Lab results
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Rainqueen77 wrote: »Saw the PA yesterday to discuss my results. He didn't say much but he made an appt for me with the endos PA in 3 weeks. Also started metformin hcl 500mg today. I am hoping my fbs starts decreasing along with my IR. Praying it clears up my acne, I'm too old for that *kitten*.
I always thought my acne should have stopped before my gray hair started. It is irritating having both.2 -
Rainqueen77 wrote: »Was arterial draw. Fasting from 9pm to 11am when blood was drawn.
I wasn't expecting anything good. That's for sure. Before keto I was a mess. Only ate junk and lots of it. Starred may 12th at 362# am 290 today.
The dr ordered me a blood sugar kit and it reads in the 90s. While the one I purchased reads 20 above. So not exact. Lol
He did say he does those tests every 3 months so I guess we'll see.
Thanks for input. I see him Thursday.
Glad you're on a good path now, tho! I suspect you'll only improve. Did you ever watch Fathead? It was the first video I watched that made the light go on in my head re: cholesterol and the good and bad types. It used to be on YouTube but now you can find it free here:
https://player.vimeo.com/video/127401963
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I met with the Endo's PA. I asked her if she heard of keto. She told me she didn't agree with starving and depriving yourself. Switched the metformin for metformin XR and made an appointment with the actual Endo. Apparently her only job was to check my feet and blood pressure. Turns out the Endo appointment is 15 minutes long too! I called another office and was told their consults are an hour with the doctor, I was so shocked.
I asked the PA why I should eat a potato with dinner if it would spike my blood sugar up to 300, isn't it healthier to avoid the spike, her response - make sure you wait 2 hours to test.
I've only been given 2 strips a day for testing. Fasting and before dinner. Still in the 100-120 range with a 30 day average of 111. Next appointment is in February and I can get bloodwork done before that.
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Also I asked about the increased mpv and she said it means nothing. I asked if it was related to insulin resistance and she said no, it's nothing. Why do they test it if it means nothing? I have a huge list of questions, it's sad I have to wait until February. In the mean time I'm going to keto on.2
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Keto is not starving and depriving yourself. It doesn't make sense to eat high carb if you have pre-diabetes or diabetes. Or insulin resistance.2
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Take the metformin XR, keep doing Keto like you have as you obviously are doing well on it as evidenced by your weight loss and fairly normal A1C. That's my advice. I'm sure your labs were much worse when you started, especially if you said you had a glucose of 400 at one point.2
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I said the exact thing to her BT. I am neither starved or deprived. I thought it was hilarious. She can eat her plain dry chicken breast and steamed white rice. I'll eat my steak with butter and my green beans with bacon.6
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Popping in to say good for you for asking questions of the Endo PA. Too bad the appointments are so short and you're not given any real answers in that 15 minutes.
If I had a lot of experience with doctors and doctor visits I'd probably favor the doc that is always running behind schedule because they might be choosing to spend more than their allocated time with their patients AND I would couple that with being their 1st appointment in the day so I wasn't the one waiting.
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@Rainqueen77 -
Per Dr. Bernstein, if you can, switch from generic metformin XR to name-brand Glucophage XR, because it's more effective and easier on your digestive system.
http://community.myfitnesspal.com/en/discussion/10394798/t2d-glucophage-name-brand-metformin-generic
Also, as there's a wide spectrum of Individual differences, it may be that some combination of Glucophage XR and immediate-release Glucophage is the most effective strategy for a given T2D (though XR is usually easiest on the guts).
Good luck!1 -
I asked if glucophage was easier on the stomach, she said she didn't know about that but the xr was. Just started that Friday so we'll see what happens.0
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Rainqueen77 wrote: »I asked if glucophage was easier on the stomach, she said she didn't know about that but the xr was. Just started that Friday so we'll see what happens.
Great that you're already all over it!
PS. The best accuracy/price ratio for glucose testing seems to be the Contour Next meter & strips.
The Next meter is cheap and more consistent than the plain Contour and has backlighting for low light.
The Contour Next strips are cheap, too - recent deals on soon-expiring boxes of 50 in bulk on Amazon or eBay were as low as $.12/strip.1 -
Rainqueen77 wrote: »I've only been given 2 strips a day for testing. Fasting and before dinner. Still in the 100-120 range with a 30 day average of 111. Next appointment is in February and I can get bloodwork done before that.
I bought a couple of monitors on my own so I could have one at home and at work as well as strips. I have tested after all different kinds of foods as well as different amounts of time after eating as there are studies showing insulin response can vary. The 2 hour is "normal" but anywhere from 1 to 3 hours might be the normal for an individual.
Given glucometers are not overly expensive (especially given the cost of not properly managing diabetes), I think it is a worthwhile investment for anyone who has IR, diabetes or pre-diabetes.
I would also assume any PA who doesn't think a spike up to 300 is a less than optimal should probably find another line of work - perhaps cashier at McDonalds.4 -
Things get to a point where we have to take our own health in our own hands. I agree with @cstehansen in that a meter might be your best bet, especially to prove to your Drs who seem to be against your WOE that it's beneficial to you. Hard data shuts people up quickly. Rice and potatoes seem counter-productive to your wellness considering you're insulin resistant but if you want to experiment, take readings after each meal and log your results as best you can. You'll soon figure out what's causing the spikes and what to avoid.2
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@cstehansen - Curious how you would use a glucose monitor for IR only. My IR doesn't spike my glucose....like at all. My numbers are almost pristine, it's super annoying. I've tried testing, because I had a bad bought of postprandial somnolence, but nope, glucose numbers were good pre meal, post meal - 1 and 2 hours... etc. So I'm just wondering if there is something I'm missing, because I would TOTALLY track more if I thought it would help...0
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I'm new to keto, and to this forum. Sorry if I'm busting in and derailing this really informative, pretty-specific thread.
Are there lab tests in general that folks taking on a keto way of eating might want to consider for baseline measurements and tracking as we go along?
If there's already a thread or link to this, please let me know. I don't seem able to search the 265 pages of threads, unfortunately!2 -
@40DayFit If you ask your Dr they can fill out a form for bloodwork. You'll want a baseline before you start your diet so you can compare after 6 months/1 year etc. I ask for a full lipid panel and an LDL particle count (LDL-C and LDL-P). The particle count might not be covered by insurance but it'll be important to know if you have the good LDL that's large fluffy particles or the dense, bad LDL. Glucose, A1C count, Iron levels etc are what I also peek at.
If you tell your Dr what it's for he will know what to check off.1 -
Thanks so much, @Sarahb29! I don't even have a primary care doctor yet (just haven't felt I needed one), but definitely will look for one and get these panels before too much more time passes.
I'm on my 6th day and feel so great (bye, inflammation!) that while I started with just a 3-day, then a 7-day, then a 30-day commitment, I see that I'm committed already. Better to get those tests now before I miss the change to track a "before keto" baseline! Hopefully I can find a doc who isn't anti-LCHF.2 -
KnitOrMiss wrote: »@cstehansen - Curious how you would use a glucose monitor for IR only. My IR doesn't spike my glucose....like at all. My numbers are almost pristine, it's super annoying. I've tried testing, because I had a bad bought of postprandial somnolence, but nope, glucose numbers were good pre meal, post meal - 1 and 2 hours... etc. So I'm just wondering if there is something I'm missing, because I would TOTALLY track more if I thought it would help...
As you have mentioned in other posts, you have been fortunate so far with IR not becoming pre-diabetes or diabetes. At some point, most with IR will turn that corner, and most who know they are IR have already turned that corner. You may not since you have found out you are beforehand and have taken steps accordingly. Most of us don't find out until we have an A1c that is up to at least pre-diabetic levels. In fact, I would say only a very small % of people who don't have elevated A1c even know what IR is.
Given the trajectory of my readings over the last couple months, I may get an A1c below the technical line of pre-diabetes either with my next check in November or possibly the one after that. Even so, I will check regularly to ensure any changes I make don't lead to it creeping up. That is not a surprise I want. Once I do reach that level, I will likely add in some additional carbs and monitor effects thereof.
I will never go back to the SAD, but, having some additional carbs of the non-sugar and non-starchy variety does appeal to me from a variety and cost standpoint. I am odd in that my maintenance calorie level is about 3200-3500 a day. That is a heckuva lot of meat, cheese and eggs. Having some more spaghetti squash, zucchini, and other veggies than I currently consume does appeal to me as well as maybe putting in some sauces that I currently avoid for these veggies. If I can tolerate it, getting back up to 100g a day from 20g or so without elevating BG would be optimal. Only checking based on an A1c that only gets checked every 3-6 months is not a good way to monitor this.0 -
You know, I also asked again if they would check my insulin level she said it something they don't check. It wasn't an option. Hopefully in February my new doctor can order it. So frustrating.
I have three glucose testers, one even does ketones. I really want to order more ketone strips but it's not in the budget at the moment.
What I really want to know is how or when my blood sugar levels will lower. Why are my fasting bs over 100 still after 5 months low carb. Still I guess that's better than the 200's I used to get.1 -
@Rainqueen77 - due to the protective effect of dawn phenomenon, your body releases a burst of glucose once you hit a certain level in your bloodstream due to that natural "fasting" effect of sleeping. So nearly everyone who doesn't manipulate this will have that effect. I imagine it even happens to those of us who aren't diabetic yet.
I would probably consider your average readings to be a better indicator of your overall glucose health, though the fasting levels will continue to improve, too... Just my 27 cents...2 -
cstehansen wrote: »KnitOrMiss wrote: »@cstehansen - Curious how you would use a glucose monitor for IR only. My IR doesn't spike my glucose....like at all. My numbers are almost pristine, it's super annoying. I've tried testing, because I had a bad bought of postprandial somnolence, but nope, glucose numbers were good pre meal, post meal - 1 and 2 hours... etc. So I'm just wondering if there is something I'm missing, because I would TOTALLY track more if I thought it would help...
As you have mentioned in other posts, you have been fortunate so far with IR not becoming pre-diabetes or diabetes. At some point, most with IR will turn that corner, and most who know they are IR have already turned that corner. You may not since you have found out you are beforehand and have taken steps accordingly. Most of us don't find out until we have an A1c that is up to at least pre-diabetic levels. In fact, I would say only a very small % of people who don't have elevated A1c even know what IR is.
Given the trajectory of my readings over the last couple months, I may get an A1c below the technical line of pre-diabetes either with my next check in November or possibly the one after that. Even so, I will check regularly to ensure any changes I make don't lead to it creeping up. That is not a surprise I want. Once I do reach that level, I will likely add in some additional carbs and monitor effects thereof.
I will never go back to the SAD, but, having some additional carbs of the non-sugar and non-starchy variety does appeal to me from a variety and cost standpoint. I am odd in that my maintenance calorie level is about 3200-3500 a day. That is a heckuva lot of meat, cheese and eggs. Having some more spaghetti squash, zucchini, and other veggies than I currently consume does appeal to me as well as maybe putting in some sauces that I currently avoid for these veggies. If I can tolerate it, getting back up to 100g a day from 20g or so without elevating BG would be optimal. Only checking based on an A1c that only gets checked every 3-6 months is not a good way to monitor this.
@cstehansen - It really has been a crazy full circle effect for me, learning to be thankful for my obesity. It has definitely protected me from the worst effects of my disastrous decade of eating, for sure.
And yes, I've dropped 60-70 pounds overall in the last 5-6 years. I've been primarily low carb for the last 20 months or so...and I've been aware of my IR for almost 2 years now. So I've been fighting back. It's still hard, though, especially as the longer I fight back and the deeper I dig in information, I find out the more I actually don't know.
For example, as it stands, I can't do straight keto. It stuns my thyroid. Every. Single. Time. I have the lab numbers to prove it. And with my sugar/food triggers/binge eating/compulsive eating issues, once I hit about 40-50 grams of carbs, I want all the carbs, and so it's a downhill fall flat on my face. Since switching up my supplements, it has gotten somewhat easier to avoid the biggest hits, but I still have some triggers I haven't learned to manage yet. But most of them are easier.
I've requested a dietitian (found it it was a nutritionist after the fact, but certified by St. Anthony's, so I guess I'll see what this lady is worth) associated with my Endocrinologist's clinic to have a sit down with me to see how we can figure out how to make low carb work for me. Insulin actually tells the thyroid to bump up the metabolism, so when I sharply drop my insulin levels, my metabolism stops darned near dead in it's tracks. So there has to be something I'm missing.
And honestly, if it weren't for my PCOS and hypothyroidism, I might not have found out about the IR when I did...so I have to be thankful for developing a mess of conditions - or at least recognizing them... That is so backwards! Usually, I resent them. I guess my "sleepies" is a good indication that something I ate is bad for me! LOL
And I can definitely still improve my FBG and A1C numbers...they're at the high-middle of the range, I think...and I had a slight increase in both this last test, which I know is due to the fact that for 6 out of 9 weeks prior to my tests were during my move and totally off plan...I ran out of give a durns...which I really have to find a way to quit doing, or my health will pay dire consequences. But, I did reel it back in and kicked up about 3 weeks of healthier choices before the tests...
And the SAD sings a siren song to me, but I know it will beach me on the rocks, to my death, but once in a while, I keep trying it, only to get just to the edge of the whirlpool of no return before coming to my senses...
I agree that more data would be awesome, as I'd love to figure out my specific carb sensitivities more readily...and my threshold. For example, I know tomatoes and I are good, even up to and including a few full sized tomatoes paired with a meal or fatty cheese. However, black beans wipe me out. Refried beans do not, when pair with sour cream or other fatty content meals. Lavash Flatbreads don't seem to trigger me, but regular bread does, etc. So it's crazy how many pieces of data those of us more food/carb sensitive folks have to consider...
I'm hoping this nutritionist has half a clue, and I'll probably have a phone meeting before I agree to drive out, since it's a ways away from me...1 -
Rainqueen77 wrote: »You know, I also asked again if they would check my insulin level she said it something they don't check. It wasn't an option. Hopefully in February my new doctor can order it. So frustrating.
I have three glucose testers, one even does ketones. I really want to order more ketone strips but it's not in the budget at the moment.
What I really want to know is how or when my blood sugar levels will lower. Why are my fasting bs over 100 still after 5 months low carb. Still I guess that's better than the 200's I used to get.
Yes, low 100's are way better than 200's. The average is more important than fasting. Also, the postprandial is more important than the fasting as that will show if you are spiking and how much. It will also be where you see the effect if/when your IR begins to reverse. Depending on how far along you are on that path, that can reverse. I was just talking with a doctor friend about this last week. Personally, I am not counting on this happening as it is not going to happen for everyone, but I would love it if it would.
As for ketone strips, I know at least some of the others in this group would agree with me that these are really a waste of money. If you are eating on plan, you will be in ketosis. Once you are fat adapted it is very easy to tell as hunger changes dramatically because your body really can't seem to tell the difference between using the fat you eat vs the fat you have in storage. Personally, it would be very easy for me to know if I was out of ketosis just because hungry quickly changes to hangry.
Checking ketones around the same time as you have blood work for triglycerides might be worthwhile based on one of the other threads which shows how to use those two numbers to calculate your insulin level. Outside of that, I would say you likely have better things for which to use your money.2 -
Thanks so much, @Sarahb29! I don't even have a primary care doctor yet (just haven't felt I needed one), but definitely will look for one and get these panels before too much more time passes.
I'm on my 6th day and feel so great (bye, inflammation!) that while I started with just a 3-day, then a 7-day, then a 30-day commitment, I see that I'm committed already. Better to get those tests now before I miss the change to track a "before keto" baseline! Hopefully I can find a doc who isn't anti-LCHF.
Anti-LCHF docs are sometimes hard to find. Our doc wants to force folks on statins if their cholesterol is over 200, sigh. Btw, I've ordered my own blood work so that I could get the tests that I wanted done without arguing with my doctor. I used this company: http://www.healthcheckusa.com
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@RAC56 You are allowed to shop around for doctors, I'd be calling around until I found someone that supported or was at LEAST open minded to this WOE. Doctors should be continuously learning as part of their jobs anyway, science is always in flux as we learn more and more.
For those in the US - lab work falls under your yearly "wellness check" since it's considered preventative care, so when you go in for your wellness visit you can ask for blood work then. Most insurance should cover your visit. My full blood work cost me under $20.
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We've been shopping around for a while now. No way we would ever consider statins or going away from LCHF. I love this WOE.
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We've been shopping around for a while now. No way we would ever consider statins or going away from LCHF. I love this WOE.
It is not a bad thing to keep an open mind to the possibility that we may be wrong about how part, or all, of any diet applies to each of us as individuals. We are a long way from personalized medicine (wisely applying profound medical knowledge to individual genetics and circumstances), and never is a long time.3 -
KetoTheKingdom wrote: »We've been shopping around for a while now. No way we would ever consider statins or going away from LCHF. I love this WOE.
It is not a bad thing to keep an open mind to the possibility that we may be wrong about how part, or all, of any diet applies to each of us as individuals. We are a long way from personalized medicine (wisely applying profound medical knowledge to individual genetics and circumstances), and never is a long time.
Yeah, I understand that there may be reasons why someone might, over time, desire to change their WOE, but as far as statins go, to be honest, I'd refuse. I've known (and heard about) too many people who have had horrible side effects from those.0 -
KetoTheKingdom wrote: »We've been shopping around for a while now. No way we would ever consider statins or going away from LCHF. I love this WOE.
It is not a bad thing to keep an open mind to the possibility that we may be wrong about how part, or all, of any diet applies to each of us as individuals. We are a long way from personalized medicine (wisely applying profound medical knowledge to individual genetics and circumstances), and never is a long time.
Yeah, I understand that there may be reasons why someone might, over time, desire to change their WOE, but as far as statins go, to be honest, I'd refuse. I've known (and heard about) too many people who have had horrible side effects from those.
Yep, I had some nasty leg cramps while on Lipitor that could have woken a corpse - but not from Crestor, which I take now at a much lower dose with no obvious side effects. Who knows what our pals in BigPharma will conjure up next?
YMMV. I've already got T2D and early CVD, so it's not like I'm going to catch this stuff from a statin, but I reckon -- If I get side effects I don't like, I can stop taking the damn stuff and try something else (or not).
- But if I wake up in the ICU after a widowmaker and years of gulping fish oil, as St. Peter fades into the fog, it's a little late to find out that Crestor might have made a difference.
(On a side note - I was itching to get off metformin due to spectacular GI special effects and, by the grace of God - but really because the veterans here constantly urge folks to seek out useful information - I happened to catch Dr. Bernstein talking about the differences between friendly name-brand Glucophage and some of the incendiary generic versions of metformin. The switch made a world of difference - and that's theoretically without even changing meds!)
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BT_rescuemom wrote: »Keto is not starving and depriving yourself. It doesn't make sense to eat high carb if you have pre-diabetes or diabetes. Or insulin resistance.
For sure. Both my parents, both grandmothers, at least one aunt and my sister are all diabetic. I found out I was prediabetic at an appt several years ago. (My dr told me my results were normal but thankfully my diabetic sister told me not so I looked up prediabetes and sure enough, my numbers were in prediabetes range.) I also had high triglycerides. I went on a low carb diet (didn't know about keto at the time; I did Dukan), lost 10% of my body weight and reversed the prediabetes. The triglycerides also dropped from 217 to 52.
Good luck! Sounds like you're off to a good start even if you may need to shop around for another dr. I've been lucky that my cardiologist and my former PCP (so sad she left!!) were both supportive. My blood work was already pretty good by the time I started keto but it improved on this WOE and they were happy.3
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