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I love this. Yes, I have tried all the health diets. Gone on and off them and also tried to find some middle ground. I think beating ourselves up for eating pizza (or anything we know we "shouldn't" eat) is sometimes as harmful as eating the things that make us have an adverse reaction. I've also found that when I over do it, my symptoms get worse. Like, if I constantly eat dairy or gluten, my symptoms worsen over time until it becomes unbearable. But when I keep those things at bay for the most part, some bread or cheese every once in a while doesn't break me. I think for sure the answer lies in moderation, being kind to ourselves, and recognizing we can't control our food and environment perfectly.

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PREACH. Yes. Totally relate to everything you say here. Reintroducing dairy and seeing a long build towards worsening health is definitely an experience I've had, and I also find that a little here or there is fine if I'm mostly not eating it. The hard thing is there's no one telling me "yeah, that's real. You really do feel worse when you eat a lot of cheese but not when you eat a little." So it has taken me years to trust that it's true.

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yep. It also took me years to figure out my dairy/ gluten tolerance. It was quite literally years of yo-yo ing where I would quit dairy because of horrible digestive symptoms that seemingly came out of nowhere... only to some months later try a little and be like "I'm OK!!!" and then a little turned into more and more until I ended up with awful symptoms again, and then I'd quit again. Anyway, now I as a sort of rule don't eat dairy or gluten but the times that I break that rule, I don't beat myself up and just enjoy my bread and cheese for that moment!

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This is such a good summary. It's like there's a threshold that once surpassed my body reacts badly to!

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I thoroughly enjoyed this post.

I tried changing the food I eat but ultimately whatever the books say we need to figure out what our individual body wants. In the end I stuck with the Med diet which is what I have eaten all my life. I love the variety of all food groups. I no worse off than when I was on stricter diet eliminating whole food groups. I cook my own food so I know what goes into the meal. When I have a craving for chips or biscuits I make sure they have good ingredients. Yes, there is some sugar but that is OK too. There is a balance to everything. I did find my body can't tolerate milk. I use Oat milk but funnily enough I can have some cream (in my afternoon tea, for instance). I have cut back on yogurt but I'm totally find with cheese. When it comes to bread I have tried a lot of different kinds....it is all about the flour. I buy the breads made a the local bakery versus commercial breads. They use different flour. I buy pasta from Italy because not all flour is equal. Italian pasta has a lower gliycemic index so I don't get bloated or feel any gut pain. Each body needs certain foods for comfort and needs to avoid others. We need to be vigilant to how we react to everything we ingest to be able to make better choices.

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I really like how you are focused on the individual nature of this - I think that is so true. It's not easy to "sell" this wisdom, so we almost never hear it--it's always "eat these specific foods, eat this specific diet." I am seeing from this thread that the real balance comes when people can start recognizing our own sensitivities and managing them specifically for our own bodies.

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This approach has been the breakthrough for me. I’d never recommend a specific diet/way of eating to another (for all the reasons you mention above plus our own personal values, eg to eat meat or not to eat to eat meat as one small example ) but I would recommend connecting with your own inner wisdom every time. And learning to trust it. For everything.

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Med diet is a great place to start! And yes on bread and flour!

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Tricky though if Nightshades are on the “ avoid list”; the dominant tomatoes, plus capsicums, potatoes.etc. Traditional (durum) wheat based pasta off that list too. 😟

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You’re a brave lady, Rae, writing about this and inviting in comments. Fraught indeed.

You hit the nail on the head: “But all of this still haunts me, every single day, and I suspect that it’s the kind of thing you can never unsee.” YES SAME. At one point I was down to eating basically poultry, frozen vegetables, rice, oats, blueberries, tahini, and honey because my practitioner kept cutting things out. Truly, that was it. And I was *deeply* unwell. All of the things practitioner after practitioner told me I absolutely cannot eat ever (gluten, dairy…) I now do far better when I have them. This wasn’t always the case. And—I’m really glad to shed light on this—the years of diets, symptoms, being told what to eat, etc have really stolen away my enjoyment of food, cooking and eating. I’m clawing my way back. I’m still quite cautious but now it’s more accurately cautious.

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Interesting to hear the arc of your story with this! Yeah I had the "grains are horrible" message hammered in so hard and I realized like six months ago that actually I feel way better when I eat a solid amount of certain grains as the base of my diet. I'm trying to stay open to a lot of future evolution.

Re: bravery - turns out that on Substack with this wonderful crowd it's actually not risky at all! Not a single troll here in this thread telling me I'm the shittiest person for one reason or another. Incredible.

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Nov 7, 2023·edited Nov 7, 2023Liked by Rachel Katz

My body is definitely "ground zero" for trying to normalize myself. I grew up in a blame-centric health-obsessed family (who would "sneak in" McDonalds in shame while yelling at us kids for not "cheerfully eating" the NASTY kid vitamins). Then in my 20s, I continued yo-yo dieting until I realized that no matter which jean size I wore, I was still agitated and uncomfortable in my own skin. Intuitive eating had a lot of revelatory moments for me, and since it generally was rooted in self-compassion and looking at the whole person, I'd say it was a net positive for me. Although, as my body shape continued changing, I had to fight a different battle (being seen for me in the doctor's office, especially the OB! and not merely as a number on the scale). No matter how I have treated eating and health, the different "health camps" have required me to exclude the other. They really are warring kingdoms some days, ready to expel you for lacking purity of intention and effort. I could write a book ... Oh wait...

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Ok well...NOW I'M WAITING FOR THE BOOK!!! Yes, the warring camps are so strong and intimidating and I have seen how that all-or-nothing approach on all sides can be damaging. Tough topic....but that's what makes for the best writing :)

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Thank you, Rae, for reaching out and grabbing this third rail! I can't resist answering your question posts!

I've had some health fun and games. Cardiovascular disease is my family's signature way of death. My father and brother both succumbed to heart attacks, the latter at 48, and my mother of vascular dementia. Given that it's a disease where lifestyle modification is clearly of benefit, and my scientific background, you would think I would know better than to be a two-pack-a-day couch potato until 40. I did eventually get my shit together. I quit smoking, started working out, and improved my diet a little.

I ramped it up a lot after my brother passed at 48 in 2001. I was 50 then. Ten years later I started getting sloppy and put on some weight. I wound up spending 10 days in the ICU following a superior mesenteric artery dissection. Near death experiences are a great wakeup call!

Nevertheless, it was my wife's GI issues that pushed us to vegan. I've spent a lot of time inputting all my food in Cronometer, assessing each micronutrient and so on. It was definitely a "special interest". A lifetime around data has helped me have a healthy relationship to it, seeing these numbers as a means to an end, the end being a sustainable diet of abundance, not deprivation.

And that's where I feel I am. The foods that are beneficial to cardiovascular health are also beneficial for brain health and resistance to cancer. They're also better for the environment, animals, and the local economy. But I'm lucky. Not many are fortunate enough to have the combination of education, interest, environment, and means. I'm grateful.

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I definitely envy your relationship to personal data collection! I've never heard of a Cronometer, sounds intense :). I really can't do stuff like that without adding stress, so that makes it hard to tell if it's worth it.

I'm sorry to hear about all the tragedy in your family, it sounds like you've landed in a really, really good place. I think it's good to remember that life's long and there are usually lots of phases of health (and ill health) throughout.

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Thanks Rae. It's taken a lifetime, but at last I feel I'm in a place where I can live my life in alignment with my values, at least most of the time. The self-actualization that should be a cornerstone of our existence as humans is out of reach for so many. Worse, most don't even know it's a thing.

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Got to add, mental health is key. The mind body connection is so real.

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Nov 8, 2023Liked by Rachel Katz

Thank you for this ❤️

After ending up spending a weekend in the fetal position unable to move because my guts hated me, I went to a traditional doctor and was simply told I had IBS and was told to take a 2-week course of antacids. This was...2010 I think?

So commenced a loooong period of learning about gut health, the microbiome, etc and trying different things but nothing really made a change. I had a stomachache for a decade plus that just felt mysterious and impossible to overcome. Tried eliminating gluten, doing paleo, almost a Whole30 approach (without the sugar discipline).

Finally around 2020 I learned about FODMAPs and decided to give a low-FODMAP diet a try. It definitely made a shift. So I can’t deny that it is probably the path. And I stopped drinking (liquid gluten is still gluten, Elise Victoria!) and I know that was a huge aspect of my constant discomfort.

This comment is really rambling sorry I have a million thoughts and they’re much too hard to organize before coffee.

Anyways, low-FODMAP is helpful, great. But I had to eliminate most of my favorite vegetables. Gluten is also high FODMAP, along with beans, dairy, lots of fruits, and most alternative milks. No onion, no garlic (and growing up I was taught that every meal starts with those). So honestly I am so bored by food and disenchanted. And still having too much sugar. So not disciplined enough to do a proper elimination and test adding things back in, not careless enough to eat everything I want to, and it just feels like I’ve been in food purgatory for the past several years.

Anyways, thanks for your post. It’s nice to feel seen and understood.

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Ugh all of this is so familiar. I have also used sugar as a crutch when the diet has gotten to be too much. Like, come on, give me SOMETHING.

I don't have a lot of answers here, but I do think that, for myself, seeing the diet as a constant evolution has helped. Nothing has to be forever. Some food losses are particularly painful, but I don't think of them as one hundred percent and permanent, just making me feel better for now. Maybe I'm deluding myself but it's a helpful delusion. On this thread you'll see a lot of stories about women who backed off of really restrictive diets while maintaining a new awareness about what foods actually impact their bodies.

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Oof. Nodding my head through most of this. Gratefully, my mother, aunt, and grandmother all were hypothyroid, so my doctors knew to watch my thyroid and we found it early. The autoimmune part took seeing a Naturopath who was the wife of a colleague of my husbands just starting her practice. I ended up going on the AIP diet for quite some time. Combined with the anxiety I was struggling with at the time I was convinced that the not allowed foods were bad and it took me a very long time to go off that diet. Did it heal me? Maybe some. I think it cleaned up some gut issues I was ignoring. I stayed off gluten, however, until the pandemic when fear of leaving the house had me eating anything around the house. Persistent dizziness, various doctors and MRIs led me to pull gluten out again and lo and behold, no more dizziness. Apparently gluten can have neurological issues. I didn't know. Now I wonder if my migraines in the past were gluten related. Anyway, more recently we did some food allergy testing and I attempted to remove a few things to improve my antibody numbers. I am aware enough to know when food restriction is just not healthy for me psychologically, so I gave up after a few weeks. There is SO much around food. It is so psychological, on top of all of the cultural messages. Right now, while I know all of the ways that I could eat healthier, I choose a route that's more relaxed about food because I know how easily I can slip into a more disordered relationship with food. I could go on, lol.

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Nov 7, 2023Liked by Rachel Katz

Thank you - this really resonates with me. Currently on medi diet (for PCOS and also navigating own fertility journey), there is a whole other level of changing things up for anyone who has gone through ivf. I definitely see food as medicine and have felt the benefit of modifying (as my nutritionist said to me, don’t take away but add more nutrient dense foods to the lake!) Still on the fertility train but at least am much more in tune with my body, and for me, it’s now about my long term health.

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Thanks for sharing. I love the framing of adding good stuff rather than eliminating bad stuff.

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Nov 8, 2023Liked by Rachel Katz

Can we also have a conversation about how once you get pregnant, there’s a sense that if your kid has ANY health problems at all it’s because you ate the wrong thing? Or didn’t feed them the right way? Asthma, allergies, and eczema are like the top 3 ailments of pediatric age group but there are so many signals that it is every individual mom’s fault.

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Ugh ya, I don't even wanna go here, but someone should (maybe me, later, lol). I can see how I have internalized this message, even while knowing/believing that these ailments are clearly results of systemic forces in our world in the last few decades.

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Rae-as always thanks for sharing your journey so openly.

It always helps me feel less alone. Dave had a bad reaction the other weekend to crisps (chips) and it turns out they had barley vinegar on them. An allergen, an inflammatory, a histamine. I bought them as a “weekend treat” and when I realised I just sobbed because it feels like I can’t HOLD all of the allergens and the things and I resent there is SO much to do in it all and often times our conversations are all about diet.

This week he’s away and I’ve put the mental load down and food is easy and triggers are less.

Ultimately, the metal load of shopping for a restrictive diet is exhausting. I love my husband of course and I so want him to be well. I do my absolute best but my brain is so very tired of navigating 3 meals a day for four of us 7 days a week.

Feeling like there must be more support or more simplicity or something for us all.

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Goodness Claire I didn't realise you were dealing with this too. We are five adults living together. I cook big meaty meals for the others and a very restricted diet for me. It's exhausting! Two of my sons do some cooking and I have recently stopped cooking for them at the weekends. But still I have to shop and plan meals. Enjoy your week of food intolerance freedom!

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I’ve tried all the diets, including elimination/food allergy/anti-inflammation/candida diets under the supervision of functional medicine docs. Despite symptoms of fatigue and brain fog, I was never really doing them for better health, I was really always searching for the weight loss holy grail. I never saw a difference in how I felt, and in the case of strict elimination diets (I once went six months without dairy, gluten, sugar, alcohol, nightshades), I never saw weight loss. Cutting out gluten did clear up my adult acne, but I’ve had gluten back in my life now for many years, and my acne never came back.

I am one of those people naturally living in a bigger body, and it’s taken 40-something years to realize it’s not something I can diet or over exercise my way out of. I quit diets for good a year ago after my second child with anorexia relapsed. Since then I’ve worked to reframe health and fitness beyond appearance, and it’s been incredibly liberating. We all have our own paths, and elimination diets can be life-saving for people with certain illnesses. For me, I’m finding a more balanced way of eating and living now.

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Nov 7, 2023·edited Nov 7, 2023Liked by Rachel Katz

I was once recommended to go on the FODMAP diet, but I wasn't well set-up to do it. I just paid loads of attention to how my body reacted after everything I ate, and realized that generally, my IBS was triggered by sugar and greasy foods. Once I stopped eating those specifically, I found I could eat greasy foods again, and even some sugar (though I'm less tolerant of corn syrup than real sugar). It's mainly just large quantities of sugar that will upset the balance and get me out of whack. So if someone offers me a donut, I might cut it in half if I know I'm on a pretty even keel. If I'm not so in balance, I'd pass it up.

However, I did a deep dive into UPF (ultra processed food) recently, and have grown even more aware of how different foods affect me. I've lost my taste for foods stuffed full of "flavors," emulsifiers, fluffers, etc. I'm so aware of how bad it feels in my gut that I don't enjoy eating it anymore. Thank you, Chris van Tulleken. I'm sure it's better for my health, but it's also sometimes exhausting finding/making good food.

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Very interesting - the experience of being told to go on a diet but not being set up to do it seems super common, and I've had that experience too. FODMAPs in particular is so complicated, it's like having an additional part-time job.

It's cool that you have been able to figure out over time what works for you and when and in what quantities (I think these last two are very under-recognized variables!). I feel like I am on that journey but still midway, not totally able to predict my reactions yet. But I can see a way there, which is cool.

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Nov 7, 2023Liked by Rachel Katz

There was a really interesting podcast on Peter Attia’s Drive 277 ‒ Food allergies: causes, prevention, and treatment with immunotherapy | Kari Nadeau, M.D., Ph.D. She covered sensitivities and allergies and I thought it was interesting that the amount of exposure to something can impact your reaction. If you get enough exposure to something, it can trigger your immune system. So there is a lot of variability. So if you’re Gluten sensitive, and just keep consuming even at low levels, eventually the inflammation triggers your immune system to come and help address the issue. That helped me understand why, while I avoid gluten, a little soy sauce on sushi doesn’t seem to make a difference. She also mentioned that it’s non natural additives like emulsifiers, that can cause a lot of sensitivity issues.

I had hashi and my thyroid is totally burned out as a result. It was discovered while I was pregnant at 40. I was probably wheat sensitive my entire life. I had all sorts of digestive issues and being pregnant was the best I’d felt in that regard, probably due to the tamping down of my immune system. Apparently there is now a connection to hashi and preeclampsia, which I also had. So I wished I knew more earlier but my experience confirms everything you’ve said. I’m gluten free and I use a cgm, so I avoid most carbs and processed foods. Glucose monitoring is an easier way to avoid a lot of bad things, imo.

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Thanks so much for sharing your story! It's crazy how common it is to get diagnosed with Hashimoto's while pregnant or right after. I didn't know about the Hashi's/preeclampsia link. I always feel like my doctors want to downplay Hashimoto's--if I'm taking the thyroid replacement, then I'm GOOD, so the story goes. So I have really had to seek out information about the disease, and all the ways it can manifest, and all the theories about causes and treatments, etc. Thanks for sharing the podcast rec, I will definitely take a listen.

Really interesting to hear about your experience with glucose monitoring. So are you basically paying attention to which foods or combos of foods spike your blood sugar and then avoiding those? Has it given you any surprising insights, other than that lots of sugar and carbs will cause a spike? If you don't mind sharing!

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There is some thinking that type 2 diabetes doesn’t happen overnight. Over time, constantly overtaxing your pancreas will impact your vascular system so that by the time you meet the lab criteria for diabetes, you’ve already caused vascular damage that will continue. It may contribute to cardiovascular issues. I’m very active and thin, but I was also diagnosed as prediabetes. So my glucose metabolism is not great. When I started using the monitor, I had to radically change my eating to avoid spikes. I cut out all processed food (any flours, pastas,rice) . And what carbs I ate had to be consumed with a lot of fiber or protein to offset the effect. No more Thai food or potatos (it’s effect is like an oral glucose tolerance test for me). I cut out all fruit except for small apples with the peel in tact.... maybe a few berries but only with something fatty and protein laden like Greek yogurt so lots of examples but at the end of it, you can’t go wrong with any veg or protein. I feel SO MUCH better. When I do have a treat that is going to run up glucose (like sushi) I really feel it because what goes up a lot comes down a lot. And that feels pretty crummy.

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Wow, I can relate to most of this. You see, I'm currently crossing my fingers and toes - hoping that I am not experiencing another flare-up of diverticulitis after battling the flu or a stomach virus last week. It's not my fault that this is happening per se but, what did I do upon finally feeling better last week from the flu??? I ate a huge, sugary, processed chocolate mint bar and two granola bars. Later that day, I started feeling really gross, heavy and headache-y and, a few days later, the signs of diverticulitis are here. Sigh...

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Ugh, yeah, I blame literally every cold or bout of fatigue on something I ate. In fact I have a head cold right now that I'm attributing to a few servings of cheese. I don't think it's healthy, or true (probably), but since the affects of food on my body are definitely real, I tend to take the analysis too far.

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Sleepy and can't put a lot of smart words together for a response here but so much of all of this was compelling. <3

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Nov 9, 2023Liked by Rachel Katz

OK, so I developed painful sacral/hip pain at 16 a few months after a bout of osteomyelitis in my left foot ( following a skin rub abrasion turning into an ulcer just above my ankle) and following a fall onto my left hip whilst using a stick to walk with after the month long plaster cast came off my foot following removal of dead bone due to the osteomyelitis.

7 years followed during which visits to orthopaedic Specialists, X-Rays, Physiotherapy, all fail to find a diagnosis or resolve the pain.

I cannot run ( at all), dance, walk up stairs without hip pain in every step.

I use to cross country run, ride horses... no longer.

Somehow I get a referral to an Ear, Nose, Throat Specialist for an Allergy Test. Positive results for Nightshades, onions, wheat, dairy ( except butter), egg yolk, oranges, chocolate/cacoa, coffee, pine needles even a little to “ horses” that I’d spent frequent time with over previous 10 years.

I’m told to avoid these things. I go home to my shared apartment & go through the pantry contents.

The only thing in there I can eat is rice.

Plus fresh fruit/veges ( except nightshades & onions) & no meats are on the “avoid list”.

So, no more bacon & eggs, no Italian food ( tomatoes/wheat pasta etc), black tea only, etc etc.

This is 1975; there are no alternative grain carbs ( corn, rice, buckwheat etc) products, breads/pasta etc) available. I try tinned ( approved) goats milk but cannot handle its grassy flavour in dishes or drinks ( like tea) that I’d usually put milk into. Years latter I find a fresh goat milk dairy nearby and their unpasteurised milk , icecreams, hard cheeses are fantastic! 🙂

Anyway, I stick to the restricted diet. Drink dandelion or chicory/beet coffee, mashed turnip not potato, discover flavourless rice cakes/crackers , find one recipe book that teaches me to make oat & rice based biscuits etc. It’s a bit of a lifesaver because I’m fanging for carbs/breads. Heavy cornbred & go easy on the oats because I know oatmeal porridge when a kid, would cause me to break out in hives.

6 weeks on this “diet”, and all pain is gone. I can actually run on the grassy playing field opposite our home. !!! WOW!!

However I can’t maintain the diet as I shortly after move to a “ live in” job in a remote area in which meals are provided and alternatives ( few as are possible) are not available. Symptoms return. I battle on.

3 years latter (7 after pain started), in pain and frustration I visit a major city teaching hospital’s GP Clinic. Very quickly I see: X-Ray, Orthopaedic, Neurological, Dentistry, Specialists.

After an excruciating EMG Test the Neurologist says I have some minor damage to muscle fibres in one leg but not enough to be creating my symptoms ( which now include massive, incapacitating muscle spasms in my back/diaphragm).

He makes a tentative “ diagnosis “ outside his Specialty & refers me to “the Rheumatic Clinic”. 😳

That Specialist takes blood. A “ New Test” comes back positive for a protein indicative of the Condition Ankylosing Spondylitis! Painkillers ( Aspirin ) & exercises to maintain mobility are prescribed. Diet? Nope, everything I read about possible remedies, phoo phoo anecdotal advice from other sufferers about “ avoiding Nightshades, dairy, wheat.....”.

So why was I pain free the 3 years before?

I never took the medication route except if suffering spasms ( or associated vision threatening Iritis), never for more than a few days. I went back to horse riding 10 years later when pain lessened in my hip. Soft tissue & Chiropractic bodywork helped. I never got back to running though.

Yes, I think the knowledge around diet/health relationship has come a long way in the last 40 years.

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Wow, what a story, thanks for sharing it. I too think the relationship between diet and health has come a long way...and also that it still has a long way to go. Even today I'm not sure what to make of food sensitivity testing--I've done it twice and had completely different results each time. Either way, it sounds like from your lived experience you can tell that diet has had an impact on your pain--I have had that experience too. At the end of the day that's something I can trust!

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Interestingly, having suffered the physical joint pain for years before “ diagnosis “, I took particular note of Prescribed medicines Indomethacin/Naproxen side effects of “ peptic ulcers, perforation of the oesophagus, kidney damage “ etc if taken long term or not as prescribed (eg: take with food/don’t lie down after taking etc).

So , most of the time, I took “the pain over the pill”. Over the preceding years I’d developed a high pain tolerance out of necessity and my family has never been one in which “ popping a pill will fix everything “. I feel there was a high level of intuitive avoidance around this more than any particular dogma or philosophy.

But I have a strong feeling that by not taking the NSAIDs unless suffering an acute incapacitating attack of inflammation, I have saved myself from a whole lot of possible “ gut pain” & even more serious consequences like kidney failure? I wonder how much of our upset digestive systems, fatigue, etc come from side effects of medications, but also even more from the social environmental demands made upon us in workplaces and in trying to meet family demands etc

How much is due to excessive psychological & physical stress such as shift work effects on circadian rhythm /sleep cycles etc. The link between those & “gut issues” have been coming to light much more in recent years.

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