IanH

You assume this: " If you daily take less than this then eventually you will waste away.."  Depends on what you mean by waste away! When you reduce your caloric intake your requirement reduces.  Caloric requirement is not a fixed number, the body is more flexible than that. (As you said "minimal requirement") I suppose my choice of the word "requirement" is causing a problem here. However I still see "requirement" as the best way I can phrase it can you think of another?

Another thing associated with teenage abdominal pain is eyesight. It is often difficult for a young person to know whether their visual acuity is good or slightly off. Astigmatism in particular can cause strain in the abdominal muscles. Alleviated by corrective vision.

I have been keen on DHA for cvd however a recent meta analysis found otherwise: \

Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks - Meta-analysis of 10 Trials Involving 77 917 Individuals

JAMA Cardiol. Published online January 31, 2018. doi:10.1001/jamacardio.2017.5205

The studies used dosages from 226mg/d to 1800mg/d.

The dosage is contentious. I recommend 3 grams twice daily for neuropathic pain (incl fibromyalgia) and get quite good results but I also recommend it combined with vitamin D 5000iu/d

Whats your thoughts on dosage?

You could hold the tablet under your tongue until it has dissolved. Some of it will enter the blood stream directly without passing through your gut (absorption not digestion as has been pointed out). However it will have NO effect until dissolved and absorbed into the blood stream. As for the placebo effect that depends on the person and the type of pain. Ibuprophen reduces inflammatory pain which is "nociceptive" pain but has little or no effect on other forms of pain such as neuropathic pain in particular allodynia which is very susceptible to placebo effect if not too strong a pain. In fibromyalgia much of the pain is allodynia and ibuprophen has no effect.

I don't know about reversal but you can slow your aging down. Eat sub-caloric requirement and exercise regularly. You could also make sure you have an optimal blood level of vitamin D (around 40ng/ml or 100nmol/L). Why vitamin D? because it regulates more genes than any other nutrient.

What doesn't melatonin do? Check out the Journal of pineal research: https://onlinelibrary.wiley.com/journal/1600079x

They often have free to access articles and the abstracts are worth reading to get an idea of what melatonin does.

The circadian function is a small part of it's role. Incidentally most of the melatonin in your body is found in your gut.

Assuming your diagnosis of fibromyalgia is correct, one of the many symptoms of FM is peripheral (non-diabetic) neuropathy.

The similarity of FM to Chronic Fatigue syndrome is significant however some studies have reported that as much as 50% of people diagnosed with FM do not meet the criteria for such diagnosis.

Most medication and nutritional supplementation is prescribed on an individual basis but a general set of nutrients can be recommended.

Some nutrients can reduce some symptoms and some nutrients are recommended to avoid worsening of symptoms over time.

Current research shows that most sufferers of FM do have pathology in numerous metabolic pathways which seems to be as a result of fundamental problems at the genetic level.

That is, at the level of gene transcription and protein synthesis. This results in numerous enzymatic pathways being faulty. The results can be deficiencies in a number of key nutrients.

The most used are vitamin B12, B6 and B9 (folate). Research at the University of Newcastle (UK) has found that the majority of people with FM need magnesium supplements to reduce muscle cramps and twitches.

Vitamin D3 supplementation is universally recommended and this also needs vitamin K2 and zinc as co-nutrients. Also recommended is creatine, although some people report that this does nothing for them.

Some people have reported significantly reduced symptoms of pain and fatigue, as well as significant gut normalization by taking both amitryptiline and melatonin at night. The typical doses are Amitryp=15 to 25mg

and melatonin which is best taken as the bi-layered tablet: 2mg slow release+3mg fast release.

The doses of nutrients is an individual matter but typical are

B12 1mg sublingual

B6 100mg

B9 0.8 mg

magnesium citrate (or other salt but no oxide alone) 400mg-600mg

vitamin D3 5000iu

vitamin K2 1mg

zinc 16 mg

creatine 3 grams

You could also consider CoQ10 (ubiquinone or ubiquinol)

Ubiquinol is more bio-available.

Hope this has helped

IanH PhD

Has the diarrhea resolved?

You did say it was "acute" but then said it has been for a year, which would be chronic.

Are fecalysis, urinalysis, cbc, and serum electrolyte levels enough work-up for acute diarrhea?

 

I've had watery diarrhea (no fever, no abdominal pain) last year and had these labs taken which showed unremarkable results. Gave me metronidazole because amoebic dysentery is pretty common in the locality. Stool returned to normal in consistency after about a five days. Same thing happened to me recently and the labs were also normal. Prescription also consisted of metronidazole even though there was no cyst or trophozoite in my feces. I also could not believe that I would get amoebiasis twice since I'm very careful with what I eat and my housemates which are also eating the same thing didn't get loose stools.

 

Should I have been put into further work-up because the labs were inconclusive?