How the anti-inflammatory diet healed/ruined me
Two stories about my journey with autoimmune diets, completely opposite and both true
I want to talk about special diets of the hardcore health variety: autoimmunity diets, gut health diets, FODMAPs, anti-inflammatory diets—that type of thing. I know this subject is fraught, and I have been scared to approach it head-on. There are people who have completely changed their state of health using such diets, and journalists who write extensively on ways the Standard American Diet (SAD) is killing us, backed by strong evidence. There are other people who feel that our culture is diet-obsessed and also have great evidence for it, often suggesting that restrictive diets are a sign of wealth, privilege, and cultural obsession with skinny white women. I bet those last two sentences made a number of people’s blood boil—that is the nature of this topic. Diets are divisive and emotional and connected with every other big theme of our time: class, race, our food system, climate, politics, body image, media and…oh my, why did I decide to write about this again?
But this topic has been a big part of my life in recent years, and I often cover the related topic of gut health, so I feel compelled to dig in a little despite the many land mines. I’d like to approach this knotty topic the best way I know, from the personal. I don’t know what your experience has been here, but I can tell you mine, and, spoiler alert, it’s riddled with all the conflict inherent in the broader cultural conversation. So let me tell you two stories about my journey with autoimmune diets, completely opposite and both true. Then we will see what we can take from this (it won’t be neat and tidy…it never is).
How an anti-inflammatory diet healed me
It was April of 2022, and I wanted to start working on getting pregnant for the second time. I say “working on” because it was going to be a long road. It would require another egg retrieval and then the long slog of IVF transfers. As part of the standard testing that precedes the process, I got a thyroid test. The results were so abnormal that the doctor thought it was a lab error. A re-test showed that it was not an error, and further testing revealed a high level of antibodies to my own thyroid, confirming Hashimoto’s Thyroiditis, or thyroid autoimmunity.
So, what does a well-to-do, educated millennial white woman in San Francisco do when she wants to get pregnant and learns she has an autoimmune condition? We go look for all the information, the best alternative doctors, the best supplements, and critically, the best diet. Not to be glib about my demographic, but I have met so many me’s over the past two years. Thyroid autoimmunity is one of the most common autoimmune disorders, and it tends to show up around the time women are having babies. It is very often caught the way that mine was caught, during infertility treatments (not, I might mention, during the many years I went to doctors for fatigue, and rashes, and sinus inflammation, and gut issues, a verifiable menu of autoimmune symptoms). In other words, there are a lot of us spending lots of money trying to have a baby, already tinkering with our bodies, and in the process revealing, to our horror, that our bodies are attacking themselves. Shit, shit, shit, time to rally all our powers to fix this.
And that’s what I did. I interviewed four functional medicine doctors and chose one who put me on an elimination diet for the summer: no grains, no dairy, no eggs, no nightshades, no fatty meat, only cold olive oil, never heated, no fruits with a high glycemic index, and so on. I executed on this, fairly completely for two months, even while on vacation, along with an extensive supplement protocol. Then I added back various foods one at a time to see if I had a reaction. I ultimately landed on a fairly standard autoimmune diet, eliminating gluten, dairy, various oils, most processed food, and (on good days) most sweeteners. So yeah…the diet sucks.
But then there were the undeniable results. The most notable was that I no longer had a major afternoon energy crash. Since I can remember, most days around two or three my body had felt like I must MUST get into bed. This was usually not an option, which resulted in pretty miserable afternoons. Suddenly, sailing through 3 pm with energy to spare, I felt like I had gained a new superpower. My bloodwork also showed a remarkable shift. The level of antibodies against my thyroid dropped from 556 IU/mL to 94, (normal is less than 9), a decline that another doctor told me she had never seen before. I did end up getting pregnant, which is what started this whole thing, and who knows how much that mysterious process is related or not to the changes I made. But in no uncertain terms, qualitatively and quantitatively, my health improved, and I attribute a large part of that to the diet.
So, health-oriented diets: they are great, everyone who is sick or ever might get sick should do them.
Right?
How an anti-inflammatory diet ruined me
It was the spring of 2018 and I was struggling. My startup was floundering, and I was constantly strung out and exhausted—I could sleep for fourteen hours and wake up feeling tired. I was getting sinus colds every two weeks or so. I had chronic diarrhea. Casting around for solutions after being dismissed by an array of specialists, I turned to my long-time acupuncturist, who had helped me through years of chronic foot pain, and signed up for her wellness class. There, I was instructed that there is so much I can do to heal myself: breath work, sun gazing, raw water, bare feet on bare earth, and, critically, diet. Her top recommendations were removing processed foods, gluten and dairy, sugar, and rancid oils (sound familiar?). In this wellness class I was shown videos about monks who shrank tumors through meditation. I was regaled with stories about people who had driven cancers into remission through dietary changes. I thought these stories were both extreme and compelling, but primarily I thought that if there was even a chance that dietary and lifestyle changes could achieve such results, then it was worth trying. There seemed to be no downside, except missing pizza, and I was strong enough for that.
So, when I went on the elimination diet in the middle of 2022, I was primed with these specific beliefs: I can control my health outcomes, diet is a primary way to do so. All it takes is some willpower. I just need to be determined enough, disciplined enough, willing enough to never eat ice cream again. This line of thinking echoes down the decades from the New Thought movement, which began in the mid-19th century as an American and British paradigm of self-healing through “well-mindedness,” the idea that if only you are optimistic and believe hard enough, you can will your body to heal from any ailment. While healing through a diet is different from healing through positive thinking, they share a foundational belief that our good health is squarely within our control. This, of course, implies that the converse is true as well: if your sickness worsens it is a result of your own mental frailty or failure of willpower or lack of trying hard enough.
This line of thinking is a powder keg for a perfectionist like me. Oh, you mean all I have to do is find the perfect diet, and never stray from it, and I can be healthy again and also conceive babies, my greatest wish? COOL, let me spend every waking hour analyzing my every bite, and not just what I’m eating, but also how I’m eating—is it mindful enough? Slow enough? Am I allowing my incredibly intelligent digestive system to send information about the levels of fat and protein in each bite so that my body produces just the right amount of bile for my stomach to perfectly break down the food for the best possible nutrient absorption? Am I eating the exact right mix of good fibers to feed only the best microbes and am I starving the pathogens of sugar? Is my tiredness today because of the ginger soy salad dressing I ate yesterday that may have contained soy sauce which may have had wheat in it? If you have no idea what I’m talking about, I feel very happy for you. This state of affairs is honestly miserable.
I noted above the fact that my dietary changes had a big impact on my energy and blood work. The elimination diet also significantly worsened my constipation, which the functional medicine doctor chalked up to my body “not being able to digest that much fiber.” Another thing wrong with my body! Add that to the list of things to fix. I became nothing short of obsessed with the frequency and consistency of my bowel movements, my window into health, as well as the small vicissitudes in my energy level. I interpreted every cold as a failure of my adherence to my diet—I let something inflammatory slip in and here we are, sick again. I wouldn’t go so far to refer to this relationship with food as an eating disorder, but it does have some of the qualities: the obsession and preoccupation with food, the ruminating over what I did or didn’t eat, the placement of food at the center of my behavior and even identity.
Dang.
Is there any win to be found in here? Are my positive health outcomes worth all the rest? I definitively do not know, and this is why I try my best to never give unsolicited advice about food. I can very strongly see both sides of the argument, I can actually see them both in my own brain right this second: diets can be healing. The very same diets can be ruinous.
Where am I now with all of this? I still do not eat gluten. I relaxed on sugar, and I eat little bits of dairy here and there. I definitely have adverse physical and psychological responses to certain foods (like gluten), or certain volumes of foods (like an overload of sugar), and I take these seriously because they affect my quality of life. A slice of pizza takes me out for two days, that is real and clear to me. But I have really tried to relax my ongoing bite-by-bite analysis. I try to eat some veggies each day, for example, as opposed to ensuring that I have eaten four servings of dark green leafy veggies each day. I have not retested my thyroid antibody levels recently, but I have been able to maintain generally high energy levels and a good quality of life.
But all of this still haunts me, every single day, and I suspect that it’s the kind of thing you can never unsee. I was told repeatedly that I could completely control my health, and I have seen some clear relationships between my diet and my health, and I think will always believe I could be doing a little more, trying a little harder to make myself healthy.
So now my project is to try and find some middle way. It’s really hard to do.
I do take some comfort (and some grief) in the ecological view of autoimmune diseases, which pops up now and then in chronic illness writing. The idea is that the reactions within our bodies are connected with the systems of our world. Sure, I can try and control my food intake, but I can’t control the US food system. I can’t control the air I breathe and or the sedentary lifestyle that my job demands or the fact that our world is not set up for humans to spend a lot of time in the woods. I can fight against all these forces—buying organic, using air purifiers, going on hikes—but I have to acknowledge that it’s an uphill battle. I live in an ecosystem that I can’t control, and am affected by it every day, and that’s a reality I cannot change.
Relinquish control, you say? LOL. I’ll try.
Tell me…
Have you ever tried an anti-inflammatory diet? How did it go?
How much of your attention goes toward your diet/eating these days? Do you wish it was more/less?
Food is fraught - is there anything that helps comfort/relax you around the subject?
I love this. Yes, I have tried all the health diets. Gone on and off them and also tried to find some middle ground. I think beating ourselves up for eating pizza (or anything we know we "shouldn't" eat) is sometimes as harmful as eating the things that make us have an adverse reaction. I've also found that when I over do it, my symptoms get worse. Like, if I constantly eat dairy or gluten, my symptoms worsen over time until it becomes unbearable. But when I keep those things at bay for the most part, some bread or cheese every once in a while doesn't break me. I think for sure the answer lies in moderation, being kind to ourselves, and recognizing we can't control our food and environment perfectly.
I thoroughly enjoyed this post.
I tried changing the food I eat but ultimately whatever the books say we need to figure out what our individual body wants. In the end I stuck with the Med diet which is what I have eaten all my life. I love the variety of all food groups. I no worse off than when I was on stricter diet eliminating whole food groups. I cook my own food so I know what goes into the meal. When I have a craving for chips or biscuits I make sure they have good ingredients. Yes, there is some sugar but that is OK too. There is a balance to everything. I did find my body can't tolerate milk. I use Oat milk but funnily enough I can have some cream (in my afternoon tea, for instance). I have cut back on yogurt but I'm totally find with cheese. When it comes to bread I have tried a lot of different kinds....it is all about the flour. I buy the breads made a the local bakery versus commercial breads. They use different flour. I buy pasta from Italy because not all flour is equal. Italian pasta has a lower gliycemic index so I don't get bloated or feel any gut pain. Each body needs certain foods for comfort and needs to avoid others. We need to be vigilant to how we react to everything we ingest to be able to make better choices.