How Much Sugar Is Too Much? Guest Column By David “Wolverine” Smith

How Much is Too Much Sugar

Guest post written by David “Wolverine” Smith.

Most people who have considered a low carb diet are drawn to the idea because of the weight loss potential. The proven weight loss success of the low carb diet is often discarded by the mainstream health gurus by claiming that a person still place himself at risk because of the increased fat intake. It’s absurd that the critics of a low carb diet have been successful preaching that any diet that can reduce obesity somehow places a person at a greater risk for diabetes, heart disease and cancer, when these very diseases seem almost synonymous with obesity.

It is often stated that excess sugar in the blood leads to elevated insulin levels, which drives fat to be stored in fat cells and can ultimately lead to insulin resistance (type 2 diabetes). This is so commonly discussed that I wish to avoid this argument for now, and point out lesser known problems associated with elevated blood sugar. These facts indicate that humans were not designed for a high carbohydrate diet.

Before I can discuss these facts and how I came to learn them, I must explain my unique circumstances. In September of 2009, I was the victim of a medical accident which left me without small intestines. I will not go into the details of how this life-altering incident came about, because the purpose of this article is to share with you the potential damages that accompany the American lifestyle of taking a daily roller-coaster ride of blood sugar spikes and crashes.

David "Wolverine" Smith
David “Wolverine” Smith, September of 2009

(Many people seem to assume that when I say I lost my intestines I am referring to the loss of my colon. Actually, I maintained two thirds of my colon. I actually lost all but 10 inches of my small bowel, a vital organ – usually more than 25 feet long – which absorbs nutrients and hydration for the body. This was a life-threatening condition, whereas loss of the colon is not.)

Unable to survive very long without intestines, I underwent a full intestinal transplant on March 23, 2010 at Jackson Memorial Hospital in Miami, Florida. So from September 2009, until March, 2010, I lived with no small bowels. I was kept alive by infusions of a compound mixture called TPN (Total Parenteral Nutrition). TPN contains water, vitamins, minerals (electrolytes), amino acids and lots of dextrose (sugar). Though the human need for fats is well understood, there is little success in lipid infusions for patients who have lost their bowels. A small quantity of a soy-based lipid formula (Intralipids) is infused, but these lipids are notorious for causing liver failure over time, so the largest source of calories for TPN patients remains sugar.

It is consistent for our modern medical system to believe that the majority of calories in the human diet should come from sugar, rather than fat, but this macronutrient balance causes a high mortality rate in TPN recipients. In the last seventy years, the average American has increased his dietary sugar intake from about 25 pounds per year to about 156 pounds per year. If we were truly a species designed to thrive on such a high carbohydrate intake, then the infusion of TPN would not offer so many problems and ultimately lead to the premature death of those who are dependent on it.

At the time I was living on TPN, none of the doctors treating me had knowledge of intestinal transplants. The doctors were quite frank with my wife and me, predicting that I would only live two to three years if I was lucky. Other than the threat of liver failure from the lipids that they were infusing, there were three other possible ways that my life could be cut short, and they were all a result of the high sugar content of the TPN.

Sugar & Dehydration

Ice-Cold Water Bottle Tip On Your Low-Carb Lifestyle

I had heard that heavily sweetened beverages can cause dehydration. If that beverage contains caffeine as well as sugar, dehydration can become a severe problem. Because my stoma was less than a foot from my stomach, everything that I ate and drank would pass straight out of my stomach and into an ostomy bag. The doctors placed no restrictions on what I could eat or drink, but I learned soon enough that my life depended on making the right choices.

Whenever I drank a beverage with sugar in it, the result was a higher than usual output from the stoma. It didn’t seem to make sense – if I drank a cup of fruit juice, my ostomy would output two cups of fluid! If the beverage had both sugar and caffeine, like coffee, tea, sodas or energy drinks, the ostomy would output three times the amount of fluid intake.

No doctor or nurse could explain to me how I could output more than I drank – or they didn’t want to take the time. The pharmacist that compounded my TPN finally explained to me how this was happening. When we consume a large quantity of sugar, the stomach must secrete more water in an attempt to dilute the sugar to be processed and absorbed.

In a person with functioning intestines, this water would be reabsorbed into the bloodstream by the colon. My colon was being by-passed, so instead of recapturing the water, it was lost forever through the stoma. Because of this, the volume of fluids I took in had to be measured and recorded along with the volume of fluids output from my stoma. If the output was higher than the input, the difference had to be made up by infusing a hydration fluid called lactated ringers (water and electrolytes). If the balance was not closely monitored and maintained, I could either die from dehydration or become over-hydrated, risking a pulmonary edema or congestive heart failure. It was quite a balancing act, and my life was on the line.

You may be thinking that there is no danger as long as you have a healthy colon, but that is not the case. The excess water secreted into your intestines to dilute the sugar will be lost to the bloodstream until the water can be reabsorbed in the colon. Transit time can vary from person to person; this water can be unavailable for the eight or more hours that food spends moving through the intestines.

If you drink increasing quantities of sweetened drinks to quench your thirst you will stay in a perpetual state of dehydration, even though the water never leaves your body. This stresses your renal (kidney) system. Is it any wonder that hypertension has become so prevalent?

The pharmacist gave us the recipe for the WHO re-hydration therapy fluid, which was horrible to gag down. (Similar to Pedialyte – yuck!). The hydration replacement fluid tasted more like the TPN (yes, I once tasted the TPN). TPN had more of a salty taste and was only lightly sweetened. I can’t imagine how much damage those syrupy sweet drinks do to our arteries if the TPN can destroy a vein in 24 hours – which, I learned, it can.

Sugar & Lowered Immune System and Infection

Colorful Donuts with Frosting

About nine weeks after losing all of my intestines I learned about another deadly issue with having sugar infused directly into your arteries. I had been home from the hospital for about three weeks, which would end up being the longest period I would spend outside of a hospital over the next two years, when I mysteriously began to run a slight fever. It was pretty low, and I really wanted to ignore it, but my wife insisted on rushing me to the ER.

Within 24 hours of being admitted to the hospital my fever spiked in excess of 105 degrees Fahrenheit. The cultures came back positive for a gram negative infection in the catheter port. Because the port had been colonized with the bug, the TPN was flushing the pathogens directly into my heart and throughout my body. I was in septic shock within hours, placed on pressors and rushed to surgery to have the port catheter removed.

I was hospitalized for more than six weeks to recover from this sepsis. I was released from the hospital, back home for less than three days, when I was again rushed to the ER with another fever. This time the cultures came back positive for a systemic fungal infection called candida.

Because of the high carbohydrate consumption in the U.S., many Americans suffer localized candida infections: thrush, yeast infections, colon infections, etc. But when candida becomes systemic, it has a very high mortality rate. I was informed by the hospital staff that candida is the single biggest killer of TPN patients, and very difficult to control. The candida had colonized the port and was being fed by the sugar in the TPN.

Following my transplant, I regained the ability to absorb food and hydration and was no longer in need of TPN. The recovery from the transplant required many weeks in the hospital. While hospitalized, I was fed a diet very high in carbohydrates and very low in fat, simply because that is what hospital dieticians still believe is a heart healthy diet – but this ignores the fact that it promotes the growth of infections.

I again fell ill to a gram negative infection. Because I had been placed on very powerful immune suppressant drugs to preven rejection of the transplanted organ, I failed fast. I was in septic shock by the time I reached the ER, and was placed in a coma for the next three weeks because I had lost the ability to breathe on my own and required a respirator.

After my final release from the hospital, I finally had complete control over my diet and was able to adopt a low carb diet, very rich in healthy fats. I have been living on that low carb diet for more than two years now and have not had an infection since adopting it.

All of the other transplant recipients that I have stayed in contact with have had several systemic infections over the last couple of years. The only difference between them and me is that I consume far fewer carbohydrates than they do. A coincidence?

Sugar & Arterial Damage And Inflammation

The New Science of Sugar Addiction

One of the more frightening prospects that I was hit with before I had even recovered from the two life-threatening surgeries to remove my bowels, was the fact that the high sugar content of the TPN was slowly killing me. By the time I awoke from the second surgery, a port catheter had been surgically implanted in the right side of my chest. The catheters would had two or three leads that dangled from my chest. On the inside, the separate leads merged into one large line that was inserted into the superior vena cava, where it tunneled to within an inch of my heart.

It was explained to me that the high volume of the TPN that I needed could not be infused through a peripheral line, even in the largest veins of the arm. The high amount of sugar is extremely caustic to the walls of the artery and would destroy a vein, causing failure within minutes. Unfortunately, this was put to the test a couple of times, with painful results.

When I had infections in the ports, the catheters had to be removed and no new catheter could be implanted until the systemic infection was cleared. These were horrible times for me, because I could not be fed, and I was already grossly underweight. Rather than let me starve completely, the doctors ordered several arm peripherals be placed and PPN (Partial Parenteral Nutrition) to be infused in place of the TPN. Although the concentration of sugar was considerably less than that infused with the TPN, the veins that were accessed would typically fail within the first 24 hours.

After the first hour, the vein would begin to burn as if Tabasco sauce were being infused. By the time I could no longer stand the pain, the vein would typically blow-out and the PPN would infiltrate under the skin. This is a very painful wound and would happen every 24 to 36 hours – also accompanied by a DVT (Deep Vein Thrombosis).

Because of the caustic nature of sugar to the arterial wall, the doctors predicted that I would eventually lose access to the only six arteries into which catheters can be surgically implanted. I was warned that this could be the point at which I could no longer receive TPN and would die. Based on the high volume of TPN I required, the doctors predicted that this would take two to three years.


This is how I learned just how corrosive sugar is to the human artery. This is likely why diabetics suffer a much higher risk of heart disease (atherosclerosis) – because of the massive inflammation of the arterial walls from consistently high blood sugar. This damage to the arterial wall ultimately allows cholesterol, calcium and white blood cells to get trapped behind the endothelium layer, oxidize and continue to accumulate until it ruptures and forms a clot.

There is little doubt in my mind that the excessive quantity of sugar in the American diet is far more problematic than the quantity of fat. As Americans have reduced fat intake and increased carbohydrate consumption, we have seen a significant increase in heart disease onset by atherosclerosis. Doctors are well aware of the damage resulting from the high sugar content of the TPN, yet they don’t seem to make the association with the sugar in the American diet.

I believe that the problem is one of cognitive dissonance on the part of the doctors, medical associations and the government. They have invested so many years in the vilification of saturated fat that they cannot change their stance now. Their endorsement of trans fats in the ’70s and ’80s backfired, leaving only carbohydrates to endorse. Thus they make a distinction between sources of sugar molecules to create a villain.

First we were informed of the fictional “Good cholesterol” vs. “Bad Cholesterol” — “Luke, come over to the dark side of cholesterol”. (There is only one type of cholesterol. LDL and HDL are the proteins that carry cholesterol). Now we have “Complex Carbohydrate” vs. “Refined Carbohydrate.” I don’t see the difference – and neither does your body. Who cooks this stuff up? I suspect corporate advertisers, because it is actually more similar to a children’s story than anything resembling science.

The marketing of these magical “complex carbohydrates” is a desperate joke. The idea is that there is a carbohydrate that breaks down at a slower rate and doesn’t a spike in the blood sugar – has a “low glycemic load.” If you are measuring time in nanoseconds, I guess there would be some difference, but I doubt that those few seconds really matter.

These “Complex Carbohydrates” only look complex on paper because they are very long strings of glucose molecules attached by covalent bonds. The problem is that it takes the amylase (enzyme) in human saliva seconds to break down long “complex” starch molecules into simple glucose; it happens before they reach the stomach. By the time this starch reaches your small intestines, it is pure glucose and will spike your blood sugar as quickly as a Snickers bar.

There have been marketing attempts to differentiate between cane sugar and corn syrup, claiming that one is healthier than the other (cane growers attempt to sue corn growers for calling HFCS “corn sugar”). Sugar is sugar, whether chained together as long starch molecules, refined from cane, beets or corn; polysaccharides or monosaccharides – we have to simply reduce the total quantity of carbohydrates in our diet. Humans are not designed to handle massive amounts of carbohydrates.

Somehow, only sugars that taste sweet to us have been singled out as being harmful. The only sugar – other than sugar alcohols – that tastes sweet to humans is fructose. Glucose is not sweet at all, yet permanent nerve damage can begin when the blood glucose level exceeds 150 mg/dl. All carbohydrates in excess can dehydrate, promote infections (and tumor growth) and cause damage and inflammation to the arterial walls.

The TPN that was infused into my blood did not taste sweet, yet it was caustic enough to destroy a vein within a few hours. Remember that.

Guest post by David “Wolverine” Smith. To learn more about David’s rantings of an intestinal transplant survivor, please visit Roar of the Wolverine.

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  1. Your story brought back so many memories for me. I, too, was on TPN and also developed sepsis. I have Crohn’s disease and it is mainly in my small intestine. A year-and-a-half ago I had numerous fistulas and an abcess that left my small intestine unable to function and I learned just how important that organ is. You can live without a colon–not so long without a functioning small intestine. I needed surgery in an attempt to save my life, but that also required an ostomy. I was told at the time that it could be temporary, depending on how I recovered and healed. After surgery, I went in search for answers as I didn’t want to live with an ostomy if I could do something about it.

    I discovered that following a low-carb diet and avoiding sugar like the plague has a tremendous impact on my disease. I was able to have reversal surgery in February of this year and have been in remission since. I know it’s because I changed what I eat. My doctors and surgeon think I’m a miracle case and still fail to see the connection between carbohydrates and sugar when it comes to intestinal disease. I too believe it is a problem of cognitive dissonance on the part of the medical community and I hope your story and others will make them change their thinking in the not so distant future. The sooner, the better.

    Thank you so much for writing about your experience–it’s hard for me to even talk about mine as most people have a hard time understanding such complications. I am so happy you are doing better and I wish you continued good health.


    • Carolyn, I am very sorry to hear about your problem. I met a young woman at the transplant hospital, who had lost all of her bowel to Crohn’s Disease. Like you, she suffered from many fistulas. Unfortunately, her condition worsened until she required a multivisceral transplant, including six organs in all. She is still alive and doing pretty well, but refuses to adopt a low carbohydrate diet.

      She still has a lot of problems with dehydration and has to keep a PICC line installed for extra hydration. Of course, this PICC line has lead her to several bad infections. I am glad that you have opted a low carb diet and I a not surprised that you are doing better on it. I hope one day that people like you and I can serve as evidence that the low-carbohydrate approach is the superior way of treating these diseases of the intestines.

      Did you find that when you had an ostomy, that its output would increase if you ate or drank sugar? This was the first indicator to me that sugar cause dehydration.

      • I did notice that would happen when I ate or drank sugar. I was so under-weight leading up to my ostomy surgery and after it that my doctors told me whatever liquid I drank had to have calories. They told me not to drink water, drink juice and not to drink diet soda, to have a regular one–both options are loaded with sugar. I was also told to try and drink four Ensures a day (more sugar). From a calorie standpoint it made sense but I was constantly thirsty and forever emptying my ostomy pouch. It was annoying.

        After I started doing some research into diet and crohn’s, I discovered that juvenile diabetes is considered an autoimmune disease too. I had a younger sister (13 months) that was diagnosed with this when she was 10– about 40 years ago now. She could never stay away from sugar and the diet they prescribed at the time was very hard to follow. She ultimately lost her eyesight in her 20’s and had a kidney transplant in her 40’s. She passed away about 6 years ago from a heart attack.

        I had an aha moment when I read about that. I wondered if crohn’s disease and juvenile diabetes were related somehow and decided to try a low carb diet and avoid sugar, which is what a lot of Type 2 diabetics do. I think there is some correlation with insulin and bowel disease. I truly believe adopting a low carb diet is the reason I was able to have the reversal surgery. I gained 20 lbs. and felt better than I had in a very, very long time. Elaine Gotschall wrote a book on restricting carbohydrates as a way to control and reverse crohn’s and other intestinal diseases. The book is about 20 years old now, but pure genius on her part and is based on solid science. It doesn’t cover insulin per se, but is based on the theory that restricting carbohydrates cuts off the “food” supply for the bad bacteria that causes the immune response. I still have a hard time understanding why doctors don’t know about it or use it as a starting point for treating intestinal disease.

        Currently, I have to take a pretty strong immunosuppresant drug–Humira. I don’t know if I’ll ever be able to be off of it, but I have hope that it might be possible. I am sorry to hear about the young woman you met who refuses to try a low carb diet. I just can’t imagine not trying it if it could possibly prevent her dehydration and perhaps she wouldn’t need a PICC line anymore. I never want to have another one. I never again want to be as sick as I was. I have never felt so awful or been in so much pain–I know exactly how it feels to be dying and I want to do anything in my power to prevent that for as long as possible.

        Thank you again for writing about your experience and what you have learned. I didn’t know they did small intestine transplants until I read your guest post. You have given me hope that if I ever do require something like this, I will be able to survive. You have truly been an inspiration to me and validation that a low carb diet works. I hope too that one day we can serve as evidence that a low carb diet is THE way to treat intestinal disease.

        It has been so great to talk to you about this. Thank you for responding to me and I look forward to your other upcoming articles.

  2. wow, I feel weak with empathy…what an awful time to go through. Thanks for sharing with us 🙂

  3. Carbs are dehydrating. That was the missing piece. Now I make sure I wait 4 hours after eating to sleep, and drink water beforehand if I get thirsty. I used to wake up in the middle of the night with low blood pressure/high heart rate and dehydrated, and was constipated later.

  4. Dextrose is definitely sweet and is not fructose. The rest of the article is a great read and very interesting.

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