How I conquered AS naturally

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I was diagnosed with Ankylosing Spondylitis (Click here) seven years ago.  I went from feeling OK one day to being in the hospital the next.  I could barely walk or turn my head because I was so stiff.  The episode occurred after I went out drinking and consumed 6 beers over a eight hour period.  I tested positive for HLA-B27 and have a fused Sacroiliac joint.  I also had Irritable Bowel Syndrome IBS and a history of pretty severe allergies to pollen and molds since I was a child, as well as a history of Colitis in my family.  My father had Colitis in his 40's and had a colostomy to address the internal bleeding.  

For years I was treated with a TNF Blocker to treat the Ankylosing Spondylitis with nominal results.  Unfortunately I suffered from side effects such as Psoriasis, and an increased susceptibility to Staph infections.  Unable to manage the side effects, I decided to see if I could treat the condition naturally.  For over a year, I researched information on the web, saw a knowledgeable Naturopath, and went through a lot of trial and error.   

Starting an Elimination Diet
Based upon some testing from my Naturopath it was determined that I was suffering from Candida overgrowth.  Interestingly, my first flare-up occurred several months after being given antibiotics, which not only kill bad bacteria but also the good bacteria in your gut which can lead to antibiotic resistant strains of bad bacteria overgrowth.  For more information on managing Candida, here's a good website on the topic: Ridding your body of Candida

During the summer of 2010, I went on a strict elimination diet for two months, cutting out all sugars and processed foods.  I took antifungals to kill the Candida as well as vitamin supplements including large doses of Magnesium.  My diet consisted of meat, fish, eggs, nuts, vegetables and water

Over the two month period I lost 20 pounds, my IBS disappeared, I went from a flare up to having zero pain and for the first time I could lay flat on the floor and my head touched the ground.  Note my neck is not fused.  This was the first time in seven years that I was able to do this.  And this was without doing any stretches!!

Good and bad bacteria
I found a good article detailing the link between Klebsiella bacteria and AS.  It was identified that the Klebsiella bacteria mimics the HLA B27 gene and can lead to an autoimmune response where the body attacks the HLA B27 molecule thinking that it is a foreign body.  I suspect that the cause of my AS was the Klebsiella bacteria verses Candida fungus but have no way of knowing for sure as the elimination diet had the effect of killing both.  As I discovered, diet can also be effective in killing Klebsiella.  The following article details how a low starch diet kills the Klebsiella microbe.  I also began taking Oregano oil to kill the Klebsiella.  My understanding is that you need to be careful which brand you purchase as the content in different brands varies widely.  Unfortunately the high quality brands are also quite expensive. Here is a study that confirms that Oregano oil helps to kill many types of Enterobacteriaceae bacteria including Klebsiella bacteria. 

While taking any supplements that kill the bad bacteria in your gut, I found it was also critical to replace the good bacteria with Probiotics.  For the first year I purchased probiotics from the health food store, but in the summer of 2012 I learned about the importance to eating fermented foods for gut health.  I discovered that fermented foods like Kim-chi and Sauerkraut have trillions of good bacteria compared to the supplements that you can buy at the health food store.  This makes sense:  our ancestors ate fresh vegetables during the summer months and then pickled the rest to carry them through the winter.  But in our modern diet, fermented foods are lacking.  So I eat a few spoonfuls of sauerkraut or Kimchi a day and have stopped buying and taking (often expensive) probiotics.  In over two years, I have had no issues with this approach. 

Histamine Intolerance
As the next step in the elimination diet, I began adding certain foods back in to identify which foods were causing issues.  The biggest thing that I craved was fruit so I first tried an apple.  I got IBS symptoms within 15 minutes of eating the apple. I tried other types of fruit over the next week and continued to get sick.  I went back to the web to search for an answer.  What I determined from that research is that I have a problem with foods that have high Histamine levels (Cheese, Beer, processed meats, vinegar, fruits, etc.).  The following online article Histamine link to Autoimmune disease was helpful in detailing the link between histamine intolerance and diet.  For me, the simple solution to the problem was to include the supplement Diamine Oxidase when consuming high histamine foods. 

Gluten Intolerance
The next food I tried to add back was wheat.  While I didn't have an immediate reaction, within about 2 weeks my stiffness and psoriasis started to come back.  Since then, I have found Gluten to be problematic for me.  While I tested negative to Celiac disease and for a having a wheat allergy, if I consume small amounts of gluten my Psoriasis comes back and I begin to have joint stiffness in my tendons.  "Small amounts" for me means milligrams of gluten. If gluten is the issue for you as well, you'll need to read the labels on your foods to find which products have gluten, and pay special attention to sauces.  Look for Malted Barley Syrup or Modified Food Starch on the label to avoid.  You will likely have to avoid things like Soy Sauce, gravy, and many other sauces that use flour to thicken the sauce. 

Gluten intolerance is increasingly common today, and the causes are well documented.   Carbohydrates turn to sugar in the gut, and that includes wheat products.  Too much sugar has an inflammatory effect on the body, which can lead to many diseases including diabetes and heart disease.  Diets high in sugar and carbohydrates feed Candida and Klebsiella, which can lead to overgrowth.  The cause is pretty clear: modern humans have only been eating a high carbohydrate diet since the Agricultural Revolution around 10,000 years ago.  Our modern diet is not natural. Prior to the Agricultural Revolution, people ate meat, vegetables, fruits, nuts and drank water. The Paleolithic diet, closely mirrors this.  The key is to limit processed foods and foods high in starch and grains, such as bread, wheat products, potatoes, white rice, etc. Another diet which is very similar is the London AS or low starch diet.  Note I did not follow this particular diet.  Here is a list of foods high in starch to avoid. 

Hydration
During the elimination diet, I was overly optimistic that I could go back to enjoying alcohol.  Over the years I have noticed a direct correlation between my back muscle stiffness and drinking alcohol.   At this time, I came across several articles that talked about dehydration associated with muscle pain in AS patients (for more detail, read about the Dehydration link to Autoimmune diseases).  As you are probably aware alcohol is a dehydrant. I found that by staying away from alcohol and coffee, and drinking 2 quarts of water every day that the muscle stiffness went away.  More on this later in the blog....

Lets take a moment to look at the body as a whole system.  My body was inflamed by bacterial overgrowth in the small intestine.  I believe this was caused by Gluten destroying my intestinal lining, and leading to Leaky Gut Syndrome.  Your body uses histamine to initiate the inflammatory process.  When I took in foods that were high in histamine I was exacerbating the response.  Your body uses Diamine Oxidase to digest the histamine but at some point your body reaches a tipping point where there is not enough Diamine Oxidase to digest all of the histamine which resulted in an IBS response.

Dehydration was another major factor for me.  When your body is dehydrated it pulls water away from the muscles into the vital organs.  This in turn causes muscle stiffness and pain.  Another side effect of the dehydration is that it causes Histamine levels to rise.  It is a vicious cycle that gets worse over time.  Here's an article that describes the Histamine and Water relationship. You should not under estimate the impact of dehydration and it's effects on the body.  Your body is made up of 80% water.  The average person is so used to drinking coffee, sodas, fruit juice, etc. that they frankly don't get enough water to support normal body function.  Since I increased my water intake I haven't needed to take the Diamine Oxidase tablets as often presumably because I have lowered the Histamine levels in my body by increasing my hydration level.

Diets
In the summer of 2011, I saw a new Medical Dr who was also a Naturopath.  He suggested I try the Blood Type diet. The basic concept of the blood type diet is that your body has evolved to eat certain foods based upon the blood type that you inherited from your ancient ancestors. If you eat foods that your body wasn't designed to eat it can cause an inflammatory response.  You can find out more by reading Eat right 4 your type.  

In November 2012, I read a book called The Primal Blueprint. The diet described in the book is very close to the Paleo diet but allows you to have dairy and dark chocolate. The diet stresses staying clear of all grains and legumes.  I have decided to start adding back some of the foods on the avoid list in the Blood Type diet, like certain meats and vegetables to see if it had any negative impacts. I didn't notice any negative impact from adding back foods like chicken, pork and avocado's which were on the avoid list for those with B blood type in the Blood Type Diet. 

So which diet solved the problem?  One thing to note is the commonalities between all the diets (Paleo, London, Blood Type and Primal Blueprint): they are all low in carbohydrate, no processed foods, and no gluten / wheat products.  Because it was key for me to get my gut flora healthy, the Paleo diet was critical in killing off the bad bacteria (Klebsiella).  But, for me it was also important to pick a diet that was least restrictive.  Converting to the Primal Blueprint has been a reasonable dietary approach that continues to keep me in remission.  Yes I have tried cheating, and I always paid for it with stiffness and fatigue for several days while my system flushed out the toxins.  The important factor is to listen to your body as you go through this process and avoid anything that causes symptoms.

Here's an example of what I eat daily
Breakfast 
Berries
Bacon or sausage and eggs
Lunch
Meat (turkey or beef), vegetables; a starch like yams or  rice in moderation
Snack
Avocado, nuts and berries
Dinner
Meat (beef or fish), vegetables and a starch like a squash or rice in moderation
Dessert 
Dark chocolate

Vitamin deficiency and supplements

Vitamin D is one of the supplements we haven't discussed yet.  One finding shows that people with autoimmune disease are chronically low in Vitamin D.  The question is whether low vitamin D is the cause or the symptom?  I had taken huge doses of Vitamin D over the course of 3 years and during that time my symptoms reduced.  Today I take a nominal dosage Vitamin D due to the findings in the following Vitamin D Study. This also makes sense from the perspective that bacterial overgrowth appears to be a contributing factor in AS.  Interestingly my vitamin D levels remained at the recommended level while taking a nominal dosage and continuing to eat right. This is likely because my body is no longer in an autoimmune state. I also began taking Vitamin K2 supplement as it is key in the regulation of Vitamin D.

I had an epiphany while on vacation in August 2013 regarding the root cause of my AS symptoms. A few weeks before the vacation I had a bout of the stomach flu so I stopped taking the magnesium supplement.  This was a mistake but a blessing in disguise.  While on vacation we were hiking and my wife noticed that I was starting to stoop with my head forward. I also felt stiff.  Later that evening I had one vodka drink and then went to bed.  I woke up at 2 AM with my back killing me.  I took a magnesium supplement and by morning my pain was gone as was the stiffness.  It was at that moment that I realized the implications of what had just happened.  The bout of diarrhea coupled with excessive sweating on the hike and the vodka drink had depleted my magnesium levels and since I wasn't taking my magnesium supplement my body was in a distressed state.  Click here to learn more about magnesium depletion.  Magnesium deficiency can lead to muscle knots, spasms and stiffness. Your muscles are a Calcium Magnesium Pump, which means that when you flex, it's the Calcium that causes the muscle fibers to contract.  When you relax the muscle it's the Magnesium that causes the muscle fiber to release.  If you are lacking Magnesium in your body it can cause muscle knots to form. Since magnesium is the chemical that is used to relax your muscles, I realized that the reason for the characteristic AS stoop in my posture and muscle stiffness was due to the lack of magnesium.  Once my magnesium levels were restored the stoop became less and yes I can still lay flat on the ground :-)

In December 2013, I found a research paper relating to Klebsiella and Magnesium.  The study was done at the University of Geneva titled "Role of magnesium and a phagosomal P-type ATPase in intracellular bacterial killing".  They found that Kil2 Knockout cells transport magnesium into the phagosome and that magnesium is required for optimal protease activity and efficient intracellular killing of Klebsiella.  So based upon this not only does magnesium help your muscles relax but also helps kill the bacteria that is believed to cause AS.

Conclusion
In order to treat AS I had to treat the body as a whole and there wasn't one easy fix. In my case this comes down to a systemic problem: the inability for me to digest histamine properly coupled with a damaged gut lining caused by gluten resulted in IBS.  Gluten also became a toxin in my body resulting in arthritic joint pain and psoriasis whenever consumed.  The chronic diarrhea led to low magnesium levels, which led to muscle stiffness and stooped posture.  The right solution for me? Control the IBS and maintain gut health via dietary changes and supplement with magnesium to prevent stiffness.

Here is a summary of the key problems that were causing my health issues:

Yeast and mold allergy
Gluten intolerance
High histamine levels
Bacterial overgrowth
Magnesium deficiency
Enzyme deficiency
Dehydration

These problems led to a disease state diagnosed as Ankylosing Spondylitis, Irritable Bowel Syndrome, Chronic Fatigue Syndrome and Psoriasis.

The right fix for me was:

Eat a Paleo diet - Especially avoiding any products with Gluten in them
Take oregano oil daily to kill the bacteria (note: only a few weeks of consumption was needed);
Take Probiotics containing Lactobacillus daily
Avoid foods high in mold or yeast or take Histame whenever I consume them
Drink plenty of water and limit  beverages high in sugar or dehydrant (coffee, alcohol, sodas, etc.) 
Supplement with vitamins where I have a deficiency (Magnesium and Vitamin D)
Exercise and stretching several times a week
Stopped taking probiotics and started eating fermented foods (Summer 2012)
Started the Paleo Blueprint diet in November 2012
Stopped eating fermented foods due to histamine issues (2013)
Starting eating very spicy curries weekly in place to using oregano oil periodically (Summer 2015)

While AS clearly has a genetic component, there is more to it.  One in every 17 people has the genetic component that is associated with AS.  Of that percentage one in 85 have AS and of that roughly one in 775 people require treatment.  I found an interesting book which explains how chronic stress can result in Adrenal Fatigue resulting in chronic illness and autoimmune diseases such as AS.  Definitely a good read.
 

Today, I am symptom free and enjoy active sports such as wake boarding, dirt bike riding and snow boarding.  I have been able to get my life back with a few changes in my daily routine.  I hope you find my story helpful.  I would be very interested if anyone else has success with some of the things that helped me......Mike

Please note: I am not a Doctor nor am I medically trained.  This blog is not an endorsement for any products or medical practices.  Always consult a health care professional before starting any health program. While the information in this blog has helped me with A.S. it may not help you.