Wilma Posted September 17, 2023 Share Posted September 17, 2023 My dd is a college freshman, living a couple of hours away. She's doing great in general -- happy, is making friends, good roommates, doing well in classes. She's an endurance athlete, training significantly six days a week. During high school, she met a few times with a dietician who helped dd figure out what, how much and how often she needed to be eating, which honestly is a ton. The tricky part is that she has developed some on-going nausea. Like almost daily, she's throwing up. Certain foods, like saucy stuff, is almost always causing nausea. Other things are hit and miss. But it is such a bummer for the girl! It was already a bit of an issue (mainly just feeling queasy, not usually actually throwing up) last year, but has gotten worse. The dietician suspected it was stress-related, which is the working theory. Dd doesn't *feel* particularly stressed, but what else could it be? This is NOT an eating disorder situation - the girl legitimately wants to fuel her athletic endeavors. What would you do with/for this kid? I've thought of suggesting a counselor to talk through stressy stuff, a GI doc to rule out any actual GI problems, getting her back to the dietician that was so helpful here. WWYD? Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted September 17, 2023 Share Posted September 17, 2023 Our BTDT was to run some basic bloodwork to check for anemia and thyroid and the basic stuff. Then we went to GI to deal with the hidden acid reflux and food intolerances. We did a lot of elimination diet stuff to further sort things out once we knew what was in the allergy category and what we suspected was in the intolerance category. We basically have chipped away at stuff until we got to some answers. If you think stress is also part of the picture, I see no problem with starting therapy now while you work through the med angle. 5 Quote Link to comment Share on other sites More sharing options...
Wilma Posted September 17, 2023 Author Share Posted September 17, 2023 Do you think anemia, thyroid, acid reflux, food intolerance, etc., would be likely to strike a teen? She had been without food problems at all until her senior year of high school. Probably checking it all out makes sense, though. 4 minutes ago, prairiewindmomma said: Our BTDT was to run some basic bloodwork to check for anemia and thyroid and the basic stuff. Then we went to GI to deal with the hidden acid reflux and food intolerances. We did a lot of elimination diet stuff to further sort things out once we knew what was in the allergy category and what we suspected was in the intolerance category. We basically have chipped away at stuff until we got to some answers. If you think stress is also part of the picture, I see no problem with starting therapy now while you work through the med angle. Quote Link to comment Share on other sites More sharing options...
Jaybee Posted September 17, 2023 Share Posted September 17, 2023 Personally, I would start with the physical angle, since she doesn't seem to have other signs of a stress reaction. I'd start with allergy testing/intolerances, because allergy food tests are quick and easy to do. Intolerances can be more difficult. And thorough bloodwork, including a check for H. pylori. Those two things can rule out or find some of the most simple answers. It's hard when something is assumed stress-related when there is actually a physical cause, because it can cause a person to start doubting themselves and how they feel. 5 Quote Link to comment Share on other sites More sharing options...
Wilma Posted September 17, 2023 Author Share Posted September 17, 2023 Just now, Jaybee said: Personally, I would start with the physical angle, since she doesn't seem to have other signs of a stress reaction. I'd start with allergy testing/intolerances, because allergy food tests are quick and easy to do. Intolerances can be more difficult. And thorough bloodwork, including a check for H. pylori. Those two things can rule out or find some of the most simple answers. It's hard when something is assumed stress-related when there is actually a physical cause, because it can cause a person to start doubting themselves and how they feel. That makes sense. She keeps thinking she'd know if she were super stressed. 1 Quote Link to comment Share on other sites More sharing options...
Jaybee Posted September 17, 2023 Share Posted September 17, 2023 1 minute ago, Wilma said: That makes sense. She keeps thinking she'd know if she were super stressed. My mother occasionally suffered from a bleeding ulcer. Thankfully, it was never in a life-threatening range or anything. But this was before it was discovered that H. pylori was a bacteria that caused ulcers. She was told it was from worry. So she would beat herself up for worrying, and try to do better, while at the same time, she didn't actually feel like she was worrying too much. And she would have to follow a specific diet. When really, all that time, she just needed antibiotics. But doctors didn't know back then. I guess it is from her experiences that I want to encourage following other leads first. Anyway, that may not be your dd's problem (I looked up the symptoms and nausea is included), but I know it is frustrating for people (usually women) when their symptoms are dismissed and given an emotional cause when there really might be another cause. Not that therapy isn't a great answer for the problem of being overstressed, but it isn't going to help much if she has something else going on. 6 Quote Link to comment Share on other sites More sharing options...
Heartstrings Posted September 17, 2023 Share Posted September 17, 2023 Doctors dismissing young women’s complaints as stress or anxiety is so common and is often wrong. It’s lazy doctoring. You should really insist that they at least attempt looking for an underlying physical reason. 14 2 Quote Link to comment Share on other sites More sharing options...
Terabith Posted September 17, 2023 Share Posted September 17, 2023 I had major issues with nausea and vomiting from about age 7 till sometime in college. Never really figured out what it was, and I gained a lot of weight after I stopped throwing up every time I ate. No real idea what caused it. Quote Link to comment Share on other sites More sharing options...
Katy Posted September 17, 2023 Share Posted September 17, 2023 It’s worth seeing a doctor for. It might be acid reflux. It might be an ulcer, herniated stomach (basically stomach pulled halfway through her diaphragm), or something else like fructose intolerance, early MODY diabetes, or I’m sure 5 dozen other things. Most of which aren’t a big deal but can turn into a big deal over time if they persist. Quote Link to comment Share on other sites More sharing options...
Jaybee Posted September 17, 2023 Share Posted September 17, 2023 3 minutes ago, Katy said: fructose intolerance, My son's gf can't eat anything with corn syrup in it. Which rules out lots of packaged sweets and sodas. She has anaphylactic allergies to tree nuts, but peanuts just make her nauseated. Etc. Quote Link to comment Share on other sites More sharing options...
Wilma Posted September 17, 2023 Author Share Posted September 17, 2023 It seems clear that she should see a doc - some of those possibilities sounds kind of scary! And I would truly hate for dd to be thinking her stress/anxiety/anything is causing a problem that it's actually not. Would you send your college freshman to a regular general practitioner in her college town? A special GI type doc? Here or there? We don't regularly see anyone here, so there would probably be equally good. Quote Link to comment Share on other sites More sharing options...
Jaybee Posted September 17, 2023 Share Posted September 17, 2023 (edited) 6 minutes ago, Wilma said: It seems clear that she should see a doc - some of those possibilities sounds kind of scary! And I would truly hate for dd to be thinking her stress/anxiety/anything is causing a problem that it's actually not. Would you send your college freshman to a regular general practitioner in her college town? A special GI type doc? Here or there? We don't regularly see anyone here, so there would probably be equally good. Personally, I would have her go to one where she lives, since she doesn't have anybody where you are anyway, as long as you think she will follow up on it. It would be a lot easier for her to work out appointments. I would probably start with a GI doc (who might take it more seriously), but she should probably have a general practitioner, and a GI doc might have to have a referral to them. Ask her to make sure you can get her medical information, and hopefully access to her portal. ETA: In the meantime, she might try a modified elimination diet--such as leaving off corn syrup, etc., to see if it has any effect. Are there foods/drinks that she started eating/drinking in the last year or so, or has she changed her diet since going to college? Edited September 17, 2023 by Jaybee Quote Link to comment Share on other sites More sharing options...
klmama Posted September 17, 2023 Share Posted September 17, 2023 FWIW, a young relative had that problem until adding more fermented foods to the diet. Kombucha was/is the biggest help. Quote Link to comment Share on other sites More sharing options...
regentrude Posted September 17, 2023 Share Posted September 17, 2023 Check her gallbladder function. 3 Quote Link to comment Share on other sites More sharing options...
Starr Posted September 17, 2023 Share Posted September 17, 2023 I would suggest the medical work up but don’t rule out disordered eating if all else looks good. There are plenty of people who want to be healthy that have food issues. Hopefully something easy comes up soon. Quote Link to comment Share on other sites More sharing options...
katilac Posted September 17, 2023 Share Posted September 17, 2023 (edited) 1 hour ago, Wilma said: Dd doesn't *feel* particularly stressed, but what else could it be? Plenty of things! And she certainly knows if she's stressed or not. You specifically mention sauce, which to me generally equals both dairy and high fat. If she can eat dairy otherwise, I'd agree with @regentrudethat the gallbladder should be checked out. I'd go the medical route first. It can take freaking forever to nail down a diagnosis. She needs to practice firmly pushing back on the idea that it is stress. And that dietician should have referred her out for ongoing nausea. Edited September 17, 2023 by katilac 2 Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted September 17, 2023 Share Posted September 17, 2023 Endurance athletes burn through different levels of macros and micros than normal athletes. (I have family that do ultra marathons--100 milers.) She may be hyponatremic or have other really easy to solve things going on. But, you aren't going to know if you don't run the basic bloodwork. The fact that whatever dietician she's been working with hasn't red flagged her ongoing nausea and other issues and pointed her towards a doctor is a red flag, imo. Nausea isn't uncommon among endurance athletes, there's always a lot of people who throw up during the last half of races when the body really begins to feel the strain, but you don't assume it's exercise related stress until you've done your homework. If she can't keep up with her fueling plan, that's a big problem. So---do your homework, iykwim. Also, if she's nauseous every day and this isn't easily solvable, I'd really ask her whether taking a break and seeing if she sees improvement outside of endurance sports. Her body may just not be weathering the strain well. A lot goes on hormonally when you're deep into an endurance strain. 3 Quote Link to comment Share on other sites More sharing options...
catz Posted September 17, 2023 Share Posted September 17, 2023 Is she eating significantly different than she was at home? Is she on a dorm meal plan? I would follow up with medical for sure. Possibly with allergy. That said, if you're throwing your hands up in the air, I had a bout with GI/IBS including a small ulcer as a young adult during time of large changes. I didn't at the time recognize it as stress related. But once I agreed to do a round of meds for anxiety, etc, it was clear it was related and that did help settle things down. I do think some bodies are prone to that tie together. That doesn't mean you might not find something else, like I said, I had a small ulcer found. Taking small doses of soluable fiber, probiotics, watching pricessed sugar intake are all helpful for me too. 1 Quote Link to comment Share on other sites More sharing options...
Emba Posted September 18, 2023 Share Posted September 18, 2023 Is she eating on a regular sort of schedule? I know in college my eating habits were irregular, and it made me nauseous to go too long without eating, then I wouldn’t be able to eat much when I did eat. has she been to any developing countries for mission trips or travel? This is probably not the problem, but when I lived in Ecuador I got some parasitic amoebas that would make me throw up after meals. Not every time, but particularly after rich meals or if I got up and was active, even just a little, after a meal. I’m not sure if intestinal parasites would occur to most American doctors right off, especially if she didn’t mention any travel. 1 Quote Link to comment Share on other sites More sharing options...
ktgrok Posted September 18, 2023 Share Posted September 18, 2023 daily nausea = GI doctor time. Absolutey. Could be celiac, an ulcer, reflux, slow emptying stomach issue, esophageal issue, etc etc. Needs to see a GI doctor. I wouldn't bother doing labwork until you see them as they will want more stuff run anyway. 2 Quote Link to comment Share on other sites More sharing options...
elinnea Posted September 18, 2023 Share Posted September 18, 2023 4 hours ago, prairiewindmomma said: Endurance athletes burn through different levels of macros and micros than normal athletes. (I have family that do ultra marathons--100 milers.) She may be hyponatremic or have other really easy to solve things going on. But, you aren't going to know if you don't run the basic bloodwork. The fact that whatever dietician she's been working with hasn't red flagged her ongoing nausea and other issues and pointed her towards a doctor is a red flag, imo. Nausea isn't uncommon among endurance athletes, there's always a lot of people who throw up during the last half of races when the body really begins to feel the strain, but you don't assume it's exercise related stress until you've done your homework. If she can't keep up with her fueling plan, that's a big problem. So---do your homework, iykwim. Also, if she's nauseous every day and this isn't easily solvable, I'd really ask her whether taking a break and seeing if she sees improvement outside of endurance sports. Her body may just not be weathering the strain well. A lot goes on hormonally when you're deep into an endurance strain. I agree with prairiewindmomma regarding the dietician and the needs of endurance athletes. Unless the dietician is specialized in working with certain populations their recommendations are usually focused to the average person and therefore unhelpful. When one of my kids was newly diagnosed with an eating disorder they sent us to a regular dietician. Lovely lady and she had great suggestions but not appropriate for someone with an ED. When we finally were able to see a dietician that specialized in eating disorders we saw much more improvement. So in your case I would definitely check out her other physical stuff but also see if you can find a dietician that has experience with endurance athletes. Quote Link to comment Share on other sites More sharing options...
athena1277 Posted September 18, 2023 Share Posted September 18, 2023 5 hours ago, Wilma said: It seems clear that she should see a doc - some of those possibilities sounds kind of scary! And I would truly hate for dd to be thinking her stress/anxiety/anything is causing a problem that it's actually not. Would you send your college freshman to a regular general practitioner in her college town? A special GI type doc? Here or there? We don't regularly see anyone here, so there would probably be equally good. Does her school have a clinic? That might be a good first stop. They should be able to do basic bloodwork and refer her to a specialist if needed. Quote Link to comment Share on other sites More sharing options...
BeachGal Posted September 18, 2023 Share Posted September 18, 2023 The intense exercise your daughter is doing could be causing her gut problems. She could try taking zinc carnosine which can improve the lining of the gut. Drs Best is a decent brand. Just one capsule per day should do. Talk this over with the dietician first. https://www.dougcookrd.com/gut-health-benefits-of-zinc-carnosine/ Certain supplements can cause nausea if the dose is too high or too prolonged. She might also want to see a GI doc as well. Quote Link to comment Share on other sites More sharing options...
lewelma Posted September 18, 2023 Share Posted September 18, 2023 (edited) Is she really skinny? When my son got super skinny after a difficult and protracted wisdom teeth situation (7 removed and 2 in his sinuses, yes 7), he couldn't eat. And once he couldn't eat, then he lost his appetite, and when he did eat he felt nauseated. We got a liver function test that said he was eating muscle because he was so skinny - basically in ketosis. I'm just throwing this out there if she is underweight as that can cause the nausea. Edited September 18, 2023 by lewelma 1 Quote Link to comment Share on other sites More sharing options...
Wilma Posted September 18, 2023 Author Share Posted September 18, 2023 17 hours ago, prairiewindmomma said: Endurance athletes burn through different levels of macros and micros than normal athletes. (I have family that do ultra marathons--100 milers.) She may be hyponatremic or have other really easy to solve things going on. But, you aren't going to know if you don't run the basic bloodwork. The fact that whatever dietician she's been working with hasn't red flagged her ongoing nausea and other issues and pointed her towards a doctor is a red flag, imo. Nausea isn't uncommon among endurance athletes, there's always a lot of people who throw up during the last half of races when the body really begins to feel the strain, but you don't assume it's exercise related stress until you've done your homework. If she can't keep up with her fueling plan, that's a big problem. So---do your homework, iykwim. Also, if she's nauseous every day and this isn't easily solvable, I'd really ask her whether taking a break and seeing if she sees improvement outside of endurance sports. Her body may just not be weathering the strain well. A lot goes on hormonally when you're deep into an endurance strain. I've wondered, too, if she needs a break. It seems like a sort of natural slackening of the training schedule will happen after mid-October, and we'll keep an eye to notice whether there is any change with the nausea at that point, while also checking out the bloodwork, etc. Quote Link to comment Share on other sites More sharing options...
Wilma Posted September 18, 2023 Author Share Posted September 18, 2023 8 hours ago, lewelma said: Is she really skinny? When my son got super skinny after a difficult and protracted wisdom teeth situation (7 removed and 2 in his sinuses, yes 7), he couldn't eat. And once he couldn't eat, then he lost his appetite, and when he did eat he felt nauseated. We got a liver function test that said he was eating muscle because he was so skinny - basically in ketosis. I'm just throwing this out there if she is underweight as that can cause the nausea. Not excessively skinny - sporty/strong and slim, but definitely hungry. Quote Link to comment Share on other sites More sharing options...
EKS Posted September 18, 2023 Share Posted September 18, 2023 Is it possible she's pregnant? Quote Link to comment Share on other sites More sharing options...
Wilma Posted September 18, 2023 Author Share Posted September 18, 2023 11 minutes ago, EKS said: Is it possible she's pregnant? Not a crazy idea, but no. Quote Link to comment Share on other sites More sharing options...
Wilma Posted September 18, 2023 Author Share Posted September 18, 2023 13 hours ago, athena1277 said: Does her school have a clinic? That might be a good first stop. They should be able to do basic bloodwork and refer her to a specialist if needed. For sure, yeah. Good idea to start there! Quote Link to comment Share on other sites More sharing options...
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