Something I never understood about PCOS

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I've had doctors continually tell me if I lose weight the symptoms will lessen. I wish there was more of a clarification because when i started gaining weight it was fast and nothing I did would let me lose weight. I was diagnosed at 15 because I gained 70 pounds in a matter of months even though my eating habits hadn't changed. To this day the only time I've been able to lose weight is to barely eat. When I was younger I cut down on food significantly..I ate maybe 1000 calories a day. Last year I lost 40 lbs because money was tight so I ate a big meal once a day and maybe snack on something if I have money leftover. I recently gained it ALL back plus some without changing my habits and am back in the same position. Metoformin never worked for me but i'm trying an anti-androgen med. I was wondering if anyone who has had similar problems with PCOS been able to fight it? It seems like for me at least weight loss eases my symptoms until it doesn't and I gain weight again like crazy. It is getting to the point to where I am considering surgery.

Replies

  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    The doctors that say that need smacked, in my opinion. That ranks right up there with "if you aren't losing weight, then clearly you're eating more calories than you're burning" (especially in cases where the calorie count is already absurdly low).

    Technically, they're right (mostly), because fat cells generate estrogen (so, less fat equals less estrogen equals symptom improvement), contributing to our hormonal imbalance (most of us have a too high ratio of estrogen to progesterone), and contributing to our weight issues.

    However, our weight doesn't usually cause our PCOS, nor does it cause the hormonal imbalances in the first place. It exacerbates them, yes, but doesn't cause them (otherwise, thin people wouldn't have PCOS), and in fact, it's usually the other way around -- the PCOS causes the weight gain.

    First of all -- get blood work done, if you haven't already. Get the following:

    fasting insulin (not just glucose, normal glucose does not necessarily mean normal insulin)
    testosterone
    estrogen
    progesterone
    free T3
    free T4
    reverse T3
    liver enzymes
    cholesterol (the more detailed, the better)

    The T3/T4 stuff is thyroid. I'd venture to guess that some of your issues lie in thyroid function, especially if your fasting insulin is below 15.

    From there, consider the following dietary/supplement/lifestyle changes:

    Set protein to 1g/lb (.5g/kg) of lean body mass
    Lower carbs to 100g or less (especially if your triglycerides come back high, which they likely will), consider trying a ketogenic diet
    Increase fats to fill in the rest, or at least .35g/lb of total bodyweight (don't be afraid of saturated fats and cholesterol, they're vital for proper hormone function and nutrient absorption)
    If your fasting insulin is about 15 or higher, take milk thistle (supports liver function and can help lower your fasting insulin by improving the liver's ability to handle insulin)
    Get more sunshine (or barring that, supplement Vitamin D)
    Supplement iodine, especially if thyroid function is low, and/or eat more iodine-rich foods
    Include coconut oil and coconut products in your diet (the medium change fatty acids are awesome for the body and support metabolism)
    Lift weights or other progressive strength training program (awesome for bones and hormones)
    Cut out processed, refined foods and especially refined sugars (endocrine disruptors, elevate triglycerides, and other issues)
    Cut out soy (particularly non-fermented) and limit nuts (phytoestrogens)
    Limit or cut out dairy, particularly any that still contain protein (casein is very insulinogenic, which even if you don't have insulin issues, can contribute to weight gain, because insulin is a growth hormone)
    Switch to glass containers, away from plastic and lined metal (BPA and other endocrine disrupting chemicals)
    Switch away from teflon and other "non-stick" utensil coatings in favor of stainless steel and silicone (endocrine disruptors)
    Invest in a good water filter that filters out 99% or more toxins (I personally prefer the reverse osmosis system we have)

    If your doctor won't work with you, or still insists that you just need to lose weight, then fire them and get a new doctor. If you're currently working with more than one, fire them all if needed, at least for dealing with the PCOS. I recommend finding a doctor that works holistically and understands that our food and environment have a huge impact on us, so doctors that practice functional medicine, and you may even want to consider some forms of alternative medicine, such as naturopathy (I don't support homeopathy, but the holistic approach used is largely sound and can be helpful, especially when conventional medicine fails us). Don't be afraid to be choosy and "interview" various doctors, until you can find one that can genuinely help you. One of the best things you can have in your toolbox is the backing of a doctor.
  • RenaTX
    RenaTX Posts: 345 Member
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    However, our weight doesn't usually cause our PCOS, nor does it cause the hormonal imbalances in the first place. It exacerbates them, yes, but doesn't cause them (otherwise, thin people wouldn't have PCOS), and in fact, it's usually the other way around -- the PCOS causes the weight gain.


    ^^ This for sure. I suspect PCOS runs in my family. My grandmother had fertility issues and my 1st cousin also has fertility issues. My cousin is NOT over weight at all and my PCOS probably has been with me my entire life because I didn't have periods until an OBGYN put me on birth control.

    Everything else is a huge YES too. If I could hug ya Dragonwolf I would!
  • Alliwan
    Alliwan Posts: 1,245 Member
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    If I could hug ya Dragonwolf I would!

    haha! I agree, Dragonwolf has given us lots and lots of good information and places to research ourselves in the few months ive been here. I love reading her posts as I always learn something new!

    Thx Dragonwolf!
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    If I could hug ya Dragonwolf I would!

    haha! I agree, Dragonwolf has given us lots and lots of good information and places to research ourselves in the few months ive been here. I love reading her posts as I always learn something new!

    Thx Dragonwolf!

    :smooched: :blushing:

    Aww, thanks ladies!
  • MeepleMuppet
    MeepleMuppet Posts: 226 Member
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    If I could hug ya Dragonwolf I would!

    haha! I agree, Dragonwolf has given us lots and lots of good information and places to research ourselves in the few months ive been here. I love reading her posts as I always learn something new!

    Thx Dragonwolf!

    Yes. Make her your friend. She's a breath of fresh sanity.
  • CatShelton
    CatShelton Posts: 147 Member
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    I am an RD with a specialty in endocrine disorders. Dragon Wolf is amazing! I want to hug her too. I couldn't have said it better myself! Listen to her.
  • enasab111
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    I took a bunch of tests and the only thing i was told was that my testosterone is a little high. I guess i am probably insulin resistant considering he asked me to get back on metformin, but it does nothing for me AND the symptoms are terrible for me. I was also tested for cortisol but that hasn't come back yet. I feel like I have constantly heard that line because doctors don't really have the answers to this particular disorder. I hear it from every doctor i've been to. I've gone through a lot of them this year and fired quite a few (one insisted I was diabetic because i'm fat) so I want to give him a fair shot since he has been listening to me so far.

    Thank you for all your help and I will be trying this now!
  • RenaTX
    RenaTX Posts: 345 Member
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    I took a bunch of tests and the only thing i was told was that my testosterone is a little high. I guess i am probably insulin resistant considering he asked me to get back on metformin, but it does nothing for me AND the symptoms are terrible for me. I was also tested for cortisol but that hasn't come back yet. I feel like I have constantly heard that line because doctors don't really have the answers to this particular disorder. I hear it from every doctor i've been to. I've gone through a lot of them this year and fired quite a few (one insisted I was diabetic because i'm fat) so I want to give him a fair shot since he has been listening to me so far.

    Thank you for all your help and I will be trying this now!

    I would think you would have had to take a test. My RE had me take a glucose test to verify if I was.
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
    Options
    I took a bunch of tests and the only thing i was told was that my testosterone is a little high. I guess i am probably insulin resistant considering he asked me to get back on metformin, but it does nothing for me AND the symptoms are terrible for me. I was also tested for cortisol but that hasn't come back yet. I feel like I have constantly heard that line because doctors don't really have the answers to this particular disorder. I hear it from every doctor i've been to. I've gone through a lot of them this year and fired quite a few (one insisted I was diabetic because i'm fat) so I want to give him a fair shot since he has been listening to me so far.

    Thank you for all your help and I will be trying this now!

    Ask to see the results, if they did a metabolic panel, insulin should be on it (as well as blood sugar and possibly A1C). Barring that, you can pick up a blood glucose meter from pharmacies (since your doctor is working with you, he might be willing to give you a prescription for it to help lower your out of pocket costs). I personally prefer One Touch. Start testing your blood sugar for at least a week or two just as you would if you were diabetic. That will give you a good dataset for your blood sugar levels, and will be useful to see what foods affect your blood sugar levels. You should never go over 140 (or whatever the mmol conversion is, if you use that system), and ideally not much over 120. If you're in the 120-140 range, then you're at high risk for developing Diabetes in the future, and anything over 140 starts getting into clinical Diabetes territory and nerve damage risk.

    If you do, you'll really want to watch your carbs and especially avoid sugary stuff and minimize or heavily balance starchy carbs. It may also be beneficial to consider supplementing with cinnamon (helps blood sugar) and milk thistle.

    If you don't, then that's a great sign, though you'll probably want to tweak your diet based on where your blood sugar levels are at, especially if they start showing signs of impaired glucose tolerance (big jump between fasting levels and 1 and 2 hour post-carby meal, and 2 hour is higher or close to 1 hour; a 3 hour test can be done, too - should be close to fasting, it's a problem if it's closer to 1-2 hour tests).

    That said, if you don't respond to Metformin (note that it may or may not help you lose weight, that depends on whether the insulin resistance is the primary underlying cause of your weight issues, but it should show in your fasting insulin levels), there's no sense in being on it. It has one purpose, and one effect -- increase the liver's insulin sensitivity. If it's not doing that for you, then the side effects aren't worth it, and it's probably doing more harm than good to you (the kind of GI disruption Metformin causes can't be good for the gut flora, which are needed for a multitude of reasons).
  • enasab111
    Options
    I took a bunch of tests and the only thing i was told was that my testosterone is a little high. I guess i am probably insulin resistant considering he asked me to get back on metformin, but it does nothing for me AND the symptoms are terrible for me. I was also tested for cortisol but that hasn't come back yet. I feel like I have constantly heard that line because doctors don't really have the answers to this particular disorder. I hear it from every doctor i've been to. I've gone through a lot of them this year and fired quite a few (one insisted I was diabetic because i'm fat) so I want to give him a fair shot since he has been listening to me so far.

    Thank you for all your help and I will be trying this now!

    Ask to see the results, if they did a metabolic panel, insulin should be on it (as well as blood sugar and possibly A1C). Barring that, you can pick up a blood glucose meter from pharmacies (since your doctor is working with you, he might be willing to give you a prescription for it to help lower your out of pocket costs). I personally prefer One Touch. Start testing your blood sugar for at least a week or two just as you would if you were diabetic. That will give you a good dataset for your blood sugar levels, and will be useful to see what foods affect your blood sugar levels. You should never go over 140 (or whatever the mmol conversion is, if you use that system), and ideally not much over 120. If you're in the 120-140 range, then you're at high risk for developing Diabetes in the future, and anything over 140 starts getting into clinical Diabetes territory and nerve damage risk.

    If you do, you'll really want to watch your carbs and especially avoid sugary stuff and minimize or heavily balance starchy carbs. It may also be beneficial to consider supplementing with cinnamon (helps blood sugar) and milk thistle.

    If you don't, then that's a great sign, though you'll probably want to tweak your diet based on where your blood sugar levels are at, especially if they start showing signs of impaired glucose tolerance (big jump between fasting levels and 1 and 2 hour post-carby meal, and 2 hour is higher or close to 1 hour; a 3 hour test can be done, too - should be close to fasting, it's a problem if it's closer to 1-2 hour tests).

    That said, if you don't respond to Metformin (note that it may or may not help you lose weight, that depends on whether the insulin resistance is the primary underlying cause of your weight issues, but it should show in your fasting insulin levels), there's no sense in being on it. It has one purpose, and one effect -- increase the liver's insulin sensitivity. If it's not doing that for you, then the side effects aren't worth it, and it's probably doing more harm than good to you (the kind of GI disruption Metformin causes can't be good for the gut flora, which are needed for a multitude of reasons).

    I know I am not diabetic and have been tested for it many times. That isn't something that has ever been an issue with me. Maybe my problem is that I just don't know enough. I don't know if I am insulin resistant or if the weight gain only/mainly came from a unbalanced hormones. I think that has been what is holding me back from losing weight or losing then gaining it right back. So far I reduced my carbs and it has REALLY helped. Instead of 50 percent I changed it to 40% on my profile to see if that will help. So far so good so thank you!
  • enasab111
    Options
    I took a bunch of tests and the only thing i was told was that my testosterone is a little high. I guess i am probably insulin resistant considering he asked me to get back on metformin, but it does nothing for me AND the symptoms are terrible for me. I was also tested for cortisol but that hasn't come back yet. I feel like I have constantly heard that line because doctors don't really have the answers to this particular disorder. I hear it from every doctor i've been to. I've gone through a lot of them this year and fired quite a few (one insisted I was diabetic because i'm fat) so I want to give him a fair shot since he has been listening to me so far.

    Thank you for all your help and I will be trying this now!

    I would think you would have had to take a test. My RE had me take a glucose test to verify if I was.

    that particular doctor wasn't looking at my chart or order any tests. just made assumptions
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    I know I am not diabetic and have been tested for it many times. That isn't something that has ever been an issue with me. Maybe my problem is that I just don't know enough. I don't know if I am insulin resistant or if the weight gain only/mainly came from a unbalanced hormones. I think that has been what is holding me back from losing weight or losing then gaining it right back. So far I reduced my carbs and it has REALLY helped. Instead of 50 percent I changed it to 40% on my profile to see if that will help. So far so good so thank you!

    Testing glucose as though you were diabetic isn't to see if you are diabetic, but rather to have a by-proxy measure of your insulin sensitivity (with the idea that large spikes and drops in glucose correspond to large drops and spikes in insulin), in lieu of getting the actual blood tests done. Insulin resistance does not necessarily equate to diabetes.

    That said, if the metabolic panel has been done, then your fasting insulin has been measured (it's part of the metabolic panel). Regardless of what your doctor went over with your, or even that he said "you're not diabetic," ask for a copy of the test results.

    To help illustrate my point, here's a piece of my story:

    According to LabCorp (blood testing company), you have to have a fasting insulin over something like 20 or 25, and/or a fasting blood glucose over 100 to be considered even prediabetic. My fasting insulin was 18 and fasting blood glucose was 90, both on the high end, but far from setting off red flags when going by LabCorp's cutoffs. Yet I couldn't lose weight to save my life (not kidding, was doing an hour a day of moderate to intense exercise, 5 days a week, and restricting my calories per MFP's recommendations). In order to lose any amount of weight, I had to eat basically nothing (not kidding, we're talking 800-1200 calories, while still doing those moderate-high intensity workouts), suffice to say, that would last all of three days before I passed out from exhaustion.

    The two doctors I saw before (I got lucky), insisted that I simply wasn't trying hard enough, that 2000 calories (what MFP provides me on the sedentary settings, and about what the other three or so calculations give me, for losing a pound a week) was too much. One suggested I should join Weight Watchers, to help keep me accountable and "provide motivation." Even my own husband suggested a method to 'better motivate" me to lose weight (because, you know, looking in the mirror every day and seeing someone who's overweight and feels like crap isn't motivation enough).

    I finally found a doctor that understood how the insulin resistance progression works. I'm not diabetic yet. I'm not even prediabetic anymore. However, I will be if something doesn't change. It's just a matter of time. We already knew that I responded to Metformin, so she prescribed it to me. Tested a couple of months (and 10lbs) later, and my insulin went from 18 to 12.

    And that's the problem with both the medical threshold for Diabetes, and the idea that because your numbers are "normal," your body is working just fine and it must just be you. The medical threshold for Diabetes doesn't start until your glucose is regularly above 140, but by that point, the damage is already done. So, even without being Diabetic, you may still benefit from making sure your blood sugar is under control (low carb diets are great at this, but the meter can help fine tune things). Likewise, while you may not be "insulin resistant enough" to throw red flags, it might still be enough to throw off your body.

    That's what I was trying to get at (and what this was intended to clarify), but regardless, it's awesome to see you're seeing results from changing your diet, and results are what matters. So - :drinker:
  • RenaTX
    RenaTX Posts: 345 Member
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    Testing glucose as though you were diabetic isn't to see if you are diabetic, but rather to have a by-proxy measure of your insulin sensitivity (with the idea that large spikes and drops in glucose correspond to large drops and spikes in insulin), in lieu of getting the actual blood tests done. Insulin resistance does not necessarily equate to diabetes.

    That said, if the metabolic panel has been done, then your fasting insulin has been measured (it's part of the metabolic panel). Regardless of what your doctor went over with your, or even that he said "you're not diabetic," ask for a copy of the test results.

    To help illustrate my point, here's a piece of my story:

    According to LabCorp (blood testing company), you have to have a fasting insulin over something like 20 or 25, and/or a fasting blood glucose over 100 to be considered even prediabetic. My fasting insulin was 18 and fasting blood glucose was 90, both on the high end, but far from setting off red flags when going by LabCorp's cutoffs. Yet I couldn't lose weight to save my life (not kidding, was doing an hour a day of moderate to intense exercise, 5 days a week, and restricting my calories per MFP's recommendations). In order to lose any amount of weight, I had to eat basically nothing (not kidding, we're talking 800-1200 calories, while still doing those moderate-high intensity workouts), suffice to say, that would last all of three days before I passed out from exhaustion.

    The two doctors I saw before (I got lucky), insisted that I simply wasn't trying hard enough, that 2000 calories (what MFP provides me on the sedentary settings, and about what the other three or so calculations give me, for losing a pound a week) was too much. One suggested I should join Weight Watchers, to help keep me accountable and "provide motivation." Even my own husband suggested a method to 'better motivate" me to lose weight (because, you know, looking in the mirror every day and seeing someone who's overweight and feels like crap isn't motivation enough).

    I finally found a doctor that understood how the insulin resistance progression works. I'm not diabetic yet. I'm not even prediabetic anymore. However, I will be if something doesn't change. It's just a matter of time. We already knew that I responded to Metformin, so she prescribed it to me. Tested a couple of months (and 10lbs) later, and my insulin went from 18 to 12.

    And that's the problem with both the medical threshold for Diabetes, and the idea that because your numbers are "normal," your body is working just fine and it must just be you. The medical threshold for Diabetes doesn't start until your glucose is regularly above 140, but by that point, the damage is already done. So, even without being Diabetic, you may still benefit from making sure your blood sugar is under control (low carb diets are great at this, but the meter can help fine tune things). Likewise, while you may not be "insulin resistant enough" to throw red flags, it might still be enough to throw off your body.

    That's what I was trying to get at (and what this was intended to clarify), but regardless, it's awesome to see you're seeing results from changing your diet, and results are what matters. So - :drinker:

    Hey Dragonwolf-

    The glucose test given to me by my RE was to verify if I am insulin resistant and that came back negative so he decided Metaformin wouldn't help me. The glucose test given to me would have determined if I was insulin resistant correct?

    Thanks !
  • dragonfly123321
    dragonfly123321 Posts: 51 Member
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    I do agree with the low carb high protein like Dragonwolf suggests I find it so had to do I can only do it so long then I feel like I will go carb crazy but doing that is what got me to loose the 44 lbs that i lost along with circuit training with kettle bells but now I have been stuck for months I got a heart rate monitor that says I burn 700-900 calls during my hour workout & i do that workout at least 4 times a week its so frustrating
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    Hey Dragonwolf-

    The glucose test given to me by my RE was to verify if I am insulin resistant and that came back negative so he decided Metaformin wouldn't help me. The glucose test given to me would have determined if I was insulin resistant correct?

    Thanks !

    Was it the oral glucose tolerance test? That's the one where they give you glucose water, then measure your blood glucose level an hour or two later. If that's the one and it comes back negative, then it's a pretty fair bet it's right (at least in the clinical sense that you're not over the threshold for a diagnosis).
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
    Options
    I do agree with the low carb high protein like Dragonwolf suggests I find it so had to do I can only do it so long then I feel like I will go carb crazy but doing that is what got me to loose the 44 lbs that i lost along with circuit training with kettle bells but now I have been stuck for months I got a heart rate monitor that says I burn 700-900 calls during my hour workout & i do that workout at least 4 times a week its so frustrating

    No, no, no! Not high protein! Low carb, high fat, moderate protein. Protein is not fuel, carbs and fat are. If you lower your carbs, you must increase your fats in order to stay healthy. Otherwise, you risk protein poisoning (aka "rabbit starvation") and nutrient deficiencies. That's probably why you can't sustain it and end up with cravings that only fat or carbs can sate.

    Here's what I generally recommend:

    Protein - about 1g/lb (.5g/kg) of lean body weight
    Carbs - an amount that works for you and your goals. If you want ketogenisis, then you'll want to be under 50g or so (or 20-30g net carbs). For general low carb, I recommend aiming for a cap of 100g total (which is pretty easily attainable if you stick with non-starchy vegetables as your main carb source). You don't need a ton of carbs, even if you're active. Your performance will likely suffer for a short while, until you're adapted to the new level of carbs. Give it at least a solid month at your chosen carb level, then adjust if necessary (ironically, going into ketosis might actually do better than higher low-carb levels, as your body would be adapted to using ketones as a primary fuel source).
    Fat - fill in the rest, but should be at least .45g/lb of total body weight. If you can't get that without dropping your carbs to 0 (or less if it were possible), then you're probably not eating enough in general. Yes, that means it's going to look like a scary high number, but that's okay. Fat is not the devil, not even saturated fat, not even if you've been told you're at risk for cardiovascular disease (it's carbs that raise triglycerides and lower HDL, by the way, particularly the refined crap). Get your fats from high quality sources, and get them mostly as monounsaturated and saturated fats, some polyunsaturated fats are fine, but make sure you get ample Omega-3 fats (most polyunsaturated fat sources are very high in Omega-6, which, while essential, is counterproductive beyond 2:1 Omega-6 to Omega-3; seed and nut oils, to compare, have ratios starting at about 25:1 and some as much as 5000:1, if they have Omega-3 fats in them at all). The minimum amount is what's needed to support hormone balance and nutrient absorption.

    If you decide you want to try low carb, it's very important that you give it a solid month. Do not quit after a day or two, because it's hard, especially if you were eating in the ballpark of 300g of carbs a day (I've seen people do this, it drives me up a wall, because it continues to reiterate the myth that this isn't sustainable -- it very much is, if you take the time to adjust). There's an adjustment period, it's well-documented, called "carb flu," "keto flu," or "induction flu." Carbs, particularly refined ones, follow pathways similar to that of opiods, and triggers serotonin release. You're basically going through withdrawal, not unlike the withdrawal you get from caffeine. For most people, it will last a week, sometimes two. If you're seriously overhauling your diet (ie - from Twinkies and Big Gulps to Whole 30), then it might last longer and may take nearly the full month to get through it. Stick it out, though, because it's very, very worth it. During that time, I also recommend not trying to eat at a deficit. Instead, eat when you feel the need to, but give your body good foods and plenty of fat. The stress of the transition, coupled with the stress of cutting calories can be overwhelming. It might be a good idea to track, just to make sure you're eating enough. I know, it sounds insane, but eating this way has a suppressive effect on the appetite, and life will be far easier if you're eating enough food during this time. It's also good to track to reset your calorie gauge. It may seem like you're eating a ton, but you're probably eating far less than what you thought.
  • RenaTX
    RenaTX Posts: 345 Member
    Options
    Hey Dragonwolf-

    The glucose test given to me by my RE was to verify if I am insulin resistant and that came back negative so he decided Metaformin wouldn't help me. The glucose test given to me would have determined if I was insulin resistant correct?

    Thanks !

    Was it the oral glucose tolerance test? That's the one where they give you glucose water, then measure your blood glucose level an hour or two later. If that's the one and it comes back negative, then it's a pretty fair bet it's right (at least in the clinical sense that you're not over the threshold for a diagnosis).

    Yup. I had to fast , have blood drawn, then drink nasty , sugary orange stuff and then have more blood drawn . It was 4 hours + and about 9 blood draws .
  • RenaTX
    RenaTX Posts: 345 Member
    Options
    I do agree with the low carb high protein like Dragonwolf suggests I find it so had to do I can only do it so long then I feel like I will go carb crazy but doing that is what got me to loose the 44 lbs that i lost along with circuit training with kettle bells but now I have been stuck for months I got a heart rate monitor that says I burn 700-900 calls during my hour workout & i do that workout at least 4 times a week its so frustrating

    No, no, no! Not high protein! Low carb, high fat, moderate protein. Protein is not fuel, carbs and fat are. If you lower your carbs, you must increase your fats in order to stay healthy. Otherwise, you risk protein poisoning (aka "rabbit starvation") and nutrient deficiencies. That's probably why you can't sustain it and end up with cravings that only fat or carbs can sate.

    Here's what I generally recommend:

    Protein - about 1g/lb (.5g/kg) of lean body weight
    Carbs - an amount that works for you and your goals. If you want ketogenisis, then you'll want to be under 50g or so (or 20-30g net carbs). For general low carb, I recommend aiming for a cap of 100g total (which is pretty easily attainable if you stick with non-starchy vegetables as your main carb source). You don't need a ton of carbs, even if you're active. Your performance will likely suffer for a short while, until you're adapted to the new level of carbs. Give it at least a solid month at your chosen carb level, then adjust if necessary (ironically, going into ketosis might actually do better than higher low-carb levels, as your body would be adapted to using ketones as a primary fuel source).
    Fat - fill in the rest, but should be at least .45g/lb of total body weight. If you can't get that without dropping your carbs to 0 (or less if it were possible), then you're probably not eating enough in general. Yes, that means it's going to look like a scary high number, but that's okay. Fat is not the devil, not even saturated fat, not even if you've been told you're at risk for cardiovascular disease (it's carbs that raise triglycerides and lower HDL, by the way, particularly the refined crap). Get your fats from high quality sources, and get them mostly as monounsaturated and saturated fats, some polyunsaturated fats are fine, but make sure you get ample Omega-3 fats (most polyunsaturated fat sources are very high in Omega-6, which, while essential, is counterproductive beyond 2:1 Omega-6 to Omega-3; seed and nut oils, to compare, have ratios starting at about 25:1 and some as much as 5000:1, if they have Omega-3 fats in them at all). The minimum amount is what's needed to support hormone balance and nutrient absorption.

    If you decide you want to try low carb, it's very important that you give it a solid month. Do not quit after a day or two, because it's hard, especially if you were eating in the ballpark of 300g of carbs a day (I've seen people do this, it drives me up a wall, because it continues to reiterate the myth that this isn't sustainable -- it very much is, if you take the time to adjust). There's an adjustment period, it's well-documented, called "carb flu," "keto flu," or "induction flu." Carbs, particularly refined ones, follow pathways similar to that of opiods, and triggers serotonin release. You're basically going through withdrawal, not unlike the withdrawal you get from caffeine. For most people, it will last a week, sometimes two. If you're seriously overhauling your diet (ie - from Twinkies and Big Gulps to Whole 30), then it might last longer and may take nearly the full month to get through it. Stick it out, though, because it's very, very worth it. During that time, I also recommend not trying to eat at a deficit. Instead, eat when you feel the need to, but give your body good foods and plenty of fat. The stress of the transition, coupled with the stress of cutting calories can be overwhelming. It might be a good idea to track, just to make sure you're eating enough. I know, it sounds insane, but eating this way has a suppressive effect on the appetite, and life will be far easier if you're eating enough food during this time. It's also good to track to reset your calorie gauge. It may seem like you're eating a ton, but you're probably eating far less than what you thought.

    Ah the Whole30. On another board I frequent a poster talked about this. It really makes a lot of sense. The website she gave us was http://www.whole30.com/

    There is a book you can buy and the website has a support forum. I think I'm going to buy the book, read it and give it a try in May or June. My schedule is really packed at the moment so finding time to read the book will be the biggest challenge right now.
  • diwijo13
    diwijo13 Posts: 106 Member
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  • KnitOrMiss
    KnitOrMiss Posts: 10,104 Member
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    Lots of great but overwhelming info here...I have nearly every symptom on this list (though some are managed). However, I have a huge one that isn't on this list but that I've recently had suggested to me as related - and that is that literally, every single time I eat or work out in any way, I pass out (I call it narcing out b/c I doze off and never realize it until I am waking up). I've gotten in such trouble at work (on more or less my final warning). I have an appointment with a new Endo next week, and I've no idea where to start on the formal diagnosis and treatment... Overwhelmed to say the least!!