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When Laine wrote last week’s post about why people with autoimmunity and the often-concomitant hormonal imbalances are sometimes dismissed or told they’re “difficult cases,” I had to chuckle. 

I was going to write something similar for this week’s post, but she beat me to it. 

I thought, Fair enough, it was a great post and I don’t need to say more because Laine covered it. 

But the next day, one of my clients said something to me that not only harkened back to Laine’s post, but also inspired me to write V2, so to speak, about the importance of sequencing an approach to immune modulation and balancing hormones. 

Let’s call her Kim. This isn’t Kim. >>>

Kim wasn’t happy with me. She wasn’t happy in general, because of what she was experiencing in our program together. In fact, she was angry. 

It was a tough conversation, which I outline below. 

Some background…
As Laine and I tell all of our clients, we don’t have a cookie cutter program. Each client is treated as an individual and we take people where they are – from those just learning about what gluten is and where it hides out to those who’ve been on AIP for a while.

That said, we do have a framework for our programs, of course, which you have to have when sequencing an approach. But that framework is made from branches that sway with the wind vs. rigid steel. In other words, we have to be nimble and flex with our clients, depending on how they’re understanding, implementing, and feeling.

One of the biggest components – if not the biggest – of what we do with our clients is to help optimize their digestive function. To heal the gut. It’s critical for not only immune modulation, but also balancing hormones.

Healing the gut goes well beyond taking out a few trigger foods and seeing what happens. (This oversimplified approach is often what people have tried, without success, and why they end up coming to us or other practitioners like us.)

Once someone has their sea legs under them with our dietary and supplement recommendations for the process of regenerating the epithelial cells of the lining of the digestive wall, we start layering some other things in, like restoring hydrochloric acid and mitigating yeast and bacterial overgrowth.

We sequence.

If someone were to implement all of these tactics simultaneously (which is what many are gung-ho to do), it would likely backfire and almost inevitably cause a Herxheimer reaction – a toxic response to the waste that’s being produced by the detoxification process. (It’s also called “herxing.”)

People often think of herxing in the context of a yeast/candida cleanse. But you can certainly herx from an elimination diet, which is a detox. A gentle detox, but a detox nonetheless. 

I don’t want to scare anyone here – in years of doing this work, I’ve had very few clients who’ve had an intense Herxheimer reaction to the diet itself. But it does happen occasionally – and although it sucks at the time, it doesn’t last long and it speaks to the importance of needing to do it in the first place.

And when people come out on the other side, their lives have been changed.

Kim is one of the few who’ve had an intense reaction.

She was one of those rare cases – she felt terribly at the onset of her elimination diet: pounding headaches, extreme fatigue and irritability, and the aches. She was so angry and frustrated, she didn’t email me to tell me what was going on. (Had she reached out, I would have told her that some powered fiber and activated charcoal would have gotten her through things quickly – most people feel much better within the day.)

Here’s an abbreviated version of what went down at our next session, where she told me how badly she’d been feeling: 

K (voice cracking): “Why didn’t you tell me this might happen? You should have told me. I’m so angry and frustrated. I mean, why keep going? I feel way worse than when I started.”

Me: “You’re right, we didn’t talk about it specifically, mostly because it’s rare that this happens. Also, it is mentioned in one of the handouts I sent, but I understand if you missed it.”

[We then had a discussion about the efficacy of powered fiber and activated charcoal, but she was so dejected, she was unconvinced it would help.]

K: “We’re only two sessions into my program. Is this what I’m supposed to expect from here on out? If so, I’m done. Just keep my money.”

Me: “No, you’ll get through this soon. I’m here to support you through it. I know this probably isn’t what you want to hear, but how you’re feeling right now speaks to how much you’re detoxing – it speaks to the importance of doing this.”

[Then I stressed how she could feel better – likely by that evening – if she went to her co-op immediately and got the additional (and very inexpensive) supplements.]

K: “So where do we go from here? What else are you going to have me do? Am I going to detox even more?” 

Me: “When you’re ready, I’d like to work on cleansing yeast and bacteria. But let’s get you through this first. It’s possible that you experience another mild Herxheimer reaction, but perhaps you won’t. We can take things slowly and see how you do.” 

K (voice cracking): “OMG, are you serious? Why didn’t we talk about this earlier? Or why didn’t you just put me on the yeast and bacterial cleanse at the same time that I started the diet? I wish you had – I mean, why not just get it all over with at the same time? So you’re going to make me drag this out? I don’t get it. How am I supposed to make progress? I’ve followed you for a long time and you’ve often said that a lot of your clients feel better within a few days, but that’s certainly not my experience. I don’t think I can do this. Am I the exception? I guess I am – because that’s what I’ve heard from a lot of other providers, even my doctor. I feel completely hopeless.”

Me: “I understand where you’re coming from, but please also understand that I’m not making you do anything. I’m offering suggestions based on what I know works – and you’ll get through this. Please don’t give up hope. Every situation and every person is unique. That’s why Laine and I take people where they are – and support them through all of it. I don’t think you’re an exception.

“Knowing what we know now about how challenging the start of the diet has been, if you’d started everything at once, things could have been much worse – you likely would have had a major herx that could’ve left you unable to go to work for a couple of days. And now that your body has been through this initial wave of detoxing, I highly, highly doubt that the next level of cleansing will be this uncomfortable, if you herx at all.”

[We then had a discussion about the efficacy of powered fiber and activated charcoal, but again, she was so dejected, she was unconvinced it would help.]

K: “Whatever, but I still don’t know why we didn’t talk about this earlier, so I could be prepared.”

Me: “I understand. And if you remember, we discussed a high-level program overview in our Jumpstart session, where I shared the different things we’d be working on. In my experience, getting ahead of ourselves doesn’t serve anyone. If anything, it overwhelms people. Had I come right out of the chute with suggesting a bunch of strategies at once, not only might you have had a major herx, but it would likely have felt like too much. It can give people analysis paralysis and they feel like doing nothing – or quitting. One of the most important things that Laine and I do for our clients is to help to mitigate overwhelm, not add to it.”

[Pregnant pause.] 

Again, I do NOT want to scare anyone here. Kim’s reaction was rare – she’s maybe one of four people in the entire 10 years I’ve been coaching to have this type of reaction. The vast majority of our clients DO feel remarkably better even a week into our gut-healing protocol.

Kim did email me on Monday morning to say that the powdered fiber and activated charcoal “worked like a charm.” Whew. [Insert me wiping my brow.]

So now, she’s ready – she’s ready to take the next steps that will foster real transformation. Those layers. With the right sequencing.

We still have quite a bit of time together and now that she’s over the hump and feeling so much better, she’s going to have the energy and clarity to keep going. I think it’s going to be smooth sailing from here on out.

She even said, and I quote directly, “I know I was really hard on you. I’m sorry – I was in a really bad place. I really understand why we’re doing things this way. I appreciate you doling things out over time because you’re right, I probably would have freaked out if we’d done everything at once. I didn’t realize how badly I really needed all of this and I wouldn’t have been able to handle it.

“I feel completely differently in my body now. I feel better than I have in a really, really long time. No one has ever approached my situation this thoroughly or given me this much support. I know that I have a ways to go, but I can see the light at the end of the tunnel. I’m excited to keep going.” 

[Insert me wiping my brow.]