Low carb and on insulin

[Annb]

I've been practising lchf for something like 18 months with no effect on my BG levels or on my (acknowledged) overweight(edness). In fact, to keep my BG under some sort of control, ie in the 8 - 12 range rather than in the 12 - 22 range I have had to increase the amount of insulin I am injecting. Maybe this is one reason why I keep piling on the weight.

In the last few weeks, I have started intermittent fasting, then tried adding the 5:2 diet to that and in the last week or so I have been eating only one small meal a day and trying to keep the calories in that meal down as close to 500 as possible, and sometimes lower. I know this is a bad idea in terms of general health but feel that I must find a way to reduce BG levels at the very least.

But it's complicated. I did start taking a multivitamin tablet recommended by my pharmacist, but it caused severe stomach problems (much like the iron supplement prescribed by my doctor some months ago and which I stopped taking). At least on the one meal a day I can cut out 2 of the insulin doses each day, only now injecting before my one meal and at night. A couple of days ago I had a hypo during the night. That's the result and that's what I have to be careful about. I guess I'll start reducing the overnight dose if I can (but BG wasn't so low last night and a slightly higher dose than it used to be, but not as high as recently) resulting in a very reasonable 6.8 this morning. Of course, it's much higher as the day progresses with no food and no insulin. Not sure what it is at present until I test before my meal.

I have no medical support for what I'm doing and I know the health professionals around here would throw their hands up in horror - possibly quite rightly, But what is a girl supposed to do?

 

[Goonergal]

@Annb I can’t help with regards to LCHF and insulin, but going to tag a few people, including some type 1s who eat low carb, as they may be able to help @LooperCat @NicoleC1971 @JAT1 @xfieldok

Also tagging @Millie74 so she can see the thread

 

[xfieldok]

I am no help I'm afraid. I eat keto and use the insulin to try and control what the steroids are trying to do to my levels.

Can you tell us everything you eat in a typical day please. Perhaps we can spot a tweak or two.

 

[HSSS]

How long have you been diagnosed? Is it possible you could be LADA or type 1? Did they do any testing to check?

For low carb to have no effect at all (whichever type) sounds a bit odd. I echo the above request to list what you eat in order to see if there are any carbs hiding that you aren’t aware of.

 

[Annb]

For the last 18 months my meals have consisted of fresh (or frozen) meat, occasional processed meat such as salami, Parma ham, bacon, sausages, (Not very often because I don't like the way that meat is cured.) eggs, cheese. I use onions and some tomatoes, some green leafy veg, some lettuce and cucumber, bell peppers and occasional chilli peppers. I use double cream and some coconut milk, plain Greek style yoghurt, Somme strawberries and raspberries and an occasional apple.n On an odd occasion I have had oatcakes which always push BG way up and once in a while a couple of RyVita, which are usually not as bad, but bad enough.

In recent weeks I have been eating one small meal a day of meat and maybe cabbage or onion or once in a while some simple salad veg.

I have had a c-peptide test done which shows I am T2 and that I have a lot of insulin in my blood with nowhere to go. I assume it is this which is causing the weight gain. To a degree, when I add extra insulin to the mix it does help to keep the BG down to something like an acceptable level (diabetic nurse thinks my levels are very good! I beg to differ.)

I was put onto insulin because I was taken into hospital for investigations due to the dire effect that Metformin was having on me. I was not allowed food or drink until after the procedure, which actually did find some maligant polyps, nor was I allowed to take Metformin for the 3 days I was in hospital. That's when I was put onto an insulin pump. I was told I could come off insulin again once the procedure was over, but that never happened.

It seems likely that I developed gestational diabetes 50 or so years ago but was only diagnosed about 12 years ago. I'm not sure but I think the serious weight gain and the uncontrolled BG only happened after being put onto insulin. Hindsight is a fine thing but mine isn't working as well as it should. To be honest, I was already overweight and trying to diet about 50 years ago, but it never worked, despite been fit and active at that time. Not any more. I'm neither fit nor able to be active so my calorie requirement must be pretty small.

I take Metformin, Spironolactone, Furosimide, Diltiazem and Levothyroxine. Spiro. and Furos. to get rid of fluid gather in my lower body, Diltiazem for high blood pressure and Levothyroxine to repair damage done to my thyroid during other throat surgery. Some of these - or other medications I no longer take, could also have contributed to my current situation. The past doesn't really matter - now is where it's at and when I need to take action for myself.

 

[Annb]

@Annb I can’t help with regards to LCHF and insulin, but going to tag a few people, including some type 1s who eat low carb, as they may be able to help @LooperCat @NicoleC1971 @JAT1 @xfieldok

Also tagging @Millie74 so she can see the thread

Thanks Goonergal. I was asking how to do that, but hadn't seen your offer to tag Millie74.

 

[DCUKMod]

For the last 18 months my meals have consisted of fresh (or frozen) meat, occasional processed meat such as salami, Parma ham, bacon, sausages, (Not very often because I don't like the way that meat is cured.) eggs, cheese. I use onions and some tomatoes, some green leafy veg, some lettuce and cucumber, bell peppers and occasional chilli peppers. I use double cream and some coconut milk, plain Greek style yoghurt, Somme strawberries and raspberries and an occasional apple.n On an odd occasion I have had oatcakes which always push BG way up and once in a while a couple of RyVita, which are usually not as bad, but bad enough.

In recent weeks I have been eating one small meal a day of meat and maybe cabbage or onion or once in a while some simple salad veg.

I have had a c-peptide test done which shows I am T2 and that I have a lot of insulin in my blood with nowhere to go. I assume it is this which is causing the weight gain. To a degree, when I add extra insulin to the mix it does help to keep the BG down to something like an acceptable level (diabetic nurse thinks my levels are very good! I beg to differ.)

I was put onto insulin because I was taken into hospital for investigations due to the dire effect that Metformin was having on me. I was not allowed food or drink until after the procedure, which actually did find some maligant polyps, nor was I allowed to take Metformin for the 3 days I was in hospital. That's when I was put onto an insulin pump. I was told I could come off insulin again once the procedure was over, but that never happened.

It seems likely that I developed gestational diabetes 50 or so years ago but was only diagnosed about 12 years ago. I'm not sure but I think the serious weight gain and the uncontrolled BG only happened after being put onto insulin. Hindsight is a fine thing but mine isn't working as well as it should. To be honest, I was already overweight and trying to diet about 50 years ago, but it never worked, despite been fit and active at that time. Not any more. I'm neither fit nor able to be active so my calorie requirement must be pretty small.

I take Metformin, Spironolactone, Furosimide, Diltiazem and Levothyroxine. Spiro. and Furos. to get rid of fluid gather in my lower body, Diltiazem for high blood pressure and Levothyroxine to repair damage done to my thyroid during other throat surgery. Some of these - or other medications I no longer take, could also have contributed to my current situation. The past doesn't really matter - now is where it's at and when I need to take action for myself.

AnnB - How closely is your thyroid monitored? Many, many who find themselves hypothyroid find, even on treatment, they remain symptomatically hypothyroid, whether by not recognising which levels actually make a difference to metabolic health, and so very often under-medicated.

If your medics tell you you thyroid is OK, please don't accept it. Please get the numbers. You really need TSH, FT4, T3 and your antibodies checked, then also a few vitamin levels, as our vitamins (B12, D, Folate and Ferritin) need to be in very good order for optimal metabolic health.

The list of symptoms for hypothyroidism is very long, can be very vague, and shared over a very large number of conditions, but it makes interesting reading.

 

[xfieldok]

Back to diet, yours looks pretty good.

I too love ryvita, but have found I can't just eat one! Not good. We are all different, our tolererances to foods are different. I have the occasional sausage, but always 97 percent meat, and I check the lable for dodgy ingredients. I am VERY careful with onions. I find a sliver or two is OK but more and I am in trouble. I wouldn't touch oatcakes or apples. I have to be careful of carrots. I even have to be careful when tomatoes are super sweet when in season. We can only taste and test.

I have learned how versatile cauliflower is. I love pancetta. Have you discovered the "thin" noodles/pasta?

Celeriac to top a shepherds or cottage pie is fab (now that we are moving towards the cold weather).

 

[Millie74]

@Annb I can’t help with regards to LCHF and insulin, but going to tag a few people, including some type 1s who eat low carb, as they may be able to help @LooperCat @NicoleC1971 @JAT1 @xfieldok

Also tagging @Millie74 so she can see the thread

Thanks for the tag. I don’t take insulin at the moment, although I did 12 years ago with gestational diabetes. I have just been struggling to hit targets with LCHF. Lunch and dinner fine! Breakfast is the problem. I have lost nearly 2 stone doing it. Just not hit hba1c targets.

 

[Millie74]

Sorry responded to Goonergal. Trying to respond to all. New to forum. Posting in the wrong places!

 

[Millie74]

I've been practising lchf for something like 18 months with no effect on my BG levels or on my (acknowledged) overweight(edness). In fact, to keep my BG under some sort of control, ie in the 8 - 12 range rather than in the 12 - 22 range I have had to increase the amount of insulin I am injecting. Maybe this is one reason why I keep piling on the weight.

In the last few weeks, I have started intermittent fasting, then tried adding the 5:2 diet to that and in the last week or so I have been eating only one small meal a day and trying to keep the calories in that meal down as close to 500 as possible, and sometimes lower. I know this is a bad idea in terms of general health but feel that I must find a way to reduce BG levels at the very least.

But it's complicated. I did start taking a multivitamin tablet recommended by my pharmacist, but it caused severe stomach problems (much like the iron supplement prescribed by my doctor some months ago and which I stopped taking). At least on the one meal a day I can cut out 2 of the insulin doses each day, only now injecting before my one meal and at night. A couple of days ago I had a hypo during the night. That's the result and that's what I have to be careful about. I guess I'll start reducing the overnight dose if I can (but BG wasn't so low last night and a slightly higher dose than it used to be, but not as high as recently) resulting in a very reasonable 6.8 this morning. Of course, it's much higher as the day progresses with no food and no insulin. Not sure what it is at present until I test before my meal.

I have no medical support for what I'm doing and I know the health professionals around here would throw their hands up in horror - possibly quite rightly, But what is a girl supposed to do?

Sounds like you are trying really hard and frustrating not to get the results you want. Your approach to LCHF sounds good. The 5:2 worth a go too. Strange you are not getting results, as your approach is really good. I can get results as the day goes on low carb. But get some random high fasting and always high breakfast readings.

 

[Annb]

AnnB - How closely is your thyroid monitored? Many, many who find themselves hypothyroid find, even on treatment, they remain symptomatically hypothyroid, whether by not recognising which levels actually make a difference to metabolic health, and so very often under-medicated.

If your medics tell you you thyroid is OK, please don't accept it. Please get the numbers. You really need TSH, FT4, T3 and your antibodies checked, then also a few vitamin levels, as our vitamins (B12, D, Folate and Ferritin) need to be in very good order for optimal metabolic health.

The list of symptoms for hypothyroidism is very long, can be very vague, and shared over a very large number of conditions, but it makes interesting reading.

My thyroid is tested once in 6 months and I'm only told the result if I insist on getting feedback because if the dr thinks it's OK they don't give any feedback. Even then, they'll only say there's no problem. The surgeon who did the surgery was surprised that I needed any thyroxine at all, she thought I would get away with it after she removed parathyroid glands. But, at present, I'm on 75 mcgm a day. Because of my restricted diet, I am pretty sure that my vitamin and mineral levels are depleted but don't seem to be able to take supplements. One doctor did put me onto iron supplements and said that, if that didn't work I would have to have iron into my vein, as I had about 3 years ago. The pills can't have worked because I couldn't take them. He has never followed up. But then, I've been a bit anaemic ever since I was pregnant with my first son - 52 years ago - and I'm still here.

My brother is always telling me to get the numbers, but doctors here seem to be unwilling to give up their authority and impart information and since I don't really understand them, I haven't pushed too hard. My son, on the other hand makes sure that he knows everything there is to know about the conditions he suffers and asks for information and discusses it with his doctors, who get rather annoyed because he seems to know more than they do. Even my brother, living in the south of England has to be very insistent to get the results he wants. However, it's understandable that he does insist because his life depends upon the information being up to date and correct. I would have thought that doctors would be glad for patients to take control of their own health issues, but they don't!

 

[HSSS]

The results are yours and you are entitled to the breakdowns and numbers. Be insistent. Even if you are a bit baffled it’s possible to find people and sources to help understand them.

 

[Annb]

Back to diet, yours looks pretty good.

I too love ryvita, but have found I can't just eat one! Not good. We are all different, our tolererances to foods are different. I have the occasional sausage, but always 97 percent meat, and I check the lable for dodgy ingredients. I am VERY careful with onions. I find a sliver or two is OK but more and I am in trouble. I wouldn't touch oatcakes or apples. I have to be careful of carrots. I even have to be careful when tomatoes are super sweet when in season. We can only taste and test.

I have learned how versatile cauliflower is. I love pancetta. Have you discovered the "thin" noodles/pasta?

Celeriac to top a shepherds or cottage pie is fab (now that we are moving towards the cold weather).

Thanks for your input. I only eat RyVita once in a blue moon and don't really enjoy them much but it's the best option when I really need something. Oatcakes are even less frequently used, only on those occasions when my BG does drop (quite rare). Apples also very rarely. Onions I use if I am making a slow-cooked meat dish and then one medium onion for 4 meals-worth of meat, so not just a sliver, but not much and not very often. I forgot to mention before that I also have some butternut squash, once in a while. I also very occasionally have cauliflower but never cauliflower rice - seems to be too concentrated, or too much, and it upsets my stomach. In any case it is higher carb than broccoli, which I also use occasionally. I also, once in a while, have mushrooms. I made a celeriac dish last week - a take on dauphinoise - and have made 4 meals out of one - 3 in the freezer and one used. I might make cottage pie with some of the celeriac in the freezer, as you suggest.

I-m not sure what "thin noodles" are. If you mean those made with different non starchy plants - I have and they made me quite ill. I have a boxfull of them in my larder, wondering what to do with them. Soya noodles don't make me ill, but I don't like them much.

 

[Annb]

The results are yours and you are entitled to the breakdowns and numbers. Be insistent. Even if you are a bit baffled it’s possible to find people and sources to help understand them.

There is one doctor that I know of here who is sympathetic to low carb and I'm trying to get an appointment to see her - difficult to say the least. When I do get an appointment, I will ask her for figures.

 

[DCUKMod]

My thyroid is tested once in 6 months and I'm only told the result if I insist on getting feedback because if the dr thinks it's OK they don't give any feedback. Even then, they'll only say there's no problem. The surgeon who did the surgery was surprised that I needed any thyroxine at all, she thought I would get away with it after she removed parathyroid glands. But, at present, I'm on 75 mcgm a day. Because of my restricted diet, I am pretty sure that my vitamin and mineral levels are depleted but don't seem to be able to take supplements. One doctor did put me onto iron supplements and said that, if that didn't work I would have to have iron into my vein, as I had about 3 years ago. The pills can't have worked because I couldn't take them. He has never followed up. But then, I've been a bit anaemic ever since I was pregnant with my first son - 52 years ago - and I'm still here.

My brother is always telling me to get the numbers, but doctors here seem to be unwilling to give up their authority and impart information and since I don't really understand them, I haven't pushed too hard. My son, on the other hand makes sure that he knows everything there is to know about the conditions he suffers and asks for information and discusses it with his doctors, who get rather annoyed because he seems to know more than they do. Even my brother, living in the south of England has to be very insistent to get the results he wants. However, it's understandable that he does insist because his life depends upon the information being up to date and correct. I would have thought that doctors would be glad for patients to take control of their own health issues, but they don't!

AnnB - Can't you have access to your medical records to view them?

Honestly, when it comes to thyroid, there is a very, very strong culture of well enough, often coupled with they major symptoms being pretty general, it's rarely the first port of call for investigation, unless there is significant, unexplained weight gain, hair loss; particularly the eyebrows and often feeling the cold.
If you vitamins are out of whack, your thyroid will struggle more.

Please do find out at least what your TSH is. Anything over 2 tends to suggest your thyroid is struggling. The NHS diagnostic threshold is 5.0, where symptoms exist and 10 asymptomatically.

If your thyroid is struggling, many people find it very hard to lose weight. Your levothyroxine dose is very modest. knowing a minimum of your Free T4 result would allow you and your doctor to assess whether there's room to trial an increas in your dosage.

To be clear, I am not telling or even hinting that you alter our own dose of levothyroxine, but I'd suggest it could be worth exploring.

 

[Annb]

AnnB - Can't you have access to your medical records to view them?

Honestly, when it comes to thyroid, there is a very, very strong culture of well enough, often coupled with they major symptoms being pretty general, it's rarely the first port of call for investigation, unless there is significant, unexplained weight gain, hair loss; particularly the eyebrows and often feeling the cold.
If you vitamins are out of whack, your thyroid will struggle more.

Please do find out at least what your TSH is. Anything over 2 tends to suggest your thyroid is struggling. The NHS diagnostic threshold is 5.0, where symptoms exist and 10 asymptomatically.

If your thyroid is struggling, many people find it very hard to lose weight. Your levothyroxine dose is very modest. knowing a minimum of your Free T4 result would allow you and your doctor to assess whether there's room to trial an increas in your dosage.

To be clear, I am not telling or even hinting that you alter our own dose of levothyroxine, but I'd suggest it could be worth exploring.

Thanks for that. I'll have to start researching this whole issue - maybe get No 1 son to help me with that - he's a lot brighter than me.

I can't get access to medical records online - our surgery/health board don't do that.

 

[milesrf]

[snip]

I take Metformin, Spironolactone, Furosimide, Diltiazem and Levothyroxine. Spiro. and Furos. to get rid of fluid gather in my lower body, Diltiazem for high blood pressure and Levothyroxine to repair damage done to my thyroid during other throat surgery. Some of these - or other medications I no longer take, could also have contributed to my current situation. The past doesn't really matter - now is where it's at and when I need to take action for myself.

One thing that helped me with fluid gathered in my lower body - putting enough pillows at the foot of my bed that my feet were higher than my heart while I slept.

 

[Pete46]

@Annb My wife has had an underactive thyroid for nealry 40 years and finds these two sites invaluable: http://www.thyroiduk.org/ and https://healthunlocked.com/thyroiduk. Hope these are of some use to you too.

 

[Annb]

Thanks @milesrf and @Pete46 for that advice. I'll see what I can do with pillows and will also follow up those links.