Insulin suppression

(a97f7425e41bf0302b59) #1

Has anyone heard of insulin suppression? Dr Rob Cywes speaks to that. What are the thoughts on that? I’m wondering if that’s what’s happening with me

(KM) #2

What do you mean by “what’s happening to you?”

(a97f7425e41bf0302b59) #3

The problem is that, although I’ve been keto for a long time, my A1C is going up and so are my BG numbers. Dr Cywes also believes that extra high cholesterol is also a sign of this. It’s like he’s describing me. Higher A1C, higher BG in general, BG numbers taking much longer to come down and very high cholesterol. This is not something I can ignore. It might be how long term ketoers end up and it might actually be beneficial but at this point I simply don’t know. My A1C was down to 5.2 and it’s risen to 6.0. Is that dangerous? Is it something I need to worry about? That’s the rabbit hole I’m going down now.

#4

A 6.0 is only an average of 126, so not freak out levels at all, but definitely don’t like the term Insulin "suppression. Insulin isn’t your enemy, chronically high Insulin is. How bad is your cholesterol? Do you track your dietary intake? Also, even at 5.2 that’s an average of 103, so a difference of 23, which is well within a normal (small) transient rise. Not a huge deal, don’t want your average to be that, but the difference as a whole isn’t bad. Do you know what your fasting insulin is, or how long it takes you to return to baseline after a large rise?

#5

I am data driven, so I would want to see the following related to Heart health:
apoB to predict risk
Full Lipid panel
Lp(a)
APOE (genotype) This tells you your risk level but not how much atherosclerosis is currently present.
Homocysteine
Uric acid
Thyroid function
Iron
Ferritin
CAC score
A CT angiogram

OGTT/Kraft where they also test insulin levels with extractions every 30 minutes over a course of 2 hours.

The world of medicine is not perfect but the more information you have or your doctor has it can potentially save your life. Keep in mind that most people who have high blood pressure don’t even know it. This is why it is called the “Silent killer.”
Most cancers if caught early can be treated successfully.

(Alec) #6

Here’s my opinion of what is going on here: the A1C test assumes that your red blood cells live for a certain timeframe. This number is usually quoted as 3 months as that is the normal time that they live (in the general population).

However, if your blood sugar is generally low and your systemic inflammation is generally low, your red blood cells can last longer… I have heard Ken Berry talking about up to and maybe longer than 4 months. If the red blood cells just last longer than the average, then your A1C will go up… not because your average BG is higher but because the red cells are lasting longer exactly because your average BG is low and inflammation is low.

This effect is mentioned in the article below… it is a bit technical, and it doesn’t go into the details of this effect, but it does mention it.

I also suggest that if you are concerned by this, get a CAC scan done, get a fasting insulin level test done a few times (alas, there is no such thing as a continuous insulin monitor!), and also do a regular BG check using the normal strips, and monitor the BG level in various scenarios. Or even better get a CGM for a month or 2… I reckon there’s lots to learn with these tools!

If you are truly keto, and your BG level is not being spiked by ingested carbs, then the only root cause if your BG is really rising is that your body is making it… it seems to want it. Now, the question is: why?

(You've tried everything else; why not try bacon?) #7

First, let’s start with what will make your doctor freak out, cholesterol. What about it is high? Do you have a lipid panel you could post? I’d be particularly interested to know what your ratio of triglycerides is to HDL, because that’s the number to watch. Low triglycerides and high HDL are a sign of cardiovascular health, no matter what the rest of your cholesterol is doing. Lowering LDL with a statin does nothing to reduce cardiovascular risk, because cholesterol does not cause cardiovascular disease. It is a nothing more than a marker of the metabolic condition that actually causes cardiovascular disease.

Now, as for your blood sugar: are you under a lot of chronic stress these days? Short-term stress the body is designed to handle; it’s long-term stress that does damage, and part of that damage is from raising blood sugar.

Also, are you eating enough fat? Amber O’Hearn’s hypothesis is that people can be afraid of fat and not eat enough; the body then compensates by making glucose from protein.

Next, what are you eating, these days? Take a good, hard look at your diet, to see if carbohydrates have crept in anywhere. If you eat any processed foods, re-examine the labels, because manufacturers often re-formulate their products to lower their costs, and the new formula can contain more of the unhealthy ingredients. If you are eating any seed oils (so-called “vegetable” oils), remove them from your diet, because they cause inflammation, which can raise blood sugar.

Lastly, what does the rest of your blood work look like? It would be interesting to know what your inflammatory markers are doing, plus things like liver and kidney enzymes.

Bear in mind, also, that cholesterol, blood sugar, insulin, and several other markers are quite variable, and one blood test a year hardly captures any of that volatility. Also, the HbA1C test and some of the others are highly susceptible to how hydrated you were at the time of the blood draw, whether you didn’t fast long enough or fasted for too long, and all that sort of thing.

(Alec) #8

HALLELUJAH!!! Preach it Brother!!

#9

There’s research showing that the risk of developping diabetes complications such as neuropathy, nephropathy and retinopathy increase with your A1c. If my memory is correct, it becomes more serious when your A1c is around 6.5% and it gets worse the higher it goes.

Also, there’s research linking fasting blood glucose (FBG) to CVD and other unwanted health outcomes.

So, I was particularly concerned when after a while on a keto diet, my FBG and A1c were increasing. I was told to decrease carbs even more and went carnivore. My FBG increased even faster and was already above 110 mg/dL.

I had by then developed a fear of carbs. But I fought that fear and reintroduced carbs in my diet. After a difficult transition, my FBG that was already above 110, came down. My last blood panels showed a FBG in the high 80s mg/dL.

All the markers of insulin resistance changed and are now excellent.

How is your FBG?

(Bob M) #10

That’s because instead of your body producing blood sugar for whatever it thinks it’s good for, you’re getting blood sugar from bouts of higher carb, so your body has to produce less.

And since most markers of “insulin resistance” contain fasting glucose (are there any that don’t, other than LPIR?), you’re get a better value for “insulin resistance”. But are you really more insulin sensitive because you’re now eating carbs? I don’t know, but I doubt it.

All you’ve done is gotten a different number on some metric. We would need a large study of people who are keto/carnivore with higher “fasting” glucose versus a group that eat some carbs to lower their “fasting” glucose and follow them for 5+ years to figure this out. Personally, I doubt either side is better off, other than I don’t think bouts of high carb are good for anyone.

#11

Perhaps. Time will tell and I’ll re tweak if necessary.

My CGM data has radically changed for the better, as did my lab results. For the moment, I’ll accept that as proof it’s working for me.

(Kent) #12

Corals, when you say you re-introduced carbs into your diet, what are you talking about with regards to amount? You went from 20g a day to 30g? 40g? ???

#13

Hi Kent. At this moment, I’m not counting, but I’d say about 100 g a day on the days I eat many carbs. It was less, but my blood glucose has been so good, I’m slacking. It’s the effect of being on vacation, too.

I’ll be back to work soon and I’ll stop with the slacking. Not because of any issue, since I didn’t put on weight, but just to be healthier, since in these carbs there are bad choices, too.

(Kent) #14

Corals, It’s been a 5 months. Any updated news/thoughts/info on the whole re-introducing carbs situation?

#15

Hi Kent.

Yes. My blood sugar is almost normal now.

But: in the meantime, I’m using hormonal replacement therapy and I can’t be sure that’s not what is helping the most.

Now I’m avoiding only sugar, pasta and bread. I eat all the other things and my blood glucose seems to be rather ok. I’m practically vegetarian, now, because I never loved meat anyway. Not counting carbs.

I eat veggies, ocassionaly fruit (don’t like fruit, that’s why I say ocassionaly), fish ocassionaly, meat ocassionaly. Lots of chickpeas (my staple is lots of veggies like pumpkin, carrots, aubergines, with a good amount of chickpeas). I have a lot of cheese (always loved it) and yogurts. Also, about 2 eggs per day (my favorite protein rich food). I don’t eat butter like before and avoid too many saturated fats, because I do want to keep my cholesterol in the normal range. I’ve noticed sat fat increases my cholesterol. Pity, because I love butter!

#16

While eating saturated fats does raise cholesterol, that’s not synonymous with bad. Our hormones require cholesterol as it’s the building block of most of them, especially steroid hormones. Skin takes a huge hit on lower cholesterol diets as well. Since cholesterol being the cause of coronary disease is debunked at this point, worry about the breakdown, not the serum level. Especially if those numbers are from an outdated calculate panel and not an NMR.

#17

Cholesterol is very much needed by our bodies. But like water, also super necessary, there’s such a thing as too much. It shouldn’t be low and it shouldn’t be high.

(Brian) #18

Interesting discussion. I’ve heard Dr. Cywes’ YouTube videos on this subject and am not too quick to write them off.

Just like some might do really well on a diet with 100g / day of carbs, some will find that too much. Who’s right? Who’s wrong? I think we get too wrapped up in ourselves and forget that not every human will be a carbon copy of the next.

If your numbers are excellent on a strict carnivore diet, great! If your numbers are becoming skewed in some way on that same strict diet over time, I applaud those who look for an answer as to why and what they can do about it.

We tend to become enamored with what we choose and wanna “defend it to the death”. It is a wise person who continues to evaluate and react to the changes as they happen. I’ve known people who have done well as vegans for a short time. I do not believe that is a healthy place to hang out for too long, though. (Your opinion may vary, and that’s OK.)

In my own personal opinion, I think Dr. Cywes has some legitimate arguments against just letting one’s pancreas sit idle, pretty much forever. Doesn’t mean we need to eat boxes of donuts every so often. Giving it something to do on a regular basis, though, I can see the argument for that. (Again, you may disagree.)

He often says at the ends of his videos that if you want a consultation, to get in touch. Maybe that wouldn’t be a bad idea. (?)

(KM) #19

You actually pinpointed my biggest frustration. There is little or no data as to where those numbers “ought to be”, given a strict carnivore diet - or even a moderate keto diet. @SomeGuy Joey mentioned this in his thread about heart arrhythmia; apparently his magnesium needed to be much higher than the normal range for someone eating SAD.

On one hand I don’t want to be “defending my diet to death”, perhaps there are elements that are not working, on the other, I’m not sure where to draw a line regarding asymptomatic changes in lab results. I find it difficult to be enthusiastic about any testing, considering my results are likely to be either off the charts due to my diet, or potentially “normal”, but a big problem for me personally due to my diet, and in either case the person interpreting the data seems unlikely to have anything useful to tell me, as the data to inform interpretation apparently doesn’t exist.

(Bob M) #20

I think it’s hard to know. January 1 of next year will be my 13th year on keto, yet my last 12+ hour fasting insulin level was 12.5. I’ve gotten similar fasting insulin (though maybe 8+ hours of fasting and not 12) from 3.7 to 33. Why? And why isn’t mine 3 or 4? (Some people say if your fasting insulin is >4, you’re “insulin resistant”, but I’ve run out of things to try to lower

Similarly, while I do get cramps periodically, I haven’t figured out why. If I was to increase my carbs and get no cramps (which some people say happens to them), why? What’s the difference?

Supposedly, if you have lower insulin, you tend to need more salt, magnesium, potassium, because your body doesn’t hold onto it. Maybe that’s what happens with some people – they feel better on higher carb because they go from really low insulin to higher insulin, but this stabilizes their electrolyte intake? Whereas some of us never get (consistently) that low in insulin, so we don’t have the same effect and have better electrolytes?

I think human variability means that we’ll never figure out – for everyone – what these numbers should be. But maybe we could get a good range?