Tag Archives: autoimmune

The Functional Medicine and Gut Health approach to managing chronic conditions including eczema

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I have written briefly about Functional Medicine earlier in my posts. I have also mentioned how I have gradually moved towards it over the past couple of years through my research to find a less harmful way of managing my daughter’s extremely severe eczema. I  have shown her to a Functional Medicine practitioner in London this past July and got some tests done to determine her Gut Health. The tests show that she indeed has a “leaky gut” or “intestinal permeability” issue. But before I get to that, in this post I would like to cover Functional Medicine and Gut Health in much more details and why we should all know more about it. (Of course just to be clear, I write as a parent who is trying out a Functional Medicine approach for her child and not as an expert or health professional).

A BESPOKE medical approach

We are all used to wearing clothes which fit us well and pay a premium if we need to for clothes which are customized for our body shape and size. But when it comes to health, we are used to an approach which is just the opposite. It is a “one size fits all” approach!

This has worked well in the past when we were dealing with infectious diseases like chicken pox, measles, cholera, small pox and others which have been brought under control which much-needed antibiotics and antifungal medicines. But a lot of the medical issues that we are facing today are due to not only our genetic predisposition, environment but also our lifestyle choices (food habits, diet and exercise) and stress. Hence, most of the times we do not realise that a lot of our chronic medical problems (autoimmune disorders like rheumatoid arthritis, coeliac disease, Grave’ disease and others like migraines, digestion issues, allergies, psoriasis etc) cannot be wished away by just popping a pill.

We will need to look beyond pills to deal with most chronic conditions. Luckily for us, there is an entire stream of medicine which is geared to do just that.

What is Functional Medicine?

Functional Medicine is an approach which is different from the conventional way that we use to deal with any kind of illness currently. Conventional medicine is of course necessary for dealing with acute illnesses which require immediate intervention either through medication or through surgery. So one needs to be very clear whether the health issue is an acute illness or a chronic one. Also, while conventional medicine focuses on symptom relief, Functional Medicine addresses the root cause of a problem. It has a patient centric approach that tries to find the root cause of any illness or condition by looking at each patient differently based on his/her lifestyle choices, food and dietary habit, genetic and environmental factors and other psychological factors like stress which has a tremendous bearing on a person’s well-being.

Functional Medicine is also science based and combines conventional medicine with a holistic approach by adding diet, supplements and stress management techniques etc which are not usually used in conventional medicine treatments. What is also important that it uses scientific methods like laboratory testing and latest diagnostic techniques to find out the root cause of any illness. Functional Medicine thus provides tools for the patient and the practitioner to customise and design a health management programme for each individual which is geared up to create health and not just to banish illness.

Ayurveda- a holistic approach towards diseases

Here I would like to mention briefly about our traditional treatment philosophy which is also patient centric and holistic in its approach towards diseases. In India, we have a tradition of healthcare called Ayurveda which translated in English literally means the “science of Life”. It focuses on how to prevent illness and how to address the root cause if it happens and is one of the earliest holistic treatments known to man. In that sense Ayurveda has a lot in common with Functional Medicine. But with the progress of Western medicine it has taken a kind of backseat in India over the years.

(I have written about our experience with Ayurveda in my earlier post- https://eczema-anindianperspective.com/2014/08/25/our-tryst-with-ayurveda-and-our-first-eczema-support-group-meeting-in-mumbai/).

Ayurvedic treatments are based on the principles of wholeness and balance. That is why the mind, body, spirit, emotional balance of a person as well as diet, lifestyle, stress is considered to be as important for treatment if not more than the actual medicine. It emphasises on treating the cause and not just the symptoms and hence looks to preserve a person’s well being and not just treat him. Unfortunately, due to various reasons (which is beyond the scope of this blog) ayurveda has come to relegated as an “alternative” medicine. This was all the more so due to a revolution in the history of medicine brought about by the discovery of antibiotics in the 20th century which has saved countless lives. But today we face a very different challenge which may need to be tackled quite differently.

Chronic illness- a growing phenomenon

As we all know the use of antibiotics has helped saved millions of lives since its discovery and has even helped eradicate diseases like smallpox etc. This new era of medicine honed its skills in targeting a particular agent which caused an infectious disease and then evolved to treat a particular symptom caused by a disease. This is the current approach of medicine towards all illnesses. But while acute medical issues have been dealt with very well by conventional medicine, chronic and lifestyle related issues are not faring as well. And the incidence of chronic illnesses are increasing exponentially led by the USA and followed by other countries all around the world.

(Sources: http://www.who.int/dg/speeches/2011/global_forum_ncd_20110427/en/

http://www.cgdev.org/doc/expert%20pages/nugent/Nugent_Annals_article.pdf)

A chronic illness also does not go away on its own, indeed grows worse over time and usually has multiple causes. The medications usually only treat the symptoms which make recurring episodes a regular feature. This means leading a life visiting doctors, popping pills and putting up with many symptoms. This is even more problematic since ironically we are living longer lives than our previous generations.

Also a myth that has been associated with chronic diseases and developing countries like ours is that chronic diseases affect only the elderly and wealthy parts of a society and is prevalent primarily in developed countries. That notion no longer holds any truth. This problem is all the more compounded when you add in the economic costs associated with the growing burden of chronic noncommunicable diseases. We now not only have to deal with the rising healthcare costs associated with chronic illnesses over long periods of time, we also have to factor in the loss in income due to same.

In India, the incidence of  Type 2 diabetes is steadily reaching epic proportions especially in the urban areas. Autoimmune disorders like Rheumatoid Arthritis, eczema and others like heart diseases, migraines etc are also on the rise.

Some of the articles whose links are given below will give you some idea of the criticality of this situation globally and in India-

http://www.who.int/chp/chronic_disease_report/part1/en/

http://archive.oxha.org/initiatives/economics/chronic-disease-an-economic-perspective

Gut health and Functional Medicine

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Functional Medicine recognises that though the symptoms may be similar in two different individuals, the medical approach required to deal with them will usually be radically different. This is due to the fact that while the manifestations of the disease is similar in both individuals, the genetic makeup of both are different, environmental factors like exposure to toxins are different and their lifestyles will also be completely different.

In this post I am focussing on one major aspect of Functional Medicine which is being recognised as the root cause of most chronic conditions including autoimmune diseases. That aspect is our “gut health” (or lack of). The others include genetic predisposition, lifestyle and environmental factors concerning each individual.

We are slowly coming around to this very important fact that our microbiome (or the many thousands of types of bacteria and other microorganisms which reside in our gut or intestines) determines our health and causes many autoimmune and other disorders when compromised. We carry about 2 kilograms of these microbes in our gut consisting of roughly tens of trillions in numbers and a part of the microbiome is unique to each of us.

This intestinal mircoflora has various important functions such as

  • digestion and absorption of certain foods
  • aids in the production of some vitamins such as Vitamin B and K
  • it has a protective function in keeping toxins, allergens out and balancing  out the unfavourable microbes
  • forms a protective barrier as a part of our immune system

Our gut system becomes off-balance and our health suffers when there is too much of harmful, pathogenic microorganisms like bad bacteria, yeast and parasites and too less of the health promoting bacteria. As mentioned earlier, this leads to chronic illnesses which are far more serious than just indigestion and heartburn.

Our gut health can become adversely affected due to various reasons like

  • a high calorie, sugar laden, processed food, low fibre diet that promotes the wrong kind of microflora
  • high use of medications like antibiotics which disturb the balance between the good and the bad bacteria
  • undetected low grade food intolerance and allergies (gluten, eggs, dairy etc)
  • deficiencies in pancreatic enzymes leading to issues with digestion and absorption of foods
  • toxins like mold, chemicals, pollutants etc which affect the gut and thus the health adversely
  • and last but not the least stress

Another serious issue which can crop up due to poor gut health is intestinal permeability or leaky gut syndrome. The lining of the gut acts as a barrier by containing the undigested food, toxic wastes and harmful microbes and filtering out only the required nutrients after breaking down the food into vitamins and minerals. This incredibly useful gut immune system may develop tiny gaps in the intestinal wall and allow leakage of undigested food particles, microbes and metabolic wastes which the body would then recognise as foreign invaders. This is called the leaky gut syndrome and can cause one to become allergic to all kinds of foods since the immune system starts defending the body against what it perceives to be foreign invaders. The hyperactive immune system if left untreated over prolonged periods of time can create inflammation and may eventually manifest itself in the form of various chronic conditions. Depending on the symptoms the illness is then classified as digestive disorders like Irritable Bowel Syndrome; migraines, chronic fatigue, arthritis, eczema and other autoimmune conditions.

(Sources for further reading-

http://www.medicalnewstoday.com/articles/290747.php

http://www.ncbi.nlm.nih.gov/pubmed/22583600

http://www.medicalnewstoday.com/articles/285122.php)

How is Functional Medicine really useful?

Abstract word cloud for Gut flora with related tags and terms

Given this backdrop Functional Medicine is poised to play an important role. By customising medical care based on the individual and not the symptoms of the illness, Functional Medicine is concerned with the problems afflicting the various organs and systems inside the body. As mentioned earlier it our intestinal (or gut) health which determines which nutrients are absorbed by our bodies and which toxins, mircobes and irritants are expelled. If anything happens to disturb this balance and affect our gut health adversely, it affects our health in myriad ways. (I have briefly touched upon this topic in my earlier post- https://eczema-anindianperspective.com/2015/06/12/not-all-those-who-wander-are-lost-eczema-and-our-ongoing-journey/). Functional Medicine focuses on this very important aspect of our health by trying to heal the gut health first and foremost in tackling chronic illnesses and autoimmune conditions.

Some of the basic changes that we can make to heal our gut would be

  • eat whole unprocessed foods like vegetables, fruits, nuts seeds etc which are high in fibre, nutrients
  • limit intake of sugar and processed foods
  • cut out/limit foods which you are sensitive to (gluten, dairy, eggs, shellfish)
  • take help to increase healthy bacteria in the gut and repair the instestinal wall (if damaged)

Functional Medicine also advocates the 4 R programme which acts as a framework based upon which we can make changes to improve and repair our gut health.

1. Remove- remove the allergens ( gluten, dairy, eggs, shellfish etc), inflammatory foods like sugar, processed foods and other irritants like alcohol, tobacco etc

2. Replace- replace the good stuff which are essential for good gut health like digestive enzymes and of course whole, unprocessed plant based foods, low sugar diet

3. Reinoculate- this step is all about restoring the balance of good bacteria in the gut microflora.This is done by taking prebiotic and probiotic supplements (containing the benefical bifidobacteria and lactobacillus species).

4. Repair- the necessary ingredients have to be reintroduced for the gut to repair itself which includes supplements like zinc, omega 3 fatty acid and vitamins.

There are tests available for determining the gut health. I am not sure about the availability of these tests in India yet though there is a clinic in Kochi called Heal Wellness which claims to be the first IFM certified clinic in India. (I am also not aware of any further details other than that what they have provided on their website).

A few of these tests include intestinal permeability test through urine samples; nutritional evaluation tests which can determine nutritional deficiencies and hence help in supplementation and comprehensive stool tests to determine the microbiome health in the gut. There are Functional Medicine practitioners who are health professionals trained and certified by the Institute of Functional Medicine (IFM) who can help in determining which tests need to be carried out and the subsequent course of action.

The Institute of Functional Medicine is the main body for Functional Medicine and is based in Santa Fe, USA. It was cofounded by Dr Jeffrey Bland who is considered to be the father of Functional Medicine. He has also written several books on this subject and if you want to know more about chronic illnesses and why they happen; the role of Functional Medicine etc you can read his book ” The Disease Delusion“.

(You can read more about IFM here – https://www.functionalmedicine.org/AboutFM/History/)

Physician- heal thyself!

There are some well-known Functional Medicine practitioners who though trained initially in conventional medicine are now following Functional Medicine principles in their work. Some of them had a taste of Functional Medicine when they suffered from their own health issues. Where conventional medicine failed them, Functional Medicine was able to control and even reverse the chronic condition in one case. Now they are all following Functional Medicine approach in treating themselves and their patients. You can read about them here-

Dr Mark Hyman (https://www.functionalmedicine.org/AboutFM/ourteam/faculty/bios/hyman/)

Dr Robert Hedaya (https://www.functionalmedicine.org/AboutFM/ourteam/faculty/bios/Hedaya/)

Dr Gerard Mullin at John Hopkins Hospital (http://thefoodmd.com/about/)

Dr David Perlmutter (http://www.drperlmutter.com/)

Dr Mark Houston (https://www.functionalmedicine.org/AboutFM/ourteam/faculty/bios/Houston/)

Dr Amy Myers (http://www.amymyersmd.com/2013/01/heal-your-gut-heal-yourself/)

Dr Terry Wahls (http://terrywahls.com/about/about-terry-wahls/)

Our health in our hands

Fruits And Vegetables Diet Word

Our health is determined by a myriad factors but the basic ones are our diet; lifestyle; exercise and movement levels; stress related factors; our environment; personal relationships and our relationships within the community.

Also, my experience of dealing with my daughter’s severe eczema over the past few years has taught me that we need to take some responsibility for our own health instead of leaving it completely to our doctors. We also need to take care of our health not just when we fall ill but much much before.

That means taking care of our bodies and treating it as a friend rather than an adversary that needs to be either tamed (through various fad diets) and/or ignored (either intentionally or unintentionally) till such time an illness crops up. (Of course one can always fall ill even after taking adequate care but then like much else in life there are no guarantees here only possibilities) I would rather try to explore all the possibilities that life has to offer rather than have regrets due to a lack of effort, wouldn’t you?

The good news is that today we have access to information, knowledge and the experiences shared by other people on their own journey from sickness to health that we can all learn from. We can thus work along with our health professionals and use their expertise and knowledge to improve and maintain our own health. An example of a person coming to this realisation the hard way and which proved to be a major turning point in his life is the top tennis player in the world, Novak Djokovic. You can read about his story in the book “Serve to Win”. One should however keep in mind that each of us is unique and what works for one person will not necessarily work for another. You will have to patiently find out what works for you and your loved ones.

“Take care of your body; it’s the only place you have to live”

Take Care Of Your Body Quote

I started writing this post planning to simply introduce the Functional Medicine approach to dealing with chronic illnesses like eczema, diabetes, migraines etc based on my understanding. But I realised that I also needed to include a detailed background given the increasing incidence of these illnesses in our lifetime. I hope I have been able to share a bit of what I have understood about this issue that you may or may not have been aware of.

I started on this quest because of and for my daughter who suffers from severe eczema and which is being managed through strong immunosuppressive medications. My family and I have reached this stage through a lot of trial and error but always with the guidance of our doctors who have been with us every step of the way. We have already seen some results with the changes we have made in our daughter’s diet but we still have some way to go. We will be starting treatment based on Functional Medicine principles soon for her with the help of an IFM certified practitioner. We are taking an informed decision based on studies backed by science and evidence and which has helped so many others like her to cope with various chronic illnesses. Even if we can simply heal her gut to begin with will itself be a minor victory.

I share all this with you so that it may encourage you to find out a bit more for yourself if you need to. We often do not realise how much more can be done to improve the quality of our lives if we really wish to. As one wise person put it very simply, we have only one life and one body. Our health depends on what we do with it.

“Not all those who wander are lost” (eczema and our ongoing journey)

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There are many of you who have been following us on our journey as we deal with our daughter’s severe eczema over the years. There have been many ups and downs; times filled with a seemingly never ending despair and other times where we see the silver lining that is hidden behind the dark clouds. We have many nights of sleeplessness, days and nights filled with endless itching and bouts of crying when it gets too much sometimes. There is also THE question which comes up once in a while, “Why me?” I have no real answer to her question which would satisfy her need to know.

But I do know this! 

Through all  these times we have experienced many precious moments filled with small pleasures, much love and loads of fun. We have learned how to appreciate all that we have by focussing on all the good things in our life rather than all that we do not have. This helps to put things in perspective and never fails to bring a smile to our faces. We have also learned to accept that our life and our daily routine is usually quite different from others and we have made peace with it. We simply have different requirements than most other families when we travel, eat out and socialise amongst other things.

We have come to realise over a period of time that this is our new “normal”. Whatever normal family life we had envisioned for ourselves when we had our first child fell by the way side when our daughter’s eczema became a huge part of our lives. We have simply changed the definition of leading a “normal” life and now use one which works for us! 

Our life has thus changed drastically over the past few years in terms of lifestyle, food habits and priorities. I have been sharing these changes with you through my blog for almost two years now. In this post, I have shared the actual changes that we have made to our food habits over the past 9 months or so.

Our diet today based on eczema safe foods

 

I had mentioned in my post last month (https://eczema-anindianperspective.com/2015/04/08/you-are-what-you-eat-eczema-and-food/) that I would write about her diet in details in my next post and here I am!

It has been roughly about 6 months since I started to follow a very specific diet to control my daughter’s eczema based on the book “The Eczema Diet” by an Australian nutritionist, Ms Karen Fischer. The initial 3 months have been the toughest so far with restrictions on the number of fruits, vegetables and spices amongst other things. I did however prepare her mentally over a period of time prior to starting her on the diet to make this transition as smooth as possible. This is a huge change in lifestyle since food comprises a big part of our lives and this change needs to be handled well especially for a child. Once my daughter understood why we were making these changes and how it had benefited others like her suffering from eczema, she became a willing participant. 

These restrictions are to repair my daughter’s system from within by restricting the intake of the various naturally occurring chemicals (salicylates, sulphites and MSG), allergens, anti nutrients and restore acid alkaline content in the body. Eczema unfriendly food groups like ,wheat, dairy, eggs, sugar etc were all removed even though initially I did give her low gluten foods like spelt flour, rye and barley (no wheat). Eventually over the past few months her diet has been gluten and dairy free, she mostly has organic grains and produce, no refined sugars are added (only much less acid producing maple syrup and golden syrup in low quantities is allowed) and mostly free of preservative/chemical/colouring free (the only exception is the occasional rice pasta).

Simultaneously the acid-alkaline balance in her body is being restored through a higher intake of alkalising foods like moong bean sprouts, celery, beetroot, carrots etc on a daily basis and taking only those acid-forming foods like legumes/wholegrains/chicken etc which are good for skin or are nutritious in other ways. Restoring this acid-alkaline balance is very important because our diets nowadays tend to be filled with mostly acid forming with foods like bread (containing yeast); sugar in processed foods like breakfast cereals, bakery items apart from beverages (fruit juices, sodas etc); corn and corn based foods; cheese just to name a few. While going to an extremely alkaline diet is not recommended, our body needs a healthy and balanced diet to maintain healthy kidney function and prevent weakened bones, muscle wasting and of course the itchiness which is prevalent in those with eczema.

(Further reading resources: http://www.mindbodygreen.com/0-5165/Alkaline-Acidic-Foods-Chart-The-pH-Spectrum.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/)

The diet is divided into 2 phases- Phase I and Phase II and I have written about them in my earlier post-

https://eczema-anindianperspective.com/2014/12/29/our-new-eczema-diet-and-a-heart-full-of-gratitude/

Phase I–  The phase I recipes were very basic and initially I followed most of the recipes given in the book. But I had to adapt some of the recipes a bit to suit our Indian taste and add a few of my own in order to ensure that I could give her some variety even with all the restrictions. She was allowed only garlic and parsley as far as spices and herbs were concerned which proved to be the toughest part about following the diet since Indian food is filled with all kinds of spices. The other difficult part was cutting out all (100%) processed foods and eating only homemade food. Some of the foods that my daughter enjoyed in the first phase were baked fish (pomfret) with garlic in white sauce made of soy milk and brown rice flour; baked chicken in garlic and in a similar sauce; mutton/chicken biryani (or lightly flavoured mutton/chicken in a kind of rice pilaf) with only garlic and broth as the main flavour.

While initially it was difficult for her to forego a lot of her favourite foods (pizza, Maggi noodles, baked items like doughnuts, cupcakes, biscuits and candies to name just a few), over a period of time she has accepted it as a way of life and has made peace with it. In response, her skin condition improved visibly and her itching reduced to an extent. But I should also mention here that since she was started on a new immunosuppressive medication (Methotrexate), the changes would be due to both her medication and diet. But while medication would have helped to suppress and control her eczema, her skin tone has gone back to what it was 2 years back and all the weight that she had put on due to oral steroids simply fell off. I attribute these two significant changes to the changes in her diet.

Phase II – The second phase has been much easier to follow as compared to phase I. Also the fact that I have honed my skills as a baker and chef has helped immensely. I can honestly vouch for the fact that necessity is the mother of invention! All the restrictions that circumstances have placed upon my daughter and as a result on our family have helped me to innovate and become a better cook/baker than I would possibly have ever been otherwise.

Our family is eating a larger variety of healthy foods than ever before with minimal processed foods (so bye-bye preservatives, sugar, chemicals, refined and simple carbohydrates, junk foods) and loads of heart healthy, skin friendly fruits, vegetables and protein (mostly fish and chicken) with natural/organic ingredients. The fallout of all this is that both my husband and I have shed some of our excess weight naturally as a result of incorporating green and healthy juices/smoothies, healthy snacks etc into our own diet.

(You can read more here- https://eczema-anindianperspective.com/2014/12/29/our-new-eczema-diet-and-a-heart-full-of-gratitude/)

SInce I had to restrict my daughter’s diet to ones with very specific ingredients, I started making a lot of the desserts/foods like crackers, cookies, doughnuts, cakes etc with eczema safe ingredients at home. Over the last 6 months I have added a lot of variety in terms of foods like jowar, brown rice and brown rice flour, flour, quinoa, sweet potato, sprouts (all kinds), vegetable juices and smoothies. Quite a few of these changes have been for the entire family.

There are however “The Itchy Dozen” foods according to the book which are healthy for most people but do not usually suit those with eczema and is best avoided. Some of these foods that I now avoid giving my daughter are tomato, corn, grapes, dried fruits, deli meats (sausages, ham etc) since all these foods are high in amines, sulphites and MSG (in varying proportions and various combinations). You can read more about these foods at the link given below-

http://www.eczemalife.com/pages/top-12-eczema-itchy-foods-to-avoid

A few suggestion for meals and snacks

Making snacks which are tasty and at the same time eczema safe has been a big challenge but I have managed to adapt and find alternatives which work for us. Working with Indian staples like puffed rice or murmura, flattened rice or poha, lentils and pulses like moong daal, red chana, kabuli chana some of the food items I started making are mentioned below-

  • bhel (a dry mix of puffed rice, potatoes, carrots, coriander leaves, cucumber with citric acid and a touch of cumin)
  • potato/sweet potato tikkas with/without mutton kheema/minced spiced with ginger, coriander, whole cumin (mashed potato croquettes shallow fried in the pan)
  • Moong daal chilla (or crepes with moong daal soaked overnight and then made into a batter) with onions, coriander accompanied by mint and coriander chutney
  • hummus dip(chickpeas, garlic and citric acid with a bit of cumin) and vegetables like carrots or cucumber
  • popped jowar (a delicious alternative to popcorn) is a favourite for both my children and is made pretty much the same wasy as pop corn

Some of the main courses that my daughter enjoys apart from our regular Indian meals are-

  • veggie and rice pasta with loads of garlic and mixed herbs (no cheese) with/without chicken
  • Brown rice and moong daal dosa with potatoes (I am not giving her any fermented products yet)
  • mixed veggies and rice flavoured with broth and a few whole spices (bay leaf, cinnamon and cardamom) with/without chicken
  • I make various soups with eczema safe and skin friendly vegetables like beetroot, sweet potato, carrots, and others like chicken and veggies soup, chicken and pasta soup, mutton stew (occasionally)
  • brown rice noodles (occasionally) with veggies

You can be as creative as you want but the key thing here is to plan ahead. Also, keep in mind that eating healthy does not mean eating only a few foods and having dull or unappetizing foods. Since I have been forced to look outside my comfort zone of eating/preparing the same foods all these years, it has actually opened my eyes to the amazing variety and richness of foods that is available to everyone if one knows where to look.

The availability of different varieties of foods (quinoa, gluten free flours, golden syrup, organic produce, kinds of microgreens and salads, gluten free milk like almond and soya to name a few) both offline through Godrej Nature’s Basket and Foodhall stores in Mumbai and online (gourmetco.in, foodesto.com, naturallyyours.in) have really helped us a lot.  

It’s not a diet, it’s called Eating Healthy

As our daughter now says, she is not following any particular diet as of now but simply eating “healthy”.This is true not only for her but for the entire family. Of course it is not always very simple or easy to eat healthy especially while travelling or eating out even though our daughter’s eating out now is extremely restricted for obvious reasons. But now I realise that after more than 9 months of changing our food habits at home, my husband and I tend to think twice before we order the next cake, sugary drink or buy a packaged food. What started off as a necessity to manage our daughter’s eczema has become a habit for us. It became easier for us to accept and change our food habits once we realised the critical importance of diet in managing chronic illnesses like eczema (I have written about this in my earlier post- https://eczema-anindianperspective.com/2015/04/08/you-are-what-you-eat-eczema-and-food/).

Also, even though I have expanded her diet and modified it to suit our Indian tastes over a period of time, the book “The Eczema Diet” is what first made me consider food and diet as a tool for managing eczema. I have now come across and follow various other blogs and websites which are dedicated to managing various kinds of chronic conditions through food and dietary changes, reduction in stress levels, yoga and other forms of mind- body excercise etc.

As mentioned in my post (https://eczema-anindianperspective.com/2015/04/08/you-are-what-you-eat-eczema-and-food/) we will be getting some tests done in London with the help of a Functional Medicine practitioner for “gut health” permeability. Gut health is determined by a healthy variety and a community of about 100 trillion microbial cells in our digestive tract and impacts our physiological, nutritional, metabolic well-being including our immune system. It is now considered to be one of the leading causes of all kinds of chronic illnesses like coeliac disease, irritable bowel syndrome, eczema (now considered to be an auto immune disease), Graves disease, Hashimotos just to name a few and it’s importance is best explained by the image below. I will be wrtiting more on these once we get tests done next month and have more clarity on the same.

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You can do your own research on this and use this knowledge to make an informed decision about the making food and diet an important part of the treatment for your child or anyone suffering from autoimmune disorders/chronic conditions.

(Image source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065426/figure/F1/)

(Further reading: http://www.nih.gov/researchmatters/october2014/10062014autoinflammatory.htm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3667473/)

Not all those who wander are lost

And so it is with us. Our journey is long and is filled with twists and turns and Atopic Dermatitis seems to be our constant travelling companion whether we like it or not. So over a period of time, we have learned to gracefully accept these circumstances to make our journey more comfortable and even memorable. This is true even though all the while we are constantly trying to manage our daughter’s eczema in ways which are less harmful to her in the long run. Whether we realise it or not, sometimes it is the journey which teaches us a lot about our destination….

 

 

 

 

 

 

Our new eczema diet and a heart full of gratitude

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It has been some time since I have put up a post. There have been a couple of developments at my end due to which I have been a bit tied up. The first and the most important one is that the combination of the new immunosuppressive medication, Methotrexate, and her new diet seem to be working for my daughter. I will be writing more on this particular diet later in this post.

The second one is that the support group for eczema that I started a few months back has been slowly gathering steam at a pace that I am comfortable with.

And last but not the least, I also want to express my gratitude and share with you this time the amazing team of doctors in Mumbai behind Aiyana’s medical treatment over the years all of whom have helped us in their own ways to deal with her severe eczema.

Diet and its impact on various disorders

diet

I had been reading about how diet affects one’s body in various ways and is especially important when dealing with autoimmune disorders and chronic conditions like eczema. Doctors do not really recommend any dietary changes unless allergy tests prove to be positive for various foods. However, I found that there more than a few genuine cases where people suffering from severe autoimmune and other disorders like Hashimoto, Lupus, Postural Tachycardia Syndrome, Irritable Bowel Syndrome as well as eczema have found relief from the symptoms due to dietary changes and have managed to go off medication completely over time.

It took me more than 6 months to come to this point of view after reading about the life altering experiences of these people and then figure out a diet which I was willing to try out on my daughter. The life stories of some of the people who influenced my decision to try out diet as an option for my daughter are captured in their blogs whose links are as given below-

http://deliciouslyella.com/philosophy/about/– This blog is by Ella who has Postural Tachycardia Syndrome, a relatively rare and painful illness with no known cure and she managed to go off her medications completely after about 18 months of changing her diet

http://www.naturallysassy.co.uk/about– This blog is by Saskia, a ballet dancer with chronic eczema since childhood and who has completely gotten rid of her eczema by altering her diet

http://www.choosingraw.com/about/– This blog is by Gena who has battled with anorexia, Irritable Bowel Syndrome and who now successfully uses a mix of raw and cooked vegan diet to keep herself healthy

http://www.amymyersmd.com/about/my-story/– The last link belongs to a website by Dr Amy Myers, a doctor of functional medicine suffering from Hashimoto’s ( a chronic and painful condition of the thyroid gland with no known cure) who has brought her severe thyroid condition under control after changing her diet/nutrition and life through meditation, yoga, supplements amongst others.

(Functional medicine integrates traditional Western medical practices with what is sometimes considered “alternative” or “integrative” medicine, creating a focus on prevention through nutrition, diet, and exercise; use of the latest laboratory testing and other diagnostic techniques; and prescribed combinations of drugs and/or botanical medicines, supplements, therapeutic diets, detoxification programs, or stress-management techniques.)

Source: https://www.functionalmedicine.org/

The Eczema Diet

Eczema-Diet-2nd-Ed-Front-Cover-192x300

In my post https://eczema-anindianperspective.com/2014/09/23/products-and-resources-which-help-to-manage-eczema/, I had very briefly mentioned that I was planning to start my daughter on a diet for eczema based on the book “The Eczema Diet” by the Australian nutritionist, Ms Karen Fischer. Her daughter had severe eczema as well when she was a 2-year-old and with changes in her diet, Karen managed to control the eczema successfully. She has since written this book based on her own experience with her daughter and the feedback over the years from her patients who have successfully brought their eczema under control using this diet.

This diet is practical and comprehensive with information on products and backed by research; it has menus and recipes for babies, children and adults. It also has non diet information like skin care products and general recommendations for eczema. The objective of this diet is to temporarily take out all the eczema unfriendly foods from the diet and add all foods which are highly nutritious and eczema safe.

There are 2 stages to this diet- Stage 1 and Stage 2 .

Stage 1 is primarily to heal the gut by avoiding foods with any kind of artificial chemicals and limiting naturally occurring eczema unfriendly chemicals (like MSG or salicylates) ; allergens (eggs, wheat or dairy products); anti nutrients (phytic acid, sugar, processed foods) and acid forming and other foods which increase itchiness (oranges, corn, tomato, dairy, grapes, dried fruits). This diet thus helps restore the acid alkaline balance in the body.

Stage 2 is an extension of the first stage where the food groups are gradually expanded by adding back different food groups in moderation ( no processed foods, artificial colourings, preservatives etc) depending on the improvement in the skin condition. The diet also has recommendations on supplements like vitamins, probiotic, glycine, flaxseed (Omega 3) amongst others which are very important in helping the body cope with eczema since the child might not be consuming adequate quantities of the same from food.

I started this diet for my daughter after going through it thoroughly and arranging for most of the eczema safe ingredients as there are quite a few changes in ingredients that we usually use at home. Infact, it took me almost a month to assimilate all the information, answer the different questionnaires and make notes and list down the essential foods and recipes as a part of my preparation before starting this diet.  It’s been about 2 months since I have started this diet for my daughter.

Since it is pretty restrictive in the first stage, I took my time to prepare my daughter mentally for what was to come in the following months by telling her about the diet. I also made her read excerpts from the book about other children who have benefited from this diet and have seen their eczema either disappear almost completely or finally come under control. Only when I was sure that she was ready for this change and that I had prepared adequately for this diet did I finally start the diet for her.

The recipes and menu

recipes

Over the past couple of months I have tried out various recipes from this book as well as developed and modified some recipes from this book using eczema safe ingredients. This is to ensure that Aiyana not only followed this diet completely with no exceptions but also had a wide variety of options to keep her from feeling deprived of all the store-bought and other foods that we are all so used to having nowadays. The good part about doing all this apart from the health benefits for my daughter is that my entire family now has much less processed foods, negligible amount of junk foods, healthier organic and fresh foods, homemade preparations of bakery and other  foods with no sugar and preservatives.

This has not been easy especially since I have had to cut out sugar, dairy, wheat, eggs and all processed foods, all spices ( apart from garlic and salt) out of her diet and give her a  very limited variety of fruits and vegetables. These last couple of months I have extremely been busy with this diet trying out the book’s recipes and new recipes almost on a daily basis since I have had to modify some of them to suit her needs and our Indian palette. This has been made more difficult since the recipes in the book are for meant to suit an European palette while we are used to our Indian spices and foods. What has helped me is my past experience with gluten-free cooking for my daughter in 2012 ( I have covered my experience in the post- “Eczema and diet” ) and my determination to ensure that I find a way to manage my daughter’s health in a more natural way in the long run.

The book can now be purchased both as a paperback and kindle version online at amazon.in.

When there’s a will there is a way

 inspire-31What encourages me is that Aiyana’s skin condition has improved in the last couple of months. Here I should also add that we had to start her new immunosuppressive medication around the same time as the diet and that the new medicine also takes 3 to 4 weeks to show results. But with my experience of giving her the third immunosuppressive medication (Cyclsosporine, Azathioprine, Methotrexate) I can say with conviction that the only medicine which has truly worked for her and made her skin completely smooth and normal all over has been oral steroid in high doses. The other medications have either just about helped keep her eczema under control (Cyclosporine) or brought about bone marrow suppression (Azathioprine); I have covered the effects of Azathioprine and our traumatic experience in my earlier post “…the tough get going (Part 2)“.

Hence, I am really happy to see that after starting her on this diet her face is totally clear of any rashes and has finally got back that healthy glow that had disappeared under the effect of all the strong medicines being given to her. I am willing to continue the hard work required to carry on with this diet and keep her motivated to follow the same for the next few months at least. I will keep you posted on further developments about my daughter’s skin condition in relation to this diet in my future posts.

 A heart full of gratitude

thank you

As the year comes to an end, I stop to count my blessings for all the good things in my life and my heart is filled with gratitude for all those doctors who have been with us in my family’s difficult journey in the past few years. In this post I would like to thank the amazing set of doctors behind Aiyana in her fight against eczema. I have briefly mentioned them in my earlier posts as well but have never mentioned their names which I do now with their consent.

 

 

Dr Shashi Merchant is Aiyana’s pediatrician from Breach Candy Hospital, Mumbai, and has known her since birth and held her as a newborn baby. She has been a pillar of strength and is unwavering in her support and care for my daughter. She gave us hope when we needed it the most in the darkest of moments when Aiyana was fighting for her life in the hospital last year. We are all lucky to have had her on our side in this journey.

Dr Amrita Talwar is Aiyana’s main dermatologist for the past 4 to 5 years now and has done much more and beyond than required as her role as a doctor. Without her help and guidance about the myriad aspects of dealing with eczema (including the essential but non medical ones) life would have been significantly more difficult for us. I have her to thank for encouraging me to write about our experience and starting this blog and for pushing me and helping me to start the Eczema Support Group.

Dr Manish Shah is a leading senior pediatric dermatologist and is the dermatologist whom we consult regarding her immunosuppressive medications and narrow band UVB treatment. He gives us advice when required and gives us much-needed guidance about giving these strong medications as well as dealing with and minimising the harsh side effects. We are very grateful to have him as Aiyana’s consultant dermatologist.

Dr Mahesh Balsekar is another well-known pediatrician in South Mumbai with Breach Candy Hospital. He is the one who diagnosed and admitted Aiyana to the hospital in time last year (Dr Merchant was on holiday at that time) which ultimately saved her life. Dr Balsekar thus gave her and the doctors at Breach Candy Hospital a chance of fighting her life threatening infection. My heart swells with gratitude for Dr Balsekar for keeping our family intact and saving my daughter’s life.

We are also grateful to the entire pediatric division of Breach Candy Hospital, haemotolgists Dr Antia and Dr Agarwal and the entire support staff at the hospital for playing a very important role in our daughter’s stay at the hospital last year.

A new year, a new beginning

new year

And so another year ends and a new one is about to begin soon. May the new year be filled with joy, laughter and good health. But may you also find the strength to overcome whatever obstacles lie in your path and remember to enjoy every precious moment with your friends and family.

From my family to yours–

A Happy 2015!