One Down, Two to Go

It appears I’ve successfully discontinued one of my three blood pressure medications.  At the beginning of February I was taking the following:

  • Hydrocholothiazide 25mg/day
  • Methyldopa 250mg 3x/day
  • Verapamil ER 120mg/day

I started the Verapamil on 1/12/17, after my weight had climbed due to unnecessary hydrocortisone use, and my blood pressure had climbed with it. I’ve now lost the hydrocortisone weight plus a few more pounds (down almost 13 pounds since starting Weight Watchers), and I decided a couple weeks ago to see what happens if I taper off the Methyldopa.  So I did, with my doctor’s blessing.  Blood pressure this morning was 130/86.

I suppose I’ll hold off on more changes till my weight drops some more.  I wasn’t sure the Methyldopa was actually doing anything, but I’m sure the remaining ones are.

Weight Watchers – 1 Month Review

I’ve been doing Weight Watchers for 4 weeks.

I’m allowed 30 “points” per day, plus an additional 35 points per week to use at my discretion (used to be 45 per week but I lost weight and they adjusted that down to match current intake needs).  Typically I eat all of my 30 points per day and most days I use none of the extra weekly points.  I see those as insurance, so I don’t feel guilty if I accidentally go over or if I’m just unusually hungry one day.

Here’s what I ate yesterday – this was exactly 30 points worth of food:

diet

Each time I enter my diet into Cronometer (only about 1x per week) I find that I’ve had between 1500 and 1800 calories per day, around 30g of fat, 225g carb, and 140g protein.  I seem to be eating the same things every day – I could really change it up a little I suppose.

Here’s the nutrient breakdown from what I ate yesterday (just the food, before any supplementation):

nutrition1

nutrition2

Some of the micro-nutrition is falling short, but when I add in my multivitamin, Vitamin D, Vitamin K, and magnesium supplements and the salt I add to food I’m up to meeting 95% of nutrition targets – but still lacking in calcium, potassium, and iron.  I’m not sure I care about the iron though.  I haven’t had my “cycle” in almost a year, so I’m now at risk of too much iron rather than not enough.  Calcium and potassium…hm…I should add some daily greens.  If I add a cup of cooked spinach I’m up to 98% of nutritional targets met.

So how are my other health markers?

I’m down an inch on my waist and my pants fit.  I threw out my yucky fat pants a couple days ago because they were falling off.

Here’s my fasting blood sugar:

fbg

I was hovering between 115 and 125 for a while there, and then has gone up since I started walking.  Weird!

Here’s my weight:

weight

I wrote a couple days ago that I got hungrier after I started walking.  That has evened out and I’m back to normal hunger/satiety again.

I was listening to Bulletproof Dave Asprey’s recent podcast with Dr. Sylvia Tara on the subject of fat.  In it Dave mentioned that there’s a hormonal response to losing weight that causes the near-inevitable regain later on.  I went to his blog to read more about it – on this subject, he says:

One of the reasons old-fashioned, calorie-restricted diets tend to fail is because these diets make you really hungry and cause food cravings.

Cutting calories to lose excess weight changes your hormones that control hunger and satiety so that after you starve yourself enough to lose some weight, your brain and gut start making your hormones work against you.[1],[2]

Your hormones scream, “eat more and gain that weight back!” So you do. And so begins a lifetime of yo-yo dieting, the one I used to live.

He goes on to talk about how ketosis can cause a hormonal change that “resets” the system to avoid the weight gain:

Your intestines release CCK after you eat, and it is a powerful regulator of food intake—so much so that injecting people with CCK (in a controlled study!) will cause them to cut their meals short.][4]

Your body secretes less CCK after you lose weight. In other words, when you are thinner, you will feel less sated with the same meal than you did before losing the weight. So you’ll crave more unhealthy foods. However, weight loss with ketosis keeps you from getting caught in this trap.

In fact, a recent study in the American Journal of Clinical Nutrition showed that even after 8 weeks of weight loss that resulted in significant reductions in CCK, just one week of ketosis returned CCK to baseline (pre-weight loss) levels.[4] In other words, even if you use famine-level calorie restriction to lose weight, you’d better pound the butter and cut carbs at the end unless you want to crave food all the time.

Personally I find what I’m doing now to be much more satisfying than a ketogenic diet.  I’m not sure what my blood markers look like right now – I might have triglycerides in the 500s – but I feel really good every day and I know I can have anything I really want and continue to lose as long as I cut back somewhere else.  I do plan on testing Dave’s assertion about ketosis though – as I get closer to my goal I’ll try a week or two of ketogenic eating and see if it makes it easier to avoid the regain.

Walking

I’ve increased my walking to between 7000 and 10,000 steps per day.  Since I did that about 3 days ago I’m hungrier.  It’s a little annoying.  I suppose I’ll stick with it though or else I’ll lose my $40 StepBet investment.  Also, exercise is supposedly good for you…you know, cuz science says.  So there’s that.  I haven’t seen further improvements with regard to weight loss or blood sugar management lately – Weight is around 201.5 and fasting blood glucose is hovering around 120.  I’ll be patient though.  Really.  I will.

 

Transition

Before I forget all about this, I wanted to talk for a minute about the transition my body has been going through since being able to eat different foods again.

Remember back when I put it all together that histamine intolerance was a significant issue for me?  Looks like that was a little less than 2 months ago.  Soon after that – on 12/29/16 – I stopped eating foods high in histamine.  Then a few days later – on 1/3/17 – I started taking Culturelle Probiotics.  By 1/6/17 my hot flashes were almost gone.

Then I had a week of die-off, after which I could eat anything without becoming depressed.

Since then my mood has remained great, my weight has slowly been dropping (not without effort, I admit – I’m consciously adding about 10 servings of fruit/vegetables a day – none of which I could eat 2 months ago). Between now and then though, there were some weird things going on.

When I first started eating starches and fiber my tongue would swell and my throat was sore every day.  It would start after eating something starchy/containing fiber and continue for hours, and then fade, to be repeated again next time I ate something like that.  I would also get pressure in my lower-left ribcage area, which I think was a swelling of my spleen.  I started taking an ibuprofen when all of this got to be too uncomfortable.  These symptoms – the sore throat, the swollen tongue and spleen – have gradually gone away over the last few weeks, and I haven’t needed ibuprofen for at least 2 weeks now.

Another strange thing has been sharp stabby pains in weird places around my body that have come and gone.  I’ve felt them in my individual toes, left side of abdomen, and pelvis.  These pains were severe enough that it made me wince and gasp, and then it would disappear for a few minutes or a few hours…and then come back.  These have also disappeared over the past few weeks.  It felt like an electrical short circuit or something.  I imagine the gut bugs were tap dancing on individual nerves.

My hot flashes have returned, as I mentioned earlier, since I stopped paying attention to eating a low-histamine diet.  They’re starting to bother me now, so I’m going to eliminate tomatoes, bananas, and leftover meats again.  I hate eliminating anything at this point – really tired of eating weird diets – but as the weather gets warmer these hot flashes are going to get annoying.

Losing It

Excess body fat, that is.

Down 10.5 pounds as of this morning, since I started following Weight Watchers (WW) online program 3 weeks ago.  Truth be told, I have signed up for WW in the past but was unable to stick with the plan because I couldn’t tolerate any fruits and vegetables…and without produce this plan is near impossible.  What I like about it is that it’s really 100% positive – there’s no shaming or punishment for missteps.  There’s also no need to count calories or grams – I just put the food eaten into the online tracker and everything is assigned a points value based on nutrient composition. You can eat anything at all and still be “on plan” as long as you can work it into your points.  I have 30 points a day to “spend” however I want.  Fruits and vegetables are nearly all 0 points, so there’s never a need to be hungry.  Just eat.  There are also an extra 45 points per week to spend on anything at any time – so if I eat something that isn’t awesome there’s a forgiving points cushion there to catch me.

To give me more incentive to exercise I have also joined StepBet.  From their website:

StepBet is a fitness game that motivates you to be more active. Players “bet” on themselves to meet their personalized step goals during every week of the game, and win money if they do. The cash prize, accountability, and community support help you become more active while having fun!

If you hit your personalized step goals for the entire game, you split the pot with the other winners. That means you get your bet back plus a profit.

So I have 6 weeks of walking ahead of me with $40 on the line.  My Fitbit will report back to StepBet folks.

I also signed up for a DietBet (same company).  I’ve bet $100 that I’ll be down to 199.6 pounds by March 4th.  I’m within 2 pounds of that now, so I’m pretty sure I’ll make it.

Here’s what I ate yesterday:

today

I’d like to be clear once again that until I started taking Culturelle Probiotics, which dramatically altered my gut flora, I was unable to eat whole fruits or vegetables, starches, or fibers without becoming incapacitated with depression.  Now that my gut is working normally (maybe even optimally) I can eat these things and stick to a diet plan like WW.  Weight loss may come down to a certain macronutrient balance or even Calories-In-Calories-Out (CICO) – I don’t know for sure – but I do know that if you can’t tolerate healthy foods it’s much more difficult to make a long term change.

I think the probiotics also reduced systemic inflammation, causing hormonal changes (e.g., reduced cortisol) that are now allowing body fat to be released.  I spent months and months eating low-carb (even no-carb at times) and not understanding why other people I knew were able to lose eating that way while I didn’t.  I think my body was inflamed due to gut dysbiosis, putting me in a constant state of stress and making weight loss impossible.  It’s also possible I was just eating too much, but I was listening to hunger cues and never eating past that.

So…bottom line…maybe weight loss is as simple as CICO – but until my body was able to tolerate healthy low-calorie foods, a CICO approach wasn’t possible for me.  If you’re having trouble losing weight, I strongly recommend taking a good look at what may be going on in the gut.

Fasting Insulin and Current Diet

I had a fasting insulin run a couple days ago, as a measure of insulin (in)sensitivity.  Let’s compare:

12/15 – 20.9 (while eating high-carb, low-fat)

2/9/16 – 20.7 (while eating low-carb, high-fat)

8/31/16 – 24.6 (while eating moderate carb and high-fat)

2/13/17 – 20.0 (while eating high-carb, low-fat)

The reference range is 2.6-24.9 uIU/mL, so I’ve been at the top of this unfortunate range for quite a while.  It appears that what makes things much worse is when both carbs and fat are high.  It also appears nothing diet-related gets me below 20.0….yet.  I’m going to test again in a few months and see if my current plan and/or probiotic has a longer-term effect.  In the meantime, blood sugars are coming down following a low fat plan, currently around 110-120 each morning.

Here’s what I ate yesterday (and this is typical right now):

typical

(Edited to add…I also had an apple I forgot to include above.)

Oh – also I’m down around 9 pounds now, on this diet.  Not much exercise.  I’ve started wearing a pedometer and I walk 3000-4000 steps per day, just as part of my normal routine.

Grateful

I’m so grateful for the relief of being able to eat a normal healthy diet and still feel happy.  I feel happy every day, all day now.  Even when something happens that shouldn’t make me feel happy, I still feel happy. I wonder if feeling happy gets boring after a while?  I doubt it.

I spend my days now feeling a combination of relaxed, aware, creative, and at peace.  All of the searching I did during my DECADES of depression gave me the tools I need to feel great – all I needed was my biology to cooperate.  In my 20s I would make lists of things I accomplished so I would stop hating myself.  It didn’t work, but I felt more accomplished.  In my 30s I read tons of spiritual books on creating one’s own life and on having gratitude for what I have.  I knew in my head that I was grateful for all the privilege I know as a white woman in America with eyes, ears and legs that all work well.  I still couldn’t overcome the sadness and anger I felt most days.  I remember going to a therapist when I was 32, saying, “I just feel sad.  I want to stop feeling sad.”  Therapy didn’t help my mood, but it made me better at communicating and helped me to understand myself.

But all that reading, all that therapy, all that list-making and self-esteem building and affirmation chanting and appreciation-list-writing – all of that was actually doing something for me.  I just couldn’t tell because my brain was being poisoned by something in my gut.  Now that the poison is gone (at least as long as I take Culturelle – I may never give up this precious supplement), I’m left being able to actually experience the structure that was being built all those years.  I hear people around me complain about their jobs or their kids….and I’m just so grateful I get to be here at all.  And completely confident in my ability now to create whatever life I want.

I think of all that meat I ate over the last few years…meat and cheese were some of the only foods I could reliably eat without losing my mind.  I’m now 2 weeks into Weight Watchers and down 8 pounds.  I eat fruit and vegetables, rice, potatoes, bread, meat, eggs – anything and everything I really want, I just work it in.  I have no cravings for sugar so I’m not eating that.  I’m not counting calories but I’d guess I’m eating around 1500 a day.  High fiber, low fat.  My fasting blood sugar is now around 112 every day – down from 160s in December.  Blood pressure is ok – I’m starting the gradual taper of one of the 3 prescription meds I’m taking to control it.

I don’t know if this will last forever.  I’m appreciating it all while I can.