With all our talk of opiate withdrawal syndromes accompanied by nausea, headache, fatigue, and depression, it can be daunting, even terrifying, to people who face the prospect of tossing all wheat and grains into the trash bin, vowing to never let a Danish, donut, or dish of pasta cross your lips again. So it may help to lay out a timeline of what and when various changes can develop in the Wheat Belly wheat- and grain-free lifestyle.
You can expect different symptoms and health conditions to recede at different rates, since they are caused by a variety of different mechanisms. For instance, the direct gastrointestinal toxic effects of gliadin-derived peptides and wheat germ agglutinin that underlie acid reflux and irritable bowel syndrome symptoms typically cease within days of consuming no wheat or grains. The iron, zinc, magnesium, and calcium absorption blocking effects of grain phytates stop immediately with grain elimination (with blood and tissue levels rising over weeks to months), while vitamin B12 and pernicious anemia can require months to improve, since the autoimmune destruction of stomach parietal cells that allow B12 absorption require months to recover (if it recovers at all). Different conditions, different causes within wheat and grains, different timelines to recede or disappear.
This makes for substantial variation in the wheat- and grain-elimination experience among individuals. While many enjoy prompt relief from say, acid reflux, joint pain, leg edema, and mind “fog,” as early as the first 3-5 days, others require 6 months to obtain relief from rheumatoid joint pain or psoriasis.
Note that timelines quoted below are approximate, depending on, for instance, the quantity of grains consumed previously, status of bowel flora (and the quality and consistency of efforts to restore), glandular and hormonal status, age, sex, form and intensity of inflammatory or autoimmune response, and other factors. Nonetheless, we can indeed construct a rough timeline to help you anticipate how and in what sequence your grain-free experience may play out.
Week 1: This is, for about half of us, the worst part of the experience of eliminating wheat and grains. This is the period made miserable by withdrawal from the opioids of grains, resulting in fatigue, nausea, headache, and depression—all the features of an opiate withdrawal syndrome—and cravings for foods made of grains. Recognize that this does not represent a need for something in grains—just withdrawal from opiates. Light-headedness and muscle cramps can develop, so be sure to hydrate, use mineral-rich salt, and take magnesium supplements.
Despite the rigors of withdrawal, weight loss can nonetheless proceed, often rapidly. Many, though not all, people experience weight loss at the rate of up to one pound per day for the first week, losing a combination of visceral fat and water. It is also at the end of Week 1 that sleep begins to improve: It becomes deeper and more restful, with fewer restless leg tendencies.
As mentioned above, direct gastrointestinal toxic effects, especially acid reflux (“heartburn”) and irritable bowel syndrome (IBS), begin improvement during this first week. (Relief from IBS, however, can be limited by substantial distortions of bowel flora; the first week is when you should have also begun a high-potency, multi-species probiotic and prebiotic fibers, as discussed in Wheat Belly Total Health and summarized in the Wheat Belly Blog.
Week 2 through 4: For most people, Week 2 marks a big turnaround in emotions, energy, joint health, and skin health. Typical observations during this period include relief from joint pain in fingers and wrists; relief from depression; relief from appetite stimulation, including the 24-hour-a-day food obsessions experienced by people with bulimia and binge eating disorder; and relief from common skin conditions such as eczema, acne, and seborrhea.
For the majority of people, weight loss continues, though it may slow from the rapid pace of the first week. Most people feel a surge in energy at this time, and many people who experience chronic migraine headaches experience partial or total relief. Women with painful and turbulent premenstrual syndrome symptoms may begin to feel them recede at Week 2 or just beyond, depending on when in their cycle they began the grain-elimination process.
Week 5: The early period of opiate withdrawal should have completely passed by now for everyone, and those people who developed abnormal metabolic reliance on carbohydrates during their former grain-consuming life should begin to acquire higher levels of energy. Depriving the body of carbohydrates, especially grain amylopectins, results in a drop in energy until the body adapts by ramping up the process of fat mobilization. Once that occurs, energy increases further, mood improves, and exercise performance improves.
If you chose to exercise during the first few weeks of grain elimination, you probably noticed that running, swimming, biking, and other activities were difficult during the first few weeks, with reduced energy, slower times, and overall poor performance. Once you reach Week 5-6, though, performance for most athletes surpasses levels achieved prior to grain elimination. Carb loading is no longer necessary and carbohydrate supplementation needs are much reduced or eliminated during prolonged efforts. Less-serious exercise efforts, such as jogging 5 miles, biking 20 miles, or doing aerobics for an hour, do not require carb intake, energy drinks, energy bars, or other supplementation, as your body is more efficient at drawing energy from fat stores.
People with chronic fatigue syndrome or fibromyalgia typically respond at about this time, partially or completely, with surges in energy and mood and relief from muscle pain, joint pain, and stiffness. Hormonal issues, such as tumultuous menstrual periods in women and enlarged breasts in men, typically require this long to improve. The hormonal distortions that cause these issues, such as inappropriately high estrogen levels and inflammatory phenomena, recede with visceral fat, which should, by this time, have shrunken dramatically.
Week 6 and onward: Six or more—sometimes many more—weeks are usually required for more complex conditions that involve autoimmunity and inflammation to recede or reverse. Autoimmune conditions such as rheumatoid arthritis, lupus, multiple sclerosis, Hashimoto’s thyroiditis, polymyositis, polymyalgia rheumatica, psoriasis, and others typically start to respond at about this time, with continuing improvement over the next several months. (Persistence of such issues often suggests small intestinal bacterial overgrowth, SIBO that will need to be addressed for further recovery.) Inflammatory conditions, such as osteoarthritis of the hips and knees, also respond more slowly, providing relief over the following few months. The degree of response is highly variable, depending on the extent of bony damage, which does not reverse with grain elimination. Neurological conditions also require more time to respond, given the slow and limited potential for nervous system tissue to undergo repair. Multiple sclerosis, the impaired coordination of cerebellar ataxia, and the tingling and pain of peripheral neuropathy can require months to years to respond or, at least, stop progressing further. Neurological impairment from grain consumption should be treated as autoimmune conditions, and the strategies discussed need to be followed consistently over a long period.
Undoing all the harmful effects of wheat and grain consumption doesn’t happen overnight, but unfold over weeks or longer. But know that, by taking this path, you are being given magnificent control over health, weight, and appearance, something that conventional dietary guidelines cannot do. And, the longer you stay on course, the better your health becomes without all the incredible health-disrupting effects of grains.