Leaving meds & non-hunger question

(Sharon A Peters) #1

This is a two-fer: I have begun an experiment to track my BG every couple of hours throughout the day, for a trial period of 4-6 weeks. I eat with a 4-hour feeding window in the late afternoon; I have been keto for awhile now. I have been on Metformin since my diagnosis in the late 90’s - but I thanks to this group and my readings, I believe that I was T2D long before that.
In the last couple of days and in the midst of my BG checking frenzy, I found that I had a high of 101 and a low of 82, with 87 - 94 being the most frequent reading. So. I decided to stop the Metformin (500 mg/2x day); last dose was 11/28 in the morning. So far my readings have continued between 82 and 96 (with a large cup of very strong coffee, 1ozl HWC).

So, question 1: is there a residual effect of Metformin? Should I expect those numbers to go up, even with adherence to keto and a 4 hour window? Is it better to step it down? Of course, my frequent readings are the best guide as to what’s up with the BG, but I’d like any additional info or comments from those who have been there. As it is, I am pretty excited, especially because I have been a bit sporadic with my exercise program.

Question 2: and this is an old one … I know not to force myself to eat to macros unless I am truly, physiologically hungry - especially my fat macro; however … there are times when I am just not hungry at all, so I just do not eat (this is not a planned fast), and, of course, I fall below - sometimes well below - my macros for protein. Is this a problem? I feel well otherwise, just not hungry, and, given my history, I do not want to eat just for the sake of eating … even if it is keto. What’s the general word on this? I get it that I should eat when I am hungry … but with this woe, I am shocked at the fact that I can now tell the difference between body hunger and emotional hunger.

Thanks in advance!!!

(Keto in Katy) #2

I can’t speak to the Metformin question, but regarding hunger I would listen to my body. We have hunger signals for a reason. If you feel well and are not hungry, I don’t see an issue there. I sometimes go 24 hours without eating, I just get busy and the day passes while I feel fine, and then I enjoy dinner later.

Congrats to you on your progress.

(Doug) #3

Sharon, what I see for Metformin is a half-life of 6 hours. Thus, half of it’s gone after 6 hours, three-quarters is gone after 12, seven-eighths at 18, etc. Getting into the second day, you should be on your own. :slightly_smiling_face:

Ketogenic eating reduces the need for insulin as you know - in the coming days you will see how you’re handling your current diet and the resultant blood sugar numbers. If they don’t go up much, then you may be insulin sensitive enough at this point for what you’re eating and how often you eat.

Once in a while not hitting your protein macro number - no big deal at all, in my opinion.

(You've tried everything else; why not try bacon?) #4

In your place, I would be sure to keep tracking glucose for a while, just to make sure nothing unreasonable is happening. If it stays down, then go for it.

I will point out, however, that Dr. Phinney’s company, Virta Health, is perfectly happy keeping patients on some level of Metformin, even after weaning them off the rest of their drugs, and I believe Professor Noakes mentioned in a recent interview that he still takes Metformin. So it doesn’t sound like the end of the world if you don’t end up completely off it.

(Richard Hanson) #5

Hi Sharon,

I was also T2D, fifteen years, and on 6 medications including 75 units/day of insulin. I am 5 months keto and taking no prescriptions for the least several months.

It sound like you are doing fantastic.

Before I was prescribed keto, I was on 2000 mg/day of Metformin. It was the last T2D medicaiton I stopped taking. I first cut back to 1000 mg/day, then to zero, but I went back on 1000 mg/day for an additional month after my fasting BG number went up a bit. It is now all gone.

If you find that your fasting numbers stay in the healthy range, then if it was my choice, and it was, I stopped taking Metformin, twice. :wink:

For Question 2: I would not force myself to eat unless I was having issues with continued weight loss to the point that being underweight, below a normal BMI, became a health issue. At that point, before that point, I would have a chat with my doctor.

Oh … did I remember to say that you are just Amazing!

Keto for Life!

Best Regards,
Richard

(Sharon A Peters) #6

Well, went off Metformin with my pm dose on November 26th. I check BG probably 4-5 times a day in order to establish some sort of baseline and to closely monitor levels in case I do need to go back on my dose. Have been running between 83 and 96 most of the time, tonight 81 before dinner and one hour after beginning to eat, 93. I’ll take it! I will be finished with exams and grading Monday, 12/11, and look forward to developing a workable exercise program (HIIT, Yoga, and weights); as it stands, I am rather more sedentary than I like - which makes the numbers all the more incredible. I’m on a 24-hour IF cycle, with occasional reversions to 22/2 or 20/4 should I feel hungry … which I mostly do not. I rather like being my own science experiment …

(Sharon A Peters) #7

Thanks!!! It feels like a real accomplishment. I see my internist in January. I am planning to knock him off his chair with my labs.

(You've tried everything else; why not try bacon?) #8

That’s the spirit! Can’t wait to hear how it went . . . :grin: