Where To Begin?

[oldfriend]

I'm new to the forum, relatively new to Ray Peat, and not so new to diet and persistent GI issues and a general but debilitating malaise. I've been diagnosed with CFS, IBS, Gastritis, Chronic Fissures, etc. etc. I began working with a new GP recently who ran a series of panels and quickly came back with a diagnosis of 'Pregnenolone Steal Syndrome'.
My estrogen, cortisol, and glucose levels are on the high side, while my Free T, DHEA, Progesterone, Pregnenolone, and Vitamin D are all on the low side. Apparently my ongoing gut inflammation is responsible for the high cortisol and resulting PSS diagnosis. I was also surprised that my total Testosterone levels are quite normal or even high, while my Free T levels are quite low.
Unfortunately this is as far as I could get with this particular GP though, as this Hormone Therapy approach is new for him. He recommended something called HOPE therapy (High Fiber, Omega 3 Oils, Probiotics, Enzymes....dairy is bad, meat is bad, chia seeds are good, grains are good) that seems to based on a program some TV personality established. This in combination with OTC hormone therapy will apparently correct my impaired digestion and lower cortisol I won't dismiss the hormone supplementation, but I've been around long enough to know that this approach to diet is not an effective one for me. This reluctance seemed to anger my GP, and it was later when I tried to discuss alternative options like cyproheptadine that I discovered he could only see the world through HOPE-colored glasses.
So, other than a referral back to the GI doctor and a seemingly less endless wait to get an appointment, I'm pretty much at a loss of what to do next.
I got turned onto Matt Stone after a bout of GAPS and FODMAP-induced constipation, and almost instantly started moving my bowels again. But it wasn't long before I started having bad reactions to the cow casein and high starch. I had a brief interlude with SCD, but wanted to incorporate some of the Matt Stone ideas after a few weeks. That's when I discovered Ray Peat and this forum. I like a lot of Ray Peats ideas as they seem to reflect what I've intuitively learned about diet and how it affects my body over the years. Still, I'm struggling to work out a good baseline diet and thought I would ask for some advice here ( relating to diet, supplementation, and lifestyle in fact).
Here's what I'm trying so far:

Breakfast:
OJ with gelatin, sometimes add MCT oil and honey
Yogurt - Goat Milk (SCD style) or Coconut Milk
Fruit

Lunch:
Meat - Liver, Ruminant, or Shellfish
Bone broth soup with gelatin, root vegetable/squash and coconut oil
Fruit
Cheese or Yogurt

Afternoon:
A juice version of the raw carrot salad with coconut oil (is this a big no-no?)

Dinner:
Same as lunch

Snacks:
Fruit
Cheese
Yogurt
Pork Rinds
Jello

Supplementation:
Multi-vitamin
B complex
Vitamin D
Vitamin E
L-5-MTHF
Digestive Enzymes with every meal
Cascara Sagrada every other night before bed

Lifestyle:
Heat Lamp for 20 mins 3-4 times a day

I feel like I'm currently needing to increase my protein intake, and decrease my fat, meat, and lactic acid intake but I'm very reluctant to add dairy that isn't fermented or aged. Cheese already feels like a gamble as it can be constipating if eaten too frequently. I have an issue with casein and egg (both yolk and white) allergy going back to when I was a child. Goat milk seems to be more tolerable, but then there's the issue of lactose. SCD claims that lactose is a big concern for digestively-challenged folks and tends to feeds the bugs that live in my large intestine. My experience has not disproven this theory. Perhaps it is a good idea to use a product like Lacteeze drop in my milk to reduce the amount of lactose while I get reacquainted with dairy? The only drawback I can see is that it contains glycerin.
The other thing I'm concerned with is my dependence on fiber. I already skin and cook veggies into submission, but I wonder if the volume of fiber I eat is keeping the inflammatory process alive and well.
I do know from past experience that there is a delicate balance for me, as too low fiber leads to slow moving bowels and painful (hard stools) BMs.

With supplementation, I'm gearing up to order my first round of hormone cocktail. The way it was explained to me, all hormones are derived from the master hormone Pregnenolone. Why then does it make sense to order Preg., Prog., and DHEA and not just triple my dose of Pregnenolone? I suspect that the answer might be that my adrenals are bypassing the process of conversion to Progesterone and DHEA to produce more Cortisol? I just ordered Cyproheptadine from alldaychemist.com and am considering Cynoplus as well. Any thoughts?

Last but not least, the heat lamp thing. I've been using it for a few days now, and I like it. My question is how often, and where? I read thyroid and testes somewhere. What distance should I keep from the heat lamp? Also, any words of caution with heat lamp use?

Thanks in advance!

 

[member 2106]

Juiced carrots won't have the desired effect.

 

[grenade]

Hey @oldfriend - how have you been feeling lately?

Honestly, your routine looks pretty spot on.

The only comments I'd like to make are: 1. carrot juice will not
provide the benefit of raw whole carrots, 2. cypro, indeed try out cyproheptadine.
3. the benefit of taking pregnenolone with DHEA seems to be that more of it will convert into progesterone and less into cortisol. Haidut wrote about it in bis priginal thread for the product "Pansterone". Now, taking DHEA topically in small doses should ensure it doesn't convert to estrogen, but some people still experience estrogen symptoms regardless of dose or application-type. Then you may feel better simply taking more pregnenolone without DHEA.

 

[sele]

@oldfriend

There's no such thing as 'Pregnenolone Steal Syndrome'.
RP does not support it.

He recommended something called HOPE therapy (High Fiber, Omega 3 Oils, Probiotics, Enzymes....dairy is bad, meat is bad, chia seeds are good, grains are good) that seems to based on a program some TV personality established.

Please dump your GP ASAP!

Yogurt - Goat Milk (SCD style) or Coconut Milk

When trying to fix GI, please refrain from anything that has bacteria in it.
Why coconut milk?
Do not use if it has carrageenan in it.
Go to cronometer and punch in your daily food and see if your getting 200g+ of sugar and 80g+ protein.
Like @grenade said, avoid the carrot juice. You don't want carotene. You want only the fiber.

Digestive Enzymes with every meal

What kind?

Cheese already feels like a gamble as it can be constipating if eaten too frequently.

Drink some magnesium bicarbonate water. It's easy to make. Helps with constipation.

but I wonder if the volume of fiber I eat is keeping the inflammatory process alive and well.

Only safe fiber is from carrots and bamboo shoots.

Start with only 4 oz of warm cow's milk for couple of days. Then increase 4 oz to 2x or 3x a day. Your body will begin to produce lactase again. If uncomfortable just back down. Do not force yourself to anything.

My question is how often, and where? I read thyroid and testes somewhere. What distance should I keep from the heat lamp? Also, any words of caution with heat lamp use?

15-20 min once a day is enough to give you results. 1-2 feet away where you don't feel too hot. Red light is used to activate cytochrome oxidase and can be used on any exposed skin.

Go slow with supps and red light. Less is more.
Focus on food.

 

[oldfriend]

I APOLOGIZE IN ADVANCE FOR THE LONG POST

Thanks for the replies. I've tried a lot of things since I wrote the first post and while some progress has been made I'm still searching for a good baseline. Cyproheptadine and Thyroid have been tremendously helpful, and looking at old lab work I can see that Thyroid has always been a weak link. When I was at my worst TSH was at 3.13. Recently it was 1.75. It's a crime that the issue was never addressed by my MD.

As for diet, one thing that seemed to help immensely was the MAP method of amino acid supplementation.
I found that cutting out meat helped to reduce fatigue and a general sense of malaise. But it comes with its own hurdles, as I'm not sure how to meet my calorie needs without it.

This led to the reintroduction of milk and starch.
I chose sushi rice after experiencing gas with potatoes and it seemed to help with the lack of energy at first, but I'm slowly swinging back to high cortisol symptoms.
I've concluded that milk is not an ideal food for me, at least not yet, because I'm constantly stuffed up and sneezing. Cypro helps here, but I might be falling into the trap of masking symptoms that require a modification of my diet.

I've been able to gain weight consistently (a good thing) with these high-calorie foods, but it might be attributed to high cortisol. I seem to be able to tolerate milk even less as the days go on, and my guess is that cortisol and allergies are pushing me back to a hypothyroid state in which the body is not able to process it efficiently. Another suspicion is that on days that my thyroid is underperforming the milk is not getting enough stomach acid to digest properly.

I notice that I feel colder when I consume so much liquid. Perhaps I should switch to Cheese and see how I go with that.

Any tips to make my life easier during this phase would be appreciated.

Some questions that come to mind are:

One reason for trying MAPs and the above mentioned high calorie foods is that it takes so much time to eat anything else. Any ideas for simplification?

Which cheeses have worked for people that don't tolerate milk well? Fat is an important consideration here, and the protein in cottage cheese might be problematic because it hasn't been denatured.

Should I try to push through the initial discomfort of eating potatoes to see if they will be tolerated better over time?

Gas has been getting worse on my current diet and that means an increase in endotoxin right? I'm not sure my liver is working up to snuff so I want to reduce endotoxin as much as possible. My ALT was below the reference range on my last set of labs and I haven't gotten a good explanation for what that could mean. One doctor suggested that it could mean that my liver isn't getting good blood flow and that seems to tie in with my fears of the varicocele embolization procedure I had done.

THANKS

 

[Pointless]

Doing a great job so far, and I see many parallels with my own condition. Try caffeine starting from a low dose of 50 mg and increasing to 1 gram per day split into three doses. This will increase sense of well-being and liver function. The liver is extremely important as many people swear by liver rejuvenation as their main sticking point.

Good luck

 

[oldfriend]

Try caffeine starting from a low dose of 50 mg and increasing to 1 gram per day split into three doses. This will increase sense of well-being and liver function.
Good luck

I can't tolerate high doses of caffeine. A daily cup of regular coffee is enough to push me into cortisol domination. I've been having a strong cup of decaf 1-2 times a day though

 

[Pointless]

I can't tolerate high doses of caffeine. A daily cup of regular coffee is enough to push me into cortisol domination. I've been having a strong cup of decaf 1-2 times a day though

And having a cup a day hasn't increased your tolerance? Interesting. I used to be extremely sensitive but built up from a cup of soda a day to 600 mg right now. I've gone higher in the past.