I tried the paleo diet for athletes, but found my body couldn't even tolerate fruit. I don't think its wheat, cuz I get the reaction even with fruit. I've been eating a very low carb (i.e. ketogenic diet) during the week, and then allowing more carbs on the weekend when I ride longer. While I feel great during the week, am losing weight (finally) and can handle my commutes, its not working for long rides. I did try to increase my carbs the night before a longer club ride this weekend (had some rice and fruit with dinner), and then some yogurt with granola and banana for breakfast, and ate gatorade and gels throughout the ride, but I had two scary things happen after about 90 minutes (and after I sent my riding buds away cuz I couldn't keep up). At one point I was riding in the road and not shoulder, and asked myself, why aren't you in that wide shoulder, and told myself I thought it was too rough but when I looked at it, while I could see the road I couldn't discern its texture. I stopped to touch it, and then realized I better eat a gel and rest a bit before getting back on the bike. The problem is when you are confused its hard for your brain to decide if its safe to continue or not. Then further on I nearly rode in front of a car, but another car honked at me and made me realize what was happening so I could avoid a collision. At that point I took a very long rest, drank a lot of gatorade, ate a gel, but after about 30 miles I had to have my husband pick me up, I just didn't feel safe out there. It was like no matter how much sugar I would eat, it just wouldn't get into my cells.
I finally had my appointment with the endocrinologist today. I really liked him. The first thing he did was give me a modern glucose meter (for free!). It uses a lot less blood than mine, and you can even adjust the depth of the prick so I can test my blood easily and pretty painlessly. I picked this endocrinologist because he specializes in both thyroid and endocrine problems, and he clearly appreciated it when I told him that in the past when my thyroid was under good control so was my 'diabetes'. I have always been a borderline diabetic, borderline because as long as I was eating well and exercising, the tests would be negative or just slightly off, and then when I was diagnosed as hypothyroid I kind of blew it off and thought that was the problem all along. He told me that its important to find out why my glucose metabolism is disregulated. He had no problem with my controlling it for now with the low carb diet while we sort it out, but then that creates problems for cycling. Rather than just ordering a glucose tolerance test, he is going to order a whole battery of fairly complex metabolic tests (for example, there is another co-hormone that works with insulin inculin I think he said, that he thought might be off that is treatable) and then I'll go to a special clinic and spend the day there for all the testing (he said he is writing an experimental protocol, I thinks he wants to write a paper on me, he said that will also help with testing costs, since insurance won't pay for all the unusual tests). He said instead of just eating 100g of glucose, they will feed me a precise mix of glucose, protein and fat (like in real food), and then measure insulin, glucose, glucagon, inculin, and other hormones over 6 hours. Hopefully this way I won't get as sick as in a traditional glucose tolerance test and he'll still get the data he needs. In the meantime, I am supposed to monitor my blood glucose 1.5 hours after each meal and during exercise (no one will ride with me if I have to stop every hour to measure my glucose levels, but that's OK, I don't feel great having people with me that just worry about me). He also wants me to carb load more heavily prior to a long ride, by eating ~200 g of carb the night before, so I will eat high carb on the weekends when I do my long rides and low carb during the week, and again monitor my glucose levels. I am also going to go back to riding with one of those tanks on bike with gatorade in a sippy straw so I can drink small amounts more frequently (I had to do this before going on thyroid meds). The other thing he did was to change my thyroid medication. Even though my thyroid tests look good, he said I could still have a problem converting T4 to T3 (tests aren't sensitive enough) so he reduced my dose of T4 and supplemented it with bioactive T3, and we'll see if that improves my glucose control (T4 gets converted to T3 as needed by the body). He said he has a lot of patients that are really doing well on this (I used to take 175 ug of synthroid, now I will take 150 ug of synthroid and 5 ug of cytomel daily).



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