Supplement Overload

Remember a few months ago when I went to see a naturopath?

And he sent me for all sorts of blood tests that confirmed that I was NOT low in iron or B12?

And then he sent me home with a list of vitamins, digestive enzymes and fish oil to add to my diet?

Well, I added them. As instructed.

I even worked out a vitamin schedule to fit them all in without overlapping the things that should not be overlapped.

- one digestive enzyme tablet and a vitamin D with breakfast, along with a teaspoon of fish oil in my breakfast shake
- vitamin C (sometimes with iron) around 10:30am
- digestive enzymes, a calcium and a K2/D3 gel at lunch
- vitamin C in the afternoon
- digestive enzymes with dinner,
- and a multivitamin before bed.

I've been doing that since October. Every day.

I'm getting kinda sick of all the pills I have to take. I'm also getting kinda nervous because the supply I bought when I started this whole thing will be running low within a few weeks and the cost of replenishing is making me nauseous.

On top of all that, there have been a rash of articles lately in the newspapers and magazines as well as CBC interviews with people talking about the amount of money we waste on vitamins and other supplements that are often unnecessary and sometimes downright harmful.

I don't feel any different since I've started taking them. I'm not sure if I'm supposed to or not but I don't. No more energetic. No 'healthier'. I don't sleep better. My blood sugar doesn't behave any differently whether I take digestive enzymes before a meal or not. The only thing I've noticed is that I have not yet been sick this year. Considering the amount of cold germs I'm exposed to every day, that is a pleasant surprise.

Still though I'm beginning to doubt my regimen. And beginning to wonder if I really need to be taking all that I'm taking.

My diabetes doctor put me on vitamin D years ago. My naturopath agreed.

My family doctor put me on calcium late last fall after getting the results of my bone density scan back. My naturopath agreed.

The other stuff? My naturopath put me on it all and no one else has had any input to agree or disagree. So I don't know what they would say if I asked but I can guess they would tell me that most of it is unnecessary.

Does that mean they are right?

Why should I give one doctor's opinion more weight than another's.

Argh!

So I continue to take what I've been taking. Until they run out. And then I decide whether or not to get more. At this point, I'm leaning rather heavily towards not getting any more of any of it - except vitamin D and calcium.

We'll see.

Blood Test Results

Last Friday, on my much-needed day off, I headed over to the naturopath for my follow-up appointment.

I went in full of questions and left full of things to think about.

First of all, I got my blood work results back. After complaining about fatigue, I had been sent for the following blood tests:
- iron
- ferritin (think of ferritin like my iron stores)
- vitamin d
- vitamin b12
- thyroid

Being low in any of these things can result in fatigue so it was worth checking out. I figured I'd be low in iron, low in ferritin and wouldn't have been surprised to find out everything else was low too.

Instead, my iron was fine, my ferritin was fine, my vitamin d was fine, my thyroid was fine and my B12 levels were the highest he's ever seen in someone who is not getting B12 injections.

Well wasn't that nice to hear on a cold Friday morning in November? I asked if I was too high and he said no. Just higher than he is used to seeing. I asked how that was possible since I don't take extra B12 or do anything special to try to get it in my diet. He said I might just be absorbing it really well from my VEGA powder or my multivitamin. Whatever the reason, the blood results were fine which means I have a few less things to worry about.

He then told me that he thinks he figured out that weird thing that happens in my ears when I run. He said it was called 'exercise-induced eustachian tube disfunction'. A long name to be sure but it's not dangerous or problematic. On the other hand, there isn't much we can do to prevent it from happening either. It happens when I run for over an hour and goes away when I stop running. If I start up again, it comes back almost immediately. In my body's struggle to deal with it, it also affects my breathing and I find myself gasping for breath for a few minutes once I do stop.

(For the record, I googled it when I went home and read all about it. Sounds exactly like what I am struggling with. My GP, diabetes doc and my ear nose and throat specialist couldn't figure it out - I'm impressed my naturopath did and that he did it so quickly.)

So I have a diagnosis for my ears and confirmation that my blood test results were good. So what's up with the fatigue you ask?

Here's where things took a turn and I left the appointment with a lot to think about.

"Eustachian Tube Disfunction can sometimes be related to food allergies. So can unexplained fatigue. You're probably not going to want to hear this but I'm going to recommend you try an elimination diet to see if you have any food allergies."

What??!?

He talked about the four most common food allergies (dairy, wheat, eggs and soy) and suggested that, ideally, I would eliminate all of them from my diet for six weeks and then reintroduce them one at a time. "If you're not willing to do that, at least try wheat and dairy."

Bleh!

I drove home and thought about it. I told Doug what the doctor suggested and we talked about it. I thought about it some more.

Pros: if I really do have a food allergy, doing this might help me identify it, make changes to my diet and feel better overall. Not that I feel bad - I just have ears that plug up on long runs and I personally think I'm more tired than I should be given the amount of sleep I get.

Cons: I turn my diet upside down for six weeks. Just in time for Christmas. I wouldn't be able to eat out (easily anyway), I'd have to rethink every meal I eat, I'd be the most annoying dinner guest ever (did I mention Christmas is coming?) and I'd be pretty annoying to live with because every meal would potentially involve two meals and a lot of discussion to ensure all my allergens are avoided. And for what? I have no other reasons to think I have food allergy so it could all be for not.

I did think about doing it after Christmas but we're traveling in February, spending a week with friends, and doing things throughout the year that would never make it easy to find a six-week chunk of time where I can eat every meal at home without too much fuss.

Don't get me wrong. If I had a legitimate food allergy, I'd make all the dietary changes I needed to make to be healthy. But, because all of this is hypothetical, I'm really hesitant.

So, after a weekend of thought, I emailed my naturopath. I said I would continue with everything else he recommended, I'd increase my veggie intake, perhaps cut down, when reasonable, on my wheat, soy, eggs and dairy but I would not be doing the elimination diet at this time.

I felt both relieved and disappointed as I hit 'send'. I also felt like a tiny bit like a jerk since I went to him for advice but didn't take it. It is, however, my life and, ultimately, I need to make the choices that make the most sense for all involved.

So I did.

Any. Day. Now.

I feel like I'm poised, legs slightly bent, ready to spring.

I have done my research, got my doctor's note and called my insurance company. I'm poised and ready to spring the second they announce the Dexcom's release in Canada.

Any.

Day.

Now.

I've done my research and narrowed down my selection for the new GPS (running/cycling/swimming) watch (watches?) I want to buy. Now I'm scouring websites and waiting for Black Friday deals. Pre-Christmas deals. Boxing Day deals. Waiting for the price to drop to a point where I'm ready to buy.

Any.

Day.

Now.

It's getting colder in Canada and I've traded in my running shorts for my winter running tights...which are just a bit too bit. Not too too big but big enough that, even when I tie them up tight, I have to hike them up a few times on runs. I'm waiting for the December sale at our local running club to buy a new, smaller pair.

Any.

Day.

Now.

I've diligently written down everything I ate for a week. I'm religiously taking my digestive enzymes before every meal. I've gone for bloodwork. I've found a website that sells the stuff I need at a pretty decent price. Now I'm just waiting patiently for my second naturopath appointment at the end of next week to see what they say about everything and what they recommend I continue to take.

Any.

Day.

Now.

I'm working to improve my swimming speed to go along with my new and improved swimming stroke.

I'm waiting for the late fall Clinique Bonus Days at Holt Renfrew so I can get a fabulous gift when I buy more face cream.

I'm looking forward to my trip to Toronto this Saturday so that I can stop in at a new fancy pen store to buy more ink for my fountain pen...and maybe buy that lovely kelly green fountain that just came out.

I try hard to live in the moment but sometimes it feels like I'm spending more time looking down the road thinking:

Any.

Day.

Now.

What Our Bodies Tell Us

When I checked into the hospital 11 years ago I had lost a lot of weight and was looking pretty awful. I was newly (as in less than two hours before) diagnosed with type 1 diabetes. An endocrinologist was assigned to me. He came to visit me in my room and we chatted for a few minutes.

He then stood at the foot of my bed and asked me to look at him.

I did.

He asked me to turn my head to face the window.

I did.

He announced that I was severely dehydrated.

"How do you know?" I asked, thinking that I drank more water at that point that the rest of my family combined.

"Your nose" he replied.

He had never seen me before so had no idea what my nose normally looked like. But he was able to, correctly, determine that I was severely dehydrated based on what it looked like. He transferred me to Intensive Care, put me on insulin and looked at my nose every time he came to visit. Within a few days, he was happy with how it had 'filled out'.

I have known people whose doctors have diagnosed a deficiency in one thing or another by looking at their fingernails and the ridges that formed there. Horizontal ridges mean on thing, vertical ones mean another.

I find that kind of stuff fascinating.

It's obviously not going to work with every possible diagnosis but our bodies tell us much more than we realize.

The other night I was telling my sister that my naturopath put me on digestive enzymes. She laughs and said that her naturopath did the same for her.

"Did he look at your tongue?" she asked.

No.

Apparently the colour of one's tongue gives a good indication of their digestive prowess. A rich, red colour means, as she puts it, a person can digest a tin can. A pale tongue means that they have difficulty digesting food that isn't cooked.

At a yoga retreat she attended a few years ago, everyone had to show their tongues and they were told what percentage of their diets should be raw and what percentage should be cooked. So interesting.

It sounds part voodoo but also makes sense. My tongue, like my sister's, was pretty pale when we compared to others around us. I do have difficulty with large amounts of uncooked veggies and, like her, would probably have been put on a 90% cooked diet at that yoga retreat. Even the fruit was cooked, just a bit, to help aid in the digestion.

Noses, tongues, fingernails. I'm guessing I haven't scratched the surface on the little hints our bodies give as to how they are doing.

Admitting is the First Step

I was driving home yesterday afternoon and listening, as always, to CBC Radio One.

It's a rare day when I'm am not fascinated by what they are talking about.

I missed the beginning of the interview and didn't catch who exactly they were interviewing. Whoever it was was talking about the growing number of people out there who are using some form of alternative therapy. My ears perked up when she said ''naturopath".

The speaker did not have any problem with naturopaths but she did say that many traditional family doctors do.

Because of that, many patients keep that information from their family doctor. They also, often, refrain from mentioning that they are taking fish oil. Or Coenzyme Q10. Or any other non-traditional supplement which, according to the speaker, can interact with pharmaceutical drugs in unexpected ways.

The message was not to stop taking supplements. Nor was it to stop taking pharmaceuticals.

It was to be open with everyone about who you are going to see, what you are taking, and why.

It's interesting.

When I went to the naturopath last week, they asked me to fill out a form with all the medications I was taking and the doses. I didn't hesitate and put every little pill down. I even put down the Vega powder I put in my breakfast shake because it's pretty high in a lot of things and I didn't want them recommending something that might lead to my taking too much.

On the other hand, when I go to my family doctor and they ask what I'm taking, I have no problem listing all the medications that they, or my diabetes doctor, prescribed. I do, however, refrain from mentioning my Vega powder. Or my iron pills.

I haven't seen my GP since I saw my naturopath but I'll be there early in the new year. I already know I'm going to think several times before 'admitting' that I'm taking a teaspoon of fish oil in my breakfast and digestive enzymes before meals.

Because I'm pretty darn sure I'm going to get a sigh and a polite lecture.

I also know that I'm going to think twice about telling my diabetes doctor because I've asked her several times about supplements for people with type 1 and she has always insisted that I only need Vitamin D and nothing else.

I'm not sure what the problem is exactly. I'm a firm believer that I am responsible for my own health and that the doctors, nurses and dieticians I see are there to help me make good choices and understand my options. They are not my bosses and they don't have the right to tell me what to do or not do. They can make recommendations and provide information to help me make my own choices.

And yet I am not thrilled at the idea of telling them about the naturopath in my life and the fact that I'm giving their advice as much weight as everyone else's. I won't do everything they recommend either but I'll certainly consider it seriously.

I have a few months before my next 'traditional' appointment which should give me enough time to get used to the idea that I'm going to have to look my doctor in the eye and say 'yes, I'm taking fish oil and enzymes'.

Do we have a problem?

A Naturopath Report

Last night, after work, I headed down to a small little house with a sign out from that, among other things, confirmed that I was at the right place.

For better or for worse, I was about to head into my first naturopath appointment.

I wasn't sure what to expect but I had some pretty good ideas of what I did and did not want.

I did not want to be told to dramatically change my diet, to give up sugar (wouldn't that be a neat trick for a type 1?), red wine, chocolate, my morning coffee etc etc.

I did not want to be told that I need to take a bunch of weird smelling herbs and tinctures at every meal to balance my chakras or realign my feng shui.

I did want someone who understood type 1 diabetes, the challenges of eating properly to fuel all the activity I do. I wanted someone who would listen to my list of issues (fatigue, ear plugging weirdness, lower than ideal bone density) and work me me to see if there are things I can do feel a little better, a little more energized and a little less prone to breaking.

Guess what?

I got it!

We chatted for an hour and a half and didn't even get to everything. He had obviously done his homework and asked intelligent questions about diabetes, continuous glucose monitors, insulin usage etc. He even laughed at my subtle diabetes jokes that only people who get it would laugh at.

He listened to my concerns and suggested some blood tests based on what I said. I was handed a requisition form to have my ferritin tested, my B12 levels, vitamin D and thyroid. Things I have either never had tested or haven't been checked for in years.

He thought I might have difficulty absorbing minerals (iron, calcium etc) and suggested a digestive enzyme test for a few days. He gave me some samples to try and I am to report back at my next appointment as to how things felt.

He suggested a tablespoon of fish oil in my breakfast shake which is an antioxidant and will help reduce inflammation. He promised that it doesn't taste like fish. "More like lemons" he insisted.

He suggested vitamin K2. Vitamin D helps the body absorb calcium but Vitamin K2 is important in helping get the calcium from the blood into the bones. "Like how insulin gets sugar from my blood to my muscles?" I asked. "Exactly!" was the response.

Finally, he suggested Vitamin C with bioflavenoids. It's an antioxidant, improves collagen production (which helps strengthen bones) and improves immune function.

That was about the point when I asked for tips re when to take what. Iron shouldn't be taken with anything else other than vitamin C. Calcium and Vitamin D should be taken together - ideally not at meals. Vitamin K2 should be taken with a meal. It gets tricky.

We talked about what to take when. I got my blood work form. I booked a follow-up appointment in a few weeks and I promised to email a week's worth of food diary info. "Everything I eat and drink? Even Dex 4s and 3am fig newtons?" I asked.

"Everything" he said.

Right-o.

The only thing that didn't get resolved? My ear plugging thing. I described it, he asked a ton of questions. At the end, he was just as perplexed as every other doctor I've spoken to.

"Let me do some more research" he said.

Next appointment is November 22nd. Stay tuned for blood work results and a report on how well my digestive enzymes are doing.

The Week in Review

Lots of little things happened this week so I thought a weekly report, complete with bullet points, was the way to go.

• On Tuesday I received information re the cost of new Dexcom that is coming to Canada. 
• On Wednesday I called my insurance company who said that they would cover $1000 of the $1500 cost for the receiver and transmitter and 100% of the cost for the sensors. All I needed was a prescription from my doctor for all three things. Woohoo! 
• On Thursday I called my best contact at the Niagara Diabetes Centre and explained the situation. My next appointment there is not until February and they are booked so tightly that I won't be able to get in any earlier. She said to email her all the details of what I need and she will speak with the doctor who will be back next Tuesday (October 29th). She said that she did not think it would be a problem to get me a prescription written. Yes! 
• On Tuesday AND Thursday I ran with my new earbuds. The Yurbuds for women. I was more than a little skeptical when I put them in and they felt like they were barely hanging on. I was more than a little impressed when I ran six kilometres and they held on tight and sounded great. I never once had to reach up and adjust. They did not slip or slide nor did the cord bunch or pull. I love them and they will definitely be joining me on the half marathon this Sunday. 
• A few weeks ago I wrote a blog wondering about naturopaths. I had never been to one but thought I might like to try. I looked up several in our area. I contacted one by email who was slow to respond and rather unhelpful. I contacted another, asked if they were knowledgeable of type 1 diabetes and athletes. He responded saying yes, he understood type 1 diabetes, knew a lot about sports nutrition and also guessed (correctly) that I might be running in the Niagara half marathon this weekend.  My gut said go so I booked an appointment for next Wednesday after work. I am really looking forward to it. 
• On Thursday I went to my favourite running store after work. I was all excited because my Brooks adrenaline shoes now came in a fabulous colour combo of purple and lime green. 

Pretty eh? 

• They had my size which was pretty exciting in and of itself as I wear a rather uncommon 10.5 Wide. 
• They opened the box to show me and I looked down to see these shoes staring back at me. 

What!?!

• I asked for the purple ones like the ones on the shelf. I was told that Brooks does not make the colourful options available in the wide sizes. Just in the regular sizes. I asked if Brooks discriminates against wide people for any particular reason. I was told that this is how they always do it. I suggested that the next time the Brooks rep comes to the store they could be told about their very unhappy customer with the extra wide feet who likes bright colours. I left with yet another pair of boring, sissy, blue and white shoes. Perhaps the 2014 edition will be a little flashier?
• I was reading an article in Triathlete magazine about on-line dating for triathletes. The article gave a list of things not to talk about on your dating profile or on the first few dates with non-triathletes. One of them was bedtimes. The article strongly suggested that you don't mention about going to bed every night at 8:30pm in order to get up at the crack of dawn. I just want to say, for the record, that it was 8:45pm when I read the article, lying in bed. I read the line out loud to Doug who was happily lying right beside me reading his own bedtime story. Guess it helps to date within the tribe doesn't it? 

And that, my friends, is all she wrote.