New Plan 3.0

I’ve been eating starches for almost 2 week now, and they make me feel like taking a nap. Every time.  Some of the common reasons folks get tired in the middle of the day are sleep deprivation, lowering of stress hormones, and food intolerance.  Hm…There’s no way I’m this sleep deprived.  There’s no way my stress hormones are super-high and the starches are lowering them, thus revealing my “true fatigue” (cuz if that were the case, sugar would have made me sleepy too). There’s no way I’m intolerant of every kind of starch…is there?  Is it possible white potatoes, sweet potatoes, rice, oatmeal, and gluten free bread/pasta are all making me tired because my body is completely intolerant to all of those foods?  No.

I don’t know why this is happening, but it sucks.  I can handle about 1/4 cup of potatoes with a meal before I get too tired to function.  And even then I don’t have much energy.

So my conclusion – for now – is that I won’t find the solution to these problems in my diet…because EVERYTHING (with the exception of maybe milk and dill pickles) seems to be killing me or killing my enjoyment of life.  Or both.

So here’s my new plan:

I’m going to focus instead on exercise.  The last time I got in the habit of bicycling every day my blood sugar improved dramatically, dropping to within normal ranges within a week. I stopped because it got cold outside and because I was afraid my slowing pulse meant my thyroid wasn’t happy.  Things are more dire now….because now I have diabetes, for realz. Uncontrolled diabetes.  A couple days ago my fasting blood sugar was 155 – not an all time personal record or anything, but too flippin high.  When I first started eating starches my fasting blood sugar dropped to between 110 and 120 for a few days (don’t know why) – now it’s above 130 every day.

Yesterday I started biking.  I biked today too, and will tomorrow.  And the next day.

So what to eat?  For now, mostly Peat-friendly foods, without much of a plan. Someone on Facebook linked to this interesting study about saturated fats causing greater insulin resistance than monounsaturated fats.  They found that among people who ate less fat than the median (I think it’s less than 37% of calories, but I’m not sure and don’t have the full-text of the study), monounsaturated fats (e.g., olive oil) promoted insulin sensitivity, while saturated fats caused greater insulin resistance.  Can’t say I’ve ever heard that before.  I do eat about 40% of my calories in the form of saturated fats right now, so it may be a good idea to try substituting some olive oil, and reduce fat overall.  So that’s what I’m going to do. I’m not going to be crazy about it, but I’ll stop adding fat when its not necessary, and swap out some of the saturated fat for a while.  Olive oil has more PUFA than either butter or coconut oil, but that’s just going to have to be ok.  For now.

I predict my fasting blood sugar will be in the 90s within 2 weeks.

My resistant starch + probiotics experiment continues.  I’m so scared to up my potato starch intake because of the extreme GI distress it caused me before.  But I must.  Maybe tomorrow.

If my blood sugar isn’t under control within 1 month, I’m going to see a doctor and get medication.  I feel like my time to noodle around has run out.

I’m so tired from eating starches – even just 1/2 cup of potatoes or rice – 15g of carbohydrate – that I find myself avoiding them.  Low carb is no good for my thyroid.  High sugar no good for my triglycerides.  Out of time, out of ideas.  If exercise and olive oil don’t fix this very soon I’ll have to give in.

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.

Train Wreck

Fasting blood sugar this morning: 143.  Not awesome.

Weight steady for 6 days straight at exactly 207.5.

Still having hot flashes.  Is it possible it’s completely unrelated to the niacinamide/aspirin regimen I just started?  How could that be when the hot flashes started right after I started taking these supplements 3x a day?  Well, to be accurate they started 3 days after I started taking them, exactly when I increased the niacinamide to 250mg 3x/day from 100mg 3x/day.  They’re annoying now.  I can’t seem to correlate them to anything.  They happen in the middle of the night, right before eating, right after eating protein, right after eating sugar, an hour after eating sugar…If this was a stress response related to not enough sugar I think it would be prevented by eating it, right?

I’m starting to feel discouraged.

I started the niacinamide to address my ridiculously high triglyceride level.  However, various sources around the web say that niacin (NOT the non-flushing niacinamide) is more effective for this.  And apparently both niacin and niacinamide can cause higher blood sugar in diabetics (yup, got that too).  I feel like I’m completely fucked!  I mean, I’m trying to fix one thing and it’s making the other thing worse…and I’m not even sure it can possibly help the first thing, plus weird hot flashes.  WTF IS GOING ON WITH ME?

I haven’t even told you the best part yet.  For the last few months I’ve been feeling a sort of pressure under my left ribcage.  It had recently been turning into discomfort, and a little bit of pain throughout my upper torso. Research on the web suggested in might be an enlarged spleen, which can signal that other organs (like the liver) are having some kind of problem. That’s why I got labs done a couple weeks ago, including a complete blood count (CBC) – to look for elevated liver enzymes or other indicators that some organ might be struggling or fighting an infection or something.  After seeing those triglyceride numbers I was motivated to stop with the starches (again) and started eating a low fat diet – because hell, I’ve tried everything else, right?  (Well, and also because Ray Peat suggested it might be a key to lowering my blood sugar.)  Well, since I’ve been eating lower fat the pressure under my ribcage has gotten better – it’s not gone, but I’d say 75% improved, and the pain is gone.

I consulted Dr. Google again today, and it turns out high triglycerides can cause inflammation of the pancreas.  Definitely when trigs are SUPER high, like over 1000 mg/dL, but who knows – maybe when lower but still high (like me)?  Symptoms of pancreatitis: pain/pressure in upper abdomen, radiating to the back, as well as other things like nausea (which I didn’t have).  Holy crap – so now my pancreas is about to explode?  Recovery from mild pancreatitis involves a low-fat diet (maybe that’s why mine is helping?) and medication to reduce triglycerides.  Oh, and stop eating sugar and fat.

I’ve decided to get another fasting lipid panel done tomorrow, to see if I’m on the right track.  Our local health department will do it for $20, and you get the results right away….so I’ll be following up on this tomorrow.  If things are NOT even a tiny bit improved after abstaining from starches, eating lower fat, and taking niacinamide and aspirin 3x a day, I’ll be seriously reconsidering the path I’m on.  I FEEL better with a Ray Peat inspired diet, but if my labs continue to suck I’m going to have to change directions.

Here’s my diet breakdown today:

crono

Carb/Protein ratio and Calcium/phosphorus ratios were short of ideal today, and fat was a little too high.

And did I mention it really pisses me off that niacinamide raises blood sugar!?

Crap.

High Carb Low Fat – Day 7

Fasting blood sugar this morning: 125.  Heading in the right direction.

Hot flashes – almost gone.  Had 1 early this morning, and one about 5 minutes ago.  I completely skipped the niacinamide today in order for my body to stop doing whatever weird thing it was doing. I was feeling achy yesterday and today, as well as fatigued and a little irritable earlier today – around 7:00PM all of that stuff went away.  I’m wondering if the problem may not have been the niacinamide itself but some extra ingredient in the tablet. I did go ahead and buy pure niacinamide powder and received that in the mail yesterday…but over the past week I’ve been taking these tablets because I already had them. The ingredient list on the bottle states that it also contains “cellulose, stearic acid, silica, and magnesium stearate.”  I’m suspicious because niacinamide has a very short half-life, like it can be measured in minutes (about 45).  250mg was not a particularly big dose, even 3x a day.  I just don’t think the niacinamide itself would have continued to be problematic all the way into today.  Oh well…I’ll be increasing slowly to see if the hot flashes and other symptoms return. Starting tomorrow I’ll be using pure niacinamide powder – no weird ingredients.

Macros and nutrition today:

crononutrients

I really felt like I needed more fat today, so I did have a little more than I’m shooting for these days.  Fat was 27% of calories.  Calcium to phosphorus ratio wasn’t awesome today – I was about 600mg of calcium short of a 1:1 ratio.  Carb to protein ratio was not quite 2:1 – I was short about 30g of carbohydrate.  I could probably just go drink some juice…but that’s getting silly.

Liver for dinner tonight.  I have to say, soaking liver in milk makes it so much better.  I got out of the habit of doing that for a while and liver was starting to really bother me – the smell, the taste, plus sometimes I’d feel nauseated after eating it.  Then a few weeks ago I started soaking it in milk for a few hours while it thawed in the refrigerator, and then rinsing the liver before cooking it.  No more icky smell and the taste is milder.  Today I actually ate it raw.  Just easier that way sometimes.  Washed it down with a cold glass of milk.

Till tomorrow.

Update: I woke up at 12:30AM hungry, so I added 1/2 cup of orange juice and 1oz cheese to the above totals. It might make sense for me to post these the following day, to ensure all food consumed is accounted for.  But really….by the next day I don’t want to think about what I ate yesterday.

High Carb Low Fat – Day 5

Fasting blood sugar this morning was 128 – not as low as I’d like to see.  Maybe 55g of fat a day (my average the last few days) is too much to make a difference with blood sugar?  Last time I attempted to reduce fasting blood sugar by cutting fat (with success) I was averaging a little lower – like 48g.  That’s not a big difference…hard to say. Without eating starches it’s difficult to keep fat low.  I have to eat frequently because the stuff I’m eating just seems to burn up quickly, leaving me hungry otherwise.  All in the name of science.  I’ll just continue for now.

Here was my diet and macros today:

crono

Did ok…maybe too much white sugar rather than fruit…Carbs to protein was 2:1.  Calcium to phosphorus was a little short of 1:1 (1724mg to 2048mg).  I seem to consistently fall short 300mg.  Fat was 21.6% of total calories.  One question I seem to get a lot is how come I’m not eating more vegetables?  My answer to that is why would I?  I like veggies if they’re bathed in butter and cheese…otherwise not so much.  And nutritionally it’s not hard to get the nutrients in vegetables from other sources.  As an example, here is the nutritional breakdown of what I ate today:

nutrients

See all those orange bars that are completely filled up?  Those are nutrients that I have consumed enough of today.  Less than 5 grams of PUFA (usually I shoot for even less than that).  All amino acids.  I fell short with folate (only had 92%), iron (lower iron is a good thing), manganese (I’m not actually sure where you get manganese), and potassium (only 92%).  And to be fair, I am supplementing several of the fat-soluble vitamins (A, D, K, and E).  I’m not that worried about it though because I eat liver once a week and stock up on all of these things.  So…why eat veggies unless you really like them?  I guess they might fill me up a little…but fruit actually fills me up just as well and keeps my energy level high too.

It’s no accident that the foods I’m eating are high in nutrition. That’s why Ray Peat recommends them.  My diet is by no means a perfect Peat diet – he probably wouldn’t be in favor of chicken or ham (both animals are fed soy and corn and are therefore relatively high in PUFA) but I do eat the lowest fat organic versions of these items.  I’m not sure how he’d feel about the 3 Musketeers bar.  I was out flying kites with my daughter and that’s all there was to eat nearby.  Again with needing to plan better.  Still, could have been much worse.

I increased niacinamide to 250mg 3x a day yesterday, and since yesterday I’ve been having hot flashes.  I’m familiar with the feeling – I had them when I was taking fertility drugs to get pregnant, and again after quitting the Wiley Protocol, when my estrogen levels dropped.  I wonder if its having some effect on my estrogen?  Then again, this is niacin – even in the form that doesn’t cause a “flushing” reaction, I suppose it could be warming me up. I’ve been putting on and taking off my sweater about 10 times a day.  We’ll see if it continues.  It’s not completely unpleasant…just something I’m noticing.

Overall I feel great.

Update: I got hungry before bed and ate more after posting this.  I won’t be obsessive and update all of my new totals, but I will say my new carb:protein ratio is now a little better than 2:1, my calcium:phosphorous ratio is slightly improved, total calories is 2367, and 22% of calories came from fat.

High Carb Low Fat – Day 4

Well, it took a few days, but my fasting blood sugar was again down below 120 this morning.  The scale is down a few pounds too, but too soon to tell if that’s a trend – those pounds come back every time I eat starches and go away every time I stop.

You know, it’s really hard to eat low fat. I was so darn happy to be able to eat gobs of fat when following a Paleo diet, and then when following a Kruse diet, and then when following a Nutritional Ketosis diet, and then when just eating whatever the hell I wanted.  No wonder everyone hates that stupid food pyramid, with that teeny tiny box at the top with a teeny tiny stick of butter sitting in it.  Well, that and the fact that it doesn’t work because of all the poisons taking up the biggest section.  But I digress.

Here’s my stuff for today:

crono

Carb to protein ratio – 2:1

Calcium to Phosphorus ratio: almost 1:1 (1964mg cal to 2195mg phos)

Fat: 21.7% of calories today.

 

High Carb Low Fat (HCLF) – Day 2

My stats for today:

crono2

Did better today keeping meat consumption (and thus phosphorous) low.  Calcium:Phosphorous ratio today was just under 1:1 (2095mg cal, 2161mg phos).  Had almost a 3:1 carb to protein ratio – that’s a first for me.  I’m struggling a little to eat enough sugar – I just don’t gravitate toward it the way I do to salt and meat.  I realize that marshmallows aren’t ideal food, given that white sugar contains no nutrients other than, well, sugar for energy.  It’s an easy food to take with me when I go out though, and it’s a nice combo of carbohydrates and gelatin with almost no fat.  Fat was a little higher than ideal today at 23% of total calories consumed, but still pretty low.

Plan of Attack

I’m very much back on track now…inspired by my last set of not-so-hot labs.

My short term goals are as follows:

Maintain a higher-carb, lower-fat diet in order to reverse my type 2 diabetes and reverse my abysmal lipid panel.  Rationale:

  • Lower fat to address high blood sugar (<20% of total calories, or in the neighborhood of 40-50g/day).  My dabbling in low-fat eating in the past month or two suggests that Ray Peat may be on to something when he talks about the Randle Cycle.  He says glucose oxidation is impaired by a high fat diet and/or fatty acids in the blood stream.
  • Higher carb in order to reduce stress hormones (namely, cortisol) (>250g carbohydrate) – Nearly all in the form of simple sugars – no starches, as those make me depressed, with the goal of eating at least a 2:1 carbohydrate:protein ratio.
  • High calcium intake (nonfat dairy, most likely), low phosphate intake (less meat).  I’m going to shoot for a 1:1 calcium:phosphate ratio.
  • I’m not going to make any effort to restrict calories.  That’s stressful and no fun.

Change my supplement routine to include the following:

  • Aspirin 100mg 3x/day
  • Niacinamide 100mg 3x/day
  • Vitamin K2 1mg 3x/day
  • Cynoplus (T3/T4 combo) increased from 1/4 tab daily to 1/4 tab 2x a day.  I may increase further in a few weeks, but that’s it for now.

The aspirin reduces inflammation.  Niacinamide inhibits the release of free fatty acids into the blood, and vitamin k2 ensures that blood clots normally despite the aspirin, and that calcium goes into the bones rather than the soft tissues.  Cynomel provides thyroid hormone that I don’t seem to be making enough of (evidence: total cholesterol of almost 300).  I’ll continue to take Vit D (5000 IU), Vitamin A (2500 IU), and Magnesium Glycinate.

Knowing that I have a tendency toward poor planning and then eating whatever’s available, I’m going to create some accountability for myself with this blog.  I’m going to post a screenshot of what I enter into Cronometer every day.  Here’s today:

Crono1

This will make it difficult for me to rationalize eating things that don’t support my goals.  Also it’ll force me to take a critical look at what I’m eating each day so I can learn from it and do better.  Today, still too much meat…instead of chicken breast I should have had more dairy or something with gelatin in it.  At the time I just wanted to stop feeling hungry – a big dose of meat does that well.  Time to learn new strategies.

Macro % today:

  • Protein: 30.9%
  • Carbs: 50.4%
  • Fat: 18.6%

More to report tomorrow.

Physics

I’ve been known to say that for every diet, there’s an equal and opposite binge.  At least, that’s always been my experience.  When I dieted down to a size 10 for my wedding 7 or 8 years ago, the regain began as soon as my honeymoon.  Within 4 months I was back up 35 pounds to my previous weight – about half the time it took me to lose it.

Anyway, I think the same can be said of the stomach flu.  Every stomach flu has an equal and opposite refeed to return the body to a state of homeostasis.  I am just not stable right now – I’ve had serious cravings for salt, starches, and protein.  It’s been impossible the last 2 days for me to eat all the sweetened milk and coffee I’d been living on for weeks prior.  So what I’m going to do is indulge my cravings for a few days and wait till they die down again.  At that point I’ll give low-fat a go again.  In the meantime I’m going to keep tracking everything so I can attempt to draw conclusions as to which factors in my diet are at the root of my hyperglycemia.

Oddly, this morning my blood sugar was 100.  That’s after 119 grams of fat yesterday (about 2x as much as I was shooting for).  So, things are not clear right now at all.  I can only conclude there’s an equal and opposite reaction going on as my body recovers from being sick.

Next post: How I feed my kid.

HSLFDE – Day 8

Day 8 of the High Sugar Low Fat Diabetes Experiment.

Blood sugar this morning: 130.

Confounding variables: 3 or more

I started this experiment thinking the only thing that could get in my way was my own inability to tolerate endless sweet beverages.  Of course, that was silly.  I got a stomach virus (variable #1) that lasted 3.5 days, which ran my body ragged and caused a chain reaction of variables resulting in, among other things, eating starches (variable #2), lower appetite for dairy (#3), and higher appetite for fat (#4).

So now my blood sugar is high again and I don’t know why, exactly.  But I shall not beat myself up about it – all there is to do is get back on track.  So I’m back to shooting for fat being around 20% of calories (or less).

My weight is back up to 207 today – still a net loss.  We’ll see what happens next.