Originally posted by Dr. Davis on 2013-09-27
on the Wheat Belly Blog,
sourced from and currently found at: Infinite Health Blog.
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Note: a newer edition of this post is found at: PCM:
WBB: How to survive wheat withdrawal 
Surviving wheat withdrawal
Wheat withdrawal can be unpleasant business. Read
the many thousands of comments on this blog describing the physical and
emotional turmoil that develops in the first few days of wheat avoidance
and you will come to appreciate just how awful it can be.
It is important that wheat withdrawal is
recognized for what it is, as some people say, “I feel awful. It
must mean that I need wheat.” Nope. It is a withdrawal
syndrome, a good thing, a transitional phase as your body tries to
return to its normal state.
Wheat withdrawal has been labeled by different names
over the years–“Atkin’s flu,”
“Paleo flu,” “keto flu,”
“low carb flu,” etc. Because this only happens with
the various forms of carbohydrate restriction (there is no corresponding
“low-fat flu” or “Ornish flu”), it has
often been attributed to the delayed conversion of a glycogen/glucose-dominant
metabolism to that of fatty acid oxidation. This is true . . .
but only partly.
Yes, forcing the conversion from a constant flow
of carbs from “healthy whole grains” and sugars to increasing
the enzymatic capacity to oxidize fats does indeed cause several weeks of
low energy–but how do we explain the depression, nausea, headaches,
lightheadedness, dehydration, emotional outbursts, intensive wheat cravings,
bloating, constipation, even intensification of joint pain, effects that
are not likely attributable to hypoglycemia or poor mobilization of energy?
Delayed ramp-up of fatty acid oxidation is indeed part of the
reason for the phenomena of wheat withdrawal, but does not explain all of it.
Most of these phenomena are caused by withdrawal
from the gliadin-derived opiates in wheat, the 4- to 5-amino acid long
polypeptides that increase appetite and cause addictive eating behaviors. You
can actually trigger the syndrome abruptly in someone who is not wheat-free by
giving them naloxone or naltrexone, opiate-blocking drugs. Because it is a form
of opiate withdrawal, it cannot be entirely avoided with known strategies. In
other words, an alcoholic (not an opiate, of course, but the situation is very
similar) who wishes to rid her life of alcohol can only do so by stopping the
flow of alcohol and suffering the withdrawal consequences–there’s
no way around it. Alcohol withdrawal phenomena, such as hallucinations,
disorientation, and seizures, can be blunted with very high doses of
benzodiazepines and other drugs, so this is obviously not something you can
manage on your own. (The doses required for an alcoholic, for instance, are
fatal for non-alcoholics.)
So what can you do to smooth the wheat withdrawal
syndrome that involves 1) a soft opiate withdrawal, and
2) delays in gaining higher levels of fatty acid oxidation?
Here are a few strategies:
1) Hydrate–Ridding yourself
of wheat involves diuresis, or fluid loss. This is due to the loss of the
gliadin protein that causes sodium retention, as well as resolving
inflammation previously triggered by gliadin-derived peptides, intact
gliadin, and wheat germ agglutinin. Urine, for instance, should always be
nearly clear, not a dark, concentrated yellow.
2) Use some salt–e.g., sea
salt or other mineral-containing salt to compensate for the loss of
urinary salt. Salt, along with water, addresses the common lightheadedness
3) Take a probiotic–e.g.,
50 billion CFUs or more per day containing mixed species of
lactobacillus and bifidobacteria. This accelerates the conversion to
healthy bowel flora off the disruptive effects of this potent bowel
toxin called wheat. This addresses the common bloating and constipation,
usually within 24 hours of initiation. This should be necessary for
no more than 4 to 8 weeks. (If symptoms such as heartburn or bloating
return when probiotics are stopped, this suggests that there is
something else wrong, such as failed cholecystekinin signaling
to the pancreas, pancreatic enzyme insufficiency, hypochlorhydria, etc.
that requires a formal assessment.) Among the best[formerly]: VSL3, Garden of Life,
and Renew Life brands.
magnesium–Magnesium deficiency is widespread and
is associated with osteoporosis, hypertension, higher blood sugar, muscle
cramps, and heart rhythm disorders. For unclear reasons, these phenomena
are magnified during wheat withdrawal. Magnesium supplementation can
thereby have some dramatic benefits during wheat withdrawal. Unfortunately,
most magnesium supplements are better as laxatives than as sources of
absorbable magnesium. Among the best: magnesium malate at a dose of
1200 mg two or three times per day (weight of the magnesium + malate,
not just “elemental” magnesium). Source Naturals makes a
5) Supplement omega-3 fatty
acids–There are plenty of reasons to supplement omega-3
fatty acids to make up for our aversion to consuming the brains of land
animals and only occasional reliance on seafood. But during wheat
withdrawal, weight loss proceeds at a rapid clip for most people, a
process that involves massive mobilization of fatty acids into the
bloodstream (evidenced on a cholesterol panel as higher triglycerides).
Omega-3 fatty acids partially protect us from the adverse effects of this
flood of fatty acids, as it activates the enzyme, lipoprotein lipase, that
helps clear them from the bloodstream. I advocate an EPA + DHA
intake of 3000 mg per day (the dose of omega-3 fatty acids, not
of fish oil). The best fish oil is in the liquid triglyceride form, not the
common ethyl ester capsules, as the triglyceride form is better absorbed
(particularly the DHA). My favorite brands because of meticulous production
NutraSea and Nordic Naturals.
6) Supplement iodine–The
average person is marginally deficient in iodine, particularly in people
who avoid use of iodized salt. Ironically, the more you avoid processed
foods (as we do with wheat elimination, given wheat’s ubiquity),
the less iodized salt you get. Avid exercisers also are more iodine
deficient than average, given iodine loss via sweat. This has gotten so
bad that I have actually found many people with goiters (enlarged thyroid
glands). Even a modest lack of iodine leads to lower output of thyroid
hormone (especially T4), resulting in mild hypothyroidism that
impairs weight loss, can make fatigue worse, increase LDL cholesterol
and triglyceride values, and even increase cardiovascular risk. Iodine
is an essential trace mineral: everyone needs it (though people with a
history of Hashimoto’s thyroiditis or thyroid nodules will have to
be extra careful; I’d like to say consult your doctor, which is
true if you have a doctor knowledgeable about iodine, which is less
than 1% of my colleagues). I advise patients to supplement iodine
as inexpensive drops, capsules, or kelp tablets (dried seaweed) to
provide 500 mcg iodine per day.
Those are the supplements that have proven tried
and true in reducing at least some of the most common struggles with wheat
withdrawal. Because these supplements do not entirely address all
the issues, especially low energy, I am always on the lookout for ways to
make this process easier. On the list of supplements/strategies that we
are exploring (and are therefore only speculative for this application):
Generation UCAN–I first learned about this
from Peter Attia of The Eating Academy, as he is an avid
fan of this polymeric preparation of corn-derived maltodextrin. (Yes:
derived from corn that is non-genetically modified and is a purified
carbohydrate polymer, no proteins.) It’s unusual lengthy structure
of 500-700 glucose residues means it does not yield the osmotic effect
of maltodextrins, nor does it cause a rapid rise in glucose, but a very
low-grade trickle of glucose. These effects make it useful for very
long-distance exercise that depletes glycogen stores and can result in
low blood sugar. The slow trickle of glucose form this preparation is
usually insufficient to generate much of a rise in blood sugar. This has
the potential to prevent the marginal hypoglycemia characteristic of wheat
withdrawal when taken, e.g., ½ to 1 scoop twice per day.
Interestingly, more and more people are observing that, even outside
the wheat withdrawal period, weight loss from fat develops.
(That’s an entire discussion of its own.)
VESPA–This unique polypeptide preparation
from the Asian Mandarin wasp enhances fatty acid beta oxidation, one of
the limiting factors in converting from glycogen-dependent metabolism to
fatty acid-dependent metabolism. Like Generation UCAN, these lessons
have been learned from high-intensity exercise experiences and may be
transferable to the setting of wheat withdrawal.
Over the 2+ years since Wheat Belly first
made bookstores and upset many people in the wheat world, we’ve
learned many new lessons on how to best deal with the phenomenon of wheat
withdrawal. If you’ve got some strategies you have found useful,
please speak up and post a comment here.