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.