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In working with clients, many of the same questions come up over and over because with so much quality information out there, it can be overwhelming to sort out who to listen to, who’s just trying to sell you something, what really matters, what doesn’t, and, once you think you have your box of tools assembled, how to sequence an individualized approach to get lasting results.

Our clients ask great questions – questions that underscore how smart, insightful, intuitive, and committed they are.

Here are some of our most frequently asked questions – some big and some small – and their important, sometimes unexpected answers.

Why doesn’t my doctor know any of this lifestyle medicine stuff?
Right. Great question. The short answer? Medical school trains doctors to treat symptoms, not root causes.

The ability to treat symptoms is essentialwhen the symptom is pain from a shattered femur and the root cause was tripping down the front steps. Surgery may be mandatory if you want to walk again, but it wouldn’t help if your doctor came over to your house and investigated your front stoop (the cause) instead of putting your bone back together.

Treating symptoms is less helpful when the symptom is muscle pain and the root cause is a nightshade intolerance. 

You can treat the muscle pain with Advil or some other NSAID, but if you keep eating nightshades, you end up in a vicious and deteriorating loop of being continually exposed to the root of the issue, whereby paving over the problem with pharmaceuticals never gets you anywhere and actually causes more systemic inflammation.

(Many pharmaceutical interventions are helpful for addressing certain conditions, of course. We don’t eschew all traditional approaches and we recognize their value in many situations.)

I know a kid who has a peanut allergy. If he even walks by a peanut butter sandwich, he goes into anaphylactic shock. When I eat dairy (or gluten/corn/soy/other trigger food), I don’t feel anything right after the fact. So my symptoms can’t possibly be related to food, right?
Classic food allergies and food intolerances are both considered “sensitivity-related illnesses” but they trigger different immune pathways. Symptoms of food allergies show up immediately and with explosive force. Symptoms of food intolerances can show up as many as three days after exposure and manifest in often unexpected ways, from insomnia to muscle pain to bloating. Food sensitivities and intolerances are just as real as classic food allergies, but are more diffuse and a bit more challenging to detect.

Sleuthing out sensitivities is one of the most significant – and rewarding, both for us and our clients – piece of work that Jill and I do with the people we work with. It’s nothing short of life-changing.

Since oats are naturally gluten-free, why are some packages labeled gluten-free and others aren’t?
Oats are inherently gluten-free, but there’s a widespread problem with cross-contamination both in crops and in grain processing facilities. Oats labeled gluten-free haven’t been exposed to gluten-containing foods or crops. Stay safe: buy “gluten-free!”

Do I have to give up coffee during an elimination diet?
Some experts say yes, absolutely, caffeine has to go. Some say a small amount of caffeine is fine. My advice is always client-specific and depends on how much caffeine a person is already drinking. Are they drinking it only in the morning as a much-loved ritual or are they propping themselves up with non-nutritional energy throughout the day and using caffeine as a crutch to cope with fatigue? Big difference.

Do they have a habit of drinking coffee on an empty stomach vs. with or after their breakfast? Another big difference. I never recommend any type of caffeine on an empty stomach because of the negative effects on the adrenals and blood sugar regulation.

If someone has severe migraines, I often suggest giving up caffeine completely during an elimination diet since it’s such a common trigger for headaches.

[For more about coffee, go here for Jill’s post, Coffee is Good, Toxic Coffee is Bad.]

Do I have to give up alcohol during an elimination diet?
Same advice as above, including the bit about an empty stomach, how much is being consumed, and migraines. An additional thing to remember about alcohol is that it turns to sugar in the body, so if blood sugar dysregulation is a concurrent problem, you may want to “just say no” to all alcohol during the diet.  

Back to that ritual thing – if someone isn’t over-consuming alcohol and enjoys a small glass of wine a couple of nights a week with dinner, I often recommend they drink an organic pinot noir, which has the highest resveratrol content of any wine, regardless of country of origin. Resveratrol helps to tame inflammation, regulate the immune system, and has cancer-protective benefits. But don’t let this give you license to over-consume alcohol! You can also find resveratrol in red grapes, blueberries, cranberries, peanuts, pistachios, cocoa, and dark chocolate.

When will I see results?
This, too, depends on the person. But most people who start an immune modulating protocol experience results within a week. 

From there, it’s usually an upward spiral: feeling so much better makes the protocol easier to do, and the more a person continues the healthy changes, the better they feel. A true positive feedback loop.

A few people don’t experience results right away, and while this can be discouraging, it’s not a sign that the protocol isn’t working. It’s usually a sign that one’s system just needs more time to clear out toxins and heal from food sensitivities and intolerances.

If this happens to you, try not to give up hope and remember that, no matter what, undertaking an immune modulating protocol is a profound act of self-care and intrinsically very healing. You’re doing something transformative for your health, whether you feel it yet or not.