Questions about insulin

[Jan18]

if your TG is higher than 80 it seems there's still excess carbs consumptions. Increasing fish oil may help from my experience.

Yes, doctor said to add in one more fish oil dose every other day and I pushed my carb grams down since then. Hoping next test better!

[Jan18]

I'm guessing your hydroxybuterate is β-hydroxybutyrate and you are in ketosis. If you get a meter, you can check, but again I wouldn't stress about it. BTW, Theresa's numbers for this metric are in this ballpark...

EEEEK! I found this about alpha-hydroxybutyrate, Tincup! It's the measurement that can distinguish between insulin-sensitives and insulin-resistives.

Article is from 2010. "Insulin resistance is a risk factor for type 2 diabetes and cardiovascular disease progression. Current diagnostic tests, such as glycemic indicators, have limitations in the early detection of insulin resistant individuals. We searched for novel biomarkers identifying these at-risk subjects."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2878333/

[slacker]

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?

Hi Jan;

There are a lot of moving parts on this path, and most people are most successful making small sustainable changes, one step at a time. And as TheresaB says, one plan doesn't work for everyone. What works for her may not work for you. So no one here can really tell you what you should be eating, but can share what has worked for them. It can help to make changes that you think you can stick with long term, if they work for you. A lot of tweaking is needed. Theresa and Tincup follow the Gundry approach with great success; other members do not. Each of us is on our own personal path, with some similarities.

I think using a ketone meter would be helpful for you. There are several threads on this subject. It can be a bit tedious, but you can find them with our search function - magnifying glass in right upper corner of website. Searching on "mojo" or "Precision Xtra" may do the trick. I think the Precision Xtra was the first meter that could test both glucose and ketones, with 2 different strips needed. The ketone strips are expensive. The Mojo meter has less expensive ketone strips, and can test for glucose as well (2 different kinds of strips), so is more cost effective. It's possible that the mojo meter came out after Bredesen's book was published.

If you are already in ketosis, you don't need the MCT oil. MCT helps people get into ketosis; it doesn't minimize keto flu. If you are having keto flu, it's a sign (but not proof) that you are in ketosis.

I know this is really hard and complicated. Please be gentle and patient with yourself. Members like Theresa and Tincup have been doing this for a long time. It's great to have them as guides. I learn so much from them.

[Tincup]

So before I read your stuff, can I ask if you are a "remote" patient of his? I see you live in Colorado. How does that work? And does his staff answer you about lab results questions or does he personally?

We are remote. My wife and I schedule an hour (1/2 each, which is minimum) phone appointments many months (usually 6) in advance. About 6 weeks prior, we contact the office and they ship us lab kits and requisitions for all the labs he orders. We make an appointment with a local phlebotomist who draws the blood, spins it down and FedEx's the samples to the lab - about 4 weeks prior to the call. Some of the labs have a deal with our phlebotomist and will compensate them, the rest, we have to pay them out of pocket. The labs do run through our insurance. We have a 25% co-pay and the total for each of us is about $2000 with our co-pay being about $500 (for each of us). I think his cost is $375 per 1/2 hour - out of pocket.

We call the office and get them to email us the labs prior to the consult. We also scan and send them any other labs we've had, supplements we are taking as well as how we are eating his diet (we are on no meds). At the appointed time, he calls us. We use a Google Voice number forwarded to one of our cell phones on speaker. We can then record the call (which he permits).

Before the call, we make up a list of questions. He goes over both of our labs first. We then ask questions from our list in whatever time is left.

We have met him in person several times at conferences, but not for an exam.

[Jan18]

There are a lot of moving parts on this path, and most people are most successful making small sustainable changes, one step at a time. And as TheresaB says, one plan doesn't work for everyone. What works for her may not work for you. So no one here can really tell you what you should be eating, but can share what has worked for them. It can help to make changes that you think you can stick with long term, if they work for you. A lot of tweaking is needed. Theresa and Tincup follow the Gundry approach with great success; other members do not. Each of us is on our own personal path, with some similarities.

I think using a ketone meter would be helpful for you. There are several threads on this subject. It can be a bit tedious, but you can find them with our search function - magnifying glass in right upper corner of website. Searching on "mojo" or "Precision Xtra" may do the trick. I think the Precision Xtra was the first meter that could test both glucose and ketones, with 2 different strips needed. The ketone strips are expensive. The Mojo meter has less expensive ketone strips, and can test for glucose as well (2 different kinds of strips), so is more cost effective. It's possible that the mojo meter came out after Bredesen's book was published.

If you are already in ketosis, you don't need the MCT oil. MCT helps people get into ketosis; it doesn't minimize keto flu. If you are having keto flu, it's a sign (but not proof) that you are in ketosis.

I know this is really hard and complicated. Please be gentle and patient with yourself. Members like Theresa and Tincup have been doing this for a long time. It's great to have them as guides. I learn so much from them.

Thank you, slacker. I value everyone's contributions to my questions so much. And yes, Theresa and Tincup have been so helpful to me, as have you all!

I ordered the Mojo meter last night from its site, but now am wishing I checked Amazon for it, as I have Prime and would like it yesterday!! I'll be patient and hope it arrives in a timely fashion.

I tend to freak out with out of whack values -- my lipids are bad but I opted not to do a statin, because my Dad died in 2006 from the "rare, but serious side effect" of Lipitor. (While he was dying, I was in contact with NIH and Dr. Graveline, the astronaut-physician who helped identify osteoporosis with the astronauts being weightless in space. Graveline experienced "transient global amnesia" --I think he coined that -- with high doses of Lipitor when it first came out, as did others. He did a lot of research and was warning people about high doses. Doses now are much lower. He also tried to warn about depletion of CoQ10 and said anyone on Lipitor should be taking it. At that time, few, if any doctors were prescribing it along with Lipitor.) After muscle pain, my dad developed an "ALS-like" (Mayo Clinic's diagnosis) condition.

When I moved to this area five years ago, I chose my internist from Top Doctors and she has proved time and again to be on top of certain things, like new measurements for cholesterol, etc. (At our last appointment in November, however, she hadn't heard of Bredesen and was intrigued. She also checked out the qualifications of my functional medicine doctor (Emory, Air Force, Stanford and a few others) and was impressed with that, though couldn't comment on her, not knowing anything about her. My personal opinion of my functional medicine doctor is that she is well educated on what many, if not all, of my test results mean, but not as conversant with Gundry's diet protocol as you here and even as I am from studying him. For instance, she said sweet potatoes are not to be eaten, and Gundry says resistant starches "in moderation" -- and there were some other things I thought she should know, but didn't....so we'll see if I stick with her or find another one.

Back to my internist, I told her my Alzheimer's history and my Dad's history and she said she was going to run a lot of tests and if insurance wouldn't pay for them, her practice would. Turned out to be $2000 worth of tests my insurance wouldn't cover and she did! That's how I discovered my ApoE4 gene. She also pointed to one result (sorry, forgot what) and said it was why both my Dad and I shouldn't be on Lipitor (although there were other statins that were okay for me/him because of the way they worked, versus the was Lipitor works.) I still balked on using a statin. So I've been running around with increasing LDL numbers and it has to stop!

I asked her why her practice covered those costs and she said she is part of a consortium of medical professionals who are compiling data, trying to convince insurance companies to cover these tests. She said it is standard of care in Europe. (But you know how corrupt the health insurance industry is here!) By the way, she graduated first in her class at Emory, did her residency there and subsequently served as Chief Resident in internal medicine. So I believe she is well-educated. But the best thing about her is how open she is to hearing what I'm discovering and to welcoming my questions.

I'm not sure how I got off on the tangent of telling you all that. And if it is not appropriate or to the point of what this forum is for, please tell me and I'll dispense with the personal stuff.

Oh, I know why -- I wanted to tell you my lipids and why I'm a bit scared right now: LDLp went from 2659 to 2589 and it's supposed to be 700-1000, Gulp! sdLDL went from 45 to 35 and its range is supposed to be <20. Ox LDL went from 84 to 74 and its range is supposed to be <60. Total cholesterol 301 (I know total is less important than those small particle LDL's...) and HDL is 60.

It's improving, so that's good. My cardiologist wanted me on a statin, but when I told him the protocol I was doing, he said if I keep improving at 3 month intervals, then keep doing this. I'd see if I "plateaued" at a certain point and if that's a good point, no need for a statin.

So that's what worried me, too -- getting those LDL particles down!

And I just found this, talking about some studies that seemed to indicate statins do not lower -- and may, in fact, increase -- small LDL. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929871/

[Jan18]

We are remote. My wife and I schedule an hour (1/2 each, which is minimum) phone appointments many months (usually 6) in advance. About 6 weeks prior, we contact the office and they ship us lab kits and requisitions for all the labs he orders. We make an appointment with a local phlebotomist who draws the blood, spins it down and FedEx's the samples to the lab - about 4 weeks prior to the call. Some of the labs have a deal with our phlebotomist and will compensate them, the rest, we have to pay them out of pocket. The labs do run through our insurance. We have a 25% co-pay and the total for each of us is about $2000 with our co-pay being about $500 (for each of us). I think his cost is $375 per 1/2 hour - out of pocket.

I have Medicare and an F-plan supplement and I have to pay for my functional medicine doctor's appointments in total. She is $165 per 1/2 hour. But my lab tests so far have all been covered 100%.

How does a co-pay work? Surprisingly, I have never had insurance with a co-pay. Does that mean you only had to pay $500 of the $2000?

[Jan18]

Questions for anyone:
Do we track grams of net carbs or carbs? Cronometer's default is net carbs and I thought I'd read it is the net carbs on keto that are the important ones. Should I also check the box on Cronometer for "include sugar alcohols in net carbs?" I've read what net carbs are and how you get to them with subtracting fiber, but wonder what Gundry says should be our 10% carbs? Net carbs or total carbs?

Is there such a thing as too low of a carb intake?

When Gundry says "in moderation" on his Keto Plant Paradox Plan (i.e. for resistant starches like sweet potatoes or Barely Bread products) what exactly is "in moderation?" Once a day, once a week, once a month? Or is that determined individually by ketones/glucose/or other numbers?

[Tincup]

Do we track grams of net carbs or carbs? Cronometer's default is net carbs and I thought I'd read it is the net carbs on keto that are the important ones. Should I also check the box on Cronometer for "include sugar alcohols in net carbs?" I've read what net carbs are and how you get to them with subtracting fiber, but wonder what Gundry says should be our 10% carbs? Net carbs or total carbs?

Some diabetics and especially T1's need to track total. I have a T1 friend that says she's a "termite" and will turn anything into glucose.

Once you get a monitor, it will become clear what works for you.

Is there such a thing as too low of a carb intake?

Biologically no. There are a whole group of people who do very well eating "zero carb" or "carnivore." One of them is a good friend. She fixed a very long term bipolar issue doing this. What is common between her and Gundry - plants are the problem. Only Gundry would say only certain plants are the problem.

When Gundry says "in moderation" on his Keto Plant Paradox Plan (i.e. for resistant starches like sweet potatoes or Barely Bread products) what exactly is "in moderation?" Once a day, once a week, once a month? Or is that determined individually by ketones/glucose/or other numbers?

It is individual. If, for example, you were a cancer patient or a diabetic, you'd not be eating these. Also some resistive starches have much more of a carb/glucose punch than others.

[Tincup]

Do we track grams of net carbs or carbs? Cronometer's default is net carbs and I thought I'd read it is the net carbs on keto that are the important ones. Should I also check the box on Cronometer for "include sugar alcohols in net carbs?" I've read what net carbs are and how you get to them with subtracting fiber, but wonder what Gundry says should be our 10% carbs? Net carbs or total carbs?

Some diabetics and especially T1's need to track total. I have a T1 friend that says she's a "termite" and will turn anything into glucose.

Once you get a monitor, it will become clear what works for you.

Is there such a thing as too low of a carb intake?

Biologically no. There are a whole group of people who do very well eating "zero carb" or "carnivore." One of them is a good friend. She fixed a very long term bipolar issue doing this. What is common between her and Gundry - plants are the problem. Only Gundry would say only certain plants are the problem.

When Gundry says "in moderation" on his Keto Plant Paradox Plan (i.e. for resistant starches like sweet potatoes or Barely Bread products) what exactly is "in moderation?" Once a day, once a week, once a month? Or is that determined individually by ketones/glucose/or other numbers?

It is individual. If, for example, you were a cancer patient or a diabetic, you'd not be eating these. Also some resistive starches have much more of a carb/glucose punch than others.

Gundry goes through a fair amount on this podcast.

[Jan18]

Can someone please tell me if I am supposed to start a new topic thread for this post? It does reference insulin, but....

Just saw this and although it doesn't blast keto entirely and completely (acknowledges that "some" people might do okay on keto) it really criticizes it. But it does reference high intake of animal sources, so I assume it is talking about the Atkins method, not Gundry's version of keto.

Does this article just show that most people don't know about Gundry's research and Bredesen's? Is there proof that long-term keto is too acidic like the article says or is the fact that Bredesen has us in "mild ketosis" and actually, being keto-flexible, a whole different thing than what this article is criticizing? That's my take on it, but was curious as to your opinions.

https://www.prevention.com/weight-loss/ ... m_term=hed