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Determining optimal body composition/weight to minimize inflammation & joint load & help sleep

Answered on August 19, 2014
Created February 08, 2011 at 10:35 PM

I'd appreciate advice on helping me figure out next steps in my health promotion:

Postmenopausal, 11 months of paleo: gluten-free, no added sugar/processed food products, restricted carb diet. Protein intake between .5-1gm/kg. Butter and olive oil were fat sources with recent addition of coconut oil. I eat homemade full fat yogurt, use the whey in main dishes, and eat cheese without ill effects.

My BMI has dropped and stayed put at about 21.7, with body fat about 16.5%. My HbA1c is 4.9, fasting bgs run 77, and post prandial bg's stay below 120. Trig 49, HDL 85, tot chol 220, so no worries there.

My next issue is to try to determine how much more weight and body fat I can lose to minimize significant chronic pain with flares from lumbar spinal stenosis (multiple injuries since teen years from lifting and turning patients, doing farm chores, etc), newly dx hip osteoarthritis, old knew osteoarthritis, and very painful arthritis in base of thumb.

I walk around 8 mi/day (hand carry 20+ lbs 3-4x/wk), have tried yoga - love it but realize that I need a teacher or partner in order to do it, am on a wait list to learn Tai Chi, and otherwise, do not engage in any other activities.

My sleep is horrible. At night, 3 hours total broken into two or three "naps" is the norm, and at least once a week, I don't sleep at all. I have impeccable sleep hygiene, have tried various meds and supplements, used IF, re-timed meals, re-timed activity, etc. and nothing has made the slightest difference.

I also have very poor learning, attention and concentration, which I attribute in large part to sleep deprivation. I'm pretty sure I'm keto adapted.

I take no meds, prescription or otherwise, as NSAIDs, transdermal hormone therapy, sleep meds, non opioid pain meds, etc have failed to bring any relief for any of the above issues.

Hot and cold therapy haven't helped with pain or relaxation into sleep, either.

Can someone help walk me through figuring out what else I might try? Thanks so much-

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 09:15 PM

Thanks, Helen - I'll check it out.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 09:15 PM

Thanks: I do eat bone broths - they are wonderful in this cold weather. So far, have hit a wall on getting a sleep eval. Every doc want another doc to recommend it. Dentist just doesn't know about it, so I'll keep it in mind.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 09:13 PM

Thanks - she was just in town, and I wasn't able to see her. But I'll keep looking.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 09:13 PM

Mostly decaf and always only in the morning. Thanks for the activity suggestions. I'll check them out. I'm on the "starving artist" financial plan, so have to keep low/no cost in mind for alternatives.

E7a462d6e99fec7e8f0ddda11b34a770

(1638)

on February 09, 2011
at 04:41 PM

I would second the recommendation to get checked out for sleep apnea. Your local hospital should be able to give you a reference for a sleep disorders center or ear/nose/throat specialist if they do not have one themselves (many do now). You can try the dentist route, but a full sleep study could save you money in the long run by determining what might be the underlying problem instead of trying things willy-nilly. My husband became a different man after he started using a CPAP machine and it made an enormous difference in his health too. Good luck.

06d21b99c58283ce575e36c4ecd4a458

(9948)

on February 09, 2011
at 02:05 AM

Esther Gokale has a youtube vid here. http://www.youtube.com/watch?v=-yYJ4hEYudE

2b8c327d1296a96ad64cdadc7dffa72d

on February 09, 2011
at 02:03 AM

add bone broths to your regimen. Lots of minerals there in proper balance to help with osteoarthritis and/or osteoporosis symptoms. VitD supplementation is good, but VitD with VitA AND Collagen (and other minerals found in bone broth) is most excellent.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 01:04 AM

I do eat some nightshades, and your suggestion is worth trialing. Thanks. I regularly eat sweet potatoes, rarely rice and very rarely a potato. I had a course of phys tx after the hip OA dx last summer. The pain worsened, even though I gained strength and flexibility. I'm at a loss as to how to build more muscle, as I already exercise to pain tolerance. I am beyond tired from a lack of sleep, and I'm totally out of ideas for playing around, but thanks for the encouragement!

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 12:56 AM

Thanks so much. Vit D level=69. I have most of the symptoms of upper airway resistance syndrome. There's an argument that it is on a continuum with OSA, and another that says it's a distinct disorder. So far, haven't been able to determine which doc/specialist might be able to evaluate and treat - am investigating dentist first since one primary treatment is using a mouth appliance to reposition the jaw.

1acc4ee9381d9a8d998b59915b3f997e

(2099)

on February 09, 2011
at 12:49 AM

I take a product called Iodoral. It worked miracles for me.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 12:39 AM

Thanks, Helen. I very recently began using iodized salt, and I eat fatty fish and shellfish regularly. I'm not sure how else to supplement there. I also have been using Epsom salts the way you described. So far, no effect.

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5 Answers

1
21fd060d0796fdb8a4a990441e08eae7

(24543)

on February 09, 2011
at 01:00 AM

I'd say forget about the weight, and either buy Esther Gokale's posture/movement book, or go to one of her workshops.

You're not obese, and the modicum of extra weight is not intimately tied to pain signals that persist. In other words, weight is a proximal indicator of deteriorating joints, but the causes of joint pain rarely lie there except in upper BMI echelons.

06d21b99c58283ce575e36c4ecd4a458

(9948)

on February 09, 2011
at 02:05 AM

Esther Gokale has a youtube vid here. http://www.youtube.com/watch?v=-yYJ4hEYudE

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 09:13 PM

Thanks - she was just in town, and I wasn't able to see her. But I'll keep looking.

1
Cab7e4ef73c5d7d7a77e1c3d7f5773a1

(7304)

on February 09, 2011
at 12:14 AM

Have you tried eliminating nightshades? Some people report problems with those.

I would not try to lose any more weight. At 16.5 percent body fat, you are in the lower range of healthy for a woman. If anything, I would try to build more muscle to take some of the impact off of your joints.

Also, you mentioned you're keto-adapted. Have you tried adding some starch in? Potatoes, sweet potatoes, or white rice might be good to play around with to see if it makes a difference.

Keep playing around with your sleep. I'm sure you know the importance of getting enough, especially for dealing with injuries and chronic conditions.

Good luck! And report back if you find any solutions.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 01:04 AM

I do eat some nightshades, and your suggestion is worth trialing. Thanks. I regularly eat sweet potatoes, rarely rice and very rarely a potato. I had a course of phys tx after the hip OA dx last summer. The pain worsened, even though I gained strength and flexibility. I'm at a loss as to how to build more muscle, as I already exercise to pain tolerance. I am beyond tired from a lack of sleep, and I'm totally out of ideas for playing around, but thanks for the encouragement!

1
06d21b99c58283ce575e36c4ecd4a458

(9948)

on February 08, 2011
at 11:52 PM

What jumps out at me is your osteoarthritis. It is well known that Vit D3 facilitates absorbtion of calcium into the bones and prevents or relieves osteoporosis and arthritis...along with a wheat free/gluten free/sugar free diet....which apparently you have dialed in...judging by your lipid profile. Congratulations.

I also know that Vit D3 supplementation can alleviate aches and pains fibromyalgia.

I do recall I saw somewhere that fruit intake seems to be corolated with arthritis because of the fructose.

I am surprised that you have not seen any improvement in your arthritis by the elimination of wheat & sugar products. Be sure you are not consuming any psuedo sugars ala aspertame or any of the other chemical sweetners. Our bodies recognize these as sugar and mess with our blood sugar levels.

For post menopausal, I would be surprised if you really need to get your BF less than 16.5.

As you have identified, sleep deprevation certainly can lead to attention-learning problems. What helped me somewhat is doing tabata wind sprints...going all out running for 20sec and then rest for 10sec and then repeating 8 times. Total workout time 4 min. Do you have that much time in your day? Just three days a week. Such high intensity short duration activity tends to alleviate cortisol problems...which can cause sleep problems.

Also, are you sure you do not have sleep apnea. I used to think that only overweight people had sleep apnea because of lots of fat in and around the airways. But I know one relatively thin healthy person with sleep apnea. Getting diagnosed and getting a CPAP probably saved his life. Sleep apnea starves the body of needed oxygen and weakens the heart muscle and can lead to a coronary heart event.

You have done a great job so far. Keep the n=1 experiment going in your journey to good health.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 09:15 PM

Thanks: I do eat bone broths - they are wonderful in this cold weather. So far, have hit a wall on getting a sleep eval. Every doc want another doc to recommend it. Dentist just doesn't know about it, so I'll keep it in mind.

E7a462d6e99fec7e8f0ddda11b34a770

(1638)

on February 09, 2011
at 04:41 PM

I would second the recommendation to get checked out for sleep apnea. Your local hospital should be able to give you a reference for a sleep disorders center or ear/nose/throat specialist if they do not have one themselves (many do now). You can try the dentist route, but a full sleep study could save you money in the long run by determining what might be the underlying problem instead of trying things willy-nilly. My husband became a different man after he started using a CPAP machine and it made an enormous difference in his health too. Good luck.

2b8c327d1296a96ad64cdadc7dffa72d

on February 09, 2011
at 02:03 AM

add bone broths to your regimen. Lots of minerals there in proper balance to help with osteoarthritis and/or osteoporosis symptoms. VitD supplementation is good, but VitD with VitA AND Collagen (and other minerals found in bone broth) is most excellent.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 12:56 AM

Thanks so much. Vit D level=69. I have most of the symptoms of upper airway resistance syndrome. There's an argument that it is on a continuum with OSA, and another that says it's a distinct disorder. So far, haven't been able to determine which doc/specialist might be able to evaluate and treat - am investigating dentist first since one primary treatment is using a mouth appliance to reposition the jaw.

0
Ceda025d1f349bc43be115a5f9199fb1

(501)

on February 09, 2011
at 03:49 PM

Your diet sounds good. Not sure what your caffeine intake is like, but I would consider that in regard to your sleep problems. Diet is not a panacea. Sounds like you have some wear and tear on your body. Agree with the Gokhale recommendations above, her class is well worth taking if it comes to your area. Structural integration or Rolfing is expensive but might be useful as well. Pilates, movement or yoga instruction from a teacher that focuses on your biomechanics rather than getting you into a specific position or movement pattern. Most of all, I would consider strengthening the muscles around your arthritic joints using a safe, measurable approach like the one in Body by Science. If you have a facility near you, Med-X makes a highly specialized spine strengthening machine that might help with your back. Lastly, pain is mulitfactorial and there are social and psychological inputs into many people's chronic pain. Consider cognitive behavioral therapy if you think it might be indicated. Opioids for long term pain is often a recipe for disaster, due to tolerance, hyperalgesia and other brain based changes. Good luck!

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 09:13 PM

Mostly decaf and always only in the morning. Thanks for the activity suggestions. I'll check them out. I'm on the "starving artist" financial plan, so have to keep low/no cost in mind for alternatives.

0
1acc4ee9381d9a8d998b59915b3f997e

(2099)

on February 08, 2011
at 11:31 PM

The poor learning, attention and concentration sounds like me when I was iodine deficient. Iodine deficiency also caused me to have muscle weakness and stiffness, too. You might want to try Epsom salts baths, too, for the sulfur and magnesium they contain. Put 2 or 3 cups of Epsom salts into a tub of water that is as hot as you can stand it and soak for at least 20 mins. Magnesium is a miracle when it comes to muscle stiffness and tension and sulfur is good for cartilege.

1acc4ee9381d9a8d998b59915b3f997e

(2099)

on February 09, 2011
at 12:49 AM

I take a product called Iodoral. It worked miracles for me.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 12:39 AM

Thanks, Helen. I very recently began using iodized salt, and I eat fatty fish and shellfish regularly. I'm not sure how else to supplement there. I also have been using Epsom salts the way you described. So far, no effect.

F1cd291cf9ba1ebd9a9db21d3dd09735

(436)

on February 09, 2011
at 09:15 PM

Thanks, Helen - I'll check it out.

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