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Category: Paleo Diet

  • Iodine for Hypothyroidism: Crucial Nutrient or Harmful Toxin?

    Post From https://chriskresser.com/iodine-for-hypothyroidism-crucial-nutrient-or-harmful-toxin/

    In a previous article I showed why, when used alone, thyroid hormone replacement often fails. In this post I’ll explain why optimizing your iodine intake is so crucial and why both too little and too much iodine can be harmful.

    Iodine and hypothyroidism

    Iodine deficiency is the most common cause of hypothyroidism worldwide. Once researchers realized this, health authorities around the world began adding iodine to table salt.

    This strategy was effective in correcting iodine deficiency. But it had an unanticipated—and undesired—effect. In countries where iodine has been added to table salt, the rates of autoimmune thyroid disease have risen. The following is just a sample of studies around the world demonstrating this effect:

    Why does this happen? Because increased iodine intake, especially in supplement form, can increase the autoimmune attack on the thyroid. Iodine reduces the activity of an enzyme called thyroid peroxidase (TPO). TPO is required for proper thyroid hormone production.

     Iodine deficiency is the most common cause of hypothyroidism worldwide. Optimizing your iodine intake is crucial, and both too little and too much iodine can be harmful.

    On the other hand, restricting intake of iodine can reverse hypothyroidism. In one study, 78 percent of patients with Hashimoto’s regained normal thyroid function with iodine restriction alone.

    Selenium deficiency and Hashimoto’s

    However—and this is a big “however”—it appears that iodine may only pose a problem for people with Hashimoto’s and other autoimmune thyroid diseases in the presence of concurrent selenium deficiency. One study in rats found that those given excess iodine only developed goiter if they weren’t consuming adequate selenium.

    Other studies have shown that selenium protects against the effects of iodine toxicity and prevents the triggering and flaring of autoimmune disease that excess iodine without selenium can cause.

    In my practice I always test for both iodine deficiency and Hashimoto’s when a patient presents with hypothyroid symptoms. If they are iodine deficient, I will start them on a trial of iodine and selenium together. In most cases, patients see a significant improvement. In a minority of cases, they cannot tolerate supplemental iodine even with adequate selenium intake.

    Testing for iodine status

    In most population studies, iodine is tested using spot urine, which is convenient and easy and correlates fairly well with recent iodine intake. However, studies have shown that spot urine and even 24-hour urine collections have high variability due to significant day-to-day variations in iodine intake.

    Some clinicians have advocated iodine challenge urine testing, where a patient takes a large dose of iodine, often 50 mg, and collects urine for 24 hours afterward. This is based on research showing that 90 percent of ingested iodine should be excreted in the urine when the patient has sufficient iodine intake in the diet (1). However, this testing has not been validated to my knowledge and has been heavily criticized by several iodine researchers (2).

    In my clinic, I use a combination of three tests:

    • 24-hour urine iodine: to assess recent iodine intake
    • Serum thyroglobulin: high thyroglobulin indicates low iodine status, and levels above 40 mcg/L are suggestive of deficiency (4)
    • Hair iodine: to assess long-term iodine intake (3)

    Correcting iodine deficiency

    If iodine deficiency is suspected and there is no evidence of Hashimoto’s, supplementation with doses of 200 to 300 micrograms of iodine are safe and well tolerated. However, I would still recommend monitoring thyroid antibodies and other thyroid markers closely. Higher doses of iodine supplementation should only be used under medical supervision.

    If iodine deficiency is suspected and you have Hashimoto’s, you can still try supplementing, but I would start with a very low dose, perhaps 100 micrograms of iodine, or simply increase intake of foods that contain iodine, such as sea vegetables, fish heads, or dairy.

    You’ll also want to make sure that you are getting adequate dietary selenium to protect against any negative effects of excess iodine. The richest source of selenium is Brazil nuts, but it is also found in high quantities in seafood and organ meats.

    The post Iodine for Hypothyroidism: Crucial Nutrient or Harmful Toxin? appeared first on Chris Kresser.

  • Egg Tacos With Avocado and Lime

    Post From https://www.marksdailyapple.com/egg-tacos-with-avocado-and-lime/

    These aren’t fried eggs, nor are they scrambled. The eggs in these tacos are just slightly set, with a warm, runny yolk that is barely scrambled into the whites. Slide one of these gently cooked eggs into a warm tortilla, top with cool avocado and lime and slices of jalapeno and you’ve got the perfect breakfast taco. Although these egg tacos are delicious for dinner, too.

    The main reason to gently scramble an egg is that it tastes delicious. The whites are fully cooked, but the yolk is runny, which gives the egg a soft and creamy texture. The second reason to gently scramble an egg, rather than whisk it all together and cook it over high heat, is that the cholesterol stays intact. Meaning it’s not oxidized, which is a healthier way to enjoy eggs.

    These egg tacos are a delicious alternative to meat tacos. They’re perfect with a simple topping of avocado, cilantro and jalapeno, but feel free to pile on fresh tomatoes or salsa, too.

    Servings: 4 tacos

    Time in the Kitchen: 20 minutes, plus time to make tortillas

    Ingredients

    • 3 avocados, cut into small chunks
    • 2 teaspoons fresh lime juice (10 ml)
    • ½ cup finely chopped red onion, divided (120 ml)
    • 4 eggs
    • ½ cup finely chopped cilantro (120 ml)
    • 2 jalapeno peppers, sliced
    • Salt, to taste
    • Tortillas of your choice*

    *About the tortillas… Three choices include Primal TortillasCassava Flour Tortillas, or (in the spirit of a Primal compromise or for non-Primal family members) a Corn Tortilla.

    Instructions

    In a medium bowl, gently mix together the avocado and lime. Add salt to taste. Set aside.

    Add a little avocado oil or butter to a small saucepan over medium-low heat. Add about a tablespoon of red onion, and cook for 2 to 3 minutes until the onion softens slightly.

    Crack one egg into the hot pan with the onion. Use a spatula to break the yolk and gently stir it once or twice into the white, but don’t scramble the yolk fully into the egg white. Let the egg cook for 1 to 2 minutes until the bottom and white of the egg begins to set but the yolk is still soft.

    *Another way to gently scramble eggs is to separate the whites and yolks. Add the egg white to the pan first and cook it for several minutes, then add the yolk for the last minute of cooking.

    Slide the egg and red onion into a warm tortilla. Sprinkle cilantro on top. Top with avocado and a few slices of jalapeno.

    Macros (without tortilla):

    • Calories: 331
    • Fat: 27.5 grams
    • Protein: 10 grams
    • Carb: 5.5 grams

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    The post Egg Tacos With Avocado and Lime appeared first on Mark's Daily Apple.

  • Watercress With Seared Prosciutto + Peaches

    Post From https://nomnompaleo.com/post/92016862558/watercress-with-seared-prosciutto-peaches

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    Heads up: A ten-minute Whole30 summer meal comin’ your way: Watercress with Seared Prosciutto and Peaches!

    I’m not kidding—this simple salad takes NO. TIME. AT. ALL.

    Prosciutto-wrapped peaches on a bed of bitter greens is a classic Italian starter that I used to order every time I spotted it on a summer menu…’til it finally dawned on me that this dead-simple recipe can be made at home for pennies on the dollar. Yeah, I can be dense sometimes. It took this old dog a decade to learn this peachy new trick, but hey: better late than never, right?

    Once ripe peaches made their first appearance of the year at the local farmers’ market, I started making this savory, sweet, and assertive summer salad on a regular basis. Can you blame me? I mean, the hardest part is just wrapping prosciutto around peach slices!

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    Most recipes call for grilling the porky peaches, but I’ve found that searing ’em in a skillet is a much easier and faster method. (In fact, it takes longer to fire up the barbecue than it does to prepare and eat this gorgeous hot-weather salad using a skillet.)

    Plus, I’ve replaced the usual bed of arugula with watercress. Why? ’Cause she’s the new Queen Bee of the vegetable aisle (that’s right: move over, kale), and I’ve been doing my darnedest to incorporate this nutrient-packed powerhouse into my diet. The warm peaches wilt the watercress slightly, making each mouthful  a kaleidoscope of flavors and textures.

    What do you say? Ready to try your hand at my favorite summer salad? Let’s make Watercress with Seared Prosciutto and Peaches!

    Serves one* as an entree or two as an appetizer

    Ingredients:

    • 2 cups watercress, thin stems and leaves only
    • 1 ripe (but still firm) peach
    • 6 thin slices prosciutto (I like La Quercia brand)
    • 1 teaspoon ghee or avocado oil
    • 1 tablespoon extra virgin olive oil
    • 2 teaspoons aged balsamic vinegar
    • 1 tablespoon shelled dry-roasted and salted pistachios, roughly chopped
    • Freshly cracked black pepper

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    Equipment:

    Method:

    Grab a big bunch of watercress and pick off the tender leaves and thin stems until you have 2 cups of salad greens. (Reserve the rest to add to soup. Like Simple Egg Drop Soup!)

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    Wash and spin dry the greens before dumping ’em on a plate.

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    Slice your peach in half, remove the pit, and divide each half into thirds to get six slices. Wrap a slice of prosciutto around each wedge of fruit.

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    The prosciutto should be coiled flat and tight around the peach slice.

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    While you’re preparing the peaches, heat a skillet or griddle over medium-high heat. Add the ghee or avocado oil, and swirl to coat the pan. When the pan is hot, lay the peaches on one side and cook for about a minute or until browned. Then, flip each wedge over onto its other flat side, and cook for another 30-60 seconds.

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    When the peaches are browned on both sides, flip them peach-skin side down. and brown the bottom for 30-60 seconds.

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    Place the hot peaches on the bed of watercress. Chop up the pistachios and sprinkle on top of the salad.

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    Add a generous drizzle of extra virgin olive oil and balsamic vinegar to taste, and top with freshly cracked black pepper.

    Watercress With Seared Prosciutto + Peaches by Michelle Tam https://nomnompaleo.com

    Look! It’s summer on a plate!

    You can watch a replay of me making this salad live in my kitchen on Facebook on July 11, 2018:


    Looking for more recipe ideas? Head on over to my Recipe Index. You’ll also find exclusive recipes on my iPhone and iPad app, and in my cookbooks, Nom Nom Paleo: Food for Humans (Andrews McMeel Publishing 2013) and Ready or Not! (Andrews McMeel Publishing 2017)!

    Recipe IndexNom Nom Paleo CookbooksNom Nom Paleo App

    PRINTER-FRIENDLY RECIPE CARD

    Watercress with Seared Prosciutto + Peaches

    Cook 10 mins

    Total 10 mins

    Author Michelle Tam

    Yield 1 serving

    Heads up: A ten-minute meal comin’ your way: Watercress with Seared Prosciutto + Peaches!

    Prosciutto-wrapped peaches on a bed of bitter greens is a classic Italian starter that I used to order every time I spotted it on a summer menu…’til it finally dawned on me that this dead-simple recipe can be made at home for pennies on the dollar. 

    Ingredients

    • 2 cups watercress, thin stems and leaves only
    • 1 ripe (but still firm) peach 
    • 6 thin slices prosciutto (I like La Quercia brand)
    • 1 teaspoon ghee or avocado oil
    • 1 tablespoon extra virgin olive oil
    • 2 teaspoons aged balsamic vinegar
    • 1 tablespoon shelled dry-roasted and salted pistachios, roughly chopped
    • Freshly cracked black pepper

    Instructions

    1. Grab a big bunch of watercress and pick off the tender leaves and thin stems until you have 2 cups of salad greens. (Reserve the rest to add to soup. Like Simple Egg Drop Soup!) Wash and spin dry the greens before dumping ’em on a plate.
    2. Slice your peach in half, remove the pit, and divide each half into thirds to get six slices. Wrap a slice of prosciutto around each wedge of fruit. The prosciutto should be coiled flat and tight around the peach slice.
    3. While you’re preparing the peaches, heat a skillet or griddle over medium-high heat. Add the ghee or avocado oil, and swirl to coat the pan. When the pan is hot, lay the peaches on one side and cook for about a minute or until browned. Then, flip each wedge over onto its other flat side, and cook for another 30-60 seconds.
    4. When the peaches are browned on both sides, flip them peach-skin side down. and brown the bottom for 30-60 seconds.
    5. Place the hot peaches on the bed of watercress. Chop up the pistachios and sprinkle on top of the salad.
    6. Add a generous drizzle of extra virgin olive oil and balsamic vinegar to taste, and top with freshly cracked black pepper.

    Courses Salad

    Cuisine Italian, Paleo, Primal, Gluten-free, Whole30, Summer

    The post Watercress With Seared Prosciutto + Peaches appeared first on Nom Nom Paleo®.

  • The latest science behind a keto diet

  • How Matt and Megha became interested in the keto diet

  • RHR: The Ocular Microbiome, with Dr. Harvey Fishman

    Post From https://chriskresser.com/the-ocular-microbiome-with-dr-harvey-fishman/

    revolution health radio

    In this episode we discuss:

    • What is the ocular microbiome?
    • How the microbiome affects eye diseases
    • T cell activation in the eye
    • HLA-B27 and genes that play an important role in immune function
    • A nutrient-dense and anti-inflammatory diet for eye health
    • Antibiotics prior to surgery

    Show notes:

    [smart_track_player url=”http://traffic.libsyn.com/thehealthyskeptic/RHR_-_The_Ocular_Microbiome_with_Dr._Harvey_Fishman.mp3″ title=”RHR: The Ocular Microbiome, with Dr. Harvey Fishman” artist=”Chris Kresser” ]

    Chris Kresser: Dr. Fishman, welcome to Revolution Health Radio. I’m so happy you could join us. I’ve really been looking forward to this.

    Dr Harvey Fishman: Thank you so much for having me, Chris. This is wonderful.

    What is the ocular microbiome?

    Chris Kresser: So, my audience has been well aware of the gut microbiome for many years. We’ve also talked about the skin microbiome. We talked about the vaginal microbiome, the lung microbiome, more recently the nasal microbiology, and so it’s not surprising to learn that there is also an ocular microbiome. I’m really looking forward to talking to you more about this and how it contributes to eye disease. Because in the conventional world, the options for preventing eye disease in the first place and then addressing them, I think, have come a long way but maybe still leaves something to be desired. I’d first love to start out with just hearing a little bit more about your background, how you became interested in the ocular microbiome in your work as an ophthalmologist, and what led you down this path.

    Dr. Fishman: That’s great. So, I have a pretty interesting background, where I started off in the world as a physical chemist, studied neuroscience. I was in an analytical chemistry microfluidic laser lab at Stanford and really got interested in how to measure molecules almost at the single molecule level. We were looking at vesicular and synaptic release, neurotransmitters, and what the chemical basis of learning and memory was.

     You’ve heard of the gut microbiome—and maybe even the skin, nasal, and vaginal microbiome. But did you know that the eyes also have a microbiome and that it plays a key role in ocular health? 

    That was sort of my background, and then I sort of did some interesting work in neurobiology, looking at retinal cells and how they grow and their regeneration, so I’ve had a lot of sort of technical background and analytical chemistry background. And then the last couple of years, I started getting very interested in the microbiome of the intestine and the gut, which led me into this whole world of what is actually happening in the eyes. Is there an ocular microbiome and is there a biome that controls disease in the eye that similar to that in the gut?

    What’s interesting is that I didn’t necessarily sort of think about it in those ways. I actually got into my research that I’m working on right now is we’re actually looking at how to measure cancer on the eye. We’re using some of the analytical techniques that I developed or had been working on for my whole sort of academic career, which is how do you measure very small amounts of materials in microenvironments, and so I naturally led to this concept of how do you measure cancers on the eye. We started using similar techniques and sort of the illumina high throughput sequencing technology using 16S rDNA and rRNA to look at different things on the cancer. Chris has led me right into how they are looking at the microbiome and that’s sort of what got my interest sparked. The other thing that’s sort of interesting is I’ve been working with a company called Microbiome to do some studies where I’m actually looking at intestinal microbiomes and how that compares to disease in the eye. That’s sort of a whirlwind tour of how I got interested.

    Chris Kresser: Right. It’s a fascinating background, and as is often the case, it seems like in some way you could have never designed this career path or predicted it would happen, but when you look at it in retrospect, it seems like each step kind of perfectly informed the next step.

    Dr. Fishman: That’s right. It’s actually really interesting; I never in my wildest dreams would have thought that I’d be doing genomics, and in fact one of my previous advisers always laughs because I’m doing genomics and I was a physical chemist and a microanalytical guy.

    Chris Kresser: Right, right.

    Dr. Fishman: Whippersnapper.

    Chris Kresser: Right. So let’s talk a little bit about the ocular microbiome and what we know about it so far and what we don’t know about it. Do we have any sense of the number of species, microorganisms, what the functions of the ocular microbiome are? I imagine it’s significantly less developed as a field of study than the gut microbiome, but what do we know so far?

    Dr. Fishman: It’s really the beginning of this field. What’s interesting about the microbiome of the eye is that we’ve been interested in, as ophthalmologists, not me personally, but at the ophthalmology community, we’ve been very interested in the bacteria that lived on the eye. The reason is that most of our intraocular surgeries like cataract surgery, vitreoretinal surgery, corneal surgery, when you make incisions into the eye, most of the serious infections that occur, occur because the exogeneous either bacteria that live on the lashes, the eyelid margin, or in the cornea. And so we’ve been very interested in this for years, and they’ve done a lot of interesting work, but the concept of the ocular microbiome, whether there’s like some low-level core bacteria and microbiological species that lives on, in, and around the eye, that’s really kind of a new concept.

    One of the papers that has come out just recently was actually by Mark Wilcox. I don’t know if you’re familiar with it; it was a major paper in 2017, and they looked at basically the temporal stability and composition of the ocular surface microbiome. It was probably one of the best papers, if not the sentinel paper in the field. What they found is … well, there’s a couple of things they found, that first of all the ocular biome is very different, if at all, than the microbiome of the intestine. One of the things that they found is that in addition to other work that’s been done, is that it’s actually a pretty low number of species. I mean, there’s a diverse number of species, but it’s a low number. It’s just a regular number. And then there was some work that was done by Russell Van Gelder who’s also shown similar work, but basically they started to talk about a bacteria microbiome that’s just very small in number.

    Chris Kresser:  It’s interesting; there is some parallel too with the gut. For most of the 20th century, we were very well aware of the existence of pathogenic bacteria, parasites and other organisms that could cause dysfunction in the gut, and most of the focus there was on identifying those pathogens and then treating the disease, eradicating them if possible with antibiotics or treating the diseases that were caused by them, whereas now at least, the awareness has shifted, and to some extent toward how do we support and nourish the protective microbiome and look at it more in the context of an ecosystem where we understand that if the health of the ecosystem is the primary focus, then that may actually be the most effective way of protecting against pathogenic activity.

    Do you think that something similar is going to happen with the ocular microbiome or that it’s just too— because it’s not as significant in terms of the volume of the number of organisms and we may not have as much ability to influence it with things like diet and lifestyle, we’re not going to go down a similar path there?

    How the microbiome affects eye diseases

    Dr. Fishman: It’s a great question, and that’s really what a lot of … myself and many other people are working on—whether you can influence it. I have some anecdotal discussions on that, papers as well, that actually would suggest that you may be able to do the exact same thing for the ocular health as you do for the gut health. Let me give you a couple examples. There are some really significant diseases of the eye, like, for example, dry eye disease, which is actually an area that I’m super interested in and really focusing a lot of my academic and clinical research. Dry eye disease is … they think there’s a very big component of how the ocular microbiome interacts with the cornea and the lid and so forth, but there are also a bunch of other diseases like episcleritis, chronic follicular conjunctivitis, pterygium, or surfer’s eye, scleritis, even things that are as interesting as macular degeneration and glaucoma, a lot of people are starting to have … some of these diseases are actually idiopathic, not macular degeneration necessarily, but like episcleritis and dry eye disease. There are these so-called idiopathic diseases. What we think is that it’s really controlled by dysbiosis of microbiome.

    Chris Kresser: Wow, that’s interesting. For listeners, idiopathic means “we don’t really know.” It’s a fancy way of saying, “We don’t know where this comes from or how it starts.” It’s fascinating and by now not surprising, given what we talked about at the beginning of the show, we know now about the microbiome is not just in the gut. There’s microbiology and virtually in any surface that interacts with the exterior world, whether it’s the gut, the inside of the gut, technically is outside the body. We’ve talked about that on the show, which is always kind of fascinating, especially if you haven’t thought about that, and then the lungs, which of course interface with the exterior environment, and the skin, the vagina, there’s a penis microbiome, and clearly these organisms are playing some important role and clearly there’s something about the modern lifestyle that is antithetical to the health of microbiomes. I imagine with the ocular microbiome, is it influenced by the same factors? Does systemic antibiotic use contribute to a degradation of the quality of the ocular microbiome? Are any kind of eye products that people use like drops, can they interfere? What do we know about that?

    Dr. Fishman: Right. Those are great. Certainly areas that people are looking at. In the eye, there are so many aspects of the eye in terms of the ocular microbiome of the eye that makes it complex because the thing about the microbiome of the eye is that it’s not only that we think a core microbiome exist in a very low level, there’s a lot of other bacteria and other species of organisms that sort of “contaminate” those measurements and also the surface.

    One of the interesting things, there’s a lot of sort of noise, in the sense that there’s the noise from contaminants at any one time on the eye can overwhelm the signal of the actual microbiome. But what does seem to occur is that it’s very possible that when people have sort of acute issues is because they do get some sort of dysregulation of their normal biome by this sort of contaminant. The sort of things that can really change the ocular surface biome is exactly the source that you’re mentioning. If you use makeup, if you use products—Latisse, for instance, the Latisse, which people use to make their eyelashes grow longer contain a lot of— basically cause of the eyelashes that have more inflammation, more debris on them and that those are basically culture plates for bacteria on the eyelashes. That really does change it.

    A lot of what you’re mentioning really is sort of the dry eye disease realm, which is that all these different products that people use, including unnecessary eye drops or things like viral bacterial conjunctivitis, which you wouldn’t use an antibiotic but that changes the microbiome. The other thing that is very fascinating is parasites. It turns out Demodex, I’m sure you—maybe we had many shows on Demodex, but Demodex is a big, big deal, and there is an interesting sort of life cycle of Demodex in the lashes and how that relates not only to the skin microbiome, but actually of people who have dysbiosis of their intestine. It’s just incredibly fascinating and it plays into the whole ocular rosacea story as well.

    Chris Kresser: Not too long ago we had a periodontist, Al Danenberg, who’s been through my clinician training program and is a really knowledgeable guy. He has looked at the connection between the gut microbiome and the oral microbiome and has found from his perspective and from what the research is showing that when there’s a disruption in the oral microbiome, it’s usually or often driven by dysfunction of the gut microbiome rather than the other way around, although certainly we know that infections in the mouth can influence the gut and other parts of the body, but because stomach acid protects against, hopefully if it’s sufficient, a lot of what we would swallow and the saliva from the mouth that the relationship is probably more strongly influenced in the other direction. Has there been much work done on the influence of the gut microbiome on the ocular microbiome?

    Dr. Fishman: That’s a huge area that people … there’s a lot of really interesting work, but just to kind of go back to what you said, there was a really interesting paper that came out that talked about the oral microbiome linked to neurodegeneration and glaucoma.

    Chris Kresser:  Ah …

    Dr. Fishman: We actually know that there are people with worse oral disease and dental disease. Actually, you have higher rates of primary glaucoma than other people, and that was a very well done study that was recently published. Essentially one of the things that we’ve known forever, and as a medical student, we learned very early in the game, the connection between ulcerative colitis, Crohn’s disease, and uveitis. You may have touched upon before, but that is one of the most clear-cut associations that we have enough knowledge. In fact, ophthalmologists often sometimes will look … brilliant clinicians … when the person comes in and we see uveitis and then we do a little bit of the history and it turns out that they have Crohn’s and then we send them to the GI specialist and the GI guy thinks we’re brilliant. We’ve discovered Crohn’s disease by looking in their eye and yet there are a few associations.

    What’s interesting is that there are multisystem disorders, autoimmune diseases that are associated with uveitis that are absolutely related to the gut and in other areas. That’s an area that NIH is doing a very—there is a big push to look at the association. In particular, some of the work they’re doing with T cell activation, both protective T cells and non-protective T cells, and how it influences uveitis, and they’ve been looking at some really interesting experimental autoimmune uveitis models, the EUA, so to speak, and they looked at how the regulatory T cells in the gut and other tissues really affect the uveitis and so forth.

    Chris Kresser: I think there are probably a fair number of listeners who are not that familiar with disease. Uveitis being an inflammation of the middle layer of the eye, right?

    Dr. Fishman: That’s right.

    Chris Kresser: With the connection between the gut and depression for example, the speculation is that in terms of the mechanism is that inflammatory cytokines are produced in the gut and they enter the bloodstream, perhaps because the barrier is permeable and they travel through the blood and they cross the blood–brain barrier and they suppress the activity of the frontal cortex, and that’s one way gut pathology can lead to anxiety and depression.

    In the case of the connection between the gut and eye disease, let’s take ulcerative colitis and Crohn’s, which are both autoimmune GI pathologies. Is the speculation that the systemic inflammation caused by the autoimmune disease is what’s causing the inflammation in the eye, or is it that something related to a disruption of the microbiome leading to maybe the production of certain chemicals or inflammatory cytokines or something that’s more specific to the microbial ecology of the gut is the contributing factor, or do we just not really know?

    T cell activation in the eye

    Dr. Fishman: One of the thoughts, and there was a paper that … and these are all interesting, really recent papers like 2015 to 2016, but there’s that commensal microbiota and bacteria in the gut that activate T cells. These T cells then circulate and then actually pass into and through the retina, in other parts of the eye, to then activate directly. It’s definitely via the immune system, but there are very specific immune cells that actually can penetrate into the eye. There’s always been that thought that the eye is immunologically pristine, and that really is obviously not the case, but there are very selective T cells that can in fact get into the eye or pass into the eye, and so that’s what we think that is going on, is that there’s a dysregulation in the microbiome of the gut.

    As you pointed out, you get T cell activation, and then it actually activates the local immune system in the eye. Actually, a really interesting situation that we see with respect to that, we actually can see diseases like sympathetic ophthalmia, which is a disease where if you injure one eye, activation of the T cells from one eye actually can go to the other eye, and you can actually lose the other eye, so you could actually have a question where are you …

    Chris Kresser: Oh, wow.

    Dr. Fishman: Yes, it’s awful. That’s why people have to get their eyes enucleated or taken out when they have a trauma. They have to do that within about 10 to 15 days or sooner because they can get this autoimmune activation that can actually blind them in the other eye. It’s just fascinating how that works, but that is sort of the same idea in the gut that you get with activation, and it causes inflammation. One of the things that we know, Chris, and this is my own personal experience in my practice, and I’ve seen this over and over and over again, is that my uveitis patients, they always come in with an active disease, almost always some kind of a gut-related situation that sets off their uveitis or inflammation. They’ll come in and I’ll say, “What did you do last week?” “I was in Las Vegas and then we ate a lot of carbohydrates,” and these are patients who are very strict about being on a gluten-free diet, and they just say they cheated, so to speak, they had a bad weekend, fun weekend, but now they’re paying the price and then they come back and they get uveitis. I can’t tell you the number of times I’ve seen that. It’s just clear cut. That’s actually withm in particular, HLA-B27 uveitis. I don’t know if you have covered that, but that’s a big area.

    HLA-B27 and genes that play an important role in immune function

    Chris Kresser: I love to hear a little bit. I’m familiar with HLA-B27 and AS, ankylosing spondylitis, and the connection there. In fact, in our clinic, we will often test patients for HLA-B27 if they have joint pain, and if they test positive for Klebsiella bacteria on the stool test, I forget the name of a physician in London who discovered that connection, but then we’ll often put them on a low-starch diet and will treat the Klebsiella, and their joint pain will go away, or at least that will significantly improve. Tell me more about HLA-B27 and the eye.

    Dr. Fishman: That’s our biggest immune screening. We screen for that in every single uveitis patient and screen for HLA-B27. In fact, 50 percent of every non-necrotising anterior uveitis, which is just a fancy word for basically idiopathic, meaning we don’t know what the cause is, it’s almost always related to an HLA-B27-positive uveitis, and so we see that all the time. Those patients are particularly sensitive to changes in their diet, and a lot of those patients, I will really push for strong control, at least in my practice. We always start off with a gluten-type restriction because that seems to be one of the big areas that sets off uveitis. HLA-B27 is such a prominent factor in most of our inflammation. You can also get sclerites with HLA-B27, you can get uveitis, you can get episcleritis, any of the autoimmune diseases around the eye seemed to be linked to that marker.

    Chris Kresser: Just for the listeners, if your eyes are glazing over here, we’re geeking out a little bit, but I want to back up. HLA-B27 is a gene, and it’s one that plays a really important role in immune function. Its prevalence varies around the world in different ethnic groups and populations. I think it’s about 8 percent in Caucasians, maybe this 2 to 9 percent in Chinese, 4 percent North Africans. As I was mentioning before, the association that I was most familiar with, I’m really fascinated to learn about the connection with uveitis is with ankylosing spondylitis. Back in the ’80s, there was a physician in London, whose name I’m unfortunately forgetting at the moment, and he was treating patients with AS, and by accident some of them he put on a low-carb diet for weight loss, and their AS improved dramatically. He did some more research and he found that there is a greater abundance of Klebsiella in stool samples of patients with AS, and then he found that Klebsiella bacteria that have preference for starch, and the patients that he put on a low-carb diet were of course eating a lot less starch. The low starch intake starved the Klebsiella and reduced the Klebsiella, which then reduced the autoimmune attack against the HLA-B27-expressed enzymes that were in the joints, and that’s reduced the symptoms of AS, or ankylosing spondylitis, but there was later research that showed that sometimes can be connected to Crohn’s disease. You just told me that Crohn’s is connected to uveitis. Things like this, there’s a very interesting connection going on here, and that it may possibly a low-carb, low-starch diet, if it works for AS and HLA-B27, might be effective for uveitis.

    Dr. Fishman: Absolutely. I basically, in a very non-scientific way, have my patients try these diets and often they don’t want to go on to these heavy-duty immunosuppressants like methotrexate or Imuran. They want a natural … not natural, but they want a way to control the inflammation not to do these other sources. They will grab it, and a lot of the way I practice is I’ve learned so much from the multitude of patients who tell me, maybe the patients who have seen you as well, I learn from them what works, and I can then pass it on to other people. But in terms of the gut association with HLA-B27, it’s fascinating when you were mentioning Klebsiella, it turns out that Klebsiella as well as other bacteria … and in particular, there’s a big connection with blepharitis and dry eye disease. In fact they did a study where they looked at patients—Bacillus was the other one—they looked at a setting where they looked at patients who had dry eye disease, and it turned out that Bacillus and Klebsiella were the huge association with blepharitis and dry eye disease. Just as an aside, another very interesting thing, because I’m very interested in dry eye disease and a lot of people with ocular rosacea, there is that story that the microbiome of your gut are being eaten, so bacteria that actually get eaten by the parasites, which hurt the Demodex on your eyelashes and your hair follicles, they eat the bacteria, then the parasites puke up the bacteria, and then the products and the exogenous components from the bacteria then irritates the eyelashes and the meibomian glands, which are glands in your eyelid, cause severe dry eyes. That’s this interesting lifecycle between bacteria, Demodex.  The other thing that I’ve looked at, and I know that you guys have talked about SIBO, and there seems to be this association with SIBO, bacteria, blepharitis, Demodex and ocular rosacea and dry eye disease.

    Nutrient-dense and anti-inflammatory diet for eye health

    Chris Kresser: Fascinating. I mean, there’s so many directions, but it all really comes back to, I mean, I think one of the things I like to emphasize, these discussions are fascinating and they’re important, and these lines of research are really crucial to figuring out what’s going on, and at the same time it comes back to the same basic steps that we need to take. Eat a nutrient-dense, anti-inflammatory diet, make sure you’re taking care of your gut microbiome, avoid unnecessary antibiotics.Make sure to eat plenty of fermented foods and fermentable fibers. It can be easy to get overwhelmed by the complexity of all of these connections, but the good news is that usually it’s just the same simple steps that we need to take in order to protect our health.

    Dr. Fishman: Absolutely. One of the things that we found, and you’ll just be amazed, ophthalmologists, we have been running the largest nutritional study in the history of mankind, and it was for macular degeneration. That statement is not a trivial one. I don’t know if you’ve talked about this, and essentially the use of lutein as the advancement in your diet. There are a lot of interesting connections between the intestine and macular degeneration, and there’s a big suggestion that the intestinal dysbiosis as seen in AMD patients … and when you’re doing these supplementations, you’re really supplementing the intestinal microbiome to reduce inflammation in the retina, which is actually the cause of macular degeneration, so it’s just incredibly fascinating. Every time I leave my patient, I feel that there are two things I want you guys to leave this office with because I don’t have the bandwidth, obviously, that your practice has in terms of … I have this focus on different things, but I tell them spinach pills, which is just spinach and omega-3 fatty acids. Omega-3 fatty acid is a very interesting controller of eyelid health and dry eye disease despite the fact that there was a recent paper that came out that disputed that, and I would really argue that that was not a very well-done … it was a study that was well done, but they had a lot of problems with it. My two big go-to things at least in my practice are spinach and fish.

    Chris Kresser: That certainly fits into the context of the nutrient-dense, anti-inflammatory diet. It’s really fascinating to me how the change, I think, that’s happening in medicine, not just in functional integrative medicine but even in conventional medicine, that we started out allopathic medicine grew out of this Cartesian dualistic framework, where the body is basically just a bunch of disconnected parts that are kind of loosely connected, but not really influencing each other, and now we’re really starting to understand that under traditional systems of medicine, they certainly didn’t get everything right, but the one thing that they did get right was this idea of holism, that every part of the body is connected to and influences the body as a whole.

    Now we’re seeing this, I think, really play out. Look, it’s Crohn’s disease and ulcerative colitis increase your risk of eye inflammation. We now have the inflammatory cytokine model of depression that shows that inflammation in the gut can cause inflammation in the brain and symptoms that mimic depression. We’ve got connections between dysfunction in the HPA axis and stress and all kinds of skin conditions like eczema and psoriasis. I mean, the list goes on and on, and now we’re adding to this the connection between the oral microbiome and the gut microbiome and inflammation in the eye, which even just, I think, 20 or 30 years ago would have been completely dismissed as a woo-woo kind of out-there stuff. It’s just encouraging to me that we’re really starting to move, no matter what kind of perspective on medicine, we’re talking about into a more holistic view of the body.

    Dr. Fishman: There was an interesting paper where one researcher looked at treating, it wasn’t a corneal ulcer, but they were treating sort of a conjunctivitis using a probiotic eye drop.

    Chris Kresser: I was going to ask you about that.

    Dr. Fishman: There’s a disease called vernal keratoconjunctivitis, and that’s a pretty tough one to treat. Vernal means spring, and basically it’s allergic conjunctivitis. A lot of kids get it, and the way we typically treat that is with steroids and so forth, which you obviously don’t want to do for children. There was a paper back in 2008 where they looked at using a probiotic eye drop, and they found it was equivalent to some of the other drops that they were using, which to me makes complete sense. I had a very interesting case recently of a patient who had actually an open globe. She actually had some sort of a tube that was put in for glaucoma, and it eroded through the conjunctiva. Bottom line, you see an open globe and she had opened up for essentially six months and nothing happened. She didn’t get an infection, nothing. For whatever reason, she had a very well-controlled ocular biome.

    One of the interesting questions that we’re now looking at is how do the intestinal, oral, or skin biomes relate to the ocular microbiome? I think it’s a pretty clear situation, and we know and I’ve had private conversations with some pretty famous microbiologists, anything that comes out of your intestine is going to be in your eyes, so basically just think of it that way. I mean, it doesn’t sound great, and I joke with my patients, “You’re basically getting poop in your eyes, and it happens all the time, every single day.” That’s what happens, not to be completely crap, but that is the connection.

    Chris Kresser: Yes, yes. That’s interesting. The probiotic eye drop reminds me of, I talked about this before, the nasal microbiome and the connection between the nasal microbiome and sinusitis. Dr. Susan Lynch at UCSF has done some really interesting work in this area. She did a fascinating study that was both animal and human, and they had an animal model of sinusitis, and they found that the main difference between animals with sinusitis and the controls was not—and this was true in humans too—was not the presence of certain pathogens. It wasn’t that the people with sinusitis had much higher levels of fungus or certain species of pathogenic bacteria. The biggest difference between the two groups was microbial diversity.

    Dr. Fishman: Right.

    Chris Kresser: The people who were the controls, the people who didn’t have sinusitis, had a much richer diversity of healthy protective bacteria, whereas the people who had sinusitis had a lower diversity, even when the presence of pathogenic species was basically the same. There was no difference between the two groups. The difference was that the healthy people had much higher levels of protective bacteria, and then she went a step further, and in the animals, they treated them with antibiotics until they were basically depleted of the microbiome in both the healthy controls and the animals with sinusitis. And in one group of animals, they didn’t do anything. They just let the bacteria grow back as they would, and then the other group, they inoculated them with a protective species, Lactobacillus sakei, which they had observed in higher numbers in the healthy controls. And those animals that were inoculated with that nasal probiotic didn’t develop sinusitis or anything the other animals that were not inoculated with that. That really actually speaks to probiotics in both maintaining and then restoring a healthy microbiome as being a more effective strategy than using antibiotics or antimicrobials to try to get rid of pathogens.

    Dr. Fishman: Right. When you mention those two things, there were two interesting things that come to mind. The first one, just to let you know that there was a paper that came out in Nature in 2016 which said exactly the same thing. They were looking at Sjӧgren’s disease—for your listeners, it’s one of the most severe forms of dry eye disease and other dry parts of your body. They found the exact same finding, that people with the severity of Sjӧgren’s disease was inversely correlated with microbial diversity in your gut.

    Chris Kresser: Wow.

    Dr. Fishman: And with just as clear as day. It was just super clear that this was the case. We know, and I know from my own clinical experiences, that people who have, do have, a much higher control level, people who do a better job in terms of their diet, people who are more precise about the food that they eat and so forth, do much better with dry eyes. Dry eye disease, for the longest time, we’ve been treating dry eye disease with omega-3s or any type of fatty acid, but any sort of derived can lead to that. What I always mention is that, is it actually the omega-3 acting directly in your eye, or is it basically an activation, a biological cascade, that then causes the improved function in the eye? I clearly believe that it is a cascade effect because there is no way that just a simple little fish oil capsule could have that much of an improvement in people with dry eye disease.

    Chris Kresser: Right, right.

    [Crosstalk]

    Chris Kresser: Go ahead, please.

    Antibiotics prior to surgery

    Dr. Fishman: Yes. I just have one other really interesting comment, which was one of the things that is interesting is that you talked about treating infections with basically displacing the bad bacteria with “good bacteria” and so forth, and that whole concept, which makes a lot of sense. One of the things that we’ve seen is that in eye disease, especially in ocular surgery, we routinely treat our patients basically from medicolegal reasons with antibiotics prior to surgery.

    Chris Kresser: Right.

    Dr. Fishman: It turns out that the studies are coming out that there’s no data whatsoever to support those claims.

    Chris Kresser: Yes.

    Dr. Fishman: Those are billions of dollars a year in an antibiotics that were sold by pharmaceutical companies to basically do nothing and maybe, who knows, but maybe actually not even improve outcomes, but maybe make outcomes worse by selecting for bacteria that if it does get into eye, it actually would be a much worse situation.

    Chris Kresser: Right.

    Dr. Fishman: That’s really interesting data that we have.

    Chris Kresser: That happens, of course, not just in the world of the eye, ocular issues, but of course in the dental surgery, where patients will often come and say, “Oh, I’m about to get this dental surgery. My dentist is just prescribing antibiotics prophylactically.” Of course I’ve had the thought, “Well, okay, does this become a self-fulfilling prophecy?” Because we know that disruption of the oral microbiome with antibiotics can actually predispose you to an oral infection, and so by prophylactically prescribing an antibiotic is not really prophylaxis, or is that actually more likely to develop an infection? And as you said, not only have you reduced your body’s ability to fight the infection, if it does happen, by reducing the number of beneficial protective bacteria, you’ve also potentially contributed to creating a more resistant strain of pathogenic bacteria by killing the ones that were least … the types of pathogenic bacteria that were least robust and just leaving the ones that were more robust.

    Dr. Fishman: Well, there is some evidence that suggests that may actually be the case. I mean, with eye surgery, we use povidone iodine before surgery. That is the gold standard and at least cuts down sort of universally all … it doesn’t select, do you know what I mean? You’re not selecting for bacteria. You’re basically wiping it out. Antibiotics, on the other hand, are probably selecting for it. That’s a good example where that period self-selecting bad bacteria really might be coming true. It’s very interesting where we’re going, especially with the eye, because there are still many “idiopathic” diseases and infections that really relate to the biome, not only of the eye, but also the gut being the cause of it.

    Chris Kresser: Who knows? Maybe someday you’ll go to the dentist and you’ll get a dental probiotic instead of antibiotic for an infection. Maybe you’ll go to your ENT for an ear infection, and instead of putting antibiotic ear drops, they’ll put in probiotic ear drops. You’ll go the ophthalmologist and instead of getting antimicrobial treatment, you’ll get probiotic eye drops. Seems that’s not far-fetched at this point.

    Dr. Fishman: Not at all. In fact, you might argue we’re already doing that through indirectly by using our gut as a way to … [crosstalk]

    Chris Kresser: Right. To modulate.

    Dr. Fishman: Correct.

    Chris Kresser: Well, this has been really fascinating, Dr. Fishman. I’ve enjoyed talking with you, and I think the listeners are really going to get a lot out of this, and it’s hopeful. I feel hopeful to know that there are folks like you who are exploring these new frontiers and really kind of pushing the boundaries and questioning some of the most basic assumptions that we’ve made and finding a new path forward that could lead to better, safer treatments. Where can folks learn more about your work or if people are in the Bay Area? It sounds like you definitely are still seeing some patients. Tell us where people can learn more.

    Dr. Fishman: Sure. Well, they can always find me on my website, which is www.fishmanvision.com, and they can get involved in my practice in multiple ways. I definitely see patients. Half the time I’m seeing patients, half the time I’m doing research.

    [Crosstalk]

    Chris Kresser: It looks like they can do some video consultation as well. Is that right?

    Dr. Fishman: Yes. For people in California, I can do video consultations if they can’t make it to the office. Especially for dry eye disease, it’s very helpful.

    Chris Kresser: Right, right. Great. Well, keep us posted on your research. We’d love to hear it, stay in touch, and have you back on the show at some point and just keep track of your work. These are really exciting developments.

    Dr. Fishman: I really appreciate the opportunity, and I wanted to thank you because we’ve shared some patients, and their lives have actually changed because of the work that you’re doing with them, so thank you.

    Chris Kresser: Fantastic. It’s my pleasure. Take care.

    Dr. Fishman: Okay, thank you.

    The post RHR: The Ocular Microbiome, with Dr. Harvey Fishman appeared first on Chris Kresser.

  • When Chronic Illness Makes You Feel Like a Burden – a Guest Post by Kerry Jeffery

    Post From https://www.thepaleomom.com/chronic-illness-kerry-jeffery/

    Kerry Jeffery (B.A.) is a qualified Clinical Hypnotherapist, Counselor, and Life Coach, living well with Hashimoto’s Thyroiditis, Celiac Disease and Antiphospholipid Syndrome in Melbourne, Australia. She is the author of “Moving through the Grief of Chronic Illness: A 9 phase model from anxiety to resilience” to help people understand the many complex emotions that come with becoming chronically ill. Kerry works with people all over the world, helping them heal the emotional and psychological side of chronic illness. She specializes in safely removing past and present trauma, guilt, anxiety and all of the effects chronic illness can have on your relationships. Kerry is also an expert at overcoming the effects of toxic relationships and dealing with toxic family or parents.

    Kerry works primarily on Skype and offers a free 20-minute Discovery Session on her website:  www.emotionalautoimmunity.com


    One of things that chronic illness is really good at is creating lots of grief and guilt. It can feel like you have lost the person who you once were.  The capable, active, energetic and independent person who used to be able to get things done, stay out late, burn the candle at both ends and bounce back after a good nights sleep and eat whatever they wanted. Becoming chronically ill is a life-changing event that affects every single area of your life, and the worst impact it can have is on your relationship with your partner.

    The guilt can start in simple ways. You start feeling guilty because you can no longer do the things that you used to do for yourself or your partner or your children, so you find yourself apologizing all the time.

    I’m sorry that you have to help me.

    I’m sorry that I can’t get things done.

    I’m sorry that I am letting you down.

    I’m sorry that I am always sick.

    Then gradually, over time, the way that you think about your partner can begin to change. Somewhere along the way, as your chronic illness takes more of a toll on you and your life, your partner changes from being your friend, lover, and co-parent, to becoming your caretaker, provider or manager of your health and medical appointments. Even worse, they can become someone who doesn’t seem to understand or make allowances for the many ways having chronic illness has changed your life and expect you to carry on as normal. However, there is no more normal and everything feels different now. The lens through which you view yourself and your relationship grows increasingly dark and negative as the guilt really begins to set in. You feel like you can no longer do your share around the house because you feel so sick and exhausted all the time, so you can feel like everyone is judging you as being lazy or disorganized.

    So you feel guilty. If you are a parent, you can feel like you are ruining your children’s lives because all they see is a parent who is constantly sick. You feel guilty about what this is doing to them and how it will affect their future. If you need to make dietary changes, like switching to AIP to help reduce your flares and create some healing, you can feel that you are depriving your partner and family of all of the foods that they love and enjoy, so you feel guilty for taking that away from them. You can’t stay out late anymore or socialize because you are exhausted or in pain or so brain fogged that you can’t even think, so you have to keep saying no to all of the social invitations and events. You feel guilty because you feel like your friends will think that you no longer care or want to see them and that your partner is missing out because of you.

    Pain, disability and lack of energy means that your sex life can begin to suffer. Chronic illness can change so much about you that you can look in the mirror and no longer even recognize yourself. You start to wonder how your partner could ever think you are attractive, let alone sexy and your self-confidence goes out the window. Even if you do have the time and energy for intimacy, the anxiety and self-consciousness gets in the way, so the guilt gets even bigger. There can come a point where the guilt becomes so bad that you start feeling sorry for your partner, because you no longer feel like the person that they fell in love with.

    You can even find yourself starting to believe that your partner would be better off without you. In fact, you may even feel that you need to offer them an “out” from the relationship, because somewhere along the way, you feel like you have become someone who is just dragging them down, spoiling their enjoyment of life and holding them back from the happiness that they deserve.

    You feel like you have become a burden to them.

    The more guilt you feel, the more you begin to withdraw from your partner, from your children and from your life. Guilt changes everything and it can poison everything that you care about. But here is the thing about guilt: Guilt is the great deceiver. It whispers in your ear, trying to make you believe that all of your worst fears and doubts are coming true and if you let it, guilt can ruin your relationships. Guilt can lead you to a dark and dismal place where you are not able to make the right choices for yourself or for your relationship because you feel like a burden.

    Feeling like a burden stops you from really hearing what your partner is actually saying to you. Feeling like a burden sinks you further down into depression, apathy and hopelessness. Most of all, feeling like a burden stops you from actively creating solutions and adapting to the changes that chronic illness has brought into your life. However, there is one big truth about feeling like a burden that you really need to hear and accept and understand.

    You can only feel like a burden if you allow yourself to believe it.

    The truth is that you are still the same amazing and wonderful person that your partner first fell in love with. You are still as lovable, worthy, deserving and enough as you have ever been

    The only difference is, that now you are a person going through a life-changing crisis that everyone in your life will need to adapt to and live with as well.

    If you are in a relationship, chronic illness is something that you both need to deal with, just like any other crisis or challenge in your relationship so far. Don’t believe me? Let’s flip the situation and turn it around. If this was happening to your partner instead of you, what would you do? Would you see your partner as a burden or would you want to face the challenges as a couple and find ways to adapt and change and face it together? Would you want to blame your partner and abandon them or would you want to find ways to support them and make your lives together as happy and fulfilling as you can? The truth is that chronic illness is one of those devastating and challenging events that can happen to anyone at any time through no fault of their own.

    Chronic illness is not something you deserve or created or brought upon yourself because of something you may have done in the past. We still don’t know exactly what causes chronic illness, but what we do know is, that as individuals, we have enormous power and influence to change our lives and create the best possible health and happiness we can.

    So how do you stop feeling like a burden?

    Begin by understanding that continuous guilt is a useless and crippling emotion. Guilt is meant to be a powerful reminder of when we have stepped outside our own moral compass and done something that we feel was wrong, that we need to own and apologize for. It helps us learn to take responsibility, be honest and live up to our own standard of what being a good person means.

    Getting chronic illness is nothing to feel guilty about.  It is something that can happen to anyone at any time and it is not your fault. So start really listening to what your partner is telling you without letting guilt whisper in your ear. If your partner is telling you that you will both work it out and find a way to manage this, believe them. Go back to what you would do and how you would feel if the situation was reversed and your loved one was chronically ill and let that ground you in what is true. Understand that what you are going through is for now, not forever.

    Feeling like a burden can fool you into believing that things are going to be this way for the rest of your life and none of us can see the future. We can only do the best that we can with the present moment that we have right now and the only sure and certain thing in life is change. As you begin to work through all of the complex emotions of becoming chronically ill, you will begin to adapt and feel more in control. Remind yourself of all of the difficult things that you have already overcome.

    When you stop believing in the things that guilt is telling you, that resilience and strength and determination will begin to come back. Talk to your partner openly and honestly about how you are feeling. Tell them that you feel that you have become a burden. Tell them that you feel like you are dragging them down and how worried you are about your future together. Having an open, honest and vulnerable conversation with your partner can create a wonderful opportunity for more connection, trust, love and commitment between you both and make your relationship even stronger.

    Right about now, I know exactly what you are going to say: but what if they tell me that I am a burden? What if my fears are true?

    As hard and as heartbreaking as this can be to hear, at least you will know exactly where you stand and what you can expect from them. If this does happen, chances are that there have been issues in your relationship that were already there, long before the chronic illness arrived. The chronic illness has just made them so clear that they can no longer be ignored or denied. Continuing to feel like a burden and not talking about it, will only continue to keep you stuck in guilt, anxiety and stress, all of which is enough to trigger your autoimmune conditions and make you feel even worse.

    What I have seen in so many cases with the couples that I work with, is that marriages and relationships where one person has chronic illness can grow even stronger, closer and more loving than before. It can create new opportunities for you to both see what is really important in your relationship and that can only happen once you choose to let go of the guilt and stop believing that you are a burden. Feeling like a burden will deprive you of all of the joy, comfort, love, reassurance and connection that is available to you right now.

    Guilt is a normal phase of the grieving process and it can be overcome if you are willing to be honest, vulnerable and have the tough conversations. You are only a burden if you believe yourself to be. Don’t let the guilt tell you otherwise.

    Would you like to work with Kerry? She offers a free 20-minute Discovery Session on her website:  www.emotionalautoimmunity.com

    The post When Chronic Illness Makes You Feel Like a Burden – a Guest Post by Kerry Jeffery appeared first on The Paleo Mom.

  • 6 Benefits of Red Light Therapy (and how it improved my skin!)

    Post From http://www.rubiesandradishes.com/2018/06/28/6-benefits-red-light-therapy-improved-skin/

    How Red Light Therapy Improved My Skin

    Be sure to use code ‘ARSY’ for $25 off of your Joovv light!  I’ve been spending most mornings, in front of a red light looking like an alien. My 6-year-old finds this hilarious. For months, I’ve been religiously including red light therapy in my morning routine and I’ve experienced better sleep, a happier mood and improved […]

    The post 6 Benefits of Red Light Therapy (and how it improved my skin!) appeared first on Rubies & Radishes.

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