Topic Explanation:

The forum discussion revolves around a user who has been living with an ileostomy and a "Barbie butt" for over 13 years. Despite not having skin issues, they are struggling with fatigue and low energy due to inconsistent vitamin D and iron levels. They cannot tolerate oral supplements and rely on infusions, which are slow to arrange and take time to improve their levels. This cycle has been ongoing, affecting their ability to engage in daily activities and maintain a positive outlook.

Advice and Insights:

1. Supplement Alternatives:
- Consider gummy vitamins, liquid drops, or gel capsules as alternatives to traditional supplements.
- Sublingual supplements for vitamin D and iron can bypass the digestive system and may be more effective.
- Ferrous gluconate is suggested as an alternative to ferrous sulfate for better absorption.
- Sucrosomial iron, such as SiderAL Forte, is recommended for those who cannot tolerate traditional iron supplements.

2. Diet and Lifestyle:
- Increase intake of red meat and cook with a cast iron pan to boost iron levels.
- Spend more time in sunlight to naturally increase vitamin D levels.
- Maintain a varied diet to ensure a broad intake of vitamins and minerals.

3. Medical and Professional Support:
- Seek a second opinion or change doctors if current medical advice is not effective.
- Consult with a dietitian for personalized dietary advice.
- Ensure comprehensive micronutrient testing to identify deficiencies accurately.

4. Additional Supplements:
- Consider vitamin B12 injections if absorption is an issue, especially if parts of the intestine have been removed.
- Explore magnesium supplements to support energy levels and overall health.

5. Mental and Emotional Well-being:
- Engage in activities that boost motivation and mood, such as listening to uplifting music or creating a daily "To Do" list.
- Consider low-dose antidepressants as a last resort for mood enhancement.

6. Hydration and Electrolyte Balance:
- Use products like Vidrate to maintain electrolyte balance and hydration.

7. Community and Support:
- Engage with support groups and forums for shared experiences and advice.
- Consider the companionship of a pet to encourage physical activity and emotional support.