Please Help

Commented on February 23, 2015
Created February 23, 2015 at 4:40 PM

Hello all,

A little background - I'm 26, 5'4, 132lbs. In November 2012, I broke my rib and my doctor did a whole bunch of blood work. My hemoglobin a1c was 6%. She sent me to the endocrinologist and that's where my journey began. Endo ran blood work - a1c dropped to 5.4 (I did lower my carbs a bit, I don't really remember to be honest), fasting BG was ok, cholesterol was perfect.
Fast forward - I haven't had blood work in about a year. A year ago, my fasting bg was 105, a1c was 5.5. Had glucose tolerance test which showed reactive hypoglycemia - endo says it's insulin resistance (although all of my ranges were "normal" but my 3hr blood sugar was 50), holistic doctor says it's adrenal fatigue.
i have antibodies to my pancreas and to my thyroid. thyroid levels were normal a year ago. antibodies to pancreas were low, but "still there" (as my endo put it).
I cannot lose weight for the life of me. it's slow and annoying, and i lose and gain the same 2lbs.
I am tired as all hell, always constipated, no motivation, depressed, anxious, moody.
decided to go keto - less than 20g carbs a day since January 5, 2015. before that, i was doing moderate carbs (about 75-90g a day) and my fasting blood sugars were 80-90, postprandial completely normal, back down to 90 2 hours after a meal. i workout - i do fasted cardio in the morning and lift weights at night (this is what my schedule allows). 
SINCE I HAVE DONE KETO - my fasting blood sugars are consistently above 100. usually around 115.
I have lost 2 lbs. I have gained it back. i lost it again, etc.
i had a cheat meal - french toast with bacon - i felt like my eyes were swollen, tired, very buzzed feeling. check blood sugar an hour after eating that it was 175. 10 minutes later it was 143. 2 hours after meal it was 100. 3 hours it was 90. 

WHAT HAVE I DONE? I have an appt with a new endo on Thursday. Hoping my blood work shows some answers.
I have no changed my exercise routine - only my food. I have read about physiological insulin resistance, but it seems my body is very slow to producing an insulin response now. Do you think going primal/paleo and upping my carbs back to 50g would solve this? Anyone else have this experience?


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on February 23, 2015
at 04:57 PM

Some of this is not a problem.  I can't speak to the antibodies, however, when you do a Very Low Carb diet, or a ketogenic diet, or fast, this causes a mild form of insulin resistance that's there on purpose as a biological protection mechanism.


Your muscle tissue becomes insulin resistant so as to spare glucose for long nerve tissues and red blood cells.  Your muscles, heart, and many types of brain cells will then switch to using ketones as a form of energy.  You should do the glucose tolerance test again, but for about a week or two before the test, you should start eating paleo friendly carbs, maybe 200g/day.


If there's no issue, the insulin resistance will go away.  This doesn't mean that you need to stay on a higher carb diet all the time.  Rather, it means that the medical industry just isn't aware of this mechanism, and misdiagnoses it.


It could well be that you're insulin resistant if you have issues with your pancreas, above and beyond this mechanism.


Please do not revert to grains, you'll just damage your health from gluten, gliadins and all the other nasties.  You can use stuff like white rice, sweet potato, white potato (if you don't have nightshade issues), carrots, yams, tapioca.


If you have been doing VLC for a long time, and fasting for a long time your adrenals can get in trouble - you'll raise your stress levels and this will also cause raised blood glucose, an inability to lose fat, and interrupted sleep patterns.  That's a very big problem, so you may want to ensure that you're either only doing VLC, or doing fasting with some carbs and that your sleep isn't interrupted, or otherwise problematic, and that your stress levels are low.


(Part of the problem is that the signal to the liver to make glucose from protein is cortisol, when you constantly avoid carbs, this becomes a chronic signal.  Since cortisol is also our stress hormone, this translated into a higher level of stress, and becomes a problem.  Not all people experience this as a problem, some do just fine on it.  Certainly consuming higher protein that you'd normally need helps as it prevents catabolism of muscle for gluconeogenesis.)


on February 23, 2015
at 05:02 PM

Thank you SO MUCH. I am thinking of going back up on my carbs, but 200g seems like too much for me. I have made myself so afraid of carbs. And yes, I would focus my carb intake on gluten free options. I understand gluten is so bad for autoimmune diseases.


Do you think 50-75g carbs is a safe amount to start with? I have been VLC since January 5, 2015. It was my new year's resolution to lose some weight - not damage my body lol. I want to go back to paleo/primal eating, no doubt about it. Just want to choose a safe amount of carbs to introduce my body to...I don't want to gain weight.



on February 23, 2015
at 08:52 PM

I'd say it's a good idea to at least do 50-100g a day.  If you must stay in ketosis, you'll have to experiment the hard way to figure out what works without disturbing sleep, or at least increase your meat intake.


If you want to try to determine your glucose tolerance test, you'll for sure need to use much higher carbs than that for at least a week.


One thing you could do is to buy a cheap glucometer - there are kits on amazon for $10 or so for the bayer one - I think it comes with 10 strips, so you may want to get a 50 pack of strips or a 100 pack of strips.  That way you can test your blood sugar levels yourself and even do your own glucose tolerance test.

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