I'd appreciate advice on helping me figure out next steps in my health promotion:
Postmenopausal, 11 months of paleo: gluten-free, no added sugar/processed food products, restricted carb diet. Protein intake between .5-1gm/kg. Butter and olive oil were fat sources with recent addition of coconut oil. I eat homemade full fat yogurt, use the whey in main dishes, and eat cheese without ill effects.
My BMI has dropped and stayed put at about 21.7, with body fat about 16.5%. My HbA1c is 4.9, fasting bgs run 77, and post prandial bg's stay below 120. Trig 49, HDL 85, tot chol 220, so no worries there.
My next issue is to try to determine how much more weight and body fat I can lose to minimize significant chronic pain with flares from lumbar spinal stenosis (multiple injuries since teen years from lifting and turning patients, doing farm chores, etc), newly dx hip osteoarthritis, old knew osteoarthritis, and very painful arthritis in base of thumb.
I walk around 8 mi/day (hand carry 20+ lbs 3-4x/wk), have tried yoga - love it but realize that I need a teacher or partner in order to do it, am on a wait list to learn Tai Chi, and otherwise, do not engage in any other activities.
My sleep is horrible. At night, 3 hours total broken into two or three "naps" is the norm, and at least once a week, I don't sleep at all. I have impeccable sleep hygiene, have tried various meds and supplements, used IF, re-timed meals, re-timed activity, etc. and nothing has made the slightest difference.
I also have very poor learning, attention and concentration, which I attribute in large part to sleep deprivation. I'm pretty sure I'm keto adapted.
I take no meds, prescription or otherwise, as NSAIDs, transdermal hormone therapy, sleep meds, non opioid pain meds, etc have failed to bring any relief for any of the above issues.
Hot and cold therapy haven't helped with pain or relaxation into sleep, either.
Can someone help walk me through figuring out what else I might try? Thanks so much-