Time for turning it up a notch

(Rick) #1

Hello all, hope all is well. I have been on a plateau for 3 months, and while there are those who have been so for longer than I, it seems like an eternity to me. I had my hunch why proven today, when I received my latest labs (markers improving, but slowly). I had talked my endo into ordering a fasting insulin test to see the extent of my problem, it came back with a value of 21. So, that was a sound slap in the face and gave me the answer (at least I think) why progress is at a standstill. Is this a reasonable guess, @richard? With baseline insulin that high, my bodyfat is not going anywhere. ANYWHERE.

So, my frustration is high, I am very discouraged. I will not give up, but right now I am so bummed out. Even strict keto only gets you so far, and it didn’t get me far at all. The obvious and only path ahead is with extended fasting broken up by periods of intermittent fasting. I will keep on, but it’s so hard on my self esteem. So please bear with me, I may need a bit of support from time to time. If that doesn’t work I will have to accept being in a permanent 70 lb fat suit. End whine.

(Heather Miller) #2

Sounds like you know exactly what you need to do. Build up your fasting muscle slowly or jump right in, depends on your personality which will be better for you. You can do this and we are here to support you!

(8 year Ketogenic Veteran) #3

Hey Rick man you got this! you just need to start fasting. Are you on any medications right now for blood glucose? If not, fasting is going to be easy for you. Have you been doing keto long enough to be fully fat adapted? If so fasting is going to be easy for you. Do you know about the monthly Zorn fast? We start another one next Thursday would you like to do it with us? It’s almost 4 full days but you don’t have to do it that long you can go as long as you’d like. I’ll link it for you as soon as I write it up. I’m doing that now.

(Rick) #4

No diabetes meds, started keto Sept. 4 last year. I’ve been good…

I’m in for the Zorn fast, for sure!

(8 year Ketogenic Veteran) #5

I posted the link above in my comment. See you then.

(Richard Morris) #6

Yes - this is when we plateau when we meet the level of our fasting insulin.

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But this is actually a good news bad news thing.

The good news is that your body fat has apparently become healthier. It is now holding onto energy as it is supposed to when insulin goes up. When most of us type 2 diabetics start on keto our body fat is totally ignoring insulin it is so broken. So that plateau is a sign that you are becoming healthier.

The bad news is that elevated insulin is doing damage to your vascular system … there is a little good news here as well though as is it’s probably a LOT less insulin than you used to be making. So while your insulin is higher than it should be, you have slowed the progression of cardiovascular disease, but not completely stopped it.

This is mine

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You’ll see mine was over 30 at my first measurement … but that was 3 years into a ketogenic diet. I was likely over 300 before I started not eating food that raised my insulin (ie: Keto). You’ll also see that I went off metformin to make an argument that I didn’t need drugs to manage my glucose. But you’ll see my insulin required jumped up. SO I am back on metformin again.

We have multiple tissue around our bodies that each get a vote on how much insulin will be required and one or more is keeping it elevated. In both of our cases it’s not adipose tissue, cos that is doing it’s job now. Cells in the hypothalamus become insulin resistant too and they drive the pancreas directly via the vagus nerve. Alpha cells in the pancreas become IR and they drive how much glucose the liver makes - which drives insulin secretion. The liver too has a vote. So do muscle cells. And I suspect there are dozens of other sources that I am not aware of.

Our jobs now is to keep our bodies tissue stewing in as little insulin as we can for as long as we can and eventually that should reduce how much insulin our bodies think it needs to make … in other words Keep Calm and Keto on.

But at least you now have a benchmark to measure your progress against.

(Rick) #7

So perhaps asking the endo (who I see Feb 5) for a prescription for Metformin may be helpful in parallel with adding fasting more to my approach.

(jilliangordona) #8

I went on metformin after not losing weight on keto for a year, and shortly after a had a nice “whoosh” weight loss effect. It can definitely be advantageous if you can tolerate it, it can be a wreck on the digestive system!

(Richard Morris) #9

If you are insulin resistant, metformin is one of the few drugs we have that will reduce that - so your endo may consider that a good strategy.

(Rick) #10

Thank you sir for your wisdom. Your advice carries a lot of weight with me.

(Richard Morris) #11

Well I am still working a lot of things out, but my own body is on the same chopping block as yours … so I am very motivated to get this right.

(Rick) #12

So just how does Metformin work to lower insulin? I sure hope this helps my situation, I’m getting pretty tired of my body fighting me every step of the way, almost as if it’s the ultimate stubborn 5 year old throwing a tantrum…

(Rick) #13

I really do not want to come across as an impatient complaint king…it is simply that I have come through so much and have been fighting to regain my health for so long that I have seen (and still do see) keto as the only correct way out of this nightmare - and for some reason my body was balking at getting better. Finding out my serum insulin is still high explains a lot, and offers a course of action. But it is the only flicker of hope I have left. Fortunately I am stubborn and will never quit. Hopefully I can eventually continue to health, but man it is tough right now. I just hope the flicker of light does not go out…

(H) #14

Not sure these words will be of much comfort but I just want to say it’s good that you’re communicating on here, looking for support and a solution from a community of people who understand the journey you’re on. Even though the pace of your results has led to some frustration, keep reminding yourself that you’re on the right path, even if it happens to be a boring stretch of the right path. At least it’s not the wrong road entirely, which I would guess most of us on here feel about previous strategies. You’re doing great. Your body is healing in ways that might not be reflected in numbers. It took you time to get to the point you’re at, it’ll take time to get away from it. Be stubborn about enjoying the process, not about reaching the goal.

IF and EF seems to have broken a stall I had. Highly recommended.

(jilliangordona) #15

Metformin lowers blood glucose, therefore your body will lower it’s exaggerated insulin response that is created via insulin resistance. As I said previous I have had positive success with it

(Dan Dan) #16

For those who don’t know about Metformin

People without diabetes sometimes take metformin for weight loss or for conditions like polycystic ovary syndrome (PCOS). It’s one of the best, most affordable and most successful chemical medicines ever invented.

For many people diagnosed “Type 2,” the big problems are in the liver. Scientists have found a “molecular switch” called CRTC2 that controls this process. When the CRTC2 switch is on, the liver pours sugar into the system. When there’s enough sugar circulating, CRTC2 should be turned off. The turnoff signal is thought to be insulin. This may be an oversimplification, though.

In many patients with type II diabetes, CRTC2 no longer responds to rising insulin levels, and as a result, the liver acts like a sugar factory on overtime, churning out glucose [day and night], even when blood sugar levels are high.” Because of this, the “average” person with Type 2 diabetes has three times the normal rate of glucose production by the liver

Metformin prevents the liver from dumping more glucose into the blood. Scientists used to think it worked by telling CRTC2 to cooperate with insulin (in other words, reducing insulin resistance.) But new studies have found that metformin actually works by bypassing CRTC2 and directly telling the liver cells to hold the sugar.

So if your CRTC2 switch is busted, you need some metformin in your blood at most times, to prevent the liver’s dumping glucose.

It seems that for people whose leaky livers are the main factor in their sugar levels, taking 500 milligrams of metformin four or five times a day might be optimum. But everyone’s different, and it takes some work (with your doctor) to find what pattern works best for you.

Metformin takes a couple of hours to fully absorb, and lasts about five hours in most people. (Half-life in the body is about six hours.) There is also an extended release form that can be taken once or twice a day.

It might help to learn when your liver tends to dump sugars. This might require frequent monitoring for a while.

“May the Force (fat adaption) be with you”

IF/EF Keto WOE is Self-Discovery :wink:

Good luck and much success in your journey in IF/EF Keto WOE :grin:

#17

As said above, Metformin helps reduce the liver dumping glucose into the blood stream, and it lowers blood glucose levels. Somewhat. A good way of thinking about it is that is lowers blood glucose a little, all the time. It certainly doesn’t ‘iron out’ peaks after meals, if someone is eating in a way that creates those peaks in the first place.

It also takes a few weeks of consistent use before the body is using Metformin to max effect, so it needs to be taken consistently. Many people think that popping a pill after a meal is to help reduce blood glucose from that meal. A better way of looking at it is that taking it with meals reduces the chance of digestive discomfort that may happen if it is taken on an empty stomach. And that Metformin works in the background to reduce liver dumps a little, and blood glucose a little.

The drug info cautions people to avoid taking Met with stomach upsets and if not eating, so I personally think it inadvisable to take when fasting.

How long do STALLs last?