Difficult Situation-Physically & Mentally

[Frogbreath]

I apologize in advance for the long post.

I'm 57 and seriously obese - 251 lbs on a 5' 1" skeleton

I have Type II diabetes non insulin dependent & HBP controlled with meds.
I have bipolar disorder with anxiety that is mostly controlled by meds although the depression can still get pretty severe.

I got an adjustable gastric band (AGB) put in this past August and I slowly lost 30 or so pounds. It does enforce a limit on the volume of food I can eat and that has helped. I was LC before I got the band and wasn't losing and my theory was that I ate such a large volume that the massive amount of calories were overcoming the low carbs.

Now I've stalled out since Nov. Apparently depression prevents weight loss for me too. So many things raise my blood sugar that I can hardly manage it. Every morning it's between 170 and 190 no matter what I ate the day before (it's called dawning). First thing in the morning is the highest it will be all day, unless I eat something really bad - which I haven't done in a long time. By lunch time it's in the normal range, around 100, and in the evening it starts creeping up again. If I exercise to any extent it goes up and if I'm stressed it goes up regardless of what I eat. My doctor says that I'm making way too much insulin but my body isn't using it normally. He likes the low carb plan - except that it's no longer working well for me. I doubt that it will work while my insulin level is high.

Now that the depression has lifted for the most part, I'm ready to get things going again. I'm trying to follow the band rules as closely as I can: at least 3 ozs of protein first, then low starch veggies, and anything else after that, if there's room. I should have 3 meals like that a day and a snack or two. Some people with the band count calories and some count carbs and some do neither. People lose an average of 1 to 2 pounds a week. I'm way on the wrong side of that average. What can someone as insulin resistant as I am, and with a hair-trigger pancreas, do to make low carb work? I'm asking you guys because I have yet to meet a doctor or nutritionist who has a clue what to do. What would you do if you were me?

[Jr8Fan]

My best friend had gastric bypass. She was told to follow Atkins, to get her nutrition and to keep her sugar normal. She also found that as long as she followed the Atkins plan, she avoided some other problems, such as nausea, heartburn and diarhea.

I don't know if this will work for you, but it worked for her.

[Zuleikaa]

I apologize in advance for the long post.

I'm 57 and seriously obese - 251 lbs on a 5' 1" skeleton

I have Type II diabetes non insulin dependent & HBP controlled with meds.
I have bipolar disorder with anxiety that is mostly controlled by meds although the depression can still get pretty severe.

I got an adjustable gastric band (AGB) put in this past August and I slowly lost 30 or so pounds. It does enforce a limit on the volume of food I can eat and that has helped. I was LC before I got the band and wasn't losing and my theory was that I ate such a large volume that the massive amount of calories were overcoming the low carbs.

Now I've stalled out since Nov. Apparently depression prevents weight loss for me too. So many things raise my blood sugar that I can hardly manage it. Every morning it's between 170 and 190 no matter what I ate the day before (it's called dawning). First thing in the morning is the highest it will be all day, unless I eat something really bad - which I haven't done in a long time. By lunch time it's in the normal range, around 100, and in the evening it starts creeping up again. If I exercise to any extent it goes up and if I'm stressed it goes up regardless of what I eat. My doctor says that I'm making way too much insulin but my body isn't using it normally. He likes the low carb plan - except that it's no longer working well for me. I doubt that it will work while my insulin level is high.

Now that the depression has lifted for the most part, I'm ready to get things going again. I'm trying to follow the band rules as closely as I can: at least 3 ozs of protein first, then low starch veggies, and anything else after that, if there's room. I should have 3 meals like that a day and a snack or two. Some people with the band count calories and some count carbs and some do neither. People lose an average of 1 to 2 pounds a week. I'm way on the wrong side of that average. What can someone as insulin resistant as I am, and with a hair-trigger pancreas, do to make low carb work? I'm asking you guys because I have yet to meet a doctor or nutritionist who has a clue what to do. What would you do if you were me?I'm not surprised your weight loss stopped. It's winter and you're probably vitamin D deprived. Insulin, and blood pressure naturally rise in the winter, and weight loss naturally slows or stops. I suggest you add start taking these supplements in addition to whatever you're taking now which should include a good multivitamin with minerals (2 pills per dose).:


Twice a day
2-7 Vitamin D, 1,000 IU (more in winter or if you have vitamin D deficiency related problems such as diabetes, hypertension, insulin resistance, PCOS, obesity, digestive problems, cancer, etc.
2-3 Calcium with magnesium combo, 300-600 mg calcium and 150-300 mg magnesium per pill (a total of 1800 mg of calcium and 900 mg magnesium a day)
1 GTF chromium, 200 mcg
1 gymnema sylvestre, 400 mg
2 cinnamon, 375 mg

You should see a significant change in your readings and feelings within 7-10 days. Please closely monitor BG and BP readings from day 1 and be in contact with your doctor though because some have experienced more rapid improvements. Close monitoring is also required because medications need to be cut and medicating at same levels can put readings too low for safety.

Just my experience with others taking the above.

Oh, the D, calcium, and magnesium will take care of the depression also. I know you live in Florida but it's not a matter of warmth but of sun/light intensity. And if you're in the house a lot or customarily wear sunscreen or covered in clothing when you go out you're most likely deficient in vitamin D.

[taming]

Does the doctor who did the surgery have a nutritionist s/he works with? It sounds like LC is the standard way of eating following the procedure, so I would expect that there is a nutritionist or dietitian that does consultations for the patients post-op.

[AZDweller]

OK, just my two cents. This is not meant to set off World War III, just scientifically founded -- the scientific method and control vs. variable. Don't change everything at once. If you're going to try a supplement, try one at a time and see if it works. I'm not a big proponent of supplements, but I've found that psyllium husk capsules and a daily multivitamin have been helpful to me. The first for regularity and the second because my diet isn't balanced every day.

Lo carb has a wonderful effect on depression. The mood swings that accompany sugar spikes are awful. My husband takes antidepressants and has been in much better control since starting LC.

I would make sure that you don't try to do LC, low fat. Some people try that -- doesn't work and usually ends up stalling you. Do the program. For your own health, be on top of your blood sugar as much as possible. You want to keep your eyes and extremities, right? I think I would see about consulting with a nutritionist if one is available. Many of these things are complicating each other -- as one gets better, you will see changes in all of them. Dr. Atkins, in DANDR, describes metabolic syndrome so well. Even if you aren't considering a change in program, it might be a good read for you.

Slow and steady -- you didn't get here overnight and you won't get out of it overnight, either. :agree:

[manaburrn]

Every morning it's between 170 and 190 no matter what I ate the day before (it's called dawning). My doctor says that I'm making way too much insulin but my body isn't using it normally. Something's not right here. If you're eating low carb, and you have "way too much insulin" (which would cause your blood sugar to go way low), then where are these 170-190 glucose levels coming from?

[Jen B]

I'm a firm believer in natural remedies.

Apple cider vinegar can help blood sugar. Use Bragg's organic ACV with the 'mother' in it. I've even read that people taking diabetes meds have to cut them down after starting ACV. Vinegar pills aren't good. Go for the real thing. Here's a good article: http://www.mercola.com/2005/jan/22/vinegar_diabetes.htm

Cinnamon is another good aid for blood sugar. I like to use a teaspoon per day. http://www.mercola.com/2004/may/1/cinnamon_diabetes.htm

These are both metabolism boosters as well and cinnamon helps to suppress my appetite and cravings.

[otenn]

Cinnamon is another good aid for blood sugar. I like to use a teaspoon per day. http://www.mercola.com/2004/may/1/cinnamon_diabetes.htm

These are both metabolism boosters as well and cinnamon helps to suppress my appetite and cravings.


....ok, I'm curious! How do you fit the teaspoon of cinnamon into your diet every day? You can't just pop a teaspoon in your mouth! :) How do you get it in?

[Shreen]

Hi, I am a pharmacist, and some meds- including insulin, and glyburide or other sulfonylureas, make you gain weight. As long as you do not have any kidney disease, you should be on Glucophage (max dose, probably- also dec. appetite and inc. insulin sensitivity. Also a "glitizone" drug such as Actos or Avandia. You are young and these are the best meds for you. Be careful - you said you have HTN- any CHF?- some of these may be dangerous w/ CHF. W/ these drugs, your insulin needs will go down - continue to do LC. Unfortunately, bipolar patients and any psychiatric patients tend to be overweight for some reason. I have had depression and I know how horrible it is- I cannot even imagine a manic episode...

The more insulin you use, the more sugar needs you will have. In addition, "dawning" may be caused by nighttime HYPO- glycemia. If you are on too much insulin, at night you bottom out, your body compensates by breaking down glucagon from your liver, and you are HYPER- glycemic in the morning. Consider doing blood glucose tests four times daily and maybe once at maybe 3 AM- just to see any trends. You may need to decrease your insulin dose. If you need to tell me doses of insulin and/or meds, maybe I can help you. email me at shreenrx~adelphia.net.
Hope it helps (stay away from herbs- they may interact w/ your meds...)
Good luck!
Shreen

[Dodger]

After reading the Dr. Berstein 'Diabetes Solution', the high morning blood sugar readings are not unexpected. It is a natural phenomena and not something to get excited about. Reading that book was an eye opener to me on what has to be done to control diabetes. Anyone with diabetes or who wants to know more about diabetes should get the book.

[AZDweller]

Many anti-depressants make one prone to gaining weight. With all of your challenges, this might not be as easy for you as for some. But please stay with it.

[ProfGumby]

....ok, I'm curious! How do you fit the teaspoon of cinnamon into your diet every day? You can't just pop a teaspoon in your mouth! :) How do you get it in?


Howdy, can I take a shot at the answer to your question?

I add cinnamon to my protein shakes, to yogurt, over the top of LC ice cream, in ricotta or cottage cheese, on cream cheese on a tortilla(LC toast or LC bagel too) and I make a wicked, coconut milk custard type desert with cinnamon in that.

I do not eat any of these every day, but the idea is to have enough of my frequent foods, and occasional treats with the cinnamon added. In this fashion, I get about 1 teaspoon a day, minimum.

Hope that helps!

[alisbabe]

I'd also suggest a high dose of high EPA fish oil. I take it for depression and it's supposed to be effective for bi-polar too.

http://www.nofreudnoprozac.org/

[statjunk]

I'm sorry to hear that you are struggling to reach your goals. I hope that the information provided by others here can help you.

Tom

[Frogbreath]

Something's not right here. If you're eating low carb, and you have "way too much insulin" (which would cause your blood sugar to go way low), then where are these 170-190 glucose levels coming from?

It's caused by Insulin Resistance meaning my body doesn't use insulin readily. So high amounts of it fail to lower my blood sugar and at the same time my liver continues to release stored sugars at night. For a normal person that prevents developing hypoglycemia during sleep. Ironic, huh?

[manaburrn]

So theoretically speaking, if you go off carbs completely, your liver will eventually run out of the stored sugar, and your blood sugar will come down.... but then the excessive insulin will make you go hypoglycemic?

Oh, man :(

[Frogbreath]

After reading the Dr. Berstein 'Diabetes Solution', the high morning blood sugar readings are not unexpected. It is a natural phenomena and not something to get excited about. Reading that book was an eye opener to me on what has to be done to control diabetes. Anyone with diabetes or who wants to know more about diabetes should get the book.
I just ordered the book from Amazon. Have you read The Schwarzbein Principal? I wonder how their theories compare. I'm not too freaked out over the blood sugar readings, but I do suspect it's interfering with weight loss. Years ago I did LC and lost all excess weight easily. That was before I was lured into the whole wheat, vegetarian, soy bean nightmare, and, to be fair, a lot of carb binging. Even just 7 years ago LC helped me lose steadily. That was interrupted by a major life crisis and now I'm trying to find a way to deal with this again, but the rules have changed! Finding what works in life seems to be a moving target. :read:

[Dodger]

I have not read The Schwarzbein Principal. It's one of those books on my 'to read' list.

[SusanKH]

Frogbreath,
I'm diabetic, and have been for years. Glucophage is a wonderful drug, although I had gastrointestinal problems with it for the first 6 months. My bs readings are always higher in the mornings, no matter how I adjust my meds. I think some of us are just prone to it. However, it has not stopped or hindered my weight loss in any way. If you're not on it, I would seriously ask my doctor about it. It's also known as metformin (one is the generic name). Like the others, I encourage to keep trying. Depression is a terrible, terrible thing to deal with. But I do believe that getting some weight off will help, even if your depression is due to chemical imbalances. I wish I could help more, and please know that we all support you here.
Susan

[Wyvrn]

You say you eat protein and then low-starch veggies but where is the fat? You may find it impossible to get into ketosis without getting most of your calories from fat, especially saturated fat from natural sources like meat, butter and coconut.

Wyv

[KareninDE]

I'm not too freaked out over the blood sugar readings, but I do suspect it's interfering with weight loss. Years ago I did LC and lost all excess weight easily. That was before I was lured into the whole wheat, vegetarian, soy bean nightmare, and, to be fair, a lot of carb binging. Even just 7 years ago LC helped me lose steadily. That was interrupted by a major life crisis and now I'm trying to find a way to deal with this again, but the rules have changed! Finding what works in life seems to be a moving target. :read:

The elevated insulin levels will definitely interfere with weight loss, and may also have some negative impact on your depression. I didn't see a mention of exercise. If you're not already exercising regularly, you should start immediately. Exercise has a real, measurable positive effect on insulin resistance, and will generally help lower insulin levels. It also has been demonstrated as very effective with depression. Moderate or even long, slow exercise is better than very vigorous, especially at the start. You don't want to cause a lot of stress.

Been there done that with the vegetarian whole grain thing. I think for some folks it is really downright harmful. Keep up the good work. I think you can beat this.

Oh, I remember reading on another low-carb forum that diabetics would have a late-night snack with a few carbs, along with protein and fat. They said that helped give the insulin something to work on so they were less likely to hypo during the night and then have a big dawn effect bg rise. Don't know if that is still considered good advice, but it makes sense and may be worth trying.

Karen

[Try4Me]

You have a lot of unusual circumstances to try and find the "one" thing that will help. Try the meds your doctor says to take, and then try small meals throughout the day. My daughter had gestational diabetes and the nutritionist told her this would keep her insulin more leveled out. You should also get the book by Dr. Bernstein. At least the more knowledge you have the more you can help yourself. Good Luck!

[Frogbreath]

You say you eat protein and then low-starch veggies but where is the fat? You may find it impossible to get into ketosis without getting most of your calories from fat, especially saturated fat from natural sources like meat, butter and coconut.

Wyv

I just figured that out in the last 3 days just from reading different threads at this site. I "know" that saturated fat is a good thing...but there's that lurking fear I absorbed long ago when the low fat craze hit. Without really thinking about it I've put big time limits on saturated fat - and fats in general - only skim milk and lean meats. I can't be sure of course, but I did drop a couple of pounds this weekend despite not being perfect with the carbs. I actually had bacon with my egg yesterday morning...whoo hoo! I didn't have cravings later in the day and I feel better too - more energetic.