# Malabsorbing, vitamin deficiencies, and the struggle of health.



## livelovelaughride (Sep 13, 2011)

I feel for you, hon. Iron supplements are interesting in that "usually" only 1/20 of the dosage can be absorbed by the guy. So a 20 mg dose will give you 1mg of iron. Iron is more easily absorbed when taken with citrus, so orange juice, tomato juice, you get the idea. I hear there is another new form of iron supplement that is more readily bio available but I don't recall its name.

I'm not a nutritionist but hopefully someone can shed more light. Have you thought about taking the liquid trace mineral supplements - they are from a form of nutrient rich material called fulvic acids...really rich earth humus.

The iron in vegetables is usually not as bio available because of the phytic acids that binds with it ....or is it oxalic acid. I am fuzzy on that, but again eating with a vitamin c source will help in absorption. Vitamins taken as 'ascorbate' form are generally easier to absorb. The commercially available "EmergenC Super Gram 3" covers this base. I would consult a naturopathic doctor or a Nutritionist. Best of luck.


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## anndankev (Aug 9, 2010)

Oh dear, I don't see how so many ailments could fit into you. Your heart is so big and your self so small there just shouldn't be enough room.

Take care of yourself with the same perseverance and manner as you have taken care of so many others, animal and human, and you will come out OK.

I'm sure many here on HF who know of these things will advise and help you on your way to good health.

Get well soon.


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## redpony (Apr 17, 2012)

Have you tried chewing a couple of Tums (or generic) to get some calcium in you? In the past, I have taken them daily as I was told that they would help ease menstrual cramps and it does work! But it takes a month or two of taking them every day before it kicks in. Anyway, that might be a way to get some calcium.
_Posted via Mobile Device_


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## SueC (Feb 22, 2014)

Hey Endiku

Sorry about all that stuff you are juggling there. Right off the bat, let me suggest a couple of good books that will help you with quite a few of your questions, plus allow you to do as much as you can possibly do through food itself rather than supplements (so you can reduce the amount of supplements you need to take, and have less things interfering with each other).

There's a wonderful book called _Foods that Harm - Foods that Heal_, put out by Readers Digest and written by very good nutritionists. The Australian edition had our Rosemary Stanton as consultant nutritionist and is excellent - I've not seen other editions. What it does is present a range of illnesses and foods in A-Z form, wonderfully user-friendly, yet highly informative and detailed. It has comparatively few flaws in the science behind the nutrition advice and is really excellent overall. You can look up things like anaemia, osteoporosis, auto-immune disorders and the nutritional aspects of their management; and also foods themselves, and learn about problems with supplements, how to make supplements work more effectively for you if you can't get around them, etc. It's a joy to read this book - won't give you headaches (which internet trawling on these subjects frequently will) - yet I doubt that even 5% of consulting general doctors would know even half of what is in this book. I think it's really empowering to have a book like that.

Also very good is _Immunity Foods for Healthy Kids_: _More Than 250 Natural Foods and Recipes to Keep Your Child's Immune System Fighting Fit_ by Lucy Burney. It's not just about kids, and while not as comprehensive as the first book I've recommended, is totally worth getting for some things it covers the other one does not, and for super recipes that will be helpful, delicious and not hard to do. This is a "food as medicine" book, but stands out way above the mass of mediocre books on the topic. It's also very good on a variety of immune disorders.

When you have malabsorption, you can end up very nutrient depleted and actually need supplementation, at least for a while, sometimes for life. Some of the vitamins/minerals you mention can also be given by intramuscular injection or as slow-release subcutaneous pellets, which often gives you better absorption than via the gut, especially with coeliac disease etc, and should be less expensive than $400 per visit as IV nutrition (and don't you guys have subsidised health care for students etc where you are? If not, how do you guys cope - do you just not get treated if you can't pay the bill?).

If you can mostly correct some of your deficiency "backlogs" then it will get easier for your body to start healing the various problems. Right now you're in a situation where you have one problem on top of another, and creating more problems. It's a vicious cycle, but one you can start breaking out of. 

Re your anaemia, elemental iron supplements are pretty poor compared to heme form iron (animal-source iron: red meat etc), which is more easily absorbed. Also elemental iron can drive up your infection risk and interfere with the absorption of other nutrients. If I had to have supplementary iron I couldn't get through my food, I'd probably go for shots. Whenever you are eating iron-rich foods, remember to also eat foods rich in Vitamin C to optimise absorption.

If you take loads of tablets, you can actually damage your gastrointestinal lining in the process - less of a problem when you split things up through the day and have things with meals, but you can see why minimising that is a good idea if possible. Nausea and heartburn after tablets is a pretty good indicator to change tactics.

That you eat kale and spinach is super, they are excellent in many ways - but remember, they don't contain heme-bonded iron, which comes from animal sources, and can only be one weapon in a wider arsenal.

The two books I mentioned will explain all those things much better than I can in a tiny post, and inspire you to eat wonderful stuff, have smoothies, even make icy poles that will help rather than harm the physical problems you are dealing with - using healthy ingredients targeted at your nutrient needs - and without being a chore, or super-complicated to do. Best of luck with it! Hope you get better soon.


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## DuffyDuck (Sep 27, 2011)

Can I add, to SueC's post..
That once you have an idea of ingredients that will benefit you, try looking at pintrest.
The recipes on there are amazing, and cater for all types of diets. Fun, easy and tasty!


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## 4horses (Nov 26, 2012)

Have you tried liquid vitamins? Nutritional drinks such as boost and ensure? There are several others. I can't think of the names...Orgain maybe?

Sometimes protein bars have added vitamins and minerals.

I did okay on the Nature Made liquid vitamins.

I like tums and those do not seem to bother me. I have acid reflux so I take them before bedtime. I refuse to take other antacids as they will cause me to get small intestinal bacterial overgrowth. 

Google the team inspire website. They are one of the best places to ask questions. I joined the AGMD GI motility disorders group and made several friends there.


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## Lockwood (Nov 8, 2011)

Forgive me if I've already told you about this supplement because I know I've talked about it before, just can't remember to whom.

My son was a preemie and has had nutrition issues since birth, among other preemie issues. As a toddler he was diagnosed with Celiac, severe GERD, and a huge laundry list of big allergies, cow's milk in any form being a big one. At the time we struggled just to get him on the percentile chart for children's weight gain and he usually hovered less than 5%.

I worked with a nutritionist at a well known children's hospital and the only thing we could find to supplement him with that would not upset his other health conditions, GERD, Celiac or allergies was a product called EO28 Splash. (I will PM you more info on it and a pic of the labels)
It's a milk free, gluten free, nutritional supplement that designed for kids with stomach tubes or who cannot take solids in any form. Initially the hospital nutritionist was able to get our insurance to cover it, and after that the pediatrician writes a script and insurance covers it.

My son still needs and takes it (he's 11 now.) It comes in a drink box, like juice, and in fruity flavors that are not that bad (i've tasted the stuff).
It's loaded with calories, about 250 per box, and it fills in the nutritional gaps without upsetting his stomach or digestive system, which is extremely sensitive!
I too cannot even take iron tablets, and trying to find safe and allergy free vitamins for my son has been a nightmare because along with typical allergies, he has some very strange ones that rule out many of the "allergy free" things out there.

Anyway, I'll send the info to you later today and maybe you can see if it could help or give your Dr any ideas of things to look for.
It's not a well known product and something the nutritionist initially had to research to find, but it works for us. 
Kiddo hovers around the 45 to 50% now. While he would never ever be called chubby, at least I no longer have to shop in the slim only section for him...which even that stuff used to fall off of him.

(If I've already told you about this stuff before, just tell me never mind)


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## jaydee (May 10, 2012)

Vitamins and minerals are always best if they're a part of the food you eat - and if you do take them as pills you should take them with a meal so they absorb better
With the calcium - there are lots of non dairy foods that are calcium rich - and the same with iron, you just have to get more inventive
You might find the 'Gummy Vitamins' easier to take than dry pills.


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## 4horses (Nov 26, 2012)

I almost forgot to add. The antidepressant Mirtazapine (Remeron) can be helpful for gastrointestinal disorders. It is an appetite stimulant and can increase gastric emptying (make food move from the stomach faster). It may help decrease acid reflux, or is at least worth trying.

It does cause weight gain, and I would describe it as similar to pot, as it will increase appetite. Not that I've ever tried Pot, but it definitely increases appetite and helps with nausea.

Prokinetic effects of mirtazapine on gastrointestinal transit | Gastrointestinal and Liver Physiology


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## BlueSpark (Feb 22, 2012)

one of the keys to absorbing vitamins and minerals is fats and acids. Take your supplements with a glass of water with apple cider vinegar, and make sure you have fats with your veggies, things like butter(if you can have butter?)olive oils, etc. They really help. I had issues with this and even taking large amounts of supplements wasn't helping. Turns out I had cut out to many fats, which my body needed to absorb them.

alfalfa can help a lot for anemia, they sell tablets and Liquid.


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## Endiku (Dec 6, 2010)

Thank you everyone for your wonderful advice! Sorry about how sporadic and poorly put together that post was. I'm all over the place this week.

Before I say anything else, I have to mention that because of my autoimmune disorders and the horrific pace at which I was getting new allergies, I'm on a rotation diet and I have a huuuuuuuge list of foods that I can not eat. However, for the sake of this thread here are the biggest 'no nos' that I have food-wise.

Red meat (which is horrible since I NEED that for iron)
Dairy products
Almonds (technically legumes)
Chickpeas
Tree nuts. I've become iA allergic to peanuts in the past 6 months.
Acidic fruits. Actually, there are very few fruits I CAN eat. I can have a slice or two of a peach, nectarine, or something similar but oranges, lemons, plums, pineapple (ESPECIALLY PINEAPPLE...SO MUCH PAIN) and things like that are huuuuge no nos. I can't handle any form of juice, unless it is just a sip. Smoothies I can do, if they are less than 25% fruit and mostly vegetable, soy milk, etc.
Pears
Cinnamon
Cumin
Nutmeg
Large amounts of fiber
more than 3 g or so of fat at a time. This is because I have no gallbladder to regulate my bile, not even natural juices to break down the acid in my body due to sjogrens, and GERD on top of that which is activated by fat as well as many other things.
Spicy foods (again, no gallbladder and too much acid)


Those are the biggest issues for me but like I said there are many others. The things that ARE safe for me in a large quantity are egg, soy, chicken or fish (I eat a LOT of fish. Trout, salmon, tilapia, and sometimes catfish), berries (not strawberries. I can eat this in small amounts), seeds (pumpkin, sunflower, sesame, etc but I have to be careful about the amount of fat. I eat a LOT of sunflower seeds), broccoli, spinach, kale, melon, squash, potato, rice, tapioca, amaranth, millet, and teff. 

SueC thank you so much for those book suggestions. I'm definitely going to purchase that first one as it sounds VERY helpful! I really wish I could handle red meat, but the only red meat I can even somewhat tolerate is deer, which I have a hard time getting since everyone here wants to eat their own and I don't have anywhere that I could personally hunt or anything. Beef and things like that make me vomit and give me big time GI problems. I used to be able to eat them. Not anymore. In answer to why IV is so expensive for me, my insurance works in a way that I put money into an account each month, directly from my check. I can use that money for any medical expenses I have, but anything else is out of pocket UNTIL I hit my $5000 deductible, at which point the insurance covers 75% of certain bills including clinic visits and large things like surgery or IV nutrition. But I'm a long way off from $5000 and it starts over on January 1st of every year. If I can't pay for it, I don't get it. 

At the moment I take no medications or tablets. I WAS taking 20 g (yes, grams) of Cholestramine binding powder per day to thicken my bile and stop the constant diarrhea that I had which made me lose 12 lb. I also took 1-2 Excedrine Extra Strength Migraines, 80-100 mg of Pantoprazole Protonix (antiacid, and I had to take this much to keep from vomiting bile every morning), and antinausa medications. I've eliminated ALL of those with changing my diet, and have minimal GERD now with just occasional stomach upset. I've also gained 10 lbs which puts me back into the 'safe' zone for my weight, thankfully! I'm 91 lbs and 4'11. My appetite has improved drastically...I used to NEVER get hungry and looking at food made me nauseated. Now I feel hungry and eat normally. But obviously there is something still very wrong because even though I weigh enough now, I'm severely malnourished vitamin-wise. I really want to stay away from any medications though, as I feel like they only put bandaids on something that should be amputated....

How would I go about getting shots/pellets? My dietician? It may be worth asking about because like I said, I can't do $400 per IV. Unfortunately my dietician doesn't know how to help me much more than he is, because I DON'T have a G tube (though I do take care of kids who have them. Ouch.) and I have SO many food restrictions. Any time he has a suggestion, I react badly to it when I try it. Very frustrating. I'm looking for someone else but there are SO few options, and with my school and work, I have a hard time getting appointments.

4horses, I can drink one certain form of BOOST and do  anything else has allergens that I can't have. Liquid vitamins and chewables do not work for me.

I didn't think of taking tums for calcium. Maybe that is something I could try!

Lockwood thank you so much! I'm going to bring that up to my doctor and dietician. I drank something similar for a while when I was so sick that I couldn't really eat at all. They made me a little bit sick but I mostly tolerated them. They were mixed berry flavor and I'm pretty sure they were what kept me alive. The only problem is, my insurance DOESN'T cover those or I'd get them again. In fact when I did get them I was sort of buying them the wrong way...from a friend who got 2 cases a month but didn't need that much. Because I don't have a diagnosis for celiacs I have a hard time getting anything covered nutritionally.
(long story but I started the diet without the diagnosis. Now the only way to get the diagnoisis is about $800 and requires me to go on a gluten challenge and ruin the healing my body has done.) I'm going to tell my doctor about EO28 Splash. Maybe I can somehow get it.

Jaydee I just looked up calcium rich non dairy foods and turns out I eat a lot of those, which is great! I didn't even realize that some of the foods I eat are calcium rich.

BlueSpark, it is difficult for me to do that because of my no-gallbladder issue. No butter for me, and no apple cider vinegar. I'll try eating something higher fat, such as sunflower seeds or certain fish though, with my vitamin to see if it will help!

I guess the big underlying thing for me in all of this is, I AM eating healthy. Every calorie I put in my body, everything I put into my mouth, has a purpose and I never eat empty calories. I work hard to eat foods with the right amounts of the vitamins and minerals I need....yet I am STILL absorbing. And I can't take pills. I have no idea what to do because it appears that anything I eat isn't be processed and isn't being used. It just sort of floats right on through and while I keep from getting skinny with what I eat, the malnutrition is still there. This was supposed to stop happening when I stopped eating gluten, but hasn't and it makes me feel lousy. I don't know how to fix my body so that what is going into my mouth is actually being used in my body for what it is needed for.


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## Lockwood (Nov 8, 2011)

Endiku said:


> Lockwood thank you so much! I'm going to bring that up to my doctor and dietician. I drank something similar for a while when I was so sick that I couldn't really eat at all. They made me a little bit sick but I mostly tolerated them. They were mixed berry flavor and I'm pretty sure they were what kept me alive. The only problem is, my insurance DOESN'T cover those or I'd get them again. In fact when I did get them I was sort of buying them the wrong way...from a friend who got 2 cases a month but didn't need that much. *Because I don't have a diagnosis for celiacs I have a hard time getting anything covered nutritionally.
> (long story but I started the diet without the diagnosis. Now the only way to get the diagnoisis is about $800 and requires me to go on a gluten challenge and ruin the healing my body has done.) I'm going to tell my doctor about EO28 Splash. Maybe I can somehow get it.*


I don't know of this helps to know, but kiddo doesn't get the EO28 because he's a celiac, he gets them because he demonstrates a need for a nutritional supp because of GI and allergy issues. 
My Pediatrician passes the info on to the referral staff in the office (the go-getters..) and they make the case for kiddo, which has always been approved. I don't know your insurance company, but I'm guessing you show more of a need for something like this than kiddo does.
We've had a few different insurances over the years and because it's by a script, they have mostly or completely covered it.

Like I mentioned in the PM, I have the list if the exact ingredients, and what I like about the site is they show the breakdown of how they make the product and how the protein structures are put together, which is different and one of the reason kids with G-tubes tolerate them so well. 

I understand about your celiac diagnosis. I also opted not to go back on gluten to cause damage to my intestines just so the test could confirm that I'm also a celiac, in addition to kiddo. He's the celiac and I'm the gluten intolerant one.


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## piglet (Oct 2, 2012)

I cook with cast iron. I think it helps with iron levels.

I hope you get things figured out for your diet. (your problems make my problems seem pretty petty)


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## Endiku (Dec 6, 2010)

Hmmm. I would think, then, that rthr blood panel results from when they measured my vitamin levels should be enough, because clearly I need something more than what I eat now.

One thing I am super grateful for is that now that I am officially mdisgnosed with Sjogrens Synsrom, doctors are taking me seriously. I ditched my GI doctor, got a dietician, rheumatoist, and a immunologist, and ever since then I've actually at least had people BELIEVE me. For so long no one did because every test I had done showed clesr?. My GI tract DOES process food enough to keep it moving for the most part, at least until it gets to the middle of my small intestine, so they didn't see why I could be having so many bathroom problems, all of the vomiting and nausea, the burning, etc. Despite the fact that my whole tract was covered in THICK bile that should have only been in my see stomach. 

Its actually pretty weirs though. I am one of the few people with Sjogrens who has pretty much ALL of the possible I symptoms...and it isn't a rare disease... yet no one ever suggested I could have it. I actually found it myself while watching my favorite show, mystery diagnosis, and they shared the story of a lady with almost EVERYTHING I have. I researched it, was pretty sure I had it, found a rheumy, got tested, and had the diagnosis within 2 months of seeing that show. The only problem is, there is no cure and it gets worse as you age, but I already have an advanced stage. So I may be very, very sick as an adult. It also increases my chance of osteoarthritis, rheumatoid arthritis, and lupus as well as hashimotos and other autoimmune disorders. Sjogrens wouldn't kill me but the others can. 

Ssjogrens may or may not be why I malabsorb..but basically what my body seems to do is take food and break it down super fast so that I don't have time to absorb anything, then it just stops andnsits in my colon for long periods of time. Fun!


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## jaydee (May 10, 2012)

Not sure if it helps but I have lupus which first manifested itself when I was 12 but at that time no one knew what it was so I struggled on for years often thinking that even my own family sometimes thought I was faking illness to get out of things. It was actually a relief to have it diagnosed when I was much older and totally by accident as I was having some in depth tests to try to find out what was happening to me - Anyways even though you are stuck with it for me its gone into remission and other than the rheumatoid arthritis that still flares up I'm healthier now than I was when I was a teenager


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## Endiku (Dec 6, 2010)

I'm so glad that is in remission for you Jaydee! I agree 100% though. Having a name for something helps a lot, even if it is a bad name, because you know WHAT you're dealing with.


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## disastercupcake (Nov 24, 2012)

I can only recommend that you see an accredited Nutritionist. 

Besides being able to work with your doctor on your medications, a Nutritionist will be able to set out specific guidelines for what to eat, when, how much, etc. 

If you check out this website, ppnf.org, there is a directory to professionals in healthcare that use nutrition to heal. Also there is invaluable information on the site. This organisation has helped me personally in finding professionals and later for education.

In general, supplemental vitamins and minerals are poorly absorbed, and rarely act like the natural ones they are supposed to replace. Many synthetic vitamins and inorganic minerals can cause worse deficiencies because they displace the real ones. 

I wish you luck in your search for health!


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## Endiku (Dec 6, 2010)

I see a dietician, which is the same thing as a nutritionist.  I like him better than my other two options ( it many because of my insurance) but he still isn't all that helpful because he isn't really used to all of the weird allergies I have I guess..


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## Lockwood (Nov 8, 2011)

Endiku said:


> .... he still isn't all that helpful because he isn't really used to all of the weird allergies I have I guess..


But that's just it, he should be. 
The person we were referred to was a specialist in coming up with diets for kids with all kinds of issues.... G-tubes, GI issues, allergies, celiac, GERD,... you name it.
I guess I'm a little confounded because diets for healthy people isn't generally what these types of people do. Is there a larger medical center/area your insurance will cover and allow you access to more in depth care with folks who have more experience or training?

I realize your case is unusual, but at least your guy should use his resources to contact those who may be more experienced in order to help you.


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## Endiku (Dec 6, 2010)

Yoiu would think! He works in the medical center and SHOULD be really good...and he is, for some cases I guess. He does deal with g tubes and such and actually I think he is just so used to fixing everything with formulas thru a tube and nothing by mouth that he doesn't know what to do with me. I want to actually be eating what I need and he cant seem to figure out how to help me do that. Weird. He would rather just IV it to me or shove pills of vitamins down my throat even though that doesn't work for me.

I don't really have any other options. The other person I went to wouldn't even do a blood analysis and I only have 3 dieticians as options that my insurance covers within a 35 mile radius.


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## disastercupcake (Nov 24, 2012)

Endiku said:


> I see a dietician, which is the same thing as a nutritionist.  I like him better than my other two options ( it many because of my insurance) but he still isn't all that helpful because he isn't really used to all of the weird allergies I have I guess..


A dietition is not a Nutritionist 

They both deal with food so its easy to think they are the same but what they do is entirely different. I would still suggest looking into it, especially if the dietitian seems inadequate or not quite as knowledgeable as he should be!
_Posted via Mobile Device_


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## Endiku (Dec 6, 2010)

Oh! Well now I am questioning everything my doctors have told me. LOL.


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## disastercupcake (Nov 24, 2012)

Endiku said:


> Oh! Well now I am questioning everything my doctors have told me. LOL.


I applaud you! You have every right, and indeed the responsibility, to question your healthcare providers and research your alternatives. 

Just a warning though, bring up hollistic or natural methods as espoused by Nutritionists will most often yeild unfriendly and degrading responses from medical doctors. Not all the time of course, just most 
_Posted via Mobile Device_


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## 4horses (Nov 26, 2012)

Have they tested you for excessive bile acid?
Bile acid diarrhoea: For 40 years, doctors said I had IBS. In fact, it was a hormone problem cured by a simple pill | Mail Online

I really think you should try finding a new doctor. I went through 6 gi doctors before I found a good one. I lost 40lbs. Had a seizure from my potassium levels getting too low. I was deficient in vitamin d and b12 as well. 

It took 4 years and lots of experimental meds but I'm nearly fully recovered and gained back those 40lbs. I get intestinal bacterial overgrowth and at one point was on a different antibiotic every month. Now I only need antibiotics once every few months. I can now eat almost anything after being on liquids for 4 years.

You should get tested for bacterial overgrowth or malabsorption. It is a simple test to check for hydrogen in you breath. Google hydrogen breath test. You may need to repeat the test with different sugars to determine what you are intolerant to.


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## Endiku (Dec 6, 2010)

Very interesting article. I haven't been told it is particularly that, but when I had an endoscopy and colonoscopy done they basically told me exactly that. My bile overproduces bile constantly and it is very acidic and very thick, therefore coating and destroying my insides. I wonder if that hormone would help me. No one has ever mentioned it to me...


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