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Underweight - Now It's Getting serious

I have to agree with others who state that you aren't eating enough. My partner is eating 1750 calories per day on a low carb diet. She consumes 80g of carbs a day max, usually 50. She is 5'8 and losing weight at a rate of about 2lbs per week. She is non diabetic and this is deliberate.

In my book, my first reaction to your daily menu was that there is not enough food there to stop you losing weight. I'm also on lchf and my bloods recently were astonishing, so I don't believe that your cholesterol count would get worse. I think you'd find it spectacularly better, but if you don't try you won't find out. Equally, there is now a lot of evidence that cholesterol count is not an indicator of cardiovascular issues.

As andbreathe has said, you either increase your calories by carbs and see what happens to your blood sugar or do it by fats and see what happens to your cholesterol. If I were to bet, I'd go with the fats.


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Dear SJC,

Hello from the USA! I could have written your initial post, so I have a lot to say! But first of all, what are "stones"? It doesn't sound like it translates to "pounds," our unit of weight measurement here in the states.

A year ago, routine blood work indicated I was pre-diabetic, based on an elevated fasting BG and A1C. At the time, I weighed 129 lbs. (how many "stones" is that?); not overweight for my height of 5' 6", but I still carried 10 unnecessary pounds.

Subsequently, I learned about the success of the Diabetes Prevention Program (DPP), based on an extensive clinical trial done here at our National Institutes of Health (NIH). Participants in the DPP (all pre-diabetic) who lost 7% of their body weight - along with moderate exercise - reduced their progression to Type 2 diabetes significantly.

So I embarked on a program of weight loss, determined to lose the 10 lbs. All the current literature recommended a low-card diet for the control of blood sugar, so I eliminated all starchy carbs (rice, pasta, white bread) and rich desserts from my diet. My ballpark carb intake was 30-40 carbs per meal, and I didn't pay any attention to calories at all. The weight came off slowly and steadily, and I was thrilled! It never occurred to me that I would lose too much weight.

But I did. My weight goal was 117 to 120. When I hit 115, I felt and looked too thin. But I rationalized: Hey, I weighed 115 when I got married! (30 years ago) But the pounds continued to melt away...114, 113...112. Finally I took a look at my food diary (which I keep religiously) and was shocked when I realized that my low-carb diet was often yielding a paltry 1,000 calories per day - maybe 1,200 on a good day. And I knew that to sustain a weight of 117,would require a daily caloric intake of 1,600.

So I made an appointment with a nutritionist who specializes in diabetes, pre-diabetes, and insulin-resistance. I had my initial meeting with her just this afternoon! She was amazing. She looked over my BG records and my food diaries. She concurred that my target calorie intake should be 1,600.

Here were her specific suggestions: 1) Increase portion sizes. For example, I'd been eating only half an orange, half an apple, 3 oz. of meat, etc. per meal. She said, eat a whole orange, whole apple, and more meat, etc. 2) Add Chia to my morning oatmeal and maybe to my Greek yogurt. 3) Add flaxseed to salads, vegetables, etc. 3) Increase my intake of whole-grain pasta! Here's a shocker: If you chill the pasta after you cook it, and then re-heat it, the structure of the pasta changes, and it will not spike your BG. (I tried it this evening, and it worked!) 4) Increase your intake of fiber in general, because it has a stabilizing effect on blood sugar, which enables you to eat more carbs, hence more calories!

My nutritionist also said to stop weighing myself every day, so I'm going to weigh on "even" days of the calendar.

All right, SJC - we're in this together! Please keep me posted, and I'll do the same.

Pam
 
Hi Pam

14 pounds = 1 stone but they're figures used in the UK and once used in Australia.. US conversions suggest it.s 1.12 in your language. We use kilos downunder ... but enough of that.

To this issue

Here were her specific suggestions: 1) Increase portion sizes. For example, I'd been eating only half an orange, half an apple, 3 oz. of meat, etc. per meal. She said, eat a whole orange, whole apple, and more meat, etc. 2) Add Chia to my morning oatmeal and maybe to my Greek yogurt. 3) Add flaxseed to salads, vegetables, etc. 3) Increase my intake of whole-grain pasta! Here's a shocker: If you chill the pasta after you cook it, and then re-heat it, the structure of the pasta changes, and it will not spike your BG. (I tried it this evening, and it worked!) 4) Increase your intake of fiber in general, because it has a stabilizing effect on blood sugar, which enables you to eat more carbs, hence more calories!

Here are my comments

1. No. Oranges are straight sugar (juice MUCH worse) Portion sizes are another debate
2. Yep but oatmeal can cause issues.
3. Pasta? Yep, possible and it's a known factor (re-heat) but many MANY people cannot tolerate it regardless. Depends on amount and when you test with your meter..
4. No comment other than to say carbs eventually break down into sugars and many here subscribe to a (LCHF) low carb hi fat diet.

Best Mike
 
Has your thyroid been checked @SJC?

I had an overactive thyroid when I became underweight, seven stone and I am 5'7' and was put on medication for a year and it worked. You may not display all the symptoms but would be worth checking to see if you can relate to any of them. Mine were being masked by a beta-blocker that I take for blood pressure.

http://www.bupa.co.uk/health-information/directory/o/overactive-thyroid

I found that peanut butter and hummus helped with the weight gain and if you like cheese, that is calorific.
 

I will try increasing portions a bit. My fasting bg is always 4.6 -5.2 . Many thanks.
 

Had two thyroid tests in the last year.
 
I snack on cheese as well as having it on toast. I tried the cold pasta thing. If I reheat it does still elevate my bg quite a lot. If eaten cold not quite so much but I hated it cold. My dietician told me to have rice pudding for goodness sake. She also said a piece of chocolate cake once or twice a week wouldn't hurt because theres a lot of fat in it so it shouldn"t spike me. I gave fruit up as a bad job because my BG didn"t like it at all. Six bluberries were sending my bg up to the high 7s and that was in full fat natural yoghurt.

My dietician also told me that everybodys bg can go up to the high 7s after a meal and it's what happens over the next few hours that's important. She said it's all about the bg staying high that's important. She said if my bg is always going back to the 5s after 3-4 hours I have nothing to worry about.

I have read that MOST prediabetics will go on to get diabetes within 10 years but I have never heard of people staying prediabetic for life or completely reversing it.

That's another question I have..if you manage to get your bg out of prediabetic range as I have and you are consistently eating a LCHF diet why doesn't it just stop rising ? I can't even work out why it went from 37 to 40 in three months and that was just adding an extra piece of burgen a day. One piece of bread? Isn't that a sign of how careful I should be? When it went down to 37 I was probably eating around 1200 calories a day. As you can see that's clearly not enough. I upped to 1500 and it went up to 40. So I would imagine anything over 1700 would take me back into prediabetic range. If I ate 2000 a day I reckon it would be a very short time before I am diabetic.
 
Just thought I would add that when you are losing weight your cholesterol levels especially LDL will increase because as your fat cells shrink the stored cholesterol has to be ejected into the blood stream. This then take time to be removed from your system by your liver and gall bladder. I watched a video saying it takes up to 4 weeks of stable weight for your cholesterol levels to settle down. They also recommended that you shouldn't let the doctors do any tests whilst you are losing weight as blood pressure and blood sugar levels can all go in any direction.

I would say eat more (of whatever you want) stop losing weight and then after a month get retested.
 


The bottom line is you have to do something different to what you are doing now. What you are doing now is not working, in terms of your overall well-being. If you continue as you are now, you will become ill, in due course. If you eat more and your HbA1c rises, there is no guarantee you will ever become diabetic. Conversely, there is no guarantee you won't become diabetic. Don't forget the diabetic diagnosis is an HbA1c of 48 or greater. At 40, you are some way from that threshold.

So, whilst I would rather never have had my diabetic diagnosis, and I am fortunate I have my bloods in a good place using diet and exercise, but frankly, I'd rather be a functioning diabetic popping a pill or two each day than ending up with major organ damage due to starvation and malnutrition; which is potentially where you are heading at present.

I'm sorry if that is all very harsh, but right now you are going to have to choose from a list of options you don't like. You've had some great suggestions here, but as I say, it's you who lifts the fork to your lips.
 
I find my BG rises when I'm putting on weight, and drops when I'm losing it.
Which makes sense, as I must be transporting the glucose around to be storing it as fat somewhere.

So long as it goes to a 'normal' level again when I am a constant weight, and stays within the targets for normal range at other times, I'm ok with that.
I'm happy
if my fasting is below 5.9
if I'm below 7.8 2 hours after a meal
between 4.4 and 6.6 generally

Non diabetics do indeed see spikes, I have tested a few others over time.

Interestingly, if I eat when I'm high, or low, I still have the same ceiling, so a meal that causes a rise still won't push me too high, I'll hit my ceiling, and stay there.

I also eat to target one specific thing at a time,
in my case it was weight loss, not gain,
then I adjusted things to target my cholesterol.

On my maintenance diet now I balance all three, BG, weight, cholesterol, but it's long term, they all have peaks and troughs.

As I final thought if you have been LC for a while, carbs will have a higher impact on your BG initially, until you readjust to digesting them again, then the impact will be lessened, so you will have to accept a higher hit initially, until you plateau out again.
 
I don't mean to offend, but as a sufferer from health anxiety, your posts often smack of that as an underlying issue to all of this. Stress alone can cause elevated BS levels so my suggestion is to try and tackle the psychological side of this as well as getting the everyday balance between carbs, fats and calories sorted. As andbreathe has said, you may never become diabetic but far better to be on a few pills than to be doing to yourself what you currently are doing. I appreciate you have had a difficult time with cancer and ongoing health issues but until you start to calm down a bit, you re going to be running round in circles tweaking to no great avail. I wish you well xx
 

I respect what you are saying, but it's not that I was anxious and then I got pre diabetic. All this is bound to have a knock on effect psychologically. Health anxiety is akin to hypochondria. I know because I am a trained anxiety management therapist, and I can tell you I am only concerned because whatever I do it doesn't seem to work. I am actually very happy about the improvement in my one kidney for example. That's why I dare eat more nuts and protein now.

What isn't told in this picture I have drawn, is how professionals have scared me then disappeared for a long while.

I was having problems with a dropping single kidney function - yes of course I was concerned. Was working on that.

Suddenly out of the blue I am told I am pre diabetic - doc just said you are a borderline diabetic so you better watch your diet - That's all he said!

I found this site and learned about LCHF and implemented it - still no support from either a dietitian, a Diabetic nurse or anyone.

Then for a few months kidney fluctuated in function - confused me a bit. My kidney specialist told me not to eat too much protein, in fact he said to cut down, even though I was losing weight and told him I was trying LCHF. HE said, you don't need to get diabetes now that wouldn't be a good thing.

Then Kidney improved with LCHF - relief but weight loss was rapid - concern for me.

Then my weight was dropping so much I mentioned it to my GP who said he would get a nurse to weigh me fortnightly. - He told me it was a concern.

Then I saw my gastroenterologist and he said he wasn't happy with my huge weight loss and he wanted to check something sinister wasn't going on - hence this endoscopy next week .

When you have different people keep telling you they are concerned but not giving you active advice, you feel pretty alone with it all.

I have recently found a dietician who seems very interested to help me but I don't know how much to trust her. Chocolate cake? Rice pudding?
 

That's very interesting, thanks. I think I have to experiment and be a bit bolder to see what happens because even if it does increase, I have proved I can get it lower - obviously at the expense of huge weight loss though.
 
I also am under weight my GP prescribed a product called Calogen which helped me to put weight on .I try to keep my calories up as much as possible but I admit that it is difficult without putting the BG s up I am a type 2
CAROL
 
I have come to the conclusion, for me, it's about balancing everything in my lifestyle.
I have experimented, I know what makes my BG rise, I know what makes me put on weight, and I can also lower both again.

So I can't say I like seeing high numbers, no one does, but I can predict them, and know what will cause them.
Sometimes other things in the mix can take priority, and I expect my numbers to rise on odd occasions.
(Like my over eating at christmas, but now it's January the diet is on, and my weight is going down, I knew I was gaining weight, as both the scales, and my fasting level told me, now they're both going down again)

But so long as overall, my meter average, my HbA1c, all match, and all are in the normal range, I don't mind.

I also found for me, exercise plays a great part in keeping BG low, probably due to the increase in muscle and less insulin resistance
 
_____
Hello Mike! Thanks so much for your reply! I don't know if I'll ever be able to think in terms of "stones", but thanks for explaining it!

In terms of your responses, clearly every person's metabolism is different; that's what makes diabetes so tricky. Certainly some diabetics cannot handle much fruit, or even grains. (And I don't consume fruit juice.) My endocrinologist insists I am not a type 2; he will not even call me pre-diabetic, preferring the term "glucose intolerant." But based on my BGs I consider myself pre-diabetic - which is why I have been following a reduced-carb diet.

So for now, I can handle small portions of fruit (1/2 cup), and some grains. A bowl of oatmeal every morning with 1/2 cup blueberries does not spike my BG. As for pasta, I'm thrilled to learn the benefit of chilling it - but even then, I eat it seldom and in small portions.

Being thin and diabetic/glucose intolerant, or whatever, puts you in one lonely corner. Some overweight people resort to diet pills. If only there were a "reverse diet pill" - a calorie pill for people like me, who just want to add a few pounds.

Again, thank you so much for your thoughts. Any ideas or weight gain are most welcome!
 
Pleasure Keep working at it until you find a solution
 
Hi, I can see it's been a while, I hope you have solved your problem and stopped losing weight. If not, then O would also advice you to increase your intake of fat and thereby calories. It sounds as if you don't get a lot of saturated fats, and you might be able to increase your caloric intake that way.

I'm on sick leave from an overuse injury and trying to get stronger through rehabilitation training. As such I can't exercise more than I do, and I need to be in energy surplus to be able to rebuild muscle. I don't have a huge appetite and not eating carbs I find it hard to eat enough. So I eat cheese, nuts, peanut butter and low carb chocolate mousse in between meals. The mousses helps!
 

Hi
I was thrilled to read this as it makes me feel less alone with the problem for one thing and it is making me feel like that a bit. I was a little sad to see the response to it though and that's what I am finding and what makes it all so complicated. It seem not one size fits all about all this prediabetes/diabetes thing. Oatmeal does spike my BG quite a bit. Not horrendously but I only have 2-3 tablespoons of it. I used to have a bowl full of porridge before all this every morning but those days are gone. I tried the reheated wholemeal pasta and that went into the 7's too, and I only had 2-3 tablespoons of wholemeal spaghetti.

My last three month blood test was 40 but prior to that it was 37 and I was thrilled back then. I know 40 is out of the pre-diabetic range, but all I had done in that three months was increase my Burgen soya and linseed bread to an occasional two rounds a day instead of one - that made it climb by 3 on the test. My assumption is that the more of any carbs I add will at the least send me into pre-diabetic range again, and if it can climb that easy in three months, then I wouldn't be that far off becoming diabetic.

I look awful. Was never a big girl! All this diet lark has aged me about ten years to look at. I look drawn and I really am a bag of bones. I haven't been testing at all this last two months because I honestly find it all quite depressing. What I don't know doesn't hurt me I guess. Know it's wrong but hey I have to live without worry from day to day. No one told me to test anyway and my dietician thinks I was crazy for testing (don't they all when you are prediabetic?)

I daren't increase my saturated fat much more. My bad cholesterol has already risen quite a lot since this started ( although the good cholesterol went up a bit too). My BP increased a bit generally too.

I am on the calogen drinks three times a day which is adding 480 calories to my daily diet. I have been adding up and I am on around 1800 calories on a good day and on a bad day maybe 1500-1600. Some days I just don't feel very hungry but I force myself. I wonder if the calogen is making me feel fuller??

Please do keep us up to date Pam as we might be able to encourage and support each other. Thanks
 

Know what you mean. I just wish there was a way to put weight on. I am doing pretty much all of the right things. I eat butter..a pack a week! I eat 6 eggs a week now. I eat loads of cheese every day. I eat 2 avocados a week. I have been adding flaxseed, seeds, and nuts to full fat yoghurt for months. My BG doesn't like gravy! Even when I thin it out my BG rises a lot. I hate dry foods! I am adding a dollop of full fat mayonaise to things occasionally. I eat full fat yoghurt every morning for breakfast. I have switched to full fat milk ( my dietican told me to try and drink half a pint every day).
 
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