Drae's got Labs!

[drae]

2018, February 1

PHYSICAL MEASUREMENTS
BMI .............................................. 36.3
Waist (inches) ............................. 48
Blood Pressure .......................... 140/86

BLOOD TESTS
HbA1c ............................................ 9.5 ..... HIGH ... <5.7 % of total Hgb
Cholesterol, total ....................... 220 .... HIGH ... 100-199 mg/dL
Tryglycerides .............................. 180 .... HIGH ... 0-149 mg/dL
HDL Cholesterol ......................... 54 .................... >39 mg/dL
VLDL Cholesterol (Calc) ............ 36 .................... 5-40 mg/dL
LDL Cholesterol (Calc) .............. 130 .... HIGH ... 0-99 mg/dL
Homocysteine ............................. 10.4 ... HIGH ... <10.4 umol/L
C-reactive protein (Quant) ....... 2.6 ................... 0.0-4.9 mg/L

I would really appreciate any and all thoughts, suggestions, insights. This is the first time I have been above "pre-diabetes" and know it is due especially to a couple trips late 2017 where I lived on Mountain Dew and fast food. I am determined to turn that around immediately (like maybe VLCHF diet). Also get the supplements right and for sure keep up the exercise. I lost 3 pounds in January in spite of adding 3-4 tablespoons of good fats, increasing eggs and avocados. Not in ketosis yet, but close to 18 hours IF, no snacks and, best of all, low carb with no added sugar.

Help, please.
Drae

Mod question: should I have posted this on my supplements thread?

[slacker]

BLOOD TESTS
HbA1c ............................................ 9.5 ..... HIGH ... <5.7 % of total Hgb
Cholesterol, total ....................... 220 .... HIGH ... 100-199 mg/dL
Tryglycerides .............................. 180 .... HIGH ... 0-149 mg/dL
HDL Cholesterol ......................... 54 .................... >39 mg/dL
VLDL Cholesterol (Calc) ............ 36 .................... 5-40 mg/dL
LDL Cholesterol (Calc) .............. 130 .... HIGH ... 0-99 mg/dL
Homocysteine ............................. 10.4 ... HIGH ... <10.4 umol/L
C-reactive protein (Quant) ....... 2.6 ................... 0.0-4.9 mg/L

Mod question: should I have posted this on my supplements thread?

Hi Drae. As you know, the HbA1C level is concerning. Most (US) providers will want to put you on medicine immediately. It is worth negotiating about., continuing lifestyle changes and re-checking in 3 months. I feel that you can get the A1C down below pre-diabetes with the lifestyle changes you have initiated, over time. If I remember correctly, you have already lost weight through LCHF and exercise. So things are moving in the right direction. Your trigs will improve with your improvement in diabetes/IR. C-reactive protein is higher than ideal; it too may very well improve with lower A1C. I am not worried about the total cholesterol or LDL levels.

I would focus attention on getting the homocysteine down. You may want to start at the wiki for help. There are also multiple threads available for more of a discussion and understanding of other's homocysteine woes.

Please don't be concerned about where you post! I always prefer starting a new thread for a new topic so it's easier to find. And the "Our Stories" forum is the ideal spot for posting lab results. Otherwise the information can get lost in the shuffle...

On a personal note, I really appreciate your addition to our tribe! Thanks for sharing your journey and positive attitude.

[drae]

I would focus attention on getting the homocysteine down. You may want to start at the wiki for help. There are also multiple threads available for more of a discussion and understanding of other's homocysteine woes.

Thanks, slacker! As you know this is just the kind of help I need. Okay. I have a three-front campaign to plan.
1. Reverse the diabetes and insulin resistance.
2. Do what ever it takes to get the homocysteine down, including, what in the world is methylation?
3. Don't forget my three new daily priorities for February, and, keeping my January priorities going until they are solid.

I will keep reading on the homocysteine. So far it has not been sinking in, but now that I have a number that will help. (Thanks, JulieG!)

As far as reversing the diabetes, I am not having trouble fasting 18 hours or getting off the added sugar. I still sometimes crave at night but I am still (rarely) eating a meal that contains wheat or starch, so if I crave I eat a serving of Gundry's nut mix. I have been eating two meals a day for over a month, between 12pm and 6pm, and, I can tighten up and enter the food on cronometer and watch my carbs.

Here is my question du jour: I want to do the 20 carbs a day and see if I can reverse the insulin resistance quick. Is this a bad idea? Why? Remember, fasting does not bother me. I have experience totally changing my food and saving my life so have no problem doing it again. I just want to make sure I'm making a smart choice of plans. I could alternatively do the very low calorie thing (4-500?) that the University in UK investigated.

What I cannot do yet is buy the keto meter this month. Have to wait a month. Labs and supplements were this month. Is there any reason I should not do the 20 carbs a day or very low calorie diet without checking blood sugar or ketones? I mean, it would still be good food, right? Would it be a problem to stay on it a month?

Other options? I'm getting on the homocysteine, too. My new supplements and more c8 MCT oil arrive tonight, plus, I have plans! What? a social life with some of my bestest! YEA.

Thanks, all.
Drae

[slacker]

Thanks, slacker! As you know this is just the kind of help I need. Okay. I have a three-front campaign to plan.
1. Reverse the diabetes and insulin resistance.
2. Do what ever it takes to get the homocysteine down, including, what in the world is methylation?
3. Don't forget my three new daily priorities for February, and, keeping my January priorities going until they are solid...

Here is my question du jour: I want to do the 20 carbs a day and see if I can reverse the insulin resistance quick. Is this a bad idea? Why? Remember, fasting does not bother me. I have experience totally changing my food and saving my life so have no problem doing it again. I just want to make sure I'm making a smart choice of plans. I could alternatively do the very low calorie thing (4-500?) that the University in UK investigated.

What I cannot do yet is buy the keto meter this month. Have to wait a month. Labs and supplements were this month. Is there any reason I should not do the 20 carbs a day or very low calorie diet without checking blood sugar or ketones? I mean, it would still be good food, right? Would it be a problem to stay on it a month?

Hi Drae -

I agree with reversing diabetes and IR as job #1! May I suggest moving homocysteine to #3? It will require additional supplements to implement, and additional labs once the new supps are on board to fine tune. Solidify January and February priorities first, then move on to treating homocysteine. If you have time to research it now, great!

I highly suspect that we have members out their who stick to 20 carbs a day (you know who you are). Most people have better long term success with a slow and steady approach that is sustainable over time. I do not support the very low cal diet you mention for this reason. It might be very difficult to stay keto-adapted on 500 cals a day prior to reaching a state of metabolic flexibility (ex Tincup). Given your ability to fast comfortably over long periods of time, I suspect you are in nutritional ketosis already.

I would love to hear from others on your very good questions. You are ultimately the decider, but the group input is helpful.

[Julie G]

I'm so proud of you for checking homocysteine. You instinctively knew that it would be high. Now, you have every reason to get on board with the right B vitamins.

Here is my question du jour: I want to do the 20 carbs a day and see if I can reverse the insulin resistance quick. Is this a bad idea? Why? Remember, fasting does not bother me. I have experience totally changing my food and saving my life so have no problem doing it again. I just want to make sure I'm making a smart choice of plans. I could alternatively do the very low calorie thing (4-500?) that the University in UK investigated.

I admire your resolve, drae! This approach will turn your glycemic markers around in a hurry, but twenty grams of carbs a day isn't enough. In another thread, I recommended a diet comprised of less than 20% carbs. I suggest you go to http://www.cronometer.com and sign up for a free account. Go to "Profile" and enter your data (height, weigh, activity level.) Be sure to indicate that you'd like to lose weight. That will give you an excellent idea of how many calories you should be consuming a day. If your caloric requirements are 2,000 (wild guess), at 20%, you'll need 100 grams of carbs per day. Enter everything that you eat into the food diary to help you keep track. A cup of raw spinach for instance is 1.1 grams of carbs, cooked broccoli is 11 grams, red cabbage is 6 grams, cooked mushrooms are 8 grams, parsley is less than 4 grams, red romaine is less than 2 grams, twelve spears of cooked asparagus are 7 grams. I'm sharing these examples to let you know how many wonderful, yummy veggies you can eat before you reach 100 grams. I don't want you to feel deprived. FWIW, the macronutrient ratios that I loosely track are carbs-19%, protein-13%, fat-68%. (My fat is comprised of high polyphenol EVOO, avocados, olives, nuts, fatty fish.) Most meals are tons of vegs, a small serving of protein, and generous amounts of EVOO (mix with a good balsamic vinegar or lemon & lime for some zest) with lots of herbs and spices for flavor. Following this approach, with a fast & exercise, will likely get you into ketosis. Be on the lookout for the keto flu. Great advise here on how to avoid. Keep us posted on your progress. So proud of you!

[TheresaB]

what in the world is methylation?

By golly, we have a wiki article on that very subject https://www.apoe4.info/wiki/Methylation

[Stavia]

Drae you have had very good advice.
Your priority now needs to be reversing your diabetes.
Yes this HbA1c is in the diabetic range. But it is completely reversible.
Most of your other suboptimal markets are secondary to this condition.
The homocysteine is a separate issue which can be addressed now with three supplements or at a later stage.

There are several dietaty approaches. The slower but more sustainable method as Julie explains. The Jason Fung/Mark Mattson shock to the system fasting/low calorie method which can reverse diabetes in a few months as you suggested but it is safer if this has medical supervision and expert dietary advice. Plus/minus metformin to improve your insulin sensitivity. All will work if followed properly. Chose whatever you think you can manage.

[anne from california]

The homocysteine is a separate issue which can be addressed now with three supplements ...

Stavia, what are the three supplements? (I haven't yet had my homocysteine levels checked, but I'm curious if I'm already taking any of the three supplements you're referring to.)

Drae, I enjoy the heck out of your cheerful, optimistic and lively posts! I love how you're eating this elephant one bite at a time, with monthly goals. I'm struggling to restart, possibly because I went at it too hard to start, and at the holidays to boot. I've got a functional medicine doc appointment coming up in mid-April and really want to be well established on keto 12/3 (or so), exercise, sleep and some supps before I shell out for the expensive labs. Exercise and sleep in pretty good shape, getting back to it on some supps (methylBs, zinc, d3, curc, fish oil, working up to mag), but really struggling with restarting keto. BUT new month, new start. Fired up the cronometer, it's been a good day (except for a couple potato chips) and I am on my way!

[Tincup]

Drae,

Congratulations on what you've done so far!

Are you on diabetes meds?

If not then you can likely proceed with less caution. If you are on meds, then titrating them down as you fast and/or restrict carbs is crucial as you don't want to risk hypoglycemia.

References on T2 diabetes reversal:

Dr. Bernstein’s Diabetes Solution Bernstein is an ~84 year old T1 diabetic engineer who went to medical school in his 40's. He really pioneered using portable glucometers to figure out how diabetics should eat. He still has a full practice as well as hosting a monthly Q&A for folks to send in their questions. I highly recommend reading his book as well as watching his YouTube Diabetes Univeristy.

Jason Fung is a Toronto nephrologist who has been treating people with T2 (and other issues) with fasting for quite a few years. He's written quite a bit about diabetes on his blog, here and here. He also has a book on fasting. He releases one on T2 in April.

Diet Doctor (run by a Swedish doctor) has a good section on T2.

Let me know if you want more info, PM me to make sure I see your request or question.

[Stavia]

Anne, methylB12, methylfolate and P5P

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