It's time to tell you what I know and you may not want to hear. Unlike many or most other diet advocates, we don't hide from problems around here. We self-experiment, use evolutionarily-backed reason and principles, form reasonable hypotheses, experiment more, figure it out, and fix it. We're animals, and there will be a way, for everyone.
Don't be surprised, but not everyone reports all systems normal -- or even great -- on the Paleo-like diet long term; which, generally, is the elimination of grains, sugar, processed food, vegetable oils (eat meat, fish, fowl, natural fats in abundance, veggies, some fruit, some nuts). Some include dairy to tolerance and some -- including myself -- don't worry about starch so much, now that I'm at a normal weight and body composition. But most -- including myself -- still stay low to moderate carb. I probably average less than 100g per day, but that would be an average.
Having the blog I do, I get lots of comments and lots of emails. Here's a quick summary of the problems I've seen reported, and I'm generally going to go from most common to least, based on my general impression.
- Diarrhea. This is a big one, and one I've suffered from, time to time and rather inexplicably.
- Hypothyroidism. I was hypothyroid and on synthetic T4 for years before, even as I was gaining weight. When I rapidly began to lose and realized I didn't need the GERD or allergy meds anymore, I willy-nilly dumped the T meds as well. Then I tested 16 on TSH (you want about 1 or less). I stuck with the plan and TSH actually improved, but only to 11. Then I went on natural T, i.e., Armor (which includes T3, because sometimes the problem is an inability to convert from the inactive T4 to active T3). Now my numbers are pretty normal. But for others, hypothyroid seems to manifest after going on Paleo.
- Lack of motivation, depression. While I was losing fat, I was sky high exuberant All. The. Time. Once I got below 185 (5'10), things began to change for me and I didn't feel like I was on a high so much. There was even depression sometimes and I've heard this reported by others. In my case, futzing around with added fat seems to have done the trick and now I'm flying pretty high most of the time. I add butter -- lots -- to just about everything, and then there's the "Liquid Fat Bomb." For me, that's an "energy drink" like none other.
- Super high cholesterol. This is an issue I have not experienced at all, and my "numbers," for what they're worth, have only gotten better with HDLs in the 130s, LDL (direct measure) in the 60s, and Trigs -- what you would expect for a low-carber -- in the 50s. But I've gotten emails from a few people who have gone from total C in the low 200s pre-Paleo to over 500 and 600 and climbing. Heres' a recent example, the worst one (there are others, but less pronounced): pre-Paleo TC of 240, now nearly 600. He eats very LC and even Trigs have climbed from low 100s to nearly 170 (and LDL from 150s to 480s!!!).
- Weight gain. I've only had this reported by women, so far. My own gains have never been more than 3-4 pounds, and I've always considered that just noise. But a couple of women have recent reported gains of as much as 10 pounds, and these are people who weight less than 150.
I have a general speculation that I wanted to put out there, and then leave the whole shebang up to readers and myself to dig deep. There's some people who need help out there; and especially, I'd love some of my MD friends to weigh in if they can.
I speculate that the periodic diarrhea along the way some experience is a result of toxins stored in body fat being released. Funny, but I put this out there to an emailer the other day with this problem, and then just last night, I watched the latest episode of House...and at a point during his effort to diagnose, he speculated that the particular problem could be toxins stored in body fat being released due to reduced caloric intake. (I mainly watch House 'cause he's an arrogant, irreverent asshole, and therefore pretty cool.)
I'm wondering about the multi-faceted effect of losing fat. As I've blogged, no such thing as a low-fat diet; it's like eating lard. When you're losing weight, a lot of your energy is fat from your own body. I think perhaps the low-cal and low-fat dieters don't get the high that Paleos like myself did because they're losing weight through malnourishment (In terms of dietary intake, fat making up the balance). But a Paleo diet rich in meat & fat forms a great foundation, upon which the added fat from your own body just puts you over the top. The most common experience from Paleos initially losing weight? "I feel great!"
But what happens when the fat is gone?
Alright all you brains. Have at it.