related to my liver. I will probably take the pills just to be safe. Would that work?

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Simon April 6, 2013 at 5:17 pm

This all seems good for people with a ‘normal’ system ( yes I know, sigh, what is normal?). However, how does this help someone who is trying to maintain a paleo lifestyle yet have salicylate, amine and glutamate intolerance. I had a typical paleo dinner last night utilizing ingredients from Robb’s book and today I feel as though I have a massive hangover without the pleasure of having had a drink. I am hoping that it is a methylation problem as my 13 year old son is also displaying the same type of food intolerance symptoms.
I have asked this question repeatedly in the paleo arena and most people do not want to know about this as it could potentially demonstrate flaws in the Paleo lifestyle of eating. I honestly do not want this to be so as I’m one of those people that long for proper health through a Paleo lifestyle. At the moment my regular diet consists of about 5 ingredients and I find myself saying if only I could eat all the things on a paleo diet!

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Laura April 11, 2013 at 6:02 pm

Good info but I’d like to alert peoiple on one pint. I have an over active CBS which means I need a low -sulphur diet. Sulphur is not good for everyone’s detox system.

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Celia April 20, 2013 at 5:48 pm

Hi Chris,

What are your thoughts/do you have any thoughts on Oil Pulling for detox?

Thanks,

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