A physician friend of mine answered a question I had asked.
Dear Brian,
Now to your insulin question: (long answer offered before reviewing your material)
My insulin level was 3 after a 72 hour fast. The question is How low can you go?
As I said, Normal values, especially in America, are no longer my ideals!
Protein in an intact stomach can raise the insulin levels.
Fasting, of course, is pretty much guaranteed to lower it.
Jason Fung, MD is a Nephrologist in Toronto, Canada.
I have been following his blog weekly for about 4 years -
https://idmprogram.com/blog/
He is especially interested in insulin, DM2 and fasting.
He was treating DM2 (800 patients) last year initially
with extended fasting (10 to 14 day only water and vitamins),
especially if the patient is over weight.
(His treatment may be different this year.)
He is very critical of current medical treatment of diabetes (DM2)
(a nutritional disease with a total body hyperinsulinemic state
that should not be treated with insulin injections, in pursuit of "normal BLOOD sugars")
I preordered his
The Complete Guide to Fasting:
Heal Your Body Through Intermittent, Alternate-Day, and Extended (2016)
and following the protocols in this book,
I have successfully completed some "extended fasts"
(5 - 72 hour fasts, 4 - 120 hour fasts and 1 - 240 hour fast.)
It becomes easy to maintain an only water fast after the first day or two.
Strength, mental clarity and energy levels are fine
(watching for hypovolemia, of course)
My weight comes down dramatically,
and this new found power to control my weight
has worsened the "Emotional Eating" component of my weight problem -
I am now cheating more because I can lose it later.
My comment in purple: Bob I am worried about the nitrogen balance with fasting.
________________________________
My question about your Uric Acid is from another book I liked,
older (2012) but also by an independent thinking MD.
I take 500 mg Vit C (Costco chewable) daily in two doses
and I am lowering my uric acid (per Dr. Johnson's suggestions)
with Allopurinol 300 QD (partly for hyperuricemia of fasting,
and partly because of the protein quantities I eat)
I occasionally get pain in the proximal phalange of the great toe,
and the Allopurinol seems to help, though my uric acid has never been above 7.
________________________________
We have many things to talk about,
I would especially like your comments on the four books
and the blog mentioned above, most especially the 2018 book.
Cheers,
Bob
Dear Bob,
Thanks for the information.
My friend Ivor Cummings has a book Eat Rich Live Long Feb 2018
which I have read and reviewed on Amazon.com.
Thus I am somewhat familiar with fasting.
I did fast for 30 hours once. I was surprised it was not very difficult.
My FBS was better and my nutritional ketosis went higher.
I wish I had gotten an Insulin level.
I think it is clear that early insulin resistance
does have increased insulin levels
(even with fasting glucose of 95?)
Ivor in his book above suggests that we can start LCHF or Atkins
on people EARLY on to prevent the IR from getting worse.
I agree with Ivor.
No guideline advises checking insulin levels on a routine basis.
Thus I never did it on my patients unfortunately.
I think my insulin level is normal now because I have had DM2 since 1998.
When I took insulin in the early years
I did have to take very high doses of insulin to control my glucose to normal levels.
I no longer take insulin as it caused me to gain 20 pounds
and found Invokana to substitute for insulin
with subsequent 30 lbs weight loss.
My insulin is now low because I think enough of my pancreatic Beta cells have died.
I still have insulin resistance thus
the normal insulin level of 6 or 8
doesn't control my fasting glucose which is usually around 150.
To address the IR I have decided to go back on ACTOS 15 mg.
My waist is still 41 inches. In the last 2 years I have been down to 199.
My waist did decrease a little but not less than 40 inches.
I could try fasting more but I find that too difficult
as a lifelong practice at my age.
I could stop drinking and watch my protein intake more carefully.
i.e. less than100 grams a day.
However that would be no fun, and I worry about developing sarcopenia.
Thus I am trying ACTOS and >150 g protein/day and
weight lifting 5-6 days a week
alternating upper and lower body doing 25 repetitions to feel a burn in the last 3 reps.
The goal is to do 3 sets. I am up to 3 sets on legs but only one set upper body.
As I have taken ACTOS with high protein and weight program
my Bioelectrical impedance scale results have been:
wt fat% water% muscle lbs Fat Free Mass Visceral Fat
5-3-18 210.3 26.5% 54.4% 39.7 15
Started ACTOS 15 mg 6-20-18
Resumed Testosterone 100 mg once a week IM 7-30-18
7-17-18 218.5 26.8% 54.1% 41.1 73.1% 17
7-19-18 217.2 26.5% 54.4%
ACTOS causes water weight gain.
Reason for the concern in people with congestive heart failure.
I was on ACTOS 45 mg years ago.
Dr. Eric Westman suggested I stop it.
I did and I quickly lost 10 lbs
but my FBG went up to 300 despite being on LCHF.
I have not noticed a change in my FBG presently:
7-19-18
Fasting Glucose 145
Ketones 1.5
