Reader Q&A #6: Antibiotic Recovery, Intermittent Fasting + Hypoglycemia, Supplements and Timing

Today’s questions from What When Wine Diet readers cover an array of topics! Let’s dive right in, shall we?Reader Q&A 6

QUESTION #1: RECOVERING FROM ANTIBIOTICS
Our first question comes from Chad in West Virginia, who wrote the review in my recent guest post! Chad had to take some antibiotics for a tooth infection, which disrupted his Intermittent Fasting routine, and re-instigated cravings:

West VirginiaI saw you mentioned antibiotics previously, but I think your insight into what happens when you need them and how it affects everything (and advice) would be helpful. I know I didn’t expect to be tossed so far off the wagon so quickly and I didn’t expect to find myself enslaved to cravings again. Anyways, any advice on recovering would be awesome! Thank you again!” – Chad 

Oh antibiotics – the epitome of a love/hate relationship, if there ever was one! When absolutely necessary, antibiotics can be live saving. But boy do they wreak havoc on your gut microbiome!

The billions of bacteria living in your gastrointestinal tract help you process your food, produce energy for your cells and immune system, and ward off nasty pathogens. You live in a symbiotic relationship with these little buggers, and need them for health and vitality. Antibiotics, which are intended to kill the bad guy bacteria in your system, also wipe out the good bacteria. This easily throws your whole system out of whack, and actually makes you more susceptible to future infections. Go figure.

So what is one to do when an antibiotic is absolutely necessary? Rebuild that gut microbiome!

You can do this by consuming probiotics (the actual good bacteria) through fermented foods and probiotic supplements, as well as prebiotics – the fibrous food to feed them. I go into detail about all of this here, but here’s the quick version:

PROBIOTICS – HSO Soil Bacteria

PROBIOTICS – Non-HSO Bacteria (Lactobacilli, Bifidobacterium, and other strains)

  • Fermented Foods With Live Cultures: Raw, unpasteurized sauerkraut, kimchi, kefir, yogurt, and red wine, oh hey!
  • Supplements: TruNatureBio-Kult VSL#3 (VSL#3 is apparently the creme de la creme, though I have not personally tried it)

PREBIOITICS 

  • Common potentially Paleo-friendly foods with prebiotics include asparagus, bananas, chicory, garlic, onion, and Jerusalem artichokeResistant starches also contain prebiotics, and include cooked and then cooled sweet potatoes, green bananas, potato starch, and plantains. 

Note: People debate about whether to take probiotic supplements while on antibiotics. Some say it “lessens the slaughter” as it were, while others see it as money down the drain. I personally have no idea, so I say just focus on the recovery aspect. When you’re done with your antibiotic run, begin implementing probiotics in the form of both supplements and food. Play around with the supplements till you find one (or two) you like. Everybody’s unique gut biome is different, and will respond differently.

Check out these links for more information on gut health:

Your Gut & You, Part I – Inflammation & The Immune System
Your Gut & You Part II – The Gut Microbiome
Your Gut & You Part III – Diet & Supplement Solutions
Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain – for Life (David Perlmutter)
Fix Your Gut: A Book Dedicated to “Fixing” All Your Digestive Ailments and Concerns (John Brisson)

Remember, you have felt fantastic before, and you can again! It’s never too late to start afresh, and build anew! Never! And the great thing about Intermittent Fasting, is once you really plug into that fasted state, it just becomes so easy 🙂 My favorite thing to say to myself, when I’ve fallen off the wagon or am struggling with gut problems or inflammation, is to say, It can only go up from here! 

QUESTION #2: INTERMITTENT FASTING & HYPOCLYCEMIA 
Our next question comes from Nicole in Montana:

montanna“Hi, I’m at the part in your book on Intermittent Fasting, and had a question. Do you have any thoughts on people doing this that have hypoglycemia? I have cut down to two meals, with a small snack between. If I do less, I become sick. If it helps, many doctors have told me to eat crackers, but honestly that doesn’t help. The best thing that helps are nuts, especially almonds. I wasn’t sure if you had any research, or thoughts on this, and if Intermittent Fasting was obtainable?  Thank you, I truly love your book and have learned so much!” – Nicole

Ok, before I say anything, I want to emphasize that I am definitely not a doctor. However, I can give you my basic opinion based on what I do know. So here goes!

Hypoglycemia is a condition where one’s body does not adequately control blood sugar levels. When a hypoglycemic person’s blood sugar drops, they can become dizzy, tired, weak, confused, or even faint. I think the fact that eating crackers doesn’t help Nicole, while eating nuts does, is very telling. It highlights the all too common modern response to treating blood sugar regulation issues… with sugar. The idea is “well if your blood sugar is low, we better add more sugar to fix the problem,” rather than addressing or trying to fix the root issue of why the blood sugar is low in the first place. Adopting an overall diet which allows the body to rely less on blood sugar, and more on alternative substrates (fatty acids and ketones), is a better long term approach to managing insulin and blood sugar problems, in my opinion. This would be a Paleo diet on the lower carb side, forgoing fruits and safe starches like sweet potatoes, which could cause blood sugar fluctuations.

So if you’re hypoclgemic, I’d suggest starting with a low carb Paleo diet, and then add intermittent fasting into the mix once you’ve got your blood sugar under control. Using a high fat, low carb diet approach will shift your body into a constant fat burning mode, and hopefully help out your root problem with blood sugar regulation. (Low carb and ketogenic diets have proved remarkable for diabetes!) This will regulate insulin, and likely help with your hypoglycemia in general, allowing you to go longer between meals. If you can get your body into an awesome fat burning state, you can then experiment with Intermittent Fasting. Start with a small fasting window, and gradually increase as you feel comfortable.

If you’re still struggling, try some bulletproof coffee in your fast, or supplement your fast with MCT or coconut oil. I think IF is definitely attainable, and maybe even intensely helpful! Perspective is everything 🙂 I’ll keep my eyes out for future studies and research!

QUESTION #3: SUPPLEMENT RECOMMENDATIONS AND TIMING

Our last question comes from Tori in Seattle:

Washington“Love your book!  I read it in two days cover to cover. I started my fast today and oddly, I don’t feel hungry in the least bit. I last ate last night at 9:00 and it is a little after 1:00 in the afternoon, now.  I have a question about the timing of taking supplements. I have taken vitamins in the past on an empty stomach in the morning and feel quesy, to the point of dry heaving, trying to throw up. When should I take the supplements? On an empty stomach or in the evening when I eat? Also, what supplements are the best to start with?” – Tori

In general, you should strive to obtain most of your nutrients from food. However, our modern diets (even when Paleo!) are often lacking in adequate nutrition due to modern processing and different farming conditions, so supplementation can be important. Things just aren’t the way it was, as it were. Different supplements require different mechanisms for optimal absorption, and there are just so many supplements, depending on what your personal goals. (The What When Wine Diet contains a guide to 30+ supplements, organized by goal.)

For starters, if you’re nauseous from a supplement protocol, you should probably stop it. I say probably, because there are rare occasions where nausea may be a result of bacteria or candida die-off (a Herx reaction), which is actually a good thing. Kinda like the whole denial means Freud is right hypothesis. But I’ll save that for another post! Assuming the nausea is not a Herx reaction, then it may be caused by a leaky gut barrier, or personal intolerance/allergy.

For example, I take a ton of supplements, but only (relatively) recently realized just how important avoiding fillers is. I didn’t think a smidge of a stearate here, or some rice protein there, would matter…but they add up. I’ve now become something of a supplement snob, and buy supplements with absolutely no even slightly harmful fillers. In fact, I now favor the pure powdered forms to be extra safe, which work especially well on empty stomachs during fasting, requiring no digestion. Purebulk.com has become my favorite for cheap, pure, powdered forms of basically everything. As for pill brands, I adore GAIA Herbs and Twinlab – they seeem to avoid all fillers and coatings. Runner up brands (AKA: Check the label!) include LifeExtensionJarrow Formulas, and occasionally Now Foods.

As for absorption, the majority of vitamin supplements are fat soluble, best absorbed with foods. On the other hand, water soluble vitamins (like all the B’s, and Vitamin C ) can go a la carte! (Though too much vitamin C on an empty stomach can cause distress or loose bowels.) Supplements which boost energy (think caffeine, ginseng, rhodiola, etc.) are also good an empty stomach, since they’re not competing with energy production from food.

Here are my favorite go-to supplements for health in general, which are generally lacking in the modern dietand when to take them.

  • Vitamin D – Fat Soluble, With Food
    • Most people are deficient in vitamin D.  Supplementing with Vitamin D can help with the absorption and assimilation of other nutrients. It also boosts the immune system, insulin secretion, heart functioning, blood pressure regulation, brain development, and mood.
  • Fish Oil – With Meals or on an empty stomach
    • Taking fish oil daily is key for supporting a healthy, anti-inflammatory Omega 3/6 ratio. Supplementation with Omega-3s is a notably slow process, as you have to gradually change the fat ratio in the individual cells of the body. Favor consistent, long-term supplementation of “smaller” amounts of Omega-3s (while minimizing Omega-6 consumption), rather than short-term, intense Omega-3 supplementation. With fish oil, commitment is key!
  • Magnesium – With Meals, or as a drink on an empty stomach, a la Natural Calm.
    • Magnesium is a wonder mineral, often deficient in the modern diet. It is involved with all enzymes in the body using ATP for energy, and is vital for a healthy heart, gut, digestion, and life in general! It can also help you de-stress, and fall asleep at night!
  • A Probiotic – With Meals
    • See question #1 for more on probiotics! People debate about whether to take probiotics with meals or on an empty stomach. I believe it’s probably best to take them with food, or better yet, get them from food!
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