Hemoglobin
 

I'm sitting in dismay. Wanting to howl over this.

I've been doing LCHF since May, and have lost about 28 lbs. Tuesday, I just had my hemoglobin checked and the doctor says I'm still in "pre-diabeties" stage at 5.7 (which is where I was a year ago)

WTF???

So what are some of the reasons I've not budged?

1. Can you post a few days meals so we can see any potential hidden causes?

2. Did you go same lab? Each one has slightly different cut offs for this test.

Deep breath- try not to get frustrated. I know it is hard when you do all the "right things" and your body doesn't cooperate. And hey, you aren't diabetic, so even staying just behold the threshold is nerve wracking at best, you are keeping it in check right now. You might want to come peruse diabetes sub forum down below.
I'm a type 1, but almost all the others there are type 2. Besides we have more in common than we think.

Hmmm. Not sure of the lab, done in the same network, but through different doctors. One by regular doctor, the other by gyno.

My typical day:
24 oz. bulletproof coffee; 2 tbl. of cream OR 4 tbl. HNH, 1 tbl. coconut oil, squirt Splenda Zero

About 1 or 2 pm:
2 eggs fried in butter OR scrambled with 1 tbl cream, w/ 2 slice bacon OR 3 links BrownNServe sausage

4 - 6 oz chicken/fish/pork or beef
2 cups broccoli/leafy veg with butter, OR salad with 2 tbl low carb ranch dressing
sometimes 2-4 oz. cheese

Occasionally (2 week) 1 oz. of macadamia nuts, OR 2 tbl. natural peanut butter on celery if extra hungry

Water

That sure seems like a good menu to me.
Do you have a home BS testing kit to see what's going on when?
I wonder what would happen if you ate your first meal earlier.
There is a syndrome, (can't remember the name) but your BS is high when you wake up and until you eat your first meal. Have you read about that one? There are tons of posts about it here, somewhere...

I just ordered a Ketonix. It hasn't arrived yet, but I'm hoping that will help me figure out if I'm doing things right. Im guessing I'm not be in ketosis.

Who knows. But it will have to send me in the right direction- I hope.

I'll search for the posts you mentioned. Thanks!

Oh about testing, what I meant was a blood sugar testing machine with strips. I bought one for about $20 and found strips for about $8. You prick your finger and drop a spot of blood on the strip, enter the strip into the little machine and presto, your blood sugar is measured.
It fluctuates throughout the day and maybe for a couple of days you can test several times throughout the day and log it to see if there is a pattern throughout the day.

I agree, the menu looks great.

I also second Meme's suggestion to purchase blood glucose meter. Keep a log of readings, so you can see patterns.

The syndrome she referred to is the dawn phenomenon. It is a left over from our caveman days- the liver dumps stored glucose into blood stream during early morning hours to provide you energy to go hunt for meal. Otherwise, you might just keep snoozing. This is a common problem for people with diabetes.
I use significantally more insulin between 5-9 am than any other time of day, even though I don't eat until 11-noon.

When I asked if lab was same. I mean the physical lab itself (the office that drew the sample). Each varies slightly for what the cut offs are, and vary in how readings are measured. So if you went to different offices, you aren't truly comparing apples to apples.

Final point- ketone strips won't tell you much for this purpose. Being in dietary ketosis does not necessarily mean your blood sugar is healthy. Also, you can have great blood sugars and not be in ketosis.

Again, keep in mind- you are doing all the right things. Keep doing them! You still aren't diabetic :thup:
If your blood sugar continues to rise, this is actually what you need to keep doing in addition to using whatever treatment your Dr selects. But either way, going back to old diet will DEFINITELY lead to diabetes in your case (you must be very insulin resistant to have he,ogle in reading that high on a ketogenic diet). So just stay on course, and hopefully you will see those blood sugars come down!

Do you exercise? Even just walking can make a huge difference.

My BG numbers stayed up until I gave up cow's milk dairy and eggs. Now, even my first reading (always higher because of dawn syndrome) is in the 80s.

You could try that. It takes time for all the crap caused by the dairy to leave the system, especially the HF dairy we use when eating LCHF. Such an n=1 experiment doesn't cost anything and I doubt it could hurt you.

Good suggestions, especially about more testing with a regular BG meter to watch post-prandial reactions to certain foods. It looks like you already have a restricted eating window too, using BPC, a good plan. Agree that 5.7 is nothing to worry about, labs do use different ranges but often "pre-diabetes" is 5.7 to 6.4 , so some minor variation from the sample or lab tech reading the results could move you from very lowest of the "pre" to perfectly normal.

And Chris Kresser has reasons that HbA1c might not be all that its cracked up to be, especially for LCers. Having a computer count amount of sugar stuck to RB cells seems to me a test open to variation. https://chriskresser.com/why-hemogl...eliable-marker/

You have done very well losing 28 pounds in 9 months, but it is also possible that you have not resolved your insulin resistance yet. A waist to height ratio less than half is one simple indication of IR, and at the same height, gender and near in age, it takes a while to get metabolically healthy.

Hang in there, you are doing well, don't let one tiny point on a large number range define you. Were other numbers OK? Was there a Fasting BG also lab tested? What about fasting insulin? (Not common, but some LC doctors add it to the usual lab tests). Lipids? Liver?
How to do feel, happy on your LC plan? Other health improvements? Check your health holistically and you likely are much better than 9 months ago!

Have you tried intermittent fasting? I didn't start testing my BG until I was 9 or 10 months into this WOE. I was surprised to find that my FBG and premeal BG was still in the low 100's. I started doing a couple of 18 hour fasts per week (no food after dinner and then skip breakfast). And with fear and trepidation for fear of hunger I even managed to do a couple of 23 hour fasts (dinner to dinner). My average BG dropped by about 20 points within 6 or 8 weeks. After that I worked on eliminating snacking between meals and getting a 12 hour fast in on most days. My BG has remained stellar ever since even though I am eating more carbs than I was 2 years ago when I started the fasting experiment. I can't prove that the fasting is what resulted in the wholesale drop in my BG, but the two things did happen in the same window of time.

I went through and go through same thing. The only thing seeming to help me is IF. Check out Dr. Fung if you haven't already. Some may not agree with IF but it sure helps those of us that struggle with diabetes. Only wished I had started IF long ago. Due to diabetes I also have had a struggle even losing weight. Now, I do basically 1 meal a day if that. If I need something in between it's usually an iced coffee or reg coffee with hwc or bone broth which holds me over till my next meal. I consume a nice LCHF, moderate protein meal and it satisfies me until the next day. Meal of eggs/bacon- I am full for an entire day. Key for me has been with no snacking and 1 meal a day I am able to better keep bs down to an acceptable range. As I lose weight I also find I get full much quicker which probably helps me too. When I first started this woe, think it took a long while just to clear my body of all the stored sugar, clean out a fatty liver and pancreas. IF has helped me tremendously with that. We are all different so what works for some may not work for all but this has just been my experience. The longer I have been this woe, the better and healthier I have felt but I have remained in a very strict Atkins Induction most of the time. I rarely go outside of that, at least not until I get to goal. 28lbs is wonderful, don't get discouraged.

Michelle, what a wonderful testimony to the power of a very LC plan + IF to reduce BG levels and reach a healthy BMI. Congratulations on all your many health improvements.

One thing you don't touch on. My husband is pre-diabetic or diabetic. Eating lc is what I credit with keeping him from developing full blown diabetes that needs to be medicated.

But what we have found that really impacts his readings is walking. We take a walk (maybe 20-30 minutes, nothing too rigorous, just around the neighborhood), after dinner. When we get busy and don't have time to walk for a couple of weeks, his numbers go back up to the high end of pre-diabetes. When we walk at least 5 times a week, his numbers stay low.

His doctor thinks it is just coincidental, as it is all still in the "pre-diabetes range". But we have noticed this pattern for the last five six years, so I think there is something to it.

Do you walk, or exercise?

All good advice!

My previous HbA1c was about 9 months ago, at fasting level. The recent one wasn't fasting. I have been doing IF. I eat dinner about 7 and don't eat again until about 1-2 next afternoon. I do have my bullet coffee in the morning though. Maybe that's knocking me off.

I used to walk a LOT on my treadmill. But sort of tapered off due to extreme boredom. But have started back up again outside. I need the stress release, and the sunshine (this time of year I go into a SAD decline -lack of light exposure, not American diet!) I've also recently gotten a therapeutic light.

My other numbers have done well, good things up, bad things down, but my doctor got weird that my LDL went up slightly, but I expected that, and am not concerned.

I know I'm doing well. Tightened up my carbs, and scale is moving again. Officially hit 30 lbs down today!

And, I'm a total wimp. I bought a glucose meter and bruised my finger with first usage. I HATE needles. So at this point, I'm going to take everyone's council; things aren't critical. Keep keeping on. I'm moving in the right direction, and not going to sweat it. :-)

The human body produces glucose from much more than just carbs, might be the cause of your A1C level. Google gluconeogenesis, it might be your answer.