Dealing With Possible Reactive Hypoglycemia--One Month Later
I wanted to give you a quick one-month update on my progress dealing with a possible case of reactive hypoglycemia (although my symptoms don't match the definition of this condition found on Wikipedia). This seems like an incredibly odd subject to be talking about as someone who has been faithfully livin' la vida low-carb for the greater part of the past 4 1/2 years. How can a low-carber be dealing with something like this when a low-carb diet is supposed to be one of the best diets for stabilizing blood sugar levels and, more importantly, reducing insulin levels?
As you know, I've been speaking with noted New York City low-carb doctor Dr. Keith Berkowitz who has been the only low-carb expert I've ever heard even talk about this phenomenon. His theory about reactive hypoglycemia for long-term low-carbers who have lost a lot of weight (like me!) seems to be valid on the surface (I'll be conducting a follow-up podcast interview in mid-July with Dr. Berkowitz to answer a TON of questions that you have submitted for him to answer). But something very odd has been happening with my blood sugar levels and that even includes after I've consumed a VERY high-carb meal.
You'll recall last month I did an experiment where I splurged out on some pizza to test what would happen to my blood sugar since eating a "normal" low-carb meal produced a significant DROP in my blood sugar. I couldn't believe it was possible for your blood sugar to go DOWN after a meal, so I forced the issue by consuming more carbs in one sitting than I had done since I started livin' la vida low-carb in January 2004.
The result? My fasting blood sugar of 91 actually DROPPED to 90 when I checked it one hour after eating (WOW!) all those slices of pizza, it finally rose to 100 by the second hour, and was back down to 98 by the third hour after this extremely high-carb meal. It was quite an illuminating self-experiment that had me scratching my head about what the heck was going on. I have been spending a lot of time over the past month trying to figure this out and I'm still perplexed about it.
On the advice of Dr. Berkowitz, I implemented several strategies for dealing with this as well as the coinciding slight weight gain that seemed to happen at the same time I started resistance training beginning in December, including eating lots of small meals about every couple of hours (see my menus blog), getting adequate quality sleep, continuing with my exercise routine including my weight training, and trying to lower the stress in my life by taking more breaks from my work. When I started this I weighed 274 pounds and today I weighed 262.
Although it has been moderately successful with bringing my weight down, I can see the numbers starting to stall out again as of late and I can't help but go back to what is happening with my blood sugars again. Could this have something to do with my weight being elevated? Did the creatine I took in the first six weeks of my weight training impact my blood sugar levels and get 'em all messed up? The honest answer is I don't know.
Since I have been doing this new routine for about a month now, I decided this morning to check my fasting blood sugar level and then several more times in the hour following a typical low-carb breakfast meal of eggs and sausage. This was a little larger meal than what I've been eating as part of my new "small" meals strategy, but not that much bigger. When I checked my blood sugar at 8:00am, the reading was 93 which is exactly where it should be after a night of fasting. So far, so good.
At 8:15am, I had that delicious egg and sausage meal that took me about five minutes to consume. At 8:20am, just after finishing my meal, I checked my blood sugar again and it had already dropped seven points to 86. Curious about this sudden drop, I then checked my blood sugar level again fifteen minutes later at 8:35am and it had jumped UP to 102. Hmmmm, now this was interesting. That made me want to see what would happen in fifteen more minutes at 8:50am and my blood sugar was back down to 92 again. For kicks, I measured it two more times at 15-minute intervals at 9:05am and 9:20am and my blood sugar was 89 and 92 respectively. I stopped measuring because it was almost time to eat again.
So what am I to make of all of this? Had I only checked my blood sugar after one hour as is typical, then I would have seen virtually NO change in my blood sugar. But doing this today in 15-minute increments was quite educational. It seems my blood sugar reaction is happening faster than normal which could be a good thing or a bad thing. Perhaps my body has become super-efficient at processing the foods I consume so there is no major impact on my blood sugar. Granted, my meal was virtually ZERO carbs, so the reaction should have been minimal.
Next week I'll be going back to see my low-carb doctor to have a blood glucose tolerance test run. They will be checking not just my blood sugars, but also my insulin levels after drinking a big glass of sugar water. This will be the tell-tale sign of what is happening to me and I'm curious about the insulin. Will it be off the charts which could explain why my blood sugar DROPS after a high-carb meal? If so, then what can be done to control this insulin release since I'm already livin' la vida low-carb. You will be the first to know these results as soon as I get them back and analyzed. We will figure this out together because this could help so many people.
I'll also be having a few more tests run just to check on them as possible culprits in this. My thyroid is fine based on the previous tests that were run at my last visit. So it's not that. The human body is a complex machine and sometimes it just takes time working through all the tests to come up with the answer. We are all different and there are any number of reasons that can explain what is happening. I just want to know THE reason. Is that too much to ask? :)
The good thing is I'm not in any pain because of what is happening. Other than the added weight, my quality of life is pretty normal. I'm still very active playing volleyball, lifting weights, shooting basketball with the middle school-aged girl across the street, mowing the grass, etc. Life continues on despite all of this. And that's my attitude about it right now--just keep on keepin' on and not worry about it. Worry produces cortisol which is a nasty stress hormone that can cause problems similar to insulin. It too could be an issue, so I'm gonna have it measured as well.
THANK YOU to everyone who has been following my story with this blood sugar thing with great interest and concern. I appreciate your comments and e-mails in support for me as I go through this. What I've found is I'm not the only one dealing with this and that's comforting in and of itself. In a way, I'm glad this is happening to me because I get to see what it's like to struggle somewhat. And I'll be danged if I let this thing beat me up and defeat me. I'm stronger than it is and I WILL prevail over it through the strength of the Lord and by the wisdom of the doctors who are overseeing my progress.
Let me encourage you to NEVER GIVE UP in your pursuit of health because it is the best thing you could ever do for yourself. When I weighed 410 pounds and was on a one-way ticket to the graveyard just a little over four years ago, I didn't feel like I'd ever find the hope to become that man I was intended to be. But today I stand before you a changed man and proud to say by the grace of God I am better off than I was back then.
While I may be having some tough times right now, I KNOW this situation is NOT impossible. There is an answer and I'm gonna keep searching for it until I find it. There's no going back to unhealthy eating ever again no matter how hard it gets. That's what my brother Kevin chose to do with his life and now he has less than a year left to live. It was his personal choice just as we all have that decision to make for ourselves. You can NEVER go wrong choosing to do something positive for your health.
MAKE THAT HAPPEN today and you'll reap the benefits of it for many years to come. Keep at it and whatever you do--NEVER GIVE UP!!! YOU are worth it and the best is yet to come. Make us all proud by doing the things you have to do to shed the pounds and improve your health. YOU CAN DO IT!!!
7-2-08 UPDATE: Last night I received a telephone call from a nutritionist who used to work with the Atkins Center back when Dr. Atkins was still around. She wanted to know how she could help me with this hypoglycemia issue I seem to be dealing with. I told her what was happening even after a low-carb meal and she brought up something I hadn't really thought much about before, but it makes sense. She said that perhaps my body is converting most of the protein I am eating (and I do eat a rather moderate amount of protein) into sugar/carbs through gluconeogenesis which is producing an insulin response.
So, despite the fact I am eating low-carb meals, the protein makeup of those meals could, in essence, be tantamount to eating carbohydrates. That sounds so messed up on surface value, but apparently my body must be extra sensitive to the protein I am consuming if it is doing this. I don't know for sure if that's what is happening, but it's the best theory I've heard yet.
So next week I am getting a glucose tolerance test (GTT) run and several people have said I need to eat upwards of 150g carbs daily in the few days leading up to test. I'd never heard of this, but apparently it was pretty well-known so you don't skew with results that you are looking for. I asked my low-carb doctor about this and here was his response:
Maybe...maybe not. It depends upon the question that we want to answer.
If you want to compare your results to what is thought to be the "normal response," then yes, carb eating would be good.
However, if you want to figure out what is happening to you after eating a low-carb meal (to look into this low blood glucose issue when eating low-carb), then no extra carb eating is needed.
We can start the test after you eat a low-carb breakfast. I also want to check the insulin at each time point to assess the pancreas response.
Don't I want to know what's happening after a low-carb meal or is it more beneficial to do a standard GTT? I'm open to your input about this. If I'm gonna do the standard, then I need to start eating a few more carbs beginning on Friday leading up to the Monday morning test.
As you know, I've been speaking with noted New York City low-carb doctor Dr. Keith Berkowitz who has been the only low-carb expert I've ever heard even talk about this phenomenon. His theory about reactive hypoglycemia for long-term low-carbers who have lost a lot of weight (like me!) seems to be valid on the surface (I'll be conducting a follow-up podcast interview in mid-July with Dr. Berkowitz to answer a TON of questions that you have submitted for him to answer). But something very odd has been happening with my blood sugar levels and that even includes after I've consumed a VERY high-carb meal.
You'll recall last month I did an experiment where I splurged out on some pizza to test what would happen to my blood sugar since eating a "normal" low-carb meal produced a significant DROP in my blood sugar. I couldn't believe it was possible for your blood sugar to go DOWN after a meal, so I forced the issue by consuming more carbs in one sitting than I had done since I started livin' la vida low-carb in January 2004.
The result? My fasting blood sugar of 91 actually DROPPED to 90 when I checked it one hour after eating (WOW!) all those slices of pizza, it finally rose to 100 by the second hour, and was back down to 98 by the third hour after this extremely high-carb meal. It was quite an illuminating self-experiment that had me scratching my head about what the heck was going on. I have been spending a lot of time over the past month trying to figure this out and I'm still perplexed about it.
On the advice of Dr. Berkowitz, I implemented several strategies for dealing with this as well as the coinciding slight weight gain that seemed to happen at the same time I started resistance training beginning in December, including eating lots of small meals about every couple of hours (see my menus blog), getting adequate quality sleep, continuing with my exercise routine including my weight training, and trying to lower the stress in my life by taking more breaks from my work. When I started this I weighed 274 pounds and today I weighed 262.
Although it has been moderately successful with bringing my weight down, I can see the numbers starting to stall out again as of late and I can't help but go back to what is happening with my blood sugars again. Could this have something to do with my weight being elevated? Did the creatine I took in the first six weeks of my weight training impact my blood sugar levels and get 'em all messed up? The honest answer is I don't know.
Since I have been doing this new routine for about a month now, I decided this morning to check my fasting blood sugar level and then several more times in the hour following a typical low-carb breakfast meal of eggs and sausage. This was a little larger meal than what I've been eating as part of my new "small" meals strategy, but not that much bigger. When I checked my blood sugar at 8:00am, the reading was 93 which is exactly where it should be after a night of fasting. So far, so good.
At 8:15am, I had that delicious egg and sausage meal that took me about five minutes to consume. At 8:20am, just after finishing my meal, I checked my blood sugar again and it had already dropped seven points to 86. Curious about this sudden drop, I then checked my blood sugar level again fifteen minutes later at 8:35am and it had jumped UP to 102. Hmmmm, now this was interesting. That made me want to see what would happen in fifteen more minutes at 8:50am and my blood sugar was back down to 92 again. For kicks, I measured it two more times at 15-minute intervals at 9:05am and 9:20am and my blood sugar was 89 and 92 respectively. I stopped measuring because it was almost time to eat again.
So what am I to make of all of this? Had I only checked my blood sugar after one hour as is typical, then I would have seen virtually NO change in my blood sugar. But doing this today in 15-minute increments was quite educational. It seems my blood sugar reaction is happening faster than normal which could be a good thing or a bad thing. Perhaps my body has become super-efficient at processing the foods I consume so there is no major impact on my blood sugar. Granted, my meal was virtually ZERO carbs, so the reaction should have been minimal.
Next week I'll be going back to see my low-carb doctor to have a blood glucose tolerance test run. They will be checking not just my blood sugars, but also my insulin levels after drinking a big glass of sugar water. This will be the tell-tale sign of what is happening to me and I'm curious about the insulin. Will it be off the charts which could explain why my blood sugar DROPS after a high-carb meal? If so, then what can be done to control this insulin release since I'm already livin' la vida low-carb. You will be the first to know these results as soon as I get them back and analyzed. We will figure this out together because this could help so many people.
I'll also be having a few more tests run just to check on them as possible culprits in this. My thyroid is fine based on the previous tests that were run at my last visit. So it's not that. The human body is a complex machine and sometimes it just takes time working through all the tests to come up with the answer. We are all different and there are any number of reasons that can explain what is happening. I just want to know THE reason. Is that too much to ask? :)
The good thing is I'm not in any pain because of what is happening. Other than the added weight, my quality of life is pretty normal. I'm still very active playing volleyball, lifting weights, shooting basketball with the middle school-aged girl across the street, mowing the grass, etc. Life continues on despite all of this. And that's my attitude about it right now--just keep on keepin' on and not worry about it. Worry produces cortisol which is a nasty stress hormone that can cause problems similar to insulin. It too could be an issue, so I'm gonna have it measured as well.
THANK YOU to everyone who has been following my story with this blood sugar thing with great interest and concern. I appreciate your comments and e-mails in support for me as I go through this. What I've found is I'm not the only one dealing with this and that's comforting in and of itself. In a way, I'm glad this is happening to me because I get to see what it's like to struggle somewhat. And I'll be danged if I let this thing beat me up and defeat me. I'm stronger than it is and I WILL prevail over it through the strength of the Lord and by the wisdom of the doctors who are overseeing my progress.
Let me encourage you to NEVER GIVE UP in your pursuit of health because it is the best thing you could ever do for yourself. When I weighed 410 pounds and was on a one-way ticket to the graveyard just a little over four years ago, I didn't feel like I'd ever find the hope to become that man I was intended to be. But today I stand before you a changed man and proud to say by the grace of God I am better off than I was back then.
While I may be having some tough times right now, I KNOW this situation is NOT impossible. There is an answer and I'm gonna keep searching for it until I find it. There's no going back to unhealthy eating ever again no matter how hard it gets. That's what my brother Kevin chose to do with his life and now he has less than a year left to live. It was his personal choice just as we all have that decision to make for ourselves. You can NEVER go wrong choosing to do something positive for your health.
MAKE THAT HAPPEN today and you'll reap the benefits of it for many years to come. Keep at it and whatever you do--NEVER GIVE UP!!! YOU are worth it and the best is yet to come. Make us all proud by doing the things you have to do to shed the pounds and improve your health. YOU CAN DO IT!!!
7-2-08 UPDATE: Last night I received a telephone call from a nutritionist who used to work with the Atkins Center back when Dr. Atkins was still around. She wanted to know how she could help me with this hypoglycemia issue I seem to be dealing with. I told her what was happening even after a low-carb meal and she brought up something I hadn't really thought much about before, but it makes sense. She said that perhaps my body is converting most of the protein I am eating (and I do eat a rather moderate amount of protein) into sugar/carbs through gluconeogenesis which is producing an insulin response.
So, despite the fact I am eating low-carb meals, the protein makeup of those meals could, in essence, be tantamount to eating carbohydrates. That sounds so messed up on surface value, but apparently my body must be extra sensitive to the protein I am consuming if it is doing this. I don't know for sure if that's what is happening, but it's the best theory I've heard yet.
So next week I am getting a glucose tolerance test (GTT) run and several people have said I need to eat upwards of 150g carbs daily in the few days leading up to test. I'd never heard of this, but apparently it was pretty well-known so you don't skew with results that you are looking for. I asked my low-carb doctor about this and here was his response:
Maybe...maybe not. It depends upon the question that we want to answer.
If you want to compare your results to what is thought to be the "normal response," then yes, carb eating would be good.
However, if you want to figure out what is happening to you after eating a low-carb meal (to look into this low blood glucose issue when eating low-carb), then no extra carb eating is needed.
We can start the test after you eat a low-carb breakfast. I also want to check the insulin at each time point to assess the pancreas response.
Don't I want to know what's happening after a low-carb meal or is it more beneficial to do a standard GTT? I'm open to your input about this. If I'm gonna do the standard, then I need to start eating a few more carbs beginning on Friday leading up to the Monday morning test.
Labels: blood sugar, health, Jimmy Moore, Keith Berkowitz, low-carb, reactive hypoglycemia, weight loss
posted by Jimmy Moore at
6/30/2008 09:14:00 PM
47 Comments:
How many carbs are you having daily? Do you think we low carbers need to high-carb occasionally? See Mark's latest post:
http://www.marksdailyapple.com/dear-mark-ketosis/
Hi Jimmy,
I hope you get it all figured out! So just a heads up about the upcoming GTT with insulin. Be sure to ask the doctor about what kind of diet he wants you following for the 4 days preceeding the test. Dr. Atkins said that you needed to consume about 150carbs minimum for 4 days preceeding the test in order not to skew the results. I would assume that is still the case these days?
Good luck!
Hiya Jimmy!
I have been following your daily menus and blogs, and wish you great success with figuring this situation out! :)
I was just wondering... have you tried checking your blood sugars after you eat the bars or SF items? I would be interested in seeing the results.
Have you ever tried the Zero Carb approach? I never have, but have been reading about it recently on the forums.
Thanks,
Kathy in TX
THANKS Kathy! My BS right now is already so erratic, so I'm not sure what purpose it would serve to test after eating the low-carb bars. Until I can eat eggs and sausage without my BS going crazy, I don't think measuring it any other time is gonna show anything. No, I don't think a zero carb approach is right for me. There are others who enjoy it, but I like the phytonutrients I get from eating salad greens and non-starchy veggies.
Pooti, the doctor who subscribes low-carb diets for his patients, didn't mention anything about this. But I'm curious what purpose this carb-loading serves...doesn't make any sense to me.
Sue, my carbs stay pretty low--less than 40g daily. I never read anything from Dr. Atkins that talked about carbing up--EVER. That just doesn't make sense to me since the objective of low-carb living is to keep your body's chemistry in balance. Introducing sugar/carbs to my body is NOT good.
Hi Jimmy, you would need to ask the lo carb gurus such as Dr. Mary Vernon that question. She mentions it in the Diabetes Revolution book and so did Dr. Atkins in DANDR. Also Dr. Bernstein talks about that. As I understand it, it has something to do with an inaccurate response to 100g of glucose when the body isn't used to consuming that much glucose. But that's about all I understand. I just know that all the experts recommend it so that your test is accurate.
Also, the reason to test a bar is because any meal you put in your mouth will react differently because it has a different balance of macronutrients associated with it. For me, my body treats sugar alcohols exactly like it treats regular sugar so the sugar free candy just doesn't work for me. Dreamfield's pasta also acts on me just like regular pasta, it just acts at about 3-4hours instead of at 90 minutes to 2 hours post prandial. I use blood sugar testing to verify whether or not I'm going to have a problem with a particular food or meal.
Again, I've never heard of that before, pooti. My doctor is one of the leading low-carb physicians in the United States, so he knows best about the GTT.
As for the bars and testing, I understand all of that. But when my BS response is abnormal like it is right now, what purpose does it serve? Remember my pizza binge? My BS DROPPED after eating 350g carbs, so not much would be revealed after eating a bar. See what I mean? :)
Jimmy,
I found this in the Mary Vernon book Atkins Diabetes Revolution. It is pretty much a repeat of what Atkins said in DANDR:
Atkins Diabetes Revolution Page 62:
Preparing for the GTT:
For the results of your oral glucose tolerance test to be accurate, you will need to start preparing a few days in advance. The test is only accurate if you've been eating 150 or more grams of carbohydrate a day for several days running. Of course, if you're following the standard American diet, you're eating that much and more and you won't have to change your diet to prepare for the test. If you've been following a low-carbohydrate eating plan, however, you'll have to go off it and eat at least 150grams of carbs each day for four days. Is that a reason to eat a whole bunch of jelly doughnuts? No way. Use those carb grams on the best possible foods, such as whole grain breads, fruite, potatoes, legumes, and starchy veggies. Spread the carbs evenly across your meals and eat them with foods that contain protein and fat.
Before the test, you must fast for 12 hours. It's okay to drink as much water as you want during this time. You'll also be able to drink water during the test, but you won't be able to eat (or smoke). Some prescription medications, such as thiazide diuretics, beta-blockers, oral contraceptives, steroids, and some psychotropic medications can affect the results of your test. Be sure to tell your doctor about all your medications in advance and discuss whether any will affect the test.
Doing The GTT:
As we just discussed, if you are currently restricting carbs, to ensure accurate results on the glucose tolerance test, you'll have to prepare a few days in advance by eating more carbs. The GTT has three components: It measures blood sugar levels, insulin levels, and the present or absence of sugar in the urine. The first blood sample, taken before you drink th eglucose solution measures what's called your baseline fasting blood sugar and insulin. A urine specimen is also tested for the presence of glucose. It is then up to your doctor's discretion whether to give you the glucose drink or proceed instead wiht a post prandial test (see page 71 for more on that). Assuming it is ok to proceed, you drink a measured amount of a very sugary solution to test your body's response over the next five hours...
Hope this helps Jimmy!
THANKS for the info, Pooti! I'm calling my doctor today. :)
When you get done chasing all over those rabbit trails and your brain kicks back in and your carbohydrate addiction kicks back out, I think you will realize what a bunch of hogwash 'hypoglycemia' and eating all those small meals is. -- It is simply a guise for maintaining a lower level carbohydrate addiction on into infinity!
Break the addiction and eat good meals and forget about it!
You will lose weight and feel great! -- Maintain that addiction and you will lose!
Again, I've never heard of that before, pooti. My doctor is one of the leading low-carb physicians in the United States, so he knows best about the GTT.
I'm not pitooti, but Dr. Vernon has written about it and so has Dr. Eades - it has something to do with enzymes in the process of digesting sugars - when you low-carb for a period of time, you make less of the enzymes and thus, when you have a sudden load of carbohydrate (glucose solution) you wind up with potentially skewed results. I'm sure either Dr. Vernon or Eades would give more details in an email if you contacted them!
THANKS Regina! Already have. :)
Very inspiring post Jimmy!
All of the best, looking forward to read the follow ups.
Was wondering, maybe one can find a way to speed up that glyco...esis thing that turns the proteins into carbs/energy.
I wonder what would happen if you add even more dietary fat, maybe the secret is to add more fat and less proteine or anything that can turn into carbs/glucose hence causing a release of insulin and blood sugar levels drop. Ever tried that and testing ?
Oh and addition to the more-dietary fat, have you considered adding more vitra-nutrients, I mean really pushing the the chromium, l-carnatine, coQ10, alpha lipoic acid, biotin and those other blood-regulating nutrients ?
THANKS JayCee! I'm certainly not opposed to eating more fat and less protein than I am to see if it would make a difference. But that egg and sausage breakfast was pretty high-fat, low-carb so I'm not sure if it would accomplish much.
As for the supplements, I take many o those already as part of my healthy lifestyle. :) THANKS for your comments!
Someone mentioned adding more supplements, including ones I've been taking.
So I thought I'd report that I seem to have broken through a plateau (actually a slight weight gain) by going off all supplements. (I wasn't taking anything unusual.)
It's too soon to tell for sure (could be coincidence or something else) but I dropped a pound and a half after the first day I went off the supplements, three-quarters of a pound the next day, and another half a pound this morning so am now at my lowest weight for years. This is huge compared to what I consider good weight loss of 4-6 pounds a month.
I'm planning to add the supplements back one at a time to see what happens.
But it certainly couldn't hurt anyone to try going off their supplements for a day.
Actually, Susan, I went off of all my vitamin supplements for TWO WEEKS when I first started trying to deal with this weight gain a couple of months back. NO IMPACT. We looked at this and I was hopeful that's all it was, but that's not my issue. :) THANKS for sharing!
Hi Jimmy
Why not check with Dr. Bernstein on this? I know you have an outstanding physician who truly believes in low carbs but Dr. B is a diabetologist who not only believes in low carbs but also is an encyclopedia of knowledge when it comes to blood sugars.
Good luck.
BTW - Kevin is in our prayers.
THANKS lovinglife! But to be honest with you, Dr. Bernstein is VERY difficult to speak with. I tried interviewing him for my blog a couple of years back and it was an arduous task. I guess he thought I was anti-low-carb or something because he was quite antagonistic towards me. I'll take my chances with Dr. Eric Westman at Duke. Plus, I've contacted Dr. Mary C. Vernon about this, too, so we'll get to the bottom of it. THANK YOU again! :)
Your blood sugar looks awful stable to me. Since insulin promotes fat storage, is it possible that you're overly sensitive to insulin? I guess if that was the case, you'd pass your glucose tolerance test with flying colours, and your insulin levels would come in normal or low-normal. Hope you don't mind, I just find this stuff really interesting.
Jimmy, I assume that when you wrote that you went off all vitamin supplements, you were including minerals and other miscellaneous supplements such as fish oil, CoQ10, amino acids, etc.
Also, don't forget that many commercial products such as bars and protein drinks are fortified with all sorts of vitamins and minerals, etc. So if you really want to get off all supplements, you need to check labels.
Oh, it was so hard, Susan. But yes I gave up my fish oil, CoQ10 and EVERYTHING that I normally take for vitamin and mineral supplementation. In fact, I didn't even eat any bars or any other low-carb "products" that were supposedly the culprit in my weight gain. NO CHANGE. Again THANKS for thinking.
Donny, I don't mind at all. And I tend to agree with you that this could indeed be a sign that my body handles my blood sugar levels REMARKABLY well. But I can't help but wonder what is happening to my insulin levels during this "stable" blood sugar. Is it off the charts or where it should be? That's what I'd like to know. And is any of this related to my elevated weight of late? We'll know more soon after these tests are done. I'm happy to share about this because I know there are many others in the same boat who'd like to find answers.
Two weeks is about like one good breath of fresh air. -- Not nearly enough!
That's your opinion Tom and I can appreciate that. But not all of us are purists like yourself. THANKS for sharing as always. :)
Regarding carb loading for 3 days before you have a GTT. "If you were going in for an official post-meal test, ordered by your doctor, you would be told that you have to eat 150 grams of carbohydrate during 3 days before your test to get a valid result.:
See this link. It is about doing a homemade GTT and the fact that your blood glucose will be higher if you do not do a 3 day carb load prior to doing the test.
"http://www.phlaunt.com/diabetes
/14046889.php"
i'd predict that you have high insulin levels after eating but your low carb lifestyle keeps you from losing sensitivity to your insulin.
if you continued carbo-loading you'd eventually become resistant to the amount of insulin you produce.
a fasting blood sugar in the 90s isn't what I'd call "right where it should be" the cut off for impaired fasting is 99. it's okay but it's getting on the higher side.
and i wouldn't put much store in repeat glucometer readings like you are doing every 15 minutes. There is a margin of error in those readings and a reading can vary from one second to the next.
your apparent "reactive hypoglycemia" is merely the same sensitivity that made you obese in the first place. you produce a butt load of insulin. your hyperinsulemia doesn't disappear on a low carb regimen but it is drastically improved. such an extreme case of hyperinsulemia will also be affected by food volume, saturated fat, and relative caloric value.
if you are hyperinsulemic (which i believe you will discover you are) any excess calories from any macronutrient--carb, protein, or fat, will go into the fat cells more readily than in the context of a normal insulin response.
this is why the smaller meals spaced out are working for you. wait the stall out keep your meals small and frequent and you will continue to see a drop (I predict).
Twelve pounds in a month? Keep doin' what you're doin'!
Jimmy,
Thanks for sharing this story about what's going on with you. It's no wonder that so many people have such a difficult time losing weight. Sometimes our bodies don't react like the "test subjects", and then when we are like mini-dectectives trying to figure out why, too many of us throw in the towel and give it up. I'm for one am very thankful that you are so diligent in trying to track this down for yourself. It gives us more information about the stumbling blocks we might meet. Keep up the good fight and sharing of the news for us all to benefit from. All the best.
Shari
THANKS Steve! Most of that 12 pounds happened in a little more than a week when I first started this new plan of action. The last week or so has been back to the same up 2 down 2 up 2 down 1 up 3 down 2...yadda yadda yadda! I'm certainly not gonna change what is working, but figuring out what can bring about the losses consistently is my priority right now.
By the way, I asked my doctor about whether I need to "carb up" as has been suggested for my glucose tolerance test on Monday. Here's what he said:
Maybe...maybe not. It depends upon the question that we want to answer.
If you want to compare your results to what is thought to be the "normal response," then yes, carb eating would be good.
However, if you want to figure out what is happening to you after eating a low-carb meal (to look into this low blood glucose issue when eating low-carb), then no extra carb eating is needed.
We can start the test after you eat a low-carb breakfast. I also want to check the insulin at each time point to assess the pancreas response.
Don't I want to know what's happening after a low-carb meal or is it more beneficial to do a standard GTT? I'm open to input.
Thanks, but my take on 'purists' is like my take on 'idealist', to extreme and to perfect for the real world and something that could never be accomplished by even one person, much less the masses. -- So we just blow past that! -- I'm a 'naturalist', a very doable, traditional, way of eating or as nearly as we can get is my 'ideal'! -- We can do that!
"Don't I want to know what's happening after a low-carb meal or is it more beneficial to do a standard GTT? I'm open to input."
Neither one of them is going to tell you anything! -- All it is is a bunch of readings that show how unbalanced our body chemistry and insulin levels are when we sometimes eat a variety of different carbohydrates and other stimulants at different times and portions throughout our lives. -- It will validate, yes we spike and fall with or without glucose because our system is so messed up from the constant or occasional carbohydrates we ingest and yes, we can eat controlled amounts of carbohydrates in smaller amounts and with fat and protein and on a continuous basis and maintain a more constant level and a milder continuous 'high'!
I'd pay you $100 if I could to get you to read "Dr. Bernstein's Diabetes Solution". He is the uttermost expert around on the subject. A true live saving book to those that apply the principles. There is a wonderful forum to join with experienced low carbers as well. I think with the weight lifting and the normal morning high BS you sound to be in great health!
Hope this helps.
I appreciate the monetary offer, but I have read Dr. B's book on diabetes health. I agree he's THE expert on the subject and I'm well aware of his forum. :)
Again, I'm not saying that my numbers are necessarily BAD, but they are not typical. Is that a good thing? Perhaps, but it doesn't explain my inability to get my weight back down yet. I do FEEL healthier than ever other than the added 25-30 pounds.
There is a lot to be said for FEELING GOOD. Glad you are feeling that way!
I have been off the wagon for a year, but back on track a few weeks. I am just beginning to not feel lousy again.
Interesting! Hope you get your answers soon. I think I read somewhere though that recently you lost 12 or 20 lbs in one month!! Wow, I don't think you have a problem losing weight - and let me see, hmmm 180 lbs in one year! I'd say you're a professional at losing weight. You'll get there - the last pounds to a "perfect" weight are much harder to lose. I think for most people, it is the last 10 lbs, but for you being a taller person, it is probably the last 20 to 30 lbs.
"Don't I want to know what's happening after a low-carb meal or is it more beneficial to do a standard GTT? I'm open to input."
I think your BG numbers are going to be POSSIBLY higher if you don't do the 3 day carbo load. That was all I was trying to indicate by my prior post. I think it will be VERY interesting to see your insulin levels under either condition. The BG values will be more accurate I assume as they will be via blood draws sent to the lab. Meters are not as accurate.
The only question is how you are going to define 'standard' low carb breakfast. Is that your choice of food or the doctor's?
I would think whatever is typical for ME for breakfast, JD. That's usually a couple of eggs and maybe some sausage.
I suspect on a high-carb meal your pancreas is working really hard to secrete insulin to regulate blood sugar. That’s probably why the doc recommended frequent small meals to keep the insulin and sugar swings to a minimum.
On the usual low-carb meal, as already mentioned, too much protein can convert to sugar. Ron Rosedale recommends calculating your protein requirements. Once calculated, it might be interesting to check your meals via a diet analyzer (ie Fit Day) to see how things shake out. If the protein is high, the extra can be substituted with fat in the diet as the fat doesn’t provoke an insulin response like sugar. So, it would be more of a low carb, moderate protein, high fat diet. That’s kind of the Rosedale Diet in a nutshell.
On the GTT,it would be interesting to try it both ways, but I’d probably go with the low carb prior to testing as this is your normal diet and way of eating.
Your doctor will be measuring both your glucose and insulin response to see how things are working, and you will definitely get a response after drinking a glucose solution.
Keep us posted.
THANKS bethers! You know I'll be updating with the results when I get 'em! :)
Jimmy, you want to know what's going on when you eat a low carb meal. That's what is really pertinent right now. Dr. Westman has it figured out just as you maintained. I'd follow his lead and get him to make the call.
Does he feel there is an atypical response goin on with you?
I've decided to do the low-carb meal with no carb load-up. He just wants to see what the insulin is doing after a low-carb meal.
Hey Jimmy
My doctor is checking EVERYTHING with me. I know you are getting your cortisol done. However make sure that when you had your thyroid checked that your free T3 and free T4 were checked as well as your ferratin level.
I know you are seeing a low carb expert but a lot of docs don't do the proper thyroid tests.
Lynn
THANKS Lynn! My thyroid has been checked and all is well there. It's something else, but I appreciate your feedback. We're gonna get it. :D
Hi Jimmy,
I'm sure you are already aware of this, but I learned in Dr. Bernstein's book that we have 2 phases of insulin secretion. The first happens immediately upon eating, which would explain your slight dip in blood glucose right after eating, as your body uses its stored insulin. The second happens later, which would explain the slight rise in your glucose after this, don't you think?
If you are concerned about the late timing of the peak in your glucose, doesn't a high fat meal slow down the glucose peak in our systems?
It wouldn't surprise me if you were converting protein to glucose-- the brain and heart will demand glucose no matter what you're eating, and will direct the body to produce it, either by converting dietary proteins or body tissue.
You might be able to moderate the process-- essentially slow it down-- by adding fiber to each meal. I don't know how many veggies you can consume on your current regimen, but doing a blood sugar experiment with a veggie breakfast omelet meal might show some interesting results. Either that or fiber tablets (or powder).
I'm quite prone to reactive hypoglycemia myself, and the fiber thing does seem to help, along with frequent meals. Good luck!
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