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The first GAPS cookbook. Over 140 GAPS friendly recipes.

A MESSAGE FROM DR. NATASHA CAMPBELL-MCBRIDE: HELP! At the last WAPF conference I met dozens of wonderful people, who were telling me how the GAPS Programme changed their lives and lives of their families. These people gave me an idea: WE NEED TO PUBLISH ALL THESE STORIES AS A BOOK! There are millions of people and families out there in desperate situations, who believe the mainstream establishment that there is nothing they can do to help themselves. Your stories - stories written by real people, will show those families that there is a way out and there is hope! Please, write your story and send it to me, Dr Natasha Campbell-McBride, at [email protected] It is your choice to publish your story under your real name or just the initials. YOUR STORY MAY SAVE MANY LIVES! THANK YOU! ********** This site supports digestive healing following the GAPS (Gut and Psychology Syndrome) diet created by Dr. Natasha Campbell-McBride.

Our goal is to spread Dr. Campbell-McBride's message and introduce you to the natural path of digestive healing.

For detailed information on the GAPS diet please refer to: Gut & Psychology Syndrome by Dr. Campbell-McBride

A Very Brief History The Gut and Psychology Syndrome Diet has its foundation on the Specific Carbohydrate Diet (SCD) created by Dr. Sidney Valentine Haas to heal digestive disorders. SCD gained great popularity after a mother, Elaine Gottschall, healed her own child and became an advocate for SCD. Elaine Gottschall is also the author of the popular book Breaking the Vicious Cycle. Intestinal Health Through Diet. Dr. Natasha Campbell-McBride has taken SCD and evolved it further to create a full protocol for healing digestive disorders and subsequent issues. Dr. Natasha Campbell-McBride

Dr. Natasha Campbell-McBride holds a degree in Medicine and Postgraduate degrees in both Neurology and Human Nutrition. In her clinic in Cambridge she specializes in nutrition for children and adults with behavioral and learning disabilities, and adults with digestive and immune system disorders. Dr. Campbell-McBride set up The Cambridge Nutrition Clinic in 1998. As a parent of a child diagnosed with learning disabilities, she was acutely aware of the difficulties facing other parents like her, and she has devoted much of her time to helping these families. She realized that nutrition played a critical role in helping children and adults to overcome their disabilities, and has pioneered the use of

probiotics in this field. She believes that the link between learning disabilities, the food and drink that we take, and the condition of our digestive system is absolute, and the results of her work have supported her position on this subject. In her clinic, parents discuss all aspects of their child's condition, confident in the knowledge that they are not only talking to a professional but to a parent who has lived their experience. Her deep understanding of the challenges they face puts her advice in a class of its own.

**This site should be used as a complement to Dr. Campbell-McBride's book Gut and Psychology Syndrome and is in no way a substitute for all the information provided within it.**

GAPS™ and Gut and Psychology Syndrome™ are the trademark and copyright of Dr. Natasha Campbell-McBride. The right of Dr. Natasha CampbellMcBride to be identified as the author of this work has been asserted by her in accordance with the Copyright, Patent and Designs Act 1988. Published by: International Nutrition, Inc. 11615 Crossroads Circle, Suite D Middle River, MD 21220 (800) 899-3413 [email protected] www.gapsdiet.com

*The statements on this site have not been evaluated by the Food and Drug Administration. Nothing on this site is intended to diagnose, treat, cure, or prevent any disease.

GAPS™ and Gut and Psychology Syndrome™ are the trademark and copyright of Dr. Natasha CampbellMcBride. The right of Dr. Natasha Campbell-McBride to be identified as the author of this work has been asserted by her in accordance with the Copyright, Patent and Designs Act 1988.

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Simplified GAPS Outline Here is a simplified outline of the GAPS Nutritional Program. Please refer to Gut and Psychology Syndrome for more detailed information. Printer Friendly Version

THE NUTRITIONAL PROGRAM 1. Diet 2. Supplementation 3. Detoxification and Life-style Changes

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1. Diet The recommended diet for GAPS patients is largely based on the Specific Carbohydrate Diet (SCD). The main difference pertains to dairy products. SCD permits lactose-free dairy products. Lactose is a milk sugar. GAPS and people with digestive problems are unable to digest it and must avoid it. Fermented dairy products such as yogurt are largely lactose free as a result of the fermentation process where by the fermenting bacteria consume lactose. Apart from lactose, milk contains casein which will absorb through the damaged gut lining and act as a toxin in the body. Another problem with dairy is how it relates to food allergies and intolerances. A milk allergy is one of the most common allergies. Even in breast-fed babies where the mother consumes dairy products the child may develop colic due to sensitivity to dairy antigens being passed through the mother's milk. For all of these reasons, GAPS children and adults should not consume dairy products until their digestive system is well enough to handle them. The diet's only exception to this is milk fat (ghee or clarified butter) because it contains virtually no milk proteins or lactose and is generally well tolerated.

Please refer to "The Diet" section for a list of recommended foods.

2. Supplementation The essential supplements for GAPS patients: A. An effective therapeutic strength probiotic B. Essential Fatty Acids C. Vitamin A D. Digestive enzymes E. Vitamin and mineral supplements. A. An effective therapeutic strength

probiotic Probiotics are most commonly used in the treatment of gastro-intestinal disorders: viral infections of the digestive tract necrotising enterocolitis in infants intractable pediatric diarrhea pseudomembranous colitis traveler's diarrhea Clostridium Difficile enterocolitis enterocolitis Helicobacter infection enteropathogenic E. coli infection inflammatory bowel disorders: Crohn's disease, ulcerative colitis and chronic pouchitis irritable bowel syndrome lactose intolerance prevention of colonic cancer in laboratory studied In addition to digestive issues many other health problems have been shown to respond to treatment with probiotics: allergies including food allergy autism chronic viral infections urogenital infections hepatitis, liver cirrhosis and biliary disease tuberculosis meningitis malignancy arthritis diabetes

burns of various degree perioperative care and intensive care in surgical patients and patients with massive blood loss clinical infections autoimmune disorders While many conditions may benefit from the use of probiotics, the above list has had scientific papers published on the benefit of probiotics with the specific condition. General Guidelines for choosing a good probiotic: a. A good probiotic should have as many different species of beneficial bacteria as possible. b. A mixture of strains from different groups of probiotic bacteria is more beneficial than just one group. c. A good probiotic should have a concentrated amount of bacteria: at least 8 billion of bacterial cells per gram. d. The manufacturer of the probiotic should test every batch for strength and bacterial composition and should be prepared to publish the results. (Bio-kult is the recommended probiotic and Dr. Campbell-McBride is one of the inventors) B. Essential Fatty Acids GAPS children and adults should have a group of essential oils supplemented: a. A good seed/nut oil blend in the ratio of 2:1 of omega-3:omega-6 fatty acids. b. Cod liver oil to supply EPA, DHA, vitamin A and vitamin D. c. Fish oil with higher ratio of EPA to DHA, as more EPA seems to be

beneficial for GAPS patients. There are no toxic levels for these oils. C. Vitamin A As listed previously, vitamin A is recommended in the form of Cod Liver Oil (CLO). Vitamin A deficiency can cause digestive problems. Leaky gut and malabsorption are the typical results of vitamin A deficiency. Unfortunately, due to digestive problems, GAPS children and adults usually cannot absorb or use many forms of vitamin A, commonly found in supplements. A natural form of vitamin A found in CLO appears to be the best form for these patients. D. Digestive Enzymes People with abnormal gut flora almost without exception have low stomach acid production. Toxins produced from bacteria such as Candida and Clostridia have a strong ability to reduce secretion of stomach acid. Stomach acid is the first barrier for huge numbers of microbes arriving with every bite of food or drink we consume. If the stomach is not acid enough, these bad microbes may have a chance of colonizing in the stomach itself. Dr. Campbell-McBride recommends that GAPS patients supplement with stomach acid. The most physiological preparation available is Betaine HCl with Pepsin. Pancreatic Enzymes These are the enzymes people generally think of when hearing the words "digestive enzymes". These enzymes are usually combinations of proteases, peptidases, lipases, amylase, lactase and cellulase.

In a healthy digestive tract, these enzymes are naturally produced by the pancreas. If normal stomach acidity can be returned, these enzymes should work efficiently. Dr. Campbell-McBride recommends supplementation with stomach acid. If you feel benefit from the use of these supplements, make sure they do not contain fillers or binders which may interfere with the healing process in the gut. E. Vitamin and Mineral Supplements Dr. Campbell-McBride does not generally recommend any vitamin or mineral supplementation at the beginning of the program. Some patients may require targeted supplementation but this is a matter for a qualified practitioner to decide. If you are going to use supplements: a. Choose supplements without any ingredients which may aggravate the gut condition. b. Choose supplements with a high absorption rate. c. Keep supplements to an absolute minimum.

3. DETOXIFICATION AND LIFE-STYLE CHANGES The first and most important thing is to remove the main source of toxicity, which means cleaning up and healing the gut. Since this alone will not rid the body of years worth of toxic build up in the system, juicing is recommended. Juicing provides very concentrated fruit and vegetable nutrients to the body in an easily absorbed form. Black Elderberry is also beneficial and has strong immune-stimulating properties and it is one of the most powerful anti-viral remedies known to man. The General Toxic Load

An important part of the treatment is reduction of the general toxic load. Keep your house chemical free and avoid bringing anything into the home which will let off chemicals such as new carpet, furniture, and paints. Also remember that your skin absorbs just about everything it comes in contact with so be very cautious with the products you put on your skin. Household plants are great at reducing the toxic air in our houses. They consume the toxic gases and replace them with oxygen and other beneficial substances. This is a brief summary of important points addressed in Gut and Psychology Syndrome. It is very important to read the sections devoted to these areas in the book for a clear understanding of each.



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THE GAPS DIET Natural Digestive Healing

GAPS Outline Introduction Diet Full GAPS Diet Getting Started Bio-Kult Probiotic Dairy

GAPS Introduction Diet Gut and Psychology Syndrome Introduction Diet The Introduction Diet will not be found in the book Gut and Psychology Syndrome. Dr. Natasha Campbell-McBride has provided this information free of charge to all families interested in starting the GAPS diet. It is essential to have the book Gut and Psychology Syndrome to implement the GAPS diet effectively.

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Dr. Natasha Campbell-McBride recommends that GAPS patients follow the Introduction Diet before going into the Full GAPS Diet. Depending on the severity of the condition, you can move through the Introduction Diet as fast or as slow as the condition will permit.

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Following the Introduction Diet fully is essential for people with serious digestive symptoms: diarrhea, abdominal pain, bloating, some cases of constipation, etc. The Introduction Diet will reduce the symptoms quickly and initiate the healing process in the digestive system. Even for healthy people, following the Introduction Diet when experiencing a "tummy bug" or diarrhea will clear the symptoms quickly and permanently usually without needing medication. Constipation In cases of stubborn constipation, introduce freshly pressed juices earlier in the diet, from stage 2: start from carrot juice first thing in the morning and take your cod liver oil at the same time. The juice will stimulate bile production as many cases of persistent constipation are due to poor bile production. When there is not enough bile, the fats in the food do not digest well; instead they react with salts and form soap in the gut, causing constipation. Removing dairy may also help. Food Allergies and Intolerances People with food allergies and intolerances should go through the Introduction Diet in order to heal and seal their gut lining. The reason for allergies and food intolerances is so-called "leaky gut"

when the gut lining is damaged by abnormal micro flora. Foods do not get the chance to be digested properly before they get absorbed through this damaged wall and cause the immune system to react to them. Many people try to identify which foods they react to. However, with damaged gut wall they are likely to absorb most of their foods partially digested, which may cause an immediate reaction or a delayed reaction (a day, a few days or even a couple of weeks later). As these reactions overlap with each other, you can never be sure what exactly you are reacting to on any given day. Testing for food allergies in notoriously unreliable: if one had enough resources to test twice a day for two weeks, they would find that they are "allergic" to everything they eat. As long as the gut wall is damaged and stays damaged, you can be juggling your diet forever removing different foods and never get anywhere. From my clinical experience it is best to concentrate on healing the gut wall with the Introduction Diet. Once the gut wall is healed, the foods will be digested properly before being absorbed, which will remove most food intolerances and allergies. Those without serious digestive problems and food intolerances can move through the Introduction Diet quite quickly. However, please do not be tempted to skip the Introduction Diet and go straight into the Full GAPS Diet, because the Introduction Diet will give your patient the best chance to optimise the healing process in the gut and the rest of the body. Skipping the Introduction Diet may lead to long-term lingering problems, difficult to deal with. If you have decided to go straight into the Full GAPS Diet, keep in mind that about 85% of everything your patient eats daily should be made out of meats, fish, eggs, fermented dairy and vegetables (some well-cooked, some fermented and some raw). Baking and fruit should be kept out of the diet for a few weeks, and then be limited to snacks between meals and should not replace the main meals. Homemade meat stock, soups, stews and natural fats are not optional - they should be your patient's staples. *Note: Those who start with the Introduction Diet will introduce dairy earlier than those who go right into the full GAPS diet. Always do a sensitivity test prior to introducing dairy.

GAPS Introduction Diet - IMPLEMENTING THE DIET Provided by Dr. Natasha Campbell-McBride 1. Introduction Diet 2. The Full GAPS Diet with the typical menu INTRODUCTION DIET

EVERY MORNING Start the day with a cup of still mineral or filtered water. Give your patient the probiotic. Make sure that the water is warm or room temperature, not cold, as cold will aggravate his or her condition. Only foods listed are allowed: your patient must not have anything else. On the First Stage the most drastic symptoms of abdominal pain, diarrhea and constipation will quickly subside. If, when you introduce a new food, your patient gets back diarrhea, pain or any other digestive symptoms then he/she is not ready for that food to be introduced. Wait for a week and try again. If you suspect an allergy to any particular food, before introducing it do the Sensitivity Test. SENSITIVITY TEST Take a drop of the food in question (if the food is solid, mash and mix with a bit of water) and place it on the inside of the wrist of the patient. Do it at bedtime. Let the drop dry on the skin, then let your patient go to sleep. In the morning check the spot: if there is an angry red reaction, then avoid that food for a few weeks, and then try again. If there is no reaction, then go ahead and introduce it gradually starting from a small amount. STAGE 1 Homemade meat or fish stock. Meat and fish stocks provide building blocks for the rapidly growing cells of the gut lining and they have a soothing effect on any areas of inflammation in the gut. That is why they aid digestion and have been known for centuries as healing folk remedies for the digestive tract. Do not use commercially available soup stock granules or bullion cubes, they are highly processed and are full of detrimental ingredients. Chicken stock is particularly gentle on the stomach and is very good to start from. To make good meat stock you need joints, bones, a piece of meat on the bone, a whole chicken, giblets from chicken, goose or duck, whole pigeons, pheasants or other inexpensive meats. It is essential to use bones and joints, as they provide the healing substances, not so much the muscle meats. Ask the butcher to cut in half the large tubular bones, so you can get the bone marrow out of them after cooking. Put the bones, joints and meats into a large pan and fill it with water, add natural unprocessed salt to your taste at the beginning of cooking and about a teaspoon of black peppercorns, roughly crushed. Bring to boil, cover and simmer on a low heat for 2.5-3 hours. You can make fish stock the same way using a whole fish or fish fins, bones and heads. After cooking take the bones and meats out and sieve the stock to remove small

bones and peppercorns. Strip off all the soft tissues from the bones as best as you can to later add to soups or encourage your patient to eat all the soft tissues on the bones. Extract the bone marrow out of large tubular bones while they are still warm: to do that bang the bone on a thick wooden chopping board. The gelatinous soft tissues around the bones and the bone marrow provide some of the best healing remedies for the gut lining and the immune system; your patient needs to consume them with every meal. Take off all the soft tissues from fish bones and heads and reserve for adding to soups later. The meat or fish stock will keep well in the fridge for at least 7 days or it can be frozen. Keep giving your patient warm meat stock as a drink all day with his meals and between meals. Do not use microwaves for warming up the stock, use conventional stove (microwaves destroy food). It is very important for your patient to consume all the fat in the stock and off the bones as these fats are essential for the healing process. Add some probiotic food into every cup of stock (the details about introducing probiotic food follow). Homemade soup with your homemade meat or fish stock. Please look for some recipe ideas in the recipe section of the book. Here we will go through some details, specific for the Introduction Diet. Bring some of the meat stock to boil, add chopped or sliced vegetables: onions, carrots, broccoli, leeks, cauliflower, courgettes, marrow, squash, pumpkin, etc. and simmer for 25-35 minutes. You can choose any combination of available vegetables avoiding very fibrous ones, such as all varieties of cabbage and celery. All particularly fibrous parts of vegetables need to be removed, such as skin and seeds on pumpkins, marrows and squashes, stalk of broccoli and cauliflower and any other parts that look too fibrous. Cook the vegetables well, so they are really soft. When vegetables are well cooked, add 1-2 tablespoons of chopped garlic, bring to boil and turn the heat off. Give your patient this soup with the bone marrow and meats and other soft tissues, which you cut off the bones. You can blend the soup using a soup blender or serve it as it is. Add some probiotic food into every bowl of soup (the details about introducing probiotic foods follow). Your patient should eat these soups with boiled meat and other soft tissues off the bones as often as he/she wants to all day. Probiotic foods are essential to introduce right from the beginning. These can be dairy based or vegetable based. To avoid any reactions introduce probiotic foods gradually, starting from 1-2 teaspoons a day for 2-5 days, then 3-4 teaspoons a day for 2-5 days and so on until you can add a few teaspoons of the probiotic food into every cup of meat stock and every bowl of soup. If your patient is ready to introduce dairy, then use your homemade yogurt or kefir. If dairy is still out [by results of sensitivity test or

negative reaction when introducing it], then into every cup of meat stock or soup add juice from your homemade sauerkraut, fermented vegetables or vegetable medley (please look in the recipe section of the book). Make sure that the food is not too hot when adding the probiotic foods, as the heat would destroy the beneficial probiotic bacteria. Ginger tea with a little honey between meals. To make ginger tea, grate some fresh ginger root (about a teaspoonful) into your teapot and pour some boiling water over it, cover and leave for 3-5 minutes. Pour through a small sieve and add honey to taste (optional). STAGE 2 Continue with Stage 1. Keep giving your patient the soups with bone marrow, boiled meats or fish and other soft tissues off the bones. He or she should keep drinking the meat stock and ginger tea. Keep adding some probiotic food into every cup of meat stock and every bowl of soup: juices from sauerkraut, fermented vegetables or vegetable medley, or homemade kefir/yogurt. Add raw organic egg yolks. It is best to have egg yolks raw added to every bowl of soup and every cup of meat stock. Start from 1 egg yolk a day and gradually increase until your patient has an egg yolk with every bowl of soup. When egg yolks are well tolerated add soft-boiled eggs to the soups (the whites cooked and the yolks still runny). If you have any concerns about egg allergy, do the sensitivity test first. There is no need to limit number of egg yolks per day, as they absorb quickly almost without needing any digestion and will provide your patient with wonderful and most needed nutrition. Get your eggs from a source you trust: fresh, free range and organic. Add stews and casseroles made with meats and vegetables. Avoid spices at this stage; just make the stew with salt and fresh herbs (look for a recipe of Italian Casserole in the recipe section of the book). The fat content of these meals must be quite high: the more fresh animal fats your patient consumes, the quicker he or she will recover. Add some probiotic food into every serving. Increase daily amount of homemade yogurt and kefir, if introduced. Increase the amount of juice from sauerkraut, fermented vegetables or vegetable medley. Introduce fermented fish, starting from one piece a day and gradually increasing. Look for recipes in recipe

section. Introduce homemade ghee, starting from 1 teaspoon a day and gradually increasing. Look for recipe in recipe section. STAGE 3 Carry on with all the previous foods. Add ripe avocado mashed into soups, starting from 13 teaspoons and gradually increasing the amount. Add pancakes, starting from one pancake a day and gradually increasing the amount. Make these pancakes with three ingredients: 1) organic nut butter (almond, walnut, peanut, etc); 2) eggs; 3) a piece of fresh winter squash, marrow or courgette (peeled, de-seeded and well blended in a food processor). Fry small thin pancakes using ghee, goose fat or duck fat. Make sure not to burn them. Egg scrambled with plenty of ghee, goose fat or duck fat. Serve it with avocado (if well tolerated) and cooked vegetables. Cooked onion is particularly good for the digestive system and the immune system: melt 3 tablespoons of duck fat or ghee in the pan, add sliced large white onion, cover and cook for 20-30 minutes on low heat. Introduce the sauerkraut and your fermented vegetables (your patient has been drinking the juices from them for a while now). Start from a small amount, gradually increasing to 1-2 tablespoons of sauerkraut or fermented vegetables per every meal. STAGE 4 Carry on with all previous foods. Gradually add meats cooked by roasting and grilling (but not barbecued or fried yet). Avoid bits, which are burned or too brown. Let your patient eat the meat with cooked vegetables and sauerkraut (or other fermented vegetables). Start adding cold pressed olive oil to the meals, starting from a few drops per meal and gradually increasing the amount to 1-2 tablespoons per meal. Introduce freshly pressed juices, starting from a few

spoonfuls of carrot juice. Make sure that the juice is clear, filter it well. Let your patient drink it slowly or diluted with warm water or mixed with some homemade yogurt. If well tolerated gradually increase to a full cua a day. When a full cup of carrot juice is well tolerated try to add to it juice from celery, lettuce and fresh mint leaves. Your patient should drink the juice on an empty stomach, so first thing in the morning and middle of afternoon are good times. Try to bake bread with ground almonds or any other nut and seeds ground into flour. The recipe (please look in recipe section of the book) requires only four ingredients: 1) nut flour; 2) eggs; 3) piece of fresh winter squash, marrow or courgette (peeled, de-seeded and finely sliced); 4) some natural fat (ghee, butter, goose or duck fat) and some salt to taste. Your patient should start from a small piece of bread per day and gradually increase the amount. STAGE 5 If all the previous foods are well tolerated try to add cooked apple as an apple pure. Peel and core ripe cooking apples and stew them with a bit of water until soft. When cooked add some shee to it and mash with a potato masher. If ghee has not bee introduced yet add duck or goose fat. Start from a few spoonfuls a day. Watch for any reaction. If there is none gradually increase the amount. Add raw vegetables starting from softer parts of lettuce and peeled cucumber. Watch your patient's stool. Again start from a small amount and gradually increase if well tolerated. After those two vegetables are well tolerated gradually add other raw vegetables: carrot, tomato, onion, cabbage, etc. If the juice made from carrot, celery, lettuce and mint is well tolerated, start adding fruit to it: apple, pineapple and mango. Avoid citrus fruit at this stage. STAGE 6 If all the introduced foods are well tolerated try some peeled raw apple. Gradually introduce raw fruit and more honey. Gradually introduce baking cakes and other sweet things allowed on the diet. Use dried fruit as a sweetener in the baking.

As I mentioned before, your patient may be able to move through the Introduction Diet faster or slower depending on the stool changes: let the diarrhea start clearing before moving to the next stage. You may have to introduce some foods later than in the program depending on his/her sensitivities. Make sure that you carry on with the soups and meat stock after your patient has completed the Introduction Diet at least once a day. After the Introduction Diet is completed and when your patient has more or less normal stools move into the Full GAPS Diet. THE FULL GAPS DIET A Typical Menu: Start the day with a glass of still mineral water or filtered water with a slice of lemon. It can be warm or cold to personal preference. If you have a juicer your patient can start the day with a glass of freshly pressed fruit/vegetable juice diluted with water. A good juice to start the day is 40% apple + 50% carrot + 10% beetroot (all raw of course). You can make all sorts of juice mixes, but generally try to have 50% of therapeutic ingredients: carrot, small amount of beetroot (no more than 5-10% of juice mixture), celery, cabbage, lettuce, greens (spinach, parsley, dill, basil, fresh nettle leaves, beet tops, carrot tops), white and red cabbage, and 50% of some tasty ingredients to disguise the taste of therapeutic ingredients: pineapple, apple, orange, grapefruit, grapes, mango, etc. Your patient can have these juices as they are, with some yogurt or diluted with water.

Every day our bodies go through a 24 hour cycle of activity and rest, feeding and cleaning up (detoxifying). From about 4 am til about 10 am the body is in the cleaning up or detoxification mode. Drinking water and freshly pressed juices will assist in this process. Loading the body with food at that time interferes with the detoxification. That is why many of us do not feel hungry first thing in the morning. It is better to have breakfast around 10 am when your body has completed the detox stage and is ready for feeding. At that stage we usually start feeling hungry. Children may be ready for their breakfast earlier than adults.

BREAKFAST CHOICES A variation of English breakfast: eggs cooked to personal liking and served with sausages and vegetables, some cooked, some

fresh as a salad (tomato, cucumber, onions, celery, and fresh salad greens, etc.) and/or avocado and/or meat. The yolks are best uncooked that the whites cooked. Use plenty of cold pressed olive oil as a dressing on the salad and eggs. Mix a tablespoon of pre-soaked or sprouted sunflower and/or sesame and/or pumpkin seeds with the salad. Sausages (full fat) should be made of pure minced meat with only salt and pepper added. Make sure that there are no commercial seasonings or MSG (Monosodium Glutamate) in the sausages. I recommend finding a local butcher, who would make pure meat sausages for you on order Avocado with meat, fish or shellfish, vegetables raw and cooked, lemon and cold pressed olive oil. Serve a cup of warm meat stock as a drink with food. Pancakes made with ground nuts. These pancakes are delicious with some butter with honey, or as a savory snack. If you blend some fresh or defrosted berries with honey, it will make a delicious jam to have with pancakes. Weak tea with lemon, ginger tea or mint tea. Any of the home baked goods: muffins, fruit cake and bread.

LUNCH CHOICES Homemade vegetable soup or stew in a homemade meat stock. Avocado with meat, fish, shellfish and raw and/or cooked vegetables. Use olive oil with some lemon squeezed over it as a dressing. Serve a cup of warm homemade meat stock as a drink. Any meat/fish dish with vegetables.

DINNER CHOICES One of the dishes from the lunch or breakfast choices. There are many recipes found in the book. You can also take old recipes and give them your own GAPS diet update.



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The Diet THE FULL GAPS DIET For many GAPS patients, the diet should be followed for two years at least. The book Gut & Psychology Syndrome will provide recipes and more explanation about the diet.


The best foods are eggs (if tolerated), fresh meats (not preserved), fish, shellfish, fresh vegetables and fruit, nuts and seeds, garlic and olive oil. Apart from eating vegetables cooked, it is important to have some raw vegetables with meals, as they contain vital enzymes to assist digestion of the meats. Fruit should be eaten on their own, not with meals, as they have a very different digestion pattern and can make the work harder for the stomach. Fruit should be given as a snack between meals. It is very important to have plenty of natural fats in every meal from meats, butter, ghee, coconut (if tolerated) and cold pressed olive oil. Animal fats on meats are particularly valuable. Fermented foods (sauerkraut, yogurt, and kefir) are also a very important part of this diet in addition to homemade meat or fish stock. It is recommended to take a cup of warm meat or fish stock with every meal as a drink as well as soups and stews made with the meat or fish stock. The stock, kefir and fermented vegetables will over time restore the stomach acid production, which will improve digestion. It is best to avoid processed foods (any packet or tinned foods). They are stripped from most nutrients that were present in the fresh ingredients used for making these foods. They are a hard work for the digestive system and they damage the healthy gut flora balance. On top of that they usually contain a lot of artificial chemicals, detrimental to health, like preservatives, colorants, etc. Try to buy foods in the form that nature made them, as fresh as possible. RECOMMENDED FOODS Almonds, including almond butter and oil Apples Apricots, fresh or dried Artichoke, French

Asiago cheese Asparagus Aubergine (eggplant) Avocados, including avocado oil Bananas (ripe only with brown spots on the skin) Beans, dried white (navy), string beans and lima beans properly prepared Beef, fresh or frozen Beets or beetroot Berries, all kinds Black, white and red pepper: ground and pepper corns Black radish Blue cheese Bok Choy Brazil nuts Brick cheese Brie cheese Broccoli Brussels sprouts Butter Cabbage Camembert cheese Canned fish in oil or water only Capers Carrots Cashew nuts, fresh only Cauliflower Cayenne pepper Celeriac Celery Cellulose in supplements Cheddar cheese Cherimoya (custard apple or sharifa) Cherries Chicken, fresh or frozen Cinnamon Citric acid Coconut, fresh or dried (shredded) without any additives Coconut milk Coconut oil Coffee, weak and freshly made, not instant Collard greens Colby cheese Courgette (zucchini) Coriander, fresh or dried Cucumber Dates, fresh or dried without any additives (not soaked in syrup) Dill, fresh or dried Duck, fresh or frozen Edam cheese Eggplant (aubergine)

Eggs, fresh Filberts Fish, fresh or frozen, canned in its juice or oil Game, fresh or frozen Garlic Ghee, homemade (many store varieties contain non-allowed ingredients) Gin, occasionally Ginger root, fresh Goose, fresh or frozen Gorgonzola cheese Gouda cheese Grapefruit Grapes Haricot beans, properly prepared Havarti cheese Hazelnuts Herbal teas Herbs, fresh or dried without additives Honey, natural Juices freshly pressed from permitted fruit and vegetables Kale Kiwi fruit Kumquats Lamb, fresh or frozen Lemons Lentils Lettuce, all kinds Lima beans (dried and fresh) Limburger cheese Limes Mangoes Meats, fresh or frozen Melons Monterey (Jack) cheese Muenster cheese Mushrooms Mustard seeds, pure powder and gourmet types without any non-allowed ingredients Nectarines Nut flour or ground nuts (usually ground blanched almonds) Nutmeg Nuts, all kinds freshly shelled, not roasted, salted or coated (any roasting must be done at home) Olive oil, virgin cold-pressed Olives preserved without sugar or any other non allowed ingredients Onions Oranges Papayas Parmesan cheese Parsley Peaches

Peanut butter, without additives Peanuts, fresh or roasted in their shells Pears Peas, dried split and fresh green Pecans Peppers (green, yellow, red, and orange) Pheasant, fresh or frozen Pickles, without sugar or any other non-allowed ingredients Pigeon, fresh or frozen Pineapples, fresh Pork, fresh or frozen Port du Salut cheese Poultry, fresh or frozen Prunes, dried without any additives or in their own juice Pumpkin Quail, fresh or frozen Raisins Rhubarb Roquefort cheese Romano cheese Satsumas Scotch, occasionally Seaweed fresh and dried, once the Introduction Diet has been completed Shellfish, fresh or frozen Spices, single and pure without any additives Spinach Squash (summer and winter) Stilton cheese String beans Swedes Swiss cheese Tangerines Tea, weak, freshly made, not instant Tomato puree, pure without any additives apart from salt Tomato juice, without any additives apart from salt Tomatoes Turkey, fresh or frozen Turnips Ugly fruit Uncreamed cottage cheese (dry curd) Vinegar (cider or white); make sure there is no allergy Vodka, very occasionally Walnuts Watercress White navy beans, properly prepared Wine dry: red or white Yogurt, homemade Zucchini (courgette) FOODS TO AVOID

Acesulphame Acidophilus milk Agar-agar Agave syrup - main carbohydrate is a complex form of fructose Algae - can aggravate an already disturbed immune system Aloe Vera - please go to "FAQs" for additional information on when it can be introduced Amaranth - is a grain substitute, contains starches Apple juice - usually has sugar added during processing Arrowroot - is a mucilaginous herb and loaded with starch Aspartame Astragalus - contains polysaccharides Baked beans Baker's yeast - contains saccharamyces cerevisae Baking powder and raising agents of all kind - baking soda can be used for specific medical issues, please view the "FAQs" section Balsamic vinegar - most found in stores have added sugar Barley Bean flour and sprouts Bee pollen - irritating to a damaged gut Beer Bhindi or okra Bicarbonate of soda Bitter Gourd Black-eye beans Bologna Bouillon cubes or granules Brandy Buckwheat Bulgur Burdock root - contains FOS and mucilage Butter beans Buttermilk Canellini beans Canned vegetables and fruit Carob Carrageenan - is seaweed and high in polysaccharides Cellulose gum Cereals, including all breakfast cereals Cheeses, processed and cheese spreads Chestnuts and chestnut flour Chevre cheese Chewing gum - contain sugars or sugar substitutes Chick peas Chickory root - contains high amounts of FOS Chocolate Cocoa powder - please see "FAQs" for more information Coffee, instant and coffee substitutes

Cooking oils Cordials Corn Cornstarch Corn syrup Cottage cheese Cottonseed Cous-cous Cream - contains lactose Cream of Tartar Cream cheese Dextrose - in commercial products it is not the pure form Drinks, soft Faba beans Feta cheese Fish, preserved, smoked, salted, breaded and canned with sauces Flour, made out of grains FOS (fructooligosaccharides) Fructose - extracted from corn and has a mixture of other trisaccharides Fruit, canned or preserved Garbanzo beans Gjetost cheese Grains, all Gruyere cheese Ham Hot dogs Ice-cream, commercial Jams Jellies Jerusalem artichoke Ketchup, commercially available Lactose Liqueurs Margarines and butter replacements Meats, processed, preserved, smoked and salted Millet Milk from any animal, soy, rice, canned coconut milk Milk, dried Molasses Mozzarella cheese Mungbeans Neufchatel cheese Nutra-sweet (aspartame) Nuts, salted, roasted and coated Oats Okra - mucilaginous food Parsnips Pasta, of any kind Pectin Postum Potato white

Potato sweet Primost cheese Quinoa - 60% starch Rice Ricotta cheese Rye Saccharin Sago Sausages, commercially available Semolina Sherry Soda soft drinks Sour cream, commercial Soy Spelt Starch Sugar or sucrose of any kind Tapioca - starch Tea, instant Triticale Turkey loaf Vegetables, canned or preserved Wheat Wheat germ Whey, powder or liquid Yams Yogurt, commercial While this diet is very close to the SCD, there are a few changes. One important difference is that the GAPS diet removes casein in addition to lactose in the beginning stages of the diet. Baking soda is also not recommended for use in cooking. Please read the chapter "Digestive Enzymes" in the Gut and Psychology Syndrome book for additional information on baking soda.



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Natural Digestive Healing GAPS Outline Introduction Diet Full GAPS Diet Getting Started Bio-Kult Probiotic Dairy Stools FAQs Pregnancy and Baby Resources GAPS Cookbook Support Contact Us Testimonials

Getting Started Starting a new diet can seem very overwhelming. When you have digestive issues it is even worse. Here we provide some recommendations on getting started. Essential Beginning Supplies Gut and Psychology Syndrome by Dr. Natasha CampbellMcBride

Therapeutic strength probiotic (Bio-kult is recommended) Organic meats and vegetables including meat bones for stock Safer household and personal care products Cooking supplies for making meat stocks and fermented vegetables (If finances are an issue, finish the products you have and replace them with more natural products. There are also some very inexpensive natural solutions you can find for household cleaners using vinegar, baking soda, and lemon. Search online for some fast and easy recipes that are just as effective and cost only pennies.)

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Food processor Juicer Grinder (for making nut flours and nut butters) Freezer containers WHERE TO BEGIN Read Gut and Psychology Syndrome by Dr. Natasha Campbell-McBride. It is very important to fully understand the GAPS Diet before you start. Starting the diet incorrectly

may lead to unnecessary diarrhea, constipation, severe die-off symptoms, and hunger pains. Be Patient! Please remember that this is going to be a slow process. You should not do the GAPS Diet unless you are willing to fully commit to doing it properly and are willing to stick it out for 2 years if necessary. While some people notice immediate improvements, all progress will be very individual. Start Slow. Depending on your current diet and digestive health, transitioning to the GAPS Diet may be a dramatic change. The Introduction Diet will be a necessary first step for those with serious digestive problems and food intolerances. Be Prepared. It may be beneficial to do a few trial runs before going into the Full GAPS Diet or Introduction Diet. Try making sauerkraut or fermented vegetables and meat or fish stocks. Once you have a good handle on these recipes, all other GAPS foods should seem relatively easy.

Once you are ready to start, we recommend starting with the Introduction Diet to allow your body to adjust to the changes gradually. If you do not have serious digestive problems or food intolerances, you should be able to move through the Introduction Diet in a matter of days.



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GAPS Outline Introduction Diet Full GAPS Diet Getting Started Bio-Kult Probiotic Dairy Stools FAQs Pregnancy and Baby Resources GAPS Cookbook Support Contact Us Testimonials Physicians Wholesale Gaps Guide Blog

Bio-Kult Probiotic Bio-Kult is a unique probiotic with a high concentration of 14 strains of beneficial bacteria. Bio-Kult is the recommended probiotic for those following the Gut and Psychology Syndrome Diet and was formulated by a team of doctors including Dr. Natasha Campbell-McBride. View the Bio-Kult Brochure here. View the Bio-Kult Label here.

It is recommended to build your dose of probiotic slowly. Start with a very small amout (example 1/4 capsule for 35 days) and see how your body responds. Observe the patient for any "die-off" symptoms (including, but not limited to fatigue, nausea, bloating, diarrhea, constipation, low grade fever, headache, and flu like symptoms). If there are none then, increase the dose slowly. When you see a reaction, let your patient settle on this dose until the "die-off" symptoms disappear. Then increase the dose again and let the patient settle on it. Keep increasing the dose until a therapeutic level is reached (p. 171 in GAPS book for therapeutic dosage based on age). This period of building up the dose can take from a few weeks to a few months in different patients. Once the patient has reached the therapeutic dose level it should be maintained for approximately six months on average. It takes at least this length of time to remove the pathogenic flora and start re-establishing normal gut flora. Adhering to the diet is absolutely essential in this period.

If you continue the feeding of your pathogens in the gut with sugar and processed carbohydrates then the probiotic will not have much chance of helping you. Order Bio-Kult here. *The statements on this site have not been evaluated by the Food and Drug Administration. Nothing on this site is intended to diagnose, treat, cure, or prevent any disease.


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Dairy Introducing dairy seems to be one of the more confusing areas in the GAPS diet. The Gut and Psychology Syndorme book recommends introducing dairy very slow on pg. 95, but the Introduction Diet recommends homemade yogurt from the beginning. This is because some GAPS people are able to tolerate well-fermented homemade whey and yogurt from the beginning. This is not true for everyone so it is important to do a sensitivity test before introducing any dairy product.

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For all GAPS patients with serious digestive disorders and food intolerances, it is highly recommended to start with the Introduction Diet. If you have decided to go right into the Full GAPS Diet, please find below basic dairy introduction steps. You should expect a minimum of 18 months for all dairy to be successfully introduced.

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When introducing dairy, it is recommended to first perform a sensitivity test as outlined in the Introduction Diet. All dairy products should be gradually introduced starting with 1 tsp for a few days and slowly increasing. If any negative response is observed, the patient is not ready for that particular dairy product and it should be avoided until additional healing has taken place. Please remember, these recommendations are for those who plan to skip the Introduction Diet. INTRODUCING DAIRY Avoid all dairy products for a minimum of 4

weeks. Step 1 - Introduce organic unsalted ghee (recipe available in Gut and Psychology Syndrome) Step 2 - Introduce organic unsalted butter Step 3 - Introduce homemade kefir, yogurt and fermented cream Step 4 - Introduce homemade cheese Step 5 - Introduce mature traditional cheese Step 6 - Introduce double cream and clotted cream Avoid all milk and milk substitutes. *The statements on this site have not been evaluated by the Food and Drug Administration. Nothing on this site is intended to diagnose, treat, cure, or prevent any disease.


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Natural Digestive Healing GAPS Outline Introduction Diet Full GAPS Diet Getting Started Bio-Kult Probiotic Dairy Stools FAQs Pregnancy and Baby Resources GAPS Cookbook Support Contact Us Testimonials Physicians Wholesale Gaps Guide Blog

Stools The Bristol Stool Form Scale The Bristol Stool Scale or Bristol Stool Chart is a medical aid designed to classify the form of human feces into seven groups. It was developed by Heaton and Lewis at the University of Bristol and was first published in the Scandinavian Journal of Gastroenterology in 1997. The form of the stool depends on the time it spends in the colon.

Type 1 has spent the longest time in the colon and type 7 has spent the least. Stools at the lumpy end of the scale are hard to pass and often require a lot of straining. Stools at the loose or liquid end of the spectrum can be too easy to pass - the need to pass them is urgent and accidents can happen. The ideal stools are types 3 and 4, especially type 4, as they are most likely to glide out without any fuss. What type of stools are best? The feeling you need to go is definite but not irresistible Once you sit down on the toilet there is no delay No conscious effort or straining is needed The stool glides out smoothly and comfortably Afterwards there is only a pleasant feeling of relief All this is most likely if the stool is Bristol Stool Form Scale, type 4

*When it comes to defining the "ideal" stool, there is some debate. For another interpretation, please view Fiber Menace.



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FAQs Please find below GAPS questions that are not addressed in the GAPS book. Each month new questions are answered by Dr. Natasha Campbell-McBride and posted below. Questions may be submitted to [email protected]. Only general GAPS questions, not specific to individual medical concerns/conditions will be considered. Please do not ask any question where the answer is addressed in the GAPS book.

MOST RECENTLY ADDED FAQS (May 2011) New Article by Dr. Natasha Campbell-McBride "One Man's Meat is Another Man's Poison!" How do we best make the transition from enemas (used every night for months) to unassisted daily relief? I recommend leaving it without an enema for 2-4 days: your bowel should start producing stools. In the meantime start your day with a freshly pressed juice of oranges or grapefruit. Eat cooked beetroot regularly. Avoid sweet vegetables, such as winter squashes for a few weeks. Take HCl&Pepsin 1-2 capsules at the beginning of your meals. Try to take supplements of spirulina, blue-green algae, chlorella or dunaliella; many patients find them very useful in resolving constipation. Please, see other questions on constipation, which will help you with dietary changes. If there is no stool after four days of waiting, do an enema with 1 teaspoon of bicarbonate of soda + 1 teaspoon of sea salt per litre of water: do just 1 litre to empty the lower parts of the bowel without getting higher. It will take time for your bowel to start functioning normally again after long-term enemas, so be patient and give yourself plenty of time for opening your bowel. It helps to distract your mind from opening our bowel while on the toilet, so read a book or occupy your mind with something else. Leave it to your bowel to do the job, it knows what it is doing and your mind can actually interfere with the process. Are shirataki noodles (from konjac root) ok on GAPS and if so, what stage would they be allowed on? I have no experience with shirataki. They contain complex

carbohydrates, so I would not try them until your digestive symptoms are gone. When you tried them once and there are no reactions, then perhaps you can introduce them. I understand that GAPS patients have a lot of food sensitivities/allergies and some of them are identified during the Intro diet and eventually resolved as the gut lining heals. What about the patients that have so called environmental allergies, i.e. reactions to pollen, dust mites, etc? Should they expect their issues to be resolved only after their gut completely heals? GAPS Nutritional Protocol re-balances immunity, so its major arms (Th1 and Th2) get back into balance. It is an imbalance between these parts of the immune system that lead to allergies. I see allergies to dust mites, pollen, animals and other environmental influences disappear in my patients all the time. But if a patient goes back to eating junk food and sugar, these allergies can come back. What do you suggest for people who have high amounts of klebsiella and clostridium bacteria in their body? Cut out all foods containing FOS? These microbes are best fought with probiotics. Usually the diet and good quality therapeutic probiotics take them under control. If after six months on the GAPS programme they still cause trouble, then a course of appropriate antibiotic can be administered. Make sure to continue with the GAPS diet and high doses of probiotics through the antibiotic treatment and afterwards. What do you recommend for bacterial vaginosis that came back after an antibiotic cream given to me by my obstetrician / gynaecologist? You need to restore your normal vaginal flora. To do that insert 1-2 capsules of a good quality probiotic into your vagina at bedtime for a few nights; and apply homemade kefir all over your groin area daily after a shower or a bath. I have read that people are healing on a zero carb diet (meat, fat, eggs). Some even claim they saw no healing on GAPS but are healing on a zero carb diet. What is your thought on this type of diet, particularly how it relates to gut flora? I do prescribe a no-plant diet for some patients, where they do the Introduction diet without any vegetables or fruit at all for a few weeks. It helps children with hyperactivity and diarrhoea, and people with severe digestive problems with diarrhoea and blood sugar problems. Everybody is different and it is important to fine tune the GAPS diet for your individual situation. In addition to juicing, elderberry and plants (all mentioned in the book), are there other detoxing methods recommended for GAPS patients? If one wanted to undergo an intense detox, is there a recommended procedure? Do you recommend using detox protocols in addition to juicing to remove problem heavy metals? I do not recommend any other detox procedures for the first two

years of the programme, as the GAPS Nutritional Protocol will restore your own detoxification system in the body, so it starts functioning again and removing toxins naturally. However, in some cases the toxic load can be too high and still producing symptoms after two years; in these cases I recommend natural chelating substances such as HumetR and HMD™ (Heavy Metal Detox). Seaweed and probiotics are also strong chelators of toxins. Many people find fasting very helpful. Fasting is best done in a dedicated clinic under supervision, and people who do best with it are those who are fairly well nourished (not underweight). There are many other powerful detox protocols available around the world and it is best to do them in dedicated clinics. I know quite a few people who have attempted various protocols with different results, ranging from none to spectacular. The outcome depends very much on your own detoxification system in the body working well, and that is what GAPS programme can do for you – it will restore your detox system. Do you recommend the removal of silver fillings if there is a high level of mercury or other heavy metals? Absolutely! However, it is very important to work with a holistic dentist, as conventional dentists are not trained in safe removal of amalgam fillings. Metals in the mouth create electric currents and different fillings acquire a positive or a negative charge. These electric charges need to be measured and fillings need to be removed in a certain order, starting from the largest negatively charged one. After the first one is removed, the currents in the mouth need to be measured again, as the charges will change. Please, read an excellent book by Dr. Hal A Huggins It’s all in your head; it will explain to you all the important considerations in safe removal of amalgam fillings. What is your opinion on using Dr Brownstein’s iodine protocol to detox fluoride, chlorine and bromides? I have no experience with this protocol and cannot comment. I recommend iodine paint as a form of testing and supplementing iodine in the initial stages of the GAPS Programme (please see other questions under THYROID). Later on, when seaweed is introduced it will supply iodine in a natural form. In order to use iodine properly the body needs many other nutrients, such as vitamins A, D, K, B group and other. The GAPS diet will remove nutritional deficiencies naturally through food, so iodine can be used by the body efficiently. At the same time under GAPS Nutritional Protocol the detoxification system in the body starts working again, so toxins such as fluoride, chlorine and bromides can be removed naturally and safely by your own body (without you having to figure out all the immense chemical complexities of how to do it). After doing the diet for a year and seeing a lot of healing, just before my last menstrual cycle I got very severe fatigue, brain fog, radiating pain, stiff neck and headache. I never had these symptoms before and I am at a loss as to what could have caused it. Any suggestions on managing this new symptom?

It is possible that you got a viral infection. Try to take L-lysine 3-4 grams per day as a supplement and remove citrus fruit, nuts and greens from the diet for a while; try to go back to rich soups and stews with sour cream and kefir. Another thing to do is to find a good homeopath and see if that can help. Does the GAPS diet heal fructose malabsorption, or would the GAPS diet need to be modified? This condition is part of GAP Syndrome as well as lactose intolerance and most-sugars-intolerance. Why? Because in people with abnormal gut flora enterocytes (the cells which line the gut) are damaged and unable to fulfil their main function: digestion of sugars. The fructose malabsorption became prominent since highfructose corn syrup came on the market: this is a processed sweetener which is extremely harmful to health. But as it is cheep to produce and very profitable for the manufacturers many processed foods and drinks are sweetened with it nowadays. GAPS diet removes double sugars and there is no need to modify it. If you have been specifically diagnosed with fructose malabsorption, you may want to avoid fruit and honey initially. As you go through the GAPS Introduction Diet, your enterocytes will start recovering and you will be able to re-introduce honey and fruit. I know that you warn against taking calcium as it can cause the depletion of other minerals in the body as it chelates. What can someone do to make sure they get enough calcium when they cannot tolerate any of the calcium rich foods like leafy greens, nuts or fermented dairy? Please look at other questions under SUPPLEMENTS. There is no need to worry about calcium, it is present in most foods and meat can be a very good source of calcium in a good balance with magnesium. Bone broth and vegetables will add more. My son’s fingernails have quit growing since we started GAPS over a year ago. I cannot remember the last time I cut them. Is this cause for concern? No! I would not worry about it as long as your son is generally healthy and doing well. It is possible that his body is using nutrients for more important functions at the moment rather than building nails. As he gets well nourished and the body has plenty of nutrients to spare, his nails should start growing again. Are homeopathic meds allowed on GAPS? Homeopathy combines with GAPS very well and I recommend it. Homeopathic remedies can help you to get through die-off easier and to overcome many stubborn problems. Is plain carbonated water (seltzer) allowed on GAPS? Yes! What is the typical time frame for giving HCl&Pepsin? I have given it

to my two young sons and it seemed to help, but it would be difficult for my youngest to express whether or not it is causing stomach distress. What would be the minimum amount of time I should try using it with them? How will I know when it is OK to stop? Long-term consumption of HCl&Pepsin can cause stomach irritation. Generally for children I recommend to use cabbage as a stomach acidity stimulator: give them cabbage juice, fresh cabbage salad or a small helping of sauerkraut 5-10 minutes before the meal, and their stomachs will be ready and full of acid. If this measure is not enough, then use a little of HCl&Pepsin with large meals only. What is there difference between algae and seaweed that seaweeds are allowed and algae are not? Actually seaweed is a form of algae, strictly speaking. This is a good point which slipped my attention, thank you for pointing it out. As nutritional supplements algae are commercially cultivated and can be sold under names of spirulina, algae, chlorella and dunaliella. Both seaweed and algae can be introduced when the Introduction Diet has been completed and there are no more digestive problems. Keep in mind that supplements of algae can cause diarrhoea and can be very helpful in resolving constipation. Chicken bones that have been simmered for 24 hours are very soft and can be eaten, and it’s easier to eat them than to try to get the marrow out of them. Is there any harm to a GAPS patient to eating the bones as well as the marrow if they have been cooked for the 24 hours? Yes, you can eat soft bones, they will do you a lot of good. I still don’t understand if the GAPS diet and SCD actually heal celiac, Crohn’s disease and gluten intolerance or whether they just manage it. For example, would a person with celiac, who successfully did the GAPS diet for 2 years, then be able to eat gluten? Or would they be less sensitive to gluten of they had it in limited quantities? Or would they need to continue to not eat gluten but have overcome the symptoms of celiac? GAPS diet may cure celiac disease and other inflammatory bowel condition, not only manage them. Of course, everybody is different and would take different time to heal. When your digestive symptoms are gone completely and have not been present for six months at least try to make some homemade sourdough pancakes: mix white wheat flour with your homemade kefir or whey to a thick pancake-batter consistency and ferment in a warm place for 2-3 days; then add a few eggs, salt and some melted animal fat to the mixture and make thin pancakes (crepes). Eat one or two of these pancakes and then observe your digestive system for 4-5 days: if nothing has happened then you are ready to have sourdough. To make sourdough bread mix white wheat flour with salt and your homemade kefir or whey; kneed the mixture well until it does not stick to your hands anymore; press the dough into a loaf tin, apply some fat to the top (so the dough does not dry on the top), and put into a warm place for 2-3 days for fermenting (it will rise naturally in that time); bake at 200C (390F) for 20-35 minutes (test if ready

with a dry knife). Initially only have homemade sourdough bread or pancakes (for a few months). When those are well tolerated, you can try to eat a small piece of commercial sourdough bread. My two year old son passes nearly all vegetables, well cooked, blended or otherwise undigested in his stools. Does this mean that we should be avoiding vegetables altogether for now? Is this due to a lack of microbes and something that will improve in time? It seems to me like it would not be healthy to exclude all vegetables form his diet. If the stool is normal then don’t worry about it, he will start digesting vegetables in time. If he has a propensity for diarrhoea then it may be a good idea to remove all vegetables and just follow the Introduction Diet without any plant foods at all for a while. When stools became consistently normal, you can start introducing vegetables. Could you please discuss migraines; what causes them? Can they be prevented? Is there anything that can be done to stop the pain? Is there a difference between ones that happen randomly and ones that happen with menstruation or ovulation? Migraines are vascular headaches which usually happen in one side of the head. First a spasm happens in the wall of a meningeal artery; the spasm does not last long (a few minutes) and is followed by a paralysis of the wall of the artery, which can last for days. The paralysis leads to swelling and inflammation of tissues around the artery wall, causing a headache. What cause the spasm in the first place? Many factors can do that and we do not have all the pieces of the puzzle yet. In GAPS patients it is toxicity from the gut that plays a major role. One mechanism is overproduction of histamine in the gut (which is produced by pathogenic microbes), which drop the blood pressure too low and initiate the spasm. Around menstruation and ovulation a rapid change in hormones in the body can initiate a migraine. In the second half of the menstrual cycle our immunity is suppressed by progesterone, so any overgrowth of pathogens in the gut and elsewhere in the body gets more active, producing more toxins than usual and initiating the migraine. GAPS Nutritional Protocol over time will help to reduce amounts of toxicity in the body, re-balance hormones and as a result help with migraines. As an emergency procedure many people find coffee enemas very helpful. Coffee enemas are one of the best ways of cleansing your liver and speeding up detoxification process in your body. It gives a good pain relief as well. To prepare the coffee bring to boil 1 litre of water, add 3 table spoons of organic ground coffee, boil for 2 min, then reduce the heat to a minimum, cover with a tight lid and simmer for another 10-15 min. Cool down and strain. Before doing the coffee enema, it is a good idea to have a good cleansing enema with warm water (dissolve ½ a teaspoon of sea salt in the water and ½ a teaspoon of bicarbonate of soda). To clear your bowel completely let some water into your bowel (about one litre), empty. Then let more water into the bowel and empty again. Do it 2-

4 times until the water starts coming out looking fairly clean to indicate that your bowel is empty. After your bowel is empty, slowly get the coffee into your rectum. Remove the tube and lie down on your right side or any other comfortable position. Try to keep yourself comfortable and warm. It is desirable to keep the coffee inside for 15 min before emptying your bowel. Initially you might not be able to hold it for that long. Don’t worry about it. With time and experience you will be able to do it. To hold the coffee longer, I recommend keeping the pipe in your rectum for a while (after the coffee has gone in) to allow gases to escape: accumulating gas stretches the bowel and causes an urge to empty too quickly. Coffee enemas help in majority of migraine headaches, but not in all cases. Sometimes painkillers have to be taken as well. But clearing the bowel helps long term, as it reduces the amount of toxicity coming into the body. In an earlier question you said that if a person is stuck in the intro stage, then perhaps a natural anti-parasitic/anti-bacterial remedy may be helpful. Could you give a suggestion about how a person could begin doing this? Are any of these remedies safe for young children? There are many anti-parasitic natural supplements on the market which can help: garlic extract, olive leaf extract, oregano oil and grapefruit seed extract. The first supplement, which I find useful, is garlic extract. Always start from a small dose and gradually increasing it. The dose can be increased to quite large amounts: some adults take 5-10 grams every day, for a child 500mg – 1 gram with food is usually enough. Once garlic is well tolerated, olive leaf extract can be added, starting from a small dose and gradually increasing to 1-2 grams twice a day for adults; for children 500mg twice a day is usually enough. Once garlic and olive leaf extracts are well tolerated, oregano oil can be added, starting from a small dose (1-5 drops) per day and gradually increasing to 30-40 drops for adults and 5-10 drops for children. The last supplement to add is grapefruit seed extract, starting from 1-2 drops a day and gradually increasing to a dose that is tolerated: adults manage to get up to 10 drops 2-3 times per day, for children 4-5 drops may be enough. There are many brands of these supplements on the market, try to find good quality. Some herbal preparations include MSM (Methyl Sulphonyl Methane), which is a good source of sulphur, essential for detoxification and controlling parasites in the body. If the herbal preparation does not include MSM, you may want to add it to the mix. Start from a low dose and gradually increase to the level of 1-2 grams per day for children and 4-5 grams per day for adults. ****************************************************** ADRENALS What recommendations are there for GAPS patients for boosting their adrenals?

Adrenals love fat and cholesterol. So, as far as the diet is concerned, eat lots of animal fats with every meal and cholesterol-rich foods, such as egg yolks, sour cream, butter and fatty fish. Another essential for the adrenals is sleep! Sleep is really not optional, so organise your life in such a way that you can have a nap every afternoon and a good long sleep at night. Another essential is to lower your stress, which is easier done than you may think. Stress is not the event itself; it is your attitude to this event. Research shows, that people react to stress very differently depending on their attitude to life. The one, who generally has a negative personality and tends to worry a lot, has all the stress hormones and destructive chemicals racing around their bodies. But the person, who has a philosophical and positive attitude to life, will have much less stress chemicals in their blood and will cope much better. It is the first type of people that “burn” their adrenals out. There are excellent books on this subject: you can start from Dale Carnegie’s book “How to stop worrying and start living”, for example. AUTOIMMUNE I have heard rumours that a book for autoimmune conditions will be coming out. Will the recommendations differ greatly from those in the GAPS book? What should I do now while I am waiting for the new book? Yes, I am working on the new book, called GUT AND PHYSIOLOGY SYNDROME, which will cover autoimmunity amongst other conditions. You do not have to wait for that book, as the treatment for those conditions will essentially be the same: the existing GAPS Nutritional Protocol. Would the GAPS diet do anything to help heal someone with Parkinson’s disease? I have no experience in treating Parkinson’s disease with GAPS Nutritional Protocol. However, there are many indications to show that Parkinson’s disease is autoimmune in its origin. GAPS Nutritional Protocol heals the gut and re-balances immunity; so it should lay the foundation for recovery. I would try it. BACTERIA I have been reading conflicting information regarding bacteria and where they reside. Some sources say the small intestine should be sterile and have not bacteria in it and that both lactobacillus and bifidobacterium live in the large intestine only. Other sources indicate that bifidobacteria live in the large intestine while lactobacillus reside only in the small intestine. What is your thoughts on this? The whole digestive system is populated, from your mouth to the end; there are no sterile areas in the digestive tract. Bifidobacteria are strict anaerobes; the best conditions for them exist in the large

bowel, that is why they are very numerous there. Lactobacilli can use oxygen and also can live in anaerobic conditions, so they are present everywhere, including the small intestine. Why does it take so long to change the bacterial profile in the gut? It can be quick to get ill, while healing always takes time. It can take a long time to normalise gut flora in a person with gut dysbiosis because the gut is occupied by thousands of pathogenic species of microbes. They dig themselves in very well in the gut lining, and to drive them out is not easy: the probiotic microbes have quite a fight on their hands. Another problem is that, whether we use fermented foods or commercial probiotic supplements, the numbers of active microbes we introduce are very small. There is no way at the moment (which means we don’t know any way) to flood the gut with probiotics safely, because we don’t know enough about them. Recent scientific data shows that there are hundreds of thousands of various species of microbes in a healthy gut! With our current knowledge we can only introduce a few at a time – those that we know, such as lactobacilli, bifidobacteria and few others. There are a few doctors in the worlds who are trying to copy Nature: they use a procedure called faecal transplant: a stool from a healthy donor is mixed with water and introduced into the gut of the patient (through the tube into the stomach, or into the bowel as an enema). In many patients this fixes the problem, though it does not work for everybody. Faecal transplant introduces the whole immensely complex flora of a healthy gut, without us knowing what species of microbes are there and what other factors we are introducing. I am sure that many of you watched films about animals, where a baby elephant would consume mother’s stool with relish. For us, humans, this looks repulsive and unacceptable, but obviously these animals know something we don’t. Faecal transplant does what these baby elephants do, and maybe this will be the way in the future to restore the gut flora quickly. How does GAPS diet deal with small intestinal bacterial overgrowth (SIBO)? Because fermented foods and probiotic can actually feed SIBO, what is your recommendation on how to address this situation? Majority of GAPS people have this problem. Just follow the GAPS programme, it will feed the gut and re-balance immunity and the nervous system in the gut wall. The body knows how to heal itself, just give it the tools. BIOFILMS How do we know if the pathogens in our gut have created biofilms? If there are biofilms, do we need to do or take anything to remove those biofilms in addition to the GAPS protocol and diet or will it get rid of those biofilms? Most (if not all) microbes form biofilms. Biofilm is simply a

community of microbes which grow together or a surface and are imbedded in various substances they produce (proteins, carbohydrates, etc). Biofilms are not necessarily something bad that should be “got rid off”, as beneficial flora in the gut forms them too. We don’t know enough about this subject yet to start taking action, particularly destructive action. Just work on improving your gut flora; as the beneficial microbes win, they will deal with the pathogens in their own way, including removing their biofilms. CALCIUM & MAGNESIUM Will my child get enough calcium on the GAPS diet? Do we need to supplement calcium? There is plenty of calcium in nuts, particularly almonds, meat broth and vegetables. When fermented dairy are introduced there will be even more calcium in the diet. Calcium has to be balanced with other minerals, particularly with magnesium. Supplemental calcium usually causes deficiencies in many other minerals, as it chelates them and does not allow them to be absorbed. That is why I do not recommend calcium supplements. When you get calcium from natural foods you get it in combination with many other minerals and other nutrients, which allow the body to use them all appropriately. Calcium works in opposition to magnesium in the body. GAPS patients are usually deficient in magnesium. Supplementing calcium will make that deficiency worse with serious consequences. What causes leg cramps in GAPS patients and what should be done if this is a common issue? Magnesium deficiency causes leg cramps. What causes magnesium deficiency? Many factors: toxins from the gut, mercury, lead, any other toxic chemical accumulating in the body, nutritional deficiencies, infections, etc. But the number one cause of widespread magnesium deficiency in the population is consumption of processed carbohydrates, sugar in particular. GAPS diet removes processed carbohydrates and includes foods rich in magnesium. Many people use supplements of magnesium, which may or may not work, as there are many factors involved in magnesium metabolism in the body. Fat soluble vitamins A, D, K and E are one of the most essential nutrients for the body to be able to absorb and use magnesium from food or supplements. To supply these vitamins we need animal fats: fats on meats, butter and sour cream. In order for magnesium to work it needs other vitamins, minerals and amino acids, as they all work as a team. So, diet as a whole is the most effective treatment. CANDIDA / YEAST Is there anything you can do to reduce Candida in the mouth (thrush)?

It is important to populate the mouth and throat with beneficial bacteria. To do this, take a mouthful of yogurt, kefir or 2 opened Bio-Kult capsules on the tongue after everything you eat. Do the same thing at bedtime after you have cleaned your teeth and do not plan on eating or drinking anything else. Can a patient with candida use fruit-based vitamin C products such as acerola and amla? Or will it exacerbate the Candida? Candida will feed on any sugar, including your own gut lining (the cells there are covered by a sugar layer, called glycocalyx). So, it is a balancing act: if natural products such as dried acerola and amla are helping you in other ways, don’t worry about candida and continue using them. If they are not making much difference, then don’t use them. What specific recommendations are there for GAPS patients struggling with Candida? It is impossible to completely eliminate Candida. We can only control it by strengthening the immune system and using some anticandida remedies. The GAPS diet builds up the immunity over time very well. There are many good natural remedies on the market, such as oregano, olive leaf extract, grapefruit seed extract, garlic and herbal mixes to bring candida down a bit. It is important to introduce natural remedies gradually, controlling the die-off reaction; start with one remedy, then add others one by one. Some people find relief with mainstream anti-fungal medications. Trouble is that drugs cannot be taken for long periods of time (apart from Nystatin), as they are toxic and have side effects. If the drugs work, they may provide an immediate relief, but when they are stopped, the problem may come back fairly soon. Natural remedies can be taken for long periods of time without harm, that is why it is a good idea to start with natural remedies, continue taking them through the drug treatment and to follow with the natural remedies when the drug has been stopped. Another measure is alkalizing: candida thrives in acid environment and hates alkaline environment. The most effective and inexpensive remedy is pure bicarbonate of soda, It is quite effective when used as a topical application on athletes' foot (put some powder into your socks and shoes), mouth candida (brush your teeth with bicarbonate of soda instead of toothpaste), any other fungal skin problems and as baths (add about a cup of bicarbonate of soda to the bath water). Taking bicarbonate of soda internally can be effective in reflux, indigestion and other internal candida problems. For internal use dissolve 1/2 a teaspoon of aluminum-free bicarbonate of soda in a glass of water and drink on an EMPTY stomach. It is not recommended th have more than 2-3 glasses of this solution per day, as it may affect the kidney function. Start with 1/2 a glass first thing in the morning and gradually build up to 2-3 glasses per day. A more expensive alternative is buying a good water ionizers (there are a few on the market), which produces alkaline drinking water. There are health centers and pharmacies around the world, which purchase these ionizers and sell the alkaline water in bottles. Introduce alkaline water gradually.

How should S boulardii be dosed when used for candida? Always start from a small dose and gradually increase it to a therapeutic level, stay on this level for 3-4 months, then gradually reduce to none. For an adult the therapeutic dose is usually 4-5 billion live cells per day. For a child use smaller doses depending on the age of the child: 3-5 years of age the dose is 1 billion live cells per day, for 6-11 years of age 2 billion per day, for older children 34 billion per day. I would not use S boulardii with children younger than 3, it is better to use homemade kefir for these children. It is important to always combine S boulardii with other probiotics, as it should not be allowed to dominate in the gut. Based on my experience, I would not use S boulardii permanently, only as a course. On a long term basis it is better to use kefir, which contains a group of beneficial yeasts as well as bacteria. I would like to know how GAPS eradicates systemic yeast versus yeast overgrowth in the colon. It is impossible to eradicate yeast from the body, systemic or in the colon, as yeasts are a natural part of our bodily flora. They fulfil many useful roles in the body, one of which is dealing with toxins: the body “employs” yeast as a sponge to absorb heavy metals and other toxins, so these poisons do less damage. That is why yeast overgrowth always comes with toxicity. You may attack yeast with anti-fungal medication, which may work temporarily, but as long as there are toxins in the body to deal with, yeast will come back. GAPS programme works on many levels: it removes the main source of toxicity in the body by improving gut flora and gut function; it rebalances and nourishes immune system, so it deals with pathogens in its own unique ways; and it restores normal microbial balance in the body. And the normal microbial balance includes yeasts - many varieties of them living side-by-side with bacteria, viruses, protozoa and other microbes. You have to understand that about 90% of your body are microbes; you are only 10% - a shell and a habitat for these microbes. Work with them rather than against them, restore normal balance amongst them, and they will serve you well. If one is hypoglycaemic with candida issues, where can carbs be obtained from? The legal carbs all seem to have too high a GI such as squash, cooked carrots, etc, fruits will also be tricky and of course grains and beans are difficult to digest despite some being low GI. Throw in the possibility of nightshade/sulphur sensitivity as well and it is seemingly impossible to get any carbs in at all. Carbohydrates are one macro-nutrient, which is not essential, strictly speaking. Protein and fats are essential for us to consume, but not carbs. People with candida do best on high-fat and highprotein diet, rather than on carbs. Meats contain some carbohydrate in the form of glycogen, so a piece of meat (with fat on it of course) will provide you not only with protein and fat, but with some carbs.

CHILDREN My child got strep throat with high temperature, and my doctor has prescribed antibiotics. What should we do? Will the antibiotics destroy all our efforts with GAPS? There are situations when antibiotics are necessary, and Strep throat is usually one of those situations. It is important to take streptococci under control, as they can trigger an autoimmune reaction in the body leading to damage of heart valves. Just make sure to give your child plenty of probiotics and immune-boosting foods during the illness and after it. Probiotics: open a capsule of a probiotic and pour the powder on your child’s tongue after every meal and at bedtime. This will help to populate your child’s throat with beneficial bacteria, so they will take streptococci under control now and prevent any new infections in the future. Food: during the infection feed you child lots of hot chicken stock and chicken soup with kefir, yoghurt or sour cream added. Do not give your child anything cold until the throat is much better. So, no raw fruit or vegetables, no salads, no baking and no cold drinks; only hot soup, hot camomile tea with raw honey, well-cooked fatty gelatinous meat (cooked in water) and eggs with onion. Here is an immune boosting recipe to use during any infection, particularly in the throat: fry 2-3 eggs in generous amounts of goose or duck fat (or any other animal fat) so the whites are gently cooked and the yolks are left runny; slice large white onion and cook in generous amounts of animal fat under a lid for about 20 minutes, until the onion is soft and sweet; serve the eggs and the onion together with all the fat, which they were cooked in, and pour some cold-pressed olive oil on top. This dish is very gentle and soothing on the throat, the fat and the egg yolks will dissolve any damaged tissues and help to remove them; the eggs, fat and cooked onion feed the immune system locally in the throat, and boost systemic immunity as well. Give this dish to your child twice a day, and the sore throat will melt away quite quickly. This is food that should be given to patients in hospitals, whose tonsils have just been removed. What do you recommend for children who grind teeth? Is this a sign of anything? Teeth grinding or bruxism is caused by contractions in jaw muscles during sleep. Just as with many other muscle-tone abnormalities, which we see in GAPS patients, I believe it is caused by a combination of toxins, coming out of the gut, and nutritional deficiencies. Bruxism is a common symptom of digestive disorders and GAPS conditions, such as anxiety, bi-polar disorder, autism, ADHD, etc. Severe teeth grinding can damage the teeth and lead to headaches and pain in the facial muscles in the morning. GAPS programme will remove this symptom over time. In the meantime try to use a mouth guard to protect your child’s teeth during sleep (the one rugby players use works well). To relax the muscles before sleep it may be helpful to take two supplements at bedtime: magnesium (amino acid chelate) and a supplement, which increases

serotonine production (the usual ingredients are 5HTP, niacin, B6, folic acid, biotin and zinc). With both supplements start from a small dose (about half the recommended dose for the age of your child) for a few nights, and then gradually increase the dose. Increase the amounts of fat in the diet of your child, particularly raw fat, such as raw butter and homemade sour cream (made out of raw cream). Another thing to consider is taking common worms under control, as their activity can lead to teeth grinding. Please look at questions on worms and parasites and their treatment with Vermox (mebendazole 100mg). Enuresis (bed-wetting) and polyuria (excessive urination) are common concerns of parents before GAPS and seem to increase during the early stages of GAPS. Please comment. Please, read my article on Food Allergy, which explains this issue in detail. Urine is one of the venues for toxins to leave the body. Abnormal gut flora produces a lot of toxins, which are excreted in urine. This toxic urine irritates the lining of the bladder and causes a low grade inflammation there, so the person gets symptoms of chronic cystitis. The bladder does not want to hold toxic urine, so the person has to empty it frequently. If a child (or an adult) with this condition is fast asleep, then the bladder may empty without waking up the person, hence bed-wetting. Die-off increases levels of toxins in the body, so the urine will become more toxic, exacerbating the problem. It is always important to control die-off by slow introduction of probiotics and various foods. GAPS Programme will eliminate this problem long term, as it will remove its cause. In the meantime do what works to help the situation: drink plenty of water, supplements of cranberry help to reduce inflammation in the bladder, use various mechanical alarms and devises developed for enuresis, wake your child up a few times during the night and take him/her to the bathroom. Foods high in salicylates and oxalates can make the problem worse, so try to avoid these foods for a while until things get better. When the natural defences of the mucous membranes of the bladder are damaged by toxins in the urine, then any infection can join in easily. So people with this problem get urinary infections frequently which have to be treated with antibiotics. Populating that area with beneficial flora will prevent urinary infections. So, I recommend applying homemade kefir or yoghurt all over the groin after showers and baths. Probiotic microbes will slowly travel up the urethra into the bladder, protect it and help it heal. Should we be concerned with consuming foods high in manganese? Could children with autism have a similar condition to manganese madness? I heard that some cases of autism were greatly worsened by excess manganese being in the brain and a diet avoiding foods high in manganese was advised. Manganese is an essential trace element involved in many functions in the body. Toxicity from manganese is known in industrial steel workers, particularly welders, who are exposed to concentrated manganese fumes and dust; some pesticides and pharmaceuticals

have large amounts of manganese and can lead to an overdose. Infant soy formula has recently emerged as the new source of manganese toxicity, amongst many other harmful influences it has on a baby’s body. Toxicity from food is generally not known, as in the food this element comes in a complex with hundreds of other nutrients, which balance each other out. Foods rich in manganese are soy, various greens (mustard greens, chard, kale, lettuce, collard, etc), pineapples, beans, maple syrup and raspberries grown on manganese-rich soil. Manganese deficiency can look very similar to excess: problems with balance and motor co-ordination, mood, behaviour, skin problems, reproductive problems, etc. In autistic children an excess in manganese is usually not due to high intake (unless the child was brought up on soy formula), but due to abnormalities in metabolism and general toxicity. These children show abnormalities in most elements we test for: copper, zinc, magnesium, calcium, molybdenum, etc. To handle metals the body needs fat-soluble vitamins (A, D, K and E), protein and many other nutrients. As the child goes through the Introduction diet, these nutritional deficiencies will be slowly eliminated, so the child’s body starts handling manganese and other metals appropriately. Soy, maple syrup and many varieties of beans are not allowed on the GAPS diet. While on the Introduction GAPS diet the person is not likely to consume pineapples, raspberries or greens to any degree. If a case of manganese toxicity has been diagnosed, then it is a good idea to avoid all greens and other manganese-rich foods until the tests are better. The same goes for infants who were fed soy formula. But, for majority of people following GAPS this issue should not be of concern. Do you agree with current medical recommendations for delaying high-allergen foods such as peanuts and tree nuts? At what age should these foods be introduced to young children? Please look at the New Baby diet on in the 2010 version of the GAPS book . About 2-3 months after the beginning of the diet I recommend introducing pancakes made with nut butter (hazelnut or almond). It is always a good idea to do the Sensitivity Test prior to introducing any new food, including nut pancakes. In my experience majority of babies tolerate these pancakes perfectly well, once they have been through all the previous stages of their GAPS New Baby diet. My 18 month old has an extremely bloated belly. I know this is common during healing, but is there anything I can do to alleviate it? He seems uncomfortable, especially after eating. The bloating does not go down even after a bowel movement. There is an excessive gas production in your child’s tummy. Try to go back to the second stage of the Introduction Diet and keep your child on it for a while. Dill seed tea helps: put a teaspoon of dry dill seeds into a pan, add a cup of cold water and bring up to boil. Take off the heat and let it cool down slowly. Give your child 2-3 teaspoons with water or meat stock a few times per day. A small daily enema after passing stool will release old matter from the bowel quicker and speed up the healing process. For a child of this

age it is best to use a bulb syringe enema kit; use warm water with a pinch of Celtic salt dissolved in it. Since starting the diet my son’s stools have consistently floated. Is this cause for concern? Not at all. Whether the stool floats or sinks depends on its density, which in turn depends on the mixture of foods eaten. In your book you mention that GAPS people often have an overgrowth of sulphate-reducing bacteria. If I suspect this to be the case in my child, should I avoid feeding him foods that contain high amount of sulphur? No, do not remove sulphur-containing foods! Sulphur is essential to re-build you child’s gut, immunity and liver function. GAPS people are already deficient in sulphur; they cannot get enough of it. As the gut flora starts changing the beneficial microbes will take care of the pathogens and normalise your child’s sulphur metabolism. Many parents who show the GAPS diet to their paediatricians are told that the diet is too low in carbohydrates and this can be harmful to the child? There is no training in nutrition in medical schools, so generally your doctor knows no more than any lay person, who derives their knowledge about food from food industry advertisements in the mainstream media. The nutritional dogma, dominated by “science” funded by food industry, has pronounced proteins and fats as evil, so there was nothing else left to replace them but carbohydrates. So, the population has been subjected to decades of propaganda that we all need lots of carbohydrates, and doctors were brainwashed just as much as everybody else. Strictly speaking carbohydrates are the only macro-nutrient, without which humans can live perfectly well in good health. But we cannot live without proteins and fats, which have been vilified by the nutritional establishment. If parents intend to vaccinate do you have a recommended vaccine schedule they should follow? What age to start, how often to receive, which order, etc? Please, read the chapter on vaccinations in my GAPS book. In my opinion babies in GAPS families should not be vaccinated until the age of 4 - 5 years. Strictly speaking the only two vaccinations that can be considered important are tetanus and polio. Other vaccinations are not essential; in fact it is better to let your child go through those childhood infections. Just make sure that your child is well nourished and he or she will sail through those infections and come out stronger with a more robust immune system. It has been recorded that those people who went through measles, mumps and other childhood infections, virtually never succumb to auto-immune disease or allergies. And it is a fact that complications of these infections arise only in children, who are malnourished, particularly with deficiencies in vitamins A and D. If you decide to vaccinate, the

order of the vaccines is not so important. What is very important is to have every vaccine separately; I do not recommend combined vaccines. It is also important to space the vaccinations at least 3 months apart. Make sure that your child is well nourished and has no colds, coughs or any other problems at the time of the vaccination. If any of the vaccines caused a reaction, let your child recover fully before considering the next vaccine: I would recommend waiting for about 6 months. The latest stool analysis of my child has shown growth of Streptococcus in it. My doctor recommended an antibiotic, which made my child worse. What should we do? I have to tell most of my patients not to rely on testing too much. Every test can only identify what it knows; it cannot find what it has not been designed to find. It is a fact that little knowledge can be more dangerous than no knowledge at all. There are many potentially pathogenic microbes in human stool and in the gut flora. The fact that the laboratory identified one of them does not mean that we must go chasing after it. Trying to kill streptococci with antibiotics we would kill many beneficial bacteria and activate other pathogens, which could have been dormant, and which may be far more dangerous than the streptococci. So, in the big picture in the gut the antibiotic would do more harm than good. We are dealing with an immensely complex microbial world in the gut, which we only just started learning about. We know very little yet, our modern science is in its infancy on this subject. That is why it is best to rely on centuries old wisdom of treating the gut holistically with diet and probiotics, giving it time and patience. CONSTIPATION, DIARRHEA, STOOL ISSUES If constipation persists for several months, does it mean you are doing something wrong? Is there anything you recommend in addition to enemas and juicing to help this? Try to replace high-protein dairy with high-fat dairy. In my experience adding high-protein dairy: whey, yoghurt and kefir, does miracles for those who are prone to diarrhoea. Constipation, however, is a different matter. If your patient is prone to chronic constipation introduce high-fat dairy: ghee, butter and sour cream, but not high-protein dairy, such as yoghurt, whey, kefir and cheese: high protein dairy can aggravate constipation. High fat content of sour cream will lubricate the gut wall and soften the stool. How is it that flax seeds can be used for constipation? Won’t they damage the gut lining like other fibrous foods? I do not recommend taking flax seeds, particularly in the initial stages of the programme. When soaked overnight, flax seeds absorb a lot of water and turn into a jelly. It is thought that this waterabsorbing quality of flax seeds helps with constipation. However, it does not help everybody, and yes, flax seeds are very fibrous and

have other anti-nutrients. After 2 years on GAPS I still have undigested vegetables in my stool and they take about 3 days to go through my digestive tract. I keep reading that any undigested food feeds pathogens and fungi. Is this true and if so, should I just cook the veggies in my broth and then strain them out? I assume after cooking the veggies for 35-40 minutes all the nutrients are in the broth anyhow? It is normal to see some undigested vegetables in your stool, particularly if they were eaten raw and not chewed very well. It is also quite normal for them to take three days to get through your digestive tract. They do not feed microbes any more than any other food would do. Raw vegetables are important to eat, as they provide active enzymes and other nutrients, which are destroyed by cooking. Providing that you have no diarrhoea, you do not have to cook all your vegetables. Indeed, when you boil vegetables, a lot of nutrients from them finish up in the water. That is why it is best to eat boiled vegetables as a soup with the broth you cooked them in, so no nutrients are wasted. I have recently begun juicing – just green veggies. I have severe candida overgrowth. My question has to do with the colour of my stools. They are very green. Does that mean I am not digesting them well and should I stop? Or do I push through and it will eventually resolve itself? Yes, it should resolve itself in time. It is the same as when people start drinking lots of carrot juice, their skin turns yellow. Try to whisk some raw eggs and raw sour cream into your juices: this will turn them into delicious smoothies, which will balance your blood sugar and boost your immunity. It will also assist the absorption of chlorophyll from your green juices, so it does not escape in your stool. If a food causes a minor upset, such as gas, phlegm, slight change in stool, etc., will healing be prevented if this food is continued to be consumed? These reactions tell you that your digestive system is not ready for that food to be introduced. Remove it for a couple of weeks, then try again as a part of your meal; not on its own, and not on an empty stomach. Please read Food Allergy to learn more. Since starting the diet my son’s stools have consistently floated. Is this cause for concern? Not at all. Whether the stool floats or sinks depends on its density, which in turn depends on the mixture of foods eaten. If GAPS patients see undigested food in their stool, should the undigested food be avoided? Not necessarily. There are many foods which go through most of us

undigested, such as sweet corn, for example. If there are symptoms, such as abdominal pain, flatulence, etc, as well as undigested food in the stool, then it may be sensible to remove it for a while and see if that helps. Since going on GAPS I have not had a bowel movement. When having enemas the water is expelled and then a bowel movement is stimulated, but it is not a formed stool - it is only mush or water mush. Is this to be expected or does it indicate something? Should I somehow be treating for diarrhoea as well as constipation? Of course the stool expelled during an enema is not formed: the water you put into your bowel dilutes it and turns it into a mush. If constipation is consistent, then there are several things you can do: · Have more cooked vegetables and gelatinous meats, and reduce muscle meats in your diet. Increase animal fat consumption with your meals. · Replace yoghurt and kefir (high-protein dairy) with sour cream (high-fat dairy). Make the sour cream at home, preferably from raw cream, using yoghurt culture initially, then start using kefir culture. This measure along helps many people to resolve constipation. · Introduce juicing earlier: make a juice from a mixture of fruit and vegetables, and then whisk 1-2 raw eggs into it and a generous dollop of homemade sour cream. This will make a delicious “milkshake”, which will provide you with magnesium and other substances. Drink your GAPS milkshake first thing in the morning, about 20-30 minutes before breakfast. When making juice use highmagnesium fruit and vegetables, such as oranges, celery, apples, carrots, cabbage, beetroot and greens. · Supplementing magnesium may help: use amino acid chelates of magnesium as a daily supplement. As a laxative you can use magnesium oxide occasionally. When reading your recommendations for constipation it seems to me that dairy plays a key role. What if you cannot tolerate dairy? Constipation is not about dairy, it is due to lack of beneficial microbes in the gut and an imbalance of the intestinal nervous system: the sympathetic nervous system is too active, while parasympathetic is suppressed. By restoring gut flora with probiotics and diet, we resolve constipation long-term. Short-term we need to re-balance the nervous system with diet. In order to activate the parasympathetic nervous system and to calm down the sympathetic one we need raw juices, rich in magnesium, potassium and other substances; we need more animal fat with meals, and we need to change the ratio of vegetables to meats in our meals (less muscle meats and more vegetables with gelatinous meats). Please, look at the previous question. COOKING, PREPARATION, INGREDIENTS & MISC FOOD Why is bicarbonate of soda for baking not recommended in the GAPS

diet? GAPS patients almost invariably have low stomach acid production. Bicarbonate of soda is a strong alkali and will reduce the stomach acid even further. Please, read the chapter 'Digestive Enzymes' in order to fully understand this issue. When making broth, is there any nutritional difference between shorter cooking times as described in the GAPS book and extended cooking times as recommended by WAPF? What about adding vinegar while cooking? In the GAPS book I have described how to make meat stock. There is a difference between meat stock and bone broth. Meat stock is made with raw meat on a bone and it needs to be cooked just long enough to cook the meat thoroughly (2-3 hours), so it can be eaten, and so the bone marrow can be taken out of the bone and consumed. The meat stock made this way is usually clear and delicious, with an excellent nutritional value: it is particularly rich in amino acids. Bone broth is made out of bones which can be raw or cooked or a mixture (many people collect cooked bones from their meals, keep them in the freezer and use them for making the broth). In order to leach minerals out of the bones we add vinegar to the water. It is not necessary to add vinegar to the meat stock unless you need it for a particular taste. Bone broth may have quite a different nutritional composition from the meat stock and a different taste. Both are beneficial and should be used in GAPS diet. Is baking with honey safe? Dried fruit as a sweetener in baking would be a better option. Natural good quality honey is "alive", which is why it is recommended to buy unpasteurized, untreated honey, straight from the bees and collected in ecologically clean areas. However, in some recipes honey works quite well. From my clinical experience and the experience of Elaine Gottschall there have never been any "toxic" reactions to baking with honey. What are the requirements for fruit as it relates to the GAPS diet? How should GAPS patients evaluate fruits not listed in the book (durian and lychees, for example)? Fruit is not essential to eat, strictly speaking; we can live without it perfectly well. But, of course, it is delicious and nice to include into the diet, particularly for children. It is important to make sure that your gut is ready for fruit before introducing it. Fruit must be ripe! It is best if it was ripened on the tree, so look for locally grown fruit. When several fruits are introduced and there are no problems with digesting them, then you can experiment with fruits which are not listed, such as lychees and durian: your body will let you know if you are ready for them or not. Is there a limit to the amount of nuts and nut products one should consume on the GAPS diet?

All foods should be consumed in sensible amounts, including nuts. I have met many families who 'started the SCD'. The trouble was that their version of SCD was lots of baking with ground almonds, because so many GAPS children are fussy with food and would only accept sweet things. Naturally these families did not see the expected improvements, because no child or adult can live on ground almonds and honey most of the time. Nuts are very fibrous and hard work for the digestive system, that is why they are introduced in later stages of the GAPS Diet, and only when the severe digestive symptoms are gone. I recommend that many patients ferment nuts in the initial stages, as it makes them more digestible. If the GAPS Introduction Diet is followed correctly and nuts are introduced at the right time, the majority of patients find no trouble with eating sensible amounts of nuts. In the GAPS book it says to use raw nuts only, not roasted. I wonder why? I can eat raw nuts instead, but pecans, for example, have a richer flavour if gently roasted. Is home roasting of nuts recommended? I recommend buying raw nuts, not roasted, salted or processed in any other way, because we cannot trust the industry to process nuts for us. At home we use them for baking, which cooks them. So, you can roast them gently at home, making sure not to burn them. Is parchment paper safe to use in baking? The short answer is yes. I am sure there are things in the paper which in theory may be problematic, but I have never met anybody who reacted to baking paper. Could you tell me why some cheeses are allowed on the diet while some others are not? What is the criteria that makes a cheese allowed? How can I be sure if it is OK to eat a cheese as many are not listed in the GAPS book? The list of allowed cheeses has been provided by Elaine Gottschall, who researched this subject, measuring lactose levels in cheeses. However, that was many years ago; cheese production methods change all the time and new varieties of cheese come to the market. So, if the cheese is not listed, find out how the cheese has been made. You want to know if it was fermented in a traditional way and no other ingredients have been added after fermentation. It is best to get mature cheeses, which have been fermented long enough to remove all lactose and to pre-digest protein. You have to be sure that your body is ready for this cheese, so try a tiny piece first and see what happens; you body will let you know if you are ready for it. When can cocoa or cocao be introduced? Cocoa is SCD illegal. However, I find that many people can start having it occasionally on the Full GAPS Diet, once the digestive symptoms are gone. Find pure organic cocoa powder. Mixing the

powder with some honey and sour cream makes a delicious dessert, and you can add it to your homemade ice cream or cakes. After trying it for the first time, observe your patient for any reactions. Cocoa is very rich in magnesium and some essential amino acids and, unless your digestive system is not ready for it, there is no need to avoid it. I have seen a lot of controversy regarding flax and chia seeds and their mucilaginous properties. Are either of these seeds GAPS-legal, and if not why? What about flax oil? It is mentioned in the GAPS book that it should not be taken alone. How/when should it be taken? Flax and chia seeds and oils are allowed on the Full GAPS diet. As a whole seed they are very fibrous and should not be consumed until diarrhoea has cleared completely. People who are prone to constipation find it useful to take a teaspoonful of these seeds every morning, after the seeds have been soaking in water over night (they become jelly-like). The oils from these seeds must be cold pressed without application of chemicals or high pressure. The oil of flax is too high in omega-3 fatty acids - that is why I do not recommend supplementing it on its own. It is better to take it in a mixture with other cold pressed oils, such as evening primrose oil or starflower oil. Chia oil is new on the market; it appears to have a more balance fatty acid composition, so it may be OK to take it on its own. However, it is a good idea to alternate oils in your diet, not sticking to one particular oil for long periods of time, as all of these oils have their own pluses and minuses. Also, it needs to be remembered that the bulk of fats in the GAPS diet comes from animal foods; these oils are just a supplement, taken in a complex with animal fats, olive oil and coconut oil. Is there any specific ratio of meat to vegetables that GAPS patients should adhere to? There are no exact ratios, as it depends on the weather and your physical state. In cold weather you may want less vegetables and more meat and hot meat stock. In hot weather you may want more salad and lighter meals with less meat. Listen to your body, it will tell you what it wants on any particular day. Is it necessary to consume both cooked and raw food? Can one follow the Primal diet and GAPS diet simultaneously? When we talk about raw and cooked we have to separate the animal products from the plant foods. Plant foods: in a raw state they contribute live enzymes and other undamaged active substances, which clean and detoxify the body, but they do not feed us too well, as raw plants are largely indigestible. Cooking plants makes them more digestible, so they feed us better, but the live enzymes will be gone. Fermentation makes plants more digestible and full of enzymes, as well as probiotic microbes; and there is no cooking involved. So fermented plants are often better than raw or cooked, and indeed in all traditional diets plant foods were largely consumed fermented. Some

seasonal plants, such as soft berries, should be eaten straight from the bush to the mouth. They haven’t got much in them to feed us, but they are full of detoxifying substances. The best way to preserve berries is fermentation, for example making vinegar. Animal products: dairy should be consumed either raw or fermented. Egg yolks should be consumed raw. Whites can be consumed raw as well, but their slimy consistency and taste are a problem for many people, so I recommend gently cooking the whites, leaving yolks raw or minimally cooked. Raw meats are a good source of parasites and infections, particularly in our modern world where food travels long distances. Yes, raw meat is full of active enzymes and other good things, but we can add enzymes to the meal by eating cooked meat with fermented and raw vegetables. If you had a chance to get organic meat fresh from your local farmer, then you can preserve some cuts of it yourself without cooking by salting it in a traditional way, fermenting or making meat jerky. Softer cuts, such as fillet steak you can eat raw making traditional dishes, such as steak tartar. Many lean muscle meats can be cooked rare or medium rare, particularly lamb (which is considered to be the cleanest meat). Most of other places on the animal will have meat too chewy to eat raw, so it is best to cook it. If you were lucky to get hold of a fresh wild salmon, I have some recipes in my book on how to marinate it without cooking. Most other fish needs to be cooked very lightly, as overcooked fish and shellfish become tough and chewy. Apart from wild salmon I do not recommend to eat raw fish, as it is easy to pick up parasites from it, as indeed is a common problem in Japanese who eat raw fish regularly. You cannot eat bones and joints of animal or fish raw, so we make meat and bone broth from them. That way nothing gets wasted. So, as you can see it is possible to combine Primal diet and GAPS. It is a matter of balancing your meals to include cooked foods and raw foods, which you feel comfortable and safe eating, and find tasty and appealing. It is important to enjoy your food, not only focus on its nutritional value! When getting around to introducing buckwheat, quinoa and millet are all of these supposed to be fermented, or just the buckwheat? Please, read the chapter Coming off the GAPS diet, p.155 in the new edition of my book. The recipe section provides a recipe for fermenting grains (p.195). I recommend that all grains get fermented, not just buckwheat. Is raw coconut sap vinegar OK on GAPS? Yes! Can you tell me if nettle tea is allowed on the GAPS diet? I see that nettle is not on SCD, but I don’t know about the tea. Nettle tea is so full of nutrients and minerals; it would be a shame to give it up nutrient-wise. Yes, nettle tea is allowed. Nettles are very nutritious. I have a recipe of nettle soup in my book, and I recommend using fresh nettle leaves

in juicing. Do not use nettles in pregnancy because it can initiate contractions. For this reason nettle infusion has been traditionally used in the third stage of childbirth, when the baby is out, but placenta is still in and needs some encouragement to come out. Is mead in small amounts GAPS allowed? Yes, as long as it is made with honey and not with sugar (as sugar is often not completely removed by fermentation). Are the following allowed: ginseng, kava, valerian root, Irish moss tea, plant fibre in supplements? Yes, herbs are generally allowed as a tea or an extract. When the diarrhoea has cleared, you can start consuming them raw and dried, as by then your gut should be able to handle fibre (herbs are usually fibrous). Is soured milk GAPS legal? Tequila? Only homemade fermented milk products are allowed. Tequila is a distilled product like vodka, and if nothing else has been added, it should be OK occasionally and in small amounts. Are the following GAPS foods legal: adzuki beans, coconut aminos, hemp seeds? Adzuki beans are not allowed, as more than 60% of them are complex carbohydrates. Coconut aminos is a supplement; from what I can see on the manufacturer’s information it should be OK. Hemp seed is very fibrous and low in useful nutrition, apart from the oil. So, if you want to try hemp seeds I would only try them when all digestive symptoms are completely gone. Is liquorice root tea GAPS legal? Yes, liquorice tea is allowed. Can sweet potatoes be consumed fermented, for instance in the African beverage mentioned in Nourishing Traditions, or perhaps some other form? We’re not certain whether the fermentation would beneficially change the problematic starches. If not at first, would this possibly be an advanced food (fermented organic sweet potatoes)? While on the GAPS diet sweet potato is not allowed. And there is no real need for it as we can have butternut squash, which has a similar taste and texture. I am not aware of any research into how much starch is left in fermented sweet potato recipes. So, it is better to keep on the safe side until the person is able to tolerate fermented grains and new potatoes. When the programme has been completed, you can gradually introduce all sorts of wholesome foods, including sweet potato, fermented or not. Are certain legumes, prohibited on the GAPS diet, allowed if they are

sprouted? Specifically: sprouted garbanzo, adzuki, mung and snow pea. Also if they are, would they have to be cooked to introduce these sprouts? Legumes are generally hard to digest, so I do not recommend rushing with their introduction. When your digestion is much better and you have been on the Full GAPS Diet for a while, try to have a tiny amount of sprouted legumes of your choice and see how your body reacts to them. The longer they are sprouted, the less starch will be left in them, so you can try them raw or cooked to your liking. Raw will have active enzymes to help you to digest them, while cooked they are gentler on your gut lining. But first make sure that your digestive system is ready for them. CYSTITIS Please comment on interstitial cystitis and how GAPS can help? Please read the article Food Allergy, it will explain this issue to you in detail. DETOXING, DIE-OFF, & OTHER SYMPTOMS What are "die-off" symptoms? As you introduce a probiotic into the digestive system, the pathogenic bacteria, viruses and fungi there will be dying, which releases more toxins. This increase in toxicity may produce a socalled "die-off" reaction, when you may feel more tired or generally "off color". It is a temporary reaction and usually lasts from a few days to a few weeks in different people. To make this reaction as mild as possible, build the dose of Bio-Kult slowly. The quickest you can go is adding 1 capsule to the daily dose every 4-7 days. You can build the dose much slower, depending on your reaction. If you get a severe reaction, cut the daily dose down to the previous level and settle on it. Then carry on increasing the dose. Why do my symptoms seem to be getting worse on the GAPS diet and Bio-Kult? Die-off releases more toxins than usual. Your symptoms may get worse initially but this is a temporary reaction and will pass. Build up the Bio-Kult very slowly to decrease this response. If the Full GAPS Diet is causing your symptoms to get worse with no gradual improvements, it is recommended to go back and follow the Introduction Diet. If a food causes a minor upset, such as gas, phlegm, slight change in stool, etc., will healing be prevented if this food is continued to be consumed?

These reactions tell you that your digestive system is not ready for that food to be introduced. Remove it for a couple of weeks, then try again as a part of your meal; not on its own, and not on an empty stomach. Please read Food Allergy to learn more. How can you tell the difference between die-off and food intolerance? For example, how do you know if flatulence is caused by the meal you just ate or from the meal prior to that one? The die-off symptoms can be new symptoms or can be your usual symptoms getting worse, when you introduce new diet, probiotics or anti-parasitic, anti-fungal/anti-bacterial remedies. Food intolerance symptoms appear when you introduce new foods into your diet. If you have been eating a particular food routinely, which you suspect as causing food intolerances, remove it for 3-4 weeks, then try to eat it again. Your body will let you know if you are intolerant to it. Production of gas takes time; it is the pathogens in the gut (usually fungi) that convert food into gas. So, it is your previous meals that produced the gas. Every meal sends a propulsion reflex down the digestive system, so that gas in the bowel may be released when you are eating your next meal. Is die-off dangerous? What symptoms are warnings that you should slow down? Should the GAPS diet be done under the supervision of a healthcare professional? It is always a good idea to work with a good healthcare professional. However, thousands of people around the world have implemented GAPS diet on their own with very good results. Die-off is very individual and depends on the severity of the condition. If we are dealing with a severe condition, then die-off can be very serious and should be controlled by slow introduction of foods and probiotics. Is insomnia a common die-off response? Do you have any recommendations for overcoming insomnia? Many toxins coming from the activity of unhealthy gut flora disrupt our neurotransmitters in the brain. Neurotransmitters are chemicals which brain cells use to communicate with each other, such as serotonine, adrenalin, dopamine, melatonin, endorphins, etc. – there are about a hundred neurotransmitters discovered so far. Die-off releases more toxins than usual and, if a person has a problem with neurotransmitter disruption already, then it will get worse. One of the functions of neurotransmitters is regulation of sleep. Serotonine, GABA and melatonin are the three neurotransmitters connected with sleep and relaxation in particular, and it is a good idea to boost their production with supplements, if insomnia is a problem. To boost serotonine production we need an amino acid 5HTP (5hydroxytryptophan), for GABA we need taurine and glutamine. These amino acids need co-factors to be converted into neurotransmitters: niacin, vitamin B6, folic acid, biotic, zinc, magnesium, vitamin B1, vitamin B12 and pantothenic acid. There are supplements on the market, which contain all these ingredients with about 100mg of 5HTP, 500mg of glutamine and 500mg of

taurine. Always start with a low dose and build gradually; the optimal dose is very individual. In many people just boosting production of serotonine and GABA is enough to remedy insomnia. If it is not enough, then try to add melatonin. Melatonin is produced in the brain at night, however in order to produce it in the dark we need a good dose of light during the day. Spending some time in bright sunlight every day will boost your melatonin production (no sunglasses, as the light needs to reach the brain through the eyes). Supplements of melatonin are available ready made; start from a low dose at bedtime (1-3 mg) and, if it is not making any difference, slowly increase the dose. Which symptoms should you push through and which symptoms are a sign that you should remove the food? If the symptoms are due to die-off, initiated by the introduction of probiotics, the diet or natural anti-parasitic remedies, then continue gradual increase of the remedies and gradual progression through the diet, keeping the die-off at a manageable level. If new symptoms appear after introducing new food, then you are not ready for that food (your gut lining is not ready). Remove the food, work on healing your gut lining with the diet and probiotics for a few weeks, and then try the new food again. Do you recommend or support the use of activated charcoal, clay or vitamin C for detox use during die-off? Yes, many people try these remedies and find that they help. Will toxins and lead and mercury toxicity cause tight muscles? If so, will certain muscles be more prone to tightness, i.e. muscles that have been problematic during die-off? Yes, toxins can cause muscle pain, spasms and tightness. Any muscle can be affected, it is individual. If a particular group of muscles was problematic during die-off, then it is likely that they will be targeted by toxicity. Even the smallest amount of any probiotic food or supplement causes me severe bloating, fatigue and pain. How do I do the diet if I can’t take probiotics? Are there any conditions where probiotic are not recommended? People suffering from ME, chronic fatigue syndrome, fibromyalgia and some other debilitating conditions often have difficulties introducing probiotics. The reason for that is the die-off effect: it is so severe in this group of patients that they find it very difficult to cope with. Just start from a tiny amount and go up very slowly. I have patients who start from 1/18 th of a capsule of the Bio-Kult (or as much powder as would fit on the end of a sharp knife), and it takes them months to get up to one capsule per day. The same with fermented foods, start from a tiny amount per 5-7 days; as your body gets used to that amount, start taking it a bit more frequently.

When you can take that tiny amount every day, start increasing the dose. Proceed in this very slow manner. It is important for you to introduce probiotics in the form of food or supplement. You just have to go slowly. If symptoms from introducing a food are mainly non-digestive, such as increased salivating and brain fog, might this be a reaction to work through? Or does it still signal a faulty immune system and thus one should back off that food? These symptoms look like food allergy or intolerance. Always do the sensitivity test with any suspicious food before introducing it. If the test is negative, then just introduce it at a pace that is manageable for you: start with tiny amounts as a part of the whole meal, not on its own. If, even in tiny amounts the reaction is too much, then stop, give yourself a few months to heal and then try again. As the gut gets healthier, you will be more able to digest that food properly rather than absorbing it partially digested. DIABETES, INSULIN & LEPTIN Do any modifications need to be made to the GAPS diet for patients with insulin resistance? GAPS diet is very beneficial for people with type-two diabetes, obesity, and other forms of insulin resistance, as it cuts out complex carbohydrates. People with this problem need to limit their carbohydrate consumption; so don’t go heavy on honey or SCD desserts. It is essential to have plenty of animal fats for these people in order to keep their blood sugar at the right level. In order to do that I recommend having a few tablespoons of coconut oil, raw butter or homemade sour cream every half an hour throughout the day. Freshly pressed juices have many sugars in them: in order to balance these sugars with fat and protein, blend into the juice 1-2 raw eggs and 1-2 tablespoons of homemade sour cream or raw butter or coconut oil (per person). Once your juice is mixed with eggs and fat, you do not need to worry about how sweet the juice may be: you can juice carrots, beetroot, apples and pineapples. For people with sugar cravings and other difficulties in blood sugar control, it is a good idea to mix raw butter or coconut oil with a little raw honey to taste; make the mixture in advance and keep eating it throughout the day. This mixture will help you to come through the initial stages of treatment. When sugar cravings are gone, you will be able to maintain your blood sugar normal between meals without having to eat anything. Does GAPS help with leptin resistance and if so, how? Leptin resistance is similar to insulin resistance and is usually found in overweight people. GAPS diet is a low carbohydrate diet; it helps with weight loss and insulin resistance, so it should help with leptin resistance too.

Will the GAPS diet help cure and prevent diabetes? There are two forms of diabetes: type one and type two. Type one is an auto immune disorder, where the body attacks and destroys the insulin-producing cells in the pancreas. All auto immunity is born in the gut. Following the GAPS Programme will heal the gut and restructure the immune system. In my experience, as the patient progresses through the treatment, he or she is able to slowly reduce the dose of insulin and in many cases to stop the injections altogether. Type two diabetes is caused by the body becoming insulin resistant because of continuous consumption of processed carbohydrates. GAPS diet removes all processed carbohydrates, so the body can heal the damage and remove diabetes. Once better, as long as the person continues to stick to low-carbohydrate nourishing diet for the rest of his or her life, the diabetes should never return. EMFs (ELECTROMAGNETIC FIELDS) Is our gut flora sensitive to the electromagnetic fields in our environment? Is the influence of these fields good or bad? If the influence is bad, what can we do about it? EMF (electromagnetic field) is a growing concern in the modern world, and many GAPS people are sensitive to it. Research shows that it is damaging to humans, animals and microbes. I have not seen any studies on gut flora specifically, but I would imagine that the EMF influence is not good. On the whole it is a good idea to avoid exposure to EMF by staying away from high-power electricity lines, mobile phone masts and other sources. Make sure that you don’t live close to any powerful source of EMF, switch off your computers and TV screens when you are not using them, and do not become attached to your mobile phone too much. Babies and children can be very sensitive to EMF; I had families in my clinic where the baby would not sleep until all electrical devices in the house are unplugged from the sources of electricity. FERMENTED FOODS & DRINK How long should kefir be fermented? Is there some lactose left in it? Kefir should be fermented for 24 hours minimum. Fermentation is a natural process: that is why it cannot be 100% predictable. Some batches of kefir may taste more sour than others, and every batch will have different amounts of lactose left in it. There is some lactose left in all fermented dairy products, even in aged cheese. It is the probiotic microbes in your gut flora, which we are providing in kefir and other fermented dairy, which break the lactose up in your gut. Indeed, vast majority of people have no problem with tiny amounts of lactose left in their homemade fermented dairy. In particularly sensitive individuals I recommend fermenting yoghurt or kefir longer (36 hours or even more), which will make it taste very sour but will reduce the lactose content. As you progress through the

GAPS Programme and your gut starts healing, you may find that you can tolerate more and more lactose to the point of eventually trying raw milk and cream without fermenting them. I bought some sauerkraut from a holistic company, and it gave me a lot of gas and fermentation in my bowel. The company told me that sauerkraut was completely natural and organic. When I make my own sauerkraut I do not have these symptoms. Why? The sauerkraut you bought has not been fermented long enough. It has not completed the fermentation process, where enough lactic acid accumulates in the cabbage to suppress microbial activity and stop the fermentation. If the cabbage and other vegetables are still fermenting, they will continue fermenting inside your digestive system, producing gas and giving you unpleasant symptoms. This applies to sauerkraut, kimchi and all other fermented vegetables. Sauerkraut takes about 2-3 weeks at a room temperature to complete fermentation, kimchi and other vegetable mixtures may take longer. How do we know if the fermentation is complete? It stops producing gas, the vegetables taste sour and do not spoil at all at room temperature or in the fridge, even if they get dry. Are there any health conditions that would require fermented foods to be limited or avoided? Fermented foods are teaming with beneficial microbes, which cause a die-off reaction. At the same time they are full of active enzymes and active nutrients, which can initiate “detox” and healing restructuring of the tissues in the body. All three can cause discomfort and unpleasant symptoms. That is why it is important to introduce fermented foods slowly and gradually, starting from juice of a plain sauerkraut or vegetable medley. Avoid mixtures which contain chilli peppers or other spices initially, start from plain mixtures of just cabbage and carrot in sauerkraut, and cabbage, beetroot and garlic in the vegetable medley. Make sure that the fermentation process is completed: the gas production stops and the product is quite sour- tasting. To complete the fermentation may take a few weeks longer than the recipe states, because of various differences in the vegetables, the temperature and other factors. I find it easier to drink fermented veggie juice instead of the veggies. Is it beneficial to eat fermented coconut or apple cider vinegar with each meal? Can they be eaten in replacement of fermented solid veggies or are thy less beneficial? Will the consumption of these vinegars or lemon juice lower my stomach acid too much? It is absolutely fine to have fermented vegetable juices or juices pressed from fermented vegetables, as long as they have not been pasteurised. The same for vinegars: they are very beneficial to add to your water and to have between and with meals, as long as they are raw, not pasteurised. Many GAPS people find fibre a problem; and it may remain a problem for quite a long time, for some people for years. So drinking juices, rather than eating the vegetables is a good option for these people. The juice will provide probiotic

microbes, enzymes and all the other benefits of the fermented vegetables, but without the fibre. Consumption of raw vinegar or lemon juice will not reduce your stomach acid, just the opposite: they will stimulate its production and help your body restore normal stomach acidity over time. How long after making yoghurt do the beneficial bacteria stay viable? Is there a window of time in which a batch of yoghurt should be eaten? Should yoghurt be frozen? No, it is best not to freeze yoghurt, as it will kill a lot of the probiotic bacteria in it. Yoghurt stays alive for a very long time, in the fridge for a few months; it may continue fermenting very slowly and becoming more and more sour-tasting, but it will still be good for you, and it will still be good to use as a starter for making more yoghurt. So, if you are going away on holiday, for example, it is fine to leave your yoghurt in the fridge; when you come back it will taste very sour, but you can make new fresh yoghurt from it in 24 hours. Is Kombucha allowed on Gaps? How do you know when all the sugar has fermented out? Yes, kombucha is allowed, but I would not introduce it until you move to the Full GAPS diet. At that stage, if a little sugar is left in your kombucha, it will not do you any harm, as your gut will be strong enough to handle it. Just ferment it the usual way, so it tastes sour. What would be the optimal amount of kefir and or yoghurt to consume daily? Can over-consumption be a problem? The optimal amount is individual and should be found by gradual introduction of yoghurt and kefir, which is done as part of the Introduction Diet. Many people find two cups of yoghurt or/and kefir per day as a good amount; other people find that too much, yet many of my patients happily have much more than that per day. Over-consumption can swing a person, who used to be prone to diarrhoea to becoming prone to constipation. So, it is a matter of balance. If constipation has become an issue, then I recommend switching to fermenting cream, rather than milk: in many people that solves the constipation problem. Do fermented foods help fight parasites? Fermented food introduce beneficial microbes into the body, which will play their part in a very complex interaction of various microcreatures, who already live there. We do not know what exactly they do, but in a clinical setting regular consumption of fermented foods helps to eliminate digestive symptoms, caused by parasites. FOOD INTOLERANCE & SENSITIVITIES How can you tell the difference between die-off and food intolerance?

For example, how do you know if flatulence is caused by the meal you just ate or from the meal prior to that one? The die-off symptoms can be new symptoms or can be your usual symptoms getting worse, when you introduce new diet, probiotics or anti-parasitic, anti-fungal/anti-bacterial remedies. Food intolerance symptoms appear when you introduce new foods into your diet. If you have been eating a particular food routinely, which you suspect as causing food intolerances, remove it for 3-4 weeks, then try to eat it again. Your body will let you know if you are intolerant to it. Production of gas takes time; it is the pathogens in the gut (usually fungi) that convert food into gas. So, it is your previous meals that produced the gas. Every meal sends a propulsion reflex down the digestive system, so that gas in the bowel may be released when you are eating your next meal. Is it possible to be sensitive to bone broth? What should you do if you are reacting to bone broth? It is possible to be sensitive to any food, though sensitivity to bone broth is quite rare. Try to make different meat stocks and see if you can find one that you can tolerate: from a whole chicken, from a leg of lamb, from a joint of beef, from a whole fish (gutted, but with the head and tail), from pigeons, pheasants, a joint of venison, a joint of pork, etc. Make sure that not only bones are used but a good piece of meat on the bone. Make sure that you start with uncooked meat and bone and don’t mix meats from different animals: just make a chicken stock or a lamb stock, etc. Once a food has been successfully introduced without any negative reaction, can the sensitivity to that food come back in the future? It can, unfortunately. It all depends on how “leaky” your gut wall is at the time. Many factors can damage your gut wall: stress, parasites, cheating on the diet, getting run down, travelling, etc. If that happens, try to go back to the Introduction Diet and heal your gut again. How do you go about implementing GAPS for someone with severe meat allergies (except fish) – to the point that they get very ill immediately after ingesting them? What would be your plan of action? It is very rare to be allergic to all meats. Try wild game, such as pheasant, pigeon, quail, deer, wild boar, or whatever other wild meat you can get locally. We start from meat stock, made with these meats. Regardless of your experiments with wild meats, also make fish stock from heads, bones, fins and meat of large fish or whole small fish (about a kilo per a five-litre pan). Please, look for recipes in my book on how to make fish stock. Fresh water fish is very good, if it comes form clean lakes and rivers. Deep-water sea fish is preferable (such as herring, sprats and anchovies) to the coastal ones (such as cod and mackerel). Also avoid large carnivorous fish, such as tuna, shark or sword fish. Make sure to alternate varieties of fish; do not fall into a routine of eating the same species all the time.

Which symptoms should you push through and which symptoms are a sign that you should remove the food? If the symptoms are due to die-off, initiated by the introduction of probiotics, the diet or natural anti-parasitic remedies, then continue gradual increase of the remedies and gradual progression through the diet, keeping the die-off at a manageable level. If new symptoms appear after introducing new food, then you are not ready for that food (your gut lining is not ready). Remove the food, work on healing your gut lining with the diet and probiotics for a few weeks, and then try the new food again. What about phytates and other anti-nutrients in food? All foods contain substances, which can be damaging to the human gut and the rest of the body. Plants contain phytates, lectins, oxalates, salicylates, phenols and who knows, what else. Animal foods are largely made of proteins, every one of which can cause allergies. So, should we stop eating at all? It is a matter of what you can digest and assimilate at any particular point in your life. Even people, who consider themselves healthy, have periods in their lives when they are run down or under stress. These are times to be kind to your digestive system and not eat things, which are hard to digest. Following the GAPS Introduction Diet allows people to heal their gut by eating easily digestible foods, so later they can safely introduce foods, which are harder to digest. In your book you mention that GAPS people often have an overgrowth of sulphate-reducing bacteria. If I suspect this to be the case in my child, should I avoid feeding him foods that contain high amount of sulphur? No, do not remove sulphur-containing foods! Sulphur is essential to re-build you child’s gut, immunity and liver function. GAPS people are already deficient in sulphur; they cannot get enough of it. As the gut flora starts changing the beneficial microbes will take care of the pathogens and normalise your child’s sulphur metabolism. Even the smallest amount of any probiotic food or supplement causes me severe bloating, fatigue and pain. How do I do the diet if I can’t take probiotics? Are there any conditions where probiotic are not recommended? People suffering from ME, chronic fatigue syndrome, fibromyalgia and some other debilitating conditions often have difficulties introducing probiotics. The reason for that is the die-off effect: it is so severe in this group of patients that they find it very difficult to cope with. Just start from a tiny amount and go up very slowly. I have patients who start from 1/18 th of a capsule of the Bio-Kult (or as much powder as would fit on the end of a sharp knife), and it takes them months to get up to one capsule per day. The same with fermented foods, start from a tiny amount per 5-7 days; as your

body gets used to that amount, start taking it a bit more frequently. When you can take that tiny amount every day, start increasing the dose. Proceed in this very slow manner. It is important for you to introduce probiotics in the form of food or supplement. You just have to go slowly. GAS/FLATULENCE As far as I understand, gas is a sign of fungi presence in the gut. Should one go back to the second stage of Intro and stay on it until there is absolutely no gas? Does one have to eliminate gas completely in order to heal his gut or will it just heal over the course of time? Yes, gas is produced largely by fungi in the gut. Some amount of gas is normal, but not too much. You do not have to go back to the Intro diet, but just remove foods for a while which may be feeding fungi: fruit, nuts and baking. HAIR Why do some GAPS patients experience tooth discoloration and hair loss? Tooth discoloration and hair loss are very rare in GAPS patients, and usually happen in very toxic people, particularly people with metal toxicity. Hair and teeth are those places where the body often stores toxins in. Many things happen in the body, as the GAPS program is initiated. We don't know what happens exactly, but it is possible that the hair, full of toxins, get dropped by the body to allow new "clean" hair to grow. With teeth: I have seen autistic children who had their permanent teeth growing with black spots imbedded in them. One particular boy displayed noticeable improvements in his autism in the weeks following the removal of the black spot by the dentist. It is possible that his body had stored mercury from vaccinations or some other toxins in the growing tooth. We don't know what happens exactly, but it is likely that the detoxification initiated by the GAPS Nutritional Protocol starts shifting the toxins around, which may be the cause of tooth discoloration in the initial stages. In the long run, however, your child is likely to grow beautiful whit teeth, as I have seen in so many GAPS children. Can the GAPS diet help with alopecia? Alopecia can be caused by many things: nutritional deficiencies, allergy, hormonal imbalance, toxicity, auto immunity, diabetes, vascular abnormalities, etc. No matter what the cause, following GAPS will help to balance your hormones, remove nutritional deficiencies and toxicity, re-balance immunity and improve circulation. So, give it a try.

HEADACHES Chronic headaches - is this a sign of GAPS? There are many different forms of headaches. Migraines often respond to GAPS treatment well. Headaches due to high blood pressure will respond well, as most cases of hypertension are due to magnesium deficiency, which GAPS programme will eliminate. Many headaches are due to food allergy and intolerance. Healing the gut will eliminate the allergy and the headaches. Many headaches are hormonal: abnormal gut flora upsets the hormonal balance in the body, leading to headaches. GAPS programme will allow your body to bring the hormones into balance. Most headaches, no matter what origin, have a toxic component to them. Most toxins in the body come from the gut, so healing the gut and cleaning it up will reduce the toxic load in the body and help with headaches. Many headaches have a tension component to them due to our fast-paced stressful lives. The GAPS diet will nourish the adrenals and allow the body to cope with tension and stress much better. But good sleep, enough sleep, and giving yourself some time every day to do something relaxing and pleasant just for you, will help with all forms of headaches. HEART DISEASE Dr. Campbell-McBride advocates eating animal fats and cholesterolrich foods. What about heart disease? To understand fully how and why heart disease develops please read my book, "Put your heart in your mouth! What really is heart disease and what we can do to prevent and even reverse it." The idea of fats and cholesterol-rich foods "causing" heart disease and other manifestations of atherosclerosis stems from an infamous DietHeart Hypothesis, first proposed in 1953. Since then the science and clinical experience has proven this hypothesis to be completely wrong. However, since 1953 a large political and commercial machine has been built based on this hypothesis: these powers do their best to keep the mistaken diet-heart hypothesis alive for as long as possible. It has been proven that natural animal fats, dairy fats, eggs, fresh fish and other natural sources of cholesterol have nothing to do with heart disease and are essential to health. It has also been proven that all artificial fats vigorously promoted to the population, such as all cooking and vegetable oils, margarines, butter replacements and other processed fats cause heart disease, cancer, diabetes, psychiatric and neurological disease and many other health problems. GAPS patients require a lot of natural fats and natural cholesterol in their diet in order to restore their brain function and immune function. ILLNESS & MEDICATIONS What should I do if I get a "tummy bug" while on the diet?

If you or your child gets a "tummy bug" or any other kind of diarrhea remove all nuts, raw vegetables and raw fruit out of the diet. Stay on a low fiber diet: meat stock, meats, fish, eggs, fermented dairy and cooked vegetables (skinned, de-seeded and well cooked with meats as soups and stews) and cooked fruit until diarrhea completely clears. After stools stay normal for a week at least, re-introduce raw fruit and vegetables slowly, one at a time and starting from small amounts. Do OTC (Over the Counter) medications for cough, cold, flu and fever have a negative effect on the digestive system? What do you recommend parents give their children for these conditions? Over the counter drugs for colds do have a negative effect on the digestive system and the immune system. Apart from the drug itself they contain sweeteners, flavours, fillers, binders and other ingredients, which will do you or your child no good. What do I recommend instead? I cover this subject in the chapter on ear infections in the GAPS book - I recommend plain aspirin. Aspirin is one the safest medications known to man. However, in the last few decades the pharmaceutical patent has run out on aspirin, so it became unprofitable for the manufacturers. So, they needed to replace it with new drugs which have fresh patent (paracetamol, ibuprofen, etc.). In order to convince the public and the medical profession to replace aspirin (one of the most trusted and proven medications on Earth) with their new drugs, they had to vilify aspirin. So aspirin was attached to a very rare condition with a scary list of symptoms, called Reye’s syndrome: the symptoms range from vomiting and neurological impairment to liver damage. Reye’s syndrome was first described as a consequence of a severe viral infection in malnourished children. Apart from viruses a long list of chemicals can cause this condition: pesticides and insecticides, aflatoxin, alcohol, emulsifiers, tetracyclines, valproate, warfarin, isopropyl alcohol, pteridines, hypoglycine and other chemicals, widely present in our personal care products, domestic cleaning products, pharmaceutical drugs and food. The association of Reye’s syndrome with aspirin is dubious to say the least and has been criticised by many experts at the time. But because aspirin has become unprofitable, the pharmaceutical industry used whatever little evidence they had to withdraw aspirin from use in children, while in adults the use of it now comes with dire warnings in large print; and every pharmacist selling aspirin has been instructed to question the buyer about how much they buy and for what use. The drugs which replaced aspirin are far more dangerous than aspirin can ever be. For example, paracetamol is the most common drug in suicide, as an overdose of it can irrevocably destroy the liver; ibuprofen is known to cause heart attacks and other heart trouble. Aspirin should not be taken on an empty stomach, so I recommend to have some hot meat stock with fermented dairy (sour cream is the best) prior to taking aspirin or with it. For children I recommend getting soluble aspirin (the usual dose is a tiny tablet of 75mg); dissolve one tablet in some camomile tea with a bit of honey. Give some of this tea to your child fairly hot from a teaspoon; in small children a few teaspoons can be enough to reduce high temperature

and make the child feel better. Alternatively, you can dissolve aspirin in a cup of hot chicken stock and give it to your child the same way as the chamomile tea. Keep your child wrapped up warm, let him or her sleep as much as possible, and the cold will vanish quickly. If you are working with an experienced homeopath, you can get some remedies for colds, which can also be quite effective. INSOMNIA Is insomnia a common die-off response? Do you have any recommendations for overcoming insomnia? Many toxins coming from the activity of unhealthy gut flora disrupt our neurotransmitters in the brain. Neurotransmitters are chemicals which brain cells use to communicate with each other, such as serotonine, adrenalin, dopamine, melatonin, endorphins, etc. – there are about a hundred neurotransmitters discovered so far. Die-off releases more toxins than usual and, if a person has a problem with neurotransmitter disruption already, then it will get worse. One of the functions of neurotransmitters is regulation of sleep. Serotonine, GABA and melatonin are the three neurotransmitters connected with sleep and relaxation in particular, and it is a good idea to boost their production with supplements, if insomnia is a problem. To boost serotonine production we need an amino acid 5HTP (5hydroxytryptophan), for GABA we need taurine and glutamine. These amino acids need co-factors to be converted into neurotransmitters: niacin, vitamin B6, folic acid, biotic, zinc, magnesium, vitamin B1, vitamin B12 and pantothenic acid. There are supplements on the market, which contain all these ingredients with about 100mg of 5HTP, 500mg of glutamine and 500mg of taurine. Always start with a low dose and build gradually; the optimal dose is very individual. In many people just boosting production of serotonine and GABA is enough to remedy insomnia. If it is not enough, then try to add melatonin. Melatonin is produced in the brain at night, however in order to produce it in the dark we need a good dose of light during the day. Spending some time in bright sunlight every day will boost your melatonin production (no sunglasses, as the light needs to reach the brain through the eyes). Supplements of melatonin are available ready made; start from a low dose at bedtime (1-3 mg) and, if it is not making any difference, slowly increase the dose. INTRODUCTION DIET Once the Introduction Diet is completed, is there a scenario where one should go back on the GAPS Intro Diet? Yes, there is, and not just one. People get tummy bugs, travel diarrhea and other infections, which can damage the gut. People have to take antibiotics or other drugs for various reasons, which can throw you back quite a bit. Stressful situations in the family or work can weaken the whole system and bring symptoms back.

Going back through the Introduction Diet helps to eliminate those problems quickly and without any complications. How long should you expect to be on the Introduction Diet? Is it harmful to be on it for too long? What should individuals do who find themselves stuck on a particular stage for an extended period of time? It is very individual how long to stay on the Introduction Diet and how quickly to move through it. Some people get through in a matter of a few weeks, others take months. It depends on the severity of the condition. Some people get through it and feel well on the Full GAPS Diet, then something happens (an infection, a stressful situation or an accident), and the person finds it necessary to go back to the Introduction Diet for a while. As long as plenty of good quality animal protein and fats are consumed and freshly pressed juices, there is no harm in adhering to the Introduction Diet long term. If you find yourself "stuck" on a particular stage, it means that the pathogens in your gut need more than the diet and probiotics. So, it makes sense to explore natural anti-parasitic and anti-fungal/anti-bacterial remedies to bring the pathogens under control. There are many good remedies on the market, such as oregano, olive leaf extract, grapefruit seed extract and herbal mixes. It is important to introduce natural remedies gradually, controlling the die-off reaction; start with one remedy, then add others one by one. Many people find that taking under control worms and other parasites with natural remedies allows them to move on through the Introduction Diet. Some people find relief with mainstream antifungal, anti-parasitic and anti-bacterial medications. The trouble is that drugs cannot be taken for long periods of time, as they are toxic and have side effects. If they work, they may provide an immediate relief but, when they are stopped, the problem may come back fairly soon. Natural remedies can be taken for long periods of time without harm, that is why it is a good idea to start with natural remedies, continue taking them through the drug treatment and to follow with the natural remedies when the drug has been stopped. When should supplements be introduced during the Introduction Diet? Which should be introduced first: probiotics, cod liver oil, fish oil, nut/seed oils? In the first two stages of the Introduction Diet I recommend not to introduce any supplements, just introduce fermented foods. In a small number of patients no fermented food can be tolerated, so for these patients I recommend introducing a probiotic gradually starting from a tiny dose. From the third stage, if fermented foods have been successfully introduced, you can start introducing the probiotic and the cod liver oil in tiny amounts, gradually increasing the daily dose. When cod liver oil has been introduced (the full dose is taken daily), introduce fish oils. When olive oil is being introduced, you can introduce cold pressed nut/seed oils gradually with meals. For those who started from the Full GAPS Diet, probiotics and cod liver oil can be introduced from the beginning, starting from a tiny amount and gradually increasing the dose. When cod liver oil has been successfully introduced, start the fish oils and the nut/seed oils.

Some families report vomiting during the Introduction Diet as a die-off reaction. Can you please address this issue and how families should proceed? Vomiting can be a sign of hypoglycaemia: as we cut out many carbohydrates in a person with an overgrowth of yeast, it is easy for the blood sugar to drop too low. In that case give your child some apple or orange juice and see if it helps. Freshly pressed juice from apple or orange with carrot is best, but if the situation is urgent use a commercial juice. If this measure helps, then use this juice in as small an amount as possible to remedy the nausea and vomiting, when it happens (ice lollies or ice cubes, made in advance from freshly pressed juice, may provide immediate help). In the long run stick to the diet and make sure that your child has plenty of animal fats: they will regulate the blood sugar level. Allow your child to eat often and in small amounts (to graze) to keep the blood sugar steady, rather than insisting on set meal times. As the die-off subsides, so will the nausea and vomiting. Ginger tea is a known remedy for nausea; use it as a drink between meals. Since starting GAPS Intro 2 weeks ago I have noticed what looks like a fine white powdery substance in my urine. There is not a large quantity, but enough that it’s noticeable to me. A few of us on the message board have had this symptom and I’d like to know if it is something I should be concerned about or see my medical doctor for? It would be a good idea to test your urine, when you notice this powder in it, as it may be a number of things: calcium salts, oxalates, protein complexes or something else. The important thing to observe is how you are filling: if you feel well then probably there is no need to worry. GAPS Introduction Diet initiates a clearout of toxins from the body; these toxins can precipitate various salts in urine and fall out as a white-looking powder. How do patients progress if they only tolerate a very limited diet? Food intolerances are due to damaged gut lining. If you cannot introduce a particular food, it means that your gut lining is not ready for it. Please read Food Allergy to learn more. It makes sense to look at taking pathogens under control (please look at other FAQs on this), because these pathogens may be interfering with the healing process in the gut. Why is carrot juice the first juice we need to tolerate before moving forward with juicing? When can one introduce citrus juices? Carrot juice is the basis of all juices - it is very therapeutic, gentle on the gut lining and tasty. That is why it is introduced first. Orange or grapefruit juice is quite acid and has other irritating substances in it, that is why I recommend to introduce it on the Full GAPS Diet, when quite a bit of healing has happened in the gut. A bit of fresh lemon squeezed into a glass of water is usually tolerated well and can

be introduced earlier, as well as a little of raw cider vinegar added to water. Just make sure that diarrhoea has cleared first. Ketosis and GAPS. Is it induced via GAPS Introduction diet? Is it a danger in doing GAPS Intro? Is it one and the same as die-off? How to prevent it? There is a popular myth that sugar is the main source of energy in the body; this myth has been created by commercial companies selling sugary foods and drinks, and by funded by them “research”. Mainstream nutritional institutions are funded by food industry, so they are the main propagators of this myth. Here is the truth: vast majority of all cells in the body use fats as a source of energy: your heart, your muscles, your inner organs, etc. Whenever fat is used as a source of energy ketone bodies are created. There is no need to fear ketosis, as we all have it now and then almost every day (it is very different from diabetic ketosis, induced by non-functioning pancreas). It is possible that during the Introduction diet there will be periods of ketosis, but don’t worry about it as normally you would not feel it at all. Eating vegetables will prevent ketosis. Ketosis is not the same as die-off. How long should it take on the GAPS diet for under eye darkness to disappear? If one has completed the Introduction diet and darkness is still there is this a sign that something was not done correctly? Dark circles around eyes is a sign of toxicity and allergy. GAPS programme is a journey, some people find that they get better quickly, others need more time and other interventions, such as chelation of heavy metals, neutralisation of allergies, etc. Consider GAPS programme as a basis for your recovery, a foundation of your health. For many people GAPS is all it takes to get well. For others, after building the foundation, they have to build other structures on top of it to get completely well. How long should you expect to be on the diet before you notice improvements? I know this can be very individual but is there an amount of time where if you have not seen any improvements the diet might not be right for you? This is very individual and your choice. Give the diet 6 months, if you do not see anything happening, try to stop it. Some of my patients found that when they stopped the diet, they realised that it was working! JUICING In the GAPS book you recommend juicing greens such as kale, spinach and cabbage among other vegetables. However, it is my understanding that some vegetables contain anti-nutrients, and should thus be primarily consumed cooked (for example cooking spinach reduces oxalate content). How is juicing such vegetables beneficial?

All foods contain anti-nutrients, plant and animal. The beautiful thing is that spinach is not made from oxalates only: it contains hundreds of other substances in a natural balance. Some of these substances are known to prevent cancer and to clean the liver; if you cook spinach these substances will be destroyed. We don’t make juice just from spinach either, we add other fruit and vegetables, and we can also add raw eggs and sour cream to the juice to balance it further. It is all a matter of balance and personal sensitivity. If a person has particular sensitivity to oxalates (burning urination for example), then oxalate-containing foods need to be avoided until the gut heals enough to be able to handle them. But if there is no such sensitivity then there is no need to be afraid of spinach or cabbage or broccoli or any other food just because some anti-nutrient has been found there. I find it too expensive at this point to be juicing for six people on the diet. Is there any benefit in using non-organic veggies for juicing or would it be better to skip the juicing because of the pesticides, etc? I know organics are preferable, but until the summer, we can’t afford the expense. Organic produce in our supermarkets is expensive! But that is not the only problem with it: most of this produce comes from large industrial farms, which use exhausted soils. As a result their organic fruit and vegetables may not contain pesticides, but they do not contain much useful nutrition either. Non-organic fruit and vegetables in the supermarkets are not as expensive as the organic ones, but they are devoid of nutrition and full of pesticides, which in reality makes them really expensive for your body. Supermarkets are not a good place to buy fruit and vegetables. It is best to find local produce, grown in people’s private gardens, allotments and small farms. They may not be organic (though these producers do not use much in a way of chemicals), but they will be rich in minerals and other nutrients; and the price will be much lower. Don’t worry if you are not juicing at the moment. Perhaps, next summer you can find good local producers and stock up with inexpensive, but nutrient-dense local fruit and vegetables. KETOSIS Ketosis and GAPS. Is it induced via GAPS Introduction diet? Is it a danger in doing GAPS Intro? Is it one and the same as die-off? How to prevent it? There is a popular myth that sugar is the main source of energy in the body; this myth has been created by commercial companies selling sugary foods and drinks, and by funded by them “research”. Mainstream nutritional institutions are funded by food industry, so they are the main propagators of this myth. Here is the truth: vast majority of all cells in the body use fats as a source of energy: your heart, your muscles, your inner organs, etc. Whenever fat is used as a source of energy ketone bodies are created. There is no need to fear ketosis, as we all have it now and then almost every day (it is

very different from diabetic ketosis, induced by non-functioning pancreas). It is possible that during the Introduction diet there will be periods of ketosis, but don’t worry about it as normally you would not feel it at all. Eating vegetables will prevent ketosis. Ketosis is not the same as die-off. LIVER & GALLBLADDER What liver support would you recommend for GAPS patients? Many patients report struggling with congested / toxic livers adding to digestive problems such as constipation and fat digestion. Please look at the question on gallstones. GAPS people usually have lots of gallstones blocking the bile ducts. Without good flow of the bile we cannot digest fats. Three measures over time will remove the stones and restore normal bile flow. Juicing is one, particularly apple, celery and green juices. Adding some herbs to your juices will support the liver: fresh dandelion leaves, roots and flowers, burdock leaves and a little ginger root. Coffee enemas are the number two: this procedure makes the liver cleanse itself and flush the toxins out through the bile, removing the stones at the same time. Third - good amounts of fat in every meal: the fat stimulates the bile flow and removes the bile stones on a daily basis. If initially you are unable to digest fat, start from a small amount with every meal and gradually increase: use both animal fats and cold pressed oils. In the initial stages supplementing Ox Bile with every meal will help you to digest fats (you should be able to find supplements of ox bile with some additional digestive enzymes from most multi-supplement companies). There are herbal supplements for liver support on the market containing milk thistle, dandelion, phyllanthus, liquorice, burdock and other herbs. It is important to complete the Introduction Diet first before trying these supplements; it is also very important to find a supplier of good quality organic herbs to make sure that the herbs have not been grown in areas contaminated with lead or other industrial pollution. What effect does caustic bile have on inflammation in the gut? How does one manage a situation whereby one cannot tolerate any die-off or foods or supplements that have an impact on detox pathways (sulphur, amines, salicylates, glutamate, etc), when their liver is jammed and thus struggle to do any gut healing? Conversely if the liver and gallbladder are supported, such that bile flow is improved, how can one avoid or reduce the abrasive nature on the gut of toxic bile? Please, view FAQs on liver support, these will explain to you why your liver may not be functioning well, and what to do in this situation. If the person is eating enough fats with meals, the bile will be handled properly by the gut, even if toxins are present in the bile. LYME DISEASE

Many people are coming to the GAPS diet with or after having been treated for Lyme disease. What are your recommendations for these individuals? I recommend that you follow the Introduction Diet. If you find it too difficult, then implement the Full GAPS Diet first; you may be able to do the Intro diet later. The standard treatment for Lyme disease is antibiotics, lots of them. So, the gut flora in these people is damaged and needs restoring. NAUSEA & VOMITTING What is your advice for those of us who suffer from nausea after eating moderate amounts of fat with meals? What causes this and what are the immediate and long-term remedies? Please, read the sections on gallstones and liver. When you are unable to release bile for fat digestion, you may feel nauseous and find it difficult to digest fats. Take ox bile with your meals for a while and introduce fats gradually. Eating fermented vegetables with your meals, particularly at the beginning of your meals will also help.

NUTRITION Will the GAPS diet provide all the necessary minerals needed, even for those with proven or suspected mineral deficiencies? Mineral metabolism is complicated: it is not just a matter of intake of minerals. To be absorbed, minerals require acids, which are produced by healthy gut flora. To be utilised appropriately by the body, minerals require fat soluble vitamins A, D and K. If a person is deficient in those vitamins and suffers from gut dysbiosis, then no matter how many mineral supplements he or she takes, and no matter how rich in minerals the diet is, those minerals will not be utilised appropriately. Another big issue is that the body accepts organic minerals only in complex with protein and amino acids. Many mineral supplements supply inorganic minerals, which the body cannot utilise. Mineral water is not a good source of minerals either, as it contains inorganic minerals and in tiny amounts. The best source of minerals is natural good quality food: meats, organ meats in particular, fish, eggs, fermented dairy, fermented or cooked vegetables and fruit. Fresh food provides minerals in an organic form packaged with amino acids and, in the case of animal foods, fat soluble vitamins. Just make sure to buy good quality foods: organically grown and from free-range animals, raised on natural pasture. The GAPS program works at normalizing the gut flora, so it can assist in absorption of minerals, and the GAPS diet provides ample amounts of fat soluble vitamins to process them properly. Some people find it helpful to supplement particular minerals for a while, following testing. An excellent natural balanced source of all

minerals and trace elements is seaweed. It is illegal on SCD, on GAPS I allow it to be introduced once severe digestive symptoms are gone. [Seagreens seaweed products are the only certified organic seaweed products available. Please go to the GAPSdiet online store for more information.] PARASITES & WORMS Is the GAPS diet beneficial to someone who has the Blastocystis parasite? The parasites like carbohydrates, so it seems that this is an ideal diet to get rid of them. However, I hear that the blastocystis eat and live on probiotics, so the fermented vegetables and probiotic supplements could make the parasites thrive? What are your recommendations for getting rid of blastocystis? Blastocystis hominis is a protozoan, which we can get from food and drink, other people or animals. In majority of people it causes no problems, but in people with weakened immunity and abnormal gut flora, it can cause diarrhoea, bloating, nausea, abdominal pain and anal itching. Many other symptoms have been attributed to this parasite as well. Mainstream treatment involves various antibiotics, often combinations of them; but unfortunately there is no unified effective treatment to eradicate it. I have stated my opinion on parasites in other questions or worms and parasites: we all have parasites in our digestive systems. They are a part of our gut flora, so there is no need to fear them or to attack them without good cause. Work on your gut flora using GAPS Programme, get it in balance and all the micro-creatures there will control each other. If you got an acute infestation with this parasite, then a short antibiotic treatment may be helpful. In chronic cases antibiotics are usually of no help; they will only damage your gut flora further. You recommend Ovex for worms. Here in the USA it is available as Vermox by Rx only. Can we use herbal preparations for worms? What about tapeworms? I recommend Mebendazole, 100mg (available in Europe as Ovex or Pripsen) as an easy and quick option for common worms, like hookworms, pinworms and some round worms. Take 2 tablets per day (chew one in the morning and one in the evening) for 3 days, repeat this course after 10-14 days to kill remaining eggs. Worms generally are nearly impossible to eradicate, they almost always come back. Herbal preparations work while you take them, but as soon as you stop, these kinds of worms usually re-surface, as they do after Ovex as well. The advantage of Ovex is that it works in 1-3 days, where herbal treatment takes months. Ovex does not address tapeworms. Those are more difficult to remove and for those I would recommend a medication to start with, then followed by herbals. Generally speaking, we all have worms. The important question is: are they affecting your health? If yes, then it is a good idea to fight them. But if they do not bring any symptoms, then there is no need to attack them, as they are a part your inner eco-system and may fulfil some useful roles, such as regulating immunity and

preventing autoimmune disease. The typical symptoms of common worms getting out of control are crampy pain in the middle of your abdomen, particularly after food in the mornings, difficulty putting weight on, persistent anaemia (usually hookworms) and bouts of irritating dry cough (the larvae travel up the breathing passages into the throat to be swallowed again). Many GAPS patients are struggling to fight various forms of parasites. What foods should be avoided to help starve the parasites, such as a roundworm? Processed carbohydrates, sugar and other processed foods feed parasites. These foods are not allowed on the GAPS diet. However, parasites are adaptable, if you deprive them of one food source, they will use another. Generally speaking, worms and other parasites are an inevitable part of life, everybody has them. In the majority of people they cause no symptoms and, unless they cause problems, there is no need to attack them. Worms may fulfill some useful functions in the body by controlling other microbes and stimulating immunity. For example, it has been discovered that some worms have a balancing effect on the immune system and may prevent autoimmunity. For those with a history of worms, can Vermox be used preventatively? Is it harmful to do 2-3 treatments a year? Yes, it can be used preventatively 2-3 times a year. Do fermented foods help fight parasites? Fermented food introduce beneficial microbes into the body, which will play their part in a very complex interaction of various microcreatures, who already live there. We do not know what exactly they do, but in a clinical setting regular consumption of fermented foods helps to eliminate digestive symptoms, caused by parasites. For pet owners, while there are many benefits, should there be any concerns about picking up parasites? Should any precautions be made when living with pets? Pets are wonderful: they provide an unconditional love for the whole family, and they provide stimulation for the immune system. The important thing is to have healthy pets, and in order to do that they must be fed properly. Dogs and cats have not been designed to eat grains or soy. Commercial pet foods are largely made out of grains and soy; that is why, thanks to the commercial foods, our dogs and cats get arthritis, autoimmune disease and cancer. On top of that they get skin problems, such as dermatitis and eczema, shedding allergy-causing dandruff. Feed your pets the way Nature has designed them to eat, and you will never need to worry about your pet’s health. Cats do best on raw meat with fat on it, raw milk, raw fish and raw liver. An occasional leftover of cooked meat and fish will do them no harm. Dogs do very well if you mix raw minced meat (with good amounts of fat) with some finely chopped raw carrot and

live yoghurt. Raw eggs, raw milk and raw fish should also be a regular part of their diet. Cod liver oil and fish oil are very good for dogs, particularly in winter. Occasional cooked vegetables and meat, left over from your dinner, will also do your dog no harm. You will find that feeding your dog and cat that way will cost you less, than buying commercial pet food, and you will save a fortune on vet’s fees. Worm your dog or cat once every 6-8 months, and don’t worry about parasites: we all have them and no less than our dogs or cats. PREGNANCY & NURSING Any special recommendations for pregnant women? For pregnancy, the diet is very important. The birth canal also needs to be prepared for birth by populating it with beneficial bacteria. To do that, apply live yogurt or kefir on your genital area after you bathe, particularly in the last trimester. Also apply kefir or yogurt on your breasts and armpits. Every 2-3 weeks, insert 1-2 capsules of Bio-Kult in the vagina at bedtime, particularly if there are any unpleasant symptoms in that area. The introduction diet is not recommended for pregnant and breastfeeding mothers. For those women starting the diet at this stage, should fermented dairy be avoided? Should these women follow the long dairy introduction? If you have been eating good quality dairy products before your pregnancy, when starting the diet you do not have to go through the Dairy Introduction Structure (p.121 in the new edition of the GAPS book), just continue consuming fermented dairy products. If you were not eating dairy products before, then it is a good idea to follow the Dairy Introduction Structure, but introduce ghee and butter straight away, as they will provide you and your baby with very valuable nutrients. When ghee and butter are well tolerated, gradually introduce homemade sour cream. After the sour cream you can try to introduce full-fat cheese. It is the dairy fats you need the most during pregnancy, so go for the high-fat dairy foods. Should juicing be done by pregnant and nursing women? Yes! To avoid any reactions, start slowly from small amounts of juice per day and gradually increase. It is a good idea to balance your juice with fat and protein by making GAPS milkshake: make a juice from a mixture of fruit and vegetables, then whisk 1-2 raw eggs into it and a generous dollop of homemade sour cream. Do you recommend any special supplements during pregnancy? What about a multivitamin? During pregnancy the most important supplement is good food, particularly natural animal fats, meats, fermented dairy, eggs and liver. These foods will provide fat-soluble vitamins, all B vitamins, lots of folic acid and all other essential nutrients. Add good quality

vegetables and fruit, a bit of seaweed, and you will have everything you need. Eating liver daily is particularly important in pregnancy; for example, it is still traditional in France and Belgium to give pregnant women liver pâté on a daily basis. It is best to eat fermented foods daily, but if you cannot eat them for whatever reason, take a commercial probiotic. If you are not eating enough high-fat animal foods, take good quality cod liver oil. Spend at least 3 hours per day in the fresh air in the sun. Sunbathe, if possible; the sun will provide you with plenty of vitamin D and many other benefits. We are all bombarded by marketing of various supplements; women produced healthy babies for millennia without any supplements, just by eating well, sleeping well and spending most of their days outdoors. I understand the dangers of doing Intro while nursing. Do you have any advice on what to do if eating the full GAPS diet (nuts, dairy, eggs, coconut oil, etc) causes reactions in the Mother? Do these not get passed on in the breast milk as well, and cause reactions in the baby, if the baby is also intolerant to them? Yes, this is a serious concern. That is why it is best to do the programme before conception. But of course life is not planned and predictable, and some women have to start the diet while pregnant or nursing. Just do your best to keep your gut working well by eating homemade soups and stews made with meat stock every day. Make sure to eat plenty of animal fats. Avoid raw nuts, soak them overnight in salty water and use them in baking – this way they are easier to digest. If you are reacting badly to certain foods, then avoid them. Limiting fibre in your diet, which means limiting raw plant foods, will reduce food intolerances and reactions. You can have all the benefits of raw fruit and vegetables making juices from them. Eat your vegetables well-cooked as a soup or stew. Concentrate largely on eating animal foods (meat, fat, eggs, organ meats, fish, high-fat dairy), as they are easy to digest, and they provide concentrated amounts of nutrition for you and your baby. If you are eating dairy, concentrate on having high-fat products, such as butter and ghee, sour cream and natural creamy cheese. RESTLESS LEG SYNDROME Can Restless Leg Syndrome be helped with GAPS? Yes! This unpleasant condition is due to lack or abnormal metabolism of magnesium in the body; often both are involved. Just supplementing magnesium may not help, as the toxins in the body interfere in its functions. Nevertheless, try to supplement magnesium and continue with the GAPS programme, which over time will remove toxins from your body and improve magnesium functions. Another thing to consider is dentistry: though your legs seem to be far away from your teeth, the restless leg syndrome is often caused by metals in your mouth (in dental fillings, bridges and crowns). Nickel, gold, silver, titanium and of course amalgam can create a condition, called oral galvanism. Simply put, oral galvanism is like

having an active electric battery in your mouth, with currents between different teeth. The electricity in your mouth is picked up by your nervous system, causing very unpleasant symptoms far removed from the teeth, such as in your legs, arms and elsewhere. A good environmental dentist will be able to measure electric currents in your mouth. SCD (SPECIFIC CARBOHYDRATE DIET) SCD vs GAPS? As I explain in my book Gut and Psychology Syndrome, GAPS has evolved from SCD. When my book was first written, Elaine Gottschall read it and was very complementary about it. We never met, but we corresponded regularly and I would say, that we had a professional friendship. It is up to every individual to decide what is right for him or her: SCD or GAPS. I have many patients who used to be on SCD, and then switched on to GAPS with good results. Also GAPS is not just a diet, it is a Nutritional Programme. SUPPLEMENTS & VITAMINS Can Bio-Kult be given to infants? Probiotics are safe at any age. New born children get their first dose as they emerge through the vaginal canal and further inoculations from sticking dirty fingers into their mouth. The dose needed for an infant is basically enough to get through the stomach - 1 or 2 capsules daily is probably enough in most cases. You can't overdose - you just won't get any extra benefit from giving more than is needed and it will cost more! [Please consult your healthcare practitioner before giving any supplements to infants.] Who should take Betaine HCl with Pepsin? Not everyone should take Betaine HCl right from the beginning, particularly children. In many GAPS people, stomach lining can be too sensitive to tolerate it. Usually for children it is not recommended at the beginning at all; later on if there is excessive burping after food, which will indicate low stomach acid, it may be introduced. In adults, it is recommended for people with excessive burping. You may want to introduce the Betaine after the meal, (not at the beginning as it usually indicates on the label) to avoid burning the stomach. When a good amount of healing has taken place, the person can start taking it at the beginning of the meal. Is castor oil recommended? Not routinely. An overnight application of castor oil on the abdomen of the person, covered with a hot towel and a hot water bottle can be helpful in cases of chronic constipation. Some chronically constipated people find it helpful internally.

Is colloidal silver safe and do you recommend to use it? No, I do not. Silver accumulates in the body: people, who take it for long periods of time get a grey skin colour. It is a very old antiseptic; it was proposed around the same time when mercury was used as an antiseptic. It is indiscriminate in attacking the microbes: it attacks the good and the bad, just like antibiotics do. Are there any specific recommendations for a good seed/nut oil blend? You do not have to find an exact ratio of omega-3 to omega-6 in the oil, just make sure that it is pure and good quality and has more omega-3 fatty acids in it, than omega-6 (we get quite a lot of omega6 from nuts). Aloe Vera and Seaweed? These products should be avoided by those with severe digestive issues. Once your digestive system is fairly healed through the GAPS protocol, Aloe Vera and Seaweed can be slowly introduced if desired. Is nutritional yeast GAPS legal? Yes, some species of yeast are allowed, providing that the person is not allergic to it, as some people with yeast overgrowth can be. Kefir contains yeast species (which are recommended for the majority of patients) and in many patients S. boulardii is recommended as a supplement, which is also yeast. If an individual seems to be sensitive to one of the recommended supplements, how should you proceed? Many people report having difficulties with cod liver oil. There are several reasons for why a supplement may disagree with you (providing that the supplement is of good quality and works at all). It may cause a detox / healing reaction, which in the long run may be better for you, but at the moment is too severe. In the case of probiotics it may be a die-off reaction. Or it may be just unsuitable for your health condition or constitution. Strictly speaking supplements are not 100% essential; it is the GAPS diet that will do the work for you. So, if a supplement is causing a serious reaction, just stop it and give all your attention to the diet for a few months. Then, when your digestion is considerably better and you feel that a particular supplement may be of help now, try it again, starting from a tiny dose. Cod liver oil, other fish oils and evening primrose oil may be problematic for people with seizures, tics, Tourette and other involuntary movements. We don’t know why: whether some healing restructuring of the brain gets initiated by these oils or some other mechanism is at work, but the seizures can get worse; so, it is a good idea to avoid these oils in people with involuntary movements. With probiotics: control the die-off by starting from a very small dose and increasing the dose very gradually. If no

amount of probiotic can be tolerated, then work on fermented foods first as part of the diet. It is a good idea with all supplements to start from a small dose and build the dose up gradually, observing your body. We are all different, we all have unique physiology; a supplement that worked for your friend is not necessarily going to work for you the same way. Is Bentonite Clay GAPS legal and is it recommended? No, it is not recommended to use bentonite clay, particularly when digestive symptoms are present. When you have been on the Full GAPS Diet for a while and your digestive symptoms are gone, then you can experiment with nutritional supplements and remedies (such as bentonite clay), if you feel that they may be helpful to you. How should S boulardii be dosed when used for candida? Always start from a small dose and gradually increase it to a therapeutic level, stay on this level for 3-4 months, then gradually reduce to none. For an adult the therapeutic dose is usually 4-5 billion live cells per day. For a child use smaller doses depending on the age of the child: 3-5 years of age the dose is 1 billion live cells per day, for 6-11 years of age 2 billion per day, for older children 34 billion per day. I would not use S boulardii with children younger than 3, it is better to use homemade kefir for these children. It is important to always combine S boulardii with other probiotics, as it should not be allowed to dominate in the gut. Based on my experience, I would not use S boulardii permanently, only as a course. On a long term basis it is better to use kefir, which contains a group of beneficial yeasts as well as bacteria. I was able to get to the therapeutic probiotic dose in a matter of days and have not seen any sign of die-off. What does this mean? It may mean that your body compensates well for various toxins and your liver is processing them well. Or it may mean that you are not processing your sensory input well. We are all different: some of us have acute senses and react to the smallest pain quite dramatically; others are able to tolerate quite a lot of discomfort without much reaction. Many GAPS people have a high threshold of pain, which is particularly pronounced in some autistic children: they can hurt themselves quite badly and show no reaction, as they do not feel the pain the way they should.

I have read that prolonged use of magnesium citrate tablets/capsules can cause the body to become lazy and that peristalsis will stop? Do you agree with this theory? I was taking roughly 1,000mg at night to help me sleep and so I would have a bowel movement in the morning. After reading about peristalsis I quit taking magnesium citrate. I am finally having daily bowel movements without it, but now I wake up 4 to 5 times during the night and my blood sugar seems higher. I would like to add this supplement back in but I am hesitant? I would not recommend taking any supplement on a permanent

basis. It is better to have magnesium in food form in fruit and vegetables: oranges and other citrus fruit, greens, natural local apples, etc or juices made from them (drinking a green juice first thing in the morning will regulate your bowel). Nuts are usually rich in magnesium. If you are not eating sugar or any other processed carbohydrates, then your body will handle magnesium well without loosing it. To sleep better you may try other approaches, for example try to boost your serotonin production by taking 5HTP supplement for a while. Try to take melatonin for a while. Try some herbs, such as valerian and hops. Spirulina will help with both bowel movements and sleep. Some people advise the use of hydrogen peroxide to get rid of the bad gut flora. Would that be a good idea? Could it help GAPS patients? The short answer is yes. However, due to taste and immediate die-off it is far from easy to take hydrogen peroxide (H2O2), and in my experience vast majority of people, having tried it, simply cannot do it. You need 35% food grade H2O2, which you can get in some health food stores. It is recommended that you start from a few drops per glass of water on an empty stomach once or twice daily, and gradually increase the concentration by adding one more drop at a time. Once consumed H2O2 breaks into water and free oxygen, which is considered to be the most deadly agent on this planet for any microbe. People with GERD, reflux and other stomach problems may find it helpful to take H2O2 on an empty stomach, because their problems are largely due to yeast overgrowth in the stomach. After initial die-off, as the stomach becomes more sterile, the symptoms may clear. It is essential to use only food grade H2O2, as other preparations may have chemicals added to stabilise it. I don’t routinely recommend hydrogen peroxide, as it is quite harsh and can cause a very serious die-off reaction. Does diatomaceous earth help the digestive system? I have no experience with this substance and cannot comment. Do you recommend or support the use of activated charcoal, clay or vitamin C for detox use during die-off? Yes, many people try these remedies and find that they help. What is your opinion on EMs (Effective Micro-organisms)? EM concept is very similar to what we understand about gut flora: it is a complex world of various microbes living side-by-side and affecting each other, as well as the host. The original development of the concept is attributed to a Japanese Professor Teruo Higa. The EM formulas are mixtures of various bacteria and fungi; originally they were used in silage preparation in farming. Now there are many various proprietary formulas on the market under the name of EM. Professor Higa classified the microbes in any natural ecosystem into three groups: beneficial, negative and opportunistic. Exactly the same classification exists for human gut flora. EMs aim

at boosting the beneficial microbes in order to keep the system healthy. So, any multi-strain probiotic can be considered an EM, as it is a mixture of beneficial microbes. Even the smallest amount of any probiotic food or supplement causes me severe bloating, fatigue and pain. How do I do the diet if I can’t take probiotics? Are there any conditions where probiotic are not recommended? People suffering from ME, chronic fatigue syndrome, fibromyalgia and some other debilitating conditions often have difficulties introducing probiotics. The reason for that is the die-off effect: it is so severe in this group of patients that they find it very difficult to cope with. Just start from a tiny amount and go up very slowly. I have patients who start from 1/18 th of a capsule of the Bio-Kult (or as much powder as would fit on the end of a sharp knife), and it takes them months to get up to one capsule per day. The same with fermented foods, start from a tiny amount per 5-7 days; as your body gets used to that amount, start taking it a bit more frequently. When you can take that tiny amount every day, start increasing the dose. Proceed in this very slow manner. It is important for you to introduce probiotics in the form of food or supplement. You just have to go slowly. Does the acidity of certain supplements, for example Betaine HCl or vitamin C in the form of ascorbic acid cause any irritation to the gut? Yes, it does! That is why these supplements need to be taken carefully and only when they are needed. Take Betaine HCl only with main meals when fats and meats in the meal will bind it. Don’t take Betaine HCl permanently, it is a temporary measure. In the long run restore your normal stomach acid production with cabbage juice, sauerkraut and other fermented cabbage recipes. I generally do not recommend ascorbic acid as it is an irritant to the gut lining. GAPS diet provides plenty of vitamin C in the food form (particularly when juicing is introduced). If you wish to take a supplement, it is better to have vitamin C in a whole natural form, such as acerola cherry powder. Will natural remedies such as grapefruit seed extract and oregano oil kill the good bacteria like antibiotics do? Yes, they will. That is why they need to be used only in certain cases, when the overgrowth of a particular pathogen, such as candida, warrants its use. While attacking candida with these remedies, keep adding beneficial bacteria to the gut in the form of both fermented foods and a good quality probiotics. Are tinctures of digestive aids such as ginger or mugwort GAPS allowed? Yes, as long as they do not contain sugar or any other non-allowed ingredients. Alcohol is commonly used as a preservative in tinctures,

which is OK: as tinctures are taken in minute amounts the dose of alcohol is insignificant. I have been recommended to try bitters. Are they GAPS legal? Many bitters contain sugar and other ingredients added. So, read the ingredients list carefully: if it contains only herbs then try it. It is a strong alcoholic beverage and should be consumed in very small amounts after food. TEETH Why do some GAPS patients experience tooth discoloration and hair loss? Tooth discoloration and hair loss are very rare in GAPS patients, and usually happen in very toxic people, particularly people with metal toxicity. Hair and teeth are those places where the body often stores toxins in. Many things happen in the body, as the GAPS program is initiated. We don't know what happens exactly, but it is possible that the hair, full of toxins, get dropped by the body to allow new "clean" hair to grow. With teeth: I have seen autistic children who had their permanent teeth growing with black spots imbedded in them. One particular boy displayed noticeable improvements in his autism in the weeks following the removal of the black spot by the dentist. It is possible that his body had stored mercury from vaccinations or some other toxins in the growing tooth. We don't know what happens exactly, but it is likely that the detoxification initiated by the GAPS Nutritional Protocol starts shifting the toxins around, which may be the cause of tooth discoloration in the initial stages. In the long run, however, your child is likely to grow beautiful whit teeth, as I have seen in so many GAPS children. Does over-consumption of nuts and seeds cause tooth decay? The GAPS diet does not equate to eating nuts only, it is a varied balanced diet. I have not seen any tooth decay with GAPS diet, just the opposite. I have children in my clinic, who had terrible problems with milk teeth, but once on GAPS Nutritional Programme they grow beautiful healthy permanent teeth. I remember one child, who had 11 filling put into his milk teeth at the age of four, as his tooth decay was terrible. He went on GAPS Programme at the age of five and now, at the age of 12, he has the most beautiful smile with white, perfectly shaped, healthy teeth. Should any precautions be taken when dental work is needed? Is it possible for cavities to resolve on their own with the GAPS diet? What if a root canal is recommended? Please, look inside your mouth and consider a question: how many functional teeth you would have left if it wasn’t for the modern dentistry? For many people the answer is going to be: not many!

Yes, root canals are not ideal, but I am sure you know many people with quite a few root canals in their teeth, who are functioning perfectly well and can be considered healthy. It all depends on the balance of things in the body: if your immunity is strong and well nourished, it will keep your root canals and other places of chronic infection under control. So, keep your immune system well nourished with animal fats, probiotics and good quality homemade food. I would recommend working with your dentist to use the least toxic alternatives, but if the root canal is recommended then you will probably have to have it. I do not know anybody whose root canals resolved on their own. Try to find a holistic dentist, there aren’t many of them, but if we all start demanding it, more dentists will have to get trained to become holistic. Eat well prior to the treatment and sleep well, avoid late nights or alcohol. Do the same after the treatment. Taking some natural vitamin C (such as acerola cherry) for a few days prior to treatment and after it is helpful. THYROID If one has hypothyroidism, should they be concerned about the goitrogenic properties of cabbage when it comes to eating sauerkraut? If so, how much would be an acceptable amount? I have hypothyroidism and generally drink three tablespoons of sauerkraut juice prior to each meal. I take medication for hypothyroidism; will sauerkraut juice suppress my thyroid function? Three tablespoons of sauerkraut juice will not suppress your thyroid function; I have never seen such effect in my patients. I have not found any studies on this subject, but during fermentation many substances in the cabbage change, so it is possible that the goitrogenic substances may have been destroyed. In addition to the GAPS diet, to support a weak thyroid (hypothyroid), is careful supplementation with Lugol solution acceptable or would this be discourages? Many people are deficient in iodine, which is essential for thyroid function. Every one of us has a unique individual need for iodine, so the standard daily recommended allowances are usually not helpful. To test if your body needs iodine (and to supplement it) paint a patch the size of your hand on your skin using Lugol solution or an iodine tincture. The solution will colour that patch of your skin brown. If in 24 hours the brown colour has disappeared (which means that iodine got absorbed through the skin), then your body is deficient in iodine. If you are on the GAPS introduction diet, you can supplement iodine by taking the Lugol solution or by painting the brown patch on your skin every day (choose a different patch of the skin every time). If you are on the Full GAPS diet and your digestion is OK, introduce seaweed: there are many supplements of kelp on the market or other high-iodine varieties of seaweed (such as knotten wrack seaweed or askophyllum nodosum) [Please view the Seagreens products at our online store]. Eating seaweed (or taking it as a supplement) is the best way to supply your body with iodine

long-term. To work out what dose of seaweed you need, keep using the skin test while gradually increasing your daily dose of seaweed. VERTIGO Is vertigo common in GAPS patients? Will it improve on the GAPS programme? Yes! Vertigo happens in many GAPS people because of toxicity in the brain altering the sensory perception. Another problem for these people is overproduction of histamine (many pathogenic species of microbes in the gut produce histamine). Excessive release of histamine drops the blood pressure down and causes vertigo, dizziness and fainting episodes. GAPS programme will change the gut flora, reduce histamine production and reduce the toxins reaching the brain. WARTS After over a year of being gone, my warts have come back on the GAPS diet. How do you suggest handling these? In my experience it is due to the general pH shift in the body: when we get too alkaline, warts and other viral infections thrive; when we get too acid, yeast thrives. To shift your pH try to avoid fruit, particularly citrus, nuts and chocolate for a while and see if that makes a difference. When warts appear, use a standard topical salicylic acid preparation (it is sold in pharmacies under different brands around the world). 35% food grade hydrogen peroxide also works well of fresh warts (apply a drop and let it dry; keep applying twice a day until the wart is gone). Old protruding warts are best tied-off: use a strong cotton or silk thread, make a loop and tie it tightly on the neck of the wart; the thread will stop the blood supply to the wart, so it will dry and fall off in a few days (to speed the process up you can apply 35% hydrogen peroxide to this wart as well). WATER How much water should be consumed? Should anything be added to the water? Water should be drunk between meals, as too much water with meals interferes with digestion. With meals I recommend to drink meat stock with some sauerkraut juice or homemade yogurt/kefir, adults can have a glass of dry red wine. The meat stock and the wine are good digestives. I do not believe in commonly published recommendations, which state that everyone should drink 1.5-2.5 liters of water every day. The water requirement changes from day to day, depends on what the weather is like, how we feel on that

particular day and what activities we undertake. Your body will tell you how much water you need on any given day by making you feel thirsty. If you are not thirsty, there is no need to force those litres of water down yourself, despite what popular books may say. A lot of thirst is a sign of too much acidity in the body; many toxins are acids. Water will only dilute the acids; you may drink lots of water and still feel thirsty. That is why it is important to take steps to alkalize your body: a 1/2 teaspoon of natural unprocessed salt added to water, a tablespoon of apple cider vinegar, a piece of lemon squeezed into water, eating a fresh rip apple or a fresh juicy carrot, drinking freshly pressed vegetable/fruit juice will alkalize your body and quench the thirst more effectively, than just drinking water. WEIGHT I seem to be gaining weight specifically in my hips, thighs and even my calves. It seems like it may be fluid retention, especially in my calves. What could be causing this? Is there anything I should do? If it is not fluid, why would I be gaining so much fat in these certain areas? It is natural for women to lay fat on their thighs and hips. In our modern world it became fashionable for women to look like little boys: with narrow hips and small bottoms. This is not normal. So, it is possible that your body is re-structuring itself into feminine shape you are meant to have. Swollen calves are a different matter: this is likely to be water retention, which is usually due to toxicity in the body. Try to do a few coffee enemas to clear your liver, and start juicing. Make sure to add plenty of greens to your juices: dandelion, dill, stingy nettles, coriander, parsley, ship sorrel and sage (add these greens to a nice sweet tasting juice from a mixture of carrots, apples, pineapples, a little celery and beetroot; then add 2 raw eggs and some sour cream, whisk and enjoy). Apart from helping you to detoxify, the juices will boost your minerals to assist the kidneys in water removal. After reading your book about dietary fat, cooking fats, and toxins stored in body fats, I now am wondering what your understanding of belly fat on individuals is? Fat is the preferred source of energy for most of the cells and organs in the human body. Body fat is stored energy. There are two main depots of energy in the body: under skin fat and visceral fat (belly fat). Under skin fat is an endocrine organ producing certain hormones essential for human physiology, such as leptin, resistin and cytokine TNF alpha. Women normally have more under skin fat than men, as female hormones lay the foundation for feminine fat storage on hips, breasts, buttocks and thighs, giving women their beautiful shape. Male hormones favour storage of under skin fat on the upper body, giving men their masculine shape. Regular consumption of sugar, flour and other processed carbohydrates alters hormonal balance in the body: that is why nowadays we see many women with male-type

bodies and many men with feminine looking bodies. Belly fat is largely a storage space for quick energy: this energy is stored inside the abdomen around inner organs: intestines, bowel, stomach, liver, kidneys, etc. Normal amounts of visceral fat are essential to support and insulate our inner organs. Processed carbohydrates in the body are quickly converted into fat. Some of this fat is stored under skin, which has a limited storage capacity. But if the carbohydrates keep coming, excessive fat is largely stored in the abdomen. Alcohol is a form of energy, which is quickly converted into fat and stored almost exclusively in the abdomen, giving the person a “pregnant” look. Fat attracts water: almost a quarter of belly fat tissue can be stored water. Men (and women) who drink too much alcohol regularly without consuming too much carbohydrates have large, hard-to-touch bellies with very little under skin fat – a “pregnant” belly; a belly full of fat and water. Men and women who indulge in both (too much alcohol and processed carbohydrates) will have large hard bellies and too much fat stored under skin as well. The obesity epidemic is caused by processed carbohydrates which came to dominate our modern diets. Natural animal fats (butter and fats in eggs, meat and fish) balance our hormones and go into our bodily structure. Unfortunately, our modern diet is very low in these nourishing fats. Eating lots of carbohydrates while depriving your body of essential-to-life animal fats lead to obesity, diabetes, heart disease, cancer, auto immunity and most other modern plagues. Am I going to lose weight on the GAPS diet? I am already underweight and find it very difficult to gain weight. Regular consumption of grains and processed carbohydrates causes water retention in the body. As you stop consuming these foods, you will loose that excess water and hence loose some weight, which usually happens in the first few weeks. Without the water retention you will get to your real weight and size, which will show you the real extend of your malnutrition. As you follow the GAPS nutritional protocol your digestive system will start absorbing foods properly and nourishing you; you will start building dense bones, healthy muscles and other tissues and organs and gaining weight as a result. You may remain fairly slim for the rest of your life (as it may be your constitution), but you will become strong, vibrant and full of energy. I have been steadily losing weight for many months and I feel like I do not look healthy. What suggestions do you have for patients losing too much weight? Please view the answer above to "Am I going to loose weight on the GAPS diet? I am already underweight and find it very difficult to gain weight. " WOMEN ISSUES & HORMONES

Is PMS a sign of digestive issues? Can the GAPS diet help with common infertility issues such as endometriosis and PCOS? Some women report irregularities and loss of menstruation during die-off. Is this cause for any concern? Digestive system is always involved in PMS, PCOS, endometriosis and other hormonal abnormalities: toxins produced by unhealthy gut flora interfere in the delicate balance of hormones in the body some hormones become low or insufficient, other hormones become excessive. When the die-off is initiated, more toxins are released into the bloodstream, so your typical hormonal symptoms these toxins cause, become more acute. Indeed the menstruations may become irregular and PMS may get worse. Die-off is temporary, so these symptoms will pass. Just keep them under control by gradual introduction of probiotics, fermented foods and food items, which you may be sensitive to. I do not specialise in infertility or other female reproductive problems, but I have many patients, who started the GAPS Programme, and their first symptoms to go were symptoms of PMS. More chronic conditions such as endometriosis and PCOS take longer to remedy, but GAPS Programme works well for many women with these conditions as well. In order to make steroid hormones (and all sex hormones are steroids) we need plenty of cholesterol and animal fats. So, for all these conditions it is essential to have high-fat and high-cholesterol diet, where main sources of fat are animal products: meats, eggs, fish, butter and cream. Women, who are trying to conceive, should consume 2 cups of homemade sour cream per day, as well as 4 fresh eggs and plenty of fatty meats and fish. As the gut flora becomes more normal and the gut wall heals, the toxins will disappear, and your hormonal system will come back to normal balance. Is it realistic for me to think that GAPS could help my body naturally increase its progesterone level? Yes, GAPS programme will re-balance your hormones to normal production. Progesterone has to be balance by other hormones, and only your body knows how to do that and in what proportions. Try not to interfere in this process by taking any hormonal preparations: drugs or natural. Can your spouse pass bad bacteria to you? Should any precautions be taken? My husband will not follow the diet and I know he has gut issues and I am trying to heal my own issues. We all pass microbes to each other on contact. But, if we live in fear of that, then our lives will be very difficult. Mother Nature gave us immune systems in order to deal with microbes. As long as we keep our immunity strong there is no need to worry about who we are in contact with. I would not want you to banish your husband out of the house in order for you to heal. Just work on boosting your immunity and his: maybe he will agree to take probiotics and cod liver oil capsules? If both of you increase animal fat consumption with your meals, then your immunity will be stronger and more able

to deal with invaders. Should any precautions be taken when choosing feminine care products? We need to be very careful with all personal care products! Please, read about it in the Detoxification chapter in my book. It is particularly dangerous to use any personal products in the groin. I recommend that women wash themselves with water only without using any soap, and never put any chemicals in that area. Apply your homemade yoghurt or kefir all over your groin after a bath or a shower to populate that area with beneficial flora. Once the good microbes are there, they will not allow any pathogens in. It is particularly important for pregnant women to do this, as they will pass their vaginal flora to their babies at birth. The best thing to put on your child’s nappy area is your homemade sour cream. If there is allergy to dairy, then use any cold pressed oil (olive oil, coconut oil, etc) or animal fat (lamb fat, pork fat, goose fat, etc). My doctor recommends that I avoid meat and dairy to help endometriosis, because meat and dairy contain oestrogens. What should I do? Just like us, all animals produce natural hormones, these hormones are present in all animal foods (meats, fish, eggs and dairy) and are of no concern to human physiology. We have been exposed to these hormones for millions of years in our diet and our bodies know how to deal with them: they just get digested and assimilated like any other protein. The mainstream recommendation to avoid meats and dairy is misguided and is not based on any reliable scientific evidence. In order to have healthy reproductive systems women must avoid xenoestrogens (synthetic oestrogens), which come from personal care products, contraceptive pill, HRT, many other drugs, many man-made chemicals in the environment, and processed foods; they disrupt our normal hormonal balance and can cause infertility, endometriosis, PMS and other reproductive problems. It is unfortunate that doctors give women no advice on avoiding xenoestrogens, instead they recommend to replace meat with soya, which is full of xenoestrogens. Is henna safe as a hair die? I am not aware of any research to why natural henna without any additives should not be safe. It is an herb, which has been used for millennia by people in India and other countries as a natural remedy for scalp problems, dermatitis and dandruff. The fact that it also dies your hair is a mere side effect and can be used as a bonus. MISCELLANEOUS/OTHER Is there any validity to metabolic typing? There is no doubt that we are all different genetically. Some of us come from northern stock, where for millennia meat and fish were

the staples. Some come from southern stock, where more fruit and grains were consumed. Some come from areas where dairy have been a staple for thousands of years, some have no tolerance of dairy and their predecessors never consumed milk. No matter what diet you are trying to follow, you have to find your own personal comfort zone in terms of ratio of different foods. The important point is to eat foods freshly prepared at home, as none of us on this planet has evolved to eat modern processed foods. In the Metabolic Typing you have to identify, what type you belong to: “protein type”, “carbo type” or a “mixed type”. What doesn’t seem to have been taken into account is the fact that apart from genetics our state of health is important to take into consideration. Many people in this world are addicted to sugar and other processed carbohydrates and have many health problems due to that. Their personality reflects their poor health and sugar addiction, so they may mistakenly identify themselves as “the carbo type” in Metabolic Typing. Regardless of what type you decided you belong to, you have to start from a low carbohydrate diet and then slowly proceed from that introducing carbohydrates. If you are addicted to sugar and have candida overgrowth, in this initial stage you will suffer from die-off and hypoglycaemia, which will make you feel very unwell. So many people with these problems just decide that they are the “carbo type” and revert back to their high carbohydrate diet with all the processed foods and sugar. Get yourself well first with the GAPS type diet, then your healthy instincts will come back and you will be able to find your comfort zone. Can broth / soups worsen digestion by diluting gastric juices during meals? If liquids worsen bloating during meals what would you advise? Meat stock with some sauerkraut juice added (or freshly pressed cabbage juice) stimulate stomach acid production and generally are a good digestive. Drinking it 10-15 minutes before your meal, rather than with the meal, will help you to produce stomach acid and prepare for the coming meal. Do you recommend kinesiology for testing the suitability of supplements? Energy testing, such as kinesiology, relies heavily on the skill of the practitioner and may not be 100% accurate. The reaction your body may produce on testing can reflect the die-off or detox. So, testing may confuse you. To succeed in the programme you need commitment and determination, so anything that plants doubt in your mind may not be too helpful. Which method of eating is least stressful to the body, small meals regularly or three or less square meals? Small regular meals are better for people with blood sugar problems, such as GAPS people. If you include plenty of animal fat into every meal, then your blood sugar level will by steady through the day. If you work and cannot eat all the time, then snack on raw

butter mixed with a little of raw honey to taste (take a jar with you to work or have it in the car). You can also snack on coconut oil and fresh nuts (when your gut is ready for nuts). For healthy people without blood sugar problems, it is a good idea to get hungry before their main meals, so snacking is not recommended for them. I’ve heard from a recent talk you did that we should have a minimum of 40% of our diet as fat. Is this 40% calories, or volume? This was probably said in a particular context. It is simply wrong to try and calculate composition of your meals, or calculate when you should eat and how much. These things need to be done instinctively, from the signals your body’s biology gives you, as your body has infinitely more wisdom about what it needs, than our mind and intelligence will ever calculate. Nobody in this world can tell how much protein your body needs at any particular moment of your life, or how much fat, or how much magnesium, or calcium, or zinc, or how much sleep, or how much sunshine! Only your body knows that, so listen to your body. Your bodily requirements change all the time, depending on what you are doing, what the weather is like and what state of health you are in. If it is cold and damp, and you feel run down, your body will need lots of fat and protein, so eat a hot rich meal (a stew or a roast). If the weather is hot and you feel hot and dry, a stew is the last thing you may want to eat; you may want a salad with some light meat or fish. Food needs to be enjoyable and appropriate for your body’s requirements at every meal; and the way your body tells you what it needs is by creating desires. Every time ask yourself: what do I really fancy to eat now? And your body will come up with an answer immediately, including how fatty this food should be. You talk about the path that GAPS children often follow leading to drug use. Do you have any advice for a GAPS-child-now-adult trying to heal from extensive drug use? The basis for addictive behaviour is blood sugar abnormalities. It is the swinging blood sugar levels that create lack of neurotransmitters in the brain (dopamine in particular) and desire to boost them with an addictive substance or behaviour. It is imperative for these people to keep their blood sugar at a normal level all the time. The way to do it is by consuming fat at frequent regular intervals! The best fats are raw butter, coconut oil or any animal fat. They need to be consumed every 20-30 minutes throughout the day. In the initial stages, when sugar cravings are strong, here is what I recommend: mix raw butter with some raw honey to taste (not much, just enough to please your taste buds), put this mixture into a glass jar and carry it with you everywhere. Eat 2-3 tablespoons every 20-30 minutes, even more often if the sugar cravings are bad. Raw honey in the butter will help to restore low blood sugar instantly, improve the taste of butter and add enzymes which help to digest the fat. In parallel carry another jar with you with coconut oil and eat that as well at regular intervals. With meals and snacks eat plenty of animal fats. Follow the GAPS diet strictly; it will restore your normal

production of neurotransmitters naturally, and remove addictive behaviour for good. Since going on the GAPS diet I have an acid taste in the back of my throat. What do you recommend to help with this? Have fermented vegetables with your meals and fresh vegetables too (salads made with juicy vegetables, such as lettuce, tomato, cucumber, onion and greens). They will add enzymes and help your stomach to handle food. The reason for this acid taste is likely to be reflux, as your stomach may not be producing enough acid and enzymes at this stage.



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Pregnancy and Baby GAPS Families Parents who have a child with autism, ADHD, dyslexia, dyspraxia or any other GAPS condition are quite rightly concerned when planning for a new baby. In order to give yourself the best chance to produce a healthy baby it is important to start thinking about it before conception. If you are already expecting a baby, it is best to start making changes straight away. For more information, click here. Babies Congratulations on the new addition to your family. Start your new baby off right by getting his/her digestive system off to a good start. For more information, click here.

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The first cookbook created exclusively for the GAPS diet. Internal Bliss is a cookbook designed for individuals and families pursuing the difficult journey towards digestive healing. With the GAPS principles in mind, Internal Bliss provides recipes that will satisfy all palates. **Now containing a chapter on fermented vegetables with information, directions, and 9 new recipes.** Featuring a wide variety of GAPS friendly meal ideas and treats for the entire family, including: Yogurt Cheese Deviled Eggs Lima Bean Hummus Cream of Delicatta Squash Soup Cowboy Stew

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Testimonials We would love to hear your progress with the GAPS diet. Please contact us so we can share your story with others. Your testimonial could make the difference in a life. No personal information is required. Please help other families in need of encouragement. I just wanted to tell all the families who have come to this crossroad of GAPS to take the plunge! As a mother of 2 children on the spectrum, I have been where you are. I have been desperate, alone, and overwhelmed. I have cried a lifetime of tears and every moment of despair is worth the joy I feel now. Three months ago I didn’t know what I was going to do with my son. He was regressing and angry. I knew I had to get my little boy back! I would rock him to sleep in tears whispering," come back to me my sweet Trent." I promised myself that if I ever had the answer that I would do it no matter how hard! GAPS is giving me my son back! That is worth fighting for! Trent is now categorizing cubes, cones, spheres, and cylinders! Every time I think about it, I cry! He can choose a sight word and turn it into a sentence! The point is, reach for the stars! My sweet Trent is coming back to me! My oldest son is on his way. His healing needs a little more time. His only issue is focus, other than that he is quite a character! He used to have to be on medication for anxiety. GAPS has taken anxiety away! He really is doing phenomenal! You owe it to yourself and your children to strive for better! When the going gets tough, you have your new friends here to lean on! Reaching for the stars, Cathy Carr

* * * * * * * * * * 3.5 Yr Old Boy From birth, my son had many challenges: he was premature and struggled both to breathe and to coordinate the reflexes involved in eating. Later, if not held 24/7 he would scream. People suggested he was “manipulative”, “spoiled”, etc. But to me it was clear that something was wrong and that he was simply expressing that. He was unable to eat anything except breastmilk for over two years. If

other food came even near his lips, he would vomit profusely. He was iron deficient.. Despite proper brushing, his brand new teeth rapidly disintegrated. His language was severely delayed. He would snake backward across the floor on his belly, screaming, finally pressing his forehead against a wall, terror in his eyes. Day and night, he woke fully at least every 2-4 hours. He could not tolerate baths, haircuts or toothbrushing. Incontinent, he was unable to potty train. Finally, just after his third birthday, he developed chronic diarrhea. On that count alone, my doctor suggested he might have Celiac Disease. When I researched CD, I learned that all of my son’s symptoms were addressed by that single diagnosis! There were two dietary options proposed for Celiac: The first, gluten-free, would be relatively easy to achieve, but require lifelong adherence to maintain even its limited results. The other, a diet temporarily permitting only monosaccarides, would be more challenging to implement, but would actually heal the gut, ultimately allowing for a wide range of healthy foods to be eaten. One website claimed that both Celiac and autistic symptoms could be relieved by the second one. The promise of addressing the full range of my son’s issues was the clincher. On Day One, my son had a normal stool for the first time in six weeks and, for the first time in his life, he slept through the night. On Day Three, he spoke his first sentence. That week, he potty trained himself. Since early on in the Specific Carbohydrate Diet, his language, cognition and physical development have continued to soar. He talks easily, his teeth have healed, and he eats everything we put in front of him. He is relaxed, easygoing and tremendously happy. He is highly sociable. His earlier behaviors and stools return only when he tries a food that proves too advanced for his system to handle. Early June, I transitioned him to the full GAPS program. We have seen leaps even beyond those achieved by SCD alone. Temporary setbacks notwithstanding, my boy has become a fully healthy child. It boggles my mind, every single day, that something so simple (so to speak) could have brought such tremendous changes. While GAPS’ benefits are definitely worth the effort involved, there is a learning curve. I stumbled about a lot at the beginning. The most important pieces for me have been information and support. The online communities provide these in abundance. Baden BC, Canada * * * * * * * * * * Originally posted on yahoo Group GAPShelp: Kevin lacked oxygen at birth, so in the first year of life, I already saw that he was not developing like my other kids (he is our 5th). His motor skills lagged and he cried a lot, didn't sleep so well, etc. At two, his behavior was just not

right. He never responded right to correction, would throw things in anger or frustration, cried all the time, esp when waking up, basically never happy. He didn't walk until two and then he would fall down constantly. He also began to always be starving. When he was really hungry, his face would get distorted and frozen in a strange way. I now think he was having seizures of sorts. We did not vaccinate at all and we figured out that if we fed him lots of protein type foods like meats, he would relax his body and face and be able to go play for a bit until it happened all over again in a short time. I do think that b/c we didn't vaccinate and figured out to keep feeding him this way, we were able to "coast along" like this for years. He had learning disabilities, lacked social skills and continued to have autistic traits like sensory issues, hiding under blankets, reacting to sounds, not liking people around, rigid in routines, and spinning and going on his head along with head banging. Long story shorter, we did get a diagnosis of Aspergers at one point. WE took him to doc after doc, specialist after specialist to no avail. He also strangely was NEVER once sick (we later learned that his immune sys was not working a bit) At 9 yo, he got pneumonia, followed by asthma and allergies. His eating had escalated to the point of feeding him every 20 - 30 minutes or he would have gigantic meltdowns. We eventually could not even have people over. He was given an inhaler for the asthma and suddenly, without us making the connection, he began to not respond when called, became extremely hyperactive and began to run away at all hours of the day and night requiring police to find him and being very dangerous (we once lost him in the middle of downtown Chicago). He would also try to jump out of moving vehicles, out of windows and required constant restraining. The seizures got bad, he would fall down the stairs and lose consciousness several times per day. They tried psych drugs and he almost died twice from his reaction to them (I am now grateful that we couldn't go that route). We became so desperate that we brought him home from hospital and got deadbolts to keep him from running, did all our own restraining and called alternative docs to help us. We began kefir and diet from nutritionist (basically a BED/GAPS version), took him off inhaler. His allergies were totally out of control, he could barely open his eyes from swelling, and his chin was deformed and swollen, his belly too, his whole body. He would only eat junk food and fast foods and it was incredibly difficult to transition him to the diet. The DAN (Defeat Autism Now) protocols we followed, made him worse in lots of ways b/c the chelation made him extremely violent, the B12 shots kept him awake for nights on end without any sleep, the antifungals and all those other interventions were nightmarish for him. Eventually, I resolved to use only foods and do this without any kind of docs. So for this past year, I researched and researched and was determined to bring him back from this state. We have done a combo of GAPS and BED very successfully along with lots of fermented foods and drinks. The allergies and asthma are 100% gone, the seizures we have had only one in 65 days and very mild (compared to 5-10 per day). He sings every morning and has cried once in the last 2.5 months (he used to cry for 1-3 hours at a time each day) and he can go outside again without running away. He is in martial arts, acting appropriately at church, having eye contact, no autistic traits of late and learning academics after two years of not being able to open a book. He reads before bed at an 8th grade level. It is a total absolute miracle to which I give God all the credit (there has been endless prayer at our house). I know He led us to this diet and this recovery. I am still fearful of regression (it's so hard to believe it's for real, you know) and I also fully realize that it will be possibly two more years before he is fully detoxed. The rashes he has had have been monumental and scary and he would have terrible seizures when the detox and die off was going too quickly. I think we still have a lot to learn and a lot of work to do but there seems to be a light at the end of our tunnel. I think this is a very powerful diet and detox protocol and it really does work. I feel that there is much hope and healing and we are giving our kids an opportunity at a life and future.

Sorry to be so long but I want to encourage others and I thank you all for the wonderful support. Millie * * * * * * * * * * Dear Gapsdiet.com, I have been following the GAPS diet for 5 months now with my son. I recently had to go back and start over following the Introduction Diet as you have outlined on this site. I was unaware there was an introduction diet but I am very happy to have found it. The introduction diet has made all the difference for my son in determining the foods he is unable to handle. Since starting the diet over, we have seen a huge transformation in his behavior and BMs. We have felt captive in our house for the last 3 years as a result of Tim's behavior and constant watery stools. Last Saturday we actually had a day out. It was wonderful. We still have a long way to go but we are very hopeful as we have seen more improvement in 5 months than we had previously ever seen on anything else we have tried. Sincerely, Mary San Diego, Ca * * * * * * * * * *



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Physicians Dr. Natasha Campbell-McBride will be conducting certification programs for physicians in fall 2011. A new listing of GAPS Physicians will be available at that time. In the meantime, the list below contains the contact information of professionals willing to work with those following the GAPS diet. These professionals have not had approved GAPS training and have not been approved by Dr.Natasha Campbell-McBride.

Dr. Thomas Cowan 661 Chenery St San Francisco, CA 415-334-1010 (Recommended by Dr. Natasha Campbell-McBride)

GAPS Cookbook Support Contact Us Testimonials Physicians Wholesale Gaps Guide Blog

Dr. Tim Gerstmar Naturopathic Doctor Aspire Natural Health 16455 NE 85th St, Ste 102 Redmond, WA 98052 425-202-7849 [email protected] Dr. Alkmini Anastasiadou 1556 3rd Ave Ste 210 New York, NY 10128 212-717-8800 [email protected] Jodi Barnett N.H.C. Harvested Health 2157 US Hwy 41 Schererville, IN 46375

219-227-8784 http://www.harvestedhealth.com Dr. John Feola Metro Internal Medicine LLC 6400 Arlington Blvd 940 Falls Church, VA 22042 703-241-1010 http://www.metro-internalmedicine.com Stephanie Belseth CPNP Newbridge Clinic 8200 Humboldt Ave S, Ste 301 Bloomington, MN 55431 612-730-2237 Fax 206-338-2186 www.newbridgeclinic.com

Dr. Jennifer Weiss 1212 Farmers Lane Suite 3 Santa Rosa, CA 95405 707-829-9788 www.osteopathicphysician.net

Julie Soteriou, CCN 1610 14th Street NW, Suite 102 Rochester, MN 55901 507-216-2369 [email protected]

Dr. Tony Boggess 1310 S. Main St Ann Arbor, MI 48104 734-929-2696 Fax:734-929-2703 [email protected] www.NBWellness.com

Rosann Volmert, DO

Osteopathic Family Physician 3527 Ocean View Blvd Montrose, CA 91208 626-796-3413 www.DrVolmert.com *The statements on this site have not been evaluated by the Food and Drug Administration. Nothing on this site is intended to diagnose, treat, cure, or prevent any disease.


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Wholesale Wholesale pricing is available for all healthcare practitioners, retail stores, and Co-ops. Please call or email for pricing. To all customers, we offer a 10% discount on all Bio-Kult purchases of 10 or more. If ordering 24 or more bottles, please email [email protected] for available discounts. We will match any competitors price.

Pregnancy and Baby Resources GAPS Cookbook Support Contact Us Testimonials Physicians Wholesale Gaps Guide Blog



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Home Page Welcome to GAPSdiet.com! AVAILABLE NOW!!!


The first GAPS cookbook. Over 140 GAPS friendly recipes.

A MESSAGE FROM DR. NATASHA CAMPBELL-MCBRIDE: HELP! At the last WAPF conference I met dozens of wonderful people, who were telling me how the GAPS Programme changed their lives and lives of their families. These people gave me an idea: WE NEED TO PUBLISH ALL THESE STORIES AS A BOOK! There are millions of people and families out there in desperate situations, who believe the mainstream establishment that there is nothing they can do to help themselves. Your stories - stories written by real people, will show those families that there is a way out and there is hope! Please, write your story and send it to me, Dr Natasha Campbell-McBride, at [email protected] It is your choice to publish your story under your real name or just the initials. YOUR STORY MAY SAVE MANY LIVES! THANK YOU! ********** This site supports digestive healing following the GAPS (Gut and Psychology Syndrome) diet created by Dr. Natasha Campbell-McBride.

Our goal is to spread Dr. Campbell-McBride's message and introduce you to the natural path of digestive healing.

For detailed information on the GAPS diet please refer to: Gut & Psychology Syndrome by Dr. Campbell-McBride

A Very Brief History The Gut and Psychology Syndrome Diet has its foundation on the Specific Carbohydrate Diet (SCD) created by Dr. Sidney Valentine Haas to heal digestive disorders. SCD gained great popularity after a mother, Elaine Gottschall, healed her own child and became an advocate for SCD. Elaine Gottschall is also the author of the popular book Breaking the Vicious Cycle. Intestinal Health Through Diet. Dr. Natasha Campbell-McBride has taken SCD and evolved it further to create a full protocol for healing digestive disorders and subsequent issues. Dr. Natasha Campbell-McBride

Dr. Natasha Campbell-McBride holds a degree in Medicine and Postgraduate degrees in both Neurology and Human Nutrition. In her clinic in Cambridge she specializes in nutrition for children and adults with behavioral and learning disabilities, and adults with digestive and immune system disorders. Dr. Campbell-McBride set up The Cambridge Nutrition Clinic in 1998. As a parent of a child diagnosed with learning disabilities, she was acutely aware of the difficulties facing other parents like her, and she has devoted much of her time to helping these families. She realized that nutrition played a critical role in helping children and adults to overcome their disabilities, and has pioneered the use of

probiotics in this field. She believes that the link between learning disabilities, the food and drink that we take, and the condition of our digestive system is absolute, and the results of her work have supported her position on this subject. In her clinic, parents discuss all aspects of their child's condition, confident in the knowledge that they are not only talking to a professional but to a parent who has lived their experience. Her deep understanding of the challenges they face puts her advice in a class of its own.

**This site should be used as a complement to Dr. Campbell-McBride's book Gut and Psychology Syndrome and is in no way a substitute for all the information provided within it.**

GAPS™ and Gut and Psychology Syndrome™ are the trademark and copyright of Dr. Natasha Campbell-McBride. The right of Dr. Natasha CampbellMcBride to be identified as the author of this work has been asserted by her in accordance with the Copyright, Patent and Designs Act 1988. Published by: International Nutrition, Inc. 11615 Crossroads Circle, Suite D Middle River, MD 21220 (800) 899-3413 [email protected] www.gapsdiet.com



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GAPSdiet.com Simplified GAPS Outline Here is a simplified outline of the GAPS Nutritional Program. Please refer to Gut and Psychology Syndrome for more detailed information.

THE NUTRITIONAL PROGRAM 1. 2. 3.

Diet Supplementation Detoxification and Life-style Changes

1. Diet The recommended diet for GAPS patients is largely based on the Specific Carbohydrate Diet (SCD). The main difference pertains to dairy products. SCD permits lactose-free dairy products. Lactose is a milk sugar. GAPS and people with digestive problems are unable to digest it and must avoid it. Fermented dairy products such as yogurt are largely lactose free as a result of the fermentation process where by the fermenting bacteria consume lactose. Apart from lactose, milk contains casein which will absorb through the damaged gut lining and act as a toxin in the body. Another problem with dairy is how it relates to food allergies and intolerances. A milk allergy is one of the most common allergies. Even in breast-fed babies where the mother consumes dairy products the child may develop colic due to sensitivity to dairy antigens being passed through the mother's milk. For all of these reasons, GAPS children and adults should not consume dairy products until their digestive system is well enough to handle them. The diet's only exception to this is milk fat (ghee or clarified butter) because it contains virtually no milk proteins or lactose and is generally well tolerated. Please refer to "The Diet" section for a list of recommended foods.

2. Supplementation The essential supplements for GAPS patients: A. An effective therapeutic strength probiotic B. Essential Fatty Acids C. Vitamin A D. Digestive enzymes E. Vitamin and mineral supplements.

A. An effective therapeutic strength probiotic Probiotics are most commonly used in the treatment of gastro-intestinal disorders: ! ! ! ! ! ! ! ! ! ! ! !

viral infections of the digestive tract necrotizing enterocolitis in infants intractable pediatric diarrhea pseudomembranous colitis traveler's diarrhea Clostridium Difficile enterocolitisenterocolitis Helicobacter infection enteropathogenic E. coli infection inflammatory bowel disorders: Crohn's disease, ulcerative colitis and chronic pouchitis irritable bowel syndrome lactose intolerance prevention of colonic cancer in laboratory studied

In addition to digestive issues many other health problems have been shown to respond to treatment with probiotics: ! ! ! ! ! ! ! ! ! ! ! ! ! !

allergies including food allergy autism chronic viral infections urogenital infections hepatitis, liver cirrhosis and biliary disease tuberculosis meningitis malignancy arthritis diabetes burns of various degree perioperative care and intensive care in surgical patients and patients with massive blood loss clinical infections autoimmune disorders

While many conditions may benefit from the use of probiotics, the above list has had scientific papers published on the benefit of probiotics with the specific condition. General Guidelines for choosing a good probiotic: a.

A good probiotic should have as many different species of beneficial bacteria as possible.

b.

A mixture of strains from different groups of probiotic bacteria is more beneficial than just one group.

c.

A good probiotic should have a concentrated amount of bacteria: at least 8 billion of bacterial cells per gram.

d. The manufacturer of the probiotic should test every batch for strength and bacterial composition and should be prepared to publish the results. (Bio-kult is the recommended probiotic and Dr. Campbell-McBride is one of the inventors) B. Essential Fatty Acids GAPS children and adults should have a group of essential oils supplemented: a. A good seed/nut oil blend in the ratio of 2:1 of omega-3:omega-6 fatty acids. b. Cod liver oil to supply EPA, DHA, vitamin A and vitamin D. c. Fish oil with higher ratio of EPA to DHA, as more EPA seems to be beneficial for GAPS patients. There are no toxic levels for these oils. C. Vitamin A As listed previously, vitamin A is recommended in the form of Cod Liver Oil (CLO). Vitamin A deficiency can cause digestive problems. Leaky gut and malabsorption are the typical results of vitamin A deficiency. Unfortunately, due to digestive problems, GAPS children and adults usually cannot absorb or use many forms of vitamin A, commonly found in supplements. A natural form of vitamin A found in CLO appears to be the best form for these patients. D. Digestive Enzymes People with abnormal gut flora almost without exception have low stomach acid production. Toxins produced from bacteria such as Candida and Clostridia have a strong ability to reduce secretion of stomach acid. Stomach acid is the first barrier for huge numbers of microbes arriving with every bite of food or drink we consume. If the stomach is not acid enough, these bad microbes may have a chance of colonizing in the stomach itself. Dr. Campbell-McBride recommends that GAPS patients supplement with stomach acid. The most physiological preparation available is Betaine HCl with Pepsin. Pancreatic Enzymes These are the enzymes people generally think of when hearing the words "digestive enzymes". These enzymes are usually combinations of proteases, peptidases, lipases, amylase, lactase and cellulase. In a healthy digestive tract, these enzymes are naturally produced by the pancreas. If normal stomach acidity can be returned, these enzymes should work efficiently. Dr. Campbell-McBride recommends supplementation with stomach acid. If you feel benefit from the use of these supplements, make sure they do not contain fillers or binders which may interfere with the healing process in the gut.

E. Vitamin and Mineral Supplements Dr. Campbell-McBride does not generally recommend any vitamin or mineral supplementation at the beginning of the program. Some patients may require targeted supplementation but this is a matter for a qualified practitioner to decide. If you are going to use supplements: a.

Choose supplements without any ingredients which may aggravate the gut condition.

b.

Choose supplements with a high absorption rate.

c.

Keep supplements to an absolute minimum.

3. DETOXIFICATION AND LIFE-STYLE CHANGES The first and most important thing is to remove the main source of toxicity, which means cleaning up and healing the gut. Since this alone will not rid the body of years worth of toxic build up in the system, juicing is recommended. Juicing provides very concentrated fruit and vegetable nutrients to the body in an easily absorbed form. Black Elderberry is also beneficial and has strong immune-stimulating properties and it is one of the most powerful anti-vital remedies known to man. The General Toxic Load An important part of the treatment is reduction of the general toxic load. Keep your house chemical free and avoid bringing anything into the home which will let off chemicals such as new carpet, furniture, and paints. Also remember that your skin absorbs just about everything it comes in contact with so be very cautious with the products you put on your skin. Household plants are great at reducing the toxic air in our houses. They consume the toxic gases and replace them with oxygen and other beneficial substances. This is a brief summary of important points addressed in Gut and Psychology Syndrome. It is very important to read the sections devoted to these areas in the book for a clear understanding of each.

Science and nature in balance

Visit our informative website If you are interested in the world of probiotics and wish to learn more, please make use of the Bio-Kult website. It contains everything you need to know, from technical information to research data, references and an online Q&A forum.

Contact details: Protexin Matts Lane Stoke Sub Hamdon Somerset TA14 6QE

Available in the USA from: International Nutrition, Inc 11615 Crossroads Circle, Suite D MIddle River, MD 21220, USA

Telephone: +44 (0) 8707 665108

Telephone/Fax: 800-899-3413 Website: www.nutrivene.com

E-Mail: [email protected]

Discover the health benefits of a multi-strain probiotic

[email protected] Website: www.bio-kult.com

Bio-Kult is a unique 14 strain probiotic, expertly formulated to help the digestive and immune systems, which are closely linked to our optimum health. Whether you are a Health Care Practitioner or someone who wants to know more about Bio-Kult, probiotics and gut conditions, you will find lots of useful information on this site. Plus you can order Bio-Kult and have it delivered direct  to your door.

Usage guidelines To help maintain a healthy digestive and immune system we recommend that you take 1-2 capsules twice daily with food. If you are taking Bio-Kult with antibiotics we recommend a double dose taken separately from the antibiotic, preferably at opposite ends of the day, or at least 3 hours after the antibiotic. After finishing the course of antibiotics, continue taking Bio-Kult for at least 2 weeks. Digestive disorders can vary enormously, from a mild upset caused by food poisoning to chronic disorders, such as Ulcerative Colitis. If you are taking Bio-Kult with these conditions we recommend that you seek advice from your Doctor or Health Care Practitioner for specific dosages suitable for your condition. For further advice, or to find your nearest Health Care Practitioner, please contact us on:+44 (0)8707 665108.

It will also provide details of certification, telling you, for example, that every batch of Bio-Kult is tested by an independent laboratory for bacterial count, certified by the United Kingdom Accreditation Service (UKAS), and that Certificates of Analysis are kept for every batch. www.bio-kult.com

Bio-Kult capsules can be pulled apart and the contents sprinkled on to food, mixed in a drink or swallowed whole. Guidelines for general use 1 - 2 capsules twice daily with food.

If taking 2 or more capsules daily, divide daily dose in 2

If you are taking antibiotics Take four capsules daily, ideally at a different time of day from the antibiotics.

If possible begin no later than taking the first antibiotic.

Continue taking for at least 2 weeks after completion of the antibiotic course.

For under 12s take half the adult dose.

For travellers

Take two capsules daily for one week before travel.

Increase to four capsules daily during travel.

Continue to take for at least 2 weeks following end of travel. If taking anti-malarials continue for at least 2 weeks after completion of the course.

Bio-Kult is completely safe, has no contraindications and carries no risk of overdose.

Science and nature in balance

What is Bio-Kult?

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Bio-Kult is a unique probiotic made up of 14 different strains. It is designed to help our digestive and immune systems, both of which are important in keeping us at the peak of health.

Evidence suggests that Bio-Kult’s broad spectrum of beneficial bacteria can reduce the symptoms and inflammation associated with digestive disorders and other conditions. Bio-Kult is suitable for vegetarians, is completely safe, has no contraindications and carries no risk of overdose. Bio-Kult was formulated by an expert team of doctors, nutritionists and scientists dedicated to advancing the research and use of probiotic health supplements.

Which gut conditions can Bio-Kult help?* Dysbiosis Dysbiosis is a condition in which the normal bacteria in the gut are disturbed and the levels of the essential bacteria are reduced. Evidence shows that dysbiosis is the underlying cause of many illnesses, not just those associated with the intestine. Diarrhoea Diarrhoea causes an imbalance in the gut microflora, increased gut permeability and inflammation of the intestine. If probiotic bacteria are able to colonise the gut, then it has been suggested they can be used to help treat or prevent diarrhoea. There are many studies concluding that probiotics are effective for the treatment and prevention of different types of diarrhoea. Antibiotic Associated Diarrhoea (AAD) After a course of antibiotics, the reduced levels of beneficial bacteria in the gut cause an imbalance in the microflora and can allow pathogenic (diseasecausing) species to increase. The gastrointestinal microflora are less able to resist colonisation by these unfriendly species, leading to clinical symptoms like diarrhoea. Probiotics replace the beneficial bacteria killed by the antibiotics and may prevent the pathogens from taking hold.

Traveller’s Stomach (travel sickness) Any food or water from an infected source can cause traveller’s stomach. Symptoms are mainly diarrhoea, but can include stomach cramps and nausea, often lasting for 10 days after the traveller returns home. The most common cause is contaminated food or water. The use of probiotics as a preventative for diarrhoea during travel has been studied. Evidence suggests that diarrhoea occurs less often when Lactobacilli and Bifidobacterium (species of bacteria contained in Bio-Kult) are used as preventatives and also for treatment. Candida (Candidiasis) The yeast Candida albicans naturally lives on or in most humans as a harmless organism, but it can become a major fungal pathogen. A study showed that the normal gut flora has a natural resistance to Candida albicans but this may be reduced when antibiotics are taken, leading to recurring yeast infections in women. These can be localised, e.g. in the mouth or vagina, and can spread to almost any organ system. Candidiasis can be associated with a number of conditions: chronic fatigue syndrome, arthritis, Irritable Bowel Syndrome (IBS) and allergies. Probiotic microbes suppress the growth of Candida in both the gastrointestinal tract and vagina. They also stop Candida adhering to mucous membrane. Atopic Dermatitis Eczema, suffered by 10-20% of the world’s population, makes the skin red, itchy and flaky. This happens when the skin responds to physical

or environmental irritants. Episodes of eczema can be triggered by allergic reactions to foods, particularly milk products, animals, dust, cosmetics, and viruses; also by environmental factors, such as stress. It has been suggested that some people develop atopic diseases, such as allergic rhinitis, asthma and atopic eczema, due to alterations in their intestinal microflora. Leaky Gut Syndrome Leaky gut, or intestinal permeability, refers to the gut lining, which allows bacteria and some undigested nutrients to enter the bloodstream instead of being digested and absorbed. Here, they cause the the immune system to react. The immune system cells have an inflammatory reaction that leads to autoantibody production and autoimmune disease development. Probiotics have been shown to improve intestinal permeability and reduce inflammation in Leaky Gut Syndrome patients. Irritable Bowel Syndrome (IBS) The three most usual symptoms of Irritable Bowel Syndrome (IBS) are: lower abdomen pain, diarrhoea or constipation and abdominal bloating. In IBS the intestine does not work properly. Patients may in fact have one or more of the following gastrointestinal complaints: leaky gut, dysbiosis, Candida overgrowth, parasitic infections, allergies and food intolerances. Probiotics, as well as increasing the numbers of beneficial bacteria in the intestine, may also reduce the amount of gas produced and help reduce the symptoms of IBS. Inflammatory Bowel Disease (IBD) Inflammatory Bowel Disease (IBD) is a term that embraces several conditions in which the intestine is persistently inflamed. Its two main forms are

Crohn’s Disease and Ulcerative Colitis (UC), long-term conditions whose main symptoms are diarrhoea, pain and blood in the stool. There is currently no cure. Drugs are used to reduce the inflammation. In severe cases, the damaged intestine is removed. It has only recently become clear that these diseases centre on the immune cells and tissues in the intestine that react incorrectly to normal gut microflora. Autism For reasons not yet understood, autistic children develop deficient gut flora. Lacking properly established “good” gut bacteria, essential for food digestion and absorption, autistic children can develop multiple nutritional deficiencies that drastically affect their development. In parallel, pathogenic and opportunistic microbes can develop, grow and become active, producing toxins that enter the bloodstream. Developing brains are particularly sensitive to these “toxins” and nutritional deficiencies. As a result there is no normal development of language, comprehension, behaviour etc. Over time, an efficient probiotic will re-establish the normal gut flora by clearing out the “bad” microbes and old putrefaction. The healing process then starts.

Bio-Kult capsules can be pulled apart and the contents sprinkled on to food, mixed in a drink or swallowed whole.

*Research data and references available from www.bio-kult.com

Bio-Kult_USA_Master_60&120_Labels_V5_REPRO.pdf

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Probiotic Microorganisms The healthy body naturally hosts trillions of beneficial bacteria. Amongst other things, they help to support and maintain a strong immune system and a healthy digestive system.* Today’s lifestyle of stress and poor nutrition can challenge these essential functions.* Why Bio-Kult®? The complete formula in Bio-Kult® helps balance and maintain these natural systems with the beneficial organisms necessary to keep you at your best. It is of fundamental importance that we have an adequate level of these probiotic bacteria in our bodies at all times. With fourteen strains of beneficial bacteria at a concentration of 10 billion CFU per gram, Bio-Kult® is one of the most powerful probiotic supplements available.

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Recommended Daily Intake One to two capsules twice daily with food. Children under 12 - half dose. Or as directed by your health practitioner or doctor. Do not exceed the recommended daily dose. Keep out of reach of children. Probiotic supplements should not be used as a substitute for a healthy lifestyle or a varied, balanced diet. Each capsule provides 2x109 (2billion) CFU. Store in a cool dry place. No need to refrigerate.

Supplement Facts Serving Size: 2 Capsules Servings per container: 60

Amount per serving Strains of friendly bacteria

54 mg** Bio-Kult® Probiotic Blend Lactobacillus spp. (L. plantarum, L. rhamnosus, L. acidophilus, L. delbrueckii ssp. bulgaricus, L. casei, L. helveticus, L. salivarius), Bacillus subtilis, Bifidobacterium spp. (B. bifidum, B. breve, B. infantis, B. longum), Lactococcus lactis ssp lactis, Streptococcus thermophilus **Daily value not established Other ingredients: Maltodextrin, vegetable capsule (hydroxypropylmethylcellulose, water), magnesium stearate. Allergen statement: Contains soy and milk ingredients in trace amounts. The levels of milk ingredients should not affect those who are lactose intolerant.

Distributed by: International Nutrition Inc. 11615 Crossroads Circle, Suite D, Middle River, MD 21220, USA. Made in the United Kingdom by: Probiotics International Limited.

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*This statement has not been evaluated by the Food & Drug Administration. The product is not intended to diagnose, treat, cure or prevent any disease. Y

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Probiotic Microorganisms The healthy body naturally hosts trillions of beneficial bacteria. Amongst other things, they help to support and maintain a strong immune system and a healthy digestive system.* Today’s lifestyle of stress and poor nutrition can challenge these essential functions.* Why Bio-Kult®? The complete formula in Bio-Kult® helps balance and maintain these natural systems with the beneficial organisms necessary to keep you at your best. It is of fundamental importance that we have an adequate level of these probiotic bacteria in our bodies at all times. With fourteen strains of beneficial bacteria at a concentration of 10 billion CFU per gram, Bio-Kult® is one of the most powerful probiotic supplements available. Recommended Daily Intake One to two capsules twice daily with food. Children under 12 - half dose. Or as directed by your health practitioner or doctor. Do not exceed the recommended daily dose. Keep out of reach of children. Probiotic supplements should not be used as a substitute for a healthy lifestyle or a varied, balanced diet. Each capsule provides 2x109 (2billion) CFU. Store in a cool dry place. No need to refrigerate.

Supplement Facts Serving Size: 2 Capsules Servings per container: 30

Amount per serving Strains of friendly bacteria

54 mg** Bio-Kult® Probiotic Blend Lactobacillus spp. (L. plantarum, L. rhamnosus, L. acidophilus, L. delbrueckii ssp. bulgaricus, L. casei, L. helveticus, L. salivarius), Bacillus subtilis, Bifidobacterium spp. (B. bifidum, B. breve, B. infantis, B. longum), Lactococcus lactis ssp lactis, Streptococcus thermophilus **Daily value not established Other ingredients: Maltodextrin, vegetable capsule (hydroxypropylmethylcellulose, water), magnesium stearate. Allergen statement: Contains soy and milk ingredients in trace amounts. The levels of milk ingredients should not affect those who are lactose intolerant.

Distributed by: International Nutrition Inc. 11615 Crossroads Circle, Suite D, Middle River, MD 21220, USA. Made in the United Kingdom by: Probiotics International Limited.

*This statement has not been evaluated by the Food & Drug Administration. The product is not intended to diagnose, treat, cure or prevent any disease.

Food Allergy By Dr Natasha Campbell-McBride Published in: Journal of Orthomolecular Medicine, First Quarter, 2009, Vol 24, 1, pp.31-41

Food allergies have become very common, and the trend is up. 1 Most medical practitioners find that we have to face this problem more and more on a daily basis. A recent public survey in the UK has shown that almost half the population report that they have an “allergy” to some food or foods. 2 However, the official figures for a “true allergy to food” are around 1% of the population in most developed countries. 1 The reason for this confusion is that majority of food reactions/allergies/intolerances do not produce a typical allergy test profile (raised IgE or IgG with positive prick test and/or positive RAST test). There have been different attempts to classify this group: as type B food allergy, metabolic food intolerance or simply food intolerance, rather than a “true” allergy. 3 In this group a person may react to many different foods or combinations of foods. Quite often the person is not sure what food produces the reaction, because the reaction may be immediate or delayed (a day, a few days or even a week later). As these delayed reactions overlap with each other, the patients can never be sure what exactly they are reacting to on any given day. 1,3 On top of that there is a masking phenomenon, when reactions to a regularly consumed food run into each other (the new reaction begins when the previous has not finished yet), so the connection with that food and symptoms, it triggers, is not apparent. 4 Food allergy or intolerance can produce any symptom under the sun: from migraines, fatigue, PMS, painful joints, itchy skin to depression, hyperactivity, hallucinations, obsessions and other psychiatric and neurological manifestations. However, the most immediate and common symptoms in the vast majority of patients are digestive problems: pain, diarrhoea or constipation, urgency, bloating, indigestion, etc. 3,5,6 Naturally, many people try to identify, which foods they react to. As a result many forms of testing have appeared on the market: from blood tests to electronic skin tests. Many experienced practitioners get disillusioned with most of these tests, as they produce too many false-positives and falsenegatives. 6 On top of that they lead to a simple conclusion, that if you remove the “positive” foods out of the diet, it will solve the problem. In some cases, indeed elimination of a trigger food helps. However, in majority the help in not permanent: the patients find, that as they eliminate some

foods, they start reacting to other foods, to which they did not seem to react before. The whole process leads to a situation where the person finishes up with virtually nothing left to eat, and every new test finds reactions to new foods. Majority of experienced practitioners come to the same conclusion: the simplistic idea of “just don’t eat foods, you are allergic to!” does not address the root of the problem. 3,6 We need to look deeper, at what causes these food intolerances. In order to understand it, I would like to share a case history of one of my patients. Stephanie S, 35 years old asked for my help in “sorting out her food allergies”. A very pale malnourished looking lady, (weight 45 kg with height 160cm) with low energy levels, chronic cystitis, abdominal pains, bloating and chronic constipation. She was consistently diagnosed anaemic all her life. Family background: she was born naturally from a mother with digestive problems and migraines, her sister suffered from severe eczema and her brother from GI problems. She did not have information on her father’s health. She was not breast fed as a baby and at the age of 3 months got her first urinary infection with the first course of antibiotics. Since then the urinary infections became a regular part of her life, usually treated by antibiotics; now she is suffering from chronic interstitial cystitis. Through the childhood she was very thin, always found it difficult to put any weight on, but otherwise she considered her health to be “OK” - she completed school and played sports. At 14 years of age her menstruations stopped, having started a year before. She was put on a contraceptive pill, which seemed to regulate her menstruations. Around 16 she was put on a long course of antibiotics for acne, after which developed lactose intolerance, severe constipation and bloating. Was advised to stop dairy at 18, which helped with constipation for a while, but other symptoms remained. She developed progressively low levels of energy, abdominal cramps, dizzy spells, very low body weight and very dry skin. Following numerous medical consultations and food allergy testing she started removing different foods out of her diet, but was never sure if it made much difference: some symptoms seemed to improve, others did not and new symptoms appeared. She became sensitive to loud sounds and local pollution, her shampoo and make up and some domestic cleaning chemicals. Her cystitis became chronic and was pronounced psychosomatic by her doctor. Her diet at the time of the consultation was very limited: she

seemed to tolerate (but was not entirely sure) breakfast cereals, sheep’s yoghurt, soy milk, some varieties of cheese, a few vegetables and rarely fish. Following several food allergy tests she has removed all meats, eggs, nuts, all fruit, whole grains and many vegetables. This example is very common and demonstrates clearly that just removing “offending” foods out of the diet does not solve the problem. We have to look deeper and find the course of the patient’s malady. In order to do that we have to examine Stephanie’s health history. Infancy Stephanie was born from a mother with digestive problems and was not breast fed. What does that tell us? We know that unborn babies have sterile gut. 7 At the time of birth the baby swallows mouthfuls of microbes, which live in the mother’s birth canal. 8 These microbes take about 20 days to establish themselves in the baby’s virgin digestive system and become the baby’s gut flora. 7,8 Where does the vaginal flora come from? The medical science shows that the flora in the vagina largely comes from the gut. What lives in the woman’s bowel will live in her vagina. 9,10 Stephanie’s mother suffered from digestive problems, which indicates that she had abnormal gut flora, which she passed to her daughter at birth. Baby Stephanie was not breast fed. Breast milk, particularly colostrum in the first days after birth, is vital for appropriate population of the baby’s digestive system with healthy microbial flora. 9,10,11 We know that bottle fed babies develop completely different gut flora to the breast fed babies. 11 That flora later on predisposes bottle-fed babies to asthma, eczema, different other allergies and other health problems. 12 But the most important abnormalities develop in the digestive system of course, as that is where these microbes make their home. Having acquired abnormal gut flora from her mother at birth, Stephanie had it compromised further by bottle feeding. Chronic cystitis Apart from the gut, in the first few weeks of life other mucous membranes and baby’s skin get populated by their own flora, playing a crucial role in

protecting those surfaces from pathogens and toxins. 13 As baby Stephanie acquired abnormal flora in her gut, her groin and vagina got abnormal flora too (as it normally comes from the gut). 10 At the same time the urethra and the urinary bladder would get similar to vagina flora: in a normal situation it should be predominated by Lactobacteria, largely L. crispatus and L. jensenii. 14 This flora produces hydrogen peroxide, reducing the Ph in the area, which does not allow pathogens to adhere. 15 Unprotected urethra and bladder fall pray to any pathogenic microbes, causing urinary tract infections. The most common pathogens, which cause UTIs, are E.coli, Pseudomonas aeruginosa and Staphylococcus saprophyticus,coming from the bowel and the groin. 15 Urine is one of the venues of toxin elimination from the body. 16 In gut dysbiosis large amounts of various toxins are produced by pathogens in the gut and absorb into the bloodstream through the damaged gut wall. 16,17 Many of these toxins leave the body in urine: accumulating in the bladder, this toxic urine comes into contact with the bladder lining. The beneficial bacteria in the bladder and urethra maintain a GAG layer of the bladder: a protective mucous barrier, largely made from sulphated glucosaminoglycans, produced by the cells of the bladder lining. 17 As the GAG layer gets damaged, toxic substances in urine get through to the bladder wall causing inflammation and leading to chronic cystitis. 18 And that is what happened to Stephanie: at the age of 3 months she got her first urinary infection. As her gut flora, vaginal flora and the flora of urethra and the bladder were not corrected, she suffered from urinary infections all her life and eventually developed chronic cystitis. Further damage to gut flora Because of regular urinary tract infections Stephanie had to have regular courses of antibiotics through her entire life, starting from infancy. Every course of antibiotics damages beneficial species of bacteria in the gut, leaving it open to invasion by pathogens, resistant to antibiotics. 10,19 Even when the course of antibiotic is short and the dose is low, it takes different beneficial bacteria in the gut a long time to recover: physiological E.Coli takes 1-2 weeks, Bifidobacteria and Veillonelli take 2-3 weeks, Lactobacilli, Bacteroids, Peptostreptococci take a month. 10,20 If in this period the gut

flora is subjected to another damaging factor(s), then gut dysbiosis may well start in earnest. 21 After many short courses of antibiotics Stephanie had to take a long course for acne at the age of 16. That is when she got pronounced digestive problems: constipation, bloating, abdominal pain and lactose intolerance, indicating that her gut flora got seriously compromised. From the age of 14 Stephanie has been taking contraceptive pills for many years. Contraceptives have a serious damaging effect on the composition of gut flora,leading to allergy and other problems, related to gut dysbiosis . 22,23 Malnutrition- the consequence of abnormal gut flora Stephanie suffered from malnutrition all her life despite the fact that her family always cooked fresh wholesome meals and Stephanie ate well. She was always pale, very thin and small and could never put any weight on. This is not surprising taking into consideration the state of her gut right from birth. The microbial layer on the absorptive surface of the GI tract not only protects it from invaders and toxins, but maintains its integrity. 20,21 The epithelial cells called enterocytes, which coat the villi are the very cells, which complete the digestive process and absorb the nutrients from food. 24 These cells only live a few days as the cell turnover in the gut wall is very active. These enterocytes are constantly born in the depth of the crypts. Then they slowly travel to the top of the villi, doing their job of digestion and absorption and getting more and more mature on the way. As they reach the top of the villi, they get shed off. This way the epithelium of intestines gets constantly renewed to insure its good ability to do its work well. 24 Animal experiments with sterilisation of the gut found that when the beneficial bacteria, living on the intestinal epithelium are removed, this process of cell renewal gets completely out of order. 10 The time of cell travel from crypts to the top of the villi becomes a few times longer, which upsets the maturation process of absorptive cells and often turns them cancerous. The mitotic activity in the crypts gets significantly suppressed, which means that much less cells will be born there and much less of them will be born healthy and able to do their job properly. The state of the cells themselves becomes abnormal. 9,25 That is what happens in a laboratory animal with sterilised gut. In a human body the absence of good bacteria always comes with pathogenic bacteria getting out of control, which makes the whole situation much worse. Without the care of beneficial bacteria

while under attack from pathogenic flora, the gut epithelium degenerates and becomes unable to digest and absorb food properly, leading to malabsorption, nutritional deficiencies and food intolerances. 19.21,25 Apart from keeping the gut wall in good shape, the healthy gut flora populating this wall has been designed to take an active part in the very process of digestion and absorption. 19,21 So much so, that the normal digestion and absorption of food is probably impossible without wellbalanced gut flora. It has an ability to digest proteins, ferment carbohydrates, break down lipids and fibre. By-products of bacterial activity in the gut are very important in transporting minerals, vitamins, water, gases and many other nutrients through the gut wall into the bloodstream. 10 If the gut flora is damaged, the best foods and supplements in the world may not have a good chance of being broken down and absorbed. A good example is dietary fibre, which is one of the natural habitats for beneficial bacteria in the gut. 25 They feed on it, producing a whole host of good nutrition for the gut wall and the whole body, they engage it in absorbing toxins, they activate it to take part in water and electrolytes metabolism, to recycle bile acids and cholesterol, etc., etc. It is the bacterial action on dietary fibre that allows it to fulfil all those good functions in the body. 20,21 And when these good bacteria are damaged and are not able to “work” the fibre, dietary fibre itself can become dangerous for the digestive system, providing a good habitat for the bad pathogenic bacteria and aggravating the inflammation in the gut wall.This is when gastroenterologists have to recommend a low-fibre diet. 19 Consequently, dietary fibre alone without the beneficial bacteria present in the gut can end up not being all that good for us. Stephanie also found that she became lactose intolerant after the long course of antibiotics prescribed for her acne. And indeed Lactose is one of those substances, which most of us would not be able to digest without well functioning gut flora. 25 The explanation offered by science so far is that after early childhood majority of us lack an enzyme called Lactase to digest Lactose. 26 If we are not meant to digest Lactose, then why do some people seem to manage it perfectly well? The answer is that these people have the right bacteria in their gut. One of the major Lactose digesting bacteria in the human gut is E.coli. 10 It comes as a surprise to many people that physiological strains of E.coli are essential inhabitants of a healthy digestive tract. They appear in the gut of a healthy baby in the first days after birth in huge numbers: 107 - 109 CFU/g and stay in these same numbers throughout life, providing that they do not get destroyed by antibiotics and other environmental influences. 9,19 Apart from digesting Lactose, physiological

strains of E.coli produce vitamin K and vitamins B1, B2, B6, B12, produce antibiotic-like substances, called colicins, and control other members of their own family which can cause disease. In fact having your gut populated by the physiological strains of E.coli is the best way to protect yourself from pathogenic species of E.coli. 21 Unfortunately, this group of beneficial bacteria are very vulnerable to broad spectrum antibiotics, particularly aminoglycosides (Gentamycin, Kanamycin) and macrolides (Erythromycin, etc.). 9,10 Apart from E.coli, other beneficial bacteria in the healthy gut flora (Bifidobacteria, Lactobacteria, beneficial yeastsand other) will not only ensure appropriate absorption of nutrients from food but also actively synthesise various nutrients: vitamin K, pantothenic acid, folic acid, thiamin (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6), cyanocobalamin (vitamin B12), various amino acids and other active substances. 9,10,25 In the process of evolution Nature made sure that when the food supply is sparse, we humans don't die from vitamin and amino acids deficiencies. Nature provided us with our own factory for making these substances - our healthy gut flora. And when this gut flora is damaged despite adequate nutrition we develop vitamin deficiencies. Every tested child or adult with gut dysbiosis shows deficiencies in those very vitamins, which their gut flora is supposed to produce. 25 Restoring the beneficial bacteria in their gut is the best way to deal with those deficiencies, particularly vitamin B deficiencies. 10,19,21 On testing over the years Stephanie consistently showed deficiencies in most B vitamins, fat soluble vitamins, magnesium, zinc, selenium, manganese, sulphur, iron and some fatty acids. Anaemia – another consequence of gut dysbiosis Stephanie suffered from anaemia all her life, unsuccessfully treated by courses of iron tablets. The majority of patients with gut dysbiosis look pale and pasty and their blood tests often show changes typical for anaemia. 21 It is not surprising. They not only cannot absorb essential for blood vitamins and minerals from food, but their own production of these vitamins is damaged. On top of that people with damaged gut flora often have a particular group of pathogenic bacteria growing in their gut, which are ironloving bacteria (Actinomyces spp., Mycobacterium spp., pathogenic strains

of E.coli, Corynebacterium spp. and many others). 13,25 They consume dietary iron, leaving the person deficient. Unfortunately, supplementing iron makes these bacteria proliferate, bringing unpleasant digestive problems and does not remedy anaemia. To have healthy blood the body needs other minerals, a whole host of vitamins: B1, B2, B3, B6, B12, C, A, D, folic acid, pantothenic acid and some amino acids. 24,10 It has been shown in a large number of studies all over the world, that just supplementing iron does not do much for anaemia. 27 The pathogens in the gut The most studied pathogens, that overgrow after numerous antibiotic courses are clostridia and yeasts, which normally belong to the opportunistic group of gut microbes. 28 The opportunistic gut flora is a large group of various microbes, the number and combinations of which can be quite individual. There are so far around 400 different species of them found in the human gut. 25 These are the most common: Bacteroids, Peptococci, Staphylococci, Streptococci, Bacilli, Clostridia, Yeasts, Enterobacteria (Proteus, Clebsielli, Citrobacteria, etc.), Fuzobacteria, Eubacteria, Spirochaetaceae, Spirillaceae, Catenobacteria, different viruses and many others. 13 Interestingly, many of these opportunistic bacteria when in small numbers and under control actually fulfil some beneficial functions in the gut, like taking part in the digestion of food, breaking down lipids and bile acids. In a healthy gut their numbers are limited and tightly controlled by the beneficial flora. 20 But when this beneficial flora is weakened and damaged, they get out of control. Each of these microbes is capable of causing various health problems. 29 The best known is the fungus Candida albicans, which causes untold misery to millions of people. 31 There is an abundance of literature published about Candida infection. However, I have to say that a lot of what is described as Candida Syndrome is in effect a result of gut dysbiosis, which would include activity of lots of other opportunistic and pathogenic microbes. Candida albicans is never along in the human body. Its activity and ability to survive and cause disease depends on the state of trillions of its neighbours – different bacteria, viruses, protozoa, other yeasts and many other micro-creatures. 9,19,31 In a healthy body Candida and many other disease causing microbes are very well controlled by the beneficial flora. Unfortunately, the era of antibiotics gave Candida a special opportunity. The usual broad-spectrum antibiotics kill a lot of different microbes in the body – the bad and the good. But they have no effect on Candida. So, after every course of antibiotics, Candida is left without anybody to control it, so it

grows and thrives. 30,31 Stephanie had many symptoms of Candida overgrowth in her body: low energy level, dry skin, recurrent vaginal thrush and cystitis, bloating, constipation, foggy brain and lethargy. Clostridia family was given a special opportunity by the era of antibiotics too, because Clostridia are also resistant to them. 34 There are about 100 members of this family discovered so far and they all can cause serious disease. Many of them are found as opportunists in a healthy human gut flora. 25,33 As long as they are controlled by the beneficial microbes in the gut, they normally do us no harm. Unfortunately, every course of broad spectrum antibiotics removes the good bacteria, which leaves Clostridia uncontrolled and allows it to grow. Different species of Clostridia cause severe inflammation of the digestive system and damage its integrity, leading to many digestive problems and food intolerances. 32,33 Food “allergies” and intolerances Normal gut flora maintains gut wall integrity through protecting it, feeding it and insuring normal cell turnover. When the beneficial bacteria in the gut are greatly reduced, the gut wall degenerates. 9,10,21,25 At the same time various opportunists, when not controlled by damaged good bacteria, get access to the gut wall and damage its integrity, making it porous and “leaky”. 6,28,29 For example, microbiologists have observed how common opportunistic gut bacteria from families Spirochaetaceae and Spirillaceae due to their spiral shape have an ability to push apart intestinal cells braking down the integrity of the intestinal wall and allowing through substances which normally should not get through. 13, 25 Candida albicans has this ability as well. Its cells attach themselves to the gut lining literally putting “roots” through it and making it “leaky”. 31 Many worms and parasites have that ability as well. 9,10,35 Partially digested foods gets through the damaged “leaky” gut wall into the blood stream, where the immune system recognises them as foreign and reacts to them. 36,37.38 This is how food allergies or intolerances develop. So, there is nothing wrong with the food. What is happening is that foods do not get a chance to be digested properly before they are absorbed through the damaged gut wall. So, in order to eliminate food allergies, it in not the foods we need to concentrate on, but the gut wall. In my clinical experience, when the gut wall is healed many food intolerances disappear. Healing the gut wall – the diet How do we heal the gut wall? We need to replace the pathogens in the gut with the beneficial bacteria, so effective probiotics are an essential part of

the treatment. However, the most important intervention is the appropriate diet. There is no need to re-invent a wheel when it comes to designing a diet for digestive disorders. There is a diet already invented, a very effective diet with more than 60 years of an excellent record of helping people with all sorts of digestive disorders, including such devastating ones as Crohn’s disease and ulcerative colitis. This diet is called Specific Carbohydrate Diet or SCD for short. SCD has been invented by a renowned American paediatrician Dr. Sidney Valentine Haas in the first half of the 20th century. 39 Those were the good old days, when doctors used to treat their patients with diet and natural means. Carrying on with the work of his colleagues Drs. L. Emmett Holt, Cristian Herter and John Howland, Dr. Haas has spent many yeas researching the effects of diet on celiac disease and other digestive disorders. He and his colleagues found that patients with digestive disorders could tolerate dietary proteins and fats fairly well. But complex carbohydrates from grains and starchy vegetables made the problem worse. Sucrose, lactose and other double sugars also had to be excluded from the diet. However, certain fruit and vegetables were not only well tolerated by his patients, but improved their physical status. Dr. Haas treated over 600 patients with excellent results: after following his dietary regimen for at least a year there was “complete recovery with no relapses, no deaths, no crisis, no pulmonary involvement and no stunting of growth”. The results of this research were published in a comprehensive medical textbook “The Management of Celiac Disease”, written by Dr. Sidney V. Haas and Merrill P. Haas in 1951. The diet, described in the book, was accepted by medical community all over the world as a cure for celiac disease and Dr. Sidney V. Haas was honoured for his pioneer work in the field of paediatrics. Unfortunately, “happy end” does not happen in human history too often. In those days celiac disease was not very clearly defined. A great number of various conditions of the gut were included into the diagnosis of celiac disease and all those conditions were treatable by the SCD very effectively. In decades that followed something terrible happened. Celiac disease was eventually defined as a gluten intolerance or gluten enteropathy, which excluded a great number of various other gut problems from this diagnosis. As the “gluten free diet” was pronounced to be effective for celiac disease, the SCD diet got forgotten as outdated information. And all those other gut diseases, which fell out of the realms of true celiac disease, got forgotten as

well. The true celiac disease is rare, so the “forgotten” gut conditions would constitute a very large group of patients, which used to be diagnosed as celiac and which do not respond to treatment with gluten free diet. Incidentally, a lot of “true” celiac patients do not get better on the gluten free diet either. All these conditions respond very well to SCD diet, developed by Dr. Haas. 39 Following the whole controversy about celiac disease, the Specific Carbohydrate Diet would have been completely forgotten if it wasn’t for, you guessed it, a parent! Elaine Gottschall, desperate to help her little daughter, who suffered from severe ulcerative colitis and neurological problems, went to see Dr. Haas in 1958. After 2 years on SCD her daughter was completely free of symptoms, an energetic and thriving little girl. Following the success of the SCD with her daughter Elaine Gottschall over the years has helped thousands of people, suffering from Crohn’s disease, ulcerative colitis, celiac disease, diverticulitis and various types of chronic diarrhoea. Very dramatic and fast recoveries she has reported in young children, who apart of digestive problems had serious behavioural abnormalities, such as autism, hyperactivity and night terrors. She has devoted years of research into biochemical and biological basis of the diet and has published a book, called “Breaking the Vicious Cycle. Intestinal Health Trough Diet.” 39 This book has become a true saviour for thousands of children and adults across the world and has been reprinted many times. Many Web-sites and web-groups have been set up to share SCD recipes and experiences. I have been using SCD for many years in my clinic and have to say that it is the diet for food allergies. As I work largely with children with learning disabilities, such as autism, ADHD, dyslexia, dyspraxia, etc, I have grouped these patients under the name Gut And Psychology Syndrome or GAPS. 40 I had to adopt some aspects of SCD for these patients and they have named their diet – the GAPS diet. Over the years I have developed a GAPS Introduction Diet for the more severe end of the spectrum (www.gapsdiet.com). I find that the Introduction Diet is particularly effective in food allergies, as it allows the gut wall heal quicker. The Introduction Diet is structured in stages. Unless there is a dangerous (anaphylactic type) allergy to a particular food, I recommend my patients to ignore the results of their food intolerance testing and follow the stages one by one. The Introduction Diet in its first stages serves the gut lining in three ways:

1. It removes fibre. With damaged gut wall fibre irritates the gut lining and provides food for the pathogenic microbes in the gut. This means: no nuts, no beans, no fruit and no raw vegetables. Only well-cooked vegetables (soups and stews) are allowed with particularly fibrous parts of the vegetable removed. No starch is allowed on the GAPS diet, which means no grains and no starchy vegetables. 2. It provides nourishment for the gut lining: amino acids, minerals, gelatine, glucosamines, collagens, fat soluble vitamins, etc. These substances come from homemade meat and fish stocks, gelatinous parts of meats well-cooked in water, organ meats, egg yolks and plenty of natural animal fats on meats. 3. It provides probiotic bacteria in the form of fermented foods. The patients are taught to ferment their own yoghurt, kefir, vegetables and other foods at home. These foods are introduced gradually in order to avoid a “die-off reaction”. On the first two stages of the Introduction Diet most severe digestive symptoms, such as diarrhoea and abdominal pain disappear quite quickly. At that point the patient can move through the next stages, when other foods are gradually introduced. As the gut wall starts healing, the patients find that they can gradually introduce foods, which they could not tolerate before. When the Introduction GAPS Diet is completed, the patient moves to the Full GAPS Diet. I recommend adhering to the Full Diet for 2 year on average in order to restore normal gut flora and GI function. Depending on the severity of the condition, different people take different time to recover. Children usually recover quicker than adults. Stephanie had to follow the Introduction Diet for 7 months before she started putting weight on and feeling stronger. By the time she moved to the Full GAPS Diet she had normal stools, no bloating and no cystitis symptoms; her energy levels were much improved, though she still looked slightly pale. In about a year from the start of the treatment she disappeared for 18 months, then emailed me with an update: she was doing well, her energy level was good, she had no symptoms of cystitis and her GI function was good. She put weight on: though she was still quite slim, but within the normal range.

In the last two months she started eating some foods not allowed on the diet and found that she can tolerate them on an occasional basis, including pasta, chocolate and some goods from the local bakery. Healing the gut wall - probiotics In order to heal the gut wall apart from the appropriate diet we need to replace the pathogenic microbes in the gut with the beneficial ones. The fermented foods in the diet will provide some probiotic microbes. However, an effective probiotic supplement is essential in most cases. There is a plethora of studies accumulated about benefits of probiotic supplementation for most digestive disorders, as well as many other health problems. 41-47 The market is full of probiotics in the form of drinks, foods, powders, capsules and tablets. Majority of them are prophylactic, which means that they are designed for the fairly healthy people, they are not designed to make a real difference in a person with a digestive disorder and a “leaky gut”. These people need a therapeutic strength probiotic with well-chosen powerful species of probiotic bacteria. A therapeutic probiotic will produce a so-called “die-off reaction”: the probiotic bacteria kill the pathogens in the gut, when these pathogens die, they release toxins. As these are the toxins which give the patient his or her unique symptoms, their release makes these symptoms worse, which is called the “die-off reaction”. This reaction can be quite serious and must be controlled. That is why I recommend to start the therapeutic probiotic from a very small dose, then build the dose very gradually up to the therapeutic level. Once on that level, the patient needs to stay on it for a few months: how long - depends on the severity of the condition. Once the symptoms of the disease are largely gone, the patient can start gradually reducing the daily dose to the maintenance level or can stop altogether. Stephanie took a particular therapeutic probiotic. She took one capsule per day (2 billion live cells) for a week, then increased to 2 capsules per day. On this dose her skin became itchy, she got loose stool and her cystitis symptoms got slightly worse. She understood it to be a “die-off”, so stayed on this dose for as long as it took for these symptoms to subside – 2,5 weeks. Then she increased her dose to 3 capsules a day. This increase produced

another “die-off reaction”, so she had to stay on the 3 capsules per day for a month before she could move on. In this manner she gradually got up to 8 capsules a day – her therapeutic dose. I recommended her to stay on this dose for 6 months. In this period of time all her main symptoms subsided and some started going. After 6 months, she decided to stay on the therapeutic dose for longer, as she felt well on it. After another 4 months on 8 capsules per day, she felt strong enough to start reducing the dose. She gradually reduced it to 4 capsules a day – her maintenance dose. After about 2 years on this dose she found that she could discontinue the probiotic (as it is expensive) and only take it occasionally, when she was under particular stress. References 1. 2.

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Gr”onlund MM, Lehtonen OP, Eerola E, Kero P. Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J Pediatr Gastroenterol Nutr, 1999 Jan, 28(1):19-25.

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11. Harmsen HJ, Wideboer-Veloo AC, Raangs GC, Wagendorp AA et al. Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods. J Pediatr Gastoenterol Nutr, 2000 Jan, 30(1):617. 12. Lucas A, Brooke OG, Morley R et al. Early diet of preterm infants and development of allergic or atopic disease: randomised prospective study. Brit Med J 1990;300:83740. 13. LA Shimeld, AT Rodgers. Essentials of Diagnostic Microbiology. 1999. Cengage Learning, pp.405-406. 14. Tori Hudson. Women’s Encyclopedia of Natural Medicine. Second edition. 2007. McGRaw-Hill Professional, pp.67-69. 15. H L T Mobley, J W Warren. Urinary Tract Infections: Molecular Pathogenesis and Clinical Management. 1996, ASM Press, pp.67-70. 16. Shaw W. Metabolic disease testing: the history of organic acid testing. In: Biological Treatments for Autism and PDD. 2002:25-28. ISBN 0-9661238-0-6. 17. L Gillespie. You Don’t Have to Live with Cystitis. 1996. Avon Books, pp.62-63. 18. JR Dalton, EJ Bergquist. Urinary Tract Infections. 1987. Taylor & Francis, pp.88-95. 19. Vorobiev AA, Pak SG et al. Dysbacteriosis in children. A textbook for doctors and medical students (Russian), M, “KMK Lt”, 1998, ISBN 5-87317-049-5. 20. Cummings JH, Macfarlane GT (1997). Colonic Microflora: Nutrition and Health. Nutrition. 1997;vol.13, No.5, 476-478. 21. Finegold SM, Sutter VL, Mathisen GE (1983). Normal indigenous intestinal flora in "Human intestinal flora in health and disease". (Hentges DJ, ed), pp3-31. Academic press, London, UK. 22. Falliers C. Oral contraceptives and allergy. Lancet 1974; part 2: 515. 23. Grant E. The contraceptive pill: its relation to allergy and illness. Nutrition and Health 1983;2: 33-40. 24. Seeley, Stephens, Tate. Anatomy and Physiology. 1992. Second edition. Mosby Year Book. 25. Kalidas Shetty, Gopinadhan Paliyath, Anthony Pometto, Robert E. Levin. Human gut microflora in health and disease. In: Food Biotechnology, 2nd Edition, 2006, CRC Press, pp 1133-1200.

26. Anthony H, Birtwistle S, Eaton K, Maberly J. Environmental Medicine in Clinical Practice. BSAENM Publications 1997: 142. 27. Garrow JS, James WPT, Ralph A. Human nutrition and dietetics. 2000. 10th edition. Churchill Livingstone: 249-267. 28. Wilson K, Moore L, Patel M, Permoad P. Suppression of potential pathogens by a defined colonic microflora. Microbial Ecology in Health and Disease. 1988; 1:23743. 29. McLaren Howard J. Intestinal dysbiosis. Complementary Therapies in Med 1993;1:153. 30. Gibson GR, Roberfroid MB (1999). Colonic Microbiota, Nutrition and Health. Kluwer Academic Publishers, Dodrecht. 31. Howard J. The “autobrewery” syndrome. J Nutr Med 1991;2:97-8. 32. Gibson GR, Roberfroid MB (1999). Colonic Microbiota, Nutrition and Health. Kluwer Academic Publishers, Dodrecht. 33. Kikuchi, E., Y. Miyamoto, S. Narushima, and K. Itoh. 2002. Design of speciesspecific primers to identify 13 species of Clostridium harbored in human intestinal tracts. Microbiol. Immunol. 46:353-358.

34. Hecht, D. W. 2004. Prevalence of antibiotic resistance in anaerobic bacteria: worrisome developments. Clin. Infect. Dis. 39:92-97. 35. Di Prisco MC et al. Possible relationship between allergic disease and infection by Giardia Lamblii. Ann Allergy 1993;70:210-3. 36. Bjarnason I et al. Intestinal permeability, an overview. (review). Gastroenterology 1995;108:1566-81. 37. Eaton KK, Howard M, McLaren Howard J. Gut permeability measured by polyethylene glycol absorption in abnormal gut fermentation as compared with food intolerance. J Roy Soc Med 1995;88:63-6. 38. Gardner MLG (1994). Absorption of intact proteins and peptides. In: Physiology of the Gastrointestinal Tract, 3rd edn. Chapter 53, pp 1795-1820. NY:Raven Press. 39. Gottschall E. Breaking the vicious cycle. Intestinal health through diet. 1996. The Kirkton Press.

40. Campbell-McBride N. Gut and Psychology Syndrome. Natural treatment for autism, dyspraxia, dyslexia, ADHD, depression and schizophrenia. 2004. Medinform Publishing. 41. Kirjavainen PV, Apostolon E, Salminen SS, Isolauri E. New aspects of probiotics – a novel approach in the management of food allergy. 1999(Revew), Allergy 54(9):90915. 42. Furrie E. Probiotics and allergy. Proc Nutr Soc. 2005 Nov;64(4):465-9. 43. Abrahamsson, , Thomas R., et al. "Probiotics in Prevention of IgE-Associated Eczema: A Double-Blind, Randomized, Placebo-Controlled Trial." Journal of Allergy and Clinical Immunology. May 2007 119(5): 1174-80. 18 Aug. 2008. 44. Cabana MD, Shane AL, Chao C, et al. Probiotics in primary care pediatrics. Clinical Pediatrics. 2006;45(5):405–410. 45. Drisko JA, Giles CK, Bischoff BJ. Probiotics in health maintenance and disease prevention. Altern Med Rev. 2003 May;8(2):143-55. 46. Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Review of Anti-Infective Therapy. 2006;4(2):261–275. 47. Dunne C, Murphy L, Flynn S, O’Mahony L, O’Halloran S, Feeney M, Morissey D, Thornton G, Fitzerald G, Daly C, Kiely B, Quigley EM, O’Sullivan GC, Shanahan F, Collins JK 1999. Probiotics: from myth to reality. Demonstration of functionality in animal models of disease and in human clinical trials. (Review)(79 refs) Antonie van Leenwenhoek. 76(104):279-92, 1999 Jul-Nov.

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probiotics: healing the mind The idea that disease starts in the gut is not new, but a Cambridge practitioner has taken it a stage farther by showing how the restoration of gut flora plays a crucial part in the treatment of children with learning and behavioural disorders. CAM editor Simon Martin talks to Dr Natasha Campbell-McBride, MD, of the Cambridge Nutrition Clinic. r Natasha Campbell-McBride knows about children’s health from personal experience. Her son was diagnosed autistic when he was three. At three and a half, he started a programme of treatment. Now 10, he attends a mainstream school. “I remember that traumatic moment of the diagnosis ‘Autism’, being announced to us by our doctor followed by a statement 'There is nothing that can be done', says Natasha. “Well, being a doctor myself, I have to say ‘Your doctor is wrong! There is a lot that can be done’.“ Natasha and her partner Peter were founding members of PEACH (Parents for the Early intervention of Autism in Children). PEACH is a parent-led group helping parents of children with autism Intensive Behavioural Intervention Programmes. Also known as ABA, this approach is based on highly personalised, one-to-one coaching that teaches children language, play, academic, intellectual, self-help and social skills. An ABA programme can sometimes achieve miracles, but Natasha’s research and experience has shown her that it is still not enough. “Looking back now, nobody could predict that a little boy without any language, constantly self stimulating, eating very little apart from milk from a baby bottle could undergo such a transformation. On the whole what happened to him can only be described as a miracle. However, his achievements are not due solely to the ABA programme“, says Natasha. “A huge part of his transformation was in his nutritional management. Being trained as a medical doctor I knew that conventional medicine has nothing to offer children like my son. So I went back

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to university and trained as a nutritionist. We have changed his diet and after trying various nutritional supplements we have found the ones that work. An autistic child needs a very special nutritional management, a major part of it being – putting his gut flora right! Gut flora is a living organism very sensitive to the diet, antibiotics, steroids and stress. “Diet on its own is a very powerful tool in helping an autistic child. But it cannot solve all the problems without nutritional supplements. In order to rebalance the gut flora it is essential to use a strong multi-strain probiotic. “He showed an excellent response to probiotics. From about two to three months after starting it we saw dramatic improvements in our son – his eye contact became normal and stable, the self-stimulation had almost disappeared, he generally became more aware and with us. Everybody comments on how healthy he looks. He used to be on a milk-free diet. We introduced some milk products back into his diet and found that he tolerates it now without any symptoms.“ As a result of their experience, Peter heads up Cambridge Bioceuticals, a UK company founded by a team of doctors, nutritionists and scientists dedicated to advancing the research and use of probiotics. And he has become one of many children able to be helped by a combination of treatments with one thing in common – the use of powerful, multi-strain therapeutic probiotics. “More than 400 children have gone through my clinic“, says Natasha. “Hyperactive children, children with dyslexia and asthma and eczema and ADHD and other disabilities, and what I see is that what we have in our society is an epidemic of

compromised gut flora.“ As a result, she says, we also have an epidemic of poor health in children. “We hardly have any healthy children nowadays. One survey showed that only 10% of school children did not have a diagnosed condition. If you look at a typical school, you hardly see any healthy children. Some are obese, some look malnourished, a lot of them are very pale, a lot of them have eczema, a lot of them have asthma. About 30% of them are on inhalers. The situation is very sad.“ Recent international studies have suggested a relatively strong causal relationship between increased risk of childhood asthma and exposure to antibiotics during childhood, especially during the first year of life. Prof Julian Crane of Otago University has commented: “Our paper, together with a study published …in Thorax (Farooqi IS, et al. Thorax 1998;53:927-32), raises the possibility that broadspectrum antibiotics, particularly in the first year of life, may be associated with an increased risk of atopy and asthma. For reasons that have been pointed out in both papers, these results cannot be taken as definitive, but rather as hypothesis-raising. “On the other hand, the results are plausible. Broad-spectrum antibiotics came into clinical usage in the 1960s, and their increased use coincides with the time trends for the increasing prevalence of asthma. There is a plausible mechanism, namely that broad-spectrum antibiotics may alter and reduce bowel flora and thus switch off the immunological signals that these gut bacteria send to the developing immune system.“ (1) Crane has also showed, with a study of 450 children at six

cover story: PROBIOTICS Steiner schools in New Zealand, that even with parents opposed to the routine use of antibiotics, a staggering 75% of the children had used antibiotics, 36% in the first year of life! Autism is also exploding. “In this country one child in 250 is diagnosed as autistic, when 10 years ago we had one child in 10,000“, says Natasha. This is nothing to do with improvements or changes in diagnosis, she says. “The medical establishment and the government are trying to present it that way. But what that would mean is that 10 years ago doctors were so bad at diagnosing our children that they were missing one child in 250. But autism is not a disability that goes away as the child grows up. If they had missed one child in 250 10 years ago, then we would still only have one in 250 teenagers with autism now, which we don’t. Everybody who knows and works with autism is convinced that there is an epidemic going on.“ Although various causative factors have been promoted, Natasha is convinced that disturbed gut flora is at the root of it. She has a well-worked out chain of events that even explains how a compromised flora – and all that goes with it – has been passed on through the generations. Unless it is corrected, future generations are doomed to an ever-increasing level of ill-health, with potentially no one safe from a cycle of infections, allergies, arthritis, digestive disorders, atopy and, for some, hyperactivity, ADHD and autism. I asked her to explain this devastating theory; she started with the basics. “We really started prescribing antibiotics for everything and anything in the ‘70s and ‘80s“, she says. “That’s when we started to get generations of people with compromised gut flora. Antibiotics wipe out the beneficial bacteria as well as the pathogenic bacteria. Remember, our beneficial bacteria are very vulnerable to antibiotics and get wiped out very quickly. If the course of antibiotics is short and the

person has a fairly solid gut flora, then it usually recovers. But if antibiotics are repeated quite often, and particularly when people are prescribed long courses – such as when people with acne are put on tetracycline for 2 years or so – they invariably finish up with digestive disorders like IBS, because their gut flora gets wiped up. When the beneficial bacteria are not there, then all sorts of pathogens and opportunists get a chance to grow to occupy the gut and to populate it. They start digesting food in their own way, breaking it down into inappropriate substances. And they also damage the gut lining, making the gut leaky and allowing this maldigested food to get absorbed. The immune system reacts to this maldigested food as foreign substances and hence you get allergies.“ Now maybe it’s just the fashion, but everybody you meet these days says they have some sort of allergy. It’s either hayfever or permanently runny nose or skin rashes or food intolerances. Practitioners may distinguish between true allergies and “mere“ intolerances or sensitivities, but the public doesn’t. To them, there’s not doubt whatsoever that there’s an epidemic of allergies too. “Allergies usually happen when the immune system gets out of balance“, says Natasha. “The major balancing agent of the immune system in the body is the gut with its gut flora. The flora can literally be described as the right hand of our immune system. But when the beneficial gut flora is not there, the two major arms of immunity, TH1 immunity and TH2, get out of balance. [*types of helper cells: current wisdom is that TH2 cells stimulate production of IgE, the master of allergic reactions, while Tl cells inhibit]. The end result of abnormal gut flora is a weakening of the TH1 arm; the TH2 gets overactive, and that’s the arm of the immunity that’s responsible for allergic type reactions, atopic type reactions. So instead of reacting to the

environment stimuli in a normal, natural way, people start reacting in an allergic type of way. “The gut flora’s really a huge, huge agent. On average everyone carries two kilograms of bacteria in their gut. There are more cells there than there are in an entire human body. We can’t live without this mass of bacteria and it’s a highly organised microbial world, dominated by beneficial bacteria. “What I am seeing now are generations of people in this country with compromised gut flora – because I don’t just examine the child, I get a full medical history of the parents and the grandparents. “A grandmother, for example, perhaps has arthritis, which is another sign of toxicity in the body. When opportunists and pathogenic bacteria occupy the gut, they produce a lot of toxic substances. These toxic substances seep through into the bloodstream and settle in different tissues of the body causing an auto-immune attack on those tissues as the immune system tries to clean the body up. So someone with arthritis usually has some abnormalities with the gut flora; they are being poisoned by their own gut. There is a certain level of toxicity in the body, which has particular design to settle in the joints. So the grandmother will have arthritis, or rheumatoid arthritis, or allergies or digestive disorders. “A baby is born with a sterile gut and as the baby goes throughout the birth canal at birth, it swallows its first batches of bacteria. So a major part of the gut flora which would populate the virgin gut of the baby, comes from the mother. So this grandmother gives her compromised gut flora to her daughter. So now the daughter will be prone to PMS perhaps, to migraines, to digestive disorders – that’s what I see in mothers of autistic children. Between 95-100% of mothers of children with autism, hyperactivity, asthma, eczema and other problems, also have conditions that are related to abnormal gut flora. I hardly ever see healthy mothers.

Specific carbohydrate diet – no grains, no lactose, no sucrose Elaine Gottschall says: “Of all dietary components, carbohydrates have the greatest influence on intestinal microbes (yeast and bacteria) which are believed to be involved in intestinal disorders. Most intestinal microbes require carbohydrates for energy. The SC diet works by severely limiting the availability of carbohydrates to intestinal microbes. When carbohydrates are not digested, they are not absorbed. They remain in the intestinal tract, thus encouraging microbes to multiply by providing food for them. This can lead to the formation of acids and toxins that can injure the small intestine. Once bacteria multiply within the small intestine, they can destroy the enzymes on the intestinal cell surface, preventing carbohydrate digestion and absorption. At this point, production of excessive mucus may be triggered as the intestinal tract attempts to “lubricate” itself against the irritation caused by the toxins, acids, and the presence of incompletely digested and unabsorbed carbohydrates. The SCD is based on the principle that specifically selected carbohydrates, requiring minimal digestion, are well absorbed, leaving virtually nothing for intestinal microbes to feed on. As the microbes decrease due to lack of food, their harmful byproducts also diminish. No longer needing protection, the mucus producing cells stop producing excessive mucus and carbohydrate

digestion is improved. The SCD corrects malabsorption, allowing nutrients to enter the bloodstream and be made available to the cells of the body, thereby strengthening the immune system’s ability to fight. Further debilitation is prevented, weight can return to normal, and ultimately there is a return to health.” Disallowed Foods: ■ Sugars: Do not eat sugar, molasses, sucrose, high fructose corn syrup, fructose, or any processed sugar. ■ Veggies: No canned vegetables are permitted. ■ Grains: All grains are not permitted, such as: corn, wheat, wheat germ, barley, oats, rye, rice, buckwheat, soy, spelt, amaranth, and others. Some legumes are not allowed: chick peas, bean sprouts, soybeans, mung beans, faba beans, and garbanzo beans. Starchy foods are not permitted, such as: potatoes, yams, and parsnips. Seaweed and seaweed by-products, such as agar and carrageenan, are not allowed. ■ Meats: All canned meats are forbidden. Most processed meats are not permitted. Make sure processed meat doesn't contain any harmful additive such as corn, corn products, starch, and sugars. ■ Dairy: All variations of milk are not allowed: whole, skim, 1%, 2%, chocolate, etc. Some cheeses are

high in lactose content and are restricted: ricotta, mozzarella, cottage cheese, cream cheese, feta, and processed cheeses and cheese spreads. Commercial yogurt contains a high amount of lactose and is not allowed. Heavy cream, buttermilk, and sour cream are not allowed. ■ Misc: Other foods that are not permitted include: bread, pasta, other starchy foods, canola oil, commercial mayonnaise (because of additives), ice cream, candy, chocolate, carob, whey powder, margarine, commercial ketchup, stevia, baking powder, commercial nut mixes, balsamic vinegar, and FOS (fructooligosaccharides) products. Allowed Foods – quantities are not restricted if you eat a balanced diet ■ Sugars: Honey is the only allowed sugar product. Not everyone can tolerate it, so use with caution. ■ Veggies: Most vegetables, fresh or frozen and raw or cooked, are allowed including: asparagus, broccoli, cauliflower, artichokes, beets, Brussells sprouts, cabbage, carrots celery, cucumbers, eggplant, zucchini, summer squash, rhubarb, peppers, garlic, lettuce, spinach, mushrooms (unless you have candidiasis), onions, turnips, and watercress. Be careful of raw vegetables when diarrhoea is present.

“What happens is that she initially inherited the compromised gut flora from her mum, but she grows up and at the age of 15 or 16, she goes on a contraceptive pill. Many mothers use an oral contraceptive for quite a few years before they’re ready to have children. The contraceptive pill is a steroid and that damages the gut flora even further. It has a devastating effect on the gut flora. So by the time this woman is ready to have children her gut flora is seriously compromised and that’s what she passes to her child. “Because the gut flora is the major part of the immune system, when children are born with compromised gut flora they are left immunecompromised as well. With autistic children and hyperactive children, we see that in the first year of life and second year of life they’re very prone to infections, to ear infections in particular, and a lot of chest infections as well. They quite often go through one ear infection after another and eventually they are put on permanent antibiotics, which would wipe out whatever precious little beneficial bacteria they got in there.“ If you thought that grandmother’s breastfeeding may have gone some way to repairing this damage, think again. “Breast-feeding is the best thing to establish normal gut flora. But breast milk is a two-sided coin. On one hand it’s the best food for the baby, because children who are not breast-fed develop completely different gut flora from those who are. And that sort of gut flora predisposes them later to all sorts of health problems. So breast-feeding is best. On the other hand, a woman whose gut is populated by abnormal flora will have toxins from that gut flora in her blood. And whatever’s in her blood is likely to be in her breast-milk. So she will be passing toxins through her breast-milk to her baby. “A lot of these children have low stomach acidity. So when they start solids at the age of six

■ Legumes: Dried navy beans, lentils, peas, split peas, unroasted cashews, peanuts in a shell, all natural peanut butter, lima beans, and string beans. ■ Meats: All unprocessed meats such as: beef, pork, chicken, turkey, quail, ostrich, fish, shellfish, lamb, venison, rabbit, and eggs. Some processed meats are allowed, but many require writing letters to manufacturers to verify the absence of restricted foods. Many processed meats contain sugar, starch, corn products, and other disallowed foods. ■ Dairy: All natural cheeses except those listed above are allowed: cheddar, colby, swiss, havarti, dry curd cottage cheese, etc. Homemade yogurt that has been fermented for a minimum of 24 hours is allowed and encouraged. ■ Fruits: Most fruits are allowed such as: avocados, apples, tomatoes, olives, apricots, ripened bananas, coconuts, dates, berries, cherries, citrus fruits, peaches, pears, tropical fruits, and grapes. Nuts Almonds, Brazil nuts, walnuts, chestnuts, filberts, and pecans. ■ Misc: The following foods are allowed: olive oil, coconut oil, soybean oil, corn oil, weak tea, weak coffee, unflavoured gelatin, mustard, vinegar, saccharin, and juices with no additives. • Food lists from the SCD Web Library www.scdiet.org

The diagram above demonstrates some of the interrelationships between ADD/ADHD, the immune system and the workings of metabolism. (From The Great Plains Laboratory, www.greatplainslaboratory.com/adhdbreaking.html)

months, they usually can’t digest them – particularly dairy milk proteins. This results in toxicity coming from pathogens such as the clostridia and candida families, which grow in abnormal gut environment producing particular kind of toxins that reduce the ability of the stomach to produce acids.“

Vaccinations Then we have to stir in vaccinations – another assault on the immune system. “Vaccinations are designed for healthy immune systems. But children who are born to mothers with compromised gut flora are already immune-compromised. They can’t take these vaccines. They cannot react to them the way they are supposed to. Vaccines deepen the damage to the immune system in these children. Indeed in certain cases MMR just tips the scale. In some children it’s not MMR that tips the scale it’s DPT, the triple vaccine which is given to children at a very early age – at 1.5 months, 2.5 and 3.5 months. This vaccine also contains thimerosal, a mercury-containing preservative, which is in most DPT vaccinations.“ Because of all these factors, a baby is not going to develop normal gut flora. If the normal bacteria are not there, then the coast is clear for all sorts of pathogens to take hold. On top of that, says Natasha, because the normal gut flora plays a huge role in digestion and absorption of food, these children go on to develop multiple nutritional deficiencies. “In parallel, the pathogenic flora convert the food into a whole host of toxic substances. A lot of these toxins have been well-studied and you can test for them. They have been found routinely in autistic children and in hyperactive children.“ Some of these toxins are well-known to CAM practitioners, such as the acetaldehyde produced by yeasts acting on sugars, and the ethanol that results from that when candida species get going. Others are less familiar, but can be found in the medical literature. Clostridium, for example, one of the opportunistic pathogens unleashed by antibiotics is known to produce a potent tetanus neurotoxin, which has been identified as a possible cause of autism in some case. (2) The suggestion is that this

neurotoxin can be transported along the vagus nerve from the intestinal tract to the central nervous system and into the brain, disrupting the release of neurotransmitters. Another form of clostridium produces a botulinic neurotoxin, says Natasha. Other researchers believe that sulphate-reducing bacteria in a disturbed gut flora may explain why around 95% of autistic children have low serum sulphate – about 15% of that found in controls (3). The resulting reduced sulphation not only increases gut permeability and inflammation but may also inactive neurotransmitters involved in the modulation of mood and behaviour. The sulphate research trail was kick-started by the observations of the UK self-help group Allergy Induced Autism. AIA encouraged Dr Rosemary Waring of Birmingham University, whose pioneering research proved that autistic children have problems with detoxification, so that certain foods and used neuro-transmitters are not processed effectively. (4) One of the most significant findings is that opportunistic fungi in the gut can produce opiate-like substances. Dr Alan Friedman, PhD, a Johnson & Johnson researcher with an interest in autism, has found dermorphin and deltorphin in the urine of autistic children (5). As Reading university’s Dr Max Bingham, PhD, comments, these compounds are “many times more potent than morphine“ and had previously only been found on the skin of “poison dart frogs“ and traditionally used as arrow-tip poisons and hallucinogens. There is already a well-established “opioid theory of autism“, in which researchers have confirmed that children with autism had many abnormal peptides (small pieces of partially broken down proteins) in their urine. These included casomorphine and gliadomorphin. These peptides are the breakdown products of casein and gluten, giving a sound biochemical basis for a successful dietary intervention first investigated in Norway and then replicated at the university of Sunderland’s Autism Research Unit by Dr Paul Shattock and colleagues (6). Opiates and the gluten/casein sensitivity turn autism into a living nightmare for the afflicted children. “These opiates absorb very well, cross the blood-brain barrier and then block the brain in certain areas“, says Natasha. “These children have got normal eyes, normal ears, normal tactile sensitivity, but their brains cannot process the information. So the result is that children don’t hear, don’t see and don’t feel the same way we do. The whole sensory input gets jumbled up in their heads. They don’t develop speech because they don’t hear properly. The speech that is addressed to them from their parents, from their carers, is jumbled in their heads. They can’t make sense out of it. The highly functioning autistic individual they say that quite often they can see one half of the page and can’t see the other. They can hear certain vowels and they can’t hear others. They can hear certain frequencies but not others. One child, for example, could clearly hear his mother’s voice, but not his father’s. The same happens with children with dyslexia; that’s why they can’t read, because their visual areas of the brain are blocked with toxicity.“ And this all comes from the gut. Just like the nature cure pioneers always maintained: your gut can poison you. The good news is that the gut can

cover story: PROBIOTICS be helped back into balance and the research clearly supports dietary intervention. – autism is NOT all in the mind. “Diet is a huge part of the treatment for these children“, says Natasha. “They need the kind of diet that heals the digestive tract, stops it leaking and establishes the normal gut flora.“ Natasha employs the Specific Carbohydrate Diet, a strict grain-free, lactose-free and sucrose-free meal plan that limits the particular carbohydrates needed by harmful yeasts and bacteria. (See panel.) Only mono sugars are allowed: fructose, galactose and some others found in fresh vegetables, fresh fruit and honey. The original diet was developed in the 1950s by Drs Sidney and Merrill Haas to cure patients with coeliac disease and was first published in the Haas’s book The Management of Celiac Disease in 1951. It has since been championed by biochemist and cell biologist Elaine Gottschall, MS, author of Breaking the Vicious Cycle: Intestinal Health through Diet (first published in 1987 and still in print). Gottschall’s eight-year-old daughter, diagnosed by specialists with incurable ulcerative colitis and with a deteriorating condition, was symptom-free in two years after following the Haas instructions. With more than 40 years experience of the diet, Gottschall says; “Some of the most dramatic and fastest recoveries have occurred in babies and young children with severe constipation and among children who, along with intestinal problems, had serious behaviour problems. These included autistictype hyperactivity as well as hyperactivity, often accompanied by severe and prolonged night terrors. Very often the behaviour problems and night terrors cleared up within ten days after initiation of the Haas Specific Carbohydrate Diet.“ (7) Natasha says, “Autistic disorder is essentially a digestive disorder. So once you put the digestive tract right, you lay the ground for recovery.“ Dr Andrew Wakefield is the internationally respected gastroenterologist who was researching Crohn’s and Ulcerative colitis when he found a type of inflammatory bowel disease in autistic children who had received the MMR vaccine. He was sacked when he published his findings in the Lancet. Wakefield has written: “I sit across from you as the parent and you say: 'this is what happened to my child, they were developing normally, they had speech, language, social skills, they received their MMR vaccine and they developed bowel symptoms and their behaviour deteriorated, I lost them, the light went out'. You listen to that story, you don't buy into it, but you say: 'is there anything I can do to substantiate this in my job as a physician?' You investigate the symptoms and you find that there is an inflammatory bowel disease that has gone unrecognised in these children . So the parents were right“. (8) According to Natasha, before Wakefield started investigating, the medical profession didn’t want to know about digestive abnormalities in autistic children. “How many autistic children that I see have digestive abnormalities!“ she says. “All parents talk about it. They have diarrhoea, constipation, flatulence, pain, bloating, the whole picture. So the occasional child who actually made it to gastroenterologist and whose gut has been x-rayed, invariably showed faecal compaction. Old compacted rotten faeces glued to the walls of their gut.

“Wakefield was the first gastroenterologist to seriously look at it; he found the same thing – an autistic child’s gut is chock a block. He also found inflammation, which in some features was similar to ulcerative colitis, in others was similar to Crohn’s disease and others were unique to autistic children. He found abscesses filled with pus. He found ulcers, he found compaction, he found erosions, he found the whole length was inflamed. And because these children cannot communicate, they cannot tell you that they’re in pain, cannot tell you that their tummy is hurting, the parents don’t know about it. But many do go to doctors and say ‘My child has diarrhoea’, ‘My child has constipation’. Some of these children have horrendous constipation. They don’t go to the toilet for a week to ten days and then they have an enormous, extremely painful hard stool, which cracks their anus and the anus bleeds. This sort of experience is very painful for the child, so they end up holding on for as long as they can, until they just can’t hold any longer – and they have another hard stool.“ Remember, these are children who are also unable to communicate to their parents and carers the pain they are in. Along with diet, Natasha says supplementation is very important. Probiotics are the absolute foundation – but they must be the right sort. And that means a multi-strain product containing soil bacteria, not just lactobacilli and bifidobacteria. These are what she calls “therapeutic“ probiotics as opposed to the milder, prophylactic products. “You need soil bacteria to break down the putrefaction and clear out the pathogenic flora because they are aggressive, they actually use them in industry because they have great ability to clear out putrefied waste. They work in a clinical setting far more effectively.“ Even so, a child is typically kept on the strict diet and taking probiotics for at least two years. “Nothing works that fast in nature“, she says. The good news is that autisic children are born with normal brains and recovery is possible. “The majority of them are developing normally until the scales are tipped and toxicity starts affecting their brain development. It usually happens in the second year of life. If you catch them early and you teach them appropriately, they become perfectly normal, they finish up in mainstream schools. Obviously they’re all different, some of them would have some idiosyncracies, or they’ll be a little bit eccentric, but they’re within normal range.“ Apart from fish oils, she doesn’t include many other supplements. “I do believe in providing most things through the diet with children. Once the diet is put right, the gut starts healing and the child starts absorbing nutrients from food.“ Similarly, she finds that once the gut flora is right a lot of food intolerances disappear and the major source of toxicity is removed, easing the load on the liver and detoxification systems. However, some children will need to be actively detoxified using combinations of juices. “We all have a so-called detoxification system. When the system is overloaded with toxicity, overloaded with work“, she explains, “then the more you store it in various tissues in order to deal with it later. But in children which are highly toxic, autistic children, the time never comes for the toxins which are stored in tissues.“ They also tend to store a lot of heavy metals – even so, she prefers the

gentle effectiveness of juices to chelation. “The child has a couple of 8oz glasses a day of freshly pressed juice. Therapeutic kinds of juices are generally vegetable juices, particularly green juices, which taste ghastly! So I suggest 50% of something tasty, like pineapple or orange or apple or mango, to disguise the taste of the other 50%. Of that about 40% will be carrot juice, 10% beetroot. You have to be careful with beetroot because it is extremely powerful and can really make you sick. So other juices we use are celery, lettuce and then greens like spinach, parsley, dill, fresh nettles, dandelion leaves, those sort of things.“ The children use the juices while on the Specific Carbohydrate Diet. The only other thing they drink is water – unchlorinated, bottled or filtered, and lots of it. To check progress, Natasha may use a Great Smokies stool test. “It is useful when we have been through the intial stages of the programme and if we are struggling with something and what to know what’s going on. I don’t do the test before we have done the intial baseline treatment.“ The only other test she is liable to use is the organic acid test (OAT) developed by Dr William Shaw of the Great Plains Laboratory. A noninvasive urine test, it measures around 70 different biochemical compounds, picking up abnormal urinary metabolites that are the “signatures“ that can reveal what specific overgrowth a child has. It also reveals some nutritional deficiencies. We’ll give Shaw the last word: “The last half of this century could be termed the era of antibiotics. The next century will be involved in developing new antimicrobial treatments (probiotics or beneficial bacteria) or other therapies that have less potential for harming young children. Pasteur and others found that lethal strains of bacteria could be rendered harmless if animals were given other benign bacteria simultaneously.“ (9) cam • Dr Campbell-McBride holds a Degree in Medicine and a Postgraduate Degree in Neurology. She also holds a second Postgraduate Degree in Human Nutrition from Sheffield University. In her Cambridge Clinic she specialises in Nutrition for Children with Learning Disabilities, and Adults with Digestive and Immune System Disorders. She lectures at a BANT-accredited conference in London on October 9. • Cambridge Bioceuticals Probiotics site:www.bio-kult.com Includes case histories and other articles by Dr Natasha Campbell-McBride. • Reprinted from CAM Magazine August 2003.

References 1. Wickens K, Pearce N, Crane J, Beasley R. Antibiotic use in early childhood and the development of asthma. Clin Exp Allergy 1999;29:766-771. Crane quoted at www.chiroweb.com/archives/17/17/01.html 2. Bolte ER, (1998). Autism and Clostridium tetani. Medical Hypotheses 51(2): 133-144. 3. Waring (2001). Sulphate, sulphation and gut permeability: are cytokines involved? In: The Biology of Autism – Unravelled. Conference proceedings 11th May 2001, Institute of Electrical Engineers, Savoy Place, London. 4. Alberti A, Pirrone P, Elia M, Waring RH, Romano C.Sulphation deficit in “low-functioning“ autistic children: a pilot study. Biol Psychiatry 1999 Aug 1;46(3):420-4 5. Unpublished research reported in Autism and the Human Gut Microflora, by Dr Max Bingham, PhD, Food Microbial Sciences Unit, University of Reading, accessed online at www.fst.rdg.ac.uk/research/fmsu/Autism.htm6. Shattock P and Whiteley P. (2001) How dietary intervention could ameliorate the symptoms of autism. Pharmaceutical Journal, July 7; 267(7155). 7. From chapter one of Breaking the Vicious Cycle, accessed online at http://66.40.242.169/chap1.html 8. “Why I Owe It To Parents To Question Triple Vaccine”, Andrew Wakefield explains why he first warned of a possible link between the MMR jab and autism, Sunday Herald (Scotland), 10 Feb 2002. Accessed online at http://www.sundayherald.com/22194 9. Interview with Dr William Shaw about microbial metabolites in autism and other developmental disorders, accessed online at www.autism.com/shaw-yeast/interv.html

Gut and Psychology Syndrome (GAP Syndrome or GAPS)  Dr. N. Campbell-McBride MD

We live in the world of unfolding epidemics. Autistic Spectrum Disorders, Attention Deficit Hyperactivity Disorder (ADHD/ADD), schizophrenia, dyslexia, dyspraxia, depression, obsessive –compulsive disorder, bipolar disorder and other neuro-psychological and psychiatric problems in children and adults are becoming more and more common. In clinical practice these conditions more often than not overlap with each other. A patient with autism often is hyperactive and dyspraxic. There is about 50% overlap between dyslexia and dyspraxia and 25-50% overlap between hyperactivity and dyslexia and dyspraxia. Children with these conditions are often diagnosed as being depressed and as they grow up they are more prone to drug abuse or alcoholism than their typically developing peers. A young person diagnosed with schizophrenia would often suffer from dyslexia, dyspraxia or/and ADHD/ADD in childhood. Schizophrenia and bipolar disorder are often described as two sides of one coin. We have created different diagnostic boxes to fit our patients in, but a modern patient does not fit into any one of them neatly. The modern patient in most cases fits into a rather lumpy picture of overlapping neurological and psychiatric conditions. This picture leads us to the fact that these conditions are related to each other by similar underlying causes. Let us discuss what these causes may be. What is a typical scenario we see in clinical practice? Before examining the patient it is very important to look at the health history of the parents. Whenever the parents are mentioned people immediately think about genetics. However, apart from genetics there is something very important the parents, mother in particular, pass to their child: their unique gut micro-flora. Not many people know that an adult on average carries 2 kg of bacteria in the gut. There are more cells in that microbial mass than there are cells in an entire human body. It is a highly organised micro-world, where certain species of bacteria have to predominate to keep us healthy physically and mentally. Their role in our health is so monumental, that we simply cannot afford to ignore them. We will talk in detail about the child’s gut flora later. Now let us come back to the source of the child’s gut flora – the parents. After studying hundreds of cases of neurological and psychiatric conditions in children and adults, a typical health picture of these children’s mums has emerged.

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A typical modern mother was probably not breast fed when she was a baby, because she was born in 60s or 70s when breast-feeding went out of fashion. Why is it important? Because it is well known now that bottle fed babies develop completely different gut flora to the breast fed babies. This compromised gut flora in a bottle fed baby later on predisposes her to many health problems. Having acquired compromised gut flora from the start, a typical modern mum had quite a few courses of antibiotics in her childhood and youth for various infections. It is a well known fact that antibiotics have a serious damaging effect on gut flora, because they wipe out the beneficial strains of bacteria in the gut. At the age of 16 and sometimes even earlier the modern mum was put on a contraceptive pill, which she took for quite a few years before starting a family. Contraceptive pills have a devastating effect on the beneficial (good) bacteria in the gut. One of the major functions of the good bacteria in the gut flora is controlling about 500 different known to science species of pathogenic (bad) and opportunistic microbes. When the beneficial bacteria get destroyed the opportunists get a special opportunity to grow into large colonies and occupy large areas of the digestive tract. A modern diet of processed and fast foods provides perfect nourishment for these pathogens and that is a typical diet a modern mum had as a child and a young adult. As a result of all these factors a modern mum has seriously compromised gut flora by the time she is ready to have children. And indeed clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with neurological and psychiatric conditions. Why are we talking about mother’s gut flora? Because her baby is born with a sterile gut. In the first 20 or so days of life the baby’s virgin gut surface gets populated by a mixture of microbes. This is the child’s gut flora, which will have a tremendous effect on this child’s health for the rest of his/her life. Where does this gut flora come from? Mainly from the mother. So, whatever microbial flora the mother has she would pass to her new-born child. Gut flora is something we do not think much about. And yet the number of functions the gut flora fulfils is so vital for us that if some day our digestive tract got sterilised we probably would not survive. The first and very important function is appropriate digestion and absorption of food. If a child does not acquire normal balanced gut flora, then the child will not digest and absorb foods properly, developing multiple nutritional deficiencies. And that is what we commonly see in children and adults with learning disabilities, psychiatric problems and allergies. Many of these patients are malnourished. Even in the cases where the child may grow well, testing reveals some typical nutritional deficiencies in many important minerals, vitamins, essential fats, many amino-acids and other nutrients. The most common deficiencies, recorded in these children, are in magnesium, zinc, selenium, copper, calcium, manganese, sulphur, phosphorus, iron, potassium, vanadium, boron, vitamins B1, B2, B3, B6, B12, C, A, D, folic acid, pantothenic acid, omega-

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3, 6, 9 fatty acids, taurine, alpha-ketoglutaric acid, glutathione and many other amino-acids. This usual list of nutritional deficiencies, commonly seen in these children, includes some most important nutrients for normal development of the child’s brain, immune system and the rest of the body. Apart from normal digestion and absorption of food healthy gut flora actively synthesises various nutrients: vitamin K, pantothenic acid, folic acid, thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6), ciancobalamine (vitamin B12), various amino-acids and proteins. Indeed, when tested people with gut dysbiosis always present with deficiencies of these nutrients. Clinical experience shows that restoring the beneficial bacteria in their gut is the best way to deal with these deficiencies. The majority of children and adults with neurological and psychiatric conditions look pale and pasty. When tested they show various stages of anaemia, which is not surprising. To have healthy blood we require many different nutrients: vitamins (B1, B2, B3, B6, B12, K, A, D, etc), minerals (Fe, Ca, Mg, Zn, Co, Se, boron, etc.), essential amino acids and fats. These patients not only can't absorb these nutrients from food, but their own production of many of them in the body is damaged. On top of that people with damaged gut flora often have particular groups of pathogenic bacteria growing in their gut, which are iron-loving bacteria (Actinomyces spp., Mycobacterium spp., pathogenic strains of E.Coli, Corynebacterium spp. and many others). They consume whatever iron the person gets from the diet, leaving that person deficient in iron. Unfortunately, supplementing iron only makes these bacteria grow stronger and does not remedy anaemia. To treat anaemia the person requires all the nutrients we have mentioned many of which healthy gut flora supplies.

Apart from taking a vital part in nourishing the body, beneficial bacteria in the gut act as the housekeepers for the digestive tract. They coat the entire surface of the gut protecting it from invaders and toxins by providing a natural barrier and producing a lot of anti-bacterial, anti-viral and anti-fungal substances. At the same time they provide the gut lining with nourishment. It is estimated that 60 – 70% of energy, the gut lining derives, is from the activity of bacteria, which live on it. So, it is no surprise that when the gut flora is abnormal the digestive tract itself can not be healthy. Indeed most patients with learning disabilities, psychiatric disorders and allergies present with digestive problems. In many cases these problems are severe enough for the patients or their parents to talk about them first. In some cases they may not be severe, but when asked direct questions the parents describe that their child never had normal stool, that their child suffered from colic as a baby and that tummy pains and flatulence are a common part of the picture. In those cases where these children have been examined by gastroenterologists, inflammatory process in the gut was found along with faecal compaction and an over-spill syndrome.

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Schizophrenic patients were always known to have serious digestive problems. Dr. Curtis Dohan, MD has devoted many years to researching digestive abnormalities in schizophrenia. He found a lot of similarities between coeliac disease and the state of the digestive tract in schizophrenics. Indeed, long before these patients develop psychotic symptoms they usually suffer from digestive problems and all other typical symptoms of gut dysbiosis pretty much from the start of their lives. Children and adults with ADHD/ADD, OCD, depression, bipolar disorder and other neuro-psychological problems are very often reported to suffer from digestive abnormalities. What other symptoms of gut dysbiosis do we know? Well functioning gut flora is the right hand of our immune system. The beneficial bacteria in the gut ensure appropriate production of different immune cells, immunoglobulins and other parts of the immunity. But most importantly they keep the immune system in the right balance. What typically happens in a person with gut dysbiosis is that two major arms of their immune system Th1 and Th2 get out of balance with underactive Th1 and overactive Th2. As a result the immune system starts reacting to most environmental stimuli in an allergic or atopic kind of way. A baby is born with an immature immune system. Establishment of healthy balanced gut flora in the first few days of life plays a crucial role in appropriate maturation of the immune system. If the baby does not acquire appropriate gut flora then the baby is left immune compromised. The result is lots of infections followed by lots of courses of antibiotics, which damage the child’s gut flora and immune system even further. The most common infections in the first two years of life in the children with neurological, psychological and atopic disorders are ear infections, chest infections, sore throat and impetigo. At the same time in the first two years of life the child receives a lot of vaccinations. A child with compromised immune system does not react to vaccinations in a predicted way. In many cases vaccines deepen the damage to the immune system and provide a source of chronic persistent viral infections and autoimmune problems in these children. There has been a considerable amount of research published into the state of the immune system in children with learning disabilities and psychiatric problems. The research shows deep abnormalities in all major cell groups and immunoglobulins in these children. The most common autoantibodies found are to myelin basic protein (MBP) and neuron-axon filament protein (NAFP). These antibodies attack the child’s brain and the rest of the nervous system. So, the modern child who we are talking about, did not get normal gut flora from the start and then got it damaged even further by repeated courses of antibiotics and vaccinations. As a result these children commonly suffer from digestive problems, allergies, asthma and eczema. But apart from that in children and adults who then go on to develop neurological and psychiatric problems something even more terrible happens. Without control of the beneficial bacteria different opportunistic and pathogenic bacteria, viruses and fungi have a good

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chance to occupy large territories in the digestive tract and grow large colonies. Two particular groups which are most commonly found on testing are yeasts (including Candida species) and Clostridia family. These pathogenic microbes start digesting food in their own way producing large amounts of various toxic substances, which get absorbed into the blood stream, carried to the brain and cross the blood – brain barrier. The number and mixture of toxins can be very individual, causing different neurological and psychological symptoms. Due to the absence or greatly reduced numbers of beneficial bacteria in the gut flora, the person’s digestive system instead of being a source of nourishment becomes a major source of toxicity in the body.

So, what kind of toxins are we talking about? There are many toxins, which we have not studied very well yet. But some toxins have received a considerable amount of research. Let us have a look at them. Acetaldehyde & Alcohol. What have these substances got to do with our patients? The most common pathogenic microbes shown to overgrow in the digestive systems of children and adults with neuro-psychological conditions and allergies are yeasts, particularly Candida species. Yeasts ferment dietary carbohydrates with production of alcohol and its by-product acetaldehyde. Let us see what does a constant exposure to alcohol and acetaldehyde do to the body. • • • • • • • • • •

Liver damage with reduced ability to detoxify drugs, pollutants and other toxins. Pancreas degeneration with reduced ability to produce pancreatic enzymes, which would impair digestion. Reduced ability of the stomach wall to produce stomach acid. Damage to immune system. Brain damage with lack of self-control, impaired co-ordination, impaired speech development, aggression, mental retardation, loss of memory and stupor. Peripheral nerve damage with altered senses and muscle weakness. Direct muscle tissue damage with altered ability to contract and relax and muscle weakness. Nutritional deficiencies from damaging effect on digestion and absorption of most vitamins, minerals and amino acids. Deficiencies in B and A vitamins are particularly common. Alcohol has an ability to enhance toxicity of most common drugs, pollutants and other toxins. Alteration of metabolism of proteins, carbohydrates and lipids in the body.

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Inability of the liver to dispose of old neurotransmitters, hormones and other by-products of normal metabolism. As a result these substances accumulate in the body, causing behavioural abnormalities and many other problems.

Acetaldehyde is considered to be the most toxic of alcohol by-products. It is the chemical, which gives us the feeling of hangover. Anybody who experienced a hangover would tell you how dreadful he or she felt. Children, who acquire abnormal gut flora with a lot of yeast from the start, may never know any other feeling. Acetaldehyde has a large variety of toxic influences on the body. One of the most devastating influences of this chemical is its ability to alter the structure of proteins. Acetaldehyde – altered proteins are thought to be responsible for many autoimmune reactions. Patients with neuro-psychological problems are commonly found to have antibodies against their own tissues. Clostridia Neurotoxins. There are about 100 different Clostridia species known so far. They are present in the stools of people with autism, schizophrenia, psychosis, severe depression, muscle paralysis and muscle tonus abnormalities and some other neurological and psychiatric conditions. Many Clostridia species are normal inhabitants of the human gut. For example Clostridium tetani is routinely found in the gut of healthy humans and animals. Everybody knows that tetanus is a deadly disease, due to an extremely powerful neurotoxin Clostridium tetani produces. Clostridium tetani, which lives in the gut, is normally controlled by the beneficial bacteria and does us no harm, because its toxin cannot get through the healthy gut wall. Unfortunately, patients who we are talking about, do not have a healthy gut wall. In gut dysbiosis this powerful neurotoxin may well get absorbed through the damaged gut lining and then cross the blood-brain barrier affecting the patient’s mental functioning. Many other species of Clostridia (perfringens, novyi, septicum, histolyticum, sordelli, aerofoetidum, tertium, sporogenes, etc) produce toxins similar to tetanus toxin as well as many other toxins. Dr. William Shaw at Great Plains Laboratories describes in detail a number of autistic children, who showed serious improvements in their development and biochemical tests while on anti-Clostridia medication. Unfortunately, as soon as the medication was stopped the children slipped back into autism, because these children do not have healthy gut flora to control Clostridia and not to allow their toxins through the gut lining into the bloodstream. In many cases Clostridia were not identified in the stools of these children, because Clostridia are strict anaerobes and are very difficult to study. We need to come up with some better ways of testing for these potent pathogens. Yeasts and Clostridia have been given a special opportunity by the era of antibiotics. Broad-spectrum antibiotics do not touch them while killing the beneficial bacteria in the gut, which are supposed to control the yeasts and Clostridia. So, after every course of antibiotics these two pathogenic groups get out of control and overgrow. The children that we are talking about usually are

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exposed to numerous courses of antibiotics pretty much from the beginning of their lives. Gluteomorphins & Casomorphins or opiates from gluten and casein. Opiates are drugs, like opium, morphine and heroin, which are commonly used by drug addicts. What have they got to do with our patients? Gluten is a protein present in grains, mainly wheat, rye, oats, barley. Casein is a milk protein, present in cow, goat, sheep, human and all other animal milk and milk products. In gut dysbiosis these proteins do not have a chance to be digested properly before they get absorbed in the form of substances with similar chemical structure to opiates, like morphine and heroin. There has been quite a substantial amount of research done in this area by Dohan, Reichelt, Shattock, Cade and others, where gluten and casein peptides, called gluteomorphin and casomorphin, were detected in the urine of schizophrenic patients, autistic and ADHD children. Incidentally, these substances were also found in patients with depression and rheumatoid arthritis. These opiates from wheat and milk get through the blood-brain barrier and block certain areas of the brain, just like morphine or heroin would do, causing various neurological and psychological symptoms.

We have mentioned a few toxins found in these patients. There are many other toxins, which are being studied. The mixture of toxicity in each child or adult can be quite individual and different. But what they all have in common is gut dysbiosis. The toxicity, which is produced by the abnormal microbial mass in these patients, establishes a link between the gut and the brain. That is why I grouped these disorders under one name: the Gut and Psychology Syndrome (GAP Syndrome or GAPS). The GAPS children and adults can present with symptoms of autism, ADHD, ADD, OCD, dyslexia, dyspraxia, schizophrenia, depression, bipolar disorder, sleep disorders, allergies, asthma and eczema in any possible combination. These are the patients who fall in the gap in our medical knowledge. Any child or adult with a learning disability, neurological or psychological problems and allergies should be thoroughly examined for gut dysbiosis. Re-establishing normal gut flora and treating the digestive system of the person has to be the number one treatment for these disorders, before considering any other treatments with drugs or otherwise. Dr. Natasha Campbell-McBride MD MMedSci (neurology) MMedSci (human nutrition)

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To learn more about Gut and Psychology Syndrome, how it develops and how to treat it please look at the book by Dr. Natasha Campbell-McBride

“Gut and Psychology Syndrome”. Natural treatment for autism, ADHD/ADD, dyslexia, dyspraxia, depression and schizophrenia. References. 1. Absolon CM at al. Psychological disturbance in atopic eczema: the extent of the problem in school-aged children. Br J Dematol, Vol 137(2), 1997, pp.24105. 2. Ashkenazi et al. Immunologic reaction in psychotic patients to fractions of gluten. Am J Psychiatry 1979; 136:1306-1309. 3. Baruk H. 1978. Psychoses of digestive origins. In: Hemmings and Hemmings (eds), Biological Basis of Schizophrenia. Lancaster MTP Press. 4. Bolte ER, (1998). Autism and Clostridium tetani. Medical Hypothesis 51(2): 133-144. 5. Cade R et al. Autism and schizophrenia: intestinal disorders. Nutritional Neuroscience. March 2000. 6. Dohan CF. Cereals and schizophrenia: data and hypothesis. Acta Psychiat Scand 1966; 42: 125-152. 7. Dohan CF et al. Relapsed schizophrenics: more rapid improvement on a milk and cereal free diet. Brit J Psychiat 1969; 115: 595-596. 8. Dohan et al. Is schizophrenia rare if grain is rare? Biology and Psychiatry. 1984: 19(3): 385-399. 9. Dohan FC. Is celiac disease a clue to pathogenesis of schizophrenia? Mental Hygiene. 1969; 53: 525-529. 10. Furlano RI, Anthony A, Day R et al. Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. J Pediatr 2001;138: 366-72. 11. Ferrari P et al. Immune status in infantile autism: Correlation between the immune status, autistic symptoms and levels of serotonin. Encephale 14:339344, 1988. 12. Holford P. Optimum nutrition for the mind. 2003. ISBN 0 -7499 -2213 -3.

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13. Horrobin DF, Glen AM, Vaddadi K. 1994. The membrane hypothesis of schizophrenia. Schiz Res 18, 195-207. 14. Horvath K, Papadimitriou JC, Rabsztyn A et al. Gastrointestinal abnormalities in children with autism. Journal of Pediatrics 1999; 135: 559-563. 15. Kawashima H, Takayuki M, Kashiwagi Y et al. Detection and sequencing of measles virus from peripheral blood mononuclear cells from patients with inflammatory bowel disease and autism. Digestive Diseases and Sciences. 2000;45:723-729. 16. Kontstanareas M and Homatidis S, (1987). Ear infections in autistic and normal children. Journal of Autism and Developmental Disorders, 17: 585. 17. Krasnogolovez VN. Colonic disbacteriosis. - M.: Medicina, 1989. 18. Kirjavainen PV, Apostolov E, Salminen SS, Isolauri E 1999.New aspects of probiotics - a novel approach in the management of food allergy. (Review)(59refs).Allergy. 54(9):909-15, 1999 Sep. 19. Lewis SJ, Freedman AR (1998). Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. (Review)(144 refs). Alimentary Pharmacology and Therapeutics. 12(9):80722, 1998 Sep. 20. Lykova EA, Bondarenko VM, Sidorenko SV, Grishina ME, Murashova AD, Minaev VI, Rytikov FM, Korsunski AA (1999). Combined antibacterial and probiotic therapy of Helicobacter - associated disease in children (Russian).Zhurnal Microbiologii, Epidemiologii I Immunobiologii. 1999 MarApr;(2):76-81. 21. Macfarlane GT, Cummings JH (1999). Probiotics and prebiotics: can regulating the activities of intestinal bacteria benefit health? (Review) (48 refs).BMJ. 1999 April;318:999-1003. 22. McCandless J. Children with starving brains. 2003. ISBN 1-883647-10-X. 23. Mycroft et al. JIF-like sequences in milk and wheat proteins. NEJM 1982; 307: 895. 24. Papalos D, Papalos J. The bipolar child. Broadway Books, 2000. 25. Plioplys AV at al. Lymphocyte function in autism and Rett syndrome. Neuropsychobiology 7:12-16, 1994.

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26. Reichelt K et al. Gluten, milk proteins and autism: dietary intervention effects on behaviour and peptide secretions. Journal of Applied Nutrition. 42:1-11, 1990. 27. Reichelt K et al. Biologically active peptide-containing fractions in schizophrenia and childhood autism. Adv Biochem Psychopharmacol 28:62747, 1981. 28. Rimland B. New hope for safe and effective treatments for autism. Autism Research Review International 8:3, 1994. 29. Samonis G et al. (1994). Prospective evaluation of the impact of broadspectrum antibiotics on the yeast flora of the human gut. European Journal of Clinical Microbiology and Infections Diseases 13: 665-7. 30. Schoenthaler SJ et al. The effect of randomised vitamin-mineral supplementation on violent and non-violent antisocial behaviour among incarcerated juveniles. J Nut Env Med, Vol 7, 1997, pp.343-352. 31. Singh V. Neuro-immunopathogenesis in autism. 2001. New Foundations of Biology. Berczi I & Gorczynski RM (eds) Elsevier Science B.V. pp 447-458. 32. Singh V at al. Changes in soluble interleukin-2, interleukin-2 rector, T8 antigen, and interleukin-I in the serum of autistic children. Clin. Immunol. Immunopath. 61:448-455, 1991. 33. Singh V et al. Immunodiagnosis and immunotherapy in autistic children. Ann NY Acad Sci 540:602-604, 1988. 34. Singh V et al. Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clinical Immunology and Immunopathology. 1998:89; 105-108. 35. Singh & Kay. Wheat gluten as a pathogenic factor in schizophrenia. Science 1975: 191: 401-402. 36. Sioudrou et al. Opioid peptides derived from food proteins. The exorphins. J Biol Chem. 1979; 254:2446-2449. 37. Shaw W. Biological Treatments for Autism and PDD. 2002. ISBN 0-96612380-6 38. Tabolin VA, Belmer SV, Gasilina TV, Muhina UG, Korneva TI. Rational therapy of intestinal dysbacteriosis in children. - M.:Medicina, 1998, 22p..

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39. Vorobiev AA, Pak SG et al. (1998). Dysbacteriosis in children. A textbook for doctors and medical students.(Russian). M.: “KMK Lt.”, 1998. 64p. ISBN 587317-049-5. 40. Ward NI. Assessment of clinical factors in relation to child hyperactivity. J Nutr Environ Med, Vol 7, 1997, p.333-342. 41. Ward NI. Hyperactivity and a previous history of antibiotic usage. Nutrition Practitioner, Vol 3(3), 2001, p.12. 42. Waring (2001). Sulphate, sulphation and gut permeability: are cytokines involved? In: The Biology of Autism – Unravelled. Conference proceedings 11th May 2001, Institute of Electrical Engineers, London. 43. Wakefield AJ, Anthony A et al. Enterocolitis in children with developmental disorders. AIA Journal, Autumn 2001. 44. Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children. Lancet 1998; 351:637-41. 45. Wakefield AJ and Montgomery SM. Autism, viral infection and measles, mumps, rubella vaccination. Israeli Medical Association Journal 1999;1:183187. 46. Walker-Smith JA. Autism, inflammatory bowel disease and MMR vaccine. Lancet 1998; 351: 1356-57. 47. Warren R et al. Immune abnormalities in patients with autism. J. Autism Develop Dis. 16, 189-197, 1986. 48. Warren PP at al. Reduced natural killer cell activity in autism. J Am Acad Child Phychol 26: 333-335, 1987. 49. Waizman A et al. Abnormal immune response to brain tissue antigen in the syndrome of autism. Am J Psychiatry 139:1462-1465, 1982. 50. Wilson K, Moore L, Patel M, Permoad P. Suppression of potential pathogens by a defined colonic microflora. Microbial Ecology in Health and Disease. 1988; 1:237-43. 51. Yonk LJ et al. D4+ per T cell depression in autism. Immunol Lett 35: 341-346, 1990.

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Gut and Psychology Syndrome (GAP Syndrome or GAPS)  Dr. N. Campbell-McBride, MD

Not many people would choose to become parents of an autistic child. Yet it is happening to more and more of us in our modern world. There is an unmistakable epidemic of autism going on across the globe. If this can possibly be of any comfort for a parent, then I would say that you are certainly not alone! Most parents of autistic children can clearly recall that traumatic moment of the diagnosis of "Autism" being announced to them by a doctor followed by the statement "There is nothing that can be done.” Well, being a doctor myself, I have to say that your doctor is wrong, there is a lot that can be done! I would even go further, depending on your commitment and certain circumstances, you have a good chance of bringing your child as close as possible to normality! Hundreds of autistic children across the globe, appropriately treated and educated become almost indistinguishable from their typically developing (normal) peers. My own son was diagnosed severely autistic at the age of three. Now at the age of 12 he has fully recovered and is leading a normal life. In my clinic in Cambridge in England I work with hundreds of autistic children and adults. My personal and professional involvement with autism has been my best education in how to treat this disorder effectively. Treating autism is not an easy task. It takes years of continuous effort and commitment. But, being a parent myself, I can tell you that it is one of the most rewarding experiences on Earth! In my book “Gut and Psychology Syndrome.

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Natural Treatment for Autism, ADHD, Dyslexia, Dyspraxia, Depression and Schizophrenia” I would like to share with you what I strongly believe to be the appropriate treatment for an autistic child.

So, what is a typical scenario I see in clinical practice? Before examining the patient it is very important to look at the health history of the parents. Whenever the parents are mentioned people immediately think about genetics. However, apart from genetics there is something very important the parents, mother in particular, pass to their child: their unique gut micro-flora. Not many people know that an adult on average carries 2 kg of bacteria in the gut. There are more cells in that microbial mass than there are cells in an entire human body. It is a highly organised micro-world, where certain species of bacteria have to predominate to keep us healthy physically and mentally. Their role in our health is so monumental, that we simply can not afford to ignore them. We will talk in detail about the child’s gut flora later. Now let us come back to the source of the child’s gut flora – the parents.

After studying hundreds of cases of autism in children and adults, a typical health picture of these children’s mums has emerged. A typical modern mother was probably not breast fed when she was a baby, because she was born in 60s or 70s when breast-feeding went out of fashion. Why is it important? Because it is well known now that bottle fed babies develop completely different gut flora to the breast fed babies. This compromised gut flora

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in a bottle fed baby later on predisposes her to many health problems. Having acquired compromised gut flora from the start, a typical modern mum had quite a few courses of antibiotics in her childhood and youth for various infections. It is a well known fact that antibiotics have a serious damaging effect on gut flora, because they wipe out the beneficial strains of bacteria in the gut. At the age of 16 and sometimes even earlier the modern mum was put on a contraceptive pill, which she took for quite a few years before starting a family. Contraceptive pills have a devastating effect on the beneficial (good) bacteria in the gut. One of the major functions of the good bacteria in the gut flora is controlling about 500 different known to science species of pathogenic (bad) and opportunistic microbes. When the beneficial bacteria get destroyed the opportunists get a special opportunity to grow into large colonies and occupy large areas of the digestive tract. A modern diet of processed and fast foods provides perfect nourishment for these pathogens and that is a typical diet a modern mum had as a child and a young adult. As a result of all these factors a modern mum has seriously compromised gut flora by the time she is ready to have children. And indeed clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with autism and other neurological and psychiatric conditions.

But why are we talking about mother’s gut flora? Because her baby is born with a sterile gut. In the first 20 or so days of life the baby’s virgin gut surface gets populated by a mixture of microbes. This is the child’s gut flora, which will have a

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tremendous effect on this child’s health for the rest of his/her life. Where does this gut flora come from? Mainly from the mother. So, whatever microbial flora the mother has she would pass to her new-born child.

Gut flora is something we do not think much about. And yet the number of functions the gut flora fulfils is so vital for us that if some day our digestive tract got sterilised we probably would not survive.

The first and very important function is appropriate digestion and absorption of food. If a child does not acquire normal balanced gut flora, then the child will not digest and absorb foods properly, developing multiple nutritional deficiencies.

Apart from taking a vital part in nourishing the body, beneficial bacteria in the gut act as the housekeepers for the digestive tract. They coat the entire surface of the gut protecting it from invaders and toxins by providing a natural barrier and producing a lot of anti-bacterial, anti-viral and anti-fungal substances. At the same time they provide the gut lining with nourishment. So, it is no surprise that when the gut flora is abnormal the digestive tract itself can not be healthy. Indeed most patients with autistic spectrum disorders present with digestive problems. In many cases these problems are severe enough for the parents to talk about them first. In some cases they may not be severe, but when asked direct questions the parents describe that their child never had normal stool, that their

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child suffered from colic as a baby and that tummy pains and flatulence are a common part of the picture. In those cases where these children have been examined by gastroenterologists, inflammatory process in the gut was found along with faecal compaction and an over-spill syndrome. The most recent research was performed at the Royal Free Hospital in London by Dr. Andrew Wakefield and his team. They found an inflammatory condition in the bowel of autistic children, which they have named Autistic Enterocolitis.

Well functioning gut flora is the right hand of our immune system. A baby is born with an immature immune system. Establishment of healthy balanced gut flora in the first few days of life plays a crucial role in appropriate maturation of the immune system. If the baby does not acquire appropriate gut flora then the baby is left immune compromised. The result is lots of infections followed by lots of courses of antibiotics, which damage the child’s gut flora and immune system even further. At the same time in the first two years of life the child receives a lot of vaccinations. A child with compromised immune system does not react to vaccinations in a predicted way. In many cases vaccines deepen the damage to the immune system and provide a source of chronic persistent viral infections and autoimmune problems in these children.

So, the autistic child who we are talking about, did not get normal gut flora from the start and then got it damaged even further by repeated courses of antibiotics and vaccinations. As a result these children commonly suffer from digestive

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problems, allergies, asthma and eczema. But apart from that in autistic children and adults something even more terrible happens. Without control of the beneficial bacteria different opportunistic and pathogenic bacteria, viruses and fungi have a good chance to occupy large territories in the digestive tract and grow large colonies. These pathogenic microbes start digesting food in their own way producing large amounts of various toxic substances, which get absorbed into the blood stream, carried to the brain and cross the blood – brain barrier. Due to the absence or greatly reduced numbers of beneficial bacteria in the gut flora, the child’s digestive system instead of being a source of nourishment becomes a major source of toxicity in the body.

In my book “Gut and Psychology Syndrome. Natural Treatment for Autism, ADHD, Dyslexia, Dyspraxia, Depression and Schizophrenia” we will look in great detail at what particular toxins have been found in autistic children and adults and how they make these children and adults autistic. The toxicity, which is produced by the abnormal microbial mass in the digestive tract of the child, establishes a link between the gut and the brain. That is why I named this condition: the Gut and Psychology Syndrome (GAP Syndrome). Patients with GAP Syndrome fall in the gap – the gap in our medical knowledge. As a result they do not receive an appropriate treatment.

The book on GAP Syndrome explains how and why autism develops and how to treat it using a sound nutritional protocol. The treatment is completely natural and

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can be implemented at home. It is a self-help book with a comprehensive recipe section and is written in easy to understand language. Knowledge is power! This book gives the parents the power to help their child !

Dr. Natasha Campbell-McBride, MD MmedSci (neurology) MmedSci (human nutrition) Cambridge, England

To learn more about Gut and Psychology Syndrome, how it develops and how to treat it with a sound nutritional protocol please look at the book by Dr.

Natasha Campbell-McBride “Gut and Psychology Syndrome. Natural treatment for autism, ADHD/ADD, dyslexia, dyspraxia, depression and schizophrenia.” www.mindd.org or Tel: (61) (2)9388 7383

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You

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My Son By Natasha Campbell-McBride, M.D. Dr. Campbell-McBride, a neurologist who also holds a Master's degree in nutrition, lives in Cambridge, UK, with her husband and her autistic son, who was born in the autumn of 1992. Her clinic treats autistic children from around the world, and she is currently working on a book on effective autism treatments. This story was written in February 2003. My son is 10 years old. He is in a mainstream school, doing well. His academic achievements are within normal range for 10-year-olds, although math is not his strong point. He can be clumsy as far as social skills are concerned, but he has friends, and children generally like him. He can be naïve and hyperactive at times, but amazingly mature at other times. His language is excellent with a wider-than-usual vocabulary, and he likes to write poetry and short stories. He is learning to play piano and is doing very well, particularly at composing his own music. No one would suspect what this child and his parents have been through. Nobody who meets him now would ever think of autism in connection with this boy. All this is now. I have been asked to look into the past and describe how we got here. It is always painful for a mother to recall those years of desperation and hard work with an autistic child. It is particularly painful to realize all the things you were doing wrong. If only we knew then what we know now! If only we had done this and that, when he was smaller, he may have developed very differently. However, I do not regret for a moment the mind-blowing educational journey my son took me through. When he was born, I was an M.D. trained in neurology with seven years' working experience. But as they say, doctors make the worst patients. When it comes to your own child, you are just as prone to denial and blindness as any other parent. Apart from that, as all the parents of autistic children discover, doctors know very little about autism. They are taught how to diagnose it, but when it comes to treatment, official medicine has nothing to offer. On the contrary, it is hell bent on convincing you that there is nothing you can do and that any other opinion is quackery. So, being a doctor has given me no advantage at all. Our son was diagnosed autistic at the age of three. After the initial shock and grieving my husband and I started to learn as much as we could about autism. In those days there wasn't as much information available on the subject as there is now, but at least there was something offering our son hope. I remember that somebody gave us a phone number for Dr. Rimland in California. We had a long conversation with him and as a result our son was on an ABA program by the age of 3 1/2. At the same time he started taking DMG. This conversation with Dr. Rimland was like a ray of sunshine in our lives. Here was a person who knew so much about autism and who was prepared to share his knowledge with us and help us. Here was a parent who did not accept the official position on autism and who had devoted his life to changing that position. I am sure that there are thousands of families around the world forever grateful to this man. I want to add my family to that list.

From the very beginning the ABA program was performing absolute miracles with our boy. I will never forget our first workshop with our excellent ABA consultant, who had flown to us from the U.S. At the end of an exhausting two days of training, she said that in three months' time she expected our son to speak in small sentences. All of us, including our five therapists, thought that she was dreaming, because our boy had no speech and his understanding of language was very questionable. But to our huge surprise, she was right! We have meticulously recorded that period in our son's life on video. In three months' time we were able to have quite a sensible conversation with him. As our son was moving through his ABA program I devoted my time to learning as much as possible about biology, biochemistry, and nutrition in autism. It was clear to me that our son's extreme fussiness with food—and as a result, very poor diet—had a lot to do with his autism. I went back to university and took a master of sciences degree in human nutrition. I devoted particular attention to studying the digestive system's pathology and how to treat it by natural means. The reason for my interest was the fact that our son's digestive system almost never functioned normally. Beginning the day we introduced solids into his diet, he went through a period of severe constipation, which eventually turned into constant diarrhea. Again, consulting with official medicine was a complete disappointment. Apart from symptomatic drugs with lots of side effects, it could offer our boy nothing to help with his digestive problems, constant fungal nappy rash or tremendous feeding difficulties. At the same time it was clear to me that his immune system was in disarray due to his poor nutrition. Like many autistic children he went through ear infections, chest infections, impetigo, and fungal thrush. And of course, all my medical colleagues offered were antibiotics and more antibiotics. Based on my newly acquired knowledge I changed his diet dramatically. Our ABA consultant helped us work out a system of introducing foods into our son's diet. Without that system it would have been impossible to change his diet, as he was so finicky with food. Having examined diets that have been successful for children with severe digestive problems, such as ulcerative colitis, Crohn's disease, and chronic malnutrition, I realized that just introducing a gluten- and casein-free (GFCF) diet would not be enough for my son. So I have worked on a far more natural and focused approach, which also excludes gluten and casein. The result was amazing, as if somebody had lifted a toxic fog off his brain. He was much calmer, much more able to learn. His eye contact improved on its own and a lot of self-stimulation disappeared. At the same time we introduced a strong therapeutic probiotic. There was no doubt that his gut flora was abnormal. From early on I have tried to give him various probiotics, available on the market, with no particular results, until I found a formula that worked. It was powerful enough to heal his digestive system to such an extent that we could cheat on the diet on an occasional basis without any problems. At the same time it gave his immune system such a boost that I don't remember now when he last had a cold. Now he looks a picture of health with rosy cheeks and bright eyes and he is full of energy. Since then I have developed my own probiotic formula, which works very well for autistic children and people with digestive and immune disorders.

It is impossible to overestimate the role of the family in the struggle against autism. I have seen quite a few very sad situations, where one parent is trying to help a child without the support of the other parent. Treating an autistic child is a huge undertaking and united families usually succeed much better. I would like to say that what we have achieved with our son, my husband and I have achieved together. Without my husband's constant support, intellect, and organizational skills I would not have been able to do half of what I have done in these years. Our son is very lucky to have an excellent dad, of whom he is very fond. A great part of the successful treatment of autism is the fact that parents of autistic children all talk to each other. This is where we get our strength and inspiration to carry on. Our success became an inspiration for many other families, who were calling me and who were willing to try what we did. That is how my clinic for autistic children started. Having seen hundreds of families from many different countries, I never cease to admire their determination and strength in trying to help their children. I have learned a lot from them and their experiences. A few months ago at the end of a consultation, one of the parents looked at me and asked in a stern voice, “Why haven't you written a book yet?!” That was followed by a number of other parents telling me that I must write a book on autism. I am working on it now. I feel that it is my duty to share the knowledge and clinical experience that I have accumulated over the years thanks to my son and the many families of autistic children I have met. I hope, too, that my experience will help others to avoid the mistakes that we have made. We all eventually learn by our mistakes, but time is precious for our children. The earlier we start helping them in the right way, the better chance they get to recover from autism. I believe that every autistic child has a chance, given appropriate help. And do not let anybody tell you that autism is incurable!

Update for Second Edition (November 2005): It is hard to believe that more than two and a half years have passed since our story was published in 2003. My son just turned 13. He is tall and handsome and he is a delight. In my previous story I mentioned that I was writing a book. Well, the book has been out for a year now and is very successful; a third print was done a month ago. It is called “Gut And Psychology Syndrome. Natural treatment for autism, ADHD, ADD, dyslexia, dyspraxia, depression and schizophrenia” (www.MedInform.co.uk). The book describes in detail how these conditions develop and how to treat them using a solid nutritional protocol. It has a large recipe section to help people start on the diet, as well as chapters on how to deal naturally with ear infections, constipation, toxicity, fussy feeding habits, and other issues.

My son was very proud to contribute to my book—he has written a beautiful poem, which is published at the beginning of the book. We still have not told him about what happened to him in his younger years; we decided to wait until he is older. There are no traces of autism in him now and he is leading a normal life. He is doing well at school and started playing rugby on his school team. His digestive system works like a clock now, though we still adhere to the diet, which I have described in detail in my book. The good news is that my son can have anything now on an occasional basis without it causing problems. However, the whole family is on this diet as it is very healthy and can prevent many health problems (such as weight gain, heart disease, cancer, diabetes, autoimmune problems, osteoporosis, and allergies) in all members of the family. When we go on holiday we eat what is available, but when we come back home we go back to our diet because it is good for us. Both our children have a considerable knowledge of nutrition now and we often hear them lecturing their friends on what is good for them to eat and what is not. I hope that our story can be an inspiration for parents of autistic children. Never give up on your child, and your child will reward you!

http://www.autism.com/treatable/recovered/campbellmcbride.htm

Chapter from the book Recovering Autistic Children Edited Stephen M. Edelson, Ph.D. and Bernard Rimland, Ph.D.

Does MMR cause autism? Dr. Natasha Campbell-McBride MD

Talking about autism it is impossible to avoid the issue of the MMR vaccine and vaccination in general. I my practice I see some parents of autistic children who would link their child's disorder with MMR vaccine where many can not make this connection. Following research by Dr. Wakefield there has been a lot of publicity on this subject. The government has put a lot of effort and money into convincing the public that MMR vaccine is safe. While the MMR vaccine was in the lime light, other vaccines got questioned as well, due to the fact that many of them contain Thimerosal, a Mercury compound. Others are new and have not been tested long enough, yet apparently the number of unreported complications from these vaccines is much higher than anybody would expect. On top of all this we have to remember that vaccines are commercial products made with profit in mind. Is it true that the 3 million pounds which the government recently spent on MMR promotion were paid for by the companies who have a commercial interest in this vaccine? So, does MMR cause autism? I do not believe that things are so simple. Here we have to look at autism as a whole picture and vaccination as a whole. Let us have a look at what is happening to children in our modern society. If you look around, how many healthy children would you see? Childhood asthma, eczema, diabetes, allergies, hay fever, digestive disorders, ADHD and autistic spectrum disorders have all gained epidemic proportions! The majority of siblings of autistic children have eczema, asthma or another one of those disorders. And though all these health problems appear to be different, they have one thing in common. A very big thing - a compromised immune system with suppressed Th1 and overactive Th2 parts of the immunity. These two opposing arms of the immune system normally should be in balance. But in these children they are out of balance reducing the body's ability to fight infections and predisposing the child to allergies and autoimmune reactions. A compromised immune system is not going to react to environmental insults in the normal way! Vaccination is a huge insult for the immune system. The manufacturers of vaccines produce them for children with normal immune systems which will react to these vaccines in a normal way. And perhaps 50 or even less years ago the majority of children had normal immune systems, so vaccination was producing the expected results of protection against infections without any harm for the body. However, in our modern society with our modern way of life we are rapidly moving to a situation where a growing proportion of children do not have a normal immune system and will not produce an expected reaction to the vaccine. In some of these children vaccination, putting an enormous strain on an already compromised immune system, becomes that "last straw which breaks the camel's back" and brings on the beginning of autism, asthma, eczema, diabetes, etc.. In other children, whose immune system is compromised to a lesser degree, vaccination will not start the disorder, but it will deepen the damage and move the child closer to it.

But what makes the immune system compromised? What is it in our modern life styles that does this damage? There are a number of factors which play their part in damaging the delicate balance of the immune system, but some major factors deserve particular attention: 1. Gut Dysbiosis. 2. Use of antibiotics, steroids and other drugs. 3. Consumption of sugar and processed foods. 4. Consumption of trans-fatty acids. 5. Food additives. Let's look at some of these factors in detail. 1. Gut Dysbiosis. Not everybody is aware that our bodies are a home to huge numbers of bacteria, viruses, fungi and other microbes. In a healthy body this micro-world is properly balanced and fulfils a whole host of beneficial functions, without which we would not be healthy. The largest population of microbes, called gut flora, live in our digestive systems. The gut wall with its microbial flora has been described as "the right hand" of the immune system. If the bacterial layer is damaged or worse than that, abnormal, then your immune system is trying to function with its right hand chopped off. Let us have a look at some details. •

The epithelial surface of the colon is inhabited by huge numbers of bacteria, and can be truly described as a "cradle" of the immune system, both systemic and mucosal. The beneficial bacteria in the colon, engage lymphoid tissue of the gut wall and take part in the production of huge numbers of immunoglobulins. For example, in the cell wall of Bifidobacteria, one of the major inhabitant groups of a healthy gut flora, there is a substance called Muramil Dipeptide, which activates synthesis of B and T-Lymphocytes. As a result, a healthy gut wall is literally infiltrated, jam packed with B and T Lymphocytes, ready to protect the body from any invader. Your digestive system is a major gate into the body and needs good guarding.

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The beneficial flora of the gut has got a pronounced anti-viral activity. They take part in the synthesis of such anti-viral substances as interferon, lizocym and surfactins, which dissolve the membranes of lipid envelope viruses. The food and drink which we consume are full of disease causing viruses, but the healthy gut flora would not allow them to take hold in your body.

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Immunoglobulin A is a substance which is secreted by the gut wall into the gut lumen in response to new food arriving from the stomach. It is the immune

system's way of dealing with the unwelcome invaders coming with food and drink. Fairly soon after being excreted the Immunoglobulin A naturally degrades. The beneficial bacteria in the gut slow down this degradation, allowing the Immunoglobulin A more time to do its work. •

Healthy gut flora absorb considerable amounts of heavy metals, phenols, formaldehyde and other toxic substances, acting as natural chelators and protecting the immune system from them. It is known that the immune system is particularly vulnerable to these substances.

As a result of all this activity your healthy gut flora keeps the two major arms of the immune system, the Th1 and Th2 immunity, in proper balance. The condition, when the gut flora is not healthy, is called - Gut Dysbiosis. In this condition the beneficial bacteria in the gut are damaged or eradicated. As a result the gut wall gets taken over by a large number of pathogenic and opportunistic bacteria, viruses, fungi and parasites, all producing very toxic substances. The digestion and absorption of food becomes abnormal, the gut wall becomes damaged and "leaky". But most importantly, as we are concentrating on the immune system here, the person with gut Dysbiosis becomes immune-compromised. A number of factors in our modern life styles can damage the delicate balance of the gut flora. Antibiotics and steroids are major contributors, consumption of processed foods, a toxic environment, prolonged stress, etc. Here we are talking about vaccination, so we need to look at babies' and children's gut flora. Babies get their gut flora from the mother. So, if the mother does not have healthy bodily flora, then the baby will not have it either. Widespread use of the contraceptive pill (steroids) in young girls damages the gut flora. When it is combined with regular consumption of processed sugary foods and antibiotics, then the damage gets deeper. The majority of mothers of immune-compromised children with eczema, asthma, learning disabilities, etc. show symptoms of Gut Dysbiosis, such as digestive problems, allergies, skin problems, PMS, migraines, thrush, or simply chronic lack of energy. After the baby is born the breast milk promotes the process of populating the gut wall with appropriate bacteria. Formula milk does not fulfil this function. So, breast again is the best. However, in cases when the mother has a considerable Gut Dysbiosis with an overgrowth of abnormal bacteria, fungi, viruses and parasites in her gut, she will be excreting their toxins in her milk. A lot of these toxins have an opioid structure and act on the brain as real opioids would do. In these cases the mothers report that their baby would fall asleep on the breast after a couple of mouthfuls of this opioid rich milk. In other cases the baby refuses the breast or develops an allergic reaction. The recent research shows that the toxins, produced by abnormal gut flora, play a major role in development of autism. The population of the gut wall with normal gut flora plays a major part in the appropriate development of the baby's immature immune system. If the gut flora is not normal then we can not expect a normal immune system. The breast milk provides a ready immune protection for the baby. So, while exclusively breast fed our babies can do quite well without properly developing gut flora, but when the breast feeding stops, it takes a few months for pathological symptoms to start appearing. This is

exactly when the vaccination, and I mean any vaccination, may prove to be too much of an attack on an already compromised immune system. 2. Antibiotics and steroids, including contraceptive pills, and many other drugs apart from damaging the gut flora have a direct immune suppressing effect. Their wide spread use in mothers before and during pregnancy have a damaging effect on the immune system of the future baby. Antibiotics, taken by the mother during breast feeding, will pass to the baby through the milk and add to the damage of it's gut flora and developing immune system. 3. 4. 5. Consumption of sugar and processed foods have a direct damaging effect on the immune system. On top of that these foods feed abnormal flora in the gut contributing to Gut Dysbiosis and hence to immune imbalance. Processed foods are a very poor source of nutrition and a very rich source of various toxic substances, like preservatives, colours, flavouring, aspartame, MSG, and all those E-numbers. Food additives have been shown in a vast number of studies to have a detrimental effect on the immune system, brain chemistry, liver function, etc.. On top of that processed foods are a rich source of very harmful trans-fatty acids. Trans-fatty acids are unsaturated fatty acids with changed chemical structure. They have been shown to have a direct damaging effect on immune system. Children who are routinely fed on crisps, sugary foods, soft drinks and meals out of tins and packets run a great risk of being immune-compromised. Consumption of processed convenience foods, antibiotics, steroids, and the toxic environment are all features of our modern life style. Our children are paying the price for it. It is a fact that we can not afford to ignore! So, my conclusion is that while MMR and other vaccines may not be the cause of autism, in immune compromised children they can do a lot of harm and in some children may well provide the trigger which starts the disorder.

Vaccination, which saved the lives of millions of children world-wide in the last century, is becoming dangerous thanks to changes in our lifestyles. The number of immune compromised children in developed countries is enormous and growing every day. It is time for the medical profession to review its attitude to vaccination. The cry "Vaccinate everybody!" has to change. Here is what I propose: a comprehensive immunological test has to be done with every baby before a decision about vaccination would be made. There are a number of very good tests already in existence to assess the state of one's immune system. These tests have to be put into an appropriate pre-vaccination panel for all babies and results of these tests have to be an essential part in the process for deciding which of the following steps to take: •

The standard vaccination protocol.

•

Single vaccines only.

•

Delayed vaccination until the results of the tests are better.

•

No vaccination at all. A child presenting with eczema, asthma, digestive problems or any other disorder, which would indicate compromised immunity, should be a red flag not to vaccinate!

Those 3 million pounds which the government spent on promoting MMR might have been just enough to develop such a test panel, and in my opinion, a much more worthwhile investment in the future health of our nation. Published in Issue 9 of The Autism File. February 2002

Cambridge Bioceuticals Ltd

Article by Dr Andew Barnes

Probiotic News The following article is written by Dr Andrew Barnes For seven years, a researcher into new vaccine development and the immunology of Bacillus subtilis spores (at Guy's Hospital, King's College London). Currently a freelance scientific consultant.

Bacillus subtilis: From probiotic to modern medicine I first came across Bacillus subtilis when I was invited over to Vietnam, to give a series of lectures on the treatment and spread of HIV/AIDS, at the main hospital in Ho Chi Minh City. The Vietnamese took the approach that when a person became ill, they simply took one of every known antibiotic available (all of which were available from corner shops) and one would hopefully affect a cure. That way, there was no need to spend time and money on seeking professional medical help when suffering from illness. As a consequence, people regularly killed off their entire gut flora and so took B. subtilis to help repopulate themselves. This summarises in a nutshell, the dilemma that faced the scientific community back then, with regard to B. subtilis. It was taken to help repopulate the gut, yet B. subtilis is a soil organism that cannot colonize the gastro-intestinal (GI) tract. B. subtilis needs to breathe air that contains oxygen (an obligate aerobe). B. subtilis is of course very small, so does not require lungs, but it requires oxygen just as much, and for much the same reasons, as humans do. The gut, however, contains very little oxygen, testified to by the methane generated in the hind gut (flatulence). The low oxygen levels make the gut a very bad environment for B. subtilis to grow. If the environment is not good for growth, B. subtilis 'sporulates' (changes into its 'spore' form, which is dormant and very hardy). Spores can remain dormant for many years and then germinate when the conditions are favourable. Because of the low oxygen (anaerobic) environment of the bowel, the majority of spores do not germinate and pass straight out again - at about the same rate as small polystyrene balls, if eaten, might be expected to do. It is therefore not at all obvious why someone who has killed the bacteria in their gut through the misuse of antibiotics would benefit from eating B. subtilis

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Despite this, spores are taken throughout the world, (from south-east Asia to Mediterranean Europe) to achieve that very purpose. Can a million people all be wrong? (they were about the world being flat but not about aspirin in willow bark). Alternatively, if people by their millions are taking B. subtilis, should not the effects of their doing so, be scientifically established? Since spores do not stay in the gut long, they are far more straightforward to study than many other probiotic bacteria that do colonise the gut (such as Lactobacillus & Bifidobacter strains). Furthermore, if spores help to repopulate the gut, they achieve it without interfering with the levels of gut bacteria directly. The only obvious mechanism by which they might achieve this is through the immune system. You might expect a non-pathogenic bacterium, such as B. subtilis, to be treated like food and get completely ignored by the immune system. This, as it turns out, is precisely what does 'not' happen. Recent scientific research has clearly established that spores are extremely good at stimulating the immune system, especially the innate immune system. The innate immune system forms the oldest part of the general immune system. The cells within it are found in all animals that have a backbone (vertebrates) and the receptors they employ go all the way back to fruit flies. However, far from being antiquated and useless, the innate cells are critical for telling the immune system how to respond in any given circumstance. Innate cells have been combating infections since before mankind and have become extremely effective at recognising the telltale structures found on pathogens. Because these structures are fundamental to how bacteria are made, all bacteria contain them, not just the pathogens. Furthermore, the body needs the stimulation provided by these structures to develop, coordinate and maintain a healthy immune system. Stimulation provided by recognised bacterial structures, tells the body which parts are potentially exposed to attack and require special immunological protection. The gut lining acts as a barrier to bacterial invasion. However, this barrier would soon be breached, if it weren't for antibodies made by the immune system. Antibodies bind to bacteria and viruses to prevent them from being able to infect cells. Pathogens can provide the stimulation to make antibodies, along with the other aspects of host immunity, but will do so too late to prevent the infection from occurring. However, if 'friendly' bacteria, such as B. subtilis provide the stimulation, the same benefits are achieved, but without disease. Once stimulated, the immune system prevents bacteria and viruses from crossing the gut lining and regulates bacterial levels within the gut. The immune system achieves this to a large extent by making antibodies that selectively bind and inhibit pathogenic bacteria, but not the 'friendly' ones. Science has therefore explained why regularly eating B. subtilis helps regulate the repopulation of the gut with bacteria, despite the fact that the spores may neither persist or even germinate.

Innate stimulation such as the type provided by B. subtilis has been proven to be critical for the development and maintenance of gut immunity and through it a healthy balance of gut flora. Gut bacteria stimulate gut immunity, which in turn regulates the bacteria present. However, if this balance becomes skewed, due to e.g. a bad diet, excessive alcohol intake, stress etc., the consequences can result in many conditions including constipation, flatulence, indigestion, susceptibility to infection, etc By supplementing a diet with bacteria, such as B. subtilis, many of these problems can be potentially reduced or circumvented entirely due to the gut being better able to regulate itself. However, the science goes much further than this, and suggests spores could be used in a much broader context. Disease caused by Clostridium difficile has become a bigger problem than the infamous MRSA in hospitals today. C. difficile disease is caused by the use of broad spectrum antibiotics, killing the gut flora and suppressing gut immunity. Probiotics have been shown to be effective at treating the disease after antibiotics have been lowered or stopped. However, because spores are resistant to antibiotics and have no requirement for germination, B. subtilis could potentially be used during treatment and without taking the patient off the antibiotics. Likewise, B. subtilis could also potentially be used to prevent illness due to external changes in bacteria. When travelling abroad, diarrhoea is commonly caused by drinking normal tap water (Delhi belly). This is because bacteria abroad, exhibit regional differences from those a person is used to. Natural antibodies differ from those made in response to an infection or a vaccine. They are preprogrammed into your genes because they bind to a wide range of pathogens that have been experienced in our ancestral past. Since B. subtilis spores stimulate the production of natural antibodies, they could prove highly effective at minimizing the impact of being populated by foreign strains of bacteria, either due to travel abroad or due to sudden outbreak. Footnote: B. subtilis has recently been evaluated and listed by the European Food Safety Authority as QPS (Qualified Presumption of Safety). In addition B. subtilis is rated as GRAS (Generally Regarded as Safe) by the Food and Drug Association (FDA) of the United States. Bio-Kult is the leading practitioner probiotic in the UK for Intervention, with over six years clinical use. It contains 8 strains of Lactobacillus, 4 strains of Bifidobacter, 1 Streptococcus and more importantly it's highest strength component is B. subtilis.

Cambridge Bioceuticals Ltd 38, Paddock Street, Soham, Cambridgeshire, CB7 5JB e-mail: [email protected], www.cambridgebioceuticals.com

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Article by Dr John A Jones

Probiotic News The following article is written by Dr John A Jones, MA (Cantab.), MB, BS who has been a GP in Cambridgeshire for 20 years. John has worked with probiotics for many years, is a founder of Cambridge Bioceuticals Ltd and a key member of the team that invented and developed the Advanced Probiotics Bio-Kult and Duo-Kult.

Probiotics - Dispelling The Acid Myth At birth, a baby's gut is sterile – yet within a few days a thriving bacterial flora has developed. How does this happen? Bacteria are ingested during passage through the birth canal and also during feeding and sucking on other objects. These organisms have to survive the joint hurdles of the stomach, with it's hydrochloric acid, and the duodenum where bile enters via the common bile duct. While many will not make it through, a proportion do, and it is these survivors which multiply to form the gut flora. Normally, there are over 400 different strains of organisms inhabiting our intestinal tract and co-habiting happily with us. In fact, as we have evolved, we have lost the ability to produce various compounds and now rely on our gut flora to produce them for us. Without this symbiotic relationship our health suffers and we are unable to be nutritionally complete. During life, the composition of the gut flora changes considerably, as many of the organisms are not naturally resident and have to be continually replaced. These replacements come from bacteria on and in the food we eat. There is concern that, as we have increasingly cleaned and sterilised our food and environment, we have reduced the variety and numbers of organisms we ingest. Nowadays we also eat less of the types of food that contain bacteria – fermented foods such as yoghurt, sauerkraut and kefir (a fermented milk product containing various lactobacilli & other microorganisms). A common yoghurt producer, Lactobacillus bulgaricus, was first identified in Bulgaria – a country where the population have both a long lifespan and high consumption of yoghurt and kefir. Whilst our food has less and less of the normal environmental organisms, it is somewhat paradoxical that the organisms most likely to be in our food now are 'spoilage' organisms such as Escherichia Coli and Clostridium difficile which are often pathogenic. These naturally occurring organisms are not enteric coated or otherwise protected and yet still manage to survive passage through the acidic conditions of the stomach to the alkaline environment of the intestine. How do they do this? There are a number of important factors involved:-

PTO

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Probiotics - Dispelling The Acid Myth

1. Stomach pH While the acidity (pH) of the stomach can be quite harsh at times – dropping to a pH of about 2 – at other times, such as at mealtimes it can rise to a pH of around 6. This may not sound a major change, but the pH scale is a logarithmic scale. Each 1 pH change means an increase in acidity of 10 times – so a pH of 2 is 10 times more acidic than a pH of 3, and 10,000 times more acidic than a pH of 6! A pH of 7 is 'neutral' and pH's between 7 and 14 are alkaline. This is an important fact in respect to probiotics. Whilst even the hardiest of probiotics may only survive for a short time at pH 2 they have a much longer survival time at pH 5 or 6. Taking a probiotic with food is therefore the natural way, and will also give it the best chance of survival. 2. Transit Time When you eat, food is masticated in the mouth and mixed with alkaline saliva. This food bolus then passes into the stomach, where it mixes with the stomach juices and is churned around by the stomach muscle, much like in a washing machine. This liquid part of the mixture is called chyme, and 50% of this leaves the stomach 30 minutes after eating. As probiotics are mixed uniformly with the chyme it also follows that within 30 minutes 50% of the probiotics will have passed out of the stomach, thus limiting the duration of acid exposure. 3. Probiotic Strength Bacterial survival is a numbers game. Even in the harshest environment, if you start with enough organisms, some will survive. It therefore follows that with probiotics, having a high strength will 10 improve survival. For example a formulation of ten billion per gram (1 x 10 ) will have one hundred times more organisms than one of one hundred million (1 x 108). Conversely a probiotic strength of forty billion per gram (4 x 1010) is only four time stronger than one of ten billion (1 x 1010) per gram. It is generally accepted, that at the point of consumption, a probiotic should have a concentration of at least 1 x 106 organisms per gram and that a minimum of 1 x 108 should be consumed daily for beneficial effects to be realised. To take a worst case example using the above factors:If you take a daily dose of two capsules, each containing two billion organisms, with meals and the organisms have only a 20% survival rate after 30 minutes at pH 6 then you will have eight hundred 8 million survivors (8 x 10 ) passing through from the stomach into the intestine. Most probiotics have a much better survival rate at pH 6 – usually more than 70%, which would mean that over 28 x 108 survive. Enteric coatings may increase this number even more but, as you can see, are not really necessary – historically the probiotics in nature that we have ingested with our food have never been enteric coated. Cambridge Bioceuticals Ltd are the manufacturers of Bio-Kult; the leading practitioner probiotic in the UK for Intervention, with over six years clinical use.


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Article by Dr Natasha Campbell-McBride

Probiotic News The following article is written by Dr Natasha Campbell-McBride who has a Degree in Medicine and Postgraduate Degrees in Neurology and Human Nutrition. In her clinic Natasha specialises in Nutrition for Children and Adults with Behavioural and Learning Disabilities, and Adults with Digestive and Immune System Disorders. Natasha is a founder of Cambridge Bioceuticals Ltd and a key member of the team that invented and developed the Advanced Probiotics Bio-Kult and Duo-Kult. Natasha is the author of the book, Gut & Psychology Syndrome

Irritable Bowel Syndrome & Probiotics If you have been diagnosed as suffering from Irritable Bowel Syndrome (IBS), then you are certainly not alone! About 9 million people in the UK suffer from IBS; it is the second most common cause of absenteeism – second only to the common cold. IBS has a very strong impact on patients' quality of life and is associated with a number of serious health conditions e.g. fibromyalgia, ME, and autoimmunity. To complicate matters even further, the medical profession is not sure what causes this common condition or how to treat it. The treatment offered is purely symptomatic:- drugs which relax the bowel muscles, painkillers, antidepressants etc. Until recently, the most common theory was that IBS was psychosomatic. Patients were often told that their misery was probably caused by stress and were advised to go on holiday, relax or try hypnosis. However, rapidly accumulating research is leading us in a different direction. Many medical professionals now believe, that the answer may be found in one of the most vital parts of our digestive system – the gut flora. A healthy digestive tract is largely populated by the beneficial or probiotic species of microbes, which fulfil a number of vital functions in the body. These probiotic bacteria are the housekeepers of the gut, making sure that it does its many jobs well without ever attracting your attention to it. Unfortunately, various modern factors can damage our friendly bacteria in the gut, starting a chain of health problems. Antibiotics, chemotherapy, steroids, radiotherapy, infections, pollution and many other factors can lead to a condition, called gut dysbiosis, where the 'good' probiotic bacteria get replaced by pathogenic microbes. The first place to suffer is, of course, the gut itself. In IBS the gut wall is populated by an abnormal mixture of microbes, which bring all the typical IBS symptoms of diarrhoea, constipation, urgency, bloating, flatulence, etc. The digestion and absorption of food suffer, so the person develops multiple nutritional deficiencies.

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Irritable Bowel Syndrome

The gut wall, damaged by pathogenic microbes, becomes porous and 'leaky', allowing partially digested foods and toxins to pass through. This can lead to food allergies / intolerances, fatigue, aching joints / muscles, headaches, mood swings and many other unpleasant symptoms. The gut wall in an IBS patient is sore and sensitive, that is why following the right diet is very important. In my clinical experience the Specific Carbohydrate Diet (SCD) is the most appropriate diet for an IBS sufferer. However, in order to help an IBS patient it is vital to introduce probiotic bacteria into their digestive system; both the right kind of bacterial species and in large enough numbers to drive the pathogens out and to heal the gut. Bio-Kult has been designed as a therapeutic probiotic to accomplish just that. Any therapeutic strength probiotic produces a so-called ‘die-off reaction’ - as the pathogens in the gut die they release toxins, which may bring an initial worsening of the symptoms. To control this reaction it is important to introduce Bio-Kult slowly, starting from a small dose. The dose can then gradually be increased to a therapeutic level of 8-10 capsules of Bio-Kult a day for an adult. Once on this dose, the patient needs to take it for 6 months or so, depending on the individual symptoms. When the symptoms have gone, the dose can be gradually reduced to a maintenance level, which is individual – generally 4 - 6 capsules a day. Treating IBS patients can be very rewarding - following the right nutritional protocol with the right probiotic, these patients can improve quite quickly and dramatically. As one of my patients put it: “I never ever want to be without Bio-Kult! Now I can have my meals without running to the toilet between mouthfuls of food! I can now live my life without thinking, is there a toilet in the vicinity!” Selected references: 1. Balsari, A., Ceccarelli,A., Dubini, F., Fesce,E. & Poli,G. (1992). The faecal microbial population in the irritable bowel syndrome. Microbiologica 5, 185 - 194. 2. Brigidi P at al. Effects of probiotic administration upon the composition and enzymatic activity of human fecal microbiota in patients with irritable bowel syndrome or functional diarrhea. Research in Microbiol. 2001 Oct; 152(8): 735-41 Journal Code: R6F. 3. King, T.S., Elia, M., Hunter, J.O. (1998). Abnormal colonic fermentation in Irritable Bowel Syndrome. Lancet. 352: 1187 - 1189, 1998 Oct.10. 4. Niedzielin D at al. A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome. Eur J Gastoenterol Hepatol, 2001 Oct; 13(10): 1143-7 Journal Code: B9X. 5. Nobaek S at al. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol 2000 May; 95(5): 1231-8

Cambridge Bioceuticals Ltd are the manufacturers of Bio-Kult; the leading practitioner probiotic in the UK for Intervention, with over six years clinical use.


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Arachidonic Acid is a new term for me. And after you hear Dr Natasha Campbell-McBride say it with her Russian accent…the R just wants to roll off my tongue all day. I first heard of AA when listening to Dr Natasha Campbell-McBride lecturing on autism. Arachidonic Acid is a vitally important essential fatty acid. The only way to get arachiconic acid (AA) is to eat animal fat. And since AA makes up 12% dry weight of the brain, you can see why it’s vital for Lyme patients to get plenty of it. “Arachidonic acid is a polyunsaturated fatty acid that is present in the phospholipids of membranes of the body’s cells, and is abundant in the brain.” (1) Since AA is an EFA required by humans, we must make sure our diets have plenty of good organic fats in them. If we don’t eat these fats then our bodies will draw the AA from our brains for use. Most of us can’t afford for that to happen. It’s recommended by Dr Natasha that one eat plenty of chicken fat, duck fat, pork fat and beef fat in their daily diets. She emphasizes the importance of eating the dark meat and suggests with great enthusiasm eating duck 1x week. It’s also recommended that you collect your fats and keep them in the frig for future use when cooking. Make sure that when you have your daily stock that it includes the fat. As always, it’s important to know the source of your food. The animals that are grassfed will have a better ratio of Omega 6 to Omega 3 fatty acids. Omega 3′s are important for your brain also, but AA comes strictly from Omega 6 and can only be obtained through eating animal fats. “This graph shows that grain-fed beef has a much higher ratio of omega-6 to omega-3 fatty acids than wild game or grass-fed beef. A high ratio of omega-6 to omega-3 fatty acids has been linked with an increased risk of cancer, cardiovascular disease, allergies, depression, obesity, and auto-immune disorders. (Simopoulos and Robinson, The Omega Diet, published by HarperCollins in 1999.) A ratio of four or lower is considered ideal. The ratio in grain-fed beef is more than 14 to 1. In grassfed beef, it is approximately two to one.”(2) Even the skin on animals that are grass-fed and have the proper Omega 6 to Omega 3 don’t burn when cooking like grain-fed animals. It’s a beautiful golden skin that is full of AA!

If your worrying about cholesterol-don’t. The lie about cholesterol has been proven to be just that by Sally Fallon. In fact I’ll post soon and show you the numbers on my cholesterol after switching from grain-fed animals to grass-fed. It’s pretty cool stuff. For a farmer near you check out Local Harvest and Eat Wild. (1) Wikipedia (2) Eat Wild Photo Credit: Flickr October 19, 2008 Posted by peacefulacres | Diet | AA, arachidonic adic, beef fat, brain weight, brains, chicken fat, dark meat, dr natasha campbell-mcbride, duck, eat wild, EFA, essential fatty acids, local harvest, omega 3 fatty acids, omega 6 fatty acids, pork fat, sally fallon | Leave a Comment

I can’t impress upon you how important detoxing is when healing from Lyme Disease & co-infections. Most experts agree that our symptoms are a manifestation of the biotoxins and neurotoxins in our bodies. It only goes to reason that if you can get these toxins out on a regular basis then your symptoms will decrease. When your symptoms decrease you will have less stress and your body will heal faster. Whether you are using the Rife Machine, natural ABX, synthetic ABX or herbs, you must detoxify. My chosen methods of detoxing are; coffee enemas, hydrotherapy, infrared sauna and diet. Of course there are others, but these are my favorites. I know that the topic of coffee enemas is a bit private. OK, a lot private, but sometimes these things must be talked about. For further understanding of coffee enemas you can study the work of Dr Max Gerson. Coffee enemas were in the Merck Medical Manual until 1970. They were removed as a form of treatment, due to the lack of space not due to a lack of effective treatment. Dr Max Gerson found them vital for cancer patients to heal. He used them regularly for his migraine head aches and in our family we can attest to there effectiveness for this malady. Order some brochures or other printed material and research it. You will be glad you did. Hydrotherapy is the use of water in detoxing. It was from Dr Richard Schulze, an herbalist that I learned to do this. It really takes guts, but it is very effective. Stand in the shower and use as hot, hot, hot as you can stand without burning your skin, for 30 seconds, then switch to cold, cold, cold for 30 seconds. Do this 7-8 times and it will wake you up. Hydrotherapy shocks the body. It forces the blood in and out. Focus on areas that are painful or if you think it needs attention. Dr Schulze’s patients have sworn by hydrotherapy to reduce or eliminate cysts or tumors. I did them for one complete year and have resumed them since realizing that Bartonella is quite active in my body. (I do not agree with Dr Richard Schulze on his adoption of the vegetarian diet. Dr Weston A Price proved other wise and it is that diet that I adhere to.) As Dr Schulze so accurately says, “this won’t kill you, but the disease you have will!!!”

The other area of detoxing is diet. Dr Natasha Campbell-McBride suggests that the body detoxes from 2-10 AM. She recommends not eating breakfast until at least 10 AM, allowing the body to properly detox. Dr Campbell-McBride allows juices first thing in the morning. Not canned juices. Fresh carrot, green veggies and juicy fruits. My favorite is, carrot, celery, chard or kale, beet root, and an apple. You can use which ever veggies are your favorite, but consider the biggest bang for your buck. Another great detox food is Beet Kvass; a blood tonic made from Beet Root. Beets are a wonderful detox food for the liver. Always consider nutrient dense foods even for your juices. During my most toxic days, I used the Infrared Sauna every day for 20 min’s at 125*F. During the winter months I usually ramp it up to 135*F, but it takes some time to get use to. It increases your heart rate and takes a little while afterwards of resting to get your heart rate back down to what’s normal for you. So, don’t rush these things. Make sure you take plenty of time to rest. Your skin is your largest organ. Not only does it absorb toxins but it is an excellent way to detox the body. If you dry brush your skin before entering the sauna, you will stimulate your lymphs and slough off dead skin cells. And of course drinking lots of clean filtered water is one of the very best ways to detoxify your body. It will replace the fluids lost during saunas and enemas and it will flush out toxins. It’s recommend that a person consume at least 64 oz of water a day. Here is a wonderful explanation of detoxing for cancer. Even though Lyme is not Cancer, the elements of detoxing remain the same; the need to eliminate biotoxins & with Lyme neurotoxins from the blood. INTRODUCTION TO DETOXIFICATION This article may come in handy. It is from canceroption.com newsletter. An Introduction to Detoxification by: Michael Guthrie, R. Ph. “Cancer cells produce a large number of toxins that inhibit the immune response, damage tissues and cause weight loss and other complications. Thus, a spreading cancer becomes more and more difficult to control because of an increased toxin load. There are safe, and effective ways of reducing the toxin load on the body. Detoxification is an important aspect of cancer protocols, and any kind of detoxification of the body, and is often a neglected part of optimizing treatment and clinical results. We live in a toxic world with air and water pollution, food and medication additives derived from petroleum and coal tars and other carcinogenic (cancer producing) sources. Drinking water sources when tested may show elevated levels of TCE, PCB, chloramines, dioxin and other carcinogenic substances. Even our supplemental vitamins, nutraceuticals and pharmaceutical drugs are often synthesized from sources such as genetically engineered corn, sugar or soy. These sources of raw materials are often cheaper than less allergenic sources and corn allergies constitute one of the most common food allergens in the US. Traces of allergens may cause down regulation of our immune system or a sidetracking of our bodies immune system with a consequential less than optimum immune system to fight cancer and opportunistic diseases and organisms. Cosmetics, food with hydrogenated vegetable oils, pesticides, flea collars, decaffeinated coffee and a host of other daily-encountered substances are carcinogenic! By detoxification of the body, we can optimize the well being of our healthy cells including our immune system. Everyone has some levels of mutated cells produced daily, however our immune system keeps these abnormal cells in check. Cancer cells and cancer-associated viruses are more likely to mutate and adapt to toxic environments than healthy cells. Indeed, cancer is induced in laboratory animals by giving the animals toxic substances which cause cancer by mutating normal cells to survive the toxin. Toxins in our body can accumulate in the subcutaneous fat layer under our skin and in the liver. The liver is the largest immune organ in our body and is a source of Kupffer’s cells. These cells filter and destroy foreign bacteria, fungus, viruses, mycoplasma and cancerous cells. Since the liver is our body’s j di l dl i i i i h li f i

major waste disposal system and largest immune organ, it is important to enhance liver function, reduce excessive stress and detoxify this major organ. By detoxification of the body, we enhance our clinical approach to cancer and other illnesses. It is also important to restore nutrients necessary for optimum utilization of healthy cells and immune system. Many traditional approaches to treatment of a serious disease can cause depletion of these essential nutrients. By utilizing detoxification and restoration of necessary levels of nutrients, clinical approaches are integrated and optimized for enhanced healing and well-being. Detoxification is accomplished through various supplements as well as via far-infrared saunas.” My doc has been very pleased even with the portable saunas.

Resting in my opinion is one of the most cherished gifts you can give yourself. Learn to say, “no” and “I need help”. You will become stronger and those around you will learn compassion. How will you know if you are detoxing? 1. Your body odor will stop or if you’re really dumping toxins, it will increase. (stop using regular deo/antiperspirants from the drug store). Not only are they toxic, but they clog your glands and you can’t detox. Remember your skin is one of your major detox organs. Sweat glands were made to sweat!!! I haven’t used deo/antiperspirants for over 15 yrs. I use a crystal stone sold in any health food store. Most days I remember it, but there are many that I don’t. I no longer have BO, since I practice regular detoxing. 2. You will feel better. Sometimes you feel worse, before you feel better. Sometimes upon dumping the colon and releasing lots of toxins you have a head ache. Pay attention to where the head ache is. You will learn a detox h.a. from another h.a. Mine are in my frontal lobe as opposed to an over all head ache. It is vital to be constantly replacing and replenishing the colon with good quality flora especially if you’re using coffee enemas. My favorite is Friendly Flora from Dr Rons. 3. You may experience things like, sinus drainage, fatigue, energy, intensified itching, or an intensity of symptoms prior to a relief. Every one of us is different and will have different experiences from detoxing. But one thing is universal, we must all detox. Most of Dr Natasha Campbell-McBrides work is done with Autistic Children. What I have found is that the same principles apply to those of us healing from Lyme Disease and co-infections. In this video clip she discusses some of the detoxing results. I recommend you watch all these videos that she and Donna Gates present for parents of Autistics. The info on the gut flora is vital to healing.

Gut and Psychology Syndrome (GAP syndrome or GAPS)™. Copyright and Trade Mark Dr. N. Campbell-McBride November 2003. The right of Natasha Campbell-McBride to be identified as the sole author of this work has been asserted in accordance with the Copyright, Designs, and Patents Act 1988. All rights reserved. No part of this work may be reproduced, stored in a retrieval system, or transmitted in any form by any means without the prior written permission of the author.

We live in the world of unfolding epidemics. Autistic Spectrum Disorders, Attention Deficit Hyperactivity Disorder (ADHD/ADD), schizophrenia, dyslexia, dyspraxia, depression, obsessive –compulsive disorder (OCD or bi-polar disorder) and other neuropsychological and psychiatric problems in children and young adults are becoming more and more common. In clinical practice these conditions more often than not overlap with each other. A child with autism often is hyperactive and dyspraxic. There is about 50% overlap between dyslexia and dyspraxia and 25-50% overlap between hyperactivity and dyslexia and dyspraxia. Children with these conditions are often diagnosed as being depressed and as they grow up they are more prone to drug abuse or alcoholism than their typically developing peers. A young person diagnosed with schizophrenia would often suffer from dyslexia, dyspraxia or/and ADHD/ADD in childhood. OCD children are often hyperactive with autistic tendencies and indeed they often receive those two diagnoses before being re-diagnosed as bi-polar. Schizophrenia and bi-polar disorder are often described as two sides of one coin. We have created different diagnostic boxes to fit our children in. But a modern child does not fit into any one of them neatly. The modern child in most cases fits into a rather lumpy picture of overlapping neurological and psychiatric conditions. This picture leads us to the fact that these conditions are related to each other by similar underlying causes. Let us discuss what these causes may be. What is a typical scenario we see in clinical practice? Before examining the child it is very important to look at the health history of the parents. Whenever the parents are mentioned people immediately think about genetics. However, apart of genetics there is something very important the parents, mother in particular, pass to their child: their unique gut micro-flora. Not many people know that an adult on average carries 2 kg of bacteria in the gut. There are more cells in that microbial mass than there are cells in an entire human body. It is a highly organised micro-world, where certain species of bacteria have to predominate to keep us healthy physically and mentally. Their role in our health is so monumental, that we simply can not afford to

ignore them. We will talk in detail about the child’s gut flora later. Now let us come back to the source of the child’s gut flora – the parents. After studying hundreds of cases or neurological and psychiatric conditions in children, a typical health picture of these children’s mums has emerged. A typical modern mother was probably not breast fed when she was a baby, because she was born in 60s or 70s when breast-feeding went out of fashion. Why is it important? Because it is well known now that not breast fed babies develop completely different gut flora to the breast fed babies. This compromised gut flora in a bottle fed baby later on predisposes her to many health problems. Having acquired compromised gut flora from the start, a typical modern mum had quite a few courses of antibiotics in her childhood and youth for various infections. It is a well known fact that antibiotics have a serious damaging effect on gut flora, because they wipe out the beneficial strains of bacteria in the gut. At the age of 16 and sometimes even earlier the modern mum was put on a contraceptive pill, which she took for quite a few years before starting a family. Contraceptive pills have a devastating effect on the beneficial (good) bacteria in the gut. One of the major functions of the good bacteria in the gut flora is controlling about 500 different known to science species of pathogenic (bad) and opportunistic microbes. When the beneficial bacteria get destroyed the opportunists get a special opportunity to grow into large colonies and occupy large areas of the digestive tract. A modern diet of processed and fast foods provide perfect nourishment for these pathogens and that is a typical diet a modern mum had as a child and a young adult. As a result of all these factors a modern mum has seriously compromised gut flora by the time she is ready to have children. And indeed clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with neurological and psychiatric conditions. The most common health problems in mothers are digestive abnormalities, allergies, autoimmunity, PMS, chronic fatigue, headaches and skin problems. A baby is born with a sterile gut. In the first 20 or so days of life the baby’s virgin gut surface gets populated by a mixture of microbes. This is the child’s gut flora, which will have a tremendous effect on this child’s health for the rest of his/her life. Where does this gut flora come from? Mainly from the mother. So, whatever microbial flora the mother has she would pass to her new-born child. Gut flora is something we do not think much about. And yet the number of functions the gut flora fulfils is so vital for us that if some day our digestive tract got sterilised we probably would not survive. The first and very important function is appropriate digestion and absorption of food. If a child does not acquire normal balanced gut flora, then the child will not digest and absorb foods properly, developing multiple nutritional deficiencies. And that is what we commonly see in children with learning disabilities, psychiatric problems and allergies. Many of these children are malnourished. Even in the cases where the child may grow well, testing reveals some typical nutritional deficiencies in many important minerals, vitamins, essential fats, many amino-acids and other nutrients. The most common deficiencies, recorded in these children, are in magnesium, zinc, selenium, copper,

calcium, manganese, sulphur, phosphorus, iron, potassium, vanadium, boron, vitamins B1, B2, B3, B6, B12, C, A, D, folic acid, pantothenic acid, omega-3, 6, 9 fatty acids, taurine, alpha-ketoglutaric acid, glutathione and many other amino-acids. This usual list of nutritional deficiencies, commonly seen in these children, includes some most important nutrients for normal development of the child’s brain, immune system and the rest of the body. Apart of normal digestion and absorption of food healthy gut flora actively synthesises various nutrients: vitamin K, pantothenic acid, folic acid, thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6), ciancobalamine (vitamin B12), various amino-acids and proteins. Indeed, when tested people with gut dysbiosis always present with deficiencies of these nutrients. Clinical experience shows that restoring the beneficial bacteria in their gut is the best way to deal with these deficiencies. The majority of children with neurological and psychiatric conditions look pale and pasty. When tested they show various stages of anaemia, which is not surprising. To have a healthy blood we require many different nutrients: vitamins (B1, B2, B3, B6, B12, K, A, D, etc), minerals (Fe, Ca, Mg, Zn, Co, Se, boron, etc.), essential amino-acids and fats. These children not only can't absorb these nutrients from food, but their own production of many of them in the body is damaged. On top of that people with damaged gut flora often have particular groups of pathogenic bacteria growing in their gut, which are ironloving bacteria (Actinomyces spp., Mycobacterium spp., pathogenic strains of E.Coli, Corynebacterium spp. and many others). They consume whatever iron the person gets from the diet, leaving that person deficient in iron. Unfortunately, supplementing iron only makes these bacteria grow stronger and does not remedy anaemia. To treat anaemia the person requires all the nutrients we have mentioned, many of which healthy gut flora supplies.

Apart of taking a direct part in nourishing the body, beneficial bacteria in the gut act as the housekeepers for the digestive tract. They coat the entire surface of the gut protecting it from invaders and toxins by providing a natural barrier and producing a lot of antibacterial, anti-viral and anti-fungal substances. At the same time they provide the gut lining with nourishment. It is estimated that 60 – 70% of energy, the gut lining derives, is from the activity of bacteria, which live on it. So, it is no surprise that when the gut flora is abnormal the digestive tract itself can not be healthy. Indeed most children with learning disabilities, psychiatric disorders and allergies present with digestive problems. In many cases these problems are severe enough for the parents to talk about them first. In some cases they may not be very severe, but when asked direct questions the parents describe that their child never had normal stool, that their child suffered from colic as a baby and that tummy pains and flatulence are a common part of the picture. In those cases where these children have been examined by gastro-enterologists inflammatory process in the gut was found along with faecal compaction and an over-spill syndrome. The most recent research was performed at the Royal Free Hospital in London by Dr. Andrew Wakefield and his team. They found an inflammatory condition in the bowel of

autistic children, which they have named Autistic Enterocolitis. Schizophrenic patients were always known to have serious digestive problems. Dr. Curtis Dohan, MD has devoted many years to researching digestive abnormalities in schizophrenia. He found a lot of similarities between coeliac disease and the state of the digestive tract in schizophrenics. Indeed, in my clinical practice long before these patients develop psychotic symptoms they suffer from digestive problems and all other typical symptoms of gut dysbiosis pretty much from the start of their lives. Children and young adults with ADHD/ADD, OCD, depression and other neuro-psychological problems are very often reported to suffer from digestive abnormalities though there have not been formal studies published yet. What other symptoms of gut dysbiosis do we know? Well functioning gut flora is the right hand of our immune system. The beneficial bacteria in the gut ensure appropriate production of different immune cells, immunoglobulins and other parts of the immunity. But most importantly they keep the immune system in the right balance. What typically happens in a person with gut dysbiosis is that two major arms of their immune system Th1 and Th2 get out of balance with underactive Th1 and overactive Th2. As a result the immune system starts reacting to most environmental stimuli in an allergic or atopic kind of way. A baby is born with an immature immune system. Establishment of healthy balanced gut flora in the first few days of life plays a crucial role in appropriate maturation of the immune system. If the baby does not acquire appropriate gut flora then the baby is left immune compromised. The result is lots of infections followed by lots of courses of antibiotics, which damage the child’s gut flora and immune system even further. The most common infections in the first two years of life in the children with neurological, psychological and atopic disorders are ear infections, chest infections, sore throats and impetigo. At the same time in the first two years of life the child receives a lot of vaccinations. A child with compromised immune system does not react to vaccinations in a predicted way. In most cases vaccines deepen the damage to the immune system and provide a source of chronic persistent viral infections and autoimmune problems in these children. There has been a considerable amount of research published into the state of the immune system in children with learning disabilities and psychiatric problems. The research shows deep abnormalities in all major cell groups and immunoglobulins in these children. The most common autoantibodies found are to myelin basic protein (MBP) and neuron-axon filament protein (NSFP). These antibodies attack the child’s brain and the rest of the nervous system. So, the modern child, who we are talking about, did not get normal gut flora from the start and then got it damaged even further by repeated courses of antibiotics and vaccinations. As a result these children commonly suffer from digestive problems, allergies, asthma and eczema. But apart of that in children who then go on to develop neurological and psychiatric problems something even more terrible happens. Without control of the beneficial bacteria different opportunistic and pathogenic bacteria, viruses and fungi have a good chance to occupy large territories in the digestive tract of the child and grow large colonies. Two particular groups which are most commonly found on

testing are yeasts (including Candida species) and Clostridia family. These pathogenic microbes start digesting food in their own way producing large amounts of various toxic substances, which get absorbed into the blood stream, carried to the brain and cross the blood – brain barrier. The number and mixture of toxins can be very individual, causing different neurological and psychological symptoms. Due to the absence or greatly reduced numbers of beneficial bacteria in the gut flora, the child’s digestive system instead of being a source of nourishment becomes a major source of toxicity in the body.

So, what kind of toxins are we talking about? There are many toxins, which we have not studied very well yet. But some toxins have received a considerable amount of research. Let us have a look at them. Acetaldehyde & Alcohol. What have these substances got to do with children? The most common pathogenic microbes shown to overgrow in the digestive systems of children with neuro psychological conditions and allergies are yeasts, particularly Candida species. Yeasts ferment dietary carbohydrates with production of alcohol and its by-product acetaldehyde. Let us see what does a constant exposure to alcohol and acetaldehyde do to the body. • • • • • • • • • • •

Liver damage with reduced ability to detoxify drugs, pollutants and other toxins. Pancreas degeneration with reduced ability to produce pancreatic enzymes, which would impair digestion. Reduced ability of the stomach wall to produce stomach acid. Damage to immune system. Brain damage with lack of self-control, impaired co-ordination, impaired speech development, aggression, mental retardation, loss of memory and stupor. Peripheral nerve damage with altered senses and muscle weakness. Direct muscle tissue damage with altered ability to contract and relax and muscle weakness. Nutritional deficiencies from damaging effect on digestion and absorption of most vitamins, minerals and amino acids. Deficiencies in B and A vitamins are particularly common. Alcohol has an ability to enhance toxicity of most common drugs, pollutants and other toxins. Alteration of metabolism of proteins, carbohydrates and lipids in the body. Inability of the liver to dispose of old neurotransmitters, hormones and other byproducts of normal metabolism. As a result these substances accumulate in the body, causing behavioural abnormalities and many other problems.

Acetaldehyde is considered to be the most toxic of alcohol by-products. It is the chemical, which gives us the feeling of hangover. Anybody who experienced a hangover would tell you how dreadful he or she felt. Children, who acquire abnormal gut flora with a lot of yeast from the start, may never know any other feeling. Acetaldehyde has a large

variety of toxic influences on the body. One of the most devastating influences of this chemical is its ability to alter the structure of proteins. Acetaldehyde – altered proteins are thought to be responsible for many autoimmune reactions. Children with neuropsychological problems are commonly found to have antibodies against their own tissues. Clostridia Neurotoxins. There are about 100 different Clostridia species known so far. They are present in the stools of people with autism, schizophrenia, psychosis, severe depression, muscle paralysis and muscle tonus abnormalities and some other neurological and psychiatric conditions. Many Clostridia species are normal inhabitants of a human gut. For example Clostridium tetani is routinely found in the gut of healthy humans and animals. Everybody knows that tetanus is a deadly disease, due to an extremely powerful neurotoxin Clostridium tetani produces. Clostridium tetani, which lives in the gut, is normally controlled by the beneficial bacteria and does us no harm, because its toxin can not get through the healthy gut wall. Unfortunately, children, which we are talking about, do not have a healthy gut wall. In gut dysbiosis this powerful neurotoxin may well get absorbed through the damaged gut lining and then cross the blood-brain barrier affecting child’s mental development. Many other species of Clostridia (perfringens, novyi, septicum, histolyticum, sordelli, aerofoetidum, tertium, sporogenes, etc) produce toxins similar to tetanus toxin as well as many other toxins. Dr. William Shaw at Great Plains Laboratories describes in detail number of autistic children, who showed serious improvements in their development and biochemical tests while on anti-Clostridia medication. Unfortunately, as soon as the medication was stopped the children slipped back into autism, because these children do not have healthy gut flora to control Clostridia and not to allow their toxins through the gut lining into the bloodstream. In many cases Clostridia were not identified in the stools of these children, because Clostridia are strict anaerobes and are very difficult to study. We need to come up with some better ways of testing for these potent pathogens. . Yeasts and Clostridia have been given a special opportunity by the era of antibiotics. Broad-spectrum antibiotics do not touch them while killing the beneficial bacteria in the gut, which are supposed to control the yeasts and Clostridia. So, after every course of antibiotics these two pathogenic groups get out of control and overgrow. The children that we are talking about usually are exposed to numerous courses of antibiotics pretty much from the beginning of their lives. Gluteomorphins & Casomorphins or opiates from gluten and casein. Opiates are drugs, like opium, morphine and heroin, which are commonly used by drug addicts. What have they got to do with children? Gluten is a protein present in grains, mainly wheat, rye, oats, barley. Casein is a milk protein, present in cow, goat, sheep, human and all other milk and milk products. In the bodies of children and adults with autism and schizophrenia these proteins do not get digested properly due to the fact that their digestive systems are full of abnormal

microbial flora and hence unhealthy. As a result of misdigestion gluten and casein turn into substances with similar chemical structure of opiates, like morphine and heroin. There has been quite a substantial amount of research done in this area by Dohan, Reichelt, Shattock, Cade and others, where gluten and casein peptides, called gluteomorphin and casomorphin, were detected in the urine of schizophrenic patients and autistic children. Incidentally, these substances were also found in patients with depression and rheumatoid arthritis. These opiates from wheat and milk get through the blood-brain barrier and block certain areas of the brain, just like morphine or heroin would do, causing various neurological and psychological symptoms. Based on this research the gluten and casein free diet (GFCF diet) has been developed, which helps a lot of children and adults with autism and schizophrenia.

Dermorphin & Deltorphin . These are two frightening toxic substances with opiate structure, which have been found in autistic children by a biochemist Alan Friedman, Ph.D. Dermorphin and deltorphin were first identified on the skin of a poison dart frog in South America. Native people used to dip their darts into the mucous on these frogs in order to paralyse their enemy, because deltorphin and dermorphin are extremely potent neurotoxins. Dr. Friedman believes that it is not the frog that produces these neurotoxins, but a fungus, which grows on the skin of this frog. It is possible that this fungus grows in the gut of autistic children, supplying their bodies with dermorphin and deltorphin.

Organic Acid Testing available now in many laboratories around the world identify various metabolites of microbial activity in the gut, which get absorbed and finish up in the child’s urine. Many of these metabolites are highly poisonous substances. Low Serum Sulphate is a common picture in these children, which is an indirect indication of toxicity in the body, because sulphates are essential for many detoxification processes and normal metabolism of brain neurotransmitters. In many cases the child may be getting plenty of sulphates through he diet, but they all get consumed by the detox pathways struggling with the river of toxicity, which is constantly coming from the child’s gut. At the same time another large group of bacteria, which commonly overgrow in the gut dysbiosis situation are sulphate-reducing bacteria, which make sulphur unavailable for the body to use. These bacteria metabolise sulphate coming from food into sulphites, many of which are toxic like hydrogen sulphide for example, which is the gas with rotten egg smell. Some parents of autistic, hyperactive and other children tell me that their child’s stool has this characteristic smell.

The mixture of toxicity in each child can be quite individual and different. But what they all have in common is gut dysbiosis. The toxicity, which is produced by the abnormal microbial mass in these children, establishes a link between the gut and the brain. That is

why it will be logical to group these disorders under one name: the Gut and Psychology Syndrome (GAP Syndrome)™. The GAP children can present with symptoms of autism, ADHD, ADD, OCD, dyslexia, dyspraxia, schizophrenia, depression, sleep disorders, allergies, asthma and eczema in any possible combination. These are the children who fall in the gap in our medical knowledge. Any child with a learning disability, neurological or psychological problems and allergies should be thoroughly examined for gut dysbiosis. Re-establishing normal gut flora and treating the digestive system of the child has to be the number one treatment for these disorders, before considering any other treatments with drugs or otherwise. Dr. Natasha Campbell-McBride, MD. MmedSci in neurology, MmedSci in human nutrition. The right of Natasha Campbell-McBride to be identified as the sole author of this work has been asserted in accordance with the Copyright, Designs, and Patents Act 1988. All rights reserved. No part of this work may be reproduced, stored in a retrieval system, or transmitted in any form by any means without the prior written permission of the author.

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37. Shaw W. Biological Treatments for Autism and PDD. 2002. ISBN 0-9661238-0-6 38. Tabolin VA, Belmer SV, Gasilina TV, Muhina UG, Korneva TI. of intestinal disbacteriosis in children. - M.:Medicina, 1998, 22p..

Rational therapy

39. Vorobiev AA, Pak SG et al. (1998). Disbacteriosis in children. A textbook for doctors and medical students.(Russian). M.: “KMK Lt.”, 1998. 64p. ISBN 5-87317-049-5. 40. Ward NI. Assessment of clinical factors in relation to child hyperactivity. J Nutr Environ Med, Vol 7, 1997, p.333-342. 41. Ward NI. Hyperactivity and a previous history of antibiotic usage. Nutrition Practitioner, Vol 3(3), 2001, p.12. 42. Waring (2001). Sulphate, sulphation and gut permeability: are cytokines involved? In: The Biology of Autism – Unravelled. Conference preceedings 11th May 2001, Institute of Electircal Engineeris, London. 43. Wakefield AJ, Anthony A et al. Enterocolitis in children with developmental disorders. AIA Journal, Autumn 2001. 44. Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, nonspecific colitis and pervasive developmental disorder in children. Lancet 1998; 351:637-41. 45. Wakefield AJ and Montgomery SM. Autism, viral infection and measles, mumps, rubella vaccination. Israeli Medical Association Journal 1999;1:183-187. 46. Walker-Smith JA. Autism, inflammatory bowel disease and MMR vaccine. Lancet 1998; 351: 1356-57. 47. Warren R et al. Immune abnormalities in patients with autism. J. Autism Develop Dis. 16, 189-197, 1986. 48. Warren PP at al. Reduced natural killer cell activity in autism. J Am Acad Child Phychol 26: 333-335, 1987. 49. Waizman A et al. Abnormal immune response to brain tissue antigen in the syndrome of autism. Am J Psychiatry 139:1462-1465, 1982. 50. Wilson K, Moore L, Patel M, Permoad P. Suppression of potential pathogens by a defined colonic microflora. Microbial Ecology in Health and Disease. 1988; 1:23743. 51. Yonk LJ et al. D4+ per T cell depression in autism. Immunol Lett 35: 341-346, 1990.

Gut and Psychology Syndrome (GAP Syndrome or GAPS)  Dr. N. Campbell-McBride, MD

Not many people would choose to become parents of an autistic child. Yet it is happening to more and more of us in our modern world. There is an unmistakable epidemic of autism going on across the globe. If this can possibly be of any comfort for a parent, then I would say that you are certainly not alone! Most parents of autistic children can clearly recall that traumatic moment of the diagnosis of "Autism" being announced to them by a doctor followed by the statement "There is nothing that can be done.” Well, being a doctor myself, I have to say that your doctor is wrong, there is a lot that can be done! I would even go further, depending on your commitment and certain circumstances, you have a good chance of bringing your child as close as possible to normality! Hundreds of autistic children across the globe, appropriately treated and educated become almost indistinguishable from their typically developing (normal) peers. My own son was diagnosed severely autistic at the age of three. Now at the age of 12 he has fully recovered and is leading a normal life. In my clinic in Cambridge in England I work with hundreds of autistic children and adults. My personal and professional involvement with autism has been my best education in how to treat this disorder effectively. Treating autism is not an easy task. It takes years of continuous effort and commitment. But, being a parent myself, I can tell you that it is one of the most rewarding experiences on Earth! In my book “Gut and Psychology Syndrome.

1

Natural Treatment for Autism, ADHD, Dyslexia, Dyspraxia, Depression and Schizophrenia” I would like to share with you what I strongly believe to be the appropriate treatment for an autistic child.

So, what is a typical scenario I see in clinical practice? Before examining the patient it is very important to look at the health history of the parents. Whenever the parents are mentioned people immediately think about genetics. However, apart from genetics there is something very important the parents, mother in particular, pass to their child: their unique gut micro-flora. Not many people know that an adult on average carries 2 kg of bacteria in the gut. There are more cells in that microbial mass than there are cells in an entire human body. It is a highly organised micro-world, where certain species of bacteria have to predominate to keep us healthy physically and mentally. Their role in our health is so monumental, that we simply can not afford to ignore them. We will talk in detail about the child’s gut flora later. Now let us come back to the source of the child’s gut flora – the parents.

After studying hundreds of cases of autism in children and adults, a typical health picture of these children’s mums has emerged. A typical modern mother was probably not breast fed when she was a baby, because she was born in 60s or 70s when breast-feeding went out of fashion. Why is it important? Because it is well known now that bottle fed babies develop completely different gut flora to the breast fed babies. This compromised gut flora

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in a bottle fed baby later on predisposes her to many health problems. Having acquired compromised gut flora from the start, a typical modern mum had quite a few courses of antibiotics in her childhood and youth for various infections. It is a well known fact that antibiotics have a serious damaging effect on gut flora, because they wipe out the beneficial strains of bacteria in the gut. At the age of 16 and sometimes even earlier the modern mum was put on a contraceptive pill, which she took for quite a few years before starting a family. Contraceptive pills have a devastating effect on the beneficial (good) bacteria in the gut. One of the major functions of the good bacteria in the gut flora is controlling about 500 different known to science species of pathogenic (bad) and opportunistic microbes. When the beneficial bacteria get destroyed the opportunists get a special opportunity to grow into large colonies and occupy large areas of the digestive tract. A modern diet of processed and fast foods provides perfect nourishment for these pathogens and that is a typical diet a modern mum had as a child and a young adult. As a result of all these factors a modern mum has seriously compromised gut flora by the time she is ready to have children. And indeed clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with autism and other neurological and psychiatric conditions.

But why are we talking about mother’s gut flora? Because her baby is born with a sterile gut. In the first 20 or so days of life the baby’s virgin gut surface gets populated by a mixture of microbes. This is the child’s gut flora, which will have a

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tremendous effect on this child’s health for the rest of his/her life. Where does this gut flora come from? Mainly from the mother. So, whatever microbial flora the mother has she would pass to her new-born child.

Gut flora is something we do not think much about. And yet the number of functions the gut flora fulfils is so vital for us that if some day our digestive tract got sterilised we probably would not survive.

The first and very important function is appropriate digestion and absorption of food. If a child does not acquire normal balanced gut flora, then the child will not digest and absorb foods properly, developing multiple nutritional deficiencies.

Apart from taking a vital part in nourishing the body, beneficial bacteria in the gut act as the housekeepers for the digestive tract. They coat the entire surface of the gut protecting it from invaders and toxins by providing a natural barrier and producing a lot of anti-bacterial, anti-viral and anti-fungal substances. At the same time they provide the gut lining with nourishment. So, it is no surprise that when the gut flora is abnormal the digestive tract itself can not be healthy. Indeed most patients with autistic spectrum disorders present with digestive problems. In many cases these problems are severe enough for the parents to talk about them first. In some cases they may not be severe, but when asked direct questions the parents describe that their child never had normal stool, that their

4

child suffered from colic as a baby and that tummy pains and flatulence are a common part of the picture. In those cases where these children have been examined by gastroenterologists, inflammatory process in the gut was found along with faecal compaction and an over-spill syndrome. The most recent research was performed at the Royal Free Hospital in London by Dr. Andrew Wakefield and his team. They found an inflammatory condition in the bowel of autistic children, which they have named Autistic Enterocolitis.

Well functioning gut flora is the right hand of our immune system. A baby is born with an immature immune system. Establishment of healthy balanced gut flora in the first few days of life plays a crucial role in appropriate maturation of the immune system. If the baby does not acquire appropriate gut flora then the baby is left immune compromised. The result is lots of infections followed by lots of courses of antibiotics, which damage the child’s gut flora and immune system even further. At the same time in the first two years of life the child receives a lot of vaccinations. A child with compromised immune system does not react to vaccinations in a predicted way. In many cases vaccines deepen the damage to the immune system and provide a source of chronic persistent viral infections and autoimmune problems in these children.

So, the autistic child who we are talking about, did not get normal gut flora from the start and then got it damaged even further by repeated courses of antibiotics and vaccinations. As a result these children commonly suffer from digestive

5

problems, allergies, asthma and eczema. But apart from that in autistic children and adults something even more terrible happens. Without control of the beneficial bacteria different opportunistic and pathogenic bacteria, viruses and fungi have a good chance to occupy large territories in the digestive tract and grow large colonies. These pathogenic microbes start digesting food in their own way producing large amounts of various toxic substances, which get absorbed into the blood stream, carried to the brain and cross the blood – brain barrier. Due to the absence or greatly reduced numbers of beneficial bacteria in the gut flora, the child’s digestive system instead of being a source of nourishment becomes a major source of toxicity in the body.

In my book “Gut and Psychology Syndrome. Natural Treatment for Autism, ADHD, Dyslexia, Dyspraxia, Depression and Schizophrenia” we will look in great detail at what particular toxins have been found in autistic children and adults and how they make these children and adults autistic. The toxicity, which is produced by the abnormal microbial mass in the digestive tract of the child, establishes a link between the gut and the brain. That is why I named this condition: the Gut and Psychology Syndrome (GAP Syndrome). Patients with GAP Syndrome fall in the gap – the gap in our medical knowledge. As a result they do not receive an appropriate treatment.

The book on GAP Syndrome explains how and why autism develops and how to treat it using a sound nutritional protocol. The treatment is completely natural and

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can be implemented at home. It is a self-help book with a comprehensive recipe section and is written in easy to understand language. Knowledge is power! This book gives the parents the power to help their child !

Dr. Natasha Campbell-McBride, MD MmedSci (neurology) MmedSci (human nutrition) Cambridge, England

To learn more about Gut and Psychology Syndrome, how it develops and how to treat it with a sound nutritional protocol please look at the book by Dr.

Natasha Campbell-McBride “Gut and Psychology Syndrome. Natural treatment for autism, ADHD/ADD, dyslexia, dyspraxia, depression and schizophrenia.” www.mindd.org or Tel: (61) (2)9388 7383

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You

can

get

the

book

on

Gut and Psychology Syndrome* N. Campbell-McBride, M.D. In his seminal book, Good Calories, Bad lems in children and adults are becoming Calories, Gary Taubes quotes Hilde Bruch more and more common. who wrote: "The literature on obesity is not In clinical practice these conditions only voluminous, it is alsofallofcoriflicting overlap with each other. A patient wdth and confasing reports and opinions. One autism often is hyperactive and dyspraxic. might well add to this the words ofArtemus There is about 50% overlap between dysWard: "The researches ofso many eminent lexia and dyspraxia and 25-50% overlap scientific men have thrown so much darknessbetween ADHD/ADD and dyslexia and on the subject that if they continue these dyspraxia. Children with these conditions researches we shall soon know nothing. " are often diagnosed as being depressed, Determining the causes ofthe hundreds and as they grow up they are more prone ofpsychiatric disorders and their treatment to drug abuse or alcoholism than their has almost reached that state oftotal dark- typically developing peers. A young perness. Dr. Campbell-McBride, in her bookson diagnosed with schizophrenia often Gut and Psychology Syndrome, blows away suffered from dyslexia, dyspraxia or/and some ofthefog and shows us where to look. ADHD/ADD in childhood. When we After I read it, I wrote to the author: "Had start examining the patients with these I read your excellent book forty years ago I so-called mental conditions, we find that would have thought you were nuts. Thirty they are also physically ill. Digestive probyears ago I would have seen some merit and lems, allergies, eczema, asthma, various in the last years what I have learned has food intolerances and immune system confirmed whatyou have written. It is a veryabnormalities are universally present good book. Isn't it a shame that psychiatric amongst them. We have created different illnesses arefueled by foods and the way we diagnostic boxes for these patients, but deal with them. Ironically, psychiatry may a modern patient does not fit into any never accept this idea, as it has become the one of them neatly. The modern patient unpaid servant of the drug industry. Many in most cases fits into a rather lumpy picture of overlapping neurological and thanks for sending it to me. " To learn more, please read the book by psychiatric conditions. Why are all these conditions related? Dr. Natasha Campbell-McBride, Gut and What underlying problem are we missing? PsychologySyndrome:NaturalTreatmentfor To answer all these questions we have Autism, ADHD/ADD, Dyslexia, Dyspraxia, to look at one factor, which unites all these Depression, Schizophrenia. patients in a clinical setting. This factor -Ahram Hoffer, MD, PhD is the state of their digestive system. I have yet to meet a child or an adult with We live in the world of unfolding autism, ADHD/ADD, dyspraxia, dyslexia, epidemics. Autistic Spectrum Disorders, schizophrenia, bipolar disorder, depresAttention Deficit Hyperactivity Disorder sion or obsessive-compulsive disorder (ADHD/ADD), schizophrenia, dyslexia, who does not have digestive abnormalidyspraxia, depression, obsessive -compul- ties. In many cases they are severe enough sive disorder, bipolar disorder and other for the patients or their parents to start neuro-psychological and psychiatric prob- talking about them first. In some cases the parents may not mention their child's digestive system, yet when asked direct *GAP Syndrome or GAPS™' 90

Gut and Psychology Syndrome

questions, would describe a plethora of gut problems. So, what have digestive abnormalities got to do with these so-called mental problems? According to recent research and clinical experience - a lot! In fact it appears that the patient's digestive system holds the key to the patient's mental state. What is a typical scenario we see in clinical practice? Before examining the patient it is very important to look at the health history of the parents. Whenever the parents are mentioned people immediately think about genetics. However, apart from genetics there is something very important the parents, mother in particular, pass to their child: their unique gut micro-flora. Not many people know that an adult on average carries 2 kg of bacteria in the gut. There are more cells in that microbiai mass than there are cells in an entire human body. It is a highly organized micro-world, where certain species of bacteria have to predominate to keep us healthy physically and mentally. Their role in our health is so monumental, that we simply cannot afford to ignore them. We will talk in detail about the child's gut flora later. Now let us come back to the source of the child's gut flora - the parents. After studying hundreds of cases of neurological and psychiatric conditions in children and adults, a typical health picture of these children's mums has emerged: due to various modern factors a modern mum has seriously compromised gut flora by the time she is ready to have children. Indeed, clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with neurological and psychiatric conditions. A baby is born with a sterile gut. In the first 20 or so days of life the baby's virgin gut surface is populated by a mixture of microbes. This is the child's gut flora, which will have a tremendous effect on this child's health for the rest 91

of his/her life. Where does this gut flora come from? Mainly from the mother at the time of birth. Whatever microbiai flora the mother has, she passes to her newborn child. Fathers with abnormal gut flora contribute to the bodily flora of the mother and through her to the gut flora of the child. The Role and Importance ofthe Gut Flora

Gut flora is something we do not think much about. And yet the number of functions the gut flora fulfils is so vital for us that if some day our digestive tracts were sterilised we probably would not survive. The first and very important function is appropriate digestion and absorption of food. If a child does not acquire normal balanced gutflora,then the child will not digest and absorb foods properly, developing multiple nutritional deficiencies. And that is what we commonly see in children and adults with learning disabilities, psychiatric problems and allergies. Many of these patients are malnourished. Even in the cases where the child may grow well, testing reveals some typical nutritional deficiencies in many important minerals, vitamins, essential fats, many amino acids and other nutrients. Apart from normal digestion and absorption of food, healthy gutfloraactively synthesizes various nutrients: vitamin K, pantothenic acid, folie acid, thiamine (vitamin Bi), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin Be), cyancobalamin (vitamin B12), various amino-acids and proteins. Indeed, when tested, people with gut dysbiosis present with deficiencies of these nutrients. Clinical experience shows that restoring the beneficial bacteria in their gut is the best way to deal with these deficiencies. Apart from taking a vital part in nourishing the body, beneficial bacteria in the gut act as the housekeepers for the digestive tract. They coat the entire

Journal of Orthomolecular Medicine

Vol. 23, No. 2, 2008

surface of the gut protecting it from invaders and toxins by providing a natural barrier and producing anti-bacterial, anti-viral and anti-fungal substances. At the same time they provide the gut lining with nourishment. Beneficial bacteria normally control various opportunistic and pathogenic microbes in the gut. Lack of beneficial bacteria would allow disease-causing microbes to grow and occupy large parts of the digestive system causing damage and inflammation in the gut wall. So, it is no surprise when the gut flora is abnormal, the digestive tract itself cannot be healthy. Indeed most patients with learning disabilities, psychiatric disorders and allergies present with digestive problems: constipation and diarrhoea, infantile colic and abdominal pain, bloating and flatulence, reflux and indigestion. Examination by gastroenterologists commonly reveals inflammatory process in the gut and many of these patients are diagnosed with coeliac disease. Housing a mass of pathogenic microbes the gut cannot be healthy. Indeed, long before these patients develop so-called mental symptoms they usually suffer from digestive problems and all other typical sjmiptoms of gut dysbiosis pretty much from the start of their lives. The Role and Importance ofthe Immune System A baby is born with an immature immune system. Establishment of healthy balanced gut flora in the first few days of life plays a crucial role in appropriate maturation of the immune system. If the baby acquires compromised gut flora from the mother then the baby is left immune compromised. The result is lots of infections followed by lots of courses of antibiotics, which damage the child's gut flora and immune system even further. The beneficial bacteria in the gut ensure appropriate production of different immune cells, immunoglobulins, keeping

immunity in the right balance. Damage inflicted upon the gutfloratypically leads to an imbalance between major parts of immunity, resulting in allergies, asthma and eczema - symptoms, which children and adults with neurological and psychiatric conditions commonly suffer from. There has been a considerable amount of research published into the state ofthe immune system in patients with learning disabilities and psychiatric problems. The research shows deep abnormalities in all major cell groups and immunoglobulins. The most common autoantibodies found are to myelin basic protein (MBP) and neuron-axon filament protein (NAFP). These antibodies specifically attack the person's brain and the rest ofthe nervous system. To summarize: A child born from parents with abnormal gut flora did not acquire normal gut flora from the start. Thefloramay have been damaged further by repeated courses of antibiotics and vaccinations. As a result, these children commonly suffer from digestive problems, allergies, asthma and eczema. However, in children and adults who go on to develop neurological and psychiatric problems, something even worse happens. Without control ofthe beneficial bacteria, different opportunistic and pathogenic bacteria, viruses and fungi have a good chance to occupy large territories in the digestive tract and grow large colonies. Two particular groups, which are most commonly found on testing, are yeasts (including Candida species) and the Clostridia family. These pathogenic microbes start digesting food in their own way producing large amounts of various toxic substances, which are absorbed into the blood stream, carried to the brain and cross the blood-brain barrier. The number and mixture of toxins can be very individual, causing different neurological and psychiatric symptoms. Due to the absence or greatly reduced numbers of beneficial bacteria in the 92

Gut and Psychology Syndrome

gut flora, the person's digestive system instead of being a source of nourishment becomes a major source of toxicity in the body. The mixture of toxicity in each child or adult can be quite individual and different. But what they all have in common is gut dysbiosis (abnormal gutflora).The toxicity, which is produced by the abnormal microbiai mass in these patients, establishes a link between the gut and the brain. That is why it is logical to group these disorders under one name: the Gut and Psychology Syndrome (GAPS)3. The GAPS children and adults can present with symptoms of autism, ADHD, ADD, OCD, dyslexia, dyspraxia, schizophrenia, depression, bipolar disorder, sleep disorders, allergies, asthma and eczema in any possible combination. These are the patients who fall through the gap in our medical knowledge. Any child or adult with a learning disability, neurological or psychological problems and allergies should be thoroughly examined for gut dysbiosis. Re-establishing normal gut flora and treating the digestive system of the person has to be the number one treatment for these disorders, before considering any other treatments with drugs or otherwise. Gut And Psychology Syndrome (GAP Syndrome or GAPS) establishes the connection between the state of the patient's gut and the functioning of the brain. This connection has been known by medics for a very long time. The father of modern psychiatry French psychiatrist Phillipe Pinel (1745-1828), after working with mental patients for many years, concluded in 1807: "The primary seat of insanity generally is in the region of the stomach and intestines." Long before him Hippocrates (460-370 BC), the father of modern medicine has said: "All diseases begin in the gut!" The more we learn with our modern scientiflc tools, the more we realize just how right they were. 93

References 1. Absolon CM at al: Psychological disturbance in atopic eczema: the extent of the problem in school-aged children. Br J Dematol, 1997; 137(2): 24105. 2. Ashkenazi et al: Immunologie reaction in psychotic patients to fractions of gluten. Am J Psychiatry, 1979; 136:1306-1309. 3. Baruk H: Psychoses of digestive origins. In: Hemmings and Hemmings (eds). Biological Basis of Schizophrenia. Lancaster MTP Press. 1978. 4. Bolte ER: Autism and Clostridium tetani. Med Hypoth, 1998; 51(2): 133-144. 5. Cade R et al: Autism and schizophrenia: intestinal disorders. Nutri Neurosci, 2000; 3. 6. Dohan CF: Cereals and schizophrenia: data and hypothesis./leía Psyc/íí'aíScawd, 1966; 42: 125-152. 7. Dohan CF et al: Relapsed schizophrenics: more rapid improvement on a milk and cereal free diet. BritJPsychiat, 1969; 115: 595-596. 8. Dohan et al: Is schizophrenia rare if grain is rare? Biol Psychiat, 1984:19(3); 385-399. 9. Dohan FC: Is celiac disease a clue to pathogenesis of schizophrenia? Mental Hygiene, 1969; 53: 525-529. 10. Furlano RI, Anthony A, Day R, et al: Colonie CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. / Pediatr, 2001;138: 366-72. 11. Ferrari P et al: Immune status in infantile autism: Correlation between the immune status, autistic symptoms and levels of serotonin. Encéphale, 1988; 14: 339-344. 12. Holford P: Optimum Nutrition for the Mind. 2003. ISBN 0 -7499 -2213 -3. 13. Horrobin DF, Glen AM, Vaddadi K: The membrane hypothesis of schizophrenia. Schiz Res, 1994; 18: 195-207. 14. Horvath K, Papadimitriou JC, Rabsztyn A et al: Gastrointestinal abnormalities in children with autism./Pedi'atr, 1999; 135: 559-563. 15. Kawashima H, Takayuki M, Kashiwagi Y et al: Detection and sequencing of measles virus from peripheral blood mononuclear cells from patients with inflammatory bowel disease and autism. Digest Diseas Sei, 2000; 45: 723-729. 16. Kontstanareas M, Homatidis S: Ear infections in autistic and normal children.//luíis/n Develop Disord, 1987; 17: 585. 17. Krasnogolovez VN: Colonie disbacteriosis. Medicina, 1989. 18. Kirjavainen PV, Apostolov E, Salminen SS, Isolauri E: 1999.New aspects of probiotics - a novel approach in the management of food

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energy. Allergy, 1999; 54(9): 909-15. 19. Lewis SJ, Freedman AR: Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. (Review)(144 refs). Alimentar Pharmacol Therapeut, 1998; 12(9): 807-22. 20. Lykova EA, Bondarenko VM, Sidorenko SV, et al: Combined antibacterial and probiotic therapy of Helicobacter-associated disease in children (Russian). Zhurnal Microbiologii, Epidemiologii I Immunobiologii. 1999; MarApr;(2): 76-81. 21. Macfarlane GT, CummingsJH: Probiotics and prebiotics: can regulating the activities of intestinal bacteria benefit health? BMJ, 1999; April; 318:999-1003. 22. McCandless J: Children with Starving Brains. 2003. ISBN 1-883647-10-X. 23. Mycroft et al: JIF-like sequences in milk and wheat proteins. NEJM, 1982; 307:895. 24. Pápalos D, Pápalos J: The Bipolar Child. Broadway Books, 2000. 25. Plioplys AV at al: Lymphocyte function in autism and Rett syndrome. Neuropsychobiology, 1994; 7:12-16. 26. Reichelt K et al: Gluten, milk proteins and autism: dietary intervention effects on behaviour and peptide secretions. / Appl Nutr, 1990; 42: 1-11. 27. Reichelt K, et al: Biologically active peptide-containing fractions in schizophrenia and childhood autism. Adv Biochem Psychopharmacol, 1981; 28: 627-47. 28. Rimland B. New hope for safe and effective treatments for autism. Autism Research Review International, 1994; 8:3. 29. Samonis G et al: Prospective evaluation ofthe impact of broad-spectrum antibiotics on the yeast flora of the human gut. EurJ Clin Microbiol Infect Dis, 1994; 13: 665-7. 30. Schoenthaler SJ et al. The effect of randomised vitamin-mineral supplementation on violent and non-violent antisocial behaviour among incarceratedjuveniles.JAfufÊwvMed, i997, 7: 343-352. 31. Singh V: Neuro-immunopathogenesis in autism. New Foundations Biol 2001; Berczi I & Gorczynski RM (eds) Elsevier Science B.V. pp 447-458. 32. Singh V at al. Changes in soluble interleuldn-2, interleukin-2 rector, T8 antigen, and interleukin-I in the serum of autistic children. Clin Immunol Immunopath, 1991; 61:448-455. 33. Singh V et al: Immunodiagnosis and immunotherapy in autistic children. Ann NY Acad Sei, 540:602-604,1988.

34. Singh V et al: Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clin Immunol Immunopathol, 1998:89; 105-108. 35. Singh, Kay: Wheat gluten as a pathogenic factor in schizophrenia. Science, 1975:191:401-402. 36. Sioudrou et al: Opioid peptides derived from food proteins. The exorphins./B/o/ Chem, 1979; 254:2446-2449. 37. Shaw W: Biological Treatmentsfor Autism and PDD. 2002. ISBN 0-9661238-0-6 38. Tabolin VA, Belmer SV, Gasilina TV, Muhina UG, Korneva TI: Rational therapy of intestinal dysbacteriosis in children. Medicina, 1998,22. 39. Vorobiev AA, Pak SG et al: Dysbacteriosis in Children. A Textbook for Doctors and Medical Students. M: "KMK Lt.", 1998.64. ISBN 5-87317049-5. 40. Ward NI: Assessment of clinical factors in relation to child hyperactivity.J Nutr EnvironMed, 1997; 7: 333-342. 41. Ward NI: Hyperactivity and a previous history of antibiotic usage. NutrPract, 2001; 3(3): 12. 42. Waring: Sulphate, sulphation and gut permeability: are cytokines involved? In: The Biology of Autism - Unravelled Conference proceedings 11th May 2001,/«si fleet £«g-i>i, London. 43. Wakefield AJ, Anthony A et al: Enterocolitis in children with developmental disorders. AIA J, Autumn 2001. 44. Wakefield AJ, Murch SH, Anthony A, et al. Ileallymphoid-nodular hjrperplasia, non-specific colitis and pervasive developmental disorder in children. Lancet, 1998; 351:637-41. 45. Wakefield AJ and Montgomery SM. Autism, viral infection and measles, mumps, rubella vaccination. Israeli Med Assoc J, 1999;1:183187. 46. Walker-Smith JA. Autism, inflammatory bowel disease and MMR vaccine. Lancet, 1998; 351: 1356-57. 47. Warren R et al. Immune abnormalities in patients with autism. J Autism Develop Dis, 1986; 16:189-197. 48. Warren PP at al. Reduced natural killer cell activity in autism. / Am Acad Child Phychoi, 1987; 26:333-335. 49. Waizman A et al. Abnormal immune response to brain tissue antigen in the syndrome of autism. AmJ Psychiatry 139:1462-1465,1982. 50. Wilson K, Moore L, Patel M, Permoad P. Suppression of potential pathogens by a defined colonie microflora. Microbiai Ecol Health Dis, 1988; 1: 237-43. 51. Yonk LJ et al: D4+ per T cell depression in autism. Immunol Lett, 1990; 35:341-346.

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Introduction Diet Most GAPS patients should follow the Introduction Diet before going into the Full GAPS Diet. Depending on the severity of your patient’s condition he or she can move through this program as fast or as slow as his/her condition will permit: for example you may move through the First Stage in one or two days and then spend longer on the Second Stage. Following the Introduction Diet fully is essential for people with serious digestive symptoms: diarrhea, abdominal pain, bloating, some cases of constipation, etc. This diet will reduce the symptoms quickly and initiate the healing process in the digestive system. Even for healthy people, if you or your child gets a ‘tummy bug’ or any other form of diarrhea, following the Introduction Diet for a few days will clear the symptoms quickly and permanently usually without needing any medication. In cases of stubborn constipation, introduce freshly pressed juices earlier in the diet, from stage 2: start from carrot juice first thing in the morning and take your cod liver oil at the same time. The juice will stimulate bile production as many cases of persistent constipation are due to poor bile production. When there is not enough bile, the fats in the food do not digest well; instead they react with salts and form soap in the gut, causing constipation. Removing dairy may also help. People with food allergies and intolerances should go through the Introduction Diet in order to heal and seal their gut lining. The reason for allergies and food intolerances is so-called “leaky gut” when the gut lining is damaged by abnormal micro flora. Foods do not get the chance to be digested properly before they get absorbed through this damaged wall and cause the immune system to react to them. Many people try to identify, which foods they react to. However, with damaged gut wall they are likely to absorb most of their foods partially digested, which may cause an immediate reaction or a delayed reaction (a day, a few days or even a couple of weeks later). As these reactions overlap with each other, you can never be sure what exactly you are reacting to on any given day. Testing for food allergies is notoriously unreliable: if one had enough resources to test twice a day for two weeks, they would find that they are “allergic” to everything they eat. As long as the gut wall is damaged and stays damaged, you can be juggling your diet forever removing different foods and never get anywhere. From my clinical experience it is best to concentrate on healing the gut wall with the Introduction Diet. Once the gut wall is healed, the foods will be digested properly before being absorbed, which will remove most food intolerances and allergies. Those without serious digestive problems and food intolerances can move through the Introduction Diet quite quickly. However, please do not be tempted to skip the Introduction Diet and go straight into the Full GAPS Diet, because the Introduction Diet will give your patient the best chance to optimize the healing process in the gut and the rest of the body. I see cases where skipping the Introduction Diet leads to long-term lingering problems, difficult to deal with. If you have decided to go straight into the Full GAPS Diet, keep in mind that about 85% of everything your patient eats daily should be made out of meats, fish, eggs, fermented dairy and vegetables (some well-cooked, some fermented and some raw). Baking and fruit should be kept out of the diet for a few

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weeks, and then be limited to snacks between meals and should not replace the main meals. Homemade meat stock, soups, stews and natural fats are not optional – they should be your patient’s staples. Start the day with a cup of still mineral or filtered water. Give your patient the probiotic. Make sure that the water is warm or room temperature, not cold, as cold will aggravate his or her condition. Only foods listed are allowed: you patient must not have anything else. On the First Stage the most drastic symptoms of abdominal pain, diarrhea and constipation will quickly subside. If, when you introduce a new food, your patient gets diarrhea back, pain or any other digestive symptoms then he/she is not ready for that food to be introduced. Wait for a week and try again. If you suspect a real allergy (which can be dangerous) to any particular food, before introducing it do the Sensitivity Test. Take a drop of the food in question (if the food is solid, mash and mix with a bit of water) and place it on the inside of the wrist of the patient. Do it at bedtime. Let the drop dry on the skin, then let your patient go to sleep. In the morning check the spot: if there is an angry red reaction, then avoid that food for a few weeks, and then try again. If there is no reaction, then go ahead and introduce it gradually starting from a small amount.


First stage: • Homemade meat or fish stock. Meat and fish stocks provide building blocks for the rapidly growing cells of the gut lining and they have a soothing effect on any areas of inflammation in the gut. That is why they aid digestion and have been known for centuries as healing folk remedies for the digestive tract. Do not use commercially available soup stock granules or bouillon cubes, they are highly processed and are full of detrimental ingredients. Chicken stock is particularly gentle on the stomach and is very good to start from. To make good meat stock you need joints, bones, a piece of meat on the bone, a whole chicken, giblets from chicken, goose or duck, whole pigeons, pheasants or other inexpensive meats. It is essential to use bones and joints, as they provide the healing substances, not so much the muscle meats. Ask the butcher to cut in half the large tubular bones, so you can get the bone marrow out of them after cooking. Put the bones, joints and meats into a large pan and fill it up with water, add natural unprocessed salt to your taste at the beginning of cooking and about a teaspoon of black peppercorns, roughly crushed. Bring to boil, cover and simmer on a low heat for 2,5 - 3 hours. You can make fish stock the same way using a whole fish or fish fins, bones and heads. After cooking take the bones and meats out and sieve the stock to remove small bones and pepper corns. Strip off all the soft tissues from the bones as best as you can to later add to soups or encourage your patient to eat all the soft tissues on the bones. Extract the bone marrow out of large tubular bones while they are still warm: to do that bang the bone on a thick wooden chopping board. The gelatinous soft tissues around the bones and the bone marrow provide some of the best healing remedies for the gut lining and the immune system; your patient needs to consume them with every meal. Take off all the soft tissues from fish bones and heads and reserve for adding to soups later. The meat or fish stock will keep well in the fridge for at least 7 days or it can be frozen. Keep giving your patient warm meat stock as a drink all day with his meals and between meals. Do not use microwaves for warming up the stock, use conventional stove (microwaves destroy food). It is very important for your patient to consume all the fat in the stock and off the bones as these fats are essential for the healing process. Add some probiotic food into every cup of stock (the details about introducing probiotic foods follow). • Homemade soup with your homemade meat or fish stock. Please look for some recipe ideas in the recipe section. Here we will go through some details, specific for the Introduction Diet. Bring some of the meat stock to boil, add chopped or sliced vegetables: onions, carrots, broccoli, leeks, cauliflower, zucchinis, marrow, squash, pumpkin, etc. and simmer for 25-35 minutes. You can choose any combination of available vegetables avoiding very fibrous ones, such as all varieties of cabbage and celery. All particularly fibrous parts of vegetables need to be removed, such as skin and seeds on pumpkins, marrows and squashes, stock of broccoli and cauliflower and any other parts that look too fibrous. Cook the vegetables well, so they are really soft. When vegetables are well cooked, add 1-2 tablespoons of chopped garlic, bring to boil and turn the heat off. Give your patient this soup with the bone marrow and meats and other soft tissues, which you cut off the bones. You can blend the soup using a soup blender or serve it as it is. Add some probiotic food into every bowl of soup (the detail about introducing probiotic foods follow). Your patient should eat these soups with boiled meat and other soft tissues off the bones as often as he/she wants to all day.


• Probiotic foods are essential to introduce right from the beginning. These can be dairy - based or vegetable - based. To avoid any reactions introduce probiotic foods gradually, starting from 1-2 teaspoons a day for 2-5 days, then 3-4 teaspoons a day for 2-5 days and so on until you can add a few teaspoons of the probiotic food into every cup of meat stock and every bowl of soup. Start adding juice from your homemade sauerkraut, fermented vegetables or vegetable medley (please look in the recipe section) into cups of meat stock (do not add the vegetables themselves yet, as they are too fibrous). These juices will help to restore normal stomach acid production. Make sure that the food is not too hot when adding the probiotic foods, as the heat would destroy the beneficial probiotic bacteria. In my experience a large percentage of GAPS people can tolerate well-fermented homemade whey and yoghurt right from the beginning. However, some cannot. So, before introducing dairy, do the sensitivity test. If there is no reaction on the sensitivity test, then try to introduce some whey from dripping your homemade yoghurt (dripping will remove many dairy proteins): start from 1 teaspoon of whey added to the soup or meat stock. After 3-5 days on 1 teaspoon of whey per day, increase to 2 teaspoons a day and so on, until your patient is having ½ a cup of whey per day with meals. At this stage try to add 1 teaspoon per day of homemade yoghurt (without dripping), gradually increasing the daily amount. After yoghurt introduce homemade kefir. Kefir is far more aggressive than yoghurt and usually creates a more pronounced “die-off reaction”. That is why I recommend introducing yoghurt first before starting on kefir. If your patient had no reaction to yoghurt, then you may be able to introduce kefir almost from the beginning. For those who clearly react to dairy, please look at p.95 in my book. • Ginger tea, mint or chamomile tea with a little honey between meals. Most people know how to make mint or chamomile tea. To make ginger tea, grate some fresh ginger root (about a teaspoonful) into your teapot and pour some boiling water over it, cover and leave for 3 - 5 min. Pour through a small sieve. In extreme cases of profuse watery diarrhea exclude vegetables. Let your patient drink warm meat stock with probiotic foods (preferably whey or yoghurt), eat well-cooked gelatinous meats (which you made the stock with) and consider adding raw egg yolks gradually. Do not introduce vegetables until the diarrhea starts settling down. When the gut wall is severely inflamed, no amount of fiber can be tolerated. That is why you do not rush to introduce vegetables (even very well-cooked).


Second stage: • Keep giving your patient the soups with bone marrow, boiled meats or fish and other soft tissues off the bones (particularly gelatinous and fatty parts). He or she should keep drinking the meat stock and ginger tea. Keep adding some probiotic food into every cup of meat stock and every bowl of soup: juices from sauerkraut, juices from fermented vegetables or vegetable medley, and/or homemade whey/yoghurt. • Add raw organic egg yolks. It is best to have egg yolks raw added to every bowl of soup and every cup of meat stock. Start from 1 egg yolk a day and gradually increase until your patient has an egg yolk with every bowl of soup. When egg yolks are well tolerated add soft-boiled eggs to the soups (the whites cooked and the yolks still runny). If you have any concerns about egg allergy, do the sensitivity test first. There is no need to limit number of egg yolks per day, as they absorb quickly almost without needing any digestion and will provide your patient with wonderful and most needed nutrition. Get your eggs from the source you trust: fresh, free range and organic. • Add stews and casseroles made with meats and vegetables. Avoid spices at this stage, just make the stew with salt and fresh herbs (look for a recipe of Italian Casserole in the recipe section). The fat content of these meals must be quite high: the more fresh animal fats your patient consumes, the quicker he or she will recover. Add some probiotic food into every serving. • Increase the daily amount of homemade yoghurt or kefir, if introduced. Increase the amount of juice from sauerkraut, fermented vegetables or vegetable medley. • Introduce fermented fish, starting from one piece a day and gradually increasing. Look for the recipes in the recipe section. • Introduce homemade ghee, starting from 1 teaspoon a day and gradually increasing.


Third stage: • Carry on with the previous foods. • Add ripe avocado mashed into soups, starting from 1-3 teaspoons and gradually increasing the amount. • Add pancakes, starting from one pancake a day and gradually increasing the amount. Make these pancakes with three ingredients: 1) organic nut butter (almond, walnut, peanut, etc); 2) eggs; 3) a piece of fresh winter squash, marrow or zucchini (peeled, de-seeded and well blended in a food processor). Gently fry small thin pancakes using ghee, goose fat or duck fat, make sure not to burn them. • Egg gently fried or scrambled with plenty of ghee, goose fat or duck fat. Serve it with avocado (if well tolerated) and cooked vegetables. Cooked onion is particularly good for the digestive system and the immune system: melt 3 tablespoons of duck fat or ghee in the pan, add sliced large white onion, cover and cook for 20-30 minutes on low heat until soft, sweet and translucent. • Introduce the sauerkraut and your fermented vegetables (your patient has been drinking the juices from them for a while now). Start from a small amount, gradually increasing to 1-2 tablespoons of sauerkraut or fermented vegetables per every meal.


Fourth stage: • Carry on with the previous foods. • Gradually add meats cooked by roasting and grilling (but not barbecued or fried yet). Avoid bits, which are burned or too brown. Let your patient eat the meat with cooked vegetables and sauerkraut (or other fermented vegetables). • Start adding cold pressed olive oil to the meals, starting from a few drops per meal and gradually increasing the amount to 1-2 tablespoons per meal. • Introduce freshly pressed juices, starting from a few spoonfuls of carrot juice. Make sure that the juice is clear, filter it well. Let your patient drink it slowly or diluted with warm water or mixed with some homemade yoghurt. If well tolerated gradually increase to a full cup a day. When a full cup of carrot juice is well tolerated try to add to it juice from celery, lettuce and fresh mint leaves. Your patient should drink the juice on an empty stomach, so first thing in the morning and middle of afternoon are good times. • Try to bake bread with ground almonds or any other nuts and seeds ground into flour. The recipe (please look in the recipe section) requires only four ingredients: 1) nut flour; 2) eggs; 3) piece of fresh winter squash, marrow or zucchini (peeled, de-seeded and finely sliced); 4) some natural fat (ghee, butter, goose or duck fat) and some salt to taste. Your patient should start from a small piece of bread per day and gradually increase the amount.


Fifth stage: • If all the previous foods are well tolerated try to add cooked apple as an apple pure: peel and core ripe cooking apples and stew them with a bit of water until soft. When cooked add some ghee to it and mash with a potato masher. If ghee has not been introduced yet add duck or goose fat. Start from a few spoonfuls a day. Watch for any reaction. If there is none gradually increase the amount. • Add raw vegetables starting from softer parts of lettuce and peeled cucumber. Watch your patient’s stool. Again start from a small amount and gradually increase if well tolerated. After those two vegetables are well tolerated gradually add other raw vegetables: carrot, tomato, onion, cabbage, etc. • If the juice made from carrot, celery, lettuce and mint is well tolerated, start adding fruit to it: apple, pineapple and mango. Avoid citrus fruit at this stage.


Sixth stage: • If all the introduced foods are well tolerated try some peeled raw apple. Gradually introduce raw fruit and more honey. • Gradually introduce baking cakes and other sweet things allowed on the diet. Use dried fruit as a sweetener in the baking. As I mentioned before, your patient may be able to move through the Introduction Diet faster or slower depending on the stool changes: let the diarrhea start clearing before moving to the next stage. You may have to introduce some foods later than in this program depending on his/her sensitivities. Make sure that you carry on with the soups and meat stock after your patient completed the Introduction Diet at least once a day. After the Introduction Diet is completed and when your patient has more or less normal stools move into the Full GAPS Diet.


The Full GAPS Diet Your patient needs to carry on completely avoiding starches and sugar for two years at least. It means avoiding all grains, sugar, potatoes, parsnips, yams, sweet potato and anything made out of them. The flour in your cooking and baking can be replaced with ground almonds (or any other nuts or sunflower or pumpkin seeds ground into flour). In about 1 - 1.5 years you may be able to introduce new potatoes, fermented buckwheat, millet and quinoa, starting from very small amounts and observing any reaction. Wheat, sugar, processed foods and all additives will have to be out of the diet for much longer. Slowly increase the amounts of fermented foods. You can ferment vegetables, fruit, milk and fish (please look in the recipe section). I would also recommend reading a wonderful book by Sally Fallon “Nourishing Traditions”, it will provide you with a lot of good recipes. Eating fermented foods with every meal will help your patient to digest the meal without using supplements of digestive enzymes. Make sure to introduce all new fermented foods into the diet very gradually starting from 1-2 teaspoons a day. The best foods for the GAPS person are eggs, meats and fish (bought fresh or frozen, not smoked or canned, and cooked at home), shellfish, fresh vegetables and fruit, nuts and seeds, garlic and olive oil. As well as eating the vegetables cooked it is important to have them raw in the form of salads and sticks. In this form they will provide your patient with valuable enzymes and detoxifying substances, which will help in digesting meats. Raw fruit should be eaten on their own, not with meals, as they have a very different digestion pattern and can make the work harder for the stomach. At that stage let your patient to have fruit as a snack between meals. Remember, that about 85% of everything your patient eats on a daily basis should be savory - made out of meats, fish, eggs, vegetables and natural fats. Sweet baking and fruit should be snacks between meals in limited amounts. It is very important for a GAPS person to have plenty of natural fats in every meal from meats, butter, ghee, coconut and cold pressed olive oil. The fat content of the meal will regulate the blood sugar level and control cravings for carbohydrates. If your patient gets a tummy bug or any other form of diarrhea go back to the low fiber diet for a few days: remove all nuts, raw vegetables and raw fruit out of the diet; go back to meats cooked in water and meat stock, fish, eggs, fermented dairy and cooked vegetables (skinned, de-seeded and well cooked with meats as soups and stews) until diarrhea completely clears. After the stools stay normal for a week introduce raw vegetables slowly, one at a time and starting from small amounts. When vegetables are introduced, try to introduce nuts, seeds and fruit gradually. It is important for your GAPS patient to balance the meals so that his or her body pH stays normal. All protein foods, such as meats, fish, eggs and cheese leave an acid ash in the body, which may aggravate his or her condition. Vegetables are alkalizing, so you need to combine meats, fish and eggs with good amount of vegetables cooked and/or raw. Raw fruit, vegetables and greens have particularly strong alkalizing ability. Apple cider vinegar is very alkalizing, it is good to have it every day: just add one teaspoon of cider vinegar into every glass of water your patient drinks. Hot water with cider vinegar will makes an excellent warming and alkalizing drink. Fermented foods are also alkalizing.


It is very important to avoid processed foods (any packet or tinned foods). They are stripped from most nutrients that were present in the fresh ingredients used for making these foods. They are a hard work for the digestive system and they damage the healthy gut flora balance. On top of that they usually contain a lot of artificial chemicals, detrimental to health, like preservatives, colorants, E-numbers, etc. Try to buy foods in the form that nature made them, as fresh as possible. Do not use a microwave oven, as it destroys food. Cook and warm up food using conventional oven and stove. Foods to avoid: • Sugar and anything that contains it. • Molasses, maple syrup, corn syrup, any other syrup. • Aspartame in any form, it is a potent neurotoxin (brain toxin). • Sweets, cakes, biscuits, chocolates, ice – creams. • All alcoholic beverages. An adult can have good quality wine with meals occasionally but not beer or spirits. • Tinned and processed foods, always read the ingredients label, beware of sugar, lactose, maltose, starch, corn flour, preservatives, flavorings, colors, yeast. It is best not to buy processed foods at all. • Grains: rice, corn, rye, oats, wheat and anything made of wheat flour (breads, pasta, biscuits, cakes and anything from the bakery, anything with bread crumbs or batter), buckwheat, quinoa, millet, couscous, spelt, semolina, tapioca, etc. After about 1 – 1.5 years you may be able to slowly re-introduce buckwheat, millet and quinoa (fermented to start with), but not wheat, rye or rice. • Breakfast cereals are highly processed products with virtually no nutritional value, they are full of sugar, salt, trans-fatty acids and other harmful substances. They should be out of the diet forever. • Starchy vegetables and anything made out of them: potato, parsnips, yams, Jerusalem artichoke and sweet potato. In about 1 - 1.5 years you may be able to introduce new potatoes. • Milk should be out at this stage. However, the GAPS person can have soured milk products, such as natural hard cheese, live natural yoghurt and kefir, crème fresh or soured cream, butter and ghee. There are many substances in milk, which could cause trouble, such as milk sugar lactose, casein, immune complexes, etc. Soured milk products do not contain lactose and are pre-digested by the fermenting microbes, which makes fermented milk products very easy to digest for us. I would recommend using only organic milk products and introduce them one at a time, starting from small amounts. If you were not able to introduce any dairy in the Introduction Diet, and then please look at page 95 in the GAPS book, it will explain how to introduce dairy safely. If you have introduced homemade yoghurt, kefir and ghee as a part of the Introduction Diet, then gradually introduce fermented cream and butter. When that is well tolerated try natural mature cheeses. You may want to try goats or sheep’s milk products


first as they are often better tolerated by the GAPS people, than cows. In about 1,5 -2,5 years and when all fermented dairy products are introduced, your patient may be able to drink raw unpasteurized organic milk. Introduce it gradually starting from 1-2 teaspoons a day. A GAPS person must never have pasteurized milk! • Fruit juices apart from freshly pressed. Unfortunately fruit juices (not freshly pressed by you) are a source of processed sugars and can contain a lot of fungi and moulds in them, which your GAPS patient might react to. • Beans and pulses are generally hard to digest. The two varieties that your patient can have are white (navy) beans also called haricot beans, fermented and cooked at home, and fresh green beans. Commercially available baked beans have almost 40% sugar and should be avoided. You can make your own baked beans at home (please, look in the recipe section). • Coffee is a strong irritant for the digestive tract, try to avoid it. Strong tea is not advisable either. Natural herbal teas (no flavorings added) and ginger tea are fine. Ginger tea is a well-known folk remedy for digestive problems. • Soft drinks are not allowed at all, they are full of sugar and various chemicals, which are very damaging for GAPS people. • Anything with colors, preservatives, flavorings and other chemicals. • Soya and anything made out of it. It interferes with thyroid function in the body and negatively affects hormonal balance, as it contains estrogen – like compounds. It is important to avoid all synthetic estrogens, such as from soya, contraceptive pill, many other drugs, domestic cleaning chemicals, laundry detergents, toiletries, etc. Recommended foods: • Buy fresh or frozen meats, fish and shellfish. Make sure that they are not smoked, salted or preserved in any other way. Your patient needs to have gelatinous meats every single day (meats around bones and joints, skin and brown meats on the poultry). It is important for him or her to have all the fats on the meat, eating lean muscle meats will not be good for GAPS. • Liver and other organ meats should be eaten on a regular basis. They can be cooked any way you like. It is very nourishing and is the best remedy for many nutritional deficiencies. • Eggs - the yolk is best eaten raw, the white should be slightly cooked, like for example in soft boiled or fried eggs. Make sure that you find good quality eggs, free-range organic eggs are the best. Your patient should have minimum 2-3 eggs a day as they are particularly good for restoring neurological functions. • Fresh vegetables – all types of vegetables are recommended, apart from starchy vegetables, like potatoes, parsnips, sweet potato, Jerusalem artichokes and yams. You can cook vegetables by steaming them, stewing, roasting, grilling or stir-frying. It is particularly good to eat them as a homemade soup or


stew with plenty of garlic, added at the end of cooking. Your patient should have plenty of cooked vegetables with every meal, as they are better digested than raw vegetables and are more nourishing. It is also important to have fermented and raw vegetables with every meal in a form of salads with olive oil and fresh lemon juice or as a snack. Raw and fermented vegetables will help in digesting proteins and detoxifying. However if your patient gets diarrhea then cook all vegetables until diarrhea clears. • Fresh fruit. It is important that the fruit should be ripe. After completing the Introduction Diet introduce local seasonal ripe fruit gradually. At that stage start your patient’s day from a bit of fruit and offer some fruit between meals. He or she should not have fruit if there is diarrhea. When the diarrhea has cleared he or she can start from having cooked fruit (peeled, de-seeded and well cooked with a good dollop of butter, ghee or coconut oil) and then raw, introduced slowly. • Avocado is a wonderfully nutritious fruit. Make sure it is ripe and serve it with meats, fish, shellfish and salads. • Butter is better than any so-called healthy substitutes. You can cook with it or add it into ready dishes. Butter should be bought organic and unsalted, because non-organic butter contains a lot of pesticides and antibiotics, which the cows consume. Cold pressed virgin olive oil is very good for your patient, use it in salads and ready dishes liberally. It is not a good idea to cook with olive oil because it changes its chemical structure when heated. Frying is best done with animal fats: pork dripping, lard, lamb fat, goose fat, duck fat, ghee and butter. Coconut oil and palm oil are two plant oils, very good to use for cooking. These fats do not alter their structure during cooking. They can even be re-used. Collect your own fats after roasting meats. Avoid all common vegetable cooking oils, margarines and other processed fats: they are very harmful to health. • Nuts and seeds are a wonderful source of very good nutrients. Nuts should be bought just shelled – not salted, roasted, coated or processed in any other way. This way they are an excellent source of essential fatty acids and many nutrients. However, nuts and seeds contain enzyme inhibitors, which may make them difficult to digest for some people. If you feel that it is a problem for your patient, as soon as you bought nuts to remove the enzyme inhibitors try to do the following: soak the nuts in salty water over night (1 tablespoon of sea salt per liter of water), in the morning drain them, rinse the salt off and dry in your oven -24 hours (keep checking them as different nuts take different time to dry). Your patient can also eat nuts and seeds straight after soaking without drying them. Once they are dried keep them in an airtight container or well-sealed plastic bag. They become nice and crunchy and make an excellent snack food together with dried fruit. You can grind nuts and seeds (sunflower and pumpkin) into flour consistency to make bread, pancakes and even cakes at home. My book will provide you with recipes. Ground almonds or almond flour is available in health food shops. • If your child would like to have a milk-like drink, nut/seed milk can replace all other milk while you are gradually introducing dairy. You can use almonds, sunflower seeds, sesame seeds and pine nuts to make milk. Blanched almonds make the best milk. You can add a teaspoon of flax seeds to make the milk thicker. Soak a cup of almonds in water for 12 - 24 hours, drain. Blend in a food processor with water:


for 1 cup of nuts/seeds add 1-2 cups of water. A good juicer will crash the nuts/seeds well, making a paste, which you would blend with water. Mix well and strain through cheesecloth or a fine strainer and you have got milk. You can add some soaked dates or raisins, when blending, they will make the milk sweet. If you find that the milk is too rich, just add more water. You can add some of freshly pressed apple juice or carrot juice into it to make a very tasty and nourishing drink for your child. You can “milk” the same cup of almonds a few times. Just keep the paste covered with water in the refrigerator. • You can also make coconut milk. Bring to boil (but do not boil) 1 cup of unsweetened shredded dried coconut and 1 cup of water. Cool down and blend well in your food processor. Strain through cheesecloth or a fine strainer. • It is better to replace the table salt in your patient’s diet with unprocessed salt. The salt, which is sold in shops, has been processed to remove all natural minerals apart from the NaCl. The human body needs all those minerals, that is why we must consume natural unprocessed salt. You can get very good quality sea salt called Celtic Salt or a Himalayan Crystal Salt. • Garlic is very important to eat every day. It will help to normalize your patient’s gut flora and stimulate the immune system. It is important to have it raw with meats or cooked as a part of the meal. Work on using a whole head of garlic every day (not just a few cloves). • Unprocessed honey is the only sweetener allowed (in baking it is better to use dried fruit as a sweetener). Locally produced honey is usually the most reliable.


by lydia on November 19, 2010 If you're new here, you may want to subscribe to my RSS feed. Thanks for visiting! This was the first session I attended at the Wise Traditions Conference. I took notes, but I am a slow writer and typer, so thankfully a reader sent me an email with her fabulous notes. She graciously agreed to let me use them in this post. So a huge thanks to Jenifer Andersen for her thorough notes.

GUT & PSYCHOLOGY/PHYSIOLOGY SYNDROME “All diseases begin in the gut.” ~ Hippocrates ◦If the root of the tree is not healthy, the whole tree will be sickly Roles of Gut Flora ◦Recent research suggests that 90% of the body’s cells are micro-flora ◦Beneficial gut flora (bacteria, viruses, protozoa, fungi, even worms) are essential to life & health; a sterile gut would likely be fatal ◦Gut flora is major barrier to heavy metal absorption/toxicity (mercury, arsenic, etc.); also helps block chemical toxin absorption ◦Gut flora are critical to digestion of several kinds of foods, therefore also to absorption of several kinds of nutrients ◦Some nutrients (i.e. all B vitamins) are actually produced by healthy gut flora from nutrients provided in food ◦The gut flora can neutralize toxic byproducts of digestion, as well as preventing cancer cells from developing. Long-term damage to gut flora ultimately results in digestive cancers(antibiotic use is likely a major factor). ◦Approx 84-88% of immune system is located in gut wall. The gut flora actually regulates the balance of the immune system. If the primary (gut-related) part of the immune system is damaged and not working properly, the secondary system steps up and allergies are among the results. What Can Damage Gut Flora ◦Antibiotics kill not only the bad bacteria, but also the good. After a course of antibiotics, the gut flora can take up to 2 months to recover; this is a major window of opportunity for problems to develop. Prolonged antibiotics (i.e. 6-24 months in teenagers for acne) can have extreme prolonged effects. ◦Poor diet (the modern standard diet) feed abnormal gut flora with the sugar, processed starches and chemicals. ◦Chronic disease always is related to problems in the gut flora – sometimes a circular relationship. ◦Pretty much everything a dentist uses is toxic, so it’s important to pay attention to diet & take probiotics before and after dental treatments.

A Typical Scenario ◦Babies now start out with abnormal gut flora due to the abnormal gut flora of the mother; this problem self-perpetuates through multiple generations unless deliberate action is taken. ◦Babies are born with a very immature immune system; the first few weeks are critical to establishing gut flora and therefore a healthy immune system. The most common result of of failure to develop a healthy gut flora and immune system in an infant is recurring ear infections, which starts a cycle of antibiotics and ongoing gut flora damage. ◦Vaccinations are designed for healthy, well-nourished children. Most children in the western world are not fit to be immunized because they are not healthy and properly-nourished. Damaged Gut Wall ◦With a healthy gut there are no spaces between enterocytes. Nutrients can’t get into the blood without going through the enterocytes and being checked/detoxified. ◦Food intolerances are a result of a leaky gut – of foods being absorbed before being properly digested. If the gut is healed and sealed, food intolerances can be corrected. ◦Many proteins in foods are similar to proteins naturally found in the body. Improperly-digested proteins getting through the gut wall can cause the immune system to attack similar proteins that are natural in the body, resulting in autoimmune disease. This is called “mimicking phenomenon”. ◦Toxins that get through can change the structure of proteins in the body, thereby creating strange/unnatural proteins that the immune system then attacks. This is a factor in rheumatoid arthritis, osteoarthritis, psoriasis, eczema, etc. Cleaning the Flow from the Gut ◦The lungs are a major detoxification organ Liver ◦The liver, when overwhelmed by a damaged gut, can change from being an effective filter into being a source of ongoing toxins released into the blood. ◦The liver forms bile stones that harden and the center of the stone is infection. The bile stones that harden and can’t be passed will further compromise liver function, which will cause more stones to form. This is a self-perpetuating problem, and it frequently causes problems with digesting fats. ◦Freshly-pressed celery and apple juice can help dissolve/soften bile stones in the liver. Lungs ◦Lungs are a major factor in removing toxins from the bloodstream ◦Wheezing (bronchospasm) is a biological action to close off damaged bronchi and allow them time to quickly repair (20-30 minutes usually). Asthma is when multiple sections of the lungs do this at the same time. Supportive therapy for asthma is keeping still, warm, calm and hydrated, thereby allowing the body to heal properly. ◦Asthma medications override the body’s self-healing functions, leading to major long-term lung damage. This has taken a benign, mild condition and turned it into a life-threatening problem. Gut & Psychology Syndrome: Asthma ◦When asthma treatment doesn’t allow the lungs to heal themselves and detoxify the body, the toxins have to end up elsewhere in the body. Gut & Physiology Syndrome ◦Caused by the need to eliminate toxins and undigested food through other parts of the body because the gut isn’t doing it’s job and the liver and lungs can’t do theirs. ◦Every mucous membrane is a potential means of eliminating toxins, be it bladder, sinuses, vaginal wall, or gut.

Gut & Physiology Syndrome: Autoimmunity ◦Autoimmunity always involves more than one body system because more than one toxin will be coming through the damaged gut. Gut & Physiology Syndrome ◦The conditions listed as “autoimmune” are due to being toxic. Fatigue (debilitating fatigue) is generally a first and primary symptom. Blood-Brain Barrier ◦The blood-brain barrier is similar to the gut wall in that it is supposed to be very tight. Zonulin is one of the components that maintains this tightness. ◦When toxins damage the integrity of the blood-brain barrier, toxins, microbes & antibodies pass through into areas where they do not belong, causing neurological symptoms. These symptoms may be physical (epilepsy, etc.) or psychological/behavioral (bipolar, schizophrenia, substanceabuse, etc.) Gut & Psychology Syndrome: Child vs. Adult ◦GAPS children, unhealed, will become GAPS adults with major problems ◦GAPS kids are the ones that easily are pushed into psychotic reactions and end up with extensive psychiatric problems (i.e. schizophrenia). Epilepsy in children ◦Standard treatment of epilepsy is to not really look for a cause (just classify it as “idiopathic”), but rather to just treat it by medicating to suppress symptoms. ◦If there is no biological reason for epilepsy, it is a gut problem that should be able to be healed. Eating Disorders ◦Vegetarian diets are becoming a major source of eating disorders in the western world. Children go vegetarian because they are told it’s “healthy” or “planet-saving” or “kind to animals”. Parents generally don’t object because it’s so common, but the child ends up with nutritional deficiencies (especially B12 and fat-soluble vitamins). Additionally, the diet becomes heavy in starches and sugars… eventually toxicity gets past the blood-brain barrier and alters perception and thinking. ◦Current treatment focuses only on “gaining weight and eating”. Treatment should focus on detoxification, healing and sealing the gut and the blood-brain barrier, and correcting nutritional deficiencies. A few weeks on the GAPS Introduction Diet will usually allow enough detoxification to allow self-perception to become accurate. ◦Correcting the diet is the most important part of treatment. ◦GAPS Diet was developed from the SCD (Specific Carbohydrate Diet) Foods to Avoid ◦It takes TWO YEARS on the GAPS diet to allow full healing of the gut-related ◦Starch molecules are large and difficult to digest. The final steps of starch digestion are accomplished by the enzymes of the enterocytes, which are not active in a sick gut. The starch that is not properly digested is food for pathogenic flora. ◦Sugar consumption pulls magnesium from bones, teeth, etc., and leads to magnesium deficiency. In children a main symptom of magnesium deficiency is hyperactivity; in adults a main symptom is hypertension. Blood vessels need magnesium in order to be able to relax, calcium to contract. ◦Sugars are carried into capillaries and block them, forming amyloids and causing arthritis. ◦All beans contain starch; they can be added to later diet if soaked and properly prepared. Recommended Foods ◦Foods that are homemade, easy to digest, and nutritious. ◦Animals designed to eat plant food only have several pH-neutral stomachs (rumins) full of bacteria that digest plants for them People and carnivorous animals have one acidic stomach that can digest the plant

digest plants for them. People and carnivorous animals have one acidic stomach that can digest the planteaters. ◦Healthy bowel flora will convert starches into short-chain fatty acids for absorption as fat. Few people in the western world have enough healthy gut flora to do this. This is why starches should be avoided. ◦Liver is one of the most nutritionally powerful food and should be a regular part of the diet. ◦Vegetables should be cooked well in the initial stages. ◦Fruit should be only eaten if it was ripened naturally; chemically-ripened fruit is not healthy. ◦In fermented dairy the probiotics have digested some of the proteins as well as the lactose. ◦Bees won’t eat honey that has been heated above 113º F – it is damaged. This is why honey should be cold-extracted. Meat & Fish Stock ◦Meat stock is rich in simple amino acids, gelatins, etc., that help the gut lining be able to rebuild/heal itself. Soups and stews should always be made with meat stock. ◦Bone marrow is one of the most nutritious substances on earth and should be eaten. ◦Long cooking of joint tissue results in extra collagen, which his especially essential for recovery of gut flora (especially in autoimmune situations) ◦Fish stock should be made using heads, bones, fins, tail. Breads, pies, cakes, etc. ◦These can be made using ground nuts and seeds (sunflower, pumpkin, sesame) as flour Fermented Foods ◦Not only pre-digested (and therefore easy for digestion), but also teeming with probiotics ◦Probiotics help attack pathogenic organisms that can cause problems, therefore they have to be ramped up to prevent die-off reactions ◦Sauerkraut and kimchi must be fermented long enough for a complete fermentation process, otherwise it will cause gas and digestive problems (because the fermentation must finish in the digestive tract). When the fermentation process is complete, the lactic acid stops the process; completely fermented sauerkraut will keep for a year safely GAPS Introduction Diet ◦People with signs of leaky gut need to go through the introduction diet in order to allow the enterocytes to heal ◦The current love affair with fiber is due to improper interpretation of a study of native African diets and health. Fiber is rough (“roughage”) that can further irritate an already-irritated gut. Fiber is not necessary for health. ◦The third stage of GAPS is truly complete nutrition that allows the gut lining to truly heal; it can be followed for a long period of time. Dairy Introduction Structure – Organic Only! ◦If there is no severe reaction (anaphyllaxis), dairy can be started at step 3 with fermented dairy. ◦Dairy fat is critical – the gut lining needs large amounts of fat. ◦Cultured butter is more nutritious than butter made from sweet cream. ◦Yogurt should be introduced before kefir because kefire has a more extreme probiotic content. Both are excellent for fixing problems with diarrhea, but may aggravate constipation. If there is a problem with constipation, the diet needs more fat. ◦Homemade cheese == yogurt cheese (strained yogurt) Low Fiber Diet for Diarrhea ◦Makes for quick healing of gut from illness ◦During diarrhea, give meat stock with a bit of sour cream every hour ◦Raw egg yolks do not require digestion; cooked egg yolks are difficult to digest because of changes to the protein structure

g p ◦The juice of fermented vegetables provides strong probiotic content Natural Fats ◦Fats and cholesterol are necessary building blocks of life – our cells can not develop/reproduce without fats, and cholesterol is critical to healing in the body. Cholesterol is also a basic building block for hormone production, is necessary food for brain and nerve cells, and is critical to vitamin D production. ◦Dietary animal fat stimulates glucagon production, which causes bodily fat to be burned for energy. ◦The majority of fat in human breast milk is saturated fat, with a smaller portion of monounsaturated fat.. The physiology of adults is not substantially different from that of an infant; we still need a lot of fat. Put Your Heart in Your Mouth (book cover slide) GAPS – Practical Issues Fussy Eating Habits ◦Many times the baby/child with abnormal gut flora becomes a fussy eater because the pathogenic gut flora are trying to self-perpetuate. They are less likely to have psychiatric or learning symptoms early on because it takes time for the blood-brain barrier to be compromised. ◦Solid foods for GAPS babies will cause illness symptoms that they can’t verbalize, but the baby refuses food because he makes the association that it makes him feel bad. Failure to Thrive ◦Result of fussy eating habits ◦Conventional medical care is even more damaging to this Supplementation ◦Good probiotics are a critical part of the process, as are probiotic foods ◦Multivitamins, mineral, amino-acid supplements are not necessary for everyone ◦Children may not need HCl or pepsin; only if excess burping is an issue. Cabbage juice or whey or kefir may work well in place of these (just a little before a meal). ◦Reflux can be caused by yeast overgrowth damaging the ability of the esophageal sphincter to close; the yeast overgrowth is a symptom of the stomach not be acidic enough. ◦Pancreatic enzyme production is directly dependent on adequate stomach acidity. When the stomach acidity is enough to properly digest the food, the pancreas will produce enzymes accordingly. Detoxification ◦GAPS patients are toxic, so detoxification is necessary. Cleaning up the gut is the major focus because the gut is the major source of toxins in the body. ◦The most therapeutic juices are not palatable, but they can be mixed 50/50 with carrot or apple juice to improve the flavor. The fresh juice can also be made into a smoothie with a bit of kefir and an egg yolk. ◦If doing detoxification baths, rotate the add-ins… sea salt one time, cider vinegar the next, seaweed powder the next… ◦Skin absorbs everything put on it in seconds, so eliminate toxins from personal care products.Putting something on the skin bypasses the liver’s detoxification. Natural Chelation ◦Chelation chemicals not only remove heavy metal toxins, they also remove critical minerals (especially zinc). As a result, the long-term effects of chemical chelation are very damaging. ◦Probiotics are a potent chelator of heavy metals, as are fermented foods. Constipation ◦Constipation is worse than diarrhea because toxins are staying in the bowel too long. Yeast(candida) is a major player in developing constipation. ◦Constipation should be defined as no stool for one day; enemas are sometimes quite helpful, especially if a small amount of baking soda.

small amount of baking soda. ◦Castor oil can be massaged into the skin of the abdomen (over the stomach) to be absorbed through the skin and help loosen the stool. ◦Magnesium oxide (milk of magnesia) is a rather violent solution. ◦If you are constipated, there are not enough animal fats in your diet.

Natasha Campbell Gut-and-Psychology-Syndrome GAPS Diet.pdf

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