Not Done. (And labs).

Yeah, I’ve decided to come out of retirement.

That last bout of depression was the worst I’ve experienced.  Not the longest, but the most severe.  I don’t know what’s going on with me.  Things are a bit better now.  Just milldly depressed. Thanks to friends who commented or emailed…I appreciate your support.  I really don’t mean to be this drama mama.  In real life I don’t seek the spotlight at all – I’m content for no one to notice me in the room.  I’m really not all that dramatic.  The blog is a reflection of what’s in my head though…it’s a side of me that no one in my real life gets to see. I guess there’s depression drama in my head.

I have a doctor’s appointment on Monday.  She’ll be checking the labs she ordered and seeing how this beta blocker is doing for my blood pressure.  I’ll also be talking to her about whatever the fuck it is in my abdomen that’s pushing against my ribcage for the last few months.  This might result in more (and expensive) tests, and that’s just going to have to be ok.

So how did I do?  Metabolic panel first:

metabolic panel 7-1-14

The diet I’m currently following is 95% starch free – I’d say most days I eat none, every few days I might have a bite or two of something with starch in it.  Also, it’s 95% free of glucose and fructose.  Very little juice, fruit, or table sugar.  I’m eating mostly protein, fat, and vegetables, leaning harder on the vegetables and bone-broth based soups than I used to when low-carbing.  I’m getting most of my carbohydrate calories from milk (lactose) and vegetables, around 100g of carb a day.  My diet when I had these labs done was about 50% fat, and the rest split between carbohydrate and protein.  When I became severely depressed, I had eaten a couple of bananas (they’re high in potassium, trying to bring down blood pressure).  No more bananas. Stupid starch.

Ok, let’s see what’s changed over the last couple of months:

Blood sugar and Hb-A1C are a bit improved but still high.  Not high enough to be considered diabetic though (diabetic = 126 on the fasting glucose, and 6.5 on the Hb-A1C, according to the values that came with the labs).  The far right column on the chart is the current lab “normal” ranges, which vary a bit from the previous lab I used.  The doc ordered these, so I used their lab.

Carbon Dioxide (CO2) is better now, at 26.  I attribute this to bag breathing.  I haven’t done a lot of it, but for a week or so I did it once or twice a day, while trying to normalize my blood pressure. It didn’t help my blood pressure, but seems to have made a difference in CO2 level.  I’ll continue that once a day.  Traditionally people breathe into paper bags when they are hyperventilating – I’ve been using plastic gallon-sized “food and bread bags” from my local supermarket.  Not as noisy as paper, and not as rigid as Ziploc bags.  You just make a seal over your mouth and nose with the bag and breathe normally, in through the nose, out through the mouth, until it becomes a little difficult to breathe – at that point the oxygen is about depleted, and it’s time to stop.

BUN/Creatinine ratio is slowly dropping, probably because I don’t eat as much meat as I used to.  I still eat it every day, but it used to be every meal.  Now a lot of my protein comes from dairy and bone/oxtail broths and soups.

Everything else is unremarkable.

Ok, now for the lipid panel:

lipids

Again, this is about a month into eating 100-120g of carbohydrate daily, with very little fructose/glucose or starch in my diet.

  • Total cholesterol dropped almost 50 points.
  • Triglycerides almost halved.
  • HDL up from 30 to 42.
  • LDL able to be computed now.

I guess I don’t handle carbohydrates well.  More veggies, less carbs. When I eat this way I feel good.

The recent depression has been related to eating starches, as usual.  They’re off my plate permanently now.  Or until I can figure out why that happens and fix it.

Results and Changes

Had a lipid panel done today, about 2 weeks after my last one.  Over the past week I did the following:

  • Aimed for a 2:1 carbohydrate to protein ratio.  I found this difficult because I don’t particularly like sweet food, so I fell short some days.
  • Aimed for a 1:1 calcium to phosphorus ratio, because Ray Peat says.
  • Ate no starchy foods, getting all of my carbohydrates from sugar (fruit, honey, juice, and white sugar)
  • Maintained a lower-fat diet (averaged 59g fat/day or about 24% of total calories, on average).
  • Took niacinamide and aspirin 3x a day
  • Doubled thyroid supplement (Cynoplus, a combination T3/T4) from a very small dose -1/4 tablet (7.5mcg T3 / 30mcg T4) to two 1/4 tablets per day.

The results of today’s lipid panel:

  • Total Cholesterol: 316 (first time ever above 300).  Shouldn’t increased thyroid supplement decrease cholesterol?
  • Triglycerides: 495 (a 3% improvement. I’m not impressed.)
  • HDL Cholesterol: 30 (lowest ever)
  • LDL Cholesterol: Couldn’t be computed because Trigs were so high (this was the case last time too).

So, not great.

Here’s a handy chart showing my lipid panels over the last 2 years, along with brief notes about my diet during that time:

lipid panels

So you don’t have to turn your monitor on it’s side, here are the notes that correspond with the different testing dates:

3/27/2012 – Low Carb/Leptin Reset

11/14/2012 – Low Carb + Stress (Moved to a new state, started a new and very stressful job, was doing the Wiley Protocol and supplementing estrogen + progesterone).

6/19/2013 – Low Carb, without following any particular plan.  When I ate carbs they were in the form of starches from potatoes and rice, some vegetables, no fruit.

12/30/13 – Ray Peat, low sugar – around a 1:2 carb:protein ratio.  I was fiddling around with eating fruit, juice, and sugar but I was scared by the effect it was having on my blood sugar.  It was about this time I realized I was diabetic and was afraid of eating more carbohydrates.

4/19/14 – Ray Peat, high sugar – 2:1 carb:protein ratio – I decided to jump in with both feet and start eating more carbohydrates. When this test was done I was eating high fat (90-120g/day), high sugar (over 200g/day, some of which were starches), moderate protein (about 110-120g/day).  Pressure under my left ribcage was making me concerned that something might be wrong.

5/2/14 – Ray Peat – high sugar (2:1 carb:protein), low fat (around 25% of calories), taking niacinamide/aspirin/increased thyroid to address scary lab results.

According to this, my body (well, at least my lipid panel) responds best to a low carbohydrate diet, with minimized environmental stress.  I can tell you I didn’t feel great eating low carb after a while – I felt tired all the time, irritable.  But maybe that was because I wasn’t getting enough nutrition – I wasn’t tracking my food back then – vitamins/minerals were pretty much off the radar for me. I wasn’t eating liver or taking progesterone then.

Of course, other things were worse then.  My BUN/Creatinine ratio for example, got worse the longer I was on low carb, and improved since then.

BUN

Maybe eating too much meat is stressful on the kidneys after all?

Let’s look at thyroid:

thyroid

Seems sort of unrelated to sugar intake, actually, and more related to environmental stress. When I had the labs drawn in 12/2013 I was experimenting with resistant starch.  I think that was stressful on my body – I know it was stressful on my emotional state. So that may account for the increase in TSH last December.  I know TSH isn’t the ideal measure for thyroid function, according to many people…but Peat seems to think it’s a decent gross measure, so good enough.

And of great importance to me is my blood sugar.  Let’s see the data:

blood sugar

This is a crazy graph, right?  There was definitely an increase in fasting blood sugar when I started following Peat and adding carbohydrates to my diet, but that’s to be expected.  Anyone can have “well managed diabetes” with a low carb diet.  I wanted to actually FIX my diabetes, so I was experimenting with adding carbs back in to see what it would take to do that.  From the graph it looks like the best things I did for my blood sugar were bicycle for 30 minutes a day and eat a low-fat diet.

Holy crap!  Just like my conventional doctor told me!  Exercise and eat a low fat diet!

hahaha

It does seem my current supplements are confounding things.  The graph shows that eating a low-fat high sugar diet results in lower fasting blood sugar…but not if I add niacinamide, aspirin, and increase thyroid.  Hm…interesting.  If I was a patient person, and if I really loved sweet food, I’d probably just eliminate the supplements I’m taking and go back to high-sugar/low fat for a while to see if that trend continues.

I’m neither patient nor in love with sugar.

And considering that I’m STILL having hot flashes – even while sitting right here, right now, I’m going to stop taking niacinamide, aspirin, and thyroid.  One of them is bothering me.  Later on I may try to add them in one at a time and see what I can tolerate.

So to sum up: It looks like the best thing for my lipids is low-carb.  The best thing for my BUN/Creatinine is low meat.  The best thing for my thyroid is low-stress.  The best thing for my blood sugar is low fat and bicycling 30min a day on flat terrain.  The best thing for my enjoyment of life – to not have to eat so much sugar.  I really don’t look forward to it.

So what kind of diet is low-carb, low-meat, low-fat, and lower-sugar?  Maybe one with dairy (mostly low-fat), some lean meat, lots of vegetables, some fruit (when I feel like it).  Plus avoid stress and get exercise.

I still love Ray Peat – he gave me progesterone, Vitamin E, red lights, liver, vitamin K, dairy, raw carrots, and taught me that estrogen, PUFAs and serotonin are bad guys.  I’m continuing on with much of what he has to say.  Just less sugar.  More vegetables.  More exercise.

I might as well retire the blog.  I have nothing original to say anymore.

So there it is.  That’s my new plan.

Low Carb Fail And A Good Day

Funny story.

Remember a couple days ago I wrote that I was going to do a lower-carb version of a Ray Peat diet so I could stop gaining weight?  Well I tried that yesterday.  Around 11:00AM I found myself not wanting to do anything and feeling like this:

anhedonia

That’s not me, by the way, but I literally had that look on my face and I was staring into space.  I said to myself, “Self, this is stupid. I can’t live like this.”  And then I went to get myself a big glass of orange juice.

Within 15 minutes I was tidying up the house, doing the dishes, chatting with my daughter.  ((Sigh))….I’m officially a sugar burner now.  Those days of being a fat burner are long gone.  I would never be able to tolerate the transition from energetic sugar-burner to adrenaline-driven low carber again.  So that experiment was a fail.

Anyway, today I felt really great all day.  Minimal hunger for some reason – or, at least hunger only at mealtimes.  So let’s analyze the day.

Woke up at 7:30AM – Weight still 209.4 (boo), fasting blood sugar: 122 (meh), temp/pulse: 98.6/85 (yeah!).  My morning temperature and pulse has gradually climbed from 96.9/68 to where it is now – maybe even a little on the warm side for first thing in the morning.  I’m currently taking 1/4 of a Cynoplus tablet and have been following a Ray Peat inspired diet for about 3 months.  I’m really happy with that.

On the other hand I took my blood pressure today, and it was 154/90, despite liberal use of the salt shaker, and blood sugar is also still high, despite elimination of most of my dietary PUFA.  So no miracle there by following Dr. Peat’s advice.  I’ll continue anyway, because I know salt and avoiding PUFAs are beneficial in many ways. I was hoping they would solve these problems though.  Maybe I just need to give it time.

Anyway, back to my day. It wasn’t an ideal day diet-wise – I just ate what we had in the house. We’re low on groceries. Need to shop, but it’s like 40 degrees below 0.  Brr.  Don’t wanna go out.

  • Breakfast: 3 eggs cooked in coconut oil, 8oz orange juice mixed with selzer water.
  • Snack: More OJ and selzer water, and a raw carrot.
  • Lunch: 3 slices of ham dipped in sour cream.
  • Snack: 1-2 oz. gouda cheese, orange juice
  • Snack: 1-2 oz. dark chocolate, orange juice
  • Dinner: Stew made from beef shank (made in crock pot).  I skipped the potatoes.
  • Snack: 1/2 of an apple, orange juice, cheese

Hm….so what was different about today that I felt really good?  I did avoid starches completely…and I ate more protein/fat in the morning than usual.  Other than that, not too unusual.

Oh well, I’ll try to do the same tomorrow.

Next time:  Resistant Starch – 1 month update!

Two Steps Back

I’ve been struggling a bit eating Peat style.  I think this would be a great way of eating if weight loss isn’t a goal.  The food is delicious and makes me feel great.  Only problem is I’ve been gaining weight.  I’m now up to 209.4 – almost 8 pounds over my previous unacceptable weight prior to learning about Dr. Peat.

It has to stop.  I simply cannot continue to gain weight.  My clothes don’t fit.  I avoid mirrors.  I’m discouraged.  I’ve tried to count calories, and I find it impossible to stay on a low-calorie diet while eating sugar.  There’s one woman on my Ray Peat Facebook group who has been losing weight, and she has generously shared her eating plan with us.  I’ve tried to follow it, and I just can’t.  I feel too hungry.  I guess my body is just not healthy enough yet to metabolize sugar effectively.  I think a lot of the sugar I’m eating is being wasted, my liver not effective at storing glycogen.

I’m considering doing a lower-carbohydrate version of Peat’s principles for a couple of months (and yes, I realize “a lower carb Peat plan” is an oxymoron) – just long enough to get some of the weight off.  I think my low-carb diet didn’t result in weight loss before because I was eating too much meat and no dairy. Also I was eating lots of PUFAs in daily consumption of dark-meat chicken and conventional eggs.  Now that I see how damaging those things are, of course I would continue to avoid them.

I don’t know all the answers.  I just need to do something else. I can’t continue to gain weight.

I Heart Intuitive Eating

Stopping measuring everything was the best thing I’ve done for myself in months.

Beginning 2 days ago, I only measure the basics upon rising – fasting blood sugar, temp/pulse, and weight – and then no more measuring for the rest of the day.  The purpose is for me to start making decisions about what and how much to eat based upon how I feel, not based on how many grams of protein I need to get in or how many calories I have left before I feel really bad about myself.  Since I stopped measuring everything my ability to interpret body’s signals is becoming very clear.

For example, I can now recognize two distinct kinds of hunger – hunger for sugar and hunger for a meal.  The hunger for sugar feels like a slight twinge of irritability or fatigue along with a need to eat something which I feel most in my mouth or head.  Hunger for a meal is a deeper feeling, kind of hard to explain, but it makes me feel hollow – like I really need to fill myself up.  I’m still learning to tell the difference in the moment, but when in doubt I have a few ounces of orange juice and if I’m still hungry 10 minutes later I eat something more substantial.

Also what’s great is I am learning how to control my energy levels.  If I eat too much meat I feel tired.  I now know that’s because eating protein out of proportion with sugar raises cortisol and lowers thyroid function.  Also, there’s lots of phosphorous and tryptophan in meat – a precursor to serotonin, which increases my nemesis, estrogen.  A few days ago I ate like 8 or 9 ounces of meat at once (I was worried about it spoiling and didn’t want to waste it.  Sometimes I’m such a tight wad) and within an hour I needed a nap.  When I woke up I felt all estrogen-y – sore breasts, irritable.  It’s clear to me why eating all that meat on paleo/low-carb gave me such a flat affect and made me tired.  Since then I’m becoming vigilant about having fruit or orange juice first – before protein – and only having 2-3oz of meat at a time.  If I do this my energy is high and my mood is good.  Dairy and gelatin are sources of protein that don’t make me tired.  And by the way, dairy no longer gives me asthma.  That’s over.

I’m going to continue on this way for a while – I know I probably won’t lose much weight eating whatever I want and when I want without counting calories, but right now my objective is to learn what my body needs.  Maybe after a couple weeks I’ll count something again.

Cortisol and Weight Loss: Questions

In my post yesterday, I wrote the following:

The problem with low-carb diets is the following:  The body releases insulin to process the amino acids in proteins.  When insulin rises, the body needs to raise blood sugar to avoid hypoglycemia.  If there’s no glycogen (sugar) stored in the liver cortisol is released instead, which increases blood sugar.  Cortisol suppresses thyroid function and immune function, and lowers metabolism.

I was paraphrasing what I heard Ray Peat say in an interview about sugar and carbohydrates.

But over the last 24 hours I’ve been thinking about this.  If this is the case, then why do so many people have success losing weight with low carb diets?  I decided to go back and listen again to make sure I really understood what he was saying about cortisol being released when you don’t eat carbs.  Here’s an actual transcript:

Several of the amino acids in proteins are powerful insulin stimulants, and when you eat protein by itself, you stimulate insulin secretion which is needed to metabolize the amino acids. But in reaction to the insulin, your liver has to put out glucose to keep your blood sugar going so your brain and blood cells and kidneys and so on can keep working.  And if your liver is somewhat low on glycogen, then every time you eat protein and have an insulin secretion, your body secretes a compensating amount of cortisol to bring your blood sugar back up.  But the cortisol brings your blood sugar up at the expense of protein.

[…] The first tissues that cortisol breaks down are the thymus gland and other immune cells and the muscles and if you eat lots of protein in spite of the high cortisol, you can keep your balance so you are replacing your muscles and thymus gland but you are running on a constantly high cortisol secretion.

Yeah, I heard him right.  So given this, how come people are able to lose weight on low-carb diets?  Is he saying that weight loss from low-carbing is all loss of lean tissue?  How about people who lose LOTS of weight eating low carb?

He goes on to say:

[…] I’ve seen that doctors simply neglect to measure hormones that were related to blood sugar when they would prescribe insulin, calling a person a diabetic, they said they needed to take insulin the rest of their life.  But, having some of these people test their cortisol, we saw that very many of these so-called diabetics just had very high cortisol.  Sugar happens to be the best thing for lowering cortisol to normal, and since high cortisol gives the impression of diabetes, causing high blood sugar, you get the unexpected effect of when you eat sugar you lower the cortisol, and some of these people had a very quick recovery from their so-called diabetes.

This explains why a lot of low-carbers have what they like to call “Physiological insulin resistance,” (as opposed to “Pathological Insulin Resistance”, I think).  It’s not real insulin resistance – it’s just the effect of high cortisol secondary to low-carb intake.

Which leads me to another question – when I was low carb, how come my cortisol didn’t test high(Update: The answer to this question is in the comments of this post.)

Pity Party’s Over

Yep, done feeling sad.  Now I just need to figure out what the hell to do to move forward.

I ordered a stationary bike today.  Moderate cardio exercise – about 30 minutes a day – has previously done an amazing job of lowering my blood sugar.  Check out the graph on this post I did 2 months ago.  Exercise is the best thing I know to combat Type 2 Diabetes.  Now as for what to eat…

I tested orange juice again this morning – a half cup again, this time with 3 eggs and coconut oil.  At 1 hour my blood sugar was at 150.  Although the American Diabetes Association says to shoot for blood sugar below 180 1-2 hours after a meal, that seems high to me, and I want it lower than that.  I want it at 140 or lower at the 1-hour mark.  Jenny Ruhl from bloodsugar101 states the following:

Research conducted with human patients, mice, and pancreas beta cell cultures all point to a single threshold at which elevated blood sugars cause permanent damage to your body. What is that level? 140 mg/dl (7.8 mmol/L) after meals.

The research she provides to support this statement is here.

So hm….now 1/2 cup of OJ is too much, at least in the morning.  Not only that but I was hungry again at that hour mark.  I ate 2 more eggs, went shopping, and 2 hours later I was DYING of hunger.  I mean DYING.  It felt like hypoglycemia, though if I would have tested myself my blood sugar probably wouldn’t have been low.  Came home and chugged a cup of OJ to make the pain stop.  Blood sugar instability is no joke.

I should also mention, in the past week my weight has begun climbing rapidly, even though I’m not drinking mass quantities of milk and OJ anymore.  I think I’ve gained 3 pounds this week, in addition to the 2 I’d gained over the past month.

So to summarize:

  • My tolerance for carbohydrates is very poor (though this is probably not new…I just didn’t know about it).
  • My hypertension has worsened since I increased my salt consumption.  My blood pressure has increased about 10 points – both systolic and diastolic.  Just checked it – it’s 155/109 right now.  I used to be in the 140s over the 90s.
  • I’m gaining weight (and no, it’s not muscle).

Ok, currently this doesn’t seem to be working for me.

Let’s take a moment to discuss the elements of the Ray Peat approach that I do like and that have been helpful:

  • Liver – My skin is very happy and I am really glad my family is all willing to eat it.  Put 4 oz of liver into Cronometer and just see how many nutrients this stuff has.  I wouldn’t have tried it without knowing about Peat.
  • Progest E – I can’t say for sure that it’s had a dramatic effect yet with regard to estrogen management, but I have noticed an improvement in mood symptoms related to my cycle soon after I take it.  I’ll definitely continue with this.
  • Dairy – I like dairy a lot and had no idea how many nutrients are in it till I started entering what I ate into Cronometer.  I have no problem digesting it, and the only reason I all but gave it up was because Paleo told me to.  Dairy and I are happy to be back in communication.
  • Avoidance of PUFAs – Dr. Peat’s thoughts on the detriments of polyunsaturated fatty acids make a ton of sense to me, and I’m happy to avoid them going forward.
  • Vitamin E – I’ll continue to supplement with this.  I never would have known how beneficial this vitamin is.
  • Raw carrot – I like carrots and am happy to continue eating them.  Peat says a carrot a day reduces endotoxin and provides a natural antibiotic effect.
  • Coffee – I was happy to learn that coffee has many nutritional benefits.  Currently I can’t drink it because without sugar added it makes me hungry.  But I hope to drink it again.
  • Avoidance of things that increase estrogen, serotonin, and prolactin.  Still learning about these.

Elements of Ray Peat’s work that I plan to learn more about and possibly incorporate:

  • Aspirin supplementation
  • Red light therapy
  • Lifting weights/light strength training

So what parts am I giving up for now?

  • Sugar.  I’ll be fairly low carb again to get my blood sugar under control…but who knows…maybe with exercise I’ll be able to tolerate it again.  But seriously…sugars and starches have not been treating me well.  They’re basically off the table for now.

There are some things Peat advises that don’t ring true to me:

  • Avoiding vegetables unless they are very well cooked.  Something about toxins…I don’t know.  This sounds goofy to me.  Veggies always made me feel really good.  I’ll be eating salads again.
  • Avoiding fatty fish.  I don’t know about this.  Probably need to research more, but I’m not really clear as to why he recommends this, except that omega 3 oils are unsaturated and thus unstable/easily oxidized.  How could it be that EVERYONE EVERYWHERE says that eating salmon is good for you and Peat says it’s not.  I haven’t read the research, so for now I’ll just say I’m doubtful.

Ok, that’s really all I have to say today.  Back to somewhat low carb, for now.  This isn’t the end of my health-seeking pursuits, of course.  Just a pause, and hopefully a return to baseline.