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Carbohydrate Intolerance: The Two Week Test

Carbohydrate intolerance simply means that carbohydrates, (sugars and starches in the diet), are not tolerated as well by the body as they should be. The complex part is figuring out why this is the case and to what extent they are affecting your health and your lifestyle.

If left untreated, carbohydrate intolerance, or CI, can result in many varied symptoms including: hypertension, hyperinsulinemia, polycystic ovaries, breast cancer, high blood cholesterol, pain and inflammation, Type II diabetes (“adult-onset”), obesity, stroke, and coronary heart disease. This is because all these problems are related to something called insulin resistance, which first starts as CI.

Insulin Resistance

Insulin resistance is a process in which the body is inefficient at managing sugars and starches you have eaten in your diet. When you eat a carbohydrate, such as a piece of bread or something sweet like ice cream, your body releases insulin from your pancreas to process that sugar. Without insulin, you would not be able to assimilate this sugar, called glucose, from your blood stream into your liver and muscles. In insulin resistance, your body makes too much insulin for the amount of carbohydrate consumed. This extra insulin is what causes so many of the listed problems, both functional problems (those which precede pathological), as well as pathological problems (those with tissue alterations.) Initially, the extra insulin often ends up processing sugar too rapidly and blood glucose levels are driven too low. This is called hypoglycemia or low blood sugar. This adds stress to the body and causes the production of other hormones (especially adrenal gland hormones like cortisol), which increase blood sugar levels. As CI gets worse, more and more insulin is needed to process a small amount of sugar. The insulin eventually becomes ineffective at driving the sugar into the cells where the nourishment is needed. The cells have become resistant to the insulin.

As CI is developing, the extra stress on the hormonal system, particularly to the adrenal glands, overworks these organs. This results in a complex pattern of symptoms that differ from person to person.

Symptoms of CI include but are not limited to sleepiness, drowsiness, lack of concentration, or a feeling of being bloated after a meal, especially one containing sweet foods or starches. Always feeling hungry or having weak legs or knees after eating is also a symptom of CI. These are just a few of the functional symptoms. As carbohydrate intolerance can cause major distress to your life, correcting it can result in major health improvements.

Before you know how to adjust your lifestyle so CI is not a problem, you need to find out how sensitive, if at all, you are to carbohydrates. One very effective method of finding the optimal level of carbohydrates you can handle is to do what is called The Two-Week Test.

The Two-Week Test (TWT) was originally developed by Dr. Phil Maffetone – NOT Dr. Atkins or the doc who uses a very “similar” diet in his “South Beach Diet”. Many doctors and dietary advisers have “used” Maffetone’s dietary idea over the years but his original concept is still the best. The TWT is only a test as the name states. Therefore, at the end of the two weeks, it is not advised to continue the diet further without alterations unless your physician advises you to do so. I actually like to think of this as a Four-Week Test. The reason is because the first two weeks will assess your intolerance to carbohydrates and the second two weeks will assess your tolerance to certain carbs as you re-introduce them back into the diet. I’ve seen many people over the years screw up the test after the first two weeks. They go back to eating the way they originally were and never learned what carbohydrates they could tolerate and to what degree. So think FOUR WEEKS! The test will help you decide if you really have a carbohydrate intolerance, and if you do, it will help you find the right level of carbohydrate intake for you.Writing down all your symptoms before you start the Two-Week Test (TWT) is recommended. This will give you a reference point to see how your symptoms have changed, if at all. Many people forget the severity of their problems after they no longer have them. You may also want to record your weight and any body fat measurements, as applicable.

The Two-Week Test

During the TWT you will want to avoid the following:

  • All carbohydrate foods except vegetables. This includes but is not limited to fruit, starches, potatoes, breads, rice and most processed foods. Again – no fruit!
  • Beans & legumes
  • Corn
  • Milk, yogurt, ice cream, & cottage cheese. Lactose free milk isn’t advised because most of it is loaded with stabilizers/binders. 100% almond might not be advised for most because of the natural sugars.
  • “Energy” or “Nutrition” bars, including the 40-30-30 type and “low carb brands”
  • Most alcohol and soda, including diet drinks (and anything sugar-free *Nutrasweet, Splenda, Truvia, xylitol, sorbitol, etc..).
  • Honey, molasses, maple syrup, stevia
  • Processed meats and any processed and “fake” food
  • Sweet wines, beer, liqueurs (Small amounts of dry wine and pure distilled spirits – vodka, gin, whiskey are okay.)

Eat as much of the following foods during the TWT as you like, continuing to stay away from any food you may be allergic to.

  • Whole eggs
  • Cheese (real cheese, not processed, and preferably not soft ones such as mozzarella), heavy cream, sour cream, butter
  • Meats – all meats are fine except those cured in sugars. Ideally you should not eat bacon during the TWT unless you have one that has no sugar/honey added.
  • All vegetables except corn and potatoes because those aren’t vegetables
  • Fish and shellfish – sushi is fine, keep the avocado, leave the rice!
  • Pure vegetable juice, including tomato and carrot. Yeah they’re higher in natural sugar and a tomato is a fruit but okay.
  • All nuts, seeds, and their butter counterparts including peanut butter (yeah it’s a legume but it’s okay), and coconut (including coconut milk if it’s 100% pure no-sugar added)
  • All oils, vinegar, and sugar free spreads such as mayonnaise and mustard (no ketchup and no hydrogenated oils and no sugar-added spreads)
  • Spices & herbs area all okay; as are lemon and lime
  • Lots of water! Herbal tea and coffee is okay if you usually drink it (easy on the caffeine though). NO coconut water (too high natural sugar).


  • Do not let yourself go hungry. If you are not eating many small meals throughout the day, including vegetables, your blood sugar will drop. This will cause your adrenal glands to be stimulated and, with the aid of your pancreas, mobilize extra sugar into your bloodstream. Your body will perceive this similarly to you having just consumed a few sips of soda. So eat up! Don’t worry about your fat intake or cholesterol levels. This is only for two weeks.
  • If you decide to eat some form of carbohydrate on the “Avoid List” before the two weeks is up, you will most likely get an invalid response and you will need to start over.
  • Go shopping before you start. Plan on eating all, or most all, meals at home. This will help you resist the temptations for desserts and snacks.
  • Consume plenty of water during the test.
  • Avoid demanding exercise (anaerobic exercise) during the test. Your body chemistry will be changing during the TWT and the sugars needed to run anaerobic activity will not be as readily available from you diet. So keep to aerobic activity during the TWT.


  • Re-evaluate your list of complaints. What symptoms are better? What symptoms are gone? How is your energy level? Your sleep? Your mood?
  • If you felt better, start adding small amounts of carbohydrates back into your diet. Start very small, such as a piece of fruit for breakfast, an apple at lunch, or some rice with dinner – not all 3 on one day. Just one! Try one carb for a couple days, see how you feel, then perhaps add a second.
  • Continue to stay away from all refined sugars and white flours!
  • Add the carbohydrates in during every other meal. Add in the carbohydrates until you notice some symptoms return. This will usually occur a few hours after eating the carbohydrate. It may be bloating, a depressed mood or energy level, craving for more carbohydrates, or any other symptom that improved during the TWT. This is your tolerance level and you will want to back off your carbohydrate intake slightly and maintain, but not exceed, this new level of carbohydrate intake. This should be your optimal dietary intake pattern and you can adjust it as needed; such as more carbs on harder exercise days.

Good Luck!
Dr. Gangemi




Leave a comment
  1. Mandy permalink

    Why is it that one can have cream, but not milk??

  2. Jes permalink

    Can you drink Soy Milk ?

  3. Marilyn permalink

    What are the symptoms one might experience during the two/four week test period? (both positive and negative if any)

    • That’s a broad-range answer for both. Typically during the 2 weeks, especially around days 4-8, you may be very irritable, lethargic, have some headaches, and suffer from any number of blood-sugar related problems. The more your body is used to using sugar and not fat for energy the harder it will be for you to get though those two weeks. The positive – that can be anything from weight loss to improved energy, sleep, memory, to reduced or elimination of pain. Good luck!

      • Shelia permalink

        This sounds like the Keto diet.. High fat, mod protein and little to no carbs…. My body responds well to this way of eating. I have found many carbs arent the best for me during the keto diet

  4. Can you eat sweet potatoes during the 2 weeks?

  5. Lee permalink

    if it is ok to consume nuts, wouldn’t almond milk be fine? It has no sugar, no lactose and is 100% natural. Just wondering, I am going to start this today. I am confident I have a carb sensitivity. I get sick almost immediately when I eat foods that are high in carbohydrates or a processed foods.

    • I believe almond milk, like rice and the others, is sweetened with some sugar, typically brown rice syrup. So no, you can’t use the milks.

      • Maddie permalink

        Silk makes an unsweetened Almond Milk and has zero grams of sugar in 1 cup. I use a small amount of it in my coffee. Is it acceptable to have on this two week program?

      • Lea permalink

        One only needs to look at the nutrition data on almond milk, no sugar at all. If a company adds sugar, they must list it.

        Before I found this page, I used on all foods I considered. I disagree with your recommendation for tomato juice, however. I’ve found *any* sugars/carbs are bad for me, so I avoid them. Though I do eat fresh organic tomatoes when they are in season, but not huge amounts.

  6. fern permalink

    what about fermented foods like sauerkraut and things like nutritional yeast and apple cider vinegar/balsamic.. thinking salad dressing :) and is butter ok?

  7. Jan ryno permalink

    All of my symptoms returned after the two weeks with one serving of yogurt on day 15. I tried one small serving of rice on day 16 and that was worse. Should I just keep trying one serving of different foods or do I need to go back now and start all over? I never felt better than at the end of the two weeks. I couldn’t believe it. My energy was very high. Now it’s back to being sleepy and restless sleep.

    • Sounds like you are extremely carb intolerant. So go back on the no-carb diet until you are once again symptom-free. Once you are, perhaps try some fruit and see if that works for you. If it doesn’t, and since you’ve already tried a grain and some dairy, you may just need to stick with lots and lots of veges to get your carbohydrates.

      • Jan ryno permalink

        Thanks! I tried melon yesterday and did great. I tried a peach today and did fine. Great advice. Can’t believe how much energy I have and no stomach turmoil.

        • Fibrogirl Deb permalink

          I did a ripe banana. I cheated. I felt horrible. But weeks later I can now do FROZEN bananas. WTF? Slowing down the banana digestion seems to help. Go figure?

          • The more ripe a banana is the more fructose it contains; so more reason to think FODMAPs for you.

  8. Laurie Brantley permalink

    Whenever I eat something with sugar, I will get a VERY painful dry eye. I can’t seem to find anything on this symptom in my research. My physician and eye doctors have never heard of anything like this and that is where they have left me. Do you have any helpful feedback on this symptom?

    Thanks so much for your time.

    • Hi Laurie, though I have never heard of that sugar intolerance symptom, you’re your own best doctor. It really doesn’t matter if your physicians think there is a link or not. You already know that your eye pain is a sign of sugar sensitivity. My best idea there would be because stressed out adrenal glands can cause dry eyes, and the more stressed your adrenals are, the less you can tolerate sugar. So stay off sugar 100% and deal with your other stressors in life, if any, and then after a month see if you get the same symptom.

      • Melissa permalink

        I have had to cut out potatoe products, white flour and rice out of my diet. I also cut out candy, cookies and cakes. When I ate fruit, my blood sugar would plummet and I get really weak and shaky. I started to take Plexus Slim. I have been using Plexus slim for a year now and haven’t had any problem with my blood sugar dropping. I’ve cheated for time to time and had a cookie and/or some frozen yogurt with no ill affects. However, the last few weeks, I have noticed when I certain sugary snacks, I too get painful dry eye. It feels like a hot pressure in my eyes. My eyes get bloodshot and my lids get sore, like I am really tired. I too have only found this page that references the sugar intake with dry eyes.

    • frank permalink

      might have to do with swelling and inflamation due to insulin growth factor from the sugar…a freind of mine went on a acai berry drink fast and he had to wear glasses and his eye dried
      when he went off it his eyes went back to normal.

      i have problems with green tea effecting my eyes they dry up bad~

    • Vrjak permalink

      Dry eyes and mouth have completely resolved for me on a low carb diet, until I cheat, and then the symptoms return within 22 hours.
      This is a symptom that my doctor has been trying to find the cause of, unsuccessfully for 2 years. It’s not something that makes sense, unless you look at it from an inflammation standpoint. But I’m going with what I know!

  9. Can I eat chick peas?

  10. Miranda Sullivan permalink

    Hi, I have been told that I have acid reflux, but when I look up that information it does not seem to fit. I have had problems with yeast before, so I have been told by naturalpathic type doctors to get off most carbohydrates. I lost 90 lbs and never felt better, but now that I am in a different relationship and wanted to add more carbs back in my diet, like bread because I was concerned about fiber, I gained weight back and have felt awful. If I eat cheese, it makes my stomach turn, if I eat rice, it churns, if i eat anything with sugar it churns, if I eat fruit with too much sugar in it, it churns and gets worse when I lay down. Do I just make it a point to stay off of most carbs that bother me and cheese the rest of my life?

    • Check out the new post I just put up on FODMAPs.

      • Paula permalink

        I have been mostly on a low fat, low carb diet for over 7 years, with an occasional cheat. Not over weight, 100 pounds and 5 ft tall female. I would get irritable when I would have bread, cake, or something sweeten with sugar. So I would avoid them. Back on track with my eating habits, I found my symptoms were completely different than the ones everyone have been posting. Mine are heart pounding, then hand tingling, and feet.. sometime for over 24 hours, then they would start over again. I could fall asleep without some medication. It was like I had extra energy, and adrenaline and it was not the good kind. It makes me a agitated and nervous, leading to anxiety. This week, only by accident I stop all fruit, and most other carbs. Then I felt tired and almost depressed. Ate an apple with cinnamon ( thinking it was a blood sugar issue) and I felt better. Do I have CI, even though my symptoms are different than the other posts? Is there any supplements to help this problem? Is there any treatments? Once I start shaking after eating an accidental carb, I can not make it stop, sometimes not until the next day. Can I do anything to help this? Will exercise help? Everything is ok with all the labs. Please help, this has been over 9 months of this serve problems. Thank you in advance.

        • Jenny permalink

          Among many other symptoms I get one is a shaky arm which is very severe. Since cutting out the carbs as suggested on this site no more shaky arm

  11. Scott Barker permalink

    all meats are fine except those cured in sugars

    Can you please more specific? Only meats from the butcher?

    • Meats cured in sugar are items like beef jerky and certain deli and pre-packaged meats. So you have to read the ingredients if you’re getting a cured meat.

  12. Holly permalink

    Can I have mushrooms?
    Question, I’m on day 8 and my blood sugar is more stable, but I’m exhausted and still tremendously bloated like I was before… any tips?

    • The exhaustion is most likely because your body is still in the process of shifting from primarily glucose (sugar) for energy to fat and should resolve soon. Days 5-10 are the toughest on the TWT. Bloated? – Hmmm – that usually goes away quickly when you ditch the carbs, like I note in the recent FODMAPs post. Maybe a vegetable or cheese you’re reacting to?

      And yes on the mushrooms.

  13. Liz permalink

    I am vegetarian (no fish, no meat, and I do not tolerate dairy products at all, so no dairy), how can I run this test and still have enough food not to starve? All that I am left with is vegetables, oils, and nuts.

    Also, my mother, who is seriously overweight, has developed diabetes (type 2) in her 50s. I am in my 20s, very slim. Is her diabetes a sign that I might be prone to CI, or to diabetes? I did undergo a ‘glucose test’ a few years ago, to see if I had diabetes (the doctor made me fast and then drink a glucose-heavy solution, and after a while measured the change in sugar level). I came out ok. Is that a sign that I do not have CI?

    • Hi Liz, that’s tough to do when you’re a vegetarian. I have had some of the vegetarian patients I see do the test, and it’s definitely easier for those who eat eggs and dairy (cheese). Those glucose tolerance tests are outdated. They only tell you so much – basically how you respond to a whole lot of glucose at once, which is not healthy at all. Sure a high level may somewhat indicate a problem, but it is only one part of a much larger picture of your overall health. You can still have CI and pass that test, just as some people without CI may not pass the test because it is such a shock to their system. If you feel like you’re having CI issues, you may consider some clean whey protein and eggs (if you don’t eat any) for some healthy sources of protein.

      • Rachael permalink

        I would imagine tofu and tempeh are low carb enough to be suitable for vegetarians/vegans on this test. Just avoid flavored ones that have sugars added.

  14. carol permalink

    can you eat seeds

  15. Kim permalink

    I have been having trouble digesting carbs for about three months. I did the two-week elimination of carbs, eating only meats and fats and some green veggies. I am allergic to all parts of dairy and found that even certain green veggies such as cabbage and broccoli cause the same symptoms as the fruits and starches so those are out. After doing the one food a week add-in, the only fruits I can tolerate are grapefruit, strawberries and honey dew in small amounts. Also, nuts are horrible. After changing my diet I still have fatigue, nausea and headaches daily but not as bad as before getting rid of the offending foods. The heartburn and bloating are almost gone but I still require enzymes when I eat the fruits I can tolerate. I saw my gastroenterologist today for ultrasound results of my liver and other organs because I have HCV and am planning to start interferon treatment, thinking HCV might be causing some of these symptoms. To my surprise my doc said the liver looks good but my gall bladder has pre-tumorous sludge and needs to come out before anything else happens.

    I asked if my gall bladder problem might be causing my symptoms and he said “maybe.” So you think a malfunctioning gall bladder could be the underlying cause of all this? I don’t know where to turn or what to do and am only functioning at about one third of my normal self.


    • Hi Kim, yes if your gallbladder is in that rough of shape then it can and will cause of lot of those symptoms. That is why you can’t handle nuts. Often gallbladder problems are a result of poor HCL levels in the stomach – that is what stimulates the bile to be released from the gallbladder (made in the liver) as well as the pancreatic enzymes. So perhaps the problem is there. You may also want to research some of the gallbladder and liver “flushes” out there but be aware that some are more drastic than others but typically the ones using olive oil and lemon can be very beneficial for most. But you NEED to consult with your own doc on this since everybody is different and I can’t specifically advise you since you’re not my patient. If you send me an email I might know a doc who can work with you in your area.

    • Michael permalink

      Kim – sounds like you should look into Metabolic Typing Diet and your a Protein type.

  16. HI, I have struggled with carbs on and on for years but often fall prey to the fact that I adore potatoes and bread and easily slip back in to bad habits. Did Atkins some years ago and lost 4 stone so I know how good cutting the carbs is for me, leveled out at a good weight and metabolised small amounts of carbs better than before. Recent years suffered physical problems and illness that lead to huge amount of weight gain (ageing hasn’t helped!) so need to go again with seriously cutting carbs and have decided to try your 2 weeks tester, all reads very clear & sensible to me. One question however, can I eat Butternut Squash?

    • Good luck with it, sounds like it will help. Yes you can eat butternut squash.

      • Fantastic, thanks for replying so quickly, hubby will be pleased,. One other think crossed my mind, what about Creme Fraiche, very low carb (especially the full fat version) but not quite cream , not quite yoghurt? can we have a dollop of that with meals?

        • I don’t think you can use the Creme Fraiche because it still has some carbohydrate content in it (like yogurt). If it was 100% fat then it would be okay.

          • Ah, shame, I thought it’d be low enough to slip through:
            Creme Fraiche (1 oz)
            calories: 110, fat: 100g, carbs: 1g, protein: 1g

            Does that mean carrots are out too? I was adding them in, just excluding only potato from the veggie list.

          • Well bases off those low carbs (1g) it very well may be okay. I thought it would have more. Carrots are okay. All veges are – but no corn and potatoes (which a lot consider to be veges here in the South!)

      • Suzanne permalink

        Butternut squash has carbs why can we eat it? I’m going to be starting this 2 week test tomorrow. I fit all the syptoms of carb intolerance :/ i love butternut squash though and if i could just put a few pieces in my low-carb soup or stew that’d be awesome. I use chia seeds alot.. they are okay right?

  17. Chris permalink

    Hello Dr. Gangemi,
    I have been suffering digestive issues and fatigue for a few years and have recently found out that cutting all sugars and starches out of my diet immediately remedies my stomach troubles but not the fatigue. I have completed the two week test exactly as you say but without eating any natural sugars or starches either (certain veggies, like sweet peppers), because when I do I get digestive problems. I am wondering if you think this is just a severe carbohydrate intolerance or perhaps yeast overgrowth as well due to the fatigue I am still experiencing.
    Thank you,

    • Yes, it very well could be some yeast/dysbiosis problem and that is what is causing your symptoms. I can’t give specific advice on this site, but a lot of times I’ll give patients around 5,000-10,000mcg of biotin a day and 400-500mg of molybdenum a day to help with yeast issues. Molybdenum helps the body detox from the aldehyde toxicity which is a byproduct of the yeast, and a major cause of fatigue. Biotin helps kill yeast especially when it clings to the gut walls.

      • I have a yeast problem too so thanks for the info. I was wondering how long to take these supplements for?

        Also, is cream cheese okay on the TWT?

  18. ian permalink

    I am on a diet where i hadn’t had any dairy for 4 weeks, then i had a class of semi skimmed milk and felt ill – (slight headache, slight blocked nose, fuzzy head) someone on a forum suggested i try lactose free milk, which i drank and it had no effect on me. They then suggested a try a matured cheese, that gave me the same ill felling though.

    Recently I had a food intolerance test performed against 118 types of food. I was advised I was intolerant to Apple, Pineapple, cows milk, Cranberry, plum and yeast.

    so i started drinking semi-skimmed goat milk and all has been fine until today. I bought some hard goats cheese which i put into an omlette with other ingredients and within minutes i started feeling ill – even before i had finished the food.

    Am I lactose intolerant or do i have allergy’s?

    • Hard to say whether you’re lactose intolerant or it’s a casein allergy. You can always have both. A quick run down on the lactose issue for those who would like to know >> lactose is milk sugar. Bacteria in fermented dairy convert the lactose (they eat it up to use as energy) into lactic acid. The more they consume, the more is converted. So yogurt still has some lactose, whereas most cheeses do not (depends on the cheese though). So those with lactose intolerance will feel terrible with regular milk, not as bad with yogurt, and often okay with certain cheeses. If it’s a true casein (milk protein) allergy, they will all be a problem. In lactose intolerance the person is lacking the enzyme lactase to break down the milk sugar, lactose. In an allergy their body can’t deal with casein. Then there is the third issue as I describe here in the FODMAPs Diet. This is where bacteria in your gut eat the lactose sugar as well as other sugars and cause problems. Based off your other “allergies” if I had to pick one, I’d say you have a FODMAPs problem. So I suggest you try that diet. It’s actually a very healthy diet as it closely resembles a Paleo-Diet which I think is the most ideal diet for the majority of people.

      • ian permalink

        Thank you for taking the time to respond. I’ll look into the diet you suggest. I’m curious is there no “test” that can be performed if I went to my GP and requested something?

        • I personally don’t see much benefit to food allergy tests done via a lab. There are IgG, IgE, IgA, IgM tests available but they also pick up many false positives and even false negatives. If your gut and/or immune system is stressed you’ll show up with a lot of “allergies” though there is typically one, sometimes two main culprits. Plus, you may have a reaction to a food and it may be a general intolerance, not a true allergy. I prefer manual muscle testing – but you have to find someone who is very skilled at performing it correctly, and that’s hard to find. You can’t just put a food on the tongue and crank on the arm to see if the muscle goes “weak.” That is poor testing. But done correctly, I feel it is the best. Other than that use your symptoms as a guide through an elimination diet. The lab tests, including skin scratch tests are inaccurate and a waste of money.

  19. jodie permalink

    Hi, I am just about to start the 2 week challenge again.I have tried it a couple of times now have lost 10.5 Kgs. Over the years my symptoms have got really bad to the point I gained 30kgs and bad bolting, feeling sick, extreme tiredness,broken sleep, constipation,really bad feet(hard to walk) mood swings, concentration problems, stomach pain. found out about 6 mouths ago i have non- ulcer dyspepsia, fodmaps, and now carb intolerance. i am really struggling with what to eat because with having looked at the fodmaps there are allot of fruit and veggies I just can’t have. strawberries and berry seem to play up with me ever though i can so call eat them. But i would like to ask if I can eat almond nuts, no one can tell me if I can. i feel ok when i have them but i still feel tired sometimes so i don’t know if it is me eating the almonds that is doing that or if it is my body telling me it needs to cut out more ? . please help. all the things i am eating at the moment is protein meat , capsicum,tomatoes (very small amount) cucumber, lettuce. can i have multi vitamins i need something :(

    • Love it that you call it the “challenge” – never heard that one! Almonds are on the FODMAPs as they have a lot of naturally occurring phenolys in them, so you should not eat them. I cannot recommend specific nutrients on this site for you. If you lost 10.5 KG before on the TWT then you are clearly carb intolerant and should stick with a Paleo or FODMAPs diet after the TWT.

  20. Sabrina permalink

    I recently come accross this site as I have been having issues when consuming sugars as in runny stools etc. I than came across a lot of info that carbohydrate intolerances can cause a multitude of symptoms. For the last three years I have been running around from one doctor to another trying to figure out what is causing a multitude of symptoms and just want to know if these can all truely be related to a carb intolerance. I have been having extreme joint pain, numbness and tingling, headaches, blurred vision, excessive thirst and dry mouth. Prednison and anti inflammatory drugs work wonders.All arthritis tests and xrays come back normal. My ANA comes back positive off and on. Over the summer I followed a completely raw food diet for 1 month and was almost 100% symptom free without the need for any medications. Could something other than a carb intolerance explain this? And why wouldn’t my doctors have put two and two together?

    • So your question is why, after three years, you had to be your own doctor and figure out your health problem by yourself? And why did your medical doctors fail you time and time again? I see this weekly, if not daily with patients in the office. Medical doctors don’t provide health care and disease prevention, they provide disease care and health prevention. Good for you for taking care of yourself!

  21. SteveL permalink

    I’m on day four of the test. Is cottage cheese okay during this two week period. I see that ricotta cheese is but not sure about cottage. Thanks!

  22. Fifi permalink

    I love your comment about doctors, I have had to self diagnose as well. After lengthy elimination I have found that sugar in any shape or form (wine, alcohol, tomatoes etc) is my problem and I’m no good on wheat and coffee either (coffee I think is weakening my immune system that is fighting my intolerances). I am fractioanlly better but I am still getting psoriasis and bloating so now I’m thinking – could it also be the carbohydrates turning to sugar that is adding to my sugar intolerance? Does that then mean I am also carbohydrate intolerant or is it certain carbs I need to eliminate (because they turn to sugar) like grains?

    • You should do the 2WT here or follow the Paleo Diet and eliminate all the carbs to see how you feel. Proteins will also turn into sugar if you are under a lot of stress. Psoriasis can be a fatty-acid metabolism problem or a lack of good fats, namely Omega 3s (fish & flax) and saturated (coconut, butter, egg) or monounsaturated (avocado, egg, olive oil).

  23. Ginette permalink

    I have bad acid reflux for a couple of years now. While I am on medication, it does not provide me which much relief. I am on day 4 of TST, and the heartburns almost completely disappeared within the first 24 hours. However, I feel exhausted and my heart is pounding. I am wondering whether I should still pursue the test for the remaining time, or start introducing gradually some carbs to diminish the side effects. Your advise would be greatly appreciated. Thanks.

    • Hi Ginette. You’re only on day 4 and you’ve almost completely resolved your acid reflux! Amazing, isn’t it? I can’t give you personal medical advice on this site, sorry. I will say that days 4-8 are the hardest of the 2WT to get through. The more carb intolerant you are, the harder it is to get through. Mid-second week, people get over that hump. If you decide to eat carbs during the test, even “just a few”, the test is ruined.

      • Ginette permalink

        Thanks for your quick reply. I had to take a glass of orange juice yesterday. I realise I ruined the test but believe me, it was necessary. This experience does convince me though that my severe heartburns are somewhat linked to carbs. Would you have any advice for me at this point as to what should be the next steps?

        I would also like to ask your opinion on the Montignac method in case of carb intolerance. Would following a low glycemic index strategy be helpful?

        Thanks again

        • Ginette – advice would be to start over. I don’t agree with the Montignac method. The glycemic index is rarely beneficial. Fructose is low glycemic, but not healthy in high amounts, so are many other carbs.

  24. SteveL permalink

    Are whey protein shakes allowed during the two week period? I’ve now completed week one. This has not been easy. I don’t like vegetables in general but do eat them from time to time. This past week I’ve eaten more than I care to think about. I want oatmeal or cereal! I want a cranberry scone! :)

    By the way I’m 53 and 152lbs with 10% body fat. The reason I’m giving this a try is that my glucose levels are at 108 after 12 hours of fasting. Could a carbohydrate intolerance cause this?

    • Steve, good BF % but you can still be lean and have carb issues. If you’re craving oatmeal and scones then your body is still relying on sugar for a primary fuel source, not fat. Protein shakes are only ok if they are 100% undenatured whey with no sweeteners added.

  25. SteveL permalink

    If at the end of this diet I decide that it’s right for me I have a question. My body will now be burning fat for fuel. If a month down the road I have a piece of pie (I like to bake) will all this work be undone? Does my body revert right back to burning sugar. Does this mean no more ice-cream or baked goods forever? I only ate them occasionally before but does this mean never again? Thanks.

    • Awesome question and one I’m surprised nobody has brought up before. I was just explaining this to a patient yesterday. To ease your worries, no you’re not going to shift your chemistry from fat to sugar if you have some sweets. Look at it this opposite way and it will help make sense – right now if you’re burning more sugar than fat for fuel because of your stress levels and your diet, you will not shift to more of a fat-burner just from one day of eating no carbs. Yes, it will shift a bit, but essentially you have to train your body to burn more fat than sugar and that takes at least a couple weeks, sometimes longer. (I’d say the average is 2-3 weeks.) Once this happens (shift from predominantly sugar to fat) you will know. You won’t crave sugar, your energy will improve, your mind will be more clear and sharp, you’ll sleep better, you’ll have less pain – you should feel very good! You also won’t have to rely on snacking 5-6+ times a day to keep your blood sugar balanced. Then, once you’re a fat-burning machine, eating some sugar here and there won’t be detrimental to your health. This doesn’t mean you can go back to eating high fructose corn syrup and really bad junk food though. You should eat “healthy” treats like ice cream made with heavy cream and sugar, real chocolate, or a pie that is made with real whole ingredients. Focus on a lot of fat when you have some treats – go easy on the very sugary stuff. When we bake, say brownies, we use coconut flour and honey (along with real chocolate of course). As you all hopefully realize, I practice what I preach 100%. You would never see me eating cotton candy or a funnel cake or drinking a soda. Never. My wife and I went to France last month and for one week we enjoyed some delicious desserts at every dinner, some great ice cream, and more than I care to admit of coffee, and even a few croissants (I eat very, very little wheat). I did not gain one pound or have any carbohydrate intolerance issues. The typical carb intolerant person goes on vacation and gains more fat and compromises their health in just a few days.

      • SteveL permalink

        Your comment about ice cream: Must be real ice cream made with heavy cream. Looking in the stores all of them are made with cream and milk. So does that mean it’s not real ice cream due to the milk?

        • No, by real ice cream I meant no artificial ingredients and whole cream and milk, not frozen yogurt – which is often skim milk and a lot of sugar (low fat).

  26. SteveL permalink

    Thanks for the complete response. I’ll have to look into how to modify my ingredients in baking. I’m on day 11 of the diet and yesterday I noticed I’m breathing better than before. I have allergies to tree pollen and my cat. This makes me wonder if this is a carb issue or a wheat issue. I guess will see when I start to add back foods slowly over time.

    • You bet…a lot of allergies are related to fatigued adrenal glands, from chronically high insulin and blood sugar levels. So it may just be the carbs. I’d add wheat in last. First fruits, then sweet potato, then maybe some rice, honey, dairy (lactose), corn…last is wheat.

  27. SteveL permalink

    I was wondering what order to go in. Thanks!

  28. Ursula permalink

    Hello, I’m just finishing day two and I’m already feeling less bloated. I had followed a strict low carbohydrate diet about a decade ago and lost 80 lbs. Then I was told by my doctor to stop because I was pregnant. After gaining every single pound back during pregnancy, I decided to try Weight Watchers and lost even more weight, but always felt hungry and not really satisfied. After another pregnancy, weight came back on. I managed to lose most of it doing Weight Watchers, but then my life became extremely stressful and sleepless. I’ve regained 15 pounds in the last few months which is really a lot considering I don’t eat much, but when I do eat, I’m eating carbs. I’d be eating low calorie “diet” foods and I’d still be gaining weight and my stomach looked so bloated that I look pregnant. After only a couple of days I’m feeling a difference. Do you think stress levels, which I think produce a lot of cortisol, could make a carb intolerance even worse? I definitely feel better emotionally without carbs, too. Would I have been able to lose so much weight on a conventional diet if I did have an intolerance?

    • Yes, high cortisol levels definitely make you more carb intolerant. You may initially be able to lose weight on a conventional “calorie-cutting” diet, but since they are not healthy, you’ll never keep the weight off unless you always cut calories. That is why when someone who cuts calories just starts to eat even a little bit more, say even 100 extra cals a day, they pack the weight back on. Eat healthy, get healthy, > lose healthy weight. That way when you go on vacation or want to have some good desserts you don’t put the weight back on!

  29. Bobby Spath permalink

    I am in week 7 of a 12 week marathon training program. Can I take the 2 week test and still maintain a decent enough level of carbs and electrolites in order to still complete training runs? I am running about 50 miles a week with a 18-22 mile long run as my longest.

    • Don’t change your race plan, wait until a few weeks after the race and you’re fully recovered.

      • David B. permalink

        Sir. After eating salty or sugary food, I feel like vommiting. Sometime I stop drinking water, start spitting for a while to avoid this vommit. It has been for quite a while now. Now it’s as if it remain. I have to eat food with little salt. But at a slight increase in salt cotent, it erupt. Even as I am writing this I am feeling it. To swallow my saliver is a problem. I am tired of this situation. What do I do?

        • That’s too difficult to give personal advice via on-line. Seek the help of a qualified physician.

      • Sally Daling permalink

        I have done low carb for over a year and I have stomach issues with carbs as well. I am a runner and do tri’s in the summer and really struggle to fuel my runs and exercise. Any thoughts on how to successfully supplement my workouts without blowing the balance I have found with a low carb lifestyle?

  30. TerryB permalink

    Just about to start this diet as I’m sure I have a problem with a fair few carbohydrates but I was wondering about breakfast? I’m assuming it would probably be based around eggs but are tomatoes allowed (sometimes seen them classed as a fruit not a vegetable). Going to make a big pot of vegetable ‘soup’ with carrots, swede and parsnips as I’m out at work at lunch times, is it okay to flavour it with herbs?

    Looking forward to getting to the bottom of my problems – think it’s been going on for years but been getting a lot worse over the last year or so.

    • Yup – eggs and tomatoes are good, other veges too. And yes on the herbs. More the better Good luck!

  31. Mike G. permalink

    Dr Gangemi,
    Thanks so much for your web site. After experiencing sleepiness, bloating, insomnia, and cognitive impairment for 5 years and finding no solution after visiting 7 different doctors, I tried the carbohydrate intollerance test on your web site and felt great after a few days. I also lost my constant feeling of being hungry.

    I introduced my first carb (Day 15), 1/2 cup of unsweetened oatmeal and my symptoms of sleepiness, bloating, and cognitive impairment reappeared 30 minutes after eating. On Day 16 I had a cup of 2% milk in the morning and the evening and symptoms didn’t appear. On Day 17 I had a banana and the symptoms reappeared.

    What sugars do oatmeal and bananas breakdown into and what enzymes are needed to digest these types of foods? What foods should I avoid? Is it safe to assume that milk isn’t a problem?

    Can you be healthy long-term if you avoid all carbohydrates except for non-starchy veggies? Can the veggies provide all the carbs you need?

    Thanks for all you do.

    Mike G.

    • Hi Mike, thanks for the complements. First I’ll say you’re introducing the carbs too fast. Don’t just jump from a grain (oatmeal) to dairy to a fruit day after day after day. Give it a couple days of being symptom-free (or not) before you try another food. So yeah, the milk may be okay for you (though I would recommend raw if you can get it or at least organic whole milk, not skim).

      All carbs eventually break down into the same sugars, but the simpler ones like the banana occur faster than say oatmeal. So now you try other fruits – citrus and then berries would be the ones to try next rather than an apple or pear. Most likely you’re going to want to stay off grains and just try sweet potatoes, (maybe some regular white potatoes down the road), rather than wheat.

      Can you be healthy w/o eating grains? You bet! Actually you’ll get all of the carbs you need eating mostly veges, some fruit, and minimal sweet potatoes, dairy sugar, and other sweeteners (such as honey). Shoot for around 100g total of carbs a day and more on days you exercise more intensely. I typically do 1-2 days a week on <100 carbs and 1-2 of my hard or long duration days with carbs over 150g. *Note this is not an Atkins-Type Diet where they consume <50 or often <25 grams of carbs every day. Sure you can do this now and then, but every day is not healthy.

      • Angelique permalink

        I really don’t know how old this post or the comments are, but I do want to point out that the Atkins diet has NEVER said you do not exceed 50 carbs for the rest of your life. There is honestly little difference between your test and the Atkins diet other than it’s all a time frame. Induction is 2 weeks of 25 carbs or less basically following the lists you provided. After 2 weeks you slowly re-introduce carb foods until you no longer are losing weight then you back off until you are. So say you added 50 more carbs a day to your already 25 from induction and you can still lose weight, then your carbs would be 75 a day not <50 or <25. Once you've reached your goal weight you can slowly raise them again until you completely stop losing weight typically 100 carbs a day give or take. That isn't any more or less than you have already stated you eat on any given day. Also, Atkins does not push drinking their drinks or eating their bars. Those are more for emergency snacks. It's about staying on the outside of the grocery store, with meat and fresh veges.
        I would think that if you wanted to deter folks from using a different program you would actually read about it first. I have no idea what Dr. Atkins suggested in the 60s I am only 38 but I do know that the New Diet Revolution does not any where in it state you need to be on 25 carbs or less for the rest of your life.

        • There are differences in the diet, Angelique – perhaps you should read about this first before commenting. And there are many other differences – such as only whole, natural foods are allowed – not artificial sweeteners, preservatives, etc, even if there is an “emergency.” Also you’d know this is not “my test” after reading.

          During the first 2 weeks of the TWT more than 25g of carbs via veges are recommended – The TWT is not a ketogenic diet.

          This is not all about weight loss, or a “diet” but a change in eating habits and health.

  32. Rebecca A permalink

    Dr. Gangemi,

    I am on Day 14 of the test. I have lost 6.5 pounds during the past 13 days. I have continued to feel hungry and not completely satisfied at the end of a day, although I have been eating a lot of protein and vegetables. I decided to try this test first, because my family history of diabetes and hypertension, but also because I am using Dr. Maffetone’s book for endurance training (triathlons). My workouts during these past 2 weeks have gotten harder to complete, even though they are low-heart rate aerobic workouts. I am also requiring more sleep. Does all of the above mean that I am still transitioning to fat-burning, and have some way to go? Do the results of the past 13 days mean that I was too sugar-dependent? I am planning on reintroducing a fruit with breakfast tomorrow as my first carb. (Prior to the test, I mainly got my carbs through organic fruit and whole grains-making my own bread from fresh-milled organic wheat.) Thanks for your help!

    • Hi Rebecca – typically if you’re feeling hungry on the test and eating a lot of veges already you may want to add in some more fat (eggs, coconut milk, avocados). Also consider even if your exercise is very aerobic you could be pushing your blood sugar too low with those workouts and that’s why you feel tired.

  33. Janet Dunkerley permalink

    I’ve been doctoring for years, no results. They say I have acid reflux, I have no symptons of that. A nurse recently told me I may be carb intolerant, and I read up on it, the symptoms fit me! But after eating a carb (mainly bread, potatoes and pasta in white sauces), I get bloated, gurgly stomach, then about 3-4 hrs later, I throw up, horrible taste and smell. May last an hour or 3 hours and leaves me exhausted and sore from dry heaves. I initially throw up thick brown chunky stuff, smells terrible. I do not get diahrrea. I think I’ve had it since childhood, I’m 69 now. I’m going to try this 2 week diet, I hope it helps. Can I drink hot decaf tea with sweet n low and heavy cream? I do drink iced decaf tea w sweet n low, or diet ginger ale, sometimes that soothes my stomach.

    • Janet, yes you can drink tea and you can have heavy cream (not milk though) on the 2WT diet. However, you can NEVER have Sweet N’ Low, Splenda, Nutrasweet, or any other sweetener on this diet. You shouldn’t be eating that stuff at all – read this link

      • Scott permalink

        I am still confused as to why you cannot have Stevia. It does not produce a glycemic response? Honey I could see why because it is sugar.

        • Even non-calorie “sweeteners” are going to elicit some insulin response, albeit small with Stevia. And with the 2WT you’re also trying to break that neurological response to sweetness too – your “sweet tooth.”

  34. fern permalink

    i did something like this a while ago and had great success, but it cut out dairy and meat as well, and i had a hard time sticking to it without feeling hungry. im a mom of 4 and breastfeeding.
    tomorrow i am starting this 2wt to see how i feel. but i think i know im fairly carb sensitive!
    you talk a lot about adrenal fatigue, and i have been hearing this term come up a lot question is, if i don’t get good nights sleep because i have a baby in my bed nursing at night, but i change my diet (carb free) will this still help my adrenals? or do i need to figure out a way to get a good nights sleep more often? also can you give me more info on adrenal fatigue in general?

    • Now might not be the best time for you to do the 2WT since you’re breastfeeding. I’d actually recommend the Paleo-Type Diet, (also discussed on this site) as it will provide you with some carbs from fruits and sweet potatoes. Also, when I see a patient under significant amounts of adrenal stress, I don’t typically recommend the 2WT until that is improved – though the carbs can also be a reason for the depleted adrenals. If you search this site for ‘adrenal’ you’ll find additional info on adrenal fatigue.

  35. fern permalink

    also wondering if coconut is ok? oil, meat, milk.. ect?

  36. SteveL permalink

    Does the Immuno 1 Bloodprint (IgG ELISA Assay) help understand what foods (carbs) a person is sensitive to?

    • Rarely, but sometimes it can help. Since there are other types of food reactions (IgA, IgE, and IgM) as well as IgG complexes, these labs can miss a true allergy. Plus, it depends on how accurate the lab analysis is. I don’t use these tests anymore, I found too many false positives, as often when there is one major food intolerance/allergy, the person develops an immune reaction or “leaky gut” and then it looks like they’re sensitive to many other foods.

  37. Andrej permalink

    So what hapends if someone find out that his carbohydrate intolarent after these two weeks.Just ceep on having the same diet as on those two weeks or?

    • You could if you’re carb sensitive enough, or just follow the guidelines I give for the 2 weeks following the 2WT.

  38. I have been looking for a long term healthy diet to help fix my lack of sleep, tiredness, and to help healthily get myself into a healthy body fat percentage, <8; but am still unsuccessful. I am 6' 1'' male decently fit, currently playing basketball. I weight 195-200 lbs. depending on whether I eat a lot of carbs…changes in my muscle water weight.

    I am more than willing to do the TWT, but I am concerned that during the change in sugar to fats (the next 2 weeks) that I will not be able to continue in the 2 hours of vigorous basketball practice. Can I cut out all carbs and not lose any lean muscle?

    Should I continue taking my pre-mixed creatine/carb mix? Or should I convert to a creatine/Alpha-Lipoic Acid mix (insulin mimicking agent)?
    Or stop with the creatine all together?

    Which bring me to my next question, can i take the Micellar Casein Protein mix, like before bed? And what do you mean by 100% undenatured whey protein?

    Does this help raise my metabolism? Will my body adapt and quit losing fat? Should I do a zig-zag diet with high and low calorie days to help keep my body guessing? (2-low, 2-high, 2-low, 3-high, 2-low, 2-high, 2-low, 3-high etc etc)

    Thank you very much

    • Brendan, wait until the off season to do the 2WT. Basketball is very anaerobic, you don’t need to be bonking on the court.

      Hard to say on the creatine; I’m okay with it for most but don’t stay on it. Your body fat is already at 8% BF? If so, I don’t see why you would want to get lower.

      That casein protein mix will have MSG in it. Undenatured is slow dried. I use Designs For Health “Whey Cool”.

      No zig zagging. You don’t need to keep your body guessing. That’s garbage. You burn fat by training properly, eating properly, and resting properly, for the most part. There are exceptions of course.

      • Thanks I will hold off until after basketball.

        No, not sure what body fat % I’m sure it is in between 14-20 though. Abs barely show. my goal is 8%

        I eat healthy and run my butt off and lift. I cut all sweats and candy out 8 months ago. Haven’t noticed any improvement since basketball started 2-3 months ago.

        Not sure what do to anymore. Just trying to take shed this fat off before I go to the military in a year. Nothing it working

        • 8% is lean. If you’re closer to 20% shoot for 12%. That’s very respectable for an athlete. You’ll have defined abs at 11-12%. Hard to say why you’re not losing the weight. Maybe you need to follow the Paleo-Type diet as I discuss on this site. Maybe you’re eating something you’re allergic to and just don’t know it; unfortunately hard for me to say w/o seeing you.

  39. Steve L permalink

    The last time through the 2WT diet I added foods back to quickly. So I need to go back on it again and add them back very slowly. Over the holidays I ate very badly and came away sick. However it’s just a low grade fever and head cold. However the fever is now going on a week and won’t go away! I’ve been to the doctor and if I still have it come tomorrow I have to head back for some tests. I’ve been doing the two week diet during this time anyway since I stuck at home it makes it easy. Could the diet be exacerbating my fever?

    • I don’t see why it would. If anything sugar hinders immune function. But obviously on this one, since you’re not a patient of mine, I can specifically advise you.

  40. dlcghill permalink

    I have several food allergies that cause my throat to swell, fish, shellfish, peanuts and olives. I am sensitive to pork. I tried the adkins diet years ago and GAINED weight, but did eat the sugar free sweets some. Does the results from the adkins diet mean I am sensitve to something other than carbs? Thanks

    • One problem with the Atkins Diet is the unhealthy sugar free foods allowed. (Another is that it isn’t healthy to stay so low in carbs, typically less than 25g a day, and remain in ketosis.) This does not allow the body to shift from sugar burning to fat burning. Your tissues will remain too insulin sensitive. I suggest you follow a Paleo-Type diet, as I discuss on this site, and see how you do there. It is similar to the 2WT but allows some fruit and potatoes depending on activity level. You may want to limit or eliminate those from your diet if you don’t see results; adjust accordingly.

  41. Steve Lalley permalink

    Why would things like splenda and nutrasweet be banned during the test diet? They don’t have any carbs.

    • Definitely. They are not only NOT allowed on this test but you should NEVER eat those. It’s not about the carbs/calories – it’s about health. Those aren’t healthy and they don’t deal with desensitizing your nervous system to sugar or your tissues to glucose and insulin.

  42. Steve Lalley permalink

    A friend has just completed the 2WT. She’s in her early 40s and has always felt cold. Now she doesn’t. Would the diet cause that and if so why? Thanks!

    • That’s most likely because of the decreased insulin in her body. Insulin impairs thyroid conversion, specifically T4 to T3.

  43. Gavin permalink

    I am defiantly carbohydrate intolerant. My problem is that I am training for an Ironman. The training is 7 days a week and is severe. I am in great shape, but feel very depleted after a workout like a 100km cycle. I take protein shakes as a breakfast and cut all carbs during the day. However during training I use electrolyte supplements that are laced with sugar and recovery supplements that are loaded with carbs. During races I use gels and energy bars. If not I simply would not make it. If I was not training eating no carbs would be easy. Any suggestions what I can eat as well as what supplements to take on race days?


    Gavin Magrath

    • Hey Gavin – if you’re carb intolerant and training for an Ironman then you’ve got problems because you need to rely on your aerobic system 99% of the time and fat burning, not carbs. Why the hell are you training 7 days a week? I hope one day, if not two, is easy. You should not feel depleted after 100K on the bike, or even 100mi. Have you read the SockDoc Training Principles I have on the Sock-Doc site? That’s the place to start.

  44. Aaron Garrison permalink

    Dear Dr. Grangemi,

    Thank you very much for this article. I have found this very helpful, as well as being a good, cohesive source of information. I am on day 11 of the test, and I have seen a noticeable improvement in my condition (Chronic Fatigue Syndrome).


  45. Maria Gilbert permalink

    Thank you for this article (and the others) and for the generosity of all your replies :)

  46. Maggie permalink

    What about legumes, tofu, unsweetened almond milk, raw cocoa chips (to mix with nuts), peanut butter (without added sugar), almond butter, decaf coffee, carbonated water, jicama, apple cider vinegar/balsamic vinegars?

    • What about legumes NO, tofu NO, unsweetened almond milk QUESTIONABLE – I’D STAY OFF OF DURING TWT, raw cocoa chips (to mix with nuts)ALSO QUESTIONABLE – I’D STAY OFF OF DURING TWT, peanut butter (without added sugar) OK MINIMAL , almond butter OK MINIMAL, decaf coffee OK, carbonated water OK , jicama NOT SURE – NEW ONE FOR ME – WOULD DEPEND ON CARBS, apple cider vinegar/balsamic vinegars OK?

  47. Janel permalink

    Wow, I’m so glad I found this site. I was starting to go crazy. My nutritionist put me on an food elimination diet and I found the only things I can tolerate are meat ( the more fat the better) and certain veggies. I had to cut rice out because my hands would swell and etc.

    Is it common for those with CI to have partially digested rice or any starches in their stools?

    Also are tomatoes ok to eat as well?

    • No that is not normal to have undigested food of ANY type in your stools. That’s a digestive problem somewhere along the line, and could be the reason you have CI.
      Tomatoes are okay if you feel okay eating them.

  48. Emily permalink

    I am on Day 3 of the TWT…I started doing it since I was doing 17-day diet and noticed if I veered off the diet at all, I would feel lethargic and just downright sick. I have a few questions tho. My vitamins/supplements all have wheat germ except for the Omega-3s I take. Should I discontinue use for next 2 weeks. I haven’t taken them these 3 days but was wondering if I should?!?! Also, hubby and I have caught a “bug” and are feeling miserable. Should I stick with this even through the illness or does my body need carbs to recover?
    I am also fairly egg-intolerant. They make me bloat up and feel sick the rest of the day. Is there anything I can do for breakfast besides sausage and bacon now? I had some sausage links and yellow pepper with homemade guacamole for breakfast…but could not keep this up for 2 weeks. Any breakfast suggestions?

    • You should be okay with those supps. You should also be fine on the test during a common cold; you do not need carbs to get well.
      That’s tough when you can’t eat eggs. But other than meats and cheese, those are the only sources of protein.

    • Steve permalink

      A friend of mine went on this diet and had trouble with the eggs too. I told her to ditch the whites (those are what cause some people issues particularly the burping later) and just use yolks. All went well after that.

      • Sometimes the yolks can be a problem. Actually I used to be allergic to egg yolks and not the whites, so it can go either way (or both).

        • Emily permalink

          Thanks for quick response. I will start taking supplements again. One of them is for adrenal issues so I didn’t really want to discontinue use. I will try doing yolks one day and whites another to see if I can do either alone. I have had this sensitivity since childhood…thus, I stay away from eggs as much as possible. BTW, the illness isn’t a cold but we are not sure what it is. My husband is calling it the “mini-flu” since we feel achy, but not everywhere, have chills and shakes, headaches and just a general feeling of malaise. We both slept most of the day yesterday. I stayed on TWT tho so am hoping I will be feeling much better once this bug passes.

        • Steve permalink


          • S. somers permalink

            I have been reading through all of these posts and came accross your post and felt that I need to share some info. The sickness you are feeling could possibly be a Herxheimer Reaction, fairly common when eliminating sugar or carbs from your diet. It is a withdrawl symptom, usually disappearing in a few days. Please google this and I am sure you will find sufficient info on this topic. Good Luck

  49. Christene Tashjian permalink

    I’m on day 9 of the TWT. Do I have to start over because (1) I had some tarmari sunflower seeds on a salad today with a commercial (Annie’s) dressing that had as its next to last ingredient, soy sauce and (2) I took some herbal extracts to help ward off a cold (they were tinctured in alcohol so I added hot water to the dose to help dissipate the alcohol)? Thanks!

  50. Dave permalink

    I did the TWT and did start feeling better. I try to maintain a strict diet of only meats, veggies, cheese, eggs, nuts and dressing (ranch). I have been able to completely control my stomach issues (diarrhea, bloating, gas) but still have lingering issues with feeling fuzz/irritable, especially before lunch and dinner. Is it common for these to be the most stubborn symptoms? I’m guessing this is due to me ocassionally eating foods i should not (certain sauces in receipes, beans, fruits)?

    Are you familiar with Reliv? it is an all natural soy based nutritional supplement that comes in powder form and is mixes as a shake. Seems to have helped me quite a bit, as originally not even changing my diet made me feel a lot better. One of the products is an engergy drink which contains significant amounts of Fructose, but does not seem to negatively effect me. Why would that be? Am I using up my bodies “allowance” for carbs i can tolerate by drinking this?

    Also – does staying off fruits and other carbs going to make it harder for my body to adjust back to processing them in the future? Should I be trying to slowly build back a tolerance for these things?

    Thanks fory our time.

    • Dave permalink

      Also, forgot to mention that I am trying to GAIN weight. 5’10” and started at 165-170 now down to 145 since the diet change. This seems to be the biggest obstacle to maintaining a very strict diet — i’m trying to eat enough to stop the weight loss.

      • Eat more fat and protein. That weight loss is most likely all fat and water. If you weren’t carb intolerant then you would not lose nearly as much weight – a few pounds at most. at 5’10 and dropping 20-25 pounds is quite a loss – probably the most I’ve heard of on the TWT in regards to a percentage loss.

    • If you’re eating fruit and beans then you’re not doing the TWT.
      I’m not familiar with Reliv though I would never recommend ANY soy product especially one in a powder form.
      No, staying off carbs does not make it harder to digest them if you eat them again. The point of the TWT is to realize how much you can handle w/o symptoms. If you go back to eating beans or a piece of fruit and feel worse, it’s not because you lost your tolerance for those carbs, it’s because you could never handle them in the first place. If you’re extremely sensitive to carbs especially fructose, then you may have a gut issue – check out the FODMAPS diet.

      • Dave permalink

        Thank you for the response. I did do the strict TWT, but have tried to incorporate foods back over the past 8-9 months, that is when i’ve experienced the weight loss. I’ve maintained, for the most part, a strict diet of meat, veggies, cheese and dressings.

        Would fuzzy head / irratiblity issues be consistent with a gut problem? That seems to be the most frustrating and hard to control symptom.

        • Yes, could definitely be a gut problem Dave. Try the FODMAPS diet I have here on the site.

  51. Kristen permalink

    I was reading through the comments when I came across a question so I skipped to the bottom and I’m sorry if it has already been asked. I did Atkins a few years ago and lost 40 lbs (I’m 100lb overweight). But all the fat and cholesterol felt like too much after a while. So I’m doing this test to see exactly how much carb I can tolerate in a week and also because I’m pretty sure I’ll have a nice little weight loss boost during this process (lost 12 so far on just healthier foods and calorie counting).

    Anyways, on Atkins it was always stressed full fat items like cream cheese, regular cheese, etc. I always tell my friends the real stuff is actually better than the processed “light” versions. But why is that? Is it just cause we need that fat since we’re not getting glucose anymore? Should people on regular diets really stick to the “low fat” items? I’m excited to ditch the low fat mayo and cream cheese!!!!

    Thanks! (I’m starting the test monday)

    • The low fat versions are typically very unhealthy; removing the fat increases the overall percentage of carbs thus leading to carbohydrate intolerance problems. Check out the Paleo Diet I have on this site.

  52. Natalie permalink

    I have to say reading your information finally helped me feel like someone actually knows EXACTLY what I have been dealing with for years now. Thank you for your information. My question is, after 18 days of the TWT, and feeling so much better… I added back just a tiny, I mean tiny piece of potato, and instantly I started to feel the way I did before. I originally searched for help due to migraines triggered by blood sugar ups and downs after eating. Can it take longer than the two weeks to be able to add foods back in? What if I just stayed on the TWT indefinitely, would that be a problem at all, if I continued to feel better?

    • It’s really not healthy to always eat a TWT type of diet. If the potato was a problem then try some fruit, or dairy sugar (yogurt – lactose), or a different starchy carb (sweet potato, rice).

  53. Fibrogirl Deb permalink

    I dunno ’bout carbs [not an expert] but I do have fibro and carbs of almost all types actually make me very sick. I wonder often if it is just my condition that has the symptom of carb intolerance or what. But when I fall off the low carb wagon, I’m almost bed-ridden. Hubby got sick of my fibro diet and a year later he now has fatty liver disease and he blames me for putting him on a low-carb diet. I don’t buy that logic, it having been a year later. But one bowl of Cherios and I’m in gastro hell.
    I don’t know what’s right, but I know what I have to eat to stay healthy and it’s super low-carb…like 20g a day.

    Fibrogirl Deb
    Guaifenisen Protocol and diet for Fibro
    Remission from fibro since 2007

    • Sounds like more of a gut issue – check out the FODMAPS diet on this site. Healthy fats would not cause fatty liver – too many carbs, especially refined, and fats from refined vegetable oils would though.

  54. Debbie permalink

    I have terrible stomach problems. I had the H-plori bacataria,now its gone. I have to use miralax and metamucil everyday or I don’t have a BM…. I have been doing weight watchers since Jan, I will lose one week next week I gain. I am pretty sure I have a problem with carbs. If I eat bread I bloat something terrible. Can I still drink coffee on this test, should I stop my miralx metamucil while doing this test. I am at my wits end. I am 49, 5’2 176, I just cant understand why I cant lose the weight. I excerise 5 days a week, doing yoga, and pilates and low inpact aerobics…. Thank you

    • Coffee is okay on the 2WT. If you need a laxative or more fiber via supplement to have a BM then something is not working as it should in your body. Weight loss is a lot more than just a diet – it’s hormones, exercise, lifestyle too. Weight Watchers and similar diets don’t teach healthy eating (and their food products are junk); I never recommend them.

  55. JunJUN permalink

    i will loss that much of pound if i am that kind of intolerance? yes i admit i followed a smiliar diet ebfore and i drop like 30-35 pound, and i felt wonderful, but i ate too less, and i became too skinny, but i felt extemly healthy and full of energy that time..

  56. permalink

    why diet coke is now allowed?

    • Nutrasweet is 200X sweeter than sugar, Splenda is 600X – so you will get an insulin response and increase your insulin insensitivity problems which is the whole point of the 2WT.

  57. Tanya permalink

    Thank you for all this great information! I have been suffering from terrible acid reflux due to my pregnancy so I was wondering if following this plan would be okay-I am currently 7 mo. pregnant.

    Thank you!

    • Thanks Tanya. No don’t do the 2WT now. Acid refulx when your pregnant is most often from a hiatal hernia from the stretching of your psoas (low back flexors) that have some fascial connection to your diaphragm around your esophagus. Look for tender spots in your belly in-between your navel and your hip bone and gently rub them out. Often that can relax those muscles.

  58. Chloe permalink

    Can you eat almonds?
    Also, I’m on day 3 and still feeling bloated. When should this go away?

    • Yes and you’re only on day 3. You have 11 more to go to see what symptoms change. Patience!

  59. Tanya permalink

    Thanks so much! I’ll give that a try and hold off on the 2WT until I have this little baby! Do you think it would be okay to try while nursing?

  60. Chloe permalink

    Can I do any kind of weight training for my arms? I don’t want to lose what I have.

    • Gotta keep the guns, huh? Sure you can do weights. Really the amount of anaerobic activity you do (weights or high intensity cardio) depends on how carb intolerant you are. If you’re very CI and you’re suffering thru the 2WT, then any anaerobic, (weights but more so with high intensity anaerobic) will make you feel much, much worse.

  61. Hello Doctor,
    I have all the symptoms you mentioned. Is hyperacidity also a symptom of CI? I’v undergone Vagotomy, and Pyloroplastomy, 20 years ago, but I still suffer from the symptoms.

    Anyway, I plan to do TWT. Any spices like garlic, ginger, cummin, chiles, etc, I should avoid?

    • Could be – hard to say. Could be a result of your surgeries too. All spices okay on the 2WT.

  62. Linda kerry permalink

    Can you have physillium husk on this diet?

    • Only if you’re constipated, which will hopefully get better during the 2WT but you have to make sure you’re eating lots of veges and drinking a lot of water.

  63. Stefanie permalink

    Are lentils okay to eat during the twt?

  64. Diane permalink

    I really struggle with breakfast – can I have a protein shake instead?

  65. Julia S permalink

    Dear Dr. Gangemi
    You say that (coffee?) and herbal tea should be decaf on this TWT…
    I always thought that decaffeination process is as bad as making something fat-free.
    And also, can sour cream and any of salad dressings be used?

    • Well that was a mistake (the decaf) and you’re the first person to point it out. Thank you, it’s been changed. I think there are less-harmful ways to decaffeinate beverages (without the chlorination process) and I’ve also heard that if you let tea seep for <1 minute then the amount of caffeine is very low.

      Yes - sour cream is okay.

  66. Julia S permalink

    Thank you!
    What about lemon? I know it’s a fruit but it so non-sweet :)

  67. Bee permalink

    Any adaptations for a child? Thanks for all the good info.

    • No – other than to monitor them closely and make sure they’re eating plenty of veges and drinking plenty of water.

  68. Lisa V permalink

    I am considering the carb sensitivity test though I am a little leary after attempting first phase South Beach in the summer. I lost weight quickly 8 pounds in 5 days but I felt like I was dying. On the 5th day I caved and ate every carb in sight! I gained back a couple of pounds but was fine with that since I didn’t have much to lose. Then I went away for a couple of days on hoildays and had a couple of treats and gained another 2 pounds (in spite of exercising running/walking 10 miles at least per day)which never left. Then I put on another five after that…get the picture…kept gaining after trying low carb and couldn’t follow a sensible plan anymore without falling off the wagon. (Never an issue before.)
    Tried it again at christmas and the same thing happened. Afraid that this will help me lose the now 10-15 extra pounds that used to be 5 only to gain back more again! Also I take a lot of supplements and was wondering if they are acceptable during the test. Just started Raspberry Ketones…and I know fruit isn’t allowed.

    • You’re a classic insulin resistant person. The “test” is so difficult for you because of your body’s carb addiction, and more reason you should be doing the test, sticking with it, and following the plan for the entire 4 weeks (at least) to break your addiction to carbs. If your body was burning fat and not sugar for energy your weight swings would never happen.

  69. Lisa V permalink

    So the weight swings are because of “quitting” too soon? I never had this issue before I was in fact slightly underweight (and ate tons of carbs just low fat-added healthy fat in to balance hormones and began gaining) so this is all new to me! I’ll give it a shot when I know I can commit for the two weeks.

    • That’s a big part of it. It takes at least 2, if not 3 weeks, for your body to transition from a sugar-burner to a fat-burner. You need to commit for 3-4 weeks to finally break your sugar addiction habit.

  70. Snaedis permalink

    Is 100% whey protein (lactose and gluten free) allowed ?

  71. Julia S permalink

    What about almond and soy milk?

  72. Julia S permalink

    Is it because soy is GMO in US? What if its organic and not on TWT? Sorry that I am being so annoying :)

    • Search “soy” using the right side search bar and you’ll see why in the first two articles that come up. It doesn’t matter if it’s organic.

  73. veronnica permalink

    Hi Dr. Are uncured bacon or sausage turkey or pork allowed during the TWT?

  74. Sarah permalink

    Are beets, winter squash, rutabagas, turnips, and parsnips ok?

  75. Bjerney permalink

    First, I have a friend that is doing the two week test with me, but he chews tobacco. Will the tobacco affect his results?
    ~I’ve tried have him quit but I have yet to succeed.

    Now I have a question of my own..
    Secondly, can i continue my morning workouts that consist of 30 mins cardio and then another 45-60 minutes of lifting,12-15 reps 3 or 4 sets which usually consisting of 2 or 3 major muscle groups.

    Thirdly, how do i know which cheeses i can eat and not eat? Is Mozzarella string cheese okay?

    Last do you have a recommended whey protein mix that would work for this test and the FODMAPS/Paleodiet?

    Thank you Dr. Gangemi I’ve done a 180 after finding this site!

    • First, I have a friend that is doing the two week test with me, but he chews tobacco. Will the tobacco affect his results? NOT HEALTHY BUT NO IT WON’T

      Secondly, can i continue my morning workouts that consist of 30 mins cardio and then another 45-60 minutes of lifting,12-15 reps 3 or 4 sets which usually consisting of 2 or 3 major muscle groups. DEPENDS ON HOW INSULIN RESISTANT YOU ARE. THE MORE YOU ARE, THE LESS EXERCISE, ESPECIALLY ANAEROBIC, YOU CAN HANDLE.

      Thirdly, how do i know which cheeses i can eat and not eat? Is Mozzarella string cheese okay? THEY ARE PRETTY MUCH ALL OKAY BUT EASY ON THE MOZZ.

      Last do you have a recommended whey protein mix that would work for this test and the FODMAPS/Paleodiet? WHEY COOL – UNFLAVORED:

  76. Syd permalink

    First of all, a big thank you for such an insightful read.
    Since many years I have had a strong intolerance towards certain foods and have never seriously abstained to identify the intolerable foods for myself. My biggest symptoms were skin hives, flaking on scalp, drastic hair loss that has left bald patches, fatigue and lethargy.
    Anyways, before I read your article, I independently started an elimination diet last year to lose weight and I noticed that slowly and gradually these symptoms started vanishing, my hair fall completely stopped and my energy levels multiplied. But I eventually succumbed to old habits and encountered all the symptoms again. So I have decided to try the TWT.
    My first question is ‘can I ever be able to eat like a normal person as I love milk, fruits, rice and bread? What would you suggest as alternatives to bread and rice which are most difficult for me to give up?’
    Secondly, ‘can I consume multivitamins? What type of multivitamins would you recommend to maintain energy levels as I do cardio 4-5 days a week?’ (I did read you are fine with biotin).
    Thirdly, ‘have you seen or analysed any cases where hair loss is involved in CI? Is it reversible if we eat tolerant foods?’
    Sorry for such a long query. I am to start the TWT in a couple of days after I shop for the allowed foods. It would surely be encouraging.
    Thanks heaps!!!

    • Hi Syd – I’ll be brief here. Sorry I can’t get into specifics for each individual I’m sure you understand.

      I’d say you shouldn’t want to be like the “normal” person who eats rice, milk, and bread – those people are unhealthy. Doesn’t mean you can never eat them though; it depends on how YOU react – that’s really all that matters.

      I think multivitamins are mostly junk.

      Yes hair loss can be from CI and if you correct the CI and it grows back – well, then that’s great. But it may not if the follicles are dead.

      Good luck!

  77. Bjerney permalink

    do you recommend donating blood while on the twt? im 195lbs 6′ 1″

  78. gemma permalink

    Hi, I have recently been diagnosed with PCOS and my diet consists of mainly carbohydrates but I am also a vegetarian – Is there any evidence to suggest that this diet aids conception at all?

    • That is not a coincidence – your diet and your PCOS? You can do a pubmed search and other research search and find info on insulin, testosterone, and PCOS – but do you really need evidence such as studies to suggest you change your diet when clearly something you’re doing is not right?

  79. Lizzie permalink

    Hello – I’m now at Day 5 – I don’t eat meat but I’ve been having eggs, cheese, some veggies, some nuts, cream, decaf coffee and tea. My problem is that before starting I was often feeling nauseous after meals and now it is worse. It goes away after 1-3 hours. I eat very small meals and snacks mostly.
    Is this normal?

    • No that is not normal. Sometimes feeling nauseous or bloated after eating signifies a problem with the gallbladder and since you’re eating more fat on the 2WT, you could be stressing that organ further. I don’t have an article on the gallbladder, though I will eventually. If it’s worse when you eat fat (eggs, cheese, nuts) rather than protein (chicken) or veges then the gallbladder is most likely the culprit.

      • Lizzie permalink

        Thank you very much for this reply. Should I stop the Test? – I’m now at Day 6 and apart from this nausea (and heartburn which I have regularly anyway and which was part of the reason I started the Test), I am feeling quite upbeat about it.
        Or should I switch to more veggies and chicken and fewer fats? I read that it’s necessary to eat fat because that goes through a different metabolic pathway than carbohydrates and protein, and excess protein will, in due course, be converted to carbohydrate anyway.
        I also know that I have not yet made the metabolic switch to fat-burning and I am slightly breathless walking up a flight of stairs at the moment. I am okay with all of this as long as it is part of the process of weaning my body off sugar-burning, but I don’t want to do anything that will damage anything else!

        • You have to eat an awfully lot of protein to convert it to carbs; I wouldn’t worry about that. Definitely way more than 2grams/kilogram of bodyweight.

          It’s hard to say if you should stop the test or not. You definitely need to be doing SOMETHING since you’re not feeling well, but if you’re having gallbladder problems then you at least need to modify the test and eat less fat. Also try sipping lemon juice – that can help a lot. Take 1/2 of a fresh lemon and squeeze it in 4-6 oz of water and sip it over 15-20 minutes. See how that goes.

          Obviously please be smart and responsible about trying new eating habits – especially one like this. Remember – it’s a test – not a permanent diet. Listen to your body!

  80. Ben permalink

    Hi, I am day 12 of the two week test. My diet has consisted mostly of eggs/tuna/salmon/ and a lot of cashews with a ton of Broccoli, carrots, spinach and lettuce.
    Yesterday on day 11 i accidently ate about a cup of cashews then realized they tasted different, and saw that they had 1g of sugar per serving (1/4 cup). The adding ingredient was canola oil. Will that 4g of sugar mess up the change in my body chemistry?

    unfortunately I also played a light game of basketball with a friend without eating for 3 hours, felt tired..then refueled with those tainted nuts, some walnut halves, and can of tuna.

    today i feel out of energy and tired. do i need to restart the test?

    Finally, the cashews make me bloated everyone in a while, should i continue eating them and wait for the results, or remove them from my diet?

    Thank a ton :D

    • No it won’t and nuts are going to have natural sugars in them anyway – especially almonds.
      You don’t need to restart. If a certain foods like the cashews make you feel worse, then take them out of your diet.

  81. Leona Mandryk permalink

    I have been gluten free for 18 months and 80% grain free for 10 months. I sometimes eat foods with buckwheat or rice flours. I only eat cheese, butter and cream as a dairy product. I try to stay away from any sugars. My blood pressure is good – 132/70, I take a thyroid pill daily, my weight is stable and pretty good and I am active daily. I sometimes will feel lightheaded, dizzy, shaky legs, will have to concentrate to focus on conversation or programs, and feel fatigued at times during the day. It appears that this happens after I eat fruit, potatoes, and gluten free foods. It seems that my blood sugar does up and then drops quite low. I have been diagnosed with diverticulitis about 18 months ago. Will going on the 2 week program give me insight into what could be at the root of these episodes?

    • Based off your blood sugar problems and your diverticulitis, the best diet for you may be a FODMAPS diet. That’s what I’d be trying if I was you.

  82. Helen permalink

    I have cirrhosis through Hep C and although clear of the virus now I find the cirrhosis has left me carb intolerant. 2 blueberries and one raspberry will give me diarrheoa for a day or two….. But the FODMAPS works so I stick to it. My one problem is exercise-I like to swim, I go three times a week and swim about a kilometre each time. As a result I am thin….not quite gaunt but too thin for my liking. I dont want to give up swimming but I would like to put on a bit of weight but I physically cant eat the amount of food required to achieve that (and besides, I’m worried about protein poisoning). Any ideas? Thanks for your help-its much appreciated.

    • You have to focus on staying aerobic during your workouts and eating a good amount of fat; that way you’ll keep more muscle on and hopefully gain some.

  83. Nancy permalink

    Hi Dr. Gangemi,

    I’m 41, 5’4″, 110lbs. This is the thinnest I have ever been, even though I have been somewhat athletic (taught aerobics for 15 years).

    I went on some antianxiety meds awhile back and gained 85lbs. I got to point break at that point. Went off the meds and decided to try a diet.

    I went on the HCG diet. It worked great! This diet restricts you to 500 calories a day, with very little carbs (fruit is ok, but only some.) Veggies were restricted too.

    Anyway, I’ve been off the diet for a year now. I started to run. I’m up to 5 miles a day, 5-6 days a week. Plus I walk about 2-4 miles a day at a good pace) I don’t life weights, but am in physical therapy to treat a herniated disk in my lower back, which caused me to develop foot drop at one point.

    I keep my diet to high protein as much as possible. I have been introducing carbs back into my diet…potatoes, quinoa, whole grain pasta, etc. They don’t seem to affect me, I think.

    But, I’ve also been being bad about once a week, sometimes more if I have calories left in my day to spare. I’ve never had a sweet tooth, but I seem to have one now. When I do allow myself some bad stuff (frozen yogurt/ice cream/desserts) I go NUTS! It’s like a drug. I go overboard. I don’t understand why this is suddenly happening.

    Even though I count my calories (and I’m usually able to keep it between 1500-2000 calories a day) I’ve gained weight. I was 104 a few months ago. Although most people tell me that I need to put on another 10lbs, I don’t want to.

    So, are carbs making me gain weight or could I be being bad more often than I think?

    On a side note, the days when I went crazy on desserts, I had the best runs! I feel more fueled when I eat sugary stuff than I do on a typical day. They don’t make me feel sluggish as far as I can tell.

    My parents are both type 2. I’m trying not to go there. When I got my fasting blood work done, my insulin was very low. I think it was something like 1 or less.

    My typical diet is simple (and organic as much as possible): chicken/steak/fish/almonds/eggs (mostly whites), cheese, Greek yogurt and milk (I have to admit, they’re the fat free kind. Lactaid for milk), broccoli, asparagus, onions, cauliflower, brussels sprouts, lettuce, spinach, squash/zucchini, eggplant, mushrooms, tomatoes, avocados, olives (sometimes). The fruit I eat are the fruits that were allowed on the HCG diet: strawberries, blueberries, raspberries, apples, oranges, grapefruit. As I said, on occasion, I do allow myself the starches that are supposed to be good for you. I try to stay away from fats on days when I have high carbs. I measure all my food on an app I have on my phone (Calorie Counter) I drink lots of caffeine, black with Sweet Leaf or Stevia. When neither are available, I resort to Splenda.

    I look at ingredients all the time. I avoid foods with sugar in the ingredients most of the time. And, if it has more than five ingredients, I TRY to stay away from it too.

    When I drink adult beverages, I usually go for a vodka and club soda. But, I sometimes like some wine.

    Otherwise, I drink water. About 1500-2000ml per day. (I urinate a lot, but my bowel movements leave a lot to be desired. I’m more often than not backed up)

    When I first started to introduce sugars to my diet, it was with a spoonful of Nutella. I got nauseous, dizzy, and my heart started to race. That happened three times, which is why I decided to get my blood work done.

    So, am I carb intolerant? Would love your advice!

    Sorry for the lengthy post!

    • Hi Nancy – bit too much to comment on here but briefly I don’t agree with a calorie restricted diet (HCG) that you went on. I don’t see how you can think it worked great when all you did was drastically slow down your metabolism and now you’re gaining weight again and a prisoner to counting calories. That’s no fun. You’ve got to change your eating habits as I discuss here and in the Paleo-Type diet if you really want to impact your health – in the best way possible.

      • Nancy permalink

        HCG seemed to change my body type. I lost the problem areas I always had (hips).

        I lost an additional 2 sizes after I was off the diet, over time, by continuing to eat the foods permitted on the diet, but more quantity. (i.e. no carbs other than fruits). I’m gaining now that I’ve introduced carbs. Could it be that my body fat is too low and it just wants to stabalize? (I’m at 9%)

        I have a huge appetite, so I need to keep myself in check. That’s how I do it. I agree, it sucks. But, being overweight sucks more.

        Isn’t the bottom line calories in vs calories burned?

        Thanks for your reply. I hope I kept it brief enough this time. :)

  84. Lizzie permalink

    I’ll be at the end of the Two Week Test tomorrow lunchtime. I had the following symptoms:
    Difficulty getting to sleep early; Heartburn; Sleepiness after meals; Need for caffeine; Desire for chocolate; Large stomach; Hard to concentrate.
    Results to date: heartburn is much reduced (but it isn’t one of Dr Maffetone’s symptoms), no strong desire for chocolate, and maybe some small improvements in other areas but I can’t be sure.
    What should I do now? Continue with the Test for another week or so? Gradually introduce carbs? Assume that I’m not CI?
    Is there a way to be sure, at this stage, that one is not CI?
    With very many thanks for all your help.

    • Hard to say…it doesn’t fix everything. You could try the FODMAPS diet, or Paleo Diet (which is a good diet to stay on anyway).

  85. Simon Hatfull permalink

    Hi Dr. Gangemi – thanks for putting so much effort in to both of your websites. They are an absolutely fantastic source of information and much appreciated.

    Is Quinoa ok to eat during the TWT? I can’t work out whether it is a seed, vegetable or grain… (the following link suggests it is a relative of leafy green veges – .


  86. Colin Reimer permalink

    Thanks Dr. Gangemi for taking the time to make this post. I discovered I was carbohydrate intolerant, accidentally by going on Atkins for a month. I lost 13 kg and looked and felt great. I have always been about 13 kg over weight and it never bothered me, but I have always suffered the effects of CI and was wondering why I always felt sick after eating health bread and drinking orange juice. I tried the diet because my father recommend it as he found it helped his acid reflux. It was the first diet I have ever tried. That was 7 years ago and I immediately put the weight back on and my symptoms returned. I drank zero coke while on the diet. I guess as I age my ability for my body to produce digestive enzymes had diminished. Over the last 7 years I have struggled to control my carb intake and when I do I feel great, when I don’t I feel horrible. About 5 years ago I vomited in my sleep as the heartburn and acid reflux got so bad. I do not smoke and have not drank any alcohol in the last 8 years. I ate 100 trams of cheese and drank a glass of milk about 30 minutes later my symptoms were gone. After that any time I had the symptoms, I would lean over the toilet and relax my stomach and all the bile, oils and undigested food came out. On days that I ate healthier, meaning no carbohydrates, I did not vomit or have heartburn. I drink in excess of 3 liters of zero coke a day as I can’t drink fruit juices and limit my milk intake to about one glass a day. I drank a liter of milk, a liter of juice, a liter of water and a liter of regular coke. My question is this? If I limit my carbohydrate intake to 20 to 30 grams a day I feel great even when I drink all that zero coke. Is coke the culprit? The low carb diet is hard for me to stay on, because my wife is Japanese and cooks regular healthy Japanese food, that is loaded full of cards and oils that my body can’t handle. She also doesn’t bereavement me that I have carbohydrate intolerance. Also, I am not bulimic as it is not my goal to vomit and I am not vomiting food, what I am vomiting is a highly acidic sugar based liquid about 30 minutes after digestion. I am afraid I will put myself at risk for esophageal cancer or worse. Thank you.
    *sorry for the errors. (100 grams of cheese) and (I drank 1 liter of milk, a liter of juice, a liter of water and a liter of regular coke as a child.)

    • Coke – any soda – especially diet – is often the culprit to most people’s problem. Of course you all know I don’t drink that stuff myself or ever recommend anyone to drink soda, with the exception of during an endurance event (race) and even then limited and hopefully a real sugar drink and not high fructose corn syrup.

      I also do not recommend anyone stay on the 2WT “forever”. If you do and only feel better when you do, they you are most likely missing something…maybe a gut problem and you need to be on a FODMAP Diet (look under Health tab then “Diets”). Maybe some other digestive problem.

  87. I want to start the TWT. I have a couple of questions. I read in the above to limit mozzeralla cheese. Is this because of the amount of “sugared” dairy it contains. If so, what cheeses do you recommend? Is brie ok, cheddars, I’m confused. Also, are olives and other pickled veggies ok? Pickles, pepperconi, okra, cauliflower…
    I appreciate your time and I love the fact that you commend people that have to be their own doctor! Story of my young life.

    • Thanks….we’re pretty much at the point where all these questions have been answered in the comments or in the post. Yeah I know there’s a lot of them to read through, but I will have to stop answering individual questions now and moderate instead.

      Thanks for understanding.

      • Cathy permalink

        Are pickles or pickled products ok? I’d like to snack on pickled eggs

  88. Becky permalink

    First I want to say thank you for this forum, as maffetone doesn’t have enough info in his books/site. Many of my questions were answered. Getting ready to start 2 week test tomorrow, with my 17 year old daughter who has celiac, a few questions about it.
    Can we drink coconut water, the bottles just says coconut water, I read above you can eat all forms of unsweetened coconut. Can we eat peanuts and peanut butter unsweetened and what about pumpkin?

  89. Colin Reimer permalink

    Thank you Dr Gangemi. This is just a quick follow up to comments I posted above and your suggestion that zero coke (diet) could be the underlying problem. Yesterday for breakfast I had two thick sliced toast one with peanut butter and the other with strawberry jam. ( white bread) I drank a regular glass of milk. I felt fine. Two and a half hours later I drank a zero coke 500ml. I felt fine. For lunch I had two Mc Donalds cheese burgers with a small glass of water. I felt fine. Two and a half hours later I drank another zero coke. I felt fine. For dinner I had Japanese takeout, a fried pork cutlet with curry and rice. I had a small glass of milk. I felt fine. I had a glass of water later on about an hour before bed and slept fine. I had no heart burn or acid reflux.

    If I ate any of these single foods before, I would have drank a 500 ml zero coke with them and had extreme stomach pain, acid reflux and I would have vomited after in order to relieve the pain. I do not normally eat these foods, especially on the same day, but one thing I proved, is that my digestive system works if I allow it to do its job and two, I do not have carbohydrate intolerance.

    This morning for the final test, I had a piece of chocolate cake with a coffee and within 20 minutes my stomach was showing signs of heartburn and indigestion. I will try the FODMAP diet and stop eating foods with preservatives and cut caffeine beverages out of my diet, especially during meals. I feel great that I could confirm the underlying cause and will continue to improve my health by eating the good carbohydrates and leave the rest behind. Thanks again and good luck to the rest of the people following this post.

    • ???? You’re saying that you drank Diet (Zero) Coke throughout the day with what could possibly be considered the worst intake of foods and since you had no “symptoms” you feel as though you have no carb intolerance?

      • Regarding coconut water, I’ve read all the comments and I thought I read that we should stay away from coconut water????

  90. Colin Reimer permalink

    I am just saying that I tested what could could be the worst possible food to eat and not drinking a diet coke with the meal and waiting for 2 and a half hours later to drink one, I had no symptoms. Before I would drink diet coke all day long, including with meals. That day I drank only Two 500 ml diet coke well after I ate and the food had already passed through my stomach. Yesterday I cut the diet coke completely and ate sensible meals including fresh vegetables and fresh meat and white rice and had no problems. I think before the diet coke was reacting with the carbohydrates in my stomach to produce the symptoms. When I was on the Atkins diet before, the lack of carbohydrates in my meals and drinking diet coke had me convinced that diet coke wasn’t the problem. Now I am convinced that in my case, I can eat sensible foods and cut out diet coke and return my body back to health.

  91. Amy permalink

    How can I eat all nuts when some nuts are considered a carbohydrate?

  92. Taria permalink

    Have you ever noted a link between carbohydrate intolerance and perimenopause? I am 47 and currently enjoying all the changes that time of life brings, and because my body loves to present with challenging and unusual symptoms, I am trying to figure out which of my symptoms are related to perimenopause and which may be related to what I’m eating (bloating after meals that lasts for hours, constant fatigue and inflammation of several joints). I have had about enough of the food baby feeling, and am seriously considering the TWT. It certainly can’t hurt!

    • Definitely. If your adrenal glands are fatigued then you will have more hormonal problems during perimenopause as well as blood sugar handling problems.

  93. Cole permalink

    Hi. I am a 19 yr old boy and I have had major problems with acne for the last three years of my life. After no avail as to what might be causing it, I discovered that carbs had an insane effect on my breakouts. I went on a 2 month zero carb diet and it helped immensely. The only problem was that it was really taxing on my body. The reason for this is that i have the fastest metabolism that i have ever seen. I can eat all day and won’t gain anything. I work out everyday and I find that when I don’t work out I seem to lose weight overnight. So going on the zero carb diet made it nearly impossible not to lose weight. I started eating carbs again, and it destroyed my skin. The worst breakouts I’ve ever gotten. So now I am back on the zero carb diet and I am trying to figure out ways to get the necessary calories to stay afloat. I should also mention that I am off dairy and have been for the last 3 years. Please give me any insight you might have. Do I have CI? Is this just a phase? I feel like I am withering away….

  94. Sharon LeBrun permalink

    Can quinoa be eaten during this test?

  95. Amy permalink

    Hello, Im 34 and just been told I have PCOS Ive had 2 miscarages 10 years apart. here for about 3 years and last night was my breaking point
    every time I eat I get dry heives soon as it hits my belly. I have sugar problems that run in my family with hig an low. myself have been low before I am not on anything for this at the time, I doctors do a fastig test one time every 2 months. I am scared something is not right. I have been trying to eat natrual I have cut out all bad chemicals in food I havent had pop in 2 years and everything I eat I dry heive I had hot flashes and sweats at a restraunt lastnight . everyone things its anxity of being out but it’s not I feel the change hit my body after I eat, I start feeling dizzy then sweat and then I cant move fast enough to excuse myself from dry heiving in public , I ate a taco sald and lightly sweated organic tea. then 5 hours later we drove out town to a buffett and after I picked at my first plate I lots my composier, I ate bbq chicken with skin off potatoes ,broccli, baked beens and cheese garlic roll . and Ice water. soon as I finished , my body got to feeling weird. Help. my doctors here in Indiana aren’t helping this has been my complant for 2 years now. thank you for your time.

  96. Amy permalink

    I have also suffered with chronic leg pain sents I was about 7 years old,I was told growing pains up till I was 21 , they decided to give it a name fibromylgia , but I have douted this sents. I dont have all the complants of fibroymilgia my main complaint is I hurt from my hips to my toes. When I get in cold weather my muscles tins up like a charlie house, when I get scared the smae thing just day today work around my house will hurt me ,but I do it!. My legs feel heavy the doctors will not touch my legs to feel my knots forming, they write out drugs and give handfuls of samples and spend 13 minutes with me in a cold room. I am on medicade so I feel some frown on that, I looked into lime desies but they also class fibromylgia with that. my legs are heavy tight tingly throubing pain when touched , the relife I can do for this is pool theraphy and hot showers which caused me excma last year :( . So my bf is at his end with me lol been 7 years, And I have been sick every year. my main complant is my legs and my dry heiving . My bf helps my legs by push rubing my knots with his hands, this makes my legs have more feeling in them , I refused all meds untill they can figuare out the cause of mylegs , I dont want the symptom covered up till I am digonosed right. I am an organic person with what I put in or own my body. I stoped all fibro meds they made me feel worst. I do my pain with mind control or smoke a marijiuna joint. That tends to relax my legs from clinching like a charlie hourse. I just want these knots and pain and dry heives to go away Thanks for your time again.

  97. Amy permalink

    Ok Im back if I am CI I love fruit ugh :( fresh only what fruits could I have? So I just cut out all white and sugar foods? I have been drinking Naked fruit juice alot to lately. oh and also can I still use my favorit cooking oil? Coconut pur organic pressed? What a bout peanut butter? I havent ate McDonalds in 6 years now and I cut out everything with HFCS and PGPR proply-Glycol
    and now I am having CI symptoms .

    I also hate IC of the bladder, so I changed my diet and that helped ,so now I feel like low high sugars. My great granny , my granny(shots) my mom and aunt all sugars only granny was under doc care for it.

    but I have been 34 before and 30 low , I dont have a sugar tester , I realy need one . but my doctors cant find anything wrong. but yet they see me every 3 months, what can I do to catch low sugar early? thank you for your time

  98. Linda permalink

    I’ve been on the Atkins diet for a month and have lost 22lbs and have great energy. I use to drink red wine in the evening but have stopped that and have had a small amount of Vodka. My energy level is up and require less sleep.

    3 days ago I had 2 glasses of wine which made me feel tired the next day. 2 days ago I ate a french dip sandwich & fries which caused me to be extremely tired as well and caused my muscles to hurt. Drank red wine again last night and ate deep fried fish. This morning I can hardly move because my muscles are all in pain and I feel completely exhausted. I came on line to see if I could gather any information on this subject and came across your web site here. From what I have read it seems that I may have this CI. I am so miserable today I can hardly move. This use to be the case often. After dieting for 2 weeks I required less sleep and had lots of energy. Do you think I may be effected by CI?

    • You could say that. I don’t promote “diets” though. This is an initial change in diet and a lifestyle change. You should never been eating deep fired fish.

  99. Nancy permalink

    I am completely lethargic today. My legs feel weak. Weak enough to skip my 5 mile run.

    I ate, and have eaten, Food for Life Ezekiel 4:9 Sprouted whole grain cereal. I don’t think it has affected me in the past.

    I also had some chardonnay wine last night.

    Do you think it’s the wine or the srouted whole grains?

    • Hard to say – could be the wine. If you’re doing the 2WT then you shouldn’t be eating cereal, or drinking the wine.

  100. Lindsey T. permalink

    Hi! I’m interested in trying this TWT. I previously followed a diet super low in carbs (no dairy, no fruit, no veggies with carbs except for tomato once a week) and high in protein for 2 months (called Ideal Protein) and had some success – lost about 16 lbs. I am 5′ 3″ and ended that diet weighing 122 lbs. But, starved my way through the whole diet. I had friends that were doing it with me and none of them were hungry like I was (the consultant I worked with on the diet was baffled at my hunger). I felt like if I could just have a piece of bread I would feel so much better. At the end of the diet, they had you “phase” carbs back in, though much faster than yours. That 1st day I could have carbs with breakfast only, so I had eggs, toast and yogurt. I felt 1000 times better. I don’t really have a lot of symptoms to make me think that I am carb intolerant, except that I am curious as to why I was always hungry on that previous diet. Could that still point back to an issue with carbs and blood sugar? Thanks for your insight!

    • Lindsey T. permalink

      I want to add that I have had some hypoglycemic issues before – like if I don’t eat regularly enough I get the shakes and feel dizzy – which is one reason I went on the previous protein diet was to get my blood sugar in check.

    • If you lost 16 pounds on a similar diet then it’s almost a guarantee you have a carb issue. Typically a person who is always hungry is due to lack of fats in the diet.

  101. Ramona permalink

    I recently saw an integrative doctor who is trying to get me on a vegan diet. He also ran many allergy tests (I have fibromyalgia) which came back positive (long term, chronic allergies) for gluten and yeast, as well as many, many delayed things like milk and eggs. I have been low-carbing for years, and felt great. However, when I went into peri-menopause I began gaining weight no matter what diet I was on, although much more so on the vegan diet. Can you give me some tips on what to do to lose weight in peri-menopause? This is frustrating! I am definitely going back to LC because I felt better. The knowledge of the gluten allergy helps, as I did some Atkins products (which contain gluten). Thanks!

    I forgot to add that I recently gained weight on the Atkins diet. But that it is likely related to hormone issues, and that I am on bio-identical hormones (blend between bi-est, progesterone, testestorone, and DHEA) and also Armor Thyroid 30 mg. I that I am almost through the peri part of menopause ; )

  102. Anna permalink

    What should you eat if you have a sugar low on this diet?

    • By sugar low you mean it’s actually low (blood meter) or just symptoms? You can eat more veges like carrot sticks and zucchini and also more protein.

      • Anna permalink

        I was diagnosed with low blood sugar before with insulin resistance. I also have symptoms at times. So, I should eat Veggies & protein when I start having low sugar symptoms?

  103. Neale permalink

    I am interested in trying the TWT as I suspect I am very carbohydrate intolerant. I am 35 and all of a sudden I have been gaining weight and have no idea why. Currently I eat lots of fruit, vegetables, seeds, beans and nuts. I was also eating whole grains and sweet potatos but would notice an immediate weight difference the next day. I am always always hungry. I love exercising and do a lot of running. I have gained 10 pounds since January not doing anything differently and can’t figure out why. It’s driving me nuts.

    Can one have sprouted beans such as sprouted mung beans or sprouted lentils during the TWT?

    Also, can taking probiotics

  104. Kim permalink

    Hi….could you tell me what causes CI in the first place? I was one of those people that NEVER had any problem my entire life until about early 40’s and then it all changed overnight it seems. For instance, I eat a good diet most days of lean protein, complex carbs and good fats….but on that occasional day when I eat lots of sugar… a 5 layer piece of chocolate cake……or a mexican meal with tortillas, chips and margaritas I sure pay for it., My stomach bloats out like crazy, I am so tired I can barely keep my eyes open, feel achy and my ankles swell every single time. What would cause this when I had never been this way before and nothing else really changed in my life , well except age? Thanks Doc!

  105. Becky permalink

    I did 2 week test and am on third week slowly seeing how many carbs my body can handle. My question is about my exercise, before test i was running 4 times a week, a 4 mile, two 3 miles, and a six mile. I run the Maffetone way in my heart rate and always wear a monitor. My question is my pace is 3 minutes slower per mile than before test when will it get back to normal, and is this normal?

    • Three minutes is a lot. Hard to say why that happened. Your HR should be the same. Some would depend on other factors such as what improved during the test, hormones, and other stress in your life.

      • Becky permalink

        I had no headaches during 2 week test, now at the end of week 3 and have had 3 headaches this week. Frustrating, maybe they are from CI, and added to many back in. My hormones seem better was hoping it would help with fibrocystic breast tissue pain. My chiropractor tested me on soy sauce to see if I was intolerant and I came out fine, as I had a massive migraine 5 hours after ingesting, I have had it again and i was fine, so it wasn’t soy. Still trying to figure this all out, thank you for all the resources here at your site and your other site for athletes.

  106. Hi, great website! I am positive I am CI, have tried to cut out all sugar before, but is difficult due to excessive headaches for days on end. Any ideas on how to prevent them during TWT? Also, is ricotta cheese allowed during TWT?


  107. Julie permalink


    I’ve been back and forward to my Dr for a few years now, complaining of dizzy spells/pressure behind eyes/light-headedness/nausea and have never been given a diagnosis. The only explanation ever offered to me was ‘atypical migraine’ (atypical in that I never actually get headaches).

    I also suffer from constipation, (mild) PCOS, and very obvious bloating after eating sugary things like chocolate and cake, as well as white bread etc. (Although I do try to keep a healthy diet, so avoid these things as much as possible. I have quite a sweet tooth though…). I also feel tired quite a lot, despite getting 7-8 hrs sleep a night.

    Could this be CI? From reading your site (which is fantastic, by the way) it seems likely. I have been vegetarian since I was 15 and have always eaten a lot of carbs, so CI didn’t occur to me as I never had a problem before. Dizzy spells started when I was about 18/19 maybe once a month but now I’m 23 and it’s more like twice a week. It’s starting to affect my studies and work. I’m healthy otherwise, try and eat healthily and exercise – 5 foot 7, 130 lbs.

    Thank you,

  108. Nancy permalink

    I sort of think that I have CI, but haven’t really found a pattern.

    I have not done the 2 week test. I basically live carb-less, not free. My typical carbs come from fruits and veggies.

    My question is: I’ve never had a sweet tooth. Way back when I wasn’t depriving myself of carbs, my cravings were more for fried, salty foods.

    Ever since I gave up many carbs, I have this crazy sweet tooth…for sugar. Fruit doesn’t satisfy the cravings. I go for cookies or other desserts nowadays. However, when I do allow myself the indulgence once in a while, I go nuts. I can’t stop at one cookie. I have 5 or 6…or more! I just did that tonight.

    On a side note, I had a peach today before my physical therapy workout. After my workout, I felt drained. From a peach?

    Funny thing is…I went away this weekend and had several bad foods (I was able to control myself though) and didn’t feel lethargic afterwards. Plus, I had great runs (moved up my mileage to 5.5 miles from 5)

    What’s this about? Could there be an intolerance of some sort?

    Thanks for your advice.

    • If you go too long w/o carbs you can lose insulin sensitivity to your tissues. That is not a good thing. Insulin is not a bad thing, just too much of it is. That could be the problem. Or it could be that you’re eating a carb by itself – maybe try eating with a fat (coconut milk and fruit), or some protein.

  109. Julia S permalink

    Dear Dr. Gangemi,
    I eat pretty healthy but I have a sweet tooth. When I eat any desert following normal meal I feel sick and boated (which is not the case with healthy people as I’ve noticed), but if I eat sweets, of fruit on their own I feel great. After my husband mentioned one day that I eat way to much sugar (tea, coffee, occasional deserts) then I also remembered that my primary care physician once mentioned that my sugar is bit on a higher side (borderline), I’ve realized that my eating habits are not as healthy as I thought they were. I tried cutting down on sugar but instead learned that I am apparently addicted to it! I cannot last more than 2 days without sugar I crave it like crazy when deprived and have absolutely no energy. I tried sugar free diets twice in the past and failed both times.
    In terms of my health; I’ve had stomach problems for years and then I’ve been diagnosed with stomach ulcers and duodenum inflammation and was put on omeprazole to which (as I know now) I got addicted as I’ve been taking it for 4-5 years every day. Also, I’ve been feeling light-headed when I get up and I couldn’t run because I had pain under my left rib and was out of breath and I’ve been feeling like I will pass out (condition nobody could diagnose). Almost passing out situations would happen in crowded buses with no air as well but I do not have claustrophobia.
    This past year I’ve been feeling even sicker than usual. I’ve been bloated and nauseous and I have constant acid reflux (on omeprazole!) when I eat ANYTHING. Also, extremely low energy, cannot concentrate, cannot wake up in the morning, decline in memory (and I am 31), always tired, I am out of breath after I stairway case and I sweat too much (cold and hot)(I am not overweight 145Ib, 5”10½).
    Now I’ve been diagnosed with iron deficiency anemia, insufficient Vitamin D (10), and ulcers have healed. Taking ferrous sulfate and Vit D3 doesn’t help much (blood has more iron but hemoglobin is still low, D is still way blow the acceptable range).
    After much research I’ve decided that I have dysbiosis and insulin resistance. I learned that I need to ditch Omeprazole since it could be the cause of many of my troubles. My primary care p. told me to do TWT, so I googled it and found your website. She said if you feel better on this diet then the problem is sugar.
    Today is day 12 on TWT and 11 days free of Omeprazole – cannot believe I made this far! What I feel: acid reflux is continuously killing me, I cannot tolerate non-hydrogenated healthy oils like extra virgin olive, but butter is fine. I am kind of gaining weight on this diet and feeling always hungry and still get bloated after meals. The main problem is that I have even LESS ENERGY than before, every day is harder and harder to drag my feet around, however, my head seems to be better (concentration and memory).
    I feel like when I will have to assess the situation (in 2 days) and find foods that make me sick, those foods will be the foods I eat now. I know you will probably disagree with me as you highly promote Paleo-type diet (I read most of your articles on this site) and since I have dysbiosis I would tell me to follow FODMAPs in the future but animal fatty foods make me sick and heavy and depressed (and I am not a vegetarian by any means). I no longer crave sugar at this point but I do not feel satisfied eating like this. I would rather eat oatmeal or yogurt with fruits than omelette with turkey every morning it feels so heavy. I know that once I’ll start introducing fruits I will feel better, I feel like I have healthy fats intolerance! I don’t know how to make sense of all this because overall I do not feel better, or maybe I am analyzing too early?
    I just wanted to add that I’ve been on Atkins diet once in my live about 7 years ago for a month or so and I lost 0 Ib…

    • You may have a digestive problem that needs to be looked into, perhaps a food allergy or an infection. I’m not referring much right now because I get too many inquiries but you could check the website and see if there are any docs local to you if you can’t or don’t want to see me. You should call them first though to see if they may be able to help you because there is a wide variety of skill and focus areas with AK docs. Good luck.

  110. Julia S permalink

    I wish I could see you but I am in New York – too far :(. I am at doctors offices all the time, tests (endoscopies, blood) are not showing anything. I’ve seen immunologist, gastroenterologyst, gynecologist, primary care – nothing except what I’ve mentioned above… Thank you anyway. BTW your website is great :)

  111. Julia S permalink

    I’ve tried naturopaths and homeopaths but I haven’t tried AK docs… I’ll look into it!

  112. Susan permalink

    Two questions, can I use a small about of non dairy fat free creamer and what about egg subsitute?


  113. Rhiannon permalink

    Hi there,

    I have been tested for dairy and wheat intolerances and both came back negative. I am constantly bloated and have gas and sometimes my stomach will be sore.

    Further to that, I am always tired and have terrible dark circles under my eyes.

    Could this be CI? I think I will try the 2 week test starting this week.

    • Read the section on Allergies under Health Topics – testing for food allergies is often inaccurate.

  114. Are palpitations common during the TWT?

    • Common, but not normal. This can happen from glucose imbalances or electrolyte imbalances. Try eating more veges – especially celery and squash/zucchini.

  115. hi .. when i eat suger even a little bite i feel drawsiness and Nausea and iam not obese iam thin person

  116. Lingsu permalink

    Hi doctor,

    I have a few questions and it would be great if you could offset some guidance:

    Am I allowed to eat young Thai coconuts? I cant seem to find out if it’s a fruit or not.

    How much would you recommend I cut back on coffee? Currently I have 1 to 3 smallish cups a day.

    I have an extremely hard time with carb cravings in the evening even when I am full after dinner. I could literally eat an entire bag of sweet Cherries and still want more sugar. Do you have any tips to help battle this other than just leaving the house? I feel like I just can’t seem to get through one night without caving in and having some form of sugar. It’s always fruit though- I never crave or eat candy or anything processed. I try to satiate it by eating veggies and protein but I still end up eating fruit on top of it and end up stuffed! Any help or advice would be great.


    • Coconut milk and oil is okay but coconut “water” is not.

      Coffee is dependent per the person.

      Craving fruit like that is still craving sugar. Try some more fat in your diet, that often helps. Hopefully the 2WT will help you break the cycle.

  117. Amina permalink

    What should I do if the foods listed above in the “Avoid” list are cooked with foods that are allowed to eat ? Should I avoid the cooked food completed or is it okay to pick away the high carb foods.

  118. What is the system for re-introducing foods after day 14 (Which foods should you try first, what is the order in which certain foods should be introduced, how much of each food should you introduce, when should you try food #2, should you stop eating food#1 when introducing #2, how long should you wait for a reaction to the food if any)?

  119. Natalie permalink

    Hello Dr. Gangemi,

    Thank you so much for your website and information and attention to all of the questions. Finally, I don’t feel like a mutant! I’m going to begin the TWT tomorrow and I’m so so excited and hopeful that I will finally free myself from high blood pressure medicine, pcos, etc.

    A quick question about allowed foods for breakfast though. I do have high cholesterol so my egg intake is limited (i usually don’t eat them all actually) so I’m not sure what this leaves for breakfast. Any suggestions?

    • Read this, it will hopefully change your mind on the eggs:

      • Natalie permalink

        Thank you so much for the reply – the link seems broken though :(
        Again, I can’t tell you how excited I am to have found this site and know that I’m not alone or crazy. I have struggled with infertility, high blood pressure, and cysts on top of getting sick from eating certain foods. I’m so happy to know what to weed out for 2 weeks. I have a feeling this is giong to change my life! I’ve already shared your site with many!

  120. Cheryl permalink

    I have had a cough for at least 6 months and initially thought it was a cold or allergies and then acid reflux. I have had a candida problem which I started taking probiotics for and then decided the cough was a symptom of the candida. I am now wondering if the cough is due to an intolerance to carbs. I start coughing almost instantly after eating carbs. I get a cool sensation in the back of my throat which makes me cough. Is this a known symptom of Carbohydrate Intolerance?

    • Any “symptom” of carb intolerance is one that YOU have that resolves when you restrict or limit certain carbohydrate foods.

      • Cheryl permalink

        Thank you…. I will start the 2 week test today. I can have coffee, but what kind of creamer can I use? If the creamer is non dairy is that okay or should I stick only to half and half or pure cream?

  121. Ana Vee permalink

    Hi, i read the book “in fitness and in health” a good friend of mine designed his book if i remember it correctly :) i did this test 3 years ago and i lost 20 lbs…but i gained it all after a few months since i wasnt careful. so i am doing it again and hopefully improve and be able to maintain it. this is my 2nd day and i was wondering if

    … coconut water/juice is ok.

    i love carrot juice. been drinking it regularly… but its a bit expensive from where i’m from. a more available and inexpensive juice i could think of and that i like is the coconut water/juice. would love to know if it’s ok since its a fruit, a seed and a nut all at the same time. thank you!

  122. Faith Harper permalink

    I didn’t know CI was a known diagnosis but have been experiencing it for a few months now. I started having problems over 2 years ago with lower stomach discomfort and frequent urination and discovered coming off gluten helped but didn’t cure me. I then began to realize I was sensitive to all starches and sugars and have cut way back although I still try to eat some of the lower carb fruits (apples, pears and berries). However, I have grown increasingly intolerant to carbs and the way it affects me I wake up after only 3 or 4 hours of sleep with what feels like a blood sugar drop and I’m not able to get back to sleep. I plan to try the TWT diet, but also I’ve heard that vitamin D helps with blood sugar control. If you agree, I was wondering what dosage you would recommend for OTC supplements. Thanks so much for your site.

  123. Pam permalink

    I have been recently told that I am allergic to many things I was eating on a daily basis (cheese, milk, eggs, soy, almonds, garlic, gluten, etc).

    I have cut all of these things out of my diet for the last 16 days and still have not lost 1 pound. My digestion is better as is my sinus drainage.

    I used to eat low-carb but the report said I wasn’t allergic to corn, potatoes or rice so I started to add those back in to my diet.

    Could I also be CI? If you think it is possible, do you have any tips since I can’t have cheese, almonds etc?

  124. Tenielle permalink

    Why is mayonnaise allowed? Does it not contain some form of sugar?
    Are you allowed to use soy sauce?

  125. Hi Doctor I’m from South American Brazil, We have here in Porto Alegre capital of Rio Grande do Sul a great Clinical Hospital who researches this kinds of problems. However the test they make here is genetic tests and by this way it’s possible to map all carbohydrate is suitable or not and it’s called ortomolecular medicine . As a medicine student, I wouldn’t recommend TWT for students and people who has longer intensive brain activities. What’d you have to say about?

  126. Anne permalink


    I’m hoping you can help me out. If I think I am CI… what do I do if I am diagnosed with Addison’s Disease and Hashimotis?


    • Autoimmune diseases, especially Addison’s are far beyond the scope of internet advice. Though carb issues are common with autoimmune diseases and many people benefit from a low carb diet.

      • Anne permalink

        Thanks! I definitely feel better on a low carb diet!

  127. Natalia permalink

    Hi, are green beans and peas allowed on TWT?

  128. Kelli permalink

    Hi , my name is kelli, and i have just dont the lemon clense diet i did the ten days, and came off of it the way i was suppose to. The day i started eating again i bloated like i was pregnant , also had major soreness around my belly button area, for about 4 to 5 days. All i was eating was a organic vegtable soup they suggested for after the detox, on day 4 after the detox i started introducing raw fruits and vegtables back into the diet. I have now intorduced dairy including ice cream, cheese , and some bread. I have yet to add any meat back, but im soooo bloated now having pain?! Not just soreness and bloat anymore. I was wondering if the detox could have gotten rid of so many toxins, now my body i sensitive to everything? I do want to do this carbohydrate test, only because even before the detox i will struggle with these symtoms alot exp. the bloating all the time. I do have a question about beans , because i would consider them a vegtable. Are beans ok or peas?

  129. Phoebe permalink

    I just bought Jif’s crunchy peanut butter -reduced fat . But on the nutritional label I found that it contain 4g of sugar ang 15g of CHO per serving. So does it mean that I shall hide it away from me for the next 2weeks ? And are oyster sauce , black soy sauce allowed?

  130. Phoebe permalink

    And how about Probiotics like yakult?

  131. Rachel permalink

    A naturopathic doctor just told me to cut out fruit, sugar, canola oil, maple syrup, MSG, coffee, and black tea in order to improve my health. (I am 28 and I have been struggling with stomach pain, fatigue, headaches and high blood pressure for around 5 years). I have completely eliminated all the the above foods for the past 3 weeks and I am still having similar symptoms. I also feel that without any fruit I am not getting a well balanced diet. My doctor expected me to lose 15 lbs on this no sugar-no fruit diet but I have only lost 2 lbs in 3 weeks. What do you recommend?

  132. Missy permalink

    Just found out that peanut is a legume. Been eating them for my 3rd and 4th day of the test =( do i have to restart the test?

  133. Suzanne permalink

    I have been keeping my carbs strictly under 50 daily usually around 35 for the last 4 weeks. I have not lost any weight. I’ll lose 3 or 4 lbs and then gain it right back. My calories are around 1800 a day and I do water aerobics for 30-45 minutes sometimes more at least 5 times a week. HELP! The only carbs I’m getting is from vegetables. I don’t touch any “low carb” stuff at all… i’m so discouraged!


  134. Romi permalink

    Hi Dr. Gangemi,
    What does it mean if I get very bad bloating in my tummy and have abdominal pain whenever I eat white bread, cupcakes and pizza? I believe this is the opposite of being gluten-intolerant?
    Whole grains seems to have no negative affect on me…but then I keep hearing that it’s bad for you?
    I’m so frustrated because knowing what’s “good” for you is confusing because I keep hearing different things :/

    • Seriously? You don’t think that those foods are good for you, do you? Even if it’s not the gluten it could be the sugar in them – maybe not so much the bread unless there is white sugar in that. Your health isn’t about the diagnosis. If you eat a cupcake and it hurts your belly then does it really matter if it’s gluten or not? Of course not. If someone said you’re not gluten intolerant then would you eat it? Hopefully not. With the way foods are processed there is sometimes so much more involved. Many people cannot eat wheat in the USA but they go to Europe and they’re fine = less processing.

  135. Lost Ninja permalink


    Cramps after eating.
    Overweight (have been since childhood – never seriously overweight, but never correct weight either).
    Frequent severe headaches (2-3 a week or more).
    Broken sleep patterns.
    Severe reoccurring depression (body self image issues mostly – not specifically due to weight).

    Been struggling with feeling ill all the time for many years, a few years ago I worked out that Starch was causing a specific issue for me and consequently cut out 90% of what till then I had been eating. I no longer eat rice (at all), potatoes I cut down drastically (pretty much only eat the odd chip (fry?), bread (stopped eating shop bought bread entirely now make my own using Spelt flour) and pasta.

    And that helped I began to feel healthy, but over the last month or so with no change to my current diet the old symptoms have been coming back.

    I have a sweet tooth (though as I get older I find I crave savouries more and more) I especially enjoy chocolate and mints.

    Most of the food I eat is home made – I don’t each much ready made food. However I am on an extremely limited budget due to debt and living expenses I find that even on my current diet – which includes a fair amount of cheap high carb foods I struggle to buy enough food each week, switching to high meat (I can afford one meat ‘cut’ a fortnight – generally minced beef (ground?)) and or high veg diet would make this harder.

    I do eat/drink significant amounts of milk (semi skimmed) around a litre every two days or so and large amounts of cheese.

    I want to try the 2WT diet but am worried that not having enough food will make it harder to see positive benefits. If I try it and just miss some of the meals I would have eaten, will that invalidate the test?

    Just to make clear my current food bills currently cover around 10 of 14 days (get government benefit every 14 days and I can pay for enough food to last for around 10 of those days, with the last four days covered mostly with bread & jam.


    ***Not US based so sorry if some of my food choices are unclear…

  136. Romi permalink

    I wasn’t asking because I eat these foods ALL the time. I was asking because when I (rarely) eat it I get a very bad reaction and I assumed it was the white flour in the food.

  137. Anthony permalink

    Hello Doctor, Great work. Just found your site. Very informative. I am going to try the 2 week test. I believe I am very carb intolerant. Usually when I eat foods heavy in carbs I get very sleepy. I have tried supplements to blunt the release of glucose with no luck. My sleep pattern is thrown off considerably. I use sleep aids (melatonin) nightly. I usually wake up in the morning around 5 am to 7 am. I feel fine than around 9 am i get sleepy again and have to get a couple more hours of sleep. I also have a sweet tooth. I am going to get back into working out. My question is, is lactose free milk and ice cream ok?

  138. lavanya permalink

    when eat sour, iam getting joint pains. so which treatment i have to take please tell me



  140. Trevor permalink

    Hi, hope you are well.
    I’ve just started a carbohydrate intolerance test, i’m on my third day.
    The problem is, i cycle to work, which is a round trip of 15 miles.
    On my cycle ride home i feel very tired, and my legs feel heavy. Will this pass after a few more days?

    Many thanks…………..Trevor.

    • If your bike ride is aerobic and you’re burning fat then it will not be a problem. If you’re anaerobic and burning sugar (via diet or the intensity of the bike ride) then you’ll have the heavy legs. So go easy on the bike and if it doesn’t get better then don’t ride to work until your body has shifted from a sugar-burner to a fat-burner.

      • Trevor permalink

        Leaving the bike at home is a no no. My only form of transport.
        I’d say most of my ride is aerobic, although there are a few tough hills that take me over the thresh hold.
        As soon as my foot injury heals and i’ve finished the TWT, i’m going to start on the Maffetone method. I’m sick of getting injuries from running. so i’m hoping, with reducing my carb intake, slowing down my running, i’ll start feeling alot better within myself.
        Great site by the way!


  141. Tanya permalink

    Been on the TWT for 9 days now and am really tired. Felt great the first 3 days, lots of energy, in fact, I could not get to sleep and would wake up at ridiculous hours. Now that is all gone. Is this normal ?

    Apart from the tiredness, all my stomach symptoms (bloating, cramps, twinges, not being able to eat ) have gone completely.

    I read that you can have VG juice on this diet. Is this true ? It has 6.5g sugar per serving. Is this because it is the natural sugars from the vegetables?

    Dr. Mafettone introduces carbs back on every meal, not back to back . Why is yours different ?

  142. How to be sure that my body have changed to fat burn state? I have lost 6.6lbs though TWT. I can carry out weights exercises as usual and only feel the aching and heaviness upon waking the next day. However I do feel extra heavy climbing the stairs as compared before the TWT. I”m wondering if I”ve achieve TWT since I may have accidentally ate some food to be avoided when im eating out with my family such as sauces (probably contain some sugar and legumes ?).

  143. Lee permalink

    I get a lot of pressure in my stomach, almost immediately lose energy, have hot flashes and sweating after I eat ANYTHING. I’m foggy headed, can’t sleep and feel sluggish and dim witted. I came across this website and saw the symptoms of CI and they’re exactly what I’m experiencing…esp the overwhelming cravings for sugar and chocolate. However, I sometimes test my blood sugar when I have a “loss of energy” episode and its always between the “normals” of 80-100..maybe slightly higher. My MD says I’m definitely not diabetic. I know you can’t give out advice online but could this still be CI?

    • Blood sugar has little if nothing to do with it. It’s an absolute number, not a relative number. It’s a spot check and one of what’s in your blood, not your tissues. Have your Hemoglobin A1C level checked but ultimately it doesn’t matter what you call it – you crave sugars and that’s a carb problem.

  144. Tanya permalink

    Day 13 of my TWT and yesterday and today I am exhausted. Yesterday, I had to go and sleep and it was like I had been drugged and hit over the head with a hammer. I just could not lift my head up, I was so drowsy. Had not eaten anything that I am not allowed. Scrambled egg with clotted cream and sour cream, stir fried mushrooms, onion, red pepper, spices. Nothing that I have not had before.

    Has anyone had this tiredness on this test ? I am 5 foot 4, weigh 50 kg, and have only lost 300g on this . I have not cheated at all, been extremely strict.

    I am happy as my stomach problems and constipation problems have seemed to dissappear but I can’t handle this tiredness. By 10 am I am tired.

    Please help.

  145. SteveL permalink

    Are you eating lots of vegatables?

    • Tanya permalink

      Lots of vegetables. Never eaten so many, which is why I think my constipation has abated. My stomach has never felt better. Just so tired. Trying to put as much fat into my diet via butter, nuts, cream cheese, cheese, sour cream, etc. So don’t know what it is.

  146. Ann permalink

    Can I eat onions and how many?

  147. Jerry Johnston permalink

    Hello – I’m a vegan for the last 8 years, and a strict one that drinks dairy but no eggs. Mentioning strict in the sense it’s spiritual and therefore I don’t cheat, so what knowledge I’m giving you is straight up and hopefully that’s helps in understanding my problem. Having a staple for my afternoon/dinner main dinner used to include pasta, as I need something heavy with carbs so my used to be weightlifting body didn’t shrink into nothingness, and that was starting to happen. Then all these problems with dryness of the scalp in the thinning front, I’m 60, and in between the eyes, on each side of the nose and in the ears. Also red skin each side of the nose, rashes on the back of the neck and sides, behind ears, and on the chest with pimples. After I quit pasta, everything went away and went to quinoa with the same carbs, but they digest slower making them a better on the G index. This establishes the 2 week study to the point I know sugar has a problem with my body in one of many ways. Drinking beer in college for the first time introduced some huge pimples on my back that when they exploded had a core that when put under the micro in college chemistry showed it to be yeast. Then it was clear when I remembered back when I was in my early teens I got one ear infection after another from swimming and what followed was a bunch of series of antibiotics and penicillin. So my flora has always been out of balance,especially after not quitting drinking beer until I was 60. My blood is perfect, with sugar at the top of the scale and iron at the bottom, but otherwise fine. What do you think? Sure could use some help, as those symptoms seem like nothing but they’re a real hastle, as the skin is exposed and always excess sugar or glucose, or whatever toxin is coming out on the skin.

    • Megan permalink

      you are a vegetarian, not a vegan.
      Vegan means no animal products, such as eggs, DAIRY, or honey.

  148. Celia Kay permalink

    Hi. Thanks for this site. I am on day 18. 62 years old, healthy weight, which stayed the same throughout 2 week test. Test achieved desired result of my no longer needing to eat an extra meal about 3am each night. My sleep still a bit disturbed but improved in that I don’t wake up with gnawing hunger. My question is about fruit the first thing I added back in. Careful to go slowly, I’ve tried organic raspberries, blackberries, a single plum, an apple–always with a meal, then with plain yogurt (my second-add-in). Each time I eat fruit, I crash! Weak legs, foggy brain, have to fight to stay awake. I’ve been on a diet high in vegetables and fruits for most of my life, but now I am reassessing whether fruit might be a problem. Last two annual check-ups, MD reported that I have high blood sugar which mystifies me since I eat so few sweets. Fresh fruit has been my treat of choice so now I am confused. Advice? Thanks.

    • Check out the FODMAPS diet and only eat the fruits allowed. Typically sugar problems that don’t correct are due to gut dysbiosis (unhealthy flora in digestive tract).

      • Celia Kay permalink

        Looked at the FodMops Diet and it makes no sense given the test and then what I’ve added in. Research seems thin when I looked at citations.

  149. maria moniz permalink

    I noticed a few comments on adrenal fatigue. Would you suggest that
    someone with adrenal fatigue, cut out the stimulants, coffee, tea etc.
    If so caffeine withdrawals are eminent in a time span of only two weeks .

    Any suggestions?

    Thank You

    • That’s always best. If you get withdrawal headaches or other symptoms you can slowly wean off. If you have withdrawal symptoms, you have a dependence on the drug (caffeine).

  150. Ryan permalink

    Hi Dr G,
    I’m trying to work out my health as it has not been great in years. I have serious times of fatigue which I think has to do with low blood sugar.
    I did the twt and was feeling great.
    A night after the twt I had some dark chocolate 85%. Next morning I got up and had some vegetables (I would usually have some protein but not this morning)and went surfing (I went surfing while on the twt and felt great).
    While surfing I had hypoglycemic symptoms (fatigue, numb arms and legs, struggling to keep conscious) and had to stop.

    I then ate some chicken and vegetable soup and an apple. I felt much better but still had some fatigue. I am finding when this happens it takes 3 days of the twt diet to get my energy back. I thought if I was just hypoglycemic I would be instantly better after eating but as I have said it lasts 3 days. Would you think there is something else also happening? Should I just stick to the twt or paleo diet for the rest of my life as it makes me feel great?
    I understand that you may not be able to comment on this case. I have found your site to be filled with great information. Thanks so much.

    • You never want to do the 2WT diet for the “rest of your life” – it’s just a short test. Stick with the Paleo Diet. Low blood sugar is often from lack of fat in your diet or your body not efficiently burning fat (see aerobic articles on this site and sock-doc site) :)

  151. Read through at least 75% of the questions and replies, found it all very informative and I am definately going to do the 2WT. What I am looking for to help me choose wisely, is a list of foods that are carbohydrates. I get that corn and sugar snap peas are full of sugar, but I did not realize that I should cut out grains. I eat old fashion oatmeal with coconut milk for breakfast 5 days a week, thought I was doing something good. Is there a link that you can recommend that can give me the basics? Things like, all nuts are good except for…all veggies are good except for… or here is a list of what you can eat and here is what you should definitely not eat for the 2WT but can start to slowly reintroduce afterwards. It seems that quite a few folks are looking for the same answer as me, just asking about singular items, I would appreciate the whole picture. Thanks!

    • As far as I know, the lists I have provided in this post are the most comprehensive. I’ve updated them as questions have come through, for the most part.

      • Thanks, I did print the list to keep on hand at home and work. I always hear about good carbs and bad carbs, but to tell you the truth I am not carb savy. I will definately use your list for the test, then as a guide for afterwards and see what my body says is good or bad as I slowly try to reintroduce certain items that I love, like peaches! Going shopping tonight, both my husband and I will be starting the test tomorrow. Thank you again for your reply.

  152. Paul permalink

    I “invented” this test on my own, sort of experimented and decided to go all the way and keep my food 100% carb-free. I have been symptom-free for several months, almost from the day one. Dr. Gangemi, this is just an empirical confirmation of your method.

    But how come, I had gone to several doctors – including a GI specialist – describing the symptoms, and all I got was a nebulous “all is normal”. I had been tested but nothing unusual was found; bloodwork, endoscopy etc… Are doctors unaware of this condition, or they just think that chronic bloating, excessive gas, fatigue, weight gain, nausea, constipation are all normal?

    • Ha! Welcome to conventional medicine. I have several patients every year see me after seeing top GI “specialists” at major universities such as UNC & Duke who have been told: “What you eat has absolutely no relationship to your problem.” I’ve seen this with IBS, Crohn’s, colitis, and other problems.

  153. Isabella permalink

    Hi Dr Gangemi,

    I was wondering if I can use Chia seeds and Amaranth during the TWT?

    Many thanks.

  154. Can we have peas, carrots are ok right? What about pumkin and what about stevia? Thanks so much.

  155. Vivi permalink

    Could you help me out? I have been trying to figure out if I am allergic to something I am eating after negative skin tests to airborne things like pollen, cats etc. etc. I cough all the time due to mucus in my throat, have a runny nose and sinus congestion. Tried going off dairy for awhile. Ice cream and milk cause coughing right away, but that is about it. Tried gluten to find out I was doing it all wrong. But noticing that it could be sugar, sweetened things. Could this be so? I have coughing fits throughout the day and a lot at night while laying down.

    • It could be any food. You have to omit each suspected food 100% for a couple weeks to really see if it’s a problem. I’ve seen cane sugar a few times, never beet sugar.

  156. Thank you for this interesting and helpful information.

    Sometimes minutes after I eat, I become extremely ill and weak, fatigued to the point that I must sleep, depressed, irritable, with a beating sensation in the head, and joint pain. It’s as if my life force is sucked out of me. I’ve done this most of my life and have found no help from numerous doctors.

    I’m a 48 year-old woman with type 2 diabetes and a history of PCOS (I’ve since had a hysterectomy/oophorectomy), but often when I have these spells, my blood sugar isn’t too high or low–though they seem to be linked to carbs. I’m on Metformin but that doesn’t prevent these bouts of illness.

    It happened tonight, after I nibbled some pepperoni and mozzarella when I was making pizza for the family. By the time the pizza was done, I was too ill to eat. I slept several hours.

    Are these episodes likely caused from a carb intolerance or something else? I wonder if these symptoms could be from an impaired gallbladder. I recently had an ultra sound, but it showed no stones. Thyroid and adrenal tests always come back normal. I also have some minor lactose intolerance.

    I avoid social situations and often turn down invitations to parties as I never know when one of these spells will hit me.

    Any suggestions would be appreciated.


  157. Angela Apel permalink

    Dr. Gangemi,

    I have a two year old toddler that suffers from severe bloating in her face and stomach. I have tried everything and it seems to me that when she eats fruit or carbohydrates her symptoms show up. I had her tested at a G.I the only thing that we found is that her glucose was low. When she wakes up in the morning the swelling is minimal. By the time she goes to bed she looks like twice her size. She is also obsessed with food and wants to eat as often as every 20 minutes regardless of the size of the meal. Any insight on this would be so helpful!

    • I’d take her to someone who can help you figure out a metabolic or endocrine disorder in case that could be the issue. It could be much more simple but that’s very extreme going by what you’re saying.

  158. Kerry permalink

    Is it okay to use Kefir (no additives) on the 2-week test?

  159. Jenny Finlayson permalink

    I have been pretty much carb free for a number of years now. I can only eat a small piece of kumera and small handful of nuts in a day. I cannot eat fruit as the natural sugars are too high. An odd slice of apple does not really cause problems but cannot do this on a regular basis. I have trouble with dairy food and eggs and I am vegetarian also. This means I am just eating vegetables and and nuts sometimes when I get severely hungry, I do not eat grains, meat, chicken, seafood,sugar, milk, fruit accept on rare occasions. I found this out myself as the doctors and dietitians are of no use at all. It has been about 6 very long years. Not all my problems have totally gone but most. I cannot eliminate anything else from my diet.Should I be taking anything to keep me healthy like vitamins.I do take flaxseed oil. The worst problem I am left with is psorisis at least my daughter thinks it is that the doctor has no idea what it is and said it is acnea. It is across my shoulders and is painful and itchy all at the same time and seems to bleed alot.

  160. Heather Starr permalink

    I have the neuro-muscular disease Friedreich’s Ataxia (FA), I think CI has been an issue for years. I am just learning of it. I have gained about 55 lbs, and by trying to shed the weight, I am finding out more about CI, and how it is involved in my FA.

    Is the TwT recommended? & why cant we have splenda?, ever or just on the TwT?

    • Whether you want to try the TWT, Paleo Diet, or FODMAPs diet would be up to you. For info on Splenda (and these other diets), use the search engine on the sidebar.

  161. Becky permalink

    I did the 2 week test back in May, great test I recommend to all as it taught me to eat to make my body feel great. I learned I need very low carbs no wheat and low sugars. Since Thanksgiving I have crept up my carb and sugar intake and my body is aching and I am feeling the consequences of to many carbs and sugars.
    My question is: Would you recommend me to do 2 week test all over again, or can I just get back to the low carb and sugars, or can I do a modified 2 week test with some carbs as fruits? Any thoughts on this?

  162. Rachel permalink

    Dr Gangemi,

    I’m very happy to have found you website! I’m currently on day 5 of the TWT that I’ve discovered in Phil Maffetone’s book and my question is: can you really eat as much as you want of the allowed foods? I don’t have any weight issues and have a quite low body fat index (15%) but am afraid about putting on weight if I need too much cheese or nuts… The problem is: I’m too hungry if I stick to lean meat and other lean proteins….!
    I can’t find the answer anywhere so could you please help me on this?

    I’m a ultra runner and sports coach so I’m quite active.

    Many thanks!

    • Yeah you pretty much can eat all you want, of course though that doesn’t mean you eat butter and bacon all day. :)

  163. Rachel permalink

    Many thanks for your quick reply!
    I’ll let you know how it goes…

  164. Tristan permalink

    I was on day two of the diet and forgot the part about no extrenous workouts and went to an intense 1 hour spinning class.

    About an hour after class, I got extremely dizzy, nauseous, and weak. I ate a chicken salad (stuck to the diet) and felt much better. That night around 2 AM I woke up with incredible night sweats and that morning felt so weak I couldnt even stand. My husband got me a bowl of cereal and milk (didnt stick to the diet) and afterwards I felt much better. About 3 hours later at work, I started feeling my regular symptoms after eating sweets – nausea, bloating and fatigue but then it got so bad I could barely stand again and felt incredibly dizzy. I quickly drank a bottle of orange juice and felt much better.

    Does this mean the diet is too extreme for me? Do I have something more than CI? I’ve gotten my blood sugar checked a couple times and have had a glucose test and everything has turned out fine. FYI, Diabetes and thyroid problems do run in my family..

    • It means your body is very inefficient at burning fat as fuel. I can’t diagnose you (of course), so it’s impossible to know if you have something more than CI. However, your symptoms are very similar to someone with this problem. No hard exercise and eat lots of veges. The first week to ten days will most likely be hell for you. :(

      If you decided to do the TWT you need to start all over.

  165. Juan permalink

    If i’m not wrong using fat for fuel would produce more ketones and induce a state of ketosis. Isn’t it a bad thing?

    • That’s a good thing in a low amount but even then only happens sometimes. I’m not saying you have to be anywhere near high ketosis levels for this to occur (fat over sugar).

  166. Amanda permalink

    Can carbohydrate intolerance cause dysnea from bloating in the upper digestive track and pressure on the lungs?

  167. Karen permalink

    I have spent the past few days looking at your website and find it very interesting. I was diagnosed with ME/CFS 4 years ago at the age of 40. I had been ill, getting progressively more ill for about 20 years prior to that.
    I couldn’t find any reference to ME in any of the comments but for years I have been convinced my illness is food related. To try and get Doctors to help with this in the UK is difficult to say the least!

    I have craved carbs since childhood but I would say I have a very healthy diet – Organics veggies, no processed food, cooked breakfasts, herbal teas, no alcohol, you get the picture. I have cut out wheat and dairy but only had slight improvement. All rice or pasta is whole grain. The chronic fatigue remains and now my 11 year old son has been diagnosed with it. The scary thing here is he loves his carbs!! I have been trying the two week diet for about 4 days and I feel like I’ve lost a dress size (I’m not overweight to begin with) and my head feels a little clearer but when I’m fatigued my will power is weak.

    I suppose my interest is whether ME/CFS could be partly, or even wholly,to do with the food we eat and despite the fatigue should I keep going? Getting support on this is so difficult so your information on the website is invaluable. Thank you.

    • Many diseases are linked to the foods we eat, in some way or another. Not all of them – but cleaning up you diet typically even helps symptoms from diseases which are not diet specific.

  168. Sarah permalink

    Can I have canned tomatoes during the TWT?

  169. Mattheworbit permalink

    Hi Dr,

    Thank you for your research, and for this post. I’ve read through pretty much 95% of the comments.

    I’ve been vegan for 5 years, despite being a bit of a carnivore at heart (I prefer proteins & veg and don’t desire wholegrains or fruit), but I do crave sugar, and love flour products. I know these are a no on.

    My symptoms were all non specific – excess weight gain, shakiness, confusion & frustration in the afternoons after having carbs for lunch and a need to eat extremely quickly, along with depression, dry skin, etc etc. I don’t have any intolerances, allergies, or serious health issues.

    I’ve been following your diet strictly for 5 days now, and I feel dreadful. I’ve felt pretty dreadful since day 2 – I honestly feel like I’m almost dying. Just absolutely exhausted. My brain doesn’t work – I have a “tightness” in my brain. Though, there have been times when I’ve felt fantastic – but mostly terrible, like I’ve never felt before.

    The good thing is – I am feeling a lot more satisfied -I have added some free range organic dairy in, and eggs from the neighbour’s chickens – and suddenly, I find myself full after a small amount of food, instead of the usual huge amount I’d have to eat. I’m definitely eating a lot of saturated fats.

    I just wanted your opinion – are my extreme exhaustion/frustration/lack of concentration/odd brain tightness feelings normal? Is this just my body learning to give up carbs and swap for fats? Your advice would be much appreciated.



    • I cannot offer you specific advice. But as you know, the more your body is running off of sugar and the less off fat then the more miserable the 2WT will be for you. It’s not “normal” but very common. When I have a patient do the 2WT and they hate me for it around the first week, I tell them to stick it out.

  170. shannon permalink

    have received info on making breads with grains like oats and quinoa, etc. are these allowed?

  171. Machis permalink

    I lost almost 60 lbs on a physician-supervised low carb low fat diet. While under that doctor’s care, it was discovered that I am carb sensitive. One bite of broccoli or kale, cabbage or any kind of carb pulled me right out of ketosis. Pretty much the whole three months I was on that diet, I could only eat meat and lose weight.

    Of course, that lifestyle is impossible to maintain; all the weight is back again. I am trying to go ketogenic but am concerned about the carb sensitive issue, as well as adrenal fatigue. From the research I’ve done, it seems that many folks who are like me – in the 50+ years old category – share this problem.

    What kind of guidance is offered to folks like me? I am seriously in need of some wisdom on this, since I don’t want to go meat-only for another three months.

    Thank you!!!

    • My best thought here is that there is some nutrient deficiency that is affecting or some hormonal problem (usually adrenal) setting you up for such sensitive insulin resistance. If I were you I’d see out a holistic doc who can help you figure this out.

      • Machis permalink

        Thank you for your reply. I have been seeing a naturopathic physician since August but have seen no improvement. This despite being on a regimen of pharmaceutical grade supplements and herbs, as well as being vigilant about my diet (paleo/ketogenic). My diet doctor suggested that my Native American heritage may predispose me to being carb sensitive, and that focusing on meats as a dietary mainstay may be beneficial (Type O blood, too). While that makes sense to a point, it’s not the most practical way to live. Frustrated!

        Thanks again.

  172. gurpreet permalink


    Can I use almond flour during TWT ?


  173. Lisa permalink

    Dr. Gangemi,
    I have read comments to ensure I wasn’t duplicating. Please assist with this: I have been struggling with what I have been told is hypoglycemia. I awaken with a terrible headache because of hunger. Sometimes my sugar is low, other times it’s in the 70’s (per glucometer) I eat breakfast around 6:30 but if I don’t have a ‘meal’ by 9:30, I get weak, brain-foggy, irritable, migraine, shaky. When I finally eat by 10:00, all symptoms go away except the headache. The headache from breakfast is still lingering and then the mid-lunch one adds to it. I eat lunch (I’m a teacher) at 11:30 and by then I’m actually hungry which means my headache worsens. It’s the same cycle all day. I now have an ulcer from taking NSAIDs and prescribed meds for migraines. I see an Endo who thought I had an insulinoma because of a high c-peptide level; no tumor. I know I am unable to eat sugar of any kind without the high /low sugar thing. In fact I eat any sweet of any kind before I eat a meal. I have tried your TWT. It really made me realize how poorly I eat. Everything not to eat is what I usually consume – except fruits and other sweets. I still had the fatigue and was bloated a great deal but I did feel better overall. I have to eat 6 times a day but still get the intense headaches; your thoughts?

    • Try the FODMAPS Diet now and you need to eventually get yourself to STOP eating 6X a day. Need to eat more fat & protein 3-4X a day to stabilize your blood sugar.

  174. Michelle permalink

    Hi all

    I am amazed at how confused everyone is. My advice to all is to be your own scientist and research as much as you can and then ask your question.

    We really are a product of the food industry marketing machine and it is very scary to watch. If the internet has a legacy I hope it is that we learn to heal ourselves.

    Thanks for this wonderful site. Just read it!!

  175. Lisa permalink

    I was LC (50g Carbs) Paleo for over a year and it helped with: weight loss (15+ lbs), bloating, GERD, dyspepsia, fungal infections, gas, and allergy symptoms), but the biggest issue was feeling tired/fatigued all the time, trouble concentrating and then trouble falling asleep (sometimes I lie there awake for 3+ hours). Most advice I received was to add more carbs…so…

    I decided tried more to see what would happen. I started with wheat, because it was the easiest, and at the time I was out of town, so had no way to cook. Although my energy somewhat improved, eating wheat resulted in my allergy symptoms returning with a vengeance and some bloating/gas. I went back to a week of VLC Paleo to get those symptoms under control.

    Then, about 1 week ago I tried eating some boiled potatoes, more carrots than before, and some beets, too.

    Here’s what I have noticed since trying to add back more carbs: While wheat causes me allergy symptoms (sneezing, flushed skin, itchy eyes, gut noises,) my energy improved somewhat. Potatoes seem to cause severe bloating, but my energy levels are through the roof (even right when I wake up), my moods stabilized and I fall asleep much faster. Concentration is also greatly improved. My breathing got easier and my muscles don’t seem as “achy” or weak. I had lower back pain before and that has also largely improved. I even feel like exercising! But, no matter how little potato I eat, I am bloated to the point that all my clothes are uncomfortable, and I still FEEL hungry. When eating VLC Paleo, I hardly ever felt hungry, but my energy level was so low that I rarely made it through a day of work, much less accomplished anything afterwards. Is there anything you can guess that might be the crux of my issue or a way to obtain enough carbs for adequate energy, but without all the bloating? My different body parts seem to be having quite a disagreement…

  176. MATIN permalink

    I am a diabetic patient. Due to skipping meal Metformin and diamicron harmed me. It made me hypoglycemic. When those stopped, sugar went high. I am taking insulin humalog and levemir. Though sugar is under control, But still I have lot of symptoms. My body does not accept carbs. I am eating 40 grams brown rice 5 gram cabbage or cauliflower and 2 piece chicken leg 3 times a day . My life is not normal. I am reative to tyramine rich foods, nuts, beans, figs, avacado etc. Only meat or living fish I can it. Can you please give meal plan? Or tell me how to avoid symptoms of carb intolerance.

  177. Autumn permalink

    Great information! I see that you recommend Whey Cool protein as a protein supplement, but I’m wondering if it’s okay to use during the TWT? I checked out Whey Cool’s unsweetened protein, but it appears that it has some carbs. (Maybe that answers my question!) Just wondering if there’s an alternative. I have never been able to tolerate eating breakfast early, but can tolerate drinking a protein drink within an hour or so of waking.

  178. rebecca permalink

    Hi.. eggplant and squash.. are they considered fruit or vegetables?

  179. Whatever permalink

    So, what do you do if your symptoms are worse or you have new ones? Like, oh I don’t know, can’t sleep, jittery, lousy mood, irritable. Yep don’t need you “test.” That’s what this masked low carb diet does for me. Oh yeah, I guess that’s because I would now be in starvation mode. Starving the body through ketosis. Not a very nice option. No thanks.

  180. Is coffee ok? and I love me some flavored coffee creamer. Is there a creamer that i can use during this TWT??? Fat free, Sugar free??? Please say yes!! LOL

  181. Linda Swanson permalink

    I have completed the twt ( only it has been more like four weeks as I’m not exactly sure as to what order carbs should be added and I feel so good that I don’t want to ruin this). After eating 3 spoonfuls if organic brown rice I immediately began to yawn and had difficulty swallowing saliva. I felt as though there was a lump in my esophagus. I began yawning again today after eating a few bites of fresh apricot. Frozen raspberries are fine, but when I ate an apple I immediately went to sleep in my chair. I immediately fell asleep after eating a few roasted peanuts, too, but they were fine prior to this. Raw walnuts gave me a painful bubble sensation in my esophagus with excessive mucus relieved only by burping it up. it sounds awful and it is. Especially in a restaurant. Help! I haven’t seen the yawning and esophagus issues in this forum. Can you help me?

  182. Mary Ellen permalink

    over the years I have noticed that when eating the “whites” – sugar, flour, breads, dairy – including yogurt & milk, rice, pasta, potatoes, any processed foods, I gain weight and it happens overnight! Nobody believes that even a small serving of anything – like a salad with breaded chicken, would have an affect on me but it does! Not only do I feel like a whale but the weight goes up. I appreciate the fact that I found this article and all of your comments because that is how I’ve been handling my situation. Even though I was doing rigorous exercise, I still could not even eat anything in the wheat versions either! I do however use protein shakes and the Atkin’s bars in between. My intake of veggies has greatly increased even though I can’t stand them, this is just the way it has to be if I want to keep myself healthy. I still am approx. 50 pounds overweight but this will reduce in time as long as I maintain a strict diet without eating any of the foods that create my weight gain. Thank you!

    • Jenny permalink

      I also have found the same and eat heaps of vege in everyway imaginable fortunately I am vegetarian and I love them but I also have problems wth eggs and dried beans as too much protein means I get the most terrible night cramps. So quiches and fritatas are out just salad and steamed boiled baked etc. Vege it is tough goig but so are the problems when you eat wrong. You have a choice to feel well or not to feel well. I also have the same pro lems with fruit. I can fill an A4 page with my symptoms if I eat wrong. I can not work or do anything really and depression sets in big time. I get pressured at work and everywhere as I do not fit in socially as all I can drink is water.

    • Jenny permalink

      just read your message. I have found the very same things you have and I am vegetarian so eat only vegies but I do love them just long to be able to end my meal with something different. I can not eat fruit either. This leaves me with veg. plus veg plus veg everyday. As soon as I get sick of it or get pushed by some professional to eat differently I am in big trouble. My symptoms could fill a A4 page as my councillor got me to try things and I wrote out what happened. I also get very depressed and suicidal when I digress from my diet. I cannot eat eggs either as they give me terrible night cramps. I have found that tomatoes also give me huge problems. No eggs cuts out frittata and quiche etc so until some one can find out what is wrong. It is veg for breakfast lunch and tea. Only water to drink and no social life as that is too difficult. If I go out for the day I have to take all my food as there are food additives in so many things. I feel trapped but have learnt to live with it for about 4 years now.

  183. Kathy permalink

    Thank you for all the fantastic advice and information. I am on day 8 of the 2-week test. Days 1-3 were OK, 4-6 very lethargic and sluggish, but from day 7 I feel great with lots of energy, no bloating or sore stomach, alert and sleeping well. I am now concerned about coming off the test and adding carbohydrates again. I was wondering if you could tell me what kind of carbohydrates you include in your diet, and what amount/frequency. I understand that carbo tolerance differs for each individual, but some kind of guideline would be useful as I would like to remain at the minimum level possible, if possible.
    Thank you for your time.

  184. Sarah W. permalink

    I worry about not getting enough B vitamins and fiber without “good” carbs…. how do you account for missing the best and most valuable parts of the foods you can’t eat?

  185. Paula permalink

    Hi Jenny,
    Thank you for your comment. My heart pounding has been reduced since since I stopped all grains and fruits too, but my hands have a tingling or numb sensation. I wake up with the sensations and like I was shot out of a cannon!! The websites state you will have more energy when you stop bad carbs, which was great when I first started with the SB diet 7 years ago. I felt rested with an abundance of energy, Now, It feels like the opposite, when I have carbs… I do not get sleepy. I get nervous and jittery! It is like I can not turn off the energy or jittery feeling. It can last all day. It is possible I have something else along with CI, however, can not find a doctor who can tell me what is wrong, including C!. Any suggestions of what type of Doctor I can go to that might specialize in this. Thanks again.

    • Jenny permalink

      I am currently seeing a natural healing person who does a asyra analysis where you hold two copper bars and a machine analyses every cell in the body and gives a report and then she treats me naturally and with homeopathy. It is rather expensive and I have only seen her once so it is still early days and is very expensive so can not tell you much yet. But even she does not seem to understand my problems that affect every part of my existence. She treats the body holistically and hopes everything will come right with time. I see her again this week. But good luck as I have been to doctors specialists and health people and no one understands or listens to what I am saying. We had a barbeque breakfast at work the other day and I sit there with my cup of hot water and some biscuits made from entirely seeds while the rest partake of all the goodies not very socially acceptable I am afraid. My social life is non excitant I am afraid. Each day is a challenge and I take one day at a time even though I have lived like this for 3 to 4 years it does not get any easier. The only thing that keeps me going is the knowledge of all the symptoms I have as soon as I go off my ‘diet’ I am unable to eat eggs or tomatoes and margarine is off my list as well so it is just vegetables for me and the more green everything is the better. I am vegetarian as well but am sure I would react to meat as this test came up with beef as a being 1 of the things I am allergic to as well. I have soup with coconut cream in it for breakfast. Salad or steamed vege or stir fry for lunch with kumera in some form as chips or baked or just boiled. Tea finds me eating a small salad or more soup and maybe some of my seed biscuits. Jenny

  186. grant permalink

    On the two week test, Can i have Iso Whey Protein, and the Herbalife nutritional shake??

  187. Monica permalink

    I have a problem, I have intolerance to sugar and diary. Difficult to know the right food to eat in those two weeks. Can you help? Thank you.

  188. Sophia permalink

    Hi doctor, thanks for all of this information!

    I started the TWT yesterday— but wanted to ask about cinnamon and a specific almond milk. I put both cinnamon and almond milk in my coffee, just noticing that cinnamon is actually very sweet.

    Also– is cardamom ok? and rose or orange blossom waters okay? (They are distilled, used in cooking).

    I basically took organic heavy cream and beat it with cardamom, cinnamon, and orange blossom water. It’s like a dessert but I’m now thinking that’s not ok?

    Here’s the almond milk ingredients if you don’t mind checking:


  189. Shelly Clark permalink

    I am SO glad I came across this site!!! I’ve lived the last 4+ years on a strictly gluten free diet, the first few years of which were very limited. But as I became more familiar with shopping for, and preparing, gluten free meals, my health once again started to decline. When I’d get sick, I always suspected gluten poisoning, as the symptoms I experienced were identical to those of Celiac, But I could never identify HOW I’d been contaminated. In June of last year, after months of being so ill I literally could not get out of bed some days, I got desperate. I ate meat, cheese, and vegetables only, peanut butter, eggs, and gluten free nut crackers with tuna, and drank nothing but water. I lost 19 pounds in 19 days. The only sweet I had was marshmallows. I began to worry what my limited diet was doing to my long term health so I expanded my diet to include gluten free cereals and breakfast bars, and gluten free corn muffins, gluten free bread once a week. When I ate the breads, either the sandwich bread or corn muffins, I would have to take a laxative pill several nights in a row because my bowels would completely shut down. Once again, symptoms returned. :(
    I finally decided to see a doctor. He did a complete Autoimmune Diseases panel, checked my thyroid, tested me for late-stage Lyme disease and numerous other things, and then referred me to a rheumatologist and a gastroenterologist, neither of which have been seen as of yet. He’s convinced, although results of the blood work were negative, that I have Lupus (I have what he calls a “butterfly rash”, and all of my symptoms are consistent with Lupus, he says). But after reading the information on this site, I’m convinced I’m carb Intolerant. I am on day three of the TWT, and already feel different, much like I did last year when I cut all those things out of my diet; however, this evening I’m feeling an ache under my right ribs and between my shoulder blades. I’ve had gallbladder problems in the past and I”m certain that’s what’s going on now. I’d rather not have to contend with a full-blown gallbladder attack. Can you offer some suggestions that might help calm this monster before it takes over? How do I modify the diet to accomodate this irritable beast?? Thank you! :)

  190. Sophia permalink

    Ricotta Cheese?

  191. maxine nikita permalink

    i tried the two-way test, true enough, all my symptoms were gone! i am slimmer now, enough energy to meet the day, can walk up and down the stairs and more relax now. i knew now how to reduced my carb intake. i thanked God for you your articles on Carb Intolerance. God bless!!!

  192. Susan Francis permalink

    This is day 12 of the Two Week Test. I am not feeling a lot better. Still feel weak after eating and fighting to stat out of bed. I have not cheated. I have been diagnosed with adrenal fatigue and candida. Will continue the ttw because I am pretty sure I have CI, but wondering if the other conditions might be causing my symptoms. By the way, I have lost from 107 to 101. 5’4″ tall. Can’t afford to lose too much more weight. Any advise is appreciated.

  193. Kasey permalink

    I am sensitive to carbs. Primarily to flour and sugar. I have been living a 10net carb lifestyle for the last 6 months. My blood pressure is under control, my periods are regular (Doctor says that we can try to have a family now!!), my cholesterol is normal, and out of the woods for diabetes. I have gone from 301lbs to 185lbs in a total of 9months.

    I have tried to add back in carbs with no success. But, I am ok with that. I knew living without certain carbs was a lifestyle change. I was hoping it wasn’t going to be permanent.

    Best of luck to anyone eliminating carbs.
    You can do it!!!

  194. heather permalink

    Hi, i have tried the carb detox, which is great the first 5-7 days, but after that I start to feel so weak, dizzy, blacking out, headache, tired, moody, no energy at all!! On the plus side i was losing weight( I need to lose). I have tried to eat more, but i still don’t feel right. Could this be a problem with my sugar getting too low or something Im not aware of? Oh and at night when i lay down to sleep i feel horrible( almost flu symptoms).

  195. Nancy Estelle permalink

    I was initially diagnosed with an auto immune issue and put on an AIPaleo diet. Unfortunately, I do not do well on any starchy carb veggies like potatoes, sweet potatoes, butternut squash, spaghetti squash… I have recently been to another doc who said I had insulin resistance, adrenal fatigue, very low sodium potassium ratio, and a calcium mag imbalance as well. He told me to stay off carbs and put me on nutritional supplements to raise the other electrolytes. For a long time I thought this was SIBO. But, the more I read here, it sounds more like this carbohydrate intolerance. What is the difference between CI and SIBO. I really believe I should be taking a better probiotic. Would you agree? Also, I have lost 23 lbs this past year and am very thin (5’7″, 115)…what can I do to gain some weight eating for CI?

  196. sierra permalink

    is anyone else severely reactive to food like me? all i can have is chicken, eggs, steamed spinach, steamed broccoli and steamed carrots. raw vegetables hurt my stomach. I recently discovered nuts do not agree with me…. ugh if i crash and have a piece of candy or something sugary i have the worst symptoms plus the next morning i will be 4-5 lbs heavier!! is anyone else in the same boat as me? i need some encouragement :(

  197. sierra permalink

    i believe i am severely insulin resistant, and I’ve been diagnosed with adrenal fatigue and PCOS they said my thyroid is in normal range but i find that hard to believe. if i follow the TWT will i lose weight or with all my problems will it take even longer?

  198. Jenny permalink

    Hi! I am in the same boat with the same problems. I have just been diagnosed with cancer after spending 18 months listening to others who tell me it is in my HEAD and have told me to eat other things. I ended this year so sick and 2 days before Christmas was told I have Cancer and am now struggling with other things as well. Jenny

  199. SteveL permalink

    I am in the same boat in that I am very carbohydrate intolerant. If I eat even a bit to many carbs my sinuses swell and my blood sugars rise. It is not easy to eat low carb but I’m finding it easier the longer I go. I am wheat free now and that helps a lot. Once you’ve managed to go wheat free for say six weeks that won’t be hard to stay that way from there on out.

  200. marlene permalink

    dr young says lentils and soybeans are low carb…could they be included for a vegan?

  201. Spiralgal permalink

    I am a mess and want to try the challenge. I have motility issues that started with stomach spasms and bloating whenever I ate starches like potatoes, bananas or a sugary item like dried apricots. Now it happens with everything I eat with a full autonomic response…stomach spasm, dry eye, headache, running nose, weakness, confusion, pain in the ears. It is difficult to eat or even drink because I react. So I want to try this, but I am allergic to eggs and all dairy. I can eat veggies and grass fed meats and wild fish, but that is it. How do I get the calories I need? I am already very very thin and don’t want to lose any weight…plus I often get hypoglycemia. Suggestions of how to get enough calories?

  202. Marco S. permalink

    Hi Dr. Gangemi, I write from Italy. I am 38 years, weight 59 kg and 1.73 high. I write from so far away because this is one of the few sites that I found that talks about carbohydrate intolerance. I think I’m intolerant to carbohydrates because I have all the symptoms you mention and I have since I was a child. I tried the TWT and I was much better, the problem is that as I go back to eat some carbohydrate back all the symptoms and I get sick.
    In particular, my symptoms are abdominal pain, nausea, diarrhea, heartburn, bloating, borborygmi, heaviness, fatigue, heavy legs and muscles, difficulty sleeping and breathing, fissures and red spots on the body and many others.
    A question that I’d like to Dr. Gangemi, in addition to the TWT is whether there is any medicine or holistic remedy for reducing sinotomi?
    At this time I take probiotics only Solgar Acidophilus Bifidus.

  203. Michelle permalink

    What if I am pregnant and have GD. Can I follow this? I find that my blood sugars are a lot better when I don’t have any carbs. I am not on insulin just being monitored. When I have carbs/grains my blood sugars rise to just above normal.

  204. LInda permalink


    This is all very interesting and might be the solution to a problem that no doctor in has been able to help solve in 40 years – but………it seems harder than is possible to want to do when vegan. Is tofu considered a processed food? Oh, it comes from soya bean, so not allowed. Without fruit or sweet potato, or almonds, I’d be so severely restricted. Sunflower seeds and vegies just don’t seem enough. Advice please. After 1.5 weeks on a high gluten diet for a coeliacs test (am pretty sure it’s not the problem), I really think CI is it. Perhaps I need to have two weeks off work to do it and see?

  205. Zaph permalink

    So, basically this is LCHF. Definitely helps.
    If there are further issues, combining with Low FODMAP will probably cure the rest. It just means there’s not that much left to eat. Yay!

  206. sofia permalink

    Hi great website and so glad I found it!

    My Question is: would you advice to try the twt free of carbs first and see what symptoms are experienced when adding carbs back in before trying the Fodmaps diet, or go straight for the Fodmaps?

    I am 29 years old and over the last decade I have struggled with my diet and have had many symptoms and acute episodes including pain, bloating, constipation, diarrhoea, piles, achne x3 times, psoriasis, weight gain, abdominal spasms, ulcers, fatigue, dry eyes, I have PCOS and most recently i have a rash on my arms and legs that is very sporadic and just two weeks ago I had hammertoe surgery for something that started out as a tingling/numbness feeling in my feet when i was walking/exercising (no real explanation for same). I have tried a strict gluten free and dairy free diet which helps but still cant eat gluten free carbs and I definitely still have allergies/intolerances. But now im wondering if I could have SIBO or dysbiosis. or is it even possible to have something like that for such a long time. If so what test can diagnose?

    all of your help is much appreciated

  207. Tracey permalink

    Hi, these symptoms sound similar to MS. I have the headache, bloating, loss of energy, weakness and the ever unpleasant feeling of being off balance. I am interested in trying this test, I am wondering if this and MS can mimic eachother. I have not gone back to the doctor to find out because I am afraid of hearing the worst, I may be in denial but it is hard to express what I feel my body doing I feel like I am crazy. Just seems like one person can not feel this bad, any advise I would really appreciate I am tired of being this way.

  208. Andrea permalink

    I have pcos and do a full time low carb no sugar diet. When I do eat bread my face hands legs and feet swell like crazy. Is this a gluten allergy or just insulin resistance?

  209. Andrea permalink

    Hi, I have a question regarding carb fueling and running.Most of the the questions on the website revolve around triathalons and longer endurance events than I do. I am insulin resistance, D1 college runner and having performance issues. We race 6k and was wondering if low carb would work because all my races are 6k or less? How do I determine carb needs for training/racing when the longest we train is 90 minutes, once a week.I would like to do the TWT when I start my 2 week rest period but don’t know what to change when I start training again.

  210. jim permalink

    Is there a way to do this test and follow up and incorporate my glucose meter. I suffer from Dawn syndrome where my morning glucose is always high then drops during the day.

  211. jim permalink

    WHat would a good target be for post meal and morning glucose if I were trying to eliminate the chance f plaque build up ?

  212. Salma permalink

    I didn’t realise up till now why I was having lose control. Out of the usual experiencing after eating sugary fruits had the same situation I was assuming due to lactose problem. I had my food I test done, I should avoid 65 out of 360. Will it get cure as it all started from series of antibiotics. Please advise. Thank you

  213. jaime permalink

    I have eaten Peanut butter all My life, until recently I cant seem to digest it. It keeps awake at night, I am restless break out in sweats and I get cramps. I usually end up being sick in the middle of the night (several times) as if my stomach is no longer able to metabolize it. I wake up unsteady with what some might refer to as “flu-like symptoms”, have I somehow developed an allergic reaction to peanut butter? Because that would be sad.

  214. Marco permalink


    I’ve read the whole article and all of the comments – thank you so so much – and as I’ve noticed that the carb intolerance and other intolerances seem always connected to lack of enzymes and of good gut bacteria, why shouldn’t some good probiotics and digestive enzymes help you heal?
    Would it be possible to heal definitively after doing a TWT and by adding high quality probiotics and enzymes as supplements (amylase, ecc.)?
    Do you recommend them, and if so, for how much time?

  215. Shirley Ledgerwood permalink

    I did the 2 week test and there was a DRAMATIC change in the way I felt, functioned, etc. In the past I could tolerate a small amount of carbohydrates, but now I cannot even eat an apple or a peach, I sleep for long periods of time (if I were to eat a baked potato I would sleep for at least 4 days, waking only to go to bathroom–so I do not eat potatoes, corn, etc). Also, I have swelling all over my body, legs, arms, face, etc. and I gain from 8 to 10 lbs. I have a very small urine stream, etc. After the initial phase passes I then start urinating normal stream and amount, swelling goes away and I will lose 8 to 10 lbs over a 2 day period. It seems something needs to be done since I cannot tolerate any carbs but my primary care physician has run TSH and various blood tests and he tells me that he doesn’t doubt what I am telling him (he has seem me swollen and always wants to have an ultrasound to check for blood clots in my legs, etc). It does not seem healthy to not eat any carbohydrates. Please give me your opinion. Thanks.

  216. Shirley Ledgerwood permalink

    I should have mentioned in my previous comments that I have celiac disease so no wheat, oats, etc and am also lactose intolerant. So you put this together with no carbs and eating is pretty dull not to mention almost impossible as to eating out,etc. Any advice would be appreciated.

  217. WOW! This is GREAT stuff! I’m enjoying these comments and the WONDERFUL knowledge of Dr G.(if you will)!! I recently en countered some burning sensations in my legs and couldnt figure out what the hell it was.However it felt like i was being poisioned or something to that effect. Then i noticed this week when i ate certain foods while sitting, the burning sensation would come after digesting that particular food. As long as im walking or standing there’s no burning feeling, the moment i stop and sit it comes.I NOW understand this to be carb related almost 100% certain, however a diabetes may be on its way.BUT NOT HERE! Im going to fight that DEMON with an Muhammad ALI JAB from DR .G’s 2 week TEST! HAAA HAAA! PEACE UNTO ALL.

  218. Nancy permalink

    Within the last 3 or 4 months I have been experiencing problems. Every time I eat and sometimes drink, I get this uncomfortable feeling in my stomach. Not one of being nauseated and not painful. Example: If I drink coffee in the morning, by the time I get to my office I am feeling ill. Any ideas?

  219. Mark permalink

    Dr. Gangemi, I have had many of the symptoms you mentioned for years, especially the lack of energy. I also had border line high cholesterol. I did what my doctor recommended to lower it but nothing worked so he put me on the pill. Some time later, I tried the South Beach Diet to lose a few pounds and something extraordinary happened. I went carb free for the first 2 weeks eating eggs, bacon, grilled chicken and all the other things my doctor told me NOT to eat. When it was time to get my cholesterol checked again, I was nervous and I was thinking of excuses to tell my doctor. To my surprise, I not only lost 10 pounds, and had much more energy, my bad cholesterol levels dropped a huge amount. I told my doctor and he looked at me strange. No one has been able to diagnose my conditions until I read your article. Thank you so much, but why don’t more doctors seem to know about this. I was tested for low T, diabetes, and a host of other things, but not what you mention.

  220. DEE permalink

    Thanks for this posting! I have been going crazy trying to help myself. Every morning when I eat one single french toast, or 1 slice of bread im so tired, but if i eat 2 slices I am extremely uncontrollably tired to the point that I feel like i just had a huge thanksgiving dinner. That is not normal. I get headaches as well. I will try this as well and make a dr appt.

  221. Nancy permalink

    I am a 39 year old femaile in pretty good shape. 5ft6 and 63 kilos work out 5 x a week doing yoga and cardio. Non drinker/smoker.
    I have a 10 yr. history of neuropathy from either from a gut infection or antibiotics toxicity or both. It was very stable for many years but antibiotics flares it up and it settles down again. Recently I have noticed I cannot tolerate sugars,starches or any carbs because it worsens my neuropathy kind of like a diabetic but without the diabetes or Insulin resistance.

    I have switched to protein and fats but I am finding it very very hard. All sugars, artificial sweeteners,fruit, and pasta,bread,rice are causing my nerves to flare, I am feeling very discouraged. I had all normal bloodwork and no food allergies. I was only low on iron probably do to menses.

    Any advice would be a blessing!

    Thank you,

  222. Claudia permalink

    What if you are CI with insulin resistance and vegetarian? What can you eat?

  223. Eileen permalink

    Hi Doc, could a sebhorrhic dermatitis be cleared with this diet/way of eating.

  224. Samantha permalink

    Very glad I came across this post. I have these symptoms: sleepiness, drowsiness, lack of concentration, or a feeling of being bloated after a meal, especially one containing sweet foods or starches.

    Other than the symptoms, I would say I am in good physical shape–a little ab fat; would like to see more def without feeling weak. 42y 5′ 97-100lbs. I run, yoga, and/or skip rope at least 3-4x/week. My goal is to achieve higher focus, energy and mental clarity. Seems I go into a hazy state after eating, eyes feel sensitive to the air (dryness and some pain/discomfort around eyes), trouble concentrating and bloat. I believe the TWT will be life-changing. I read the post twice and everyones comments last night.

    Woke up to the possibility of feeling great and decided to start TODAY—no reason for delay. I am committed to feeling like I did in my 20’s in 2015 (today is Sunday, December 7, 2014). Thank you, Dr. G and all those who have contributed to this conversation. Be well.

    All the best,

    • Samantha permalink

      Day 2: back to Day 0. Sunday night I caught a cold and down with fever today. I am sure I caught the cold from a family member on Friday night and that may explain the sinus and head cold feeling Saturday morning.

      Sunday night’s experience for me was very interesting and what I consider a (possible) breakdown to breakthrough …

      I got ~3lbs of grass fed beef bones from whole foods. After roasting, I put the bones in boiling water that has organic celery, carrot, onion, etc and then turned down the heat to simmer on low. I used Ozarka filtered water. About 30 minutes or an hour later, I get a stuffed up feeling, coughing, sneezing and runny nose. I thought something was not right because I’ve never had a quick onset of something like that so I suspected something with the beef broth vapors. I googled about beef broth vapors and found someone else experiencing the same symptoms! Was a nice validation.

      Seems like the cold was moving through it’s cycle since I noticed something Saturday morning but the vapors made it worse. I couldn’t sleep until I turned the pot off and open windows and fans to air out the vapors. My thought was.. the fluoride in the water (and the bones) that caused the symptoms all this time!

      (Not willing to be 100% yet but second thought is that I may be allergic to amines from the meats. I don’t do well after having food with MSG in it either.)

      I make chicken(mostly) and beef broth often but not daily and it seems no matter what day, I get the foggy head and focus/concentration, zombie feeling and I drink 4-5 cups of Ozarka water daily—flag. I limit my carb/sugar intake. Almost 4 years since moving back to where I am now, I’ve been feeling foggy headed and loosing hair a little more than usual (symptoms of fluorine toxicity/sensitivity).

      I’ve been suspecting that it was chicken broth or chicken. No upset stomach, I just go into a state of low focus and drowsy feeling, head fog. Recently, I noticed feeling that way after a warm shower or bath. Before my cold, I took cold showers because it felt good and revitalizing.

      So my conclusion is that I think it’s the fluoride before I look at carbs or sugars as culprits (secondary). The times that I did feel better (or more like myself) were when I worked out or did yoga and sweat a lot. Then I drink the ozarka water and shower in fluoride and chlorinated water and get the sniffles (lately). Fed up.

      I plan to get over this cold and drink plenty of water (not Ozarka) to leach out the F and will find a way to detox from it properly. I chose Fiji water (unless there’s something better) to drink for the next couple of weeks and see if the foggy headedness gets better. Instead of showering using the default shower head, I bathe with the cold Ozarka water so to limit my exposure to fluorine from the shower head to experiment.

      I share this because maybe others are experiencing the same symptoms and it could be due to sensitivity to fluoride. I know that’s a lot to share but, any thoughts, Dr. G?

      Thank you :)

  225. jaymay permalink

    Hello Dr

    I have seen that someone posted they will make a stew with parsnips, are parsnips allowed as I presumed they were high in carbs/sugars.
    I am going to start the TWT in a few weeks.
    I have tried many elimination diets and supplements and I am hoping that I get results from this test, my main symptom is lower abdominal bloating.

  226. Helene permalink

    Thanks for a great post. One question: Are avocados allowed during those first two weeks?

  227. Hektor permalink

    Thank you for this !

    Had all the symptoms since I was 19. Now im 32..

    I went to 5 specialist in Denmark when I was around 21. and they all said there was nothing wrong and is was just in my head. as they didn’t believe it came a after a meal when I was 19.

    My biggest problem is the bloating.

    But when I was 29 I actually fixed it myself. and found out if I lived on a low carb diet it was much improved.

    But 3 weeks ago all the symptoms came back , and nothing helped. usually I should just stay away from alot of carbs in around 4 days and it would be back to normal.

    But for 2 weeks I been eating as healthy as ever, and im still bloating. So I can fit my clothes. that I could 4 weeks ago.

    But my mistake was eating banana , having milk and some chocolate on my protein pancakes. According to this article.

    But on day 1 now. and looking forward to the progress.

    anyway thx that someone actually cared enough

  228. Alex permalink

    Hey Doc,

    Whenever I eat carbs, probably more than 75g a day, I feel terribly bloated and have gas all day long. Doesn’t matter what carbs, have tried targeting only certain carbs but they all have the same effect on me. About a year ago, I cut out carbs almost completely. I ended up losing about 10-15lbs in about 3-4 months. I also had no energy in that timespan.. but other than that I felt great.

    How can I reduce carbs without the lack of energy and without the weight loss? I’m actually trying to bulk back up via weight lifting cause I never wanted to lose weight and I need carbs for energy. Any suggestions?

  229. Kennedy permalink

    I am wondering why I might get an upset stomach from Cadbury mini eggs. Every time I eat them I have bad stomach pains and diarrhea. What could be cuasing this? I am 15 and female.

  230. Karlyn permalink

    Please could you tell me if brown rice four is acceptable during the 2 week test?

  231. Kagney permalink

    In regards to drinks, is soda water or tonic water okay?

  232. Henrietta permalink

    Hi Dr G. i have been to numerous doctors and they have said my health is fine. I have been sleeping around 12 hours a night, getting up in the morning feels like someone has drugged me. Can i all of a sudden become intolerant to highly processed foods and carbs. Please answer this seems to be my last hope.

  233. Dr, Gangemi,

    Thank you for this website. So much good information. I’ve only begun to explore it. I have three questions.

    First, is garlic and onion powder okay during the TWT? Not sure if they qualify under the herb and spice category.

    second, I wanted to clarify something. You said carrot juice is okay. But I checked out Dr. Maffetone’s website and noticed that he says no. Not sure which way to go.

    Lastly,and probably most important. I bought a package of cooked chicken at the store today–just plain cooked chicken. the package says unprocessed, but the ingredients list includes a trace amount of corn starch that adds just 2 tiny carbs per serving. Is it okay to eat it or not?

    Thanks for your help.

  234. Crystal permalink

    Finding this some four years post publishing date but writing on the off chance someone finds and reads all the comments, as I have. I was diagnosed (actually I self-diagnosed via internet research and took the info to my PCP and insited on a blood test) with Reactive Hypoglycemia back in 2000 after literally dozens of doctors had told me my symptoms, which I insisted ALWAYS came after eating, were either in my head or nothing related to food. One doctor in the late 90’s even told me my symptoms were the result of a “poor attitude” and if I would “just find joy” in all the tasks of my day, my symptoms would disappear. Its been very difficult to remain on a good eating plan in this world of processed foods and busy lives, and I mess up a lot, only to pay for it in suffering and pounds later. i just want to tell anyone who suspects they have Carb Intolerance; Weight-Loss Resistance, Reactive Hypoglycemia, etc., to keep researching, reading and LEARNING from all the good resources, like this website, as much as you can. The info is there for you if you’re willing to look. Don’t settle for a diagnosis that doesn’t make sense to you. only YOU know your body and how it feels from various triggers.

  235. missjaye permalink

    Thank you, I have been Atkins eating for purposes of weight loss for the past 3 weeks and feel better digestively than I have in years. I have had symptoms of hyperinusulinemia and hypoglycemia and have been able to attribute symptoms to times when I have eaten far more carbs than usual – i.e. a bagel for breakfast – hunger, irritability, emotional lability, agitation, etc. It’s validating to have some additional insight into what’s been going on.

  236. Sualtan permalink

    It is clear I have CI because I have tried the TWT partially and it worked like a dream in eliminating the symptoms I have. But partially because I live in africa and you seem only concerned with the western palate. So I would like to know whether or not whole wheat means is on or off eat list for the TWT. This is important and you could save my life here. By whole wheat meal I mean a meal made of ground wheat we make into a paste which we then eat with soups made of vegetables, meats and oils. Very urgent response required please. Thanks a lot.

  237. Radka permalink

    Dear Dr. Gangemi,
    I have been on low carbs diet since December 2014. On this no-carbs diet, the symptoms like bloating, inflammatory diarrhea and nausea disappeared. But during these six months I became very exhausted. I have 46 kgs currently, still losing weight and I am worried about my health and sustanability of my strength while keeping this diet. I can not exercise anymore, I hardly handle my work because of great fatigue. Before the bloating has started, I was strong, vivid high mountains-trekker. But now, I am very weak, my muscles have no fuel anymore since the carbs are cutted-off or I have inflammatory diarhea after each carbs food (rice, fruits).

    Doctors detected good levels of enzymes and higher values of IgE of plasmocytes and suggested a food allergy. The tests are still running.

    Can you recommed some source of carbs to feed muscles which might be less provocative for the bowels to regain my strength?
    Thank you very much. Ànd sorry for my English, I am not native.

  238. I use to think I was having hot flashes but I have finally figured it out, I start to profusely sweat after I eat and it last for about 10 -15 minutes and then I feel fine. I would like to try this diet, I’m 55 and have had my BS checked and everything was fine, but in the back of my mind I think I have problems metabolizing sugar and starches, is this going to make my sugar drop to the point of hypoglycemic episodes? I hate this feeling and I don’t sleep either.

  239. Taryn permalink

    Just want to thank you on how clear you have written this. I have shown so many people how obvious CI is but you’ve really made me comprehend it. Thank you again.

  240. Juan permalink

    I’ve been for four days with the carb free diet and I feel really great and pain free, thanks a lot! The only problem is that I’m already too skiny and I’m loosing weight very fast! How can I avoid this? Thanks in advance for your prompt reply.

  241. Sean permalink


    I love the comments sections have been reading and getting loads of ideas also the explanation of lactose intolerance was amazing summed it very simple so thanks

    My questions are

    Regarding meats can I eat salami or pepperoni are they classed as processed??

    Also regarding mayonnaise see below for the ingredients for a supermarket one is there anything there “ glucose syrup “ jumps out for me as a no no but I might be wrong should I avoid this product all together??

    Water , Rapeseed Oil (28%) , Spirit Vinegar , Glucose Syrup , Pasteurised Salted Free Range Egg Yolk (5.5%) [Pasteurised Free Range Egg Yolk, Salt] , Sugar , Modified Maize Starch , Dijon Mustard [Water, Mustard Seeds, Spirit Vinegar, Salt, Preservative (Potassium Metabisulphite), Acidity Regulator (Citric Acid)] , Salt , Concentrated Lemon Juice , Acidity Regulator (Citric Acid) , Stabiliser (Xanthan Gum) , Preservative (Potassium Sorbate) .

    Thanks in advance

    • Sean permalink

      This is another brand

      Rapeseed Oil (78%) , Water , Pasteurised Free Range Egg & Egg Yolk (7.9%) , Spirit Vinegar , Salt , Sugar , Flavouring , Lemon Juice Concentrate , Antioxidant (Calcium Disodium EDTA) .

      It seems more suitable but still has sugar does it matter??

  242. Pam permalink

    What, if any, alcohol is allowed during the two week test period?

  243. Pam permalink

    Follow up question: What is the optimum ratio of protein to carb to fat on this program?

  244. I have been eating nothing but sugar in the form of cakes, cookies, etc., with coffee and milk for the past eight months. Diet is horrible. Two months ago I had my bloodwork done, and everything came back normal including an adrenals test to see if they were okay. The past two mornings after eating my sugar breakfast and drinking a green drink, my left leg has been getting weakness, and this morning my right leg was also a tad weakened. Of course, I panicked which made my blood pressure soar, so I took five Valium, which always works. Eventually everything went back to normal. This scares me. Several years ago my left leg actually went numb all the way up my left side into my jar. I had a T.I.A. due to high blood pressure (untreated.) Is all this sugar the reason my left leg gets weak after breakfast?

  245. jakob permalink

    I lived on oatmeal for the last 3 days and yesterday had some sugar and my stomach felt bad and had diarrhea.
    If this starch thing why can i then tolerate oatmeal

  246. carol permalink

    Hello, My legs and arms burn really bad after i eat a carb. this began after i had two mri”s with contrast , within the same week. now a year later i am still burning. my sugar is 90 . what do i do. are there medications to stops this burning ? thank you- carol

  247. Niki permalink

    Hi there,
    I stumbled upon your website while googling some of my symptoms and just wanted to say, ‘WOW! What a wealth of knowledge and information I’m finding here.’ Finally, something to set me on the right track. I’ve been experiencing signs of things being off for a couple years but this summer has hit me hard. I’m a generally fit and healthy person, turning 30 next year i enjoy rock climbing, kayaking, biking and backpacking. I’m 5’4″ and 115lbs (and have been for 10 years). I typically feel strong and able, with plenty of energy to run my farm, my business, and play outdoors. I thought that I was a healthy eater. I grow most of my own meat and 1/4 of my veggies and buy the rest local and organic. I don’t eat much processed foods except potato chips. But I do eat a lot of carbs and sugar. Carbs probably make up 50% of my diet and sugar about 10%. Despite my “healthy” lifestyle, this summer I’ve been hit with odd symptoms that doctors can’t seem to help me with: general malaise, overwhelming fatigue, mild depression, joint pain, back pain, digestive issues including inconsistent bowel movements, cramps, general colic, and more recently, severe pain after meals. These symptoms are seriously interfering with my life. I don’t have the energy to do the things I enjoy anymore.

    There are no medical explanations for my complaints, my blood tests and urine come back normal, I even had an ultrasound done to make sure I didn’t have gallstones or a duct obstruction. Next I will get myself screened for H pylori. But, in the meantime, I am trying your Two Week Test. I am on day 3 and I’ve been keeping a food journal. I generally am eating only one or two different foods at a time so I can determine if any one thing is making me ill. Based on my gut responses I have replaced hard cheeses with full fat, low sugar yogurt. The cheese seems to give me cramps while the yogurt makes me feel good. I hope that doesn’t mess up your test. I eat about 1/4 cup at a time, morning and night, by itself. It has only 2.5 g Carbs and 1.5 g sugar in 1/4 cup. I think the six probiotic and yogurt cultures are helping me. I also drink home made kombucha and water kefir for probiotic boosts, in case it is gut dysbiosis that is causing my symptoms. I am hoping that sticking to the two week test will help me get to the bottom of my issues. I just want to thank you for all the information you’ve made available for free here. Its very hard to find good dietary and health advice, there is so much garbage out there. Please let me know if I’ve ruined all my hard work by eating yogurt. Everything else I eat abides by your TWT rules.

    Sorry for the long-windedness. Thanks

  248. Anna permalink

    Can I do this whilst I am nursing?

  249. Ban permalink

    Thank you Dr.Gangemi for all the helpful information.

    for this 2 weeks diet, what do you recommend for breakfast? since bread, yoghurt, milk and fruits are not allowed, I am running out of ideas of what to have from breakfast. can we eat healthy carb such as Oat, or Rye bread?

    and is Quinoa allowed?


  250. Ann Maffioli permalink

    i have tried the twt for a month. I have felt a wide range of symptoms from headaches to fatigue. I have high blood pressure (I am on medication) and some of my reading in the am have gone up. I have been told I have a CI. Not feeling any better and wondering what to do now.

  251. Sharon permalink

    Hi I’ve been on the C.I. diet for a week today. Starting getting irritable two days ago but hanging in there…I’m worried I may have blown the two weeks by eating goat and feta cheese. Also cheddar cheese (the cracker barrel kind). Have I blown it? and need to restart?

  252. Dear Sir,

    I’ve only just started the two week/four week diet but not totally free ie. I have banana, agave syrup, almond milk, corn. It’s, I suppose, not strict. I am a Coeliac , have diabetes insipidus, ankylosing spondylitis, Meniere’s disease, hypothyroidsm and lactose intolerance. Although my diet has been strict on gluten free food, I’ve gone one step further and removed any glucose, fruit, GF breads and cakes, dairy with lactose and processed foods. Wow, my energy levels have increased and I generally feel better. I’m almost fifty and have been a strict GF person since I was 35, when my metabolism collapsed. I want to please ask your advise on exercise. I can’t raise my metabolic rate by walking or low activity tasks without sweating profusely and being dizzy. I want to understand when I should be trying to improve my activity eg morning, lunch, all the time, evening…If I could understand the metabolism in the process of activity and when is the best time to begin to add more to my fragile body. Will my body learn to handle increased activity and how should I train myself? Please help. I’m scared to push the body as I’ve had so many set backs and I don’t want to accidentally kill myself through stupidity. Yours sincerely Liana

  253. Dear Sir,

    I’ve only just started the two week/four week diet but not totally free ie. I have banana, agave syrup, almond milk, corn. It’s, I suppose, not strict. I am a Coeliac , have diabetes insipidus, ankylosing spondylitis, Meniere’s disease, hypothyroidsm and lactose intolerance. Although my diet has been strict on gluten free food, I’ve gone one step further and removed any glucose, fruit, GF breads and cakes, dairy with lactose and processed foods. Wow, my energy levels have increased and I generally feel better. I’m almost fifty and have been a strict GF person since I was 35, when my metabolism collapsed. I want to please ask your advise on exercise. I can’t raise my metabolic rate by walking or low activity tasks without sweating profusely and being dizzy. I want to understand when I should be trying to improve my activity eg morning, lunch, all the time, evening…If I could understand the metabolism in the process of activity and when is the best time to begin to add more to my fragile body. Will my body learn to handle increased activity and how should I train myself? Please help. I’m scared to push the body as I’ve had so many set backs and I don’t want to accidentally kill myself through stupidity. Yours sincerely Liana, FROM AUSTRALIA

  254. John permalink

    Can I use Kefir?

  255. Paula permalink

    I am a very active/healthy 17 year old and i began carb cycling almost four weeks ago. I typically do high carb Mon,Wed,Fri when i lift weights, and no/low carb on Tues,Thur,Sat when i just do cardio; Sundays are usually no/low carb. I usually get my carbs from fruits or whole grains, but almost a week ago, in one of my high carb days, i had half a donut (11 g carbs/2.5 g sugar) and got a strange headache. I’ve had these headaches only a few times before, but it was always when i would go out for a cheatmeal and have an excess amount of carbs. I got worried and got a fasting blood glucose test and it was around 104 mg/dl. I continue to worry and now every time i eat carbs i feel kind of strange, almost like light headaches. Is it possible that carb cycling triggered some type of carbohydrate intolerance/prediabetes?

  256. Janet permalink

    What about avocados?

  257. Meera permalink

    Wild rice is actually a seed. Is that allowed?

  258. DenisO permalink

    Thanks for the very interesting discussion. Questions:
    You say “the extra insulin often ends up processing sugar too rapidly and blood glucose levels are driven too low…”
    I agree insulin is involved in many problems, as it is a very reactive hormone that makes an electron transfer with the cell that allows the glucose receptor to open, but only if there is room for more glucose fuel in the cell. I can’t see how it can do that too rapidly, but too much insulin is bad. One cardiologist wrote that if the glucose stays in the blood, the pancreas releases more insulin into the blood. Insulin that can’t get electron-balanced because of full muscle cells, travels thru the arteries, eventually “raking” them raw, starting atherosclerosis.
    IMO, most of these problems can be resolved with a steady exercise regime. “Couch potatoes” are the cultural result of success being a chair job. Insulin resistance, to me, has to be the result of full muscle cells, no place for the blood sugar to go. If the cell receptors cannot open, of course that insulin stays in the blood, until it gets the electron or H that it needs somewhere like from the arterial intima.
    “…The cells have become resistant to the insulin.” Absolutely true.
    Great test ideas; actually amazing compared to most MD ideas.

  259. Ihab permalink

    Hi Doctor,

    before 6 months i finished the two weeks test and i lose 8 KG during that period.

    after that i did a regular blood test and the test showed a high sugar levels on fasting ( 10 hours ), i repeat the sugar test again and again but still i have that high numbers ( >140 on fasting ).

    usually my blood sugar was 95 or 90 on fasting just before the TWT, is it related?

    • That’s odd. Hard to say why that is especially with the weight loss. Perhaps measure your triglycerides and your HGBA1C too.

      • Ihab permalink

        i did the tests you have mentioned already and was high

        triglycerides: 205
        HGBA1C: 7.7

        is it related to what you mentioned in the above ,

        ” not let yourself go hungry. If you are not eating many small meals throughout the day, including vegetables, your blood sugar will drop. This will cause your adrenal glands to be stimulated and, with the aid of your pancreas, mobilize extra sugar into your bloodstream. Your body will perceive this similarly to you having just consumed a few sips of soda. So eat up! Don’t worry about your fat intake or cholesterol levels. This is only for two weeks.”

        • That high HGBA1C is an indicator of diabetes. You should be seeing a medical professional for that. You may have an auto-immune condition driven by a food you’re eating, or some other factor. There could be an adrenal issue, but I don’t think so with such a high blood sugar level and of course I can’t give you specific advice on-line. Have it checked out ASAP!

  260. katiebird permalink

    I have been off sugar and carbs for 19 days, but I still notice when I eat lunch, I get mind numbingly tired after. Today I ate a green salad with olive oil and vinegar and chicken salad with homemade mayo and water. After, I was so tired I feel asleep at work. I assumed this would not happen after I stopped eating sugar. It doesn’t happen all the time but why would it happen at all?

  261. Karen permalink

    Hi. Please could you specify what cheese is acceptable to eat? and can I continue taking feroglobin? Thank you.

  262. Judi permalink

    I have been eating extremely low carb (30 grams or less) for way to long (more than 5 years) I now seem to have no carb tolerance at all – any suggestions how to build up a bit of a carb tolerance>? It would be nice to have a piece of whole grain toast once in awhile —- I have completely given up on ever being able to have something sweet again ever —- any advice would be appreciated

  263. Candace permalink

    Hi doc! I’ve tried to read through most of your comments. However, I wasn’t finding the answer to my question.
    I’ve done the carb elimination diet before, I KNOW, I have a CI. So why do I eat carbs, I’m weak! Haha more serious now.
    I know I have to get off the carbs again, both for CI and yeast issues.
    I’m pregnant, I’m 34, and my blood sugar is all over the map, I’m boarder line GD! I feel so much better when I don’t eat carbs, however, being pregnant I don’t want to over stress my adrenals or pancreas. Do I just eliminate most carbs and sugars and still maintain a meat fruit and veggie diet? I do I need to perform the TWT again to get my body back off burning sugars instead of fat.
    I don’t crave “sweets”, I just eat a lot of carbs. The most sweets I eat are once maybe twice a week, more so since this pregnancy. Donuts will put my blood sugar at 183, 2 hours after eating 3….while s’mores pie will give me 135, 1 hour later. Don’t be too cruel, I’m pregnant. I make allowances for junk because they taste so yummy! I did however utilize the time to test my blood sugar. I’ve never been gd, or diabetic. But I fear I may be soon if I don’t step into action!
    What can/should I do while pregnant, I’ll also be nursing after baby is born.
    My best diet/reaction to diet was my exclusive meat, veggie, fruit diet. Is that completely healthy?! I wouldn’t eat rice, it makes me bloat, no potatoes, didn’t like the way I felt. Definitely no pasta! I can’t eat beans, they make me sick.
    I love nuts, so I would eat that too!

    • Candace permalink

      Also, I’m not an extremely heavy girl, I’m 6 months pregnant, and while over weight. Not obese. I weigh 170 at 6 months pregnant.

  264. Gerom permalink

    Hello DR,

    I’ve been experiencing a feeling of choking and depression above adam’s apple area for around 1 month. I included in my diet salty foods and fish, i stopped eating sweets, the feeling has gone away! Now i resumed eating sugars again and started to feel same old kind of heavy throat symptons but not as severe as before, would u be able to advice what’s wrong with me?



  265. art pletcher permalink

    I have suffered from this all my life, and am an extreme case. As a teenager, I tested positive for hypoglycemia on three occasions. In my 30s, I began noticing inflammation and mouth ulcers when I ate starchy carbs. In my 40s, These symptoms became more intense and more sensitive to starchy carbs, as well as fruit. Now in my 50s, I am limited to only your list above, except only a limited amount of vegetables.
    I’m becoming concerned about my limited choices! Is there any medical treatment, other than food avoidance? Please, provide any helpful information. Thanks

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