Hell in a nutrional handbasket

[marc11864]

Grrrrrrrrr

And again, grrrrrr  .

Proper nutrition, multivitamins, HAART... what's a person to do?

Back ground; AIDS diagnosis, positive since 2005, t-cells never above 423 usually hovering in the 330/375 range, undetectable viral loads until my latest test in November when I "blipped" at 90 though I still haven't established it was just a blip.

Back around May of last year, my previous doctor cautioned that my Vitamin D levels were dangerously low so I started intermittently taking about 1800 to 2000 IU.

After relocating to the east coast, I had my new doctor retest and my levels were still below normal. Since then I've had significant GI issues that had me in the ER with no significant diagnosis. Due to the symptoms, my own diagnosis is gallbladder and/or gallstones. This is in addition to the possibility that I also have kidney stones. Since my last Vitamin D test, I've mega-dosed taking in the neighborhood of 4500 to 8000 IU a day. Now I read on WebMD that mega-doses can also cause kidney stones exacerbating what I believe that I already have to contend with. I've been able to determine that Atripla which I've taken since 2008 can cause low Vitamin D levels.

I'm down to about 800 calories a day since mid December, with zero fat, due to the nausea I've experienced from any fat product (gallbladder?).

Is anyone else having issues with managing nutritional balances? Have any suggestions besides talking to the doctor who seems to be treating me as just another HIV patient? 

[mecch]

I can't comment on most of that.
But only the 800 calories a day. That is not good.  Please explain why, again?  Aren't you wasting on that little energy?

[marc11864]

Hi mecch. Thanks for responding.

I know it is a concern but I have had to seriously restrict my diet due to the symptoms that I believe are related to someone having gallbladder/gallstone problems. I had to wait a month to see a gastroenterologist. The area I moved to has few of them available and tomorrow's appointment is only a consultation. No tests.

[mecch]

Well please try to give a clear list of your health problems to whatever doctor you see and ask how it can all be followed up.
And please find a way to eat more calories. If the fat is making you sick, OK, but there are proteins and carbos you can eat or take as shakes to keep the energy input up to healthy level.
Also, I hear you that you aren't getting the expert treatment you need. But also, you can't self diagnose. Please try to get a doctor to take on these issues and also answer some of your fears.

[BM]

4,000-5,000 units of vitamin D a day during the cold months is fine. 1,000-2,000 units during the summer is more sensible if you're getting moderate sun exposure.

A multivitamin is probably a good idea, but the amount of vitamin D in most formulations is inadequate to appreciably raise blood levels.

[odyssey]

Just so you're aware, eating a zero fat diet is NOT a good idea, even if it may seem to alleviate your symptoms. There are things our body needs called essential fatty acids that we cannot produce and we must consume! Dietary fat is an important part of a healthy diet. I actually asked my dietitian just the other day about fat content in a healthy diet and she said at an absolute minimum you should be getting at least 10% of your daily calories from fat!

And yes, 800 calories is way to low! The average guy has a basal metabolic rate around 2000 calories a day just to maintain his weight, at 800 your body is going to start destroying its own muscle tissue and holding on to any calories you eat as fat when you do start eating again. Not the way to go! Find a BMR calculator online and determine your exact BMR and then you will know how much to eat!

Pressure your doctor for answers! Ask for a referral to a nutritionist (Registered Dietitians are the gold standard, that's what mine is!), keep fighting the good fight!

odyssey

[thom k]

Marc,

I am sorry to hear about your situation. 

I am curious as to whether or not you've tried eating nuts and seeds.  They are pretty nutrient dense and are a good way to get calories without having to eat a lot of food.  They do contain fat, but I wonder if it would be tolerated better since its a whole food. 

good luck and keep us posted.