Should I keep follow-up appt with endo?

jesse's mom

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no just thinking of throwing fruit at the Dr you felt the need to be polite with... and just thinking about your symptoms and my diet. I try to eat at least one avocado per week for the nutrients. And if I am going to throw a fruit at anyone, boy the avocado would be great, pineapples might hurt someone;)
 

Mary

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no just thinking of throwing fruit at the Dr you felt the need to be polite with... and just thinking about your symptoms and my diet. I try to eat at least one avocado per week for the nutrients. And if I am going to throw a fruit at anyone, boy the avocado would be great, pineapples might hurt someone;)
I would NOT waste an avocado on that doctor!! Would much rather throw a mushy old tomato, or maybe a pineapple! :whistle:
 

Learner1

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I'd have to dig into this, but phosphorous is used in making AMP, ADP, and ATP, right? So when you added it to begin with and got energy was it that you were making more ATP. Then you crashed. Why didn't it recycle?

My brain is not on today, but maybe you can look into it.

Thanks for The kefir suggestion, but milk products do me in.:bang-head:
 

Mary

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I'd have to dig into this, but phosphorous is used in making AMP, ADP, and ATP, right? So when you added it to begin with and got energy was it that you were making more ATP. Then you crashed. Why didn't it recycle?
I don't know. That's what I was hoping the endo could tell me. I may have phosphate diabetes (see the link I posted above - and phosphate diabetes has nothing to do with diabetes mellitus). Again, I first became aware of this issue (low phosphorous) when I took thiamine and it seemed to be a refeeding syndrome response, just as I had one with potassium and methylfolate. And I still have to take extra potassium every day. So maybe a similar mechanism is at work here.

Thanks for The kefir suggestion, but milk products do me in
It's not the only source of phosphorous - it was a just a quick and easy way for me to find out that my severe fatigue was caused by low phosphorous. I eat very little dairy products, but occasionally have kefir and cheese. Now I primarily take a monosodium phosphate supplement, in small doses. But I'm sure you can find other sources of phosphorous - kefir was just the simplest for me to do.

BTW, low phosphorous also affects my mental functioning (no big surprise!) It affects my mood, my ability to deal with issues, it makes it hard to function basically. e.g., the last couple of days I have been dragging both physically and mentally, and things have been much harder for me to deal with and finally last night I realized my phosphorous may have tanked. I took some and this morning feel much better. I try to stay on top of this but it's not that easy.

I am going to go see a different endo in Los Angeles who is supposed to be very good (got his name from a member here) and there are several things I want him to check out, including anything he can about phosphorous. And after that, depending on what he says, I may go to see a nephrologist - if I have phosphate diabetes, it has something to do with the kidneys. It's very confusing, there is no clear road map here.

But again - you were wondering why your bones were dissolving - you could have an issue with phosphorous. I don't think doctors look at this or even think about it in connection with osteoporosis, but phosphorous is crucial for bone health. And it affects energy and brain function, everything. And even though nothing has shown up on blood work or I'm sure your doctors would have found it by now, it doesn't mean everything's okay. My phosphorous in general looks fine on blood work, just like my potassium does. But they're not fine.
 

vision blue

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Hope you didn't go back to him. haven't read thru all replies. I often keep repeating to myself "No one cares" when I debate whether to cancel an appt that i know will have zero beneifts and plenty of costs.

had a similar endocrinologist visit. i was surprised becasue people always seem to like their endos (as opposed to say GI specialists). Cared only about ruling out pheo and though did not even do that properly, was not interested in anything else, not even that i had similar symptoms to my mother who died of a neuroendocrine cancer. Was so so sick when i went in to her, right there in front of her and she was useless and insulting and not interested in the many things i brought to her to discuss. I was so pissed I even wrote a polite but critical letter to her .
 

Mary

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Hope you didn't go back to him. haven't read thru all replies. I often keep repeating to myself "No one cares" when I debate whether to cancel an appt that i know will have zero beneifts and plenty of costs.
Nope, I'm not going back. That's a good mantra ("nobody cares") - he didn't care and probably doesn't even remember me, but I am going to write him a letter and enclose information about the 2-day exercise test and PEM, just to make me feel better --
 

vision blue

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Yeah, and even more so, appts get filled really fast- doing someone a favor who tried to get an appt, and now suddenly can with your cancellation. no one cares...

sure, agree- if letter makes you feel better go for it - me too- have to do what benefits us, if that's a letter- sometimes only control we have- then why not. but only if you'd feel better, not becasue "you should" - since no one cares...

lets hope we all get gifts in our stockings of the perfect doctors - allies - this holiday season.
 

Learner1

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@Mary This might be of interest. Note the SNP on SLC34A3:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024687/

Therefore, decreased muscle ATP synthesis, in part, may explain muscle weakness associated with hypophosphatemia and may serve as a noninvasive marker for hypophosphatemic myopathy.

Hypophosphatemia causes severe muscle weakness in many organisms, including humans, dogs, and rodents. As muscle function in hypophosphatemic individuals rapidly returns to normal when physiologic Pi levels are restored, muscle weakness is likely directly related to blood Pi concentration, although it is possible that other changes in bone and mineral metabolism caused by hypophosphatemia are involved

How did you figure out your intracellular phosphate was low? What test did you run?

The ideal would be to consult with a mitochondrial anf metabolism specialist, which seems to be a scarce breed...
 

Learner1

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@Mary I just got Spectracell results back today. Not my favorite test, but I got it for free.

Even though im on a lower carb diet andif I eat fruit it's lower sugar and I eat no processes foods, it said I was slightly fructose intolerant.

Here's the explanatory sheet - note the mention of low phosphorous being related. Might this be worth investigating in your phosphorous quest?
 

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Mary

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Note the SNP on SLC34A3:
I'll have to check this out. I do have my 23andme results but am having some computer issues so can't access them right now, but will look it up - thanks!
Therefore, decreased muscle ATP synthesis, in part, may explain muscle weakness associated with hypophosphatemia and may serve as a noninvasive marker for hypophosphatemic myopathy.
I wonder what testing would determine decreased muscle ATP synthesis if it is to serve as a biomarker. I know that low phosphorous can cause severe fatigue - I've experienced it! And I've also experienced a return of energy after drinking lots of kefir or taking a phosphate supplement, similar to loss of energy with low potassium and return of energy after supplementation.

The ideal would be to consult with a mitochondrial anf metabolism specialist, which seems to be a scarce breed...
Of course they are scarce! Any doctor who knows anything about our issues is scarce, and most don't take Medicare. I tried seeing the endo in this thread, which was useless. I'm going to be seeing another endo in Los Angeles probably in February, for whom I have to pay cash, but I'm going to do it. I have a couple of things I want to run by him, including seeing if he knows anything about low phosphorous issues. You had mentioned parathyroid functioning and that's one of the things I want to ask him about.

There is also the potential issue of phosphate diabetes (study linked above), which I believe a nephrologist has to check out, and I may be looking into see a specialist there as well. For both of these doctors it will be a drive to L.A., which is always rough but there's no other way.
 

Mary

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@Mary I just got Spectracell results back today. Not my favorite test, but I got it for free.

Even though im on a lower carb diet andif I eat fruit it's lower sugar and I eat no processes foods, it said I was slightly fructose intolerant.

Here's the explanatory sheet - note the mention of low phosphorous being related. Might this be worth investigating in your phosphorous quest?
That's very interesting - sure, it's probably worth looking into. It looks like the testing would be $390, I doubt if Medicare would pay for it but I can look into it. So I'll have to think about this, whether it's worth the money. Actually a simple thing to do would be to act like I was fructose intolerant and avoid all the sources of sugar they mention. I don't eat a lot of sugar though I do eat a bit of honey and sometimes jam. I do eat fairly low carb too.
 
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