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[Stavia]

Gemma you are not selfish at all. There may be other members too shy to post who are reading this right now and it may help them.
I will be very suprised if you are insulin resistent so underweight and with a Triglyceride level of 69. I wonder if you are being unnecessarily strict with your new diet.

I would suggest the following
1. don't panic. it will take you at least 6 to 12 months to find the optimal diet for yourself.
2. make changes one at a time so you know what impact each change has
3. follow Susan's recommendation. It is very sensible. Then share the results with us and we can advise. The heavy metal testing is not that important right now. You only need Hba1c, fasting insulin, D3, B12.
There is no point in doing calcium, it is not related to diet whatsoever. If you dont eat enough your body takes some from your bones to keep the blood level constant hence osteoporosis in calcium deficiency
Blood ketones change from minute to minute.
Fasting glucose isn't necessary.
A repeat lipid profile isnt necessary so close to your last one.
Serum magnesium is useless, you will need a red cell msgnesium.
Your doctor might be happy to order this plus zinc because of your low body weight and restricted eating and past anorexia.
4. Download an app called cron-o-meter and log your food for a week, then show us and we can help advise.

good luck!
remember it doesn't have to be done all today. It took me about a year to get it all right, and I continued to eat wholewheat toast for at least 6 months of that time. Sustainable carefully considered changes win the race.
In my primer I recommend slow dietary transitions.

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[GemmaJ]

Hello Stavia,

I haven't been able to reply for the last few hours because I actually felt really emotional reading your words. I am nearly always unnecessarily strict with myself and always filled up with guilt about food and nutrition so you are dead right.

I will take on everybody's advice and do my best. I'll sort out the blood test and the Cron-o-meter App and be back soon. You are all so kind - thank you. Honestly, finding all of you and reading all your inspiring stories has been more than a lifeline - it's been my salvation really.

Thank you,

Gx

[WhatNext]

Hi Gemma,

I just got around to reading this thread--welcome! I noticed that you included probiotics as one of the supplements you take. I wonder if there has been a discussion of probiotics here? I took them for a while but stopped. I was taking them on the recommendation of a co-worker, a man whose BMI I would estimate to be about 36. I'm a woman, the same height as you, and my BMI is 20.8. One claimed benefit of probiotics is weight loss, which I guess is the result of food moving through your system faster: they help keep you "regular". Let me just say that I am regular without them thank-you-very-much. On them I was.... well, I quit taking them. You might have an easier time putting on some weight if you stop taking them. Eating a healthy diet should keep your gut bacteria healthy without them.

That's just my opinion and my n=1 experiment, others may feel very differently and if so please chime in.

WhatNext

[Stavia]

Be kind to yourself Gemma

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[slacker]

I wonder if there has been a discussion of probiotics here?

WhatNext

A website search of "probiotics" yielded a wealth of threads that include the topic of probiotics. You might want to start with the thread called "Probiotics" under the Prevention and Treatment category. In brief, there is growing evidence that the gut and brain have an intimate relationship, and that probiotics in some cases can improve the gut and so improve the brain. There is less and less support for continuing probiotics long term. Many "alternative" books on the gut tend to have a weight loss angle, which may be more of a publishing house marketing ploy to increase sales than anything else

[GemmaJ]

Ok...it's slightly embarrassing why I take probiotics (only for last month) but here it goes. I have to take the combined contraceptive pill for osteoporosis (the oestrogen - sorry British spelling!). I've done this for about 20 months now, after the doctor saw how low my oestrogen levels were naturally, but 6 months ago I started having a terrible time on it - migraines, sore breasts, lots of bleeding and for the first time in my life, recurrent episodes of vaginal thrush, hence the probiotics! The ones I take are called 'intimate' one (haha!) and have definitely helped as no thrush for a month now. So, they're not gut ones I'm afraid and in hindsight, I probably shouldn't have listed them but was just reeling them off in my head as I typed!

Funnily enough, the DNA test showed that I have difficulty metabolising oestrogen so all my problems above could be linked to that. I finally have an appointment in two days' time to see a 'reumatico' (apparently a specialist in bones!) at the hospital so I'm hoping he may come up with some other options for me. It's a bit of a worry because I'm also aware of how important oestrogen is for AD prevention in middle aged women....

So, sorry to disappoint...I'm hoping to stop my 'intimate' pills soon!!!!

[WhatNext]

Today I learned there's a search box for the website! It doesn't show up when I'm on my phone, as I am now.

I'm aware of the importance of gut bacteria, and I've heard of the -- pardon me -- "poop transplants" that have been done to get the bacteria from a healthy person's gut into the gut of someone with an otherwise untreatable disease. But my understanding of it is that everyone's gut bacteria are as unique as their fingerprints, and transplanting one person's gut flora into another's can cure them but also have unexpected side effects. An over-the-counter probiotic may be great for some but not at all helpful for others. In my case my gut function is better without it. But again, this is my n=1 experience.

[slacker]

50kg is considered the threshold to maintain bone density. .

Stavia, is this a weight threshold for everyone, or based on Gemma's height and resultant BMI? If true for weight alone, can you suggest a reference? Many thanks...

[Stavia]

50kg is considered the threshold to maintain bone density. .

Stavia, is this a weight threshold for everyone, or based on Gemma's height and resultant BMI? If true for weight alone, can you suggest a reference? Many thanks...

Slacker I cannot give you a reference. It is from personal correspondence with Prof Ian Reid, one of the top experts in the world in this field. It is unpublished and based on decades of experience in the field. I have been working with him unofficially on a pragmatic pathway for osteoporosis management in primary care.

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[slacker]

50kg is considered the threshold to maintain bone density. .

Stavia, is this a weight threshold for everyone, or based on Gemma's height and resultant BMI? If true for weight alone, can you suggest a reference? Many thanks...

Slacker I cannot give you a reference. It is from personal correspondence with Prof Ian Reid, one of the top experts in the world in this field. It is unpublished and based on decades of experience in the field. I have been working with him unofficially on a pragmatic pathway for osteoporosis management in primary care.

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Thanks Stavia; I appreciate the source whether published or not. I worked with a rheumatologist/ osteoporosis expert on this side of the world, and other than low BMI being a risk factor (common knowledge), he never mentioned a specific weight or BMI as a threshold to maintain bone density. I am open to other sources of information. (Inquiring minds want to know... )

But please clarify for me: is it the weight of less than 50 kg or a BMI below a specific level that Dr Reid has observed as the threshold of increased concern?