Extreme insulin resistance page

[Marll]

So, I'll give everyone a quick rundown and then looking for a bit of advice:

My wife recently has come down with many health related issues that went unaddressed for a while because doctors kept telling her that she's "fine". It all started about 2.5 years ago when she gave birth to our son. Pregnancy was great, no issues, she felt fine after the first trimester, but during the birth things fell apart. The doctor that did her epidural stuck her with needles 9 times, never got it right and in the process mananged to damage a disc in her back. Hospital found no fault, so all attempts to get the recovery paid for were for naught. During the "treatment" for her herniated disc she was given steroids that made her gain 60lbs in just under 3 months (!?!?!) and weight is causing more issues with her back.

I started us back on a low carb diet about 1 year 3 months ago because I knew that it was anti-inflammatory (we did Atkins for years, but slipped back into a SAD lifestyle) and within weeks she went from not being able to walk without assistance to being mostly ok. I then sent her to a naturopath in Bellingham, WA that agrees with a low carb lifestyle and we found that she had:

Hypothyroidism
Insulin Resistance
Gluten Intolerance (extreme)
High blood sugar

She is now getting her thyroid under control, but even on over a year of low carb/paleo eating, cutting out most processed foods, no sugar, no grains, minimal fruit, she's lost and regained the same 5lbs for over a year. It appears that she is so insulin resistant that even the 20g or less of carbs a day from vegtables is too much.

I don't like the idea of taking pills or anything that one doesn't have to, but wondering if we should push to get a perscription for Metformin until she can loose weight and get her insulin sensitivity back to a more acceptable range. Her weight is playing hell with all of the following:

Thyroid
Back pain issues
Appearance
Body image
Sleep (sleep apnia)

She doesn't mind eating low carb/paleo, but is getting discouraged by the lack of results. She knows that she can't have gluten any more, but I can see her gravitating towards higher sugar foods, because "Why not, I'm always going to be fat and broken, might as well eat what I ******* want!".


Any help or advice is much appreciated.

[teach2183]

It sounds like her hypothyroidism is not under control. Eating very low carb, especially long term, can cause major thyroid issues. Have you tried increasing her carbs to a more manageable level (50-100) to see how her body responds? When I go VLC for more than 2 weeks I start gaining weight. Perhaps her body needs more.

[Marll]

I'm not sure that's really an issue. Her thyroid levels are closely monitored by her doctor and have been rising to more normal levels. That being said, even with her thyroid levels coming up to a normal/normal-high level she's not loosing weight, blood sugar still is elevated (over 100 fasting) and she'll eat anywhere from 20-30g carbs a day (usually right around 20g). For a while we were eating around 50-60g a day and she was steadily gaining 1-2lbs a week.

In the same space of time I've lost 65lbs.

[Marll]

Also I should mention perhaps that beyond a bit of heavy cream and some cheeses we don't eat any dairy, we don't eat any soy (doctor strongly discourages even small amounts), don't eat grains of any kind. We have started sourcing all of our meat locally and will have a 1/2 grass fed cow delivered this fall.

I cook everything in butter, tallow that I've rendered myself from beef suet, bacon grease, olive oil or coconut oil. I do not use any vegtable oils.

We supplement certain vitamins that we/she is defficient in:

Vitamin D (We live in the Seattle area, so this is a must)
Vitamin B12 (she had/has low levels of B12, but coming up)
Fish oil

She's sort of in a catch 22 situation. He back is hurting so she can't move normally and can't exercise, so weight loss is slowed. But even before doing Atkins she was able to loose weight effortlessly with minimal activity and kept it off for years (until like idiots we slid back into a SAD routine). If she could even loose 20-30lbs I think that many issues will start to repair themselves and she can get back to normal.

Best thing she has going on is that her blood work for cholesterol is amazing...no chance of heart disease at least, HDL through the roof and triglycerides at sub-basement levels

[marcadav]

I'm not sure that's really an issue. Her thyroid levels are closely monitored by her doctor and have been rising to more normal levels. That being said, even with her thyroid levels coming up to a normal/normal-high level she's not loosing weight, blood sugar still is elevated (over 100 fasting) and she'll eat anywhere from 20-30g carbs a day (usually right around 20g). For a while we were eating around 50-60g a day and she was steadily gaining 1-2lbs a week.

In the same space of time I've lost 65lbs.

What tests are being done to determine appropriate thyroid levels? I ask because I was kept under-medicated, ill, and fat for years because my TSH was in the hyPER range.

Also, it can take the body time to heal before weight loss happens, after thyroid issues are found and optimized. A wise woman on another forum for thyroid issues recommended not trying to lose weight until thyroid levels (free T4, free T3) have been optimal and stable for at least 6 months.

Health and healing over weight loss worked for me. When I concentrated on eating and living healthy after my thyroid meds were optimized, weight loss did follow.

[RobinNM]

Is she on thyroid replacement hormone and is she still on the steroids? Despite what the doctors tell us, I had a horrible time on thyroid medication and since I was only slightly hypo, I elected to go off of it. I gained weight and I looked like I was about 15 months pregnant. Horrible. The doctors will tell you it's not possible, but that could be one of the factors if she is on thyroid hormone supplementation. The steroids play bloody hell with your blood sugar as well. Is she still on those at all?

The other thing that you might do along with tracking the carbs is track the calories. There are those who don't think calories in/out don't matter, but for myself it makes a huge difference. I know even if I eat less than 50 carbs if I manage to have 1600 calories or so, I'm not going to see any difference on the scale the next day. Try cutting out dairy completely. You said a bit of heavy cream and some cheese and even a little bit may be a trigger for her. I would also not add any fats other than what's absolutely necessary to cook and I'd even try to maintain that as low as possible. Some people do very well with extremely high fat and others have ot limit that to some extent as well.

[Marll]

She's no longer on steroids at all, and hasn't been on them for about 1.5 years, it's just that when she WAS she gained 60lbs in about 2.75 months. The steroids were their lame attempt to control the pain in her herniated disc.

Calories shouldn't be a problem either, as she's around 1200-1400 daily, I can't imagine going much lower than that. I highly doubt that fat in the food is an issue either.

Again I'm not sure that drugs are the answer, but after reading a ton on it, the fact that her blood sugar when fasting and eating low to very low carb each day still hovers in the Type 2 diabetes range is concerning. Metformin being a very well tested drug may be able to help her get over the hump, as it appears that she is so insulin resistant.

Has anyone else dealt with extreme insulin resistance? Her doctor says that her thyroid is finally stablizing.

[marcadav]

She's no longer on steroids at all, and hasn't been on them for about 1.5 years, it's just that when she WAS she gained 60lbs in about 2.75 months. The steroids were their lame attempt to control the pain in her herniated disc.

Calories shouldn't be a problem either, as she's around 1200-1400 daily, I can't imagine going much lower than that. I highly doubt that fat in the food is an issue either.

Again I'm not sure that drugs are the answer, but after reading a ton on it, the fact that her blood sugar when fasting and eating low to very low carb each day still hovers in the Type 2 diabetes range is concerning. Metformin being a very well tested drug may be able to help her get over the hump, as it appears that she is so insulin resistant.

Has anyone else dealt with extreme insulin resistance? Her doctor says that her thyroid is finally stablizing.

Two things:
1. Steroids taken for a length of time have the potential to hinder adrenal function. This can create a myriad of issues. You might want to google it, see if it applies and then address any issue found.
2. Low carb can increase fasting blood glucose levels. Have you considered buying a cheap meter and strips (Walmart has a meter for under $10 and corresponding strips -100 for $36) and checking postprandial BGL levels.
Here's a good site for blood sugar issues:
Blood Sugar 101

[Lily Marie]

How much protein is she getting? Eating too much - especially when not exercising causes it to be excessive and spike blood sugar levels. I think it turns into glucose, but not positive. All I know is that it DOES raise your blood sugar if you eat more than your body needs.

[Moochy]

You might want to visit Chirs Kresser's site, he has an excellent reputation for helping people in a difficult situation and is peer respected by the community.