I was reading over at Lowcarber.org a couple of days ago, and ran into something interesting in the Atkins' section. Someone was asking if a long-term ketogenic diet had the capacity to "cause" insulin resistance and hypoglycemia. Her concern was because of an interview that Jimmy Moore had with Dr. Keith Berkowitz of the Center for Balanced Health.
Now I'm not completely sure "where" this interview came from, since I only have dial-up and can't listen to Jimmy's podcasts. So I'm just "assuming" that's what this is. The transcript for an interview Jimmy had with Dr. Berkowitz a little while ago. It can be found here, if you scroll down to post #8.
Like many of these forums, the response was a bit under the weather. Which always tends to make me want to shake some "sense" into these folks. As only ONE poster even addressed the true issue being discussed in that interview. Hypoglycemia. Everyone who responded to the original poster's question (up to the last response I read sometime last night, at least) got hung up on the doctor's use of the term "Insulin Resistance." Even though the doc didn't use it correctly.
There seems to be a LOT of confusion regarding Insulin Resistance, Hypoglycemia, Type 2 Diabetes, and the like. With a great many folks over there believing Insulin Resistance and Hypoglycemia to be exactly the same thing. Which they aren't.
Insulin Resistance is when insulin isn't doing it's job of shuttling glucose into muscle cells for energy, so glucose builds up in the bloodstream. The result of which is high insulin levels (since the pancreas keeps pumping out insulin until the body finally figures it out) PLUS high glucose levels. While hypoglycemia is when you are soooo sensitive to insulin that insulin works toooo well, and shuttles toooo much glucose into muscle cells that the glucose level in the blood drops quickly below normal. The result of which is NORMAL insulin levels, and LOW blood glucose. Sometimes dangerously so.
So on the one hand, we have Insulin Resistance, where your body is resisting the insulin you are producing. But on the other hand, we have hypoglycemia, where your body is basically going into metabolic overdrive.
The interview is a very interesting one, because despite the reactions of the greater majority of low carbing folks disagreeing with the idea that low carb "can" CAUSE hypoglycemia in those who have lost a great deal of weight on this type of program, I personally believe it's a very good possibility.
Since I've been going through much of the same types of symptoms the past 6 months or more myself.
Those of you who have been reading my blog for any length of time, know I've been chasing after all kinds of things over the past year -- from Kimkins to thyroid issues, to Lyle McDonald's Leptin theories, his PSMF and Flexible Diet programs, trying to narrow down what is wrong with me.
My weight loss has virtually come to a complete hault, due to hunger issues and cravings getting the better of me whenever I try to go back on Induction, or "anything" akin to low carb. And I haven't been able to get myself back into Ketosis lately either...not without suffering severe hypoglycemia attacks. Or what I'm "assuming" are hypoglycemic attacks. Most of you know, I've been getting downright SICK, in addition to being shaky, weepy, depressed, and craving things I haven't been tempted to eat for the past year and a half.
With refeeds NOT really "curing" the problems. At least, not so far. Oh...I feel BETTER when I refeed. BETTER when I eat at least 100g carbs per day. And I have more energy than I know what to do with. I feel pretty good, in fact. Vertigo is essential gone. But whenever I try to do anything less, whenever I try to go back to low-carb dieting, I get this kind of blood-shaking, buzzy type of feeling, (heart palpitations?), nausea, and I crash-and-burn every time. Without EVER going "into" Ketosis.
So I don't know if it's increased liver issues, (as Lyle McDonald suggested to a poster over on his older site) or hypoglycemia, or what. But for now...I'm keeping an open mind. Because I really AM having the problems that Dr. Berkowitz discusses in this interview. I lost 85 pounds in 2007, then came to a squeezing halt, with hypoglycemic symptoms ever since.
Does that mean low carb "causes" hypoglycemia? I don't know. But...from my own current understanding, the path to diabetes is Insulin Resistance/Syndrome X to Hypoglycemia to Type 2 Diabetes. It's looking like for some folks, low carb doesn't stop the progression of the disease. But I'm not putting myself into any boxes. I could be completely wrong.
So check out the lowcarber.org post, and let me know what YOU think--
Thursday, July 17, 2008
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6 comments:
Sorry you can't hear my podcasts, but I'll be airing a special two-part follow-up interview with Dr. Berkowitz the first week of August answering all the questions people had about the first interview, including the golden question of whether long-term low-carb "causes" reactive hypoglycemia and insulin resistance. You won't want to miss the surprising results. My podcast address is TheLivinLowCarbShow.com.
Perhaps it is weight loss (=lower bodyfat) that causes hypoglycemia and not lowcarb as such. I never had much weight to lose and induction level of carbs just make me feel ill. Could it be more difficult to get energy from body fat if you don't have a lot of it? If the body keeps on wanting to use carbs when there are none, wouldn't blood sugar drop as a result of it?
Interesting discussion! I'll be following your blog to see where it develops.
Hi, Vickie!
OnPoint and I are having a discussion about this very thing over at Jimmy's Menu Blog.
One of the confusing things is that hypoglycemia is one of the earlier symptoms of insulin resistance.
When we eat carbohydrate or protein, the pancreas releases insulin in order to store the nutrients. In some people, over time, their liver and then their muscle become resistant to insulin action. The pancreas responds by cranking out more insulin. Sometimes it overshoots the mark and glucose levels drop too low after a meal--hypoglycemia is the result.
More insulin, of course, eventually produces more insulin resistance. So the pancreas sends out even more insulin. The positive feedback loop continues until the pancreas reaches the limit of insulin it can produce. At that point, the person experiences hyperglycemia. There isn't enough insulin available to force glucose into the muscles, so it stays in the blood and blood sugar readings skyrocket. In other words, fullblown type 2 diabetes.
Speaking only theoretically, it appears to me that Jimmy Moore is in the early stages of insulin resistance. His pancreas is compensating but is overshooting the mark, and is producing too much insulin for a given amount of carbs and protein. His insulin goes up and stays up for hours, but his blood glucose stays about the same.
What to do? Eat less protein? Eat fewer carbs? Eat every 5-6 hours? Eat every 2-3 hours? Take a drug to block gluconeogenesis? I did #1,2 and 3 and it's working for me. But who knows if it's generalizable to other people?
Jimmy,
Thanx for the info.
Mariasol,
Thanx for your comments. You could very well be right about the "key" being fat loss itself, rather than anything specific to low carbing. Kindda like how inflammation issues correct themselves irregardless of the diet used to achieve the fat loss.
Hey Stargazey,
Thanx soooo much for stopping by! I was just 'about' ready to run you down since I'm having so much trouble trying to figure out where to go next with all of this.
I had forgotten that 2big is always talking about Insulin Resistance being a PATH. With fat cells being the last to become resistant to insulin.
So what you say here about the muscles, and then the liver becoming resistant in turns, makes sense. Since I hadn't reached the point where I was gaining weight or not losing when I first started having problems. Just ravenous hunger and cravings hitting me outta nowhere.
I'll head on over to Jimmy's menus and catch up on your discussion with OnPoint.
Thanx again.
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