Boy Invites Autistic Friend To Birthday, Then Mom Adds Handwritten Note About Their Friendship

When parents first discover that their child is afflicted with an illness that will affect their interactions with others, it’s hard to imagine what life will be like for them. The parents learn to adapt their schedules and needs to fit those of the child’s, in hopes that life will be easier for him or her. Often, however, people outside this child’s family may not consider his or her needs in the same way.

But as mom of three Tricia Klein found out, there are a few kind souls who are considerate of her child’s needs. Tricia’s son, Timothy, was diagnosed with nonverbal autism at 2 years old. Since then, she has helped her son overcome the daily challenges he faces. Though he struggles with interacting with others, he loves many of the same things other 7-year-old kids enjoy: he likes to play soccer, swim, and watch YouTube videos. But it isn’t uncommon that his mom has had to decline his invitations to parties because of his condition.

But one day, a note from a mother whose son was in Timothy’s class changed that.

Scroll down to find out what that mom said that moved Tricia to tears!

Please SHARE to show your support for this amazing mom!

Tricia Klein

Tricia’s son, Timothy, was diagnosed with nonverbal autism. This diagnosis makes it hard for him to interact with others, especially in large groups. She would have to decline his classmates’ invitations to parties.

Tricia Klein

But one of the mothers, whose son is friends with Timothy, decided to send Tricia a note, along with the invitation.

Tricia Klein

The note read: “Carter sat beside Timothy at school and he always talks about him. I really hope he can come. We are renting a bounce castle that we can attach a small bounce slide at the bottom. We will also have water balloons and water guns. Maybe Timothy can come earlier in the day if it would too much with the whole class. Let me know so we can make it work.”

Tricia Klein

The note moved Tricia to tears. To her, the final phrase “we can make it work” meant the world!

Please SHARE if this mom’s note would have made you tear up, too!

By:Ann-Sophie Kaemmerle

Take 2 Minutes and Experience Autism Through Carly’s Eyes—It’s Breathtaking

This is breathtaking. See inside the mind of someone with autism, and you’ll never look at people with this condition the same way again.

When Carly was just two-years-old, she was diagnosed with severe autism. Her condition stopped her from speaking and doctors said she would likely never intellectually develop beyond the mind of a child.

However, she made progress with her therapists, and after years of effort in behavioral and communication therapy, she had a huge breakthrough. One day during therapy she reached out for a laptop and typed, “HELP TEETH HURT,” and it blew everyone away.

This event started Carly’s new journey of hope and helped crush stereotypes about people who suffer from severe autism.

Experience autism through Carly’s eyes in this amazing first-person video.

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How Does Asperger’s Syndrome differ from Autism?

What distinguishes Asperger’s syndrome from autism is the severity of the symptoms and the absence of language delays. Children with Asperger’s syndrome may be only mildly affected and frequently have good language and cognitive skills. To the untrained observer, a child with Asperger’s syndrome may just seem like a normal child behaving differently.

Children with autism are frequently seen as aloof and uninterested in others. This is not the case with Asperger’s syndrome. Individuals with Asperger’s syndrome usually want to fit in and have interaction with others; they simply don’t know how to do it. They may be socially awkward, not understand conventional social rules, or may show a lack of empathy. They may have limited eye contact, seem to be unengaged in a conversation, and not understand the use of gestures. However, the fact that some persons with Asperger’s may make eye contact does not rule out the diagnosis for them. Therefore, a child who can make eye contact could still have Asperger’s syndrome.

Interests in a particular subject may border on the obsessive. Children with Asperger’s syndrome frequently like to collect categories of things, such as rocks or bottle caps. They may be proficient in knowing categories of information, such as baseball statistics or Latin names of flowers.While they may have good rote memory skills, they may have difficulty with abstract concepts.

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One of the major differences between Asperger’s syndrome and autism is that, by definition, there is no speech delay in Asperger’s. In fact, children with Asperger’s syndrome frequently have a large vocabulary and can talk a lot; they simply use language in different ways. Speech patterns may be unusual, lack inflection, or have a rhythmic nature or they may be formal, but too loud, too quiet, or high pitched. Sometimes their speech can be informal when it needs to be formal, or vice versa. They also may not be able to communicate the message that is most important, especially when they are stressed or upset.

Children with Asperger’s syndrome may not understand the subtleties of language, such as irony and humor, or they may not understand the give and take nature of a conversation. Another distinction between Asperger’s syndrome and autism concerns cognitive ability. While some individuals with autism experience cognitive delay, by definition a person with Asperger’s syndrome cannot possess a “clinically significant” cognitive delay and most possess an average to above average intelligence. While motor difficulties are not a specific criteria for Asperger’s, children with Asperger’s syndrome frequently have motor skill delays and may appear clumsy or awkward.

What is Lyme? An Introduction That Many People Do Not Know

Lyme disease, also known as Lyme borreliosis, is an infectious disease caused by bacteria of the Borrelia type.The most common sign of infection is an expanding area of redness, known as erythema migrans, that begins at the site of a tick bite about a week after it has occurred. The rash is typically neither itchy nor painful. Approximately 25–50% of infected people do not develop a rash. Other early symptoms may include fever, headache and feeling tired. If untreated, symptoms may includeloss of the ability to move one or both sides of the face, joint pains, severe headaches with neck stiffness, or heart palpitations, among others. Months to years later, repeated episodes of joint pain and swelling may occur. Occasionally, people develop shooting pains or tingling in their arms and legs. Despite appropriate treatment, about 10 to 20% of people develop joint pains, memory problems, and feel tired for at least six months.

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Lyme disease is transmitted to humans by the bite of infected ticks of the Ixodes genus. Usually, the tick must be attached for 36 to 48 hours before the bacteria can spread.In North America, Borrelia burgdorferi sensu stricto and Borrelia mayoniiare the cause.In Europe and Asia, the bacteria Borrelia afzelii and Borrelia garinii are also causes of the disease.The disease does not appear to be transmissible between people, by other animals, or through food.Diagnosis is based upon a combination of symptoms, history of tick exposure, and possibly testing for specific antibodies in the blood. Blood tests are often negative in the early stages of the disease.Testing of individual ticks is not typically useful.

Prevention includes efforts to prevent tick bites such as by wearing long pants and using DEET. Using pesticides to reduce tick numbers may also be effective.Ticks can be removed using tweezers.If the removed tick was full of blood, a single dose of doxycycline may be used to prevent development of infection, but is not generally recommended since development of infection is rare.If an infection develops, a number of antibiotics are effective, including doxycycline, amoxicillin, andcefuroxime. Treatment is usually for two or three weeks. Some people develop a fever and muscle and joint pains from treatment which may last for one or two days. In those who develop persistent symptoms, long-term antibiotic therapy has not been found to be useful.

Lyme disease is the most common disease spread by ticks in the Northern Hemisphere. It is estimated to affect 300,000 people a year in the United States and 65,000 people a year in Europe.Infections are most common in the spring and early summer. Lyme disease was diagnosed as a separate condition for the first time in 1975 in Old Lyme, Connecticut. It was originally mistaken for juvenile rheumatoid arthritis. The bacterium involved was first described in 1981 by Willy Burgdorfer.Chronic symptoms are well described and are known as post-treatment Lyme disease syndrome, although it is often called chronic Lyme disease.]Some healthcare providers claim that it is due to ongoing infection; however, this is not believed to be true. A previous vaccine is no longer available. Research is ongoing to develop new vaccines.

Things That Sometimes Work If You Have Anxiety

Anxiety disorders are the most common class of psychiatric disorders. Their US prevalence is about 20%. They’re also among the least recognized and least treated. We have sort of finally beaten into people’s thick skulls that depression isn’t just being sad, and you can’t just turn your frown upside down or something – but the most common response to anxiety disorders is still “Anxiety? So what, everyone gets that sometimes.”

But it’s hard to describe how disabling anxiety can be. A lot of people with nominally much worse conditions – depression, bipolar, even psychosis – will insist that they want their anxiety treated before anything else, because they can live with the rest. On the other hand, while a lot of people with psychosis have enough other problems that treating the psychosis barely puts a dent in their issues, a lot of people with anxiety would be happy and productive if they could just do something about it.

Since I’ve gotten some positive comments on my discussion of depression treatments I thought I’d go through some of the things I’ve seen used to treat anxiety. I’ll include the same disclaimer:

This will be inferior to reading official suggestions, but you will probably not read official suggestions, and you may read this. All opinions here are my own, they are not endorsed by the hospital I work at, they do not constitute medical advice, I have a known habit of being too intrigued by extremely weird experimental ideas for my own good, and you read this at your own risk. I am still a resident (new doctor) and my knowledge is still very slim compared to more experienced professionals. Overall this is more of a starting point for your own research rather than something I would expect people to have good results following exactly as written.

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I’ll mostly be talking about what’s called generalized anxiety disorder, with some applicability to panic disorder. Social anxiety, specific phobias, et cetera are their own thing, as is anxiety secondary to other illnesses – but some of the advice may cross over. I’m not going to get too into diagnosis, because generalized anxiety disorder is pretty much exactly what you think it is and a lot (though not all) of this will be applicable for subclinical anxiety as well.

I. Diet And Lifestyle

You didn’t think you were going to get out of this part, did you?

Pretty much every study – epidemiological or experimental, short-term or long-term, has shown that exercise decreases anxiety. The effect seems limited to aerobic exercise like walking, running or swimming, preferably for longer than twenty minutes. Various mechanisms have been postulated including norepinephrine, endogenous opioids, and decreased inflammation.

There’s less agreement on diet. The people who hate fat says high-fat diets cause anxiety. The people who hate carbs say high-carb diets cause anxiety. The people who hate processed food say processed foods cause anxiety. The people who recommend fish oil for everything say insufficient fish oil causes anxiety. None of it seems super credible, but Mayo Clinic has some suitably bland advice.

The one very important connection – if you drink too much coffee, or any other source of caffeine, that will make you anxious. I once had a patient come to me with severe recurrent anxiety. I asked her how much coffee she drank, and she said about twenty cups per day. Suffice it to say this was not a Dr. House-caliber medical mystery.

Also needless to say: get enough sleep. Seriously. Get enough sleep.

Many people find that various breathing exercises or other sorts of mindfulness activities can be helpful in the short term and sometimes build skills useful for the long term. My hospital gives people these handouts on breathing techniques and progressive muscle relaxation. I’ve made fun of HeartMath in the past, but I only learned about them because many people find some success, probably placebo-ish, with their quick coherence technique. If you’re an overachiever and want to get really into this sort of stuff, people always say good things about yoga and especially pranayama breathing. Studies seem to back this up (1, 2, 3) though you’ve got to be careful to weed out the studies by very religious Hindus trying to prove they’ve been right all along.

Meditation has similarly positive results. Here’s a study showing that an intervention to teach patients meditation resulted in decreased anxiety with p < 0.001 even three years later. Here’s a meta-analysis of 39 studies finding an effect size of about 0.6 (medium) in the general population, and an effect size of about 1.0 (large) in people with anxiety disorders. But here’s an equal and opposite review that found only “equivocal” results. As far as I can tell, most people investigating meditation think it works pretty well. The meditation techniques that seem to work best are mindfulness meditation and transcendental meditation. You can learn a little about mindfulness meditation here. In order to learn about Transcendental Meditation, send a check made out for $5000 to Maharishi Mahesh Yogi, PO Box….

II. Therapy

Cognitive-behavioral therapy works okay for anxiety just like it works okay for everything else. The Big Graph O’ Effect Sizes says that psychotherapy on average has an effect size of 0.51 in generalized anxiety, compared to medication’s 0.31. This shouldn’t be taken too seriously – the confidence intervals overlap and there’s a wide range of efficacy for different medications – but you won’t be doing any worse by going for the therapy first. Even theCochrane Review, famous for never drawing any conclusion other than “more research is needed”, is tentatively willing to say that psychotherapy works for anxiety disorders. Their study trends towards finding that cognitive behavioral therapy works better than supportive therapy, but is unable to prove significance – apparently more research is needed.

Exposure therapy can also be useful for panic attacks or specific phobias. This is where they expose you to the thing you’re scared of (or deliberately initiate a panic attack) and keep doing it until you stop being scared and start being bored. According to a bunch of studies it works neither better nor worse than cognitive-behvioral therapy for most things, but my unsupported impression has always been that it’s better at least for panic disorder. Cognitive-behavioral therapy seems clearly superior for social phobia.

You can get psychotherapy from any qualified psychotherapist, a category including counselors, social workers, psychologists, and sometimes psychiatrists. Ones who use “a school” (for example, describe themselves as practicing cognitive behavioral therapy) are usually considered better than those who don’t (“Oh, I do a little of everything with every patient”). If you can’t find (or don’t want to find) a good therapist, there is preliminary evidence that a good self-help therapy workbook (“bibliotherapy”) is about as good as real therapy – including for anxiety (study,other study, yet another study).

I have no special insight into which self-help workbooks are any good, but The Cognitive Behavioral Workbook for Anxiety: A Step-By-Step Program seems to get pretty good ratings.

III. Medications

To be tried after diet and lifestyle interventions when possible.

Medication can work either instead of or in addition to therapy. There are at least seven categories of commonly used conventional anxiety medications: SSRIs, SNRIs, antihistamines, antipsychotics, anticonvulsants, benzodiazepines, and azapirones. These can be divided into mostly-acute (antihistamines and benzos) and mostly-long-term (SSRIs, SNRIs, anticonvulsants, azathioprines), with antipsychotics kind of being a tossup. Depending on whether you just need to get through the occasional panic attack or whether you’re in a chronic unremitting anxiety state, you might want one, the other, or both.

You probably know antihistamines (example: Benadryl) from the many common over-the-counter members of this class. They have some mild short-term anti-anxiety effects. Benadryl will work in a pinch if you need something without a prescription, but the most commonly used anxiolytic antihistamine is hydroxyzine (“Vistaril”, “Atarax”), which is a bit more powerful and less likely to make you fall asleep. As far as anxiolytics go it’s pretty safe as long as it doesn’t make you too sleepy. If you just need something to take the edge off the occasional anxiety attack, this works fine.

Benzodiazepines (examples: Xanax, Ativan, Valium, Klonopin) are very effective in the short-term but also very controversial. In some people they are very habit-forming and can produce a picture very similar to addiction to alcohol (which they chemically resemble). Keep in mind how bad an idea it might be to become extremely addicted to prescription pills that you may suddenly lose access to depending on how your doctor is feeling (you might expect doctors would take the difficulty of coming off these drugs into account, but you might expect a lot of things from doctors that don’t always happen). Studies suggest benzodiazepines can sometimes build tolerance, and that after a month or two of frequent use, they lose their positive effect and you need them just to feel normal. That having been said, a subset of patients – and I can’t tell at this point if it’s a majority or a minority – go on benzodiazepines, do very well, stay on them for long periods without getting dependent, and never have anxiety again. It’s kind of a crapshoot. The most generally recognized “safe” use of benzos is the occasional Xanax to deal with rare but very stressful situations (for example, flying on an airplane if you’re scared of heights). Other people say Klonopin is safer than some of the others and that it’s worth a shot as long as you realize that “Klonopin dose gradually creeping upwards” is a sign that you’re getting into a bad place and need to react immediately. Most people recommend trying other things first before you come here, but once you’ve exhausted other options these can be a powerful last resort.

SSRIs (examples: Prozac, Celexa, Lexapro, Zoloft) are the mainstay of chronic anxiety treatment just like they’re the mainstay of chronic everything-else treatment. As usual, they have real but modest effects after about a month or so, more in some people and less in others. As usual, if one SSRI doesn’t work for you, you might want to try another. These are pretty safe aside from the sexual side effects. Some people get mild withdrawals if they go off these too quickly, so don’t do that. A lot of people use both an SSRI for chronic treatment, plus either an antihistamine or benzo for “break-through” anxiety.

SNRIs (examples: Effexor, Cymbalta) are like SSRIs, but for two neurotransmitters instead of one. This is supposed to make them a little bit more effective. Maybe they are, maybe they aren’t. Fewer sexual problems than SSRIs, but worse discontinuation syndrome. They’re a good second-line chronic medication if SSRIs don’t work. Effexor is probably the best.

Azapirones (example: BuSpar) is, unusually, a rare drug which is specifically targeted at anxiety, rather than a being a repurposed antidepressant or something. BuSpar is very safe, not at all addictive, and rarely works. Every so often somebody comes out with a very cheerful study saying something like “Buspar just as effective as benzodiazepines if given correctly!” and everybody laughs hysterically and goes back to never thinking about it.

Anticonvulsants (examples: Depakote, Neurontin, Tegretol, Lyrica) are seizure medications that sometimes sort of work for anxiety. Most of them have strong side effects and limited utility. The exception is Lyrica (pregabalin), which is pretty new but has shown excellent safety and efficacy in studies. It doesn’t have an FDA indication for anxiety and it’s pretty expensive, so you might have a hard time getting it, but it is at least a well-kept secret.

Atypical antipsychotics (examples: Seroquel, Zyprexa, Abilify, Geodon) are, as always, overused. Most of them either make you gain lots of weight, put you at increased risk for heart rhythm problems, make you feel terrible, put you at risk of permanent movement disorders, or all of the above. They do often treat anxiety, sometimes very well, and psychiatrists like them because they’re good all-purpose no-nonsense drugs with big advertising budgets, but unless you’re also psychotic consider trying some other things first before you try these.

An article in Journal of Psychopharmacology tries to compare the efficacy of all of these classes of drugs and gets the following effect sizes (bigger number = bigger effect):

Pregabalin: 0.5
Antihistamine: 0.45
SNRI: 0.42
Benzo: 0.38
SSRI: 0.36
Azapirone: 0.17
Alternative medicine: -0.31

(remember, other studies suggest psychotherapy is around 0.5)

I heavily challenge the claim that antihistamines are more effect than (or anywhere near as effective as) benzos. I don’t know the confidence intervals on these numbers, so I would suggest reading it as “Everything is about equally effective, except azapirones which aren’t as good”. Their “alternative medicine” category was mostly kava and homeopathy, and I have no idea why it came out negative (kava’s pretty good, and homeopathy shouldn’t separate from 0).

There are also some less commonly used drugs that might help people who don’t respond to any of these.

As usual, MAOIs are very effective, moderately dangerous, and super hard to get. They seem to work especially wellfor panic disorder and social anxiety.

Clonidine is a medication usually used to control blood pressure. It’s somewhat effective against anxiety and some people think it should be used more. But it can cause you to become too sedated (abnormally low heart rate) and in some people it makes anxiety worse for some reason.

Beta-blockers (example: propranalol) are another blood pressure medication. It is especially effective against somatic symptoms of anxiety – racing heartbeat, shaking, et cetera – and sometimes getting rid of those can make the anxiety go away entirely. It’s most famous for its use against performance anxiety: about a third of musicians use them in concerts, and I’ve heard similar rumors about public speakers, actors, et cetera. I used to think this was a little-known piece of trivia, but whenever I bring it up to doctors (“Hey, did you know some people use beta-blockers for performance anxiety”) the usual response is “Oh, yeah, I prescribe myself some of that when I have to give a presentation at grand rounds.” They don’t seem quite as good for longer-term anxiety disorders, though some people have had good results with them.

I once saw an excellent psychiatrist whom I deeply respect try everything on a patient with severe treatment-resistant anxiety with no results whatsoever until finally he came to Thorazine. This treated the patient’s anxiety pretty well, at the cost of provoking quite a bit of anxiety in the doctor.

Without meaning to give medical advice, and with the caveat that you should ask your doctor for their opinion – one good pharmacological treatment algorithm for anxiety disorders is:

If you just have occasional outbursts that bother you, take occasional doses of hydroxyzine.

If you have a longer-term problem, start with an SSRI. If that doesn’t work, either try more SSRIs and SNRIs, or go to Lyrica. You might as well be on BuSpar somewhere in the process too. If none of that works, choose your poison (or have it chosen for you) among MAOIs, benzos, clonidine, or antipsychotics.

IV. Alternative Treatments

To be used out of curiosity or desperation only – you have other options and these are not guaranteed safe or effective.

Massage therapy, acupuncture, aromatherapy, and everything else in the category of “unnecessarily medicalized relaxing thing” all perform very well as long as you don’t look too hard for a suitable control group. Yes, these are probably placebo, but they’re very effective placebos and if they both work I would rather take a placebo than an antipsychotic.

Inositol and l-theanine are both found in small quantities in the diet (inositol in some vegetables, theanine in tea) and supplementing them has been inconsistently found to help with anxiety. Inositol had some preliminary evidencefor effectiveness in panic disorder, but a more recent meta-analysis was unimpressive. I can only say that I have some anecdotal evidence of extremely positive reactions to inositol, but we all know what they say about anecdotal evidence. Keep in mind that the dose used in studies is way larger than the dose anyone will give you – usually corresponding to about 20 of those 500 mg inositol pills a day. This makes it expensive and inconvenient, and most people just compromise by taking so little inositol it shouldn’t possibly be able to have any effect. L-theanine also hasa lot of small studies in support, although there’s some question on whether it works on its own or whether it just has useful synergistic effects with caffeine. Sun-theanine is generally considered the most effective form, and recommended dose is about 100 – 400 mg. Both these supplements are afaik very safe and a good option for people who want to test things that might or might not work but have minimal risk. Magnesium should also be in here somewhere.

GABA is the main inhibitory neurotransmitter in the nervous system, and a lot of these other interventions are attempts to convince the brain to release more GABA or potentiate the GABA that’s already released. Can we just cut out the middleman and ingest GABA pills directly? The supplement industry would like you to think so, and you can certainly buy them anywhere supplements are sold, but it’s generally believed that orally ingested GABA can’t cross the blood-brain barrier. The Russians have developed a modified version of GABA that doesn’t have this problem; called picamilon, it seems to be a pretty popular anxiety treatment on the other side of thePharmacological Iron Curtain. It’s pretty easy to get as a non-prescription supplement here in the West. There are very few studies on it, the ones that exist are in Russian, and I have nothing to go on but a couple of anecdotal reports, most of which are positive (though I personally noticed no effects). But the mechanism of action is plausible, and the long history of successful Russian use at least suggests it probably won’t kill you immediately. Most common dosage seems to be about 100 – 300 mg.

The nootropics/supplement/nutraceutical community also suggest ashwagandha and bacopa for anxiety; various low-quality studies support the use of both (ashwagandha meta-analysis, bacopa study 1, bacopa study 2, bacopa study 3). Bacopa may take several months of frequent use before it starts working; I tried it briefly and had to stop because of gastrointestinal side effects, which are pretty common. There’s also some worry around heavy metal contamination. Swanson’s and Nootropic Depot’s are two that have third-party testing showing they’re uncontaminated.

Kava is a traditional drink from various Pacific islands with anxiolytic properties. Multiple meta-analyses including a Cochrane review find it to be an effective anxiety treatment, but its safety is in question after reports of several cases of liver failure caused by the plant. This may be yet another case of people exaggerating freakishly rare side effects; the risk has been estimated at less than one in a million doses (though remember that if you take it daily for ten years, that number bcomes 1/300). Others suggest a rate as low as one in a hundred million but this assumes zero underreporting; others challenge this assumption. Possibly it is only poorly prepared kava causes liver problems; for traditionally prepared kava, look for preparations that specify they are made from root/rhizome material only. The American Academy of Family Physicians recommends that:

Physicians who supervise patients taking kava for the treatment of GAD should take care to avoid the following: (1) high dosages (more than 300 mg per day); (2) combining kava with hepatoactive agents; (3) using non-root preparations; and (4) exposure for longer than 24 weeks. Use of WS1490 standardized kava extract is also recommended. If these safety precautions are followed, kava can be appropriate therapy for selected patients diagnosed with GAD

Don’t take kava if you have any liver problems, if you’re on any medications that might interact with it, or if you plan on drinking alcohol at the same time. Consider talking about it with your doctor first and getting plans to check liver enzymes regularly.

Selank is an experimental Russian anti-anxiety medication going through their version of clinical trials. It’s a bit high-maintenance – you have to keep it refrigerated or else it decays, and the only two functional means of administration are injection or nasal spray – but anecdotal evidence is extraordinarily positive. No side effects have been found thus far, but needless to say by the time you get to “injecting experimental Russian medications into yourself” we have left the point where we can entirely guarantee this is a good idea. Ceretropic sells a nasal spray version, which is probably more convenient than having to inject it.

Phenibut is another Russian anti-anxiety medication, but it’s very addictive and dangerous. Even the fearless people of r/nootropics stay away from this one. Highly un-recommended.

Overall, the best evidence seems to be for l-theanine (especially if you drink coffee) and bacopa (especially if you’re willing to wait months for any effect), with picamilon also worth your time to try and Selank as an option for the very adventurous.

V. Conclusions

No treatment stands out as extremely effective, and the best route to dealing with anxiety probably depends on many factors like your amount of free time, your motivation, your access to medical care, and your willingness to put up with side effects. After you’ve fixed lifestyle issues, I think any of “self-help workbook”, “start SSRIs”, or “try l-theanine” are good first options. On the other hand, benzodiazepines, antipsychotics, and kava are all options I would hold off on until you’ve tried a couple of other things.

Like with the depression post, the most important conclusion you can take from this is that you have lots of options. Please don’t let people give you an SSRI and then give up. Work with your doctor. Anxiety actually has a pretty good prognosis if people work on it, but it can be a difficult and frustrating process. Just remember: there are lots of options.

Uncomfortable Truths About the ADHD Nervous System

Easily bored, sensitive to distractions, creative and intense. If you grew up with ADHD, chances are you always felt “different.” Now here’s a scientific explanation, finally, of why we act the way we do.

What I have come to understand — something that people with ADHD know from an early age — is that, if you have an ADHD nervous system, you might as well have been born on a different planet.

Most people with ADHD have always known they are different. They were told by parents, teachers, employers, spouses, and friends that they did not fit the common mold and that they had better shape up in a hurry if they wanted to make something of themselves.

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As if they were immigrants, they were told to assimilate into the dominant culture and become like everyone else. Unfortunately, no one told them how to do this. No one revealed the bigger secret: It couldn’t be done, no matter how hard they tried. The only outcome would be failure, made worse by the accusation that they will never succeed because they don’t try hard enough or long enough.

It seems odd to call a condition a disorder when the condition comes with so many positive features. People with an ADHD-style nervous system tend to be great problem-solvers. They wade into problems that have stumped everyone else and jump to the answer. They are affable, likable people with a sense of humor. They have what Paul Wender called “relentless determination.” When they get hooked on a challenge, they tackle it with one approach after another until they master the problem — and they may lose interest entirely when it is no longer a challenge.

If I could name the qualities that would assure a person’s success in life, I would say being bright, being creative with that intelligence, and being well-liked. I would also choose hardworking and diligent. I would want many of the traits that ADDers possess.

The main obstacle to understanding and managing ADHD has been the unstated and incorrect assumption that ADDers could and should be like the rest of us. For neurotypicals and ADDers alike, here is a detailed portrait of why those with attention deficit do what they do.

Why We Don’t Function Well in a Linear World

The ADHD world is curvilinear. Past, present, and future are never separate and distinct. Everything is now. ADDers live in a permanent present and have a hard time learning from the past or looking into the future to see the inescapable consequences of their actions. “Acting without thinking” is the definition of impulsivity, and one of the reasons that ADDers have trouble learning from experience.

It also means that ADDers aren’t good at ordination — planning and doing parts of a task in order. Tasks in the neurotypical world have a beginning, a middle, and an end. ADDers don’t know where and how to start, since they can’t find the beginning. They jump into the middle of a task and work in all directions at once. Organization becomes an unsustainable task because organizational systems work on linearity, importance, and time.

Why We Are Overwhelmed

People in the ADHD world experience life more intensely, more passionately than neurotypicals. They have a low threshold for outside sensory experience because the day-to-day experience of their five senses and their thoughts is always on high volume. The ADHD nervous system is overwhelmed by life experiences because its intensity is so high.

The ADHD nervous system is rarely at rest. It wants to be engaged in something interesting and challenging. Attention is never “deficit.” It is always excessive, constantly occupied with internal reveries and engagements. When ADDers are not in The Zone, in hyperfocus, they have four or five things rattling around in their minds, all at once and for no obvious reason, like five people talking to you simultaneously. Nothing gets sustained, undivided attention. Nothing gets done well.

Many people with ADHD can’t screen out sensory input. Sometimes this is related to only one sensory realm, such as hearing. In fact, the phenomenon is called hyperacusis (amplified hearing), even when the disruption comes from another of the five senses. Here are some examples:

> The slightest sound in the house prevents falling asleep and overwhelms the ability to disregard it.

> Any movement, no matter how small, is distracting.

> Certain smells, which others barely notice, cause people with ADD to leave the room.

ADDers have their worlds constantly disrupted by experiences of which the neurotypical is unaware. This disruption enforces the perception of the ADHD person as being odd, prickly, demanding, and high-maintenance. But this is all that ADDers have ever known. It is their normal. The notion of being different, and that difference being perceived as unacceptable by others, is made a part of how they are regarded. It is a part of the ADDer’s identity.

20 Things to Remember If You Love a Person With Dyslexia

It’s hard to understand it, isn’t it?

If you’re not one of the ten to fifteen percent of the population with dyslexia, it’s really hard to understand what it’s like.

It’s easy to think that it’s a bit of a scam. That if people with dyslexia worked harder, and really applied themselves, they could “get over it.” But that’s not the case.

Life is actually much more difficult for people with dyslexia. They have brilliant minds, but they’re hard to focus.

Dyslexia is a gift—the gift of being able to see things from lots of different points of view, all at once. But the gift comes with a curse, and the curse is that it’s hard to prioritize, or make sense of, all those perspectives.

People with dyslexia can be hard to live with, and hard to love, because their brains work so differently to ours. Even if you love someone with dyslexia, the day-to-day living with it can drive you insane. Because they can forget things, believe they’ve said or done things they haven’t, be incredibly messy and disorganized, and be less socially aware than other people.

The best thing you can do is to understand more about dyslexia, so you’re less exasperated and more sympathetic.

This is an insight into how their minds work.

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1. They have lifestyle challenges.

Dyslexia is much more than just having difficulty reading, writing, and using numbers. They see the world in a completely different way, communicate differently, and have trouble organizing things.

Some people describe it as a lifestyle challenge, others as a lifestyle curse, because it affects almost all aspects of their lives.

2. They can seem weird.

Despite their high intelligence, and because they see so many different perspectives at once, they can appear incoherent in conversation. They can come out with strange ideas, and lack the ability to check if their thoughts are suitable for conversation. They can seem almost autistic because they’re often unaware of social rules.

3. They find details exhausting.

Because their brain is less efficient at processing letters and sounds, it has to work harder—much harder. So any time spent reading, using numbers, or focusing on details is really, really exhausting.

4. They function differently on different days.

Some days they seem to function better than others, and can appear to be improving. Other days, it’s like everything is getting worse. There’s no reason, and no pattern. It just is.

5. They are highly creative.

Their ability to view the world from all perspectives makes them highly creative. They can come up with wildly creative ideas, partly because they’re not constrained by the laws of physics, mathematical logic, or the impossible.

6. They see things that others don’t.

Like words moving on the page, or even off the page, and letters flipping about. You know how challenging it can be to read letters and numbers incaptcha? Imagine reading a whole book like that. Or reading a book through a magnifying lens that a child is holding, and moving about.

They can even see the word cat more than 40 different ways.

7. They get overwhelmed by what they see.

They see so many possibilities that their thoughts can become garbled and distorted. It’s hard to sort through all that information and work out what’s important or appropriate. Without the ability to filter, this special gift becomes a tragic, confusing, disability.

8. They are more likely to have ADD.

People with dyslexia are more likely to have ADD. About 40% of people with dyslexia have ADD, and 60% of people with ADD have dyslexia.

9. They can experience thoughts as reality.

They can fully believe they’ve told you something, that they haven’t, or swear that you haven’t told them something that you have.

Often they express themselves in such a unique way that their message hasn’t come across coherently. And they may not realize that this aspect of their communication is part of their dyslexia.

10. They may not know they have dyslexia.

According to the Mayo Clinic, dyslexia can go undiagnosed for years, and may not be recognized until adulthood. This is one reason why it’s hard to calculate the number of people with dyslexia. And, unfortunately, people with undiagnosed dyslexia often label themselves as stupid or slow.

11. They think in pictures instead of words.

Not surprisingly, they tend to be highly visual, think in pictures, and utilize visual aids to help them plan and organize their lives. Rather than using self-talk, their thought processes are more subliminal. Most people with dyslexia are not even aware that they do this.

12. They will always have dyslexia.

They can learn to read and spell, but they will always have dyslexia. To make life easier, a font and a dictionary specifically for people with dyslexia are on the way.

The font is designed to avoid confusion, and add clarity, while the dictionary will favor meaning over alphabetical order.

13. They use their brain differently.

People with dyslexia don’t use their brain the same way that most of us do. Their brain underutilizes the left hemisphere—the area required for reading—and the bridge of tissue between the two sides of the brain (the corpus callosum) doesn’t function in the same way. So, their brain doesn’t always direct information to the correct place for processing.

14. They get it from their family.

Dyslexia is inherited, and most people with dyslexia have an aunt or uncle, or a parent or grandparent with dyslexia. Scientists have discovered that the DCD2 appears to be a dyslexia gene.

15. They often have low self-esteem.

People with dyslexia are just as intelligent as the rest of us. And they’re fully aware that other people can read and write much more easily than they can. So they feel stupid compared to other people.

As Albert Einstein said:

“Everybody is a genius. But if you judge a fish by it’s ability to climb a tree, it will live it’s whole life thinking it’s stupid.”

16. They have different symptoms.

Dyslexia is a tricky thing, because no two people have the exact same symptoms. Some lose things, or have poor organization skills. Some are slow at reading or have poor comprehension. Some may have difficulty organizing ideas to write, or have difficulty processing auditory information. Some also have difficulty sequencing the days of the week, or months of the year.

17. They are full of contradictions.

They may be highly aware of their environment, but appear lost. They may recognize, or read, a word on one page but be unable to recognize it on the next. Their brains are often very fast, but they appear slow, because they’re filtering through all the possibilities that they see.

18. They have great strengths.

People with dyslexia are often very good at reading people, and have great people skills. They usually have fantastic memories, and rely on them. They’re often good at spoken language, and frequently spatially talented (think architects, engineers, artist and craftspeople). They are highly intelligent, and intuitive, with vivid imaginations.

19. They can be incredibly successful.

People with dyslexia can be incredibly successful, often because of their dyslexia.

Famous people with dyslexia include entertainers like Whoopi Goldberg, Jay Leno, Henry Winkler, Danny Glover and Cher. As well as artists like Leonardo da Vinci, Tommy Hilfiger, Andy Warhol and Pablo Picasso.

Carole Grieder and Baruj Benacerraf utilized their dyslexia to becomeNobel prize-winning scientists. People with dyslexia also go on to be writers and journalists like Scott Adams (of Dilbert), Agatha Christie, F Scott Fitzgerald, and Fannie Flagg (the author of Fried Green Tomatoes at the Whistle Stop Café).

20. They can change the world.

People with dyslexia can, and have changed the world. People like George Washington, Richard Branson, Henry Ford and Stephen Spielberg have changed, and continue to change, the world we live in.

People with dyslexia are kind, creative, highly intelligent beings who are just as frustrated at their inabilities as you are. They just can’t take a break from the way their minds work.

Instead they rely on the people that love them to help them interpret the world, and to help them function in a world that’s not adjusted to their needs.

Yes, they can be frustrating to love at times, but they have incredible, unique, world-changing gifts.

With your help, maybe the person you love can change the world too.

6 Instances of Discrimination People with Disabilities Face Every Day

Discrimination is a fact of life for many groups of people, but to be honest, I never really gave much thought to discrimination growing up. It wasn’t until I became disabled when I was 14 years old when I finally understood what discrimination meant. It meant not only being misunderstood, but being rudely mistreated. No one truly understands what discrimination is until they’re on the receiving end of things.

To say it has been a real wake-up call these past 20 years of disabled life would be a huge understatement. My goal however has always been to be grateful, not bitter, about these discriminatory occasions. Wisdom can be found everywhere too and there are a handful of things you tend to run into daily. I’m sure you’ve experienced many of these hundreds of times if you have a disability.

For some keen insight into real life with a disability, here are seven examples of the most common examples of discrimination people with disabilities experience every day.

Store employees assuming we’re stupid.

shopping wheelchair

Go to the grocery store, the movie theater, a store in the mall, a restaurant or any public-type place that has employees, and five times out of ten you’ll run into an employee who will automatically assume you’re ill-equipped mentally because of an obvious physical disability.

This happens to me constantly, especially if I’m at a grocery store with an able-bodied friend. Every time at check out, the cashier will always ask my friend if she wants paper or plastic, directing all her questions towards her, never assuming I’m the one who’s paying. Very, very frustrating.

Taxis passing us by.

taxis nyc

If you live in a big metropolitan area like NYC, chances are you’ve experienced taxis passing you by quite often. People with disabilities constantly complain that taxis pass them by when they’re out on the road trying to hail a cab. Taxis frequently avoid passengers with physical disabilities, not wanting to deal with our extra needs, seeing them as a headache and not looking at us as an equal customer.

Little do they know that we do not demand their assistance. Anyone with a disability hailing a cab solo can likely handle the entire transfer on their own.

Stairs in public spaces.

stairs wheelchair

You go to grab a coffee or meet a friend for lunch, but wait — you can’t get in. This is architecture discrimination at its finest and we encounter it every day. Despite the misguided notion that certain buildings are grandfathered-in to the ADA and do not need to be accessible, umm no, they do. Any public space must.

That means any store, restaurant, hotel or bar needs to meet all the ADA requirements. The sad part is how so many owners simply don’t care and choose to blatantly discriminate. Clint Eastwood’s refusal to make his hotel ADA accessible goes down as the worst.

Wheelchair “quotas.”

person in wheelchair sad

“Sorry, no more wheelchairs allowed.” Concert venues, airplanes, city buses, amusement park rides — quotas on how many wheelchairs are allowed in certain places are a reality of disabled life. They’re instated for safety, but they’re also highly limiting, generally only allowing a half dozen people with disabilities or so into an event or two people who use wheelchairs on a city bus.

These rules can be highly limiting, forcing us to change our plans. Very often when I try to buy tickets for a show, the wheelchair tickets have long been sold out, leaving me no option but to not go. While this isn’t considered illegal discrimination, in my eyes it is just as bad.

Strangers pretending they don’t see us.

disabled person ignored

Once in a while you’ll run into someone who’s not very pleasant. Maybe they’re budding in line in front of you, or avoiding your gaze when you’re looking for someone to help you grab something from the shelf. These folks like to pretend they don’t see us, thinking it’s easier to do that than just interact with us.

This also will happen in a crowd when people are trying to get past you. Moms with strollers are the worst. They will ignore you just so they don’t feel bad about ramming into you to get where they’re going.

People taking our parking spots.

handicapped parking spot

It happens all the time — able-bodied individuals parking in handicapped parking spaces. The convenience is just too hard to deny. And while this is all fine and dandy when it’s in the middle of the night and there’s no one else at the store, they generally take our spots in the daytime, especially the good ones that have extra room for our ramps.

Whatever you do, don’t let these daily discriminatory occasions bring you down. Patience is huge in the life of a wheelchair-user, especially if you want to survive and do so with grace. Discrimination may even be your reality for upcoming several years. However, if you can use each time you discriminated against as a learning opportunity, then you’re on your way to true success.

Tim Noakes – The Idiot’s Guide to LCHF and Banting

By Marika Sboros

Some doctors and dietitians will still tell you a low-carb, high-fat (LCHF) diet is dangerous. That’s despite compelling evidence to show safety and efficacy of LCHF for weight loss, diabetes, heart disease, cancer and even dementia.

LCHF is a global phenomenon. In South Africa, there are more than three million “Banters”, as fans of LCHF regimens are known in that country. Banting pioneer is University of Cape Town emeritus professor Tim Noakes, a world-renowned scientist and medical doctor. Here, in a Q&A, Noakes gives the basics and an Idiot’s Guide to getting started on the LCHF path.

Is LCHF a diet?

No, it’s a lifestyle.

Is your diet’s right for everyone – a one-size-fits-all?

There’s no such thing. No diet is right for everyone. LCHF is best for people with insulin resistance (the inability to tolerate carbohydrate).

Is it correct to call your diet “Banting”?

It’s probably more correct to call it Ebstein – after German physician Dr Wilhelm Ebstein who first made it high-fat. That was the diet Sir William Osler promoted in his monumental textbook: The Principles and Practices of Medicine,published  in 1892.

Is LCHF a fad?

Anyone who claims Banting or Ebstein diets are fads knows nothing about medical nutrition history. Nutrition did not begin in 1977 as our students seem to be taught.

Is LCHF the same as Paleo?

The Paleo diet is slightly different. It promotes consumption of only those foods that would have been available to Paleolithic man from about 2.5 million years ago to the Agricultural Revolution starting about 12 000 years ago.  Foods allowed on Banting but excluded on Paleo are dairy. Paleo allows fruits but Banting excludes many.

What about Atkins?

The Atkins diet is similar to Banting. Perhaps Banting promotes the use of low-carb vegetables rather more than Atkins did, but the differences are trivial. This shows that (i) first priority, and the commonality of all these diets, is to cut carbs and sugar (and vegetable oils) and (ii) whether you go Paleo or Banting or Atkins is determined by how you respond to the different options in the different diets.  To find the ideal low-carb diet you need to experiment to see how you respond.

PandaIs LCHF extreme?

It depends what you mean by extreme. Moderation is a smug, puritanical word. No mammal eats in moderation. In nature all diets are extreme: lions eat only meat, polar bears mainly fat, panda bears only bamboo shoots, giraffes only acacia leaves.

Is it balanced?

Balance is what has worked for each of these species for millions of years. LCHF can be extremely low in carbohydrate – the one nutrient for which humans have absolutely no essential requirement, but that depends on how sick you are. In 1977, when we were told to eat diets extremely high in carbohydrates, human health started to fail globally.

Your recommended carb range is <200g to <25g, correct? What are the indications?

It depends how insulin resistant you are and how much exercise you do. If you are completely insulin sensitive (that is, you tolerate carbohydrates well, have low fasting blood glucose, insulin and triglyceride concentrations, low small LDL particle numbers; low HbA1c; high HDL-cholesterol concentrations; and absence of fatty liver) and exercise regularly a few hours a week, then it is can be safe to ingest up to 200g carb per day, or at least until your HbA1c rises above 5.5% . That’ll be time to start reducing the carbs.

On the other hand, if you are profoundly insulin resistant with type 2 diabetes, morbidly obese, or with heart disease, cancer or dementia, you’ll probably do best on a very low-carb  diet of about 25 grams carbs per day. This won’t  change even if you do more exercise. Exercise is helpful but doesn’t obviate the need to eat very few carbs, even if you exercise for many hours a week.

What carb-fat-protein ratio is best?

It depends how sick you are. If you’re diabetic, we say 20% to 30% protein, 60% to 70% fat, 5% carbs. The sicker you are, the more fat you need because fat is insulin-neutral. The more insulin resistant you are, the more fat you can eat, because even when the pancreas fails, fat is the only fuel you can metabolise safely without requiring insulin. It’s perfect for blood sugar control.

Any weighing of food on your diet?

No. That’s a joke. You can’t predict accurately the absolute calorie content of foods when eaten by humans. You don’t know how many calories each person needs. The only way to work that out is by weighing yourself. If your weight stays stable, you’re eating the same number of calories you are expending. If you’re lean, that’ll probably be the correct number of calories for your body and activity level. There’s no other way remotely accurate enough to measure your calorie needs. We don’t tell people how many grams to eat daily, except for carbs. If you are really sick or markedly insulin resistant, the key is 25g maximum daily.

Raising SuperheroesIs Banting (LCHF) dangerous for babies?

No. It’s common in many traditional societies such as the Inuit in Canada, the Maasai in Kenya. The choice between health and ill health begins with infants as soon as they’re weaned. Babies should not be weaned on to traditional high-sugar, high-carbohydrate processed cereals. The science behind it is in our book, Raising Superheroes.

What does LCHF mean for infants?

Meat and veg because these foods optimise brain development. The infant brain grows at a fantastic rate for the first two years of life. The only way to optimise that growth is foods high in what are called brain-specific nutrients. These are found in highest concentrations in real foods, especially seafood and shellfish, but also in dairy, eggs, liver and meat. They are not found in high-carbohydrate, high-sugar processed foods. Meat, liver and fish alone are babies’ first foods in many traditional societies.

Is Banting for babies low-carb?

No, only compared to traditional high-carb, high-sugar, low-fat guidelines.

What’s all the controversy around ketosis – is it really so dangerous?

Ketosis is a perfectly natural condition in which the liver increases its production of ketone bodies (from circulating fats). Consequently, ketones can substitute for glucose as a fuel for the muscles, heart and brain. Ketosis from intermittent fasting is probably the natural human state. Indeed in the 1500s, Europeans typically ate once a day, not 3-6 times as we now do. We are beginning to realise that ketones have many other beneficial effects beyond simply providing an energy source to replace glucose. Researchers are studying these effects and adding further evidence for unexpected medical values of the low-carbohydrate diet.

Are there different forms of ketosis?

Yes, two important forms of ketosis: nutritional ketosis and diabetic ketoacidosis. They are polar opposites. Nutritional ketosis is one of the most important adaptations in the human body. It allows humans to survive periods of starvation without destroying their brains (from a lack of blood glucose supply). It develops when dietary carbohydrate (and protein intake) is restricted and fat intake is greatly increased in persons who continue to secrete some insulin.  Therefore, those are ones who don’t have type 1 (insulin-deficient) diabetes.

Nutritional ketosis is very different from diabetic ketoacidosis. Ketoacidosis occurs in persons with insulin-deficient type 1 diabetes and who are unable to produce even a trace of insulin. It is a life-threatening condition. The treatment is replacement of insulin and correction of the other metabolic abnormalities including the severe acidosis.

How best to define and differentiate nutritional ketosis and diabetic ketoacidosis?

By the levels of blood ketones that occur in either condition: in nutritional ketosis values are seldom greater than 1-2mmol/L and there is no acidosis; in diabetic ketoacidosis, blood ketone values can go as high as 30-50mmol/L (with an associated and life-threatening acidosis).  Remember, the ketones are not the danger here; the acidosis is.

How can people get into nutritional ketosis?

To get into nutritional ketosis, you need to reduce your carbohydrate intake to 25g/day, eat less protein and lots of fat.  The easiest way to reverse nutritional ketosis within 15-30 minutes is simply to eat some carbohydrate or protein.

Is saturated fat ever a health threat?

It can be, in the presence of a high-carbohydrate/sugar diet that causes elevated insulin concentrations due to the excessive carb intake. Insulin directs an altered metabolism with the formation of the damaging oxidised (LDL) cholesterol that’s probably a key component in heart disease.

What’s the key here?

To eat a diet that keeps blood insulin and glucose concentrations low. That’s because elevated insulin concentrations especially are linked to long-term health problems. We say: eat what your appetite directs you to. Once you cut the carbs we think your brain will tell you if you need more fat or protein. It’s about finding the balance that works for you.


Real Meal RevolutionOn to LCHF fundamentals: what to cut out?

Bread, potatoes, rice, pasta, pizza, sugar, all grains, cereals, processed, packaged, boxed, adulterated foods, cakes, sweets, biscuits, fizzy drinks, all the addictive things. Anything sweet, starchy has to go,  and low-fat foods.

What stays in?

Fat and protein. You can eat fat in relatively unlimited amounts, but only moderate protein. A healthy high-protein diet for humans doesn’t exist. If your diet was 100% protein, you’d get sick and die. You can’t really overdose on fat; it reduces appetite; it’s the best way to get over sugar addiction.

What are good protein sources?

Eggs, full-fat dairy, cheese, yoghurt, fish, chicken – with the skin, not battery fed –  and some meat, preferably organic, or at least pasture-raised, not from animals raised in feed lots and fed grains because that destroys the meat’s quality. Meat’s not a main focus, but we like lamb because it’s fatty and pasture fed. Boerewors is fine but without cereal in it, and bacon, preferably not very smoked.

And good fat sources?

Butter, cream – ladle meat and veg with butter; put cream in tea or coffee. Coconut oil is very healthy, everyone should have two tablespoons daily. Avocados, nuts – almonds, walnuts, pecan nuts, especially macadamia nuts, they are like drops of fat. All tree nuts, not peanuts or cashews. They’re legumes, not nuts.

What about vegetables?

All vegetables have carbohydrates; we recommend those with lowest-carb, highest-nutrient content: leafy greens such as kale, it’s one of the most nutritious vegetables; cauliflower, broccoli, they’re on our green list – (in The Real Meal Revolution).

What about 5-a-day fruit and veg?

It’s unscientific advice.

Is it possible to be an LCHF vegetarian?

Yes, by eating a high-fat version – by including nuts, avocados, dairy and other safe oils, like olive oil. But, please, no “vegetable” (seed) oils as these are highly toxic. The problem for vegetarians and vegans is if that they are insulin-resistant, their high-carbohydrate vegan or vegetarian diets could cause weight gain. It could also worsen insulin resistance with time.

Is it possible to be vegan on LCHF?

Well, I know a vegan athlete, a former professional cyclist who eats 80% fat in his diet. He ate lots of coconut oil and avos. It’s an extreme diet that works for him. Clearly, his gut flora can handle it. I know someone who eats only raw meat. We don’t know what the bacteria in their guts are doing, and how those bacteria might compensate for what we might perceive as intake “deficiencies”.

Some people won’t lose weight on LCHF even when they follow the rules rigorously. Why?

The key to obesity control is to understand the role of the human brain homeostat (appestat) that controls energy intake and energy expenditure. For millions of years, the appestat worked perfectly, exactly matching how much we ate to exactly how much energy we expended each day. The controls are so exquisite they must be accurate to within a few calories per day. If not, no human would ever be weight-stable for any length of time.

The appestat works so that if you exercise less on one day, you don’t become fat the next. You simply eat less and maintain the same body weight. Conversely, if you exercise more, you don’t lose weight, you just eat more.  Unfortunately, the appestat doesn’t work the other way: if you eat too many calories (because highly addictive, sugar-rich foods have hijacked the appestat) the appestat doesn’t force you to go out and exercise off those extra calories.

So what’s the real magic of ‘Banting’?

The reason  Banting  works so effectively in so many is because it quietens the appestat so that calorie consumption drops without hunger and weight is lost effortlessly.  In most people, the reduction in daily calorie intake is probably in the range of 10% to 50% of daily calories, again without hunger. For some, especially women who have experimented with many different diets over the years, this doesn’t happen. Their appestat function has perhaps been “damaged” by years of calorie restriction and hunger; instead of reducing calorie intakes on LCHF, they actually increase their intakes and gain weight.

In some it seems that instead of producing greater satiety, increased fat intake actually increases hunger, so they eat more and gain weight. The key may be to increase protein intake and reduce the fat intake.  Some believe that dairy is especially fattening for this type of individual.  It is also important to move progressively to eating less frequently so that at most, you eat one full meal a day with much smaller snack-type meals in between large meals.

How much weight is safe to lose quickly?

Most of those who try Banting respond positively and lose sometimes unimaginable amounts of weight. The greatest amount reported to me has been 150kg!  Billy Tosh in Cape Town set another record by losing 83kg in 28 weeks – no one else I know has come close.  These people do it by increasing their fat intakes, cutting sugar to zero grams per day and limiting carbs to less than 25 g/day. To achieve this they have to cut out essentially all processed foods and start cooking for themselves.

For those with abnormal appestat function not corrected by carbohydrate restriction, it may be necessary initially not to eat too much fat and to focus more on increasing protein intake and eating less frequently by practising some degree of intermittent fasting.

You’re a fan of intermittent fasting?

Yes!  The damaging effect of eating carbohydrates is that it produces an insulin response which is exaggerated in those with insulin resistance. Worse, we now know that every time you over-secrete insulin, your body becomes slightly more insulin resistant.  Intermittent fasting does the opposite – by reducing the frequency with which you secrete insulin, intermittent fasting reduces the probability that you will develop worsening insulin resistance leading to type 2 diabetes.

What about alcohol?

It’s a toxin, and slows weight loss on LCHF regimens significantly. We say: first lose weight, and  reintroduce alcohol in small amounts if you must. LCHF is a fine line. Thus, if you don’t fall on the right side of the fat, protein, carb ratio, just one apple, a beer or two glasses of wine will put you on the wrong side. In that case, you won’t enjoy the benefits you should from cutting carbs.

No sweet “cheat” treats at all?

A small piece of dark chocolate is fine, but many people can’t eat just one small piece  – like smokers who can’t have one cigarette. However, the key is to get sugar out the diet. People don’t understand how addictive sugar is, or what it actually is – not just sucrose, the white stuff. If you can get people down to 25g of carbs a day for a few months with no added sugar, the brain no longer searches for sugar. That’s what makes our diet so successful.

And best snacks?

Nuts, biltong, cheese, coconut – I love coconut chips best of all – and full-cream yoghurt.

Are “cheat days” on Banting really so bad?

Again, it depends on your level of insulin resistance and degree of sugar and carbohydrate addiction.  The worse your  insulin resistance, the more damaging each cheat day will be to long-term health. That’s because each day increases your level of insulin resistance.  If you have a sugar addiction the cheat day ensures the addiction will continue. The analogy is to smoking or drinking. because no addict can continue indefinitely to smoke or drink “in moderation” or on a cheat-day.

Is LCHF only for the rich?

No.  Our Eat Better South Africa campaign shows it’s possible to Bant by eating foods that are as cheap as the cheap high-carbohydrate, highly-processed foods that are currently the sole option for many of the poorer South African communities.

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Why some people don’t lose weight when Banting

There is no doubt about it, banters lose weight more successfully and sustainably than anyone on any other diet. However, some people do struggle, and there are many reasons for this, the main one being that like a stowaway on a ship, hidden carbs are somehow sneaking into the diet whether the dieters know it or not.

Without becoming obsessive, there are a few things you can eradicate if you find yourself in this situation. The below are common mistakes:

Eating hidden carbs

Good places for carbs to hide include sausages (rusk, soya, wheat, sugar etc), all processed food (that’s why real food is so important), and even things like biltong can be full of sugar, soya powder and corn flour. So make sure you know what you are eating. If your butcher doesn’t give you a straight answer on what other than meat and fat goes into his sausages, get a new butcher who will.

If you’re struggling, drop the dairy for a while. You might just find the results you were looking for start to happen immediately

Overdoing the dairy

Dairy products appear to be fine for people who have very little (such as a cup of tea daily with a splash of milk, or a piece of cheese twice a week), but the sad truth is that dairy is delicious and it is easy to eat too much. Yogurt for breakfast, cheese for lunch, numerous cappuccinos throughout the day (with cream!), tea with milk, latte’s, smoothies and low carb cakes and desserts. Dairy has a fair amount of lactose present, and it appears to spike insulin disproportionately even for the amount of lactose present. What this means is that you will not burn fat if you have even a reasonable amount of dairy. If you’re struggling, drop the dairy for a while. You might just find the results you were looking for start to happen immediately.

Overeating nuts

This is another stumbling block. Nuts are fine and good – but when you overeat them, you definitely will slow weight loss or even put on weight. They are delicious, we know, so take your (our) weakness into account and when you divide nuts, break them into portions form the get-go so you know what amount you can have each time. That way you have no excuses to give yourself if you overeat nuts.

Trying to go low fat and low carb

This doesn’t work. Low carb diets require high fat diets for fuel, or you will be constantly hungry and end up overeating or resorting to carbs to satisfy your need for fuel. The body can only burn carbs and fat – if you restrict carbs, it has to burn fat. Give it both, and it will store the carbs as fat.

Eating fruit

No, fruit is not essential to life, and in effect, is just another way to carbo-load. It’s full of sugar and will cause insulin to shoot up, thus storing the sugar as fat.

Eating too often and eating too much

When banting, the idea is not to eat as much as possible of the green listed foods. We all eat too much food, and the idea is to eat just as much as you need, no more. You need to fight your body’s primal instincts to store up on food for the next Ice Age. In time, you’ll find you can exist well on much less food, even just one or two meals a day. Eat to hunger, not routine.

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Not eating enough fat or protein

By going too low on either of these you will become hungry, and the whole thing will start all over again. But fat and protein take longer for your body to process, leaving you feeling satiated for longer after a meal, whereas carbs give you a spike and then a low.

Eating ‘Red Foods’

A lot of red listed foods may not contain carbs but will contain other things that inhibit weight loss. Be sure to avoid any red listed items at all costs. Soy, for instance, is really unhealthy and causes weight gain (even though it is low in carbs). If you’re a bloke, it also results in a bunch of weird hormonal changes (oestrogen production, testosterone reduction etc) so it’s best avoided.

I’ve been banting for a month now and haven’t lost any weight. I found this article which might help people in similar situations.