I began my paleo diet and bio hacking adventure about 18 months ago, but feel I have hit a brick wall and need some help to better understand my labs and situation. I???m hoping that someone might be able give me some deeper insights on reactive hypoglycaemia, elevated morning cortisol, high cholesterol and what I feel is probably secondary hypothyroidism (low T3 to T4 ratio and slightly elevated TSH).
I am from England, 24 years old, lean with relatively good muscle tone, 6ft and 75kg. I am pretty physically ???fit??? despite health issues. I was quite severely overweight for a few years as a teenager, but lost the weight in my late teens. I also had neck surgery when I was 11 years old due to an aneurysmal bone cyst and I had to have my C6 vertebrae completely removed. I now have a junkyard of titanium in there and was exposed to some serious EMF with multiple scans, MRIs and Xrays throughout childhood. I have also snapped my ACl and torn cartilage in both knees from playing sports. However, I feel that these accidents were not bad enough to have merited such damage if I had been healthier. My tally of general anaesthetics and operations is now up to 10. Can???t be good.
Since starting paleo and dabbling with a ketogenic diet many of the health issues that I have been dealing with for years have actually worsened considerably. I feel my underlying metabolic/hormonal/gut problem has been brought to light by low-carb living rather than caused by this way of eating. I see this as a good thing and this is why I have persevered in the hope that this new information and lifestyle would allow me to get to the bottom of it once and for all.
I have bad acne on my face and chest, dark shadows under my eyes, dizziness upon rising or after eating sugar, frequent headaches, reactive hypoglycaemia, digestive issues, food intolerances, constipation, poor concentration and mental acuity, brain fog, excessive sweating, anxiety and general fatigue. However, I am still able to find the energy to exercise (weightlifting, climbing, jogging and biking) and feel much better when I do. Nonetheless, deep down I can sense that excessive exercising and high-carb living has only been masking a deeper hormonal imbalance and giving me some temporary adrenaline and endorphins to run off.
When I try to eat a ketogenic diet my energy levels drop severely, my blood sugar gets very low and I get dizzy. A post-prandial reading of 54 mg/dl would be common. I also tend to feel very depressed and find it hard to function efficiently on a day-to-day basis. I get very skinny, can see my ribs, feel like I am loosing muscle and becoming skinny fat. My hunger also completely disappears, my digestion seems to slow and food feels heavy in my stomach. However, my appetite/manic cravings for carbs are constant.
My naturopathic doctor tells me that I do have a leaky gut and also that my liver is not in good shape, especially phase II function and bile production. I suspect I am not digesting fats well and consequently struggling to use them as fuel. I have been referred to an endocrinologist who performed an overnight dexamethasone suppression test. However, my cortisol levels apparently remained at such a high level that he questioned whether I had actually taken the drug ( I don???t have specific figures yet). He wants to perform further tests to find out why. I feel like he doesn't have a clue and won't be able to help me. I'm pretty sure I don't have Cushing's Syndrome and that the high cortisol levels are more likely linked to blood sugar imbalances.
I also had an oral glucose tolerance test in which three hours after drinking 75g of liquid glucose my blood sugar level dropped to 50 mg/dl and I had all the symptoms of reactive hypoglycaemia. However, my glucose level never went above 110 mg/dl at any point, which according to my endocrinologist suggests that I am highly insulin sensitive despite obvious blood sugar issues.
I have been hugely inspired by Dr. Jack Kruse???s incredible work and all the information he has made available. It has shown me what tests I needed to get privately to finally persuade the unsympathetic doctors that something is actually abnormal and that I am not too young to have any issues.
Since they aren???t of much use here in the UK I was hoping for some help to better understand my labs, what could be the real root cause of my issues, whether I am actually leptin resistant or not, and if my neck surgery and knee injuries could tie into my current problems? Any tips, info or advice on how to move forward from here would be massively welcomed.
Below are the labs I have managed to get either privately through Genova Diagnostics or through my doctor:
Adrenal Stress Profile
Cortisol levels (nmol/L)
8am: 33.3 (12-22) HIGH
12 noon: 10.7 (5 - 9) HIGH
4pm: 5.5 (3 - 7)
12 midnight: 2.4 (1 ??? 3
12 noon: 0.17 nmol/L LOW
4pm: 0.19 nmol/L LOW
DHEA Mean: 0.18 nmol/L (0.40-1.47) LOW
DHEA Cortisol Ratio: 0.35 nmol/L (2.0-6.0) LOW
Adrenal Stress stage = resistance stage 2 maladaptation
Thyroid + reverse T3 (Genova Diagnostics)
Total Thyroxine (T4) 106 nmol/L (58-154)
Thyroid Stimulating Hormone (TSH) 3.87 mIU/L (0.4 ??? 4) Borderline High
Free Thyroxine (FT4) 16.5 pmol/L (10-22)
Free T3 (FT3) 3.33 pmol/L (2.8-6.5) Borderline Low
FT4:FT3 ratio 5 (2-4.5) HIGH
Reverse T3 0.37pmol/mL (0.14 - 0.54) Normal
(Reverse T3 23.9 ng/dL (9.0 ??? 35.0) Normal)
Does this T3 result rule me out from being leptin resistant in spite of hormonal and blood sugar issues?
More recent standard Thyroid Function Test
Serum TSH 2.61 mU/L (0.3 ??? 5.00)
Serum Free T4 16.4 pmol/L (11.0 ??? 23.0)
Vitamin D ??? I had previously been taking 5000 IU of D3 per day as I was presuming low-levels based on time of year and ASI results. Could the high cortisol be preventing absorption on a cellular level? I stopped taking supplements after first test.
31st Dec 13 Total Hydroxyvitamin D level 177 nmol/L (50 ??? 100) HIGH
1st March 14 Total Hydroxyvitamin D level 111 nmol/L (50 ??? 100) HIGH
Serum Cholesterol 7.9 mmol/L (305 mg/dl) (<4) HIGH
Serum Triglycerides 0.5 mmol/L (44 mg/dl) (0 - 1.7)
Serum HDL level 3.1 mmol/L (120mg/dl) (>1)
Serum LDL level 4.6 mmol/L (178mg/dl) (0 -3) HIGH
Total cholesterol HDL ratio 3 (0 -5)
C- reactive protein (CRP) 0.9mg/L(0 ??? 5.0)
Erythrocite sedimentation rate (ESR) 4mm/h (0-20)
Secretory IGA 115.9ug/mL (118-641) LOW
Serum vitamin B12 1248ng/L (172- 1162) HIGH
Serum Folate 8.7ug/L (4.6-18.7)
HbA1c level 33mmol/mol (<53)
Liver function test - all results well within normal range
Full blood count ??? all results now in the normal range. However, a few months ago my neutrophil count was very marginally low and my Mean Corpuscular Volume (MCV) was also marginally high. Anyone know if this can be of significance?
On an Elemental Hair Analysis my mercury was slightly high (2.4ug/g ??? (<1.32)) while my phosphorus levels were also high (212ug/g ??? (104-206)
Thanks in advance for any help.
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