Grain-free diets can be truly amazing tools for those with autism, ADHD, allergies, autoimmune and digestive disorders. But with diet, as with other things in life, one size does not fit all. You may be aware of the popularity of Paleo or Primal diets and other grain-free diets such as the Specific Carbohydrate Diet and GAPS. You can read more about them in my article Is a Grain-Free Diet Right For You. These diets have tremendously positive results for some people, but there are some potential issues with these diets that people should be aware of.
It is not uncommon for my clients as well as other people on grain-free diets to have other complicating dietary restraints such as food allergies and intolerances that further narrow the diet. If someone is limited because they can’t or won’t eat vegetables, can’t eat fruit or tolerate fructose or FODMAPS foods, or they have other limitations such as oxalate, salicylate, amine or glutamate foods, they sometimes end up overeating meat. People on grain-free diets also often eat a lot of meat to fill them up and make them feel satiated. Some clients come to me eating multiple servings of protein at every meal.
As I explained in Too Much Blame on the Grain, a reliance on too much meat in the diet can lead to toxic levels of ammonia in the body. As protein is broken down to amino acids, ammonia is formed, and high levels of ammonia can be produced in the body from consuming excess protein. This ammonia can damage the kidneys, liver, and other organs including the brain. The urea cycle has to work hard in order to detoxify all that ammonia. Because there is an intricate relationship between the urea cycle and the Krebs cycle, or citric acid cycle, when we drive the urea cycle hard in that manner, we can affect the Krebs cycle and this can impact the generation of energy in the mitochondria and certain markers on an Organic Acid Test (OAT).
There is nothing inherently dangerous about a grain-free diet. But everyone has a different tolerance for protein, carbohydrates and fats in the diet, and any diet should be tailored to individual needs. Natasha Campbell McBride’s One Man’s Meat is Another Man’s Poison explains this beautifully. While some people seem to thrive on high-protein diets, others may seem to do fine for a while, but without realizing it the levels of ammonia are building and causing a whole new set of symptoms and problems. You may feel more fatigue or notice brain fog, or see flapping or stimming in your children, for example.
One factor that plays a role in a person’s tolerance for protein is a gene called CBS. You may have heard about the MTHFR polymorphism; there certainly seems to be a lot of talk about it in the circles I run in today. The truth is that there are many methylation cycle defects and MTHFR is just one of them. In my opinion, the CBS gene is much trickier to deal with, and incorrect diet and supplementation can really have serious health consequences in those with CBS. People with CBS polymorphisms can already have a tendency toward high ammonia, so additional ammonia created by diet or improper supplementation could create additional problems. The full effect of CBS is beyond the scope of this article, and I will address it in a future article for those that are interested, but I mention it as an example of a person who may be predisposed to ammonia problems and where a high-protein diet can do more harm than good.
Ammonia in the body, whether it comes from diet or any other factor, requires detoxification by the urea cycle. This detoxification of ammonia depletes BH4, or Tetrahydrobiopterin. BH4 is an intermediate that plays a crucial role with neurotransmitters such as serotonin and dopamine. So excess ammonia in the diet depleting your BH4 can affect mood, sleep, and the development of language. A lack of BH4 due to ammonia detoxification also creates oxidative damage in the body as peroxynitrite or superoxide can be produced. Lower levels of BH4 can even lead to higher histamine levels by affecting mast cell degranulation. These high histamines can cause more than the sniffles. You can learn about how histamines affect sleep, migraines, OCD, the gut and more in my article Could Histamine Be Sabotaging Your Digestive Health.
Some of you may already know that you carry the MTHFR A1298C allele. MTHFR is receiving much attention, and this attention is well-deserved. The MTHFR A1298C variant may also affect BH4 levels. So high ammonia from a high-protein diet and the detoxification of this ammonia may further deplete BH4 in those with MTHFR A1298C, leading once again to those mood, sleep, and language development issues.
There are also other methylation cycle defects that affect dopamine, serotonin, and urea cycle function that complicate issues even more.
It is important to talk to your doctor before reducing protein in the diet. Protein reduction can trigger a lot of detoxification. Ammonia in the gut can also affect gut pH and therefore the balance of microbial flora, so any quick changes can cause gut imbalances. When it comes to dietary change, or adding supplements to your program, I always tell my clients that “slower is faster”. When I work with clients with high ammonia to reduce protein in the diet, we do it very, very slowly as to avoid triggering rapid detox and undesirable symptoms.
Everyone needs protein, fat, and carbs in their diet, and the ratio of these macronutrients needed by each person is very individual. If you are not getting the results you want on a healing diet, you might need to make some adjustments. It is not a bad idea to do some genetic testing, particularly if you are not progressing on a grain-free diet. There are two great options for doing so. Nutrigenomic Testing through Dr. Amy Yasko is more expensive, and requires a few drops of blood, but focuses on genes more specific to the methylation cycle and the implications of methylation cycle defects and ways to bypass them. Additionally, there is a forum available to ask questions and biochemical testing through Dr. Amy is an option. 23andMe is a saliva test and it is more affordable but requires more work in order to interpret the results and their implications. I actually ran both tests on my family members because they both have their strengths and their weaknesses, and I wanted a more complete picture of our health risks. Also, I am just a biochemistry geek. 🙂 Right now 23andMe is running an awesome promotion. Get your 23andMe DNA kit for $99, all additional kits are 20% off.