Updated Labs and Gut Health

I didn’t get everything tested – just the basics, which is what I could afford right now.  Here they are, with the current results in RED.

3/27/2012 11/14/2012 9/6/2013 12/30/2013
Units Ref
Glucose 98 98 117 114 mg/dL 65-99
Hb A1C 6.4 <7.0
Uric Acid 5.9 5.2 5.4 5.4 mg/dL 2.5-7.1
BUN 19 25 18 18 mg/dL HIGH 6-24
Creatinine 0.69 0.73 0.57 0.6 mg/dL .57-1.00
eGFR 108 101 113 111 mg/dL >59
BUN/Creat Ratio 28 34 32 30 HIGH 9-23
Sodium 138 139 139 138 mmol/L 134-144
Potassium 3.8 3.8 4.5 4.1 mmol/L 3.5-5.2
Chloride 1.3 104 103 104 mmol/L 97-108
Calcium 9.3 9.2 9.4 9.2 mg/dL 8.7-10.2
CO2, Total 28 20 mmol/L 19-28
Phosphorus 3.6 4.1 4.0 3.4 mg/dL 2.5-4.5
Protein, Total 6.8 6.9 7.2 7.1 g/dL 6.0-8.5
Albumin 4.3 4.4 4.4 4.1 g/dL 3.5-5.5
Globulin, Total 2.5 2.5 2.8 3.0 g/dL 1.5-4.5
A/G Ratio 1.7 1.8 1.6 1.4 1.1-2.5
Bilirubin, Total 0.2 0.3 0.3 0.3 mg/dL 0.0-1.2
Alkaline Phosphatase, S 63 64 70 62 IU/L 25-150
LDH 142 137 137 143 IU/L 0-214
AST (SGOT) 20 14 12 15 IU/L 0-40
ALT (SGPT) 25 17 18 20 IU/L 0-32
GGT 14 14 27 20 IU/L 0-60
Iron 66 81 116 88 ug/dL 35-155
WBC 8.7 x10E3/uL 3.4-10.8
RBC 4.36 X10E6/uL 3.77-5.28
LIPIDS
Cholesterol, Total 222 297 270 274 mg/dL HIGH 100-199
Triglycerides 107 203 288 312 mg/dL HIGH 0-149
HDL Cholesterol 54 56 43 46 mg/dL >39
VLDL Cholesterol 41 58 mg/dL HIGH 5-40
LDL Cholesterol 147 200 169 166 mg/dL HIGH 0-99
T. Chol/HDL Ratio 4.1 5.3 6.3 6.0 HIGH 0.0-4.4
Estimated CHD Risk (Tot. Chol/HDL) 1.4 1.8 HIGH 0.0-1.0
OTHER
Vitamin D 34.2 67 (on 11/11/13) ng/mL 32-100
Insulin, Fasting 27.9 uIU/mL HIGH 2.6-24.9
hs-CRP 8.65 8.12 13.58 mg/L HIGH 0.00-3.00
THYROID 3/27/2012 11/14/2012 6/19/2013 12/30/2013 Units Ref.
TSH 1.7 4.01 1.55 2.92 uIU/mL 0.450-4.500
Thyroxine (T4) 4.1 8.9 7.4 6.9 ug/dL 4.5-12.0
T3 Uptake 32 25 27 24 % 24-39
Free Thyroxine Index 2.5 2.2 2.0 1.7 1.2-4.9
T4, Free (Direct) 1.04 0.97 ng/dL 0.82-1.77
Reverse T3 20.9 10.2 ng/dL 9.2-24.1
Triiodothyronine (T3) 126 120 ng/dL 71-180
Thyroid Peroxidase TPO Ab 10 8 IU/mL 0-34
Antithyroglobulin Ab <20 <20 IU/mL 0-40
Free T3 2.9 2.8 pg/mL 2.0-4.4

The first two columns (3/27/12 and 11/14/12) are when I was eating low carb with about 5% of my diet being carbohydrates for the first, and 10-15% for the second.  The third column (9/6/13) I was floundering around, trying on various diets/lifestyles.  At that time, about 20% of my diet was carbohydrate.  In November I started paying attention to Ray Peat and I increased my carbohydrate consumption to 40-50%, most in the form of simple sugars/fruit.  My blood sugars started soaring though, so a few weeks later I switched from simple sugars to starches and cut the quantity down to about 30%, while increasing protein.

So how am I doing?

Blood sugar – fasting glucose is high (but not over 126), HbA1C is not ideal, but is not in the diabetic range, and fasting insulin is high.  These factors suggest to me that I am more likely VERY insulin resistant, but not necessarily diabetic yet.  The fact that my body is still pumping out that much insulin is a good thing.  My pancreas isn’t dead yet.  I’m certainly very close to type 2 diabetes, if I’m not there yet…and I know I need to take this very seriously.

Thyroid – I was hoping eating carbs would help thyroid function.  However, if TSH is a reliable marker (and Ray Peat says it is) it looks like I did best with some carbs but not many.  Of course my triglycerides were happiest with none, but you can’t please everyone.

Lipids – OMG, I’m so about to die of a heart attack.  Triglycerides absolutely not going in the right direction…HDL was highest on low carb, LDL a bit better now than it was last winter but still not good.  I have been taking very small doses of T3 every day (6mcg), but that clearly isn’t enough to have an impact on cholesterol.  Will have to increase it.

Other – That CO2 number is terrible.  What happened there?

My ability to interpret labs is limited – please feel free to add your interpretation in the comments.

And in other news, I’ve decided my gut is completely torn up from 2 rounds of antibiotics this year, and that’s why I’m having trouble tolerating the potato starch.  I’ve decided I’m going to mix it with all kinds of junk and make it into BIONIC FIBER.  (<– Imagine I said really loud with an echo.)   I’m on day 3 of probiotics.  I’m going to fix my gut biome, dammit!  But most importantly, I have baseline data for my Resistant Starch Experiment.

My Body Is A Science Experiment

…and this experiment is failing.

Today I measured my blood sugar…every hour, from 8AM till 7PM, and documented what I ate, so I could learn the effect that my new higher-carb diet is having on my endothelium.  Well, I learned.  And it isn’t good.

8:00AM – Fasting blood sugar today was 138 mg/dL.

It’s been on the rise, and these days it’s high whether or not I eat starches.  I got up twice in the middle of the night last night and had a snack, trying to avoid the Dawn Phenomenon (stress hormones causing a large release of glucose into the blood).  Didn’t work…but it was better than yesterday!  Yesterday’s fasting blood sugar was 147.  These are the highest fasting blood sugar readings I’ve ever recorded…and I’ve been recording them with some regularity for the last 20 months or so.

8:45 AM – Breakfast: 5 grapes, milk with honey mixed in, 8oz of orange juice.  About 10 minutes later I realized there wasn’t much protein or fat there and I had 2 eggs scrambled in coconut oil. Here’s the breakdown of my breakfast:

  • Calories: 536
  • Protein: 22g (18% of calories)
  • Carbohydrate: 76g (54% of calories)
  • Fat: 17g (29% of calories)

9:45 AM – 1 hour after eating

  • Blood sugar: 295

WHAT?!?!

Holy Schnikeys!  I’ve never seen a number like that on my meter.  That’s like…really fucking high!  I washed my hands – cuz maybe there was a drizzle of honey stuck on my finger or something – and then tested again…still fucking high.

  • I felt fine, a little low energy.
  • Temp and pulse were good – 98.7 and 87, respectively.

10:45 AM – 2 hours after eating

  • Blood sugar: 186

Ok, now this is where I started to get worried.  It’s one thing to clobber my body with a bunch of simple sugars and have my 1-hour post-prandial reading be high (…or really fucking high…) but the 2-hour reading shouldn’t be over 140, even by pretty conservative standards.

Uh…hm.  I guess maybe I’m diabetic?

Well, there are ways to determine this for sure.  What a doctor will typically do, given my fasting blood sugar reading and my post-prandial sugar levels, is order a Glucose Tolerance Test (GTT).  This involves the patient ingesting 60 grams of easily-digestible carbohydrates and then measuring blood sugar every hour for the next 3 hours.  I had this done when I was pregnant at 28 weeks (and I failed…hello gestational diabetes).  Well, I don’t need no stinking doctor…I can measure out 60 grams of carbs and see what my body does for the next 3 hours.  And I’m going to do this tomorrow.  So stay tuned.

Ok, back to my freak out.

OMG OMG OMG…diabetic?  Like for reals diabetic?  Without the “pre-” in front of it?

Anyway, on with my day.

At this point I was questioning everything.  Maybe Ray Peat is brilliant but doesn’t really know shit about impaired blood sugar management?

11:45 AM – 3 hours after breakfast

  • Blood sugar: 112 (whew…at least I’m prolly not gonna die TODAY.)
  • Temp: 98.8
  • Pulse: 86
  • Blood pressure: 141/89
  • Felt ok, no hunger, low energy

12:00 Noon – Ate lunch.  Decided to do another test.  My body didn’t like simple sugars much so how about complex carbs?  Ate a really big meal of the following:  7oz boiled potatoes, 3 T. butter, 3 T. sour cream, an egg, and some cheese.  The meal was 52% fat, 39% carbohydrate, and 9% protein.  And a lot of calories.

1:00 PM – 1 hour after eating

  • Blood sugar: 94

Wha?  What the hell is that?  I’m diabetic dammit!  Where’s my 3-figure blood sugar reading?  Are potatoes some kind of miracle food that lowers blood sugar?

  • Temp and pulse remained steady at 98.6 and 88.
  • Felt ok, no hunger, a little lethargic.

2:00 PM – 2 hours after eating

  • Blood sugar: 133.

My notes next to this reading in my notebook say, “Weird.”

I guess it’s not that weird though…the huge amount of fat I put on the potato slowed the absorption of the sugar into my system.  Didn’t hit at one hour, it hit at 2 hours.  But even that hit is pretty mild.

3:00 PM – 3 hours after eating

  • Blood sugar: 125
  • Temp/pulse: 98.6/88
  • Hunger – 0

4:00 PM – 4 hours after eating

  • Blood sugar: 113
  • Temp/pulse: 98.8/84
  • Hunger – 0

5:00 PM – 5 hours after eating

  • Blood sugar: 102
  • Temp/pulse: 98.8/85
  • Hunger – 1

So summary up to this point:  Eating simple sugars gives me the blood sugar of a diabetic.  Eating potatoes with lots of fat keeps me satiated for 5 hours and doesn’t have much impact on blood sugar.  Not what I would have expected!  And then….

5:45 PM – Ate dinner.  More potatoes (4 oz), 1 T coconut oil, 1 T sour cream, and an egg.  The meal was 61% fat, 11% protein, and 27% carbohydrate.

6:45 PM – 1 hour after eating

  • Blood sugar: 161

Huh…well, maybe I needed to really douse those potatoes in fat the way I did at lunch to suppress the rise in blood sugar?  Whatever.  So confusing.  No fun when your experiments aren’t replicated.

Didn’t get to check my blood sugar at the 2 hour mark because I was putting my little girl to bed, but I checked about a half hour later.  it was 125.

Overall summary:  Simple sugars make me diabetic.  Potatoes aren’t magical after all.  Fat is magical but only in extremely large quantities.  Interestingly, the potatoes and massive quantities of fat were so satisfying I ate about 500 calories less today than yesterday, with no hunger.

Going Forward:  It’s time to get serious about managing my blood sugar.  I’m going to do the homemade GTT tomorrow, just to get a baseline, and then after that I’m going to be limiting carbohydrates to about 15g per meal. I’ll also be exercising most days – probably a combination of light cardio (e.g., walking) and lifting weights.  I’ll continue eating Peat-friendly foods, and I’ll continue tracking my temps and pulses.  If they suffer or if I start feeling depressed most days I’ll think about adding T3.

On a side note: One thing is for sure….No matter what, I’m going to keep eating liver.  My skin looks amazing!  Love that Vitamin A.  Old acne scars have even disappeared.

Will report the results of my Glucose Tolerance Test.

Today I’m thankful to have the time, the means, and the intellect to be able to experiment like this and interpret the results.  I’m a very fortunate person indeed.

Tomorrow is my favorite holiday.  Happy Thanksgiving.

The Slow Boat to Optimal

As usual, I don’t have a whole lot of time to write.

Nine minutes, actually.

Had Cold Bath #7 yesterday.  The tub in the basement is staying pretty cool, particularly since it’s in the 80s outside this week.  Yesterday the water started at 61 deg F, and after my 30 minute bath was 63.  I’m barely even cold after these baths now – I’d say I feel cool but definitely not chilled.  On Dr. K’s forums people talk about feeling uncomfortably chilled for 6 hours after their bath.  Granted, they’re using water that’s about 10 degrees colder than me (simply because I haven’t bothered to figure out an economical way yet to generate ice).  Other folks are also having much more of a detox reaction than me.  Again, I’m sure it’s related to how cold the water is.  It seems to me, particularly given that there’s no research on this stuff yet, that people could be experimenting a little more.   Maybe shooting for skin temps of 50-55 deg F isn’t ideal for everyone.  Wouldn’t it be better to have slower results with less detox and less problematic chilling throughout the day/evening/night?

I’m encouraged in this line of thinking by Ray Cronise, who says that benefits can be had at temps as high as 80.  I guess I’ll continue my n=1 and see if there are indeed benefits to slower, warmer CT – getting acclimated to 60 degrees before I attempt 50.  I’m going on vacation in a few weeks, and didn’t want to be in the midst of a hormonal detoxy mess during it.  I’ll probably add ice to the water when I get back.