I’m stuck. Nothing is going down.

HSSS · Mar 12, 2021

Ok quick summary to a long post. Bgl and weight won’t come down after being static for a couple of years. Don’t know what to do next.

Diagnosed 3 yrs ago at 55mmol Hb1ac and fasting of 7.3. Immediately went keto and at 3 months down to 44hb1ac. I’ve stayed between 41 and 43 since. I initially lost 15kg and reached normal bmi. Over the last 18 months 5kg has crept back on and I’m just into overweight again. It seems stable for now. My fasting is typically mid 6’s even on the many days I do a 16 hrs fast. During the day I’m pleased if I get into the 5’s as it’s too often stuck in the 6’s. I actually want to reach 4’s and 5’s pre meals but it’s proving elusive. Meals never take me more than 2mmol over pre eating, often less at the 2hr mark. I’m 50 and likely had insulin resistance issues for 20yrs, quite possibly undiagnosed GD at that point x3.

I still eat much the same way and don’t think I’ve usually got carb creep going on unnoticed. Bgl have been static for years. I seem pathologically incapable of recording macros and weighing foods. I rarely remember after breakfast and in a large family situation it’s particularly awkward with many one pot meals. I already loathe the kitchen and this makes it worse. I got a ketone meter recently to use that to check things for creep and still register a reading in the mornings, usually 0.5 ish so I take it that my carbs are not preventing ketosis. I don’t eat large amounts, nor do I binge on fats. (I used to). I’ve tried cutting my “treats” of wine and 85% chocolate and nothing has changed.

So what else can I do? why hasn’t it got better than this? Why is my IR not reducing past the initial improvement? and why has weight gone up even though bloods remain static?

I’ve considered lowering carbs more but it just won’t work for me without feeling deprived and miserable. I guesstimate I’m at about 20-40 a day so not too many more to cut anyway.

I’ve considered longer fasting and even tried it but I simply cave before I even reach 24hrs and it doesn’t fit well with life as the family chef.

I’ve considered more exercise. I don’t like exercise for the sake of it, never have, and struggle to find legitimate purposeful activities that accidentally provide it, especially in lockdown and with my degree of caution around people in these covid days even when more is allowed.

Ive considered insulin testing to see that’s an issue but 1. there nothing local and 2. I can’t afford it at present.

I’ve considered metformin to reduce the background levels that seem to be my problem seeing as diet works to avoid spikes. I really wanted to avoid this but it’s feeling more and more inevitable.

I know it’s not a terrible status quo but it’s not as good as I want it to be.

lucylocket61 · Mar 12, 2021

Are you menopausal or peri-menopausal?

My experience is that, after 9 successful years of diet controlled, my fasting blood levels remain around 8. I have accepted this as just the way my body works.

HSSS · Mar 12, 2021

That’s a possibility, one that I can’t do much about though without a time machine. If all else fails it might explain why this is happening. I still need to decide how to react to/deal with it though.

Oldvatr · Mar 12, 2021

It might be worth exploring and experimenting with some supplements. I am specifically thinking those directly involved in the metabolism of carbs. One that I have very recently tried myself (with success I might add) is zinc. The other one I have had mild success with is magnesium. One I definitely found worthy of a look is chromium picolinate.
These three basic minerals are involved in the chemical reactions in the Krebs or Citric cycles that control the burning and storage of glucose in the muscles. One thing to note about these supplements, in particular, is that they are noted to only have an effect if your diet is lacking them, and they have no effect once your body has caught up. They are normally provided in the western diet from fruit and veg, but if doing keto, then these could be in foods you no longer eat.

I have also had some effects from Bitter Melon, and also Gymnema Sylvestre. These are ayurvedic medicines used commonly in Asian countries. Again they are not long-term items, but I have successfully replaced my Metformin with them and noticed no rise in bgl.

I too am chief cook and bottle washer in my homestead, and I am personally content to bumble along with my HbA1c around 40, and my weight to remain static. I could go lower, but that would start to become inconvenient. As it is my daughter is now 'low carb' and shares my meals, but would resist going keto. Her goto is vegan crisps and pancakes or popcorn when peckish.

LaoDan · Mar 12, 2021

For me, exercise is the greatest tool after diet. Like changing my diet, it was tough getting started, but now it’s part of my daily routine. I just do it.

lucylocket61 · Mar 12, 2021

HSSS said:
That’s a possibility, one that I can’t do much about though without a time machine. If all else fails it might explain why this is happening. I still need to decide how to react to/deal with it though.

menopause (which takes about 10 years in total, it doesnt start or stop when periods cease) has a similar affect on our hormones as puberty. Maybe read stuff about the effect puberty has on hormones and blood sugar levels? I accept the hormone swings as inevitable, and dont let them bother me. I know that, int he long run, dong my best is all I can do as i ride this out.

best wishes to you.

NicoleC1971 · Mar 12, 2021

HSSS said:
That’s a possibility, one that I can’t do much about though without a time machine. If all else fails it might explain why this is happening. I still need to decide how to react to/deal with it though.

I have just turned 50 too and the peri menopause/memopause is the first thing I thought of when reading your post. There's a good article on Diet Doctor that might help you but you say you're already fasting which I know was one of their breaking through tips.
TBH you also sound a little down on yourself whilst you are at least acknowledging that your neither your weight or blood sugars are bad. It sounds as if you are expecting more at this point in spite of all your diligence. You've started hating your kitchen and this sounds really uninspiring tooand I hope you can get some inspiration from somewhere particularly as the Covid restrictions lift and the weather gets better.
Re the exercise thing, I agree that exercise you do as a chore is just that and will feel too much on top of dietary restrictions but I think if you can make it into something you have to do e.g. always taking stairs, walking where you might habitually drive, gardening, dancing or something to calm the stress such as a stretching session to calm down cortisol levels maybe? Or even paying a PT so that you've put your own cash into it can help with commitment and motivation. Muscle sensitivity to insulin will improve by doing some strength stuff and if yo haven't done much of it recently then you're in a good place to get a metabolic boost out of it not to mention a serotonin one.
As for the IR why not try the poor man's version i.e. blood lipids hdl/triglycerides ratio will give some indication of how your body is handling whatever carbs you are eating. I think it's supposed to be a ratio of 1 to 1.5 (trig/hdl).

woollygal · Mar 12, 2021

HSSS said:
Ok quick summary to a long post. Leaves and weight won’t come down after being static for a couple of years. Don’t know what to do next.

Diagnosed 3 yrs ago at 55mmol Hb1ac and fasting of 7.3. Immediately went keto and at 3 months down to 44hb1ac. I’ve stayed between 41 and 43 since. I initially lost 15kg and reached normal bmi. Over the last 18 months 5kg has crept back on and I’m just into overweight again. It seems stable for now. My fasting is typically mid 6’s even on the many days I do a 16 hrs fast. During the day I’m pleased if I get into the 5’s as it’s too often stuck in the 6’s. I actually want to reach 4’s and 5’s pre meals but it’s proving elusive. Meals never take me more than 2mmol over pre eating, often less at the 2hr mark. I’m 50 and likely had insulin resistance issues for 20yrs, quite possibly undiagnosed GD at that point x3.

I still eat much the same way and don’t think I’ve usually got carb creep going on unnoticed. Bgl have been static for years. I seem pathologically incapable of recording macros and weighing foods. I rarely remember after breakfast and in a large family situation it’s particularly awkward with many one pot meals. I already loathe the kitchen and this makes it worse. I got a ketone meter recently to use that to check things for creep and still register a reading in the mornings, usually 0.5 ish so I take it that my carbs are not preventing ketosis. I don’t eat large amounts, nor do I binge on fats. (I used to). I’ve tried cutting my “treats” of wine and 85% chocolate and nothing has changed.

So what else can I do? why hasn’t it got better than this? Why is my IR not reducing past the initial improvement? and why has weight gone up even though bloods remain static?

I’ve considered lowering carbs more but it just won’t work for me without feeling deprived and miserable. I guesstimate I’m at about 20-40 a day so not too many more to cut anyway.

I’ve considered longer fasting and even tried it but I simply cave before I even reach 24hrs and it doesn’t fit well with life as the family chef.

I’ve considered more exercise. I don’t like exercise for the sake of it, never have, and struggle to find legitimate purposeful activities that accidentally provide it, especially in lockdown and with my degree of caution around people in these covid days even when more is allowed.

Ive considered insulin testing to see that’s an issue but 1. there nothing local and 2. I can’t afford it at present.

I’ve considered metformin to reduce the background levels that seem to be my problem seeing as diet works to avoid spikes. I really wanted to avoid this but it’s feeling more and more inevitable.

I know it’s not a terrible status quo but it’s not as good as I want it to be.

I’m exactly the same,
I’ve been doing strict keto (most days under 10g and defo not over 20] for the past 6 weeks or so. For the last few weeks I’ve intermittent fasted doing 16/8. I’m exercising.
Still nowt.
I’ve dropped a couple pounds then it goes back up.

it’s annoyign isn’t it and frustrating because there is nothing that can be done to change it.
Have you talked to your GP about HRT.
There is lots of myths (a bit like type 2] and about hrt being bad but there is someone called dr Louise newson who is the menopause doctor and she has lots of fantastic info that dispels those myths.
I don’t know whether hrt would help but if it is to do with age and hormones logically it must do something.

im certainly going to speak to the dr and ask her advice. She knows my weight isn’t shifting but just says the insides are getting healthier, but I don’t like it and I am in the overweight zone if not more. It’s not comfortable I don’t like how my clothes feel.

Good luck and I hope you find something that helps.

MrsA2 · Mar 12, 2021

HSSS said:
Ok quick summary to a long post. Leaves and weight won’t come down after being static for a couple of years. Don’t know what to do next.

Diagnosed 3 yrs ago at 55mmol Hb1ac and fasting of 7.3. Immediately went keto and at 3 months down to 44hb1ac. I’ve stayed between 41 and 43 since. I initially lost 15kg and reached normal bmi. Over the last 18 months 5kg has crept back on and I’m just into overweight again. It seems stable for now. My fasting is typically mid 6’s even on the many days I do a 16 hrs fast. During the day I’m pleased if I get into the 5’s as it’s too often stuck in the 6’s. I actually want to reach 4’s and 5’s pre meals but it’s proving elusive. Meals never take me more than 2mmol over pre eating, often less at the 2hr mark. I’m 50 and likely had insulin resistance issues for 20yrs, quite possibly undiagnosed GD at that point x3.

I still eat much the same way and don’t think I’ve usually got carb creep going on unnoticed. Bgl have been static for years. I seem pathologically incapable of recording macros and weighing foods. I rarely remember after breakfast and in a large family situation it’s particularly awkward with many one pot meals. I already loathe the kitchen and this makes it worse. I got a ketone meter recently to use that to check things for creep and still register a reading in the mornings, usually 0.5 ish so I take it that my carbs are not preventing ketosis. I don’t eat large amounts, nor do I binge on fats. (I used to). I’ve tried cutting my “treats” of wine and 85% chocolate and nothing has changed.

So what else can I do? why hasn’t it got better than this? Why is my IR not reducing past the initial improvement? and why has weight gone up even though bloods remain static?

I’ve considered lowering carbs more but it just won’t work for me without feeling deprived and miserable. I guesstimate I’m at about 20-40 a day so not too many more to cut anyway.

I’ve considered longer fasting and even tried it but I simply cave before I even reach 24hrs and it doesn’t fit well with life as the family chef.

I’ve considered more exercise. I don’t like exercise for the sake of it, never have, and struggle to find legitimate purposeful activities that accidentally provide it, especially in lockdown and with my degree of caution around people in these covid days even when more is allowed.

Ive considered insulin testing to see that’s an issue but 1. there nothing local and 2. I can’t afford it at present.

I’ve considered metformin to reduce the background levels that seem to be my problem seeing as diet works to avoid spikes. I really wanted to avoid this but it’s feeling more and more inevitable.

I know it’s not a terrible status quo but it’s not as good as I want it to be.

I could have written this! Share your frustration.

I am older (over 60) and through the menopause and just feel that with everything I am doing, my levels should be lower.
Whats all this rubbish about fbg taking 6 months to come down? I'm just coming up for a year and fbg is exactly the same as the first weeks I started testing.
I am modestly active, I do a class once a day either aerobic or yoga and walk for at least an hour at least 3 times a week
I've just today tried a libre to see of that gives me any clues

As for the kitchen I've encouraged my hubby and son to do more of the cooking, but that doesn't help me fast as I am duty-bound to try their dishes
I would like to try OMAD but my hunger kicks in as soon as I even think about doing it!

I think the books dear @HSSS would say longer fasts and resistance exercises.

Maybe get locked in your bedroom and you have to force your way out?

Or a short, sharp very low cal just for a week or 2?
I don't really know, but am on your team and watching thread with interest

lucylocket61 · Mar 12, 2021

I may have mentioned elsewhere that, over the 9 years since diagnosis my fasting blood sugar levels remain around 8. It's just what my body does in the morning.

HSSS · Mar 12, 2021

lucylocket61 said:
menopause (which takes about 10 years in total, it doesnt start or stop when periods cease) has a similar affect on our hormones as puberty. Maybe read stuff about the effect puberty has on hormones and blood sugar levels? I accept the hormone swings as inevitable, and dont let them bother me. I know that, int he long run, dong my best is all I can do as i ride this out.

best wishes to you.

Oh I’m aware of the considerable effects perimenopause is having. I just feel the need to manage/mitigate these effects rather than just accept them. But yes doing our best is all we can do. I’m just trying to ensure I’m doing MY best. Puberty the first time wasn’t much fun. Doing it in reverse isn’t much better.

HSSS · Mar 12, 2021

NicoleC1971 said:
I have just turned 50 too and the peri menopause/memopause is the first thing I thought of when reading your post. There's a good article on Diet Doctor that might help you but you say you're already fasting which I know was one of their breaking through tips.
TBH you also sound a little down on yourself whilst you are at least acknowledging that your neither your weight or blood sugars are bad. It sounds as if you are expecting more at this point in spite of all your diligence. You've started hating your kitchen and this sounds really uninspiring tooand I hope you can get some inspiration from somewhere particularly as the Covid restrictions lift and the weather gets better.
Re the exercise thing, I agree that exercise you do as a chore is just that and will feel too much on top of dietary restrictions but I think if you can make it into something you have to do e.g. always taking stairs, walking where you might habitually drive, gardening, dancing or something to calm the stress such as a stretching session to calm down cortisol levels maybe? Or even paying a PT so that you've put your own cash into it can help with commitment and motivation. Muscle sensitivity to insulin will improve by doing some strength stuff and if yo haven't done much of it recently then you're in a good place to get a metabolic boost out of it not to mention a serotonin one.
As for the IR why not try the poor man's version i.e. blood lipids hdl/triglycerides ratio will give some indication of how your body is handling whatever carbs you are eating. I think it's supposed to be a ratio of 1 to 1.5 (trig/hdl).

Lots of good points here. Yes I do expect, and want, more. I’ve always hated the kitchen but I do cook from scratch almost every day low carb/keto. I have a decent quality variety, just hate the effort it requires just don’t have a lot of capacity for more effort. The weather improving will extend my repertoire undoubtedly. If nothing else my eldest likes to bbq and cooking outside feels better even if the family get sick of bbq variations

I am down. For lack of progress, for lockdown, for risk of illness, for other life reasons. Nowhere near as bad as it has been previously by far, but not as good as it could be. I’m pretty self aware on this front.

Exercise used to be dance. I am not happy going to dance classes/meetings which involve rotating partners usually and are not the same as a singleton online and can’t see that changing for some time. I don’t have the finances to pay for anything right now as I am on unpaid leave. Yes I need to find motivation for strength exercise but it simply isn’t there and I can’t find it.

Lipids ratios last test were Good to excellent, hdl good to great and trig below 0.8 so great. If my IR is doing well why isn’t my bgl? Or weight? These are my unanswered questions.

HSSS · Mar 12, 2021

Thank you all for your views. Please keep any ideas coming.

There does seem to be a theme of women of a certain age having similar issues.

MrsA2 · Mar 12, 2021

On line dance/exercise about £4-5 a class, some free too.
I do both Paracise (Kate crofts in East Surrey) and Flexercise (Melody Sturt in East Surey), both brands have classes across the country but on zoom distance is no object so I've put my leaders names in brackets. Both have great music and are fun, really mood lifting, and all done from safety and privacy of own home/bedroom. No one watches you as too busy trying to follow the steps and moves themselves.

Also modern line dance has brilliant range tracks and absolutely no partner needed. Check out Dancezing, or you tube "line dance" for free teach yourself

Also I remember this podcast as being particularly women centred
https://podcasts.google.com/feed/aH...zUtZDRiYi00ZDRjLWE0YzQtZDA1NmRmNzI0NGUy?ep=14

Hope at least one of the above helps, from one who has been there

Brunneria · Mar 12, 2021

Yes, women of a certain age have a very different experience from men, or women not of a certain age.
I think that women with a history of weight issues and insulin resistance before menopause are likely to have higher insulin resistance during and after menopause than their contemporaries, which will continue indefinitely.
Just because the forum is filled with triumphant (and wonderful) success stories does not mean will all be so lucky.
Hormonal issues such as hypothyroid and PCOS just pile on the hassle.

Factors which may also affect the situation may be use of artificial sweeteners and diet drinks, use of keto baked goods, use of bread and flour substitutes, chocolate, alcohol, dairy, nuts, cheese. Obviously, people vary tremendously in their reactions to each of those, and there are probably many more I haven’t mentioned.

Exercise is fabulous at reducing insulin resistance - temporarily.
I have completely given up on it to help my IR, because it turns out that it only works for me for a few hours, then resets. And as I get fitter, it takes more and more effort to achieve the same result.
These make rapidly diminishing returns, and I have zero interest in exercising 4 or 5 hours a day, spread through the day, especially since my knees now make even a trundle with the dogs impractical.

HSSS · Mar 13, 2021

MrsA2 said:
On line dance/exercise about £4-5 a class, some free too.
I do both Paracise (Kate crofts in East Surrey) and Flexercise (Melody Sturt in East Surey), both brands have classes across the country but on zoom distance is no object so I've put my leaders names in brackets. Both have great music and are fun, really mood lifting, and all done from safety and privacy of own home/bedroom. No one watches you as too busy trying to follow the steps and moves themselves.

Also modern line dance has brilliant range tracks and absolutely no partner needed. Check out Dancezing, or you tube "line dance" for free teach yourself

Also I remember this podcast as being particularly women centred
https://podcasts.google.com/feed/aH...zUtZDRiYi00ZDRjLWE0YzQtZDA1NmRmNzI0NGUy?ep=14

Hope at least one of the above helps, from one who has been there

Thanks but I do salsa, Latin, modern jive and even some ballroom. Line dancing is not my thing. I’ve tried the classes my usual groups do and they aren’t for me and now too costly. It’ll be there again in the future for sure but not right now.

HSSS · Mar 13, 2021

Brunneria said:
Yes, women of a certain age have a very different experience from men, or women not of a certain age.
I think that women with a history of weight issues and insulin resistance before menopause are likely to have higher insulin resistance during and after menopause than their contemporaries, which will continue indefinitely.
Just because the forum is filled with triumphant (and wonderful) success stories does not mean will all be so lucky.
Hormonal issues such as hypothyroid and PCOS just pile on the hassle.

Factors which may also affect the situation may be use of artificial sweeteners and diet drinks, use of keto baked goods, use of bread and flour substitutes, chocolate, alcohol, dairy, nuts, cheese. Obviously, people vary tremendously in their reactions to each of those, and there are probably many more I haven’t mentioned.

Exercise is fabulous at reducing insulin resistance - temporarily.
I have completely given up on it to help my IR, because it turns out that it only works for me for a few hours, then resets. And as I get fitter, it takes more and more effort to achieve the same result.
These make rapidly diminishing returns, and I have zero interest in exercising 4 or 5 hours a day, spread through the day, especially since my knees now make even a trundle with the dogs impractical.

Mmmm something to consider. I had half my thyroid removed 3 years ago. Allegedly levels remain ok as of 6 months ago. Tsh has doubled since pre op (half the organ doing twice the job?) but still well within normal, T4 and a single t3 reading remain stable ish well inside normal.

Minimal sweetener (erythritol 2 or 3 teaspoons a day) no diet drinks, rarely keto baked goods ie once a month or less, no bread subs, almond flour very occasionally ie a few times a month, 85% choc seems to make no difference at a square or two a few times a week, alcohol vastly reduced to the odd glass of red wine which makes no difference to any readings, not too many nuts( 2 or 3 tablespoons of chopped pecans/walnuts a week) and no difference in readings noted, cheese not excessive (6-8 tablespoons a weeks grated cheddar) and again no difference noted.

It’s seeming more and more likely my age/hormonal situation is the largest confounding factor. But other than accept it what next?

Some form of strength/muscle building exercise that feels part of everyday life or fun rather than exercise is one option. Ideas from people that like type b fun please?

extending fasting maybe but i seem to get to a point where I liver dump and rise after 14-16 hrs. Perhaps it’s beneficial draining of the liver, perhaps it’s simply bgl rising. Thoughts?

hrt? Loathe to go there as no other bothersome issues around time of life.

metformin? Loathe to go there simply because I want to do this without meds. should I remain stubborn?

VashtiB · Mar 13, 2021

I agree with @Brunneria that some artificial sweeteners and keto baked goods seem not to increase my levels when I eat them but the next day my fasting levels and others are higher. I'm not sure why just my experience.

A suggestion only is to have a few days only of much lower carbs to see if it has any effect- if it doesn't then there is no point even trying to reduce your carbs generally. It may be that they do go lower but not enough to make it worth your while- diminishing returns. Either way if you just treat it as an experiment rather than the plan for longer term it may not feel like deprivation as it is very short term.

women do seem to draw the short straw a number of times.

Good luck.

HSSS · Mar 13, 2021

VashtiB said:
I agree with @Brunneria that some artificial sweeteners and keto baked goods seem not to increase my levels when I eat them but the next day my fasting levels and others are higher. I'm not sure why just my experience.

A suggestion only is to have a few days only of much lower carbs to see if it has any effect- if it doesn't then there is no point even trying to reduce your carbs generally. It may be that they do go lower but not enough to make it worth your while- diminishing returns. Either way if you just treat it as an experiment rather than the plan for longer term it may not feel like deprivation as it is very short term.

women do seem to draw the short straw a number of times.

Good luck.

I rarely have baked goods, sweeteners are minimal neither make any difference to bgl,or next day levels and how do you go “much lower” than 30g a day

HSSS · Mar 13, 2021

Oldvatr said:
It might be worth exploring and experimenting with some supplements. I am specifically thinking those directly involved in the metabolism of carbs. One that I have very recently tried myself (with success I might add) is zinc. The other one I have had mild success with is magnesium. One I definitely found worthy of a look is chromium picolinate.
These three basic minerals are involved in the chemical reactions in the Krebs or Citric cycles that control the burning and storage of glucose in the muscles. One thing to note about these supplements, in particular, is that they are noted to only have an effect if your diet is lacking them, and they have no effect once your body has caught up. They are normally provided in the western diet from fruit and veg, but if doing keto, then these could be in foods you no longer eat.

I have also had some effects from Bitter Melon, and also Gymnema Sylvestre. These are ayurvedic medicines used commonly in Asian countries. Again they are not long-term items, but I have successfully replaced my Metformin with them and noticed no rise in bgl.

I too am chief cook and bottle washer in my homestead, and I am personally content to bumble along with my HbA1c around 40, and my weight to remain static. I could go lower, but that would start to become inconvenient. As it is my daughter is now 'low carb' and shares my meals, but would resist going keto. Her goto is vegan crisps and pancakes or popcorn when peckish.

Off to source some of these for some experiments of n=1. Thank you for the ideas. Nothing ventured nothing gained. (Or lost hopefully).

I’m stuck. Nothing is going down.

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