In my practice, most the clients I am working with have chronic illnesses and are very inflamed so it is common for them to have trouble taking nutritional supplements. I get told so many times by my clients that they can’t take supplements because they don’t react well to them. There is a process called HAMP (homeostasis altering molecular process) effect, where any change in homeostasis is inflammatory. So often times when a person who has had a chronic illness for a long time starts to take supplements and their homeostasis starts to change their body produces ALOT of inflammation as it starts to re-regulate itself.
Here are some things worth thinking about if you are sensitive to supplements. Bring it up with your practitioner to make sure you are going about things safely.
- I like to be sure the client doesn’t have a mammal meat allergy. This is an IgE antibody mediated reaction to galactose-alpha-1,3-galactose, commonly referred to as alpha-gal. Individuals with this antibody react to the carbohydrate moiety of mammal meat. The antibody reaction can occur after a bite from the Lone Star tick. The connection with sensitivity to supplements is that supplements that are in gelatin capsules can be a problem. It’s not the ingredients in the capsule. It’s the capsule. So talk with your doctor practitioner about testing you for this antibody if you are reacting to supplements.
- For some clients, there is significant enough gastrointestinal dysregulation that the consumption of any food will upregulate both inflammation and mast cell degranulation, such that most meals or supplement ingestion involves feeling worse. People learn to adapt to this in relation to food, simply because there isn’t an option not to. They will tell me they feel bad all the time and that they have reactions to food, as well as to supplements. They may have narrowed their food choices enough to create a failure of oral tolerance, which is supported by food diversity, so they’re stuck in a feedback loop that’s hard to overcome. Clients who are experiencing this extreme sensitivity to everything they ingest (due to an inflamed gut) will eat food, even if it makes them feel awful because they have no choice but taking supplements is something they aren’t comfortable doing. In this situation, we start with just a few remedies to start shifting the gut from an inflamed state and start building back oral tolerance. The issue with this is that it takes A LONG TIME TO ACHIEVE. So the client has to be wiling to stick with it for the long haul. As their gut becomes less sensitive, we can start adding in more supplements. I initially will start with slippery elm tea, gelatin (if there is no meat allergy), Lglutamine (if there is no cancer/tumours), and transcutaneous vagal nerve stimulation along with a completely soothing diet consisting of cooked veggies that have been pureed, meats that have been cooked low and slow so they are soft, some low starch carbs such a ss quash and berries and some healthy fats.
- There are two forms of psychological influence in these cases worth considering. First, clients with complex chronic illness often have body inflammation that drives CNS inflammation, stimulating CRH activity, which drives sympathetic nervous system activation. This worsens the underlying anxiety that develops over time, when these individuals find themselves unable to get proper help. Their sympathetic response promotes mac NFkB production. If this affects the GI tract, epithelia will drive Th2 cytokine production and mast cell degranulation. Now the client is way too close to the threshold of mast cell degranulation, or over the threshold. And Th2 cytokines the epithelia are making are TSLP, IL-33 and IL-25, which also drive ILC2 production. ILC2’s are like Th2 cells but they are fast responders and don’t require antigen presentation, so they can trigger the key cytokines a Th2 cell triggers (IL-4, IL-5, IL-13) and drive the Th2 response symptoms in minutes to hours after eating or taking supplements, versus 3-5 days for a brand new Th2 reaction to a new antigen. So, the extent of inflammation and sympathetic activation can put the person at or past the threshold of reactivity. For this, working on the stress response is key along with inhibiting inflammation quickly with high dose curcumin, slippery elm and some homeopathics.
- The other psychological component is that the client can have an almost Pavlovian reaction to foods or supplements that they’re worried about. This can happen when the person has had so many problematic experiences with foods or supplements. They tried a new supplement and then anticipate a negative reaction, which drives the sympathetic nervous system. This makes them more inflamed, increasing histamine release. But also, the stress chemistry drives apoptosis of Th1 and NK cells, so the client shifts into Th2 dominance, increasing the likelihood of a problematic histamine reaction. They need to work on mindset shift and taking remedies to help bring down the stress response.
- And then there’s the HAMP reaction. In brief, any change in homeostasis, even towards a better biology, can trigger inflammation in susceptible individuals.
In these cases, I focus on three areas early in the case…
- Avoidance of inflammatory and histaminic foods.
- Elimination of foods to which a person has IgG antibodies. This requires complete avoidance of foods to which the client has an antibody response.
- Reduction of histaminic foods, to move the client away from the threshold of reactivity. This requires enough elimination of histaminic food that their histamine burden falls below their threshold of clearance capacity. That is not a requirement to completely avoid all histaminic foods.
- Downregulation of IL-4 with perilla extract.
- Reduction of histamine burden. This involves stabilization of mast cells, improved histamine clearance, and clearance of mast cell mitochondrial DNA fragments that re-inflame the intestine. A beautiful supplement for this is Pure Encapsulations Hist Reset.
For these clients, I try to install each of these steps slowly, starting with very low doses of supplements (parts of capsules or the amount you can swipe up with your fingertip) once or twice a day. The person needs to ride a gradual dose curve up to a more normal dose. The very low doses aren’t expected to create improvement so much as build the persons capacity to tolerate higher doses.
It can also be useful to start with substances normal to the body, like vitamins, minerals, or glutathione. These have several advantages. They are single substances (versus an herb, which could have fifty active components). The fact that they’re normal to the body means there’s less chance of a reaction. And the individual can be appropriately reassured about the first two points, which will help on the psychological side.