The Revenge of the Pike

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Fatigue and Pain Sent Her to the ED: Medical Mystery Solved

Dr. Michael Ruscio

Aglaee Jacobs M.S., R.D.: Digestive Health With Real Food

Intestinal Methane Overgrowth

Keri writes:

Gluten tag from your old home of New Braunfels! I really appreciate you two and your no nonsense, but super informative podcast. It always hits home for me. I have gone back and forth between keto and carnivore since 2019. Felt great at first, but the last 18 months have had weight gain, bloating and constipation. Never really had a weight issue before. I’m 5’7” and have averaged 135 pounds pretty consistently. I was referred to a gastroenterologist, did the breath test, and tested very high for intestinal methanogenic overgrowth (IMO). The doctor gave me a two week dose of xifaxin and that was it. No other protocol or follow up. I just finished the antibiotic with no relief. I am an active 52 year old, weight train 3 to 4 days a week, take my dog for a hour walk almost every day, gets lots of Texas sun, drink only water with LMNT of course. My two part question to the both of you is how in the world was I blessed with this lovely methane bug and is there any way to rid myself of it? Any supplements? I am taking berberine. I also have hypothyroidism and take desicated thyroid for that. The more I research, the more confused and overwhelmed I get. It seems it’s a little different from your standard SIBO. I’ve heard some doctors say to follow fodmap and others go all the way to carnivore. Any suggestions would be super appreciate, as I value your insight greatly.

All the knowledge, how to implement it

Tracie writes:

Hey Robb and Nikki, I've been listening to your podcast since my first rebel reset back in 2021 and have greatly appreciated the work that you do and the community I have found here at the healthy rebellion. I feel like I have all the knowledge that I could ever need to optimize myself, but I'm still not implementing it in the right way to improve my body composition. I feel like I've been doing B+ work since 2021, and A+ work for the past 3 months but I haven't seen any results. I'm a type A personality but I've learned to forgive myself for not being perfect, and have added a little meditation in my life. I'll lose 5-10 lbs and then it always comes back. I'm 33, female, 5'4", and 175 lbs. I was 125 lbs when I was vegan in college at 20 but of course had no muscles and mild anemia, I figured that was still a healthy target weight for me. I don't even care what the scale says, I just want to look good naked! I slowly gained weight over the last decade due to burritos, pizza, beer, stress, and smoking. I really was a hot mess until 2020. I've been approaching my failure through the lens of Boyd Eaton's evolutionary discordance hypothesis. I'm wondering if it's appropriate to tackle body composition issues using the old evolutionary discordance hypothesis, and if there have been any recent updates to it? 

I figure I'm not losing weight because my nutrition/exercise regime is still too much of a departure from the ancestral model but I've been eating paleo since 2021 and feel like I have balanced my 4 pillars. I'm taking Chris Kresser's Adapt Natural bundle to cover the declining nutritional quality of our foods. I use 2-3 sticks of LMNT a day, sometimes an extra to compensate for the hot and humid east coast summer. I Started doing Paul Saladino's animal based thing in August 2022 and it was great post gut dysbiosis (that was October 2021) but I also feel like the fruit and dairy are not helping the body composition. I hate to not eat them since they are nutrient dense and I do like how I feel.

I went to see Dr. Ruscio for the gut dysbiosis and feel fully recovered but my relationship with vegetables has never been the same and Paul caters to that. I see people rocking the vegetables in the healthy rebellion though and I sometimes wonder if I could do keto, although I do suffer from hypoglycemic episodes and get really lethargic when I try to get down to 25 grams of carbs. I have taken the Keto Masterclass. I feel like my electrolytes are on point though so I should be lethargic, and I love salting my food and eating salty olives/pickles. I only drink 12-18 ounces of coffee day, so that doesn't seem like the culprit. 

What really annoys me and why I decided to write to you is because I am now exercising the most I ever had in my life and still not slimming down. I still just look puffy all over. I hike 5-7 miles a week with a 10-15 lb backpack, and one of those hikes is up a small east coast mountain. I get 5 miles of walking in most days a week, I run 3-4 miles a week 1-2 miles a day on top of the walking, and am now adding BJJ 3-4 hours a week, I don't lift weights and know this would be huge but I don't know how and cant afford a personal trainer yet. Hoping the BJJ does the trick, my training load is high but its enjoyable. I have used chronometer to track what I'm eating periodically, so I know I get 125+ grams of protein, 120 from animal sources (lots of steak, chicken, and pork) but I do eat 2300 calories easy. I'm doing 120-150 grams of carbs from mostly fruit, an ounce of maple syrup sometimes or a few tablespoons of honey also contribute. Diana Rogers suggests 1500 on her sustainavore course as a starting point. How many calories should I go for? That's got be my issue, I'm eating enough calories to maintain weight and I got to go into a comfortable non-lethargic deficit. Advice would be much appreciated!

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