Questions about insulin

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Jan18
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Questions about insulin

Post by Jan18 »

Can someone please help me with this?

I read Bredesen's book last August 2017. In December 2017, when I started with a functional medicine doctor, who trained on Bredesen's protocol, my insulin had just registered 5.0 on my internist's November 2017 labs. And looking back to yearly labs, it varied very little from that. A month later in December 2017, bloodwork for my functional medicine doctor it came back at 16! After cutting dairy way down (to a few T of Half and Half in a cup of coffee daily and an ounce of feta in eggs) and cutting out wheat (except for minimal sourdough, real sourdough) and cutting out most sugars (and I haven't eaten packaged foods in ages...my sugars would be in "treats", usually something chocolate) AND taking XYMOGEN's Methyl Protect and Ortho Molecular's Mitacore prescribed by my doctor, along with my usual D3+K2, fish oil, CoQ10 and magnesium, my homocysteine went from 14 to 7 - yay! She attributed that to the Methyl Protect. My glucose went from 94 - 85. But my insulin went from 16 down to 12 (after it had been 5.0) What happened???

Has anyone heard of "things getting thrown out of whack" by changing your diet? I admit, I was not eating as strictly as I am now (70% good fats, 20% protein, 10% carbs) but why would my insulin go UP when I had cut out most wheat and grain, white potatoes, sugars, beans, all fruits except small berry portions, and am watching the carbs??? I track daily on cronometer.com. When I was eating all of those things, and occasional popcorn or chips and desserts and burgers and pizza and ice cream and a lot of stuff I cut out, it was 5.0! I'm so exasperated!
Last edited by Jan18 on Mon May 28, 2018 1:17 pm, edited 2 times in total.
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Re: Questions about insulin

Post by TheresaB »

Jan18 wrote:But my insulin went from 16 a month after it was 5.0 only down to 14. What happened???
It's possible nothing happened. Back in March at Low Carb Breckenridge, Dr Catherine Crofts gave a presentation on hyperinsulinemia and introduced the concept of an insulin oscillatory pattern. Basically insulin is not static, taken just 15 minutes apart, a person's insulin reading could be drastically different. This was not the primary focus of her talk, so I don't know much about this, but I've attached a screen shot of the slide and eventually a video of her presentation will be available on the internet.
insulin oscillatory pattern.JPG
Do you know your HbA1C? While that's a measure of glucose, it's an average over the previous 2-3 months and since insulin reacts to glucose, it would be a good indication if the large insulin swing was within normal variation or not.

Here's another thought, the lab could have made a mistake. Happened to me with my ApoB reading, after 4 fairly consistent results, my last lab test showed my ApoB more than doubled, impossible. Labs sometimes are in error.
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Re: Questions about insulin

Post by Jan18 »

[/quote]Do you know your HbA1C? While that's a measure of glucose, it's an average over the previous 2-3 months and since insulin reacts to glucose, it would be a good indication if the large insulin swing was within normal variation or not.[/quote]

Thank you, Theresa. Your post calmed me down.

I checked my labs and my HbA1c went from 5.8 (intermediate risk 5.7-6.4) to 5.5 (optimal range less than or equal to 5.6) These are values given to me by True Health Diagnostics LLC laboratory.

Short answer, HbA1C = 5.5.

My glucose was 85. My estimated average glucose was 111.2 Both numbers are reported as optimal.

However, my insulin resistance values are bad. As I mentioned, insulin 12, which you explained could be a result of insulin oscillatory pattern. But can you speak to these numbers = Leptin 59, Free Fatty Acid 0.86, hydroxybutyrate 5.9, Linoleoyl-GPC 12.5. The last two values my doctor said were indicative of prediabetes. That also caused me alarm.

I am confused, as I thought glycemic control was key to insulin resistance.
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Re: Questions about insulin

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Jan18 wrote:My estimated average glucose was 111.2 Both numbers are reported as optimal.

However, my insulin resistance values are bad. As I mentioned, insulin 12, which you explained could be a result of insulin oscillatory pattern. But can you speak to these numbers = Leptin 59, Free Fatty Acid 0.86, hydroxybutyrate 5.9, Linoleoyl-GPC 12.5. The last two values my doctor said were indicative of prediabetes. That also caused me alarm.

I am confused, as I thought glycemic control was key to insulin resistance.
Glycemic control is key, but your average glucose of 111 is what I consider high. It also is not just as simple as lower your glucose and the insulin goes down, especially if you are prediabetic, because the insulin in our body is not responding normally. The GOOD NEWS is you still have an insulin response and this situation is reversable, it doesn’t have to become full Type 2 Diabetes.

Simply put, prediabetes is too much of the hormone insulin – hyperinsulinemia. The body is working hard to produce the insulin constantly, whether or not it’s responding to a load of glucose, because it’s also needs the insulin to work on storing fat. The body is overworked, unhappy, and inflamed. This can happen in both fat and genetically predisposed skinny people.

I’m not familiar with the two biomarkers that your doctor says are indicative of prediabetes, I trust he’s correct. However I am familiar with the first two measures and they do tell me things are awry. If the measure is the same as mine, ng/ml, your leptin is considered “normal range” but it’s on the high side of it. (Remember “normal range” is typically a statistical extraction of most the samples collected, since a significant proportion of people are T2 Diabetic or prediabetic, the “normal” range is extracted from a lot of unhealthy people). Leptin is another hormone, it’s produced by adipose tissue (fat in the body), it inhibits hunger and “holds hands” with insulin, as insulin goes, leptin goes. I’m not the measure of everything, but the highest my leptin has ever been on my lab tests was 18.4. I still deal with hunger issues, although greatly dampened since going ketogenic, so I can imagine you’re really struggling, my heart goes out to you. Our doctor, Dr Steven Gundry says you want low leptin. My husband’s leptin has been recorded as “red” for being too low on lab tests before, Dr G is fine with that.

Your free fatty acid production is also high. Not an area I’m conversant in, but basically this tells me that there’s impaired FFA uptake and release.

Here are some references I’m recommending to help you better understand insulin resistance and what to do about it:
  • 1. Here is a video with a link to the slides given by Dr Ted Naiman. This presentation really helped me understand what goes on in the body when dealing with insulin resistance. https://denversdietdoctor.com/ted-naima ... sulinemia/

    2. Here's another video by Dr Jason Fung. It didn’t “speak to me” as much as Dr Naiman’s did, but I include it because I respect Dr Fung, his clinic has helped countless folks with prediabetes/T2 Diabetes, it might speak to you. https://denversdietdoctor.com/dr-jason- ... esistance/
    I haven’t personally read it, but Dr Fung also has a book The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally, but I imagine it’s probably a very good book full of helpful easy to understand advice if it’s anything like his book that I did read, The Complete Guide to Fasting. He also has lots of info/videos on his website: https://www.dietdoctor.com/authors/dr-jason-fung-m-d

    3. Speaking of fasting, this is something I’d recommend you investigate. Fasting (can be hours, not days) can help lower the level of insulin the body constantly circulates, this article better explains. http://www.buttermakesyourpantsfalloff. ... n-problem/

    4. Lastly, exercise, High Intensity Interval Training plus resistance training is synergistic with diet to lower insulin resistance.
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Re: Questions about insulin

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I appreciate you answering so much, Theresa, so please do not read any frustration in this directed at you. But I'm at my wit's end with this information!

I do fast 14-16 hours a day and have been doing so for months. I simply cannot understand how my numbers have gotten worse (except for the homocysteine, which my doctor attributes to the Metagenics Methyl Protect which is largely B vitamins and folate) Tests showed I wasn't metabolizing B vitamins. That seems solved.

But I fast and I start eating so much healthier and my insulin skyrockets!!!! For years it has been around 5.0 and I ate whatever. How can this be?

Is it exercise? I was so active as a kid -- running, running, sports. Gymnastics, cheer and dance as a teen. Then BAM! Car accident at 18. Herniated discs, whiplash, etc. Decades of trying to work around the unresolved pain with every kind of exercise I could find. Couldn't Jazzercise anymore. Couldn't run. Couldn't dance anymore. Sustained torn meniscus and two surgeries. One exercise hurt my back, one hurt my knees. At last I took up cycling and did about an hour a day and loved it --- until someone ran into me and I broke a wrist several years ago. (Reluctantly gave up cycling, figuring now at 68, if someone ran into me again, I might break another bone. There comes a time in life when you need to tweak your exercise to fit your age. Don't want to do a Sonny Bono!) Finally had one knee replacement a year ago and now I'm in PT for a foot problem and still the other knee needs a replacement. So I can't even WALK for exercise! I am trying to do the recumbent bike now, since even water aerobics hurts my foot and bad knee. Even the water doesn't shield it from the pain. I used to have my heart rate in the aerobic range for my age for a good solid 45 minutes just doing my own version of "water dancing/jogging," but haven't been able to do that. All this to a girl who LOVED exercise and sports.

But I'm wondering if the exercise isn't the missing key. And I feel like crying. (I know I shouldn't send this now in the afterthrows of reading your response, but I thought I was doing better and to hear I've now become prediabetic, I am reacting...)

It has been a struggle just to give up dairy and wheat and grains and beans and so many other foods only to end up with HIGHER insulin levels. I feel desperate.
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Re: Questions about insulin

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P.S. Theresa, I eat 1200 calories a day. I track everything on cronometer.com. I'm eating the percentages of fat, protein and carbs I mentioned above. And I usually eat twice a day. First meal with eggs and veggies and avocado anywhere from 11AM to 1PM. Second meal anywhere around 7-8PM. I've lost about 12 pounds since my highest weight. I don't get hungry!!! I thought that was because of the higher fat content, more satiety.

So what you are saying is that the higher your leptin is, the LESS hungry you feel, right? Now I do remember reading that obese patients were eating less and not being hungry because of higher leptin levels, I think.

I experienced some lightheadedness, brain fog last January when I started to eat keto and wasn't sure what it was. Short story: Saw internist, functional med dr., even cardiologist and ear doctor to see if they knew cause of lightheadedness. It was so uncomfortable and scary. Nothing wrong. Figured it was keto flu. Stopped eating so strictly, because I just wanted that lightheadedness to stop!

One piece of good news is that my blood pressure readings have really improved since I've changed my diet. :D And I do see some improvement in my memory...some.

Have MCT oil now, but haven't used it and scared to. Don't want my cholesterol to go up higher and it is likely to with MCT oil. But haven't really gotten into keto mode, I imagine.

Do you think my first step would be to get a keto meter (blood) and just full out do Gundry's 3 step program WITH the MCT oil temporarily as Bredesen suggests (using it to combat keto flu symptoms temporarily, since it would raise my already high cholesterol, then go off of it?) Or are you shaking your head over there thinking, "What? You haven't gotten a keto meter already? You should've started with that!"

I guess I'm so hesitant to do that, given how scary it was to be lightheaded for weeks back in January.
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Re: Questions about insulin

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Jan,

Yes, it is frustrating. I, too, am confused by your numbers and I’m so sorry to have upset you. I don’t mean to diminish your frustration with platitudes, I hope I’m not coming across like that, I genuinely hope I might spark something that might lead to an answer.

But here I am, going to start with a platitude: everyone’s body is different, what works for many, doesn’t always work for everyone.

Your carb tolerance may be lower than others. There are those who react greatly to any carbohydrate intake and must be very strict with maintaining low levels. This was why the Atkins diet recommends different phases where you start with very low carbohydrate intake, then add carbs in 5 gram increments to determine the level of carbohydrates that is right for that individual.

Maybe you just have to “break through that wall” then progress can occur. Your fasting 14 to 16 hours a day may not be enough. That above link that referenced, Fasting and the 50% Insulin Problem recommends a starting point of 16 hours.

Stress can elevate glucose and impede progress. I know someone going through cancer treatment, wtih chemo and radiation he couldn’t keep anything down, he was in deep ketosis as a result, yet his glucose was disproportionately high. Why? I'm guessing the stress of the situation and treatment, or maybe something else?

Lastly, you may be doing all the right things, it just may take a while. I remember a Q&A session where a woman had made dietary changes but was frustrated she hadn’t made better progress, the doctor’s answer was basically, it can take time, unfortunately sometimes a lot of time. Yeah, that sucks, but please don't give up.

You’re loading your food intake into chronometer, that’s great, but you said you don’t have a glucometer, so you know the “go-in-zas” but you don’ know the “go-out-zas.” Let’s take broccoli. It’s a good low carb food, right? I know someone who can’t eat broccoli because it spikes her glucose. Don’t know why, but she never would have figured that out without a glucometer. If you know what your food is doing to your glucose, you can focus on less or more of that food. Measure your glucose at one hour after eating, for most people, that's a good point to see what the meal is doing to your blood sugar. Ideally, at two hours after eating, blood glucose levels should be back to normal, that's ideal, don't get hung up on trying to get that, work on keeping the glucose response to a meal reasonable. Get a good glucometer, cheap glucometers are out there, but the results are, well, you get what you pay for. I have a Keto-Mojo, it measures glucose and ketones, I like it. If you’re not into measuring ketones right now, you don’t have to buy the ketone strips.

Regarding leptin, you want it LOW, just like insulin. And if you lower your insulin, you should lower your leptin.

Lastly I’m so sorry you’re so challenged with exercise. I understand, although I’m not as challenged as you. I’ve had 3 surgeries on my right foot and LOTS of physical therapy. I’m a couple years out from my last surgery but I’m still going to multiple appointments every week (strength training at the gym, laser therapy, acupuncture, a rolfer, a manual manipulative osteopath, massage therapy) all in an effort to relinquish the pain and get my body back in balance. At least can I walk, just not nearly the distance I used to. For me, I emphasize resistance training, and short burst exercise (High Intensity Interval Training - HIIT) because it is less stressful on the foot. Can you at least do upper body resistance training? The upper body has smaller muscles so the benefit is less than working the legs, but I’m guessing there could still be benefit. The pain of my foot has thrown off my walking mechanics resulting in odd muscle compensation patterns throughout my body from the foot to the shoulders. I’ve developed arthritis in my hips and I am desperately trying not to experience any further degradation. In addition to my above strategies, I also go to easy yoga classes to try to keep my muscles flexible and balanced. Many of my poses are far from perfect, but any yoga instructor worth his/her salt will never push you to do a position you can’t do, I’ve never had a problem with an instructor "shaming" how I do a position. Yoga also helps reduce stress.
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Re: Questions about insulin

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Jan18 wrote:However, my insulin resistance values are bad. As I mentioned, insulin 12, which you explained could be a result of insulin oscillatory pattern. But can you speak to these numbers = Leptin 59, Free Fatty Acid 0.86, hydroxybutyrate 5.9, Linoleoyl-GPC 12.5. The last two values my doctor said were indicative of prediabetes. That also caused me alarm.
Jan, "hydroxybutyrate 5.9." I searched on hydroxybutyrate, and all that came up is beta-hydroxybutyrate. This is a serum ketone and 5.9 mmol/L would be a high number. Either indicative of very low carbs and modest protein, extreme caloric restriction, an extended fast, exogenous (supplemental) ketones or a lot of MCT oil prior to the test. I'm curious if it is in fact beta-hydroxybutyrate?
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Re: Questions about insulin

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Tincup,
It has a symbol in front of it that my keyboard, of course, doesn't have. So I only wrote "hydroxybutyrate." It is not the symbol for the Greek letter, beta, however. I wish I could draw it here for you or take a photo of it and post it, but I don't know how to do that. Both that and Linoleoyl-GPC are in the category of Insulin Resistance on my lab results. The test was a fasting blood test and I've been eating low carb, modest protein, high fat and 1200 calories daily. I need to lose weight (like 40 pounds!) so I am restricting calories to lose a pound a week.

Haven't been able to do a regular exercise program, or even walk, so I sit a lot. I hate it! I am in PT for my foot and I hope to resolve that to be able to walk for exercise and get back to water aerobics. In the meantime, I'm trying to incorporate and build up a stationery cycling program and some weight training. I'm just beginning that. Don't know if that would have anything to do with the hydroxybutyrate.

Thank you so much for that info! Do you think it is indicative of my calorie restriction? I haven't opened the MCT oil yet, so have taken none. Except for that, it seems the other indications of beta-hydroxybutyrate are good! So why would my doctor call it indicative of prediabetes?

May I ask you and anyone here (please) what I should be eating? Was I supposed to dive in with Gundry's list of foods and be very, very strict about it and use a ketone meter and MCT oil for keto flu? I didn't do that. Here's what I did: I just started basically with 1200 calories, eliminating most dairy, eliminating wheat and grains, except for "real" sourdough bread, which Gundry seemed to say in his book was okay (page 51) but only one slice a day, concentrating on good fats of olive oil, avocados, walnuts daily and salmon once a week (should probably do more.) As I studied more, I realized my protein was too high so that's when I instituted the 70/20/10 percentages of macros.

Saw your reply first, so perhaps some of these questions have been answered by Theresa. Will read hers now. Thank you, both!!!
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Re: Questions about insulin

Post by Jan18 »

OMG....don't stress, don't stress.

Hit a wrong key and a huge response to you, Theresa, got erased. I am not up to the effort to recreate it now. Blood pressure, blood pressure. ;)

Will recreate the whole thing tomorrow. Ugh.

But if you see this before I respond to your last post, do you suggest your meter as the best one? What about the one Bredesen mentions in his book? I know I can get that on Amazon.
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