Hi All You Lo Carbers!
I absolutely love Dr. B's philosophy! I'm T1 x almost 20 years, a new pumper, and the law of small numbers is certainly a no-brainer. I was eating less than 30 carbs a day for 2 mos and, in my ignorance, I ate mostly fatty meats. My total cholesterol and LDL went off the charts and then my doc clued me in to eating leaner meats, which I do now.
But even so, my TC and LDL are still higher than I'd like. I am unwilling to start statins.
Dr. B assures us that his own lipids are very low and ours will be too. In this group, I see that members eat meat and cheese, just like Dr. B recommends. I've read that only about 30% of high cholesterol is caused by diet; that there is a genetic component. Can you share your experiences with low carb diets and resulting high lipids?
To be honest, a low carb plant based diet sounds just to awful to me, so I can't consider nuts and spinach only. I love the eggs, cheese, chix, turkey etc too much.
p.s. Yesterday my new endo looked at my pump reports and suggested I am not eating enuf carbs. I am very thin and she must have taken that into the equation too. That was predictable, wasn't it?! Wait til she sees my lipid values!
Much more important than yout total Cholesterol is the ratio HDL/LDL and triglycerides and the HDL level. If your HDL is high that's not a problem. the worst is LDL and VLDL being high. some doctors don't ask for the lipid profile to be itemised. Some now believe that only High VLDL matters. It's worth discussing all this with tyour team
I'm type 1 since a very long time and I read Dr Bernstein, and I started low carbs diet near 2 years ago. I believe in small numbers Cindy but I can't live with the numbers of carbs of dr Bernstein. So there is a before and an after in my diabetic life; before Ieat more than 130 grammes of carbs each meal (lunch and dinner) my blood sugar was very high after meals and many complications. After my reading, I eat only 40 grammes of carbs at each meal and my A1C is around 7. I still take care about fat but I eat more vegetables and more meats, and some cheese? And my cholesterol is low and OK. Because of a big open heart surgery in 2003, my cardio put me under statins but no trouble with my numbers of cholesterol. And I'm thin (you can look on my photos's profile). I made an adaptation of dr Bernstein diet. This is my small experience, if it can help you.
I have to agree with you about the very low 10 carbs per meal recommendation. When I do it I feel deprived and have knawing hunger between meals. It's hard for me to wait for the next meal. People say to up the protein, but I do that. It's a double edged sword. I love not seeing high bs #s, but I pay for it in being hungry all the time and losing weight.
Yesterday my new endo barely commented on my last 6.4 A1C... instead she spent more time telling me to eat more carbs and not run low so much of the time. What a mixed msg. My best A1Cs are by NOT eating more carbs. I'm going to ask her what her targets and values are for a T.
If you're eating sufficient protein & fat, you won't be hungry & craving more carbs. Low carb isn't low fat. Believe a mistake people often make following restricted carbs is also doing low fat. That's a prescription for starvation:) The way to gain some weight, if you want to, is to slowly increase protein. You may not be getting enough. I found it hard to increase protein because I felt stuffed & made protein shakes because there's only so much meat I can eat.
I've gotten the eat more carbs lecture because I'm thin also. No thanks.
My lipid profile improved greatly from low carb & was far better than when I was a vegetarin eating extremely low fat. As Hana said, the ratio is what's important. I eat cheese, cream, butter, coconut oil, nuts. No vegetable oils, except unheated olive oil, & no transfats.
Another thing to look at is thyroid status. Hypothyroidism causes unhealthy serum lipids. Thyroid problems are common among diabetics & very common in women. Unfortunately, doctors only test TSH, which is useless. Free T3, Free T4 & Reverse T3 are the tests to determine thyroid function.
Gerri, I suspect you have a medical degree because you may have cracked the nut for me! I do indeed have a hypothyroid condition! It is being treated, but as I told my new endo, I think I need to up the strength of the Rx. I am feeling the old symptoms return. (To her credit, she did order a Free T3, Free T4, TSH, and ATPO, whatever that is) So maybe that condition IS a factor in raising my lipids.
As for feeling hungry between meals, I must admit that I have felt that way all my life, not just since T1. I have a very small meal-time capacity and have always been more suited to 5 small meals/day rather than 3 larger meals/day. I do think that's the beauty of a pump tho, in that you can actually have a snack.
Cindy, I do have a medical degree, but don't tell anyone because I'm embarrassed by the ineptitude of my colleagues--lol!
ATPO is the test for thyroid antibodies to see if you have Hashimoto's. Have you gotten the test results?
My doctor pushed statins at every visit. He'd give me an Rx. I'd throw it in the trash. As he was insisting on statins, though my ratio was good, I was insisting that I needed thyroid supplementation increased instead. After several rounds of that, I did get thyroid med increased & my lipid profile improved again.
Great your endo tested FT3 & FT4. That's usually a battle. Try to get Reverse T3 done as well. If your RT3 is high, you're not getting the benefit of supplementing. The ratio between FT3 & RT3 needs to be high to be healthy. Just had my RT3 done & my ratio is quite low. I had to explain to my doc what this meant to get meds increased:) There are reasons why RT3 can be high. Endos know less about thyroid disorders than they do about diabetes & once again we have to be our own advocates & researchers.
Are you taking Synthroid?
Hear you on small meal capacity. I can't eat a lot at once either.
Not to hijack this thread, but a question re: the thyroid levels. After many years of being stable, my hashimotos thyroid keeps going hypo (measured by tsh) and they increase the levothyroxine. I already have osteopenia and don't want the incresed meds. Why are the t3, t4, reverse t3 better than tsh? BTW, I started taking the levothyroxine in the middle of the night and brought TSH down from 6 to .4 in four weeks. I found that very interesting. I am underweight due to low carb diet, but LDL is over 130 and I wonder if the fluctuating thyroid is affecting this. I just starting eating meat a month ago so that is not the reason for high ldl.
Here's a good explanation of TSH http://www.stopthethyroidmadness.com/tsh-why-its-useless/. To know thyroid levels, Free T4, Free T3 & Reverse T3 are critical. T4 converts to T3, but for most hypothyroid people this conversion doesn't happen & they remain hypo despite increased doses. Adding more levothyroxine won't help. Levothyroxine (Synthroid) is T4. When there's too much circulating T3, the body converts it to RT3, a form unusable by cells. Several reasons why RT3 could be high, including inadequate cortisol (adrenal hormone) &/or low ferrintin levels (iron stores). Both are needed to get T3 into cells. With the appropriate tests, a ratio of Free T3 & RT3 is known. A healthy ratio is 20 or above. TSH alone tells nothing.
It's not fluctuating levels that effect lipids, but inadequate levels.
We need correct thyroid levels. Why are you concerned about
increased doses with osteopenia?
Thanks Gerri, I do have below average cortisol levels, in fact they gave me an acth stim test, which I passed. My ferritin is also at the low threshold. I can change the ferritin with supplements; I did not realize being low was affecting anything. I don't think I can do anything about the cortisol. Re: the osteo, a doctor told me once that taking thyroid hormone increased osteo risk. So, I just assumed it was the amount of levo I was taking.
I have high RT3 & a low FT3/RT3 ratio. A healthy ratio is 20 & mine is 9.09--bad. Recently had a complete iron panel & ferritin is fine. All my doctor would do was serum cortisol, which doesn't reveal much. I'm going to pay for my own cortisol DHEA saliva test. It's not expensive to send off to a lab. It measures cortisol by testing four times during the day. It's not the total or average that counts, but if cortisol levels are normal at specific times. For example, if cortisol is high at night people have trouble sleeping. If it's low in the middle of the day, people lack energy. If it's really high, it means adrenals are ready to poop out & become deficient. Thyroid & adrenals are inter-related. You can do something about cortisol by supplementing. From what I've read, cortisol is treated for a relatively short time to get adrenals balanced. Not lifelong like thyroid.
I need to research thyroid supplementation & osteo risk. I'm guessing that research was done just on levothyroxine & not with subjects using natural dessicated thyroid or those on only T3 or a combo of T3 & natural. Calcium supplements interfere with thyroid supplement uptake.
Many people find that after 6 months their lipids improve. This is because it takes time for your body to get used to it's new fuel source.
I am very grateful to Dr. Bernstein for his book and advocacy of a low carb and healthy diet. Others, including non-diabetics, are coming round to advantages of this kind of approach, too.
I eat more than 30 carbs per day, but adhere to the kind of foods he advocates - it is not only nuts and spinach! In fact, he recommends that nuts be eaten sparingly if at all (as it's hard to stop, once you get started, a fact which I can attest to).
My A1C is coming down, little by little, and I'm now at 6.3. Pretty good, considering that my pump has let me down with non-delivery of insulin at regular intervals.
But just like you, one of my nurse educators looked at me very sternly when she noticed I was light on carbs. I lost a lot of weight when I came down with Type 1 very suddenly. However, my weight is just about right, now, so my medical team are quite approving of that.
They have been impressed with how even my blood sugars have been over periods of time. And I have not been starving myself, but adhering to Dr. Bernstein's advice on what is good for us, and avoiding what will cause spikes in BGs. It's the spirit of the advice, rather than the letter of it that I follow, and it is immensely helpful.
By the way, my last LDL was 83, I think, and HDL was off the charts - over a 100, so my Primary Care Practitioner gave up on her insistance on statins for me! It will be interesting to see if yours improves if you adhere to his advice on lots of green veggies!
Best of luck!