Surviving wheat withdrawal

Wheat withdrawal can be unpleasant business. Read the many thousands of comments on this blog describing the physical and emotional turmoil that develops in the first few days of wheat avoidance and you will come to appreciate just how awful it can be.

It is important that wheat withdrawal is recognized for what it is, as some people say, “I feel awful. It must mean that I need wheat.” Nope. It is a withdrawal syndrome, a good thing, a transitional phase as your body tries to return to its normal state.

Wheat withdrawal has been labeled by different names over the years–”Atkin’s flu,” “Paleo flu,” “keto flu,” “low carb flu,” etc. Because this only happens with the various forms of carbohydrate restriction (there is no corresponding “low-fat flu” or “Ornish flu”), it has often been attributed to the delayed conversion of a glycogen/glucose-dominant metabolism to that of fatty acid oxidation. This is true . . . but only partly.

Yes, forcing the conversion from a constant flow of carbs from “healthy whole grains” and sugars to increasing the enzymatic capacity to oxidize fats does indeed cause several weeks of low energy–but how do we explain the depression, nausea, headaches, lightheadedness, dehydration, emotional outbursts, intensive wheat cravings, bloating, constipation, even intensification of joint pain, effects that are not likely attributable to hypoglycemia or poor mobilization of energy? Delayed ramp-up of fatty acid oxidation is indeed part of the reason for the phenomena of wheat withdrawal, but does not explain all of it.

Most of these phenomena are caused by withdrawal from the gliadin-derived opiates in wheat, the 4- to 5-amino acid long polypeptides that increase appetite and cause addictive eating behaviors. You can actually trigger the syndrome abruptly in someone who is not wheat-free by giving them naloxone or naltrexone, opiate-blocking drugs. Because it is a form of opiate withdrawal, it cannot be entirely avoided with known strategies. In other words, an alcoholic (not an opiate, of course, but the situation is very similar) who wishes to rid her life of alcohol can only do so by stopping the flow of alcohol and suffering the withdrawal consequences–there’s no way around it. Alcohol withdrawal phenomena, such as hallucinations, disorientation, and seizures, can be blunted with very high doses of benzodiazepines and other drugs, so this is obviously not something you can manage on your own. (The doses required for an alcoholic, for instance, are fatal for non-alcoholics.)

So what can you do to smooth the wheat withdrawal syndrome that involves 1) a soft opiate withdrawal, and 2) delays in gaining higher levels of fatty acid oxidation? Here are a few strategies:

1) Hydrate–Ridding yourself of wheat involves diuresis, or fluid loss. This is due to the loss of the gliadin protein that causes sodium retention, as well as resolving inflammation previously triggered by gliadin-derived peptides, intact gliadin, and wheat germ agglutinin. Urine, for instance, should always be nearly clear, not a dark, concentrated yellow.

2) Use some salt–e.g., sea salt or other mineral-containing salt to compensate for the loss of urinary salt. Salt, along with water, addresses the common lightheadedness symptoms.

3) Take a probiotic–e.g., 50 billion CFUs or more per day containing mixed species of lactobacillus and bifidobacteria. This accelerates the conversion to healthy bowel flora off the disruptive effects of this potent bowel toxin called wheat. This addresses the common bloating and constipation, usually within 24 hours of initiation. This should be necessary for no more than 4 to 8 weeks. (If symptoms such as heartburn or bloating return when probiotics are stopped, this suggests that there is something else wrong, such as failed cholecystekinin signaling to the pancreas, pancreatic enzyme insufficiency, hypochlorhydria, etc. that requires a formal assessment.) Among the best: VSL3, Garden of Life, and Renew Life brands.

4) Supplement magnesium–Magnesium deficiency is widespread and is associated with osteoporosis, hypertension, higher blood sugar, muscle cramps, and heart rhythm disorders. For unclear reasons, these phenomena are magnified during wheat withdrawal. Magnesium supplementation can thereby have some dramatic benefits during wheat withdrawal. Unfortunately, most magnesium supplements are better as laxatives than as sources of absorbable magnesium. Among the best: magnesium malate at a dose of 1200 mg two or three times per day (weight of the magnesium + malate, not just “elemental” magnesium). Source Naturals makes a great preparation.

5) Supplement omega-3 fatty acids–There are plenty of reasons to supplement omega-3 fatty acids to make up for our aversion to consuming the brains of land animals and only occasional reliance on seafood. But during wheat withdrawal, weight loss proceeds at a rapid clip for most people, a process that involves massive mobilization of fatty acids into the bloodstream (evidenced on a cholesterol panel as higher triglycerides). Omega-3 fatty acids partially protect us from the adverse effects of this flood of fatty acids, as it activates the enzyme, lipoprotein lipase, that helps clear them from the bloodstream. I advocate an EPA + DHA intake of 3000 mg per day (the dose of omega-3 fatty acids, not of fish oil). The best fish oil is in the liquid triglyceride form, not the common ethyl ester capsules, as the triglyceride form is better absorbed (particularly the DHA). My favorite brands because of meticulous production techniques: Ascenta NutraSea and Nordic Naturals.

6) Supplement iodine–The average person is marginally deficient in iodine, particularly in people who avoid use of iodized salt. Ironically, the more you avoid processed foods (as we do with wheat elimination, given wheat’s ubiquity), the less iodized salt you get. Avid exercisers also are more iodine deficient than average, given iodine loss via sweat. This has gotten so bad that I have actually found many people with goiters (enlarged thyroid glands). Even a modest lack of iodine leads to lower output of thyroid hormone (especially T4), resulting in mild hypothyroidism that impairs weight loss, can make fatigue worse, increase LDL cholesterol and triglyceride values, and even increase cardiovascular risk. Iodine is an essential trace mineral: everyone needs it (though people with a history of Hashimoto’s thyroiditis or thyroid nodules will have to be extra careful; I’d like to say consult your doctor, which is true if you have a doctor knowledgeable about iodine, which is less than 1% of my colleagues). I advise patients to supplement iodine as inexpensive drops, capsules, or kelp tablets (dried seaweed) to provide 500 mcg iodine per day.

Those are the supplements that have proven tried and true in reducing at least some of the most common struggles with wheat withdrawal. Because these supplements do not entirely address all the issues, especially low energy, I am always on the lookout for ways to make this process easier. On the list of supplements/strategies that we are exploring (and are therefore only speculative for this application):

Generation UCAN–I first learned about this from Peter Attia of The Eating Academy, as he is an avid fan of this polymeric preparation of corn-derived maltodextrin. (Yes: derived from corn that is non-genetically modified and is a purified carbohydrate polymer, no proteins.) It’s unusual lengthy structure of 500-700 glucose residues means it does not yield the osmotic effect of maltodextrins, nor does it cause a rapid rise in glucose, but a very low-grade trickle of glucose. These effects make it useful for very long-distance exercise that depletes glycogen stores and can result in low blood sugar. The slow trickle of glucose form this preparation is usually insufficient to generate much of a rise in blood sugar. This has the potential to prevent the marginal hypoglycemia characteristic of wheat withdrawal when taken, e.g., 1/2 to 1 scoop twice per day. Interestingly, more and more people are observing that, even outside the wheat withdrawal period, weight loss from fat develops. (That’s an entire discussion of its own.)

VESPA–This unique polypeptide preparation from the Asian Mandarin wasp enhances fatty acid beta oxidation, one of the limiting factors in converting from glycogen-dependent metabolism to fatty acid-dependent metabolism. Like Generation UCAN, these lessons have been learned from high-intensity exercise experiences and may be transferable to the setting of wheat withdrawal.

Over the 2+ years since Wheat Belly first made bookstores and upset many people in the wheat world, we’ve learned many new lessons on how to best deal with the phenomenon of wheat withdrawal. If you’ve got some strategies you have found useful, please speak up and post a comment here.

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121 Responses to Surviving wheat withdrawal

  1. Tony says:

    I have been practicing a grainless diet for over a month. I was doing very well until I went home for the holidays to visit my parents: a very Italian household. So I at lasagna for a week, I had a few chocolate chip cookies everyday, and I had pizza one day. The day that I ate pizza, I had the most horrific gas you can imagine. The kind that can make everyone in a room to run out.

    So after my wheat friendly diet at Mom and Dad’s house I went back to my home in New York to celebrate New Years. That night I had another heavily-wheat-friendly dinner: homemade pasta and homemade Italian bread. On New Years day I had meat raviolis: again more wheat. Out of all the days, the pizza night was extraordinary in terms of digestive discomfort and gas. The second worst night was New Years Eve which I at a lot of bread.

    I find that bread bothers my stomach a lot more than just eating pasta alone.

    So the day after new years day, Jan 2, I went back to basically my Paleo Diet. No more grains of any kind. I started off with some coconut flour pancakes. I later went to the gym. And I stayed at home the rest of the day eating a grainless diet. Shortly after lunch I had diarrhea. A lot. But I felt find. By the next night I was developing a canker sore on the right side of my tongue and I had a fever.

    The next morning I took some advil. I had some aches and pains in my legs and lower back. The canker sore was getting bigger and causing more pain.

    By the next evening, I my right tonsil was very swollen. So I went to the doctor. He prescribed me an antibiotic and and an anti-viral medication. I took my first does and went to bad.

    The next morning I didn’t feel better or worse. By the end of the day the canker sore got worse and I had developed one on my pallet behind my front teeth. I woke up this morning and the pain was excruciating. I had pain in my right jaw and developed another canker sore on the right side of my pallet. I went back to the doctor.

    She gave me a steroid immediately for the inflammation in my mouth and jaw. She changed the antibiotic and gave a me a topical solution to deal with the pain on my tongue. As I writing I’m feeling a little better and the fever is gone. But I still have the canker sores. I’m going to see an ENT tomorrow. I also did tests for strep, flu, and mono. All negative under rapid tests. I also gave blood today to test for STD’s.

    I’m reading this article and everyone else’s comments and I wonder: Am I going through some kind of grain withdrawal. The doctor’s assistantment told me that my body is putting up a big fight against some kind of virus or infections because the all the inflamation in my mouth, jaw, and lymph nodes.

    Has anyone experienced canker sores as a result of stopping grains? While I’m a big supporter of a grainless diet, I am Italian. Once totally go gluten-free, I can NEVER cheat once in a while or I’ll get very sick?

    I’ll know more tomorrow after I see the ENT. But I’m wondering if my going back and forth between weeks of grainless meals, followed by a week full of grains, is causing my immune system to go crazy!

    Any thoughts would be appreciated.

    • Louise VILLENEUVE says:

      Hi

      I have not been diagnosed with celiac yet….and hope I won’t be, however last year I completed my blood work to see my intolerances through my naturopathic doctor. I score really high for wheat and all other gluten products, I also scored really high for all dairy products, soya, corn, eggs (all types) cranberries and crab. I am also allergic to most fruits and vegetables when eaten in the raw form. I also can not tolerate raw almonds and some seeds if they have soy lecithin. I get blisters in my mouth within seconds of eating it. I know it can be a challenge not eating gluten, however I am finding it very challenging not to eat any of the above as so many products contain corn or soya lecithin.

      After one month of doing really well off the above food, my old ways slowly crept in again last summer and now I sure am paying the price with excessive weight gain, etc.

      I always look about 8 months pregnant and people come up to me asking when I am due. My 8 year daughter often comments on my big belly. I always have embarrassing gas, tired every afternoon and I snore like crazy. I way about 210 lbs and am 5’6. I have chronic back pain.

      For the past few days I’ve been eating lots of greens with seed and chicken, some smoothies with raspberries and rice or almond milk etc. some gluten free pumpkin muffins I baked.

      I am writing as I do need help and support. When can I start noticing improvement? I know it’s been years of abuse on body and it can’t be undone quickly.

      Any sugar free suggestions for breakfast ( ie no maple syrop) …besides grapefruit, smoothies and trail mix.
      Ps the only fruit and vegetable I tolerate in the raw form are strawberries, raspberries, bananas, grapefruit, tangerines, cucumbers.

      Any other advice, suggestions would be greatly appreciated.

      Thank you very much.

      Louise

      Sent from my iPad

    • david says:

      Hi, I’m of German/UK descent and have had a sore like that when stopping gluten. I was also adding lemon to my tea at that time, though, which could have been a/the cause.

  2. Amanda says:

    I am on day 6 of no gluten. Today I woke up & feel really tired. I am bloated, upset stomach, achy. Another symptom I have had is hands & feet falling asleep easily. I thought maybe coming down with the flu but now wondering if gluten withdrawal. I also have a ton of congestion & phlegm (gross I Know). I have read wheat belly & have been to a ND who suggested the book & she said symptoms sounded like a food allergy. I had blood taken & am still waiting on results. I decided to eliminate wheAt in the meantime in hopes I would feel better. It sounded like the wheat withdrawal symptoms are usually in 1st few days & then relief starts. My scale has not really moved. Weight loss is not my main goal but need to lose 20lbs. Again I expected a little weight loss in week 1. I am feeling frustrated and wondering if something else is going on. I do feel like I have had less cravings & not as hungry as before. I did feel some increased energy on days 3 & 4. I am going to try probiotics like others have suggested. I am just not feeling confident that what I am doing is the right path. Do I just stick it out and have faith in the process? I have another week to get results from blood work. Should I call Dr. & consult her? Thanks in advance for any help!

    • Dr. Davis says:

      It would be a darned shame if you start the journey back to health, have to endure effects to undo all the problems created, then give up because the process is unpleasant.

      I’d say stay the course and things get better. It took many years to disrupt health; it takes more than a few days to correct.

  3. Jill says:

    I am on day 5 of being wheat free. What a tough week. Day one wasn’t bad but by day 3 I felt bad. I can’t exactly place it but I just didn’t feel well. I had terrible pain in my upper calves . Yes exactly the same on both legs. It felt as though I worked out and was about to get a cramp in my calf, but it didn’t happen. I hadn’t worked out. I was very tired and really a bit depressed. I was forcing myself to do things. If I could have I would have sat in the recliner all day with a blanket and done nothing! Well today day 5 I feel so much better, my calves don’t hurt anymore and I emotionally feel better. I believe this is all due to a wheat withdrawal . I have not cut out all carbs like I have done in the past so it is totally incredible that wheat can do these things! I always thought it was carbs that did this, WOW iwheat must really wreak havoc on our bodies is if this is what happens when I eliminate it. I look forward to feeling even better in the future.

  4. Jennifer says:

    I’ve been gluten free since the first of the year (22 days). However, I started weaning myself slowly in November. I didn’t want to deprive myself over the holidays considering I’ve had my symptoms for years. At any rate, perhaps my slow change over has put off my withdrawal symptoms a bit. I didn’t start to really feel bad until 2 weeks in. I had pain in my calfs, much like I had recently worked out. I also have some serious tension in my neck and shoulders. I became more tired than usual. I started getting really bad headaches between days 14 and 16. They feel much like migraines that I’ve had in the past. The last two days I’ve had rumbling in my stomach and gas. I considered gluten contamination, but I’ve rechecked everything I’ve eaten and I don’t think that’s the problem. After doing some searching, I believe that all of my symptoms are gluten or wheat withdrawal, but it seems strange that it took 2 weeks to start for me. Again, maybe it’s because I took a more gentle approach to going gluten free. I’m just wondering how long this will last. Any thoughts?

  5. Bethany says:

    I started going grain free on Monday, January 20th.
    It’s day four and I’m SUPER bloated! I had piercing stomach pains about an hour ago and my belly is very swollen! I’m not pregnant, and this bloating isn’t like your normal “I ate too much”. I wonder if it’s inflammation from the detox. But I was hoping to get rid of this wheat belly…lol. I suppose I should give it time.

    Other symptoms I’ve had are dry skin. I’ve always had dry skin (one symptom of wheat for me) and it kind of broke out more. Perhaps I need more of the good Omega-3 fats and to keep hydrated better.

    No fever though! In fact, I’ve been able to go running and do other activities just fine. I did however get pretty mood swings. The kind of irritable mood you get when you ate too much sugar. But I didn’t eat any sugar.
    I hope this is just detoxing, cause I would like to get rid of the belly :)

    • Dr. Davis says:

      Many people with this effect, Bethany, do better with a high-potency probiotic taken for several weeks.

      This may reflect a transition in bowel flora.

      • Jane Jacobson says:

        I listened to the audio version of Wheat Belly twice while escaping the sun for two weeks between Jan 25 and Feb 8. I also read Grain Brain. Both scared the bejesus outa me. I began tapering off wheat and carbs but gave the wheat the boot for real by Feb 1st. Its now Feb 14 and I am an emotional basket case!
        Afraid to give up all carbs, so do you have any kind words of advice? I am very nervous as to how long this will last. It’s a debilitating dissociative mess. Can’t find anything to grasp meaning from and having trouble focussing and being motivated to get anything accomplished.

  6. Jane Jacobson says:

    Oops… I meant escaping the SNOW.