I have just received a letter from the hospital detailing my diagnosis, can anyone help me please?

[phipps]

Diagnosis -

Fibromyalgia syndrome
Obesity (BMI 31)
Migraines

and 3 others that I already knew.

Medication -

Duloxetine 60mg once daily instead of citalopram prescribed today.
Amitriptyline 30mg night-time, can be increased to 40-50mg later (not much higher while on SSRI/SNRI)
Citalopram 20mg/day long-standing to be discontinued now (I think this is a possible cause of my weight gain.)

Referred to physiotherapy (not sure why.)

I was told by a dietitian if you UNDEREAT by a too much your body goes into starvation mode and hangs on to the fat. So you need to eat more than you are, but make sure it's healthy stuff. So have a chicken breast with a big old pile of veg and a couple of table spoons of brown rice/pasta. Or a couple of boiled eggs and a slice of toast for brekkie. My dietitian told me to basically eat 25% less calories than I need, and exercise vigorously for an hour a day, this would lead to a gradual weightloss that could be maintained instead of starvation mode where my body would shut down rather than function effectively and lose fat. So far it is working, I have lost 7lbs in 5 weeks and it feels like it's gone for good instead of all that yo yo crap I used to do!

Aim for 1200-1500 calories a day and an hour of fast walking, and see how you are doing after a couple of weeks. Good luck with it. I have endometriosis and workaholic tendencies lol, it's only just hitting me I need to take care of myself more than I have!!!

I think I have that, paddingtonbear1, but my GP is adamant I haven't even though i have family history.

Sorry just seen your cereal comment - because they are full or carbs and most people don;t have enough milk to have a significant protein content. It has been proven that people who have eggs for breakfast are thinner and lose more weight than people who don;t but it may well be the protein generally that is the issue as most people can;t imagine having much protein based breakfasts other than eggs as it isn;t really part of our culture.

I have to keep my protein intake up consistently (for medical reasons) and breakfasts consist of boiled eggs or cottage cheese with fruit/nuts, baocn or sausage sandwich for a treat or ham and cheese (low fat) sandwich ususally accompanied shortly after (about an hour later) by a skinny latte. I have been known to resort to an Atkins cereal bar if pushed becasue they have 11gr of protein for about 160 cals with a latte (about 5 gr protein and 50 cals)

I get teh Sainsb's low fat one too. No probs with kids as they shouldn;t be eating enough of it anyway for it to be a problem.

I don't think an hour a day of vigorous exercise is realistc for many people. The key is small permanent changes so up your walking by 15 mins a day to start with (every day)

And if your protein intake is not adequate its very easy to lose lean muscle rather than fat and to have thinning hair [sorry I could bore for England on the importance of protein!]

Have you had a blood test for your thyroid? What was your result? Have you tried a slimming club? (ww or slimming world)

oh and just to say that I'm not in teh carbs are poison camp but it is noticeable that most people way over rely on carbs when their lifestyle doesn't require it (not very physically intensive).

are you superskinny Kewcumber? I like the idea of sausage sandwiches for breakfast!!

I split it up Kewcumber. A half hour fast walk through the park with the baby napping in her buggy in the morning, and a little trot round the canals for a half hour after work. It's definitely doable if you split it up. So actually it's not really all that vigorous but I do work up a sweat am hoping to work my way up to the C25K. Baby steps. Couldn't run for a bus at the moment.

CCF - sausage sandwich treat = one sausage and one slice of bread so don't get too excited!

No not super skinny but have lost 5.5 stone (and still not even at the foothills of slim never mind skinny)

Wow, five and a half stone is amazing! mmm....have kids sausages in the freezer.... (though a bit sad we're not talking thickly buttered doorsteps..dream on,eh?)

kewcumber - i might have too pick your brains further re diet as mine is nutritionally deficient atm and my normal food intake consists of chocolate only (stress and illness related) plus i have sporadic high exercise levels so getting the balance is a nightmare. Especial with a fooked sleep pattern. finding something i want to eat is 99% of the battle as food and i have fallen out. thus i have put on weight.

If I'm honest my weight ss has partially worked becasue I have convinced myself that food is fuel. I don;t need to like it or treat myself with it or feel good or bad when I eat it but I do need to be responsible and make sure I eat what I need to stay healthy. I had a potenitally life threatening illness 2 years ago followed by unexplained multiple types of anaemia then an operation on my stomach: it all kinda puts food in perspective.

You need to decide what you need to eat and eat it then allow yourself a small amount of calories for things you fancy. If you're going for chocolate go for very strong chocolate (aldi do a very delicious dark chocolate almond and orange mini bar which has converted every milk chocolate lover I've ever met),

Disturbed sleep patterns cause weight gain so worthwhile trying to sort that out if you can.

I also take a good quality multi-vit and mineral and a fish oil

oh an everyone should eat a brazil nut every day for the selenium

My GP always said that diets are not useful in the long-term as the body goes in starvation mode. Instead eat healthily and try to exercise more. Can you be referred to a nutrionist? Most people on diets lose a lot and then it comes all back again plus more.

That makes a lot of sense. tbh if i could take a pill with all the nutrition in that i needed for the day and not bother to eat then i probablly would take that option. I am going to have to look at what i need and then how to get it.

I dont suppose you know what i am likely to be lacking that will cause terrible cramps in my legs? or is it just the sudden 2 week break from exercise due to illness?

I'm just changing from Citalopram to a different ad, but its taken about a month to come off them, and can only start new one next week - do check if you need to do this .
DIDragons: Could be lack of salt (cramps)
Mother took quinine for these, but lemon juice in warm water before bed was also recommended.

cramsp - could be exercise, replace fluids and salts might help and properly stracthing your calf muscles.

Other nutritional remedy (it works!) is tonic water. The quinine treats it - I used to find about 500 mls a day worked (mine was caused by sleep apnoea- so I guess thats a possibility too but not so likely if you are a reasonably slim woman). The amounts of quinine in tonic water is presumably pretty low but I found it enough to stop the cramps - was recommended by my GP

temporary sleep apnoea might be the cause. i am recovering from a horrific sinus infection which has affected my general breathing never mind that during my sleep. Although training 8hrs-14hrs/wk and suddenly non due to illness prob doesnt help. will look into the quinine.

thank you

Friday morning is weigh in day and I have put on 4lbs since last week. I have been for a run every morning but clearly isn't enough. Rubbish wise all week I have had about 7 chocolate eclair sweets, a 2 finger kitkat and a bar of chocolate.

Thyroid results were TSH - 1.18 up from 7.74.
T3 was 4.7 and T4 was 12.7 from 11.6. All within normal levels so GP said I don't have a thyroid problem.

Breakfast today was 2 scrambled eggs on 2 small slices of toast, the bread is full of seeds.

I do have food issues but have massively improved them in the last month or so. I am so tired all the time though and it gets me down.

Phipps- don't get too downhearted- you CAN do this!

A run might only be using up 200-300 cals- which is the equivalent of a few sweets.

It might take you 2 weeks to shift 2 lbs, but slow and steady will do it.

Make sure you don't snack on rubbish and stick to lean protein, fruit and veg and a small amount of carbs.

Eating 6 small meals a day can speed up your metabolisim- a samll meal might be a banana, apple, low fat yoghurt, 10 nuts, but all within your daily total- not in addition to.

how did your tsh change from 7.78 (hypothyroid) to 1.18 (definitely not hypothyroid)?

Phipps - go and see a nutritionalist. I think you aren't eat enough/eating the wrong foods (not enough protein like Kew said)

I saw a nutritionalist 2 weeks ago as I keep putting on weight despite exercising 3x week and sticking to approx 1000 cals a day.

She drew out a blood sugar graph for me - showing that only eating cereal, salad and baked potato caused continual blood sugar spikes, which make your body produce insulin, which is then stored as fat.

It was a complete eye opener to me - I thought I was on a super-model type diet but I was just making myself fatter and fatter.

She has given me an eating plan, in which I have to eat regularly (no more than 3 hours before food intake). It is very high protein, lots of vegetables, minimal fruit.

I am eating lots but have lost 9 pounds in two weeks!

(Oh, and I had to break my Diet Coke habit - apparently that was keeping my body producing adrenalin which would impede the weight loss).

ColdComfortFarm - I don't know. The GP sent me for TSH, T3 and T4 tests and the blood people took it upon themselves not to do the Ts so I had to go back about 10 days later and have all 3 done.

I would love to see a nutritionist. How do I go about it please?

T3 not Ts.

If you do see a nutritionist, see one who has a science degree in nutrition-or dietetics- a BSc.There are plenty of quacks out there who call themselves nutritionists or nutritionalists, who have done other courses that are not really proper courses- they are therapy courses at a much lower level, often done as distance learning.

Real nutritionists are also called dietiticans and could work in the NHS.

They have had to do a 3-4 year degree course at a university.