Well, here's the latest update in the diet wars. This one is cautiously optimistic. I think that the key to Michael's fatigue is all about carbohydrates... not enough of them. I was so convinced that this couldn't really be the problem that the fact of the matter is that I didn't listen well about this. But I think it is. It takes him a LOT of energy just to move around. Protein and fat are not quick-access energy sources. Carbs are. I started reading a pile of the symptoms related to insulin resistance and low blood sugar and so on, plus some anecdotal stuff, and I think I put it all together, and to me, the big short-term answer is fruit. We can't go back to the bread and grain and so on for quick energy, for a thousand reasons, but he has to be able to get more quick energy to give the protein and slow carbs time to kick in.
So for the last few days, we've been eating a diet that I'd call more paleo. No grains, etc., minimal dairy (we both seem to tolerate minimal dairy well... and hey, if there had been a cow wandering on the steppes, you'd have milked it before you ate it, wouldn't you?), and he gets a little low glycemic fruit with every meal (berries and melon and the occasional apple, which is not so low-glycemic but better than tropical fruit). I'm eating very little of the fruit, but the payoff for me in this is that I'm not eating a lot of cheese, something that is easy for me to greatly overconsume.
And so far... my weight is actually a little lower. His weight is a little lower, too, but that's just today. His blood sugar readings are pretty ok. Mine (we've been testing me, too, just for the hell of it...) are a little weird, though, and I don't much want to think about that at the moment. And the plus... he's feeling BETTER. Not so fatigued. Not all the way to feeling great, but he's been more like himself the last few days than in ages.
This all seems hopeful.