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I have had spots similar to the OP on the fingers, though not in the same quantity. I have also had vertical splinter haemorrhages in the nails, but again its sporadic so I thought perhaps just a result of trauma. That said I have also seen a change in nail appearance, vertical ridges...

Hi @LucyLouWho, Liver Function Tests, standard panel of ALT, bilirubin etc. I had a slightly enlarged liver and increasingly elevated ALT & bilirubin that improved after removing carbs. Only 2-3 times the normal range so not enough to attract suspicion of primary liver disease so it was assumed...

I hope you find something that works for you. We are all individual in our requirements. Interestingly there is evidence that non alcoholic fatty liver disease can be reversed through ketogenic diet and that appears to have been the case with me. My LFTs have never been so good :)

Hi @Cinders66, Check out these threads & videos: https://www.s4me.info/threads/dr-david-m-systrom-at-bwh-has-evidence-of-sfpn-in-some-patients.4855/ https://www.s4me.info/threads/webinar-exercise-research-in-pots-its-not-deconditioning-dysautonomia-international-tuesday-jan-16-7-8pm-est.1917/...

CPET abnormalities in our patient group are usually quite non-specific. The CPET can give some indication of where the limitation lies but no distinct cause in most cases. For me it was concluded that there was likely no respiratory limitation but moderate functional impairment from...

Just my own experience but taking B12 on its own caused my folate (B9) to tank and make me feel considerably worse. Multivitamins & B complexes would also make me generally feel worse and more symptomatic. More recently I was recommended methylated multivitamins on account of 23andme results. I...

This is a good point. The incremental work ramp rate is usually given in watts, I think I did 15W though can't be sure. Not sure if your CPET was done in a sports centre @Snow Leopard, but the 3x I did were in a clinical setting and sounded a little different. The power ramp was constant with...

Brighton Uni also offer a CPET for £180+VAT. You can pay more for some blood measures like lactate and other metrics. http://issuu.com/universityofbrighton/docs/sescu_postcard_-_laboratory_assessm/1?e=2898258/8628439

101 possible causes but just to give you the benefit of my experience: Increased urinary frequency is a well recognised symptom in POTS - if I am on my feet more I will pee more, especially towards the end of the day & in the night (despite not changing consumption of fluids). It got a lot...

I'd also want to exclude the possibility of autonomic problems like POTS if not done so already, as that can have quite an impact on thirst & urinary frequency from several angles.

Really interesting to see L-Lactic acidosis present in some SIBO patients too. Could explain why I had a sky-high serum lactate test (L-lactate) one day but not on repeat - only difference that was obvious was one was before a meal and the other was after.

I've just recieved my referral to investigate for SFN, fully expected it to be a punch biopsy but was surprised to see it'll be an alternative method instead: Sympathetic Microneurography. Looks to be a very specialised conduction technique. The referral has come from a neurocardiology...

N=1 experience here but just to temper expectations: I've dealt with a couple of myologists (Neurologist specialising in muscle disease) recently, one of which was the go-to guy for performing skin punch biopsy to investigate SFN. In the context of POTS, both felt it was an unnecessary...

You're welcome, glad it helped. Thanks for the link. I know what you mean about the digestion problems, it can be infuriating. Some days I'll be really pleased about managing to eat an evening meal without bloating and pain, only to find when I have a drink of water 1hr later everything...

Agreed. A common problem I had was very acute nausea & vomiting in the mornings, reliably brought on if I consumed fluids (a cup of tea or taking pills) on an empty stomach. I'd have to do the same and force down something dry at the same time as trying very hard not to vomit. Once there was...

Hi @Ravn, Yes, I think your theory is possible, perhaps even likely with a background of POTS, I have had a very similar experience. I've been ill for decades but approx. 2 years ago everything became much worse with frequent unexplained crashes throughout the day and night like clockwork &...

I really respect Systrom's work - it couldn't have been easy to convince funders/patients to do invasive CPET studies!! Nice to see him coming across well in these interviews too. I know of a few people that have seen him clinically too, with mixed results (if Pyridostigmine doesn't help you are...

Glad I could help. Yes, I think the effects of these episodes are incredibly draining and that fact perhaps isn't well enough recognised. The same goes for OI episodes (prolonged standing aggravating POTS, syncope/near syncope from NMH etc.), they really take their toll later in the day & again...

I'm not 100% clear on what you have written, perhaps some auto-corrects are not helping. It sounds like they did a ACTH stim test to exclude adrenal insufficiency, which is not an investigation of blood glucose. The finger prick spot testing you performed was a direct investigation for blood...

Best of luck with the changes, I hope they help again. The NMH would put you in an OI category, where many of us are overly sensitive to carbs. Do you know what investigations you had before? It seems that a prolonged (4hr) glucose challenge + insulin monitoring in hospital is needed to really...