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Extremely confused - Insulin Resistant PCOS been given medication

Discussion in 'Prediabetes' started by Donought, Nov 9, 2020.

  1. Donought

    Donought · Active Member

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    Hi All,

    I've just been reading my way through so many threads on here and it seems as though everyone is really supportive and knowledgeable so thought I may tap into some of that if I may.

    On Friday I was diagnsed with Insulin resistant PCOS, adrenal fatigue (HPA axis disruption), menopause, and high blood pressure. I paid to see a private endo and he was lovely. Really listened and spent over 4 hrs with me understanding my history before he made a diagnosis.

    I'm a little confused re the insulin resistance because I am a bit weird. I tend to spike 3hrs after a meal then crash about 4hrs after. I'm guessing more reactive? Endo put me on metformin to lower insulin levels although I have also started on LCHF with high fat and high fibre. Endo told me to eat every 3hrs whereas previously I had been going for a big breakfast - oats, chia seeds, hemp seeds, spinach, berries, avo, coconut milk then nothing for lunch and a veggie dinner.

    He said the high blood pressure is from the hyper after eating - 180/150 3hrs after a McDonalds egg muffin and two hash browns (I knew it would be last one guilt free!). Couldn't test my blood sugar at the time. I'm on propranolol for the high blood pressure. It doesn't seem to be working as I had a high BP after eating (3hrs) yesterday along with feeling so hungry, pain in my stomach, nausea etc which made me think my high BP was caused by hypos, not hypers? I ran out of testing strips so got some new ones today to keep an eye on it.

    My HbA1c is always around 35 but endo said it's an average and if I'm swinging between the two so wildly it may 'seem normal' but isn't.

    Anyway, this is a very long waffly intro to say help! Anyone any experience of this and assuming LCHF works should I consider withdrawing the metformin? I am usually extremely anti meds and would prefer trying the natural way but after 8 yrs of fighting being told 'there's nothing wrong with you' I will gladly take anything to start feeling normal.

    Thanks :)
     
  2. Antje77

    Antje77 LADA · Moderator
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    Hi @Donought , and welcome to the forum!
    I don't know much about anything you're experiencing but I'll tag @Brunneria who may have some thoughts :)
    Wish you all the best!
     
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  3. EllieM

    EllieM Type 1 · Moderator
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    You could have a look at the reactive hypoglycemia forum (@Antje77 has already tagged @Brunneria and @Lamont D might also like to comment). Unfortunately RH often goes along with blood sugars rising before the lows (one of the experts will correct me if I'm wrong). BUt the good news is the treatment for RH is exactly the same as for T2 - drop the carbs.

    https://www.diabetes.co.uk/forum/category/reactive-hypoglycemia.70/
     
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  4. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi and welcome to the forum.
    Your post is a bit of a ramble but I get the gist.
    I have reactive hypoglycaemia and your endo has already told you the standard eat every three hours advice as I did when first diagnosed.
    And of course because we need certain vitamins, we need to have certain types of food for fibre and so on, we can't do without carbs, eat high GI carbs etc.
    However, if you do all this, you won't improve much.
    I am going to recommend you read the reactive hypoglycaemia forum and see if something there rings true for you.
    What tests have you had?
    You said you spike around three hours, then go hypo at four. I have similar but my spike is before one hour then hypo after three and a half hours.
    Every glucose tolerance test I have had it is the same. This is called ' Late Reactive Hypoglycaemia' and it is food derived. If I don't eat, I don't get the hypers or the hypos.
    If I eat carbs, without intervention I would definitely go hyper then hypo.
    I am weird, because it is rare condition, and my endocrinologist has confirmed this.
    But, and more importantly, when in control, my blood glucose fasting levels and my Hba1c levels are in normal range. So we are not diabetic.
    It used to be called, idiopathic postprandial Hypoglycaemia. In other words unknown after food Hypoglycaemia.
    I was taken off metformin before diagnosis, as I was not diabetic or needing the drug, it all depends on what your endo is trying to achieve with everything else that is going on with you.
    I am following a Keto diet along with intermittent fasting, this is really very low carb diet, I prepare every meal. I have found a balance of protein and fats that are healthy for me! I started with food, so I will add that as we are weird, we cannot eat normal.
    What is usually healthy foods for non diabetics are not healthy for us. Carbs are carbs and they make us unhealthy. I have an intolerance to many foods, I have an intolerance to lactose, to any grains and most importantly starchy vegetables.
    I don't eat manufactured food, I only eat fresh meat and vegetables, lots of eggs, fish and so on. I use saturated fat, no vegetable oils or such.

    You are not the only one who can write long posts. I ramble all the time.

    If you are not sure, ask the question, if you want dietary advice ask, if you need help in understanding the condition or an explanation of what actually happens after food, I will try and help you.

    Keep safe
     
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  5. JoKalsbeek

    JoKalsbeek I reversed my Type 2 · Expert

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    Hi @Donought ,
    I am a T2, but as has been state before, the treatment for RH and T2 are virtually the same. Little to no carbs, no spike, and in RH's case, no hypo afterwards. So give the low carb a proper go indeed. Before I started on the low carb journey, my blood pressure was normal. Now it's actually low, so I do need my extra pinches of salt here and there. If you do go down this road, keep an eye on your blood pressure. The propranolol might need reducing in dosage if the room goes black if you stand up too fast eh. And test your heart out, you want to know what your bloods are doing when you feel off, like with the stomach pain and nausea.

    You're going to be okay, keep asking questions and being your own guinea pig!
    Jo
     
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  6. Donought

    Donought · Active Member

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    Hi Guys,

    Thank you ALL so much for your responses. I didn't realise how much all this has thrown me until I read your lovely, helpful posts. Knowing I AM going to be OK and I am in control is so useful to remember.

    Jo - I'm taking your advice and keeping on checking out the heart as I think the propranolol may need increasing as it doesn't seem to be working. I spoke to a pharmacist yesterday who said it should work within minutes and definitely hours. I'll an eye on it.

    Lamont - thank you so much. Did my bloods today and peaked at 1hr too...it's all so very strange. Thankfully no hypo though as I have cut out the carbs but finding it really tough today. I will go over to the reactive group as some of the stuff I read, may even have been one of your posts, sounds so similar to me. I think my endo my have known I was reactive but just lumped me as insulin resistant because of the PCOS because he did ask if I drop below 3.9, which I do between 3-4 hrs after a high carb meal. Used to pass out on my office floor a few years ago after a baked bean baked potato.

    Endo told me he was trying to reduce my insulin by using the metformin. I'll head to the reactive room and have a nosey. Thank you all for being so generous with your time and knowledge, good to know I'm in a safe place and somewhere I can ask questions without getting eye rolls (my family are fed up with me always having some symptom or another, at least now I know what it is).

    Cheers,
    D
     
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  7. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    I was told about twenty years ago, that this meal jacket potato with baked beans is probably the most important I could eat, especially if I also ate the skin. They're good carbs, fibre, low fat and vitamins and because of portion size it will help you lose weight!
    And I believed the dietician that told me this!

    If only I could tell her now, what I think!

    Keep safe
     
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  8. Donought

    Donought · Active Member

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    It's absolutely bonkers isn't it. And it takes so much effort to fight against a system that we assume is trying to help us but actually seems designed to make us fail.
     
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  9. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    The crazy thing is that if you look around the internet the truth is out there. There is so much evidence of how carbs and sugar impact health.
    The opposition to live your life in getting your energy and glucose you need without carbs is how humans have survived since the first day man walked on this planet.
    As long as we have protein, vegetables, fats, we just don't need carbs.
    And we could do without all the confectionary that is overloaded with sugar and carbs, junk food and additives.
    I am definitely not a low carb diet nutter that will tell everyone they should, it's only when I see what is going on with dietary advice, is shocking and of course I have been through a lot and found out why I have this condition. And the only treatment is a dietary lifestyle.

    Keep safe
     
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  10. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    I was told the same thing at my diabetes education sessions in 2017 - they described it as 'a good lunch' so they are probably still coming out with the same dangerous 'information'.
     
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  11. Donought

    Donought · Active Member

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    Shocking isn't it!
     
  12. Donought

    Donought · Active Member

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    I've dug out my old BS monitor and started testing these past few weeks. Can anyone shed any light on what's going on? I am peaking between 30-60 mins eating low carb getting a reading of 9.5/ 10 then it starts to come down. Other times I will go from 5.6 to 8.4 but then stay around 7.8 for 3 to 4 hours. I've been quite headachy and these tend to coincide higher readings. I seem to be extremely sensitive to any changes in my body - I know when my blood pressure is high but according the Dr's I shouldn't. I know when it's 110/100 for example.

    I've been keeping low carb, lost 6kg, been walking every morning but still BS seems to be high along with blood pressure. I know I've only been at this for 5 weeks but I thought there may be some changes to BS. I've ordered a couple of libre sensors as I've been waking up with night sweats etc.

    Any thoughts greatly appreciated.
     
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  13. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    I think that, having gone through similar, the high spikes in my case, was more than probably insulin resistance, which gave me a very weak initial insulin response, so there was nothing to stop the glucose impact on my blood. Then my pancreas created more insulin and didn't stop unless I had something to eat again.
    I found out through an eOGTT, what was happening, and why it caused the symptoms.
    My food diary gave clear results, that after eating certain foods, my spike was high, eating the foods that didn't spike me, didn't trigger the insulin overshoot.
    My spike was in diabetic range after eating but not fasting, or Hba1c, which was telling my endocrinologist, I wasn't diabetic and I was having hypos which was caused by foods and not like any type of diabetes.

    Having a glucometer and testing, recording and experimenting were the proof I needed to show how my body works after eating.

    Keep safe and best wishes
     
  14. Hotpepper20000

    Hotpepper20000 · Well-Known Member

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    I have PCOS and it is extremely difficult to loose weight. Metformin does help for me as well as cutting out all grains, legumes and root vegetables. I have lost 60pounds and have been able to keep it off for 3 years but the remaining 40 are stubborn. It takes time . I think with PCOS it takes longer then for those with out.
     
  15. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    I have just reread your post, the awareness is something I know is happening and I feel more or less the same symptoms as you are, after a while on low carb you can become hyper or hypo aware. So when your blood glucose goes out of normal range, you get the symptoms.

    As for BP, I can tell you if you persist with low carb, then you will see some improvements soon. I have been on meds for hypertension, and my blood pressure was always been relatively high, until I found that it was my body getting worse, effectively, slowly killing me. Despite being the recommended healthy diet.
     
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  16. Donought

    Donought · Active Member

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    Yeah the PCOS is a real pain in the butt. I think I will have to go hard go super low carb, no root veggies etc. Well done on such a massive weight loss and keeping it off, that's the tricky part. I think I'm just in a slump. Was all gung ho after he diagnosis, was actually relieved I wasn't a raving hypochondriac, so I embraced low carb etc and now a few weeks in I'm just bleugh. So grateful to have this forum to vent and receive great advice from people who have been through and it are going through it. So hard swimming against the tide.
     
  17. Donought

    Donought · Active Member

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    Thanks Lamont. I will persist. I remember you saying you are reactive aren't you? I'm wondering if I may also be the same. I love data so will do some serious food diary keeping (which I hate) then crunching of numbers (which I love).

    Hope you're doing OK and taking things easy and being gentle with yourself. Sending you lots of festive cheer!
     
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  18. Hotpepper20000

    Hotpepper20000 · Well-Known Member

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    Ya it’s difficult. Make sure you are replacing the carbs with full fat.
    It will help with the emotional and physical feelings of blah.
     
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  19. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Yes, that's right, Reactive Hypoglycaemia. Too much insulin, carb intolerant!
    I'm doing better, I still look back at times to my food diary and when I see the improvements and knowing how toxic some foodstuffs are for me.
    Knowledge is key, knowing your body and knowing your healthy balanced diet is critical to my future health.

    Have a wonderful Christmas, don't go mad on the mince pies!

    Keep safe and best wishes.
     
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