What is failure to thrive?

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My husband is not eating and sleeping a lot. He has multiple health issues. One doctor gave him that diagnosis.

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Low albumin leads to increased morbidity/mortality. The Albumin level reflects nutrition, along with low phosphorus.
Albumin is a high molecular weight protein in the blood. If the albumin is low, the person is more apt to have edema in their lower extremities. Maintaining a proper albumin level is important to decrease edema, as the high molecular weight of albumin draws fluid from the tissue (edema, lymphedema) called “ third spacing”, back into the blood stream decreasing the edema.
Normal Albumin is 3.5-5.5; lower than 3.5 means malnutrition. Lower than 3 is worse. You will see low Albumin in liver disease as well, thus fluid retention.
The med that increases appetite is Megace. It is given for one to two months only to improve appetite and usually works pretty well, especially in the elderly.
Low phosphorus levels reflect poor nutrition as phosphorus is in so many foods, if the phosphorus is low means the person is not eating. 
Sometimes you can turn it around - my DH was going through that this past spring.

I did a lot of research and started with a better Probiotic and learned about Candida Control. It doesn't try to kill the Candida (we need it) but it does control the overgrowth.  You clean out the gut and the appetite can come back.  There isn't a lot of information in the medical field but there is a lot of information available online.  (His doctor told me that they don't really know what to tell me for a 96 year old. So I turned to Google and Common Sense.)

Never give up until the last breath. I started giving him Barlean's Chocolate Silk Greens in his Hot Cocoa (he was still willing to drink that with ice cream).  The Hot Cocoa I made him (and still do) starts with heated Ensure Strawberry Plus as that is what the VA sends. It's all about cleaning out the gut and putting in nourishment. I calculated his Hot Cocoa to be 500+ calories after I added the instant cocoa and ice cream.  3 a day got him back on his feet.  He also wanted fish sticks, nothing but fish sticks - so I went to the store and bought fish sticks.

I did learn that if I didn't give him what he wanted, he wouldn't eat. So I gave him whatever he wanted and it was Hot Cocoa with ice cream and Fish Sticks.

He gets one 30-billion Probiotic (keep it refrigerated) and one Candida Support in the morning and another Candida Support at night as it calls for 2 daily. His son was here yesterday (he lives in another state) and he was amazed at the difference.   Candida Support is made by NOW and available on Amazon.

DH is 96 and some days the only thing he 'eats' is his Hot Cocoa with ice cream - but he's back to doing PT outside the house again. He walks with a rollator.

FYI, I don't skimp on the cocoa mix - he has a large plastic mug he likes and I use 1TBL Ghirardelli Premium and 2 TBL Nestles (the Nestles is cheaper) and along with the Ensure it makes for a meal. I must use thickener in it as he has Dysphagia which is a swallowing problem. One day he asked for it 4 times and I kept making it for him. I was 'told' to give him whatever he wants.

I learned the hard way; he won't eat what I want him to eat - he will only eat what he says he wants.

"It ain't over til the fat lady sings, and I ain't singing yet."
Exactly what you just stated: he is not eating enough to sustain life. Whatever his medical issue is, the disease process is naturally occurring and taking over his will to live. Or he may be on supportive therapy and not progressing. Trying to get him to eat or move about can be very frustrating for you. Plus as his muscles waste away, he will not be able to resume activities as previous. Have you been approached about Palliatve or Hospice care?
Garden Artist
I'm sorry. I can't remember. He had an excellent internal med doctor who did all the blood work and explained about the albumin. This was in the 90s so a few years ago. We were told to provide him anything he would eat. His favorite was a vanilla malt ( not a milk shake-lol).
He was recovering from a severe skin disorder that required him to take very harsh medication that not only killed his appetite but gave him med induced diabetes. That I remember was Prednisone. Part of a cocktail of drugs to knock out the skin disorder. We were told to ignore the diabetes (which went away when the treatment was over) and offer him anything he would eat.
His dermatologist found this new internal doctor for us who focused on the weight loss. He was three hours away but amazing.
He introduced me to the concept of working with HH for blood tests instead of doctor visits which were hard on someone like my dad. I also decided then to go to the best doctor regardless of the distance and not to the most convenient. I discovered that no matter how great the doctor, the staff and the associated hospital were just as important and of course the right insurance plan.
My dad was such a success story that all the staff would turn out to get a look at how well he was doing when we made our annual visit.
We also started dad on a solid breakfast. Eggs, oatmeal, toast or biscuits and fruit. This really helped as well. He was very malnourished. He was so weak when we took him to the first visit he couldn't stay in his seat without sliding down out of his seatbelt. His ankles were weeping which I learned can be a sign of the albumin not being at the correct level.
Sorry I no longer have that information. I would like to know myself. He died in 2005 a month shy of 90. So he lived about seven years after that episode and was very active for most of that time.



I've heard this term used when an infant didn't gain weight inspite of taking formula or breast feeding. Sometimes the baby would lose too much weight. Usually additional nutrient was added.
My dad was once told this when his albumin tested low and he was losing weight. After "fattening " up his diet and adjusting his meds ( including a med to increase his appetite) his weight went up along with his albumin levels.
In elderly patients, failure to thrive describes a state of decline that is multifactorial and may be caused by chronic concurrent diseases and functional impairments. Manifestations of this condition include weight loss, decreased appetite, poor nutrition, and inactivity.Jul 15, 2004
Wow! I just checked phosphorus foods and learned that most of the foods he used to eat are now ver boten b/c of the dysphagia diet. (pumpkin seeds, grains, nuts, cheeses....) However, I did find a few that I can add in higher quantities - beans and salmon being two.

I feel like I've just been enlightened, and am so appreciative of your input.
97YearOldMom and Shane, thanks for the excellent insight into this issue of failure to thrive, which is more complex than I realized.

I think I need to create a chart with contents of various "elements", such as albumin, to figure out if my father is getting enough. He's been malnourished for a few years but the only recommendations thus far are to take Boost or Ensure Plus.

Your posts and insight have made me open my eyes. Perhaps there's much more going on with Dad, and it's complicated by the limited dysphagia diet he's on.

Your posts are also a reminder why I have little respect for PCPs. We saw the PA of a new one a month or so ago. She noted the emaciation, but said nothing about blood work, just noted that he had declined (which depressed him), and ordered home care to establish a baseline for Palliative Care (good move though).

I need to get my best Sherlock Hat (no pipe, though) and figure out what's going on.

Thanks to both of you. I'm copying your posts for future reference on this issue.
97YearOldMom, would you mind telling me which med was used to increase appetite? I'm generally opposed to adding meds, but if it could help my father's appetite, I'd be interested.

Thanks for the mention of albumin; I'm going to check that out.
Such helpful posts (that didn’t have any Thumbs Up yet..?!) Thanks from me too for this info, hadn’t heard albumin discussed and I'm really glad to know!

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