T2 or NAFLD? ...or, a funny thing happened on the way to the surgery

[MrsA2]

"Cancer" is perhaps too wide a term here. Yes I can see some cancers being linked to metabolic issues, but what about those that form elsewhere, or that form in childhood?

 

[Melgar]

It is nutrition and better healthcare that is allowing us to live a lot longer, hence the higher rate of cancers. Many things cause cancers, what we eat, what toxins we put in our bodies, alcohol, smoking, excess sugar, burnt food (apparently) , environmental conditions, pollution, our working environment, stress , the sun, and not to mention our own susceptibility through our genes. Even Some diseases cause cancers to emerge. I have no doubt metabolism can be a factor too. In the animal world, death from simply living in a predatory, dangerous wild environment determines the length of an animal’s life. Our own domestic animals live a lot longer.

A good friend of mine, many years ago, was an ultra marathon runner. His diet was to be admired. At 40 he got cancer and died. All his brothers died too, a fault down the male line. Same with my mother‘s bothers, all died of cancers. And kids with cancers heartbreaking.

I, myself, would rather live a happy life than sit worrying about what I eat in all honesty. Live life to the full. Eat drink and be merry as the saying goes, as tomorrow we will be dead.

 

[Bcgirl]

Oh, cancer….the dreaded and feared cancer
almost three years ago today I went for my annual mammogram, and at the end of November (while I was going through airport security ) I got the call…early stage breast cancer. Dang. By this time I hadn’t eaten a grain for years but was still consuming carbs, loved my desserts. After the call we went on our holiday (ok with doctor) and I had time to think about things…seven weeks of thinking before my return to surgeries and radiation. During that time I stopped all sugar, I knew it was not good for cancer.
how did I get cancer…who knows? Mom had breast cancer, I did love my sweets, I smoked a long time ago, I took bioidentical hormones…..what was it? I had to let that go, I will never know. What I do know is that I can keep sugar , aka carbs, very low. It’s no guarantee but it’s worth a shot. I exercise a lot. I am happy. I do yoga. I don’t drink. I am loved. That’s all I can do….i do not want this to return.
I will eat, drink and be merry…but with out sugar and alcohol. It’s meat and water for me…with a few berries here and there and maybe, just maybe, an occasional ice cream.

 

[Chris24Main]

@MrsA2 , @Melgar and indeed, anyone... I don't invoke the term lightly, and I do totally understand the need for sensitivity. My Father in law only weeks ago succumbed to Cancer, and it's always heartbreaking.

But - understand also that I'm only saying a very specific thing - cancer cells live by fermenting sugar. Cells become cancerous because of damage to the mitochondria that isn't fixed. The science suggests that the DNA view of cancer is wrong, because its a downstream effect, not a cause, therefore the vast majority of cancers are very similar.

The damage that triggers this is the laundry list of different causes, but where we think of these as "different" cancers, and the guidelines about what to do then becomes overwhelming - to the point that any sensible person will not choose to stress about it, and enjoy life, sure.. I get and support that.

But - if you understand that the underlying basis of almost all cancer is unhealthy mitochondria fed by fermented sugar.. and if you happen to be Diabetic and motivated to better control your blood sugar by any way that works for you...

then ... you are benefiting yourself doubly by the actions you take every day. It doesn't mean you cannot contract cancer, but there really is good science to suggest that you should feel that you are supporting the odds in your favour. That means you too @Bcgirl - amazing and positive attitude. I am humbled.

 

[Chris24Main]

For what it's worth, my own father contracted an extremely rare form of cancer in the jawbone, most likely picked up from a virus in Africa, where we lived most of my childhood. What happened to him is still decades later, difficult for me to express. Not a single change to lifestyle would have stopped that from happening - some cancers are different in the way that they start.

 

[Melgar]

@Chris24Main , if fermented sugar is the feeder of cancers, how can we explain cancer in animals who only eat a meat diet. Cats for instance develop cancers.

 

[Chris24Main]

This isn't an "if" question, Otto Warberg literally was given the only nobel prize for medicine for figuring this out in the forties.

I realise I'm trying to both over-simplify and at the same time breach really difficult stuff, but let me try...

the distinguishing feature of a cancer cell, is that the metabolism of the cell itself changes from burning fuel, to what all cells did in our shared past before there was any oxygen to breath- they ferment fuel rather than burn it (because they now lack the functioning part of the mitochondria that drives this process). That part of it really isn't in question, it's just thought by most of medical science to be an interesting side point, not the whole match.

Thats it, really. Now, fuels that can be fermented include an amino acid called Glutamine, but I think that the most obvious answer to your actual question is that cancer in the wild is very very rare, and most cats with cancer are as a result (per my conversation with our vet) of us humans feeding them carbs.

I'm definitely not saying that if you reduce sugar you cannot get cancer, and most of the research done is on animals, so I'm definitely not saying that animals cannot get cancer. But - look - you more than anyone will understand Lactic acid - that's kind of the same thing - otherwise healthy cells that are not getting enough oxygen under strain.. they fall back on an older energy pathway, you just can't keep on doing it.. cancer cells are like that all the time.

I realise how ... I don't know ... sensationalist it sounds, and I'm not doing the science justice... plus; it's a big enough thing to chew on even without dealing with all the baggage that comes with dealing with Diabetes, so maybe I'll call it there and carry on reading... There is more I'd like to say, but despite what it looks like, I am trying to rein myself in... but I really do think that anything we are doing to help with Diabetes control of blood glucose will also be protective as far as cancer (or ongoing cancer treatment) goes.

 

[Melgar]

I recall a friend of ours who died of breast cancer she was 28 when she died. I remember she refused all cancer treatment, against all medical advice. She pursued this rigorous diet, no meat, no carbs just cooked veggies. The cancer spread and in her final hours she was begging the Drs to give her the conventional treatment, remove her breasts, chemo but it was too late. We scattered her ashes in the Scottish highlands.

@Chris24Main I’m certainly not dismissing the fact that cancers feed on fermentation, and cutting down on fermentable energy sources would decrease cancer growth, I guess I’m suspicious because you would think that we would be looking more at diet as part of the treatment program.

 

[Chris24Main]

You would, wouldn't you?

This is really what I was alluding to ... the more you dig into the history of how "we know what we know" - there is a common thread that gets to a kind of post-war optimism that the balance of knowledge has shifted into a new age ... and everything that came before is discredited.

In some ways, that is totally justified, colonialism, eugenics, you could make up quite a significant list of things that have shifted in our collective consciousness and stuck, for the better.

But - around the same time, there is an entrenching of the belief that saturated fat is the cause, or at least the driver of all heart disease, which you can draw a straight line (along with the adoption of seed oils) to where we are with chronic non-invasive disease (most obviously T2DM) and at around the same time, you have this entrancing concept that soon we will understand the genetic makeup of the human DNA, and that cancer is a disease where the DNA gets "broken" and cells go into an unstoppable growth. Cancer is a genetic disease, that we will cure with modern science.

In both cases, these theories sit badly on all the existing science up to that point (though in both cases, the marketing job is so complete, that you have to dig quite hard to see the wood from the trees), and yet have become so fixed throughout the medical research industry, that all the (vast amount of) money flows into proving the theory.

and yet, in all that time, and it's sixty plus years in both cases, the evidence base is only getting weaker all the time. In any other field they would have collapsed - imagine if air traffic safety had continued to decline at the rate of continued incidence of cancer, or rates of T2DM?

Our generation, that were kids in the Seventies, are totally embedded in this, and so you get exactly the reaction you have - surely if this is the case, we would be looking more at the diet? - then look at the marketing budget of Kellogs. Realise that Coca-Cola is funding most of the nutritional research. Discover that Phillip Morris owns Oreo cookies. Understand that Pfizer has earned nearly $150 billion from selling Lipitor.

Yes - that really is true, one company, one branded medicine, it's out of patent now, so the yearly revenue is dropping, but over lifetime, $141,000,000,000

So - how much can anyone make by encouraging people to eat less often, and more unbranded food? Cause that's what it takes... and the answer is just simply that you cannot. Outside of social media influencers, and authors, nobody is making money from good advice.

It may work... it may actually be in line with what we used to know all along... it may make much better sense of the available evidence, but it's much more profitable to sell you the food, then sell you the medicine you need to survive the food.

 

[Chris24Main]

More specifically, to answer your direct question - I'll have to defer to Thomas Seyfried again.. and this from memory, so excuse the vagueness. One of the tipping points for him personally (he is an evolutionary biologist by training) is that he was at a time working two research grants, into epilepsy and a novel drug that a company had developed, but didn't understand.

He was finding (in lab conditions) that the drug was extremely effective at stopping epilepsy. So, the company was very excited about this.

To cut a long story short, the effect of the drug turned out to be that it inhibited the cells' ability to work with glucose. Thus, it was turning the cells to ketosis. Glucose levels in the cells went down, ketones went up - epilepsy stopped.

As soon as he declared this to the drug company - the funding was immediately cut.

Because - diet was more effective.

His fundamental point is that current treatment for most cancer is not only inhumane (which I fundamentally agree with) but actually makes the condition worse in a lot of cases. He has proven results of killing cancer by starving the tumors. Again, reasonably technical, but the simple version is that you get the patient into therapeutic ketosis, dropping blood glucose to the point that there isn't enough for the cancer cells, then "pulse" Glutamine.

What that means is this amino acid (which can also be fermented) is essential in a way that glucose is not, so you can't just reduce it (it's also part of the larger answer to "why do meat eaters get cancer") - so he's developed a treatment that suddenly shocks the body by quickly reducing Glutamine, then allowing it to recover. Healthy cells have options (most in ketosis, of course), but cancer cells, who are by this point dependent on Glutamine, die off.

There is significant evidence that this treatment works, but as he puts it, he keeps being marched out of the conferences.. there's just too much invested in thinking that this cannot be true.

 

[Chris24Main]

I am sorry for your loss, of course. I'm not dismissing this, I've just lost too many people to cancer myself to easily talk about it (yeah, I know... hard to imagine given the amount I generate here) and I don't presume to know much.. only that when you are deep in lots of rabbit holes - you start to see connections.

ok

My father was operated on, post radiotherapy to remove cancer in his jaw, brought on by pipe smoking. The radiotherapy destroyed his saliva glands and made swallowing difficult. In surgery, they discovered that it wasn't in the soft tissue at all, but was in the jaw bone, a totally different type of cancer all together. The surgery went on so long he had an infarct. When he came to, everything seemed fine, but he couldn't express a thing. His brain was affected and he was now suffering from Vernick's aphasia - where you can understand language, you just lose the ability to output it. I get my ...small gift of expression.. from him, and suddenly he could express nothing.

I still have a (I can feel my pulse racing just typing, and I'm welling up) difficult time remembering an afternoon in a Danish hospital, where I had a great idea, he can't speak, but he can hold a marker pen, give him a pen and a page of paper... !!

My father started off with a capital T - everyone looked at each other; this could be a breakthrough.. then he wrote another T, then t and finally another t, and then he threw the marker pen on the floor.

You could see in his eyes that he understood everything, he just couldn't express anything. He looked at me and drew his hand across his neck - it was the only thing he could get across - "kill me now". More than twenty years on, it breaks me a little just revisiting that time.

The treatment weakened his immune system, and he died a few months later from pneumonia.

so, I do get it - medicine is not perfect, and we put so much on the people we trust to look after us, I have nothing but respect for the men and women who put themselves between us and the diseases that want to kill us.

I guess that some of what drives me (and I do recognise that I'm a little obsessive and that much of what I write must generate little more than a quizzical eyebrow lift - what on earth is he spouting now?)..

But, it's important to me -- I'm not going down the way I watched my father.

 

[Peanut234]

"What does a cat want with carbs?" love it. The kind of thing I would say.

I always forget that emotion plays a role in blood sugar. For the last 2 weeks I've been puzzled by frustratingly buoyant numbers, and then realised that I've got surgery coming up. I didn't think I was worrying about it - but apparently my subconscious is. It find it crazy that something like an upcoming meeting (etc) can cause such a chemical change.

Cancer is a tough subject. My Mum was diagnosed in the last few years with breast cancer - but an 'OK' type if there is such a thing, and now is in remission post mastectomy. We both wholeheartedly agree that hers was caused -(or majorly increased the probability) because of my fathers' distressing health problem diagnosis and her having to care for him. Her body just couldn't take the stress. Her surgery was followed by a nasty infection and 2 rounds of shingles, just to make sure she got the message.
My stress about the issue increased my pancreatitis events among other things.

 

[Chris24Main]

My mother had Malignant Cushing's syndrome listed as cause (a) on her death certificate and T2DM listed as cause II, a way further down the page. In between there is mention of a Metastatic cancer of unknown primary.

That was 2017 -
I had had no contact with her for over a decade at that point. I was convinced that she had borderline personality disorder, and viewed her as a danger to my wife and child. I'd mourned the loss of my mother for many years before she actually passed.
Anyway, she was always angry. You know, not just mildly annoyed - it could be bewildering, because you could find yourself suddenly being accused of quite extraordinary crimes, because it was the only way she could resolve how she was feeling. I used to say at the time that she would drag herself down with the weight she was carrying. "you have to learn to forgive" - I would say as a teenager...

But she just couldn't, and when my father died, I became target number one, and all the sins passed to me. (sorry if this is a bizarre turn, but I was in a forum then too, for children of affected parents - we all had spookily similar stories)

So - now, it's a lot easier to join the dots.. there is a phycological / emotional source to it that she would not admit, but the result is that she was pumping herself full of stress hormones all the time. That drives insulin resistance directly (outside of diet), and so gives rise to T2DM (skipping past the cancer for a second, but of course I join that dot too)

If it seems too far fetched, one of the particular symptoms of Cushings is a swollen face and neck - now, what is it that insulin primarily does ? drives fat storage (I know Type 1s with fat pads around the pump location, and fatty liver is all about insulin in the liver cells) - and where are these stress hormones coming from ? the neck and brain...

For what it's worth, I actually managed to go through this with my GP - you know, at the point of being asked, anyone in your family have diabetes? Firstly I forgot this detail, but more recently, when I went back through the detail, a little better armed, so to speak, I was able to say "you know that question about family members..."

and my GP went to make a note, and I stopped her - "before you write down family history of T2DM, let me tell you the rest" ... and to her credit she did, and never noted the connection as being relevant.

 

[Chris24Main]

Ho hum, I'm just tuning in to Ben Bikmans weekly lecture, and he's laying out immediately that humans simply do not produce lactic acid - and that when we think about this in terms of exercise, it's lactate, not lactic acid, and there is no point where this is happening without oxygen, it's "non-oxidative glycolysis" - so another point where I think I know a thing only to realise that the rabbit hole only gets deeper...

 

[Melgar]

Ha, emotive yet intellectually interesting. My father died of cancer, bladder cancer. I’m convinced it was environmental. When he left the army he became an engineer. He would come home smelling of all sorts of chemical smells. He was one of those people who rarely if ever got sick, then he got diagnosed with cancer and died. My brother also had cancer, testicular cancer, when in his 20’s. He survived it. So like all of us, cancer is part of our life history as well as our fear of aging into the future.

I find your discussion fascinating. I have a mind that questions everything. It’s my way of trying to understand concepts and theories. So I’m going to throw oxidative stress and free radicals at you. When I initially responded to your cancer post I gave you a very quick list of known contributors to cancers , here is the paragraph:

“Many things cause cancers, what we eat, what toxins we put in our bodies, alcohol, smoking, excess sugar, burnt food (apparently) , environmental conditions, pollution, our working environment, stress , the sun, and not to mention our own susceptibility through our genes. Even Some diseases cause cancers to emerge. I have no doubt metabolism can be a factor too.”

All these things have one thing in common, they all cause ’free radicals‘ to circulate in our bodies. Those pesky, electron-less molecules that steal the electrons from other molecules, destabilizing and damaging them. Now I do find your comments very interesting on cancers feeding on fermentable sugars, but what are your thoughts on oxidative stress ? I’m currently reading a number of research papers on the subject, particularly in relation to diabetes, but clearly it would cover cancers, brain disorders and autoimmune disorders.

Apologies if you have discussed free radicals in relation to diabetes and of course in your current discussion around cancers. I may have missed it.

 

[Chris24Main]

Right - I've sat on this one overnight, because there are so many ways to respond, but once I start, there will only be the answer I write, and I'll have lost all the possible ways of getting into it.

Firstly - thank you. I'm so grateful for being able to have this conversation. A year ago I was utterly clueless about any of this, and now, well; let's say I just have a better view of how little I know. Being challenged is the best gift I could ask for, because if forces me to focus in on the things I would otherwise skip over without really understanding, as I get older, I prefer to try to better understand than to "win" arguments.

Secondly, it's kind of a perfect set-up, because there is an easy answer to the question that fits it all together - ROS.

But - a three-letter acronym is precisely the kind of "look how clever I am" answer that I dislike, so I definitely can't do that.

I think the question of oxidative stress is one of the topics that encapsulates the larger problem of "how can I live well?". You hear, or read, one thing after another about this recommendation or that food being part of a good balanced diet because of its antioxidant properties (I read one only this morning espousing regular eating of Pineapple) - but what does it mean?

We kind of understand oxidisation - rusting is oxidisation, burning is oxidisation - so, it's a thing that happens in the presence of oxygen, but oxygen is critical to life, so what gives, and why would being "anti" that be a good thing?

And I need to take a detour into cause and effect for a second. Just to illustrate a point - I watched a thoroughly fascinating breakdown of the economics of decision-making about a year ago. Hold on there, I promise this will make sense... One of the strands of the lecture was about making sense of the voting patterns that lead to the UK leaving the EU. Now, I'm not daft enough to be offering an opinion on the politics of it, but the statistical fact was that one of the best predictors of voting intent was the proximity to a sandwich shop called "Pret-a-manger". The closer you were to one of these shops, the more likely you were to vote one way.

So, what the hell does that tell you about anything? - well, for me, anyway it's difficult to read that without my brain trying to come up with explanations - we like simple stories that make sense of the world - it's been that way since before people thought Appollo dragged the sun across the sky every day - but there is no part of my brain that thinks "maybe there was an ingredient in the sandwiches that affected how people voted".

None - I know enough about politics and sandwiches to know, with no shadow of a doubt, that these two things are not connected - they are associations, not causes. There may be a statistical connection, but not a real one.

However, I don't know enough about the chemical makeup of a Pineapple, and cell energy management to be so sure... so if I'm told enough times, I'm susceptible to believing that eating Pineapple every day might be a good thing for me because of it's anti-oxidant properties.

On the other hand, after months of educating myself on the role of the liver and insulin, I see a slice of tropical fruit as mainly sugar, which will drive elevated insulin and lead directly to oxidative stress in the cell mitochondria, if I eat it every day.

So, back to free radicals and commonalities in cancers. And what oxidisation is. (and I think the correct term is "per-oxidisation", this is one of the sources of confusion)

Well, actually, I need to back up even more a bit first. Energy.
Chris Van Tulleken, in his book on processed foods, has a lovely explanation about energy transfer. With apologies to him for butchering this passage of his book from memory, he goes through the way we eat food, breath in air, turn it into energy, and breath out CO2 and water. So far so good, sounds like burning gas; but at each stage (through the lungs, the gut, the liver, the blood cells, the endothelium, to the cell, and back up and out), there is a really complex chain of events where molecules pass bits of stuff between them, and tiny amounts of energy result, all the way down the chain. It's a much better way of thinking about nutrition, because everything we do, think move.. all of it needs tiny amounts of energy.

at the heart of most cells, you find the mitochondria.. and I'll spare you the evolutionary lecture, but they allow us to do the most critical part of this process much more efficiently - like 20 times more energy than cells were able to beforehand. This was one of the big evolutionary leaps - being able to extract that amount of energy was what enabled all complex life on the planet - so it's a big deal.

This is aspiration - taking in oxygen, getting that oxygen to the mitochondria, letting the mitochondria extract the energy from glucose or fatty acid chains and ... life. (I'm not even getting into glucose versus fat here, but that's like the difference between burning paper and coal..)

Now - when mitochondria get damaged - and they get damaged by, guess what ? - glycation from too much glucose, or nicotine, or fine particulates, or viruses, or all the things you mention and more..

(or, by the way, they are muscle cells and being asked to produce a lot of energy quickly)

the cells fall back on a way of making energy that doesn't require a fully functioning mitochondrion... substrate phosphorylase, or fermentation, which kicks in a whole other (actually confusingly, some of it's the same with glucose, you have a pathway to Pyruvate, then you can go into the mitochondria for normal oxidative phosphorylase, or not for substrate phosphorylase) chain of events which produces some ATP, but also lactate and ... drum roll..

Reactive Oxidative Species - or ROS - or more commonly referred to as free radicals.

These are then kicked out of the cell - they are extremely toxic of course, and go on to create all the troublesome oxidative stress.

This happens all the time, all over your body to some extent, if you have more glucose in your cells than the cell needs for energy in the moment - now why would that happen? and we're back to insulin.

It's a low-level chronic thing, but almost everything we are talking about is a low-level chronic thing.
Cancer cells are really when the mitochondria has broken down to the point where it cannot continue normal aspiration, but also that it cannot function in it's role of self-executioner of failed cells. Lots of ROS result, causing further damage to the cells, resulting in damage to the DNA...

but it's all downstream of the actual cause... impaired mitochondrial function.
If I haven't totally lost you by this point, the good news is that almost anything you may be doing already will improve the health and number of mitochondria (mainly in muscle and fat cells, that's where all the action is, because we are all mainly muscle and fat).

and, as a bonus, you don't need to constantly eat Pineapple to do it... in fact, then, most of the confusing fluff you are constantly bombarded with, reveals itself to be pointless noise.

 

[Melgar]

Ha, no you didn’t lose me, your response, as I expected, was as always a great read. I will get back to you with a response in good time. I have chores.

 

[Chris24Main]

So, by way of "Rethinking Diabetes" by Gary Taubes - which I would thoroughly recommend, not only was there a solid mention of this very site, but my introduction to Richard K Bernstein, who had experience as an engineer, was dissatisfied with his treatment plan, and set out to understand the mechanisms underlying diabetes, using the first blood glucose monitor, and in the process revolutionised our understanding of the condition.

It was a massive reflection of the way I see my own journey. (hubris aside)

To my surprise, when I came to dig into his story, one of the first links was right back to his page on this site:

Nicolae Paulescu was a Romanian scientist who claimed to have been the first person to discover insuli, which he called pancreine.

Nicolae Paulescu was a Romanian scientist who claimed to have been the first person to discover insuli, which he called pancreine.

www.diabetes.co.uk

Another good slap in the "nothing new here, it's all been done before"s

But it has made me reflect a little...
I, by training, and thirty years of experience, am little more than a guy who has learned to -

1 understand the mechanism at work, gather any data you can.
2 challenge my assumptions, especially things other people take for granted.
3 experiment until you can improve the control of that mechanism. Prove it.

The kind of engineering I do is called process engineering, or manufacturing engineering; basically, it's about figuring out how to make industrial things in an efficient enough way that you are not needed any more, and you can move on to the next thing that isn't working well enough.

I do recall a Halloween party years ago when I laid that out as the usual small-talk, my job was about making things in a better way; and the person replied with "what, like toasters?"

But, I digress... I don't mean to imply that this gives me any medical understanding, or indeed anything that anyone else should value, only that my entire working life has been about refining things based on those three principles, so that when I decided that "listening and doing what I was told" just wasn't working for me, it's not surprising in retrospect that I reacted the way I did - it's the only way I know how.

Possibly the most compelling thing that did strike a chord was Bernstein's description of "the law of small numbers" - what this boils down to is a kind of striving for engineering elegance - if you are trying to control something, doing so with the smallest inputs is the best way, or rather gives the best results. We kind of know that instinctively - simply trying to stand on one leg makes the point as easily as anything else.

or, to get mechanical, think about driving a car where you can either yank the steering wheel from one side to the other, or make little movements. To stretch the analogy, if a deer runs across the street, you are going to yank the wheel, but for most of the time, it's about driving in such a way that all you need are little movements...

Where it relates to the thing we are all trying to live with - is that the liver and pancreas are evolved to operate in the "small movement" manner - little adjustments to insulin or glucagon control the glucose side of the energy regulation system (I was also thinking about dropping homeostasis into this little entry, but maybe another time) and all is well. Until it isn't.

One of the questions that keeps coming up, and is super-difficult to answer well, is "is this blood glucose spike normal" - or variations of it. I see that differently - going back to the driving analogy, that's the deer running across the road... yes you can cope in the moment, but if you see the workings of the underlying mechanisms, it's really better thought of as an event that requires you to yank on the wheel - what you're really trying to do is live in a way such that "deers running across the road" are rare, and that most of the time you can drive smoothly.

That, of course, is empty and vacuous by itself (deliberately so, there is only so much I can put in a forum post), and the changes you may employ (even if you think that way) are different from one person to the next, but to me it has to start with eating and living in a way that reduces the need for over-correcting swings of insulin. How do you do that? Well, sleep, stress, exercise and many other things play a part, but there is nothing so impactful than limiting the amount of glucose piped into your liver from your gut: triggering demand for insulin.

You don't want zero insulin, any more than you want to let go of the wheel, but the less you need, the smoother things will be over time.

 

[RachelG.]

Hi all,

Sorry for hijacking this thread - I've made my way through about half of it. Some really interesting stuff about cholesterol, tryglicerides, etc and NAFLD. I've made some other posts on this forum but basically I was diagnosed with t2d a couple of weeks ago, wasn't initially sure whether to believe it as I have low ferritin and also (based on my current understanding of t2) it just didn't seem to make sense. Never been overweight, very good diet, exercise loads, have since dug around a bit more in family history and there is some stuff there but neither parent for example. I've been doing low carb for a couple of weeks and using a CGM which has 'predicted' an hba1c of 39 mmol/mol but we will see if it happens on the next blood test. It seems I am much more reactive to any kind of grain carb than small amounts of actual sugar which I found weird.

I've attached my lipid test results and my liver function test results. Do you guys have any insight into whether I should be badgering the NHS to give me a scan for fatty liver? My levels seem okay but also apparently it's linked to t2d, asymptomatic and you can present with normal ALT scores.

 

[Chris24Main]

Hi there @RachelG. - I do recall replying to you on your "just diagnosed" thread. No problem at all adding here, though you may get a broader reply outside of this thread, and as you've no doubt figured, I use this thread to delve around the darker recesses of metabolism and our understanding of how this thing works.

For me, clearly I had some questions about NAFLD - but my first recorded triglyceride levels were literally off the charts - yours are actually fairly low. Triglycerides are fatty acid chains (either digested in the lower intestines from eaten fat or created in the liver from other building blocks, most obviously Carbs..) which are joined together in a kind of triple attachment to a glycerol molecule - sounds complicated but is essentially the arrangement that the body uses to safely transport fats of different types around the body.

So - if you were concerned about NAFLD - the levels of "fat building blocks" around your liver would be the major issue - in other words, then since your serum triglyceride levels are well within range, that's what you should be discussing with your GP, though obviously I cannot diagnose, and nobody on the forum should.

Much of what you may read on this thread may not help that much though - it's all a bit overwhelming and difficult to get a hold of, and I know for a fact that I`ve gone down several blind alleys in this thread... it's as much about discussing to try to get a better understanding by testing that understanding.