Please post any questions or comments regarding a step of the Great-in-8 action plan in the corresponding section as listed to the right
Step 1: Reset
We will be adding answers to the most commonly asked questions about Step 1 of the Great-In-8 plan along with important information for troubleshooting this step here shortly.
Please post any questions or comments regarding this step below.
Q: If I am trying to get pregnant, currently pregnant or breastfeeding, what parts of the protocol should I modify?
A: First off, I want to emphasize that any and every decision made while trying to become pregnant, during pregnancy, or while nursing should be run by your OBGYN or PCP.
Here are some of my thoughts to be considered in the context of working with your doctor:
- Any dietary changes are likely fine. The low FODMAP diet has actually been shown in a pilot study to decrease infantile colic when the mother consumes a low FODMAP diet and is breastfeeding a colicky baby.
- The elemental diet is probably fine, but should be discussed with your doctor to confirm.
- As far as supplements go, fish oil, vitamin D, multivitamin, probiotics, prebiotics, and fiber are all likely fine.
- Adrenal support, hormonal support, and antimicrobials should be avoided.
- Regarding prokinetics, some are recommended against, so discuss with your OBGYN
Q: What if I’m a vegetarian or vegan? Can I still follow the protocol?
A: While I don’t have any personal biases around a vegan or vegetarian diet one way or another, it can admittedly be very difficult to follow during the protocol. Many vegan protein sources are not low fodmap or not typically included in a paleo diet. My best advice would just be to listen to your body. If you choose to incorporate some of the things that aren’t technically paleo, but are low fodmap (tofu, quinoa, etc), pay close attention to how you feel. If your gut doesn’t seem to be improving, try taking them out and seeing if that changes anything. Good luck!
Hi love the book so far just got to the Great in 8 plan. With the liquid fasting you indicate maple syrup to be added. I know this may be a frequent question but I was hoping you could explain a little further it’s effectiveness on bacteria as I was under the impression it may feed or aggravate instead of heal?
Regards
Thanks Lee,
I wouldn’t worry about the bacteria, the goal of the fast is to take pressure off the gut with liquid calories like taking pressure off a sprained ankle with rest. There is a low carb version mention in the handout, which is bone broth.
Hello! Is a simple water fast okay?
It should work, but I would work closely with a doctor if you plan on doing that.
Could we use raw honey instead, since it has antibacterial and anti-fungal qualities? Or is there something special about the maple syrup?
Raw honey is fine if you prefer it. The point is just to reduce the work your digestive system has to do for a few days.
Thank you!
I’ve really enjoyed reading the book so far. 🙂
Is there any reason not to use packaged bone broth, such as Kettle & Fire or Bonafide, for the modified fast? (Obviously it’s a lot more expensive, but aside from that?)
Any idea how much broth the average person ends up consuming, so I can plan accordingly? I’m a 130-pound female.
Thanks!
Thanks Tonya. That would be fine. It varies from person to person, I’d say err on the side of having more than you need – you can always freeze extra and use later.
Hi Dr Ruscio,
Really liked your book, which has helped me to organize my head around healing the gut!
I am bothered by a question since started my gut healing journey:
I live in Israel, where we do not have access to pasture raised grass fed meat, chicken and dairy products. We only have access to organic free range chicken, eggs and dairy products, where the chickens are being fed with organic corn, wheat and soy. Is it good enough for implementing the Paleo and the Auto Immune Paleo Diet?
Thank you!
Thanks Dor,
Yes, do not worry about the quality here. Simply do the best you can given what you have access to and you should be fine.
If you could write a review on Amazon, that would be much appreciated – https://www.amazon.com/Healthy-Gut-You-Michael-Ruscio/dp/0999766805/ref=cm_cr_arp_d_product_top?ie=UTF8
Thank you!
Hi Dr Ruscio,
Really appreciate your support.
I will review the book in Amazon and also recommend it to my relatives who have interest in improving their health.
Thank you!
Hi Dr. Ruscio,
I love the book, and I am planning on starting the great in 8 plan. My question is I am a Police Officer and work very long shifts, and then I have to train after work to qualify for my special assignments. With that being said I go through a lot of calories regularly. Is there a problem with using elemental heal and bone broth while on the fast? Or should I just one and not the other?
Thank you for providing such an incredible book. You provided answers to questions I have been having for years! I feel like I am finally going o take control of my gut.
Hey Joey,
Yes, you could use the elemental instead or with the broth due to your training needs. I’d try at least a day on the broth alone to see how you feel before adding in the Elemental Heal though. My pleasure! Would you mind writing a review on Amazon? https://www.amazon.com/Healthy-Gut-You-Michael-Ruscio/dp/0999766805/ref=cm_cr_arp_d_product_top?ie=UTF8
Hello Dr. Ruscio!
I appreciate you creating this book, I am really enjoying it and grateful for your knowledge and expertise. When I finish the liquid fast and start the Paleo Whole 30, will I resume taking all my prior supplements? I was on supplements for my adrenals, thyroid.
Thanks
Hi Carrie,
I wouldn’t recommend taking previous supplements but instead focusing on the protocol in the book. This includes adrenal support, and by improving your gut health there is a good chance you won’t need thyroid supplements. If you haven’t left a review for the book on Amazon, it would be greatly appreciated 🙂
Can the great in 8 plan be used for 9 and 11 year old children and if so what modifications would you use?
Yes, but I would bounce this off their pediatrician. Use 1/2 the dose of the listed protocols. Also, I tend to be very minimal with dietary restrictions with children, I give them lots of slack.
I am beginning the modified fast this weekend. I want to use a combination of the bone broth and the maple syrup mixture so I will have some protein from the Broth, but I am not sure if it is a good idea because I suspect I might have an issue with histamine and I have read Bone broth is high in Histamine. I do notice some flushing when I consume Bone Broth. Should I just stick with the syrup mix?
Also, the Maple syrup mixing instructions contradict themselves.
“2 Tablespoons of Organic US Grade A Dark syrup (not the commercial maple flavored syrup you
use on pancakes)”
and then a little lower it states:
“Also, the maple syrup must be grade B maple syrup, not the sugar filled syrup that is used at the
breakfast table”
So, is it Grade A or Grade B that should be used? I am also not sure about the warning about the breakfast table syrup. I use 100% Grade A Organic Maple Syrup at the breakfast table, that should work right?
Final Question, The instructions say herbal and green teas are ok during the fast, how about black coffee?
Thank You, Great Book
Thanks Travis,
Looking into the syrup issue now, I know some terminology changed and created confusion. I don’t think it makes a difference either way though.
No on coffee.
More to follow!
Thanks for getting back to me. I went ahead and did the fast the past 4 days. I only consumed kettle and fire Bone Broth (2 cups a day) green tea, bl;ack coffee and water. I consumed 2 cups of coffee a day and added collagen peptides to the coffee to help with gut healing and keep some amino acids flowing. Did I screw up and starve for 4 days for nothing? I couldn’t take going without caffeine and food for 4 days.
Nope, it’s not a problem. caffeine can be an irritant, thats all.
Use Grade A, sorry there was a typo in our sheet after current update in maple syrup labeling.
Hi Dr Ruscio thank you for your wonderful guidance! I just want to emphasize the part in the question above about using both the bone broth and maple lemonade for the 4 days. Is that alright? I tried them both today and I feel alright!
Sure, that’s fine.
I have read the book twice and marked it up. I really really appreciate your balanced perspectice and your carefulness to use good studies to make informed decisions, It has helped me sift through so much of the internet information, which is frankly, overwhelming,
I was interested to try Elemental Heal but cannot see on your store site how many servings are in a given container or how to predict how many meals it would cover. Could you supply that information?
I also don’t understand how much of an Elemental Diet to use for a meal. If you go with the basic 2000 calories a day, and a serving of it is 150 calories, it seems impossibly expensive!
Thank you in advance for your time,
Thanks Chandra, glad it has been helpful. This serving information is contained here, scroll down and view label image – https://store.drruscio.com/products/elemental-heal. Elemental diets are a bit pricey due to their strict criteria, yes. The good news is you won’t have any food cost 🙂
Hello – I’m planning on starting a modified fast in a few days and am going to do the lemon juice and syrup option. In the instructions, it says at the top to use Grade A organic maple syrup, but then a few lines down it says to use grade B. Will you please clarify? I’ve been looking at syrups online and some are classified as Grade A, but then in parenthesis say (formerly Grade B). Is that the type to use? Many thanks in advance for your help (and your book)!
Hi Emily,
Use either, I don’t think it makes much of a difference. I will post an update here soon, currently double checking this.
My pleasure 🙂
Use Grade A, sorry there was a typo in our sheet after current update in maple syrup labeling.
Love your podcast, your approach to medicine and your new book! I have Hashimoto’s and tried the AIP diet a couple years ago and settled on a paleo-ish diet which has never resolved my constipation. So after the fast, I’ve decided to try the low-fodmap paleo. For the first time in a long time my bloating is better so I think I’m on the right track- so thank you!! Constipation has not improved at all yet after a couple weeks, however. I’m wondering when I should add the probiotic and whether I should also try some GF grains to see if that helps (I’m quite active and a little underweight). Would I add grains and probiotics at the same time? Thanks again for everything you are doing!!
Thanks Suzan!
Stick to the book protocol as closely as you can. This would mean probiotics before reintroducing grains.
Hope this helps!
Hello, I enjoyed the book and was excited to start the plan with hope my IBS-D would finally clear up using a holistic dietary approach. Although I was very unsure about doing the fast as I usually eat well as I am very active with weight training etc. However I had already been following a low-FODMAP for 3 weeks with not much change so I decided it was best I at least gave the fast a go… I chose bone broth as I already make it regularly and like that it has a good nutritional profile to support me.
I attempted the fast yesterday but ended up giving up after 17 hours as I felt really sick. I thought this must be because I needed food so ate a small bowl of chicken + low-FODMAP vegetables in bone broth and some blueberries. Unfortunately I didn’t feel much better and eventually ended up with really bad diarrhoea and a lot of vomiting (including bringing all the broth back up). I couldn’t keep anything down at all and felt awful all day.
My husband has had the broth with no ill effects, so I don’t think it’s a bad batch but I am so disappointed with this reaction. Any idea why I would have reacted this way? I’ve read about cooking the broth for a long time can cause a build up of glutamine which some people are sensitive to, but I’ve had long cooked broths before without such reaction… as well as lots of L-glutamine supplementation previously too.
I’m so disheartened but will just move onto the next step with continuing an elimination diet with probiotics and digestive enzymes to support – then eventually adding foods back in…
Any advice on what happened to me would be much appreciated? I feel I gave my gut more harm than good with that first step.
I understand this can be frustrating. Some people simply don’t do well with broth, and thats OK. The lemonade may work better, however don’t worry about it can simply move forward 🙂
Hi Dr. Ruscio,
Questions please:
1.) May I alternate between Bone Broth & the Lemon/Maple Syrup water during the Fast ? Or is it imperative to choose one & then stick with it ?
2.) If I am happy drinking the Lemon Water straight without the Maple Syrup is that OK ? I have worked sooo hard eliminating sweeteners of any kind from my diet , it is disturbing to consider reintroducing one..
Thanks for your brilliant and so needed book !
Best,
Lisa
1. Yes.
2. Yes, the syrup provides calories to prevent fatigue but isn’t required.
My pleasure! 🙂 Amazon reviews are always appreciated.
I am currently taking biofilm disrupters and probiotics. And eating paleo.
I want to try the great on 8. Starting with fast. Do I stop the biofilm disrupter enzymes and all herbs during this time (oregano) and probiotics.?
It’s best to start the protocol and not be on any other supplements.
Any suggestions for an elemental diet or fast for a person sensitive to both glutamate (gluatamine) and histamine? I think I would otherwise do well on an elemental diet
I would do some experimenting. The Masters Cleans might be your best bet.
Hello!
Thank you for releasing such a great book! I have tried fasting and it does not do much for my bloating so this tells me that I need to go to Step 2. I live in Canada and cannot find FMF. Do you know if it’s distributed anywhere here at all? I couldn’t find their website.
Finding the probiotic for Lacto and Bifido is easy but the other two seem to be a bit more complicated.
Hi Amanda,
Our store can ship to Canada.
Hi two questions:
1. I am unclear if your carb guidelines are for total carbs or net carbs. The book just refers to carbs, so I assumed the goal for low carb is fewer than 100 total carbs per day. But the resources you direct to, like the Atkins counters, focus on net carbs which can be quite different (if the food has any fiber content).
2. I’m eager to start Great in 8, but I had surgery to remove endometriosis – will be 3 weeks ago when I start the liquid fast. I’m doing great with regard to healing and stamina, but have digestive ups and downs (different from my usual) post surgery – which I assume comes with the territory of abdominal surgery. Now is the perfect time for me to start the Great in 8 but will I miss key signs of food intolerance when I transition to one of the diets if I’m still recovering from surgery? I’ve been Paleo AIP for awhile, but post fast, I’m going to try Paleo low fodmap.
I really appreciate the book and it’s wonderful synthesis of all of the (conflicting) information out there. I feel you really understand the journey patients like me have been on! I love your approach and am looking forward to starting the Great in 8 protocol!
1. Total carbs, but it doesn’t really matter. The general concept is about starting lower carb and then later testing a carb reintro. Don’t get too detailed here.
2. I would start now, it won’t be perfect but that is life. You will still end up in a far better position than if you didn’t do it. You can fine tune dietary boundaries later on.
Hope this helps!
Yes, thank you so much! Starting the liquid fast tomorrow 🙂
Any suggestions for a particular diet for SIFO rather than SIBO? FODMAP has worked great for me in the past to manage my symptoms – however I now seem to be reacting (bloating, reflux) with anything that has a high fibre content (black & brown rice). Are there any strict differences in diet for SIFO & SIBO?
Hi Olivia,
I’m sorry to hear you’re reacting to so many foods, I know that can be frustrating. It may be helpful to start with a lower carb paleo diet (very similar to a candida diet) and then perform the reintroduction to see where you feel best. One of the main variables for yeast/fungus is carb intake but there is more to finding your ideal diet than just carbs. The book lays out a good plan for this. Ultimately the best diet for you is the one you feel best on and not what a given condition’s diet rules recommend. Hope this helps!
Hello. Any suggestions for someone who is very fatigued, has brain fog constantly and is unmotivated lately to pick a meal plan. start it, shop for ingredients and then cook the meals? I just don’t have the energy. Any advice? I also want to make sure I am not nutrient deficient. Thank you Dr. Ruscio in advance for the great book and for your time and consideration. Have a great day : )
Hi Chris,
Depending on what your issues are, a low FODMAP diet can be very helpful for many gut conditions. I would say keep it simple (meat, carb, veggie), cook in batches so you have lots of leftovers, and make big pot meals in a slow cooker or Instant Pot. You can also consider a grocery delivery service so you don’t have to go to the store. Good luck!
I’m just reading your book and have a question. I was recently diagnosed with microscopic colitis – looks like it was an underlying condition, made worse by immunotherapy for melanoma. Even on large doses of prednisone (to manage side effects) gluten and dairy seemed to make it worse. My enterologist suggested the immunotherapy had altered my microbiota. Colitis now under control via 12 weeks of budenoside during which I also stopped all gluten and dairy and limited fruit and veg to those which seemed to not spark off the symptoms. Immunotherapy now changed to just nivolumab which I tolerate well. I’ve started to reintroduce some foods – mostly veg and fruit – but cautiously.
Do you have any advice on microscopic colitis and diet, microbiota etc?
Hi Sophy,
Thanks for your comment and I’m sorry to hear you’ve been dealing with MC.
If you find gluten and dairy are triggering your symptoms, I’d suggest continuing to keep them out of your diet.
I’ll pass along your question to Dr. R and hopefully he’ll answer it in an upcoming podcast episode.
Good luck!
Was this ever talked about? I see a few mentions of microscopic colitis but not much detail. I ask as I used to have lymphocytic colitis that has since recovered after figuring out my own intervention of avoiding gluten and also vegetables and fruits that were harder to digest. I was diagnosed via a colonoscopy and recent exams have shown it has gone away. While it was definitely not easy to deal with I must have had a more mild case than others.
I do still suffer with Ibs and I plan on giving thie books protocol a shot even though I’ve tried most everything in the book.
Hi Mike – Not yet, looks like it’s on the list for the next episode he does answering Healthy Gut, Healthy You questions which will hopefully be sometime this month.
Thank you Drew.
Hi Sophy,
Dr R addressed your question in a recent podcast episode: https://drruscio.com/answers-questions-healthy-gut-healthy-protocol/
Dr Ruscio, my 22 year old son has been on the Paleo diet and your 3 probiotics for 3 weeks due to acne, insomnia, depression and anxiety for shoot 8 years and a tingling feeling in his skin all over his body for as long as her can remember.. He was also taking the Adrenal Support Complete. We added it a week to 10 days after the probiotics. He began getting muscle twitches all over his body. We stopped the ASC and the twitches went away a couple days later. His acne is reduced by 85%. Very cool. His mood is not measurably different and he has less energy by about 20% and just feels weak. He has eaten sweet potatoes without trouble. He is going to try rice next. We are ordering the Biota-Clear1a and then 2a. But I’m concerned about his energy and lack of change in his mood. Wondered if you had any thoughts. Thank you.
Hi Lynn,
I’m so sorry to hear about your son, and I know how confusing it can try and be to manage these sorts of conditions on your own.
I’m not sure if you’ve read Dr. Ruscio’s book, Healthy Gut, Healthy You, but if not, I definitely recommend getting a copy (https://drruscio.com/getgutbook/). It has a very thorough and complete protocol that will be suitable for handling most gut issues (which as I’m sure you know, are definitely related to depression, acne, insomnia, and energy levels).
Also, if you’d like to apply for your son to become a patient and get personalized care from Dr. Ruscio, you can do so here: https://drruscio.com/consult-dr-ruscio/
Lastly, you may want to check and see if your son is eating enough. Sometimes when people go on restrictive diets (even in the name of health), they can start under-consuming calories by accident. This can definitely impact sleep and energy levels.
Good luck to you!
Good morning Dr. Ruscio,
I just finished your book and I am excited to get started. This will be the 13th attempt to heal my gut in 5 years. I have tried everything from scd and the elemental diet to antibiotics. Ive even completed two 5-day water fasts.I have worked with a supposed functional medicine doctor that insisted on treating me for Lyme Disease with multiple prescriptions that only made my symptoms worse. I have confirmed sibo and I am histamine intolerant. I react to everyrhing including fasting, eating and supplements. My gut symptoms resolve while fasting or eating low carb but my histamine symptoms and inflammation spike so I have to cut protein and add in lots of fresh veggies which aggravates my gut. Food quiet literally makes me sick. Even the healthy, whole foods that most people thrive on.
My question is, how can heal my gut witout feeling miserable in the process? I keep telling myself I will just suck it up and power through, but then my eyes burn and water, I break out in rashes, I get muscle cramps and chronic insomnia, flaky, burning skin on my face, edema in my extremities, joint pain and extreme anxiety. That’s just a few of my symptoms, and I have to work a high stress job through it all. I believe my gut is the root cause, I have suffered with severe ibs-d for 45 years. I just cannot tolerate the high histamine protocols and supplements required to heal. My histamine reactions are too strong.
Hi Anne,
If the HGHY protocol does not provide relief, you might want to seriously consider MCAS;
https://drruscio.com/mast-cell-activation-syndrome-clinician-researcher-dr-lawrence-afrin/
https://drruscio.com/mast-cell-activation-part-2-dr-lawrence-afrin/
I hope this helps! Hang in there 🙂
Hi Dr. Ruscio,
Really enjoying the book! Not quite all the way through yet, but I’m grateful for the clear approach and thorough research that cuts through all the varied recommendations out there. I started reading it after positive SIBO test, and my naturopath gave me your Paleo Low Fodmap diet.
I’ve already been working with my naturopath but now I’m hoping to integrate your protocol. She’s already started me on antimicrobials and Paleo FODMAP. I’ve been eating very low carb for the last few days to reduce the bloating, and it helps. Is it necessary to go back and do the fast, or should I just keep moving forward at this point? If I do the fast, should I pause on the antimicrobials?
Will write Amazon review when finished. Thank you!
Hi Liz,
Thank you! You can continue forward from your current position. Once you get to maintenance you can experiment with fasting to see if it adds anything.
I would appreciate that!
I’m about to start the elemental liquid diet. I used to have a Candida overgrowth and some say it might come back after the diet. Do you recommend I take anything? I tend not to be able to tolerate many supplements though.
Also I ordered 5 tubs of the e diet formula from your website but it wouldn’t let me order more. Will that be enough? I am 5′ 8″. Thanks, Marion
Start with just the elemental and see how you do. Antimicrobials can be taken during ED if you feel like Candida is returning, but I have not found this to be an issue. Updating the store now, thanks.
I am loving your book, and am getting ready to make bone broth for my first step. I will leave out the garlic, onions, and celery, since i am trying the low fodmap approach. I suspect i might have SIBO. Can i add either fish sauce, or coconut aminos to the broth?
Thank you for such an easy to read book, that spells everything out perfectly. I am thankful to be able to try this on my own! I will write a review once i finish reading the book!
My pleasure. You could, I’d start one day without so you can compare.
Thank you, it’s appreciated!
I’m sorry, i thought of a few more questions! Is it okay to add collage pepidses, coconut oil, and/or MCT oil to the bone broth during the fast?
Also, i have retinitis pigmentosa, and take a lot of supplements to help prevent further vision loss. Should these also be stopped during the fast? Some of them include a special eye formula, taurine, vitamin A, grapeseed oil extract, and astaxanthin.
Thank you for your time!
If your doctor has recommended any of these check with him/her. If not, I prefer less is more maneuvering.
Making the broth, you ask to add vinegar. I have read that vinegar combines with the proteins and creates MSG. Is this true?
Also, are you allowed to add salt and pepper, or put in other herbs?
Try it and see how you feel. Minimal spices are best at first.
Hi Dr. Ruscio!
I posted earlier today but it does not look like it worked, I apologize if this appears twice. I am wondering if there is any danger in trying an elemental diet before doing the 2 months of herbs. I have been dealing with gut issues for almost 2 years now and have done every diet, a parasite protocol that involved herbs and supplements and anti-biotics for bad bacteria.
At this point, I just want to clear EVERYTHING out and reading about the Elemental diet it sounds like this might be the solution for me. I just was curious your input on jumping into that given my history. And was wondering if you recommend still taking the anti-microbrials in conjunction with doing that?
Thank you so much.
Hi Jessica,
Thanks for getting in touch, and I’m sorry to hear you haven’t had much luck with other diets/protocols.
The elemental diet can definitely be helpful for people who have tried everything else and haven’t gotten results.
We can’t give direct medical advice to someone who isn’t a patient, but if you’d like to set up a consult, you can do so here: https://drruscio.com/consult-dr-ruscio/
Otherwise, there’s a pretty comprehensive section in the book on how to do the elemental diet, but it’s best to do it under the care of a physician. And antimicrobials aren’t typically needed during the elemental diet.
Good luck!
I used a PPI for 10 years, and have been trying to wean myself. I was down to 1/3 of a pill once a day. I stopped completely when I started your program one week ago. The fast made me feel very ill (maybe die off), I used the Intro diet from SCDLifestyle, as recommended, and am doing the Low Fodmap SCD diet because I was diagnosed with SIBO. I get terrible heartburn and bloating/belching with any solid foods. Is this a case of getting too much stomach acid from the rebound effect from stopping the PPI, or is this from not enough stomach acid? The burning lasts for a couple hours after eating solids. Any suggestions for relief?
Hi Jeanne,
Continue working through the protocol, it’s designed to treat the underlying cause. Perhaps consider the low histamine diet, when you get there. You may also want to try a slow wean off. Make sure to keep your doctor in the loop here.
I have your book and I am anxious to begin the great in 8 plan. I am being treated for a C. Diff re-occurrence with vancomycine. First diagnosed a month ago after being hospitalized with Sepis in April. May I start anytime or wait until I’m off the antibiotics?
I would wait until after your antibiotic and until you feel like you are back to your baseline before starting. The probiotic protocol may help with the C. Diff, see if your doctor is OK with co-administration.
Hi Dr. Ruscio!
I have done the liquid fast, progressed to the paleo/low fodmaps diet and feeling much better!!!! I introduced a low dose of each of the probiotics and stopped after a week of heavy night sweats, even though my energy improved. I just wanted to confirm it was the probiotics, and it was. I still have not resumed the probiotics, but I want to, if you feel it’s safe. Also, last week I started using a bone broth protein everyday, my energy has improved, but the night sweats started again!!!! Should I expect the night sweats to subside? Or is this a sign I should stop the using the supplements. Please let me know your thoughts.
Hi Carrie,
Glad to hear your improving. You might be histamine sensitive. I’d stop the protein. Then, reintro the probios one at a time to see if the reaction is coming from 1, 2 or all. Continue any that are tolerated. Night sweats should not be occuring. Make sure to mention this to your doctor also.
Dr Ruscio,
Thank you for creating this book and process to help us experiment on ourselves in a sensible way. I only wish you had published it a year or two earlier! This is exactly what I’ve been looking for and have read SO many books and blogs. I also really appreciate your balanced approach since I’m one of those Type A’s you talked about in your book 🙂
Long story short — I went AIP/Paleo several years ago and it was nothing short of miraculous, my headaches went away overnight, my eczema cleared, my *terrible* menstrual pain went away (who knew is was related!), and the “D” part of my IBS (coast-coast swings between C & D), lost weight and my mood was the best it’s EVER been. Really everything cleared up but my lifelong slow transit/constipation. Fast forward 2+yrs of perfect health (not even a cold) and I had a job change that introduced a LOT of stress as well as frequent air travel, I stopped sleeping well, then my sleep got really bad including terrible fatigue. That lasted for ~1 yr, then I changed jobs, underwent some functional tests, treated w/2 courses of antimicrobials (note no probiotics). Got most of my energy back, but still can’t sleep more ~6ish hrs, and worse yet seem to now not tolerate cruciferous veggies (broccoli, cauliflower, cabbage, brussel sprouts) any longer which were a staple for me and my family. The other FODMAP foods don’t seem to bother me much, but these make me bloated and uncomfortable very quickly (which I don’t quite understand how it happens so fast given my naturally slow transit).
I know that my AIP/Paleo diet worked SO well for me before that stressful time and I just want to get back to that level of health and happiness (and my full suite of veggies!). Note that throughout I was super rigid about maintaining my AIP/Paleo diet (which felt like the only thing I could control) and getting some moderate exercise that I could tolerate on little sleep.
Now that I’ve recovered somewhat (little sleep –> ~6hrs, energy back) but clearly am still having some gut issues, I’m trying to figure out if I should start all over at the very beginning of your Great in 8 plan, or perhaps part way through. I’ver currently cut out cruciferous vegetables (part of low-FODMAP) which has helped but feels like I’m just treating a symptom. Any advice is greatly appreciated!
Love your book and will rate it 5 stars on Amazon. Thank you again!!
PS In case this helps others — our whole family went AIP/Paleo at the same time mainly due to my father-in-law who had been losing a 25-30yr battle with ulcerative colitis who COMPLETELY REVERSED this condition with diet changes (and went off ALL of his medication within months) and after 2 yrs his colonoscopy showed no sign (other than some scar tissue) of having UC or inflammation. My Mom lost ~40 lbs (now a healthy size) and went from pre-diabetic to normal glucose levels, and our best friend lost weight and cleared up all his sinus/allergy issues. No exaggeration the amazing effects lifestyle changes can make. It’s worth the effort.
Hi Rachel,
Thank you! I would start at the beginning. This might help you piece together some things you have not previously. Keep me posted! 🙂
Hi Dr. Ruscio,
I had a couple of questions about the modified fast.
I am wondering if taking pea protein shakes and/or leucine powder 3-4 times per day while also doing the bone broth fast would inhibit optimal healing from the fast. I want to maintain as much muscle mass as possible and know that bone broth does not contain all the essential amino acids in the quantities required to do so (or maybe I am wrong on this, so please correct me if I am).
Also, you say that one might want to avoid highly rigorous exercise. Would engaging in a full body workout every other day (this is my usual lifting routine) during the modified fast be detrimental to results? I also do about 15 minutes of fast paced incline treadmill walking everyday upon waking. Is this okay to continue?
I am so happy to have found your work and feeling hopeful about healing, something I could not have said even a mere few days ago!! Thanks!
Hi Jackson,
I would recommend altering the protocol as little as possible. A 2 day modified fast shouldn’t cause an appreciable change in body comp. Regarding training, listen to your body, he’s the boss on this, what he says goes. I find the biggest problem is people get hungry and a little tired with too much activity.
Hope this helps and keep me posted!
Thanks a lot Dr. Ruscio. I’ll stick with the protocol as outlined and be sure to listen to my body regarding the exercise!
Hi there. On day 3 of full elemental diet and realized that I am going to run out faster than I thought. Just ordered 2 more containers and am pretty sure that I will run out before they arrive. How should I handle my food intake during the interim? Chicken soup broth with boiled/steamed broccoli??? Working my way up to cooked chicken mashed? I will have to order more than 2 though because each container only lasts me about 4 days and i want to be on this for a minimum of 2-3 weeks. My constipation has not improved and the MCT oil seems to be giving me nausea. Switched to coconut oil and taking stool softener nightly. I have a problem with fats (no gallbladder) so perhaps I should take a digestive enzyme to help? ? So many issues to be addressed. Thank you. The shake tastes great.
Hi Dr Ruscio,
I suffer with chronic fatigue. I did the bone broth fast (felt a bit of anxiety but got through it). I started the Paleo whole30 and was eating moderate carb. Generally felt good eating whole foods. But fourth week I got hit with anxiety and heart palpitations. I have now increased carbs and feel better. It’s a shame as I wanted to stick with the lower carb.
I am hestitant to change the diet again to be honest as I’m exhausted from the reaction on my nervous system.
I have ordered the probiotics, digestive enzymes and adrenal support which should arrive soon. Is it worth me starting them now?
Hi Spen,
Make sure you work through all of step 1 before adding in supplements from step 2, it helps isolate variables
I received my breath test results and had an appointment for the doctor to tell me I have a sucrose intolerance, look up a few diets, come back in 6 weeks and we’ll see how you’re doing… less than thrilled I did some research and I believe I have SIBO-C. I do not want to start a protocol until I speak with someone that believes SIBO is real and if I should begin a protocol. I have the test results and my methane baseline was 55 and bumps to 73 after 120 minutes. Hydrogen remained relatively steady between 3 and 5… that said would you recommend me looking into a protocol? I keep trying different diets, vitamins, books – basically anything that I read I try. I feel like I’m making things worse, totally helpless, no one understands the daily pain/ discomfort, people think I’m faking and my quality of life is terrible because it controls me. I literally do not know what to do. Please help – any suggestions welcome ??????
If your doctor is recommending something, start there. If/when you are ready to commit to the book protocol, and as long as it’s OK with your doctor, then start the book protocol. It is very comprehensive and therefore hopefully will be able to help. Hang in there 🙂
Hi Dr. Ruscio,
Thanks so much for the book. There’s so much of this information online, and your ability to synthesize it is awesome! 2 quick questions:
1. What are your thoughts on carb restriction/ no fruit or starches for yeast? I know some sources indicate that yeast may also thrive on ketogenic type diets.
2. Any thoughts on using a Sauna to potentially increase the effectiveness of treatment? It would seem to be a good way to rid the body of toxins produced by sibo/fungal overgrowth
Thanks again, I’ll post a review on Amazon.
Nate
Thank you and my pleasure.
1. listen to your body
2. absolutely, sauna away!
Hope this helps!
My probiotics were delivered while out of town on doorstep and they were missed. They sat outside for almost 5 days. Have they gone bad? I want to make sure I’m using an effective dose.
That shouldn’t be a problem. They can be out for up to a couple week. See Step 2 QnA video 🙂
Thats OK, see step 2 comments page video 🙂
Hi Dr Ruscio
Been a fan of yours for awhile. I THOUGHT I had my diet fairly dialed in, but have had a rash that seems to be perhaps a histamine attack for about the last 36 hours.
I’ve taken LDN for the last couple years. Could this be a root cause in addition to the perfect storm of high histamine foods I seem to have been eating lately?
Do you recommend a specific DAO supplements, or have foods I seem to have been eating lately?
Do you recommend a specific DAO supplements, or have advice on what to look for in one?
I know that I can’t afford Dunwoody labs for testing.
Also a bit afraid of bone broth and lemon juice at the moment. Is there another type of reset I can do??
Thank You!!!
Hi Suzanne,
I would use the low FODMAP combined with the low histamine diet, and keep working through the protocol. Don’t waste your money on histamine testing or DAO 🙂
Don’t recommend DAO. But I am itching badly with no rash. I am nervous about starting ant… for my itching will get out of control. I am on Low FODMAP Low histamine diet and still itching, heart burn, constipation, rib and tummy pain. How to deal with itching? My doctor has nothing to offer.
Hi Christine,
I’m sorry you’re dealing with this. It sounds like you may have a bit of a unique case that needs personalized advice and attention. If you’d like, you’re welcome to apply to become a patient of Dr R’s (he does see people virtually if you don’t live in CA). You can do so here: https://www.drruscio.com/gethelp
Hi Dr. Ruscio,
I really enjoyed your book. After 9 months of actively trying to repair my gut and treat an abundance of symptoms, I’m finally feeling some relief and I’m confident that I’m on the right track with your protocol. I’m following the low FODMAP with SCD diet and I’m wondering if konjac noodles are permitted? They’re also called shirataki noodles.
Thanks so much,
Andrea
Hi Andrea,
Great to hear. I am not familiar with this. You could try and see how you respond, listen to your body 🙂
Hi Dr. Ruscio,
First of all, thank you so much for the amazing book. I really appreciate the summaries of research and the fact that you go over contradictory findings as well as replicable ones. It’s so difficult to get reliable information on health, there’s so much out there and it’s tough to know what to look for or how to interpret it. But your book does that, so thank you!
For my question: I’m on day 4 of the fast and for the last two days I’ve had nausea and diarrhea (with what seems like viscous solids). I haven’t eaten anything during the fast (no cheats), took no supplements, or medications (I’m not on anything). But I feel awful. I tried to find information online but it is all so unreliable (I read explanations like the ” the body is cleaning up the gut flora,” “it’s a symptom of ketosis caused by fasting,” and even “bile diarrhea”). My husband is doing the fast with me and he’s had no.problems.
Is my reaction common? I’m an athlete and normally consume 3-4x the amount of calories I’ve been eating, so I wonder if that could be the reason too… Otherwise, I imagine it’s a sign I should follow all steps rather than skip to 5?
Thank you for all you do!
My pleasure Kris!
Put simply, some people don’t do well on the fast. And it’s as simple as that. Keep working through the protocol and don’t over think this 🙂
there. On day 3 of full elemental diet and realized that I am going to run out faster than I thought. Just ordered 2 more containers and am pretty sure that I will run out before they arrive. How should I handle my food intake during the interim? Chicken soup broth with boiled/steamed broccoli??? Working my way up to cooked chicken mashed? I will have to order more than 2 though because each container only lasts me about 4 days and i want to be on this for a minimum of 2-3 weeks. My constipation has not improved and the MCT oil seems to be giving me nausea. Switched to coconut oil and taking stool softener nightly. I have a problem with fats (no gallbladder) so perhaps I should take a digestive enzyme to help? ? So many issues to be addressed. Thank you. The shake tastes great.
I’m guessing I didn’t not respond before you ran out, sorry. Keep working through the protocol as it will answers these questions. One step at a time 🙂
Hi Dr Ruscio
I live in South Africa and have been following your podcasts for about a year now. I was diagnosed with hashimotos and due to many years of ibs and gut pain, it made sense that the cause was leaky gut.
My doctor is hesitant about fasting since she feels that it puts a lot of stress on the body. I started on the great in 8 plan anyway and thought that the bone broth would be enough to sustain me.
I started the fast yesterday and although I wasn’t hungry, I was quite low in energy, low battery power mode. I expected that. But this morning woke up with a tremendous headache. So it’s a combination of tmj pain with sinus pain and just overall It felt like a migraine. Could this be a stress reaction to the fasting? A caffeine withdrawal? Anxiety?
I read through the comments and didn’t really see anyone else complaining about headaches.
Would really appreciate some feedback.
By the way, I’m a huge fan and am spreading the word here in South Africa about your book My doctor is even now following you.
Thanks Cindy
Thanks! It’s hard to say exactly. Try each version and if you don’t feel neutral or better, than it’s not the right fit for you 🙂
Thank you again!
Hi Dr Ruscio,
I am in the process of reading your book. I am wanting to begin eating low FODMAP, however I currently have a predominantly vegetarian diet. Are you able to recommend some good resources for eating plans, recipes etc. for vegetarians? Also, are there any other considerations I should keep in mind regarding nutrient intake when not consuming meat.
Thanks in advance,
Kyle
Hi Kyle,
We are about to update the Low FODMAP handout to include an expanded list of vegetables and some meat substitutes, this might help. It should be up soon. Other than that I would search for a vegetarian LF cookbook, I don’t know of any offhand.
Dr. Ruscio,
I reached out to you through Instagram and you suggested that I ask my question here. I’ll take advantage of having a little bit more characters to ask my question with some more detail.
I am about halfway through your book and am planning on starting the protocol after I finish reading everything. My main concern with starting the protocol is I am not getting much sleep, nor is the sleep I’m getting consistent. I have a 1-year old child that is struggling to give my wife and I any kind of consistency with his sleep. Some nights he is up every 90 minutes, other nights he sleeps for 5 hours before waking up and needing some help getting back to sleep. We are working with his pediatrician to figure out what’s going on with his sleep, but I know that my health is being directly affected by it. I haven’t been able to work out due to a lack of energy or time (I’m trying to help my wife with nighttime and early morning wakings with him as much as I can since she is a stay at home mom right now). I feel like I’m in a hormonal cluster-f*** with high cortisol/low test and that is manifesting as the beginnings of dad-bod.
My main question to you is this: Does the lack of reparative and restorative sleep negate the healing aspects of the protocol? Could I potentially have some false symptoms due to the lack of sleep?
I have yet to read past the Vitamin D section in the book, but was also wondering if there are any general wellness supplements you might recommend I take that would help support me while going through this sleep-training period with my son that would support the gut protocol (high doses of Meriva Turmeric? Fish Oil in addition to fatty fish in my diet? Rhodioloa Rosea/Ashwagandha and/or other adaptogens? Adding some juices like ginger or a green food?
Thank you for your time and insights. I appreciate it.
Hi Dr. Ruscio! I love your book. I have been recommending it to all my training and nutrition clients. My questions is this:
Is there any place for vegetarians in this protocol? I was vegan, but I introduced eggs so that I could vary my proteins as I had a lot of reactions from pea protein. However, I really do not want to eat meat. Is there anything you could recommend for vegetarians?
Thanks.
Yes, look for a vegetarian paleo or low FODMAP cook book. Or, just modify the food lists to be vegetarian as best you can. We are updated low FODMAP list now to include more vegetarian friendly foods.
Love the book and I am a vegan.
Is it ok to do a vegan paleo or vegan fodmap diet for the gut?
Yes, but it might be more difficult. We are developing a vegetarian version now and it will be added to the resources section soon.
Dear Dr. Ruscio,
I have IBS C/D (mostly C) and Autoimmune Metaplastic Atrophic Gastritis/Pernicious Anemia. In the past, I’ve controlled the worst of the IBS symptoms with a Low FODMAP diet, but my I had a slew of other symptoms (skin irritation, poor sleep, low energy, brain fog) that I felt weren’t being addressed by standard Low FODMAP.
I’ve done the modified fast and have been on a Paleo diet for the past 10 days. I’m limiting or avoiding a few high FODMAP foods (onion, chicory root, coconut flour, cauliflower), but mostly not worrying about FODMAPS. My energy is pretty good, and my skin is less irritated. I also haven’t had the really bad IBS symptoms, like nausea, bloating, cramps, so far.
However, my constipation has been really bad. How long should I tolerate this constipation? I am worried because the parts of the protocol that seem to address it are really far away.
As part of the fast and Paleo, I gave up coffee, which had definitely helped with my constipation. Is it better to tolerate the constipation for a long time, or reintroduce the coffee?
I would love some guidance here.
Best Wishes,
Sarah
You could start on the Mag Citrate now as a bowel aid. You could also bring coffee back and and see how you do. Or, both 🙂
Ok, great. I will start on the Mag Citrate now. And maybe move right into step 2?
I’ll refer you back to the book for guidance there 🙂
And thank you!
Hello Dr. Ruscio. I have your book Healthy Gut Healthy You. Currently on step 1, I have tried Paleo for 2 weeks and haven’t felt much better. Which should I try next, Autoimmune Paleo, Paleo low FODMAP, or just low FODMAP? Just a bit confused here. The book is incredible and I can’t wait to heal my gut!!
Hi Hannah,
Thanks! The book should help you with this, but Paleo Low FODMAP or Low FODMAP are good next trails to consider.
Hello. I love the book! Having said that…quick question. We are just beginning, but are trying to get pregnant as well. Should my wife stay away from the 2-4 day initial liquid fast and just eat normal food, or, do you think it’s ok?
Thanks!
Thanks! This is really your OB/Gyno’s call, I don’t think there is any problem with it though.
I loved reading the book- I found it very helpful! I’m about to start Step 1 but have a quick question. I think I may be dealing with histamine intolerance (not completely sure, but it seems that sticking to a low histamine diet helps alleviate symptoms I’ve been having like rash, faster heart rate/feeling jittery). If I’m correct, I’ve seen that bone broth and lemon juice are higher histamine foods. Do you have any recommendation for what I should drink during the fast? Do you think I should try either/both drink options and just see what happens or do you know if any lower histamine alternative? Thanks so much!
Thanks! Try them both and see 🙂
I was under the impression that fasting could make constipation issues worse (I’ve read a few things on it releasing more acid, etc). Is this true, or perhaps the drink provides enough nutrients to avoid any impact? I just finished my first day — all good so far, but definitely don’t want to worsen any constipation issues.
What are your thoughts on this?
Hi John,
I wouldn’t worry about it, the modified fast is only 2-4 days and meant to kick off the healing process.
Hi Dr. Ruscio, Thanks again for the well written and helpful book. I am currently following the paleo 30 but I only eat meat twice a week; hence most of my protein comes from fish and eggs. I have heard from various paleo sources that tinned fish is a good paleo snack. I always believed however that tinned food was unhealthy.
What’s your thoughts on this? Also, is tinned fish better than smoked fish? And lastly, Is there a limit to how much fish a week a person should consume? (I mainly eat mackerel, herring and sardines)
Thanks
Dean
Hi Dean,
Glad you’re enjoying the book! Check out this article on canned fish, which I believe will answer many of your questions: https://paleoleap.com/canned-fish-know-buy-avoid/
Good luck!
HI Dr. Ruscio! Amazing book! i am on day 3 of the fast with mostly lemonade and some bone broth. i have noticed ongoing lower back pain and hip pain and i remember a few years ago experiencing the same thing when i was strongly eating clean and low carb and had a blast of sugar. Could it be the syrup? is this a sign of some kind of sugar sensitivity? i usually have huge sweet cravings!
I will review the book when completed! thanks so much!
kim
Hi Kim,
Yes, or a reaction to some other component of the lemonade fast. Keep moving forward with the protocol and make a note to note use the lemonade again 🙂
On Day 5 of elemental shake and have had bad diarrhea. I know that this can be a side effect but for how long should i expect this? I know that everyone is different but wouldn’t this be a detriment to my gut? What is the longest that would be advisable to continue with the shake before waiting for side effects to subside? Thanks.
Hi Joanne,
After 5-7 days if the reactions haven’t abated you might be intolerant. Consider one of the other formulas listed or that the ED approach might not be a good fit for you. Make sure to check in with your doctor on this also.
First day back with food after the four day liquid fast and everything is going right through me… ugh!
Hope you’re feeling better now!
I’ve been adhering to a no-sulfur and low FOD map diet for 1 year. The book describes to try Paleo, then AI Paleo, then Low FOD in that order (pg 263 column 1) (after the initial cleanse). What if I already know that sulfur foods and all nuts will cause increased symptoms? Do I try the pyramid foods as described, anyway, try to find foods compliant with all three diets, or skip to the re-integration from sulfur foods (resource on website)?
Also the book is confusing me: How much time do I give each diet? (Page 263 = each pyramid level for 2-3 weeks, and page 266 = spend a few weeks determining which diet you feel best on.)
Hi DJ,
If you feel you have already run the dietary experiments, and settled at your ideal diet, then move to step 2. You could also try a low sulfur version of each. Give a diet a 2-3 week trial to decide if it working. If it is, ride this to plateau (just as outlined in the book 🙂 ). If diet doesn’t fully work, move to step 2.
Hope this helps.
I’ve been on a really clean and strict diet for over a year now trying to help my digestive problems, skin issues, and fatigue/brain fog. I’ve also been taking digestive enzymes/acid, adrenal support (Ashwaganhda), thyroid hormones, and Vitamins D/K/B-Complex.
I’m better on the diet and supplements but still have all my health problems, just less severe. I even did a 3-day juice fast a month ago.
My question is should I start with step 3 as I’ve already pretty much been doing steps 1 and 2 for the past year?
Thanks!
My question, above is very similar!
You could skip to 3, but you might also miss some of the nuance from the earlier steps. Ultimately its your decision.
Interested in an autoimmune Paleo diet list of products to consume and avoid. The website has a cookbook. Can you provide a list?
see http://www.drruscio.com/gutbook
I searched this link and there’s only a cookbook. Can you provide a list of what to consume and avoid?
Hi Bryan,
If you click the link for the cookbook, a food list is provided right after the table of contents.
Dr. Ruscio- I completed the elimination phase of foods almost 2.5 years ago and have been on Low Fodmap since then. I have been able to add back in a few foods after a major surgery last year for MALS. I can only eat about 17 foods with 3 ingredients being the max. My gut is still a mess- IBS-M with D predominate (treated for SIBO x3, SIFO, slow motility, and much, much more) and I am well versed in several areas of your book from all the research I have completed over the last 3 years and the 10+ doctors and dieticians I have seen. I cannot do a fast as I am underweight and malnourished so am hoping I can start with step 2. The problem is I have severe side effects from most medicines and supplements. I noticed Atrantil in your shop and I tried that 2 months ago per a GI’s suggestion and it made me more bloated than I already was – I seem to have the opposite reaction to what the supplement is supposed to do. I also noticed MotilPro which I tried last year and couldn’t take it either. I have a lengthy history with gut issues that I won’t add on here but am hoping for your opinion on starting at step 2 and skipping the fast. I also do not eat meat but drink Dr. Axe powdered vanilla bone broth twice daily. Thank you very much!
Hi Kate,
That sounds frustrating, I’m so sorry you’ve been dealing with all of that.
We can’t give you direct medical advice, but if you’d like to become a patient and set up a consult with Dr. R, you can do so here: https://drruscio.com/consult-dr-ruscio/
Sometimes people who have gut issues and are underweight actually end up gaining weight when they do an elemental diet because it allows their gut to rest and heal, which then allows them to absorb and assimilate nutrients better – so that may be something you want to consider (under the guidance of a doctor of course).
Good luck!
I’m trying not to stress out about the diet part, but I already am. I did a protocol earlier this year that included removing foods on an MRT and doing an anti-fungal protocol. I have ulcerative colitis that’s currently sort of under control (none of the common symptoms but my inflammatory and immune markers are showing it). My problem is trying to avoid allergens and intolerances without feeling too restricted. I’m pretty sure I need to avoid nightshades, and possibly nuts. I’ve never tried eliminating eggs or ghee (like AIP does). There were some other foods (like cucumber, garlic, onion) that came up on my MRT that I think I might still be sensitive to as well.
1. Should I start with paleo or AIP as my diet?
2. Do I need to toy around with cutting out or adding specific foods or trying low-FODMAP or anything else before moving on to step 2?
3. Depending on the answer to 2, how long from now should I aim to be starting step 2?
Thanks for your help. I’m heading to Amazon to leave you a review now 🙂
Hi Rachael,
I know how stressful it can be trying to stick to a restrictive diet (even if medically necessary) for a prolonged period of time.
A couple things:
1) Check out this podcast: https://drruscio.com/going-gluten-free-with-jennifer-fugo/ It’s specifically about gluten but has some helpful tips about elimination diets
2) I would definitely go based on symptoms over what the allergy test says, as those aren’t always 100% accurate.
3) I would consider working with someone (nutritionist, therapist, coach, etc) who understands what you’re going through and can help you get through it (without being miserable the whole time).
Good luck!
If neither was good above he told others to move on in the program. My itching and heartburn got way worse on bone broth. I had to start PPI’s
Dear Dr Ruscio, thanks for a great book! I work as a doctor in Sweden but here most doctors are still not familiar with the importance of gut health or what to do about it.
However, I have a question about my own health. I have problems with anxiety, a bit of depression, I wake up several times per night, I have loose stools and I am underweight. The last few years I have been under severe stress, I have also taken several antibiotics.
I have tried a low carb paleo diet (I even started with that 6 month before reading the book and before that I tried LCHF for a year) but I didn’t get better. When I tried the elemental fasting (on home made chicken broth) I had to quit that after 48h since I felt very anxious, slept worse than usual and felt very irritated although I drank a lot of the broth.
Now I am trying the low fodmap-diet since 10 days and I actually feel more happy and less anxious than I have done in a long time and my stools have gone back to normal! I have chosen to eat a mix of your paleo fodmap diet and the usual fodmap diet, that is I only eat things from the green columns in the paleo fodmap variant with the addition of gluten free oats, quinoa and lactose free yoghurt without taste.
I still feel that my health can approve a whole lot but what shall I do next? I get confused when looking at the “low fodmaps with scd” since it adds small amounts of things that are forbidden in the normal low fodmap diet but forbids for example oats and lactosefree yoghurt that are allowed in the normal low fodmap diet. Do you recommend me to continue with the diet I started 10 days ago and in that case for how long before I move on to step 2? Or do you recommend me to try the low food map with scd diet, and in that case, for how long? And what are the meaning of the four different grading based on fermeability in that list; does it mean I can eat things only from the first column from start and then add foods from the other groups? In that case when and how should I do that?
Sometimes I skip breakfast to do intermittent fasting but is this wise or unwise regarding my underweight? I guess intermittent fasting could be a good thing if you suspect SIBO? Or should I skip the fasting for now?
I would be really greatful if you could answer this because I tend to “overthink” things when I am not sure what is best to do.
Kind regards, Helena
Hi Helena,
I think you are overthinking things here. The book answers all these questions. Trust and listen to your body, that is the missing piece here 🙂
Dear Dr. Ruscio,
I love all content you have put out. I want to heal my gut from chronic constipation. I did 3 day water fast in April, which led to fecal impaction and an emergency doctor visit. Since then I was prescribed several laxative DAILY (20 ml MOM, 2x7mg Senekot and 1mg Resalor). I would like get off those laxative and found your website/podcast/book. I would like to start your protocol with the fast but worried about the impaction again. What can I do to prevent that? Should I take those laxative during and/or after the fast?
Thanks a lot for bringing great knowledge to the community.
Hi JC,
If you’ve had a bad experience with something in the past listen to your body and don’t repeat it 🙂
Hi Dr Ruscio!
I started Step 2 and have been trying to implement the probiotics. Prior to your probiotics, I was taking Betaine-HCL and Lipase. I was a little aggressive with the probiotic dosages and unfortunately started having bad acid reflux.
I don’t know if this could be a “die-off” reaction or maybe the probiotics are helping my stomach produce acid on its own, and taking a Betaine-HCL supplement is now causing too much acid. Another thought was that maybe taking the probiotics away from meals is what’s causing the reflux.
Anyway, I’m 99% positive that my health issues are caused from SIBO or other gut imbalance, could I start the step 3 supplements without the probiotics, and then add them back in a week or so into step 3?
Thank you so much!
If anything, I would stop everything, then restart one at a time to pinpoint where any reaction is coming from. Reduce variables as much as possible.
Dear Dr Ruscio.
I really enjoy the book due to learning more about the gut, the history behind everything and are glad that you took the time to investigate what is being said here.
I have started the liquid fasting, adding black coffee (for awareness). I understand that the coffee might be an irritant, however i have an ulcer and find that adding sugar to anything aggravates more than coffee for me. This is my first day, however i find that the stomach is burning a lot causing re-flux and then headaches. Is it truly wise to do fasting with an ulcer as not eating can be bad for this? (According what I have read)
I also wanted to find out how to balance an Ulcer and IBS diet as what works for the one do not work for the other or so I have found through testing different diets. I have both and I really need a solution here. Could one diet help with both these issues?
Please let me know your thoughts.
Thank you very much.
Anelle
Hello Dr.
I realized that I did not include the fasting I am using. It is the first one with lemon and maple syrup. I did not use the syrup but green tea and lemon. I also had some 100% fruit juice mango and orange with this. I answered my own question here. The high acidic intake is what is causing the re-flux as well as the burn.
I might need to go on the broth fast, however my question remains is it wise to go on a liquid diet when you have an ulcer?
Thanks anelle
Hi Anelle,
Glad you liking the book. There is no one answer here, this is what the book is meant to help you with, finding what works for you. You can also contact my office for personalized guidance.
I can’t tell you how excited I am about your book at the Great-in-8 protocol. I am one of those people who has been floundering in diets, supplements, testing, etc. for the past couple of years with little success and you have given me renewed hope. I.m planning to begin the protocol next week and just wanted to express my thanks for your expertise and accessibility (look at all these responses on the site — it’s amazing!). Thank you tons.
My pleasure!
Hey Dr Ruscio,
I’m currently a week into step 3, started straight with level 2.
I’m very interested in the Elemental Heal, could I try it either 100% or hybrid approach while taking the step 3 supplements?
Or would it be smarter to go through step 3 level 2 first then try out the Elemental Heal once off the anti microbials?
Thanks!
You could really go either way. Trust your intuition, reduce variables and listen to your body. When in doubt, follow the protocol (read carefully).
Hi Dr. Ruscio, I’m fascinated reading your book and I’m just about to start the first step on diet and I have a question.
I’m 43 y.o. and since 23 y.o. type 1 diabetic. About 10 years after diabetes I developed gluten intolerance (non celiac). I also seem to have problems with dairy. Pollen/dust alergy have accompanied me much of my life as well. And recently I started having digestive problems (similar symptoms like SIBO or IBS), so I started reducing FODMAPS and it seems to help.
My question: Should I start with the liquid fasting if I have type 1 diabetes? (I use very little insuline dosis but still).
And when I get into diets, shoould I go directly to an AIPaleo+low FODMAP diet knowing all my autoinmune conditions and if I already noticed improvement with low-FODmap?
I’m kind of worried because I don’t want to lose more weight (I’m tall and thin) so not sure the amounts of protein to eat to substitute carbs.
Thanks a lot!
Carlos Gonzalez from Spain
You may want to be careful with fasting. No, don’t assume you should be on AIP just because you have T1D.
Welcome!
Hi Dr. Ruscio, after trying to get rid of SIBO on my own for 8 months I discovered your book and read it.
My question is, during these 8 months I was trying things at random, based on what I had read on the Internet. Without yet knowing about your book, I was focusing on step 3 – remove, by cycling multiple antimicrobial agents (the list is long), and even tried the elemental diet, but was unsuccessful. Is it worth it for me to try again but start at step 1?
During my experiments, the only thing that made me feel better for a short period of time were pharmaceutical antibiotics, but then symptoms started to creep back up.
I’m wondering if doing the process outlined in your book will make a difference in how I respond to antimicrobial herbs or the elemental diet. Can probiotics/digestive enzymes and acid really make all the difference?
Hey valerie!
I’d love to chat with you about what you’re going through. My dr says shes pretty sure I have irritable bowel syndrome but sometimes I think it is SIBO that I have.
She told me that you cant really get tested for IBS and she didnt know what SIBO was.
I did the fast and on paleo ever since but I still find my stomach feeling off and that I have ro pass gas throughout the day, sometimes more than others.
I guess this means I should either switch to the paleo diet or the probiotics and antimicrobial herbs?
Hey Dr.ruscio. I’m on your website right now and found the PDF for the modified fast.. is this something i can use as well instead of just the powder that I order for the liquid fast? Sorry. I’ve ready the book but I just am not sure if those are two different options that one can do?
also! are we to buy all 3 probiotic blends, the enzymes, and adrenal and vitamin C that youve listed in step two of the protocol to ensure my gut heals properly?
its just a bit expensive, but if thats what it takes to feel better and healthy i am willing to do it 100%. thank you for your time and help
My hunch would be to use one or the other for the fast. Try the modified fast and see how that works. If you notice a 70% ish improvement then do not worry about the other fast.
You may not have to use any probiotics if the fast works for you. Try step 1 and 2 and see how you feel.
Thanks Jim!
I did the fast using the elemental heal powder. I have been paleo for about 2 weeks now and some days I feel great but others I still off and my stomach feels like it’s doing weird things and feels a bit off as well. My dr tod me from the symptoms I described that shes prett auaurauaure I most likely have irritable bowel syndrome.
I still have passing gas (mostly with no smell tho) and have some reflux or small burping eveveryday.. which I siant really.have before starting the fast but now i do.. I do feel less bloated though.
I’m wondering if should stick to paleo for a while longer or try the low fodmap or just start with probiotics and antimicrobials?
Any suggestions? Just feeling kind of lost and helpless lately with what to do now.
Thank you
I apologize if this was covered in the questions already. I am on a very low does of levothyroxine, 25mcg. Should I continue to take my meds during the protocol? I honestly can’t tell that they’re doing anything.
Hi Whitney,
It’s not advised to stop taking any prescription medications. After you go through the protocol, you may want to go get your thyroid levels re-tested, as people often see improvements in hypothyroid issues after healing the gut.
Good luck!
Can it take a while to notice effects from probiotics and digestive enzymes/acid? It’s been 4 days since I’ve begun to use them and have not noticed anything besides the fact that I’m more constipated. Is it worth continuing for 3 weeks.
Hi Valerie,
I realize it’s been a little while since you left this comment – did you continue the probiotics? How are you feeling now?
Dear Dr Ruscio.
Thank you for your book, it seems the most sensible diet advice I have read. I’m a 35yo woman who has had moderate to severe chronic fatigue syndrome and POTs for the past 2.5 years. I’ve been eating mostly paleo for the past year, which I think has helped with my mild diarrhea-tending IBS, but not with the CFS. I also tried AIP for two months with no noticeable effects on the CFS symptoms. I just did a 2 day bone broth fast, as per your book. On the morning of day 3 I was still feeling very hungry, headachey and tense, so I broke the fast. My plan was to then begin a month long low fodmap experiment. However since breaking my fast I have been getting some very severe POTs reactions to some foods that I did not notice any strong reaction to previously (I haven’t yet narrowed down which foods yet but am keeping records. The shortlist of suspects is banana, turmeric and coconut milk). My heart has been racing and pounding, especially when upright. What do you think might be going on? Thanks so much for your help! Jen
Hi Jen, I’m sorry you’ve been dealing with those symptoms! I’ve passed this question on to Dr. R, who will hopefully answer it in an upcoming podcast episode. In the mean time, definitely try and pinpoint which foods they are and keep them out of your diet for now (low fodmap or not). Good luck!
Thank you Drew
Hi Jenny,
Dr R addressed your question in a recent episode of the podcast: https://drruscio.com/answers-questions-healthy-gut-healthy-protocol/
Hello doctor, I’m really enjoying the book. Excellent work! My BM’s are perfect with the low FODMAP diet. I’m wondering though, your book says “4 berberine capsules 3 times a day”. Does this mean 12 capsules total or 4 capsules spaced out in 3 sittings? The reason I ask is because I would be surprised if the total recommended amount is 12 capsules; that seems excessive compared to the general consensus on berberine dosing. Thanks in advance if you get to my question and thanks for the book
Hi Ian,
So glad to hear you’re enjoying the book. If you feel up to leaving a review on Amazon to help get the word out, we’d greatly appreciate it (https://www.amazon.com/Healthy-Gut-You-Michael-Ruscio/dp/0999766805).
The dosage given in the book is correct – 4 capsules, 3 times per day – aka a total of 12 capsules. The therapeutic dosing for an acute infection is often times higher than general maintenance dosing for supplements.
Hope this helps!
Hey dr ruscio,?
I am starting the liquid fast with the elemntal heal tomorrow. I’ve been following the protocol in the book, but I want to double check with you- when i start eating food (paleo diet) do i add back in all the supplements and vitamins I was taking prior to the fast? Or do I need to wait a specific amount of time before adding them back in? Thank you.
Hi Dr. Ruscio,
I have been listening to your podcasts for about 2 – or 3 years and find you to be fair, evidence based and focused on patient outcome. I got 2 – copies of your excellent book, one for me and one for my son’s girlfriend who works with people with anorexia. Wondering if you will please clarify a coupe of things in the book for me.
First, you wrote that salt was an additive that can harm the gut. Will you please send me some links on your website that I can learn how to consume sodium healthily? Right now I have about 5 -1/2 tsp salt a day in my unprocessed meals and teas. Is this not the best way to take in sodium? I sweat a lot at work and exercising.
Second, In your book you gave a link to a website that cannot be found. Will you please provide another way to access this information? The link mentioned is on page 322 and it is about manual therapy for abdominal and pelvic adhesions.
Thank you so much for working so hard on this literary masterpiece.
Take care,
Jim
Thanks!
I didn’t say that, but I paper I cited did. References are listed in the book already. I wouldn’t worry about salt.
Clear Passage, search that in our searbox.
My pleasure!
Hi Dr. Ruscio,
Is there any truth to the claim that drinking coffee between meals will deplete a person’s stomach acid/HCL “stores” ? The idea was that this will occur because drinking coffee causes stomach acid release and the body can only produce so much stomach acid.
If this is in fact the case, would black tea or decaf coffee also decrease stomach acid stores?
Thanks for all that you do!
Hello He covers coffee in the book. It is thorough.
Hi Jim. I read the section on Coffee, but want to know specifically about the validity of the concept that coffee and/or caffeine will deplete the body’s stomach acid “stores.” Thanks.
I addressed the HCl-coffee connection in the book already 🙂
Hey Dr. Ruscio
I loved the book so much ! Thank you ?
A couple questions
1) when doing the liquid fast is it okay to have herbal tea (with nothing added) or black coffee?
2) once eating whole foods again after coming off the fast (doing the paleo diet or whichever one that works best for each individual) and once feeling better on it, is it okay to go out for food to have something that isnt exactly paleo /fodmap etc. Or is it very important to strictly eat along the guidelines of the specific diet for quite a fee months?
1) My hunch would be try not to have it.
2)Definitely okay and he actually encourages it in his book.
Thanks Jim!
Been on paleo doe 2 weeks anand most days I feel.great but still feel very off sometimes.
Passing gas daily. But maybe this is also because I am taking no supplements right now either? Bloating and most of stomach cramps have disappeared tho ans coffee in moderation doesnt zeem ro bother me.
Although I feel better, it’s not 100%.
I feel like I am so close to 100% though though that do you think it would be okay to so the antimicrobial herbs and probiotics instead of trying the low fodmap diet.
Or vice versa. The low fodmap and then the herbs and probiotics?
Also, I guess i was worried about going out for food because it would backtrack any progress that I may have made with my gut health since doing the fast.
Thank you !
You are welcome. I think the answers to these questions should be apparent after reading the book. Learn to trust yourself and listen to your body.
Hi Dr. Ruscio,
First of all, thanks for the book, it’s been a really good read. I wish I could follow your protocol, but I’m in a bit of an impossibility.
I have celiac disease, diagnosed a year ago, and did not get better on a gluten-free diet. In the past year, I have done an elimination diet and realized only a very limited number of foods give me no symptoms: fish, 8 veggies, various herbs as seasonings and 2 herbal teas. (I do not eat meat out of principle, fish is a concession because I cannot tolerate any vegetarian protein.) Anything else gives me bad abdominal pain 12 to 15 hrs later if tried in small quantities. Continuing the food/supplement or having bigger quantities gives me diarrhea, constant urge to go, undigested food in stool.
To note, I have a very bad reaction to minute quantities of oil, really 1-2 drops of any vegetable oil gives me bad abdominal pain 12 to 15 hrs later. However, I have no problem with large quantites of fatty fish, so it’s not the fat per se. I cannot eat anything raw.
As for your protocol, I do not tolerate fish broth, lemon (modified fast out of the question), any probiotics, nor any herbal antimicrobials. I could do a SIBO test, but even if I have SIBO, what good would the test be if I cannot use any treatment? I would try an elemental diet, but I’m afraid I would react badly to the ingredients and would prefer to avoid the expense, as my budget has already been hard tried. I am also underweight.
What would you recommend under the circumstances?
Many thanks in advance for your answer.
Consider seeing an MCAS specialist, or cautiously try what you think you can from the book protocol. Hang in there.
Has anybody here tried to get the Interfase Plus supplement in Canada? They won’t ship it here and you can’t find it in stores. What’s the alternative?
Never mind, disregard my above statement
Your Elemental Shake states it contains milk, is it lactose free by chance?
Thank you so much for your great book and this information. I love your approach to help heal without getting overwhelmed with the healing process. Thanks for helping me change my approach to healing my health. I love your podcasts as well!
Hi there!
The product is casein and lactose free and was designed to be devoid of allergens. Due to regulations, we must list milk because it does contain whey milk, however this product is very well tolerated by those who generally cannot tolerate dairy.
Where do you find these white potatoes on the low-fodmap diet? I called all around and no one carries. Sacramento, CA
Dear Dr.
I have problém with my Digestion 4 yers. I have IBS, and many intolerance, Leaky gut. When I eat non corectt Food, I have diarrhea, pain, and
vomit, mucus in the stool. Please, What kind of diet is for my? I am vegan.
Sounds a lot like SIBO-D. You could try eating ginger or making ginger tea for slowing intestinal motility and alleviating vomiting. Enteric coated peppermint oil may also help with your symptoms
Hi Dr Ruscio,
Can you please tell me which parts of the protocol need modification in pregnancy/breastfeeding?
thanks
Hi Catherine,
That would be a question for your obgyn. Good luck and congratulations!
Dr Ruscio,
I am planning to start the fast this weekend and start a paleo diet following it. On my current workout program and goal to build lean mass, I need more carbs for fuel and recovery. The book says to eat moderate to lower carbs and I don’t think lower carb will work with my program. Is it ok to keep carbs higher with fruits, veggies, and sweet potatoes? Has anyone else done this in step 1? Or, should I stop focusing on lean mass gain for this step?
You probably don’t need as many carbs as you think you do
I function better on higher carbs. Feel better, recover better, and perform better.
Hi, doctor. I have a quick question: Just wanted to know if I could substitute artemisia for artemisinin? I can’t find the latter in my area so was wondering if artemisia would have similar antimicrobial effects
Hi Ian,
I would think that would work, but the dosage may be different. i’ve passed this question along to Dr. Ruscio, and hopefully he’ll answer it in an upcoming podcast.
Excellent. Thanks
I just finished reading your book. I want to start step 1 next week.
My question is, I have had LIS surgery years ago. I have been on Magnesium ever since for my bowels.
When I have my surgeries for ideopathic Subglotten Stenosis, I get severely constipated even when fasting.
Can I take my magnesium during the fasting stage?
After doing step 1 I felt so much better. My stomach hasn’t been this great in years. I’ve been keeping my carbs in the hundreds. But I failed 2 weekends.
I’ve been struggling with candida for the last few months. Is this a problem related to my gut? Would it improve if I keep my carbs low? Or should I be doing something different? It appears every time I get my period. Is it hormone related? Trying to understand how to heal from it. Thanks.
Hi Clara,
Glad to hear step 1 was helpful! Candida is definitely related to the gut, so you may want to keep going through the steps (including antimicrobials) to help with any dysbiosis/yeast issues. Good luck!
Hi Dr Ruscio,
I have adrenal issues/insomnia, I am working with a ND, in your book you recommend adrenal glandular, she also recommend it, i read that some people have bad reaction to it, how can someone take this safely ?
ty,
Sayeed
Hi Sayeed,
Everyone is different. Some may do fine on supplements and some may have a hard time. I’d continue working with your doctor and she can help determine if the glandular is working for you or if you should try something else. Good luck!
Dr. Ruscio
I am about to start Step 1 and about a year ago I had an E95 food panel test done, which reveled that I am “sensitive” to certain foods. I have for the most part avoided these foods over the last year but experimented here and there and some of them don’t seem to bother me that much. I plan to do the Whole 30 and a lot of the foods that I am “sensitive” to per the E95 are Whole 30 friendly and I would like to experiment more with them. Any thought on this? My inclination is to try not to worry about what the E95 says and try to eat as many of the foods as possible, in order to establish the broadest diet possible. Curious what you think.
Hi Manuel,
Food sensitivity testing is not always 100% accurate. Check out this video Dr. Ruscio made about it: https://drruscio.com/food-allergy-testing/
How you feel and react to foods and your experience with them is usually going to be a better indicator than what an allergy test says.
Good luck!
I have purchased the digital version on your book Healthy Gut Healthy You on Amazon. I cannot locate your handouts for your Great in 8 Action Plan. Are they not included in this version?
Hi Linda! Here you go: https://drruscio.com/gutbook-resources/
First of all, love the book and the amount of depth it goes into. I am a 26 yo male with fairly chronic digestive issues. Type A personality working a moderately stressful job as a clinical pharmacist practitioner. I have tinkered with a lot of different therapies (extended fasts, AIP, probiotics, xifaxin, etc) in the past. Feel really good when I’m fasting, but I typically suffer from bloating and periodic loose stools when I’m not. I am pretty lean and would like to improve gut health to help put on a little weight/muscle. Feel like I have trouble getting in enough calories. I have completed the bone broth fast, and have been doing a Whole 30 diet the past couple weeks. I have been focusing on mindful eating and chewing the hell out of my food. This has seemed to help the post meal bloating, but I continue to have some loose stools and have had noticeable (by me) bags under my eyes for the past few weeks although I do prioritize 8 hours of sleep. Is it time to switch to AIP or low fodmap? Would one be better than the other based on my symptoms? Or should I move to Step 2 and continue the Whole 30? Any advice is greatly appreciated. Thanks!
The book is really informative and interesting.
As I only weigh 6st 11lbs and am 5ft 2in tall is it still ok for me to do the four day fast? Would it be better for me to do the low fodmap diet and not the palio diet. I also have an intollerance to ceisin and yeast. I have a problem maintaining my weight.
Your advice will be most appreciated.
Hi Eileen,
I’m sorry to hear you’ve been dealing with these issues, I know it can be frustrating.
We can’t give direct medical advice here, so I’d recommend setting up a consult with Dr. Ruscio if you’d like personalized direction (you can do that here: http://www.drruscio.com/gethelp)
I would note that some people who are underweight end up gaining weight when doing the elemental diet, as it helps their gut heal and they are then better able to absorb nutrients. Definitely listen to your body though.
The Elemental Heal is casein-free and the book should answer your question about low fodmap vs paleo.
Good luck!
First of all, love the book and the amount of depth it goes into. I am a 26 yo male with fairly chronic digestive issues. Type A personality working a moderately stressful job as a clinical pharmacist practitioner. I have tinkered with a lot of different therapies (extended fasts, AIP, probiotics, xifaxin, etc) in the past. Feel really good when I’m fasting, but I typically suffer from bloating and periodic loose stools when I’m not. I am pretty lean and would like to improve gut health to help put on a little weight/muscle. Feel like I have trouble getting in enough calories. I have completed the bone broth fast, and have been doing a Whole 30 diet the past couple weeks. I have been focusing on mindful eating and chewing the hell out of my food. This has seemed to help the post meal bloating, but I continue to have some loose stools and have had noticeable (by me) bags under my eyes for the past few weeks although I do prioritize 8 hours of sleep. Is it time to switch to AIP or low fodmap? Would one be better than the other based on my symptoms? Or should I move to Step 2 and continue the Whole 30? Any advice is greatly appreciated. Thanks!
Hi Kyle,
I’m glad to hear the book has been helpful so far. We’d love an Amazon review if you feel up to it.
Regarding the diets, the book covers this (try page 263) and talks about how to know when to move on to another diet and in which order to try them.
I’d also mention that it seems like you may be getting in your own head a little bit too much. Follow the protocol outline in the book, try not to overthink it, and make sure to listen to your body and your intuition, because in reality that’s how you’ll know if what you’re doing is working for you or not.
Good luck!
I know that Dr. Ruscio really drives the point home about not becoming obsessed with diet and not spending hours and hours of screen time trying to learn more about diet, to the point of creating more unwanted stress. I am 100% on board with that.
However, something that I am finding is really confusing and hard to deal with is the conflicting information regarding what a SIBO/ Low FODMAP diet should look like. For example, the SCD says that bananas are okay but “must be ripe with black spots”. The handout on this website “Paleo/ Low FODMAP” says only unripe bananas are “safe”. Another example is nuts, the SCD says just about all nuts are “legal”. The “Paleo/ Low FODMAP” handout says that almonds and hazelnuts should be avoided.
I am getting frustrated because I have completed 4 days on the modified fast using Elemental Heal and I felt the best I have felt in a long time, it was almost miracle-like. Now I have transitioned back to normal whole food for the last 4 days and symptoms are creeping right back in (loose stool, every time without fail). I do have some “suspect foods” that I think are causing issues and some of them are on the above lists but again I am finding conflicts between what should and should not be eaten/ avoided among lists that are supposed to be giving like information. I am not sure how to deal with this without getting discouraged. Any comments or advice is appreciated.
Hi Manuel,
Thanks for your comment. First of all, that’s awesome you’re feeling better after the modified fast, that’s a great sign! And it’s totally normal for there to be some road bumps when adjusting to eating normal foods again.
The reason there’s so much variation diet to diet is that everyone is different and there are multiple diets that work to help people manage symptoms. Instead of being frustrating, I’d actually think of this as a good sign, that there are multiple paths to health.
Specifically regarding bananas, they were recently re-tested by the lab that does the FODMAP testing and their status changed, which is why you see so much discrepancy on lists.
But in general, everyone is different and will have different triggers. These diets are all really just a starting place and a general guide to get you started. After that, it’s up to you to pay attention to your body and see what’s working and what isn’t.
Don’t get discouraged, try and play around and treat it as an experiment.
Good luck!
Drew, I’m sure Manual appreciates your response to his comment. Of course everyone is different and has different triggers, but he also deserves a response to the valid concerns he brought up. There is conflicting information between the book and the supporting documents. We want to follow Ruscio’s directions, but we can’t do that until he revises the food lists provided for the low FODMAP diets.
I’m excited to get started with resetting my gut, but wondered if diet modifications can help heal my 8 year old son’s gut. It was discovered that my son had a tick co-infection called Babesiosis and he was given 2 separate antibiotics to take for 2 weeks. I am worried this really messed up his gut, but he would not do well on a liquid diet for 2 days. Do you have any recommendations that I could do?
Thank you,
Kim
Hi Kim,
The diet modifications in the book could potentially be helpful, but you’ll want to check in with your pediatrician. Some of the supplements may or may not be appropriate for children or the dosing could be different. Good luck!
Hello from Africa, and a big thank you for the book and for the podcast, which have been a huge source of encouragement for me – it truly is an act of love that you would make this information accessible and I just want to ackowledge you and your team for that. I’ve shared it with my mum, and intend to share with many more people!
I’m on day 3 of the fast and have noticed that the bone broth was starting to give me diarrhea. I tried to eat a low-fodmap food and noticed it gave me diarrhea too. i’ve switched to the lemonade (without the maple syrup) to complete the 4 day liquid fast and seem to be doing ok. However, I am worried about the diarrhea coming back when I begin to reintroduce foods on day 5. Is it alright to start with the HCL, digestive enzymes and probiotic on Day 5 as i reintroduce foods? In your experience, would this help?
A big thank you once again.
Hi ZB,
So happy to hear you’re enjoying the book. We’d love an Amazon review if you feel up to it!
Occasionally diarrhea can be a side effect of the fast, so you’re not alone. Finding a diet that works for you afterward will be helpful too. Following the order laid out in the book for trying diets is key.
I’d follow the protocol as it’s written in the book (meaning diet before supplements), as it’s designed in the best way to isolate variables to see what is affecting what.
Good luck!
Hello Dr. Ruscio
Thanks for your wonderful book. I have been battling adrenal fatigue/SIBO for about 2 years and want to start your gut healing protocol. I suspect I also have an elevated mercury body burden due to having amalgam fillings for many years (they are now removed). I plan to work on mercury detox using dr. Christopher Shade’s protocol (QuickSilver Scientific), and my question is about timing of starting these protocols. my understanding is that mercury can be a big player in biofilms/fungal overgrowth. Dr. Shade’s protocol uses a GI binder that has silica in it. would you recommend doing your protocol first, and mercury detox second? or work on both at same time? Any reservations with using silica in an inflammed gut?
Thanks.
Hi Angela,
Happy to hear you’re enjoying the book. We’d love an Amazon review if you feel up to it.
Regarding your other questions, unfortunately we can’t give personalized/direct medical advice here, but I would recommend working with a qualified practitioner. Heavy metal toxicity can be a serious matter and you’ll want to work with a clinician to make sure it’s actually an issue for you before self-treating.
As far as Dr. Ruscio goes, I know he likes to “start with the gut”, but again, everyone is different and working with a practitioner will be helpful when figuring out how to layer different treatments together.
If you’d like to apply to become a patient, you can do so here: https://www.drruscio.com/gethelp
Good luck!
The link to supplemental materials has a diet similar to Paleo; is that the one to use?
Similarly, there is a link to an AIM Paleo cookbook but no actual foodlist. Where could that be found?
In the previous post my email was incorrect. It is corrected here.
Hi Becca,
Yes, use the one that’s titled Whole30. That has a food list that should be helpful.
If you click the link to the cookbook, there is a food list included there 🙂
Becca asked two different questions. The first one was about the Paleo diet, and the second one was about the AIM Paleo diet. It sounds like you didn’t read her second question: “Similarly, there is a link to an AIM Paleo cookbook but no actual foodlist. Where could that be found?” Your Whole30 download does NOT say anything about an AIM Paleo foodlist.
Is Becca’s second question going to be answered?
I was wondering if you can do a modified Elemental Diet? I can’t tolerate amino acid supplements, or folic acid. Can I make it without?
Hi Erin,
The books suggests the bone broth fast as an alternative.
Good luck!
Is there any reason I could not water fast instead of using the elemental diet? I have a pretty significant histamine intolerance and am worried about reactions on any of the elemental protocols
Hi Emily,
That would potentially work, you just wouldn’t be able to do it as long. Make sure you work with a doctor on this. Good luck!
I purchased the book, and I’m planning my shopping list. At https://drruscio.com/gutbook-resources/, the document for “Standard Low Fodmap Diet” appears to have some oversights. It does not say anything about meat, eggs, or drinks. Also, it contradicts information in the book. The book states that the fruits and veggies allowed in the Paleo Low FODMAP diet are the same as the fruits and veggies allowed in the standard Low FODMAP diet. However, the download for the standard low FODMAP Diet says to avoid eggplants, while the download for the paleo low FODMAP diet says that eggplants are safe, for example. I’m confused.
Another discrepancy is grapes. Your standard low-FODMAP list gives grapes the green light, while your paleo list says they have too much fructose.
Also, the book says that the paleo low-FODMAP diet bans rice and potatoes, while your PDF says that the paleo low-FODMAP diet allows rice and potatoes. Between the book and the PDFs, there are too many inconsistencies for me to know what to eat on either plan. I would like to follow the standard one, but it’s hard to take it seriously when the only protein it lists is tofu. (And no, I’m not looking at the vegetarian version). It looks like the PDF you currently have uploaded for your standard low-FODMAP diet is an incomplete draft.
Similarly, your PDF for the paleo low FODMAP diet allows butter and cream, while your book says that diet excludes butter and cream. This is getting frustrating.
Hi Moorea,
Thanks for your comments. We’re working on getting the handouts updated and they should be complete in a couple of days. All meat/poultry/seafood is fine. Rice/potatoes/butter are controversial on the paleo diet as some people argue they are technically not paleo, while other people include them in their paleo diets and they are fine. Since they’re low fodmap and many people tolerate them well, there’s no harm in giving them a try. All of these diets are just a starting place with people reacting differently to different foods (even foods on the green list), so the key will be listening to your body and seeing how you react. Good luck!
Thank you, Drew. I’ll look forward to the final drafts of the handouts. I’m enjoying the book.
Just as I was about to begin the antimicrobial phase of Dr. Ruscio’s protocol, I unexpectedly had to take a 7-day round of standard antibiotics (Duricef/Cefadroxyl) to treat a non-gut related medical issue that arose. Once I am finished with this 7-day antibiotic treatment, is it wise to still proceed with Dr. Ruscio’s recommended antimicrobial treatment for my gut issues? Although the antibiotic is for another non-gut related issue, I am unclear as to whether it would possibly also treat my gut dysbiosis and am trying to determine whether following it immediately with antimicrobials would be redundant or harmful.
Hi JS,
It probably would not be redundant, as antimicrobials tend to treat a wider range of ailments, with antibiotics being much more specific, but you may want to check in with your doctor to get the go ahead. Good luck!
Hi Dr Ruscio, I am half way through your book but not yet got to the treatment part. However I have been trying to correct a bad dysbiosis for 3 years already. The stool analysis done earlier this year showed 95% Enterococcus! And no good bacteria. My Dr said this is why I have insomnia & constipation as I have no good bacteria & no serotonin. He wanted to put me on weeks of Amoxcyllin but I was not keen. Although I have been on pretty strict diet for years & tried tonnes of herbal treatments & supplements, spent thousands, and to no avail. It’s pretty soul destroying. I found Resolor and have been taking that for a couple of weeks & found it helps & I also felt happier but the insomnia seems even worse, if that’s even possible. So anyway my question is should I purchase all the supplements you recommend even though I have tried similar before or should I try the Bioclear Cleansing Program that I saw advertised in an email from you? I live in NZ & I get get that stuff here. I am not sure about all your products shipping to NZ, especially the probiotics.
When I read all the possible reasons for my issues it is totally overwhelming & I cannot afford to keep blowing $$ & getting nowhere. My thought process is to use the Resolor to get things moving as only then will i be able to get on top of the bacterial overgrowth…oh I also did a SIBO test last year showing methane gas. Also wondering if LDN is a good option instead of Resolor. Thanks!
Hi Trish,
I’m sorry to hear you’ve been dealing with all of this. There’s no harm in continuing to work with your doctor and if they’re prescribing you Resolor and it’s helping that’s great. In terms of the book, I would definitely recommend finishing the book and following the protocol as written. This is the same protocol he uses in the clinic with his patients with gut issues of all types. Our store ships to NZ (you’ll just want to check and see if NZ has any rules about importing supplements). Hope this helps.
Hi! I heard you on a recent podcast and am curious to start the Great in 8. Could you clarify two things for me?
#1 – after the master cleanse/bone broth fast should I go to paleo next or semi-elemental next before doing the paleo? I am confused, because Step1B in the book says to do the fast than paleo BUT the “gutbook” resources page on your site has the elemental diets listed between the fast and paleo.
#2 – is the Whole 30 the paleo diet you want us to start with as mentioned in Step 1B?
Hi Kia,
1) paleo after the fast
2) yes
Hope this helps!
Hi Dr. Ruscio,
Thanks so much for your book. I have been struggling with gut issues for 6+ years, have tried many diets and protocols, but yours is the first I have found that has had such a clear program to follow, and I’m super excited. Two questions:
1. I have been taking HCl and digestive enzymes for a couple years now. When I come off the fast and begin the paleo diet, would you recommend that I continue with my HCl/enzymes or wait until Step 2 as written? I am curious whether there are foods that I could digest without the extra support (and I plan to take re-entry pretty slow), but I’m concerned about doing several weeks of diet-only modifications without digestive support, due to the possibility that I would acquire additional food sensitivities (I already have a long list).
2. Is there a reason you don’t include any of the “gut-healing” supplements (such as L-glutamine, for example) at any step in your process? I’d love to be able to heal without them, so will follow your process as written. Just curious about the omission, since so many others seem to think they’re necessary.
Thanks much,
Emily
Hi Emily,
Glad you’re finding the information in the book helpful!
1) I would follow the protocol as written (aka don’t add those things in until step 2)
2) vitamin D has actually been shown to be healing to the gut
Hope this helps and good luck!
Dr. Ruscio,
Enjoying the book! I’ll be starting Step 1 – modified fast. I’ve been considering a juice fast with a local organic juicery and was wondering if this would be acceptable for day 1-3. I would then follow with the bone broth. The juices are green with little to no fruit.
Thank you!
Hi Becky,
Sticking with the options recommended in the book will be your best option here. Good luck!
Dr. Ruscio recommends NAC and Interphase Plus for breaking up supposed biofilms in the gut. The problem with this approach, is there’s lack of research showing efficacy of these products for actually breaking up biofilms in humans (to my knowledge anyways). It may be helpful in gastric or upper gut issues, but who knows if it reaches lower down in the intestine without being rendered useless by digestive juices and bodily processes. Dr. Ruscio also offers no citations for the Interfase or NAC. Care to provide any evidence for these claims? Thanks
Hi Ian,
I actually do think he addresses this topic in the book in the section on biofilms, but I’ll add this question to the list for a future listener Q+A episode of the podcast.
Thanks for taking the time to comment!
I didn’t say he didn’t address it. I said there’s lack of research. Where’s the citation(s) for it? Post the research here
Hi,
I’m wondering if you could help give some suggestions on how to increase my calorie/fat intake whilst following the paleo, low Fodmap diet in step 1. I’ve been doing it for a week and a half and as nuts are a caution/avoid, I’m struggling to get enough. I’m eating some meat, eggs and using olive oil to dress food but worried it may not be enough. I generally function better on high fat instead of high carb.
Thanks 🙂
Hi Casey,
Sometimes it can take some playing around when you start the diet to figure out what works best for you. Olives are a great way to add fat/cals. Also, if you do well on higher fat, then adding additional coconut oil, avocado oil, lard, duck fat, etc to your food is a pretty easy way to increase your intake (cook your meat in it, roast veggies in it, make dressings from it, add it to smoothies, etc). You could also consider eating fattier cuts of meat (e.g. steak instead of chicken breast). Hope this helps!
I’ve bought the book but cannot access the materials in this step. The on-line link for step one goes nowhere. Where the site says “Access the support materials mentioned in the book below” (with a down carrot), I get only a pop-up thanking me for ordering the book. No link.
Is there a secret handshake? A password?
Sorry you’re having problems accessing the page! Does this link work for you? https://drruscio.com/gutbook-resources/
Hello,
First off, thanks for the book! I’ve a science background and spent 5 years sifting through articles, journals and papers and taking random pot shots at thier findings.. it’s fantastic to have so much of it out together in such a straight forward way.
I’ve IBS-C for 5 years and am underweight. FODMAP worked, and now is ineffective. I’m on the final day of my step 1 fast and have dropped even more weight.
In 4 days I am due to start a 6 day kayak trip from the Andes down to the ocean, ~5 hours paddling a day. Paleo food will be available but I’m expecting I’ll not be getting the calories or protein I need and will be heavy carbs.
My question: im keen to get my energy and bull back up in time for the trip, and have enough energy for the paddling. I’ve found a vegan rice/pea protein powder. Will supplimenting with this powder for both phasing back to whole foods and steps 1b) be appropriate?
Any alternatives if not?
Many thanks in advance,
Mark.
Apologies for the typos, sent from my phone 🙂
Hi Mark,
I assume you’ve already left for your trip so this response may be too late, but I’d say listen to your body and see how you feel. Hope it goes well!
Hello, I want to try the liquid fast for two days. I usually workout every other day, would it be better to skip lifting weights during this fast? Thanks
Hi William,
That’s your call. Listen to your body and see how you feel. The biggest problem tends to be that people get hungry and a little tired with too much activity. Good luck!
Hi Dr. R. I just completed my fast, and am moving on to paleo portion for the two weeks. It is November 30, and I am assuming I will probably have to add in the support supplements in two weeks. I have surgery December 28th they say it will take about 6 weeks to heal. My question is if I should start the support supplements after these two weeks (November 14th) or wait until 6 weeks after my surgery date. Thanks!
Hi Brittany,
Those are all questions for your doctor, as you’ll want to take their recommendations for what to do pre and post-surgery. Good luck, I hope it goes well!
Hi Dr. Ruscio,
Your book give gives me hope! I’m starting on step 2 of the program. My question is – Is it okay to take the probiotics along with thyroid meds first thing in the morning? I’m on a compounding T3 and T4. Thank you.
It’s my understanding that thyroid meds should be taken alone, but you may want to run that by your doctor.
Thank you!
After twice (Twice! I don’t learn.) deciding to eat apples within a week, I am retooling my Step 1 diet to officially cut out foods that cause oral allergy syndrome due to birch / alder pollen allergy. I’m curious if you’ve had anyone in the clinic try this approach? In my experience, “oral” allergy syndrome affects my entire digestive tract. I’m trying the book’s protocol specifically because of the gut/immune connection to see if it calms my hyper reactive immune system, which shows up as hay fever-type allergies, a tendency to get a bout of asthma with the slightest provocation (recently described more officially as hyper reactive airway disease), a tendency toward what I affectionately call the hacking cough of death (more hyper reactive airway disease), and now a worsening oral/digestive tract reactions to my favorite fruits.
There’s an interesting paper on PubMed (PMID: 24910772) that found patients allergic to birch pollen have ongoing intestinal inflammation, even outside the seasonal birch pollen season and even if not symptomatic. I’m curious if you’ve looked at this in the clinic or if anyone else reading this forum may have experience here? I’m happy to report back with my experience if interested.
I read in your book about the use of elemental and semielemental diets on days when symptoms are flaring, so I purchased Elemental Heal from your store. My question is: I have to do a clear liquid diet in a few days for a colonoscopy prep and want to know if this product would be considered a clear liquid. It looks fairly clear and would provide protein. I was thinking maybe I should mix it at less than full strength. Do you know the answer to this or do I need to contact the manufacturer? I doubt my GI doctor will know what it is. Thank you.
Hi Donna,
That would be a question for your GI doc. While they may not know what Elemental Heal is specifically, they will have likely heard of a semi-elemental diet (which Elemental Heal is) and will be able to tell you if that’s acceptable or not. Hope this helps!
Hello dear Dr. Michael Ruscio,
My name is Kira, I’m from Israel. I really liked and enjoyed your book, I got so much useful information for such a low price, it’s incredible!
I have a question for you, my husband (50 yo) used to have all the symptoms of IBS (bloating, abdominal pains, gases, loose stool), later he also started having a severe heartburn (he was even given pills) and aphthous stomatitis on his tongue and internal lips.
After reading your book I made him try the Low Fodmap diet, and he started feeling better pretty quickly.
A couple of months later all the IBS symptoms disappeared (the heartburn as well, so he stopped taking the pills).
But the aphthous stomatitis in his mouth are not going away. I mean, they are, but then they come back.
I have a question related to this.
Should he complete all 8 steps completely (until now he did only the diet, didn’t try step 2)?
And will it help him with the aphthous stomatitis?
Thank you a lot for everything,
A Worried Wife.
Hi Kira,
Glad to hear you enjoyed the book! I can’t say for sure whether or not it will help him with aphthous stomatitis, but it’s probably worth starting the protocol and seeing if he achieves more lasting improvement. Hope this helps!
Hi! I really am enjoying your book. I am having gallbladder issues which cause belching and reflux along with stomach pain. But I also am getting very constipated each month around the time I am ovulating. (also having other symptoms such as hairloss, hair on chin, cramping ect) Will doing this protocol help me at all? I have already done a 8 month protocol for Blasto Hominis, Candida and Mild Sibo with my Functional doctor last year. Some of the perscriptions and supplements were the same as you recommended, others were different. I have been seeing him 2 years and I’m still struggling with symptoms. Any advice would be greatly appreciated. Thanks
Hi Alisha,
Sorry to hear you’ve been dealing with this for so long. Unfortunately we can’t give personalized medical advice on this forum, and without knowing your medical history, it’s tough to say if this protocol will help you or not, but I will say it has helped other people with the gut issues you’ve mentioned, and addressing gut issues also can have a positive downstream impact on hormones. Good luck!
Thank you SO much for your book and for all of the help and advice you provide. My husband is looking into starting your plan in January. He has worked with a holistic dr locally, but isn’t seeing the results he would like. He is scheduled to have a colonoscopy in January, we aren’t sure of the exact date, yet. Should he wait to start until after the procedure? Also, is it advisable to go straight into the fast from the colonoscopy, or should he give it a certain amount of time before fasting. Thank you so much!
Hi Kristin,
I would default to following whatever instructions are given you from your doctor. If they say to stop supplements, etc, I would probably wait until after the procedure. And again, it’s probably a question for your doctor about how long before or after to attempt something like a fast. Good luck!
Hi! I loved the book. Trying to start step 1 and I’m having a hard time finding the recipe for the bone brother
Hi Janine,
You should be able to find it on the resources page under “Modified Fast Instructions”. Hope this helps!
Hi! The book is great.
Just one simple question.
Right now I´m doing the step 1 low fodmap Diet and feeling a lot better.
Should I go through step 2 gut support, or should I try the reintroduction phase of fodmap diet, one by one to see which ones I can tolerate and expand my diet?
Thanks.
Hi Alane,
It’s up to you. I would check out the green and gray box on page 267 about reassessing to help you make your decision.
Hello Dr. Ruscio,
I am a huge fan of all your work and very thankful for all the evidence-based, non-BS information you put out. I have picked up a copy of your book and am excited to dive in and learn as I have been struggling with GI problems for about 4 years now. It is actually the beginning of this GI distress in my sophomore in high school that led me down a route to try to eat “healthy” in an attempt to fix the problem and also try to give me an edge in my athletics (Lacrosse and football). Unfortunately, my dietary focus and manipulation led to an eating disorder and weight loss that I later received treatment for in my senior year of high school. After recovery I got back in to sports and lifting and spent a lot of time researching and looking into evidence-based information on nutrition and fitness. Despite my passion for these things, my eating disorder and GI problems continued to cause chaos at times in my life. The GI distress has never gone away, and I have been diagnosed with dyspepsia and have had my gallbladder removed. I still haven’t solved this. The current problem I face is trying to solve my GI problems while gaining weight and eating for performance. I have tried the low FODMAP diet but can’t seem to find a structure and meal composition to incorporate all I know about optimal performance nutrition as well as restricting my diet via the low FODMAP protocol. I currently face constant hunger, extreme food focus, low energy, caffeine and sweetener dependence, and brain fog. Despite these symptoms, doctors always tell me I am very healthy regardless of my low heart rate, BP, weight, and hemoglobin, which is quite frustrating as I don’t feel healthy. I have been debating whether to commit to going low FODMAP and Paleo because I definitely have the determination to do so but have been wary as to how to get the right amount of nutrition for performance.
Long story short, what would you advise for a 19-year-old college student looking to solve GI issues while gaining weight, eating for performance, and fending off eating disorder tendencies? Should I follow the protocol outlined in the book or would you advise something different? This attempt to decipher what to do has been very bothersome in my life as no one has been able to help me, so I have been left to my own devices to try to solve this discrepancy. I have been trying to find anything about eating disorders that you’ve put out, but I can’t find anything. Any advice would mean the world to me. Thanks again!
Sorry I do realize how extensive this is, and it would be best to get a consultation. However, as I mentioned, I am a young college student that does not have the money to pay for such a cost. I thought I would at least try to get some advice.
Have you been tested for any parasites, infections or had your thyroid tested (not just TSH, but a full panel)? I’m sure you’ve tried a lot to help yourself, but I think it’s important to reiterate that we should focus on the basic pillars of health first (going to bed before 10 or 11, exercise, enjoyment, stress management). Failing that, then it might be wise to test for SIBO if indicated (general stool tests from the colon don’t reveal much).Try to avoid gums and emulsifiers (guar gum, xanthan gum, polysorbate, etc) as they are suspected of disrupting bowel flora and the gut lining.
As for the hunger you mentioned, there is a specific strain of bacteria used in home yogurt fermenting that’s gaining traction as having an appetite supressing effect (among many other desirable effects): https://www.wheatbellyblog.com/2018/04/make-l-reuteri-yogurt/
You could also experiment with a lower carb diet and fasting as much as possible (because if your problem is solely bacterial related, harmful bacteria may eventually be able to be starved out and the lack of overt carbs in the diet can help improve your internal environment. Also, going a few hours in between meals is very good for SIBO to activate the MMC to sweep out excess bacteria and waste). Lastly, some people can benefit from prebiotic fiber early on, so you may want to try supplementing the more tolerated fibers (GOS and arabinogalactans). It’s hard to say if this will work though as gut terrain is so complex. We can get a pretty good indication if you have SIBO though if you end up reacting to prebiotic fibers and specifically FOS/Inulin or a RAW white potato within the first couple hours after ingestion. This can be a very telling, virtually cost-free test (the raw white potato specifically. Eat a VERY SMALL AMOUNT though at first to avoid very unpleasant GI and other symptoms). It may also be beneficial to add herbs to your diet in dishes as they are underrated and beneficial to gut flora in a variety of ways.
I would recommend Overeaters annomous. It includes all eating issues. I have tried for years to be a healthy eater but could stick to a plan. My overeating of coarse lead to health issues. But working the steps has given me the freedom to eat for my health.
Hi Joseph,
Thanks for taking the time to comment and I’m glad to hear Dr Ruscio’s work has been resonating with you. Disordered eating can actually cause many of the GI symptoms that you’ve listed, and I have found that the answer is rarely “be more restrictive”. I would actually advise looking into working on your relationship with food and seeing if that helps. Chris Sandel over at 7 Health has a lot of great free content. Good luck!
Hi there, enjoyed the book and preparing to start the fast in a couple of days.
Question about stopping the supplements. I imagine the response may be obvious with just following the protocol in the book but would like to ask in case there is a chance this might be different.
I changed my diet to paleo over 3 months ago (feel a bit better but still brain fog and fatigue) and have been getting a cold sore on my lip every 2-3 weeks which is significantly more than normal for me. Does not appear to be stress or the sun in this case but rather the change in my diet (low Lysine) as per my naturopath.
I have been taking Lysine supplements daily for 4-5 weeks and have not had a recurrence!!!
My concern is that regardless of how I might modify my diet after the fast as per the protocol, I will still be a avoiding dairy, eggs, soy, fish (dislike) etc foods that are higher in Lysine and that my cold solds would recurr without the supplement. I was already avoiding some of those foods before starting paleo a few months ago but more strictly avoided dairy, eggs, and grains (also partly due to results of fod senstivity test from few years ago that I know are not necessarily reliable).
Any thoughts on cold sores if my levels of Lysine are still low on the protocol as I plan to avoid these and only maybe add some in future if tolerated (like eggs?).
Also, can a bit of Stevia be used in lemonade fast instead of dark syrup (because already avoiding sugar for three months as well so afraid of getting cravings back…. but I saw from your other posts don’t need to have syrup).
Thank you!
Hi Joanne,
Following the protocol as closely as possible is what Dr Ruscio always recommends. But if you’re concerned, you can always run it by your doctor and see what they say. If you’re trying to avoid sugar, you may want to try the bone broth fast instead. Good luck!
Hi Dr. Ruscio!
Thank you so much for your wonderful book Healthy Gut, Healthy You.
I had a question regarding Step 3 of the protocol. If I have been taking probiotics, digestive enzymes, and an adrenal support previous to reading the book and have not had any improvement, could I skip to step 3 of the protocol or do you reccomend that I give the exact supplements that you listed a try? I know what your answer will probably be, but I just wanted to make sure before I spent money on the step 2 supplements that I could spend on the step 3 supplements instead.
Thank you for your time!
Hi Jentri,
We recommend following the protocol as written. That way, if something doesn’t work, it’s easier to trouble shoot and the question of “was I using the right products?” doesn’t come up. Hope this helps!
Thank you for writing this book and providing the Great in 8 plan. I also enjoy your podcasts. I will be starting step one of the plan fairly soon. My question is regarding PPIs. I’ve been on them since 2013 following an ERCP during which a bile duct stent was inserted. It was subsequently removed. I tried to go off of the PPI once, but was not successful. How and when do I wean myself from the PPI when on this program? Can Omeprozole be cut in half to take less dosage?
Thank you!
Hi Jan,
I replied to your question on the other post where you asked it. Make sure to work closely with your doctor when reducing meds. Good luck!
Thank you, but I can’t find the post where I asked the question. Could you provide a link?
https://drruscio.com/gastroesophageal-reflux-dr-ben-weitz/#comment-5335
Are collagen peptides or something like matcha collagen peptides acceptable?
Hi Nick,
Plain collagen could work, but I’d avoid it just so there are fewer variables.
Hi there, my main issue is brain fog. I just completed the 4 day fast. My questions are:
1) is it possible to notice significant improvements within two weeks on the diet(s) or would brain fog take longer then some of the other gut/GI issues to see changes?
2) as I return to eating now (or later with reintroduction of foods after finding a good diet for me) with plainer foods and eating the same thing for a day or two as suggested to monitor each foods and how they are tolerated, would I notice changes in my brain fog within a few hours or does it take longer to set in? I do feel some improvement in brain fog from the fast so I may be able to gage changes it is just more WHEN will I notice symptoms to see if I can in fact associate it with a particular food.
Thanks for the Harman story on brain fog!! That gave me some hope! Hoping I can see changes before 3 months ?
Who knows. Try it out and see for yourself. BE YOUR OWN experiment, just tread carefully of course
Hi Joanne,
Unfortunately, everyone is different and it’s really hard to say how soon you would start to notice a difference.
But potentially, yes, someone could notice improvements in a couple weeks with the diet change, though I don’t know what your results will be. As far as adding foods in, again this varies person to person, but I’d keep an eye out for the following day or two.
Good luck!
Hi Dr.
I did the mod fasting. Started with bone broth. I had a slight headache throughout the day but by the afternoon I started to feel so nauseous, headache increased. By the evening I started to profusely sweat and ended up throwing up all the water I drank. The next day I drank lemonade and it was a much better experience and delicious. I’ve had bone broth before and never had this reaction before. Fasted only for 2 days.
I started eating paleo. Although my energy has slightly increased, I’m still very bloated and my stomach has felt very unsettled.
Should I move on to AIP or straight to Lowfodmap diet?
Hi Erica,
In the book, Dr R recommends doing paleo for 2-3 weeks and then moving on to AIP. The info about how long to do each and in what order can be found on page 263. Hope this helps!
Hi there,
I just completed the four day fast and have started on the paleo autoimmune diet (I was doing paleo for a few months before and although I felt a bit better, it was not enough). My main issue is brain fog (occasional nausea and GI issues but not bad before).
On fast, my brain fog seemed to improve quite a bit! Since started back on food, my brain fog has returned as well as indigestion, gas, constipation regularly after eating. I feel exhausted, sleeping 10-12 hrs a night, more difficult to get up than usual.
Is this part of the transition back to food? Does this indicate anything about whether this is inflammation or overgrowth of bacteria? I will continue as planned through various diets but feel worse I think then pre-fast. On day four of eating.
Thanks!
Hi Joanne,
Keep working through the protocol. This is probably a sign that you will need to move to next steps.
Hi! I’m an autoimmune mess with lots of guts issues. Navigating through lots of suggestions for ibs, sibo (confirmed), etc. I love reading health related books. I really struggle with complete adherence to certain programs as I find it hard to manage my type 1 diabetes with the aggressive diet changes. I follow a paleo/aip style diet and have found some supplements to help ibs-c. But nothing has made me feel well throughout the whole day. So I guess what I’m looking for is guidance with diet that won’t put me in severe high and lows. And also for a plan that doesn’t tell me start probiotics bc I take probiotics I feel like I’m going to die. Long story short-does your book fit this criteria?
Hi Amanda,
As far as diets go, Dr Ruscio gives several options for you to try out and see which one you feel best on – mostly centering around paleo. The protocol does call for probiotics. Hope this helps.
Hi, I have Systemic Nickel Allergy (NAS) and many supplements contain traces of nickel or processed on machines exposed to nickel. Is it possible to follow the 8 steps without supplements or what would you suggest is the best way to heal my gut while also taking into consideration my nickel allergy?
Hi Eileen,
This is something you’ll need check in with your doctor about.
You could always try the protocol while keeping your doctor in the loop and see how they do.
Good luck!
I have been cleaning up my diet since September. The cleaner I get the worse my heart burn and all over body itching is. I had to start PPIs for I was just in to much pain. Starting Dec. 26 I did do two, two day bone broth days and then meat and greens… you talk about skin conditions but not itching with no rash.
I have felt with this in the past and 6 different Drs couldn’t help.
Hi Christine,
I’m sorry you’ve been dealing with this for so long. Check out this listener q+a podcast episode, he addresses a similar question that may be helpful: https://drruscio.com/listener-questions-feb-2018/
Also, if you’d like more personalized advice from Dr R, you’re welcome to apply to become a patient – he’s sees people in person and virtually. https://www.drruscio.com/gethelp
Good luck!
Based on experimentation and food choice that aligns closely with what I typically eat, I am transitioning to the GAPS diet. GAPS does not recommend maple syrup, and so I am considering options for the 4-day fast, including (1) substitute honey or another calorie source or (2) use maple syrup for the fast and then return to GAPS. In either case, I can minimize the quantity used. Are there significant drawback to either option? Thank you.
Hi Victoria,
A couple options here:
1) forget the maple syrup/lemon all together and go with the bone broth fast as outlined in the book as an alternative.
2) leave out the maple syrup. It’s included for easily digestible calories to prevent fatigue, but isn’t required.
3) Use maple syrup for the fast and then return to GAPS
Any of those would likely work and be just fine. Hope this helps!
Thank you. Oh my goodness, you were working late! No more questions for now, and thank you for your work.
I will be starting the modified fast and will use the bone broth, since I am taking homemade bone broth everyday already. Question is about quantity: What is the minimum I HAVE to consume (male, weight 154 lbs height 78 inches) I can happily go all day with nothing, though. Do you have a minimum I really must consume?
Looking forward to using your well thought out and common sense program. Thank you!
Hi Birgit,
Nope, there is no set amount. Just listen to your body and drink as much as you feel you need. Good luck!
Hello! I am on step three and noticed that on page 280 of the book, there is a discrepancy in the dosages for NAC and Biota-dissolve. There are bullets on the left that describe the dose, which are different than the doses listed in the chart on the right side of the page. Please clarify.
Slowly feeling better, love the book!
Hi Carrie,
This is addressed a few times over on the Step 3 page: https://drruscio.com/great-in-8-faq-step3/
It should be 1 cap 2x per day for the NAC. Hope this helps!
Dr. Ruscio – Love the book and still working my way through the chapters and I was wondering if it would be safe and/or beneficial to do the master cleanse/bone broth fast two days every week (say weekends) once you move to the next step? If so, do you still have to start slow with the cooked foods after the two-day fast, or can I move directly to working through finding the best eating plan for me? Thank you again for being so open to sharing your knowledge here and on the podcasts.
Hi Linda,
You could if you wanted to, but it’s totally up to you. Check out page 224 of the book where he discusses how some patients use it longer term. Just listen to your body and adjust accordingly. Good luck!
Hi Dr. Ruscio,
I listened to your interview on the Muscle For Life podcast.
In it you said that when writing the book, not enough research on stevia was available to make a recommendation and that now the research is there. I think the topic got changed and you didn’t end up saying if stevia is safe from a gut health perspective, so I was wondering if you could clarify if it is safe.
Thanks,
Jackson
Hi Jackson,
Dr Ruscio does support the use of stevia, based on current research.
Thank you Drew!
Hi Dr. Ruscio!
I just wanted to get a little clarification on the diet options. I tired the Low Fodmap diet back in 2015 and it helped initially, but then stopped. I have also tried other diets previously, with no change in my symptoms. Do you recommend I try all of the diets again? Or just moving on to Step 2 since they didn’t work previously?
Thanks!
Jessica
Hi Jessica,
I’d recommend trying again, since that was 4 years ago and many things have probably changed since then in your body. Follow the steps on page 263 that outline how to move through the diets before moving on to step 2. Good luck!
Hi Dr Ruscio and Drew 🙂
It’s early morning on day 4 of my fast. I’m doing the bone broth version.
Two things hampering me:
1) I’ve woken with horrible migraines every morning. Not unusual for me, but the intensity had been much worse this week. Talking to a pharmacist yesterday, it seems these may be rebound headaches from the sumatriptan I’ve been taking… Too frequently. I’ve had to take it all week up until today. I’m attempting to break the rebound cycle. My question is this: has taking the pain meds this week negativity affected what I’m doing with the fast?
2) since I’ve been fasting, and having discontinued all supplements, I’ve had increased joint pain, especially my lower back and hips. I’ve been up most of the night due to the back/hip pain. I finally gave in and got up to do yoga at 3am. Could this be from the fast? The lack of supplements? The lack of pain meds that I normally take?
Any insight is appreciated, even though I know I likely won’t hear back before the end of my fast tonight.
Many thanks,
-Jeff
Hi Jeff,
No need to worry, taking the pain meds didn’t ruin anything. As far as joint pain goes, I’m not sure if the supplements you were taking were specifically for joint pain or not. If they were, that could definitely be a cause. I hope you’re feeling better now that you’ve transitioned back to solid food.
Hey there, I loved the book Dr. Ruscio! I have just finished the bone broth fast so now I’m going onto the paleo diet for 2-3 weeks. I was wondering if I could consume hemp protein during this time?? I will be leaving a killer review on Amazon in the next few days! Thank you on your commitment and research for this book. I could not believe all the references you had!
Hi Chad,
It’s up to you. Supplementing with it occasionally is probably fine, but the fats it contains are relatively unstable and can go rancid easily, so be sure to store it in the fridge and also pay attention to how you feel when you consume it.
Ok sounds good. What kind of protein do you recommend using?
I suppose it depends on what you’re trying to achieve by supplementing with extra protein, but Elemental Heal is actually a great option because it has 27g of protein plus enough additional nutrition to either replace a meal completely or make a great addition to a healthy diet. https://store.drruscio.com/products/elemental-heal
OK awesome! Thank you!
Great book! Looking for recipe for broth and lemonade
Hi Barbara,
You’ll find them in the first link on this page: https://drruscio.com/gutbook-resources
Thanks for the book Dr Ruscio,
I’ve been diagnosed with ulcerative colitis back in November and have been fighting it ever since. My Dr never ran a sibo test or vitamin D test…
While on medication, I had every symptom, gas, bloating, severe cramps, diarrhea, etc. I noticed a couple of things and decided, against my Drs orders to take myself off the medicine. All my symptoms went away for 3 days, and then diarrhea came back.
I went through the 4 day fast, 2 days of bone broth, 2 days of the lemonade mixture. Each day, I had only 1 run of diarrhea, I figured this was normal.
Coming into the refeed, I started with homemade chicken soup, carrots, and celery. Maybe I refed too fast, but I’m still fighting the diarrhea, 48 hours later.
I don’t really have gas, but when the diarrhea hits, I can feel the pressure and it becomes urgent.
I’ve primarily been eating chicken soup and some turkey that may have gone bad with spinach.
Any advice?
Hi John,
We can’t recommend that you go off of prescribed medications. You probably want to be working with a doctor on this. If you’d like to become a patient of Dr Ruscio’s, you can apply to do so here: https://www.drruscio.com/gethelp
Along with talking to a doctor, you can play around with some other diets that could potentially be beneficial, such as GAPs, SCD, low FODMAP, etc.
Good luck!
Thank you for the reply!
I did want to clarify that Dr Ruscio and the book did not mention to come off the medicine. This was by my choice through my own education and to create my own experience.
I believe the book actually states to stay on the medicine.
To followup as well, I started to follow Paleo low fodmap as suggested in the book and things have gotten better. I have introduced vitamin d and am feeling great after a few days. I’m going to continue through the program and hopefully go back to living a normal life!
I will definitely contact Dr Ruscio if further help is needed.
Thank you again for everything
So glad you’re feeling better and the new diet seems to be helping!
Thanks for the book – it looks to be exactly what I was looking for after trying to navigate the bewildering confusion of the Internet on this matter. I am gearing up to start the initial paleo phase soon (after the master cleanse) but I’m unsure about coffee – it states in the autoimmune paleo phase to rule out coffee here, but in other places, such as the Venn diagram later in the same chapter, coffee is listed as being barred in the paleo diet in general (at least in respects to low-fodmaps/paleo) . Can I drink coffee in the in total paleo phase and if so do I still rule it out if then progressing to the low-fodmap/paleo (as well as obviously on the autoimmune paleo)? As you have probably guessed I am quite attatched to my morning coffee – I’m not convinced that green tea is gonna wake me up at 6.30!
Hi David,
Correct, coffee is out for the AIP diet plan, but you don’t necessarily need to start there. I would follow the guidelines in the book, starting with just paleo first. Coffee, in relatively small amounts, is not prohibited on a paleo diet. Check out page 191 in the book for Dr Ruscio’s take on coffee – hope this helps.
Have you any advice for a vegan about to embark on your plan? I am a little worried that my protien sources will be very limited, especially if I end up cutting nuts, seeds and legumes. I’m thinking pea protein powder, hemp protein powder and/or spirulina – are these acceptable protein sources on the autoimmune paleo diet? Even if they are I’m not sure if food rotation is going to be possible.
Thanks
Hi David,
Dr Ruscio doesn’t have any biases around a vegan or vegetarian diet, it can make the dietary protocol more difficult. Many vegan protein sources are not low FODMAP or are not typically included in a Paleo diet. My advice would be to listen to your body. If you choose to incorporate foods that aren’t paleo compliant, but are low FODMAP (tofu, quinoa, etc), pay close attention to how you feel. If your gut doesn’t seem to be improving, try taking them out and seeing if that changes anything. Do your best with the dietary aspect, and if you are not fully healed keep working through the Great-in-8 program. Good luck!
Hi Dr. Ruscio,
I read your book pretty much cover to cover and loved it. Everything resonated with me! My symptoms before this were chronic constipation over the past three-ish months (and a history of constipation, especially when traveling), plus pain from a hiatal hernia that was becoming more and more frequent. I’ve also had general digestive sensitivity and not always known what would work and what wouldn’t. So as things came to a head after these past rough few months, I found your book. I started the low FODMAP diet about 1.5 weeks ago, and within a few days, was already feeling much better. I also cut out any soy, dairy, gluten, sugar, caffeine, coffee, alcohol, tomatoes, and eggs. (The tomatoes and eggs were an intuitive choice.) Within days of the low FODMAP, the pain was gone. And within about a week, the constipation as well.
My first question: I’m now on day two of the modified fast, and I’m having a hard time with it. I don’t feel well, and feel incredibly tired and stressed out trying to fast. I’m thinking if things don’t improve today, I will just do the full two days, and then begin Paleo. Is that what you would suggest?
My second question is this: I love the results from low FODMAP, so I’ll be continuing that as I do Paleo. About 1.5 years ago, I did the Whole30 diet and didn’t see much in the way of results. Plus, I really did not like cutting out non-gluten grains. However, I’m wanting to once and for all really figure out what’s going on, and really heal my gut, so I’m thinking it’s worth it to take a little time and cut out the grains with Paleo, and just see. I would love to hear your thoughts, and also if you think one week is enough time, or if the two minimum is really needed to know. I hope to also try the AIP Paleo for one to two weeks, and really cover all the bases, and then do a slow reintroduction and testing of all the things I’ve cut out.
Thank you so much for your book and for your advice here!
Hi Angie,
So glad to hear you’re starting to feel better! I assume you already ended the fast, but the answer was yes, go ahead and end it whenever you like.
As far as how long to do each, I’d just listen to your body – if you’re feeling good, you’re probably on the right path. If not, give it a little longer or make a switch. Good luck!
“My first question: I’m now on day two of the modified fast, and I’m having a hard time with it. I don’t feel well, and feel incredibly tired and stressed out trying to fast”
Then don’t fast
“My second question is this: I love the results from low FODMAP, so I’ll be continuing that as I do Paleo.”
Just don’t eat a low fodmap diet for too long. Low FODMAP is good for a short period of time of maybe a few weeks to a couple months to shift gut ecology and then prebiotic fiber should be reintroduced. You may actually find some of your symptoms clear up this way going back to a more varied diet after following a low fodmap diet for a bit. Mark Pimentel, leading gastroenterologist and SIBO educator, even says that we should be eating a fibre RICH and higher fodmap diet when treating SIBO (which might be what you have based on your symptoms). The idea is here to bring the harmful bacteria out of spore mode by feeding them so they’re more susceptible to herbal or pharmaceutical antibiotics. Just eat VERY small amounts of fibres at first and work your way to increasing them based on tolerance
Sorry, to the admin, for the triple post. I just thought I’d add that I’m in no way speaking for Dr. Ruscio nor am I any sort of admin. I’m just providing some response that I see fits and could supplement HGHY.
Hi Dr. Ruscio,
Thanks very much for the book, its is very well written and fills me with hope :-).
I followed the low fodmap diet but it didn’t work very well (no drastic change in symptoms).
Now I’m trying to follow the AIP, but the problem I am facing is that since I haven’t consumed red meat for a long time, it has given me diarrhea every time I have try (even the bone broth!!).
Due to the restrictions in the AIP diet, I think that red meat consumption is very important.
Can you give me some advice in this sense?
Thanks very much.
Regards
Rod
Hi Rod,
I wouldn’t force the AIP diet if you’re not feeling that great on it. Just go back to whatever diet you felt the most ok on (low fodmap? regular paleo?) and then keep moving through the rest of the steps. Good luck!
Hello Dr Ruscio,
I just finished the bulk of your book, and am now beginning to read the Great-in-8 Action Plan. I look forward to doing the modified broth fast this week. I do have a question about my lifestyle going forward after this though –
I’m in a bit of different predicament than your average patient, as I am a profession brewer. As a result, I regularly consume beer for my job. I’m curious on your thoughts about the reintroduction phase, and long term gut health.
To give a quick tidbit about my lifestyle, I’m very active, and have a low carb diet (80% of my carb intake is from beer, the remaining is mainly vegatbles and low carb fruits, very rarely do I consume starchy carbs). I transitioned to this diet about 6 months ago (macros ~ carbs 15%/fats 55%/protein 30%), and have felt a huge improvement in both overall health and also in my athletic recovery time. The reason I read your book was to see if I can’t find a way to feel even healthier, in addition to figuring out certain foods I should remove from my diet.
Again, if you don’t mind sharing your thoughts, please let me know what you think about consistent, but moderate consumption of beer (I am generally drinking 2-3 pints a day; also, my beer is unfiltered)
Thanks!! And I really enjoyed the book! Excellent job on the research, and laying it out in an easy to understand format.
Hi Billy,
So glad you enjoyed the book! We’d love an Amazon review if you feel up to it.
As far as the beer goes, I would definitely keep an eye on how you feel when you take it out while following the HGHY protocol. That will be very telling for you.
Dr Ruscio has some content on gluten that you might find helpful:
https://www.youtube.com/watch?v=9jqJ2Xmy-eg
https://drruscio.com/podcast-gluten-free/
Hope this helps!
I have struggled with ADD and fatigue episodes (particularly after eating) foryears, and increasingly brain fog and memory loss for years. For almost two years, I have been trying to establish the best diet for my gut, gradually becoming more and more restrictive, only to find my symptoms getting worse. I went from mostly paleo for about a year, to true paleo for about 2 weeks, to paleo with low FODMAPS and no nightshades. I became so weak I decided to do FODMAPS without paleo restrictions and felt better, but still having major fatigue episodes and not digesting well. I was so excited to have a plan after reading your book. Then I started looking into what it would take to purchase all of the supplements from step 2 alone, and I was crushed. I simply can’t afford the plan, but at times I can barely function at work. Are there minimal steps I should take. Should I jump straight to elemental and just take the antimicrobial? I want to do the whole program but simply cannot. What recommendation could you make for me?
Hi Brad,
I’m sorry you’re dealing with this, I know how hard it can be to want to get healthy but not feel like you’re in the financial position to invest in it.
I will say this: Dr Ruscio developed this to be the most cost effective plan that he could. There’s no expensive testing required and he recommends the minimum amount of supplements he thinks will still get you the desired results. There are optional add-ons (magnesium, vitamin d, etc) that you can choose to not purchase. And the plan is also designed to wean you off of the supplements as soon as possible.
Since it’s already designed to be the most effective with the minimum amount of supplements (i.e. there aren’t any extra ones thrown in there just because), unfortunately I’m unable to tell you that just doing part of it will get you where you want to be. You can certainly jump straight to the elemental diet, but I’m not positive it will be much cheaper (though you can look on Allison Siebecker’s website for info on how to make it yourself). But it’s definitely something you can try.
In terms of the diets, feeling weak is not a good thing. Make sure you’re getting enough calories. One way to do that is to add extra fat to your meals, since that’s low FODMAP and most people react just fine to it. Also, low FODMAP doesn’t have to mean zero carb. There are plenty of carbs on the safe list, so make sure you’re getting enough of those too. Good luck!
Thanks for the candid answer. Yes, I was not getting enough calories, which is why I decided to cut the Paleo restrictions and start adding some low FODMAPS grains into my diet, but am still back and forth on what works for me and what doesn’t. I just struggle to digest anything, which makes me want to do elemental if for no other reason than I can just avoid eating for a while. And at least it would prevent me from the cost of buying food for the time. Anyway, thanks again for responding so quickly.
Many people try the elemental diet for exactly that reason – not having to think about what to eat. While some people say it’s challenging, there are definitely people that are so fed up with trying to figure out what to eat, shopping, and cooking, that they find it a relief to not have to worry about that for a couple of weeks. So it could be something you want to consider.
Also, if you’re having trouble digesting foods, I would make sure not to skip out on the supplements from the support step (digestive enzymes, probiotics, etc) since those can really help with that issue.
Thanks again. To update (this may be helpful to others), I woke up with severe abdominal pain this morning and went to the emergency room. The did an ultrasound and found a gallstone. From what I’m reading, I may have been adding too much fat to my diet to compensate for my calorie needs due to my very low carb intake while I was eating on a mostly paleo plan for a couple of years. That and rapid weight loss are apparently risk factors. Just something that others doing a similar program may want to be careful of.
Hi Dr. Ruscio,
I am working my way through your book. I just did a modified fast. I chose the lemon juice one. Because I have Fructose Intolerance, I switched out the maple syrup for dextrose powder, and I still belched like crazy for the whole 3-3/4 days from the lemon juice. I am a little nervous about trying the bone broth option because I also have Histamine Intolerance. I would like to do the Elemental Diet, but I am also sensitive to dairy, and I believe there is only one that you recommended that has no dairy, and it looks like I have to get it from my doctor (who is old school; not feeling optimistic that he will get it for me). Can you recommend any other options for me? Thank you.
Hi Robin,
A couple options for you:
1) We are coming out with a dairy-free version of Elemental Heal later in the year if you can wait that long.
2) Try Elecare by Abbott
3) Make your own.
Instructions for making your own can be found on the resources page or here: https://drruscio.com/wp-content/uploads/2018/02/2bHomemadeElementalDietInstructions.pdf
What category does Diverticulitis fall under? IBD?
It can overlap with IBS and IBD.
Hi! I have another question about the master cleanse. I notice you don’t prescribe the salt water flush part of it. Do you feel this is unnecessary or unsafe in some way? Thanks!
It is purposefully not included. Not necessary or relevant to the HGHY protocol.
Hi Dr. Ruscio,
I was wondering if it’s okay to consume garlic as part of the Paleo FODMAP diet. I noticed you’ve said to avoid garlic powder but garlic-infused oil is okay. Is whole garlic/minced garlic okay to consume?
Hi Ratula,
Garlic is high FODMAP, so most people usually do better avoiding it. The compounds in it that cause problems for people are water soluble, which is why a garlic oil tends to be safer. Consuming actual garlic would mean consuming those FODMAPs. That being said, everyone is diffrent and you can test your tolerance after removing it for a while and see how you do with it.
Hey there! I have a question about the Paleo fodmap diet. Where it says white potatoes are safe does that mean just the white potato or, does it mean white flesh potatoes like red, russet, and yukon gold potatoes are safe as well? Thanks a bunch!
Hi Chad,
Two things here:
1) a note about potatoes in general – there is some debate about whether they are technically paleo or not. They work fine for some people and for others they cause problems, so just pay close attention to how you feel when you consume them and go from there.
2) all potatoes are fine in terms of FODMAPs (except sweet potatoes), but from my experience, yukon gold and red potatoes tend to be the least problematic for people.
Hope this helps.
Ok, yes that helps. Thanks a lot!
Loving the book so far! I am currently experiencing fatigue, depression/anxiety along with just feeling all around lousy and am looking to alter my diet to improve my symptoms.
My question is regarding the first step with the cleanse. I am currently breastfeeding and am wondering if a cleanse would be a bad idea due to potentially dropping my milk supply?? Do you have any thoughts/recommendations for this? Would it be better to just skip this and go to the paleo diet first?
Thank you!
Hi Katie,
I’m not sure, that’s probably something to discuss with your doctor. I know that breastfeeding does require more calories than normal, so it may be best to skip that step. Please see the first FAQ pinned at the top of this page for Dr Ruscio’s thoughts on pregnancy/breastfeeding while doing the protocol. Make sure to keep your doctor in the loop. Hope this helps!
Hey there I just went and ordered the step 3 supplements but noticed the Biota-Clear 1B pills are out of stock. Do you have any idea when these will be back in?
Hi Chad,
Those are set to ship in the next couple of days.
Hello Dr. Ruscio,
I am currently in step 1 of the protocol and have been on a fairly strict paleo template diet for 6 months or more and still struggle with loose stools/undigested food. I have tried a low fodmap diet for the last few weeks and haven’t seen much of an improvement. My main question is in regards to maintaining bodyweight as I am very active and am having extreme difficulty to put on muscle mass especially with limited food options. I am really hoping that I can find a form of carbohydrate that can help me to fill up on as I am definetely not struggling with Weight Gain as most of the discussion in the book and in general seem to focus on. In your experience what would you recommend as far as extra calories for active men with healthy energy level that are hoping to gain weight while sticking in a generally healthy eating plan!
Hi Ryan,
A couple things: 1) At this point I would go ahead and move on to step 2 of the protocol. And stick with whatever diet you feel the most ok on. If it’s not low FODMAP, that’s ok. Step 2 may help with some of the undigested food. Though I’ll also mention to make sure to eat slowly and chew your food thoroughly. 2) Some people find added fats are a helpful way to get more calories in their diet, especially since they’re low fodmap. Coconut oil, olive oil, and grass-fed ghee (if you’re ok with dairy) are good options. Make sure to listen to your body though. Good luck!
If you already have a SIBO diagnosis would it make sense to start at step 3? If so, are the steps 1 and 2 integrated and if yes, when? Also if you are treating SIBO with xifaxan/neomycin is it advisable to include an herbal antimicrobial either along w/ or after the antibiotics? Thank you very much for clarification!
Hi Naomi,
We advise everyone to start at step 1. It sets you up to respond most favorably to the other steps. If you’re getting treated with antibiotics by your doctor, you’ll want to run that second question by them. Good luck!
I read the HGHY book and found it extremely helpful. I cannot start the full protocol for two more weeks, but I recently took the gut quiz and started the quick start protocol. I started with paleo low fodmap because I know I’m sensitive to fodmaps after 4 years of unsuccessfully fighting SIBO. I am at the stage where it’s recommended to incorporate the 3 probiotics as well as e-harmony for non-cycling women. I’m wondering when/if I should add the supplement for adrenals as suggested in the book? I understand that e-harmony should be taken for 2-3 months. Should I wait to see how I feel at that point? Sadly, I haven’t noticed any improvement yet, if anything I feel a little worse, but I’m sticking to the protocol! Thank you!
Hi Carla,
It’s ok to take them at the same time.
I ordered the Elemental Heal kind of suddenly. My diet was already reduced to about 10 items I could tolerate and I was starting to have cramps from something I was eating. I started reading the book at the same time as using EH. I have been working on diet pretty much since I first got sick 8 years ago, and especially the last 2-1/2 years. Before I knew I had SIBO, I tried probiotics with no improvement. I have recently tried to take enzymes, but my gut is so inflamed now that even they bothered me (I tried 3 different varieties). I have also been through several rounds of antibiotics and one of herbs, with no noticeable improvement. So I THINK step 3 and EH was the right place for me to start.
My question is, after the EH, what should I do next? It seems I should not go on to step 4, because I’m not taking probiotics or enzymes at this point. Do I go back to step 2?
Thanks!
Hi Connie,
I’m sorry to hear you’ve been dealing with this for so long, I know how frustrating that can be. If enzymes don’t work for you, then I wouldn’t force it.
When you’ve transitioned back to food, you may want to start with step 2. Adding in probiotics (if they work for you) and adrenal support helps lay the foundation for your gut to really start healing. Hope this helps.
hi dr ruscio and team. I have psoriasis and do low food map diet; plus some items of step 2. should I added something or retire something of the supplements for my special illness?
It seems I have serious histamines problems; so my body skin reacts bad to coffee pork and eggs which I quit. any advice for this histamine reactions?
Hi Juan,
You may want to trial the low histamine diet and see how you feel. Here’s a handout with some more info: https://drruscio.com/wp-content/uploads/2019/04/HistamineHandout.pdf
I have been battling mastitis I am not pregnant nor have ever been but i do smoke and it is more likely to happen to women who do, previously had staph but my body was able to fight it off i know the root cause is some teeth i need to have removed as I’ve taken many antibiotics for them and then for the mastitis planning to start step one but i dont know if I should start it during my antibiotic use or after I also bought some kaya probiotics which contains all of the following: Bacillus coagulans
Bifidobacterium breve
Bifidobacterium bifidum
Bifidobacterium lactis
Bifidobacterium infantis
Bifidobacterium longum
Lactobacillus acidophilus
Lactobacillus casei
Lactobacillus brevis
Lactobacillus gasseri
Lactobacillus plantarum
Lactobacillus rhamnosus
Lactobacillus salivarius
Enterococcus faecium
Streptococcus thermophilus
Other ingredients: organic rice-starch, hydroxypropyl methylcellulose (HPMC capsule, vegan). Do you think i should start the rest process after i have taken the antibiotics/probiotics or during? suggestions on which diet i should start with
Hi Mel,
I would recommend walking through the diets as outlined in the book and seeing which one you feel best on. Changing your diet while you take your antibiotics for the mastitis is most likely fine. I assume the antibiotic course will be over before you get to the end of step one in the book and then you can proceed through the steps as written. Good luck!
Hello and thatnk you for this amazing resource. I’ll be going through a colonoscopy procedure. I was wondering if after the required cleanse would be a good time to start steps 3 and 4 of remove and rebalance.
Thank you,
Michael
Hi Michael,
If you’re planning on doing the protocol from the book, I would recommend starting with Step 1. Each step lays the foundation for the next step to be more successful. If you want to skip the modified fast and move directly to the diet modifications, that’s fine. Hope this helps!
Hello – thank you for this book. It is awesome! I have spent several months working on the diet piece… Super frustrating… I feel great so long as I eat chicken soup, meat, carrots, a little zucchini / yellow squash and maybe some eggplant, salad, and cucumber. As soon as I try to have much more than this – even butternut squash, asparagus, beets, avocado, etc. I first start getting digestive symptoms, and then start having immune reactions to foods that I used to be able to eat w/o issue (eggs, dairy, nuts). Also definitely reacting to oxalates. Basically a SIBO (low FODMAP/SCD diet) is the only diet I can tolerate… but w/o oxalates, and I’m struggling to get enough calories.
Move on to step 2? For a few weeks and see how it goes before moving on to step 3?
Or keep eating chicken soup to try to keep the inflammation in the GI tract down?
Thank you so much!
Heidi
Hi Heidi,
Yeah, I’d move on to step 2. It’s possible that the added digestive support will help improve some of your tolerance. In terms of getting enough calories, if fat doesn’t cause you digestive upset, this could be a good option (coconut oil, olive oil, butter, etc) to get some extra calories in your diet. Good luck and hang in there!
Thanks. I’ve been trying fats… haven’t been able to tolerate coconut oil yet – digestive upset. I used to be able to tolerate butter… even just a couple months ago, but now I’m getting a strong immune response to it. Olive oil seems to be ok if I’m careful. =) I’ll hang in there! Just having to go slow.
Hi there! Thanks for this great book, podcast, AND this supportive forum!
I have been battling SIBO (confirmed by breath test a year ago) and likely SIFO (so many yeast infections over the years, some response to fluconazole). For the past couple of years, I’ve been toggling between herbal antimicrobial protocols, Rifaximin/Neomycin (one round of Augmentin that did nothing), biofilm disruptors, adrenal supports, low FODMAP/anti-candida diets, etc….SO many different things. I actually really appreciate the simplicity and step-wise approach; I am going to start with the modified fast (which I’ve never done) and begin to work the steps.
Few questions:
1) Step 1b involves experimenting with some diets. I’ve been on something like Alison Siebecker’s Low Fodmap/SCD combo for some time…and have steadily been removing things (like all forms of sweeteners/fruit due to fungal fears, nuts, etc), steadily painting myself into a corner with a really limited diet–and still not feeling better. I do have some fears that if I start by experimenting with Paleo first, that’s actually a big reintroduction for me–lots on there I haven’t been eating! Would it be OK to keep my diet as-is for the moment, and go right to Step 2, with the hopes that I can expand out to the other diets during reintroduction? I know I need to reintroduce, but worry I’m not ready yet.
2) Modified fast involves bone broth–I thought that was actually contraindicated for SIBO due to polysaccharides issue? I was thinking of instead trying something like this–would this work:
http://www.sistersundercover.com/sibo-broth/
3) Without magnesium citrate, everything just shuts down, and I am miserable–learned this the hard way several times. I hope it’s OK to take during Step 1.
4) I’m usually so exhausted that I use a lot of caffeine (in the form of a powdered, unsweetened, black chai tea with ginger, turmeric, spices) to prop myself up. Quitting that would cause such a reaction (that’s a process in itself!) that I can see that muddying the results of whether the fast was helping a lot. Also hope this is OK to stay on! (Or could substitute in caffeine pills as a basic way to substitute?)
I have more questions, but they are about other steps, so I’ll stop there for now 🙂
THANKS! Really appreciate y’all.
Hi Jessica,
1) Yes, you don’t need to go all the way back to paleo if you’re already on a diet that’s working for you. I’d give it a little bit after the modified fast though before you jump straight into step 2, so your body has time to get used to food again before adding something new.
2) The modified fast is not intended to starve SIBO the way an elemental diet is. We’re using it to give the digestive system a break and rest it. Step 3 will take care of the SIBO. But if you’re worried about it, the SIBO-friendly broth that you found is fine too.
3) Sure, that’s fine.
4) It’s your call. Again, the point of the fast isn’t to starve anything, but you do want to make sure you’re staying away from as many gut irritants as you can – so if there’s anything in it that could bother your gut, I’d try switching to plain black tea.
Wow, thanks for your quick and helpful response!
Check and thanks on all the above–that’s all interesting and good to know.
Ah, I thought it was the tea itself that was the problem!
Feels like the spices themselves in chai were supportive.
It’s this one, btw–and I don’t add milk or sweetener:
https://www.amazon.com/Blue-Lotus-Chai-Traditional-Steeping/dp/B0049K99RW
It’s really good 🙂
I will admit that I have, in my 20 or so years of dealing with IBS and related symptoms, definitely messed my eating patterns. Pretty disordered eating pattern right now as I avoid a lot of foods, good/healthy ones that I loved to eat, for fear of it causing my IBS symptoms. Now I’m fearful of moving “backwards”, I realize in my head that it’s not really backward, but it’s difficult going back as I have gotten better but now I don’t know what exactly works and what doesn’t.
My eating is mostly low FODMAP, low sugar, low fiber and probably other things that I’ve read “might” cause IBS symptoms. But have no idea where to go back to eating. Low FODMAP seemed like it was working until it stopped. On the plus side with low FODMAP when I reintroduced gluten it didn’t give me the symptoms that I thought it was or perhaps it doesn’t trigger me as much or at all anymore whereas it used to.
So TLDR.
How does one move from a disordered eating pattern to something more healthy, and which eating pattern/diet might be best for those who have painted themselves into a corner like this?
Hi Mike,
I so feel you on this and my heart goes out to you. Sometimes restricting things in the name of health can turn into something more destructive than helpful.
Unforunately, there’s not a straightforward answer. I would reccomend working with a nutritionist who specializes in this if it’s in your budget.
Where it gets tricky is that symptoms of disordered eating can actually mimic the symptoms of IBS so it can be challenging to parse out what’s causing what (which is where getting outside help can come in handy).
Marci Evans is an RD who has some good information about this – you might find this podcast helpful: https://christyharrison.com/foodpsych/6/the-truth-about-digestion-and-gut-health-with-marci-evans
Chris Sandel is another nutritionist who works with people with disordered eating patterns who has a great knowledge of digestion. Dr R actually had him on the podcast earlier this year: https://drruscio.com/healthy-relationship-with-food/
Hope this helps and hang in there!
Hey there,
I have been trying to order the Biota-Clear 2B capsules for a while now. I am 10 days out from switching to month 2 on my removal step so I really need these. What do you suggest if they have not been re-stocked in the next week or so??
Thank you!
Hi Chad,
Looks like they shipped yesterday, so will hopefully be back in stock in a couple days and you’ll be able to get them in time.
Okay that’s great, thank you! The Biota-Clear 2a only has 90 pills in the container, in the book it suggests taking 4 TOTAL capsules a day so this will only last 22 or so days. Would I still be alright if I took 3 TOTAL capsules per day to last the full 30 days, or should I buy another container to make it for the next 8 days leaving tons of extra capsules to spare?
Sorry for this question but money is tight and I’m getting frustrated!
Thanks again
I would recommend getting an additional bottle. You can continue to take along with the next month’s protocol until the bottle is empty.
Ok thank you
Hey there,
The Biota-clear 2a capsules are not in stock yet. I’m 4 days out from being fresh out of my Biota 1B capsules and ready to go to month 2. I’m just wondering on your thoughts what to do? Thank you again!
Hi Chad,
They have already shipped, so I would expect them to be in stock literally any day. I would keep taking what you have (i.e. if you have any 1A capsules left) and then if you have 2A you can take those while you wait for the 2B to arrive
Alright that sounds like a plan. I wasn’t sure how strict a person had to be with the antimicrobials. Thanks a lot for the swift responses! You people kick ass
Sorry that’s the Biota 2B capsules are not in stock*** My mistake but the same question still imply’s!
Greetings! I am having trouble with the modified fast. I have tried fasting in the recent past. I attempted a 72 hour fast to start and only made it 18 hours. I then moved on to 16:8 and felt great but after a few weeks started to have issues with my cycle shortening and other signs of adrenal fatigue, so I quit fasting and went to my normal way of eating which is Primal Blueprint. My cycle is finally going back to it’s normal length and my adrenal fatigue symptoms are lessening. I have Hashimotos and was diagnosed with Fasting Hypoglycemia at a young age. I am also currently breastfeeding a 2 year old. I am disappointed I can not complete even 24 hours of the modified fast, but the stomach pain, headache, stiff neck, and irritability become too much for me to handle and I am scared of messing up my adrenals again. Is it all in my head or should I just forget about it and move on to the diet portion? I plan to do Paleo low FODMAP.
Hi Nikki,
Don’t force it. Moving on to the diet portion is totally fine!
Hello Dr. Ruscio,
Thank you for your informative book, I’ll post a review on Amazon.com. I started Step 1 of the protocol using the bone broth today. I added collagen peptides to the bone broth for additional protein. So far I’ve noticed that I’m gassy and belching a lot. Why is this happening?
Thank you for your time,
Caroline
Hi Caroline,
Thanks, we would definitely appreciate a review!
There are a few possibilities for what’s going on – it could be a die-off reaction, you could be reacting poorly to the collagen, or maybe you’re reacting to something in the bone broth. For example, some bone broth has lots of onion and garlic in it, which may cause a reaction in some people with SIBO. If it doesn’t go away in a day or so, you may want to try taking out the collagen and seeing if that helps. If it gets to a point where it’s too uncomfortable, you can always stop and move to the next step in the plan.
Hello!
I am now reading the great in 8 plan and am excited to get started. My question is regarding the plan and SIBO. I have been tested positive for methane and hydrogen SIBO and my doctors protocol never worked (hence me buying the book).
Should I skip steps 1 and 2 and go directly to 3 with the antimicrobiral herbs (as SIBO is my direct issue)? Or do I just start from step 1 to ensure I get the best benefits into step 3? Thank you !
Hi Brittany,
Excited to have you on board! We definitely recommend starting with step 1 and proceeding from there. The steps are meant to build upon each other and will set you up to have a better response to the antimicrobials. Good luck!
Hey there,
its me again. I’m moving on to remove protocol level 2 now so I just want to ask a couple questions:
1) Is 1 bottle of the Artemisinin enough since I’m only taking it for 2 weeks out of the 4 weeks?
2) I wanted to make sure I should keep taking all the other supplements in the first support step. Ex: Probiotics , Digestive Enzymes and Adrenal Support?
I ask these questions because I don’t feel much better, my symptoms haven’t improved and I feel like its a lot of money to be spending when I haven’t felt much of a change. I’m getting what you could say as desperate
Thanks for everything
Hi Chad,
1) 2 bottles are needed. It’s 6 pills in the morning and 6 in the evening, which would be a total of 168 pills over the two weeks.
2) yes
Hang in there!
Roger that. Thank you
Hi I have one more question I forgot to ask. Dr. Ruscio says in his book to lighten up on diet when going into the anti microbials. I am on probiotics step for another week and on low FODMAP. I don’t even feel great on that or any diet so I know it’s not just the food.
Anyways my question is this: aren’t you supposed to be on low FODMAP when using antimicrobials to aid in the killing? I’ve also heard the opposite. Or does it matter and can I just eat a healthy Whole Foods diet with fodmaps at this point? It’s a little confusing as I’ve always read FODMAP diet with killing the bacteria and the book is a bit unclear. Thanks !!
I do have SIBO confirmed as a side note *
Hi Brittney,
If you check out the FAQ page for step 3, you’ll see your question answered in the pinned questions at the top of the page.
Hi, I just came across your book and was going to go start the Great-In-8 plan, but had a question about how to start. Long story short, I have had issues with IBS since 2011 after a giardia infection that was undiagnosed until 2013. Recently, I went through a strict 8 week low FODMAP elimination which helped somewhat and 10 week rechallenge, but didn’t get too many definitive food trigger findings because my symptoms would get better with some foods and then randomly get worse even when I wasn’t rechallenging new foods. I started the reintroduction phase and was doing pretty well and was able to work up to a pretty diverse set of foods eating a whole food Paleo like diet trying not to worry about FODMAP content and was even able to get my fiber up to about ~30-35 grams a day, but that only lasted for about 3wks when I started having severe stomach pains and greasy, floaty, and super smelly stools. I tried to wait it out for a week, but it wasn’t getting any better, so I went to the doctor to get tested and they found that I had Enteropathic E Coli.
I went through the modified fast for 2 days with bone broth, but wasn’t able to go longer because I was feeling more burning hunger pains than usual when I go without eating and I started feeling super weak and dizzy. I was able to add rice (normally tolerated well on my low FODMAP diet) and bananas. Though I was starting to feel better because it had been 10 days since my symptoms started, this morning I tried to have an egg and orange for breakfast and it shot me into the most excruciating stomach pains (8-9/10 couldn’t stand up straight and terrible runs for 4-5hrs). From what I read E. Coli infections shouldn’t last this long (day 11 now), but maybe my immune system is just weak or microbiome is more susceptible to infection because doctors put me through many rounds of antibiotics over the years due to my GI issues.
My question is would you need to modify the plan any for someone recovering from a severe E. Coli infection? (i.e. start with antimicrobials due to infection) Also, how would you recommend pacing and reintroducing foods to build back up to a diverse set of foods in Step 1 since my gut is still so over reactive and possibly more damaged now from the infection? (i.e. should I shoot for working up to full Paleo from the start or start back at Low FODMAP Paleo or AIP and work up from there?)
Thank you so much for the wonderful resource and any help would be greatly appreciated!
Hi Daniel,
Due to legal reasons, we can’t give you personalized medical guidance so I would definitely say follow your doctor’s advice regarding the e. coli infection and keep them in the loop regarding your plans to do this protocol.
Regarding the diet, I would say don’t stress too much about picking paleo vs low fodmap vs AIP – just pick one that you feel the “best” on (even if the “best” isn’t perfect) and go from there. Step 5 is when you’ll start reintroducing foods to figure out which ones work best for you. That way, you’ll have given your gut some time to heal before trying to add foods that may have previously been problematic for you. Good luck!
Hi Drew,
Thank you for the reply and totally understand the restriction as far as limitations on medical guidance go. Thank you for the advice, I will try not to worry about it too much and see what I can tolerate to begin with.
Hi
I have just started the paleo diet along with the histamine diet. I have psoriasis and allergy for almost 20 years. Recently I have pain in joints and completely tired without a reason.
My GP advice me to take fish oil ( which is from anchovies and sardines. …food to avoid in the histamine diet) and vitamin. Can I continue taking them when I am doing this diet?
Thanks.
Hi Ling,
Histamines tend to not be particularly fat-soluble, so fish oil should be ok. Of course, always pay attention to how you feel and if you think something you’re taking is making you feel worse, discontinue use and talk to your doctor.
Hi. Is it possible to have SIBO and not have any of the usual symptoms like bloating and stomach pain? My 14 year old daughter has chronic fatigue, high thyroid anti bodies, normal TSH, low ferritin. She has the coeliac genes but normal coeliac antibodies. Would you still implement the modified fast as step 1 for teenagers?
Hi Robyn,
Yes, it’s possible to have SIBO without bloating/pain. As far as the fast goes, I would proceed with caution while keeping her pediatrician in the loop. Teenagers (especially active ones) need lots of fuel to keep them healthy and energized. If she has a complicated relationship with food like many teenagers do (history of disordered eating and/or dieting), the fast may not be the best choice. If you’re worried it may be a strain on her in any way, it’s totally fine to start with the diet piece and go from there.
Love the book just about to make my bone broth. I will make a lot and freeze it. My question is do I need to heat the broth before use each time? sorry if a silly question
Hi Christine,
I imagine it would be challenging to get the frozen broth out of the jars it’s frozen in without letting it thaw. Once thawed, you could drink without heating it up as long as it’s consumed quickly. The longer it sits at room temperature, the greater the risk of it growing some type of bacteria you probably don’t want to be consuming
Hi again I am now starting the great 8 ive done phase 1 now on phase 2 I have bought all the suppliments from you. The enzimes with hc1 I have two different bottles from you. one is acid hc1 and one is enzyme hc1 do I take them both together please. Also I have ordered and received a big bottle of pure phyto ADR and I cant see what they are for and when I should take them as cant see them in the second phase?? please let me know these two questions thank you
Hi,
how does one modify the diet for gastritis or stomach ulcers? I’ve heard that more frequent smaller meals are better and I’ve also heard that fat and salt should be avoided but I’m not sure how much Dr. Ruscio agrees with those statements. Can the Elemental Diet help? Thank you.
Hi Dusan,
Other than leaving out the HCl, no modification is needed. Just follow the diet/supplement protocol as written (minus HCl). Good luck!
Good Morning-
It was suggested that to help get through the morning without breakfast, tea or coffee is an option. Because coffee is an irritant, is it doing more harm than good to have coffee on an empty stomach every morning?
Hi Lisa,
People have different reactions to cofee, so it depends on whether it bothers you or not. Check out the section in the book on coffee for more info.
If I am already aware which diet I feel pretty well on, is it suggested to still consume these foods for 2-3 weeks prior to incorporating the probiotics and support supplements or can I just jump immediately into taking them?
If you’re performing the modified fast, you’ll want to give things some time to settle down and let your body get used to digesting solid food again before adding in supplements. If you’re not doing that part of step 1, you can move on to step 2 whenever you’re ready.
Great suggestions in the resources sections for low histamine/sulfur/carb diets, but any suggestions on ideal diets for SIFO/yeast and fungal issues? Thanks!
Hi Jessica,
You don’t need to do a full-on ketogenic diet, but a slightly lower-carb diet means fewer carbs to feed the fungus. If you’re following something like the low FODMAP diet, you’ve already probably lowered your carbs naturally, which will help.
Hey there,
I Complete the level 2 protocol of step 3 in ten days. I’m assuming I will have to go on to do the Elemental/Semi-elemental Diet.
Is it important that I transition straight from the level 2 protocol to the Elemental/Semi-elemental Diet with no days off between?
OR:
When I complete the level 2 protocol can I take as long as a week to 10 days before I start the Elemental/Semi-Elemental Diet?
Thanks!
No you don’t have to start right on it. You actually may want to take a little time to see how you feel off the antimicrobials. Sometimes it can take a little while for things to settle. Good luck!
Ok thank you
Hi Dr. R. I have confirmed methane SIBO as well as probable yeast issues. My symptoms are extreme fatigue/brain fog/adrenal issues. Working with practitioner, have tried Paleo FODMAP diet and anti-microbialS for 3 months without much change. Looking into the Elemental Diets with an eye for which formula has the least likelihood to increase yeast issues…From what I can gather, your formula has less sugar but more carbs than the homemade low carb version…Any insight as to which might be better in this instance? I’m leaning towards yours bc I’ve heard the taste of homemade is bad and I can’t imagine drinking something disgusting for 2-3 weeks.
By the way I loved your book and headed over to review. Thank you so much.
Hi Emily,
There are no hard and fast rules when it comes to the elemental diet, but if you know you have yeast issues, many people take an anti-fungal during the ED. You may want to talk to your practitioner about recommending one for you (or Dr Ruscio lists what he recommends in the book). Then whichever ED you want to do is up to you – but to your point, yes, Elemental Heal is going to taste much better than the homemade version. Good luck!
Hey there! Thank you for writing this book, it’s what I have spent years searching for! I’m wondering if I can start the support supplements right away in step 1 after the fast? I’ve had food sensitivity testing before I found out that it’s useless. It basically said I’m sensitive to every food I had consumed recently before the test so I’m assuming that I have leaky gut and will need the support supplements. Any harm in starting them after the fast? Thank you so much!
Hi Jessica,
It may still be helpful to try and see if any of the diets listed in the book are helpful before adding in the second layer of supplements, which could potentially cause die-off reactions and muddy the water a bit in terms of telling what is causing what. It’s also useful to let things settle down a bit after the fast before throwing supplements in on top of that.
I just fnished reading your book and am anxious to get started but have two questions. (1) I currently take OTC supplements – calcium, lysine, & glucosimine chondroitin. Do I need to discontinue them as long as I am going through the steps or where do I bring them back in? (2) I am scheduled for a follow up colonoscopy and EGD in 6 weeks. Will this diet cause any problems with that or should I wait until afterwards to start?
Hi Rosemary,
Dr R recommends not being on any other supplements during the protocol if you can manage it. For the colonoscopy, you may want to wait until after to start, as the prep diet often causes lots of digestive upset in people and it may be easier to start everything when it’s over.
Hello !
1)I’m wondering if Dr Ruscio has any thoughts on the Fasting Mimicking Diet, formulated by Dr. Valter Longo, and whether or not this could be done instead of the 2-4 day liquid fasts Dr Ruscio recommends in his book?
2) Also, there are a few discrepancies between the FODMAP lists Dr Ruscio provides, and the SCD/FODMAP list that Siebecker provides. How should I navigate this?
Hi Henrik,
1) My understanding is that the diets serve different purposes. The aim of the fasting mimicking diet is to increase longevity while the goal of the modified fast is to give the digestive system a break. I wouldn’t recommend following the fasting mimicking diet for step one of the great-in-8 protocol, because my understanding is that you’re still consuming solid food, just not that much of it. The goal here is the completely rest the digestive system if possible.
2) There isn’t going to be one single list that’s the end-all be-all – they are all just a guide to get you started so you can figure out what works with you. I’d just pick a list and go with it, and you’ll start to get a feel of what works for you and what doesn’t – there will likely be some things that are on the “yes” list that you react to, and there may be some things that you tolerate just fine that are on the “no” list – make sure you tune into the signals your body is giving you and you’ll do fine.
Hope this helps.
Yes all this helps — thank you!
Hey there,
I’ve done step 3 level 2 of the antimicrobials and now have moved on to the semi-elemental heal
diet. I bought the FMF version which tastes amazing and I will be doing it for 2-3 weeks. Thank you Dr. Ruscio for making this Semi-elementaI formula! I have a few questions…
1) if I don’t feel 80-100% better after the 3 week semi-elemental diet, should I do one more two month cycle of the the anti-microbial herbs? OR should I move on to step 4 and start using the prokinetics right away with the Semi-elemental hybrid approach?
2) Can I have some coffee with the Semi-elemental diet?
Thank you folks once again,
Chad
Hi Chad,
That’s tough to say since everyone is so different. At that point, you may want to consider making an appointment to see Dr Ruscio to get some personalized guidance (you can apply here: https://www.drruscio.com/gethelp) since there may be other things going on in your situation. I have my fingers crossed that you’ll be feeling well enough in a couple weeks that you won’t need it.
Regarding coffee, having weak/diluted coffee once in a while is probably fine, but I would probably go for a little bit without it so that you can tell if you have a reaction to it when you add it in.
Good luck!
Ok I submitted an application form.
Thank you!
Hi again I am now starting the great 8 ive done phase 1 now on phase 2 I have bought all the suppliments from you. The enzimes with hc1 I have two different bottles from you. one is acid hc1 and one is enzyme hc1 do I take them both together please. Also I have ordered and received a big bottle of pure phyto ADR and I cant see what they are for and when I should take them as cant see them in the second phase?? please let me know these two questions thank you
Hi Christine,
I answered your question here: https://drruscio.com/great-in-8-faq-step2/#comment-7021
What blood work tests should be requested from my doctor when initially trying to diagnose potential hormone / gut issues?
Hi Lauren,
Check out page 320 of the book where he lists helpful tests. In his practice, he usually starts with a GI panel along with some other basic bloodwork. Then depending on symptoms, potentially thyroid markers and an optional SIBO breath test. Again, it really depends on the person, so check with your doctor to see what they think will be most helpful.
How does stevia impact the microbiome (as a replacement for sugar and artificial sweeteners)?
Hi Lauren,
Based on current research, it doesn’t look like stevia has a negative impact on the microbiome. Anecdotally speaking, it does seem as though some people have a hard time tolerating it and can experience digestive symptoms, so if you decide to try it, go slow.
I just completed 3 complete days of fasting (tried 4th day but was much too weak and shaky). Prior to fasting I had just returned from Mexico with stomach issues. Can I start the supplements now instead of waiting the short time frame of testing diets? I already know that I will be eating Paleo for a few weeks then gradually eliminate foods on low-fod. I’m hoping the supplements will help my stomach issues and don’t want to wait to start them. Thank you
Hi, great book/research!
The modified fast was amazing and I’m on the Paleo now.
Before this process I occasionally took a tablet of St John’s Wort and sometimes also a tablet of Kava in the mornings – I find that they help a little if I feel a little anxious about the day.
I also occasionally take a Valerium Forte at night.
Are these okay?
Hi Joel,
So glad you’re enjoying the book. We’d love an Amazon review if you feel up to it. And I’m also happy to hear the modified fast went well!
You may want to try adding in the adrenal support supplement in step 2 and seeing if you still feel you need the others. The adrenal support is designed to help support your adrenals and nervous system, and help modulate a healthy stress response. So I’d recommend trying that first and seeing how it goes.
Hope this helps!
Digestive Bitters — wondering if Dr Ruscio has anything to say on this topic? I read his book, and don’t remember him saying anything about this age-old digestive aid, unless he lumps them in with digestive enzymes. If he does recommend them, where would he put them in his ‘Great in 8’ protocol?
Thank you much
Hi Henrik,
Many people going through the protocol aren’t able to produce their own enzymes right away, so Dr R prefers supplemental enzymes, so you know you’re getting what you need to properly digest your food.
Hi
I have a histamine intolerance so react to some probiotics.Do you know if the probiotics on this site and mentioned in the book will.be safe for me to take .
Thanks Greg
Hi Greg,
Thanks for your question! It seems to be a bit of a mixed bag – a few histamine-sensitive people will have reactions and others will actually find that the probiotics improve their histamine tolerance. You could start one at a time very slowly and see how it goes (maybe starting with the soil-based). If you have a negative reaction, you can return them for a full refund.
Hey there,
So I’m technically on step 5 in the great in 8 protocol but I don’t feel the improvements I would like so now I’m going back to step 3, the remove protocol. This is he 3rd time I’m doing this 2 month remove protocol. Should I be taking the prokinetic during this last time of the remove protocol?
Thanks,
Chad
Hi Chad,
There’s no set rule here. If you feel it’s helping you, you can stay on it during the protocol. It sounds like you may have an extra tough case and may benefit from some more personalized guidance. If you want to set up an appointment with Dr Ruscio, you can do so here: https://www.drruscio.com/gethelp
Good luck and hang in there!
Ok thank you! Yup I have booked myself in January
Cheers
Hi, I’m just embarking on the great in 8 program. I have a pretty severe intolerance to sugars and starches (and gluten foods) I’ve been doing an paleo+SCD diet for near two years, and believe I might have made my condition worse. Would you still recommend a reset with bone broth fast?
Hi Dimitris,
It’s up to you. If you’re worried about losing too much weight, you can feel free to skip it. Some people who have sensitive digestion find that it helps calm things down. Listen to your intuition and do what feels right. Good luck!
Hi,
I’ve done 6 weeks on antimicrobials starting at a lower dose and on full for the last 2-3 weeks. I have had no symptoms resolution and have developed diarrhoea which I’ve never had before. Is this die-off or a sign that I should stop the anti-microbials?
Thanks
LM
Hi Louise,
I’m sorry to hear you’re not feeling well. Check out pg. 277 (Section titled “Reactions” in Step 3) which talks about the difference between die-off and an allergic reaction. If you determine it is indeed a reaction, follow the steps in the same section for figuring out what you’re reacting to and then you can use one of the replacements in the Gut Geeks section. You may also want to check out the FAQ page for step 3 (this is the page for step 1) where you can read about similar experiences other people have had. Hope this helps!
Hello,
Is there any alternatives in the liquid fast for someone who has histamine intolerance? Wouldn’t the lemon and or the bone broth both aggravate this?
If so, what suggestions would you make?
Thank you!
Hi Jake,
Good question. Everyone is different and reacts differently, so you may want to just try them both out and see. We’ve had some people with histamine issues tolerate the lemon juice/maple syrup combo just fine. If you give it a shot and feel it’s aggravating symptoms, it’s fine to just skip altogether and move on to the next step. Hope this helps!
Your book is a blessing, and I am so thankful. I will absolutely write an Amazon review. I was unable to complete more than two days of the modified fast, but even so, the abdominal bloating and discomfort went away almost immediately. I had already been on a lower carb paleo diet with lots of vegetables for years, so I jumped right into the paleo low-FODMAP. I feel great in a digestive sense when I’m careful to measure even the low FODMAP vegetables (I had two cups of collard greens rather than one, and that did not go well) and keep my portions small. However, I have lost weight I didn’t really need to lose which is fine at this point–maybe it was just “bloat,” whatever that means–but I probably shouldn’t lose any more since all of the gut symptoms came alongside amenorrhea. And, I’m hungry, which has been disrupting my sleep. I haven’t slept well since I started the fast, but I’m afraid of eating more in volume, because I’m making headway, and when I increase volume, I get discomfort. I exercise daily (always have), work full time, have two kids, and have always struggled with stress despite doing all of the recommended lifestyle modifications for stress. This year has been perhaps more stressful than most, but generally the past eight years have been quite high stress. I’ve been to the OB/GYN and the GP. Lots of blood work says my hormones are fine as are my levels of everything else, except I show up as slightly anemic WITHOUT nutritional deficiencies. (Perhaps why the fast was hard?) My guess is that stress and a very high FODMAP diet worked their combined magic on my gut. I have an appointment with a gastro guy, but I honestly don’t think I’ll need much from him (I’ll still go just to say I went) after using your protocol since it’s already working. I’ll boil this down to three questions:
1. What are your suggestions for dealing with hunger on a paleo low FODMAP diet since larger portions seem to be an issue? I get full quickly, and I’m not hungry until 2 a.m. or some strange hour like that!
2. I have about two weeks left in phase one, but would it maybe help to add in the adrenal support from step two now since stress is clearly an issue?
3. Have you ever thought of creating a private Facebook support group for people on this protocol? I was thinking it might save you some time since people could search it and weigh in on each other’s experiences.
Hi Cristi,
I am so happy to hear that the book has been helpful so far and that you’re making improvements – that’s huge!
Regarding stress, I’ll let you handle that with your doctor, but the one recommendation I would make is to consider changing up your exercise routine while you’re getting a handle on it. While exercise is an important part of staying healthy, it’s also a stressor on the body. So if you’re already stressed in other areas, adding the physical stress of intense exercise may not be the healthiest choice at the moment. I would consider trying things like restorative/yin yoga, walking, etc. It doesn’t have to be forever, but depending on the intensity that you’re doing, it could also be contributing to unwanted weight loss and/or amenorrhea.
In terms of your questions:
1) My two suggestions are A) try to make an effort to include higher calorie low fodmap foods as a bigger part of your diet if you tolerate them – e.g. more fats like olive oil, ghee, or coconut oil, and things like macadamia nuts or pumpkin seeds. B) Consider eating more often. The book does talk about meal spacing and while it is important, it’s also important to listen to your body and it’s possible that not every single thing in the book will work for your unique body. So maybe having a before bed snack will be helpful.
2) Sure, if you feel like that would be helpful, you can feel free to add them in. Just make sure you feel like you’re in a pretty stable place right now where not a lot of variables are changing, so that you can feel for any effect or reaction to the supplements.
3) Thanks for your suggestion!
Hope this helps!