RHR: Is it Possible to Prevent (or Reverse) Type 1 Diabetes?
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RHR: Is It Possible to Prevent (Or Reverse) Type 1 Diabetes?

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Antibodies to GAD are a predictor of risk and progression to the autoimmune form of diabetes. Find out what these antibodies are, how they predict your likelihood of developing diabetes, and what I recommend if you’re producing antibodies to a particular tissue.

Revolution Health Radio podcast, Chris Kresser

GAD stands for glutamic acid decarboxylase, and this is a major enzyme in the synthesis of GABA, which is one of the major inhibitory neurotransmitters in the body. I like to explain it to my patients as the off switch for the nervous system. GAD and GABA are mostly present in nerve cells, but interestingly enough, GAD is also found in the pancreas. GABA is stored in the islet beta cells that produce insulin, and it’s been known for a while that because of this, antibodies to GAD are a predictor of risk and progression to the autoimmune form of diabetes.

In this episode, we cover:

3:08  What Chris ate today
5:48  What are GAD65 antibodies?
9:17  The predictive value of GAD antibodies
18:03  What to do if you produce antibodies

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Steve Wright: Good morning, good afternoon, or good evening. You are listening to the Revolution Health Radio Show. I’m your host, Steve Wright, co-author at SCDlifestyle.com.

If you’re struggling with digestive issues, poor sleep, high stress, maybe some mood swings or energy issues, or even chronic nasal congestion, I want to let you know that Chris has put together a program that’s just for you. It’s called 14Four.me. What this is is a 14-day healthy lifestyle reset program. It’s for someone like you who’s dealing with those issues, who wants to do the different pieces that Chris talks about that go into great health. I’m talking about diet, sleep, movement, and stress. Now, trying to tackle all these issues one at a time can be daunting, and so Chris has put them together in a step-by-step, hand-holding formula, where you can basically build these habits into your daily lifestyle. It’s really helpful when starting healthy lifestyle habits that you have a program to follow, so that’s what Chris did when he created 14Four.me. If you haven’t checked it out yet, I would highly encourage it.

With me is integrative medical practitioner, healthy skeptic, and New York Times bestselling author, Chris Kresser. Chris, how’s your day going?

Chris Kresser: It’s going pretty good, especially because you sound like a big-shot radio host over there!

Steve Wright: Well, you know, who knows? We could go on from here.

Chris Kresser: Yeah, we made some big changes in our audio setup. We’re trying to get closer and closer to broadcast quality. I think we’re nearly there. The last methylation podcast with Amy was on the new equipment, and now we have Steve set up, so hopefully you’re enjoying it, all you listeners out there.

Steve Wright: Yeah, leave us some feedback. Let us know what’s working and what’s not working, but I have to say I think I’m sounding a little better.

Chris Kresser: I think you are, too. These are the same mics used on much bigger radio shows like Radiolab and This American Life. I’ve been working with this guy who has just been so generous with his time and helping us to get this all set up, and I’ve learned a lot in the process! So yeah, hopefully you’re enjoying it.

Steve Wright: Awesome. Well, before we get into today’s podcast question — and for listeners, if you’d like your question answered by Chris, make sure you go to ChrisKresser.com/PodcastQuestion and submit it there — but before we actually get into today’s question, Chris, people are dying to know, as always, what have you been eating all day?

What Chris Ate Today

Chris Kresser: Let’s see. For breakfast, we had scrambled eggs, sauerkraut, and sweet potato hash browns. And for lunch, I had some leftover ground beef with some leftover pressure-cooked-in-broth collard greens and a little bit of mashed yuca.

Steve Wright: Nice.

Chris Kresser: With butter.

Steve Wright: How do you make that mashed yuca?

Chris Kresser: You cut the yuca into quarters, and then you try to get the hard kind of thread that goes through the whole thing, and you take that out. You don’t need to. You can mash it and get it out later. Then you cut them into chunks. Then you boil it for at least 20 to 25 minutes, and that’s important to reduce the toxin load because raw yuca, cassava, or manioc, as it’s known, is toxic and goitrogenic, and so you need to boil it first. And of course, you need to boil it to mash it, too. So then you boil it and you drain it and you mash it, and you can add ghee or butter or something like that. There’s a recipe on my website called yuca al mojo, I think, and that will give you the details on how to do it. Yuca con mojo, I think. It’s a Cuban recipe.

Steve Wright: Awesome. And for those of us who love bacon, you can just put bacon in there, too, probably.

Chris Kresser: Yeah. The mojo is not so much of a mashed one. It’s usually chunks, but it’s soft and you can mash it from there if you want.

Steve Wright: Awesome. Well, let’s roll on to today’s question.

Chris Kresser: Great. Yeah, this question is from Ruth. Let’s give it a listen.

Question from Ruth: Hi, Chris. My question is about autoimmune type 1 diabetes. I’m wanting to know if someone’s presenting with elevated GAD65 antibodies — so developing the disease — is there anything, in your opinion, that can be done to reverse or stop the progression to full-on type 1 diabetes? I find it really frustrating that there’s so much information about type 2 diabetes and reversing type 2, and I just wondered whether there was anything that could be done for type 1 diabetes. Thank you.

What Are GAD65 Antibodies?

Chris Kresser: OK. Well, thanks, Ruth, for sending us that question. Let’s start by talking a little bit about what GAD65 antibodies are. GAD stands for glutamic acid decarboxylase, and this is a major enzyme in the synthesis of GABA, which is one of the major inhibitory neurotransmitters in the body. I like to explain it to my patients as the off switch for the nervous system. GAD and GABA are mostly present in nerve cells, but interestingly enough, GAD is also found in the pancreas. GABA is stored in the islet beta cells that produce insulin, and it’s been known for a while that because of this, antibodies to GAD are a predictor of risk and progression to the autoimmune form of diabetes. In autoimmune diabetes, the body attacks insulin-producing cells or even insulin itself in some cases, which then leads to insulin deficiency, and that’s why people with type 1 diabetes or type 1.5 diabetes, which we’re going to talk about in a second, end up needing to take insulin in many cases because their body is not producing the appropriate amount of insulin because of this autoimmune attack.

Insulin deficiency, of course, can also occur in the later stages of type 2 diabetes, which is not autoimmune. In that case, it happens as a result of inflammation and metabolic changes that eventually lead to a destruction of the beta cells that produce insulin. And so in the very kind of end stage of type 2 diabetes, patients will often require insulin, but that’s not typically from an autoimmune cause. Type 1 diabetes, which is usually juvenile onset and appears during childhood, is autoimmune, and that involves, as I just said, the body attacking the insulin-producing cells, and you get an insulin deficiency and have to take insulin as a result. But there’s another type of diabetes that has been referred to as type 1.5 because it kind of has characteristics of both type 1 and type 2 diabetes. Another term for it is latent autoimmune diabetes in adults, or LADA. What happens here is it’s an adult onset of autoimmune diabetes. So rather than coming on in childhood like type 1 diabetes does, it comes on later in life and has many of the same characteristics of type 1 diabetes in that it’s an autoimmune condition and it leads to destruction of the beta cells and a reduction in the production of insulin.

Steve Wright: So the only difference between 1 and 1.5 is just the time in which it strikes or becomes activated?

Chris Kresser: There are some other differences as well, and there’s some heterogeneity in terms of how it manifests, so it doesn’t always look the same. Some people are kind of closer to the type 2 presentation, and other people are closer to the type 1 presentation, but yeah, that’s the gist of it. Typically type 1 diabetes has been strictly juvenile onset, but type 1.5 is adult onset.

What Is the Predictive Value of GAD Antibodies?

The important question here is, what is the predictive value of GAD antibodies? If somebody does a test and it comes back positive for GAD antibodies, how much does that tell us about the likelihood that they will go on to develop type 1.5 diabetes or type 1 if they’re getting this test when they’re a child? Well, it turns out that GAD antibodies, even by themselves, do have moderate predictive value, but when you combine them with other antibodies like islet antigens insulin, or IAA, or IA-2 antibodies or zinc transporter antibodies, the predictive value goes up significantly. For example, some models show that having three positive antibodies implies a risk of between about 50% and 85% over five years that the patient will develop the clinical signs of type 1.5 diabetes or 65% to 85% chance over 10 years. So with three positive antibodies, that’s a relatively high chance that within 10 years you would develop the clinical signs of type 1.5 diabetes. However, there are a few studies that put it even higher than that. I saw one model that estimated that 100% of people with three positive antibodies will go on to develop the onset of autoimmune diabetes within five years. So, one antibody appears to be moderately predictive. With three antibodies, the risk is anywhere between 50% and 100% in five years, depending on what study you look at.

However, — and I think this is a relatively big however — we have to remember who the population is that is studied. In these studies where they’re looking at people who test positive for the antibodies and then following them over a course of time and checking to see if they develop the clinical signs of diabetes, this is typically an industrial population either in the US or Europe. They are people that are probably overall eating a pretty crappy diet because we know that that’s the default for most people in the industrialized world. They’re probably not getting enough exercise. They’re probably not getting enough sleep. They’re not taking care of themselves in the same way that, hopefully, all of you who are listening to this show are. We know that those kinds of environmental factors play a very strong role in the onset and progression of autoimmune disease, so for me, it stands to reason that the predictive value of these antibodies may be lower in a population of people where they’re really taking care of themselves and following all the best practices that we talk about on this show and I write about on the blog. Unfortunately, we don’t have any data on that. It would be great if we had a prospective study of people with these antibodies who were eating a paleo type of diet and living a paleo type of lifestyle and were followed for 10 years, but we don’t have that study, and we’re not likely to anytime soon.

Steve Wright: Now, are these antibodies all related to the pancreas or beta cells? Because you mentioned many of them.

Chris Kresser: Yeah, they’re all related to the pancreas or insulin-producing cells. As I mentioned earlier, some much smaller number of people actually produce antibodies to insulin itself. That’s much less common. But all these antibodies relate to the production of insulin or that system. GAD is also found in other places, though, like the brain. GAD antibodies are not exclusive to the pancreas or the function of the pancreas. As I mentioned before, GAD is present mostly in nerve cells and the central nervous system and the brain, but in this case, they are often a marker of potential for type 1.5 diabetes or type 1 diabetes, especially in the presence of these other antibodies.

Steve Wright: I’m no diabetes expert, but I’ve never heard of some of these. How often are these ever done in a clinical setting?

Chris Kresser: It’s getting more common, but you’re right; you’re not going to find them on your typical blood panel with your primary care doctor. GAD antibodies are part of the Cyrex Array 5, which is their multiple autoimmune reactivity panel, where they screen for antibodies to a number of different tissues. And the reason that panel can be a good idea in some cases is just for the reasons that we’re discussing. The production of antibodies to a particular tissue usually precedes the development of disease in that tissue or system by several years and even up to a decade or more. So if you identify the production of antibodies early on, then you have a much better chance of intervening and preventing the development of disease as you go.

Now, there’s unfortunately very little research on whether onset can be prevented because this isn’t really the specialty of conventional medicine, as we all know, i.e. prevention. Conventional medicine is much better at intervening at the far other side of the disease spectrum, when disease has already manifested and become quite severe. I really would love to see more research on, like I mentioned before, studying people who are really taking care of themselves and determining what changes people can make to prevent the onset. What we have now is just theories, and I think there are theories that are based on evidence and research, and we’re going to talk about some of those suggestions shortly, but we don’t know with 100% certainty. We can’t make any guarantees.

Steve Wright: And just for listeners, Chris, I don’t know if most people understand the difference between having an actual disease diagnosis and the level of destruction that happens from the initial onset of the ability to detect that there is some autoimmune activity. Could you just really quickly go over that?

Chris Kresser: Yeah, that’s a good question. Autoimmunity means the production of antibodies to a particular tissue. Autoimmune disease refers to a disease state that is a result of autoimmunity, a result of the production of those antibodies. You can have autoimmunity without having autoimmune disease. An example would be with Hashimoto’s, which is the autoimmune disease that is caused by production of antibodies to the thyroid or tissues in the thyroid. Only about — well, I say ‘only.’ This may sound high or low to you. I’m not sure. It’s not true that everyone that produces antibodies to their thyroid will go on to develop clinical hypothyroidism. In fact, I think in most of the papers I’ve seen, it’s between 20% and 30% of people who develop antibodies will actually ever go on to have hypothyroidism. That tells us that the production of antibodies to tissue doesn’t always lead to frank tissue destruction to a level that would cause clinical disease. It’s important to understand that distinction because it means that if you intervene early enough, you may be able to arrest the progression from just the mere production of antibodies to the destruction of that tissue that the antibodies are tagging.

What to Do If You Produce Antibodies

Let’s talk a little bit about what I would recommend in this situation if you see that you’re producing antibodies to a particular tissue, because although we don’t have proof that this will arrest the development of autoimmune disease, there is a lot of research that suggests that autoimmunity is triggered or exacerbated by a whole bunch of different factors, like intestinal permeability and poor nutrition, lack of exercise, inadequate stress management, lack of sleep or poor quality sleep, environmental toxins. I just read a really fascinating study, for example, showing that people with mercury amalgams who had positive thyroid antibodies, when they took out their mercury amalgams, their thyroid antibodies went down significantly just from removing the mercury from their mouth. And then there are chronic infections and a whole bunch of other influences. So there are a lot of things in our environment that we’re exposed to that can trigger or exacerbate autoimmunity and autoimmune disease, so in our work with patients, this is what we focus on. These are things we’ve talked about a lot, so I’m not going to go into detail on each category. I’m just going to give you some of the things to focus on, and then if you need more detail, you can check out the book and other podcast episodes and the blog, of course, and the free eBooks we have on the site.

In terms of diet, of course, you want to focus on a nutrient-dense paleo type of diet, but you might also want to consider an autoimmune protocol, especially if you think you have sensitivity to things like nightshades or eggs or dairy products. You may want to consider something like the Wahls protocol, which was developed by Dr. Terry Wahls for her in her own experience dealing with MS, autoimmune disease, a pretty miraculous response for her. It took her from being in a wheelchair to being able to walk and speak. I just saw her at Paleo f(x) a couple of weekends ago, and she was presenting there, as she often does. Pretty incredible results just by switching to a nutrient-dense, low-toxin, anti-inflammatory diet.

You’d probably want to test for food intolerances using something like Cyrex Array 3 or Cyrex Array 4. They have a new screen, Array 10, and we’ve been using it a little bit, but the jury is still out for me on that test and its value. Maybe we can talk about that a little more.

Steve Wright: Does that mean that the jury has come to a decision or at least a quasi-decision with regards to Array 3 and 4 with Cyrex food sensitivities? Because we’ve talked about those in the past.

Chris Kresser: Yeah, well, my feeling about those, I think Cyrex Array 3 is pretty reliable and accurate in terms of gluten sensitivity, and generally most foods that contain gluten don’t really have a ton of nutritional value anyway, and they’re not something that I think people should be really focusing on in their diet even if they aren’t gluten intolerant. The downside of removing gluten from your diet is not that big, and I think it’s the most advanced test for gluten intolerance out there, and we use it. I like it.

Array 4 is looking at cross-reactivity to other proteins, like eggs and dairy and other kind of alternative grains, non-gluten grains and things like yeast and coffee. There’s a whole debate about whether cross-reactivity even exists. I don’t want to go into that now, but I’ll just say that we use Array 4 as kind of a springboard for elimination/provocation testing. In other words, if someone tests positive for eggs, we won’t tell them, OK, that’s it. You have to avoid eggs for the rest of your life, no matter what. We’ll say, OK, let’s test this out. Avoid eggs for 60 days, 30 days. Add them back in and see if you notice any symptoms or if we see any changes in your labs, and if we do, well, then you probably should avoid them. If we don’t then I’m not convinced that they will need to avoid them, especially after we address the underlying issues. And that’s kind of how we’re using Array 10 as well as this point. If it comes back and says, OK, raw strawberries are off the menu. Well, let’s test that out before you completely avoid that food for the rest of your life. I think that’s generally how this testing should be used.

Gut health, of course, is another huge concern with autoimmunity. People like Dr. Alessio Fasano believe that leaky gut is a precondition to developing autoimmune disease in the first place, so getting tested for SIBO, gut infections and inflammation, intestinal permeability, emphasizing gut-healing foods, eating plenty of fermentable fibers and fermented foods and maybe even using commercial prebiotics and probiotics are all something to consider. And you can check out my free eBook on gut health at ChrisKresser.com to get started if you’re new to that.

Stress management. This is something we’re always talking about, but it can really not be emphasized enough. It’s crucial for immune health, and unfortunately it’s often overlooked. There are so many studies that show that the onset of autoimmune disease is associated with stress. We live, many of us, in a pretty stressful environment, so this is something that people really struggle with, but it’s really important to take some steps. 14Four, of course, that was one of the main reasons I did that program, was to give people some resources and tools to help them get started with these kinds of things.

The same is true for sleep. It’s crucial for immune regulation. Thirty percent of Americans are sleeping fewer than 6 hours a night, and most of us need 7 to 8 hours to function properly.

And physical activity. Not just getting enough exercise, but sitting less. Not sitting for hours and hours every day. Punctuating that sitting, if you have to sit, with frequent breaks, walking more, doing some high-intensity activity, and avoiding overtraining.

Again, 14Four is an excellent option. If you’re new to this and you want to nail your diet, stress management, sleep, physical activity, and even gut health, that will get you on the right track.

Finally, supporting T regulatory cell function. T regulatory cells, or Tregs as they’re often called, play a very important role in balancing and regulating the immune system. There are a number of things that you can do to support the Tregs, including normalizing your vitamin D levels, making sure they’re in the right range, boosting your glutathione levels through a nutrient-dense diet and supplementation, increasing your butyrate levels, which is a short-chain fatty acid that promotes T regulatory cell function and reduces inflammation. Things like curcumin, particularly bioavailable forms, like a liposomal curcumin, that’s anti-inflammatory and promotes T regulatory cell function.

And then if you have maybe all three of the antibodies, which would suggest a very high likelihood of developing autoimmune diabetes, you might consider something like low-dose naltrexone as a prophylactic. We did a show on low-dose naltrexone not too long ago, so you could give that a listen and talk to your doctor about it.

All right, Steve, that’s it for this episode. I hope it was helpful, and we’ll see everybody in a couple of weeks.

Steve Wright: Yeah, I appreciate it, Chris, appreciate all the research that you do. I know the listeners do, as well. For everybody who’s listening and you’re wondering what Chris is researching, what articles he’s reading, things that might not make it onto the RHR Show or onto his blog, he publishes all that stuff on social media. So if you haven’t yet, go to Facebook.com/ChrisKresserLAc and give him a follow and Twitter.com/ChrisKresser. Thanks for listening, and as we mentioned before, this podcast is created for you and also by you, so go to ChrisKresser.com/PodcastQuestion to submit your questions.

  1. My son is 4 years old and has been battling bouts of low blood sugar for a year. Doctors have no answers except maybe it’s early onset diabetes, but high blood sugar just low. Yesterday I gave him apple butter with cinnemon. He almost fainted after eating it, I had to carry him to bed, I forgot how cinnemon lowers his blood sugar….his sleeping blood sugar is around 70 and fasting this morning was 83. I want to prevent this progressing to type one diabetes..I’m so scared. How do I get his body to regulate his blood sugar?

  2. I think the unhealthy fluctuations in my blood sugar, which appear to be pre-type 1.5 diabetes, based on this article, are most certainly due to the chronic stress I’ve suffered as a result of childhood trauma and the resulting C-PTSD. Constant anxiety and insomnia has taken a massive toll on my health, and I notice that the worse I sleep, the worse my blood sugar readings are.

    Luckily, I have good intuition and eventually figured out that I needed to drastically reduce my stress levels, so I now base my lifestyle on low-stress activities and a very low-stress job. Reading articles like this one really helps back up my intuitive urges in regards to my health, and shows me that my body knows what it needs, as long as I am willing to listen.

    Ridding my diet of gluten and dairy also made massive improvements to my health, as well as getting officially diagnosed with intestinal parasites and therefore being able to take appropriate action to get rid of them. I had no idea how sick I was for many years, but I’m really turning things around, and this website is providing such valuable info as I continue to improve my self-care! Thanks so much for sharing your knowledge, Chris. I’ll be trying out many suggestions I’ve found here.

  3. If you keep healthy life, it is possible to prevent type 1 diabetes or reverse your diabetes.
    I was diagnosed with type 2 Diabetes and put on Metformin on June 26th, 2014. I started the ADA diet and followed it 100% for a few weeks and could not get my blood sugar to go below 140. Finally i began to panic and called my doctor, he told me to get used to it. He said I would be on metformin my whole life and eventually insulin. At that point i knew something wasn’t right and began to do a lot of research. On April 13th I found this book on http://www.wje592.com/i-am-finally-free-of-diabetes/. I read the book from end to end that night because everything the writer was saying made absolute sense. I started the diet that day and the next morning my blood sugar was down to 100, the next day was in the 90’s and now i have a fasting blood sugar between Mid 70’s and the 80’s. My doctor took me off the metformin after just one week of being on this lifestyle change. I have lost over 30 pounds in a month. I now work out twice a day and still have tons of energy. I have lost 6+ inches around my waist and I am off my high blood pressure medication too. I have about 20 more pounds to go till my body finds its ideal weight. The great news is, this is a lifestyle I can live with, it makes sense and it works. God Bless the writer. I wish the ADA would stop enabling consumers and tell them the truth. You can get off the drugs, you can help yourself, but you have to have a correct lifestyle and diet. No more processed foods.

    • This video / site says you can buy foods for $15 and raise IGF and cure diabetes. I haven’t found any research to support this claim. Sounds like spam. IGF is interesting, however.

      This is from 2000 (15 yrs ago), but I don’t think IGF has been found more recently to be the answer we are seeking.

      “Type 1 diabetes is associated with abnormalities of the growth hormone (GH)-IGF-I axis. Such abnormalities include decreased circulating levels of IGF-I. … an increase in insulin-stimulated peripheral glucose disposal was observed after IGF-I therapy… ”

      http://www.ncbi.nlm.nih.gov/m/pubmed/10905488/

      This next bit from 2012, echoes research I’ve read that says IGF is good only at certain times.

      “when IGF-1 levels drop, the body slows production of new cells and instead, repairs existing cells. DNA damage gets fixed and age-related diseases don’t happen.

      The IGF-1 hormone is one of the drivers which keep our bodies in “go-go mode”, with cells driven to reproduce. This is fine when you are growing, but not so good later in life.”

      http://leangainsguide.com/igf-1-and-fasting/

      It may just be that Type 1s are in repair mode and thus have lower IGF. Like high fasting blood sugar itself, this is a symptom, not a cause. Increasing IGF-1 doesn’t seem like a cure. There are many points along the metabolism path to push the reactions that should be happening, but unless you find the root cause, something is likely to back up somewhere else. One example of a root cause might be genetic mutations in the GCK gene that makes the molecule, glucokinase, that senses glucose for regulation. This may be why I keep coming back to an impaired fasting glucose of 110… My “normal” that the research says is dangerous long term. Broken sensor. Occasionally, if glucose meters are to be believed, I’ve banged in just the right way on the robot and the sensor worked again for a short time.

      The body is an amazing balancing act of dynamic systems. Keep at it! It’s complicated but I’m convinced there are fixes for the many different root causes of blood sugar problems.

  4. I was hoping this article would be a deeper dive into type 1 diabetes. In might have included existing data or case studies that have reversed type 1 or a specific protocol for doing so etc. Instead it turned into another broad conversation about autoimmunity with the same treatment plan. Paleo, 14-4, etc.. The people who have been following for a while might want something different/more. Thanks, Dan

    • I’m with you Dan. He didn’t even address the “or Cure” part of the question. Makes me wonder why he put it up there in the first place. Also, for me, creates a pile of distrust toward him.

      Too many of these health “Guru’s” should just shut it on certain topics unless they have a “real” answer. Me, being a type 1 for near on 20 years, never find much to go on with their comments. Lot’s of hope and no solutions.
      But then again, hope is the last to die. Right?

      So, I guess we can look for our own answers. Chris is another “non-straight-shooter” just trying to make a living selling health alternatives. Lot’s of them out there. Not all bad and I’m sure he has some good things to say. Just didn’t find it in this interview. Smfh!

  5. One request and one question:
    1. Please post the link to the research re: dental amalgams and Hashimoto’s.
    2. What the best link to follow what your currently reading?

    Thanks great info Chris!

  6. Replicating a user’s L-Carnitine experiment: On the forum here, the one that is getting shut down due to hackers, there was an interesting post in the diabetes thread right before the attack started. Someone reported readings in the 80s (even with high carb meals) by taking a gram of L-Carnatine with each meal. I replicated that study yesterday with just 500mg of L-Carnitine fumerate, Dr’s Best brand with breakfast lunch and dinner, getting 6.5 hrs sleep, not much exercise. I was extra hungry at 3:30 and ate an early dinner at that time with chicken, potatoes and white rice (no l-Carnatine) as well as a second dinner around 9pm of pork and organic corn tortillas.

    Results: This morning, using my OneTouch VerioIQ, my first two readings were 87 then 76! Totally normal range! I’m cured! No more impaired fasting glucose, right? But let’s be scientific, I thought, so I tested again: 114. WTH? Next I got what should be a more accurate meter, a special expensive glucose analyzer. I ran two more tests on the Verio and also from the same finger stick on this optical machine that I won’t name for certain reasons. The Verio gave 102 then 103 and I got corresponding readings of 113 and 122 on the “better” meter.

    What to make of this?

    Possibilities: 1) l-Carnitine messes up glucose oxidase reactions? 2) My first two tests were accurate, and because I went low my body corrected and then I went high. I’ve been told that blood sugar can change as fast as blood pressure, that is, in seconds. 3) I have some bad strips?

    How do I “eat to my meter” this morning with readings like this from 76 to 122 all between 8:04 and 8:11 am?

    • Typo: That should be “Fumarate”. The product also contains Magnesium stearate and I took an extra 200mg of Magnesium (“High Absorption, fully reacted! not buffered!”) last night before bed, same brand: Doctor’s Best, due to having muscle cramps in my feet the night before.

  7. Isn’t there also a correlation between casein intolerance, vitamin D deficiency, the GAD gene and LADA?

  8. Hi Chris, nice discussion, thank you.

    You referred to the strategy of “increasing butyrate levels” … great idea: what is your protocol for that? I understand that dietary butyrate doesn’t go far into the gut, although rectally administered butyrate probably does , but…. there must be another way!

    Thanks,

    Deborah Gordon

  9. Hi Chris,
    My sister has diabetes type 1 and that’s why I found your information very helpful. Thanks for helping so many people and taking your time to answer questions.

    All the best,
    Amber

  10. I’ve spent a year and thousands of dollars trying to reverse my high blood sugar and IA-2 antibody, trying to not progress to T1D. I’ve been writing a book as I try hundreds of things and test test test. I’m not winning the battle lately and had some fasting BSs as high as the 130s. The highest reading was the day after walking 8 miles in the B2Breakers, so I do see BS as an indicator of inflammation. I still have hope, though. I go back to things that worked in the past for me and they work again. Yesterday I was 117. Last night I took two Now brand Silymarin capsules in water an hour after eating. Later a scoop of Realfood organics brand probiotic daily powder in water and almond milk. This morning I had a 99 reading, only 6.5 hrs sleep. I did do an unusual number (for me) of pull-ups and push-ups yesterday along with a moderate amount of walking (6,000 steps by the FitBit). I expected worse because of the 6.5 hrs sleep. I keep asking myself every day, am I doing everything I possibly can? Thanks to Chris and everyone for sharing ideas!

    • I’m in the same boat, catching antibody for T1 before a diagnosis of T1. More will be joining us, sadly. One key to prolong the honeymoon is keeping BS in a good range, since high BS causes more high BS due to the damage over time that excess glucose causes. Going too low (e.g by eating too few carbs) can also cause damage and reactive highs, which is why some recommend 6 small meals a day. To avoid glyphosate, an antibiotic which damages good gut bacteria, eat only organic foods and animals fed organic food. Expensive, but probably worth it. The liver is a key player! I’m thin but too much fat (even good fats) over several days seems to cause problems for me. Same with too much fruit. Try cutting back on fructose. The 14four.me is a great starting place to learn new eating habits.

      PS. I’m pretty sure islet is pronounced EYE-let not IS-let.

      • Weird, I thought I was editing another comment I made, instead this added a new reply to my own post. This and the above reply can be deleted.

  11. I was diagnosed with type 1 diabetes at the age of 44. I was eating a very healthy diet and exercising 12+ hours per week relatively heavily. My family has a history of type 1 on both of my parent’s family lines. My sister has had the disease since she was 5 years old. Besides injected insulin, the most important factor for myself is exercise. The second is diet. Strict carbohydrate control as well as staying away from fungus toxins (black mold, black fungus) seems to be the most effective for myself.

    My mother taught us to eat healthy as we were growing up due to my sister’s condition. Regular exercise has always been important to me as well.

    Somewhat an anecdote to the “peanut gallery” Thank you for addressing this issue, nonetheless. It’s good to hear an unbiased, scientific approach to the disease. Arm waving and “shrugged shoulders” don’t help us much. Main stream moves in this direction though.

    Fred

  12. Hi Chris

    Thanks for answering my question. I was very surprised as did not expect it to get answered. I am doing all that you recommend and much more. I now have a diagnosis of LADA although still producing enough endogenous insulin to manage it on a low carb diet. I am now just hoping to slow progression and regenerate beta cells if at all possible. I am keen to hear others stories who are in the same boat, what have you learnt and what’s working for you.

  13. It would be great if you could do a more in-depth discussion about the Cyrex Array 10. I had it done a couple months ago, and let’s just say that my diet is now very limited (most meat, and about 8 veges/fruits)! It was a huge blow. I reacted to most of Array 4 foods and have been off them for 1.5 years.

    I’d be interested in hearing your thoughts on a retesting protocol, especially when reacting to so many foods. If doing one at a time, that is a lot of testing (not to mention $ for the tests). My functional medicine chiro told me this would be lifelong.

    What does reacting to so many foods have to say about my body/immune system? It seems like it’s completely run wild!

    • I’ve heard some food allergy type tests may really just be detecting if you had previously eaten those foods. Misinterpreting has caused people to totally avoid foods their immune system tagged as “known” rather than as “foe”. I’d like to hear Chris’ thoughts on that.

      PS, Great sound on this podcast. As a recording engineer my guess is that the mics are Sure SM7-B’s.

      • More details:

        I confirmed that Cyrex Array 10 does test IgA and IgG antibodies:

        “Some patients produce more IgA than IgG, or vice-versa. By combining the two on one panel, Cyrex reduces the possibility of missing reactivity”
        http://www.joincyrex.com/page/7781/Array-10-Multiple-Food-Immune-Reactivity-Screen

        If Cyrex is testing IgG4 reaction to foods, I’d like to understand how that has been validated as a useful test. I think Chris said this test is just a starting point and the real test is elimination of the food to see if that helps you.

        I had this discussion recently with my father. He now avoids a zillion foods because his functional medicine doctor ran these kinds of tests. He says he is “allergic” to almost everything. The company he used, Genova, did IgG testing. (They also have some IgE tests.)

        The view against IgG4 being useful is this:

        “IgG4 against foods indicates that the organism has been repeatedly exposed to food components, recognized as foreign proteins by the immune system. Its presence should not be considered as a factor which induces hypersensitivity, but rather as an indicator for immunological tolerance, linked to the activity of regulatory T cells. In conclusion, food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposition to food components.”

        http://www.aaaai.org/ask-the-expert/use-of-IgG-and-IgA-antibodies-in-diagnosis.aspx

        It still makes sense to me that Chris would use Array 10 to figure out what someone frequently eats and then see if removing those items helps.

        It might be that by eliminating eggs, for example, you eliminate glyphosate in your non-organic eggs from chickens fed a “vegetarian” diet, and your BS readings and symptoms improve.

        On the other hand, if you react with IgE, that test can show a potentially life-threatening food allergy. If Cyrex can test my blood for IgE any reactions to many common foods that would be great.

        “With over 4000 scientific articles using ImmunoCAP and showing its clinical value, ImmunoCAP is perceived as “Gold standard” for in vitro IgE testing”
        http://en.wikipedia.org/wiki/Radioallergosorbent_test

        Quest (used by Kaiser) has the ImmunoCAP test, and many allergens you can test, but they don’t seem to have a large panel that tests many different potential food targets at once.
        http://www.questdiagnostics.com/home/physicians/testing-services/by-test-name/immunocap.html

        I do have some histamine reactions from something: an almost constant stuffy nose and redness around my eyelids. (Saline nasal rinses help, for a while.) The eyelid problem could be demodex, since tea tree oil mouthwash on my face (keep it out of the eyes!) improves the situation.

        Seems like it would take a long time to do the elimination tests. If I eat 60 different things each week, what’s a good protocol for groups of foods to eliminate?

        I’m hoping the cure for T1D turns out to be a pheromone. You sniff it and your immune system learns not to attack your own body, the same way it learns not to attack the proteins in your foods.
        http://www.jimmunol.org/content/162/4/1994.full

        I look into this in my book (unpublished). How would you smell your own pancreas to create tolerance? The answer may surprise you.

        Thanks again Chris for this site and for directing some of your considerable talents to help those with T1D.

    • I would never counsel a patient to permanently remove foods from their diet based on results from Array 10 or any other food intolerance test. Rather, I believe the results should be used to guide an elimination/provocation protocol. For any foods you tested equivocal or positive to on Array 10, remove them from your diet for a period of 30-60 days, and then reintroduce. If no reaction, I don’t see compelling evidence to remove them from your diet.

      Also, if you have multiple intolerances that would indicate a deeper underlying problem in the get (e.g. SIBO, dysbiosis, parasites, etc.). Addressing that underlying problem is then the priority—not simply removing foods from your diet. And once you do address that problem, it often becomes possible to add some or most of those foods back in.

  14. Chris, you are outstanding, I am enjoying all your comments and research, having been in the Holistic Field since the 1960’s pioneering, and the new information coming to the forefront now is much needed…Having my own Holistic Health Show http://plv-radio.com/wise-health
    on demand, anytime…hoping to have you as a guest sometime…Love, Health & Peace Agingless Suma

  15. The best thing anyone can do is find a healthy diet you know you can stick to combined with a good exercise regime.

    I’m on the paleo diet myself and love it. I have lost a lot of weight and I feel much better with much more energy and positivity.

    The beauty about the paleo diet is that whilst there is a focus on good foods, there are so many resources to help you make these into delicious recipes. I have written about one of my favourite cookbooks here: http://cookbook-reviews.net/review-the-paleo-grubs-book/

  16. As always, great information. Only disappointed that it didn’t actually answer the question. Can Type 1 diabetes be reversed ? Ie. once the disease is diagnosed and your body no longer produces insulin … Can it repair itself. ?

    • I have not yet seen a case of type 1 diabetes being completely reversed, though I have seen progression slowed and halted, reductions in the amount of insulin needed, etc.

      • Have you tried anything off-label with patients like oral methyl-prednisolone (MP), or verapamil?

        Verapamil “is normally used to treat blood pressure and irregular heartbeats by relaxing blood vessels and increasing blood and oxygen to the heart, but it has also been found to reduce levels of TXNIP in beta cells. In doing so, insulin production can restart, and diabetes reverses. “We… know that treatment definitely creates an environment where beta cells are allowed to survive, and their survival is a major factor in potentially improving insulin production, so our hope is that we’ll see a similar effect in type 1 diabetes patients to what we have seen in our mice models,” the study’s lead researcher Dr. Anath Shalev said in a live newscast, according to Medscape.”

      • So there’s the kicker. Not a cure, right? And yet you put a teaser in the title of the interview. Not funny for us Type 1’s.
        Dr. Bernstein is the authority on this matter. You should just refer to him in the future. No other comment needed. I’d like to call you some despicable… but it wouldn’t help the conversation.

  17. Curious how this plays out. 3 year’s ago, I tested positive with antibodies for T1, began working with a chiro who identified dairy as trigger for me through muscle testing. I since eat very strict paleo and continue to work with my chiro to help preserve beta. Still producing insulin for the time being. 36 years old. God willing the changes keep me on this side and I can use my experience to influence others on the fence while they still can. I lost 40+ pounds and exercise regularly pretty intensely to Chris’s point. Curious if any others are on the same journey. My chiro has a confident tone about it when discussing that my body is in healing state because we removed the trigger and of course the body does not want to attack itself. This has been an interesting journey to say the least. Looking for support if it’s our there. I’m certainly not naive, I understand honeymoon etc but to Chris’s other point the study participants perhaps kept introducing the triggers where I hopefully removed it, similar to the mercury analogy.

    • I’m in the same boat, catching antibody for T1 before a diagnosis of T1. More will be joining us, sadly. One key to prolong the honeymoon is keeping BS in a good range, since high BS causes more high BS due to the damage over time that excess glucose causes. Going too low (e.g by eating too few carbs) can also cause damage and reactive highs, which is why some recommend 6 small meals a day. To avoid glyphosate, an antibiotic which damages good gut bacteria, eat only organic foods and animals fed organic food. Expensive, but probably worth it. The liver is a key player! I’m thin but too much fat (even good fats) over several days seems to cause problems for me. Same with too much fruit. Try cutting back on fructose. The 14four.me is a great starting place to learn new eating habits.

      • I’m surprised – not much talk about sugar or carbs. I’d be really interested in seeing this conversation expanded.

        Type 1 diabetes, maybe it cannot completely be reversed but that does not mean it should not be worked on to the best of your abilities.

        All we can do is our best.

  18. HI Chris, thanks so much for speaking on this topic. I wrote to your RD, Laura a few months ago as a young friend (9yo) has been diagnosed with Type 1. I have been managing my lupus (SLE) for my entire adult life, with nutrition and what is now called Functional Medicine. I wonder if you resources for the parents of this kid (both PhD scientists) I’m going to point them to Jeff Leach. I also wonder whether you could write or speak on childhood T1D? I suspected and Laura confirmed that most people are only talking about adult autoimmune disease and Functional Medicine for adults. I would really appreciate your input as I try to support this family.

    PS thanks for talking about stress. The more I look at it (and the more information on ACE- Adverse Childhood Events- I read about, and hidden ACEs, I see how important stress is in autoimmune and other disease.

    I am going to include here, for other readers, a blog by Veronique Mead a former physician and somatic psychotherapist in Colorado I have worked with whose area of interest has been chronic illness and trauma. She wrote her thesis on T1D. http://chronicillnessblog.com/the-chronic-illness-model/

    • Thank you Penelope for the link. My son, who is now 22 months old, was diagnosed with T1D at 11 months. We are trying to search every possible way we can do to reverse his autoimmunity. We have been on a modified GAPS Intro diet almost a year now. The link you provided gave me a whole new insight about why and how this happened to my son at such an early age. I will go deeper on ACE and try to find how to resolve it if I can.
      Chris, I also would really appreciate if you provide your opinions on T1D in very young children.
      Best wishes.

      • Hi Miray,
        I’m so sorry about your son’s diagnosis at such an early age and glad that my site seems to have offered some insights. Since there seems to be some fit with what you may have read about trauma and you are looking far and wide, you might consider an experiment. My work has found extensive support for the role of trauma, including during pregnancy, birth and in the few weeks of life – and risk for T1D.

        There is a psychologist specializing in trauma work who has published a number of studies showing that kids could recover from asthma when trauma was addressed.

        While asthma is not an autoimmune disease I’ve long wondered if his approach could possibly be helpful with other diseases, especially if treated early (he had the best success with asthma recovery in the youngest kids, usually well under 9, as your son is).

        His website is http://www.asthma-busters.org/AsthmaBusters/Research.html.

        I wish you the best on this journey.

        Veronique

        • Dear Veronique,

          I printed out both the book chapter and the article you wrote and started reading them.

          I had experienced trauma both during my pregnancy (due to a very stressful event after which I was diagnosed with gestational diabetes) and during the birth of my son (it was a c-section).

          Thank you very much for telling me about this psychologist. I will contact him as soon as possible. Although I live in Turkey, I am hopeful that he might provide his recommendations on how to move forward in our case.

          Thank you again for sharing your valuable work with us.
          Best wishes.
          Miray

          • Dear Miray,

            Thanks for sharing some of what you’ve experienced – sounds like there were some real stressors during your pregnancy and son’s birth.

            Tony’s work happens to be with mothers’ trauma and you just described some events that could well be helpful to address. It’s an odd finding that working with mother’s can help their children’s health and it likely works through epigenetics and effects of transgenerational trauma.

            Tony has often given guidelines to therapists who can then work with folks even when they are far away, so I suspect you’ll get great support in exploring this approach!

            Feel free to get in touch if you have any questions about the article and book chapter. I wish you all the best on this adventure and would love to hear how it goes for you.

            Warmly,

            Veronique

      • Hi Miray
        so glad to be of benefit to your family. The work I started with Veronique 7 years ago has really given me great insight into the psychological aspects of living with autoimmune disease. Even if you live in Turkey, I believe you can help yourself and your child. Take a look at Dan Siegel’s work (start with Parenting from the Inside Out) and also Pat Ogden, Peter Levine, Diane Poole Heller. You also might find Gabor Maté helpful. I’m glad yo uare on this site of Chris’s I find him incredibly informative especially about gut health and autoimmune disease. I think there is alot we can do to heal our gut and address autoimmune disease from different angles. I wish you well.