Very much need some advice

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Andi
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Very much need some advice

Post by Andi »

Hi. I have 2 questions that I am hoping people can help me with.

1. I have been on entocort for going on 5 months. I am one of the few who had the side effects of weight gain in my stomach and my face and neck. I am getting married in 2 months and I really dont feel good about the weight gain (I am athletic and am usually not overweight). No amount of running and working out has been able to get the weight gain off. My question is:
If I go off the entocort, will the weight finally come off? I am 54 years old as of today (today is my birthday), but very fit and athletic and I just want the weight gain to come off.

2. When I try to taper down on the entocort I get sick again. I have finally decided that my only option is to try to go gluten free. My fiancee is very supportive in this, he is willing to go gluten free, in fact he is pushing me to do this so I can get off the entocort without getting sick. My question is:
I dont know where to start. I am vegetarian and dont even know where to start with gluten free. I know that veggies, fruit, rice, and quinoa are ok, and that many sauces and soups are not. What code words does one look for besides "gluten" in the ingredients and how does one eat out in restaurants? I have so many questions about going gluten free that I dont even know where to start.

A. What to do when eating out?
B. What code words to look for on ingredients in food?
C. What are absolutely safe foods that I can eat right away?
D. It is overwhelming, how does one start?
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TooManyHats
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Post by TooManyHats »

http://www.gluten-free-diet-help.com/

The above link is a good place to go. There is definitely a learning curve in the beginning, but it does get easier.

I took steroids for a prolonged period of time. Once I stopped them, dieting did help to get the weight off.

Have you considered eliminating soy and dairy as well?

Good luck and HAPPY BIRTHDAY!!
Arlene

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Andi
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Post by Andi »

Arlene,
I am going to go to the website link you sent, thank you.
Eliminating dairy and soy will be hard because I am a vegetarian. But i am definitely eliminating every "fake" meat product that has gluten in it.

I have been athletic for years, am an avid runner and hiker, and work out every day. I eat a health diet so not really anything new I can do there to bring the steroid weight down. Hopefully just getting off the steroid and doing what I have been doing will be enough. I never had a weight problem till a few months ago after being on entocort.

Thanks for the advice and the website and the birthday wishes.
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Post by sarkin »

I think you will feel so much better if you eliminate the 'fake' foods - I was a vegetarian for many years, and a GF vegan for a while, and always found I did much better only eating real foods, not products made to act as a substitute for something else. That goes double (at least!) now that I have MC.

It is possible that once you eliminate foods that you're not tolerating, your Entocort reaction might be somewhat reduced. That would be a nice benefit and some encouragement, since it will take some time and patience to wean off the Entocort.

It seems that most here have trouble with gluten also do not tolerate dairy, though some have been able to add it back once they were in remission. You might try it temporarily, and see if it makes any difference - I am using homemade nut milk/nut creme where I might have used yogurt... takes more advance effort than picking up milk or yogurt at the market, but I'm slowly adapting my routines.

Removing gluten isn't as arduous as it sounds - it does take effort, but all eating requires some effort (shop, choose, prepare, pick a restaurant, agonize over the menu...). Luckily there are so many more gluten-free options now - though it's a little trickier for those with multiple intolerances. We were in a restaurant yesterday that had a sign about food allergies prominently displayed, with lists of common food allergens and warnings for the restaurant workers about cross-contamination!

Good luck, and happy birthday,

Sara
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Post by Joefnh »

Andi you may benefit from either the Enterolab or the MRT LEAP testing. it certainly will save a bunch of time in piecing together the puzzle of the MC diet. Like you I did see some weight gain in the face and it did go down in about 3 weeks after stopping the entocort. I was on entocort for about 8 months.

Joe
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Andi
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Post by Andi »

Sara,
You are so right about the "fake" foods, I plan to eliminate them completely. I mostly eat whole foods but every now and then after a long day it is easy just to grill a "fake" chicken or burger. But no more.

Joe,
I remember you mentioning to me about the face and neck weight. Did you also gain it in your stomach? I have never had this problem before because I am so athletic. I know that I dont look really overweight or anything but 15 lbs. is still a lot for me to gain.
I am glad to hear the face and neck gain will go away soon but I hope the rest of the weight does as well.
I have not been on this site for a while, I tend to only come on when I have a question. It is sad because everyone on here is so nice and I feel I am missing out on some potential friendships. I should try to come on more often.
I was reading some earlier posts from you about your trip to Australia and your impending move there. I am so happy for you that you have found a place that you really seem to love. I wish you the best in your future and I am happy you are doing better. You seem to have made some good friends on this forum and that is really wonderful.
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Post by Joefnh »

Andi for me it was most noticeable in my face and neck. I also gained about 12 pounds that did come off within 4 weeks.

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sarkin
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Post by sarkin »

Andi,

I lost weight when I went GF (and dropped other grains, dairy & soy at the same time). I had been retaining a lot of water, I now realize, which I thought was middle-aged pudge. I had a sudden weight loss when I was first sick, but haven't had D for some weeks and have continued to lose a bit, mostly in the belly. So you may benefit both ways... by restricting your diet, and reducing the Entocort ;)

When I get my Enterolab results, I should know whether I need to keep away from soy/legumes long-term. I think Joe's right that some testing could help assure that you're only eating tolerated foods while you're working to taper off the Entocort. Mary Beth has advised that a new, more sensitive version of the MRT testing will be available soon - that's great timing for you (and for me, too).

There are lots of great recipe sources out there for gluten-free - the celiac world has exploded with blogs, web sites, etc. I've tried a couple of recipes from http://www.elanaspantry.com/ - she uses a lot of almond flour. I'm almost certain I don't tolerate dairy, and wasn't tolerating other grains well when first sick (but I think I can handle small, occasional amounts of rice). so not all gluten-free recipes are suitable, but it's still helpful for inspiring experimentation in the kitchen.

Good luck - hope you're feeling terrific on your birthday,

Sara
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tex
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Post by tex »

Andi,

Has your doctor checked your thyroid function lately? According to a poll that we did a few years ago, the members of this board are about 7 times more likely to have thyroid issues, than someone in the general population. Many of us are hypothyroid, and hypothyroidism can certainly cause weight gains and waistline bulges that shouldn't be there.

In my case, for example, my TSH results are in the normal range, but my free T4, is below the normal range unless I take a thyroid supplement. Synthroid didn't seem to resolve my symptoms, so I take Armour, (which is the old, original treatment, that contains both T3 and T4 supplement). The newer, synthetic thyroid hormone treatments mostly contain only T4.

I'm not saying that you're hypothyroid, but it seems to go with the turf.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Andi
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Post by Andi »

Hi Tex,
I am hypothyroid, have been on thyroid meds for a few years. Like you, I was on Armour until they changed their formulation. It stopped working for me so my doctor put me on a combination of Synthoid(T4) and Cytomel(T3).
My doctor checks my numbers reguraly and they seem to be in the normal range. I am pretty sure it is the entocort that has made me gain weight. Their own website says weight gain is a side effect in some people.
I am taking the advice of many on here and am starting my third day of GF. I may have to cut out soy at some point, hopefully not dairy (I live in Vermont, home of many award winning cheeses).
I have been a vegetarian for many years and ate what most would consider a very healthy diet. But gluten was definitely a part of it and I know that if I want to get off the entocort I need to cut gluten out.

I appreciate everyone's advice. I am going to try to come on this forum at least a little more often as there are some really nice people on here.
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Post by sarkin »

Andi,

I've always been a healthy eater, too - vegetarian (or near-veg) for many years, lots of vegetables, no processed foods at all. It takes some time to wrap our minds around the idea that 'healthy' means something different. For me, for sure, it means absolutely nothing that even *might* throw my system back into flare-up. I think my best, probably only, hope of ever eating yogurt or cheese again is to have absolutely no dairy at all right now, till my system is stable. Dairy is one of the Big Biggies that people have trouble digesting, and not just those of us with MC.

Are you familiar with Brendan Brazier? He's a vegan triathlete - without grains or soy. If you could borrow one of his books from a library, it might help you figure out a safe path to figuring out your food intolerances. (I think the 'Vegan Nutrition Guide' would be the best beginning, but it may be worth getting hold of anything he's written to see if you like his viewpoint.) He sometimes 3-week programs through his web site/blog with daily menus and recipes. I've found a lot of his food suggestions helpful.

Best of luck, and speedy healing,

Sara
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tex
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Post by tex »

Andi,

Yes, there's no question that Entocort causes weight gain for some people, (it often causes an increased appetite), however, that obviously doesn't apply to everyone. My comment about thyroid issues was simply to offer a place to start looking, in the event that discontinuing Entocort doesn't resolve the weight issues. My guess is that discontinuing Entocort will almost certainly result in a loss of the extra facial "fullness". It may or may not remove the accumulated midline adipose tissue. (Hopefully it will).

The problem is that despite medical awareness and treatment of thyroid issues for almost a century, the treatment of hypothyroidism is a very inexact science. Originally, a patient's individual treatment was worked out by trial and error, based on the patient's symptoms. These days, treatments are established by trial and error, based on blood test results, mostly emphasizing thyroid stimulating hormone, (TSH), values, compared with what is considered to be a "normal" range.

The problem is, there is no proof that the so-called "normal" range, (which was developed by charting the TSH values of healthy, 20-something males), is actually correct for someone with thyroid disease. For one thing, there is evidence that some of those original cohorts actually had abnormal thyroid function, so their results obviously skewed the data, (by extending the "normal" range), and there is also evidence that many/most people being treated for hypothyroidism do much better if their TSH result is pushed down to the lower part of the so-called "normal" range. Most doctors seem to be totally oblivious to this, unfortunately.

All this suggests that using "normal" TSH values is a rather inexact way to gauge results of a treatment. There are also problems with doctors checking T4 and T3 values, when they really should be checking Free T4 and Free T3 values. The bottom line is that in reality, doctors are not particularly good at treating hypothyroidism, even though it's not exactly rocket science. They tend to rely on test results, rather than using the patient's symptoms, (and the resolution of those symptoms), to gauge their results. As long as the test results are somewhere within the "normal" range, they are happy, despite the fact that most of them use a "normal" range that is much broader than the range recommended by the American Association of Clinical Endocrinologists.

I'm guessing that you're probably already well aware of all this, but I included it, for reference, and for the benefit of anyone reading this, who may not be aware of it. Anyway, hopefully, phasing out the Entocort will resolve your weight issues, but if it doesn't, the first place that I would look, would be your hypothyroidism treatment.

I'm curious as to why your doctor switched your treatment from a natural product, (Armour), to a synthetic product, (a combination of Synthoid and Cytomel). I'm still taking Armour, (and I have also found that it no longer resolves all my symptoms), and I've been considering switching to either WesThroid or Nature-Throid. Do you know if there is a reason why your doctor skipped them to go to an all-synthetic supplement? Most of the synthetics are somewhat notorious for frequent production dosage inaccuracies, and occasionally those excursions reach dangerous levels. One of our members, for example, once received a subscription refill that was 10,000 times the correct amount, (due to a labeling error). She was lucky, and seems to have recovered normally, but some of the others who were affected by that mistake, were not so fortunate.

Good luck with the diet. I'm confident that it will allow you to accomplish your goal. And yes, please keep us updated on your progress.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Gabes-Apg »

Andi
some advice about eating out, depending on your triggers (in order of irritantce, mine are gluten, soy, yeast, dairy)

- if you can check the menus before you go in, find an item on the menu that is the safest, ie has the least amount of preperation or multiple trigger ingredients in it. Depending on the type of establishment and how much 'pre prep' they have done.

- I ask them to cook the items with small amount of butter, no oils and no flours.
- ask that any sauces, condiments etc are not placed on the food items, please put them on the side
(the reason for this is that if they are busy in the kitchen they may forget the request of 'none at all', the meal preparation has a sequence, so asking for it on the side means the meal prep is similar to the normal sequence, does this make sense, to the chef and cook staff the dish is not complete unless those items are there)

- going in early or at a time when there are less people dining, means you have a good chance of clear instructions going to the chef and him or her being able to remember to do the special request.

- using the chef cards, sometimes the wait staff may not write down all the instructions or write them down correctly, have a card that you can hand to the wait staff to hand to the chef which means the accurate message is getting to the right person.
- watch out for which drinks you order, i left the table and went to the bar to check the ingredients of the juices etc, sure enough they were cheaper types that had additives etc the only safe option for me at this venue was tap water.

For me, as I follow my MC eating plan 98% of the time, i have minimal inflammation and leaky gut issues. If i eat out and there is a bit of contimination in the meal, my body reacts about 8 - 12 hours later, and once i have that reaction i am fine.

Yesterday for a work function at lunchtime, all my normal 'protections' detailed above could not be used as it was organised by work and i didnt know the location until the day.
we got there at the busiest time, i was part of a big table of orders (18 pax), it seemed ok at first, safest menu option was the salmon no flour no oils any compliments on the side, as i placed the order the wait staff was fine, then she started coming back to confirm items on other peoples orders at the table and i thought mmmmm i am not confident about this.
my meal came and it was covered in a oily salsa, i took it back and they cooked another.
I was the only person at the table with 'special requsts' regardless 5 of the 18 meals were sent back as they were wrong or cooked wrong.

NB: my direct supervisor and another manager apologised to me regarding the venue, they said they had told the organsier to check with me about 'safe venues', and they hadnt. Their intent was to make sure i enjoyed the lunch as well.

4 hours later i started to get a small amount of pain, 7 hours later i was quite tired and still had a small amount of pain/discomfort, 11 hours later i woke (11pm) had a small MC mud situation. 18 hours later wake up and no further issues

as i dont eat out often - I am happy to pay an extra $5 or $10 for the meal and have some peace of mind that it will be done correctly.

Hope this helps
Gabes Ryan

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Post by sarkin »

Gabes,

GREAT advice about eating out - including several tips I hadn't thought of. I am sure that the fact you were back on track 18 hours after eating some trigger food is a wonderful testament to your thoughtful and diligent work that has brought you enough healing to make you resilient to the occasional glitches.

How great that managers where you work are clued up and caring. Very encouraging (and just think, you have saved some other food-non-tolerant person a lot of struggle down the road, for each person who catches on will get it when they meet someone else who can't just 'graze' on whatever foods are on offer).

Sorry you had that unfortunate meal - but I'm delighted for you that you weathered it with so little disruption.

Love,
Sara
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Post by Gabes-Apg »

thanks Sara
i didnt mind the situation as it is good to check once in a while what i can handle and what i cant and how bad the consequences will be.

speaking of weathered
....after 20 years or more of mild winters, Toowoomba is looking to be having the coldest winter ever which is just dandy (not) for my first winter here.....
for it to be so cold in May is rare.
right now 8.40am in the morning there is a 2 degrees wind chill (that is celcius which i think is about 35 F)

i have figured one can not look glamourous and be warm at the same time, so today it will be lots of layers, beanie and gloves when i go outside.

I am heading down to the infamous 'train carriages' friends place tonight. it is my dear friends birthday their fire has been running all week so it will be warmer at their place compared to mine, tonight is when i get to try the yeast free wine.
Gabes Ryan

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