2 Years Low Carb - Wanting to Quit?

[CrumblingWall]

History: 2017 December, acetone smell in my mouth, stomach pain and +++ glucose in urine after 4 days of stress at work, not eating much in the process. Normal A1c, fasting tests. Jumped on low carb diet until finding out the cause. Failed OGTT at diabetic levels via GP referral (while on low carb diet). Send to endo. Repeat of same tests + antibodies. Negative. OGTT failed again (while on low carb). Was told not diabetes. I tried to eat more carbs but my BG goes to above 8 mmol/l frequently, with like 20g of millet. Recently, I decided to break the self-imposed woe, and try to add more carbs.

Started yesterday, with millet (100g a day). Some 70% chocolate as well. Observations: BG goes to 7 mmol/l, sometimes 8 mmol/l and stays there for a long time, at least 2 hours before starting to slowly come down. Multiple doctors told me it is due to insulin resistance but I never found out if it is pathological. I am currently sitting at 7 mmol/l for 2 hours already, feeling kind of meh. I felt really hungry after the last spike and coming down.

I have subclinical hypothyrodism, according the doc, caused by low carb diet. Hormones like somatostatin, growth hormone and cortisol inhibit insulin and cause higher numbers for longer than if a person eating more carbs. I have seen many things discussed on this forum: some state that pancreas need to be primed again to produce insulin with gently carb increase, while others say normal person should just handle carbs no matter what diet they were under for weeks or months before.

So ... normal HbA1c as of 2 weeks ago, normal fasting, somewhat low FT3, feeling cold, dry skin. All the doctor told me is I can eat any amount of complex carbs like millet (she does not see any diabetes problem) but I am worried about spikes. I also notice that 2 days later, I still am insulin resistant, what is the timeframe to resolve this, if this is physiological?

 

[DCUKMod]

History: 2017 December, acetone smell in my mouth, stomach pain and +++ glucose in urine after 4 days of stress at work, not eating much in the process. Normal A1c, fasting tests. Jumped on low carb diet until finding out the cause. Failed OGTT at diabetic levels via GP referral (while on low carb diet). Send to endo. Repeat of same tests + antibodies. Negative. OGTT failed again (while on low carb). Was told not diabetes. I tried to eat more carbs but my BG goes to above 8 mmol/l frequently, with like 20g of millet. Recently, I decided to break the self-imposed woe, and try to add more carbs.

Started yesterday, with millet (100g a day). Some 70% chocolate as well. Observations: BG goes to 7 mmol/l, sometimes 8 mmol/l and stays there for a long time, at least 2 hours before starting to slowly come down. Multiple doctors told me it is due to insulin resistance but I never found out if it is pathological. I am currently sitting at 7 mmol/l for 2 hours already, feeling kind of meh. I felt really hungry after the last spike and coming down.

I have subclinical hypothyrodism, according the doc, caused by low carb diet. Hormones like somatostatin, growth hormone and cortisol inhibit insulin and cause higher numbers for longer than if a person eating more carbs. I have seen many things discussed on this forum: some state that pancreas need to be primed again to produce insulin with gently carb increase, while others say normal person should just handle carbs no matter what diet they were under for weeks or months before.

So ... normal HbA1c as of 2 weeks ago, normal fasting, somewhat low FT3, feeling cold, dry skin. All the doctor told me is I can eat any amount of complex carbs like millet (she does not see any diabetes problem) but I am worried about spikes. I also notice that 2 days later, I still am insulin resistant, what is the timeframe to resolve this, if this is physiological?

CrumblingWall - Was the doctor who told you to eat more carbs and Endochrinologist, specialising in thyroid problems, or your GP?

When you say your FT3 is "somewhat low", what does that mean, in relation to your lab's reference ranges? I'm quite impressed your FT3 was even tested. So many labs just ignore the request if the FT4 is in range, yet it is, in my view, the most important of the thyroid hormone suite.

 

[CrumblingWall]

CrumblingWall - Was the doctor who told you to eat more carbs and Endochrinologist, specialising in thyroid problems, or your GP?

When you say your FT3 is "somewhat low", what does that mean, in relation to your lab's reference ranges? I'm quite impressed your FT3 was even tested. So many labs just ignore the request if the FT4 is in range, yet it is, in my view, the most important of the thyroid hormone suite.

It was endocrinologist specialising in diabetes but also knows about thyroid issues. My FT3 is something like that: bottom range is 3.38 - (3.34 - 5.14), FT4 is 16.62 (7.87 - 20.14), TSH is 2.21 (0.4 - 3.6)

My c-peptide measured in summer was very low at 1.0 ng/ml (0.9-4) range. I did not expect it to be high because of low carbing though.

 

[DCUKMod]

It was endocrinologist specialising in diabetes but also knows about thyroid issues. My FT3 is something like that: bottom range is 3.38 - (3.34 - 5.14), FT4 is 16.62 (7.87 - 20.14), TSH is 2.21 (0.4 - 3.6)

My c-peptide measured in summer was very low at 1.0 ng/ml (0.9-4) range. I did not expect it to be high because of low carbing though.

The Endo I see for my thyroid, supports my LC way of eating, and indeed also strongly recommended I go gluten-free. Isn't it odd how, a bit like diabetes, that there are so many views and approaches. Have you had antibodies checked?

If you are symptomatic (cold and skin issues), are you on any treatment for the SC Hypo?

 

[CrumblingWall]

The Endo I see for my thyroid, supports my LC way of eating, and indeed also strongly recommended I go gluten-free. Isn't it odd how, a bit like diabetes, that there are so many views and approaches. Have you had antibodies checked?

If you are symptomatic (cold and skin issues), are you on any treatment for the SC Hypo?

It is weird. I was negative for antibodies 2 years ago. Never retested after. I guess since this forum is as close as I can get to various experiences held by many, I am interested in science that explains my situation. It is too early to tell if resistance or whatever this is reverses, it has been 2 days, but I am interested to know if people had something like that happen to them ... I guess the ones who succeeded, never returns to this forum, though.

No, endo said it is normal for thyroid to be low on keto diet and that carbs will wake it up again. My numbers were completely in range and no endo would put me on a hormone treatments.

 

[DCUKMod]

It is weird. I was negative for antibodies 2 years ago. Never retested after. I guess since this forum is as close as I can get to various experiences held by many, I am interested in science that explains my situation. It is too early to tell if resistance or whatever this is reverses, it has been 2 days, but I am interested to know if people had something like that happen to them ... I guess the ones who succeeded, never returns to this forum, though.

No, endo said it is normal for thyroid to be low on keto diet and that carbs will wake it up again. My numbers were completely in range and no endo would put me on a hormone treatments.

To be honest,if you are committed to increasing your carbs, then I'd give it longer than 3 days before deciding anything is right or wrong for you.

Aside from anything else, our bodies like to run to routines, which includes our digestive systems. Our systems like to prepare a bit for what we eat, so when we change things, they can be caught out, and not quite have all the correct digestive enzymes, or correct insulin amounts to hand. Over a few days, things could get a bit better for you (then again, they may not).

And couple of examples of this would be; when we have a big blow out, like at Christmas, perhaps, we can quite often experience indigestion, even if our systems are usually quite good. Our systems have just been a bit side-swiped by the overload.

Similarly, sometimes when a person starts on the LC was of eating, their blood sugar levels stay higher than we might expect for what is eaten. That's because their body could be releasing glucose from the liver, to keep things in the "comfort zone".

I've probably expressed that very badly, but I think, in your shoes, I'd try to give it a couple of weeks before I came to any firm conclusions.

 

[CrumblingWall]

To be honest,if you are committed to increasing your carbs, then I'd give it longer than 3 days before deciding anything is right or wrong for you.

Aside from anything else, our bodies like to run to routines, which includes our digestive systems. Our systems like to prepare a bit for what we eat, so when we change things, they can be caught out, and not quite have all the correct digestive enzymes, or correct insulin amounts to hand. Over a few days, things could get a bit better for you (then again, they may not).

And couple of examples of this would be; when we have a big blow out, like at Christmas, perhaps, we can quite often experience indigestion, even if our systems are usually quite good. Our systems have just been a bit side-swiped by the overload.

Similarly, sometimes when a person starts on the LC was of eating, their blood sugar levels stay higher than we might expect for what is eaten. That's because their body could be releasing glucose from the liver, to keep things in the "comfort zone".

I've probably expressed that very badly, but I think, in your shoes, I'd try to give it a couple of weeks before I came to any firm conclusions.

Thanks, this makes sense. It took me a while to get into ketosis, and it might take sometime to see where my real carb limits are. I should listen and trust to the doctor and see what happens.

 

[DCUKMod]

Thanks, this makes sense. It took me a while to get into ketosis, and it might take sometime to see where my real carb limits are. I should listen and trust to the doctor and see what happens.

When are you having your thyroid hormones retested?

 

[CrumblingWall]

When are you having your thyroid hormones retested?

I will try a month from now. Assuming my higher carb woe experiment works out. I was told that if one consumes enough carbs, extra glucose in diet requires more T3 to process so it should increase. It is a shame that I do not have blood results before. But during university, I was eating lots of carbs and remember my TSH was something like 1.2. 2.x is still normal range but bottom level FT3 could be what causes a cascade of issues. I can handle carbs but it takes a while to process them as well as my spikes are making me a bit ill. The experiment is worthwhile. I will never know what my capabilities are for carbs otherwise.

 

[CrumblingWall]

@DCUKMod
Talked with the doc. She said: "carbs should be consumed before physical activity. Also, eat less frequently and sometimes practice intermittent fasting. This should improve insulin sensitivity.".

In other words, she does not think my issues are very pathological. But I probably have inclination to insulin resistance which means: building muscle mass to soak up the glucose, exercise and consuming enough carbs to not cross ketosis threshold. Looks like I have a new year resolution for myself then....it will probably be swimming!

 

[DCUKMod]

@DCUKMod
Talked with the doc. She said: "carbs should be consumed before physical activity. Also, eat less frequently and sometimes practice intermittent fasting. This should improve insulin sensitivity.".

In other words, she does not think my issues are very pathological. But I probably have inclination to insulin resistance which means: building muscle mass to soak up the glucose, exercise and consuming enough carbs to not cross ketosis threshold. Looks like I have a new year resolution for myself then....it will probably be swimming!

Good luck with it all. I'll be interested to hear how your next bloods go.

 

[CrumblingWall]

Been eating more carbs ... so far, I do not see an improvement. I noticed that my BG goes up really quickly up to 8 mmol/l, where it then stays for an hour or two, then starts slowly as a turtle to come down. What does this indicate of?

 

[Resurgam]

Been eating more carbs ... so far, I do not see an improvement. I noticed that my BG goes up really quickly up to 8 mmol/l, where it then stays for an hour or two, then starts slowly as a turtle to come down. What does this indicate of?

Normality, totally normal reaction to eating carbs.

 

[VashtiB]

I'm a newbie and am reading with interest. How long was your HbA1c within the n normal range before trying this increase in carbs? How much have you increased the carbs?

Just my own personal view but maybe you need to slow down the increase in carbs- I would not like to see readings of 8. Do you try exercise when you have the readings of to bring them down faster? Again I'm a newbie so no expertise at all.

Good luck with your experiment.

 

[CrumblingWall]

Normality, totally normal reaction to eating carbs.

I expected the increase to be there. But I also read it takes a few days to get back to better carbs tolerance. I am not seeing it personally, spiking just like I did on low carb.

 

[Cocosilk]

I expected the increase to be there. But I also read it takes a few days to get back to better carbs tolerance. I am not seeing it personally, spiking just like I did on low carb.

This video might help you. Around the middle of the video, he shows 3 patients GTT lab results.(Blood glucose and insulin together.) You can see what a really healthy person's levels look like vs what someone who is insulin resistant looks like, and then someone diabetic. The healthy person only spikes to 5.6 mmol at 1 hour and is back to 4.4 mmol 2 hours after a glucose tolerance test. The person spiking to 8.8 mmol at 1 hour and back to 5.6 mmol at 2h is insulin resistant and closer to prediabetes.

 

[CrumblingWall]

This video might help you. Around the middle of the video, he shows 3 patients GTT lab results.(Blood glucose and insulin together.) You can see what a really healthy person's levels look like vs what someone who is insulin resistant looks like, and then someone diabetic. The healthy person only spikes to 5.6 mmol at 1 hour and is back to 4.4 mmol 2 hours after a glucose tolerance test. The person spiking to 8.8 mmol at 1 hour and back to 5.6 mmol at 2h is insulin resistant and closer to prediabetes.

It is not good enough evidence for anything. Showing me one person (N = 1) with great glucose handling is not addressing the question of what is normal. I have talked with doctors and even people on Reddit (who are doctors) said that normal people go much higher than 6 mmol/l, especially after lots of carbs that my concerns are of a hypochondriac. Now ... I have no doubts about the fact that there is a problem with me, maybe not a big one yet, but am getting there. My main issue is now finding out what happens if I do higher carb for a month, does it get better as body leaves ketosis behind or it stays bad. If it stays bad, I know the answer. If it does not, then I subjected myself to keto without a necessity. I am just trying to trust three doctors already who told me that I am fine .... I still have suspicions that they only consider someone "bad" if they are way too gone to IR land with burned out pancreas. But I still have a glimmer of hope I am not diabetic at only age 26.

To be fair, the above video shows something that I already seen larger evidence (N = several dozen), where people go to around 120 mg/dl and don't go much above that using CGMs. The ultimate truth will be me buying freestyle libre, putting the **** thing on and go for 2 weeks seeing what happens to my BG. If I see things getting better, good for me, if I don't, then back to lower carb it is, this time with serious adjustments with dietician and other professionals on how to not kill my thyroid in the process.

post edited by moderator for language

 

[Cocosilk]

It is not good enough evidence for anything. Showing me one person (N = 1) with great glucose handling is not addressing the question of what is normal. I have talked with doctors and even people on Reddit (who are doctors) said that normal people go much higher than 6 mmol/l, especially after lots of carbs that my concerns are of a hypochondriac. Now ... I have no doubts about the fact that there is a problem with me, maybe not a big one yet, but am getting there. My main issue is now finding out what happens if I do higher carb for a month, does it get better as body leaves ketosis behind or it stays bad. If it stays bad, I know the answer. If it does not, then I subjected myself to keto without a necessity. I am just trying to trust three doctors already who told me that I am fine .... I still have suspicions that they only consider someone "bad" if they are way too gone to IR land with burned out pancreas. But I still have a glimmer of hope I am not diabetic at only age 26.

To be fair, the above video shows something that I already seen larger evidence (N = several dozen), where people go to around 120 mg/dl and don't go much above that using CGMs. The ultimate truth will be me buying freestyle libre, putting the **** thing on and go for 2 weeks seeing what happens to my BG. If I see things getting better, good for me, if I don't, then back to lower carb it is, this time with serious adjustments with dietician and other professionals on how to not kill my thyroid in the process.

Out of curiosity, do you remember what numbers you got on your GTT while eating low carb? I had fasting 4.4 mmol, 1h 12.1 mmol and 2h 6.5 mmol. A few months earlier before diagnosis of gestational diabetes, my GTT results were: Fasting 5.1 mmol; 1h 9.7; 2h 7.4 and that was during pregnancy while I was eating all the usual carbs (plus sweets). But I did become increasingly insulin resistant as the pregnancy went on and used insulin for my fasting levels for the final weeks. I still haven't confirmed whether my spike to 12.1 mmol at 1h was just because of low carb or because I've developed more of a glucose intolerance since having my baby and being sleep deprived. When I try to reintroduce carbs, even after 3 days, I would still see 8 - 11 mmol at 1h and after pizza I was still 8mmol at 2h so I'm assuming eating low carb is doing myself a favour. But I'm 44 so I'm much closer to that point in life where diabetes can creep up fast.

 

[CrumblingWall]

Out of curiosity, do you remember what numbers you got on your GTT while eating low carb? I had fasting 4.4 mmol, 1h 12.1 mmol and 2h 6.5 mmol. A few months earlier before diagnosis of gestational diabetes, my GTT results were: Fasting 5.1 mmol; 1h 9.7; 2h 7.4 and that was during pregnancy while I was eating all the usual carbs (plus sweets). I still haven't confirmed with my spike to 12.1 mmol at 1h is just because of low carb or because I've developed more of a glucose intolerance since having my baby and being sleep deprived. When I try to reintroduce carbs, even after 3 days, I would still see 8 - 11 mmol at 1h and after pizza I was still 8mmol at 2h so I'm assuming eating low carb is doing myself a favour. But I'm 44 so I'm much closer to that point in life where diabetes can creep up fast.

Ah, yeah, I remember. 2h - 14.2 mmol/l. I did come down to 3.9 mmol/l at 3 hours though which was weird. Your resistance looks pathological, while mine is still not clear what it is. I am leaning more and more to something bad and not physiological though. I find it weird: the doctors I talk to, all of them just cannot tell me straight to my face what this is and what to do about it. Just that it is not diabetes. Idk ... that 2h GTT is very diabetic.

 

[Cocosilk]

Ah, yeah, I remember. 2h - 14.2 mmol/l. I did come down to 3.9 mmol/l at 3 hours though which was weird. Your resistance looks pathological, while mine is still not clear what it is. I am leaning more and more to something bad and not physiological though. I find it weird: the doctors I talk to, all of them just cannot tell me straight to my face what this is and what to do about it. Just that it is not diabetes. Idk ... that 2h GTT is very diabetic.

Do you test at home yet? I'd ask for another test, maybe HbA1C. If you do another GTT, insist on an insulin test for the 3 points as well. It'll give a clearer picture to know if there is a lot of insulin floating around or not. I'd say there is if you landed at 3.9 by the 3 hour mark. 14.2 is a bit high though, isn't it. I'd consider sticking to low carb till you get more answers.