Sourced from: Wheat Belly Blog, by Dr. Davis, originally posted on the Wheat Belly Blog: 2013-01-12
This 2013 Wheat Belly Blog post is mirrored on the Inner Circle PCM for historical reasons (it’s referenced by other mirrored blog posts). The original (2011) Wheat Belly book did not have this concise list. The later Wheat Belly Total Health did. The current program has similar lists and site resources with evolved detail. In particular, the Bowel Health topic gave rise to its own book, Super Gut. The probiotic products listed below are no longer endorsed by the current program. Original links have been checked, updated, and annotated as needed due to brand changes.

Nutritional supplements in the wake of wheat elimination

Consumption of modern wheat distorts health at many levels. Remove wheat, like removing a splinter that makes your finger hot, sore, and open to infection, and the body needs to readjust to this new lifestyle.

There are a number of strategies to consider to accelerate the adjustment. And there are other strategies worth considering that help recover overall ideal health. This last item, of course, is a huge issue, but there are several basic efforts that provide outsized benefits.

Among the issues/strategies to consider:

Bowel health
Remove this great disrupter of normal bowel flora called modern wheat and you need to transition back to healthier bacterial populations. After removing wheat, some people experience constipation and bloating (often misinterpreted as lack of fiber), more rarely diarrhea. Both situations can be addressed by taking a probiotic preparation that provides 50 billion CFUs (colony forming units) of lactobacillus and bifidobacteria species. I’ve had success with Renew Life (note: has since become a Clorox® brand) and Enzymatic Therapy (note: has since become Nature’s Way) brands. Because intestinal bacteria should repopulate fairly quickly, 4-8 weeks of probiotic replacement usually suffices. (Continuing need usually signals that something continues to disrupt resumption of healthy bowel flora.) If this dose of probiotic is rough on your gastrointestinal tract, you can try a lower potency preparation, e.g., 10-25 billion, for the first few weeks. A softer, slower approach is to take advantage of the “prebiotic” effects of inulin, a fiber/polysaccharide contained in some of the sweeteners used in Wheat Belly recipes, such as powdered stevia extracts with inulin, Swerve, and others; inulin encourages growth of lactobacillus species.

If this fails to provide relief from bowel complaints, such as acid reflux/heartburn, constipation, thin or liquid stools, cramps, or bloating, then it is best to undergo formal evaluation to assess for pancreatic insufficiency/failed cholecystokinin signaling, biliary insufficiency, bacterial overgrowth resistant to wheat elimination/probiotic supplementation, and hypochlorhydria. This evaluation is best undertaken by a functional medicine practitioner, naturopath, or chiropractor with interest in these conditions. An occasional person does fine on his/her own by supplementing with a pancreatic enzyme supplement such as Enzymatic Therapy (now Nature’s Way) Mega Zyme or Renew Life (now a Clorox brand) ParaZYME.

Vitamin D
I count vitamin D as secondary only to wheat elimination as among the most powerful strategies I have ever witnessed to regain ideal health. While a wheat-free diet is richer in vitamin D from eggs, mushrooms, fish, and meats, most people nonetheless remain deficient. Because most of the people I know refuse to run naked outside in a tropical sun but live indoors and/or wear clothes, and because we lose the ability to activate vitamin D as we age, supplementation is necessary for most people to achieve desirable blood levels of 25-hydroxy vitamin D. Having restored vitamin D in thousands of people over the past 6-7 years, I have found that most people require 4000-8000 units per day in gelcap form to achieve a desirable 25-hydroxy vitamin D level; I aim for 60-70 ng/ml (150-180 nmol/L). (Tablets are poorly or erratically absorbed.) Just as removing wheat mimics the natural diet of Homo sapiens that was without grains for 99.6% of the time we have walked on earth, so vitamin D supplementation restores the vitamin D we should have obtained from consumption of organ meats, mushrooms, fish, and the eggs of birds, as well as skin exposure to sun when possible.

The list of potential benefits of restoring vitamin D include relief from winter “blues,” heightened mental clarity, elevation of mood/relief from depression, improvement of memory; increased bone density/protection from osteoporosis and fracture; increased HDL cholesterol, reduced blood sugar/enhanced insulin sensitivity, reduced blood pressure; enhanced athletic performance; protection from colon, breast, prostate and other cancers; among many, many others.

NOW, Carlson, Nordic Naturals, as well as Sam’s Club and Costco, sell excellent vitamin D preparations at reasonable cost.

Omega-3 fatty acids
If you were a wild-living Homo erectus living one million years ago, hunting the African savanna, or an Ice Age Cro Magnon scratching out a living in the cold Northern European Plain of stone blades, you’d consume the snout, brain, heart, kidneys, liver, and hindquarters of auroch, ibex, reindeer and other creatures. Several pounds of animal flesh and organs per day was not uncommon. If you had access to coastal waters, you might also spear fish or scavenge shellfish. In the appropriate environment, you might also consume seal, whale, or walrus. You would thereby obtain rich quantities of omega-3 fatty acids that play varied roles in the human body, including participating in brain health and modulating the after-eating (postprandial) processing of meal byproducts.

Modern diets in which we are advised to cut fat and cholesterol and eat more “healthy whole grains” are woefully deficient in omega-3 fatty acids. A typical RBC omega-3 index (one method to gauge your omega-3 fatty acid content, obtainable as a blood test via fingerstick) of an average American is 3%, i.e., 3% of all fatty acids in red blood cells are omega-3s. The omega-3 RBC index of a wild living Homo sapiens who consumes fish and animal flesh/organs would be 8%, 10%, even higher (depending on the environment and the mix of animal and fish food sources). Interestingly, the risk for sudden cardiac death and cardiovascular events has been shown to drop off dramatically with an omega-3 RBC index of 10% or greater.

Nearly everyone achieves an RBC omega-3 index of 10% or greater with intakes of EPA and DHA (the two principal omega-3 fatty acids) of 3000 to 3600 mg per day, readily obtained by supplementing fish oil. (This is NOT the quantity of fish oil, but the quantity of EPA + DHA contained within fish oil.) The best fish oils are in the highly-purified triglyceride form, a form that requires additional purification steps beyond that usually taken to create the common fish oils on the supermarket, drugstore, or health food store shelves (the less well-absorbed ethyl ester form). The additional purification means triglyceride forms contain fewer parts-per-billion mercury, PCBs, dioxin, or other contaminants, and is better absorbed. (Notably, the prescription form of fish oil, the widely-prescribed and perversely expensive Lovaza, is the ethyl ester form.)

Supplementing omega-3 fatty acids reduces the postprandial excursions of lipoproteins (thereby reducing cardiovascular risk), reduces triglycerides, raises HDL cholesterol, reduces the proportion of small LDL particles, reduces blood pressure, enhances parasympathetic (“relaxation”) tone, and exerts anti-inflammatory effects.

The best sources of the triglyceride form of omega-3 fatty acids include NutraSea from Ascenta (now Nature’s Way Canada), Nordic Naturals, and Pharmax.

Iodine and thyroid health
If thyroid function is low, even if just by a bit, it will 1) impair your ability to lose weight, even adding weight, sometimes substantial, 2) increase LDL cholesterol and triglycerides, and thereby 3) increase cardiovascular risk. It can also be responsible for low energy, inappropriately cold hands and feet, constipation, thinning hair, and other abnormal phenomena.

Iodine is crucial for health; without iodine, thyroid hormone levels decline, you develop colds hands and feet, become tired, constipated, retain water, gain weight, develop heart failure and can eventually die. Iodine is critical for thyroid health, as it is required for the thyroid gland to manufacture thyroid hormones, T3 and T4. Iodine is also important for breast health (reducing fibrocystic breast disease, a potential precursor to breast cancer) and oral health (as salivary glands concentrate iodine for antibacterial effects).

Problem: Unless you live in a coastal environment, the food you consume likely lacks iodine if it is sourced inland. (All the iodine on earth is in the ocean.) It means that people in the midwest or other inland areas can experience iodine deficiency, as they did up until the first half of the 20th century when goiters (enlarged thyroid glands due to iodine deficiency) were everywhere, affecting 25% of the population. This is why the FDA passed a regulation in 1924 that encouraged that iodine be added to table salt, a time in which there was no TV, radio, internet, and much of the U.S. was illiterate and/or rural. Early 20th century Americans were therefore encouraged to use more salt to “Keep your family goiter free!” (This was the actual motto on the Morton’s iodized salt container.)

Excessive salt use (along with the salt-retaining properties of modern wheat) led to problems with sodium in some populations. The FDA responded by urging Americans to cut their salt consumption. People listened . . . and iodine deficiency reappeared, showing up as the symptoms listed above, the symptoms of underactive thyroid, or hypothyroidism.

Iodine deficiency is readily reversed by supplementing an inexpensive iodine supplement in capsule, tablet, or liquid form. I generally ask patients to supplement 500 mcg per day, a level higher than the 150 mcg per day RDA but a level that does not generate toxicity. (Rare side-effects are generally confined to people who have been severely iodine-deficient for an extended period and develop an overactive thyroid response, signaled by jitteriness, anxiety, and lab values suggesting an overactive thyroid, or hyperthyroidism. This is distinctly uncommon.)

Along with iodine deficiency that impairs thyroid function, we have all been exposed to a wide range of organochemicals: perchlorates residues from synthetic fertilizers in your produce, polyfluorooctanoic acid from non-stick cookware (which can persist for 10 years or more in your body or in groundwater), and many others. This can result in hypothyroidism, a very common condition. While approximately 20% of people will experience partial or total restoration of thyroid function with just iodine supplementation, the other 80% with hypothyroidism will require prescription thyroid hormone replacement. The great majority of people do best with restoration of both T4 and T3 thyroid hormones, not just T4 (Synthroid or levothyroxine). It means taking levothyroxine (T4) with liothyronine (T3) or a combination tablet containing both, such as Armour thyroid or Naturethroid. The hurdle is in trying to find a practitioner to 1) perform a full thyroid assessment, then 2) address all aspects of thyroid health, including T3.

Magnesium
Wheat consumption over many years impairs intestinal magnesium absorption. To make matters worse, modern water treatment (either municipal or home water filtration) removes nearly all magnesium from drinking water and modern produce generally contains much less magnesium (60-70% less is typical). The result: widespread magnesium deficiency. This expresses itself as cramps in the hands and calves; constipation; heart rhythm disorders; and (modest) distortions of blood sugar and elevated blood pressure.

To remedy, consume foods rich in magnesium. While green vegetables and nuts contain some, seeds–sunflower, pumpkin, sesame–are unusually rich in magnesium. Most people, however, do better by supplementing magnesium. Magnesium malate is my preferred form, such as Source Naturals, 1200 mg (total tablet/capsule weight) two or three times per day. The malate form (the malic acid “salt,” an acid from apples and fruit) is well-absorbed and least likely to cause diarrhea. (Most other forms of magnesium cause loose stools, especially the oxide form.) If constipation is a real bother for you, magnesium citrate is a better stool softener, though a bit less well absorbed; 400 mg two or three times per day.

Eliminate all modern wheat, eat real single-ingredient foods, and follow the suggestions detailed above, and I predict that 80-90% of all modern chronic conditions, including hypertension, “high cholesterol,” diabetes and pre-diabetes, joint pains, gastrointestinal struggles, depression and other psychiatric difficulties, as well as literally dozens, if not hundreds, of other conditions, will recede, if not outright disappear.

Interestingly, note that, by eliminating wheat, supplementing vitamin D, omega-3 fatty acids, and iodine, we are recreating the life of a primitive human–no primitive human consumed wheat or grains; they obtained vitamin D through sun exposure by living outdoors with greater surface area of skin exposure and/or consumption of foods containing it; obtained omega-3 fatty acids through consumption of animal organs, especially brain, and fish and shellfish, and (ideally) consumed coastal plants and animals containing iodine; consumed nuts, seeds, and drank water from a flowing stream rich in magnesium. In other words, these are the strategies we KNOW are consistent with the life created by human evolution.