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 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. Many doctors and dietary advisers have “used” his 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.
AVOID:
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
- Corn
- Milk, yogurt, ice cream
- “Energy” or “Nutrition” bars, including the 40-30-30 type
- All alcohol and soda, including diet drinks (and anything sugar-free *Nutrasweet, Splenda, Truvia, xylitol, sorbitol, etc..). Small amounts of dry wine are okay.
EAT:
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), cream
- Meats – all meats are fine except those cured in sugars
- All vegetables except corn and potatoes
- Fish and shellfish – sushi is fine, keep the avocado, leave the rice!
- Pure vegetable juice, including tomato and carrot
- All nuts, seeds, and their butter counterparts
- All oils, and sugar free spreads such as mayonnaise and mustard (no catsup and no hydrogenated oils)
- Lots of water! And herbal tea is okay (decaf) – but no sweeteners – no honey, no stevia
KEY POINTS FOR SUCCESS:
- 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.
DAY 15: TEST COMPLETED, TIME TO ASSESS THE SITUATION:
- 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
Why is it that one can have cream, but not milk??
Milk has lactose (sugar), the cream does not.
Can you drink Soy Milk ?
No milk of any kind. Heavy whipping cream is okay though.
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!
Can you eat sweet potatoes during the 2 weeks?
no potatoes, including yams or sweet potatoes
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.
what about fermented foods like sauerkraut and things like nutritional yeast and apple cider vinegar/balsamic.. thinking salad dressing :) and is butter ok?
Yes, fermented foods and butter – both okay.
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.
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.
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.
Can I eat chick peas?
Nope, sorry. Although they’re a legume (like peanuts), they’re too high in carbohydrates.
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.
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.
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?
Thanks!
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.
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.
can you eat seeds
yes you can
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.
Thanks.
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.
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!)
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,
Chris
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 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.
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.
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.
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!
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!
Cottage cheese is not allowed because it still has some lactose present (that’s milk sugar).
Thanks!
Hi
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).
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.
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.
Thanks!
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.
Thanks again!
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.
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).
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.
I was wondering what order to go in. Thanks!
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!
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.
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!
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.
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.
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 http://www.drgangemi.com/2005/04/stay-away-from-splenda-and-those-other-low-carb-sweeteners/
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 lately..my 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.
also wondering if coconut is ok? oil, meat, milk.. ect?
Yes, all coconut is okay as long as you don’t use any of the sweetened types.
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.
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.
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.
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.
I have several food allergies that cause my throat to swell shut..soy, 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.
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.
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.