How to Hydrate for Metabolic Health

How to hydrate for metabolic health (it's about quality, not quantity)

A hydration tip from a skincare expert

Did you know that Dr. Howard Murad, the skincare expert and creator of Murad skincare, does not recommend drinking 8 glasses of water per day? Instead, he suggests “eating your water” – obtaining nutrient-and-electrolyte-rich water from fresh fruits and vegetables.

Although we’re told from every corner of the internet to consume 8 glasses of water per day, there is actually no evidence that drinking this much water is beneficial.  As Dr. Murad acknowledges, drinking this much water can actually deplete electrolytes and therefore cause dehydration and premature aging of the skin. 

The metabolic approach to hydration

Two years ago, I was introduced to an unconventional but common sense approach to metabolic health by numerous bloggers and health writers. These include Ray Peat, Matt Stone, and Josh and Jeanne at East West Healing and Performance. As I’ve worked to heal my hypothyroidism and adrenal fatigue (posts on both topics are forthcoming!), I’ve found their work extraordinarily helpful.

The two main points that allowed me to make significant progress in my metabolic health include:

  1. The necessity of sugar and salt for metabolic health
  2. The problems with drinking too much water

eat for heat coverAs someone who previously saw my gigantic water bottle as an extension of my arm, I was shocked to learn that “flushing” my body with half my body weight in ounces was not only not helpful… it was harmful.

I’ve been practicing hydration for metabolic health for probably the last year and a half. Along with the other metabolic tweaks, such as the inclusion of healthy sugars in my diet, my severe hypothyroidism has improved, my constipation issues resolved, and my skin improved. The lesson? Take care of your metabolism and it will take care of you!

In this post, I want to explain the very simple concept of hydrating for metabolic health. These points come from Matt Stone’s book Eat for Heat, which I’ve repeatedly recommended here and on Facebook. This post won’t replace the book, so I still recommend that you get it. It’s only $3 for the digital version.

1. Over-hydration causes imbalanced electrolytes

We are told from mainstream and natural health practitioners alike to drink half our body weight in ounces of water per day. “It flushes everything out and keeps you hydrated. If you pee clear, it means that you are well hydrated.”

Actually, clear pee signals over-hydration, a state where the electrolytes in your body fluid is out of balance with the water levels. 

When we drink too much water, we create an electrolyte deficiency. The extracellular fluid in the body contains sodium, as well as other electrolytes. When we drink plain water, it dilutes the electrolytes which carries metabolic consequences. This is because the concentration of electrolytes in the blood and extracellular fluid is key to cell-to-cell communication and regulation.

In a non-scientific but easy-to-grasp example, Matt Stone in Eat for Heat explains,

Picture your body filled with nutritious, high-octane, electrically conductive fluids.Things work better and your cells have the ability to produce more energy at the cellular level.

It’s all about increasing the nutrients – the electrolytes, including sodium – in our body fluids. If we drink too much water, we decrease those nutrients and prevent our cells from working optimally. Water-logged cells are not happy cells! And when cells work optimally, it means that we have a high metabolism and healthy thyroid function.

2. Over-hydration further stresses adrenal glands

Over-hydration proves extremely problematic for anyone who struggles with overworked adrenal glands. The adrenal glands respond to stress with stress hormones. When stress is chronic, due to emotional trauma or a physical stressor, the adrenal glands exhaust and can no longer keep up with their hormone production. I have an upcoming post on adrenal fatigue.

In those with adrenal fatigue, aldosterone levels drop below optimal levels. Aldosterone keeps sodium in the blood. So when aldosterone is too low, we start to lose to much sodium from the blood. This causes a problematic drop in blood pressure. By drinking a lot of water, we further reduce the sodium levels in the blood and exacerbate stressed adrenal glands.

Since adrenal glands and the thyroid work hand-in-hand, we must support the adrenals to optimize thyroid health.

3. Excess water is too cooling

How to hydrate for metabolic health (it's about quality, not quantity)Body warmth is correlated to a fiery metabolism, good libido, and fertility. A cool body is correlated to poor thyroid function and a slow metabolism. How do you know if your body is cool?

Something you can do throughout the day is to simply feel your fingers and toes. If they feel chilly to the touch at any point, it points to a too cool body. You’ll notice that your fingers are colder at different times of the day. You’ll also find that they warm up, even slightly, after eating certain foods.  

Cold fingers and toes, at any point during the day, means that you need to make some dietary tweaks to warm your body. This is the whole concept behind Eat for Heat. One of these tweaks includes reducing cooling factors like water.

You will experience colder fingers after guzzling a big glass of water. However, you’ll most likely experience a warming sensation after eating “warming foods” which contain sugar, salt and/or saturated fat. By emphasizing warming foods, you’ll boost your metabolic rate which supports weight loss, adrenal health, and a healthy thyroid.

Eat for Heat explains the concept of warming foods and gives extremely helpful pointers on how to boost your metabolic rate by enjoying these foods at certain points during day. You’ll also learn how to use salt and sugar to help your metabolism skyrocket. I can’t recommend this book highly enough! I will add the disclaimer that, unlike Matt, I do not believe junk food is necessary for metabolic health. I’ve followed his concepts with real food on a grain-free diet with good results. Unrefined salt, raw honey, butter, cheese, coconut oil, dates, egg yolks… there are many powerfully warming real foods!

So, how can we optimize metabolic health with our water intake? It’s simple: 

Just drink when you are thirsty

No other creature is so removed from its instinctual programing to the point of accidentally over drinking. — Matt Stone, in Eat for Heat

If you have cold fingers and toes at any point of the day, it means that you should reduce the cooling effect of water. Don’t dump cooling water on your metabolism – you want to stoke that metabolic fire so it burns quickly and efficiently!

If you are thirsty, drink. If you aren’t thirsty, step away from the water bottle! Your body knows how to balance your body fluids. If you listen to it, it will do its job. When it comes to drinking water, don’t be silly enough to think that you know better than your inherent thirst mechanism.

Add electrolytes to your water

Another key point discussed in Eat for Heat is how to use salt to optimize your metabolic rate. Matt gives tips for eating salt at different points during the day to prevent your metabolism from stalling. One routine you can start immediately is adding a pinch of unrefined salt to the fluids that you do drink.  

When I’m thirsty, I reach for well-salted, homemade bone broth. The mineral and sodium concentration in the broth supports that nutrient-rich, highly conductive extracellular fluid. Alternatively, I’ll sip my Homemade Adaptogenic Sports Drink, which contains electrolyte-boosting honey, trace mineral drops, and unrefined salt.

Don’t dilute stomach acid

small stomachAlso importantly, do not gulp water with meals. Advice to drink a glass of water before each meal, “to fill you up,” sets you up for very poor digestion. This is because water dilutes stomach acid, and we want our stomach to be an acid tank when we are eating a meal. Powerful stomach acid prevents heartburn, gas and bloating.  

1/2 cup of water with meals is fine, but to improve digestion, enjoy a small cup of homemade bone broth. The gelatin in the broth is a time-honored secret to improve digestion. Of course, salt the broth to taste.


Are you familiar with the metabolic approach to hydration? Are you a recovering water-holic?

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  1. says

    I’m glad you brought this up! I’ve been seeing lots around blog land on this topic, and the theory makes sense. My question is this: why am I so thirsty all the time? If I wait until I feel thirsty to start drinking, I can never satisfy the thirst. I’ve tried reducing water, but I feel thirsty and/or fatigued. Following thirst cues, I can easily drink 12 cups a day. I have switched to warm liquids and eat liberal amounts of salt and don’t worry about moderate starch and natural sugars. My mom says I loved water as a toddler too, so this has been life-long. Do you have any thoughts on this from your nutrition training?

    On another note, cold fingers and toes can also be a sympathetic stress response. Many of us live at that level all the time. I’ve worked extensively on biofeedback equipment and with meditation, and have learned quite a bit about this issue. I was always told my cold hands were low thyroid, low metabolism, etc, but actually I can warm them up at will now through practices that activate the vagus nerve. I have a problem personally with hyper-vagalism, but that’s a whole other story. Fascinating stuff!

    • says

      Matt also mentions cold fingers/toes as being a stress response in the book (if I remember correctly). That is a great point! I’ve also been experimenting with visualization exercises to warm up my fingers/toes. I didn’t do anything to specifically stimulate the vagus nerve, I would just visualize warmth radiating from my extremities. Thank you for sharing your experience with this!

      As for the excessive thirst, I’ve heard that a low carb diet can often cause this issue. Nothing else comes to my mind immediately, but it is something with which I’m not familiar. Even if you are getting carbs, you might try reducing the starches (like grains) and increasing natural sugars (like fresh fruits and raw honey), which are more metabolically available. Eating juicy fruits may help you satiate your thirst while still getting in some electrolyte-supporting natural sugars.

      • says

        Thank you for the response, Lauren! I appreciate your sharing your knowledge and experience. I like the idea about juicy fruits. Yum. Perhaps some of us simply need more fluids *and* more salt and sugar to go with it. I look forward to learning more.

        • Elizabeth says

          I used to be extremely thirsty also. I believe it was a lack of electrolytes. When I started adding trace minerals (Concentrace) to everything I drank, started using RealSalt and supplemented with potassium and magnesium, the thirst went away.

    • Lasse says

      I always had problems with dehydration in heated climate. Also, in general I was often thirsty, but drinking water didn’t really help. I felt it was not being absorbed in the body, but just swishing around in my belly and I would pee a lot.
      Last few years I have been adding Himalayah salt to my water. (1 teaspoon in my 2 liter bottle). This makes it a joy to drink the water. It quenches the thirst and it “absorbs”. And I don’t have to pee constantly.

      I recently found out that I have lots of symptoms that match adrenal fatigue. So this makes a lot of sense now – how this condition can drain the body of salts and how it looks like this has been part of the situation for me.

  2. Rajiv says

    I have read eat for heat and if i remember correctly he states once you have a high metabolism the rate at which cells are repaired is increased. Then later on says that bodybuilders drink a lot of water to hydrate and that it might be helpful in that case but he’s not sure. Shouldn’t the increase in metabolism from not overhydrating cause muscle cells to repair faster? Would like to hear your opinion. Great blog btw!

    • says

      The more I learn about the metabolic approach, the more I understand that a good metabolism equals better health in every aspect, including physical and emotional wellbeing. Interestingly, one’s ability to build muscle and muscle tone is improved when metabolism is improved. So it would make sense to me that by supporting metabolism, you support the ability of muscle cells to repair.

  3. Millie says

    I like Matt’s approach which is similar to the Chinese yin and yang. I’m beginning to be more aware of the yin and yang foods I put into my diet like introducing more carbs into my diet. Check out this site

    I don’t fully believe everything from that link but just doing what makes sense.

    • says

      That’s because too much water reduces the sodium in the blood, which lowers your blood pressure. When our blood pressure is too low, we get dizzy when standing up after sitting or laying down. Interesting, right? I struggled with dizziness when I had adrenal fatigue and I was drinking too much water.

  4. Liz J. says

    Wow Lauren,
    You are always posting things that make a big difference in my life! I’m very into fitness and used to guzzle a gallon of water or more throughout each day. My adrenals have been suffering for many years, and when my doctor recommended more water to “get things going” I opted for concentrace minerals instead. I struggle with my memory due to low blood pressure, or i would have started implementing your adaptogen electrolyte beverage recipe, but once I received the tulsi…I forgot. :/ lol I am going to warm up that stock and brew up some tulsi right now. Thanks for your consistantly excelent information. You are officially my absolute favorite blogger!

    • says

      I am so happy to hear that my information is helpful to you! It’s a learning process for me, too, and I enjoy sharing what I learn. I’m doing a post about my experience with adrenal fatigue and what helped me, so I hope you’ll find that helpful too.

  5. Ina says

    If you seem to have trouble with water not quenching your thirst, try adding a pinch of salt (healthy salt), either mixed in or on the tongue after. Or add some mineral drops.

    A friend had never, ever, felt thirsty. After I hounded her for about a year she started to force herself to drink. Soon she started to feel thirsty, her skin turned from a greyish color to pink and she felt better than than she ever had before.

    I’ve worked with pregnant women and the elderly. Both groups get dehydrated easily, and suffer from dizziness and in the elderly confusion. I pregnancy the baby gets dehydrated as well, and movement is reduced.

    For some healthy adults less fluid might work but this is not for everyone.

  6. Chris says

    Is it true that the thirst mechanism doesn’t work as well when we age so we may not know that we are thirsty?…and do elderly people need as much water? Many oldies I deal with hardly drink any water.

    • says

      Many elderly are dehydrated and electrolyte deficient. I think the approach for elderly will be different than this approach… that’s a question I would ask Matt :) My first thought would be to increase both electrolyte intake and water intake. Again, the Adaptogenic Sports Drink is an excellent option for that.

  7. says

    Hi Lauren

    I’ve read your post and am reading “Eat for Heat” the theory makes sense about adding electrolytes, I drink a lot of water and always have and I don’t add any salt to my diet – I avoid salty foods and find if I add salt to anything it is too salty…I have cured myself and help others with gut disorders and the one thing I always found that helped was drinking a lot of water when symptoms flared up – I am thinking of rather recommending sipping a homemade adaptogenic sports drink throughout the day – any thoughts if this safe to drink all the time rather than straight water?

    I personally also have cold hands and feet and have been diagnosed with Rynaud’s but perhaps it’s just too much water……I shall experiment and see if the condition improves – thanks again for an interesting and thought provoking post.

    • says

      The Homemade Sports Drink is definitely safe to consume all the time! There are mild concerns that high amounts of tulsi may have a natural contraceptive property (but this hasn’t been shown in humans, only animal studies). Those trying to conceive may wish to consume tulsi in moderation. I was diagnosed with Rynaud’s many years ago but it has almost disappeared after a year of intense gut-healing and metabolism-healing :)

  8. El says

    Sorry to muddy the waters, but one symptom of chronic dehydration is the inability to feel thirst. So the comment above about the woman who didn’t feel thirsty until she forced herself to drink makes a lot of sense.

    And I’ve read in several places that drinking warm water 20 minutes before a meal INCREASES stomach acid, and that this is a highly effective and healthy practice for those of us with low stomach acid. The contradictions are so confusing!

  9. Janna says


    I have been following your blog for awhile and I love the focus you bring to the issue of gut health in particular. Having seen the reference to Eat for Heat multiple times I decided to take a closer look at it. I have not read the book, but I have explored his website (had to sign up to follow it in order to obtain the password (seriously?). I also read very thorough reviews on Amazon. Anyhow, it was totally not what I expected given the fact that the reference came from you. No wonder it’s called 180 degrees. I am sorry, the guy is a lunatic. I can sympathize with the fact that he is coming from a long history of being under-nourished and over-exercised. First of all he sounds like an illiterate junior high student with borderline offensive language who gave in to his cravings and laziness and is working really hard on trying to justify it. Feed kids sugary cereal for breakfast? Eat junk food and drink pop? I know you have said above that you do not agree with that. My question is, if his “research” lead him to making these “wise” decisions, how can you buy into the rest of it and not question it? I agree that over hydrating is a serious issue. However, how much is too much? He himself states in his book that most people are so out of tune with their bodies that they don’t even recognize the feeling of thirst until their mouth is parched. I am sure that this is what experts refer to when they say that if you are feeling thirsty it means you are already dehydrated. Personally, I do drink half my body weight which for me happens to be 8 glasses. I count herbal teas towards my water but not soup, broth or high water veg. It is quite an improvement for me because 2 years ago it was time and a half that. When I cut back I felt very thirsty all the time which can happen if you have a history of over hydrating – your body does not utilize the water properly and does not deliver it effectively to the tissue, just processes it through the kidneys. I know that if I don’t drink that amount my body ends up holding on to the water it gets – called water retention. If I drink over that amount it will hold on to water. So half my body weight seems like a perfect qty. When it comes to salt, I use about 1/2t a day of Himalayan salt. My blood tests are showing that my electrolytes are in perfect balance. That’s all I need to know I am doing the right thing. I agree with him on one point, fad diets do not do anything but cause harm, eating real food with sufficient amount of fat is key to proper nourishment and vibrant health. He is young and his body can withstand some abuse but it is going to catch up to him at some point. As for cold hands and feet, the water you drink need not be cold, especially in the cold winter months. I increased my body temp by avoiding goitrogenic foods. Not that they are all universally bad for thyroid deficient people. You can use the temperature method to see which ones work for you and which ones don’t, just get into the habit of taking your BBT first thing in the morning. I repaired my thyroid in less than a year with this method and my TSH went from 4.2 to 1.7.

    • says

      I appreciate your comment and I think you bring up some great points! Yeah… Matt has some extreme views and I certainly don’t agree with everything he says. And I also believe that we are all individuals and while I think metabolic hydration as I’ve described here is a powerful tool, that’s not to say that SO many people have drastically improved their health by drinking lots of water in conjunction to other dietary changes. If you feel best with lots of water, then that means it is probably right for you :)

  10. Nan says

    I’ve had years of adrenal/thyroid issues. Only now getting diagnosed from Naturopathic practitioner. Your posts are a God send to me. Thank you for taking the time to share what you are learning! NB

  11. Dev says

    Drink only when thirsty is good advice but the problem is many people don’t know when they’re really thirsty. I believe histamine rises with dehydration and histamine plays a role in thirst regulation. Salt may also play a role in retaining water which is why some people can drink constantly and still feel thirsty.
    A very in depth book about water is “Your bodies many cries for water” by By F. Batmanghelidj, M.D. The author suggests 1/8th of a teaspoon of salt per litre of water.

    • GVal says

      *Salt may also play a role in retaining water which is why some people can drink constantly and still feel thirsty.*
      Could you explain this a bit? Does this mean if you are constantly drinking and still feel thirsty you are retaining fluid and need more salt? Or less salt? How can you tell if this is the case? I always feel thirsty and I drink up to 12 cups per day. I don’t feel that I am retaining water (nothing is swollen except perhaps my belly but I’m not sure as I have always had a bit of a pot belly) and I pee all day and night. I feel that the water passes straight through without doing any benefit at all. If I don’t drink enough water I get headaches and feel awful but I don’t exactly feel great with what I’m having to do now either!
      What would you suggest?

  12. Cathy says

    Hi! Thanks for the interesting blog. Im wondering, i often get really thirsty in the night time and end up drinking most of the water i drink in the late afternoon, evening and often right before i go to bed ( causing me to have to get up to pee in the night often several times). Reading your post i wonder whether this could be beneficial as metabolism would naturally drop in the night?

  13. John says

    Interesting article, hydration is definitely important, especially if you have an increased sweat rate from daily activity and exercise. A hydration pack can help, I like camelbaks, and I also found this one recently, really cool

  14. says

    Hi Lauren, great blog great info. The endocrine system is so fascinating! I have some of symptons of adrenal fatigue . I’m going to a acupuncturist who says I’m yin, spleen deficient. So I am getting more rest andeating better. I went to nursing job burnout that created my state! I am menopausal and I feel my hot flushes related to all what you have said. I have told my daughter to be mindful with get life to avoid what I have and am going through. I also noted that just before I left my nursing job , I was diagnosed with hyperthyroid just a bit elevated. It is normal now but wow how stress can affect our lives! Thanks for your info very helpful.

  15. Amanda says

    Who is Matt Stone?! I can’t find his qualifications to write a book on this subject anywhere. He almost seems to intentionally leave this information out. Hell, I am an “independent researcher” by some sort of standards, but that doesn’t mean I’m qualified to give health advice to anyone. Before I consider buying his book, I’d like to know he’s not just another moron looking for money.

    I know I am being antagonistic by only commenting on the articles I am skeptical about (there are many articles here I have printed out for reference), but I fear that I would have a LOT of health issues if I followed this man’s advice, especially since I work outside in South Florida and have a history of passing out due to inadequate water intake (overheating).

  16. Ladytron says

    Hi Lauren,

    Thank you for sharing your knowledge with us, who are searching for some answers to our health problems. It’s very informative and i have discovered some interesting facts about sugar eating as well as the T-TAPP program. I am very inspired by your posts. Keep it up and God bless with all your endeavors.

  17. May says

    So what about the vegans? Haha. Should we just drink salted vegetable broth in place of the bone broth? And sorry, I know this is a pretty old post.

  18. richelle says

    Hi Lauren. Can you recommend any other drinks for this purpose? My children and I consume broth regularly. Tulsi doesn’t sound like an option for toddlers and wondering if teens or even adults should consume it regularly due to different “health warnings”. We add trace minerals (the ones you recommend) to our water – still add the pinch of salt?

  19. Christi says

    I read this awhile ago, but I’ve come back to it because I would like to forward this article to people that I know. I was wondering if you know of any studies that I could cite to further support the information you’ve provided here? So many people are confused about all the conflicting health information that they get, so I would like to be able to provide as much supporting information as I can. My husband is just one person who drinks tons of water, but I think he might want to see more evidence before he changes his mind about water consumption. Thanks for this awesome, informative blog.

  20. tessa says

    I’m coming to this post now because I am currently pregnant, and somehow can never stay hydrated. i’m never thirsty but have re-occuring asymptomatic UTI’s and All my urinalysis tests come back saying I’m not hydrated, so I drown myself during the day, with no improvements. When I do drink a lot of water, my kidneys ache. My midwife says I need to stop drinking plain water and add more salt to my diet, and I wasn’t sure how I could incorporate that into the fluid I know I need to drink during the day, but i have a better idea now! thank you

  21. Vicki says

    I was diagnosed with Hashimoto’s disease 14 years ago. I like you did not accept that I would have to be on medication for the rest of my life. As I’ve gotten older and since I had my last child at the age of 42, managing my thyroid issues and hormone imbalances have gotten harder. I have tried this diet and that diet and have never felt right. I’ve had bouts of horrible acne, brain fog, stressed out, chronic constipation, and no desire for sex.. my husband and I have most recently been doing the past metabolism diet by Haylie Pomroy. However her diet uses a number of things that I just read from your blogs are no no’s: xylitol, stevia l,ots of water drinking. My husband lost 15 to 20 pounds on it and the first month , I lost 5. And all the food requirements and food preparation stressed me out as well. I so need a diet that will work for me, be easy to follow,, not cause extra stress and be something that I could get my picky kids to eat as well. By the way I have one child that is allergic to soy and one child that is allergic to eggs and peanuts too.

  22. LizzieT says

    Would have enjoyed this article, but ads were covering a number of paragraphs….most would not allow me to remove them. I tried opting out of ads thru Google, but they still show up on your posts. Any way for me to bypass the ads?

  23. Mary Beth Neumann says

    Hi Lauren, reading about your story has actually about killed me. My 18 year old daughter had her colon removed on Jan 9th, 2015. She was diagnosed with UC a year and a half prior. I went to medical doctors and didn’t like the answer that she would need meds the rest of her life. She was on Lialda and it didn’t help so I took her to a naturopath that I thought for sure could help her as he had his colon removed as well and thats why he went into natural med. But only a few months later Lily ended up in ER and 2 weeks later after not responding to steroids or Remicade and needing 3 transfusions, the drs told us if she didn’t get the surgery she could die. I will regret this decision for the rest of my life and I cry everyday for the suffering she has endured. She is now in her freshman year of college an hour away from home. She has a jpouch now and is starting to adjust although it has been very difficult. She is absolutely the strongest girl I know. But now she is experiencing some depression. She also has tonsil stones which I never heard of but wonder if its related to whats going on with her body.

    I started reading your blog becasue I want to do whatever I can to help prevent other auto-immune diseases from poping up. I know the key is to heal her gut. The problem is, the info out there is so overwhelming. Also since her colon is gone the Drs tell me she needs to drink about 90 oz. of water a day. She has had problems with dehydration and ended up in ER a few times. Now I am wondering is she is drinking too much water? We found something that helps her stay hydrated and with B vitamins it helps her energy level. It’s called Zip Fizz, she calls it her life line. I have read the ingredients and there doesn’t seem to be anything bad but I am far from an expert. She eats hymilian sea salt a lot as well.

    Her other issue is she was tested positive for candida by her functional med dr we found after her surgeries. He has her on Sporonox and the candida diet. But I have been reading a lot about MANUKA HONEY and wonder if she should be using that even though high in sugar? Some people with jpouches have reported that it has helped the resolve and/or prevent POUCHITIS (inflammation/bacteria overgrowth of the pouch)

    Anyways, I am glad you were able to avoid surgery. I wish I had found your blog a year ago.

    My question:

    Does my baby girl have any chance at a healthy life without a colon? I can’t bear to think of her suffering forever. Do you have any suggestions? Will the grain free diet help her? Problem is that without her colon, high fiber vegetables go right through. Also worry about nutrient absorbtion. I read all about these different diets: anti-inflamatory, candida, lowfodmap, GAPS etc.. I just don’t know how or if they apply to my daughter since she has no colon.

    Sorry for the long post, I am at a loss. Theres no worse feeling than to think you have ruined your childs health forever. :(

    • says

      I can’t offer health advice in the comments, but I can tell you that your daughter sounds very blessed to have you as a mom. Please don’t think that you’ve ruined your daughter’s life, you – and her healthcare providers – were only doing the best you could do. That was my case, as well. The most heart-wrenching thing can be to look back to past situations and tell yourself, “I wish I knew then what I know now.” I’ve been there many times, but it only ruins the present and doesn’t fix the past. And I can say that I have two friends who have colectomies and they have fulfilling and joyful lives. They need to maintain a high level of attention to supporting their health, along with ongoing supplementation, and they accept that. Blessings and light to you and your daughter!

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