Bad Absorption or High Metabolism?

Diet and Nutrition
1

Growing up, I’d have extended family members comment on my eating habits: “Wow, he’s so thin, you should really be feeding this boy more!”

And, a few hours later, same people: “I can’t believe you eat that much!”

The irony wasn’t lost on me. They apparently never saw it, which made it even funnier for me.

When I started counting calories, I noticed that I’d actually start losing weight on 2500 calorie diet. That was at ~6’ and 130 lbs. On the other hand, I have friends and family that can’t eat nearly as much as me without getting fat.

So there’s always the “you just have a high metabolism” theory. But I’ve been fairly sedentary most of my life, and I struggle with my energy levels. Sometimes tasks as small as getting up from the couch and emptying the dishwasher can be physically exhausting for me.

Then there was the “clinical depression” theory. Basically “I’m just not motivated to do these tasks, and therefore I perceive them as being energy draining.” I never bought the theory, and antidepressants pretty much did nothing. (I only got effects from one of them, and all it did was make things worse.)

So I tried eating more, better supplementation, exercising more, getting better sleep (been down the medical route on this one). But my energy levels are still very low, and I still have to eat A LOT just to add a few pounds.

All of that said, it makes me wonder, maybe I’m doing all the right things… but I’m just not absorbing stuff well? If someone else can eat food and gain weight, and I eat the same thing and lose weight… and they’re a higher-energy person than I am… does it mean I’m just not getting the calories out of the food?

Are there other skinny kids that say they eat a lot (and actually do), but never really considered that it might be an absorption issue?

And if so, how do you diagnose and treat it? (Or rule it out.)

2

There are obviously people with digestive issues (leaky gut for example), there will cause a host of problems. There’s also new evidence showing that based upon ones gut flora that can change how many calories they actually extract.

That said, some people can just get away with eating more food in general, even rarer those that can live off junk and still be fine.

Simple solution, is to eat more food, as crazy as that sounds. There’s a point where one will gain weight.

There is though an interesting documentary from BBC “Why Aren’t Thin People Fat”, you may want to try to google and see if you can locate it.

3

IMO…the high metabolism angle is total BS. An excuse looking for a home.
Either way the answer is that you must eat more. It doesn’t matter if you must because you burn all those calories without effort or because your body doesn’t absorb/process them.

4

[quote]BlueCollarTr8n wrote:
IMO…the high metabolism angle is total BS. An excuse looking for a home.
Either way the answer is that you must eat more. It doesn’t matter if you must because you burn all those calories without effort or because your body doesn’t absorb/process them. [/quote]

x2, many wonder and worry too much w/o the focus on doing what needs to be done.

5

From a calorie standpoint, that makes sense. That’s what I’ve had to do [eat more], and that’s what’s worked.

For the “less than great sleep” “lack of energy” “lack of motivation”… do you think that doubling or tripling supplement dosages might also be in order?

6

[quote]LoRez wrote:
From a calorie standpoint, that makes sense. That’s what I’ve had to do [eat more], and that’s what’s worked.

For the “less than great sleep” “lack of energy” “lack of motivation”… do you think that doubling or tripling supplement dosages might also be in order?[/quote]

Working out for more than a week might be in order. Being sedentary is a lifestyle choice that your body is all to happy to oblige you by making sure you do lots of it more and more often as time goes on.

7

[quote]Professor X wrote:

[quote]LoRez wrote:
From a calorie standpoint, that makes sense. That’s what I’ve had to do [eat more], and that’s what’s worked.

For the “less than great sleep” “lack of energy” “lack of motivation”… do you think that doubling or tripling supplement dosages might also be in order?[/quote]

Working out for more than a week might be in order. Being sedentary is a lifestyle choice that your body is all to happy to oblige you by making sure you do lots of it more and more often as time goes on.[/quote]

Lol, I have worked out for more than a week. But thanks for the laugh.

I can muster the energy for a workout. I can’t for folding laundry.

8

[quote]LoRez wrote:

[quote]Professor X wrote:

[quote]LoRez wrote:
From a calorie standpoint, that makes sense. That’s what I’ve had to do [eat more], and that’s what’s worked.

For the “less than great sleep” “lack of energy” “lack of motivation”… do you think that doubling or tripling supplement dosages might also be in order?[/quote]

Working out for more than a week might be in order. Being sedentary is a lifestyle choice that your body is all to happy to oblige you by making sure you do lots of it more and more often as time goes on.[/quote]

Lol, I have worked out for more than a week. But thanks for the laugh.

I can muster the energy for a workout. I can’t for folding laundry.[/quote]

No, what I mean is this…when I was heavier, the workouts I did when leaner would have tired me out…because to put on that much size, I had to reduce activity…which leads to your conditioning going down as well…which could equate to lesser energy levels. If you are feeling that lethargic dietary changes may help if deficient. I would also focus a little more on conditioning or increasing frequency of training.

I am very interested in how many days a week you are training. I am betting less than 4 but I could be wrong.

9

Your situation sounds very similar to my own. I eat a lot of red meat and had my serum B12 levels checked. They were very, very low (red meat is the primary source for B12). After being tested for pernicious anemia (negative) my doctor determined that I had malabsorption issues. Vitamin B12 is involved in the metabolism of every cell in the body and especially affects energy production.

I started taking digestive enzymes. I wish I could say this fixed everything, but it didn’t. It did however correct my B12 deficiency and improved nutrient absorption. I was still terribly fatigued all the time. My doctor then checked my TSH (thyroid stimulating hormone) levels and found they were high, meaning I had hypothyroidism (note the inverse relationship between TSH levels and thyroid activity.)

Once this was corrected, my fatigue receded and my QOL greatly improved.

Just a few options for you to chase down if you so choose.

<------------ Not a Dr.

10

Instead of multiquoting, I’ll just respond.

I’ve been lifting 5-6 days a week; 6 if I’m in town over the weekend. 2-3 compound lifts, 2-3 isolation. Fairly short workouts, done at home. Sometimes I’ll repeat a workout later in the day.

I seem to be handling that fine.

As far as thyroid and anemia, tests 2 years ago came back negative.

However, I just met with my primary care doctor 20 minutes ago, and after talking through symptoms, he’s come up with a fairly large panel of blood tests to do. They were able to schedule me for tomorrow morning, so that’s a plus. (Results on Monday or Tuesday.)

  • vitamin d (he was iffy on my 6000IU a day dosing)
  • bunch of b vitamin tests, including b12
  • iron
  • tsh/t4
  • testosterone
  • hiv (he said it can manifest in weird ways, and just wants to rule it out)
  • about 5 other things I can’t remember

He also gave me a referral to a GI doc to evaluate stomach motility and reflux.

He’s actually hoping it’s a thyroid issue, because that’s such a straightforward fix.

Nevertheless, it should be informative. I’m glad I found a doctor who actually cares about results, and is willing to consider all of the options here, instead of the “oh, it must be your sinusitis” or “oh, it must be depression” or “oh, it must be anxiety”.

11

Get the actual lab numbers from your doc, don’t let him tell you that everything is merely “in range”. My TSH was in range and I felt like shit.

12

[quote]Dr. Pangloss wrote:
Get the actual lab numbers from your doc, don’t let him tell you that everything is merely “in range”. My TSH was in range and I felt like shit.[/quote]

Yep, that was the plan. He trusts me not to do anything stupid with them… like most people do if they actually read results.

(On a related note… why is it that almost none of the people who shop at health food stores look healthy?)

13

[quote]LoRez wrote:

[quote]Dr. Pangloss wrote:
Get the actual lab numbers from your doc, don’t let him tell you that everything is merely “in range”. My TSH was in range and I felt like shit.[/quote]

Yep, that was the plan. He trusts me not to do anything stupid with them… like most people do if they actually read results.

(On a related note… why is it that almost none of the people who shop at health food stores look healthy?)[/quote]

Because there is still unhealthy food in them :wink: and most of them probably fear eating eggs and beef :wink:

14

[quote]jehovasfitness wrote:

[quote]LoRez wrote:

[quote]Dr. Pangloss wrote:
Get the actual lab numbers from your doc, don’t let him tell you that everything is merely “in range”. My TSH was in range and I felt like shit.[/quote]

Yep, that was the plan. He trusts me not to do anything stupid with them… like most people do if they actually read results.

(On a related note… why is it that almost none of the people who shop at health food stores look healthy?)[/quote]

Because there is still unhealthy food in them :wink: and most of them probably fear eating eggs and beef ;)[/quote]

It just always struck me as odd. Those stores have some good stuff in them… things you can’t get elsewhere, and that actually do work (like vinpocetine). But the people all look sickly. I think I see more healthy-looking people at Walmart.

I mean, how good of a recommendation are you really going to get on a multivitamin from a frail looking hippie?

15

[quote]LoRez wrote:

[quote]jehovasfitness wrote:

[quote]LoRez wrote:

[quote]Dr. Pangloss wrote:
Get the actual lab numbers from your doc, don’t let him tell you that everything is merely “in range”. My TSH was in range and I felt like shit.[/quote]

Yep, that was the plan. He trusts me not to do anything stupid with them… like most people do if they actually read results.

(On a related note… why is it that almost none of the people who shop at health food stores look healthy?)[/quote]

Because there is still unhealthy food in them :wink: and most of them probably fear eating eggs and beef ;)[/quote]

It just always struck me as odd. Those stores have some good stuff in them… things you can’t get elsewhere, and that actually do work (like vinpocetine). But the people all look sickly. I think I see more healthy-looking people at Walmart.

I mean, how good of a recommendation are you really going to get on a multivitamin from a frail looking hippie?[/quote]

Likely, they are vegetarians/vegans with little knowledge when it comes to nutrition.

16

Update.

I haven’t talked to my doctor, but I did get blood test results back. For the most part everything seemed normal-ish. T4 was on the high side (1.77), but still in range. TSH was perfectly normal (2.130).

Really two notable things:

  1. high bilirubin levels (1.8 mg/dL)
  2. positive for h pylori

Bili levels can be a bunch of things, so I’m going to ignore it for now, at least until there’s more information showing up elsewhere.

H Pylori is more interesting though, seeing as it can and often does reduce HCL levels in the stomach, which then can cause bad digestion and nausea (and thus low energy, aches, poor sleep, depression). This could be the culprit.

Other things:

  • Testosterone was 793 ng/dL
  • Eosinophil levels were a bit high (12%)
  • Vitamin D was only 40.3 – that’s with 6000 IU D3 a day for a few months, so I think it’s a safe dosage for me
  • B12 and Folate were fine and in range (573 pg/mL and 7.8ng/mL, respectively)

Again, I haven’t talked to the doctor yet, but very likely we’ll run a course of PPI + antibiotics to eradicate the h. pylori, and then go from there. If lucky, this should help balance out the stomach acid and fix any digestion/absorption issues pretty quickly.

Also, I have other numbers if anyone’s wondering. Tests: blood panel, metabolic panel, vitamin b12, folate, t4, tsh, ebv, hemoglobin a1c, homocysteine, tesosterone, vitamin d 25-hydroxy, h pylori, hiv, lipase, magnesium, calcium.

17

PPI will DECREASE stomach acid, thereby slowing digestion and hindering absorption. The antibiotics is a good idea, but I would go the other direction and add a digestive enzyme/HCL supplement instead of a PPI. I would also add a probiotic, especially while on the antibiotic.

18

[quote]Dr J wrote:
PPI will DECREASE stomach acid, thereby slowing digestion and hindering absorption. The antibiotics is a good idea, but I would go the other direction and add a digestive enzyme/HCL supplement instead of a PPI. I would also add a probiotic, especially while on the antibiotic.[/quote]

I completely agree with your take on the PPI there.

It’s just, standard protocol for treating h pylori is a 7-14 course with a PPI and two antibiotics. Usually omeprazole with clarithromycin and either amoxicillin or metronidazole.

I have a very strong feeling that my doctor won’t feel comfortable deviating from the proven regimens, at least for that 7-14 day course. And for two weeks, I suppose I can deal with taking a PPI.

Now, AFTER that time, assuming breath/blood tests say the h pylori is gone, then I’ll probably go back to taking Betaine HCL/Pepsin with meals until I no longer need it.

Does that make sense?

19

[quote]Dr J wrote:
PPI will DECREASE stomach acid, thereby slowing digestion and hindering absorption. The antibiotics is a good idea, but I would go the other direction and add a digestive enzyme/HCL supplement instead of a PPI. I would also add a probiotic, especially while on the antibiotic.[/quote]

This… depending upon who you talk to, may want to use the probiotic +/- 3hrs of anitbiotic use.

And don’t buy cheap probiotics, many don’t contain live ones. Use Jarrow Formula or Mercola brand.

20

[quote]LoRez wrote:

[quote]Dr J wrote:
PPI will DECREASE stomach acid, thereby slowing digestion and hindering absorption. The antibiotics is a good idea, but I would go the other direction and add a digestive enzyme/HCL supplement instead of a PPI. I would also add a probiotic, especially while on the antibiotic.[/quote]

I completely agree with your taking on the PPI there.

It’s just, standard protocol for treating h pylori is a 7-14 course with a PPI and two antibiotics. Usually omeprazole with clarithromycin and either amoxicillin or metronidazole.

I have a very strong feeling that my doctor won’t feel comfortable deviating from the proven regimens, at least for that 7-14 day course. And for two weeks, I suppose I can deal with taking a PPI.

Now, AFTER that time, assuming breath/blood tests say the h pylori is gone, then I’ll probably go back to taking Betaine HCL/Pepsin with meals until I no longer need it.

Does that make sense?[/quote]

If your speaking in terms of picking your battles, I suppose it does. Meaning, a week or two of PPI won’t be the worst thing you’ve ever done to your health so you’ll do it so as not to pick a fight with your doc. On the one hand, it is ultimately your choice to proceed however you want, but there is maybe some wisdom in trying to keep your doc “on your side” if the topic isn’t too big of a deal. However, if you think you need to just because “that’s how they do it”, then no, I don’t think it does make sense.