Insulin Resistant Folks - Postprandial Somnolence (Falling Asleep After Eating) Question
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KnitOrMiss
Posts: 10,104 Member
So, my endocrinologist diagnosed me as insulin resistance based on my mistaken diagnosis of narcolepsy, which was triggered only by eating (45-90 minutes after), which I've now learned is a type of postprandial (after eating) somnolence (sleeping/passing out), but I called it "food narcolepsy" for years because I didn't know it was a real thing that actually happened to other people.
Well, my endo put me on Metformin ER for it. I had good reactions at first. Then dairy complicated and exacerbated the ... bathroom reactions ... anyone who's had that reaction will know exactly what I mean. So, since I did a trial of stopping it for about 2-3 months before my 6 month check in, combined with low carb eating, and my A1c and fasting insulin both showed improvements, my endo was okay with me remaining off the medication.
Fast forward a few more months. I'm now having occurrences of this, mostly after lunch, and rarely with carb heavy anything, because I just don't do carb heavy foods in general. I've recently run across information that shows that the glycemic impact of the powder/bulking agent used in most powdered form of artificial sweeteners is higher than sugar itself. Since that means that in addition to the "sweet taste" in general spiking my insulin reactions, the AS itself may also compound this reaction.
I'm starting to have more severe episodes of the sleep creeps popping back up. Literally, I will feel fully alert and be working at my desk and just nod off mid thought. Sometimes it is for mere seconds, sometimes (more often at home) for minutes. The only thing I've really changed in the last few months is that I discovered some Splenda packets at work that needed to be used up, so I'd been working them into my rotation along side stevia/erythritol blend, that on the website shows agave fiber for bulking but on my box has natural flavors listed last, but no fiber listed. I can't even figure out what I'm using (I had to change my Stevia brand, as my store stopped carrying the one I had been using).
I'm so utterly confused as to what is happening, and I was just wanting to shout out to other Insulin Resistant folks and see if they share any of these issues.
Aside from ditching the sweeteners in favor of liquid SweetLeaf, which I'm currently unable to find, and which I've been told is the only verified AS without a GI result, does anyone have any ideas or suggestions? I'm barely sweetening to tolerance anymore - not even to the level of "sweet." I'm just using them still to take the edge off of other flavors. I'm losing my mind, and my endocrinologist is about out of ideas, but he's willing to research other ideas...
Well, my endo put me on Metformin ER for it. I had good reactions at first. Then dairy complicated and exacerbated the ... bathroom reactions ... anyone who's had that reaction will know exactly what I mean. So, since I did a trial of stopping it for about 2-3 months before my 6 month check in, combined with low carb eating, and my A1c and fasting insulin both showed improvements, my endo was okay with me remaining off the medication.
Fast forward a few more months. I'm now having occurrences of this, mostly after lunch, and rarely with carb heavy anything, because I just don't do carb heavy foods in general. I've recently run across information that shows that the glycemic impact of the powder/bulking agent used in most powdered form of artificial sweeteners is higher than sugar itself. Since that means that in addition to the "sweet taste" in general spiking my insulin reactions, the AS itself may also compound this reaction.
I'm starting to have more severe episodes of the sleep creeps popping back up. Literally, I will feel fully alert and be working at my desk and just nod off mid thought. Sometimes it is for mere seconds, sometimes (more often at home) for minutes. The only thing I've really changed in the last few months is that I discovered some Splenda packets at work that needed to be used up, so I'd been working them into my rotation along side stevia/erythritol blend, that on the website shows agave fiber for bulking but on my box has natural flavors listed last, but no fiber listed. I can't even figure out what I'm using (I had to change my Stevia brand, as my store stopped carrying the one I had been using).
I'm so utterly confused as to what is happening, and I was just wanting to shout out to other Insulin Resistant folks and see if they share any of these issues.
- Doctor is reluctant to put me back on Metformin due to extreme complications with dairy in my diet causing massive gastro and restroom complications.
- I cannot take Inositol in large doses (an insulin sensitizing medication) as it seems to wreak havoc on me hormonally).
- The last time I attempted cinnamon supplements (at the same time as flax supplements, unfortunately), I broke out in a rash on my arms, and I couldn't figure out (through isolation) which supplement caused the reaction as it continued with each, long term. I'm willing to consider these again.
Aside from ditching the sweeteners in favor of liquid SweetLeaf, which I'm currently unable to find, and which I've been told is the only verified AS without a GI result, does anyone have any ideas or suggestions? I'm barely sweetening to tolerance anymore - not even to the level of "sweet." I'm just using them still to take the edge off of other flavors. I'm losing my mind, and my endocrinologist is about out of ideas, but he's willing to research other ideas...
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If I were you, I would just stop with the sweeteners. They are hard to resist, but it could at least be seen as an experiment? Maybe for 3 weeks? And what about a lower dose of metformin? 500mg never gave me diarrhea etc, but 1000 did. 500mg was just enough to help me at the time. I don't need any now. I also found that there was quite a long adjustment period for my gut to get used to metformin. I had gestational diabetes and remember it took a few weeks of taking it before the tummy issues faded.
Pre LCHF I used to fall asleep 3+ times per day and had never heard of postprandial somnolence until the low carb forum. Horrible isn't it? I still nap during the day sometimes but my 2.5 year old daughter doesn't sleep through so it is on purpose now.
Erythritol screwed with my weightloss and gave me cravings so I've even given up on that now :-(.0 -
Many years ago as an English teacher, I went to my doctor at the time complaining that I always fell asleep in my 5th period class immediately after lunch in the school cafeteria...I was in my 20's at the time (40+ years ago!!) and I don't think much was known about low carb, but he did suggest that I bring healthy lunches from home instead of the junk they were feeding the students. (Yikes - can you imagine what it was like to fall asleep in front of 30 9th graders who were also bored and likely stoned in class?!?) That food recommendation helped...but flash forward all these years, now I, too, am insulin resistant, on Metformin ER, but have overcome the initial reactions from the drug. Curious if eliminating dairy from your diet in addition to ditching the sweeteners might help you. (I gave up putting sugar in tea and coffee a long time ago and have adjusted to doing without it in beverages as well as in cooking.) Good luck to you in finding a solution to this challenge.
p.s. my low carb way of eating has helped me reduce my A1C and I've lost 34 pounds so far since February. 30 more to go and hoping to get the metformin reduced when I return to the doc for a recheck.0 -
If dairy is the thing reacting with Metformin, I'd cut it out:(
Read Dr Fung's series on fasting and why addressing the twin cycle of insulin resistance and dysfunctional beta cells in pancreas is healed with fasting. Lowcarb is good for many things, but is only a part of repairing metabolic syndrome.
If I were you, I'd also go to forums with people who have PCOS. Maybe they have more specific details/protocols/experiences to sgare.
I remember those carb coma moments. I had them after 15-20 mins. They come back sometimes, but not so severe.0 -
If I were you, I would just stop with the sweeteners. They are hard to resist, but it could at least be seen as an experiment? Maybe for 3 weeks? And what about a lower dose of metformin? 500mg never gave me diarrhea etc, but 1000 did. 500mg was just enough to help me at the time. I don't need any now. I also found that there was quite a long adjustment period for my gut to get used to metformin. I had gestational diabetes and remember it took a few weeks of taking it before the tummy issues faded.
Pre LCHF I used to fall asleep 3+ times per day and had never heard of postprandial somnolence until the low carb forum. Horrible isn't it? I still nap during the day sometimes but my 2.5 year old daughter doesn't sleep through so it is on purpose now.
Erythritol screwed with my weightloss and gave me cravings so I've even given up on that now :-(.
I have tried giving them up completely, but for now, they are a critical part of the way I stay compliant to this WOE. I can't drink tea without something to take the edge of the tannins, or it has a weird chemical type reaction in my mouth.
My body reacts to fruits the same was a junk candy, and I'm still not prepared to go fully without anything even slightly sweetish. It starts to make me a bit mental. That's why I mentioned I only sweeten to tolerance level, not to flavor preference. And eliminating dairy at this point is not logistical either.
I use heavy cream (and can't stand coconut cream/flavor) in my tea daily, and hard cheese is something I eat every day. These are considerations for down the road, but right now I cannot make the changes, as I have a huge amount of exterior stress that would make these cuts likely to increase my failure chances.
So yes, these things are on my radar as things to try, and I've already cut down my sweet profiles (I used to be a 5-heaping teaspoons per 12 oz of hot tea person....and now I do maybe 2-3 packets of sweetener in 30 oz of tea)...but I need to work on this again.
And the Metformin, I was on the 500 mg ER - and I couldn't eat any dairy or carbs 4 hours either side of my dose, so that made breakfast impossible for me at that time. Wasn't something I could figure out how to work around then... Doc is reluctant to try Met again unless symptoms continue.gerrielips wrote: »Many years ago as an English teacher, I went to my doctor at the time complaining that I always fell asleep in my 5th period class immediately after lunch in the school cafeteria...I was in my 20's at the time (40+ years ago!!) and I don't think much was known about low carb, but he did suggest that I bring healthy lunches from home instead of the junk they were feeding the students. (Yikes - can you imagine what it was like to fall asleep in front of 30 9th graders who were also bored and likely stoned in class?!?) That food recommendation helped...but flash forward all these years, now I, too, am insulin resistant, on Metformin ER, but have overcome the initial reactions from the drug. Curious if eliminating dairy from your diet in addition to ditching the sweeteners might help you. (I gave up putting sugar in tea and coffee a long time ago and have adjusted to doing without it in beverages as well as in cooking.) Good luck to you in finding a solution to this challenge.
p.s. my low carb way of eating has helped me reduce my A1C and I've lost 34 pounds so far since February. 30 more to go and hoping to get the metformin reduced when I return to the doc for a recheck.
This is scary, what they are doing to kids in school under the guise of "healthy." I've also reduced my A1C and fasting insulin levels, and I did blood work 3 months into low carb. I go back in October. I've lost roughly 20 pounds since January, but 2 full pants sizes, and going on 3 - so a mass of inches/centimeters all over.0 -
Foamroller wrote: »If dairy is the thing reacting with Metformin, I'd cut it out:(
Read Dr Fung's series on fasting and why addressing the twin cycle of insulin resistance and dysfunctional beta cells in pancreas is healed with fasting. Lowcarb is good for many things, but is only a part of repairing metabolic syndrome.
If I were you, I'd also go to forums with people who have PCOS. Maybe they have more specific details/protocols/experiences to sgare.
I remember those carb coma moments. I had them after 15-20 mins. They come back sometimes, but not so severe.
The PCOS forum that I'm in has most of the same folks as here, really. And Insulin Resistance is not limited to PCOS. Many men and diabetics and others also have it.
I am struggling with fasting, not due to the fasting itself, but rather due to the ... bathroom situation of loose stool for 4+ hours due to bile dumping if I go past about the 8 hour mark of fasting. I do not have a gallbladder, and so I get times where if I go too long without eating, my body will dump bile into my empty stomach, which burns on the exit path. I've yet to remedy this, but I'll look up the series you suggested.
The Dairy did interfere with the Metformin, but I am not longer taking Metformin due to that complication. My endocrinologist doesn't want me to go back on the Metformin if I can help it, due to the weird complications I developed.
Also, I've had dairy daily in some form since 1/15/15 which was my start date. This postprandial somnolence did not return until about six weeks ago, so maybe June? I went from January to June without issues, then starting again in June, it resurged. Because dairy was not prohibitive the first 4.5 months, I'm reluctant to put it first on the firing line now.0 -
It is amazing how differently our bodies react to things - especially when one thing works for one person and the same thing is completely wrong for another. You'll find your way...this isn't an easy process by any means.
(p.s. - the unhealthy lunch thing was in 1972!!! Hard to remember myself in my 20's when I was weighing 125 lbs!)0 -
I don't have a gallbladder either, looks like we have a lot in common!
I could not face giving up on dairy either, I love it too much. Plus I'm on a budget and can't afford every meal to be meat. I have never had a problem with dairy either that I know of. Sugar replacements I can't ever get right though.
Black coffee is gross. I haven't had tea since low carb, as I agree - it needs something sweet in it. Coffee tastes good with just cream but I doubt tea would. And ditto on coconut cream, yuck!
I'm not too sure if there is anything else to do, if there is nothing to be changed or elimated without making this WOE miserable for you. :-(0 -
I wish it were easier for you to quit all AS as that would be the easiest route by far
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Oh wow, that is a lot to sort out. I'm afraid I don't have advice to offer except to suggest looking for Stevia in the health food stores (of supplements). I've bought it there a coulple of times if Superstore was out.
Best wishes.0 -
KnitOrMiss wrote: »Foamroller wrote: »If dairy is the thing reacting with Metformin, I'd cut it out:(
Read Dr Fung's series on fasting and why addressing the twin cycle of insulin resistance and dysfunctional beta cells in pancreas is healed with fasting. Lowcarb is good for many things, but is only a part of repairing metabolic syndrome.
If I were you, I'd also go to forums with people who have PCOS. Maybe they have more specific details/protocols/experiences to sgare.
I remember those carb coma moments. I had them after 15-20 mins. They come back sometimes, but not so severe.
The PCOS forum that I'm in has most of the same folks as here, really. And Insulin Resistance is not limited to PCOS. Many men and diabetics and others also have it.
I am struggling with fasting, not due to the fasting itself, but rather due to the ... bathroom situation of loose stool for 4+ hours due to bile dumping if I go past about the 8 hour mark of fasting. I do not have a gallbladder, and so I get times where if I go too long without eating, my body will dump bile into my empty stomach, which burns on the exit path. I've yet to remedy this, but I'll look up the series you suggested.
The Dairy did interfere with the Metformin, but I am not longer taking Metformin due to that complication. My endocrinologist doesn't want me to go back on the Metformin if I can help it, due to the weird complications I developed.
Also, I've had dairy daily in some form since 1/15/15 which was my start date. This postprandial somnolence did not return until about six weeks ago, so maybe June? I went from January to June without issues, then starting again in June, it resurged. Because dairy was not prohibitive the first 4.5 months, I'm reluctant to put it first on the firing line now.
Perhaps have a look and see if the kind or amount of dairy has changed? You might have unknowingly changed the type or amount of dairy that you primarily eat and have perhaps hit a tolerance threshold.
What else has changed, recently? Have your protein or carbs creeped up? Has the percentage of carbs as sugar/non-fiber creeped up?
Unfortunately, it might also be the AS that you're using now. So you can either forego the AS and either not consume the foods you feel you "need" it in or just deal with it without. It can be done, I assure you. I've actually grown quite fond of what the coffee shops called "breve lattes," which use cream (or half and half) instead of milk, and I'm such a supertaster that all coffee tastes the same to me (bitter). I also quite enjoy most teas without any sweetener, even the black/orange that is most iced teas.0 -
Carly,
I'm not insulin resistant that I know of, but I would definitely concur that you should try to ditch the AS completely, even if just for a few weeks to gauge effects.
As you know, I was having problems with AS myself. Well, I thought it was a possibility that they were hindering my progress. I've now successfully given up sugar-free gum completely, and most remarkably I've finally done away with the sweetener in my tea/coffee. I never thought I'd be able to tolerate unsweetened drinks, but I reduced it each day, (not liking what I was drinking but drinking it anyway), and within the week I wasn't tasting much if any sweetness anymore so I nixed it completely. Now I've formed a habit of drinking it this way, it's starting to become more tolerable - even, dare I say it, nice.. sometimes. What is super nice and rewarding about drinking unsweetened tea/coffee is the knowledge that You're doing the best for your body and not ingesting anything that could be harming your health or weight loss progress. Artificially sweetened hot drinks kind of lost their appeal when I realised the sweetener was likely messing with my body.
However, I'm not entirely reformed, as I still drink Pepsi max, but this and my whey protein are my only regular sources of AS now., and the dramatic decrease in my consumption has the scale moving down again and I feel much better in myself.
I definitely think it's worth a try having a rest from sweeteners for a while and see if you find it helps. You can do it! If I can (almost!), then you can too, for sure, coz I'm a wimp! Oh and try some fruit teas too, Carly - they really helped me get accustomed to not adding sweetener. X
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Ooh, I meant to say, powdered Splenda always kicks me out of Ketosis, if I have 2 packets or more. Such a small amount but I've tested it several times with my trusty ketostix and the same thing always happens, at times it couldn't possibly be anything else causing it. I moved on to liquid sacralose which doesn't have any insulin spiking fillers, but I still do much better without it, it seems. And besides, I've read some nasty things about sacralose potentially being a carcinogen, so all in all I don't fancy adding that sort of poison to my body in large amounts anymore.0
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Just as a side note, bile should not be being dumped into your stomach. It drips into your intestines. With no gallbladder I would assume no dumping? I was told it would be a constant stream.0
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One other item to consider, since you are searching for possibilities. Has anything changed in your sex hormones? The strongest episodes of falling asleep - in my case, literally passing out - was when my baby breastfed (= tons of rapid hormone changes). HTH0
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Have you considered Metformin without the extended release? I'm insulin resistant and used to take that. It was before ER was available I think. I used to take it twice a day and did not have issues. It was recommended to eat with food, but I often took it on an empty stomach. I think we can build a tolerance for it.
Better than any medication for me was cutting out fruits and only drinking water0 -
Is this the Sweetleaf you are looking for?
http://jp.iherb.com/Wisdom-Natural-SweetLeaf-Liquid-Stevia-SweetDrops-Sweetener-Vanilla-Creme-2-fl-oz-60-ml/11070#p=1&oos=1&disc=0&lc=en-US&w=sweetleaf&rc=36&sr=null&ic=1?rcode=MUK142
I too have noticed that after lunch sleepiness, esp. after eating my homemade erythritol-sweetened bars. Guess I will order some Sweetleaf and try that. I find that I need fewer sweeteners the longer I eat lchf. Drink more water instead?0 -
OK - here's a thought somewhat out of left field, but perhaps worth considering. I've found myself a bit "fuzzyheaded" (don't know how to describe it) after lunch or afternoon. It could easily be taken care of by a nap, but didn't 'feel right'. This was especially strange to me because I usually feel so much more clear headed and energetic in ketosis.
Then I realized I hadn't been intentionally drinking water, so I drank two large glasses and immediately felt better. Then I decided I better be doing the boullion as well and that really helped.
So... you may up your salt / boullion intake a bit and make sure you're drinking enough water (usually more than we want) and see what happens.0 -
I used to get what I called "Carb induced Narcolepsy." Not any more though.
Many years ago, I working a Saturday at the office. Had an MSG laden Chinese take out lunch. Knocked me out for an hour
I just don't do high carb foods much anymore. Once is a great while and certainly never when I'm on a road trip.
At one time my A1C was approaching borderline T2. But that changed when I cut way back on carbs.0 -
Is it the PureVia sweetener that you can't find now that you were using and you were not having this reaction? I found some on Amazon.com 800 packets for like $26.0
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There was a rant here. I'm sorry deleted.0
