Metformin, Part 2

I have become discouraged, and I started taking Metformin, again.

I started exercising last week – some high intensity interval training (HIIT) or just walking as well as some basic resistance training (squats and planks, mostly).  My hunger increased.  I can’t leave for work now without packing half of the refrigerator in my bag, just to get through the day without becoming desperately hungry.  I calculated what I’m eating and when left to my intuition and one rule (Eat Real Food) I eat about 2700 calories a day, about 50% fat, 25% protein, 25% carbs.  It’s a lot of flippin food, but otherwise I feel like I’m starving.  I’m unable to keep my blood sugar stable while eating carbs unless I just eat a ton of them, and if I do that my triglycerides are 500.  I can’t tolerate too much fiber because of the endotoxin (serotonin?) problem, so a diet of low glycemic carbohydrates (beans, brown rice) is out.  And somehow in the middle of this I’ve managed to gain weight in the last week.   Bah.

I just have too much going on now.  I can’t manage it all anymore.  I can’t have marital difficulties, a socially demanding 6 year old, 1.5 jobs, and also be dealing with blood sugar swings all the time.  Plus, my former relaxation time – my lunch break – is now being used for exercise.

I give up.  Bring on the drugs.

25 thoughts on “Metformin, Part 2

  1. Nigel quotes it quite succinctly

    “Insulin increases the amount of glucose & FFAs entering fat cells, muscle cells & the liver.

    Insulin decreases the amount of glycerol & FFAs exiting fat cells & the amount of glucose exiting the liver.

    Hyperinsulinaemia (which can produce sedation) results when one or more of the following tissues loses insulin sensitivity:- fat cells, muscle cells & the liver.

    So, why do people keep saying that hyperinsulinaemia locks nutrients away in fat cells only, thus robbing other cells of nutrients, thus causing lethargy?

    The relative insulin sensitivity of tissues determines the relative partitioning of nutrients into those tissues.

    When tissues lose sensitivity to insulin, blood glucose control becomes impaired. This results in roller-coaster blood glucose levels after eating high-glycemic carbohydrates. A rapidly-falling blood glucose level causes ravenous hunger. I have experienced this during medically-monitored tests (OGTTs & an insulin shock test).

    Low-carb/ketogenic diets don’t result in a roller-coaster blood glucose level and therefore don’t cause ravenous hunger. [HIIT can lower blood sugar causing hypoglycemia increasing appletite–SWOT]- Simples!

    Overeating due to ravenous hunger is NOT gluttony, just as under-moving due to sedation is NOT sloth.

    EDIT: This didn’t go in my comment but should have:- “Low-carb/ketogenic diets result in the avoidance of moreish & calorific foods such as sweets, chocolate, cake, biscuits, pizza, Pringles etc. A single bite of such foods has a negligible effect on blood glucose & insulin levels, but encourages another bite and another and another ad nauseam, due to Food Reward. ”

    [Calories above maintenance resulting in full glycogen reserves + Carbs = increased Triglycerides – Calculate maintenance – [SWOT]]

  2. Yes, fasting is an excellent idea. But what if I absolutely can’t tolerate the ravenous hunger? This was a problem for me even before my life became too stressful. Good articles though – much appreciated insights, as always.

  3. You can go into ketosis using ketogenic diet for a few days to get blood sugar swings under control and upregulate fat burning enzymes then transition to If/ADF. I’d do 500 kcal of lclf high protein at dinner once a day with efa supplement/multivitamin Try to work your way up to 2 days in a row. 3Rd day you can eat normal lchf food..get nutritional food. Stomachs shrink and people usually get over hunger after a few sessions. 1500 kcal at dinner stuffs me on non fasting days. When you get wired/tired adrenal symptoms take a short break (weekends are good), with hclf, but you must count your calories and never eat over maintenance.

    If you are susceptible to gallstones, ursodiol can prevent them with rapid fat loss.

    Fasting can resolve gut dybiosis and liposacchrides as well over time so you can tolerate low glycemic carbs.

    Intermittent fasting attenuates lipopolysaccharide-induced …

  4. Cant think of a worse idea than fasting. The only good thing would be lowered endotoxin and relief from that but then the rest of low carb issues will decimate the rest of the metabolism.

  5. And the wild blood sugar swings jacking up her cortisol from Hi-GI blood pressure crashes is so much better? Hardly.

  6. Meant blood sugar crashes/reactive hypoglycemia. As I said, everything else she does is only a band-aid.

  7. BTW, the idea of fasting is to get rid of the visceral fat to get the beta cells working again. I suppose she could go get gastric bypass surgery…that usually reverses diabetes within weeks. I suppose some of those patients have HPA cortisol issues too even though they are just doing surgically enforced fasting.

  8. Fructose is low GI. You should look up honey and stuff. 10 days is all you need to reverse diabetes after certain forms of surgery which means your visceral fat is not causing the diabetes in the first place. The insulin resistance drops to normal way before weight loss. Better to think in terms of endotoxin.

  9. Did you read the study? 1 *gram* of fat on the pancreas was shown to cause the insulin resistance which blocked the beta cells. Rapid weight loss quickly targets the visceral fat around the pancreas, liver, etc. to get rid of that one gram.


    Nevermind fructose causes all sorts of problems in a hypercaloric environment…fatty liver, hepatic insulin resistance, visceral fat accumulation, hypertension from the uric acid, output. Sure eat 1000 calories of it and protein and you won’t have problems.

    Too bad it’s addictive and promotes overeating..chances of eating it below maintenance aren’t realistic.:

    Nevermind the candida overgrowth it causes in the gut.

    She did the Peat thing, I don’t think it worked too well.

  10. This article is ridiculous. Sorry, but it is. The hunger I’m experiencing is not a function of conditioning because hey it’s lunchtime. I’m experiencing hunger that is absolutely painful and keeps me from being able to focus on anything else. I have to eat just so I can get back to the rest of my day. I understand that most people don’t experience this – maybe you never have, and certainly the author of this article never has. But the hunger I’m dealing with is like walking around with a toothache that is made better only by eating. Its inconvenient, expensive, embarrassing at times, and completely not a psychological problem.

  11. I would love to lose that visceral fat. It’s ugly and my clothes don’t fit, let alone all the health complications. I CAN’T FUCKING DO IT WITHOUT MY HUNGER OR MY LABS GOING APESHIT. Please tell me how to do this and I will do it. Yesterday I went as long as I could without eating in the morning. At 7:10AM – 1 hour after waking up – it was too physically painful for me to not eat anymore and i had to eat something. The pain that is caused by this hunger I experience throughout the day is ridiculous. I think over the last several years of accounting for my self on this blog I’ve proven that I’m willing to commit to things. I’ve gone months at a time without eating sugar or bread or drinking anything other than water, I’ve given up drinking alcohol for months, I’ve eaten things I hate, I’ve spent hundreds of dollars on supplements each month. I’m obviously committed to this. I’m not some lazy fat fuck sitting on the couch with a bag of chips. I don’t even watch TV. I need to find a way to lose the visceral fat without the desperate and painful gnawing hunger that I encounter whenever I don’t eat or don’t eat enough. Loading up on white rice kept me from being hungry and I was starting to lose weight but my triglycerides were 500 and my fucking doctor freaked out on me. I’m willing to try anything but I’m not willing to be in pain. If you have a study for that, please send it on over.

  12. Sorry for losing my cool. It’s really frustrating and kind of humiliating to not be able to stop eating. I feel like I’m being lumped in with people who are addicted to the pleasure of eating. It’s just not that.

  13. I’ve been on metformin for 4-5 days now and it does seem to be helping already with blood sugar control. Hunger is less, anyway.

  14. That’s why I suggested doing Ketogenic dieting for a week or so. That forces your body to upregulate fat burning enzymes. Most people find fasting, in general, much easier after eating Ketogenic. If you’re on a high GI rollercoaser, the post-pranadial insulin crash following a spike causes ravenous hunger. I’m not saying do LCHF forever, but do it for a week or so, then try IFing on it…you might find it easier than jumping from High GI carb to low cal so quickly. I wouldn’t recommend doing more than 1 or 2 days of ADF (alternate day fasting) at time before a reffed. Try not to eat more than 600kcal on your “on days”. LCLF high Protein is preferable if you eat 600kcal on your on days, but it’s not crucial

    If you regularly either fast or eat LCHF, you can prevent fat burning enzymes from down regulating.

    After you transition into a place where you can fast, you can even eat carbs on your “off days” and as long as you IF regularly, most people are ok. Just try to keep it at or below maintenance on the off days, although most ADF people generally only eat 20% above maintenance anyway on their off days. Eating carbs on off days should keep your thyroid working ok too.

  15. If you want to ease into it, try doing 16/8s Ie only eat between 12-8pm. Then work to a 20/4 pattern. Then you can work up to an ADF pattern.

    One thing about Ghrelin…hunger comes in waves, and usually goes away if you put up with it for a little bit. For example if you eat breakfast lunch and dinner everyday, it will typically increase at those times a day. If you drop Breakfast and Lunch, but keep eating dinner, after a few days you’ll no longer be hungry at Breakfast and lunch (Ghrelin stops going up at those times), but it will go up at dinner. It get’s easier over time.

  16. One more bit. They’res hypoglycemic hunger (where you get grouchy, headachey, moody, dizzy), and there is ghrelin (stomach growling) hunger. Ketogenic get’s rid of the first time. Weaning your body off certain timed eating patterns reduces or even gets rid of the second.

  17. One more point. I knew a Bariatric doctor who put all his patients on an “eat all you want” ketogenic diet for one week. After one week, he transitioned him over to a 1200kcal/diet moderate carb/fat/protein. He knew upregulating fat burning enzymes makes it easier to LCD afterwards. Anytime they had a serious slipup, he put them back on keto for one week. It was trick he used to lower the hunger.

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