Extreme fatigue after eating

Chris24Main said:

What is a false high HbA1c ? that's a new one for me.
Interested rather than challenging what you say, I'd just thought it was what it is. There is a train of thought that if your blood cells are living longer (for example on a Ketogenic, therefore lower inflammatory, regime) then a given test would effectively take cells from a longer period, therefore would have more A1c products than would be expected in an average 3 month blood cell life period, so inflating the result - is that what you mean?
I would have thought in that scenario, a patient would be expected to have higher vit B12 though ... another thing to dig into...

[edit - didn't take long, and I totally retract - clearly a B12 deficiency itself causes longer red blood cell life, so gives that same effect, now to dig into why...]

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Hi, yes you're right.
There are lots of peer-reviewed articles you can find via Google Scholar.
I got told I had pre-diabetes and low B12 at the same time. About a month later, I got told I'm also anaemic. I feel there's something happening to my body that's linked. I'm also only just in the prediabetic range, so I'm curious if my HBA1c will go back to normal if my B12 deficiency and anaemia is addressed.
Your hunch about higher B12 is true, I believe, for those with Type 1. I think they can have higher B12 serum levels. And for type 2s on Metformin, that can cause a deficiency!

Chris24Main said:

@nabilla - do you mind if I ask if you have any objections to meat products - meat, eggs, dairy are all good sources of VB12 - I'm sure you will know that, so I guess I'm assuming that you are avoiding these.. which is fine, no agenda; I'm just curious...

on fasting - I've become a big fan of fasting, and I truly believe in the theory (autophagy, or essentially giving your body a chance to repair) - but it can take some effort/ planning and it definitely isn't for everyone, nor is there a "best" way to do it.. only what works for you; and you should be prepared for some time of getting used to whatever you try (once you feel well, of course) before you think about whether it makes you feel better or not.

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Hi yes I eat everything, except starchy veg and white/brown rice, pasta, bread etc.
I'm very much up for fasting. I just want to make sure I don't lose more weight if I do it.

nabilla said:

Hi yes I eat everything, except starchy veg and white/brown rice, pasta, bread etc.
I'm very much up for fasting. I just want to make sure I don't lose more weight if I do it.

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I don't need to avoid foods with B12 before testing as I've always eaten foods high in B12 and tested low whilst eating them. So it's likely an absorption issue

Bit of a moan. Ate 47g carbs today BUT had a half wholewheat flatbread smothered in ghee with my cauliflower curry tonight. 13.5g carb. 5.4 on my BGM before eating dinner and 12.2 two hours after...
So it looks like I may not tolerate wheat well.
I have two questions:
1. Any recommendations for low carb chapattis? Happy to make myself from scratch.
2. Anyone know of a more scientific method of eating to meter? Currently it's a bit of a hit and a miss. I'm thinking I need to ensure I don't eat two things together that I'm unsure of. For example, at dinner I had 30g pomegranate on my Greek yoghurt for the first time (usually berries) as well as the bread for the first time. Is there a known methodical strategy?

Also, I keep meaning to ask why, when you Google 'keto hot chocolate recipe' it advises replacing milk with single or even double cream. Is cream simply lower carb. Could I have hot chocolate made with full fat milk and cocoa and no sugar or is that higher carb than made with cream? I live hot chocolate but obvs need to either ditch it or find an alternative. Not keen on the diet stuff like options as I don't like the taste of fake sugars.

Chris24Main said:

I was making a hot chocolate for my daughter last night.. steamed milk in my espresso machine and whipped it into Cadbury's chocolate powder. totally vicarious pleasure, as I was no way going to touch it myself, but she enjoyed it...

Cream - well, there are different opinions to be sure, but thick cream had better be lower carb or otherwise I'm in trouble...
What I'm too afraid to check up on is why.. if semi-skimmed milk is basically the milk with less fat, therefore more sugar, is double cream not just more concentrated milk.. ie, just with less water and more fat? I'm not sure, but at least according to the breakdown, yes, double thick cream is very low on carbs, and I use lots of it, a spoonful or two in my Greek Yoghurt, and for making lots of sauces...

I'm not sure (myself) how you would get a large mug of hot chocolate this way - I could see using baking chocolate (high cocoa) - melting it and whipping in double cream.. but while you would end up with something nice (I think) it would be very heavy - though you could maybe make a small drink (like a choco expresso) - actually that's got me thinking, maybe I should try it...

Personally, I still prefer an actual espresso, and a couple of squares of 85% chocolate at the same time...

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Thanks for the thoughts and ideas. I might try and espresso-sized creamy choc with the high cocoa chocolate, and maybe some chilli in it!

But yes, I shouldn't forget how much I'm enjoying a couple of bits of the Lindt 90percent these days and also the fact that I really enjoy the diet. I'm kind of hitting a point where I'm kind of mourning the things I can't eat. I really enjoyed that Chapatti, but I need to focus on the fact i can still have a lamb curry or a nice big bit of fish with roast veg etc

Chris24Main said:

To your wider question, your glucose response (or more accurately your insulin and glucose response) is pretty dynamic, if you're after a better understanding, a CGM is a good way to get it, you can learn a lot about your own body in a fortnight... any spot test is good for a repeat baseline, but will be limited in understanding what happens in the couple of hours following a meal...

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Yes, this is my next thing to do. I will use the free trial. Any suggestions for making the most of that would be welcomed. For example, should I plan experiments for the two week trial? I wondered about doing a week on my current lowish carb diet and then a week where I try things I'd like to eat occasionally to see how it impacts me. Anyone think I need to do this longer than two weeks to see the benefits? If so, I can try budget for it.

Ok thanks, I'll look into doing that test.

I'll try the chickpea flour as well, I've worked with it in the past to make pakora, so!I could give that a try while I'm at it!

I'll also keep track of the gluten and fatigue you mention. I eat very little gluten just now, so that will.be easy to rule out

Outlier said:

Don't forget the brandy......

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In all seriousness, that's the final frontier! Need to do some very technical experiments about how alcohol effects my blood glucose levels. Now, where's my 2 litre beaker of red wine...

jjraak said:

Hi

A few things

B12 became a bit of a hobby horse of mine.

Read up a lot.

Seems sublingual tablets, (melt under the tongue) work almost as good as the injections do.

Other tablets don't make it past the stomach acid barrier and are almost useless, I read.

B12 like many vitamins declines around age 60 for many.

For me (60+) they left me low but I was also on met for the T2D....which can also cause a depletion.(Says inside on the safety label no one reads.

I wasn't told but found I can ask at my HBA1c testing for B12 to be measured, as I had a lot of tiredness, foggy thinking etc.
All things that could be almost assigned to a dozen issues.

Docs tested no problem, reading came back as mid 200's. (Floor is 190)
So too close for comfort .

Took sublingual supplements raised by next test up to 300+, and now resting low 500.

Can't say it's all the supplements, as had a rough few years after an accident & T2D wasn't my biggest foe.

So ate what people and hospitals provided.

Getting back to low carb slowly, but absolutely convinced the B12 supplements made a huge difference.

So your low in B12, just getting over pneumonia & age ?

Could it just a combination of all 3 dragging you down.

I know pre accident some foods even post LC gave me carb coma post dinner till I got more used to this way of eating...(Fats more satiating)

An post accident, I found myself relentlessly tired, until surgeons asked what I ate (trying to be a good T2D)
Told me I'd had major injuries and just wasn't eating enough
(Body needs more when repairing, makes sense to me)

A tad more good, more fat and that tiredness eased some .

I'd say your recent pneumonia is a also taking its toll.

Might be worth getting that B12 test, when you can and eliminating the concern and at least having a base line for your ongoing B12 measurement.

One thing if you do get blood works I read, was a rising mcv level 'can' be indicative of a B12 deficiency , but do Google to check .
Might be a guide to argue your point if docs won't do the test ...mmmhh

I noted mine was on the rise, once I noted that

*UK levels 'acceptable' at above 200.
Japan begin treating if below 600...interesting difference, I thought.

B12, always one of the usual suspects, in my eyes.

Mcv

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Hi,

Great info, thanks. I hadn't heard of the sublingual tablets but I did understand that the standard B12 vitamin pills are only useful if you're low in B12 due to being vegan as otherwise it's almost certainly an absorption issue. Can you recommend a brand?

I'm 45 years old and have generally been very high energy most of my life so I'm really hoping it's not age. I feel a lot better the past week and I do think the recovery from pneumonia has taken longer than I expected (as you suggest), so I should update this thread to say I'm feeling a lot better and with more energy than before. I've also started lifting weights again, which I think is helping in every respect.

I also think I was, like you, perhaps not eating quite enough at one point in my lowish carb journey (I can get a bit TOO into an idea) but people here prompted me to consider upping my fat intake. I've enjoyed doing this and I do think it may have benefitted me over time. I've also not gained weight. In fact I've lost 12 lbs since going lowish carb and now have a BMI of 19.9 which I'm maintaining by eating more fats (good and bad, so good quality peanut butter, olive oil, some nice cheese or chorizo from time to time, all dairy now full fat and even some double cream sometimes!). I think the fats and some extra proteins are especially useful now I'm exercising.

I have an ACTIVE B12 level from before I started taking the B12 tablets the doctor gave me. I'll use that as a baseline. It was in the borderline range - mine was 60 (25 - 70), which is why the doctor prescribed the B12 tablets. I stopped taking them as soon as I realised they were of no use (I'm not vegan). I have to wait until I'm 4 months clear of the B12 to recheck my B12 levels as the tablets interfere with the serum levels without (as you note) actually being absorbed in a way that's useful to the body. I'll also look at my MCV levels as I have just had that tested and should get the results next week.

That's really interesting about the different B12 ranges in UK vs. Japan!

Another thing I'll explore soon is MTHFR mutations as my son was tongue tied and I almost certainly was too. MTHFR mutations can cause tongue ties and also causes issues with the body being able to use B12 and folate.

I'm very curious to know if anyone here has seen their blood glucose levels becoming more stable once they've treated B12 deficiencies as I'm aware B12 deficiency can cause false high HBA1c levels. It's something I'll test myself if I do end up getting B12 injections or taking these sublingual tablets you mention.

jjraak said:

Hi

A few things

B12 became a bit of a hobby horse of mine.

Read up a lot.

Seems sublingual tablets, (melt under the tongue) work almost as good as the injections do.

Other tablets don't make it past the stomach acid barrier and are almost useless, I read.

B12 like many vitamins declines around age 60 for many.

For me (60+) they left me low but I was also on met for the T2D....which can also cause a depletion.(Says inside on the safety label no one reads.

I wasn't told but found I can ask at my HBA1c testing for B12 to be measured, as I had a lot of tiredness, foggy thinking etc.
All things that could be almost assigned to a dozen issues.

Docs tested no problem, reading came back as mid *200's. (Floor is 190)
So too close for comfort .

Took sublingual supplements raised by next test up to 300+, and now resting low 500.

Can't say it's all the supplements, as had a rough few years after an accident & T2D wasn't my biggest foe.

So ate what people and hospitals provided.

Getting back to low carb slowly, but absolutely convinced the B12 supplements made a huge difference.

So your low in B12, just getting over pneumonia & age ?

Could it just be a combination of all 3 dragging you down ?

I know pre accident some foods even post LC gave me carb coma post dinner till I got more used to this way of eating...(Fats more satiating)

And post accident, I found myself relentlessly tired, until surgeons asked what I ate (trying to be a good T2D)
Told me I'd had major injuries and just wasn't eating enough
(Body needs more when repairing, makes sense to me)

A tad more good foids, more fats and that tiredness eased some .

I'd say your recent pneumonia is a also taking its toll.

Might be worth getting that B12 test, when you can and eliminating the concern and at least having a base line for your ongoing B12 measurement.

One thing if you do get blood works I read, was a rising mcv level 'can' be indicative of a B12 deficiency , but do Google to check .
Might be a guide to argue your point if docs won't do the test ...mmmhh

I noted mine was on the rise, once I noted that

*UK levels 'acceptable' at above 200.
Japan begin treating if below 600...interesting difference, I thought.

B12, always one of the usual suspects, in my eyes.

Mcv

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Thanks again - I've already started reading up on the sublingual B12 and it's a huge relief. I had considered going down the self-injection route but I'm too anxious, so knowing there's an alternative that's actually been shown to be more effective than injections is fantastic.

jjraak said:

Not sure where that range comes from ?

As said mine spiralled down to mid 200's.

Uk levels

If your interested, in my signature is a small b movie about sally pochok(?)
A nurse who identified B12 deficiency being marked down as other illnesses .

Think murder she wrote or quincy medical coroner.

An agreeable watch but omg the lack of interest from doctors.

And if, I say if you start googling, you tube offers some startling interviews with people who slipped into that misdiagnosis, some not that long ago.
And giving some nasty issues.

A real rabbit hole, so be cautious .

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Hi, it's the range for ACTIVE B12 which has a very different range to standard B12. My area (Glasgow) now uses active B12 as standard.

I'm interested in that film! I love another B movie where women grow yams in their attics and sell it illegally to treat their menopause!

I'm lucky with my GP in general but I get the feeling even she thinks I'm losing it with my B12 .

The thing that keeps me sane is knowing how researching and advocating for my partner had radical impact on his health. My mum was also misdiagnosed and had she not challenged it, would definitely be dead. I think the doctors are excellent in general but have very limited time.and resources.

Thanks again for telling me about the sublingual B12 and the MCV markers