Surviving Die-Off

Generally, we want to limit die-off to what our body can process and move out. This means moving toward GAPS gradually, adding probiotics only after the initial stage of the diet’s die-off has passed, starting with tiny amounts of probiotics (including probiotic foods), for example, not more than 1/10th capsule of BioKult, and working up very slowly, etc.

Where acute die-off does occur, the following will make a big difference:

  • enemas
  • rotated detox (die-off relief) baths
  • avoiding probiotics and probiotic foods until feeling better
  • staying hydrated (electrolytes, not just water)
  • lots of rest
  • fresh air (open windows or sit outdoors)
  • gentle exercise (walking) in fresh air.

In extreme cases, where the die-off feels truly intolerable, activated charcoal (AC) can be considered. Purchase this from any health food store and follow the directions on the bottle. Because AC will absorb not only toxins but also nutrients, limit use to ‘as needed’.

Please do not underestimate the importance of these supports. During die-off, the body needs help to stay well. Think in threes: Three die-off relief baths; three hours of fresh air; three hours of rest in the daytime; 1-3 bowel movements; etc.

93 Replies to “Surviving Die-Off”

  1. Baden,

    I have been doing GAPS starting with the intro for nearly 6 weeks. I had begun eliminating many foods and introducing pro-biotics several weeks prior to that. I am not using dairy and started this diet due to being diagnoised with Leaky Gut. With my initial introduction of probiotics I experienced a significant rash that lasted about a week. I also experienced diarreah. I am about through the intro and feel good. I have kept fruits extremely limited (none a day to one) and have not introduced honey or sweets. I had sucessfully increased the Bio-Kult to 4 capsules and had fairly normal stools (for me) for nearly a week or more.

    On the 30th of October I added a 5th capsule. (I have always increased by one cap. at a time before with little problem). However, starting Nov 1 I have had daily diarreah, though often my first stool is normal. This is not a normal thing for me. Perhaps occassionally, but not daily. I do not feel sick. I do feel hungry. I am not tired. I am hydrated. I am continuing lots of broth and intro foods and I have cut back on the fermented foods. So my question is this… Is this most likely die-off? If so, should I press on since I feel okay and how long should I expect it to go on? For the first few days I looked carefully at my food journal and tried to make a conection to something I ate but nothing stands out.

    Also, if this is die-off and I feel okay can I keep eating all the foods that I have already successfully introduced? I feel discouraged and don’t know if I should. I had felt very encouraged by the foods I had been able to introduce and now this makes me wonder if I am doing more harm than good.

    I would really appreciate any comments or suggestions you have.

    Thank you,
    Heather

    • Hi Heather,

      Even though you have had success moving up by one cap at a time previously, I would suspect this as being the culprit this time. Most people need to increase by only 1/4 cap at a time *and*, when starting intro, start their dosages from scratch. Intro is a very sensitive time for the body.

      I would back down to the four caps and increase by only 1/4 cap, not more than once a week, from this point forward.

      Also, do you know about the Yahoo support forum? See the link in this site’s navigation.

      Sincerely,
      Baden

  2. Thanks. I’ll give that a try. But once you empty a cap. how do you evenly split it into quarters? I’ve been hesitant to try and split them.

    Heather

  3. In your post “Surviving Die-Off” you mention 1-3 activated charcoal. Will you please describe the best way to take the activated charcoal? I’ve been on phase 1 of the intro diet for 7 days and I feel so sick after every meal. My meals are consisting of Bone broth (chicken or beef), chicken or beef, carrots, and onion in a soup. I take a digestive enzyme with my meals and a CLO/BO capsule after my meal when I remember to take it. That is all I am eating. I’ve started taking activated charcoal after I eat when I feel sick, but I’m afraid it may be absorbing the nutrition I’m trying to get from my food and the CLO/BO.

    I just got your book a couple of days ago and I’ve read most of it. Thank you for being the voice to help so many of us.

    Carol

    • Hi Carol,

      What is BO? Did you mean BK? I would not recommend it during the initial wave (from Stage 1) of die-off.

      Are you having at least one bowel movement daily? If not, please use an enema to ensure this. This is the primary approach to relieving die-off.

      Also, are you doing daily die-off relief baths? These can offer incredible relief.

      The “best way” to use activated charcoal is: if safe for you to do so (no contraindications), and very minimally/rarely. Not after every meal. In the rare times of use, simply take according to the directions on your bottle, starting with the lower dose recommended and seeing how that works out.

      Also, you must move forward on the diet. 1-3 days for most people, 7 if diarrhea, cramping or intestinal bleeding then move on.

      Best,
      Baden

  4. Hi Baden,
    Thank you for getting back to us so quickly. BO is Butter Oil. I am taking a cod liver oil and butter oil blend in a capsule after each meal.

    I am taking die-off baths. They do seem to help, but I can not take daily epsom baths as I became very ill with symptoms of dehydration the morning after my second bath.

    What I am *most* concerned with right now is moving forward…you say I must move forward on the diet, and I want to but am unsure how to proceed. I’ve been on stage 1 for eight days and I am still having type 5 BMs. (soft, formed but loose) With these BMs is it OK to move on? Or do I stay where I am until I have a type 3 BM? What are the determining factors that allow moving to the next stage? I tried egg yolk (but the soup was so hot the yolk cooked in the bowl) and it made my bowels loose, so I went back to stage 1. Then I tried ghee and still have loose BMs…back to stage 1! What do you think?

    Thank you,
    Carol

    • Hi Carol,

      Every nutrient-dense food (CLO, BO) will contribute to die-off. Stop those for now.

      Die-off baths are to be rotated. One must not take the same type of bath every day.

      Yes, move forward. Seven days is the max on Stage 1, and since you have no diarrhea (diarrhea is more involved than Type 5 stools), cramping or bleeding, you would ideally have moved on after 1-3 days.

      You move forward until a food shows you a distinct reaction. If a food gives you a distinct reaction, you stop it, wait a few days, then move on to the *subsequent* food listed.

      With loose stools, avoid fibrous, cold and very acidic foods –cabbage, broccoli stalks, etc.

      For all of this information and more, please review your GAPS Guide – it is all in there.

      Also, I won’t be available for several days. For any further assistance, please be sure to check out the ‘implementation’ support group linked under the ‘support’ page in this site’s navigation.

      All my best,
      Baden

  5. Thank you Baden. If I was well enough I would see you at the Wise Traditions Conference. I know you are the perfect speaker to take Natasha’s place. Hopefully I’ll be at the conference next year!
    Carol

  6. Baden,

    You mentioned activated charcoal in your previous comments for ” Surviving Die-Off? What is this? I have never heard of it. Is it mentioned in the NCB book somewhere?

    Also, my daughter is going through die-off, we think. She is very irratable all the tiime, noone can please her, which is not her norm behavior? Have you heard of this behavior being die-off? We removed the pro-biotics and pro-biotic foods today.

    Thanks for your advice.

    Jackie

    • Hi Jackie,

      AC is an absorbent. For detailed information about AC and its uses, you can Google it or ask at your local health food store. Because it will also absorb nutrients, it should not be used more than necessary.

      Yes, irritability is a very common die-off response. I recommend doing the items suggested in this post, especially the die-off relief baths. (Type baths into this site’s search engine to find a post on that.)

      Jackie, I strongly recommend you join the Yahoo Support list. There your questions will be answered more quickly, by a number of people who have gone this journey, on any given day.

      Best,
      Baden

  7. I know it has been some time since these comments were made, but I hope someone will read this and respond.

    I am into my 3rd week of the GAPS diet (stage 1 with some ghee on the side). up till now the only die-off I have had are headaches and fatigue(and they have pretty much passed). Two days ago I took half a probiotic capsule and the other half today. Starting yesterday I have a cluster of red pimple rash like bumps that ich with varied intensity.
    Then today the same type of bumps and ich is under my breasts and on my neck at the base of my hair line.
    There are also a few bumps in the arm pit area.
    I am worried about scabies(we stayed at a hotel a short time ago).
    So are these ichy red bumps die off or could it be scabies?

    Sidra

  8. Hi Sidra,

    Yes, these bumps are very likely die-off. I say this because we commonly hear of people experiencing exactly this upon starting intro or upon introducing or increasing probiotics. To *rule out* scabies, you can ask a doctor to examine you.

    If you are taking Bio-Kult (I’m not as familiar with the strengths of other commercial probiotic formulas), I recommend in GAPS Guide that an adult start with 1/4 capsule per day, and a child 1/10th capsule per day, increasing by those amounts not more often than every 4-7 days.

    If you want to check in with others who have experienced exactly this symptom, you can post to the support list. Because most people on this very busy list cannot read all posts, use a very specific subject line, like ‘itchy red bumps – die off?’

    Best,
    Baden

  9. Baden,

    I have been doing the GAPS diet for about 3 weeks, skipped intro. I doing some honey and butter with normal stools. I have been feeling very tired with dizzy-ness, light-headedness, some nausea, and just overall drugged and foggy. These are symptoms I had prior to starting the GAPS diet and I am thinking they are worse and resurging because of the GAPS diet. My question is, do you agree and if so do I wait until they pass for a certian amount of time before I begin the probiotic?

    Also my 2 boys are on the GAPS diet as well, one with Asthma and one with general stomach issues. How do I know when to begin them on the probiotic as well?

    Thanks,
    Kelly

    • Hi Kelly,

      Yes, it is common for the symptoms that brought us to GAPS to resurge after starting, and during every subsequent round of die-off. It is temporary. The symptoms you describe could well be die-off.

      I suggest the following, in progression:

      1. Follow the steps here: http://gapsguide.com/2009/10/01/surviving-die-off/
      2. Do intro (keep your boys on full GAPS).
      3. Allow Round Two of die-off to alleviate.
      4. Start Bio-Kult at 1/10th cap.
      5. When you are feeling well, put your boys on intro.
      6. After their initial round of die-off eases, start them at 1/10th cap BK.

      All my best,
      Baden

  10. Baden,

    Thank you this is great advise. When I started GAPS I was just going from the original book and did not really know about the intro, I am glad to know I can go back to it midway through GAPS and it does make sense for me to do intro and wait to do it with the boys. As it is doing this program is time intensive and challenging to adjust to. I did GAPS a year ago but did not stick with it. But now that the whole familiy is doing it, it feels so much more do-able. Plus we had been doing dairy free and gluten free before with all organic and very limited sugar so this has not been a radical shift for us.

    I started the guidebook last night and had a hard time putting it down! so much great info in there. Thank you for putting it together for the community.

    Kelly

  11. Baden

    The past 2 days I have been having shortness of breath and skips in my heart beats, I’d say palpitations but it is rather skips. It is pretty bad, any activity makes it worse. I am lightheaded and dizzy and have a hard time catching my breath. This is very scary and I don’t know what to do.

    Please any advise will help. Activated charocol?
    Kelly

    • Hi Kelly,

      Any issue that concerns or scares you, please bring to the attention of your doctor, to rule out anything serious.

      In the meantime, please stop any supplements and ensure you are hydrated (which involves electrolytes, not just water).

      All my best,
      Baden

  12. Hello

    I’ve been reading the GAPS book by Mcbride and whilst I’m keen to put my son on it (who is 3 years old and has severe eczema) I don’t think I can cope with it just yet. So I’ve been trying to improve our diet for now and introduce fermented foods/grains/sourdough/yoghurt etc and hope that if we’re still having problems, then it will be less of a big step to do the GAPS diet later.

    My problem is probiotics! I’ve bought Bio-Kult to give my son (and I’m taking it myself). I started him on 1 capsule a day for a couple of days but his eczema got VERY bad. So I cut him down to half a capsule on Sunday but the eczema is still very severe. 🙁 I’m wondering what to do now! Do I need to stop it completely? Or go down to your recommended 1/10 dose? I had no idea I was giving him such a huge dose to start with, until he got an undefined rash on his tummy and the eczema all over his body got totally out of control. My biggest problems is how to control it now. He scratches very badly, so had open wounds everywhere (and will probably end up infected) and we always have to go over to steroids/antibiotics just to calm things down so he’s not dripping with blood! So I’m wondering if I need to stop the probiotics and perhaps have to use steroids to get things under control, and then start the probiotics again very slowly once things are going OK again.

    If you can give me any advice, I’d very much appreciate it! I’m getting rather desperate with the state his skin/health is in from the probiotics – it’s made him look very ill really.

    Thanks,
    Rachel

    • Hi Rachel,

      Your plan for dietary transition is very sound, yes!

      In terms of the eczema, please:

      1. Stop the BK.
      2. Read, and apply the tips from, this post for tips on addressing the current state:
      http://gapsguide.com/2009/05/23/eczema/
      3. After his skin has cleared, start him on maximum 1/10th cap of BK, as recommended in GAPS Guide. (You can hold off on that, too, using just fermented foods until his body can cope with more.)

      If he needs steroids or antibiotics to address infection, don’t worry about that. Do what you need to do for him and proceed with GAPS from there.

      All my best,
      Baden

    • Hi Rachel
      I have a son similar to your son’ s condition .
      I am planning to do gaps diet for him.
      I wonder how is your gaps journey going now? Is it successful?
      How is it son now?

  13. Meant to thank you sooner for your prompt & helpful reply. I’ve stopped the probiotic and have been using various medications to try and bring the eczema back under control. So hopefully when he’s a bit more stable I’ll be able to try again. It was odd how his eyes looked the way they do whenever he reacts to eggs about 12 hours after eating them – I guess it’s when they’re being digested, so likely gut related, I think – (yet this was from the probiotics). But thankfully they’re looking clear again (no more purple/flakey skin around his eyes). Just hoping the hands can recover, tho that is where we’ve struggled all winter!

  14. Hey, Baden,
    We’ve been on the diet for 3 + months and depleted our first batch of BioKult. I read on the Yahoo website that some people had great results with a probiotic from Custom Probiotics. We checked and the price was considerably lower than BioKult. So, we ordered it. It has 11 strains instead of 14 (Biokult) but many more bacterial cells per gram. The recommended dosage is way more than we would get with therapeutic dosage of BioKult. We started with the child dosage (0.1 gram, 25 million cfus) and I think I’m having some die-off. My daughter-in-law is concerned that this brand might not be as good as BioKult because they recommend such a high dosage starting off (0.8 gram, 25 billion cfus). If we began with that dosage we’d be “dead with die-off”. Did we goof by ordering from Custom Probiotics? Just wanted your opinion. I fully understand your opinion isn’t “medical advice”; experience is an excellent teacher!! Some of the information I’ve gotten from that site isn’t accurate, e.g. GAPS legal bacon was not. Thanks for all you do to help! Since your Canadian I assume you won’t celebrate Thanksgiving…so, I’ll just say, “Happy Holidays”!
    Hugs!
    Orpah

    • Hi Orpah,

      I really can’t say, as I have no personal experience with any commercial probiotic other than BK. As detailed in GAPS Guide and referenced in comments earlier today, any conscientiously-made probiotic is fine; the key is more the range of strains, amounts, etc. I wouldn’t assume one is “not as good” because it recommends a higher starting dose; every manufacturer has different ideas. I go with Dr Natasha’s simply because my experience has taught me to trust her professional opinion.

      As noted in GAPS Guide, I recommend a child or sensitive (or very ill) adult start with 1/10th cap of BK, so 1/10th of 1 billion grams. If you can figure out what the equivalent would be in the CP brand, that’s what I’d go with. If having trouble at that dose or lower, implement lots of the die-off relief remedies outlined in GAPS Guide and, if necessary, reduce the amount of probiotic even further. (Some people can only tolerate the 10th of a cap diluted in water with a small amount of that water ingested, working up from there.)

      Up here we do Thanksgiving, just a few weeks earlier than our good neighbours to the south do 🙂 Thanks for your well wishes, and Happy Thanksgiving to you! May your feast be GAPSy and your reasons for thanks plenty!

      All my best,
      Baden

  15. I started the GAPS diet 6 weeks ago and went right to the full diet b/c the naturopath felt that since I’d been following the Wise Traditions diet for a year I could skip the intro. I am doing fine except am not having a daily BM. Before starting the diet 6 wks ago I’d been taking alo vera and slippery elm supplements to help with that (I have colitis which has been under control for the last year or so thanks to those supplements and low dose naltrexone). The supplements helped with regular BM but I had to stop them b/c I’m told they are contrary to the GAPS diet. I’ve done a couple of enemas for relief but don’t think that I should become dependent on that. So far I’ve tried morning juicing of carrots and other veggies, flax seed, sweedish bitters, prune juice. Nothing seems to be helping. I’m not doing any dairy or grains although I am toying with introducing some creme fraiche for more fat hoping that might help. Any suggestions would be appreciated.

    • Hi Mary,

      Definitely do the intro (when you’re ready), regardless of having done WAPF for a year previously.

      Your body won’t become dependent on enemas. Use them to ensure a bowel movement at least every 36 hours while you continuing healing.

      Without having done intro, six weeks is too early to introduce dairy, even fermented.

      The biggest key to resolving constipation on GAPS is (a) managing die-off, and (b) getting sufficient levels of probiotic to your gut.

      For ideas on resolving constipation, see pages 89-91 in your copy of GAPS Guide, as well as pages 87-88, as well as the chapter on baths the latter refers to. (Also be sure to review the ‘book updates’ page.)

      All my best,
      Baden

  16. Hi Baden,

    We had chatted yesterday on a different post. Thank you for all the great info. I went and got supplies for the detox bath today for my son, but I’m becoming more and more concerned about dehydration.

    My son is on day 4 of the into and today he does seem to be very hungry for the first time, but is still refusing to drink anything except carrot juice. He has switched on me. The first two days he was drinking but refusing to eat, now he’s eating, but refusing to drink, which has me much more worried. I don’t want my hubby to freak and take him to the hospital.

    I was just reading about the “electrolytes, not just water” portion of your response to me and I’m confused.

    I thought we were to be avoiding sugars and fibrous veggies at this point on the diet, but the recipes I saw indicated juicing apples, celery, etc. Can you tell me a recipe that I’m able ot use with him at this point…something I could find at a normal grocery store right away?

    I’d like to run out to the store and get him whatever is needed and something that he’ll accept. For the past 2 days, he’s refusing water and not taking much broth…only carrot juice.

    I’d greatly appreciate any recommendation to get some fluids in him. Thank you!

    • Hi there,

      Is your son showing any symptoms of dehydration? eg. Is he not able to pee regularly, etc?

      Plain water can dilute one’s electrolytes, which are needed to stay hydrated and well. Thus, hydration fluids, plus carrot juice and whatever amount of broth, may be serving him better than large amounts of water.

      In emergencies, we can override any point on GAPS to ensure one’s health. Thus, if your son is giving indication of dehydration, you can use any recipe (or medical intervention, if needed) to rectify that. The baking soda, sea salt, honey is a favourite of mine, but all are good.

      Again, I’m curious as to whether your son is showing signs of dehydration?

      All my best,
      Baden

  17. Hi there,

    Thank you for getting back to me. I thought i had prepared myself for die-off, but here i am at the end of day 4 and I feel like I’m already losing it:)

    My son is has been showing extreme fatigue, sadness, crying, and a cold for the past 2 days. My biggest concerns, though are the facts that he has not had a bowel movement today and teh dehydrati9on issue,

    Yesterday’s bowel movement was very small. I gave him a detox bath today with the baking soda and epsom salts, but still no bowel movement. Can i give him another baking soda/epsom salt bath tomorrow or do i need to rotate?

    In regards to the dehydration. I did get him to drink this evening. He’s had a total of 36 oz today. 1/2 broth, 1/2 carrot juice. Is this a normal amount? I’m getting the feeling he only wants to drink things if they are flavored with the carrot juice.

    My son doesn’t speak so I don’t know if he’s having any other symptoms of dehydration (circulation issues, etc), but i would say he hasn’t urinated as much as usual today.
    Would you recommend continuing to give him 1/2 broth 1/2 carrot juice of that’s what he’ll accept or do i need to come up with a different recipe. I’m guessing he’d accept the celery, apple, carrot recipe.

    • Hi bensoncria,

      Your son’s issues are all common in die-off, yes.

      Again, I’m not sure if you’re suspecting dehydration due to observation of actual physical symptoms of that or just because he might be drinking less than usual. If only the latter, I can’t yet see reason for concern. 36oz is over a litre, which is a substantial amount of liquid for a child. People have varying needs for liquid. Also, the author of Fibre Menace notes that it is partly the push for high-fibre diets that called for an increase in liquid intake. When we start eating lots of soups, broths, veggies, etc -all of which include much liquid- we naturally go for less water.

      If no bowel movement (small is fine) within a 36 hour period, give an enema, as set out in the GAPS Guide book.

      It’s best to rotate the type of detox baths. This gives the varying benefits of each kind, and preempts irritation from any one. (You can do the baking soda and epsom salts as separate ones.) ACV baths and epsom salt baths often help my son have a bowel movement.

      Personally, I would aim to move away from the sweet (carrot, etc) juices as sweets can perpetuate his issues. I would do regular intro with him and only use sweet electrolyte options if you have reason to believe he is at risk of becoming dehydrated.

      All my best,
      Baden

  18. I actually was very confused about the carrot juice. I know we are trying to avoid sugar and sweet things, but it was recommended for constipation patients at stage 2, so i went ahead and introduced it yesterday. Would you feel that i need to remain on stage 1 at this point, then?

    He’s starting to seem very hungry, but only wants mushrooms and chicken. Still refusing everything else. At this point would you also take away his chicken and mushrooms in an effort to starve him into wanting other veggies or should i move on to stage 2 and just trust that it will all even out in the end?

    Thank you again!

    • Hi criabenson,

      What happens in intro is that the body ‘resets’ and becomes able to eat a wide range of healthy foods. ie. The kids aren’t being “stubborn” and the method, then, is not to “starve” them into compliance. Rather, in doing intro just so, we reset the body for greater capacity and taste.

      Yes, Dr Natasha’s carrot juice remedy is suitable in cases of “stubborn constipation”, but I would consider stubborn constipation to be that which overrides all the usual GAPS approaches to that issue.

      No, definitely move ahead to Stage 2. My concern with carrot juice in your son’s case is that he is refusing everything but that. When a person is refusing all but sweet foods, often the only remedy (‘reset option’) is to remove the sweet one so that he can become able to take in more and heal, including around his constipation issue.

      It might help to offer a spoon of the mushroom/chicken dish for a spoon of other foods, ie. offer his preferred food as a reward for other ones.

      This said, yes, definitely trust that it will all even out! Well said! 🙂

      All my best,
      Baden

  19. Hi Baden! I have to tell you that you are SO wonderful taking the time to help everyone through this process – you have INFINITE patience. I mainly just wanted to tell you that and that you are greatly appreciated. I pray you are taking the time to continue to have your own times of healing – sometimes just taking a break from the computer and everyone and spending time for just yourself….
    Bless you!

  20. Hello there! I am so happy to have found your site. I have 27 month old twins who until a few weeks ago when we started the intro diet could not eat food at all. They have a condition called FPIES. It is sort of like an allergy of the gut. Thanks to GAPS (and Glory to God) they are eating pretty much all of the foods on stage 1 without the typical/normal FPIES reactions. We are stuck from moving forward though because the stools are becoming constipated and the skin is having a TON of rashy pimples. I am not sure if there is a way to treat the rashes or if we should be [c]utting back on some of the more healing foods or the probiotic food. The rashes did not really start on the broths, but went crazy when we added the veggies. Also is there something we are missing that should be added since they are becoming constipated?

    They are on:
    broccoli, cauliflower, carrots, peas, onions, leeks, garlic, zucchini, ginger (w/ little honey), beef, pork, chicken, buffalo, porgy fish, lamb, celtic sea salt, winter squash, and sauerkraut juice. They also take an amino acid based infant formula (this was their sole source of nutrition until recently).

    Thanks for the help!!

    • Hi Nichole and welcome!

      That’s awesome about your twins’ progress!!

      It’s very normal to experience constipation in early intro -I believe this to be due to die-off. Skin conditions are also very common in die-off/healing.

      Going cold turkey onto GAPS or intro, and adding in probiotics (or too much probiotics) very early, etc, can contribute to more die-off than the body can process. In your GAPS Guide book, please review the sections under constipation, die-off and probiotics for more information. If after reading those you have more questions, please do post again.

      It is essential that they have a bowel movement at least every 36 hours (see GAPS Guide section on relieving constipation, as well as section on enemas, with special considerations for children). However, even where there is constipation, please move forward with the subsequent foods (not supplements) in the program.

      Great to have you with us, Nichole!

      All my best,
      Baden

  21. Hello Baden

    Gosh what a good site – I’m very pleased to have found it.

    Could I ask you something? I’ve been doing the Intro for about 6 weeks now, after doing the full diet for about 3 months. I’ve been unwell for years, not knowing what was wrong and it’s taking me ages to proceed through Intro. I’m hovering between stage 2 and 3 and Ive been there a while. Recently introduced nut butters and egg yolks. It seems my body reacts to absolutely everything and often I can’t figure out what it’s reacting to. Yesterday I took 2 CLO capsules instead of the 1 I have been taking. My eyes became very sore, my throat in need of much clearing and I felt even more tired than usual (these are old symptoms). I also had a bad headache. Today is the same. In your experience, can taking just one more capsule of CLO bring about die-off like this (I’m assuming it’s die-off), or should I be looking elsewhere for the reason?
    Many thanks
    PP

  22. Also, and apologies for posting this here but I’m not entirely sure where to post it, the link for purchasing the GAPS Guide for those of us overseas appears to be broken. I’ve tried it a couple of times and it just takes me to a blank page.

    • Hi PP,

      Yes, I believe the second capsule of CLO may well be causing troubles for you. CLO is a profoundly powerful food and, as such, triggers reactions in a lot of people. As with all concentrated foods and products, it’s really important to start with a very small amount and work up very, very slowly.

      About reacting to so many foods, please watch for a post in the (hopefully) next few days or so. Briefly in the meantime, though, I suggest you move forward unless the reactions are (subjectively speaking) very troublesome.

      Thanks so much for letting me know about the link. I have now updated it.

      Great to have you with us, PP!

      All my best,
      Baden

  23. Hello again Baden

    Thank you very much indeed for such a quick reply. I’ll plod along with the extra CLO as you suggest – I don’t mind being ill if I believe it’s in the service of health.

    And I’m glad the link is posted – I can now order a copy of the guide.

    All the best
    PP

    • Hi PP,

      I suggest holding back on the extra CLO for now. With most healing stuff, more is not necessarily better and can, instead, simply overwhelm the body thus actually slow healing. I would stick with the dose your body has accepted happily, and increase by a small amount in some weeks.

      Thanks for ordering the book 🙂

      All my best,
      Baden

  24. Hello again Baden

    Oh, I think I must have misunderstood you the first time round. I’ll happily stop the extra CLO capsule for a few weeks and try again. Thanks for clearing that up.

    All the best
    PP

  25. Thanks Baden!

    I have not gotten the guide book yet, but will.

    It had been recommended to a friend of mine by a GAPS doctor to use avocado, honey and other foods on the skin to help with the die-off skin reactions. BUT she doesn’t know how it should be done. Do you know how that works???

    Thanks!

    • Hi Nichole,

      No, I’m not familiar with applying foods to skin to alleviate die-off skin reactions. Maybe someone else on here -or on the email support lists- will know.

      All my best,
      Baden

  26. Dear Nichole

    I have had a bad experience with rubbing food (oils/butter) into my skin. However I think it was due to a freak set of circumstances i.e. the treatment I was receiving at the time – IV Chelation Therapy.

    If you do try, just wanted to warn you not to continue if you experience any itchiness in your skin.

    I have not heard of anyone else having a bad experience.

    Regards

    Carol

  27. Hello Baden,
    I started the GAPS intro diet with my 8 year old son 5 months ago. We chose the GAPS diet because of irritability, anxiousness in his behavior, frequent colds, (monthly), and a small rash at his face. The Intro diet has been very successful. He has been much more relaxed, better in school rash left, and he has gotten sick less frequently.
    Though many foods, when we introduce them, do not seem to be working; almonds, peanuts, any form of dairy. This has been very frustrating for my son and the rest of our family to an extent.
    2 1/2 weeks ago he went on a 2 night overnight with my husband, his papa, and my husband let him eat not-GAPS food-wheat, lots of sugar, chocolate, dairy, etc. Well the rash came back as did the irritability. I am writing because those symptoms are still existing. His rash has not left, it sometimes seems better, other times worse. And he continues to be unkind to his sister and and more grumpy with others.
    I have done detox baths-mostly epsom salts and sc vinegar 2 times per week and some CLO and probiotics. I don’t use the bio-kult, just good quality store bought variety. He is eating fermented food.
    Are his symptoms still existing from 2 1/2 weeks ago? IS this die-off? Is it a combo? I feel that we have back-tracked quite a bit. What can I do to get him back on track? What do you think of charcoal for children? I have also heard of taking clay internally to remove toxins…
    Can you please advise me.
    Thank you

    • Hi Sarah,

      This situation must be very discouraging for you all! Your son will heal again, though.

      It’s impossible for anyone to say what the cause of the returned and persistent symptoms is. It could be any of the reasons you propose, yes.

      It is common for nuts and dairy to be a problem, especially for people fighting an especially strong candida overgrowth. For many, these need to be left out for several months.

      I would suggest you start by returning your son to his baseline diet (whatever early intro stage he did well at), giving a daily die-off relief bath, rotating those to at least three different kinds, and seeing how he’s doing after about four days on that. Please let us know where things are at then.

      I don’t have any specific information on AC for children, nor on taking clay internally. I only know that people have reported good results in both children and adults for both. In terms of safety, etc, I can’t say. A family would need to research this specifically.

      All my best,
      Baden

  28. Here’s my question: “Why try to control die-off?”

    The GAPS diet clearly recommends to add probiotics slowly to control the die-off reaction, and to go slowly to minimize die-off. After many hours of review, I have yet to find an answer to my question. Why?

    Aside from avoiding the discomfort of feeling ill, is there any reason? I’m an intense person, and if possible, I’d prefer to slam my body with the correct probiotics, clean the gut, destroy everything bad in my gut and just deal with the suffering. I’d like to get this overwith as quickly as possible, and just deal with the symptoms while they last.

    Is there any reason not to do this? After all, the ‘die-off’ sounds a lot like a healing crisis, and that’s a good thing.

    Thanks!
    Matt

    • I recently started looking into retroviruses since I have Lyme Disease and a large number of Lyme patients test positive for a “new” retrovirus. Some of this literature talks about how “herxing” (reaction to treatment that causes such large amounts of die-off and detox that the body becomes ill) can actually trigger inappropriate immune responses and open the body up to a lot of bad things…in this case the conclusion was concerning this retrovirus and becoming suseptable to it. I am still working on all of this research, but I have come to realize first hand with my children who have a rare condition which is very much based in inflammatory response – that you do not want to keep your body in this state and that you are simply supporting your body to go through the process safely and healthfully. More is not better. This is not just discomfort, but also your bodies’ need to process all this toxic waste.

    • Hi Matt,

      That’s a great question. Yes, die-off is the same as a healing crisis. There’s a few reasons to manage die-off:

      One is so that we don’t overwhelm our bodies: organs, intestines, etc. Our systems can only process so much at any given time. Overloading it with ‘clean up’ tasks can be hard on the body and even slow healing down.

      Another is so that we remain able to function. Intense die-off can bring on lethargy, vomiting (with the threat of dehydration), depression, etc. For people needing to work, parent, prepare food, etc, unmanaged die-off can wreak havoc.

      Another is for our psychology. Intense die-off is one thing to talk about, another to experience. Living it can frighten or discourage a person to the point that they give up on healing and never, ever want to move in that direction again. Being gentle with ourselves allows us to stay in for the long haul, which healing really demands.

      Another is for our learning. Moving through die-off as gently as possible allows us the opportunity to see where we might be reacting to newly introduced foods, etc. A moderate pace allows us to gather information we otherwise might not.

      These are the reasons I recommend a gentle, managed die-off.

      This said, for various reasons -no information about a gentler protocol available to them at the time, a severely ill body, a specific opportunity to focus 100% on health with no other demands, etc- some people have gone through months of intense die-off and lived to tell the tale. I truly applaud them for hanging in there to ultimately find awesome health, but for many people I would be concerned about the abovelisted aspects.

      All my best,
      Baden

  29. I just came upon this site and am very interested… My son was diagnosed with eosinophilic esophagitis approx. three years ago (at the age of 11) and, after going the route of steroids and neocate, jr., and being on the verge of needing a feeding tube, he became well by going low carb and taking supplements, including enzymes and probiotics… He is now, unfortunately, going through a recurrance of some symptoms of parasites, which is why I’m again in research mode…it is an absolute thrill to find this site…

    Anyway, my reason for leaving this comment was to present an option (if the website administrators agree) for the epsom salt baths… I have found that adding a small amount of coconut oil to the epsom salt bathwater hydrates the skin (and coconut oil is both anti-fungal and anti-parasitical)…

    • DJ,

      I’m happy you’ve found us! We’ve seen great results for EE on GAPS. (Check out the tiny reference to it in your GAPS Guide book, top of page 60.)

      Thank you for sharing about the coconut oil, too! GAPSters tend to be big fans of its healing properties.

      All my best,
      Baden

  30. Baden –
    Thought I would leave a post although yesterday I think that you said you were going out of town.
    Day 8 of intro and moving to using avacado since I didn’t handle the egg well… I think I was ok on yogurt but wasn’t 100% so I skipped it for now. I was having heart palpitations and racing heart for 2 days so I tried some magnesium (this has helped in the past) and only took 1/2 a dose. Last night had a major panick attack (old symptom that only happened when I ate foods I shouldn’t) and bad diarreah all night. Die off? how can I help my body through it. I am doing baths and don’t take any supplements and not really any ferment juiced yet… and why after 8 days? am I harming my body any? I don’t want to do that…

  31. Hello! Me and the family are about to start GAPS…got the bone broth, soup…everything except the therapeutic probiotic. Whats the difference between BioKult, the Complete Biotic and the other supplements listed on the GAPS diet website? Do I have to wait to start til I get one of these?

    • Hi Alexis,

      The best people to direct supplement-related questions to are the owners of the GAPSdiet website. They will be able to provide wonderfully relevant assistance regarding the products they offer.

      In terms of when you need a commercial probiotic, my strong recommendation is to read through your whole GAPS Guide book then start your program on page 28 of that Guide. When taking this approach, you will not use any supplements initially.

      All my best,
      Baden

  32. My son has been on GAPS for 4 days. He is in severe die-off. He slept all day on day 2 and 3. He vomited off and on all day and night. He refuses to eat or drink broth. He only wants water. Now he has what appears to be a cold–rare sneezing, and sometimes his nose gets stuffed but he blows it and it’s gone for hours. Fever has been off and on. No bowel movements at all. Today is day 4 and he is sleeping a lot less but cannot be upright.

    Should I break the diet??

    He is five, non-verb ASD so I cannot reason with him and forcing him to do things is near impossible.

    ETA: He is not dehydrated… but I’m unsure what ‘electrolytes’ I’m supposed to be giving him. Is coconut water sufficient?

    • Hi Victoria,

      I am going to paste in what I wrote to two other families in the past little while:

      Resolving the constipation is absolutely key. Without the daily bowel movements, the toxins are circulating within their systems and while this is the case, your boys will have many issues and healing will be delayed. Resolving the constipation will also help bring your older son’s appetite back.

      The other key thing to bringing the appetite back is keeping him hydrated, which requires not simply water but electrolytes. Please see this post: http://gapsguide.com/2008/12/22/electrolyte-sport-drink/

      Do you have the GAPS Guide book? If yes, please let me know which of the suggestions under the ‘Constipation’, ‘Die-Off Relief’ and ‘Enema’ sections you’ve tried.

      Victoria, all of your son’s current issues (lethargy, refusal to eat, cold-type symptoms, etc) are common at this stage. Again, they are made much worse than they need to be by things like: jumping into the program without a good transition (starting at GAPS GUIDE page 28), skipping the die-off relief baths, skipping the bowel movements, etc. You can help him by giving him an electrolyte drink as linked to above, and a die-off relief bath. Please see: http://gapsguide.com/2009/10/01/surviving-die-off/

      All my best,
      Baden

  33. Hi:

    I was wondering what your opinion is on the inclusion of Bifidus bacteria in the BK? I too recently started taking BK and started with a 1/4 capsule and slowly upped it over the course of weeks. However, perhaps I went too fast and recently I had an inexplicable itchy rash on my forearm, which based on reading the posts above, could be caused by the probiotic. So that’s not so bad. I’ll just back down on the BK. However, I also recently started having looser BM’s which are more mucousy than usual, could this also be due to the BK? Or is it more likely caused by something bad in my diet?

    Finally, BK contains a number of bifidobacteria, do you know which was deemed the ‘bad’ one by Elaine? BK has Bifido-bifidum, breve, infantis and longum, or did she think they were all bad? I ask because I recently started using a yogurt starter that contains the following strain: Bifidobacterium Lactis, which is interestingly not in the BK. So I wonder if this may be contributing to my problem.

    Thanks,

    Bruce

    • Hi Bruce,

      Yes, rash in response to any probiotic (with or without Bifidus) is very common.

      Yes, do be sure to increase very slowly -perhaps 1/10th or 1/4 capsule per week.

      Mucous coming out in stools is relatively common and is believed by many to be a sign of healing, ie. of the body releasing protective materials no longer needed.

      Looser stools are also quite common. These can be triggered just by healing (again, the body releasing toxins and anything it no longer needs), by something in the diet, by a probiotic, by a specific bacteria, etc. Except by trial and error, it’s impossible to know what’s triggering it. My experience has led me to not concern myself with periods of looser stools. Stool often changes a lot in the first months of healing -regardless of what we’re taking and not taking.

      No, I don’t know which strains Elaine had concerns about. This information may be on the website http://www.breakingtheviciouscycle.info/

      All my best,
      Baden

  34. Hi,
    i started doing gaps 1,5 months ago. My diarrhea startet to disapear after 4 weeks. and i can slowly incorporate new foods. I have fructosemalabsorption so i´m not juicing and eat generally very little fruit, honey, and veggies. But there´s certain foods that give me severe diarrhea and there´s one thing these foods have in common. They are supposed to cause die-off because of their antibiotic action. These foods are apple cider vinegar, garlic, onions. I get severe diarrhea from these and my stool gets yellow. Do you guys think this is die-off? Should i keep eating these and live with diarrhea and will this evtl. resolve or should i stop eating antibacterialfoods? thank you in advance

    Markus

    • Hi Markus,

      I don’t think this is die-off, no.

      I wonder if you are reactive to sulfites?

      In any case, definitely stop eating any food that is triggering a reaction. Continue with all tolerated foods and all GAPS healing approaches, such as the detox baths and supplementation. Eat lots of fats (Dr. Natasha says this can help with sulphur intolerance, among other things.) Every month, you can retest one of these foods and see if your body is ready for it yet.

      All my best,
      Baden

      • Hi Baden,

        thank you very much for your fast reply. Yeah i was thinking about sulphur intolerance, too. But on the other hand i have zero issues with eggs or whey which are supposed to be a problem in people with sulphur issues.

        I will use the approach you outlined for me. My body probably just needs more time to heal.

        Thank you very much

        Markus

  35. Dear Baden,

    I am new to all this and hope you can help. I have ordered the GAPS Guide book, but live on an island and don’t expect it for a week or two. In the meanwhile I’ve read the main book and am looking through on-line stuff. It is unclear to me how long I should stay on Stage 1. I saw you tell someone not more than a week, and ideally not more than a few days. Why is this?

    I’ve been about 5 or 6 days and feel awful. I’m constipated and the enemas seem to cause residual abdominal pain. I’ve had some pain before I started but it had gone away on a temporary diet of mainly watermelon juice and some fruit smoothies. Now I am 180 degrees from that. I enjoy the soups, (but not all the chopping.)

    I am eating organic chicken broth, chicken veggies cut small, usually with onion. Some garlic, and sauerkraut. A little mint tea. Water. Plus a probiotic that I got from my doctor.

    My question is when to move on. I don’t feel like this is good to stay on Stage 1, long time. Would it be OK to move on to stage 2 and 3. When I was at Day 3 I had no symptoms except some gas. Now I have the constipation. Also intense sweating sometimes accompanied by BO. And some abdominal pain, (which I had before this, but not right before).

    I don’t want to harm myself by staying too long on Stage 1, but I don’t want to move too quickly and have to start all over again. If possible I’d like to do this right the first time.

    FYI I am a female in my early 60’s. I have auto-immune (lupus), gluten intolerance, ADD probably. I tend to get pneumonia rather easily and not be able to tolerate the drugs. I tend to get bouts of intense vomiting and dizziness/seasick type episodes. I can go for many months in between. No great diagnosis except migraine related.

    Thanks for any advice. I will keep this window open as I’m afraid I will never find this website again.

    Lynn

    • Hi again Lynn,

      (I’m working backward through comments.)

      I strongly recommend people wait for and read all of GAPS Guide before starting. This can prevent many issues. I know it’s hard to wait, but there are many things we can do in the meantime (eg. practice recipes found online), and this approach will establish the easiest, most efficient path to healing.

      This said, I will answer your questions as best as I can.

      Most people will do Stage 1 for 1-3 days, max. Only people with severe intestinal issues like bleeding will stay on Stage 1 for a week. We need to move forward, because we need the additional foods to support the body’s efforts to heal. Without severe intestinal issues like bleeding, do Stage 1 for 1-3 days, then start adding a new food, preparation-style, or supplement every four days.

      Intense sweating and body odour are signs of detoxification. Do a daily die-off relief bath to help move the toxins out.

      Your GAPS Guide book (hopefully arriving any day now) will list additional options in addressing constipation. One preferred by many is magnesium, either in the form of an epsom salt bath or in the form of a supplement.

      Lynn, I hear your confusion and encourage you to hang in there. You can always go to full GAPS for now, then read GAPS Guide, then start again. Whatever path you choose, access support throughout. Additional places for you to ask questions and access support are here: http://gapsguide.com/about/support/

      All my best,
      Baden

  36. I’m not sure if I”m doing this right, or if I’ll hear a reply, but just in case…. I tried to start Stage 2 yesterday and put a raw egg yolk in my soup. I had a bad reaction, (at least I think it was a reaction). My abdomen was bloated and uncomfortable, pained I would say. Later I had an enema and passed a long stringy thing, 6-8 inches. Any idea if that was a parasite or normal? A little later, diarrhea. Not sure what to do. Already bought the meat for my first stew, so will go ahead but no eggs for a while. Tried to make gravalax but could not take it. I’m not sure fish was fresh enough. Very hard to find fresh things here, as I live on an island, so it must all come by ship. Thanks for any advice feed-back. I have to say, when I started this I had no idea what I was taking on. There is no one here to talk to about it as no one has heard of it. So appreciate any feedback. All the best, Lynn

    • Hi Lynn,

      If abdominal bloating and discomfort followed the egg yolk, you are correct to leave all forms of egg out of your diet for now.

      As for the stringy thing that came out with your bowel movement, it’s hard to say. It could have been a parasite. It could also have been mucous. (It is very common to release strings of mucous in early GAPS.) With this, plus the loose stool or diarrhea, it sounds like your body is doing some releasing. This is fine. If you find yourself with true diarrhea, take an electrolyte drink to prevent dehydration (and let me know, so I can give some more tips).

      For the fermented fish, you can use one that has been commercially frozen for two weeks at any point before you thaw it for use. (This is good practice, as the commercial freezing will kill parasites in the fish.)

      Even though you are on an island, you can still have amazing connections with GAPSters! Please see this page for free support options: http://gapsguide.com/about/support/

      All my best,
      Baden

  37. Thanks so much for your helpful answers, Baden. When I started this diet, on my daughter’s advice, I had no idea what I was in for. I’m afraid it’s too late to turn back, or at least it seems that way. I’ll keep adding new things as you suggested, every few days. With a little luck, I’ll have the book by Tuesday, (if it survives the Fed-Ex to Canada with the surname omitted, and flies down here with friends visiting). We’ll see.

    I have no idea what these de-tox baths consist of. Hopefully it will be in the book. Meanwhile I take lots of showers.

    As for electrolyte drink, I’m don’t know of any good ones. I”m sure Gator-ade is not advisable due to dyes and additives? Maybe that’s in the book too. (next week.) Truthfully my symptoms in this regard are not too bad. It’s just new, and something that made me wonder what was going on. As long as it’s detox and it’s good, that’s fine.

    I’m thrilled to hear there is frozen fish to consider. I will try and see if we can get some here. All things are difficult to get here. :-). I take it the fish is frozen and then I make the gravalax as usual, (rather than getting frozen gravalax).

    Thanks for all your helpful answers. I’ll check out the other site you mentioned.

    Lynn

    • Hi Lynn,

      In the post you and I are conversing under, the following are linked to:

      -die-off relief baths
      -electrolyte drinks

      Just follow those links to immediate information.

      Yes, just the fish is frozen, and you thaw it to prepare the fermented fish recipe.

      All my best,
      Baden

  38. Hi Baden, thankyou for your blog. It’s very useful.

    I’ve be unwell for quite some time – Abdominal pain, bloating, insomnia, emotional troubles, helicobacter and blastocystis found in samples, unsuccessful treatment of Helicobacter spp using antibiotics. Specialist suggested Irritable Bowel Syndrome. He didn’t want to do endoscopy etc due to stress of disruption to breastfeeding my son. I really don’t know what’s specifically wrong in my gut. I’m wondering if you would suggest getting a proper diagnosis from a GP/speicialist? – this is big $$ and taking up precious time away from family of 2 little ones. Also it’s invasive.

    There has been some relief by following the gaps diet. Much better sleep YAY. Amazing burst of energy after consuming easy to absorb nutrition ie egg yolk in soup. I was concerned with big weight loss in the first week (down to 58kg).

    I’m also wondering if there’s a super link to recipe ideas you could point me to?. I’m eating mostly soup and veg patties. CLO and 2xbiokult/day. Roast meat, fish, veg for evening meals.

    I Have access to the Gaps guide and Dr Natasha’s book.

    I’m hoping to convert the whole family over for some healing but would like to get the momentum going for myself with some great recipes.

    Thanks Baden.
    Kind Regards Sherilee

  39. Hi,
    I plan on starting BioKult soon. Both my husband and I will be starting on a 1/10th capsule dosage to avoid major die-off. Can we save the rest of the capsule in the refrigerator?

    • Hi Katie,

      Yes, definitely save the rest in the fridge and use it over time -just reclose the capsule.

      I’m always so relieved to hear when people are following the tip to start with what seems like such a small amount! Great stuff!

      All my best,
      Baden

  40. Dear Baden
    I’m sorry if some of my questions are answered in your book – we’ve tried to get it but it is currently out of stock. My 14 year old son has always ‘lacked condition’ and been plaqued with congestion and immune system issues. We’ve seen that some food impacts on his behaviour, particularly Dairy which we removed from his diet two years ago. His GAPS Practitioner decided to take a ‘gentle’ approach so allowed him white rice and seaweed. She also put him on 3 BioKult tablets (which were quickly increased to 6) and 4 Fermented Cod Liver Oil tablets per day. He seemed to tolerate the supplements but we saw little improvement in his health, perhaps a decline even. He became intolerant to coconut, eggs and the list seemed to be growing. Disenchanted with the advice being given, I decided to tackle his diet myself. I have the GAPS book and have researched widely on the the internet. Following a particularly nasty virus, I took him off all supplements suddenly (which in hindsight was not a good idea). The next day he got a severe stomach ache which may have been from an excess of GAPS-permissible food on Christmas Day or withdrawal of supplements? This prompted me to start him on the Introduction Diet but it brought symptoms on fast and furious. We did not get past Day 1 as his symptoms have been very worrying. Today I am taking him to the doctors to get checked as he has been delirious, wanting to vomit, hot then cold and had breathing difficulty. I am not sure just how to proceed with GAPS. Does this all sound like severe Die-Back? He has found relief in baths and has been having 2-3 a day. I hope you’re able to throw some light on this.
    Kind regards, Steph

    • Dear Steph,

      I am so sorry your son (and you) have experienced such a hard time getting to the point of seeing some real healing.

      Some thoughts:

      1. It is wise and excellent to see a physician any time you have concern about any symptoms or experiences. Good stuff! (Not all experiences are always due to die-off, and the sheer number of people doing GAPS today dictates that some of us will experience general maladies too.) It is impossible to know what (e.g., sudden removal of supplements, addition of non-recommended foods, etc) may have triggered any issues.

      2. You may be able to access the GAPS Guide book through other distributors (perhaps Nutrivene.com can provide you a list of distributors) or by purchasing one second-hand through one of the email support lists, from someone who is no longer in need of theirs.

      3. I definitely recommend a low and slow approach. In my book, I present this not as including starches, but rather as continuing one’s current diet while gradually (over the course of 2-3 months) including more and more GAPS foods/meals/snacks until one’s whole diet “happens” to be GAPS. Only at that stage, with the body having had a chance to adjust, do I recommend starting Intro. This is the path I would recommend for your son. i.e., Going back to a diet that brought on no severe issues and starting this low and slow process.

      4. Part of the low and slow approach applies also to probiotics and supplements. For a child, I recommend starting Bio-Kult (for example) at just 1/10th of a capsule per day, and increasing by that much each week, if even that often (depending on the body’s capacity for it).

      5. Some of the experiences you describe (changes in body temperature, vomiting, shortness of breath) are indeed common in die-off. Viral symptoms are also common in die-off. The key, again, is to move very slowly and gently. This will prevent much of this, and shorten the duration and/or intensity of any that does occur.

      6. As you have found with the baths (great job!), die-off relief strategies will also be critical. They are listed here: http://gapsguide.com/2009/10/01/surviving-die-off/

      All my best,
      Baden

  41. My heartfelt gratitude to you Baden. May I just clarify your third paragraph. I had him on Full Gaps for 3 months, but found he was reacting to coconut, eggs etc. Should I return to that diet (with the exclusions) and slowly work towards Intro? He has just headed down to the shop for some hot chips which he hasn’t had for months. I misinterpreted your comment “going back to a diet that brought on no severe issues” until I again read the comment “not to include starches”. Is my understanding correct – that he’s best starting as close as manageable to the Intro, without adverse reaction.

    It’s strange, but I never considered him to be a fussy eater pre-GAPS.
    I should mention that not only does he have an aversion to plain stock, but he feels unwell after he’s had it . He won’t go near Ferments and is very fussy with his meat, disliking it boiled also cutting all the fat off it. He seems unable to stomach anything that would provide great healing. I’ve managed to work around this by blending the stock into a Pumpkin Soup for instance – slipping sauerkraut into Beetroot Dip – leaving fat in the stock and melting Duck Fat on vegetables. Its going to be tricky getting him to have a cup of stock to accompany his meals. I’ll just have to address that when I get to it and by then it might not be an issue.

    If only I could swap places with him. I’m Day 4 on the Intro and have improved significantly. I’m following Cara’s Introduction Menu for 30 days. Apart from doing good, its actually delicious! Thank you dear person. Steph 🙂

    • Dear Steph,

      You are very welcome 🙂

      For a person who had not already reached Full GAPS, I would go with anything that feels comfortable for him -including hot chips- while he begins a slow progression. i.e., Simply whatever he wants with more and more GAPS foods over the course of 2-3 months. However, since he had already successfully transitioned to Full GAPS, and had done it for three months, then I suggest Full GAPS minus anything he is reactive to (coconut, eggs).

      Make sure he starts the fermented veggies with just the juice from it, and only 1 teaspoon of that per day initially. Start this several weeks apart from commercial probiotics, so that die-off is not intense.

      Start him on short-simmered broths (“meat broths”, simmered just 1-3 hours) and with a small amount. Test different types for him. Broth need not be in a cup; please see: http://gapsguide.com/2008/12/01/bone-broth-how/

      Your workarounds to date (blending healing foods into a Pumpkin Soup, etc) are beautiful.

      Cara’s work is gorgeous, yes! Our GAPS community offers so much wonderful support, recipes, and so on!

      All my best,
      Baden

  42. It’s Steph again . . . I feel a bit of a hog with all these questions. My main issue is chronic eczema. I’m unable to put anything on my extremely dry skin without reaction (I’ve seen your link to this and have tried just about everything). Of course showering and bathing seem to exacerbate the problem. Can I have foot baths instead of full baths until such time that I can better manage things. The de-tox baths are meant to relieve die-off but for now it just adds to my problem.

    • Hi Steph,

      Yes, chronic eczema can be very stubborn and absolutely exasperating for people experiencing it.

      Yes, if showers or baths aggravate or exacerbate it, do eliminate those in favour of foot baths. Try cooler water, too.

      First, though, does every type of detox bath exacerbate the eczema for you? For some people, some bath additives worsen it and some improve or do not bother it.

      All my best,
      Baden

  43. Hi Baden,

    I have Celiac and have found that I react to any of the gluten cross-reactive foods, so I cannot tolerate dairy. I have been doing the Introduction Diet for about 10 months now. Every time I add vegetables or probiotic, I end up bloated and miserable. I have tried to research which fruit and vegetables are low ‘FODMAP’, but still get bloated. I am consuming mostly oxtail as it has been the most healing. Recently I started to pass mucusy, stringy stools again, with my daily water enema. Is it possible that the fat or meat are inflammatory? Or is it safe to assume that mucus is a good thing and persevere? Do you have any suggestions for what to add next? I really don’t want to undo all my hard work. Eggs are on the list of Gluten Cross reactive foods but tested negative on my skin test. Should I try some yolks? How about sweet potatoes? Or nuts? Any other suggestions for someone with food sensitivities?

    Thank you,
    Janet

  44. Dear Janet,

    A few thoughts…

    1. I’m not a health practitioner, so my thoughts should be regarded accordingly. I can really only speak to what I’ve seen and heard as a community member.

    2. I find that the skin test is not particularly telling, that is, if there is an red reaction, we should not eat that food, but if there is no skin reaction, the body may still be bothered by it. We won’t know until we eat it.

    3. Mucous is, yes, often a sign of healing. So if there are no other problematic aspects of your stool (e.g., blood), I would proceed as though this is positive, because in most people in early healing it is.

    4. Personally, I would try the yolks-in-soup next.

    5. If you react to a food in the Intro progression, remove it, allow your body about 4 days to heal, then move on to the next food in Intro. So yes, in your case you will skip vegetables and a probiotic, and move on to yolks-in-soups and eventually nuts. (At no point during GAPS will you introduce sweet potatoes.)

    6. When you try a probiotic, what dose are you taking? (See 2nd Edition for info.)

    7. Have you read and followed the steps in the 2nd Edition under “Resolving Food Sensitivities”? That’s the path I would take overall.

    8. Where issues are more complex, it can be a good idea to consult with a health practitioner familiar with GAPS. These are linked to from this site’s Support for You page. In the GAPS Guide 2nd Edition is a section called ‘When to Consult or Test’, which may be helpful to you.

    All my best,
    Baden

  45. I would like some clarification on this sentence in the post.
    “If no bowel movement (small is fine) within a 36 hour period, give an enema, as set out in the GAPS Guide book.”
    Does this mean, that even a small bowel movement should count as a bowel movement and an enema should not be given or that a person with a small bowel movement should be given the enema?

    • Hi Melissa,

      I apologize for responding so late: My website stopped sending me notifications of comments, so I missed a whole bunch!

      I put it this way because so many people are very resistant to doing enemas. Ideally, we get a fair amount of stool out, but if all that comes out on its own is small, I feel a person can skip the enema that day. However, if a person is willing to do an enema on a day with only a small movement, that’s great! So, a small stool means a person has a choice.

      All my best,
      Baden

  46. Baden,
    Ultimately, my question is: what is the best way to control die-off as much as possible and still try to progress through the intro diet? The specific questions are below.

    My son’s eczema is worse than ever. We are doing GAPS intro. We were on stage 2, when his symptoms became very severe.

    We backed off to stage 1, with prunes (to help with constipation). But no probiotics (in a form of fermented cabbage juice) and no fermented cod liver oil.

    His symptoms improved a tiny bit (a little less scratching), but overall, still rather severe.

    We then gave him some carrot juice (for constipation), but he scratched very badly. I think we gave him too much. So we stopped it.

    Should we try some foods from stage 2 and then 3 VERY SLOWLY, but still stay away from probiotics for now? Perhaps add just a tiny bit of carrot juice? A bit of avocado? and some fermented cod liver oil? Or is it better to introduce a very small amount of probiotics again?

    We have been doing detox baths with epsom salts, and I feel that they are helping a bit, but I do not know for sure.

    Also, we stopped doing ginger tea, thinking it might contribute to die off. But our son is very “gassy”. Should we slowly introduce ginger tea again?

    Finally, his skin is extremely dry and peeling off. My guess is this means improvement, but I was wondering if you can comment on this.

    Looking forward to your thoughts!

    • Dear Tanya,

      I apologize for responding so late: My website stopped sending me notifications of comments, so I missed a whole bunch!

      It is very, very common to see skin changes in the healing stages.

      Do you have GAPS Guide 2nd Edition? Many of your questions are addressed within that book. But briefly: You were right to stop the foods and drinks that caused reactions. Yes, if you try an item and there is a reaction, simply stop that food, wait a few days, and move on to the next food in the Intro progression. Simply add each food/supplement/etc in the order presented.

      The 2nd Edition also presents a very cautious, “low and slow” method of introducing probiotics. Whether in capsule form or from fermented foods, definitely follow that method.

      Cod liver oil is not yet introduced in Stage 1.

      Be sure to rotate the different types of detox baths rather than using only one. A daily bowel movement is the number one aspect of eliminating toxins and reducing die-off. (Please also see the book for more tips on preventing or alleviating die-off, and encouraging bowel movements.)

      Ginger tea should not be triggering die-off, so should be fine.

      Each of these aspects are addressed in GAPS Guide 2nd Edition, so I’m thinking you might not have it yet. If not, please be sure to grab a copy (around $10 for the ebook on Amazon) and read it through, as the approach and tips in it will help prevent a lot of issues, as well as answer questions that pop up along the way. Anything not covered in it, though, please do post here!

      All my best,
      Baden

  47. I have the GAPS book and yesterday I ordered your book. I am looking forward in starting the gaps program with some of my kids. I am having a big issue with my 6 month old baby and I would love to hear from you and see if you can help me. My baby started having green stools from about one month old. At the time he caught a virus from my kids and treated him with essential oils. He got over the virus yet still had green diapers with stringy mucous at times. He is also lip and tongue tied but I thought he was eating well. Now I’m thinking that maybe he isn’t getting enough hind milk. He also has red puffy looking eyes that makes me think it’s an allergy. I remember reading in the book that there can too much mucous from too much grains and sugar and it doesn’t allow the body to digest fast. I’m thinking maybe that’s the issue. I’m so confused. I follow a strict diet close to gaps besides for potatoes and rice and once a wk slice of bread. There is no sugar in my diet and I only use raw honey sparingly. Any help would be appreciated. Thanks:)

    • Hi Ray,

      I apologize for responding so late: My website stopped sending me notifications of comments, so I missed a whole bunch!

      The symptoms you are describing are quite common for people needing GAPS. My new Guide (2nd Edition, which is what you will have if you ordered just recently) has more information for babies than the 1st Edition did, as well as information about stools. My recommendation is to follow the steps in the Guide, including seeking support from a health professional if you have any concerns at all.

      A slice of bread once a week, plus rice and potatoes more often, can really impact a person whose digestion is compromised. Doing the GAPS protocol with no modifications, except those specifically prescribed by a health practitioner for a given individual, may make all the difference.

      Will you please let me know how it goes for your baby and family?

      All my best,
      Baden

  48. Hi there! I’ve ordered your book and it should be here any day. I have a question for you. I’m on stage 4 of the intro and I’ve just started bio-kult. I jumped right in taking 8 per day to get me to the therapeutic dose. I only did this because I’ve been taking a probiotic from my doctor for a year before starting gaps. This too is supposed to be a therapeutic dose. It has 1/2 trillion cfu per serving! When I started that a year ago, I definitely had die off. I have also been taking 2 prescript assist for about 2 months. So when I started bio-kult a week ago, I went down to 1 prescript assist and started the therapeutic dosage. Could I be having die off? For 5 nights now, I wake up in the middle of the night with extreme nausea. It’s so bad that I’ve tried to vomit. I’ve also been juicing and just added back carrots. Could either of those be causing the nausea? When I started intro, I didn’t gave it. I had a lot of gut movement and gas. But not nausea. Do you know what is happening to me?

    • Hi Ellie,

      Yes, that would almost definitely be die-off! As I note in the book you will soon receive, I strongly recommend starting with a miniscule portion of one capsule, and taking about six months or so to get to the therapeutic dose, regardless of what one has taken/reached before starting Intro. Intro is very powerful. Taking massive doses of probiotics during Intro will have a very different effect than taking the same during any other diet/phase.

      I strongly recommend reading the Guide’s 2nd Edition from start to finish, and following the steps presented in it. This will save you lots of money, stress, symptoms, time, and energy. However, if you were fine at Stage 4 before jumping to 8 BioKult, you can just stop those for now, carry on, and then follow the instructions in the book for introducing it.

      All my best,
      Baden

  49. Hello Baden
    I hope you’ll get notification of this message. Im french and alrdeady bought your book, and started gaps intro since a week now.
    My husband is also doing it 🙂
    i am quite confused about some details :
    – dr NCMB recommands to start with the FCLO from the beginning of intro. but you don’t. what sould we do? as i am breastfeeding i started with 5ml as recommended and my husband with 2.5 ml. (dr ncmb recommends to double the doses in the begining of the program especially if nursing)
    – we are on stage 2; i didnt have any die off symptom 🙁 is it normal?
    my husband has very low apetite, and many head aches
    – what about garlic? dr ncmp recommends 2 table spoon garlic in every cup of broth
    – lastquestion wich is the most important to me : do you honestly think i can cure my chronical constipation with gaps? i constipated for so long, and becoming hopeless because i do not see any adult testimonial regarding constipation (+ i dont know if i should introduice carrotjuice on mornring or not)

    • Hi there, Eva 🙂

      Thanks for writing. I’ll answer your questions in the order you posted them:

      1. You are correct that my suggested path is, in some areas, more conservative than Dr Campbell-McBride’s. My approach assumes a person is one of the more sensitive people, i.e., a person whose body might react to any given step. I like this path, as it reduces reactions and struggles in people, and makes the whole journey easier (physically and otherwise). As a result, even if you are nursing I recommend introducing the fermented cod liver oil later vs earlier, as detailed in the 2nd Edition of GAPS Guide. This said, you should absolutely feel free to follow the instructions as set out by Dr CM, if that’s what your health care provider or intuition urge.

      2. A few lucky people experience no die-off symptoms at any stage. This is fine! 🙂 Your body is healing regardless. Your husband’s experience is more typical. GAPS Guide 2nd Edition offers tips to ease his die-off symptoms.

      3. re: Garlic, again see #1 above. I recommend people start it later. This is because garlic is an anti-bacterial and anti-fungal, and often exacerbates the die-off experience. Early intro will bring most people enough die-off even without the garlic, probiotic capsule, coconut oil, etc. So, I suggest introducing those as you go, one at a time rather than from the start.

      4. I sure do believe that, yes! 🙂 Many people have indeed seen their chronic (even lifelong) constipation resolve via SCD and GAPS. For testimonials, if you haven’t done so already I suggest going to one of the online support forums, starting a ‘new conversation’ with the subject line ‘has your constipation resolved?’, and watching for people’s stories in response.

      5. Personally, I wouldn’t introduce carrot juice this early. I would instead work through the tips offered in my book under ‘Constipation.’ That is, I recommend you apply stage-friendly approaches.

      Eva, as you can see, it can take me a little while to be able to respond to a comment, but I do welcome all questions and try to answer each one as thoroughly as soon as I can. Please feel free to write again.

      Warmly,
      Baden

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