Brief Answer:
Welcome to HCM

Detailed Answer:
I see you have been dealing with quite a few health issues and some very complicated nutritional problems. Your first question regarding combining a high carbohydrate food with a source of protein to slow down the absorption of the blood sugar. You are correct and I will frequently recommend my patients to combine a source of lean protein with foods high in simple sugars or high in the glycemic index.

With regards to eating easily absorbable carbohydrate on its own - that has a medical purpose as well. Individuals with diabetes have a difficult time regulating their own blood sugar and may find themselves in situations where they need that fast absorbing carbohydrate such as in low blood sugar, insulin reactions, poorly controlled diabetes with frequent low dips in blood sugar. . .those are some of the reasons. But those would be the exception, not the rule.

Eating fruits and vegetables together is not nutritionally contraindicated, but may cause problems for some people. The combination may cause gas,too much bulk or fiber all at once - it again is different for everyone. Think about slices of avocodo in a nice leafy green salad with cucumbers and tomatoes. The tomatoes are fruits and you are eating them with cucumbers, a perfectly logical combination and generally digested well.

I don't know of any scientific evidence that supports this theory of food combining. I maintain an open mind that in some individuals with medical conditions, especially gastrointestinal, specific diets may be individually prescribed, but this question about food combining and whether absorption is affected is not a public health one, but a personalized one as again, there is no scientific evidence I am privy to that recommends this approach to improve someone's overall digestion of nutrients.

To answer your question on how you should eat to maintain your health and blood sugars I would say you are doing an overall good job right now except for the juices and sodas.

In the past you did mention your thyroid - please assure that your body temperature is normal which is an indicator that things are going well there. If running a low temperature make certain your multivitamin contains iodine and selenium.

Low impact exercise is a good choice but due to your osteoporosis I would advise you to walk briskly 30 minutes per day, a minimum of 150 minutes per week.

Blood sugar is stabilized by including water soluble fibers in your diet, which with your history of constipation (indicator thyroid might not be working optimally) might help two or three problems at once. These fibers are in oatmeal, cheerios, oat bread, the skin on fruit and legumes. These fibers also help lower blood fats.

Remember, legumes are high in calories/carbohydrates and can be gassey. When you cook legumes cook twice to get rid of the gassey liquid.

Also, in reviewing your records I find that you are often thirsty and drink to thirst. Be careful as excessive thirst may be a sign that your blood sugar is running high.

Sodium is in many foods and I would say that the recommendations here are to keep it below 2400 mg per day and I think HCM mentioned this in a previous query. Do you know how to read labels or have you tried salt substitutes?

More importantly as I look over your case is to get your food allergy tests back and designing a diet arount those results is more important than worrying about combining foods. Trying to manage blood sugar, lipids and food allergies will be challenging.

Senna is safe for constipation short term, stool softeners, water soluble fiber . . .

Osteoporosis - are you being treated? Calcium? Vitamin D?

Have I answered your questions? Feel free to write me back for clarifications. We have covered more territory than what you originally asked for. I am here to try to help. XXXXXXX Shattler, MS,RDN

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Brief Answer: XXXXXXX you are on the right track

Detailed Answer:

It has been a pleasure chatting with you and I am glad you are feeling more encouraged.

Are you eating Brazil nuts? Eat 2 Brazil nuts per day to help with natural selenium.There are some adaptogenic herbs and a tea that might help with the days you have extra fatigue.

Ashwagandha herb may give you needed energy. Green tea has helped others. Getting 6-8 hours sleep is very important. Ginseng tea has helped others.

Assure thyroid medication is taken correctly on an empty stomach with a full glass of water and no food or supplements for one hour after medication or two to three hours after eating. I advise clients to take in am on empty stomach.

Your thyroid medication (you are on some, correct as I don't see it listed) as synthroid is just T4, inactive hormone. Conversion to T3 needs selenium. For the thyroid to make T4 it needs iodine. Desicated thyroid is inconsistent is dosage and that causes problems. Thyroid dysfunction may cause high cholesterol and fatigue as well as depression.

I recommend that you get your thyroid under control and pursue your food allergies. The next step will be medication adjustment (if needed) and if you have food allergies, adjusting your diet accordingly.

I wish you much success. If you are satisfied with my answers please close our and rate this query. Always feel free you can come back to see me again after further developments in your condition. XXXXXXX J. Shattler, M.S.,RDN

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