Does it make sense to consult a nutritionist without a specific question?

All of those questions do pop up from time to time and I'd think most nutritionist would have come across them. So you might be able to get some help.

That said, I have periodic wolf hunger myself, and had I been my own patient as a dietician I would likely not have found anything "wrong" with the diet per se. Not with the diet I had when I had hypoglycemia either. For me I think there is some need for a compound in the body that is not being met when the wolf hunger occurs (I only had hypoglycemia the first year or so I had symptoms, then it went away), but no idea what exactly that need is. I feel best on high protein diet, which may be a clue for my own part, but know others who do well on low-carb diets that would cause me to crash..

 

The way I'm thinking about my own diet and metabolic health, is that the high protein diet is likely providing me with some nutrients that help keep some functions running. Possibly a metabolic backup system of sorts, like how the body prefer to use simple glucose as energy, but can also break down fatty acids and/or protein when necessary like when fasting. Some patients groups are advised to avoid fasting since their body's are unable to cope with the additional load of having to maintain glucose levels. I have wondered if it's something similar with me/us though it's not as extreme as say someone with liver problems or a very faulty fatty acid oxidation system.

My glucose levels are fine so I don't think it's a failure to maintain glucose like in the aforementioned examples, but maybe the extra energy required to do so is triggering PEM. Who knows. Wish we had timeseries metabolomics studies when performing a metabolic and/or exertion challenge.

I haven't calculated the percentage of energy from protein in a while, but I'm fairly certain it is >20% of my energy even on days where I'm not trying to eat a lot of protein simply due to the food choices I make. Most countries advocate for protein intake to be 10-20% of total energy intake, or 0.8g/kg body weight. The 20% is mostly for the elderly, so younger people would be advised to be at the lower end.

 

I don't know whether there is a difference between nutritionists and dieticians where you live.

As I understand it in the UK, dieticians are the fully qualified and registered people who work with individual patients with a health problem that needs changes to diet, supplements etc.

Nutritionists don't have to be registered and can have any or no qualifications. They work more on public health and healthy eating advice to maintain good health etc.

I would assume therefore that, at least in the UK we would want to consult a dietician for indivual analysis of and advice on our diet.

 

I think they're interesting, but at least where I am it is not something the dietician orders, we help with adjusting the diet to work around a metabolic problem while still getting the nutrients required. It's been a while since I was reading about these tests and I am not sure how they would be used in clinical practice except for well known metabolic disturbances.

This is difficult to answer. In my own experience as a patient trying to figure out what is going on, then there seem to be a lack of such tests.

I've had celiacs or pwIBS (possible to be screened for those) with similar questions, and the general answer has really been that we don't know exactly what is going on, and then trying to modify the diet if there are any potential causes that can be found. Typically to look at fibre, protein and fat intake to see if this can contribute to not feeling full or any triggers for hypoglycemia and/or change in stools. Two persons can have the same diagnosis and follow a similar diet, but may respond differently and we don't know why.