Friday, June 15, 2012

12 Week Check up! Insulin Resistance Factor

Tuesday was my 12 week checkup, but 'all things work' has consumed my time. First piece of news is that nothing is bad. And that is really good news. So here is the updated list of info after 12 weeks of treatment:

- My Cortisol is much lower (this is good)- This improves metabolism a tiny bit, but also helps reduce excess fluid retention. 

-Reproductive hormones look OK, but still need to monitor in next few months and watch for PCOS.

-Fasting Glucose best yet and average glucose in normal range (no where near pre-diabetes). This is very very good!

-Vitamin D is getting much better

-B12 and K are very good

-iron levels are much better

-Thyroid is good

- Blood Pressure is a little better

-Insulin resistance is very strong. Test results are showing a need for aggressive medication to untangle the kinks in metabolic machinery. (This is the not so good part of the results). 

First, let's go back and investigate Insulin Resistance because people have no clue what it is all about (and don't worry, I will attach my resource links as endnotes because I don't plagiarize). Wikipedia gives us a nice overview. It is a physiological illness where insulin (a hormone) is less effective at lower blood sugar levels. Seems simple on the surface, but how is it different than diabetes?  Well Type 2 deals with insulin deficiency (which if insulin resistance is left untreated over time can turn into Type 2 Diabetes, and Type 1 deals with the body not being about to produce insulin.

Marcelle Pick (OB/GYN NP) also has a nice explanation of Insulin Resistance. She talks about if insulin spikes too often by high carbs than your cells and brain will prevent and decrease the amount of insulin receptors. And then "eventually, this prevents glucose from getting into your cells, leading to high blood sugar and depriving your cells of the energy they need to function. This is why many women with insulin resistance experience carbohydrate cravings, fatigue and weight-gain — their cells are literally starving for energy, even when plenty of glucose is available in the blood" (Women to Women). Unfortunately, what she fails to address is other factors that can cause insulin resistance besides just having a lifestyle of unhealthy food and no exercise. Doctors have known for over 20 years there are also genetic factors, environmental factors, and even lack of food, and extreme exercise factors that can cause insulin resistance. Maybe I will save the stuff I have been told about starvation and your mind choosing not to burn energy, but to store fat for a later blog. I hope that helps with insulin resistance.

So what is on the docket for my next 6 weeks (18 weeks of treatment)?

1). Step up treatment approach for insulin resistance
-Add Topiramate (have an interesting story on this drug and Pharmaceuticals and diet pills from the 1970s for a later time).
-This helps lower a NPY neurotransmitter that signals starvation and directly slows the metabolism.   

2). Keep increase Victoza to maximum dosage in next 2 weeks. This is the hardest to do because every increase causes nausea for me until my body is used to it. 

3). Keep my Metformin the same until Victoza to maximum level then 1 week later start adding in a morning dose. 

4). Reduce B12 from 3,000 IU to 2,000 IU daily

5). Reduce Vitamin K from 4,000 IU to 3,000 IU daily

6). Don't change anything else. So keep taking a multi-vitamin, 10,000 IU of Vitamin D, 1,200 IU Omega 3, prescription Iron supplement, Blood Pressure med, and Thyroid Med daily. 


And modifications will probably happen again. Most of the 6 week checkups are to find out what is working and what needs modification. While the Victoza is definitely helping with my digestion of food, if we can't get it to start helping the insulin resistance, we have another med I will have to try. Breaking the insulin resistance is what is going to be the trickiest, but is what will start having me loose weight (which I know some people are waiting for with bated breath). 

It is funny. When someone has a broken arm and is in a cast, no one ever states, "well, it doesn't look like it is being fixed," or right after it is taken out of the cast someone usually does not bellow out, "Oh my, your arm does not look that healthy!" But something my doctor and I talked about is how to deal with naysayers who don't believe I am sick. It is hard when my only improvement has been internally and not externally. Even though I have said from day one that this will take 3-4 years to work out, they think they will see some kind of miracle weight loss over night. This is not the first time my doc has had this conversation. It is one she has had to have time and time again with her metabolic syndrome patients that have obesity as a symptom. Believe it or not, she has metabolic syndrome patients that are not obese, but have a symptoms I thankfully do not have: high cholesterol and clogged arteries.  And that is something to be thankful for! 

Until next time... when I will have lots of funny tales and anecdotes, 

Capt Mel

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