<<Disclaimer: Verify this information before applying it to your situation.>> Dear List Members, First I'd like to thank everyone who responded to my question about coping with fatigue. I received 47 responses and even though they're still coming in, I think it's time to summarize. Almost everyone mentioned the importance of STAYING ON THE DIET. "Going off the diet can damage the villi enough so that it takes months to heal," one person wrote. Treat gluten like radioactivity, somebody else said, and eliminate it. Double and treble check the diet for ways gluten might be sneaking in. Many of you also suggested cutting down or even avoiding sugar and carbohydrates. "Carbohydrates are tiring," somebody wrote. "We did not not evolve to eat them...she should eat what humans evolved to eat." This person suggested checking out the Paleolithic Diet Page at http://www.panix.com/~paleodiet/ Another person wrote "bread items made with a lot of starch can cause a spike and drop in blood sugar levels when there isn't enough fat or protein eaten with the bread to help sustain the blood nutritive level." Other suggestions re. diet were to eat more beans and rice, eat more protein, and eat more fresh fruits and vegetables. Several people said they ate six small meals a day instead of three big ones and other emphasized how important it is to keep snacks handy (like cheese, veggies, cornchips, yogurt, etc.) One person suggested increasing carbohydrates. Several suggested consulting a dietician. A lot of you recommended taking vitamin and mineral supplements because celiacs don't absorb as many nutrients from foods. Some of you suggest specific supplements. One person takes a fructose compound vitamin from Melaleuca. One person takes a multivitamin and also lecithin. Someone else said they took one dose of B-complex, 1000mg. of Pantothenic Acid and 200-400 mcg. ChromeMate Chromium. Another person takes Vit. B complex and Vitamin C.(This person suggests taking the Vit. B in the morning because it gives him/her so much energy they can't sleep at night if they take it late in the day.) One person said they took 1 or 2 mega multivitamins/day plus 4000 mg. Vit. C, 1600 mcg. Folic acid and 400 - 800 IU units of Vit. C. Several people recommended Vit. B-12 shots about once a month. Another person suggested chromium to boost energy. "The best advice I ever got," one person wrote "was to use brown rice flour, brown rice polish." They're higher in B vitamins, she said. A number of you wrote to suggest my daughter be checked for anemia. Iron deficiency is a problem with celiacs, you said. Checking her thyroid is important, too, according t some since thyroid problems are also more common among celiacs. Others said she might have an electrolyte imbalance or be dehydrated or suffer from allergies or other food intolerances or have depression (a common problem). One person suggest checking her for mononucleosis. "You don't have to be a celiac to get it!" Someone else said mercury poisoning from silver tooth fillings can cause fatigue. Another person said we needed to have one national celiac organization and should lobby those in Washington. Next to diet, most of you felt exercise was very important because it increases energy, helps build stamina and develops good cardiovascular and neuromuscular systems. Over 25% of you say you exercise regularly and you suggested deep breathing exercises, daily walks, riding a bicylce and aerobics. The important thing is to exercise everyday even if only for 10 minutes until stamina is built up. I was surprised to discover hw many of those who responded said they were self-employed. It lets you pace yourselves, you said. Those who weren't self-emplyed emphasized how important it is to find a non-stressful, non-strenuous job and work to whatever level you're able. There were suggestions to work part time or share a job with someone else. Get lots of sleep and take naps, some of you said, and one of you recommended reading books on chronic fatigue, alternative medicine, celiac disease and candida. A sauna (Finnish steam bath) will lessen the toxic load and "up" the energy level, one person wrote. Someone else said, "The first and foremost cause of fatigue in CD is undigested substances which leak into the system from the small intestine. They're called opioid peptides and come from undigested milk, gluten, and probably citrus fruit." They act like morphine and the effect is noticeable 15-30 mnutes after eating. It was written about by Dr. Karoly Horvath and you can read more about it, this person said, by visiting [log in to unmask] "Everyone needs a personal reason to be well and strong," one person wrote. "I found a sport I adore - horseback riding." The same sentiment was also eloquently expressed by another writer who said, "If your daughter can find something she...passinately wants to do above all other things, she may be able to break through the cycle." He went on to explain that it must be a passion, something she really WANTS in order to successfully drag herself over and through her exhaustion. I would like to thank everyone who took the time to write in. I never expected such an outpouring of help. Lani E. Stoneham, ME Visit our celiac web page at: http://www.freeyellow.com/members/clanthompson/index.html