Hacking Health with AIP Paleo & Lab Work: A Case Study on Restoring Wellbeing

Hacking Health with AIP Paleo & Lab Work

What does a better life mean to you?

More time with your family? More money to live comfortably while also paying for your daughter’s college education? Or perhaps greater health and vitality would enable you to do more of just about everything.

Stop for a second and figure out what one change, more than any other, would enable you to live a much fuller life.

For me, it’s a no-brainer: better living starts with my health. Suffice it to say my health struggle has been the single biggest factor holding me back from doing the things I’ve wanted to do in life.

For years I lacked the willpower to truly commit to fixing my health; I would fail and fail (and fail again). That finally changed this year, and this post details how it happened. Interestingly, it wasn’t my willpower that improved, but the system I built around my goals that helped me finally succeed.

This post is a thorough one, and you’ll see firsthand the power of two tools that have changed my life (and can change yours):

  1. The right kind of data (hint: actionable)
  2. Support systems (especially in moments of weakness)

These two tools alone can significantly improve your ability to hit the goals you know are crucial for a better life. And I want to teach you how to use them through a very personal case study on how I fought to rebuild my health.

Sound good? Let’s do this.

Health is the foundation of a good life.

Poor health is a scary thing. Not even the richest man in the world can buy back his good health after an incurable diagnosis.

On the other hand, modern technology is allowing the average person to measure and cultivate good health better than ever before. Even fifteen years ago, the health data we have access to now would’ve been near or completely impossible to get.

Why am I so excited by this? At the age of thirteen, I developed a series of chronic, painful illnesses in my digestive system that led me down a path of drugs and invasive medical procedures.  For years, nothing worked – all the while, I was choking down experimental drugs with odd side effects (e.g. suddenly making my vision too blurry to read the words on my history exam).

Lo and behold, by experimenting with gluten-free and dairy-free diets in an attempt to clear my acne at age 16, my painful stomach symptoms subsided. Ten years later, 95% of my symptoms are gone, which I estimate has saved me at least $40,000 in out-of-pocket medical expenses and thousands of hours I would’ve spent managing my condition.

To this day, I continue to treat my health more seriously than any other part of my life.

Diet isn’t always enough.

Unfortunately, sometimes diet can only get you so far. My body still needed additional help, but no one could tell me what kind of help I needed.

I still got sick more frequently than my peers and took longer to recover. I had trouble gaining weight, and experienced brain fog and brutal afternoon crashes almost daily. Something still wasn’t right, and it was holding me back.

I ruled out the obvious stuff with blood tests and doctors visits; I came back with a clean bill of health. Because I lacked data on what was wrong, my paralyzing uncertainty around the issue lasted for years.

In late 2014, I was fortunate enough to have a colleague in a similar situation recommend someone who could possibly help me: a functional medicine practitioner named Chris Kelly.

Functional medicine is a form of alternative medicine with – just like any form of non-mainstream medicine – its fair share of both supporters and critics. The approach? When recovering from chronic health issues, diet and lifestyle is half the battle. Patients also require data on where their bodies need extra support through supplementation. The key here is getting actionable data; otherwise you’re grasping at straws (as I had been doing for years).

Conventional doctors weren’t helping me, and it seemed like a rationale approach; I called Chris immediately and committed to working with him.

It was time to get serious. First up, the data.

Getting serious with data. (Read as: pricking my finger and spitting in vials.)

As mentioned in the introduction, the act of collecting meaningful and actionable data on my health was a game changer. Without this kind of data, it’s very hard to stay motivated. Why? It gives you that sense of progress required to make it through difficult endeavors, and as you’ll soon see, this experiment quickly became very difficult.

I was told to expect four at-home lab tests to arrive within a week. In the meanwhile, the first thing I had to do was start measuring my blood sugar. Simply put, you can’t expect to be healthy with your blood sugar all over the place, so that needed to tackled first.

I bought one of those blood sugar measurement kits from Amazon.com and started pricking my finger daily upon waking.

Measuring blood sugar

Measuring blood sugar. Not fun, but necessary.

I was relieved to discover that my fasting blood sugar was nice and stable. Phew.

A week later, the lab work arrived. There were four tests in total, each one requiring a rigorous “specimen collection” technique. For example, if I had to pee in a vial for a particular test (which I did), it had to be done at a certain time in a certain way with specific storage rules. It was a little overwhelming keeping track of all of the collection techniques and storage procedures.

Another test involved spitting in vials at key intervals throughout the day to measure cortisol and other hormones; no caffeine allowed all day (not fun). Perhaps most unpleasant, I had to collect multiples samples to measure “bacterial diversity” in my gut (yuck), but the deed was done.

An example lab kit is below.

One of four lab tests I did. Organic acids profile.

An organic acids profile test. Apologies for the poor photo quality.

The lab work was more challenging than I had thought, with it’s rigorous procedures, freezing/refrigerating protocol, and requirements for properly packaging and shipping the specimens. Nevertheless, I got all of the tests done in two weeks and shipped them off to the lab.

Good data tells it like it is.

Four weeks went by, and I finally got the results back from Chris, who was helping me interpret the results of the lab work.

I was shocked.

After years of eating healthier than my peers and avoiding unhealthy habits as much as possible (or so I thought), the lab work told a different story.

Low amino acid levels, a shortage of glutathione, bacterial dysbiosis, cortisol problems, and more. I cycled through bouts of anxiety, followed by gratitude that I finally had the data I needed.

If you’d read my previous post on giving up coffee for the sake of my adrenals, you would’ve seen this chart showing my dismal cortisol results.

Jon's cortisol test

Feel free to read the coffee post if you’re curious why the chart above is a terrible result. Otherwise, take my word for it; this is not a result you want to get back.

The microbiome and organic acids tests were also super informative and I ended up with a set of recommendations and supplementation to start working with.

Organic acids results - Organix

By working with Chris, I had an individualized list of supplements I needed to start taking:

  • Temporary adrenal hormone support
  • Amino acids
  • A much stronger probiotic
  • Liver support (mostly through n-acetyl-cysteine)
  • An herbal protocol for dysbiosis

As a small win, I also learned about the supplements I was purchasing, but weren’t necessary. Cutting these supplements out would save me $50 / month.

Perhaps the biggest benefit: this was the first time I’d been given actionable data to work with in almost 10 years, and I felt more motivated than I had been for almost a decade.

No more doubt and anxiety as to whether my issues were all in my head. No more frustrating doctors appointments. I had something I could work with, and it felt amazing. This motivation would last me the entire duration of the experiment (as you’ll see though, I wasn’t perfect and faltered at the end).

With the data in hand and supplements purchased, Chris instructed me on the last remaining piece: the diet and lifestyle portion of the experiment (i.e. the most difficult part).

Lifestyle upgrades. (i.e. Support Systems 101)

While I was waiting for the batch of supplements to arrive, I took a look at the lifestyle portion of Chris’s recommendations. I was already doing things like exercising daily, going on walks, and keeping a small gratitude journal. But a few practices were on this list that would be a struggle to implement.

If there’s one thing I’ve learned from gamifying my life (and my job interviews), it’s that the right system in place can make all the difference between reaching a goal and failing. A good system should start slow, be simple to use, show you your progress, incentivize you to reach the finish line in a timely fashion, and optionally involve other people in the process to hold you accountable.

1. Daily Meditation

Techniques used: Start slow, simplicity, show progress

Meditation was a no brainer. There’s so much credible research behind the importance of meditation and mindfulness, that I had no issue with someone telling me to start meditating more. Specifically for my needs, people who cannot manage stress are found to have a less robust microbiome (a bad thing).

Nevertheless, finding time for daily meditation is hard. But I started carving out a very small amount of time every morning (5-10 minutes), which still isn’t optimal but definitely better than nothing. Remember, start slow.

For simplicity, I chose one of the popular meditation apps that track your progress through the program. Simplicity and a sense of progress all in one app? Yes please. Here were the options on the table:

Headspace seemed prohibitively expensive, so I went with a combination of Calm’s free meditation timer and Buddhify.

2. Measuring Heart Rave Variability (HRV)

Techniques used: Simplicity, show progress.

What is HRV, you ask? From Wikipedia (emphasis mine):

Heart rate variability (HRV) is the physiological phenomenon of variation in the time interval between heartbeats. […] In the field of psychophysiology, there is interest in HRV. For example, HRV is related to emotional arousal. […] HRV has been shown to be reduced in individuals reporting a greater frequency and duration of daily worry.

In other words, if you’re stressing about something, you’ll see it in your HRV, which can help you realize you need to cope better with it.

Measuring HRV manually is a pain, so for simplicity I opted for an affordable bluetooth heart rate monitor and a free app (EliteHRV) to analyze the data. I’ve long wanted better awareness of my stress level, so I was excited to start measuring this every morning before work. Especially because how simple it was with the iPhone app and bluetooth heart monitor.

Here’s what the app might tell me if my HRV was lower than average that day:

Elite HRV results

Is it a perfect data-driven abstraction of my daily worry? Not necessarily. Is it simple to use and helpful in showing me my progress as I meditate more and better cope with stress? You bet.

3. AIP Paleo Diet

Techniques used: Start slow, show progress, involve others for accountability, emergency fallbacks.

This was the bomb that was dropped on my day-to-day life.

AIP is short for the Autoimmune Protocol, and is on the cutting edge of food intolerance diets, especially as it relates to autoimmune disease.

The diet that it recommends is extremely restrictive because it follows a rotation diet strategy (i.e. if we’re not fully sure if this food is safe or not based on the available scientific literature, we remove it entirely for a few months) that is built on top of what most people call a paleo diet.

Take a look at this cheat sheet from AIP blogger and chef Mickey Trescott; notice the sheer quantity of food restrictions.

AIP diet avoid list

Credit: Autoimmune-paleo.com

Skeptical? I don’t blame you. My rule of thumb is as long as I can reach all of my nutrient requirements, I’ll give an eating plan a try. In AIP’s case, it’s easy to include tons of fish, berries, and veggies into your diet (in fact, it’s encouraged), so I wasn’t worried about nutrient deficiencies. I’ve also had the benefit of meeting people who swear by this diet; not just online salesmen or “diet gurus”, but real people in the Bay Area community struggling with chronic illnesses.

AIP was going to be the hardest part of this process, no question. Pricking my finger to measure my blood sugar? Sure it sucks, but it takes one minute to do. Taking lots of supplements? I was used to doing this anyways, so no biggie. But removing all of these foods from an already-generally-healthy diet? Yikes. Say hello to spending all day in the kitchen, inability to eat out with friends and feeling restricted constantly.

Undeterred, I reminded myself that this was a long-term investment in my health, and if this diet was what I needed, all of the restrictions would be more than worth it.

I started slow with simple recipes, took photos of my successful cooking sessions (for a sense of progress), and most importantly, shared the photos online and invited people over while I cooked to hold me accountable.

I also stocked a few AIP-friendly pantry items (sardines, kale chips, coconut chips) for emergency situations where I was famished and had no energy to cook. Having these foods on hand was a lifesaver on multiple occasions.

And with each of the lifestyle changes described above firmly settled in a support system that would (hopefully) move me forward, I dived in.

Let’s do this.

Right off the bat, I started measuring my HRV and meditating first thing in the morning. Remember, I started slow, so this only took 10 minutes before breakfast.

A few days later, behold! The supplements arrived.

Supplements based on lab data

Taking these at each meal was difficult, as I needed not only 7-8 pills ready to go, but also three different liquid-based supplements measured out into my water. If you’ve spent any time with me these last 6 months, you’d have seen me at meals with my pill container and liquid dropper.

My supplement regimine

The supplements were a nuisance, but improving my cooking skills (which were fairly mediocre at the start of this experiment) was the real challenge. I had to cook a majority of my food (trust me, cooking is essential for AIP), so I needed to learn how to make it quick and tasty.

At first, I started with the basics: burgers with broccoli (sprinkled with pastured bacon).

 AIP friendly burgers and guac

But as time went on and I purchased more AIP friendly cookbooks (such as this one and this one), I found some delicious, quick recipes to help me survive at least 2-3 months on the AIP protocol. And remember, I was sharing the results of each of these recipes to get my friends and family involved in the process. The encouraging words and requests to try my food kept me going on nights where the last thing I felt like doing was cooking.

AIP friendly beef stew

AIP friendly beef stew

AIP friendly (kelp) noodle stir fry

AIP friendly kelp noodle stir fry

Mission Heirloom: An oasis in the world of AIP.

The Bay Area of California is a wonderful place to live, and the discovery of Mission Heirloom made it even more wonderful. I’m pretty sure it’s the only eatery in the world that caters explicitly to AIP diets.

The owners, Bobby and Yrmis are wonderful people, and I’ve had a great experience there every time I’ve made the trip into Berkeley. They made it much easier to comply with the diet because I finally had the ability to eat out somewhere with friends again (and give them a unique experience in the process).

If you’re ever in the Bay Area, it’s worth checking out.

Frutti di Mare seafood bowl with squid ink. Yum.

Frutti di Mare seafood bowl with squid ink at Mission Heirloom. Yum.

Six months later: the results.

It’s currently June 2015 and I’ve been through many months of the AIP diet at this point. I temporarily stopped the diet because of upcoming travel plans, but here is the short list of benefits I noticed while eating strict AIP:

  • Joints stopped feeling so stiff
  • Noticed less bloating, indigestion, and sensitive skin after 6 weeks
  • I stopped waking up with headaches and inflammation as often
  • Improved sleep (probably due to giving up coffee)
  • 80% reduction in afternoon crashes
  • Better workouts without relying on caffeine-laden gym pre-workouts

Not bad. I plan on redoing my lab tests later this year to get objective improvement metrics; I’ll update this post once I do.

Unfortunately, I didn’t execute the plan exactly as I had wanted to, which prevented me from receiving the full benefits. Next up is a discussion of my failure points.

What I messed up on.

This diet is tough; I’m only human. Here are the portions of the experiment I received an F on.

Failure to reintroduce foods properly

One of the major benefits of AIP is that once you’re ready to reintroduce restricted foods, you can do so slowly and systemically. Reintroducing foods is a process that you should do over the course of many months, so you can carefully study how your body responds. It should look something like this:

A food diary is crucial during the reintroduction process.

A food diary is crucial during the reintroduction process.

Unfortunately, here’s how I approached reintroductions:

Junk food

This is *not* how reintroductions are supposed to look. Whoops.

Thankfully, I wasn’t eating soda and chips; more so lentils, coffee, spicy foods, and nightshade veggies. But still, I lost a great opportunity to learn how my body responds to each individual ingredient restricted by AIP.

I plan to do AIP again in the future because of the benefits I noticed, and the second time around I’ll treat reintroductions more seriously. Especially because my formerly-injured joints are now stiffening up again, which leads me to believe one of the foods disallowed on the AIP diet is aggravating old injuries.

Still drinking too much coffee

Once I started drinking coffee again, it quickly started impacting my sleep. I only drink 1-2 cups a day, but my body processes caffeine slowly, so it’s still in my system 8-10 hours later.

I’m realizing I need to permanently adjust my approach to coffee/caffeine to improve my health, even though my coffee consumption is relatively moderate. It all starts with awareness, so I’m using the Up Coffee app.

upcoffee

Want to do this too? Tips for saving time and money.

This process has been incredibly enlightening, and for the first time in my life, I see a clear path ahead on the road to better health. Unfortunately, because insurance doesn’t cover this stuff, it can be a costly process. If you plan to work with a functional medicine practitioner to get lab work done to better your health, here’s what I’d recommend to mitigate costs.

1. Consider a Health Savings Account.

If your employer has health insurance plans that allow you to have a Health Savings Account (HSA), I’d highly recommend looking into it. Paying for this stuff with pre-tax earnings is a great way to effectively lower the cost.

2. Find the middle ground between factory-farmed and 100% organic, grass-fed.

Organic, grass-fed meat is becoming increasingly expensive and farmers markets in my area of the country are getting quite expensive as well (maybe it’s just a San Francisco trend). On the other hand, factory farmed meat is terrible for you, the animal, and the environment.

Thankfully, I’ve found the Whole Foods certification program to be a suitable alternative that isn’t as expensive as USDA organic certification. When I’m low on cash I buy grass-fed, grain-finished meat from Whole Foods certified farms and make sure I eat enough seafood (usually sardines) to balance out my omega 3 intake. 

I know many people in the paleo community would consider this blasphemy; I consider it a happy middle ground. If you disagree, I’d love to hear your thoughts in the comments.

3. Learn to cook.

Unfortunately, surviving the AIP diet is near-impossible without cooking for yourself (or paying for someone who will). I can’t afford a personal chef, so I learned to cook. I’d highly, highly recommend the 4-Hour Chef as a fantastic starting point for non-cooks, and then you can move on to Mickey Trescott‘s fantastic cookbook for AIP specific meals.

4. Start slow to prevent failed experiments.

The biggest time saver would have been doing the 8 week experiment perfectly the first time around. Since I messed up the reintroductions, I feel compelled to do it again since I really want that data on how my body responds to individual foods (lab work can’t give you this).

As such, I’d highly recommend moving slowly and steadily into the world of AIP before starting the full out experiment. This could include:

  • Doing 2-3 day trial runs
  • Finishing any lab work first to get it out of the way before starting the diet
  • Purchasing a piece of kitchen equipment that will assist in AIP-friendly foods.

By starting slow and easing in over time, you’re less likely to rebound from the restrictions and requirements of the AIP plan. I jumped in head first and I rebounded as soon as the 8 weeks were over.

Conclusion: Challenging but Doable.

If there’s any takeaway here, it’s this: if I can do this, you can too.

Although willpower is a limited resource, research has demonstrated that those who acknowledged the limitations of their willpower prior to doing challenging tasks performed significantly worse than their more optimistic counterparts. In other words, the first step to cultivating the willpower for this kind of experiment is seeing evidence that this endeavor can be taken on by a normal person.

What next then? Get the data you need. Then, work your butt off to build systems that will support you in moments of weakness. Continue using data as a measure of how you’re doing (emotions and placebo have a tendency to mess with your perception of progress).

If you have a lot on your plate (entrepreneurs, parents, multiple jobs, etc.), you may not be able to reach this scale of execution so quickly. Just start small and make incremental progress.

For more on just how small you should start, check out the free Tiny Habits course by the director of Stanford’s Persuasive Tech Lab, BJ Fogg. For example, if you want to start meditating, sit down in a chair and meditate for five seconds. That’s it. Then get up, and go about your day. The next week, do ten seconds. You get the idea; start small.

On a closing note, if you plan to start a similar journey to improve your wellbeing, leave a comment below or reach out to me personally at jrrera (at) gmail (dot) com. I’d love to hear more about your story.

The Top 5 Must-Have Health Supplements for High Performance

SupplementsHaving been inspired by the works of Tim Ferriss, I am seeking to apply the 80/20 rule to as many parts of my life as I can, in order to improve efficiency and cut down on some of my expenses. The 80/20 rule states that 20% of sources result in 80% of a given outcome. In this case, I believe that 20% of my supplementation results in 80% of the health benefits. I’m seeking to cut out any supplement that doesn’t fall into this 20% category.

Based on the hundreds of hours of research on health and wellness I’ve poured through in these past 4 years, here are the 5 supplements I believe every high-performing individual will benefit from.
Continue Reading…

The Overwhelming Benefits of Vitamin D

I’m a firm believer that almost everybody in developed countries have similar gaps in their diet, even people who consume a variety of fresh, whole foods. These gaps are Vitamin D, omega 3s, and probiotics. Each has its own reason for why it’s so difficult to acquire in our daily diet in optimal quantities, but today’s focus will be on Vitamin D.

This excellent presentation on Vitamin D research condenses 4 hours of research and recommendations into less than an hour. Continue Reading…

Summarizing the Latest in Clinical Nutrition (2009-2010)

Being a health nut , I could sit for hours reading up on diet, nutrition, and fitness. Unfortunately for me, my time is very limited these days. Rather than try and keep up on the latest research and news for all of my interests, which would quickly deliver a debilitating dose of information overload, I find people who aggregate all of the important trends and deliver it in summary form. This is exactly what Dr. Michael Greger does in the world of clinical nutrition research. This weekend, I watched his 3 hour DVD entitled Latest in Clinical Nutrition Vol. 4, which summarizes the important studies from 2009 to the present (mid 2010).

Below are the notes I took on the  research that I felt was most applicable. My hope is that you can benefit from these notes I took. Continue Reading…