Stuck In a Rut - Inflammation + No Weight Gain

[amaguire]

Hello:

Will echo the many praises for this site, it has helped me a lot! Sorry for long email wanted to include detail to derive best answer from the many experiences here on the site, my question is at the end ☺.

BACKGROUND
56 year old male, LC diagnosis little over a year ago via colonoscopy. Significant improvement via dietary changes (mostly thanks to this site!). Have had doctor prescribed blood tests to check for Chrohn's recently which were negative (Saccharomyces cerevisiae Antibodies, IgG & IgA).

ENTERO LAB RESULTS
Fecal Anti-gliadin IgA: 178 units
Fecal Anti-casein IgA: 252
Fecal Anti-ovalbumin IgA: 151
Fecal Anti-soy IgA: 133
Mean Value 11 Antigenic Foods: 140
3+ foods: corn, beef, almond, white potato
2+ foods: rice, oat, tuna, pork, chicken, walnut, cashew
1+ foods: none
No reactivity foods: none

DIET
Due to results have been strict no: gluten, eggs, dairy, soy, corn, beef, almond, potato, rice, walnut, cashew
What eat: ground turkey, chicken, pork, gluten free oats, coconut milk, coconut oil, olive oil, bananas, cooked carrots/broccoli, sunflower butter, gluten free bread, applesauce, squash, asparagus, clean ham lunchmeat, lentil noodles, avacado, honey, black tea 2 cups per day.

I am working with a dietician who has some experience with IBS stuff and a few LC cases. Due to weight loss, and functional issues (energy, brain fog) she's suggested I deviate from the Entero Lab not ok foods. I'm an active runner/hiker and have had to cut level about in half. Also still have some amount of brain fog (not COVID related, had it before caught) which messes with my work responsibilities.

I'm about 15 lbs from where was before (presently 145 lbs, 5'10") and dietician not OK with taking any foods away (was down to 135 lbs before started working with her).

PROBLEM
Aside from weight issue (need the activity for my mental health) have what believe to be inflammation as evidenced by 3-4x per day BM, cross section very thin ribbon like, not watery resulting on soreness and small amount of bleeding (probably hemmorroid).

QUESTIONS
1) Does my inflammation diagnosis make sense?
2) If eliminate the 2+ foods am currently eating (GF oats, chicken, and pork) which will be hard suggestions on alternatives.

Thank you for comments.

[Gabes-Apg]

A few observations questions to help identify what is keeping you inflammed

- the tea. - may have soy are you using tea bags or fresh leaves?
- lentil noodles - lentils are a legume and given your soy result you could be reacting that
- did you replace your cookware and cooking utensils?
- are you sharing kitchen with someone who is still having gluten soy etc?
- are you taking Vit D3 /magnesium? have you had Vit D levels checked?

in early stages of healing we encourage avoiding processed foods like GF bread -
why??? GF bread can still have small amounts of gluten. you might be reacting to other flours /ingredients in the bread. Is it soy free as well?
some products can be high is sugars AND it provides minimal nutritional benefit compared to safe proteins and safe vegetables

the brain fog will improve once inflammation is reduced and active forms of B vitamins will also help

suggestion - coconut oil on your bottom, it will help reduce skin inflammation /haemorrhoid issues protect the skin etc

hope this helps

[tex]

Andy,

Welcome to the group. I'll try to answer your questions. If you're asking whether your high scores seem correct, (because they're so very high), high scores are associated with length of reaction. In other words, the fact that your scores are extremely high suggests that you;vve been sensitive to most of these foods for years, causing antibody levels to continue to build. And because of that, your immune system is hypersensitive. A score of 140 on the 11 other antigenic food test is almost unheard of, and with that level of sensitivity, there's no way that you can continue to eat foods such as chicken, pork, and oats, if you intend to ever control the intestinal inflammation. The hemorrhoidal inflammation is an extension of the intestinal inflammation, and it will subside when your intestinal inflammation is brought under control.

The EnteroLab tests cover virtually all foods that are likely to cause problems for microscopic colitis patients. That means, that any food that they don't test is a possible candidate for a safe recovery diet. For example, if I were in that situation, I would be eating turkey, lamb, cabrito (goat), rabbit, duck, goose, quail, pheasant, venison, antelope, antelope, rattlesnake — anything except beef, pork, chicken, and bison, because these days, virtually all bison have DNA from domestic cattle, due to crossbreeding over the decades.

Virtually all of us react to oats, despite the fact that so many so-called "experts" insist that gluten-free oats are safe for celiacs. They're not safe, because we react to the avenin in oats, similar to the way we react to the gluten in wheat, the hordein in barley, and the secalin in rye. If you feel you can't do without a substitute for oats, try buckwheat, or quinoa. You might be able to eat sweet potatoes.

And you're going to need to cut yourself some slack on the physical activities. Exercise is good, and it does help us to feel better, but we don't have near the energy or stamina that we normally have, whenever the disease is active, because most of our energy is diverted to our immune system as it tries to fight the inflammation.

Avoid fiber and sugar, and spicy foods, at least while you're recovering, but that still leaves a lot of options. As Gabes mentioned, avoid processed foods, no matter how safe the label appears to be, while you're recovering. Eat nothing but meat, if necessary, because it has all the amino acids that our bodies need for good health. The only caveat there is that it must be fatty meat, otherwise you will soon experience rabbit starvation, otherwise known as mal de caribou, fat starvation, or protein poisoning. But the bottom line is that you need to stop eating those foods that cause your immune system to produce antibodies, if you intend to suppress the inflammation long enough for your intestines to heal.

I hesitate to state a general warning about the competency of dietitians, but I'm aware of only one dietitian in the world who is capable of advising microscopic colitis patients, and she is a member of this discussion board. Unfortunately, after she got her MC symptoms under control, she switched from offering diet advice to offering marital counseling, because it pays better, so she's no longer active on this forum. The problem with most dietitians and nutritionists is that they try to treat MC patients by applying what they've learned about Crohn's disease and ulcerative colitis, and those methods simply will not work for MC patients, because we can't tolerate a little bit of this, or a little bit of that. We have to totally avoid all food sensitivities, and I do mean all, including tiny traces, if we hope to control our disease by using diet changes.

After we've been in stable remission for a while, and our immune system settles back down to a more normal sensitivity level, we can usually tolerate minor dietary slip-ups without finding ourselves back in a full flare. But until we've been in stable remission for a while, our immune system is simply too sensitive to allow any leeway in our diet.Otherwise, Gabes covered most of the other basics.

And remember, what I've written is just my opinion — it's not chiseled in stone, and other opinions may differ. We're all learning how to best control this disease by sharing information and experiences.

Tex

[amaguire]

Hi Gabes / Tex:

Thanks for taking the time to think about my situation and reply much appreciated.

COMMENT / QUESTION TO GABES
- tea is plain old Lipton in bags
- lentil noodles got it will skip (aren't very tasty anyway didn't have that much)
- kitchen situation - yes lots of potential for contamination wife and still have kids at home.
QUESTION: I'm inferring from your note washing isn't enough to be safe?
- Mg taking 500 mg per day
- D tested, was 41 ng/ml (normal range 30-100).
QUESTION: Test was called "D,25-OH,TOTAL,IA assuming pertinent to D3 level?
- GF bread got it will stop, yes lots of ingredients (no soy). Started to use for convenience for eating sandwiches while on the run or to
be "normal" with others at work if you know what I mean.
- processed foods other than GF bread have been pretty strict on staying clean

COMMENT / QUESTION TO TEX
Ouch you've got me scared. Not complaining but honestly I don't know how can make these drastic of changes (nothing but meat), I know it is what it is. Accommodating what am doing now is hard with lifestyle (work activity level / stress and family responsibilities).
QUESTIONS:
1.) Crazy high Entero lab results - in your experience could there be an error?
2.) Immune system settling down - could what I'm doing be working and my system is still recovering and need to be patient?
3.) Timeframe for healing - I know depends on how long have had issue and for me seems like a long one -> any estimate on how long would need if were to do the "meat only" phase?

I'm with you on the doctor/dietician advice. Before Entero lab had full blood work for food sensitivities and all came back in normal range, primary care doctor sees no issues with food. Gastro guy says he can give me medications to allow me to eat chili dogs for lunch every day no problem, he crumbled up my Entero lab results when wanted to review with him in person, said if re-took test likely get opposite results ☺. Dietician skeptical of Entero results, her main concern right now is to get my weight/strength back up (given that the really bad symptoms have subsided).

Thank you both again wish you a nice day.

[Gabes-Apg]

- tea is plain old Lipton in bags
Some tea bag teas can have contaminates and the bags be made with soy - given the inflammation test results you have for now you may have to consider alternative

- lentil noodles got it will skip (aren't very tasty anyway didn't have that much)

- kitchen situation - yes lots of potential for contamination wife and still have kids at home.
QUESTION: I'm inferring from your note washing isn't enough to be safe?
for people that are super sensitive /inflammed NO washing is not enough.

I do recall a couple of our members could not wash their cookware and cutting boards in dishwasher with items that had gluten and soy.
ongoing contact with small amounts will keep you in an inflamed state
(that is why I ask these types of questions)

There was an article in the recent MC foundation newsletter about how a small sprinkle of flour in the kitchen how much gluten is in that.

- Mg taking 500 mg per day.
- what type of mag - what is the actual active MG you are having, read the small print on side of bottle
and are you spreading the dose through the day. Large amounts at once will cause D
(and you won't fully absorb it )

- D tested, was 41 ng/ml (normal range 30-100).
QUESTION: Test was called "D,25-OH,TOTAL,IA assuming pertinent to D3 level?

- GF bread got it will stop, yes lots of ingredients (no soy). Started to use for convenience for eating sandwiches while on the run or to
be "normal" with others at work if you know what I mean.
I do get it, part of life with MC is coming up with eating plan that works for work / hobbies / family etc (easier said than done)
are you having good serves of safe protein each meal?

- processed foods other than GF bread have been pretty strict on staying clean
good!! as many are high in sugar

keep reading, keep asking questions.
Do some reading in the guidelines to recovery section and member success stories area.
this will show you what others have done to reduce inflammation and 'get their lives back'
sadly there is no quick fix or one size fits all solution to life with MC.

but I will assure you, the effort you put into making eating plan and lifestyle changes to attain wellness is worth it.

[tex]

COMMENT / QUESTION TO TEX
Ouch you've got me scared. Not complaining but honestly I don't know how can make these drastic of changes (nothing but meat), I know it is what it is. Accommodating what am doing now is hard with lifestyle (work activity level / stress and family responsibilities).
QUESTIONS:
1.) Crazy high Entero lab results - in your experience could there be an error?
2.) Immune system settling down - could what I'm doing be working and my system is still recovering and need to be patient?
3.) Timeframe for healing - I know depends on how long have had issue and for me seems like a long one -> any estimate on how long would need if were to do the "meat only" phase?

I'm with you on the doctor/dietician advice. Before Entero lab had full blood work for food sensitivities and all came back in normal range, primary care doctor sees no issues with food. Gastro guy says he can give me medications to allow me to eat chili dogs for lunch every day no problem, he crumbled up my Entero lab results when wanted to review with him in person, said if re-took test likely get opposite results ☺. Dietician skeptical of Entero results, her main concern right now is to get my weight/strength back up (given that the really bad symptoms have subsided).

1.) Over the years, we've found the Enterolab test results to be very accurate. I would be very, very surprised if there were any problems with their accuracy. If you had selective IGA deficiency, then you would get false (very low) readings, because your immune system wouldn't be responding properly. About one in 500 people in the general population have selective IGA deficiency. But for your results to be artificially high, you have to have what's known as hypergammaglobulinemia, meaning that your immune system is producing too much immunoglobulin A. Theoretically that's a possibility, but I believe it's a very rare condition, and I've never encountered anyone with that problem before. Theoretically, it is a possibility, although remote.

2.) Because gluten sensitivity causes the most intestinal damage, by far, yes, I'd have to say that your intestines are probably doing some healing although you're still reacting. Reaching remission does not occur overnight, at least not for most people, and recovery is usually a lengthy journey. It takes many of us at least six months to a year on the diet, in order to reach remission. It took me a year and 1/2, about 20 years ago, because I didn't know what I was doing. I removed gluten from my diet, permanently, and in about six or eight weeks, then I was able to detect other food reactions. As long as the gluten was still in my system, I couldn't tell what I was reacting to — I reacted to anything and everything. With the gluten gone, I had to perform many experiments with food, while logging the results in a journal, until I had collected enough data to be able to see trends, so I was able to track down every food sensitivity that I had. Once I removed all my food sensitivities from my diet, I was in remission within about two weeks. So yes, this process takes patience, dedication, and attention to detail, because if we overlook one issue, it might prevent us from ever reaching remission.

3.) I wouldn't go with an all meat diet unless that particularly appeals to you, because it would surely be more difficult to get used to. Safe vegetables include squash, carrots, and for most of us, green beans. Yes beans are a legume, and therefore off limits, but when they are immature, and still growing, green beans seem to work fine. An all-meat diet will work just fine, also, but I doubt that you will heal significantly faster by doing that. I pretty much covered the time to recovery in the last section, above. I might point out that healing to the point where our intestines show a return to normal histology requires anywhere from 2 to 5 years, depending on the extent of the damage, and our age. Kids can heal in less than a year, but old codgers like me typically require about five years to complete intestinal healing. These comments are based on research done on celiac patients, but virtually all of our physical intestinal damage is due to gluten, so healing periods for MC patients should be basically the same.

Incidentally, your gastroenterologist is incorrect with his comment about the EnteroLab results. If you retake their tests, you will get very similar results. That's why we trust their results, because they are very repeatable — and that's a sign of high quality lab work. The blood tests that your gastroenterologist thinks so highly of, are typically far less accurate then the Enterolab tests. Our shared experiences here prove that point

I hope this helps,

Tex

[amaguire]

Hello Gabes / Tex:

Thanks for the answers, it's amazing how you guys have used your gifts to help other through the years - that's really apparent after spending just a little time reading this site! I'm re-reading Tex's book and your comment about not being able to detect other food reactions with gluten in system makes a lot of sense.

COMMENTS / ACTIONS:
1. Magnesium - can't tell from bottle, bought Doctor's Best as recommended 100 mg dosage and will start taking 3x per day with meals.
2. 2+ foods will eliminate.
3. Stopped taking digestive enzyme recommended by dietician plus vitamins (Balance of Nature).
4. Stopped GF oatmeal replaced with quinoa.
5. Vitamin D3 adjust dosage to 5000 mg/day.

QUESTIONS:
1. Is store bought salmon a problem (tuna is a 2+ food for me)?
2. Is a "medical food" that contains pea protein isolate, rice protein, and rice bran (in the top 5 ingredients) a no for me given rice is 2+ food for me? My dietician recommended product it's formulated for the "nutritional management of compromised gut function in IBD" UltralnflamX Plus 360 is the name. It's GF, non-GMO and formulated with CurQfen which is supposed to good for absorption (and it's expensive like $100/2 lbs).
3. Is peanut butter OK (organic no other ingredients added except salt)? (peanut a legume?)
4. Is there any issue with organic coconut milk (canned) which contains organic guar gum and xanthan gum ?
5. Are sweet potatoes ok given white potato is a 3+ food for me?

Thank you very much, I'm glad for the adjusted path your responses have help guide me with. Have a good day.

[tex]

QUESTIONS:
1. Is store bought salmon a problem (tuna is a 2+ food for me)?

Unfortunately, many of us who are sensitive to tuna, are also sensitive to salmon and other fish. Sometimes, freshwater fish will work.

2. Is a "medical food" that contains pea protein isolate, rice protein, and rice bran (in the top 5 ingredients) a no for me given rice is 2+ food for me? My dietician recommended product it's formulated for the "nutritional management of compromised gut function in IBD" UltralnflamX Plus 360 is the name. It's GF, non-GMO and formulated with CurQfen which is supposed to good for absorption (and it's expensive like $100/2 lbs).

Most medical foods contain way too many ingredients to be safe for most of us. The pea protein, especially, is a problem for most of us, rice is a problem for you, and rice brain is definitely a no-no for all of us (who are still in recovery), since fiber is not our friend while we're recovering. It serves no beneficial purpose, and it definitely irritates our gut. Rather than wasting your money on expensive protein supplements, why not get your protein the cheap way, by eating it in its original form, namely, a safe animal meat.

3. Is peanut butter OK (organic no other ingredients added except salt)? (peanut a legume?)

Peanuts are a legume, and therefore off-limits for anyone who is sensitive to soy. I would avoid any nuts while in recovery, because they are difficult to digest. As you suggest, butters of nuts are easier to digest, but many of us can't tolerate the more common nuts and nut butters. It's possible that you may be able to tolerate more exotic nuts, such as Macadamia nuts, but it would be safer to experiment with them after you are in remission.

4. Is there any issue with organic coconut milk (canned) which contains organic guar gum and xanthan gum ?

Many of us react to all the gums, because most of them are legumes, and xanthan gum is derived from the slime of the Xanthomonas campestris bacteria after the bacteria are used to ferment a carbohydrate substrate. Many supermarkets carry pure (absolutely no additives) canned coconut milk. You may have to look in the ethnic sections of the store (or in a health food store). Most of us can tolerate coconut milk, and it's a good, high calorie addition to your diet, if you need calories.

5. Are sweet potatoes ok given white potato is a 3+ food for me?

Sweet potatoes will probably be safe for you, but a few individuals do react to them. If you can tolerate them, and most of us can, they are a good high calorie vegetable. Good when baked, and sweet potato chips are usually safe. Avocados are also an option for many of us, and they're also a good source of fat calories.

Tex

[Tricia]

Good morning,

I was wondering if green beans are ok for most, what about snow and snap peas that are also eaten as the immature pod? I have a garden with lots of peas and would love to try some well cooked pea pods (and my husband can only eat so many). I used to be fine with them but have been avoiding since this flare.

Also, for me personally plantains (i bake/roast them) and plantain chips (for convenience I sometimes get Barnana brand, organic with only coconut oil and himalayan salt) work well since I can’t tolerate sweet potato. They have a lot of calories which has helped me regain a couple of pounds.

I have been on the low end of normal BMI for years but any protein powders/nutrition shakes etc no matter how “medical” makes me sick to my stomach so I definitely agree that spending money on real food has been working better for me.

I also eat a lot if avocado, coconut milk (no gums) and avocado/olive oil and fats definitely help me though I can get D if I overdo, especially coconut oil. If I had a penny for every time someone told me they could not believe I was so skinny with all the fat I eat I would be wealthy :). This myth that fat makes you fat still is going strong.

Thanks to all for sharing your diets and insights - it really is helpful!

Tricia

[tex]

what about snow and snap peas that are also eaten as the immature pod?

Good morning Tricia,

I haven't seen anyone's posted experiences with those, so I can only guess that they would probably work okay, but I would test them first, eating a small amount the first day, and if there's no reaction, repeat that for a couple of days, eating increasing amounts each day, and if you don't react after three days of testing, they're probably okay to add to your diet.

Tex

[amaguire]

Hi Tex:

Appreciated your comments, have a few additional questions please:

1. Sunflower butter OK (organic, only ingredients are sunflower and salt)>
2. Millet and teff ok alternative grains?
3. Bananas - 2x per day too much?
4. Applesauce (no sugar added, only ingredients are apples and ascorbic acid)?
5. Honey ok (use in tea)?

Thank you wish you a nice day.

[tex]

1. Sunflower butter OK (organic, only ingredients are sunflower and salt)>

It should be okay. I believe it's okay for most of us, although I've never tried any.

2. Millet and teff ok alternative grains?

Yes, those are safe, as long as they haven't been cross contaminated. Additional safe ancient grain options are amaranth, ragi, Job's tears, buckwheat, and quinoa.

3. Bananas - 2x per day too much?

That shouldn't cause any problems, unless you have histamine issues.

4. Applesauce (no sugar added, only ingredients are apples and ascorbic acid)?

Applesauce should be okay in normal serving size amounts.

5. Honey ok (use in tea)?

Honey should be okay in moderate quantities.

Tex

[amaguire]

Hello:

I'm 6 months in and have been following strict adherence to diet (Stage 1), pure foods, and Magnesium + D3 -> have some follow up questions please.

1. I still have very thin BM's one or two times per day, very small volumes. The soreness is still present.
Q: Is this an indication still have significant inflammation?

2. In additional to bananas have added 1 or 2 servings per day of other soft fruits like oranges and very ripe pears.
Q: Could this be a problem (fructose + extra fiber)?

3. I'm still really struggling with weight gain. I've monitored my calorie intake and eating 2200-2800 (big part being coconut milk, sunflower butter, lamb, and olive oil).
Q: Is this an indication still have significant inflammation + not absorbing? 6 months not long enough for healing?
I'm still pretty active but have cut way back on heavy stuff.

4. Struggling with the sustainability staying on diet. Last few weeks have been tough, I can hardly look or smell the same stuff again and again as a result am eating less. Have had to make large changes in my work (international and domestic travel back out, business meals where work gets done, etc.) and socially (active outdoor trips, meals, etc.). My energy level is far off from normal and have trouble staying warm.
Q: Are our food sensitivities permanent?

Thanks for comments I really appreciate this forum.

Andy

[tex]

1. I still have very thin BM's one or two times per day, very small volumes. The soreness is still present.
Q: Is this an indication still have significant inflammation?

Probably, to some extent, but it's mostly an indication that your intestines still need a lot of healing. The intestines heal slowly, compared with other body parts. Kid's Intestines can heal in less than a year, but it takes adults at least 3 to 5 years to heal, normally. Normal cellular histology (as revealed by a biopsy sample examined under a microscope), requires about 10 years for most of us. As an example, it took me about a year and 1/2 to reach remission, and then another year before I no longer had occasional idiopathic reactions. This was almost 20 years ago, when I knew practically nothing about the disease when I started my attempt to recover.

2. In additional to bananas have added 1 or 2 servings per day of other soft fruits like oranges and very ripe pears.
Q: Could this be a problem (fructose + extra fiber)?

Too much fruit, or other sources of fiber can be a problem because some of us are more sensitive to fiber than others. The primary problem with fruits is the sugar, because they contain not only fructose, but indigestible sugar alcohols, such as sorbitol, which tend to ferment in the colon. Be careful with citrus fruits, especially, because virtually all of us are sensitive to significant amounts of citric acid before we recover. Absolutely no raw fruit, and always peel it first. Small to moderate amounts of overcooked, peeled pears and apples should be relatively safe for most of us. Small to moderate amounts of canned fruits, such as peaches, are usually safe as long as they don't contain any added ingredients, such as artificial sweeteners or preservatives.

3. I'm still really struggling with weight gain. I've monitored my calorie intake and eating 2200-2800 (big part being coconut milk, sunflower butter, lamb, and olive oil).
Q: Is this an indication still have significant inflammation + not absorbing? 6 months not long enough for healing?
I'm still pretty active but have cut way back on heavy stuff.

The inability to gain weight indicates insufficient healing, and yes, probably some remaining inflammation. Healing is relatively slow, and trying to speed up healing by taking supplemental products advertised to heal the gut, etc., is usually counterproductive. We have no choice, but to allow sufficient time for healing. Until we heal, much of our nutritional intake is going down the toilet, so extra nutrients and extra calories are necessary just to maintain weight, let alone increase it. And remember, any calories we burn during our work or exercise are not available for weight gain. That's why we have to shift down a gear or two, unless we're able to eat enough to support the demand on the calories that we have available.

4. Struggling with the sustainability staying on diet. Last few weeks have been tough, I can hardly look or smell the same stuff again and again as a result am eating less. Have had to make large changes in my work (international and domestic travel back out, business meals where work gets done, etc.) and socially (active outdoor trips, meals, etc.). My energy level is far off from normal and have trouble staying warm.
Q: Are our food sensitivities permanent?

In general, gluten, casein, soy, and chicken egg albumin are permanent sensitivities. Other sensitivities may or may not be permanent depending upon how well we heal. Regarding boredom caused by limited diet, I have no problem eating the same limited diet selection every day, but apparently that's not true for most people. I have to limit the amount I eat, or I'll gain too much weight. But I've been in remission for over 17 years. If you absolutely need some variety your diet, you have to think out of the box. Remember, EnteroLab tests all the foods that are most likely to cause the food sensitivities that are associated with MC. That means that any foods they don't test are not likely to cause food sensitivities. That doesn't imply that you can just select new foods indiscriminately, because the issues of sugar, fiber, citric acid, etc. always exist for us (especially while we're still recovering). There are many options out there, they're just not popular. I suggest you review the newsletter published by the Microscopic Colitis Foundation about a year and 1/2 ago regarding food selections. For your convenience, here's a live link where you can read or download a copy of that newsletter:

https://www.microscopiccolitisfoundatio ... 479987.pdf

I hope this helps.

Tex

[amaguire]

Hi Tex:

Thank you for the great comments / insight really helpful as always. Have a few more comments, no real question I need to figure my next steps.

At the urging of my wife (concerns about weight loss, energy level, lifestyle changes, etc) took another appointment with my gastro doctor. He's aware of my dietary changes/why doing them although he has doubts on the stool based food sensitivity testing accuracy. Due to current symptoms had the following tests completed - all came back normal.

1. TSH (thyroid level): 1.7 (0.27-4.2 normal range)
2. Pancreatic stool (elastase level check, fat digestion): 656 (>100 normal)
3. Calprotectin (inflammation of intestines): 7 (<49 normal)

And prescribed Cholestyramine (1 scoop per day = 4 grams Cholestyramine)

He's of the opinion that should go back to a more "normal diet" to get my strength/health back - that if have issues (which he doubts) can treat with Budesonide.

Based on the information available on this forum and how much progress have made sticking to the restricted diet makes sense to me.