When Doctors Fail You

doctor
(What The Fast?!) #1

Let me start by sharing my basic info:
I’m 35, I started keto in late March, I’m 5’ 3" and I weigh about 150 lbs with 31.5% body fat.
I did a solid 3 months of keto with no weight loss or inches lost.
For the past 40 days, I have been ZC/carnivore.
I have tested EVERYTHING - lipoprofile, insulin, BG, etc. Aside from high cholesterol (normal for keto and I’m pretty sure I’m a hyper-responder), everything is normal. I don’t show signs of insulin resistance.

I went to see an endocrinologist today in the hopes that he may see something I didn’t in my hormone results. I sat down and began to tell him what I was going through (mind you, I picked this specific doctor because he’s known to really listen and get people results). About 2 minutes into the conversation, I told him I had done calorie restriction in the past, but that it didn’t work - and he said “how many calories are you eating now?” …I knew in that moment that this was about to go down the wrong path. I told him that it varied depending on my activity, because I’m a cyclist. When I ride 50+ miles, I eat more, but generally between 1400 and 2000 calories a day.

He looked down and his papers and said, “you should be eating 1000 calories a day if you want to lose weight.” I almost got up and walked out right then and there. But, I’d paid $120 to be there, so I stayed.

I argued with him and explained that I’d done calorie restriction and previously damaged my metabolism, and now I’m eating more and building it back up. He didn’t care. I asked him about potential hormone issues - he said, “are your period regular? Then you’re fine.” I asked him about low stomach acid and he said, “that’s not causing weight problems, a gastroenterologist isn’t going to help you with weight loss.”

He prescribed me phentermine. I left crying.

I know that he is wrong and misinformed, but when a doctor says these things to me, it makes me feel like maybe they’re right. Maybe I’m just doing it wrong. Maybe I just need to eat less. Maybe I’m just failing.

I know - I know he’s misinformed, but it doesn’t hurt any less to hear those things.

(Khara) #2

Extremely frustrating. Try a new doctor. And then another if you need. I’ve gotten to where I just rarely go because I don’t feel like doctors listen. I’ve self diagnosed on two major issues in the past. Had to actually make my doctors mad in order to convince them to run a test. When they begrudgingly did, it came back I was right. You know your body. Keep looking until you find the right medical expert to help you fill in the answers. Hopefully with use of this forum you’ll start to find what works. KCKO.

(Judi Campion) #3

First of all keep on Keto. Second that doctor may be a specialist with all kinds of credentials but he does not know nutrition.

Don’t give up. Read The Obesity Code. Listen to 2KetoDudes podcast. Visit you tube and look at posts from Dr Jason Fung, dr Westman, Stephen Phinney and so many more.

CICO. Really has damaged many of us. It is not the answer.

Trust your gut.

(Paula Green) #4

Oh Andrea! I’m sorry you had this experience. Of all the lovely people on this forum, you are the person I want to succeed most :slight_smile: You are so consistent with your diet and you deserve to see good results. With the amount of exercise you do and your keto/ZC diet the weight should be coming off. Something else must be going on.

A 1000 cals a day is just ridiculous and not a helpful suggestion.

I do very similar exercise to you and if I stick to around 2000 cals (of real food) I lose weight, very slowly, but it does come off… and I’m a 51 year old pre menopausal women. At your age you should be seeing results. Like I say, something else must be going on. I hope you find the answer, I really do.

(Jules Swart) #5

Sounds to me like HE is failing…he is basing his practice on outmoded thinking. I am glad you are wise enough to know that he is at fault.
All of that being said, I am very sorry that you were told nonsense that made you feel like a failure. The fact that you casually mentioned 50 mile rides clearly indicates that you make genuine efforts to take care of yourself.
Have you noticed any changes in your body during your months of keto? Are you seeing any composition changes? Are you in a position to get a dexa scan for baseline? Do you have the flexibility to pick a function med doc? Maybe a caregiver who approaches a human as a whole being, verses a non-missed cycle, might be able to dig a bit deeper for you to help you achieve your goals.
Don’t give up on yourself!

(What The Fast?!) #6

Thanks for your support you guys! It means a lot, seriously.

I was watching a Dr Westman YouTube this morning and he was talking about eating less calories as well. He said most people don’t have to track because it happens naturally, but that yes - you have to eat less calories than you expend. I think the math might be right, but that your body will find ways to burn excess energy when it’s working correctly.

I had a DEXA about 45 days ago and will be going again at the 90 day mark. No composition changes.

(Jason Fletcher) #7

The new book The Ketogenic Bible had some good sections on the metabolic advantage of keto. It has sections on feed efficiency this talks about how much fat is used for each calorie that is stored. But in the end once everything is accounted for over all grams of fat will determent weight loss. Restricting calories will reduce your burn but that is why is is suggested to cycle calories.
From what it looks like from the exercise level you do your body is going to be far more effective at using calories sparingly. Steady state cardio lowers your BMR.
Where lifting and HIIT keeps your body guessing and will not have this affect.

Do you plan this or is this just what happens when you eat to satiation?

(Doug) #8

Andrea, your journey is interesting and endearing. It really doesn’t seem fair that your diligence isn’t being rewarded more, here.

Finding what works for you as an individual seems to apply to that doctor, too. In your case, at least, it sounds like he was looking for a standard solution, giving what appear like “cookie-cutter” responses. I agree with Paula, above - you really deserve to succeed! I feel like calling that doctor and telling him, “C’mon, man - that was Andrea, and you should have opened up you mind some.”

(What The Fast?!) #9

Haha, thanks! I appreciate it! I’m going to keep sticking with ZC for now. I keep going back and forth on adding back some vegetables and lowering my protein. It’s very hard to eat lower protein amounts without anything else to eat but meat! :slight_smile: It’s nice not having to restrict though.

I don’t do steady state riding, there’s a lot of climbing, some days I do hill sprints; it ends up being more like HiiT training or high intensity cardio than anything else.

I just eat. On days where I’m doing long rides (2-5 hours), I’ll eat more. On days that I’m not, I eat less.

(Kate) #10

Very frustrating. I have had issues over the last 8 years that had me gaining and gaining weight and I saw several different Drs and Endos and basically was told the old eat less, move more. One Dr even laughed at me when I told him I was exercising 7 days a week and watching g what I eat.
My Endo tested for Cushing’s (fatigued all day and not being able to sleep until early in the morning and several other symptoms) but wasn’t taken seriously with it at the hospital by the ‘experts’ because I was losing weight (finally due to Keto). I was so frustrated because both the consultant and the registrar didn’t know what they were talking about. Very sad when you are the smartest person in the room and didn’t go to medical school.

If you don’t have insulin issues maybe have your thyroid tested. I have Hashimoto’s as well as hypothyroidism and could not lose weight for a long time. Both have different markers but most Drs and even endos don’t look at antibodies. Full panel - TSH, free T3, free T4 and antibody panel TgAb, TPO and TSI.
I get the same symptoms of hypothyroidism if my antibodies are up but it doesn’t show with the normal panel TSH etc. Not being able to lose weight is one of the symptoms.

Having a morning cortisol (8am) or midnight one also might be something you want to look into as well.

I still have arguments with my GP but the proof is in the pudding (pun intended). 80lbs lost, for the most part reversed diabetes and Autoimmune disease in remission. None of these things would have happened if I listened to his advice.
Hopefully you find out what is happening.

#11

Ugh, Andrea, I’m so sorry to hear this. The thought of you leaving the office in tears is really upsetting :frowning:

CICO always sounds nuts to me (because hormonal pathways make so much more sense, and also because the “CO” part of the equation has so many variables and so many unknowns) but my guess is that calories probably fit into the picture sometimes in some ways for some folks. However, even if you go by standard guidelines, 1000/day for an active woman of your age sounds straight-up crazy and metabolism-destroying (I wonder what this doc would make of that grim follow-up of Biggest Loser contestants?).

You’re keeping track of all of this, right? Because when you find the missing piece it will be really nice for others to know your full history.

Hugs to you, Andrea.

#12

So sorry for your frustration Andrea. Ditto on seeing a functional medicine provider, or naturopath. Have you tried reducing or eliminating cycling for a spell, just as an experiment?

#13

Try Isopure zero carb for 10 days. I’ll be on it in 8 days myself for a change down. 1 scoop twice a day with MCT oil, and then a BPC with butter, cream and MCT

#14

Forgot to add, I use a teaspoon of ground flax with each scoop of Isopure, and do the coffee first thing lol

(Keto in Katy) #15

Doctors completely failed me.

I started LCHF/keto in 2013 after seeing six different doctors because I felt like crap for months. They all did their tests and examinations and could not find anything wrong. And not a single one of them ever said anything about food. Now I know why: they know jack shit about the effects of diet and metabolic health.

A friend suggested I try LCHF because she had heard that a lot of people were doing it and feeling better, losing weight, etc. I started it, and four days later (FOUR DAYS) I felt really good. Within two weeks I felt amazing with tons of energy — eating meat, fat, butter, eggs, cheese, etc. I had just turned 51 and I felt better than I had felt in decades.

Today, at age 55, I weigh what I did in high school (165 lbs), my HDL is up, Trigs way down, CRP is perfect, 16% body fat, lifting weights 3x a week, and I feel great.

If anyone here still feels like they should always defer to the folks in the white lab coat because they are the “authorities” with framed degrees on the wall: wake up.

#16

I didn’t know whether to open a new topic, but then I remembered this thread and I think this will fit right in. First let’s start by quoting myself from this other thread:

soooo … i went to my appoinment, he told me my cholesterol was high, I told him I didn’t really mind because my hdl was high, my trigs were low and my ratios were just fine. He tried to give me statins, I refused and tried to explain why just to be dismissed. I tried to give him good calories bad calories for him to read and he told me he didn’t have time to read it!!! I tried to give him the latest study @richard posted here and he said he was fine (meaning no thank you, I am god and I know everything already you peasant). I tried to give him some links to some lectures by Peter Attia, Ivor Cummins, Zoe Harcombe, Jeffry Gerber, etc, and he said he wasn’t interested.

This left me feeling like WTF!! How are you even a doctor!!! I do all the research and serve it to you on a silver platter and you can’t even read it? You don’t have time?!? You don’t have time to study on what you do every day? You don’t have time to read some studies and get up to date with the latest research for the good of your patients? I am so mad I can’t see straight. Mind you I only went to him in the first place because he is on a paleo doctors site (and I know paleo is not keto, but it was the closest thing I could find), but it turns out only one of his DAs is paleo, and … grrr, I’m fuming. Needless to to say I am never going to him again.

Anyway, I just wanted to vent. I am tired of being my own doctor and trying to figure out everything on my own, all I wanted to know why my hair might be falling off, he just said he didn’t know but also dismissed all my theories without even listening to me … apparently my cholesterol is all that matters.

:sob::sob::sob::sob::sob:

btw, this is my cholesterol panel

tests
tests.JPG1330×298 52.5 KB

Oh, and also, I told him my insulin was high and that was a little concerning (since I know optimal is bellow 5, or more like bellow 3) to maybe discus metformin, he just looked at the lab ranges and said it was normal, nothing to see here, move along. And the reason I was tested for insulin, a1c and crp is only because I asked for them.

Sorry about the rambling.

(Doug) #17

Ouch, Carina, that doctor is just plain non-responsive. :confounded:

#18

I so bad want to give out his name, but I don’t know if that is an ok thing to do.

#19

Look into Fodmap. Even on zero carb I assume you do spices like garlic? Apparently what I recently learned from a podcast is that garlic is a fodmap or can be

(What The Fast?!) #20

On ZC, I just used salt. I used to use garlic all the time, but stopped using it because I thought it might have been an issue. (This, by the time, is totally sacreligious in my Middle Eastern family…)