I am new to the forum and very impressed with the wealth of knowledge that is here.
I am a 33y male with a 17 year history of a bronchoplearal Fistula. November 2007 I had my 8th and hopefully last lung operation. Now that I finally got the fisula squared away, I am have an awful time with what I feel is malnutrition. 4 months post surgery my bilirubin elevated only to the poing of my eyes being yellow and I dropped 20 pounds in a matter of a month (163 to 143). Along with the weight loss came a bunch of other symptoms I have never experienced in the past and from what I can tell is that they are all associated with what I eat. The symptoms include light-headedness, dizziness (like my head is floating), ringing in the ears, tingling in extremities, Shortness of breath, very anxious, heart palpitations and constant burning in my stomach. A GI Doc diagnosed me with Gilberts Syndrome and that the weight loss was due to the stress of the surgery and the month and a half of antibiotics. I was on Meropenum IV and Cipro po. He ran every gastro-test under the moon including a PET scan and found nothing. He ran basic blood work all values were normal. So he put me on nexium (no longer taking) and sent me on my merry way. I managed to stop eating wheat products through research and narrowing down what foods I was eating that was causing my symptoms.

After a couple of months I was doing well and started gaining weight back but now all my symtoms are coming back and I really think I have some sort of vitamin deficiency. I am very frustrated and don't know where to turn. Any help would be greatly appiciated!!!!

I wanted to mention that when I take a multi-vitamin, after a couple of days I start feeling worse than I was before taking them.

Thanks in advance,

Woody

What has happened to you is very complex.

A long history of medical interventions, along with drugs.
For example, Cipro causes neuropathy in some people.
The Merrem has listed hepatic side effects.

I have this post on our PN board here with ways to deal with the toxic side effects of Cipro and its related drugs:
http://neurotalk.psychcentral.com/thread54985.html

Do you have vomiting? other GI symptoms? diarrhea?
I am having a problem understanding the GI problem.
Can you list what you would eat now in a day?
Did you lose weight because you stopped eating?

Are your liver functions normal now?

In general doctors ignore the potential for drugs to cause problems in patients. Some people believe they do this because they don't want to admit to culpability.
Merrem can cause paresthesias, as well as Cipro.
I am thinking so far that you have a neuropathy. But you need to please answer more specifically what is the problem.

After surgery, patients need more protein to heal. You can get this easily with whey protein shakes. Also another element needed for healing is zinc.
I don't understand in what way you feel worse on a vitamin supplement. If you could be more specific with that --it would help clarify. Multivits typically have very little in them. So I don't understand what is making you feel worse.

Mrsd,

I was hoping that you would respond! To answer your questions, I do not have any vomiting, just nausea. I really don't eat much because my appetite is horrible. Breakfast almost never b/c when I wake up in the morning my symptoms seem to be worse. When I lost the weight it was very rapid and I was doing everything possible to stop it including drinking Ensure. All my basic blood values are normal that are included in a CBC and BMP. I guess the biggest question I have is, can you have a B12 deficiency without being anemic? And secondly what other vitimin deficiency would cause my symptoms?

The neuropathy you mention was one of the symptoms I had earlier in the year but went away as I started feeling better, now it is back along with all the others.

Thank you for your input!

Nausea could be the beginning of gastroparesis. This is when you get neuropathy of the nerves running the stomach.

It can also be from a poor lining, or from an H. pylori infection.

Essential fatty acids maintain the lining of the stomach.
This is Flax oil, evening primrose and fish oil.

So to start, I'd concentrate on them. There are foods now with them... Smart Balance Peanut Butter, Smart Balance spread (butter substitute) and Omega-3 Eggs, Smart Balance Mayo.

Start with that and you may avoid taking capsules.

For nausea I like ginger extract in capsule form. YOu take it with a glass of water and remain upright (it may reflux if you lie down). This is very inexpensive and available in most health food stores. If you take it 3 times a day for a week, and your nausea improves, then you can eat better and get those EFAs into you for repair.

I suspect you are low in B12, and if so it will add to neuropathy woes ... Long term use of acid blocking drugs block your body's ability to absorb B12.(these drugs also block folic acid, calcium, zinc and magnesium, and iron). And yes, you can be low and NOT anemic. The anemia only comes with very low levels over alot of time.
I'd start on 1mg of methylcobalamin ASAP and take it every day forever. The methyl is activated to work in your body right away, the common cyanocobalamin is synthetic and requires 4 steps to be used~~ and these may fail.

This is an example of 1mg:
http://www.iherb.com/ProductDetails....1&pid=129&at=0

this is 5mg:
http://www.iherb.com/ProductDetails....1&pid=117&at=0

The 5mg once a day for 2-3 months would work faster..if speed is important to you. This supplement is not commonly found in local stores.
One should take it on an empty stomach once a day. Food interferes with absorption.

Once your nausea settles down, then you can add other things.
I'd look at whey protein shakes with fruit (supply potassium) to improve lean muscle mass which you are losing from not eating. Whey protein is predigested and quickly utilized. (if you have some digestive problem, it usually bypasses that).
Ensure is okay, but less concentrated in this regard.

We have a member with gastroparesis on our Peripheral Neuropathy board. She can help if you need her input if this turns out to be your problem. Her user ID is kmeb.

Males have another problem with weight loss/malnutrition. The blood proteins that carry testosterone throughout the body are made from the protein you eat. When males become depleted in protein due to illness/surgery, or poor food intake, these proteins cannot do their job, and
males then suffer from LOW testosterone. Besides the sexual dysfunction, there is a loss of
muscle mass, and generalized fatigue and loss of strength and vitality.

Speaking of stomach upset...

I have had a horrible increase of headaches and low grade migraines in the last 10 days. Along with this, I have had big time problems with my stomach. I do wonder if the two things are related? The doc says I have gastritis. I can't take proton pump inhibitors (makes my head worse) and I understand these are the stomach meds most people take to help out with stomach woes. I can take Axid and my doc told me to take a very large dosage (he gave me a script instead of relying on over the counter).

I'm now taking a small amount of Fish Oil and I take plenty of B12.

Sometimes I get ginger candy from the health food store...they are yummy!

What other supplements and/or foods might I try to help heal my aching tummy? What teas are good, etc.?

I really think the natural way to go is best...I would rather not take the huge dosage of Axid for too long.

BTW, I have recently noticed that I have a lot of bloating after eating meat. I am skipping days (having vegetarian days) and feel better. The only dairy I'm eating is yogurt...and this seems to also help. Vegetables...are not problem. Most fruits...no problem. I'm wondering if it would be worth getting some testing done in this area or if I should just keep a food diary????
Thanks.

Gastritis has causes.

1) food intolerances-- like gluten

2) infection by viruses (usually short lived) or bacteria (H.pylori)

3) alcohol

4) the dreaded cancer

Gastritis that continues... should be evaluated for causes.

I would also take FLAX oil supplements, or eat it flax containing foods. The essential nature of ALA alpha linolenic acid in food is what builds the protective lining of the stomach.
Fish oils provide long chain fatty acids that are at the END of EFA chemisty. They are anti-inflammatory, but do not do the same things as Flax will. Think of the complex EFA chemistry as a long train. Fish oil is the caboose, and flax is the engine.
There are many cars inbetween! Females convert ALA into EPA and DHA (found in fish oil) up to 25%. That means that 75% of the oil is used by the body for other things, including maintenance and repair.

Axid is an H2 blocker. It blocks histamine and also reduces
acid in the stomach. Acid is needed to break up protein in your food, so it can be digested. When acid is missing because you take drugs to eliminate it, protein is NOT digested and instead moves down to the bacteria in your colon which ferment it and create GAS. All acid blocking drugs do this. It is a serious downside to them. They create a vicious circle of damage over time, while giving a superficial impression of benefit.

Well, no wonder I can't eat meat!
I do have gluten sensitity and I have not fully addressed this.
Instead, I just avoid bread (for the most part).
So...you see why I'm starting to only feel good about eating veggies! Well, at this rate I should lose weight!
My migraine meds upset my tummy and I have been stuck with Axid to help me cope with that.
I'm thinking yogurt would be helpful.
I have been taking FLAX, but thought I would stop when I added the Fish Oil.
I'm taking a children's dosage of Fish Oil (long story).
I can put the Flax back.
BTW, ironically I just discovered TLC granola/peanut bars with FLAX. Had one yesterday and another one for breakfast this morning. Goodness...they are delicious!

BTW...here is something on foods that I just got from WEB MD that looks good (foods that helps us think)
http://www.webmd.com/add-adhd/slides...wnl_day_100108

Sorry I haven't responded lately, but I was at the end of my rope. I have been in and out of the ER for severe dehydration twice since my last post.

I have been seeing the same Gastro since Feb and decided to get a second opinion from an alternative medicine DR. On my first visit I give her my lengthy medical history and promptly orders a urine and stool sample. Something my Gastro never did>>>>>>>go figure!!!!! And guess what the results showed. I have an over growth of 4 different bacteria including E. Coli.

So now I am finishing up a 2 week regiment of 500mg Flagyl and 250 mg Cipro b.i.d. She also put me on a Probiotic and Immunoglobulin Supplement.

As of 2 days ago I am able to tolerate gluten again but still have to shy away from the dairy.

My B-12 level was around 450.....I guess this would explain a lot of my symptoms. I started a B50 complex and a 2000mcg B12 lozenge but I don't like how they make me feel. With the absorbtion problem I have acquired from the intestinal infection what other b12 options are out there besides injections?????

Thanks in advance,

Woody