Problem Facets

My ability to sleep and maintain cognitive function is directly tied to my dietary adherence. I cannot sleep through the night, or sometimes even fall asleep, unless I am very full of protein. If I miss one of my protein meals during the day and do not make it up before bed, I wake up hungry and am unable to return to sleep until I consume another large portion of protein.

When I wake hungry due to insufficient chicken intake, I experience profound physical restlessness, akin to a deep nervous system shakiness. If I try to push through the day without addressing this, I often become ill within 1–2 days and experience severe cognitive disability, including:

• Difficulty focusing
• Memory gaps (e.g., believing tasks were completed when they were not)
• Challenges reasoning through problems
• Trouble speaking clearly, often stumbling over words despite normally being articulate

The only remedy when waking hungry is to eat at least one large protein serving and go back to sleep, which can often be difficult. This means that if I fail to meet my protein quota and wake hungry, I usually need a total of approximately 12 hours between going to bed, waking, prepping food, eating, and sleeping again, before I am functional again.

I follow a highly restrictive diet due to specific needs. I generally consume 4–5 lbs of boiled chicken breast daily, divided into 3–4 large meals (each 1.25–1.5 lbs pre-cooked weight). These meals are topped with a small amount of zucchini or fennel soup for minimal plant fiber and liquid. After years of experimentation, I have found that this narrow diet is the only way to maintain metabolic stability.

For years I have tried substituting other proteins, complex carbs, simple carbs, and a variety of vegetables. However, these substitutions often interfere with my ability to eat enough protein throughout the day, as they do not provide the same metabolic stability or are not as tolerable in the necessary quantities. This makes it difficult to meet my dietary needs, ultimately compromising my health. See Allergies for more details on restrictions.

I always had allergies growing up (sesame always gave me a sore throat, whole wheat bagels always gave me a stomach ache, during adolescence I became allergic to dairy) but could generally eat freely. As this digestive distress has worn on, I have become increasingly reactive to almost all foods. I used to love and happily eat green curry, but no longer tolerate coconut milk, eggplant, or almost any level of heat. I am especially reactive to raw vegetables and leafy greens — see In-depth History — as I believe this is related to the onset of my condition.

I seem to be able to tolerate chicken, tuna, light amounts of olive oil, avocado oil, minimal butter, eggs, zucchini, fennel, rice flour, oat flour and flax seeds, well-cooked onions (sometimes), and several spices (turmeric, oregano, thyme, cumin, coriander, and bay leaves).

There are a few other things I can eat, but mostly I react negatively and my diet is consistently just the above list. Reacting negatively means mostly a lot of intestinal swelling and bloating. Even in the case of things that I tolerate, if they are not chicken or tuna, they do not fundamentally sate me, and I will wake hungry if eating them over-fills me and prevents me from meeting my protein quota (e.g. eating zucchini and rice pasta and not enough chicken breast at a meal). Sleep and Cognition explains the main mechanism of wakefulness that prevents me from deviating from my diet.

The huge protein intake I am forced to maintain results in high uric acid levels in my urine and blood. Sustained uric acid levels in the blood are a concern as they can lead to gout, kidney stones, kidney disease, cardiovascular risks, metabolic syndrome, tophi formation, and increased risk of type 2 diabetes.

The high uric acid levels in the urine have led to the formation of many kidney stones, notably resulting in a hospitalization and laser lithotripsy in 2018, and then again in 2024. The 2024 incident also involved an emergency nephrostomy and multiple follow-up procedures, the severity of which was the impetus for the creation of this document.

I can only sleep on my right side. I wake hungry when sleeping on my left side or back. This is mitigated somewhat by NSAIDs, especially at higher doses. L-Glutamine supplementation also seems to mitigate this.

While seemingly trivial, this has begun to cause a lot of issues in my right shoulder, since it is so difficult to sleep in any other position and 8 hours a night is a lot on the same shoulder every night — particularly given the difficulty of introducing effective exercise interventions given my other constraints.

During moments when I was medicated and could sleep in other positions, the positive impact on my spinal health and reduced shoulder pain was very noticeable.

I have consistent infections on my skin that appear to be autoimmune related, on each of my upper lips, which I believe is a result of my skin reacting to some saliva released in the night. I also have strange skin issues starting on both of my cheeks on either side of my nose. Also, on any part of my body covered with hair — primarily my scalp and beard — I have chronic fungal infections. I'm not sure that they're fungal, but I believe them to be, because there is a fungal smell and antifungal creams give minor relief while applied.

These infections are most pronounced near my chin and on my scalp, and can be improved with sun exposure and keeping the hair short, but even with that there is constant flaking, and I have had multiple staph infections on my face when my facial hair has gotten too long, which I believe is because the immune system is run down from the constant over-stimulation.

The parts of my beard where the infection is most rampant (chin) have turned completely white. I believe this is a form of alopecia where the pigment-creating cells have been destroyed.

I also suspect a candida overgrowth in my gut (as with the skin issues, I suspect these are related to undigested sugars). Taking antifungals (both prescription and herbal, like goldenseal) mitigates this in the short term, making my digestion feel more stable and lessening the intensity of skin infections, but they have not had a lasting impact.

My body does not recover successfully from any but the lightest exercise. The most sustainable form is long, sustained, solid-state cardio (long walks, very gentle hiking).

This is very inefficient and makes it challenging to incorporate effective forms of exercise into my routine.

More muscular forms of exercise (e.g. regular crunches, lifting, etc.) often result in an outsized inflammation response, especially in the gut, making it impossible for me to get full, meet my protein quota, and recover effectively at night.

In the 18 months following my increased protein needs in 2022, the lack of time to support longer-form, walking-type exercise, coupled with chronic extreme exhaustion, has resulted in a marked decline in my musculoskeletal health, resulting in chronic numbness, unstable vertebrae, and, in one case, weeks of extreme pain and discomfort when my back went out. Weeks of PT helped to an extent, but the core issue is one of time and stamina, which I am finding it difficult to resolve under the constraints of my increased protein intake.

I have been prone to soft tissue injuries throughout my life. This began most notably with fallen arches, which have caused significant kinetic chain problems on my right side. I have since sustained small tears of the gastrocnemius tendon near the knee, along with recurring, unexplained soft tissue injuries in my back.

These injuries frequently arise from minor overuse, without any notable precipitating incident, and can result in a week to several months of disability, with tearing, swelling, and scar tissue formation.

I am extremely light sensitive, particularly around sleep. I am unable to sleep in rooms with any but the most minimal light. Even with an eye mask and most of my body covered by blankets, I will wake if dim LED lights come on in the space. Applying topical magnesium spray before bed has mitigated this slightly, but I still find it necessary to travel with blackout curtains that I can attach in any room I need to sleep in.

When I travel I fly with 3 large suction-cup blackout curtains, because I am otherwise unable to sleep well past dawn in any well-lit room.

The knuckles of my hands become dark and harder. This seems to correlate directly with how often I'm waking up in the middle of the night. I have heard at some point that this can be a sign of insulin resistance, but I have been unable to find the source.

As of September 19, 2026: blood pressure runs chronically elevated, typically in the low-to-mid 140s systolic (commonly around 143, occasionally as low as 137). During periods of acute stress, systolic readings as high as approximately 200 have been observed.