We’ve discussed underlying biochemical issues that can lead to addiction as well as specific conditions associated with the biochemical issues. Here we discuss how holistic nutrition can help attack these issues to fight addiction and substance abuse.

Eating in Recovery (or to Achieve Recovery)

We’ve been told that nutrient deficiencies are prevalent in developing and poor nations and relatively rare in modernized societies. However, the Standard American Diet (SAD) of processed foods, sugar, and trans-fats have replaced nutritious whole foods in many industrial nations, making nutrient deficiencies extremely common. Approximately ¾ of Americans do not consume the required daily allowance of folate, a B vitamin important in mental stability. Similarly, almost half of Americans do not consume the recommended daily allowance (RDA) for vitamin C (a powerful antioxidant), and almost 1/3 do not consume enough B6 or B12. Note that the RDA amounts are considered very low to begin with! These nutrients are extremely important for brain function and neurotransmitter synthesis, to name a few functions.[57],[58],[59]

In the 1970’s there was an Australian study which indicated that drug addicts lose their appetite for food and develop severe protein and vitamin malnutrition.[60] It goes on to suggest addicts avoid junk food, starchy foods, and any refined carbs. For recovery from substance abuse, or on-going substance dependency, one of the best ways to get to overcome malnutrition is to transition from the SAD diet to a more traditional or ancestral diet (Paleo Diet for Recovery is discussed below). For decades, we were taught that fat is bad for us, carbohydrates are better, and that the key to a healthy weight is eating less and exercising more. Yet despite this advice, we have seen unprecedented epidemics in obesity and diabetes. The problem lies in refined carbohydrates, like white flour, easily digested starches, and sugars. The key to good health is the kind of calories we take in, not the number.[61] Dr. Weston A. Price, from the Weston A. Price Foundation, has long warned us about the problems surrounding processed foods. Since increasing the consumption of carbs and decreasing the consumption of animal fats, our health has deteriorated. It is enlightening when Dr. Price explains the physical deterioration after traditional cultures start eating Western foods. With this said, however, 92% of doctors, including many holistic health practitioners, still recommend a low-fat diet.[62] For addiction recovery, it is recommended one look towards a sugar-free diet, reduce carbs, eat a lot of fat from such things as fatty fish, and eat animal protein at least 3x per day. The best route to recovery is to begin an ancestral diet, as elaborated below.[63]

30-Day Paleo Diet for Recovery (PDfR)- Eating for Recovery/Substance Abuse

When one’s computer starts running slowly, applications are crashing left and right and one cannot move the cursor anymore, what do you do? Control-alt-delete. Mac users hold down the power button to restart. With addiction/substance abuse, we need to do the same thing with our bodies and ‘re-boot’. In society today, our bodies are under constant assault in the modern world. Refined, processed food, environmental toxins, stress, sleep deprivation, addiction/substance abuse, and chronic infections can all wreak havoc on our health. We’re simply not adapted to live this way. Life might look a lot different today, with smartphones and electric cars, but our genetic code has not changed all that much. This means, with a few exceptions that we’ll cover below, we are still hard-wired to eat the foods our hunter-gatherer ancestors ate. When we follow that genetic template, as we did for thousands of generations, we’re naturally healthy and vital. But when we stray from it, as we have in the recent past, we suffer.

So when things start to go awry, as they do with addiction and the onset of malnutrition (or at any point during recovery) the best thing to do is to get back to basics. We return to that 2.5 million year-old genetic template that humans are meant to follow. In other words, we need to re-boot the system.

We accomplish this by committing to a 30-day period where we eliminate the modern foods that cause disease as well as the foods people are most often allergic or intolerant of, and focus on the safe, nourishing foods our ancestors have thrived on for 77,000 generations. Then, after you’ve “re-booted” and returned to that basic template, one can customize it to find the approach that works best over the long term. But first, we will look at the paleo diet for recovery in more detail.

How does the 30-Day Re-boot work?

The re-boot phase is designed to reduce inflammation, improve digestion, burn fat, identify food sensitivities, reduce allergic reactions, boost energy, regulate blood sugar, and stabilize mood. For addiction/substance abuse, the re-boot begins to tackle many of the underlying issues associated with the brain/body and provides a foundation to Thrive in recovery, or simply attempt recovery. It almost seems too good to be true, but it works. Studies have shown that no other therapy, natural or otherwise, can come even remotely close to accomplishing these goals in such a short period of time. One study from the Journal of Medicinal Food elaborates this per the following:

The evolution of the human diet over the past 10,000 years from a Paleolithic diet to our current modern pattern of intake has resulted in profound changes in feeding behavior. Shifts have occurred from diets high in fruits, vegetables, lean meats, and seafood to processed foods high in sodium and hydrogenated fats and low in fiber. These dietary changes have adversely affected dietary parameters known to be related to health, resulting in an increase in obesity and chronic disease, including cardiovascular disease (CVD), diabetes, and cancer. Some intervention trials using Paleolithic dietary patterns have shown promising results with favorable changes in CVD and diabetes risk factors.[64]

How long does this phase last?

There’s no hard and fast answer to that question, but it’s essential that one commit to making these changes for at least 30 days – without cheating. After completing the re-boot one will have a bit more leeway to go off the rails (discussed below) every now and then. But the re-boot phase is not one of those times. This is where one needs to gather their strength and buckle down.

By removing the foods that most commonly cause problems, and often provoke addiction and substance abuse, one allows the body to rest and recover from whatever symptoms those foods have been provoking. Just one cheat could trigger a whole new cascade of reactions, so one realizes it is not worth it. It is important to remember 30 days is just a minimum. Some people may need 45, 60 or even 90 days to get the full benefits of the re-boot.

What foods can you eat?

There are three categories that make it as easy as possible.

Eat liberally: enjoy as much of these foods as one likes. No counting calories or calculating ratios of protein, fat or carbohydrate. This isn’t a “cleanse” or a fast. If a food is on this list it is free to be eaten.

Eat in moderation: one can eat these foods, but don’t go hog wild with them. Below indicates how often or how much of these items are considered safe, but in general one should limit consumption of these foods compared to those in the “eat liberally” category.

Avoid completely: This is where the rubber hits the road. The success (or failure) of this diet hinges on ones ability to steer clear of these foods during the 30-day Reset.

Eat liberally

Meat and poultry – emphasize beef and lamb, but also pork, chicken, turkey, duck and wild game like venison, ostrich, etc. Organic and free-range is always preferable, but is especially so during this program.

Organ meats (especially liver)- liver is the most nutrient-dense food on the planet. If the taste of liver is an issue, one good trick is to put one chicken liver in each cube of an ice cube tray and freeze them. Then, when one is making any meat dish, dice up one chicken liver and add it to the meat.

Bone broth soups – it’s essential one balance their intake of muscle meats and organ meats with homemade bone broths. Bone broths are rich in glycine, an amino acid found in collagen, which is a protein important in maintaining a healthy gut lining.

Fish– especially fatty fish like salmon, mackerel and herring. Wild is preferable. One needs to eat three 6 oz. servings of fatty fish per week to balance your omega-6 to omega-3 ratio.

Eggs – preferably free-range and organic.

Starchy tubers – yams, sweet potatoes, yucca/manioc, taro, lotus root, etc.

Non-starchy vegetables – cooked and raw.

Fermented vegetables and fruits – sauerkraut, kim chi, beet kvaas, coconut kefir, etc. These are excellent for gut health and inoculation of healthy bacteria.

Traditional fats– coconut oil, palm oil, lard, duck fat, beef tallow and olive oil. Olives, avocados and coconuts (including coconut milk).

Sea salt and spices. Avoid sugar or artificial flavorings.

Eat in moderation

Processed meat – sausage, bacon and jerky. Make sure they are gluten, sugar and soy free and organic/free-range meat is preferable.

Whole fruit – approximately 1-3 servings per day, depending on one’s blood sugar balance. Favor low sugar fruits like berries and peaches over tropical fruits, apples & pears.

Nuts and seeds – maximum of a handful per day, preferably soaked overnight and dehydrated or roasted at low temperature (150 degrees) to improve digestibility. Favor nuts lower in omega-6, like hazelnuts and macadamias, and minimize nuts high in omega-6, like brazil nuts and almonds.

Certain legumes – green beans, sugar peas and snap peas- though technically legumes, they are usually well tolerated.

Coffee and black tea – black, or with coconut milk. Consumes this only if one doesn’t suffer from fatigue, insomnia or hypoglycemia, and only before 12:00 PM. Limit to one cup (not one triple expresso – one cup).

Dark chocolate – 70% or higher in small amounts (i.e. about the size of a silver dollar per serving) is permitted.

Vinegar – apple cider vinegar is especially well tolerated.

Restaurant food – the main problem with eating out is that restaurants cook with industrial seed oils, which wreak havoc on the body and cause serious inflammation. One doesn’t need to completely avoid, but it’s best to limit eating out as much as possible, especially during the re-boot and until symptoms from addiction improve.

Avoid completely

Dairy – including butter, cheese, yogurt, milk, cream & any dairy product that comes from a cow, goat or sheep. Ghee is okay.

Grains – including bread, rice, cereal, oats, or any gluten-free pseudo grains like sorghum, teff, quinoa, amaranth, buckwheat, etc.

Legumes – including beans of all kinds (soy, black, kidney, pinto, etc.), peas, lentils and peanuts.

Concentrated sweeteners, real or artificial – including sugar, high fructose corn syrup, maple syrup, honey, agave, brown rice syrup, Splenda, Equal, Nutrasweet, xylitol, stevia, etc.

Processed or refined foods – as a general rule, if it comes in a bag or a box, don’t eat it. This also includes highly processed “health foods” like protein powder, energy bars, dairy-free creamers, etc.

Industrial seed oils – soybean, corn, safflower, sunflower, cottonseed, canola, etc. Read labels – seed oils are in almost all processed, packaged and refined foods (which you should be mostly avoiding anyway).

Sodas and diet sodas – all forms.

Processed sauces and seasonings – soy sauce, tamari, and other processed seasonings and sauces (which often have sugar, soy, gluten, or all of the above).

Caveats and Tweaks

With certain health conditions, the basic program above needs further modification:
Those with arthritis, joint pain, autoimmune disease and severe gut issues should also eliminate nightshades and eggs. Nightshades include potatoes, tomatoes, sweet and hot peppers, eggplant, tomatillos, pepinos, pimentos, paprika and cayenne pepper. Nightshades have compounds called alkaloids that can cause inflammation and worsen joint pain in susceptible people. Eggs contain proteins that are common allergens, particularly in susceptible people. (many with addiction have severe gut issues)

Those with insulin resistance, hypoglycemia or reactive hypoglycemia, and those wishing to lose weight, should limit fruit and starchy vegetables. The total amount eaten each day should equal roughly 50 grams per day of carbohydrate, which is the amount contained in 2 servings of low-glycemic fruit (berries) and 1-2 servings of starch (i.e. sweet potato, taro, yucca, etc.). Several studies on the Paleo diet have shown that it is effective for improving insulin sensitivity and glucose control even without restricting carbohydrates. There are two reasons for this. First, a Paleo diet is naturally lower in carbohydrate than a Standard American Diet because it excludes the most carbohydrate-dense foods, such as bread, crackers, cookies, muffins, and other processed and refined foods made with flour and sugar. Second, the whole-food, nutrient-dense carbohydrates that are permitted on a Paleo diet, such as sweet potatoes, plantains, and whole fruit, do not affect blood sugar in the same way as processed and refined carbohydrates do.[65],[66]

Those with fatigue, insomnia, anxiety, mood swings or depression should eliminate coffee, tea and all caffeine entirely. Caffeine stimulates the adrenals and can worsen all of these conditions. Once your adrenal issues have been addressed, you may be able to add them back in moderation.

Those who are athletes or have high levels of physical activity may want to increase their carbohydrate intake, especially after training. As a general idea, a minimum of 600 calories (150g) per day of carbohydrate, and as much as 800 calories (200g) or more may be required to meet energy needs, depending on the intensity of training and individual tolerance.

If one still struggles with stubborn gut symptoms after working on the diet in the 3 phases (see below), there may be an underlying gut infection or unchecked chronic stress. For example, if one has an irritated, inflamed gut, certain non-starchy vegetables may be aggravating the situation. For a certain period it may be necessary to remove foods that trigger or exacerbate an immune response (thus leading to craving or a potential relapse in addiction). This includes nightshades, eggs, dairy and nuts (mentioned above). While nuts are widely recognized to be nutritious and beneficial to health, a 30-day elimination may be a good option for very sensitive patients or those with difficult-to-solve cases. Nuts are one of the more common allergens, and people in general are more likely to develop allergies and sensitivities, which could counteract efforts to heal the gut. These above are all healthy foods when well tolerated, but they may provoke or perpetuate inflammation in those with autoimmune disease. That said, not everyone will have trouble with them, so the key is to experiment to determine where one falls on that spectrum. Take them out for a full 30 days, then reintroduce one at a time to see which ones create a reaction, starting with egg yolks, then egg whites, nightshades and finally dairy (do them all one at a time). Feel free to speak to someone at Thrive Holistic Nutrition and Wellness for solutions to these issues, including such things as lab testing for food sensitivities and/or providing any needed supplementation- items for which we can obtain special practitioner pricing.

*Above was adapted from the following books: Primal Body, Primal Mind- Beyond the Paleo Diet for Total health and Longer Life; Primal Blueprint- Quick and Easy Meals; The Paleo Approach- Reverse Autoimmune Disease and Heal Your Body [67],[68],[69]

Additional Nutrient Considerations for Active Alcoholism and/or the Recovering Alcoholic

As with any addiction or anyone abusing substances, it cannot be reiterated enough that individualized nutrient therapy is critical for long-term success. A diet high in animal protein and healthy fats are highly effective. Hypoglycemia can be avoided by eating 3 nutrient-dense meals daily, along with never going more than 3-4 hours without eating. As mentioned above, at all costs one should avoid sweets, sugary beverages and starchy carbohydrates.

Bio-individualized care should also include testing for pyroluria, if symptoms are noticeable, which will determine specific nutrient needs. Testing should also include functional blood chemistry analysis, to identify nutrient deficiencies and balance blood chemistry, as well as identifying underlying infections with a compressive stool analysis. Eating the traditional/ancestral whole food diet above (Paleo Diet for Recovery) covers many of the bases by incorporating needed nutrients. This assumes one has been eating the Standard American Diet, as is seen by most within the addiction spectrum, and even those in recovery for a substantial amount of time- most persons eat a Standard American Diet!).

Other nutritional therapy for the alcoholic should include the following (particularly in early recovery, but adequate intake is needed at any point during recovery/dependancy):

B vitamins including thiamine (vitamin B1), folate, B6, B12- B1 deficiency is both the most common and the most serious B vitamin deficiency in the alcoholic. It is interesting that brewer’s yeast has one of the highest content of almost all of the B vitamins, perhaps leading to craving and sensitivity to yeast. B12 is high in such things as clams and beef liver.
Essential Fatty Acids – acquired by eating the fatty fish mentioned above, but a quality fish oil supplement can also go a long way as reducing underlying inflammation. Talk to someone at THNW for quality supplements.
Magnesium – low magnesium levels are present in as many as 60% of alcoholics and this is linked to delirium tremens. High quantities of this can be found in kelp and wheat germ. The interest in treating depression with nutrition has grown. New clinical research published in PLoS One, offers a surprising and remarkable finding by indicating magnesium supplementation was found to be a safe, fast, inexpensive, and effective treatment for mild-to-moderate depression in adults, with positive effects observed within 2 weeks (and less risk for side effects than drug treatment options).[70] Most people in the world today, however, are getting less than the recommended amount. A 2009 report from the World Health Organization stated that 75% of Americans consumed less magnesium than they need.[71]
Digestive Enzymes and HCL – Talk to someone at THNW for recommended brands. Note that our production of HCL and digestive enzymes diminishes naturally as we age, so this can make a profound difference in recovery.
L-Glutamine Powder – supplementation of about 1 grams per has been shown to reduce alcohol consumption (see also hypoglycemia appendix below for more discussion on glutamine)
Multi-vitamin/mineral – whole foods based is best as it may be the most bioavailable, talk to THNW.
Zinc – key nutrient involved in the breakdown of alcohol and can be found in oysters and pumpkin seeds.
Vitamin D – supports the immune system, and is prevalent in such things as cod liver oil, sardines and salmon. Don’t forget to get enough sun to adequate levels of vitamin D!
Chromium Picolonate or Gymnema Sylvestre – helpful for blood sugar dysregulation issues. Chromium is also high in brewer’s yeast, but also relatively high in green peppers and apples.
Antioxidants – taken either prior to or along with alcohol. This nutrient inhibit free radical damage and the development of fatty liver disease
Carnitine – inhibits alcohol-induced fatty liver. Dietary sources are richest in carnitine are red meats.
Vitamin A – deficiency is common in alcoholics and appears to work together with zinc deficiency to product the major complications of alcohol dependence. Found in higher quantities in beef liver, chili peppers, and carrots

Note- for all of the above talk to a trained nutritionist for supplementation- brands, intake amounts etc.
Adapted from The Encyclopedia of Healing Foods[72]; Digestive Wellness[73]; Potatoes Not Prozac[74]; Addiction- The Hidden Epidemic[75]

Summary of Paleo Diet for Recovery

If one is completely new to eating Paleo, we understand this can seem overwhelming. One might ask themselves “I thought saturated fats were bad”, and “aren’t whole grains healthy?” If there are questions about why the re-boot includes some foods commonly thought to be dangerous and excludes other foods commonly thought to be healthy, please speak to someone at Thrive Holistic Nutrition and Wellness (THNW). The Paleo Diet for Recovery (PDfR) above, is much more about “how” than what or why, which is what most are interested in. The best way is to simply dive in and give it a shot. It is designed to get individuals in the addiction spectrum feeling better than they have in years. It accomplishes this by reducing inflammation, improving digestion, burning fat, identifying food sensitivities, reducing allergic reactions, boosting energy, regulating blood sugar, and stabilize mood. And for those currently abusing substances, it is designed to reduce cravings and hopefully get them to a point they can put the bottle or drug down.

The first thing we do with clients at THNW is start them on a customized Paleo diet that incorporates individual biochemistry. We begin with a 30-day re-boot diet (above Paleo Diet for Addiction). In Step 2, not elaborated here, we reintroduce foods that were eliminated in Step 1. By testing gray-area foods one by one, clients can see which foods are safe to incorporate into their diet and which ones need to be removed for the foreseeable future. Finally, in step 3 we fine-tune the client’s diet to figure out what is the best balance of proteins, carbohydrates, and fats. Also, we begin to determine if an individual Thrives with three meals a day, six meals a day, or intermittent fasting. After adopting a customized Paleo diet, and addressing underlying issues, many experience dramatic improvement!

Conclusion

Personal experience at Thrive Holistic Nutrition and Wellness (THNW) has shown that, for decades now, mainstream medicine and addiction treatment centers have ignored the possibility that nutrition can help in the recovery process. Given their embarrassingly high relapse rates, detoxification centers and drug addiction practitioners need to consider new options. UCLA’s Alcoholism and Addiction Medicine Service has indicated there is a 75-80% relapse rate in most conventional treatment programs.[76] Dr. Charles Gant indicates the following:

‘…approximately 20% of all substance abusers recover with no treatment at all. In any case, if you have a substance abuse problem, your change of recovery through traditional methods is about one in four and I think those are lousy odds.’[77]

As with other addictions, many recovering alcoholics simply don’t ‘feel well’, with 75-95% experience long-term withdrawal symptoms, including depression, anxiety, irritability, nervousness, moodiness, lethargy, fatigue, ‘brain fog’, inability to concentrate, problems with abstract reasoning, irrational thought patterns, obsessive thought, poor memory, emotional hypersensitivity (cry easily or temper tantrums), emotional exhaustion, insomnia, dizziness, poor coordination, clumsiness and so on. As a result, many end up trading one addiction for another such as caffeine, nicotine and junk food for alcohol. This leads one to ask if they have truly recovered? Many in recovery conclude that ‘something must be wrong because I’m sober, but I’m definitely not enjoying myself’. They are unaware that there is a physiological (biochemical) reason for their peculiar behavior, and relatives, friends, coworkers and health care professional may label recovering alcoholics as “neurotic”, “anxiety-prone,” “chronically depressed” or “immature”.[78]

Recovery therapists who have been using nutritional approaches to treat addiction have had difficulty convincing mainstream treatment facilities of their effectiveness. It can take a long time for new ideas to be accepted by society. It will take time to educate people that, like other diseases, individuals suffering from addiction are dealing with a very real biochemical disorder. New testing procedures can identify nutritional and neurotransmitter deficiencies, hormonal imbalance (thyroid, adrenal, blood sugar, sex hormones such as testosterone) or heavy metal toxicities, which can then be corrected using sound nutritional protocols along with psycho-spiritual approaches. As Master Nutrition Therapists, at Thrive Holistic Health and Wellness (THNW), please note that we have access to practitioner discounts for quality supplements and lab testing. The costliest supplement or lab test is one that does not work or provide needed evidence for change, hence the importance of working with a qualified practitioner. If supplementation or lab tests are needed to assist with current substance abuse, or any stage of addiction recovery, please seek us out to discuss how we can meet individual needs. Supplements are largely an un-regulated industry, even within health food stores, so it is extremely important to seek quality and work with someone to figure out unique biochemical needs. Our goals at THNW include the following:

To achieve universal understanding that addictive behaviors are symptoms of biochemical imbalances.
To establish nutrient therapy as one of the foundational centerpieces in addiction recovery.
To provide nutritional protocols that, when implemented, propel individuals actively abusing substances to find recovery and/or a better quality of life.
To raise awareness that “for every drug that benefits a patient, there is a naturally occurring substance that can achieve the same effect.” Pfeiffer’s Law from the work of Dr. Carl C. Pfeiffer, MD, PhD.
To raise awareness that “if we demand behavioral change from our patients without allowing them to bring their brain chemistry into more positive balance, we simply set them up for failure.” Terry Neher, DDS, CCDC III[79]
To address the underlying causes of addiction and not just treat symptoms.
To foster a model of prevention whereby we screen for toxicities, nutritional deficiencies, and other biochemical imbalances.
To achieve and document consistent high rates of success- defined by long-term abstinence and a zest for life, as is seen by treatment centers that incorporate nutritional protocols. A zest for life that leads one to ‘Thrive’ rather than just survive, no matter where an individual finds themselves within the addiction spectrum.
To provide education that may empower family members and friends to support those within the addiction spectrum
Change the narrative around relapse being a part of recovery. The definition of addiction, stated earlier from the National Institute of Drug Addiction, indicates addiction is a ‘relapsing disease’. With discoveries of underlying physiological conditions, and implementation of nutritional protocols for those addicted, relapse is not a requirement for recovery.
To complement all conventional addiction treatment programs, including 12-step programs.

12-step programs, such as AA, often communicate not to change anything major in the first year of sobriety. However, if an individual is currently in recovery or abusing substances, there is a lot of nutritional and holistic analysis that can be done to protect, enhance, or initiate sobriety. It is our greatest passion and sincere hope that these individuals may be greatly helped by the items addressed in this document. As was stated earlier, nothing can keep a man or woman in ‘everlasting ignorance so much as contempt prior to investigation’. We hope this document educates and empowers individuals to take necessary steps when assessing substance abuse. Would you rather do something great and fail, than attempt nothing and succeed? – Robert H. Schulle

VII. Appendix

Appendix

Appendix 1- Consequecnces of Alcohol Abuse

-Anytime you get even moderately drunk, you risk:

Dehydration; Electrolyte imbalances

Gastrointestinal distress, leaky gut and bacterial imbalances

Difficulty sleeping and/or breathing

Hormone imbalances

Nutrient deficiencies

-Dangerous long-term consequences of frequent and heavy alcohol use

Alcohol is well-known to be a mitochondrial toxin and specifically a neurotoxin.

Depression

Brain cell death, memory loss, dementia and cognitive dysfunction

Malnutrition

Fatty liver

Hepatitis

Cirrhosis

Digestive dysfunction, leaky gut (intestinal permeability), upper gastrointestinal bleeding

Candida overgrowth, yeast infections, SIBO and gut dysbiosis

Several nutrient deficiencies including B vitamin deficiencies and severe mineral deficiencies

Anemia

Estrogen dominance

Loss of muscle tone, sagging skin, grey hair

Accelerated aging and reduced life expectancy by 10-12 years

Nerve damage and brain damage

Brain damage

Adrenal dysfunction

Compromised detoxification pathways

Increased risk of cancer, diabetes, pancreatitis, hypertension, heart attack and heart disease

In men, alcohol abuse causes enlarged breasts (gynectomastia), low sex drive, erectile dysfunction, reduced testosterone, decreased growth hormone production, and shrunken testes.

Appendix 2- Adrenal Fatigue

Adrenal Fatigue- Although indications of hypoadrenia can be detected using blood and urine tests, only saliva hormone testing indicates the amount of hormones found inside the cells. Unfortunately, conventional medicine only acknowledges a problem with the adrenals if the test results fall in the extreme outer ranges of hormone production.

Addison’s is a disease characterized by adrenals that are barely functions or in complete failure. This is often caused by autoimmunity, but can also be a result of severe infection or damage to the organs.
Cushing’s disease is often the result of taking steroid medications. It is a condition of extremely high levels of cortisol. It can also be caused by a malfunctioning pituitary gland. The pituitary signals the adrenals to produce cortisol, and in some instances of Cushing’s can over-stimulate the adrenals to produce excessive amounts.

Adrenal fatigue falls within the ‘acceptable’ range of conventional medicine testing. Nonetheless, sustained excess cortisol can lead to bone loss, weight gain, high blood pressure, depression, addiction and degenerative disease over time.

Appendix 2A- Supplements for Adrenal Fatigue

HCL and Digestive Enzymes
Vitamin C with flavonoids: 3,000 mg (keep vitamin C on hand as it is most concentrated in adrenals in the body, up to 5 grams per day)
Vitamin E (mixed tocopherols) 800 IU
B Complex (B6- 50-100 mg, B3- 75-125 mg, B12- 200 to 400 mcg)
Magnesium Citrate 400 mg
Calcium (750-1000 mg)

(Alternate taking magnesium one day and calcium the next- want approximately a 2:1 ratio of calcium to magnesium)

Adaptogens- ask THNW about adaptogens (herbs for adrenal fatigue)

Appendix 2B- Blood sugar and the adrenals

The adrenals glands must respond to falling blood sugar in the same way they respond to chronic stress: release cortisol, epinephrine and norepinephrine. When blood sugar spikes cand crashed throughout the day (especially coupled with emotional stresses such as work and responsibilities) it can exhaust the adrenal glands over time. Imbalanced blood sugar destabilizes mood, causing energy highs followed by fatigue, irritability, depression, and brain fog.

Appendix 2C- Pregnenolone Steal – (In men, continual stress from addiction diminishes the production of testosterone as pregnenolone is diverted the pathway to cortisol in lieu of testosterone)- To further illustrate hormones are controlled by cortisol when you are in a stress response such as Fight or Flight (often what your body identifies with addiction with constant withdrawals, mood swings, blood sugar dysregulation etc)- your cortisol robs your pregnenolone, and this is known is Pregnenolone Steal. This will lead to the loss of DHEA, Testosterone and Estrogen.

Appendix 2D- The role of stress in addiction

Stress has been mentioned above but it should be reiterated that it plays a major role in addictive behavior. Stress affects the entire body, suppressing the immune system, increasing inflammation, and disrupting hormone and neurotransmitter balance. Over time, chronic stress exhausts the adrenal glands which can trickle down into further hormone imbalance, such as hypothyroidism and insulin resistance. Both hypothyroidism and imbalanced blood sugar (which can eventually lead to insulin resistance) are associated with serotonin levels. This is only one example of how stress affects mood and perpetuates addiction. Stress depletes calming neurotransmitters contributing to anxiety and loss of control or rational thinking. In addition, stress depletes many of the neuro-nutrients necessary for optimal brain function. When stress becomes chronic, as happens with through addiction, these nutrients and calming neurotransmitters never get a chance to replenish (leading to chronic behavioral and mood disorders and addiction). Some stress relieving techniques were indicated above and should be taken seriously by those affected by addiction.

Many have indicated the involvement of the alcoholic patient in an individually tailored fitness program has been shown to improve the likelihood of maintaining abstinence. Research has shown that regular exercise is effective in the alleviating anxiety and depression and enables individuals to respond better to stress. Improved fitness may allow more effective responses to emotional upset, thereby reducing the likelihood of resorting to alcohol when the patient in involved in conflict.

Appendix 3- Hypoglycemia

Both high and low blood sugar affect mood and cognition. The brain requires a steady supply of glucose in just the right amount to function optimally (unless on is doing a ketogenic diet that also provides fuel for the brain). Sitting down and eating a large meal, or one high in sugar or refined carbohydrates, causes blood sugar to rise too high. This causes fatigue and brain fog due to the overload of sugar.

Low blood sugar causes the same reaction. We discussed how blood sugar elicits the stress response from the adrenal glands contributing to stress and anxiety. However, low blood sugar also directly affects the brain since it requires a consistent supply of glucose. During hypoglycemia, the brain is literally beginning to starve, causing it to slow down function and engage in only primitive activity. Shakiness, irritability, fatigue, and lightheadedness are all common symptoms.

The amino acid L-Glutamine can also be a key player in addiction and blood sugar dysregulation issues. L-Glutamine is a perfect fuel for the whole brain, balancing blood sugar levels to maintain energy and clear thinking. Blood sugar deficiency symptoms: irritability, shakiness, weakness, dizziness, especially if too many hours have passed since the previous meal. Symptoms of deficiency may include cravings for whatever gives quick relief to low blood sugar, like sweets, starches, and alcohol.

NOTE: Be cautious about taking L-glutamine if you have manic depression (bipolar disorder). While low doses of L-glutamine may relieve bipolar depression, in approximately 50% of bipolar cases normal doses of L-glutamine can trigger mania. (even for some that are not bi-polar L-glutamine can be too neuroexcitatory, so use with caution)

Appendix 3A- Hypoglycemia and Addiction and Notes about Bill Wilson

Bill Wilson, co-founder of Alcoholics Anonymous, became very interested in the biochemical basis of alcoholism and addiction. He researched this area extensively especially in the last years before his death. He personally suffered from hypoglycemic symptoms and depression and was known to consume a lot of caffeine and sugar. Once he took these foods out of his diet and added eating nutrition-dense foods, his blood sugar was stabilized and his sense of well being returned. He was driven to share this information with other alcoholics.

Bill W. self-published two pamphlets First and Second Communication to Alcoholics Anonymous Physicians (1965) and (1968). In 1971 after Bill’s death, Lois, his wife and founder of Alanon, published a pamphlet, The Vitamin B-3 Therapy: A 3rd Communication to AA’s Physicians stating that her husband, Bill, had become convinced that there was a biochemical connection with alcoholism and addiction. Hypoglycemia doesn’t necessarily go away when you stop drinking or using. It is a metabolic disorder that has to be corrected with proper diet and nutrition. These symptoms often correspond to addiction. The symptoms are as follows: nervousness, irritability, exhaustion, faintness, dizziness (tremors, cold sweats), depression, vertigo (dizziness), drowsiness, headaches, digestive disturbances, forgetfulness, insomnia, constant worrying (unprovoked anxieties), confusion, internal trembling, and heart palpitations (rapid pulse).

To support recovery from addiction, it is important to keep blood sugar levels balanced in order to prevent these symptoms from occurring and also to prevent sugar cravings which can lead to alcohol and drug cravings. There are some key nutrients that block the sugar cravings that come with hypoglycemia. Bill W gave one of them, B3 also known as niacin, to 30 of his alcoholic friends. After taking the niacin for a while, 70% reported they felt much better (with a reduction in symptoms and cravings).

Additional supportive evidence shows that B3 prevents the abnormal drop of blood sugar. Some other key nutrients are chromium, glutamine, vitamin C, magnesium and pantothenic acid. If all 3 heads of the dragon of addiction are fed (body (nutritional), spiritual, mental (emotional), then getting well and getting better every day can be the reality of recovery.

Appendix 4- Pyroluria

The following includes the most common symptoms associated with the condition Pyroluria. If you answer “yes” to 15 or more of these then further testing may be worthwhile:

PYROLURIA QUESTIONNAIRE

Little or no dream recall
White spots on finger nails
Poor morning appetite +/- tendency to skip breakfast
Morning nausea
Pale skin +/- poor tanning +/- burn easy in sun
Sensitivity to bright light
Hypersensitive to loud noises
Reading difficulties (e.g. dyslexia)
Poor ability to cope with stress
Mood swings or temper outbursts
Histrionic (dramatic) tendency
Argumentative/enjoy argument
New situations or changes in routine (i.e., traveling) particularly stressful
Much higher capability and alertness in the evening, compared to mornings
Poor short term memory
Abnormal body fat distribution
Belong to an all-girl family with look-alike sisters
Dry skin
Anxiousness
Reaching puberty later than normal
Difficulty digesting, a dislike of protein or a history of vegetarianism
Tendency toward being a loner and/or avoiding larger groups of people
Stretch marks on skin
Poor sense of smell or taste
Feel very uncomfortable with strangers
Frequently experience fatigue
A tendency to overreact to tranquilizers, barbiturates, alcohol or other drugs (in other words, a little produces a powerful response)
A tendency toward anemia
History of mental illness or alcoholism in family
Easily upset by criticism
Sweet smell (fruity odor) to breath or sweat when ill or stressed
Prone to acne, eczema or psoriasis
A tendency toward feeling anxious, fearful and carrying lifelong inner tension
Difficulty recalling past events or people
Bouts of depression or nervous exhaustion
Prone to frequent colds or infections

Again, if you have answered yes to 15 or more of these then consider testing further using a urinary screening test for the presence of elevated kryptopyrroles. Testing for this condition is simple, relatively inexpensive and readily accessible to anyone without a prescription.

NOTE: It’s important that a clear laboratory diagnosis is determined before attempting high dose supplementation with zinc and/or B6. Working closely with a qualified health care provider knowledgeable about this condition is strongly suggested.

Pyrolurics also have a greater than normal need for omega-6 fatty acids, particularly dietary arachidonic acid (AA–found readily in eggs, butter, red meat and liver) and the essential fatty acid GLA (gamma linolenic acid– found in supplements like black currant seed oil and evening primrose oil).

The really good news is that once diagnosed, pyroluria is very manageable with the use of disciplined supplementation–typically requiring large doses of zinc and B6 (liquid ionic zinc and a co-enzymated form of B6 known as “P-5-P” tend to work best). Also typically some supplementation with GLA is also needed, along with a diet somewhat higher in sources of arachidonic acid. Sufficiency for zinc can be determined using a “zinc tally” test and B6 sufficiency can be subjectively determined by the return of regular (remembered) dreaming. The “bad news” is that some ongoing supplementation is needed indefinitely in order for symptoms to remain manageable long term…a small price to pay for real relief. Without appropriate supplementation symptoms ten to return again in a week or two.

With appropriate supplementation and stress management mild cases of pyroluria tend to respond quickly. More severe cases tend to experience gradual and incremental improvement over a period of several months.

Additional considerations for the pyroluric include the need for improving digestion and hydrochloric acid status, avoidance of phytate-containing foods such as grains, legumes and soy, and the susceptibility to heavy metal toxicity from mercury, cadmium and copper. Where the restoration of zinc sufficiency is highly resistant one may need to pursue further testing to see if heavy metal toxicity is an issue.

Appendix 5- Food Allergies/Sensitivities

Nervous system symptoms as possible signs of food allergies or sensitivities:

Hyperactive; wild, unrestrained
Talkative behavior: explosive, stuttering, constant
Inattention- disruptive, impulsive
Short attention span
Restless legs, finger tapping
Clumsiness: uncoordinated, tremors
Insomnia or nightmares
Nervousness: irritable, upset, short-tempered
High-strung, excitable, or agitated behavior
Moodiness or depressed behavior: tired, weak, weary, exhausted, or listless
Easily moved to tears or easily hurt
High sensitivity to odor, light, sound, pain, or cold

Other medical symptoms related to food allergies or sensitivities:

Nose: year-round stuffiness, watery nose, sneezing, nose rubbing
Aches: in the head, back, neck, muscles, or joints (‘growing pains’ or aches unrelated to exercise)
Belly problems: bellyaches, nausea, upset stomach, bloating, bad breath, gassy stomach, belching
Bladder problems- wetting pants in daytime or in bed, need to rush to urinate, burning or pain with urination
Face- pale color, dark eye circles, puffiness below eyes
Glands- swelling of lymph nodes of neck
Ear problems- repeated formation of fluid behind eardrums, ringing ears, dizziness
Excessive Perspiration
Low-Grade fever
Chronic Inflammation anywhere in the body
Proneness to allergies
Resistant to weight loss (even with exercise and a low-calorie diet)

Appendix 5a- MTFHR

MTFHR gene mutation is a condition which almost 50% of population may haves . It is a condition in which one takes non-methylated folate into body and it builds up to toxic levels. After evaluating one for the gene, one needs to look to support MTFHR for such things as depression, detox etc. (methylated B’s help with all this and adequate protein for amino acids.)

An MTHFR mutation is a problem associated with poor methylation and enzyme production. MTHFR mutations affect every person differently, sometimes contributing to hardly any noticeable symptoms at all, while other times leading to serious, long-term health problems.

Although the exact prevalence rate is still up for debate, it’s believed that up to 30 percent to 50 percent of all people might carry a mutation in the MTHFR gene, which is inherited and passed down from parent to child. (1) Around 14 percent to 20 percent of the population might have a more severe MTHFR mutation that impacts overall health more drastically. (15-30% less able to process and utilize folate)

The MTHFR gene mutation was discovered during the completion of the Human Genome Project. Researchers realized that people with this type of inherited mutation tended to develop certain diseases, including ADHD, Alzheimer’s, atherosclerosis, autoimmune disorders and autism more often than those without the mutation.

Appendix 6- GI Restoration

Supplemental regimen for the restoration of gastrointestinal microbiome and mucosal integrity (once food sensitivities have been removed)

L-glutamine- primary source of fuel for enterocytes, helps to fuel the regeneration of damaged small intestine.
Probiotics (various strains): help to restore normal gut health and immune response
Grass-fed bovine colostrum- functions to reduce inflammation, protects against irritation from toxins, checks any potential infection while promoting epithelial growth and repair (helping to reduce excess permeability and leaky gut), can help promote recolonization by friendly gut flora, and is a very potent immune system modulator.
Proline-rich polypeptides (also known as colostrinin): are composed of a group of related polypeptides derived from bovine colostrum that have the unique ability to stabilize and modulate both immune and cytokine (inflammatory) process in the body. Pure bovine proline-rich polypeptides are available in oral sprays that can greatly enhance the effectiveness of restorative therapies.
Vitamin D3- helps support healthy immune function, mitigates inflammation, and can help restore normal intestinal permeability.
Omega-3 fish oil or krill oil (supplement for EPA, in particular) helps promote production of anti-inflammatory prostaglandins.
Curcumin (found in turmeric): has a powerful anti-inflammatory effect.

Note that one should continue with this regimen for one to two years in order to achive desired results. Some food sensitivities may take 6 months or longer to simply ‘calm down’. Re-introduction of any foods should be done one at a time and reactions noted over a 72 hour period before another food is added in (add only one food at a time).

Nutrition for Addiction Recovery or Active Substance Abuse – Part 5