[MischaHY]

Hey folks,

I've had progressively worsening issues with gut function, fatigue, joint pain and distension for the last 5-7 years or so.

I've back and forthed between various forms of elimination diet (definitely don't do well with lactose/legumes/cruciferous veg), but not really had any long term success and keep getting worse symptoms and also consistently putting on weight despite eating a healthy diet and also can't drop significant weight even with a 1000kcal deficit.

The most annoying thing is the joint pain as this frequently affects random fingers/wrists/knees and feels like an injury but will turn up and vanish without warning so clearly something else is going on. I did have a thyroid test done about 5 years ago which came back normal but now we're a few years down the line and things are getting progressively more frustrating. I keep finding my coffee intake increasing because I'm feeling tired in the middle of the day. I'm confident it's not overtraining because I'm careful with my volume and I sleep 7-9hrs a night. I feel like it also gets worse in the winter which if anything is a period of lower activity and more carefully controlled volume for me.

I've also considered often if it's IBS but after spending time on a strict low FODMAP diet it seems to have very limited effect and no impact on the fatigue/joint pain/distension. I've also started experiencing periods of mild depression in recent years which is much more worrying and limiting.

I'm going to go to the doctor and ask for another test of thyroid function but was hoping to get some general experience from people who might have been in a similar situation?

[dunnyg]

I'm not a medical Dr, but there is a lot of symptoms in common with Crohn's there. Not sure about the weight as I believe that is commonly the other way round (ie hard to. Maintain weight). Like I said I am not a Dr, but having been in a similar position I'd chase a diagnosis as much as you can.

Don't think you are UK based, but if you are shitting more than X times a day GPs will send you on to gastro straight away here.

Good news is there are lots of drugs out there for these immune diseases (it even is that), so it is worth chasing down the diagnosis and to improve your quality of life.

Again, I don't know what the fuck I'm on about so go see a Dr!

Good resource on Crohn's and colitis here if you want to do the classic internet self diagnosis, and later be told that all you need to do is eat less cabbage or whatever....

https://crohnsandcolitis.org.uk/

[MischaHY]

I'm not a medical Dr, but there is a lot of symptoms in common with Crohn's there. Not sure about the weight as I believe that is commonly the other way round (ie hard to. Maintain weight). Like I said I am not a Dr, but having been in a similar position I'd chase a diagnosis as much as you can.

Don't think you are UK based, but if you are shitting more than X times a day GPs will send you on to gastro straight away here.

Good news is there are lots of drugs out there for these immune diseases (it even is that), so it is worth chasing down the diagnosis and to improve your quality of life.

Again, I don't know what the fuck I'm on about so go see a Dr!

Good resource on Crohn's and colitis here if you want to do the classic internet self diagnosis, and later be told that all you need to do is eat less cabbage or whatever....

https://crohnsandcolitis.org.uk/

Thanks yeah, I've considered this as well but I don't pair up with the symptoms very well so fairly certain it's something else. Definitely going to chase a diagnosis because it's really pissing me off and limiting multiple aspects of life.

[dunnyg]

Good luck. Took me quite a while to get diagnosed, but easier to feel positive about it when there is a plan to fix/manage it.

[User deactivated.]

No medical advice but I'd expect many of those symptoms myself on a 1000kCal (massive) deficit. Over the last year or so you've dropped 5kg+ right? If you've been maintaining a weight that's below your set point (where your body wants to be naturally) then your metabolism is going to be suppressed, cortisol levels increased, testosterone levels on the floor, and probably many other effects. If you have known gut issues then calorie restriction may not be responsible for all your problems but could it be potentiating them?

[MischaHY]

No medical advice but I'd expect many of those symptoms myself on a 1000kCal (massive) deficit. Over the last year or so you've dropped 5kg+ right? If you've been maintaining a weight that's below your set point (where your body wants to be naturally) then your metabolism is going to be suppressed, cortisol levels increased, testosterone levels on the floor, and probably many other effects. If you have known gut issues then calorie restriction may not be responsible for all your problems but could it be potentiating them?

Yes very briefly but unfortunately after returning to maintenance it all immediately piled back on. I had the least symptoms bizarrely whilst dieting despite significant deficit. Since Oct I've been at around 2500-3000/day depending on output.

[MischaHY]

Plus this is a trend that's steadily exacerbated over more than 5 years whereas the dieting phase this year was about 10 weeks. I also only did the 1000kcal for short periods broken up by periods of maintenance calories to make sure things stayed normal.

[battery]

Again no medical expertise, just personal experience but have you had a full set of blood tests done recently? Things like low iron or zinc, even vitamin D can do funny things to your body.

Not sure of your age or gender but these are also all symptoms of perimenopause.

[MischaHY]

Again no medical expertise, just personal experience but have you had a full set of blood tests done recently? Things like low iron or zinc, even vitamin D can do funny things to your body.

Not sure of your age or gender but these are also all symptoms of perimenopause.

Sorry yes 28yr male so hopefully not the latter. I'm definitely going to push for bloods to be done and if no thyroid issue is present then we'll have to dig deeper because it's really pissing me off. Being heavier is one thing but the random joint pain is really limiting especially when it's in the wrists.

[sheavi]

I'm no medical expert either but work as a physio with an interest in inflammatory disorders.  I'd definately have full blood tests.

Personally I've found the York Test beneficial for identifying potential food trigger.  I've had similar symptoms. 

[Fultonius]

Again no medical expertise, just personal experience but have you had a full set of blood tests done recently? Things like low iron or zinc, even vitamin D can do funny things to your body.

Not sure of your age or gender but these are also all symptoms of perimenopause.

Sorry yes 28yr male so hopefully not the latter. I'm definitely going to push for bloods to be done and if no thyroid issue is present then we'll have to dig deeper because it's really pissing me off. Being heavier is one thing but the random joint pain is really limiting especially when it's in the wrists.

Is the joint pain associated with any swelling etc? Would be worth trying to be seeing by a rheumatologist to rule out those things, should be picked up in bloods though.

Not in any way saying this is your issue, but my mum sent me this and it's pretty fascinating:  https://www.bbc.co.uk/sounds/play/m001gj46?partner=uk.co.bbc&origin=share-mobile

[MischaHY]

I'm no medical expert either but work as a physio with an interest in inflammatory disorders.  I'd definately have full blood tests.

Personally I've found the York Test beneficial for identifying potential food trigger.  I've had similar symptoms.

Booked in for Monday morning to have a chat and get bloods taken. Love the German healthcare system.

I do have some defined food triggers but responses are inconsistent which made me wonder if it could be SIBO rather than IBS which would link in with the thyroid thing... We'll see. I just find it bizarre that even something as limiting as Low FODMAP seems to have minimal effect. You'd think there would be a shift in symptoms with that.

[MischaHY]

Again no medical expertise, just personal experience but have you had a full set of blood tests done recently? Things like low iron or zinc, even vitamin D can do funny things to your body.

Not sure of your age or gender but these are also all symptoms of perimenopause.

Sorry yes 28yr male so hopefully not the latter. I'm definitely going to push for bloods to be done and if no thyroid issue is present then we'll have to dig deeper because it's really pissing me off. Being heavier is one thing but the random joint pain is really limiting especially when it's in the wrists.

Is the joint pain associated with any swelling etc? Would be worth trying to be seeing by a rheumatologist to rule out those things, should be picked up in bloods though.

Not in any way saying this is your issue, but my mum sent me this and it's pretty fascinating:  https://www.bbc.co.uk/sounds/play/m001gj46?partner=uk.co.bbc&origin=share-mobile

No, and this is what's weird because I've had TFCC strains before in the wrists and this basically triggers the exact same pain but without the same amount of swelling. It's really weird and just appears out of nowhere - almost as if old injury sites are flaring up. The only time I've had swelling is recently some knuckle inflammation in my left pinky from full crimping which has been remarkably persistent but I've been sorting that slowly with stretching.

Cool, I'll have a listen. Sounds interesting!

[stone]

Mischa, the guy behind this was on the radio and sounded more clued up than much dietary advice has sounded (to me in my ignorance!). I wonder whether they just tell everyone to eat wholefood from 30 different plants per week though (probably not bad advice I guess). https://joinzoe.com/

[duncan]

A timely thread. I’ve just had a battery of blood tests for a separate issue and one that came up as possibly significant was a somewhat raised thyroid stimulating hormone which might indicate an underactive thyroid. This could explain the lack of ooomph I’ve felt over the last couple of years and the extra 4kg I’m carrying. There are other plausible explanations (Covid, not being 29 any more) and the Dr wants to rerun the test in three months to see if it's a consistent finding. Anyone had any experience of this? DM if you prefer.

[Paul B]

That pretty much sums up my Dad Duncan. He was lacking energy to the point he was falling asleep mid afternoon on the sofa. For reference he was in the police from 18 and did his 22 years of service and retired turning into someone that spent all of his time exercising (golf, squash, cycling, climbing). He's successfully been on medication ever since.

[MischaHY]

He was lacking energy to the point he was falling asleep mid afternoon on the sofa.

This literally happened to me the other day. When it comes to sport I seem to be able to warm myself up and get on with it but this has been taking longer recently. So annoying to have free time and just feel knackered whilst also being motivated to do things.

[petejh]

I'm no medical expert either but work as a physio with an interest in inflammatory disorders.  I'd definately have full blood tests.

Personally I've found the York Test beneficial for identifying potential food trigger.  I've had similar symptoms.

Booked in for Monday morning to have a chat and get bloods taken. Love the German healthcare system.

I do have some defined food triggers but responses are inconsistent which made me wonder if it could be SIBO rather than IBS which would link in with the thyroid thing... We'll see. I just find it bizarre that even something as limiting as Low FODMAP seems to have minimal effect. You'd think there would be a shift in symptoms with that.

Examine.com is a great resource for studies on diet and supplements, from which you can branch out to heart's content. IBS/FODMAP study summary (scroll down to 'big picture'): https://examine.com/summaries/study/1wyny9/?utm_medium=email&utm_content=ss-gluten-free-ibs&utm_source=newsletter-weekly&utm_campaign=insiders-gluten-free-ibs-230112

[SA Chris]

That pretty much sums up my Dad Duncan. He was lacking energy to the point he was falling asleep mid afternoon on the sofa.

Sounds like me. Or it could just be that I'll be 54 in April.

[MischaHY]

I'm no medical expert either but work as a physio with an interest in inflammatory disorders.  I'd definately have full blood tests.

Personally I've found the York Test beneficial for identifying potential food trigger.  I've had similar symptoms.

Booked in for Monday morning to have a chat and get bloods taken. Love the German healthcare system.

I do have some defined food triggers but responses are inconsistent which made me wonder if it could be SIBO rather than IBS which would link in with the thyroid thing... We'll see. I just find it bizarre that even something as limiting as Low FODMAP seems to have minimal effect. You'd think there would be a shift in symptoms with that.

Examine.com is a great resource for studies on diet and supplements, from which you can branch out to heart's content. IBS/FODMAP study summary (scroll down to 'big picture'): https://examine.com/summaries/study/1wyny9/?utm_medium=email&utm_content=ss-gluten-free-ibs&utm_source=newsletter-weekly&utm_campaign=insiders-gluten-free-ibs-230112

Thanks Pete. Interesting read. I'm very sceptical that gluten plays any role to be honest but I definitely react to high doses of fructans especially from cruciferous vegetables such as broccoli. Légumes also problematic. However I have a feeling that the gut issues may be more mild and that I've got other stuff going on that is causing symptoms which I've attributed to the gut issues but is unrelated. We'll see in due course.

[MischaHY]

Ok so I got the results and it's even more bizarre. Thyroid numbers look fine, cholesterol low but uric acid is at +7.8 which is right below the threshold where a medicinal intervention would be recommended (+8). This could explain the joint pain...

Anyone had experience with this? The doctor said it typically is raised from eating lots of meat/sausage... I do eat meat multiple times per week but basically just beef/chicken/pork/salmon in an unprocessed way. However I must say I grew up vegetarian and didn't start eating meat until about 6 years ago which does fall into the timeframe of things.

I've got a referral for a gastroentorologist now so will go down that road. Really appreciate any insight people might have.

[teestub]

You been seeing off the Christmas Port surplus?

[MischaHY]

You been seeing off the Christmas Port surplus?

Drinking a glass of wine or 1-2 beers a couple of times a week the last few weeks due to festivities - normally less.

[slab_happy]

If it's gout (or a sub-threshold version of it), there's a huge genetic factor -- purines in diet can affect it, but you might be having problems from a diet that most people would be fine with.

(My brother-in-law's got it.)

[teestub]

Do I remember reading that you relatively recently moved to a more keto style diet too?