Anyone here on Synthroid?

[Triskeliongirl]

TC Trek, indeed many endos don't recognize combo therapy, but I think its a lack of current education. My internist had referred me to a 'group' and then when I looked on one of the thyroid lists, I found one member of this group on that list as being open to combo therapy, so I made my appointment with him. He was willing to try it, given that I was symptomatic despite normal TSH. But, he was also smart to look for other underlying reasons for my weight problem, and found the impaired glucose tolerance. I always had just borderline high fasting glucose, but when he ran an OGTT it really showed up. Then we had my insulin measured throughout an OGTT and found out that my problem is that I undersecrete insulin, not that I am insulin resistant. THis is a bit unusual, most adult onset diabetes is due to insulin resistance but I participated in a research study by one of my colleagues who found that in fact I am unusually insulin sensitive, but just undersecrete (so I am more like a type I than type II diabetic, accept I make enough insulin to maintain glucose homeostasis in the absence of a glucose challenge). On the low carb diet, coupled with exercise (which increases number of glucose transporters on the cell membrane) I can maintain glucose homeostatsis.

In terms of low carb diet and exercise, yes, I eat ~30g of CHO a day, mostly from non-starcyy veggies. The rule is that I don't eat anything that lets my blood sugar go above 120, 30 min. after meal, and not be back under 100 2 hours after meal. In the beginning I also felt bad when I exercised, until I started learning how to use alternative fuel sources on the bike: fat and amino acid metabolism. It takes a bit of time, there is a training effect. I also consume carb free protein shakes (made w Jay Robb's whey protein powder) on the bike. These contain a mix of pre-digested and undigested proteins.

The idea (and remember I am a biochemist) is that the amino acids get deaminated to carbon skeletons, which are then TCA cycle intermediates that can be burned for energy in the muscle. Plus, they can also SLOWLY get converted into glucose by gluconeogenesis, but at a slow enough rate that it never generates a high blood sugar spike, yet still gives me glycogen stores. As intensity on the bike goes up, the ratio of carbs to fat burned does too. SO, as long as I ride at moderate intensities I am fine. I just can't handle really fast accelerations or sprint finishes, that kind of thig (basically going anaerobic) but I can hold a respectable pace in a group ride, even do a century without consuming any carbs. In addition to these shakes, I also consume almonds on longer bike rides.

It is also important to not try to do both low carb and low fat. I eat plenty of fat, and it's critical to eat plenty of protein (at least 1g/lb of LBM). I choose mostly 'healthy' fats (that is I eat a lot of fish, olive oil, etc.), but I am not afraid of red meat either. I have low triglycerides, cholesterol, etc. The high protein is important to slowly replenish glycogen stores and give glucose to your brain, but its also important to preserve lean body mass when dieting. I lost 35 lbs, but mostly fat, so now even though I weigh what some may consider a lot (140 lb) I can wear size 4-6/Small clothing.

I also FEEL absolutely great. If I eat carbs, my brain would go into a hyperglycemic fog, so I am much more clear headed and have great energy eating this way.

[tctrek]

OK - so I have high "BUN" scores on blood tests and take Metformin - 1000 MG twice a day. My sugar levels are ok as is cholesterol, potassium, etc.
So, I'm thinking I *should* be able to adjust to the low carb diet and maybe I just need to give it more time. I was drinking EAS Carb Control protein drinks 2-3 times a day as my "snack". These have 5 grams of carb each, but only 1 g of sugar. I was

I got scared when I was going out to do a 45 mile ride yesterday without carbs and fell off the wagon and ate carbs all day. I just didn't see how I was going to make it through the day on Protein.

I guess I'll give it another shot next week.

[Triskeliongirl]

You didn't say you were on metformin. That is the problem. If you are on metformin, you need to do the low carb diet under a doctor's supervision. Probably your doctor will need to lower you medication. If you don't ingest any carbs, then the metformin will make your blood sugar fall too low since your dosage was prescribed assuming you would be consuming a certain amount of carbs, which may explain why you were feeling bad.

PLEASE, ONLY DO THIS UNDER A DOCTOR'S SUPERVISION. You might want to read the book Dr. Bernstein's Diabetes Solution, and then discuss this dietary appproach with your doctor if it appeals to you. Also, what I do won't work so well on metformin, since it will inhibit gluconeogenesis.

[tctrek]

Thanks! I will definitely talk to my doctor about it before I try anything.