HGHY Great-In-8 FAQ Step 1

Great-in-8 Plan Contents

Healthy Gut, Healthy You

Please post any questions or comments regarding a step of the Great-in-8 action plan in the corresponding section as listed to the right

Step 1: Reset

We will be adding answers to the most commonly asked questions about Step 1 of the Great-In-8 plan along with important information for troubleshooting this step here shortly.

Please post any questions or comments regarding this step below.

Q: If I am trying to get pregnant, currently pregnant or breastfeeding, what parts of the protocol should I modify?

A: First off, I want to emphasize that any and every decision made while trying to become pregnant, during pregnancy, or while nursing should be run by your OBGYN or PCP.

Here are some of my thoughts to be considered in the context of working with your doctor:

  • Any dietary changes are likely fine. The low FODMAP diet has actually been shown in a pilot study to decrease infantile colic when the mother consumes a low FODMAP diet and is breastfeeding a colicky baby.
  • The elemental diet is probably fine, but should be discussed with your doctor to confirm.
  • As far as supplements go, fish oil, vitamin D, multivitamin, probiotics, prebiotics, and fiber are all likely fine.
  • Adrenal support, hormonal support, and antimicrobials should be avoided.
  • Regarding prokinetics, some are recommended against, so discuss with your OBGYN

Q: What if I’m a vegetarian or vegan? Can I still follow the protocol?

A: While I don’t have any personal biases around a vegan or vegetarian diet one way or another, it can admittedly be very difficult to follow during the protocol. Many vegan protein sources are not low fodmap or not typically included in a paleo diet. My best advice would just be to listen to your body. If you choose to incorporate some of the things that aren’t technically paleo, but are low fodmap (tofu, quinoa, etc), pay close attention to how you feel. If your gut doesn’t seem to be improving, try taking them out and seeing if that changes anything. Good luck!

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

949 thoughts on “HGHY Great-In-8 FAQ Step 1

  1. Hi love the book so far just got to the Great in 8 plan. With the liquid fasting you indicate maple syrup to be added. I know this may be a frequent question but I was hoping you could explain a little further it’s effectiveness on bacteria as I was under the impression it may feed or aggravate instead of heal?

    Regards

    1. Thanks Lee,
      I wouldn’t worry about the bacteria, the goal of the fast is to take pressure off the gut with liquid calories like taking pressure off a sprained ankle with rest. There is a low carb version mention in the handout, which is bone broth.

      1. Could we use raw honey instead, since it has antibacterial and anti-fungal qualities? Or is there something special about the maple syrup?

        1. Raw honey is fine if you prefer it. The point is just to reduce the work your digestive system has to do for a few days.

  2. Hi love the book so far just got to the Great in 8 plan. With the liquid fasting you indicate maple syrup to be added. I know this may be a frequent question but I was hoping you could explain a little further it’s effectiveness on bacteria as I was under the impression it may feed or aggravate instead of heal?

    Regards

    1. Thanks Lee,
      I wouldn’t worry about the bacteria, the goal of the fast is to take pressure off the gut with liquid calories like taking pressure off a sprained ankle with rest. There is a low carb version mention in the handout, which is bone broth.

      1. Could we use raw honey instead, since it has antibacterial and anti-fungal qualities? Or is there something special about the maple syrup?

        1. Raw honey is fine if you prefer it. The point is just to reduce the work your digestive system has to do for a few days.

  3. I’ve really enjoyed reading the book so far. 🙂

    Is there any reason not to use packaged bone broth, such as Kettle & Fire or Bonafide, for the modified fast? (Obviously it’s a lot more expensive, but aside from that?)

    Any idea how much broth the average person ends up consuming, so I can plan accordingly? I’m a 130-pound female.

    Thanks!

    1. Thanks Tonya. That would be fine. It varies from person to person, I’d say err on the side of having more than you need – you can always freeze extra and use later.

  4. I’ve really enjoyed reading the book so far. 🙂

    Is there any reason not to use packaged bone broth, such as Kettle & Fire or Bonafide, for the modified fast? (Obviously it’s a lot more expensive, but aside from that?)

    Any idea how much broth the average person ends up consuming, so I can plan accordingly? I’m a 130-pound female.

    Thanks!

    1. Thanks Tonya. That would be fine. It varies from person to person, I’d say err on the side of having more than you need – you can always freeze extra and use later.

  5. Hi Dr Ruscio,

    Really liked your book, which has helped me to organize my head around healing the gut!
    I am bothered by a question since started my gut healing journey:

    I live in Israel, where we do not have access to pasture raised grass fed meat, chicken and dairy products. We only have access to organic free range chicken, eggs and dairy products, where the chickens are being fed with organic corn, wheat and soy. Is it good enough for implementing the Paleo and the Auto Immune Paleo Diet?

    Thank you!

      1. Hi Dr Ruscio,

        Really appreciate your support.

        I will review the book in Amazon and also recommend it to my relatives who have interest in improving their health.

  6. Hi Dr Ruscio,

    Really liked your book, which has helped me to organize my head around healing the gut!
    I am bothered by a question since started my gut healing journey:

    I live in Israel, where we do not have access to pasture raised grass fed meat, chicken and dairy products. We only have access to organic free range chicken, eggs and dairy products, where the chickens are being fed with organic corn, wheat and soy. Is it good enough for implementing the Paleo and the Auto Immune Paleo Diet?

    Thank you!

      1. Hi Dr Ruscio,

        Really appreciate your support.

        I will review the book in Amazon and also recommend it to my relatives who have interest in improving their health.

  7. Hi Dr. Ruscio,

    I love the book, and I am planning on starting the great in 8 plan. My question is I am a Police Officer and work very long shifts, and then I have to train after work to qualify for my special assignments. With that being said I go through a lot of calories regularly. Is there a problem with using elemental heal and bone broth while on the fast? Or should I just one and not the other?

    Thank you for providing such an incredible book. You provided answers to questions I have been having for years! I feel like I am finally going o take control of my gut.

  8. Hi Dr. Ruscio,

    I love the book, and I am planning on starting the great in 8 plan. My question is I am a Police Officer and work very long shifts, and then I have to train after work to qualify for my special assignments. With that being said I go through a lot of calories regularly. Is there a problem with using elemental heal and bone broth while on the fast? Or should I just one and not the other?

    Thank you for providing such an incredible book. You provided answers to questions I have been having for years! I feel like I am finally going o take control of my gut.

  9. Hello Dr. Ruscio!
    I appreciate you creating this book, I am really enjoying it and grateful for your knowledge and expertise. When I finish the liquid fast and start the Paleo Whole 30, will I resume taking all my prior supplements? I was on supplements for my adrenals, thyroid.

    Thanks

    1. Hi Carrie,
      I wouldn’t recommend taking previous supplements but instead focusing on the protocol in the book. This includes adrenal support, and by improving your gut health there is a good chance you won’t need thyroid supplements. If you haven’t left a review for the book on Amazon, it would be greatly appreciated 🙂

  10. Hello Dr. Ruscio!
    I appreciate you creating this book, I am really enjoying it and grateful for your knowledge and expertise. When I finish the liquid fast and start the Paleo Whole 30, will I resume taking all my prior supplements? I was on supplements for my adrenals, thyroid.

    Thanks

    1. Hi Carrie,
      I wouldn’t recommend taking previous supplements but instead focusing on the protocol in the book. This includes adrenal support, and by improving your gut health there is a good chance you won’t need thyroid supplements. If you haven’t left a review for the book on Amazon, it would be greatly appreciated 🙂

    1. Yes, but I would bounce this off their pediatrician. Use 1/2 the dose of the listed protocols. Also, I tend to be very minimal with dietary restrictions with children, I give them lots of slack.

    1. Yes, but I would bounce this off their pediatrician. Use 1/2 the dose of the listed protocols. Also, I tend to be very minimal with dietary restrictions with children, I give them lots of slack.

  11. I am beginning the modified fast this weekend. I want to use a combination of the bone broth and the maple syrup mixture so I will have some protein from the Broth, but I am not sure if it is a good idea because I suspect I might have an issue with histamine and I have read Bone broth is high in Histamine. I do notice some flushing when I consume Bone Broth. Should I just stick with the syrup mix?

    Also, the Maple syrup mixing instructions contradict themselves.

    “2 Tablespoons of Organic US Grade A Dark syrup (not the commercial maple flavored syrup you
    use on pancakes)”

    and then a little lower it states:

    “Also, the maple syrup must be grade B maple syrup, not the sugar filled syrup that is used at the
    breakfast table”

    So, is it Grade A or Grade B that should be used? I am also not sure about the warning about the breakfast table syrup. I use 100% Grade A Organic Maple Syrup at the breakfast table, that should work right?

    Final Question, The instructions say herbal and green teas are ok during the fast, how about black coffee?

    Thank You, Great Book

    1. Thanks Travis,
      Looking into the syrup issue now, I know some terminology changed and created confusion. I don’t think it makes a difference either way though.
      No on coffee.
      More to follow!

      1. Thanks for getting back to me. I went ahead and did the fast the past 4 days. I only consumed kettle and fire Bone Broth (2 cups a day) green tea, bl;ack coffee and water. I consumed 2 cups of coffee a day and added collagen peptides to the coffee to help with gut healing and keep some amino acids flowing. Did I screw up and starve for 4 days for nothing? I couldn’t take going without caffeine and food for 4 days.

    2. Hi Dr Ruscio thank you for your wonderful guidance! I just want to emphasize the part in the question above about using both the bone broth and maple lemonade for the 4 days. Is that alright? I tried them both today and I feel alright!

  12. I am beginning the modified fast this weekend. I want to use a combination of the bone broth and the maple syrup mixture so I will have some protein from the Broth, but I am not sure if it is a good idea because I suspect I might have an issue with histamine and I have read Bone broth is high in Histamine. I do notice some flushing when I consume Bone Broth. Should I just stick with the syrup mix?

    Also, the Maple syrup mixing instructions contradict themselves.

    “2 Tablespoons of Organic US Grade A Dark syrup (not the commercial maple flavored syrup you
    use on pancakes)”

    and then a little lower it states:

    “Also, the maple syrup must be grade B maple syrup, not the sugar filled syrup that is used at the
    breakfast table”

    So, is it Grade A or Grade B that should be used? I am also not sure about the warning about the breakfast table syrup. I use 100% Grade A Organic Maple Syrup at the breakfast table, that should work right?

    Final Question, The instructions say herbal and green teas are ok during the fast, how about black coffee?

    Thank You, Great Book

    1. Thanks Travis,
      Looking into the syrup issue now, I know some terminology changed and created confusion. I don’t think it makes a difference either way though.
      No on coffee.
      More to follow!

      1. Thanks for getting back to me. I went ahead and did the fast the past 4 days. I only consumed kettle and fire Bone Broth (2 cups a day) green tea, bl;ack coffee and water. I consumed 2 cups of coffee a day and added collagen peptides to the coffee to help with gut healing and keep some amino acids flowing. Did I screw up and starve for 4 days for nothing? I couldn’t take going without caffeine and food for 4 days.

    2. Hi Dr Ruscio thank you for your wonderful guidance! I just want to emphasize the part in the question above about using both the bone broth and maple lemonade for the 4 days. Is that alright? I tried them both today and I feel alright!

  13. I have read the book twice and marked it up. I really really appreciate your balanced perspectice and your carefulness to use good studies to make informed decisions, It has helped me sift through so much of the internet information, which is frankly, overwhelming,

    I was interested to try Elemental Heal but cannot see on your store site how many servings are in a given container or how to predict how many meals it would cover. Could you supply that information?

    I also don’t understand how much of an Elemental Diet to use for a meal. If you go with the basic 2000 calories a day, and a serving of it is 150 calories, it seems impossibly expensive!

    Thank you in advance for your time,

  14. I have read the book twice and marked it up. I really really appreciate your balanced perspectice and your carefulness to use good studies to make informed decisions, It has helped me sift through so much of the internet information, which is frankly, overwhelming,

    I was interested to try Elemental Heal but cannot see on your store site how many servings are in a given container or how to predict how many meals it would cover. Could you supply that information?

    I also don’t understand how much of an Elemental Diet to use for a meal. If you go with the basic 2000 calories a day, and a serving of it is 150 calories, it seems impossibly expensive!

    Thank you in advance for your time,

  15. Hello – I’m planning on starting a modified fast in a few days and am going to do the lemon juice and syrup option. In the instructions, it says at the top to use Grade A organic maple syrup, but then a few lines down it says to use grade B. Will you please clarify? I’ve been looking at syrups online and some are classified as Grade A, but then in parenthesis say (formerly Grade B). Is that the type to use? Many thanks in advance for your help (and your book)!

  16. Love your podcast, your approach to medicine and your new book! I have Hashimoto’s and tried the AIP diet a couple years ago and settled on a paleo-ish diet which has never resolved my constipation. So after the fast, I’ve decided to try the low-fodmap paleo. For the first time in a long time my bloating is better so I think I’m on the right track- so thank you!! Constipation has not improved at all yet after a couple weeks, however. I’m wondering when I should add the probiotic and whether I should also try some GF grains to see if that helps (I’m quite active and a little underweight). Would I add grains and probiotics at the same time? Thanks again for everything you are doing!!

  17. Hello – I’m planning on starting a modified fast in a few days and am going to do the lemon juice and syrup option. In the instructions, it says at the top to use Grade A organic maple syrup, but then a few lines down it says to use grade B. Will you please clarify? I’ve been looking at syrups online and some are classified as Grade A, but then in parenthesis say (formerly Grade B). Is that the type to use? Many thanks in advance for your help (and your book)!

  18. Love your podcast, your approach to medicine and your new book! I have Hashimoto’s and tried the AIP diet a couple years ago and settled on a paleo-ish diet which has never resolved my constipation. So after the fast, I’ve decided to try the low-fodmap paleo. For the first time in a long time my bloating is better so I think I’m on the right track- so thank you!! Constipation has not improved at all yet after a couple weeks, however. I’m wondering when I should add the probiotic and whether I should also try some GF grains to see if that helps (I’m quite active and a little underweight). Would I add grains and probiotics at the same time? Thanks again for everything you are doing!!

  19. Hello, I enjoyed the book and was excited to start the plan with hope my IBS-D would finally clear up using a holistic dietary approach. Although I was very unsure about doing the fast as I usually eat well as I am very active with weight training etc. However I had already been following a low-FODMAP for 3 weeks with not much change so I decided it was best I at least gave the fast a go… I chose bone broth as I already make it regularly and like that it has a good nutritional profile to support me.

    I attempted the fast yesterday but ended up giving up after 17 hours as I felt really sick. I thought this must be because I needed food so ate a small bowl of chicken + low-FODMAP vegetables in bone broth and some blueberries. Unfortunately I didn’t feel much better and eventually ended up with really bad diarrhoea and a lot of vomiting (including bringing all the broth back up). I couldn’t keep anything down at all and felt awful all day.

    My husband has had the broth with no ill effects, so I don’t think it’s a bad batch but I am so disappointed with this reaction. Any idea why I would have reacted this way? I’ve read about cooking the broth for a long time can cause a build up of glutamine which some people are sensitive to, but I’ve had long cooked broths before without such reaction… as well as lots of L-glutamine supplementation previously too.

    I’m so disheartened but will just move onto the next step with continuing an elimination diet with probiotics and digestive enzymes to support – then eventually adding foods back in…

    Any advice on what happened to me would be much appreciated? I feel I gave my gut more harm than good with that first step.

    1. I understand this can be frustrating. Some people simply don’t do well with broth, and thats OK. The lemonade may work better, however don’t worry about it can simply move forward 🙂

  20. Hello, I enjoyed the book and was excited to start the plan with hope my IBS-D would finally clear up using a holistic dietary approach. Although I was very unsure about doing the fast as I usually eat well as I am very active with weight training etc. However I had already been following a low-FODMAP for 3 weeks with not much change so I decided it was best I at least gave the fast a go… I chose bone broth as I already make it regularly and like that it has a good nutritional profile to support me.

    I attempted the fast yesterday but ended up giving up after 17 hours as I felt really sick. I thought this must be because I needed food so ate a small bowl of chicken + low-FODMAP vegetables in bone broth and some blueberries. Unfortunately I didn’t feel much better and eventually ended up with really bad diarrhoea and a lot of vomiting (including bringing all the broth back up). I couldn’t keep anything down at all and felt awful all day.

    My husband has had the broth with no ill effects, so I don’t think it’s a bad batch but I am so disappointed with this reaction. Any idea why I would have reacted this way? I’ve read about cooking the broth for a long time can cause a build up of glutamine which some people are sensitive to, but I’ve had long cooked broths before without such reaction… as well as lots of L-glutamine supplementation previously too.

    I’m so disheartened but will just move onto the next step with continuing an elimination diet with probiotics and digestive enzymes to support – then eventually adding foods back in…

    Any advice on what happened to me would be much appreciated? I feel I gave my gut more harm than good with that first step.

    1. I understand this can be frustrating. Some people simply don’t do well with broth, and thats OK. The lemonade may work better, however don’t worry about it can simply move forward 🙂

  21. Hi Dr. Ruscio,

    Questions please:

    1.) May I alternate between Bone Broth & the Lemon/Maple Syrup water during the Fast ? Or is it imperative to choose one & then stick with it ?

    2.) If I am happy drinking the Lemon Water straight without the Maple Syrup is that OK ? I have worked sooo hard eliminating sweeteners of any kind from my diet , it is disturbing to consider reintroducing one..

    Thanks for your brilliant and so needed book !

    Best,
    Lisa

  22. Hi Dr. Ruscio,

    Questions please:

    1.) May I alternate between Bone Broth & the Lemon/Maple Syrup water during the Fast ? Or is it imperative to choose one & then stick with it ?

    2.) If I am happy drinking the Lemon Water straight without the Maple Syrup is that OK ? I have worked sooo hard eliminating sweeteners of any kind from my diet , it is disturbing to consider reintroducing one..

    Thanks for your brilliant and so needed book !

    Best,
    Lisa

  23. I am currently taking biofilm disrupters and probiotics. And eating paleo.
    I want to try the great on 8. Starting with fast. Do I stop the biofilm disrupter enzymes and all herbs during this time (oregano) and probiotics.?

  24. I am currently taking biofilm disrupters and probiotics. And eating paleo.
    I want to try the great on 8. Starting with fast. Do I stop the biofilm disrupter enzymes and all herbs during this time (oregano) and probiotics.?

  25. Any suggestions for an elemental diet or fast for a person sensitive to both glutamate (gluatamine) and histamine? I think I would otherwise do well on an elemental diet

  26. Any suggestions for an elemental diet or fast for a person sensitive to both glutamate (gluatamine) and histamine? I think I would otherwise do well on an elemental diet

  27. Hello!
    Thank you for releasing such a great book! I have tried fasting and it does not do much for my bloating so this tells me that I need to go to Step 2. I live in Canada and cannot find FMF. Do you know if it’s distributed anywhere here at all? I couldn’t find their website.

    Finding the probiotic for Lacto and Bifido is easy but the other two seem to be a bit more complicated.

  28. Hello!
    Thank you for releasing such a great book! I have tried fasting and it does not do much for my bloating so this tells me that I need to go to Step 2. I live in Canada and cannot find FMF. Do you know if it’s distributed anywhere here at all? I couldn’t find their website.

    Finding the probiotic for Lacto and Bifido is easy but the other two seem to be a bit more complicated.

  29. Hi two questions:
    1. I am unclear if your carb guidelines are for total carbs or net carbs. The book just refers to carbs, so I assumed the goal for low carb is fewer than 100 total carbs per day. But the resources you direct to, like the Atkins counters, focus on net carbs which can be quite different (if the food has any fiber content).

    2. I’m eager to start Great in 8, but I had surgery to remove endometriosis – will be 3 weeks ago when I start the liquid fast. I’m doing great with regard to healing and stamina, but have digestive ups and downs (different from my usual) post surgery – which I assume comes with the territory of abdominal surgery. Now is the perfect time for me to start the Great in 8 but will I miss key signs of food intolerance when I transition to one of the diets if I’m still recovering from surgery? I’ve been Paleo AIP for awhile, but post fast, I’m going to try Paleo low fodmap.

    I really appreciate the book and it’s wonderful synthesis of all of the (conflicting) information out there. I feel you really understand the journey patients like me have been on! I love your approach and am looking forward to starting the Great in 8 protocol!

    1. 1. Total carbs, but it doesn’t really matter. The general concept is about starting lower carb and then later testing a carb reintro. Don’t get too detailed here.
      2. I would start now, it won’t be perfect but that is life. You will still end up in a far better position than if you didn’t do it. You can fine tune dietary boundaries later on.
      Hope this helps!

  30. Hi two questions:
    1. I am unclear if your carb guidelines are for total carbs or net carbs. The book just refers to carbs, so I assumed the goal for low carb is fewer than 100 total carbs per day. But the resources you direct to, like the Atkins counters, focus on net carbs which can be quite different (if the food has any fiber content).

    2. I’m eager to start Great in 8, but I had surgery to remove endometriosis – will be 3 weeks ago when I start the liquid fast. I’m doing great with regard to healing and stamina, but have digestive ups and downs (different from my usual) post surgery – which I assume comes with the territory of abdominal surgery. Now is the perfect time for me to start the Great in 8 but will I miss key signs of food intolerance when I transition to one of the diets if I’m still recovering from surgery? I’ve been Paleo AIP for awhile, but post fast, I’m going to try Paleo low fodmap.

    I really appreciate the book and it’s wonderful synthesis of all of the (conflicting) information out there. I feel you really understand the journey patients like me have been on! I love your approach and am looking forward to starting the Great in 8 protocol!

    1. 1. Total carbs, but it doesn’t really matter. The general concept is about starting lower carb and then later testing a carb reintro. Don’t get too detailed here.
      2. I would start now, it won’t be perfect but that is life. You will still end up in a far better position than if you didn’t do it. You can fine tune dietary boundaries later on.
      Hope this helps!

  31. Any suggestions for a particular diet for SIFO rather than SIBO? FODMAP has worked great for me in the past to manage my symptoms – however I now seem to be reacting (bloating, reflux) with anything that has a high fibre content (black & brown rice). Are there any strict differences in diet for SIFO & SIBO?

    1. Hi Olivia,

      I’m sorry to hear you’re reacting to so many foods, I know that can be frustrating. It may be helpful to start with a lower carb paleo diet (very similar to a candida diet) and then perform the reintroduction to see where you feel best. One of the main variables for yeast/fungus is carb intake but there is more to finding your ideal diet than just carbs. The book lays out a good plan for this. Ultimately the best diet for you is the one you feel best on and not what a given condition’s diet rules recommend. Hope this helps!

  32. Any suggestions for a particular diet for SIFO rather than SIBO? FODMAP has worked great for me in the past to manage my symptoms – however I now seem to be reacting (bloating, reflux) with anything that has a high fibre content (black & brown rice). Are there any strict differences in diet for SIFO & SIBO?

    1. Hi Olivia,

      I’m sorry to hear you’re reacting to so many foods, I know that can be frustrating. It may be helpful to start with a lower carb paleo diet (very similar to a candida diet) and then perform the reintroduction to see where you feel best. One of the main variables for yeast/fungus is carb intake but there is more to finding your ideal diet than just carbs. The book lays out a good plan for this. Ultimately the best diet for you is the one you feel best on and not what a given condition’s diet rules recommend. Hope this helps!

  33. Hello. Any suggestions for someone who is very fatigued, has brain fog constantly and is unmotivated lately to pick a meal plan. start it, shop for ingredients and then cook the meals? I just don’t have the energy. Any advice? I also want to make sure I am not nutrient deficient. Thank you Dr. Ruscio in advance for the great book and for your time and consideration. Have a great day : )

    1. Hi Chris,

      Depending on what your issues are, a low FODMAP diet can be very helpful for many gut conditions. I would say keep it simple (meat, carb, veggie), cook in batches so you have lots of leftovers, and make big pot meals in a slow cooker or Instant Pot. You can also consider a grocery delivery service so you don’t have to go to the store. Good luck!

  34. Hello. Any suggestions for someone who is very fatigued, has brain fog constantly and is unmotivated lately to pick a meal plan. start it, shop for ingredients and then cook the meals? I just don’t have the energy. Any advice? I also want to make sure I am not nutrient deficient. Thank you Dr. Ruscio in advance for the great book and for your time and consideration. Have a great day : )

    1. Hi Chris,

      Depending on what your issues are, a low FODMAP diet can be very helpful for many gut conditions. I would say keep it simple (meat, carb, veggie), cook in batches so you have lots of leftovers, and make big pot meals in a slow cooker or Instant Pot. You can also consider a grocery delivery service so you don’t have to go to the store. Good luck!

  35. I’m just reading your book and have a question. I was recently diagnosed with microscopic colitis – looks like it was an underlying condition, made worse by immunotherapy for melanoma. Even on large doses of prednisone (to manage side effects) gluten and dairy seemed to make it worse. My enterologist suggested the immunotherapy had altered my microbiota. Colitis now under control via 12 weeks of budenoside during which I also stopped all gluten and dairy and limited fruit and veg to those which seemed to not spark off the symptoms. Immunotherapy now changed to just nivolumab which I tolerate well. I’ve started to reintroduce some foods – mostly veg and fruit – but cautiously.
    Do you have any advice on microscopic colitis and diet, microbiota etc?

    1. Hi Sophy,

      Thanks for your comment and I’m sorry to hear you’ve been dealing with MC.

      If you find gluten and dairy are triggering your symptoms, I’d suggest continuing to keep them out of your diet.

      I’ll pass along your question to Dr. R and hopefully he’ll answer it in an upcoming podcast episode.

      Good luck!

      1. Was this ever talked about? I see a few mentions of microscopic colitis but not much detail. I ask as I used to have lymphocytic colitis that has since recovered after figuring out my own intervention of avoiding gluten and also vegetables and fruits that were harder to digest. I was diagnosed via a colonoscopy and recent exams have shown it has gone away. While it was definitely not easy to deal with I must have had a more mild case than others.

        I do still suffer with Ibs and I plan on giving thie books protocol a shot even though I’ve tried most everything in the book.

        1. Hi Mike – Not yet, looks like it’s on the list for the next episode he does answering Healthy Gut, Healthy You questions which will hopefully be sometime this month.

  36. I’m just reading your book and have a question. I was recently diagnosed with microscopic colitis – looks like it was an underlying condition, made worse by immunotherapy for melanoma. Even on large doses of prednisone (to manage side effects) gluten and dairy seemed to make it worse. My enterologist suggested the immunotherapy had altered my microbiota. Colitis now under control via 12 weeks of budenoside during which I also stopped all gluten and dairy and limited fruit and veg to those which seemed to not spark off the symptoms. Immunotherapy now changed to just nivolumab which I tolerate well. I’ve started to reintroduce some foods – mostly veg and fruit – but cautiously.
    Do you have any advice on microscopic colitis and diet, microbiota etc?

    1. Hi Sophy,

      Thanks for your comment and I’m sorry to hear you’ve been dealing with MC.

      If you find gluten and dairy are triggering your symptoms, I’d suggest continuing to keep them out of your diet.

      I’ll pass along your question to Dr. R and hopefully he’ll answer it in an upcoming podcast episode.

      Good luck!

      1. Was this ever talked about? I see a few mentions of microscopic colitis but not much detail. I ask as I used to have lymphocytic colitis that has since recovered after figuring out my own intervention of avoiding gluten and also vegetables and fruits that were harder to digest. I was diagnosed via a colonoscopy and recent exams have shown it has gone away. While it was definitely not easy to deal with I must have had a more mild case than others.

        I do still suffer with Ibs and I plan on giving thie books protocol a shot even though I’ve tried most everything in the book.

        1. Hi Mike – Not yet, looks like it’s on the list for the next episode he does answering Healthy Gut, Healthy You questions which will hopefully be sometime this month.

  37. Dr Ruscio, my 22 year old son has been on the Paleo diet and your 3 probiotics for 3 weeks due to acne, insomnia, depression and anxiety for shoot 8 years and a tingling feeling in his skin all over his body for as long as her can remember.. He was also taking the Adrenal Support Complete. We added it a week to 10 days after the probiotics. He began getting muscle twitches all over his body. We stopped the ASC and the twitches went away a couple days later. His acne is reduced by 85%. Very cool. His mood is not measurably different and he has less energy by about 20% and just feels weak. He has eaten sweet potatoes without trouble. He is going to try rice next. We are ordering the Biota-Clear1a and then 2a. But I’m concerned about his energy and lack of change in his mood. Wondered if you had any thoughts. Thank you.

    1. Hi Lynn,

      I’m so sorry to hear about your son, and I know how confusing it can try and be to manage these sorts of conditions on your own.

      I’m not sure if you’ve read Dr. Ruscio’s book, Healthy Gut, Healthy You, but if not, I definitely recommend getting a copy (https://drruscio.com/getgutbook/). It has a very thorough and complete protocol that will be suitable for handling most gut issues (which as I’m sure you know, are definitely related to depression, acne, insomnia, and energy levels).

      Also, if you’d like to apply for your son to become a patient and get personalized care from Dr. Ruscio, you can do so here: https://drruscio.com/consult-dr-ruscio/

      Lastly, you may want to check and see if your son is eating enough. Sometimes when people go on restrictive diets (even in the name of health), they can start under-consuming calories by accident. This can definitely impact sleep and energy levels.

      Good luck to you!

  38. Dr Ruscio, my 22 year old son has been on the Paleo diet and your 3 probiotics for 3 weeks due to acne, insomnia, depression and anxiety for shoot 8 years and a tingling feeling in his skin all over his body for as long as her can remember.. He was also taking the Adrenal Support Complete. We added it a week to 10 days after the probiotics. He began getting muscle twitches all over his body. We stopped the ASC and the twitches went away a couple days later. His acne is reduced by 85%. Very cool. His mood is not measurably different and he has less energy by about 20% and just feels weak. He has eaten sweet potatoes without trouble. He is going to try rice next. We are ordering the Biota-Clear1a and then 2a. But I’m concerned about his energy and lack of change in his mood. Wondered if you had any thoughts. Thank you.

    1. Hi Lynn,

      I’m so sorry to hear about your son, and I know how confusing it can try and be to manage these sorts of conditions on your own.

      I’m not sure if you’ve read Dr. Ruscio’s book, Healthy Gut, Healthy You, but if not, I definitely recommend getting a copy (https://drruscio.com/getgutbook/). It has a very thorough and complete protocol that will be suitable for handling most gut issues (which as I’m sure you know, are definitely related to depression, acne, insomnia, and energy levels).

      Also, if you’d like to apply for your son to become a patient and get personalized care from Dr. Ruscio, you can do so here: https://drruscio.com/consult-dr-ruscio/

      Lastly, you may want to check and see if your son is eating enough. Sometimes when people go on restrictive diets (even in the name of health), they can start under-consuming calories by accident. This can definitely impact sleep and energy levels.

      Good luck to you!

  39. Good morning Dr. Ruscio,

    I just finished your book and I am excited to get started. This will be the 13th attempt to heal my gut in 5 years. I have tried everything from scd and the elemental diet to antibiotics. Ive even completed two 5-day water fasts.I have worked with a supposed functional medicine doctor that insisted on treating me for Lyme Disease with multiple prescriptions that only made my symptoms worse. I have confirmed sibo and I am histamine intolerant. I react to everyrhing including fasting, eating and supplements. My gut symptoms resolve while fasting or eating low carb but my histamine symptoms and inflammation spike so I have to cut protein and add in lots of fresh veggies which aggravates my gut. Food quiet literally makes me sick. Even the healthy, whole foods that most people thrive on.
    My question is, how can heal my gut witout feeling miserable in the process? I keep telling myself I will just suck it up and power through, but then my eyes burn and water, I break out in rashes, I get muscle cramps and chronic insomnia, flaky, burning skin on my face, edema in my extremities, joint pain and extreme anxiety. That’s just a few of my symptoms, and I have to work a high stress job through it all. I believe my gut is the root cause, I have suffered with severe ibs-d for 45 years. I just cannot tolerate the high histamine protocols and supplements required to heal. My histamine reactions are too strong.

  40. Good morning Dr. Ruscio,

    I just finished your book and I am excited to get started. This will be the 13th attempt to heal my gut in 5 years. I have tried everything from scd and the elemental diet to antibiotics. Ive even completed two 5-day water fasts.I have worked with a supposed functional medicine doctor that insisted on treating me for Lyme Disease with multiple prescriptions that only made my symptoms worse. I have confirmed sibo and I am histamine intolerant. I react to everyrhing including fasting, eating and supplements. My gut symptoms resolve while fasting or eating low carb but my histamine symptoms and inflammation spike so I have to cut protein and add in lots of fresh veggies which aggravates my gut. Food quiet literally makes me sick. Even the healthy, whole foods that most people thrive on.
    My question is, how can heal my gut witout feeling miserable in the process? I keep telling myself I will just suck it up and power through, but then my eyes burn and water, I break out in rashes, I get muscle cramps and chronic insomnia, flaky, burning skin on my face, edema in my extremities, joint pain and extreme anxiety. That’s just a few of my symptoms, and I have to work a high stress job through it all. I believe my gut is the root cause, I have suffered with severe ibs-d for 45 years. I just cannot tolerate the high histamine protocols and supplements required to heal. My histamine reactions are too strong.

  41. Hi Dr. Ruscio,
    Really enjoying the book! Not quite all the way through yet, but I’m grateful for the clear approach and thorough research that cuts through all the varied recommendations out there. I started reading it after positive SIBO test, and my naturopath gave me your Paleo Low Fodmap diet.

    I’ve already been working with my naturopath but now I’m hoping to integrate your protocol. She’s already started me on antimicrobials and Paleo FODMAP. I’ve been eating very low carb for the last few days to reduce the bloating, and it helps. Is it necessary to go back and do the fast, or should I just keep moving forward at this point? If I do the fast, should I pause on the antimicrobials?

    Will write Amazon review when finished. Thank you!

    1. Hi Liz,
      Thank you! You can continue forward from your current position. Once you get to maintenance you can experiment with fasting to see if it adds anything.
      I would appreciate that!

  42. Hi Dr. Ruscio,
    Really enjoying the book! Not quite all the way through yet, but I’m grateful for the clear approach and thorough research that cuts through all the varied recommendations out there. I started reading it after positive SIBO test, and my naturopath gave me your Paleo Low Fodmap diet.

    I’ve already been working with my naturopath but now I’m hoping to integrate your protocol. She’s already started me on antimicrobials and Paleo FODMAP. I’ve been eating very low carb for the last few days to reduce the bloating, and it helps. Is it necessary to go back and do the fast, or should I just keep moving forward at this point? If I do the fast, should I pause on the antimicrobials?

    Will write Amazon review when finished. Thank you!

    1. Hi Liz,
      Thank you! You can continue forward from your current position. Once you get to maintenance you can experiment with fasting to see if it adds anything.
      I would appreciate that!

  43. I’m about to start the elemental liquid diet. I used to have a Candida overgrowth and some say it might come back after the diet. Do you recommend I take anything? I tend not to be able to tolerate many supplements though.
    Also I ordered 5 tubs of the e diet formula from your website but it wouldn’t let me order more. Will that be enough? I am 5′ 8″. Thanks, Marion

    1. Start with just the elemental and see how you do. Antimicrobials can be taken during ED if you feel like Candida is returning, but I have not found this to be an issue. Updating the store now, thanks.

  44. I’m about to start the elemental liquid diet. I used to have a Candida overgrowth and some say it might come back after the diet. Do you recommend I take anything? I tend not to be able to tolerate many supplements though.
    Also I ordered 5 tubs of the e diet formula from your website but it wouldn’t let me order more. Will that be enough? I am 5′ 8″. Thanks, Marion

    1. Start with just the elemental and see how you do. Antimicrobials can be taken during ED if you feel like Candida is returning, but I have not found this to be an issue. Updating the store now, thanks.

  45. I am loving your book, and am getting ready to make bone broth for my first step. I will leave out the garlic, onions, and celery, since i am trying the low fodmap approach. I suspect i might have SIBO. Can i add either fish sauce, or coconut aminos to the broth?

    Thank you for such an easy to read book, that spells everything out perfectly. I am thankful to be able to try this on my own! I will write a review once i finish reading the book!

  46. I’m sorry, i thought of a few more questions! Is it okay to add collage pepidses, coconut oil, and/or MCT oil to the bone broth during the fast?

    Also, i have retinitis pigmentosa, and take a lot of supplements to help prevent further vision loss. Should these also be stopped during the fast? Some of them include a special eye formula, taurine, vitamin A, grapeseed oil extract, and astaxanthin.

    Thank you for your time!

  47. I am loving your book, and am getting ready to make bone broth for my first step. I will leave out the garlic, onions, and celery, since i am trying the low fodmap approach. I suspect i might have SIBO. Can i add either fish sauce, or coconut aminos to the broth?

    Thank you for such an easy to read book, that spells everything out perfectly. I am thankful to be able to try this on my own! I will write a review once i finish reading the book!

  48. I’m sorry, i thought of a few more questions! Is it okay to add collage pepidses, coconut oil, and/or MCT oil to the bone broth during the fast?

    Also, i have retinitis pigmentosa, and take a lot of supplements to help prevent further vision loss. Should these also be stopped during the fast? Some of them include a special eye formula, taurine, vitamin A, grapeseed oil extract, and astaxanthin.

    Thank you for your time!

  49. Making the broth, you ask to add vinegar. I have read that vinegar combines with the proteins and creates MSG. Is this true?

    Also, are you allowed to add salt and pepper, or put in other herbs?

  50. Making the broth, you ask to add vinegar. I have read that vinegar combines with the proteins and creates MSG. Is this true?

    Also, are you allowed to add salt and pepper, or put in other herbs?

  51. Hi Dr. Ruscio!

    I posted earlier today but it does not look like it worked, I apologize if this appears twice. I am wondering if there is any danger in trying an elemental diet before doing the 2 months of herbs. I have been dealing with gut issues for almost 2 years now and have done every diet, a parasite protocol that involved herbs and supplements and anti-biotics for bad bacteria.

    At this point, I just want to clear EVERYTHING out and reading about the Elemental diet it sounds like this might be the solution for me. I just was curious your input on jumping into that given my history. And was wondering if you recommend still taking the anti-microbrials in conjunction with doing that?

    Thank you so much.

    1. Hi Jessica,

      Thanks for getting in touch, and I’m sorry to hear you haven’t had much luck with other diets/protocols.

      The elemental diet can definitely be helpful for people who have tried everything else and haven’t gotten results.

      We can’t give direct medical advice to someone who isn’t a patient, but if you’d like to set up a consult, you can do so here: https://drruscio.com/consult-dr-ruscio/

      Otherwise, there’s a pretty comprehensive section in the book on how to do the elemental diet, but it’s best to do it under the care of a physician. And antimicrobials aren’t typically needed during the elemental diet.

      Good luck!

  52. Hi Dr. Ruscio!

    I posted earlier today but it does not look like it worked, I apologize if this appears twice. I am wondering if there is any danger in trying an elemental diet before doing the 2 months of herbs. I have been dealing with gut issues for almost 2 years now and have done every diet, a parasite protocol that involved herbs and supplements and anti-biotics for bad bacteria.

    At this point, I just want to clear EVERYTHING out and reading about the Elemental diet it sounds like this might be the solution for me. I just was curious your input on jumping into that given my history. And was wondering if you recommend still taking the anti-microbrials in conjunction with doing that?

    Thank you so much.

    1. Hi Jessica,

      Thanks for getting in touch, and I’m sorry to hear you haven’t had much luck with other diets/protocols.

      The elemental diet can definitely be helpful for people who have tried everything else and haven’t gotten results.

      We can’t give direct medical advice to someone who isn’t a patient, but if you’d like to set up a consult, you can do so here: https://drruscio.com/consult-dr-ruscio/

      Otherwise, there’s a pretty comprehensive section in the book on how to do the elemental diet, but it’s best to do it under the care of a physician. And antimicrobials aren’t typically needed during the elemental diet.

      Good luck!

  53. I used a PPI for 10 years, and have been trying to wean myself. I was down to 1/3 of a pill once a day. I stopped completely when I started your program one week ago. The fast made me feel very ill (maybe die off), I used the Intro diet from SCDLifestyle, as recommended, and am doing the Low Fodmap SCD diet because I was diagnosed with SIBO. I get terrible heartburn and bloating/belching with any solid foods. Is this a case of getting too much stomach acid from the rebound effect from stopping the PPI, or is this from not enough stomach acid? The burning lasts for a couple hours after eating solids. Any suggestions for relief?

    1. Hi Jeanne,
      Continue working through the protocol, it’s designed to treat the underlying cause. Perhaps consider the low histamine diet, when you get there. You may also want to try a slow wean off. Make sure to keep your doctor in the loop here.

  54. I used a PPI for 10 years, and have been trying to wean myself. I was down to 1/3 of a pill once a day. I stopped completely when I started your program one week ago. The fast made me feel very ill (maybe die off), I used the Intro diet from SCDLifestyle, as recommended, and am doing the Low Fodmap SCD diet because I was diagnosed with SIBO. I get terrible heartburn and bloating/belching with any solid foods. Is this a case of getting too much stomach acid from the rebound effect from stopping the PPI, or is this from not enough stomach acid? The burning lasts for a couple hours after eating solids. Any suggestions for relief?

    1. Hi Jeanne,
      Continue working through the protocol, it’s designed to treat the underlying cause. Perhaps consider the low histamine diet, when you get there. You may also want to try a slow wean off. Make sure to keep your doctor in the loop here.

  55. I have your book and I am anxious to begin the great in 8 plan. I am being treated for a C. Diff re-occurrence with vancomycine. First diagnosed a month ago after being hospitalized with Sepis in April. May I start anytime or wait until I’m off the antibiotics?

    1. I would wait until after your antibiotic and until you feel like you are back to your baseline before starting. The probiotic protocol may help with the C. Diff, see if your doctor is OK with co-administration.

  56. I have your book and I am anxious to begin the great in 8 plan. I am being treated for a C. Diff re-occurrence with vancomycine. First diagnosed a month ago after being hospitalized with Sepis in April. May I start anytime or wait until I’m off the antibiotics?

    1. I would wait until after your antibiotic and until you feel like you are back to your baseline before starting. The probiotic protocol may help with the C. Diff, see if your doctor is OK with co-administration.

  57. Hi Dr. Ruscio!

    I have done the liquid fast, progressed to the paleo/low fodmaps diet and feeling much better!!!! I introduced a low dose of each of the probiotics and stopped after a week of heavy night sweats, even though my energy improved. I just wanted to confirm it was the probiotics, and it was. I still have not resumed the probiotics, but I want to, if you feel it’s safe. Also, last week I started using a bone broth protein everyday, my energy has improved, but the night sweats started again!!!! Should I expect the night sweats to subside? Or is this a sign I should stop the using the supplements. Please let me know your thoughts.

    1. Hi Carrie,
      Glad to hear your improving. You might be histamine sensitive. I’d stop the protein. Then, reintro the probios one at a time to see if the reaction is coming from 1, 2 or all. Continue any that are tolerated. Night sweats should not be occuring. Make sure to mention this to your doctor also.

  58. Hi Dr. Ruscio!

    I have done the liquid fast, progressed to the paleo/low fodmaps diet and feeling much better!!!! I introduced a low dose of each of the probiotics and stopped after a week of heavy night sweats, even though my energy improved. I just wanted to confirm it was the probiotics, and it was. I still have not resumed the probiotics, but I want to, if you feel it’s safe. Also, last week I started using a bone broth protein everyday, my energy has improved, but the night sweats started again!!!! Should I expect the night sweats to subside? Or is this a sign I should stop the using the supplements. Please let me know your thoughts.

    1. Hi Carrie,
      Glad to hear your improving. You might be histamine sensitive. I’d stop the protein. Then, reintro the probios one at a time to see if the reaction is coming from 1, 2 or all. Continue any that are tolerated. Night sweats should not be occuring. Make sure to mention this to your doctor also.

  59. Dr Ruscio,
    Thank you for creating this book and process to help us experiment on ourselves in a sensible way. I only wish you had published it a year or two earlier! This is exactly what I’ve been looking for and have read SO many books and blogs. I also really appreciate your balanced approach since I’m one of those Type A’s you talked about in your book 🙂

    Long story short — I went AIP/Paleo several years ago and it was nothing short of miraculous, my headaches went away overnight, my eczema cleared, my *terrible* menstrual pain went away (who knew is was related!), and the “D” part of my IBS (coast-coast swings between C & D), lost weight and my mood was the best it’s EVER been. Really everything cleared up but my lifelong slow transit/constipation. Fast forward 2+yrs of perfect health (not even a cold) and I had a job change that introduced a LOT of stress as well as frequent air travel, I stopped sleeping well, then my sleep got really bad including terrible fatigue. That lasted for ~1 yr, then I changed jobs, underwent some functional tests, treated w/2 courses of antimicrobials (note no probiotics). Got most of my energy back, but still can’t sleep more ~6ish hrs, and worse yet seem to now not tolerate cruciferous veggies (broccoli, cauliflower, cabbage, brussel sprouts) any longer which were a staple for me and my family. The other FODMAP foods don’t seem to bother me much, but these make me bloated and uncomfortable very quickly (which I don’t quite understand how it happens so fast given my naturally slow transit).

    I know that my AIP/Paleo diet worked SO well for me before that stressful time and I just want to get back to that level of health and happiness (and my full suite of veggies!). Note that throughout I was super rigid about maintaining my AIP/Paleo diet (which felt like the only thing I could control) and getting some moderate exercise that I could tolerate on little sleep.

    Now that I’ve recovered somewhat (little sleep –> ~6hrs, energy back) but clearly am still having some gut issues, I’m trying to figure out if I should start all over at the very beginning of your Great in 8 plan, or perhaps part way through. I’ver currently cut out cruciferous vegetables (part of low-FODMAP) which has helped but feels like I’m just treating a symptom. Any advice is greatly appreciated!

    Love your book and will rate it 5 stars on Amazon. Thank you again!!

    PS In case this helps others — our whole family went AIP/Paleo at the same time mainly due to my father-in-law who had been losing a 25-30yr battle with ulcerative colitis who COMPLETELY REVERSED this condition with diet changes (and went off ALL of his medication within months) and after 2 yrs his colonoscopy showed no sign (other than some scar tissue) of having UC or inflammation. My Mom lost ~40 lbs (now a healthy size) and went from pre-diabetic to normal glucose levels, and our best friend lost weight and cleared up all his sinus/allergy issues. No exaggeration the amazing effects lifestyle changes can make. It’s worth the effort.

  60. Hi Dr. Ruscio,

    I had a couple of questions about the modified fast.

    I am wondering if taking pea protein shakes and/or leucine powder 3-4 times per day while also doing the bone broth fast would inhibit optimal healing from the fast. I want to maintain as much muscle mass as possible and know that bone broth does not contain all the essential amino acids in the quantities required to do so (or maybe I am wrong on this, so please correct me if I am).

    Also, you say that one might want to avoid highly rigorous exercise. Would engaging in a full body workout every other day (this is my usual lifting routine) during the modified fast be detrimental to results? I also do about 15 minutes of fast paced incline treadmill walking everyday upon waking. Is this okay to continue?

    I am so happy to have found your work and feeling hopeful about healing, something I could not have said even a mere few days ago!! Thanks!

    1. Hi Jackson,
      I would recommend altering the protocol as little as possible. A 2 day modified fast shouldn’t cause an appreciable change in body comp. Regarding training, listen to your body, he’s the boss on this, what he says goes. I find the biggest problem is people get hungry and a little tired with too much activity.
      Hope this helps and keep me posted!

      1. Thanks a lot Dr. Ruscio. I’ll stick with the protocol as outlined and be sure to listen to my body regarding the exercise!

  61. Dr Ruscio,
    Thank you for creating this book and process to help us experiment on ourselves in a sensible way. I only wish you had published it a year or two earlier! This is exactly what I’ve been looking for and have read SO many books and blogs. I also really appreciate your balanced approach since I’m one of those Type A’s you talked about in your book 🙂

    Long story short — I went AIP/Paleo several years ago and it was nothing short of miraculous, my headaches went away overnight, my eczema cleared, my *terrible* menstrual pain went away (who knew is was related!), and the “D” part of my IBS (coast-coast swings between C & D), lost weight and my mood was the best it’s EVER been. Really everything cleared up but my lifelong slow transit/constipation. Fast forward 2+yrs of perfect health (not even a cold) and I had a job change that introduced a LOT of stress as well as frequent air travel, I stopped sleeping well, then my sleep got really bad including terrible fatigue. That lasted for ~1 yr, then I changed jobs, underwent some functional tests, treated w/2 courses of antimicrobials (note no probiotics). Got most of my energy back, but still can’t sleep more ~6ish hrs, and worse yet seem to now not tolerate cruciferous veggies (broccoli, cauliflower, cabbage, brussel sprouts) any longer which were a staple for me and my family. The other FODMAP foods don’t seem to bother me much, but these make me bloated and uncomfortable very quickly (which I don’t quite understand how it happens so fast given my naturally slow transit).

    I know that my AIP/Paleo diet worked SO well for me before that stressful time and I just want to get back to that level of health and happiness (and my full suite of veggies!). Note that throughout I was super rigid about maintaining my AIP/Paleo diet (which felt like the only thing I could control) and getting some moderate exercise that I could tolerate on little sleep.

    Now that I’ve recovered somewhat (little sleep –> ~6hrs, energy back) but clearly am still having some gut issues, I’m trying to figure out if I should start all over at the very beginning of your Great in 8 plan, or perhaps part way through. I’ver currently cut out cruciferous vegetables (part of low-FODMAP) which has helped but feels like I’m just treating a symptom. Any advice is greatly appreciated!

    Love your book and will rate it 5 stars on Amazon. Thank you again!!

    PS In case this helps others — our whole family went AIP/Paleo at the same time mainly due to my father-in-law who had been losing a 25-30yr battle with ulcerative colitis who COMPLETELY REVERSED this condition with diet changes (and went off ALL of his medication within months) and after 2 yrs his colonoscopy showed no sign (other than some scar tissue) of having UC or inflammation. My Mom lost ~40 lbs (now a healthy size) and went from pre-diabetic to normal glucose levels, and our best friend lost weight and cleared up all his sinus/allergy issues. No exaggeration the amazing effects lifestyle changes can make. It’s worth the effort.

  62. Hi Dr. Ruscio,

    I had a couple of questions about the modified fast.

    I am wondering if taking pea protein shakes and/or leucine powder 3-4 times per day while also doing the bone broth fast would inhibit optimal healing from the fast. I want to maintain as much muscle mass as possible and know that bone broth does not contain all the essential amino acids in the quantities required to do so (or maybe I am wrong on this, so please correct me if I am).

    Also, you say that one might want to avoid highly rigorous exercise. Would engaging in a full body workout every other day (this is my usual lifting routine) during the modified fast be detrimental to results? I also do about 15 minutes of fast paced incline treadmill walking everyday upon waking. Is this okay to continue?

    I am so happy to have found your work and feeling hopeful about healing, something I could not have said even a mere few days ago!! Thanks!

    1. Hi Jackson,
      I would recommend altering the protocol as little as possible. A 2 day modified fast shouldn’t cause an appreciable change in body comp. Regarding training, listen to your body, he’s the boss on this, what he says goes. I find the biggest problem is people get hungry and a little tired with too much activity.
      Hope this helps and keep me posted!

      1. Thanks a lot Dr. Ruscio. I’ll stick with the protocol as outlined and be sure to listen to my body regarding the exercise!

  63. Hi there. On day 3 of full elemental diet and realized that I am going to run out faster than I thought. Just ordered 2 more containers and am pretty sure that I will run out before they arrive. How should I handle my food intake during the interim? Chicken soup broth with boiled/steamed broccoli??? Working my way up to cooked chicken mashed? I will have to order more than 2 though because each container only lasts me about 4 days and i want to be on this for a minimum of 2-3 weeks. My constipation has not improved and the MCT oil seems to be giving me nausea. Switched to coconut oil and taking stool softener nightly. I have a problem with fats (no gallbladder) so perhaps I should take a digestive enzyme to help? ? So many issues to be addressed. Thank you. The shake tastes great.

  64. Hi Dr Ruscio,

    I suffer with chronic fatigue. I did the bone broth fast (felt a bit of anxiety but got through it). I started the Paleo whole30 and was eating moderate carb. Generally felt good eating whole foods. But fourth week I got hit with anxiety and heart palpitations. I have now increased carbs and feel better. It’s a shame as I wanted to stick with the lower carb.
    I am hestitant to change the diet again to be honest as I’m exhausted from the reaction on my nervous system.
    I have ordered the probiotics, digestive enzymes and adrenal support which should arrive soon. Is it worth me starting them now?

  65. Hi there. On day 3 of full elemental diet and realized that I am going to run out faster than I thought. Just ordered 2 more containers and am pretty sure that I will run out before they arrive. How should I handle my food intake during the interim? Chicken soup broth with boiled/steamed broccoli??? Working my way up to cooked chicken mashed? I will have to order more than 2 though because each container only lasts me about 4 days and i want to be on this for a minimum of 2-3 weeks. My constipation has not improved and the MCT oil seems to be giving me nausea. Switched to coconut oil and taking stool softener nightly. I have a problem with fats (no gallbladder) so perhaps I should take a digestive enzyme to help? ? So many issues to be addressed. Thank you. The shake tastes great.

  66. Hi Dr Ruscio,

    I suffer with chronic fatigue. I did the bone broth fast (felt a bit of anxiety but got through it). I started the Paleo whole30 and was eating moderate carb. Generally felt good eating whole foods. But fourth week I got hit with anxiety and heart palpitations. I have now increased carbs and feel better. It’s a shame as I wanted to stick with the lower carb.
    I am hestitant to change the diet again to be honest as I’m exhausted from the reaction on my nervous system.
    I have ordered the probiotics, digestive enzymes and adrenal support which should arrive soon. Is it worth me starting them now?

  67. I received my breath test results and had an appointment for the doctor to tell me I have a sucrose intolerance, look up a few diets, come back in 6 weeks and we’ll see how you’re doing… less than thrilled I did some research and I believe I have SIBO-C. I do not want to start a protocol until I speak with someone that believes SIBO is real and if I should begin a protocol. I have the test results and my methane baseline was 55 and bumps to 73 after 120 minutes. Hydrogen remained relatively steady between 3 and 5… that said would you recommend me looking into a protocol? I keep trying different diets, vitamins, books – basically anything that I read I try. I feel like I’m making things worse, totally helpless, no one understands the daily pain/ discomfort, people think I’m faking and my quality of life is terrible because it controls me. I literally do not know what to do. Please help – any suggestions welcome 🙏🏼🙏🏼🙏🏼

    1. If your doctor is recommending something, start there. If/when you are ready to commit to the book protocol, and as long as it’s OK with your doctor, then start the book protocol. It is very comprehensive and therefore hopefully will be able to help. Hang in there 🙂

  68. Hi Dr. Ruscio,

    Thanks so much for the book. There’s so much of this information online, and your ability to synthesize it is awesome! 2 quick questions:

    1. What are your thoughts on carb restriction/ no fruit or starches for yeast? I know some sources indicate that yeast may also thrive on ketogenic type diets.

    2. Any thoughts on using a Sauna to potentially increase the effectiveness of treatment? It would seem to be a good way to rid the body of toxins produced by sibo/fungal overgrowth

    Thanks again, I’ll post a review on Amazon.

    Nate

  69. I received my breath test results and had an appointment for the doctor to tell me I have a sucrose intolerance, look up a few diets, come back in 6 weeks and we’ll see how you’re doing… less than thrilled I did some research and I believe I have SIBO-C. I do not want to start a protocol until I speak with someone that believes SIBO is real and if I should begin a protocol. I have the test results and my methane baseline was 55 and bumps to 73 after 120 minutes. Hydrogen remained relatively steady between 3 and 5… that said would you recommend me looking into a protocol? I keep trying different diets, vitamins, books – basically anything that I read I try. I feel like I’m making things worse, totally helpless, no one understands the daily pain/ discomfort, people think I’m faking and my quality of life is terrible because it controls me. I literally do not know what to do. Please help – any suggestions welcome 🙏🏼🙏🏼🙏🏼

    1. If your doctor is recommending something, start there. If/when you are ready to commit to the book protocol, and as long as it’s OK with your doctor, then start the book protocol. It is very comprehensive and therefore hopefully will be able to help. Hang in there 🙂

  70. Hi Dr. Ruscio,

    Thanks so much for the book. There’s so much of this information online, and your ability to synthesize it is awesome! 2 quick questions:

    1. What are your thoughts on carb restriction/ no fruit or starches for yeast? I know some sources indicate that yeast may also thrive on ketogenic type diets.

    2. Any thoughts on using a Sauna to potentially increase the effectiveness of treatment? It would seem to be a good way to rid the body of toxins produced by sibo/fungal overgrowth

    Thanks again, I’ll post a review on Amazon.

    Nate

  71. My probiotics were delivered while out of town on doorstep and they were missed. They sat outside for almost 5 days. Have they gone bad? I want to make sure I’m using an effective dose.

  72. My probiotics were delivered while out of town on doorstep and they were missed. They sat outside for almost 5 days. Have they gone bad? I want to make sure I’m using an effective dose.

  73. Hi Dr Ruscio
    Been a fan of yours for awhile. I THOUGHT I had my diet fairly dialed in, but have had a rash that seems to be perhaps a histamine attack for about the last 36 hours.
    I’ve taken LDN for the last couple years. Could this be a root cause in addition to the perfect storm of high histamine foods I seem to have been eating lately?
    Do you recommend a specific DAO supplements, or have foods I seem to have been eating lately?
    Do you recommend a specific DAO supplements, or have advice on what to look for in one?
    I know that I can’t afford Dunwoody labs for testing.

    Also a bit afraid of bone broth and lemon juice at the moment. Is there another type of reset I can do??
    Thank You!!!

    1. Hi Suzanne,
      I would use the low FODMAP combined with the low histamine diet, and keep working through the protocol. Don’t waste your money on histamine testing or DAO 🙂

      1. Don’t recommend DAO. But I am itching badly with no rash. I am nervous about starting ant… for my itching will get out of control. I am on Low FODMAP Low histamine diet and still itching, heart burn, constipation, rib and tummy pain. How to deal with itching? My doctor has nothing to offer.

        1. Hi Christine,

          I’m sorry you’re dealing with this. It sounds like you may have a bit of a unique case that needs personalized advice and attention. If you’d like, you’re welcome to apply to become a patient of Dr R’s (he does see people virtually if you don’t live in CA). You can do so here: https://www.drruscio.com/gethelp

  74. Hi Dr Ruscio
    Been a fan of yours for awhile. I THOUGHT I had my diet fairly dialed in, but have had a rash that seems to be perhaps a histamine attack for about the last 36 hours.
    I’ve taken LDN for the last couple years. Could this be a root cause in addition to the perfect storm of high histamine foods I seem to have been eating lately?
    Do you recommend a specific DAO supplements, or have foods I seem to have been eating lately?
    Do you recommend a specific DAO supplements, or have advice on what to look for in one?
    I know that I can’t afford Dunwoody labs for testing.

    Also a bit afraid of bone broth and lemon juice at the moment. Is there another type of reset I can do??
    Thank You!!!

    1. Hi Suzanne,
      I would use the low FODMAP combined with the low histamine diet, and keep working through the protocol. Don’t waste your money on histamine testing or DAO 🙂

      1. Don’t recommend DAO. But I am itching badly with no rash. I am nervous about starting ant… for my itching will get out of control. I am on Low FODMAP Low histamine diet and still itching, heart burn, constipation, rib and tummy pain. How to deal with itching? My doctor has nothing to offer.

        1. Hi Christine,

          I’m sorry you’re dealing with this. It sounds like you may have a bit of a unique case that needs personalized advice and attention. If you’d like, you’re welcome to apply to become a patient of Dr R’s (he does see people virtually if you don’t live in CA). You can do so here: https://www.drruscio.com/gethelp

  75. Hi Dr. Ruscio,

    I really enjoyed your book. After 9 months of actively trying to repair my gut and treat an abundance of symptoms, I’m finally feeling some relief and I’m confident that I’m on the right track with your protocol. I’m following the low FODMAP with SCD diet and I’m wondering if konjac noodles are permitted? They’re also called shirataki noodles.

    Thanks so much,

    Andrea

  76. Hi Dr. Ruscio,

    First of all, thank you so much for the amazing book. I really appreciate the summaries of research and the fact that you go over contradictory findings as well as replicable ones. It’s so difficult to get reliable information on health, there’s so much out there and it’s tough to know what to look for or how to interpret it. But your book does that, so thank you!

    For my question: I’m on day 4 of the fast and for the last two days I’ve had nausea and diarrhea (with what seems like viscous solids). I haven’t eaten anything during the fast (no cheats), took no supplements, or medications (I’m not on anything). But I feel awful. I tried to find information online but it is all so unreliable (I read explanations like the ” the body is cleaning up the gut flora,” “it’s a symptom of ketosis caused by fasting,” and even “bile diarrhea”). My husband is doing the fast with me and he’s had no.problems.

    Is my reaction common? I’m an athlete and normally consume 3-4x the amount of calories I’ve been eating, so I wonder if that could be the reason too… Otherwise, I imagine it’s a sign I should follow all steps rather than skip to 5?

    Thank you for all you do!

    1. My pleasure Kris!
      Put simply, some people don’t do well on the fast. And it’s as simple as that. Keep working through the protocol and don’t over think this 🙂

  77. Hi Dr. Ruscio,

    I really enjoyed your book. After 9 months of actively trying to repair my gut and treat an abundance of symptoms, I’m finally feeling some relief and I’m confident that I’m on the right track with your protocol. I’m following the low FODMAP with SCD diet and I’m wondering if konjac noodles are permitted? They’re also called shirataki noodles.

    Thanks so much,

    Andrea

  78. Hi Dr. Ruscio,

    First of all, thank you so much for the amazing book. I really appreciate the summaries of research and the fact that you go over contradictory findings as well as replicable ones. It’s so difficult to get reliable information on health, there’s so much out there and it’s tough to know what to look for or how to interpret it. But your book does that, so thank you!

    For my question: I’m on day 4 of the fast and for the last two days I’ve had nausea and diarrhea (with what seems like viscous solids). I haven’t eaten anything during the fast (no cheats), took no supplements, or medications (I’m not on anything). But I feel awful. I tried to find information online but it is all so unreliable (I read explanations like the ” the body is cleaning up the gut flora,” “it’s a symptom of ketosis caused by fasting,” and even “bile diarrhea”). My husband is doing the fast with me and he’s had no.problems.

    Is my reaction common? I’m an athlete and normally consume 3-4x the amount of calories I’ve been eating, so I wonder if that could be the reason too… Otherwise, I imagine it’s a sign I should follow all steps rather than skip to 5?

    Thank you for all you do!

    1. My pleasure Kris!
      Put simply, some people don’t do well on the fast. And it’s as simple as that. Keep working through the protocol and don’t over think this 🙂

  79. there. On day 3 of full elemental diet and realized that I am going to run out faster than I thought. Just ordered 2 more containers and am pretty sure that I will run out before they arrive. How should I handle my food intake during the interim? Chicken soup broth with boiled/steamed broccoli??? Working my way up to cooked chicken mashed? I will have to order more than 2 though because each container only lasts me about 4 days and i want to be on this for a minimum of 2-3 weeks. My constipation has not improved and the MCT oil seems to be giving me nausea. Switched to coconut oil and taking stool softener nightly. I have a problem with fats (no gallbladder) so perhaps I should take a digestive enzyme to help? ? So many issues to be addressed. Thank you. The shake tastes great.

  80. there. On day 3 of full elemental diet and realized that I am going to run out faster than I thought. Just ordered 2 more containers and am pretty sure that I will run out before they arrive. How should I handle my food intake during the interim? Chicken soup broth with boiled/steamed broccoli??? Working my way up to cooked chicken mashed? I will have to order more than 2 though because each container only lasts me about 4 days and i want to be on this for a minimum of 2-3 weeks. My constipation has not improved and the MCT oil seems to be giving me nausea. Switched to coconut oil and taking stool softener nightly. I have a problem with fats (no gallbladder) so perhaps I should take a digestive enzyme to help? ? So many issues to be addressed. Thank you. The shake tastes great.

  81. Hi Dr Ruscio

    I live in South Africa and have been following your podcasts for about a year now. I was diagnosed with hashimotos and due to many years of ibs and gut pain, it made sense that the cause was leaky gut.

    My doctor is hesitant about fasting since she feels that it puts a lot of stress on the body. I started on the great in 8 plan anyway and thought that the bone broth would be enough to sustain me.

    I started the fast yesterday and although I wasn’t hungry, I was quite low in energy, low battery power mode. I expected that. But this morning woke up with a tremendous headache. So it’s a combination of tmj pain with sinus pain and just overall It felt like a migraine. Could this be a stress reaction to the fasting? A caffeine withdrawal? Anxiety?

    I read through the comments and didn’t really see anyone else complaining about headaches.

    Would really appreciate some feedback.

    By the way, I’m a huge fan and am spreading the word here in South Africa about your book My doctor is even now following you.

    Thanks Cindy

  82. Hi Dr Ruscio,

    I am in the process of reading your book. I am wanting to begin eating low FODMAP, however I currently have a predominantly vegetarian diet. Are you able to recommend some good resources for eating plans, recipes etc. for vegetarians? Also, are there any other considerations I should keep in mind regarding nutrient intake when not consuming meat.

    Thanks in advance,
    Kyle

    1. Hi Kyle,
      We are about to update the Low FODMAP handout to include an expanded list of vegetables and some meat substitutes, this might help. It should be up soon. Other than that I would search for a vegetarian LF cookbook, I don’t know of any offhand.

  83. Hi Dr Ruscio

    I live in South Africa and have been following your podcasts for about a year now. I was diagnosed with hashimotos and due to many years of ibs and gut pain, it made sense that the cause was leaky gut.

    My doctor is hesitant about fasting since she feels that it puts a lot of stress on the body. I started on the great in 8 plan anyway and thought that the bone broth would be enough to sustain me.

    I started the fast yesterday and although I wasn’t hungry, I was quite low in energy, low battery power mode. I expected that. But this morning woke up with a tremendous headache. So it’s a combination of tmj pain with sinus pain and just overall It felt like a migraine. Could this be a stress reaction to the fasting? A caffeine withdrawal? Anxiety?

    I read through the comments and didn’t really see anyone else complaining about headaches.

    Would really appreciate some feedback.

    By the way, I’m a huge fan and am spreading the word here in South Africa about your book My doctor is even now following you.

    Thanks Cindy

    1. Thanks! It’s hard to say exactly. Try each version and if you don’t feel neutral or better, than it’s not the right fit for you 🙂
      Thank you again!

  84. Hi Dr Ruscio,

    I am in the process of reading your book. I am wanting to begin eating low FODMAP, however I currently have a predominantly vegetarian diet. Are you able to recommend some good resources for eating plans, recipes etc. for vegetarians? Also, are there any other considerations I should keep in mind regarding nutrient intake when not consuming meat.

    Thanks in advance,
    Kyle

    1. Hi Kyle,
      We are about to update the Low FODMAP handout to include an expanded list of vegetables and some meat substitutes, this might help. It should be up soon. Other than that I would search for a vegetarian LF cookbook, I don’t know of any offhand.

  85. Dr. Ruscio,

    I reached out to you through Instagram and you suggested that I ask my question here. I’ll take advantage of having a little bit more characters to ask my question with some more detail.

    I am about halfway through your book and am planning on starting the protocol after I finish reading everything. My main concern with starting the protocol is I am not getting much sleep, nor is the sleep I’m getting consistent. I have a 1-year old child that is struggling to give my wife and I any kind of consistency with his sleep. Some nights he is up every 90 minutes, other nights he sleeps for 5 hours before waking up and needing some help getting back to sleep. We are working with his pediatrician to figure out what’s going on with his sleep, but I know that my health is being directly affected by it. I haven’t been able to work out due to a lack of energy or time (I’m trying to help my wife with nighttime and early morning wakings with him as much as I can since she is a stay at home mom right now). I feel like I’m in a hormonal cluster-f*** with high cortisol/low test and that is manifesting as the beginnings of dad-bod.

    My main question to you is this: Does the lack of reparative and restorative sleep negate the healing aspects of the protocol? Could I potentially have some false symptoms due to the lack of sleep?

    I have yet to read past the Vitamin D section in the book, but was also wondering if there are any general wellness supplements you might recommend I take that would help support me while going through this sleep-training period with my son that would support the gut protocol (high doses of Meriva Turmeric? Fish Oil in addition to fatty fish in my diet? Rhodioloa Rosea/Ashwagandha and/or other adaptogens? Adding some juices like ginger or a green food?

    Thank you for your time and insights. I appreciate it.

  86. Dr. Ruscio,

    I reached out to you through Instagram and you suggested that I ask my question here. I’ll take advantage of having a little bit more characters to ask my question with some more detail.

    I am about halfway through your book and am planning on starting the protocol after I finish reading everything. My main concern with starting the protocol is I am not getting much sleep, nor is the sleep I’m getting consistent. I have a 1-year old child that is struggling to give my wife and I any kind of consistency with his sleep. Some nights he is up every 90 minutes, other nights he sleeps for 5 hours before waking up and needing some help getting back to sleep. We are working with his pediatrician to figure out what’s going on with his sleep, but I know that my health is being directly affected by it. I haven’t been able to work out due to a lack of energy or time (I’m trying to help my wife with nighttime and early morning wakings with him as much as I can since she is a stay at home mom right now). I feel like I’m in a hormonal cluster-f*** with high cortisol/low test and that is manifesting as the beginnings of dad-bod.

    My main question to you is this: Does the lack of reparative and restorative sleep negate the healing aspects of the protocol? Could I potentially have some false symptoms due to the lack of sleep?

    I have yet to read past the Vitamin D section in the book, but was also wondering if there are any general wellness supplements you might recommend I take that would help support me while going through this sleep-training period with my son that would support the gut protocol (high doses of Meriva Turmeric? Fish Oil in addition to fatty fish in my diet? Rhodioloa Rosea/Ashwagandha and/or other adaptogens? Adding some juices like ginger or a green food?

    Thank you for your time and insights. I appreciate it.

  87. Hi Dr. Ruscio! I love your book. I have been recommending it to all my training and nutrition clients. My questions is this:
    Is there any place for vegetarians in this protocol? I was vegan, but I introduced eggs so that I could vary my proteins as I had a lot of reactions from pea protein. However, I really do not want to eat meat. Is there anything you could recommend for vegetarians?

    1. Thanks.
      Yes, look for a vegetarian paleo or low FODMAP cook book. Or, just modify the food lists to be vegetarian as best you can. We are updated low FODMAP list now to include more vegetarian friendly foods.

  88. Hi Dr. Ruscio! I love your book. I have been recommending it to all my training and nutrition clients. My questions is this:
    Is there any place for vegetarians in this protocol? I was vegan, but I introduced eggs so that I could vary my proteins as I had a lot of reactions from pea protein. However, I really do not want to eat meat. Is there anything you could recommend for vegetarians?

    1. Thanks.
      Yes, look for a vegetarian paleo or low FODMAP cook book. Or, just modify the food lists to be vegetarian as best you can. We are updated low FODMAP list now to include more vegetarian friendly foods.

  89. Dear Dr. Ruscio,

    I have IBS C/D (mostly C) and Autoimmune Metaplastic Atrophic Gastritis/Pernicious Anemia. In the past, I’ve controlled the worst of the IBS symptoms with a Low FODMAP diet, but my I had a slew of other symptoms (skin irritation, poor sleep, low energy, brain fog) that I felt weren’t being addressed by standard Low FODMAP.

    I’ve done the modified fast and have been on a Paleo diet for the past 10 days. I’m limiting or avoiding a few high FODMAP foods (onion, chicory root, coconut flour, cauliflower), but mostly not worrying about FODMAPS. My energy is pretty good, and my skin is less irritated. I also haven’t had the really bad IBS symptoms, like nausea, bloating, cramps, so far.

    However, my constipation has been really bad. How long should I tolerate this constipation? I am worried because the parts of the protocol that seem to address it are really far away.

    As part of the fast and Paleo, I gave up coffee, which had definitely helped with my constipation. Is it better to tolerate the constipation for a long time, or reintroduce the coffee?

    I would love some guidance here.

    Best Wishes,
    Sarah

  90. Hello Dr. Ruscio. I have your book Healthy Gut Healthy You. Currently on step 1, I have tried Paleo for 2 weeks and haven’t felt much better. Which should I try next, Autoimmune Paleo, Paleo low FODMAP, or just low FODMAP? Just a bit confused here. The book is incredible and I can’t wait to heal my gut!!

  91. Dear Dr. Ruscio,

    I have IBS C/D (mostly C) and Autoimmune Metaplastic Atrophic Gastritis/Pernicious Anemia. In the past, I’ve controlled the worst of the IBS symptoms with a Low FODMAP diet, but my I had a slew of other symptoms (skin irritation, poor sleep, low energy, brain fog) that I felt weren’t being addressed by standard Low FODMAP.

    I’ve done the modified fast and have been on a Paleo diet for the past 10 days. I’m limiting or avoiding a few high FODMAP foods (onion, chicory root, coconut flour, cauliflower), but mostly not worrying about FODMAPS. My energy is pretty good, and my skin is less irritated. I also haven’t had the really bad IBS symptoms, like nausea, bloating, cramps, so far.

    However, my constipation has been really bad. How long should I tolerate this constipation? I am worried because the parts of the protocol that seem to address it are really far away.

    As part of the fast and Paleo, I gave up coffee, which had definitely helped with my constipation. Is it better to tolerate the constipation for a long time, or reintroduce the coffee?

    I would love some guidance here.

    Best Wishes,
    Sarah

  92. Hello Dr. Ruscio. I have your book Healthy Gut Healthy You. Currently on step 1, I have tried Paleo for 2 weeks and haven’t felt much better. Which should I try next, Autoimmune Paleo, Paleo low FODMAP, or just low FODMAP? Just a bit confused here. The book is incredible and I can’t wait to heal my gut!!

  93. Hello. I love the book! Having said that…quick question. We are just beginning, but are trying to get pregnant as well. Should my wife stay away from the 2-4 day initial liquid fast and just eat normal food, or, do you think it’s ok?

    Thanks!

  94. Hello. I love the book! Having said that…quick question. We are just beginning, but are trying to get pregnant as well. Should my wife stay away from the 2-4 day initial liquid fast and just eat normal food, or, do you think it’s ok?

    Thanks!

  95. I loved reading the book- I found it very helpful! I’m about to start Step 1 but have a quick question. I think I may be dealing with histamine intolerance (not completely sure, but it seems that sticking to a low histamine diet helps alleviate symptoms I’ve been having like rash, faster heart rate/feeling jittery). If I’m correct, I’ve seen that bone broth and lemon juice are higher histamine foods. Do you have any recommendation for what I should drink during the fast? Do you think I should try either/both drink options and just see what happens or do you know if any lower histamine alternative? Thanks so much!

  96. I loved reading the book- I found it very helpful! I’m about to start Step 1 but have a quick question. I think I may be dealing with histamine intolerance (not completely sure, but it seems that sticking to a low histamine diet helps alleviate symptoms I’ve been having like rash, faster heart rate/feeling jittery). If I’m correct, I’ve seen that bone broth and lemon juice are higher histamine foods. Do you have any recommendation for what I should drink during the fast? Do you think I should try either/both drink options and just see what happens or do you know if any lower histamine alternative? Thanks so much!

  97. I was under the impression that fasting could make constipation issues worse (I’ve read a few things on it releasing more acid, etc). Is this true, or perhaps the drink provides enough nutrients to avoid any impact? I just finished my first day — all good so far, but definitely don’t want to worsen any constipation issues.

    What are your thoughts on this?

  98. I was under the impression that fasting could make constipation issues worse (I’ve read a few things on it releasing more acid, etc). Is this true, or perhaps the drink provides enough nutrients to avoid any impact? I just finished my first day — all good so far, but definitely don’t want to worsen any constipation issues.

    What are your thoughts on this?

  99. Hi Dr. Ruscio, Thanks again for the well written and helpful book. I am currently following the paleo 30 but I only eat meat twice a week; hence most of my protein comes from fish and eggs. I have heard from various paleo sources that tinned fish is a good paleo snack. I always believed however that tinned food was unhealthy.
    What’s your thoughts on this? Also, is tinned fish better than smoked fish? And lastly, Is there a limit to how much fish a week a person should consume? (I mainly eat mackerel, herring and sardines)
    Thanks
    Dean

  100. Hi Dr. Ruscio, Thanks again for the well written and helpful book. I am currently following the paleo 30 but I only eat meat twice a week; hence most of my protein comes from fish and eggs. I have heard from various paleo sources that tinned fish is a good paleo snack. I always believed however that tinned food was unhealthy.
    What’s your thoughts on this? Also, is tinned fish better than smoked fish? And lastly, Is there a limit to how much fish a week a person should consume? (I mainly eat mackerel, herring and sardines)
    Thanks
    Dean

  101. HI Dr. Ruscio! Amazing book! i am on day 3 of the fast with mostly lemonade and some bone broth. i have noticed ongoing lower back pain and hip pain and i remember a few years ago experiencing the same thing when i was strongly eating clean and low carb and had a blast of sugar. Could it be the syrup? is this a sign of some kind of sugar sensitivity? i usually have huge sweet cravings!

    I will review the book when completed! thanks so much!
    kim

  102. On Day 5 of elemental shake and have had bad diarrhea. I know that this can be a side effect but for how long should i expect this? I know that everyone is different but wouldn’t this be a detriment to my gut? What is the longest that would be advisable to continue with the shake before waiting for side effects to subside? Thanks.

    1. Hi Joanne,
      After 5-7 days if the reactions haven’t abated you might be intolerant. Consider one of the other formulas listed or that the ED approach might not be a good fit for you. Make sure to check in with your doctor on this also.

  103. HI Dr. Ruscio! Amazing book! i am on day 3 of the fast with mostly lemonade and some bone broth. i have noticed ongoing lower back pain and hip pain and i remember a few years ago experiencing the same thing when i was strongly eating clean and low carb and had a blast of sugar. Could it be the syrup? is this a sign of some kind of sugar sensitivity? i usually have huge sweet cravings!

    I will review the book when completed! thanks so much!
    kim

    1. Hi Kim,
      Yes, or a reaction to some other component of the lemonade fast. Keep moving forward with the protocol and make a note to note use the lemonade again 🙂

  104. On Day 5 of elemental shake and have had bad diarrhea. I know that this can be a side effect but for how long should i expect this? I know that everyone is different but wouldn’t this be a detriment to my gut? What is the longest that would be advisable to continue with the shake before waiting for side effects to subside? Thanks.

    1. Hi Joanne,
      After 5-7 days if the reactions haven’t abated you might be intolerant. Consider one of the other formulas listed or that the ED approach might not be a good fit for you. Make sure to check in with your doctor on this also.

  105. I’ve been adhering to a no-sulfur and low FOD map diet for 1 year. The book describes to try Paleo, then AI Paleo, then Low FOD in that order (pg 263 column 1) (after the initial cleanse). What if I already know that sulfur foods and all nuts will cause increased symptoms? Do I try the pyramid foods as described, anyway, try to find foods compliant with all three diets, or skip to the re-integration from sulfur foods (resource on website)?

    Also the book is confusing me: How much time do I give each diet? (Page 263 = each pyramid level for 2-3 weeks, and page 266 = spend a few weeks determining which diet you feel best on.)

    1. Hi DJ,
      If you feel you have already run the dietary experiments, and settled at your ideal diet, then move to step 2. You could also try a low sulfur version of each. Give a diet a 2-3 week trial to decide if it working. If it is, ride this to plateau (just as outlined in the book 🙂 ). If diet doesn’t fully work, move to step 2.
      Hope this helps.

  106. I’ve been adhering to a no-sulfur and low FOD map diet for 1 year. The book describes to try Paleo, then AI Paleo, then Low FOD in that order (pg 263 column 1) (after the initial cleanse). What if I already know that sulfur foods and all nuts will cause increased symptoms? Do I try the pyramid foods as described, anyway, try to find foods compliant with all three diets, or skip to the re-integration from sulfur foods (resource on website)?

    Also the book is confusing me: How much time do I give each diet? (Page 263 = each pyramid level for 2-3 weeks, and page 266 = spend a few weeks determining which diet you feel best on.)

    1. Hi DJ,
      If you feel you have already run the dietary experiments, and settled at your ideal diet, then move to step 2. You could also try a low sulfur version of each. Give a diet a 2-3 week trial to decide if it working. If it is, ride this to plateau (just as outlined in the book 🙂 ). If diet doesn’t fully work, move to step 2.
      Hope this helps.

  107. I’ve been on a really clean and strict diet for over a year now trying to help my digestive problems, skin issues, and fatigue/brain fog. I’ve also been taking digestive enzymes/acid, adrenal support (Ashwaganhda), thyroid hormones, and Vitamins D/K/B-Complex.

    I’m better on the diet and supplements but still have all my health problems, just less severe. I even did a 3-day juice fast a month ago.

    My question is should I start with step 3 as I’ve already pretty much been doing steps 1 and 2 for the past year?

    Thanks!

  108. I’ve been on a really clean and strict diet for over a year now trying to help my digestive problems, skin issues, and fatigue/brain fog. I’ve also been taking digestive enzymes/acid, adrenal support (Ashwaganhda), thyroid hormones, and Vitamins D/K/B-Complex.

    I’m better on the diet and supplements but still have all my health problems, just less severe. I even did a 3-day juice fast a month ago.

    My question is should I start with step 3 as I’ve already pretty much been doing steps 1 and 2 for the past year?

    Thanks!

  109. Interested in an autoimmune Paleo diet list of products to consume and avoid. The website has a cookbook. Can you provide a list?

        1. Hi Bryan,

          If you click the link for the cookbook, a food list is provided right after the table of contents.

  110. Interested in an autoimmune Paleo diet list of products to consume and avoid. The website has a cookbook. Can you provide a list?

        1. Hi Bryan,

          If you click the link for the cookbook, a food list is provided right after the table of contents.

  111. Dr. Ruscio- I completed the elimination phase of foods almost 2.5 years ago and have been on Low Fodmap since then. I have been able to add back in a few foods after a major surgery last year for MALS. I can only eat about 17 foods with 3 ingredients being the max. My gut is still a mess- IBS-M with D predominate (treated for SIBO x3, SIFO, slow motility, and much, much more) and I am well versed in several areas of your book from all the research I have completed over the last 3 years and the 10+ doctors and dieticians I have seen. I cannot do a fast as I am underweight and malnourished so am hoping I can start with step 2. The problem is I have severe side effects from most medicines and supplements. I noticed Atrantil in your shop and I tried that 2 months ago per a GI’s suggestion and it made me more bloated than I already was – I seem to have the opposite reaction to what the supplement is supposed to do. I also noticed MotilPro which I tried last year and couldn’t take it either. I have a lengthy history with gut issues that I won’t add on here but am hoping for your opinion on starting at step 2 and skipping the fast. I also do not eat meat but drink Dr. Axe powdered vanilla bone broth twice daily. Thank you very much!

    1. Hi Kate,

      That sounds frustrating, I’m so sorry you’ve been dealing with all of that.

      We can’t give you direct medical advice, but if you’d like to become a patient and set up a consult with Dr. R, you can do so here: https://drruscio.com/consult-dr-ruscio/

      Sometimes people who have gut issues and are underweight actually end up gaining weight when they do an elemental diet because it allows their gut to rest and heal, which then allows them to absorb and assimilate nutrients better – so that may be something you want to consider (under the guidance of a doctor of course).

      Good luck!

  112. I’m trying not to stress out about the diet part, but I already am. I did a protocol earlier this year that included removing foods on an MRT and doing an anti-fungal protocol. I have ulcerative colitis that’s currently sort of under control (none of the common symptoms but my inflammatory and immune markers are showing it). My problem is trying to avoid allergens and intolerances without feeling too restricted. I’m pretty sure I need to avoid nightshades, and possibly nuts. I’ve never tried eliminating eggs or ghee (like AIP does). There were some other foods (like cucumber, garlic, onion) that came up on my MRT that I think I might still be sensitive to as well.

    1. Should I start with paleo or AIP as my diet?
    2. Do I need to toy around with cutting out or adding specific foods or trying low-FODMAP or anything else before moving on to step 2?
    3. Depending on the answer to 2, how long from now should I aim to be starting step 2?

    Thanks for your help. I’m heading to Amazon to leave you a review now 🙂

    1. Hi Rachael,

      I know how stressful it can be trying to stick to a restrictive diet (even if medically necessary) for a prolonged period of time.

      A couple things:

      1) Check out this podcast: https://drruscio.com/going-gluten-free-with-jennifer-fugo/ It’s specifically about gluten but has some helpful tips about elimination diets
      2) I would definitely go based on symptoms over what the allergy test says, as those aren’t always 100% accurate.
      3) I would consider working with someone (nutritionist, therapist, coach, etc) who understands what you’re going through and can help you get through it (without being miserable the whole time).

      Good luck!

      1. If neither was good above he told others to move on in the program. My itching and heartburn got way worse on bone broth. I had to start PPI’s

  113. Dr. Ruscio- I completed the elimination phase of foods almost 2.5 years ago and have been on Low Fodmap since then. I have been able to add back in a few foods after a major surgery last year for MALS. I can only eat about 17 foods with 3 ingredients being the max. My gut is still a mess- IBS-M with D predominate (treated for SIBO x3, SIFO, slow motility, and much, much more) and I am well versed in several areas of your book from all the research I have completed over the last 3 years and the 10+ doctors and dieticians I have seen. I cannot do a fast as I am underweight and malnourished so am hoping I can start with step 2. The problem is I have severe side effects from most medicines and supplements. I noticed Atrantil in your shop and I tried that 2 months ago per a GI’s suggestion and it made me more bloated than I already was – I seem to have the opposite reaction to what the supplement is supposed to do. I also noticed MotilPro which I tried last year and couldn’t take it either. I have a lengthy history with gut issues that I won’t add on here but am hoping for your opinion on starting at step 2 and skipping the fast. I also do not eat meat but drink Dr. Axe powdered vanilla bone broth twice daily. Thank you very much!

    1. Hi Kate,

      That sounds frustrating, I’m so sorry you’ve been dealing with all of that.

      We can’t give you direct medical advice, but if you’d like to become a patient and set up a consult with Dr. R, you can do so here: https://drruscio.com/consult-dr-ruscio/

      Sometimes people who have gut issues and are underweight actually end up gaining weight when they do an elemental diet because it allows their gut to rest and heal, which then allows them to absorb and assimilate nutrients better – so that may be something you want to consider (under the guidance of a doctor of course).

      Good luck!

  114. I’m trying not to stress out about the diet part, but I already am. I did a protocol earlier this year that included removing foods on an MRT and doing an anti-fungal protocol. I have ulcerative colitis that’s currently sort of under control (none of the common symptoms but my inflammatory and immune markers are showing it). My problem is trying to avoid allergens and intolerances without feeling too restricted. I’m pretty sure I need to avoid nightshades, and possibly nuts. I’ve never tried eliminating eggs or ghee (like AIP does). There were some other foods (like cucumber, garlic, onion) that came up on my MRT that I think I might still be sensitive to as well.

    1. Should I start with paleo or AIP as my diet?
    2. Do I need to toy around with cutting out or adding specific foods or trying low-FODMAP or anything else before moving on to step 2?
    3. Depending on the answer to 2, how long from now should I aim to be starting step 2?

    Thanks for your help. I’m heading to Amazon to leave you a review now 🙂

    1. Hi Rachael,

      I know how stressful it can be trying to stick to a restrictive diet (even if medically necessary) for a prolonged period of time.

      A couple things:

      1) Check out this podcast: https://drruscio.com/going-gluten-free-with-jennifer-fugo/ It’s specifically about gluten but has some helpful tips about elimination diets
      2) I would definitely go based on symptoms over what the allergy test says, as those aren’t always 100% accurate.
      3) I would consider working with someone (nutritionist, therapist, coach, etc) who understands what you’re going through and can help you get through it (without being miserable the whole time).

      Good luck!

      1. If neither was good above he told others to move on in the program. My itching and heartburn got way worse on bone broth. I had to start PPI’s

  115. Dear Dr Ruscio, thanks for a great book! I work as a doctor in Sweden but here most doctors are still not familiar with the importance of gut health or what to do about it.
    However, I have a question about my own health. I have problems with anxiety, a bit of depression, I wake up several times per night, I have loose stools and I am underweight. The last few years I have been under severe stress, I have also taken several antibiotics.
    I have tried a low carb paleo diet (I even started with that 6 month before reading the book and before that I tried LCHF for a year) but I didn’t get better. When I tried the elemental fasting (on home made chicken broth) I had to quit that after 48h since I felt very anxious, slept worse than usual and felt very irritated although I drank a lot of the broth.
    Now I am trying the low fodmap-diet since 10 days and I actually feel more happy and less anxious than I have done in a long time and my stools have gone back to normal! I have chosen to eat a mix of your paleo fodmap diet and the usual fodmap diet, that is I only eat things from the green columns in the paleo fodmap variant with the addition of gluten free oats, quinoa and lactose free yoghurt without taste.
    I still feel that my health can approve a whole lot but what shall I do next? I get confused when looking at the “low fodmaps with scd” since it adds small amounts of things that are forbidden in the normal low fodmap diet but forbids for example oats and lactosefree yoghurt that are allowed in the normal low fodmap diet. Do you recommend me to continue with the diet I started 10 days ago and in that case for how long before I move on to step 2? Or do you recommend me to try the low food map with scd diet, and in that case, for how long? And what are the meaning of the four different grading based on fermeability in that list; does it mean I can eat things only from the first column from start and then add foods from the other groups? In that case when and how should I do that?
    Sometimes I skip breakfast to do intermittent fasting but is this wise or unwise regarding my underweight? I guess intermittent fasting could be a good thing if you suspect SIBO? Or should I skip the fasting for now?
    I would be really greatful if you could answer this because I tend to “overthink” things when I am not sure what is best to do.
    Kind regards, Helena

  116. Dear Dr Ruscio, thanks for a great book! I work as a doctor in Sweden but here most doctors are still not familiar with the importance of gut health or what to do about it.
    However, I have a question about my own health. I have problems with anxiety, a bit of depression, I wake up several times per night, I have loose stools and I am underweight. The last few years I have been under severe stress, I have also taken several antibiotics.
    I have tried a low carb paleo diet (I even started with that 6 month before reading the book and before that I tried LCHF for a year) but I didn’t get better. When I tried the elemental fasting (on home made chicken broth) I had to quit that after 48h since I felt very anxious, slept worse than usual and felt very irritated although I drank a lot of the broth.
    Now I am trying the low fodmap-diet since 10 days and I actually feel more happy and less anxious than I have done in a long time and my stools have gone back to normal! I have chosen to eat a mix of your paleo fodmap diet and the usual fodmap diet, that is I only eat things from the green columns in the paleo fodmap variant with the addition of gluten free oats, quinoa and lactose free yoghurt without taste.
    I still feel that my health can approve a whole lot but what shall I do next? I get confused when looking at the “low fodmaps with scd” since it adds small amounts of things that are forbidden in the normal low fodmap diet but forbids for example oats and lactosefree yoghurt that are allowed in the normal low fodmap diet. Do you recommend me to continue with the diet I started 10 days ago and in that case for how long before I move on to step 2? Or do you recommend me to try the low food map with scd diet, and in that case, for how long? And what are the meaning of the four different grading based on fermeability in that list; does it mean I can eat things only from the first column from start and then add foods from the other groups? In that case when and how should I do that?
    Sometimes I skip breakfast to do intermittent fasting but is this wise or unwise regarding my underweight? I guess intermittent fasting could be a good thing if you suspect SIBO? Or should I skip the fasting for now?
    I would be really greatful if you could answer this because I tend to “overthink” things when I am not sure what is best to do.
    Kind regards, Helena

  117. Dear Dr. Ruscio,

    I love all content you have put out. I want to heal my gut from chronic constipation. I did 3 day water fast in April, which led to fecal impaction and an emergency doctor visit. Since then I was prescribed several laxative DAILY (20 ml MOM, 2x7mg Senekot and 1mg Resalor). I would like get off those laxative and found your website/podcast/book. I would like to start your protocol with the fast but worried about the impaction again. What can I do to prevent that? Should I take those laxative during and/or after the fast?

    Thanks a lot for bringing great knowledge to the community.

  118. Dear Dr. Ruscio,

    I love all content you have put out. I want to heal my gut from chronic constipation. I did 3 day water fast in April, which led to fecal impaction and an emergency doctor visit. Since then I was prescribed several laxative DAILY (20 ml MOM, 2x7mg Senekot and 1mg Resalor). I would like get off those laxative and found your website/podcast/book. I would like to start your protocol with the fast but worried about the impaction again. What can I do to prevent that? Should I take those laxative during and/or after the fast?

    Thanks a lot for bringing great knowledge to the community.

  119. Hi Dr Ruscio!

    I started Step 2 and have been trying to implement the probiotics. Prior to your probiotics, I was taking Betaine-HCL and Lipase. I was a little aggressive with the probiotic dosages and unfortunately started having bad acid reflux.

    I don’t know if this could be a “die-off” reaction or maybe the probiotics are helping my stomach produce acid on its own, and taking a Betaine-HCL supplement is now causing too much acid. Another thought was that maybe taking the probiotics away from meals is what’s causing the reflux.

    Anyway, I’m 99% positive that my health issues are caused from SIBO or other gut imbalance, could I start the step 3 supplements without the probiotics, and then add them back in a week or so into step 3?

    Thank you so much!

  120. Hi Dr Ruscio!

    I started Step 2 and have been trying to implement the probiotics. Prior to your probiotics, I was taking Betaine-HCL and Lipase. I was a little aggressive with the probiotic dosages and unfortunately started having bad acid reflux.

    I don’t know if this could be a “die-off” reaction or maybe the probiotics are helping my stomach produce acid on its own, and taking a Betaine-HCL supplement is now causing too much acid. Another thought was that maybe taking the probiotics away from meals is what’s causing the reflux.

    Anyway, I’m 99% positive that my health issues are caused from SIBO or other gut imbalance, could I start the step 3 supplements without the probiotics, and then add them back in a week or so into step 3?

    Thank you so much!

  121. Dear Dr Ruscio.

    I really enjoy the book due to learning more about the gut, the history behind everything and are glad that you took the time to investigate what is being said here.

    I have started the liquid fasting, adding black coffee (for awareness). I understand that the coffee might be an irritant, however i have an ulcer and find that adding sugar to anything aggravates more than coffee for me. This is my first day, however i find that the stomach is burning a lot causing re-flux and then headaches. Is it truly wise to do fasting with an ulcer as not eating can be bad for this? (According what I have read)

    I also wanted to find out how to balance an Ulcer and IBS diet as what works for the one do not work for the other or so I have found through testing different diets. I have both and I really need a solution here. Could one diet help with both these issues?

    Please let me know your thoughts.

    Thank you very much.

    Anelle

    1. Hello Dr.

      I realized that I did not include the fasting I am using. It is the first one with lemon and maple syrup. I did not use the syrup but green tea and lemon. I also had some 100% fruit juice mango and orange with this. I answered my own question here. The high acidic intake is what is causing the re-flux as well as the burn.

      I might need to go on the broth fast, however my question remains is it wise to go on a liquid diet when you have an ulcer?

      Thanks anelle

    2. Hi Anelle,
      Glad you liking the book. There is no one answer here, this is what the book is meant to help you with, finding what works for you. You can also contact my office for personalized guidance.

  122. Dear Dr Ruscio.

    I really enjoy the book due to learning more about the gut, the history behind everything and are glad that you took the time to investigate what is being said here.

    I have started the liquid fasting, adding black coffee (for awareness). I understand that the coffee might be an irritant, however i have an ulcer and find that adding sugar to anything aggravates more than coffee for me. This is my first day, however i find that the stomach is burning a lot causing re-flux and then headaches. Is it truly wise to do fasting with an ulcer as not eating can be bad for this? (According what I have read)

    I also wanted to find out how to balance an Ulcer and IBS diet as what works for the one do not work for the other or so I have found through testing different diets. I have both and I really need a solution here. Could one diet help with both these issues?

    Please let me know your thoughts.

    Thank you very much.

    Anelle

    1. Hello Dr.

      I realized that I did not include the fasting I am using. It is the first one with lemon and maple syrup. I did not use the syrup but green tea and lemon. I also had some 100% fruit juice mango and orange with this. I answered my own question here. The high acidic intake is what is causing the re-flux as well as the burn.

      I might need to go on the broth fast, however my question remains is it wise to go on a liquid diet when you have an ulcer?

      Thanks anelle

    2. Hi Anelle,
      Glad you liking the book. There is no one answer here, this is what the book is meant to help you with, finding what works for you. You can also contact my office for personalized guidance.

  123. I can’t tell you how excited I am about your book at the Great-in-8 protocol. I am one of those people who has been floundering in diets, supplements, testing, etc. for the past couple of years with little success and you have given me renewed hope. I.m planning to begin the protocol next week and just wanted to express my thanks for your expertise and accessibility (look at all these responses on the site — it’s amazing!). Thank you tons.

  124. I can’t tell you how excited I am about your book at the Great-in-8 protocol. I am one of those people who has been floundering in diets, supplements, testing, etc. for the past couple of years with little success and you have given me renewed hope. I.m planning to begin the protocol next week and just wanted to express my thanks for your expertise and accessibility (look at all these responses on the site — it’s amazing!). Thank you tons.

  125. Hey Dr Ruscio,

    I’m currently a week into step 3, started straight with level 2.

    I’m very interested in the Elemental Heal, could I try it either 100% or hybrid approach while taking the step 3 supplements?

    Or would it be smarter to go through step 3 level 2 first then try out the Elemental Heal once off the anti microbials?

    Thanks!

  126. Hey Dr Ruscio,

    I’m currently a week into step 3, started straight with level 2.

    I’m very interested in the Elemental Heal, could I try it either 100% or hybrid approach while taking the step 3 supplements?

    Or would it be smarter to go through step 3 level 2 first then try out the Elemental Heal once off the anti microbials?

    Thanks!

  127. Hi Dr. Ruscio, I’m fascinated reading your book and I’m just about to start the first step on diet and I have a question.

    I’m 43 y.o. and since 23 y.o. type 1 diabetic. About 10 years after diabetes I developed gluten intolerance (non celiac). I also seem to have problems with dairy. Pollen/dust alergy have accompanied me much of my life as well. And recently I started having digestive problems (similar symptoms like SIBO or IBS), so I started reducing FODMAPS and it seems to help.

    My question: Should I start with the liquid fasting if I have type 1 diabetes? (I use very little insuline dosis but still).
    And when I get into diets, shoould I go directly to an AIPaleo+low FODMAP diet knowing all my autoinmune conditions and if I already noticed improvement with low-FODmap?

    I’m kind of worried because I don’t want to lose more weight (I’m tall and thin) so not sure the amounts of protein to eat to substitute carbs.

    Thanks a lot!
    Carlos Gonzalez from Spain

  128. Hi Dr. Ruscio, I’m fascinated reading your book and I’m just about to start the first step on diet and I have a question.

    I’m 43 y.o. and since 23 y.o. type 1 diabetic. About 10 years after diabetes I developed gluten intolerance (non celiac). I also seem to have problems with dairy. Pollen/dust alergy have accompanied me much of my life as well. And recently I started having digestive problems (similar symptoms like SIBO or IBS), so I started reducing FODMAPS and it seems to help.

    My question: Should I start with the liquid fasting if I have type 1 diabetes? (I use very little insuline dosis but still).
    And when I get into diets, shoould I go directly to an AIPaleo+low FODMAP diet knowing all my autoinmune conditions and if I already noticed improvement with low-FODmap?

    I’m kind of worried because I don’t want to lose more weight (I’m tall and thin) so not sure the amounts of protein to eat to substitute carbs.

    Thanks a lot!
    Carlos Gonzalez from Spain

  129. Hi Dr. Ruscio, after trying to get rid of SIBO on my own for 8 months I discovered your book and read it.

    My question is, during these 8 months I was trying things at random, based on what I had read on the Internet. Without yet knowing about your book, I was focusing on step 3 – remove, by cycling multiple antimicrobial agents (the list is long), and even tried the elemental diet, but was unsuccessful. Is it worth it for me to try again but start at step 1?

    During my experiments, the only thing that made me feel better for a short period of time were pharmaceutical antibiotics, but then symptoms started to creep back up.

    I’m wondering if doing the process outlined in your book will make a difference in how I respond to antimicrobial herbs or the elemental diet. Can probiotics/digestive enzymes and acid really make all the difference?

    1. Hey valerie!

      I’d love to chat with you about what you’re going through. My dr says shes pretty sure I have irritable bowel syndrome but sometimes I think it is SIBO that I have.

      She told me that you cant really get tested for IBS and she didnt know what SIBO was.

      I did the fast and on paleo ever since but I still find my stomach feeling off and that I have ro pass gas throughout the day, sometimes more than others.

      I guess this means I should either switch to the paleo diet or the probiotics and antimicrobial herbs?

  130. Hey Dr.ruscio. I’m on your website right now and found the PDF for the modified fast.. is this something i can use as well instead of just the powder that I order for the liquid fast? Sorry. I’ve ready the book but I just am not sure if those are two different options that one can do?

    also! are we to buy all 3 probiotic blends, the enzymes, and adrenal and vitamin C that youve listed in step two of the protocol to ensure my gut heals properly?

    its just a bit expensive, but if thats what it takes to feel better and healthy i am willing to do it 100%. thank you for your time and help

    1. My hunch would be to use one or the other for the fast. Try the modified fast and see how that works. If you notice a 70% ish improvement then do not worry about the other fast.

      You may not have to use any probiotics if the fast works for you. Try step 1 and 2 and see how you feel.

      1. Thanks Jim!

        I did the fast using the elemental heal powder. I have been paleo for about 2 weeks now and some days I feel great but others I still off and my stomach feels like it’s doing weird things and feels a bit off as well. My dr tod me from the symptoms I described that shes prett auaurauaure I most likely have irritable bowel syndrome.

        I still have passing gas (mostly with no smell tho) and have some reflux or small burping eveveryday.. which I siant really.have before starting the fast but now i do.. I do feel less bloated though.

        I’m wondering if should stick to paleo for a while longer or try the low fodmap or just start with probiotics and antimicrobials?

        Any suggestions? Just feeling kind of lost and helpless lately with what to do now.

        Thank you

  131. I apologize if this was covered in the questions already. I am on a very low does of levothyroxine, 25mcg. Should I continue to take my meds during the protocol? I honestly can’t tell that they’re doing anything.

    1. Hi Whitney,

      It’s not advised to stop taking any prescription medications. After you go through the protocol, you may want to go get your thyroid levels re-tested, as people often see improvements in hypothyroid issues after healing the gut.

      Good luck!

  132. Hi Dr. Ruscio, after trying to get rid of SIBO on my own for 8 months I discovered your book and read it.

    My question is, during these 8 months I was trying things at random, based on what I had read on the Internet. Without yet knowing about your book, I was focusing on step 3 – remove, by cycling multiple antimicrobial agents (the list is long), and even tried the elemental diet, but was unsuccessful. Is it worth it for me to try again but start at step 1?

    During my experiments, the only thing that made me feel better for a short period of time were pharmaceutical antibiotics, but then symptoms started to creep back up.

    I’m wondering if doing the process outlined in your book will make a difference in how I respond to antimicrobial herbs or the elemental diet. Can probiotics/digestive enzymes and acid really make all the difference?

    1. Hey valerie!

      I’d love to chat with you about what you’re going through. My dr says shes pretty sure I have irritable bowel syndrome but sometimes I think it is SIBO that I have.

      She told me that you cant really get tested for IBS and she didnt know what SIBO was.

      I did the fast and on paleo ever since but I still find my stomach feeling off and that I have ro pass gas throughout the day, sometimes more than others.

      I guess this means I should either switch to the paleo diet or the probiotics and antimicrobial herbs?

  133. Hey Dr.ruscio. I’m on your website right now and found the PDF for the modified fast.. is this something i can use as well instead of just the powder that I order for the liquid fast? Sorry. I’ve ready the book but I just am not sure if those are two different options that one can do?

    also! are we to buy all 3 probiotic blends, the enzymes, and adrenal and vitamin C that youve listed in step two of the protocol to ensure my gut heals properly?

    its just a bit expensive, but if thats what it takes to feel better and healthy i am willing to do it 100%. thank you for your time and help

    1. My hunch would be to use one or the other for the fast. Try the modified fast and see how that works. If you notice a 70% ish improvement then do not worry about the other fast.

      You may not have to use any probiotics if the fast works for you. Try step 1 and 2 and see how you feel.

      1. Thanks Jim!

        I did the fast using the elemental heal powder. I have been paleo for about 2 weeks now and some days I feel great but others I still off and my stomach feels like it’s doing weird things and feels a bit off as well. My dr tod me from the symptoms I described that shes prett auaurauaure I most likely have irritable bowel syndrome.

        I still have passing gas (mostly with no smell tho) and have some reflux or small burping eveveryday.. which I siant really.have before starting the fast but now i do.. I do feel less bloated though.

        I’m wondering if should stick to paleo for a while longer or try the low fodmap or just start with probiotics and antimicrobials?

        Any suggestions? Just feeling kind of lost and helpless lately with what to do now.

        Thank you

  134. I apologize if this was covered in the questions already. I am on a very low does of levothyroxine, 25mcg. Should I continue to take my meds during the protocol? I honestly can’t tell that they’re doing anything.

    1. Hi Whitney,

      It’s not advised to stop taking any prescription medications. After you go through the protocol, you may want to go get your thyroid levels re-tested, as people often see improvements in hypothyroid issues after healing the gut.

      Good luck!

  135. Can it take a while to notice effects from probiotics and digestive enzymes/acid? It’s been 4 days since I’ve begun to use them and have not noticed anything besides the fact that I’m more constipated. Is it worth continuing for 3 weeks.

    1. Hi Valerie,

      I realize it’s been a little while since you left this comment – did you continue the probiotics? How are you feeling now?

  136. Can it take a while to notice effects from probiotics and digestive enzymes/acid? It’s been 4 days since I’ve begun to use them and have not noticed anything besides the fact that I’m more constipated. Is it worth continuing for 3 weeks.

    1. Hi Valerie,

      I realize it’s been a little while since you left this comment – did you continue the probiotics? How are you feeling now?

  137. Dear Dr Ruscio.

    Thank you for your book, it seems the most sensible diet advice I have read. I’m a 35yo woman who has had moderate to severe chronic fatigue syndrome and POTs for the past 2.5 years. I’ve been eating mostly paleo for the past year, which I think has helped with my mild diarrhea-tending IBS, but not with the CFS. I also tried AIP for two months with no noticeable effects on the CFS symptoms. I just did a 2 day bone broth fast, as per your book. On the morning of day 3 I was still feeling very hungry, headachey and tense, so I broke the fast. My plan was to then begin a month long low fodmap experiment. However since breaking my fast I have been getting some very severe POTs reactions to some foods that I did not notice any strong reaction to previously (I haven’t yet narrowed down which foods yet but am keeping records. The shortlist of suspects is banana, turmeric and coconut milk). My heart has been racing and pounding, especially when upright. What do you think might be going on? Thanks so much for your help! Jen

    1. Hi Jen, I’m sorry you’ve been dealing with those symptoms! I’ve passed this question on to Dr. R, who will hopefully answer it in an upcoming podcast episode. In the mean time, definitely try and pinpoint which foods they are and keep them out of your diet for now (low fodmap or not). Good luck!

  138. Dear Dr Ruscio.

    Thank you for your book, it seems the most sensible diet advice I have read. I’m a 35yo woman who has had moderate to severe chronic fatigue syndrome and POTs for the past 2.5 years. I’ve been eating mostly paleo for the past year, which I think has helped with my mild diarrhea-tending IBS, but not with the CFS. I also tried AIP for two months with no noticeable effects on the CFS symptoms. I just did a 2 day bone broth fast, as per your book. On the morning of day 3 I was still feeling very hungry, headachey and tense, so I broke the fast. My plan was to then begin a month long low fodmap experiment. However since breaking my fast I have been getting some very severe POTs reactions to some foods that I did not notice any strong reaction to previously (I haven’t yet narrowed down which foods yet but am keeping records. The shortlist of suspects is banana, turmeric and coconut milk). My heart has been racing and pounding, especially when upright. What do you think might be going on? Thanks so much for your help! Jen

    1. Hi Jen, I’m sorry you’ve been dealing with those symptoms! I’ve passed this question on to Dr. R, who will hopefully answer it in an upcoming podcast episode. In the mean time, definitely try and pinpoint which foods they are and keep them out of your diet for now (low fodmap or not). Good luck!

  139. Hello doctor, I’m really enjoying the book. Excellent work! My BM’s are perfect with the low FODMAP diet. I’m wondering though, your book says “4 berberine capsules 3 times a day”. Does this mean 12 capsules total or 4 capsules spaced out in 3 sittings? The reason I ask is because I would be surprised if the total recommended amount is 12 capsules; that seems excessive compared to the general consensus on berberine dosing. Thanks in advance if you get to my question and thanks for the book

    1. Hi Ian,

      So glad to hear you’re enjoying the book. If you feel up to leaving a review on Amazon to help get the word out, we’d greatly appreciate it (https://www.amazon.com/Healthy-Gut-You-Michael-Ruscio/dp/0999766805).

      The dosage given in the book is correct – 4 capsules, 3 times per day – aka a total of 12 capsules. The therapeutic dosing for an acute infection is often times higher than general maintenance dosing for supplements.

      Hope this helps!

  140. Hello doctor, I’m really enjoying the book. Excellent work! My BM’s are perfect with the low FODMAP diet. I’m wondering though, your book says “4 berberine capsules 3 times a day”. Does this mean 12 capsules total or 4 capsules spaced out in 3 sittings? The reason I ask is because I would be surprised if the total recommended amount is 12 capsules; that seems excessive compared to the general consensus on berberine dosing. Thanks in advance if you get to my question and thanks for the book

    1. Hi Ian,

      So glad to hear you’re enjoying the book. If you feel up to leaving a review on Amazon to help get the word out, we’d greatly appreciate it (https://www.amazon.com/Healthy-Gut-You-Michael-Ruscio/dp/0999766805).

      The dosage given in the book is correct – 4 capsules, 3 times per day – aka a total of 12 capsules. The therapeutic dosing for an acute infection is often times higher than general maintenance dosing for supplements.

      Hope this helps!

  141. Hey dr ruscio,😊

    I am starting the liquid fast with the elemntal heal tomorrow. I’ve been following the protocol in the book, but I want to double check with you- when i start eating food (paleo diet) do i add back in all the supplements and vitamins I was taking prior to the fast? Or do I need to wait a specific amount of time before adding them back in? Thank you.

  142. Hey dr ruscio,😊

    I am starting the liquid fast with the elemntal heal tomorrow. I’ve been following the protocol in the book, but I want to double check with you- when i start eating food (paleo diet) do i add back in all the supplements and vitamins I was taking prior to the fast? Or do I need to wait a specific amount of time before adding them back in? Thank you.

  143. Hi Dr. Ruscio,

    I have been listening to your podcasts for about 2 – or 3 years and find you to be fair, evidence based and focused on patient outcome. I got 2 – copies of your excellent book, one for me and one for my son’s girlfriend who works with people with anorexia. Wondering if you will please clarify a coupe of things in the book for me.

    First, you wrote that salt was an additive that can harm the gut. Will you please send me some links on your website that I can learn how to consume sodium healthily? Right now I have about 5 -1/2 tsp salt a day in my unprocessed meals and teas. Is this not the best way to take in sodium? I sweat a lot at work and exercising.

    Second, In your book you gave a link to a website that cannot be found. Will you please provide another way to access this information? The link mentioned is on page 322 and it is about manual therapy for abdominal and pelvic adhesions.

    Thank you so much for working so hard on this literary masterpiece.

    Take care,

    Jim

    1. Thanks!
      I didn’t say that, but I paper I cited did. References are listed in the book already. I wouldn’t worry about salt.

      Clear Passage, search that in our searbox.

      My pleasure!

  144. Hi Dr. Ruscio,

    I have been listening to your podcasts for about 2 – or 3 years and find you to be fair, evidence based and focused on patient outcome. I got 2 – copies of your excellent book, one for me and one for my son’s girlfriend who works with people with anorexia. Wondering if you will please clarify a coupe of things in the book for me.

    First, you wrote that salt was an additive that can harm the gut. Will you please send me some links on your website that I can learn how to consume sodium healthily? Right now I have about 5 -1/2 tsp salt a day in my unprocessed meals and teas. Is this not the best way to take in sodium? I sweat a lot at work and exercising.

    Second, In your book you gave a link to a website that cannot be found. Will you please provide another way to access this information? The link mentioned is on page 322 and it is about manual therapy for abdominal and pelvic adhesions.

    Thank you so much for working so hard on this literary masterpiece.

    Take care,

    Jim

    1. Thanks!
      I didn’t say that, but I paper I cited did. References are listed in the book already. I wouldn’t worry about salt.

      Clear Passage, search that in our searbox.

      My pleasure!

  145. Hi Dr. Ruscio,

    Is there any truth to the claim that drinking coffee between meals will deplete a person’s stomach acid/HCL “stores” ? The idea was that this will occur because drinking coffee causes stomach acid release and the body can only produce so much stomach acid.

    If this is in fact the case, would black tea or decaf coffee also decrease stomach acid stores?

    Thanks for all that you do!

      1. Hi Jim. I read the section on Coffee, but want to know specifically about the validity of the concept that coffee and/or caffeine will deplete the body’s stomach acid “stores.” Thanks.

  146. Hi Dr. Ruscio,

    Is there any truth to the claim that drinking coffee between meals will deplete a person’s stomach acid/HCL “stores” ? The idea was that this will occur because drinking coffee causes stomach acid release and the body can only produce so much stomach acid.

    If this is in fact the case, would black tea or decaf coffee also decrease stomach acid stores?

    Thanks for all that you do!

      1. Hi Jim. I read the section on Coffee, but want to know specifically about the validity of the concept that coffee and/or caffeine will deplete the body’s stomach acid “stores.” Thanks.

  147. Hey Dr. Ruscio

    I loved the book so much ! Thank you 🙏

    A couple questions

    1) when doing the liquid fast is it okay to have herbal tea (with nothing added) or black coffee?

    2) once eating whole foods again after coming off the fast (doing the paleo diet or whichever one that works best for each individual) and once feeling better on it, is it okay to go out for food to have something that isnt exactly paleo /fodmap etc. Or is it very important to strictly eat along the guidelines of the specific diet for quite a fee months?

      1. Thanks Jim!

        Been on paleo doe 2 weeks anand most days I feel.great but still feel very off sometimes.

        Passing gas daily. But maybe this is also because I am taking no supplements right now either? Bloating and most of stomach cramps have disappeared tho ans coffee in moderation doesnt zeem ro bother me.

        Although I feel better, it’s not 100%.

        I feel like I am so close to 100% though though that do you think it would be okay to so the antimicrobial herbs and probiotics instead of trying the low fodmap diet.

        Or vice versa. The low fodmap and then the herbs and probiotics?

        Also, I guess i was worried about going out for food because it would backtrack any progress that I may have made with my gut health since doing the fast.

        Thank you !

  148. Hey Dr. Ruscio

    I loved the book so much ! Thank you 🙏

    A couple questions

    1) when doing the liquid fast is it okay to have herbal tea (with nothing added) or black coffee?

    2) once eating whole foods again after coming off the fast (doing the paleo diet or whichever one that works best for each individual) and once feeling better on it, is it okay to go out for food to have something that isnt exactly paleo /fodmap etc. Or is it very important to strictly eat along the guidelines of the specific diet for quite a fee months?

      1. Thanks Jim!

        Been on paleo doe 2 weeks anand most days I feel.great but still feel very off sometimes.

        Passing gas daily. But maybe this is also because I am taking no supplements right now either? Bloating and most of stomach cramps have disappeared tho ans coffee in moderation doesnt zeem ro bother me.

        Although I feel better, it’s not 100%.

        I feel like I am so close to 100% though though that do you think it would be okay to so the antimicrobial herbs and probiotics instead of trying the low fodmap diet.

        Or vice versa. The low fodmap and then the herbs and probiotics?

        Also, I guess i was worried about going out for food because it would backtrack any progress that I may have made with my gut health since doing the fast.

        Thank you !

  149. Hi Dr. Ruscio,

    First of all, thanks for the book, it’s been a really good read. I wish I could follow your protocol, but I’m in a bit of an impossibility.

    I have celiac disease, diagnosed a year ago, and did not get better on a gluten-free diet. In the past year, I have done an elimination diet and realized only a very limited number of foods give me no symptoms: fish, 8 veggies, various herbs as seasonings and 2 herbal teas. (I do not eat meat out of principle, fish is a concession because I cannot tolerate any vegetarian protein.) Anything else gives me bad abdominal pain 12 to 15 hrs later if tried in small quantities. Continuing the food/supplement or having bigger quantities gives me diarrhea, constant urge to go, undigested food in stool.

    To note, I have a very bad reaction to minute quantities of oil, really 1-2 drops of any vegetable oil gives me bad abdominal pain 12 to 15 hrs later. However, I have no problem with large quantites of fatty fish, so it’s not the fat per se. I cannot eat anything raw.

    As for your protocol, I do not tolerate fish broth, lemon (modified fast out of the question), any probiotics, nor any herbal antimicrobials. I could do a SIBO test, but even if I have SIBO, what good would the test be if I cannot use any treatment? I would try an elemental diet, but I’m afraid I would react badly to the ingredients and would prefer to avoid the expense, as my budget has already been hard tried. I am also underweight.

    What would you recommend under the circumstances?

    Many thanks in advance for your answer.

  150. Hi Dr. Ruscio,

    First of all, thanks for the book, it’s been a really good read. I wish I could follow your protocol, but I’m in a bit of an impossibility.

    I have celiac disease, diagnosed a year ago, and did not get better on a gluten-free diet. In the past year, I have done an elimination diet and realized only a very limited number of foods give me no symptoms: fish, 8 veggies, various herbs as seasonings and 2 herbal teas. (I do not eat meat out of principle, fish is a concession because I cannot tolerate any vegetarian protein.) Anything else gives me bad abdominal pain 12 to 15 hrs later if tried in small quantities. Continuing the food/supplement or having bigger quantities gives me diarrhea, constant urge to go, undigested food in stool.

    To note, I have a very bad reaction to minute quantities of oil, really 1-2 drops of any vegetable oil gives me bad abdominal pain 12 to 15 hrs later. However, I have no problem with large quantites of fatty fish, so it’s not the fat per se. I cannot eat anything raw.

    As for your protocol, I do not tolerate fish broth, lemon (modified fast out of the question), any probiotics, nor any herbal antimicrobials. I could do a SIBO test, but even if I have SIBO, what good would the test be if I cannot use any treatment? I would try an elemental diet, but I’m afraid I would react badly to the ingredients and would prefer to avoid the expense, as my budget has already been hard tried. I am also underweight.

    What would you recommend under the circumstances?

    Many thanks in advance for your answer.

  151. Has anybody here tried to get the Interfase Plus supplement in Canada? They won’t ship it here and you can’t find it in stores. What’s the alternative?

  152. Has anybody here tried to get the Interfase Plus supplement in Canada? They won’t ship it here and you can’t find it in stores. What’s the alternative?

  153. Your Elemental Shake states it contains milk, is it lactose free by chance?

    Thank you so much for your great book and this information. I love your approach to help heal without getting overwhelmed with the healing process. Thanks for helping me change my approach to healing my health. I love your podcasts as well!

    1. Hi there!

      The product is casein and lactose free and was designed to be devoid of allergens. Due to regulations, we must list milk because it does contain whey milk, however this product is very well tolerated by those who generally cannot tolerate dairy.

  154. Your Elemental Shake states it contains milk, is it lactose free by chance?

    Thank you so much for your great book and this information. I love your approach to help heal without getting overwhelmed with the healing process. Thanks for helping me change my approach to healing my health. I love your podcasts as well!

    1. Hi there!

      The product is casein and lactose free and was designed to be devoid of allergens. Due to regulations, we must list milk because it does contain whey milk, however this product is very well tolerated by those who generally cannot tolerate dairy.

  155. Where do you find these white potatoes on the low-fodmap diet? I called all around and no one carries. Sacramento, CA

  156. Dear Dr.
    I have problém with my Digestion 4 yers. I have IBS, and many intolerance, Leaky gut. When I eat non corectt Food, I have diarrhea, pain, and
    vomit, mucus in the stool. Please, What kind of diet is for my? I am vegan.

    1. Sounds a lot like SIBO-D. You could try eating ginger or making ginger tea for slowing intestinal motility and alleviating vomiting. Enteric coated peppermint oil may also help with your symptoms

  157. Dear Dr.
    I have problém with my Digestion 4 yers. I have IBS, and many intolerance, Leaky gut. When I eat non corectt Food, I have diarrhea, pain, and
    vomit, mucus in the stool. Please, What kind of diet is for my? I am vegan.

    1. Sounds a lot like SIBO-D. You could try eating ginger or making ginger tea for slowing intestinal motility and alleviating vomiting. Enteric coated peppermint oil may also help with your symptoms

  158. Dr Ruscio,

    I am planning to start the fast this weekend and start a paleo diet following it. On my current workout program and goal to build lean mass, I need more carbs for fuel and recovery. The book says to eat moderate to lower carbs and I don’t think lower carb will work with my program. Is it ok to keep carbs higher with fruits, veggies, and sweet potatoes? Has anyone else done this in step 1? Or, should I stop focusing on lean mass gain for this step?

  159. Dr Ruscio,

    I am planning to start the fast this weekend and start a paleo diet following it. On my current workout program and goal to build lean mass, I need more carbs for fuel and recovery. The book says to eat moderate to lower carbs and I don’t think lower carb will work with my program. Is it ok to keep carbs higher with fruits, veggies, and sweet potatoes? Has anyone else done this in step 1? Or, should I stop focusing on lean mass gain for this step?

  160. Hi, doctor. I have a quick question: Just wanted to know if I could substitute artemisia for artemisinin? I can’t find the latter in my area so was wondering if artemisia would have similar antimicrobial effects

    1. Hi Ian,

      I would think that would work, but the dosage may be different. i’ve passed this question along to Dr. Ruscio, and hopefully he’ll answer it in an upcoming podcast.

  161. Hi, doctor. I have a quick question: Just wanted to know if I could substitute artemisia for artemisinin? I can’t find the latter in my area so was wondering if artemisia would have similar antimicrobial effects

    1. Hi Ian,

      I would think that would work, but the dosage may be different. i’ve passed this question along to Dr. Ruscio, and hopefully he’ll answer it in an upcoming podcast.

  162. I just finished reading your book. I want to start step 1 next week.
    My question is, I have had LIS surgery years ago. I have been on Magnesium ever since for my bowels.
    When I have my surgeries for ideopathic Subglotten Stenosis, I get severely constipated even when fasting.
    Can I take my magnesium during the fasting stage?

  163. I just finished reading your book. I want to start step 1 next week.
    My question is, I have had LIS surgery years ago. I have been on Magnesium ever since for my bowels.
    When I have my surgeries for ideopathic Subglotten Stenosis, I get severely constipated even when fasting.
    Can I take my magnesium during the fasting stage?

  164. After doing step 1 I felt so much better. My stomach hasn’t been this great in years. I’ve been keeping my carbs in the hundreds. But I failed 2 weekends.
    I’ve been struggling with candida for the last few months. Is this a problem related to my gut? Would it improve if I keep my carbs low? Or should I be doing something different? It appears every time I get my period. Is it hormone related? Trying to understand how to heal from it. Thanks.

    1. Hi Clara,

      Glad to hear step 1 was helpful! Candida is definitely related to the gut, so you may want to keep going through the steps (including antimicrobials) to help with any dysbiosis/yeast issues. Good luck!

  165. After doing step 1 I felt so much better. My stomach hasn’t been this great in years. I’ve been keeping my carbs in the hundreds. But I failed 2 weekends.
    I’ve been struggling with candida for the last few months. Is this a problem related to my gut? Would it improve if I keep my carbs low? Or should I be doing something different? It appears every time I get my period. Is it hormone related? Trying to understand how to heal from it. Thanks.

    1. Hi Clara,

      Glad to hear step 1 was helpful! Candida is definitely related to the gut, so you may want to keep going through the steps (including antimicrobials) to help with any dysbiosis/yeast issues. Good luck!

  166. Hi Dr Ruscio,
    I have adrenal issues/insomnia, I am working with a ND, in your book you recommend adrenal glandular, she also recommend it, i read that some people have bad reaction to it, how can someone take this safely ?

    ty,
    Sayeed

    1. Hi Sayeed,

      Everyone is different. Some may do fine on supplements and some may have a hard time. I’d continue working with your doctor and she can help determine if the glandular is working for you or if you should try something else. Good luck!

  167. Hi Dr Ruscio,
    I have adrenal issues/insomnia, I am working with a ND, in your book you recommend adrenal glandular, she also recommend it, i read that some people have bad reaction to it, how can someone take this safely ?

    ty,
    Sayeed

    1. Hi Sayeed,

      Everyone is different. Some may do fine on supplements and some may have a hard time. I’d continue working with your doctor and she can help determine if the glandular is working for you or if you should try something else. Good luck!

  168. Dr. Ruscio

    I am about to start Step 1 and about a year ago I had an E95 food panel test done, which reveled that I am “sensitive” to certain foods. I have for the most part avoided these foods over the last year but experimented here and there and some of them don’t seem to bother me that much. I plan to do the Whole 30 and a lot of the foods that I am “sensitive” to per the E95 are Whole 30 friendly and I would like to experiment more with them. Any thought on this? My inclination is to try not to worry about what the E95 says and try to eat as many of the foods as possible, in order to establish the broadest diet possible. Curious what you think.

  169. Dr. Ruscio

    I am about to start Step 1 and about a year ago I had an E95 food panel test done, which reveled that I am “sensitive” to certain foods. I have for the most part avoided these foods over the last year but experimented here and there and some of them don’t seem to bother me that much. I plan to do the Whole 30 and a lot of the foods that I am “sensitive” to per the E95 are Whole 30 friendly and I would like to experiment more with them. Any thought on this? My inclination is to try not to worry about what the E95 says and try to eat as many of the foods as possible, in order to establish the broadest diet possible. Curious what you think.

  170. I have purchased the digital version on your book Healthy Gut Healthy You on Amazon. I cannot locate your handouts for your Great in 8 Action Plan. Are they not included in this version?

  171. I have purchased the digital version on your book Healthy Gut Healthy You on Amazon. I cannot locate your handouts for your Great in 8 Action Plan. Are they not included in this version?

  172. First of all, love the book and the amount of depth it goes into. I am a 26 yo male with fairly chronic digestive issues. Type A personality working a moderately stressful job as a clinical pharmacist practitioner. I have tinkered with a lot of different therapies (extended fasts, AIP, probiotics, xifaxin, etc) in the past. Feel really good when I’m fasting, but I typically suffer from bloating and periodic loose stools when I’m not. I am pretty lean and would like to improve gut health to help put on a little weight/muscle. Feel like I have trouble getting in enough calories. I have completed the bone broth fast, and have been doing a Whole 30 diet the past couple weeks. I have been focusing on mindful eating and chewing the hell out of my food. This has seemed to help the post meal bloating, but I continue to have some loose stools and have had noticeable (by me) bags under my eyes for the past few weeks although I do prioritize 8 hours of sleep. Is it time to switch to AIP or low fodmap? Would one be better than the other based on my symptoms? Or should I move to Step 2 and continue the Whole 30? Any advice is greatly appreciated. Thanks!

  173. First of all, love the book and the amount of depth it goes into. I am a 26 yo male with fairly chronic digestive issues. Type A personality working a moderately stressful job as a clinical pharmacist practitioner. I have tinkered with a lot of different therapies (extended fasts, AIP, probiotics, xifaxin, etc) in the past. Feel really good when I’m fasting, but I typically suffer from bloating and periodic loose stools when I’m not. I am pretty lean and would like to improve gut health to help put on a little weight/muscle. Feel like I have trouble getting in enough calories. I have completed the bone broth fast, and have been doing a Whole 30 diet the past couple weeks. I have been focusing on mindful eating and chewing the hell out of my food. This has seemed to help the post meal bloating, but I continue to have some loose stools and have had noticeable (by me) bags under my eyes for the past few weeks although I do prioritize 8 hours of sleep. Is it time to switch to AIP or low fodmap? Would one be better than the other based on my symptoms? Or should I move to Step 2 and continue the Whole 30? Any advice is greatly appreciated. Thanks!

  174. The book is really informative and interesting.

    As I only weigh 6st 11lbs and am 5ft 2in tall is it still ok for me to do the four day fast? Would it be better for me to do the low fodmap diet and not the palio diet. I also have an intollerance to ceisin and yeast. I have a problem maintaining my weight.

    Your advice will be most appreciated.

    1. Hi Eileen,

      I’m sorry to hear you’ve been dealing with these issues, I know it can be frustrating.

      We can’t give direct medical advice here, so I’d recommend setting up a consult with Dr. Ruscio if you’d like personalized direction (you can do that here: http://www.drruscio.com/gethelp)

      I would note that some people who are underweight end up gaining weight when doing the elemental diet, as it helps their gut heal and they are then better able to absorb nutrients. Definitely listen to your body though.

      The Elemental Heal is casein-free and the book should answer your question about low fodmap vs paleo.

      Good luck!

  175. The book is really informative and interesting.

    As I only weigh 6st 11lbs and am 5ft 2in tall is it still ok for me to do the four day fast? Would it be better for me to do the low fodmap diet and not the palio diet. I also have an intollerance to ceisin and yeast. I have a problem maintaining my weight.

    Your advice will be most appreciated.

    1. Hi Eileen,

      I’m sorry to hear you’ve been dealing with these issues, I know it can be frustrating.

      We can’t give direct medical advice here, so I’d recommend setting up a consult with Dr. Ruscio if you’d like personalized direction (you can do that here: http://www.drruscio.com/gethelp)

      I would note that some people who are underweight end up gaining weight when doing the elemental diet, as it helps their gut heal and they are then better able to absorb nutrients. Definitely listen to your body though.

      The Elemental Heal is casein-free and the book should answer your question about low fodmap vs paleo.

      Good luck!

  176. First of all, love the book and the amount of depth it goes into. I am a 26 yo male with fairly chronic digestive issues. Type A personality working a moderately stressful job as a clinical pharmacist practitioner. I have tinkered with a lot of different therapies (extended fasts, AIP, probiotics, xifaxin, etc) in the past. Feel really good when I’m fasting, but I typically suffer from bloating and periodic loose stools when I’m not. I am pretty lean and would like to improve gut health to help put on a little weight/muscle. Feel like I have trouble getting in enough calories. I have completed the bone broth fast, and have been doing a Whole 30 diet the past couple weeks. I have been focusing on mindful eating and chewing the hell out of my food. This has seemed to help the post meal bloating, but I continue to have some loose stools and have had noticeable (by me) bags under my eyes for the past few weeks although I do prioritize 8 hours of sleep. Is it time to switch to AIP or low fodmap? Would one be better than the other based on my symptoms? Or should I move to Step 2 and continue the Whole 30? Any advice is greatly appreciated. Thanks!

    1. Hi Kyle,

      I’m glad to hear the book has been helpful so far. We’d love an Amazon review if you feel up to it.

      Regarding the diets, the book covers this (try page 263) and talks about how to know when to move on to another diet and in which order to try them.

      I’d also mention that it seems like you may be getting in your own head a little bit too much. Follow the protocol outline in the book, try not to overthink it, and make sure to listen to your body and your intuition, because in reality that’s how you’ll know if what you’re doing is working for you or not.

      Good luck!

  177. I know that Dr. Ruscio really drives the point home about not becoming obsessed with diet and not spending hours and hours of screen time trying to learn more about diet, to the point of creating more unwanted stress. I am 100% on board with that.

    However, something that I am finding is really confusing and hard to deal with is the conflicting information regarding what a SIBO/ Low FODMAP diet should look like. For example, the SCD says that bananas are okay but “must be ripe with black spots”. The handout on this website “Paleo/ Low FODMAP” says only unripe bananas are “safe”. Another example is nuts, the SCD says just about all nuts are “legal”. The “Paleo/ Low FODMAP” handout says that almonds and hazelnuts should be avoided.

    I am getting frustrated because I have completed 4 days on the modified fast using Elemental Heal and I felt the best I have felt in a long time, it was almost miracle-like. Now I have transitioned back to normal whole food for the last 4 days and symptoms are creeping right back in (loose stool, every time without fail). I do have some “suspect foods” that I think are causing issues and some of them are on the above lists but again I am finding conflicts between what should and should not be eaten/ avoided among lists that are supposed to be giving like information. I am not sure how to deal with this without getting discouraged. Any comments or advice is appreciated.

    1. Hi Manuel,

      Thanks for your comment. First of all, that’s awesome you’re feeling better after the modified fast, that’s a great sign! And it’s totally normal for there to be some road bumps when adjusting to eating normal foods again.

      The reason there’s so much variation diet to diet is that everyone is different and there are multiple diets that work to help people manage symptoms. Instead of being frustrating, I’d actually think of this as a good sign, that there are multiple paths to health.

      Specifically regarding bananas, they were recently re-tested by the lab that does the FODMAP testing and their status changed, which is why you see so much discrepancy on lists.

      But in general, everyone is different and will have different triggers. These diets are all really just a starting place and a general guide to get you started. After that, it’s up to you to pay attention to your body and see what’s working and what isn’t.

      Don’t get discouraged, try and play around and treat it as an experiment.

      Good luck!

      1. Drew, I’m sure Manual appreciates your response to his comment. Of course everyone is different and has different triggers, but he also deserves a response to the valid concerns he brought up. There is conflicting information between the book and the supporting documents. We want to follow Ruscio’s directions, but we can’t do that until he revises the food lists provided for the low FODMAP diets.

  178. First of all, love the book and the amount of depth it goes into. I am a 26 yo male with fairly chronic digestive issues. Type A personality working a moderately stressful job as a clinical pharmacist practitioner. I have tinkered with a lot of different therapies (extended fasts, AIP, probiotics, xifaxin, etc) in the past. Feel really good when I’m fasting, but I typically suffer from bloating and periodic loose stools when I’m not. I am pretty lean and would like to improve gut health to help put on a little weight/muscle. Feel like I have trouble getting in enough calories. I have completed the bone broth fast, and have been doing a Whole 30 diet the past couple weeks. I have been focusing on mindful eating and chewing the hell out of my food. This has seemed to help the post meal bloating, but I continue to have some loose stools and have had noticeable (by me) bags under my eyes for the past few weeks although I do prioritize 8 hours of sleep. Is it time to switch to AIP or low fodmap? Would one be better than the other based on my symptoms? Or should I move to Step 2 and continue the Whole 30? Any advice is greatly appreciated. Thanks!

    1. Hi Kyle,

      I’m glad to hear the book has been helpful so far. We’d love an Amazon review if you feel up to it.

      Regarding the diets, the book covers this (try page 263) and talks about how to know when to move on to another diet and in which order to try them.

      I’d also mention that it seems like you may be getting in your own head a little bit too much. Follow the protocol outline in the book, try not to overthink it, and make sure to listen to your body and your intuition, because in reality that’s how you’ll know if what you’re doing is working for you or not.

      Good luck!

  179. I know that Dr. Ruscio really drives the point home about not becoming obsessed with diet and not spending hours and hours of screen time trying to learn more about diet, to the point of creating more unwanted stress. I am 100% on board with that.

    However, something that I am finding is really confusing and hard to deal with is the conflicting information regarding what a SIBO/ Low FODMAP diet should look like. For example, the SCD says that bananas are okay but “must be ripe with black spots”. The handout on this website “Paleo/ Low FODMAP” says only unripe bananas are “safe”. Another example is nuts, the SCD says just about all nuts are “legal”. The “Paleo/ Low FODMAP” handout says that almonds and hazelnuts should be avoided.

    I am getting frustrated because I have completed 4 days on the modified fast using Elemental Heal and I felt the best I have felt in a long time, it was almost miracle-like. Now I have transitioned back to normal whole food for the last 4 days and symptoms are creeping right back in (loose stool, every time without fail). I do have some “suspect foods” that I think are causing issues and some of them are on the above lists but again I am finding conflicts between what should and should not be eaten/ avoided among lists that are supposed to be giving like information. I am not sure how to deal with this without getting discouraged. Any comments or advice is appreciated.

    1. Hi Manuel,

      Thanks for your comment. First of all, that’s awesome you’re feeling better after the modified fast, that’s a great sign! And it’s totally normal for there to be some road bumps when adjusting to eating normal foods again.

      The reason there’s so much variation diet to diet is that everyone is different and there are multiple diets that work to help people manage symptoms. Instead of being frustrating, I’d actually think of this as a good sign, that there are multiple paths to health.

      Specifically regarding bananas, they were recently re-tested by the lab that does the FODMAP testing and their status changed, which is why you see so much discrepancy on lists.

      But in general, everyone is different and will have different triggers. These diets are all really just a starting place and a general guide to get you started. After that, it’s up to you to pay attention to your body and see what’s working and what isn’t.

      Don’t get discouraged, try and play around and treat it as an experiment.

      Good luck!

      1. Drew, I’m sure Manual appreciates your response to his comment. Of course everyone is different and has different triggers, but he also deserves a response to the valid concerns he brought up. There is conflicting information between the book and the supporting documents. We want to follow Ruscio’s directions, but we can’t do that until he revises the food lists provided for the low FODMAP diets.

  180. I’m excited to get started with resetting my gut, but wondered if diet modifications can help heal my 8 year old son’s gut. It was discovered that my son had a tick co-infection called Babesiosis and he was given 2 separate antibiotics to take for 2 weeks. I am worried this really messed up his gut, but he would not do well on a liquid diet for 2 days. Do you have any recommendations that I could do?
    Thank you,
    Kim

    1. Hi Kim,

      The diet modifications in the book could potentially be helpful, but you’ll want to check in with your pediatrician. Some of the supplements may or may not be appropriate for children or the dosing could be different. Good luck!

  181. I’m excited to get started with resetting my gut, but wondered if diet modifications can help heal my 8 year old son’s gut. It was discovered that my son had a tick co-infection called Babesiosis and he was given 2 separate antibiotics to take for 2 weeks. I am worried this really messed up his gut, but he would not do well on a liquid diet for 2 days. Do you have any recommendations that I could do?
    Thank you,
    Kim

    1. Hi Kim,

      The diet modifications in the book could potentially be helpful, but you’ll want to check in with your pediatrician. Some of the supplements may or may not be appropriate for children or the dosing could be different. Good luck!

  182. Hello from Africa, and a big thank you for the book and for the podcast, which have been a huge source of encouragement for me – it truly is an act of love that you would make this information accessible and I just want to ackowledge you and your team for that. I’ve shared it with my mum, and intend to share with many more people!

    I’m on day 3 of the fast and have noticed that the bone broth was starting to give me diarrhea. I tried to eat a low-fodmap food and noticed it gave me diarrhea too. i’ve switched to the lemonade (without the maple syrup) to complete the 4 day liquid fast and seem to be doing ok. However, I am worried about the diarrhea coming back when I begin to reintroduce foods on day 5. Is it alright to start with the HCL, digestive enzymes and probiotic on Day 5 as i reintroduce foods? In your experience, would this help?

    A big thank you once again.

    1. Hi ZB,

      So happy to hear you’re enjoying the book. We’d love an Amazon review if you feel up to it!

      Occasionally diarrhea can be a side effect of the fast, so you’re not alone. Finding a diet that works for you afterward will be helpful too. Following the order laid out in the book for trying diets is key.

      I’d follow the protocol as it’s written in the book (meaning diet before supplements), as it’s designed in the best way to isolate variables to see what is affecting what.

      Good luck!

  183. Hello from Africa, and a big thank you for the book and for the podcast, which have been a huge source of encouragement for me – it truly is an act of love that you would make this information accessible and I just want to ackowledge you and your team for that. I’ve shared it with my mum, and intend to share with many more people!

    I’m on day 3 of the fast and have noticed that the bone broth was starting to give me diarrhea. I tried to eat a low-fodmap food and noticed it gave me diarrhea too. i’ve switched to the lemonade (without the maple syrup) to complete the 4 day liquid fast and seem to be doing ok. However, I am worried about the diarrhea coming back when I begin to reintroduce foods on day 5. Is it alright to start with the HCL, digestive enzymes and probiotic on Day 5 as i reintroduce foods? In your experience, would this help?

    A big thank you once again.

    1. Hi ZB,

      So happy to hear you’re enjoying the book. We’d love an Amazon review if you feel up to it!

      Occasionally diarrhea can be a side effect of the fast, so you’re not alone. Finding a diet that works for you afterward will be helpful too. Following the order laid out in the book for trying diets is key.

      I’d follow the protocol as it’s written in the book (meaning diet before supplements), as it’s designed in the best way to isolate variables to see what is affecting what.

      Good luck!

  184. Hello Dr. Ruscio
    Thanks for your wonderful book. I have been battling adrenal fatigue/SIBO for about 2 years and want to start your gut healing protocol. I suspect I also have an elevated mercury body burden due to having amalgam fillings for many years (they are now removed). I plan to work on mercury detox using dr. Christopher Shade’s protocol (QuickSilver Scientific), and my question is about timing of starting these protocols. my understanding is that mercury can be a big player in biofilms/fungal overgrowth. Dr. Shade’s protocol uses a GI binder that has silica in it. would you recommend doing your protocol first, and mercury detox second? or work on both at same time? Any reservations with using silica in an inflammed gut?
    Thanks.

    1. Hi Angela,

      Happy to hear you’re enjoying the book. We’d love an Amazon review if you feel up to it.

      Regarding your other questions, unfortunately we can’t give personalized/direct medical advice here, but I would recommend working with a qualified practitioner. Heavy metal toxicity can be a serious matter and you’ll want to work with a clinician to make sure it’s actually an issue for you before self-treating.

      As far as Dr. Ruscio goes, I know he likes to “start with the gut”, but again, everyone is different and working with a practitioner will be helpful when figuring out how to layer different treatments together.

      If you’d like to apply to become a patient, you can do so here: https://www.drruscio.com/gethelp

      Good luck!

  185. Hello Dr. Ruscio
    Thanks for your wonderful book. I have been battling adrenal fatigue/SIBO for about 2 years and want to start your gut healing protocol. I suspect I also have an elevated mercury body burden due to having amalgam fillings for many years (they are now removed). I plan to work on mercury detox using dr. Christopher Shade’s protocol (QuickSilver Scientific), and my question is about timing of starting these protocols. my understanding is that mercury can be a big player in biofilms/fungal overgrowth. Dr. Shade’s protocol uses a GI binder that has silica in it. would you recommend doing your protocol first, and mercury detox second? or work on both at same time? Any reservations with using silica in an inflammed gut?
    Thanks.

    1. Hi Angela,

      Happy to hear you’re enjoying the book. We’d love an Amazon review if you feel up to it.

      Regarding your other questions, unfortunately we can’t give personalized/direct medical advice here, but I would recommend working with a qualified practitioner. Heavy metal toxicity can be a serious matter and you’ll want to work with a clinician to make sure it’s actually an issue for you before self-treating.

      As far as Dr. Ruscio goes, I know he likes to “start with the gut”, but again, everyone is different and working with a practitioner will be helpful when figuring out how to layer different treatments together.

      If you’d like to apply to become a patient, you can do so here: https://www.drruscio.com/gethelp

      Good luck!

  186. The link to supplemental materials has a diet similar to Paleo; is that the one to use?

    Similarly, there is a link to an AIM Paleo cookbook but no actual foodlist. Where could that be found?

      1. Hi Becca,
        Yes, use the one that’s titled Whole30. That has a food list that should be helpful.

    1. Becca asked two different questions. The first one was about the Paleo diet, and the second one was about the AIM Paleo diet. It sounds like you didn’t read her second question: “Similarly, there is a link to an AIM Paleo cookbook but no actual foodlist. Where could that be found?” Your Whole30 download does NOT say anything about an AIM Paleo foodlist.

      Is Becca’s second question going to be answered?

  187. The link to supplemental materials has a diet similar to Paleo; is that the one to use?

    Similarly, there is a link to an AIM Paleo cookbook but no actual foodlist. Where could that be found?

    1. Becca asked two different questions. The first one was about the Paleo diet, and the second one was about the AIM Paleo diet. It sounds like you didn’t read her second question: “Similarly, there is a link to an AIM Paleo cookbook but no actual foodlist. Where could that be found?” Your Whole30 download does NOT say anything about an AIM Paleo foodlist.

      Is Becca’s second question going to be answered?

  188. I was wondering if you can do a modified Elemental Diet? I can’t tolerate amino acid supplements, or folic acid. Can I make it without?

  189. I was wondering if you can do a modified Elemental Diet? I can’t tolerate amino acid supplements, or folic acid. Can I make it without?

  190. Is there any reason I could not water fast instead of using the elemental diet? I have a pretty significant histamine intolerance and am worried about reactions on any of the elemental protocols

    1. Hi Emily,

      That would potentially work, you just wouldn’t be able to do it as long. Make sure you work with a doctor on this. Good luck!

  191. Is there any reason I could not water fast instead of using the elemental diet? I have a pretty significant histamine intolerance and am worried about reactions on any of the elemental protocols

    1. Hi Emily,

      That would potentially work, you just wouldn’t be able to do it as long. Make sure you work with a doctor on this. Good luck!

  192. I purchased the book, and I’m planning my shopping list. At https://drruscio.com/gutbook-resources/, the document for “Standard Low Fodmap Diet” appears to have some oversights. It does not say anything about meat, eggs, or drinks. Also, it contradicts information in the book. The book states that the fruits and veggies allowed in the Paleo Low FODMAP diet are the same as the fruits and veggies allowed in the standard Low FODMAP diet. However, the download for the standard low FODMAP Diet says to avoid eggplants, while the download for the paleo low FODMAP diet says that eggplants are safe, for example. I’m confused.

    1. Another discrepancy is grapes. Your standard low-FODMAP list gives grapes the green light, while your paleo list says they have too much fructose.

      Also, the book says that the paleo low-FODMAP diet bans rice and potatoes, while your PDF says that the paleo low-FODMAP diet allows rice and potatoes. Between the book and the PDFs, there are too many inconsistencies for me to know what to eat on either plan. I would like to follow the standard one, but it’s hard to take it seriously when the only protein it lists is tofu. (And no, I’m not looking at the vegetarian version). It looks like the PDF you currently have uploaded for your standard low-FODMAP diet is an incomplete draft.

      1. Similarly, your PDF for the paleo low FODMAP diet allows butter and cream, while your book says that diet excludes butter and cream. This is getting frustrating.

        1. Hi Moorea,

          Thanks for your comments. We’re working on getting the handouts updated and they should be complete in a couple of days. All meat/poultry/seafood is fine. Rice/potatoes/butter are controversial on the paleo diet as some people argue they are technically not paleo, while other people include them in their paleo diets and they are fine. Since they’re low fodmap and many people tolerate them well, there’s no harm in giving them a try. All of these diets are just a starting place with people reacting differently to different foods (even foods on the green list), so the key will be listening to your body and seeing how you react. Good luck!

  193. I purchased the book, and I’m planning my shopping list. At https://drruscio.com/gutbook-resources/, the document for “Standard Low Fodmap Diet” appears to have some oversights. It does not say anything about meat, eggs, or drinks. Also, it contradicts information in the book. The book states that the fruits and veggies allowed in the Paleo Low FODMAP diet are the same as the fruits and veggies allowed in the standard Low FODMAP diet. However, the download for the standard low FODMAP Diet says to avoid eggplants, while the download for the paleo low FODMAP diet says that eggplants are safe, for example. I’m confused.

    1. Another discrepancy is grapes. Your standard low-FODMAP list gives grapes the green light, while your paleo list says they have too much fructose.

      Also, the book says that the paleo low-FODMAP diet bans rice and potatoes, while your PDF says that the paleo low-FODMAP diet allows rice and potatoes. Between the book and the PDFs, there are too many inconsistencies for me to know what to eat on either plan. I would like to follow the standard one, but it’s hard to take it seriously when the only protein it lists is tofu. (And no, I’m not looking at the vegetarian version). It looks like the PDF you currently have uploaded for your standard low-FODMAP diet is an incomplete draft.

      1. Similarly, your PDF for the paleo low FODMAP diet allows butter and cream, while your book says that diet excludes butter and cream. This is getting frustrating.

        1. Hi Moorea,

          Thanks for your comments. We’re working on getting the handouts updated and they should be complete in a couple of days. All meat/poultry/seafood is fine. Rice/potatoes/butter are controversial on the paleo diet as some people argue they are technically not paleo, while other people include them in their paleo diets and they are fine. Since they’re low fodmap and many people tolerate them well, there’s no harm in giving them a try. All of these diets are just a starting place with people reacting differently to different foods (even foods on the green list), so the key will be listening to your body and seeing how you react. Good luck!

  194. Just as I was about to begin the antimicrobial phase of Dr. Ruscio’s protocol, I unexpectedly had to take a 7-day round of standard antibiotics (Duricef/Cefadroxyl) to treat a non-gut related medical issue that arose. Once I am finished with this 7-day antibiotic treatment, is it wise to still proceed with Dr. Ruscio’s recommended antimicrobial treatment for my gut issues? Although the antibiotic is for another non-gut related issue, I am unclear as to whether it would possibly also treat my gut dysbiosis and am trying to determine whether following it immediately with antimicrobials would be redundant or harmful.

    1. Hi JS,

      It probably would not be redundant, as antimicrobials tend to treat a wider range of ailments, with antibiotics being much more specific, but you may want to check in with your doctor to get the go ahead. Good luck!

  195. Just as I was about to begin the antimicrobial phase of Dr. Ruscio’s protocol, I unexpectedly had to take a 7-day round of standard antibiotics (Duricef/Cefadroxyl) to treat a non-gut related medical issue that arose. Once I am finished with this 7-day antibiotic treatment, is it wise to still proceed with Dr. Ruscio’s recommended antimicrobial treatment for my gut issues? Although the antibiotic is for another non-gut related issue, I am unclear as to whether it would possibly also treat my gut dysbiosis and am trying to determine whether following it immediately with antimicrobials would be redundant or harmful.

    1. Hi JS,

      It probably would not be redundant, as antimicrobials tend to treat a wider range of ailments, with antibiotics being much more specific, but you may want to check in with your doctor to get the go ahead. Good luck!

  196. Hi Dr Ruscio, I am half way through your book but not yet got to the treatment part. However I have been trying to correct a bad dysbiosis for 3 years already. The stool analysis done earlier this year showed 95% Enterococcus! And no good bacteria. My Dr said this is why I have insomnia & constipation as I have no good bacteria & no serotonin. He wanted to put me on weeks of Amoxcyllin but I was not keen. Although I have been on pretty strict diet for years & tried tonnes of herbal treatments & supplements, spent thousands, and to no avail. It’s pretty soul destroying. I found Resolor and have been taking that for a couple of weeks & found it helps & I also felt happier but the insomnia seems even worse, if that’s even possible. So anyway my question is should I purchase all the supplements you recommend even though I have tried similar before or should I try the Bioclear Cleansing Program that I saw advertised in an email from you? I live in NZ & I get get that stuff here. I am not sure about all your products shipping to NZ, especially the probiotics.
    When I read all the possible reasons for my issues it is totally overwhelming & I cannot afford to keep blowing $$ & getting nowhere. My thought process is to use the Resolor to get things moving as only then will i be able to get on top of the bacterial overgrowth…oh I also did a SIBO test last year showing methane gas. Also wondering if LDN is a good option instead of Resolor. Thanks!

    1. Hi Trish,

      I’m sorry to hear you’ve been dealing with all of this. There’s no harm in continuing to work with your doctor and if they’re prescribing you Resolor and it’s helping that’s great. In terms of the book, I would definitely recommend finishing the book and following the protocol as written. This is the same protocol he uses in the clinic with his patients with gut issues of all types. Our store ships to NZ (you’ll just want to check and see if NZ has any rules about importing supplements). Hope this helps.

  197. Hi Dr Ruscio, I am half way through your book but not yet got to the treatment part. However I have been trying to correct a bad dysbiosis for 3 years already. The stool analysis done earlier this year showed 95% Enterococcus! And no good bacteria. My Dr said this is why I have insomnia & constipation as I have no good bacteria & no serotonin. He wanted to put me on weeks of Amoxcyllin but I was not keen. Although I have been on pretty strict diet for years & tried tonnes of herbal treatments & supplements, spent thousands, and to no avail. It’s pretty soul destroying. I found Resolor and have been taking that for a couple of weeks & found it helps & I also felt happier but the insomnia seems even worse, if that’s even possible. So anyway my question is should I purchase all the supplements you recommend even though I have tried similar before or should I try the Bioclear Cleansing Program that I saw advertised in an email from you? I live in NZ & I get get that stuff here. I am not sure about all your products shipping to NZ, especially the probiotics.
    When I read all the possible reasons for my issues it is totally overwhelming & I cannot afford to keep blowing $$ & getting nowhere. My thought process is to use the Resolor to get things moving as only then will i be able to get on top of the bacterial overgrowth…oh I also did a SIBO test last year showing methane gas. Also wondering if LDN is a good option instead of Resolor. Thanks!

    1. Hi Trish,

      I’m sorry to hear you’ve been dealing with all of this. There’s no harm in continuing to work with your doctor and if they’re prescribing you Resolor and it’s helping that’s great. In terms of the book, I would definitely recommend finishing the book and following the protocol as written. This is the same protocol he uses in the clinic with his patients with gut issues of all types. Our store ships to NZ (you’ll just want to check and see if NZ has any rules about importing supplements). Hope this helps.

  198. Hi! I heard you on a recent podcast and am curious to start the Great in 8. Could you clarify two things for me?

    #1 – after the master cleanse/bone broth fast should I go to paleo next or semi-elemental next before doing the paleo? I am confused, because Step1B in the book says to do the fast than paleo BUT the “gutbook” resources page on your site has the elemental diets listed between the fast and paleo.

    #2 – is the Whole 30 the paleo diet you want us to start with as mentioned in Step 1B?

  199. Hi Dr. Ruscio,

    Thanks so much for your book. I have been struggling with gut issues for 6+ years, have tried many diets and protocols, but yours is the first I have found that has had such a clear program to follow, and I’m super excited. Two questions:

    1. I have been taking HCl and digestive enzymes for a couple years now. When I come off the fast and begin the paleo diet, would you recommend that I continue with my HCl/enzymes or wait until Step 2 as written? I am curious whether there are foods that I could digest without the extra support (and I plan to take re-entry pretty slow), but I’m concerned about doing several weeks of diet-only modifications without digestive support, due to the possibility that I would acquire additional food sensitivities (I already have a long list).

    2. Is there a reason you don’t include any of the “gut-healing” supplements (such as L-glutamine, for example) at any step in your process? I’d love to be able to heal without them, so will follow your process as written. Just curious about the omission, since so many others seem to think they’re necessary.

    Thanks much,
    Emily

    1. Hi Emily,

      Glad you’re finding the information in the book helpful!

      1) I would follow the protocol as written (aka don’t add those things in until step 2)
      2) vitamin D has actually been shown to be healing to the gut

      Hope this helps and good luck!

  200. Hi! I heard you on a recent podcast and am curious to start the Great in 8. Could you clarify two things for me?

    #1 – after the master cleanse/bone broth fast should I go to paleo next or semi-elemental next before doing the paleo? I am confused, because Step1B in the book says to do the fast than paleo BUT the “gutbook” resources page on your site has the elemental diets listed between the fast and paleo.

    #2 – is the Whole 30 the paleo diet you want us to start with as mentioned in Step 1B?

  201. Hi Dr. Ruscio,

    Thanks so much for your book. I have been struggling with gut issues for 6+ years, have tried many diets and protocols, but yours is the first I have found that has had such a clear program to follow, and I’m super excited. Two questions:

    1. I have been taking HCl and digestive enzymes for a couple years now. When I come off the fast and begin the paleo diet, would you recommend that I continue with my HCl/enzymes or wait until Step 2 as written? I am curious whether there are foods that I could digest without the extra support (and I plan to take re-entry pretty slow), but I’m concerned about doing several weeks of diet-only modifications without digestive support, due to the possibility that I would acquire additional food sensitivities (I already have a long list).

    2. Is there a reason you don’t include any of the “gut-healing” supplements (such as L-glutamine, for example) at any step in your process? I’d love to be able to heal without them, so will follow your process as written. Just curious about the omission, since so many others seem to think they’re necessary.

    Thanks much,
    Emily

    1. Hi Emily,

      Glad you’re finding the information in the book helpful!

      1) I would follow the protocol as written (aka don’t add those things in until step 2)
      2) vitamin D has actually been shown to be healing to the gut

      Hope this helps and good luck!

  202. Dr. Ruscio,

    Enjoying the book! I’ll be starting Step 1 – modified fast. I’ve been considering a juice fast with a local organic juicery and was wondering if this would be acceptable for day 1-3. I would then follow with the bone broth. The juices are green with little to no fruit.

    Thank you!

    1. Hi Becky,

      Sticking with the options recommended in the book will be your best option here. Good luck!

  203. Dr. Ruscio,

    Enjoying the book! I’ll be starting Step 1 – modified fast. I’ve been considering a juice fast with a local organic juicery and was wondering if this would be acceptable for day 1-3. I would then follow with the bone broth. The juices are green with little to no fruit.

    Thank you!

    1. Hi Becky,

      Sticking with the options recommended in the book will be your best option here. Good luck!

  204. Dr. Ruscio recommends NAC and Interphase Plus for breaking up supposed biofilms in the gut. The problem with this approach, is there’s lack of research showing efficacy of these products for actually breaking up biofilms in humans (to my knowledge anyways). It may be helpful in gastric or upper gut issues, but who knows if it reaches lower down in the intestine without being rendered useless by digestive juices and bodily processes. Dr. Ruscio also offers no citations for the Interfase or NAC. Care to provide any evidence for these claims? Thanks

    1. Hi Ian,

      I actually do think he addresses this topic in the book in the section on biofilms, but I’ll add this question to the list for a future listener Q+A episode of the podcast.

      Thanks for taking the time to comment!

      1. I didn’t say he didn’t address it. I said there’s lack of research. Where’s the citation(s) for it? Post the research here

  205. Dr. Ruscio recommends NAC and Interphase Plus for breaking up supposed biofilms in the gut. The problem with this approach, is there’s lack of research showing efficacy of these products for actually breaking up biofilms in humans (to my knowledge anyways). It may be helpful in gastric or upper gut issues, but who knows if it reaches lower down in the intestine without being rendered useless by digestive juices and bodily processes. Dr. Ruscio also offers no citations for the Interfase or NAC. Care to provide any evidence for these claims? Thanks

    1. Hi Ian,

      I actually do think he addresses this topic in the book in the section on biofilms, but I’ll add this question to the list for a future listener Q+A episode of the podcast.

      Thanks for taking the time to comment!

  206. Hi,

    I’m wondering if you could help give some suggestions on how to increase my calorie/fat intake whilst following the paleo, low Fodmap diet in step 1. I’ve been doing it for a week and a half and as nuts are a caution/avoid, I’m struggling to get enough. I’m eating some meat, eggs and using olive oil to dress food but worried it may not be enough. I generally function better on high fat instead of high carb.
    Thanks 🙂

    1. Hi Casey,

      Sometimes it can take some playing around when you start the diet to figure out what works best for you. Olives are a great way to add fat/cals. Also, if you do well on higher fat, then adding additional coconut oil, avocado oil, lard, duck fat, etc to your food is a pretty easy way to increase your intake (cook your meat in it, roast veggies in it, make dressings from it, add it to smoothies, etc). You could also consider eating fattier cuts of meat (e.g. steak instead of chicken breast). Hope this helps!

  207. Hi,

    I’m wondering if you could help give some suggestions on how to increase my calorie/fat intake whilst following the paleo, low Fodmap diet in step 1. I’ve been doing it for a week and a half and as nuts are a caution/avoid, I’m struggling to get enough. I’m eating some meat, eggs and using olive oil to dress food but worried it may not be enough. I generally function better on high fat instead of high carb.
    Thanks 🙂

    1. Hi Casey,

      Sometimes it can take some playing around when you start the diet to figure out what works best for you. Olives are a great way to add fat/cals. Also, if you do well on higher fat, then adding additional coconut oil, avocado oil, lard, duck fat, etc to your food is a pretty easy way to increase your intake (cook your meat in it, roast veggies in it, make dressings from it, add it to smoothies, etc). You could also consider eating fattier cuts of meat (e.g. steak instead of chicken breast). Hope this helps!

  208. I’ve bought the book but cannot access the materials in this step. The on-line link for step one goes nowhere. Where the site says “Access the support materials mentioned in the book below” (with a down carrot), I get only a pop-up thanking me for ordering the book. No link.

    Is there a secret handshake? A password?

  209. I’ve bought the book but cannot access the materials in this step. The on-line link for step one goes nowhere. Where the site says “Access the support materials mentioned in the book below” (with a down carrot), I get only a pop-up thanking me for ordering the book. No link.

    Is there a secret handshake? A password?

  210. Hello,

    First off, thanks for the book! I’ve a science background and spent 5 years sifting through articles, journals and papers and taking random pot shots at thier findings.. it’s fantastic to have so much of it out together in such a straight forward way.

    I’ve IBS-C for 5 years and am underweight. FODMAP worked, and now is ineffective. I’m on the final day of my step 1 fast and have dropped even more weight.

    In 4 days I am due to start a 6 day kayak trip from the Andes down to the ocean, ~5 hours paddling a day. Paleo food will be available but I’m expecting I’ll not be getting the calories or protein I need and will be heavy carbs.

    My question: im keen to get my energy and bull back up in time for the trip, and have enough energy for the paddling. I’ve found a vegan rice/pea protein powder. Will supplimenting with this powder for both phasing back to whole foods and steps 1b) be appropriate?

    Any alternatives if not?

    Many thanks in advance,

    Mark.

    1. Hi Mark,

      I assume you’ve already left for your trip so this response may be too late, but I’d say listen to your body and see how you feel. Hope it goes well!

  211. Hello,

    First off, thanks for the book! I’ve a science background and spent 5 years sifting through articles, journals and papers and taking random pot shots at thier findings.. it’s fantastic to have so much of it out together in such a straight forward way.

    I’ve IBS-C for 5 years and am underweight. FODMAP worked, and now is ineffective. I’m on the final day of my step 1 fast and have dropped even more weight.

    In 4 days I am due to start a 6 day kayak trip from the Andes down to the ocean, ~5 hours paddling a day. Paleo food will be available but I’m expecting I’ll not be getting the calories or protein I need and will be heavy carbs.

    My question: im keen to get my energy and bull back up in time for the trip, and have enough energy for the paddling. I’ve found a vegan rice/pea protein powder. Will supplimenting with this powder for both phasing back to whole foods and steps 1b) be appropriate?

    Any alternatives if not?

    Many thanks in advance,

    Mark.

    1. Hi Mark,

      I assume you’ve already left for your trip so this response may be too late, but I’d say listen to your body and see how you feel. Hope it goes well!

  212. Hello, I want to try the liquid fast for two days. I usually workout every other day, would it be better to skip lifting weights during this fast? Thanks

    1. Hi William,

      That’s your call. Listen to your body and see how you feel. The biggest problem tends to be that people get hungry and a little tired with too much activity. Good luck!

  213. Hello, I want to try the liquid fast for two days. I usually workout every other day, would it be better to skip lifting weights during this fast? Thanks

    1. Hi William,

      That’s your call. Listen to your body and see how you feel. The biggest problem tends to be that people get hungry and a little tired with too much activity. Good luck!

  214. Hi Dr. R. I just completed my fast, and am moving on to paleo portion for the two weeks. It is November 30, and I am assuming I will probably have to add in the support supplements in two weeks. I have surgery December 28th they say it will take about 6 weeks to heal. My question is if I should start the support supplements after these two weeks (November 14th) or wait until 6 weeks after my surgery date. Thanks!

    1. Hi Brittany,

      Those are all questions for your doctor, as you’ll want to take their recommendations for what to do pre and post-surgery. Good luck, I hope it goes well!

  215. Hi Dr. R. I just completed my fast, and am moving on to paleo portion for the two weeks. It is November 30, and I am assuming I will probably have to add in the support supplements in two weeks. I have surgery December 28th they say it will take about 6 weeks to heal. My question is if I should start the support supplements after these two weeks (November 14th) or wait until 6 weeks after my surgery date. Thanks!

    1. Hi Brittany,

      Those are all questions for your doctor, as you’ll want to take their recommendations for what to do pre and post-surgery. Good luck, I hope it goes well!

  216. Hi Dr. Ruscio,

    Your book give gives me hope! I’m starting on step 2 of the program. My question is – Is it okay to take the probiotics along with thyroid meds first thing in the morning? I’m on a compounding T3 and T4. Thank you.

    1. It’s my understanding that thyroid meds should be taken alone, but you may want to run that by your doctor.

  217. After twice (Twice! I don’t learn.) deciding to eat apples within a week, I am retooling my Step 1 diet to officially cut out foods that cause oral allergy syndrome due to birch / alder pollen allergy. I’m curious if you’ve had anyone in the clinic try this approach? In my experience, “oral” allergy syndrome affects my entire digestive tract. I’m trying the book’s protocol specifically because of the gut/immune connection to see if it calms my hyper reactive immune system, which shows up as hay fever-type allergies, a tendency to get a bout of asthma with the slightest provocation (recently described more officially as hyper reactive airway disease), a tendency toward what I affectionately call the hacking cough of death (more hyper reactive airway disease), and now a worsening oral/digestive tract reactions to my favorite fruits.

    There’s an interesting paper on PubMed (PMID: 24910772) that found patients allergic to birch pollen have ongoing intestinal inflammation, even outside the seasonal birch pollen season and even if not symptomatic. I’m curious if you’ve looked at this in the clinic or if anyone else reading this forum may have experience here? I’m happy to report back with my experience if interested.

  218. Hi Dr. Ruscio,

    Your book give gives me hope! I’m starting on step 2 of the program. My question is – Is it okay to take the probiotics along with thyroid meds first thing in the morning? I’m on a compounding T3 and T4. Thank you.