I found myself in an awkward situation recently which resulted in me ordering a comprehensive set of blood tests. If you don’t care about my little drama of ordering the tests, skip ahead 2 paragraphs.

See I had just quit my job and on my last day they let me know that all the money I had contributed to my FSA (Flexible Spending Account) would be forfeited to my soon to be ex-employer. As I wracked my brain to think of a way to use my my FSA in 1 day, I hit upon direct blood tests. You can go online and directly order pretty much any blood test, they will have their in-state doctor review your information and order the test. So I loaded up my cart with “goodies” and tried to checkout. Lucky me, even though my FSA coverage didn’t end until the next day, my employer had cancelled my FSA early… boo I called up the FSA company and they gave me the news that I could pay for the tests myself and then submit a claim to be reimbursed. My bill was for $1,200 so after a bit of nail biting (would they really reimburse me?!) I went ahead and ordered the tests on my own dime. Wonder of wonders, the check just arrived in the mail. I feel like I won the lottery. :)

The Tests

Okay! Back to the tests. I had ordered some tests that I had heard were critical for diagnosing some of my issues but could never get a doctor to care enough about to order the test for me. Here is what I ended up getting:

Diabetes

I had been diagnosed with Type 2, based on my weight but I had always been concerned that I may be a Type 1.5. So these test would be helpful in finally answering that question.

• A1C
  Tells me how well I have been managing my blood sugar, I know I had not been doing well so it seemed like a good idea to get a baseline of how bad I had let things get.
• Insulin
  Tells me how much insulin I am still making and if I have insulin resistance
• C-Peptide
  Indicates insulin production See Blood Sugar 101’s explanation
• GAD-65 Antibodies
  Tests for Type 1 / Type 1.5, where your body’s immune system is attacking your pancreas

Celiac

When I learned that gluten is what has been causing me such extreme pain, chronic diarrhea and other bathroom fun, I removed it from my life and am a happier person. However I had heard that if one has Celiac, then it is important to avoid gluten beyond just for the benefits of a happy pooper. If one is regularly getting small doses of it, but not enough to send you do the throne, it can still lead to long term health issues down the road, like cancer. Plus I was tired of people asking if I was just following a “fad diet” or if I had “a real allergy”… grrr

It was a Celiac Disease Comprehensive Antibody Profile, but here are all the items the test for:

• Deamidated Gliadin Abs, IgA
• Deamidated Gliadin Abs, IgG
• t-Transglutaminase (tTG) IgA
• t-Transglutaminase (tTG) IgG
• Endomysial Antibody IgA
• Immunoglobulin A, Qn, Serum

Thyroid

I continue to have issues with weight gain, very cold hands and feet (they turn white), dry skin and hair loss. I also have an enlarged thyroid. My doctors have only ever tested for TSH and total T4, which I have read is not enough to identify all possible thyroid problems, just the most obvious.

• TSH
  Is your pituitary gland screaming at your pancreas for more thyroid hormones?
• Total T4
  Inactive thyroid hormone
• T4 - Free
• Free T4 Index
• Total T3
  Active thyroid hormone
• T3 Uptake
• T3 - Free
• Reverse T3
  Unusable T3

Misc.

• Leptin
  Identifies leptin resistance, an issue with most overweight people
• NMR Lipid Profile
  Measures the size of the lipoproteins

The Results

I just got the results today and am not familiar enough with some of the tests to interpret the results just yet. However a few jumped out at me:

• My A1C has gone up from 5.0 to 5.8. Plus my fasting insulin has gone up from 4 to 24. Hello insulin resistance! Proof once again to myself that my diet is not a cure, it is control. Hop back on that wagon silly pants!
• I came back positive for a few of the Celiac antibodies. Considering I have been strictly gluten-free for 6 months (stupid Christmas…), I do not plan on the standard course of action of eating gluten for weeks then taking a bowel biopsy for a conclusive diagnosis. This is enough for me to say yes I have Celiac and I should never again let myself have “just a bit” during holidays.
• My GAD-65 (pancreas antibodies) came back as ”< 1.0", hurray for a somewhat working pancreas and a solid Type2 diagnosis!

That’s all I know for now and will report back later when I have figured out the other test results. This has served as the well-deserved kick in the pants go back to my original ketogenic diet and stop listening to all those silly doctors, nurses and blogs out there suggesting that anything other than very low-carb is healthier for me.

If you are one of my 10 regular readers, waves, then you may have noticed that I have been absent lately, from my blog, site, twitter, online forums, etc. Long story short, 1 year ago I quit my stressful job to get a grip on my health and figure out my life. HA! On one level that worked, the anxiety/stress induced physical symptoms have all gone, no more “Am I having a heart attack?” moments. On the other hand, not having a job for a year has brought about its own brand of stress… mostly depression.

I hadn’t tested my blood sugar in six months, my one drink a month was turning into one a week, I stopped caring if I ate gluten-free carbs, wasn’t tracking my food logs or weight… I am sure you can fill in how well that was working out for me. Things I had once enjoyed, like my pet-project Bytes for Health, I stopped caring about or didn’t have the energy to bother with. Boo hoo, poor me and all that jazz.

The other week someone from my online diabetes forum reached out to me, sharing her own troubles with depression and sticking to the whole “caring about dying from diabetes” deal that usually motivates me but lately hadn’t. If you are reading this, you know who you are and thank you. While she didn’t give me a very well-deserved kick in the pants, she did inspire me to try to get a handle on things again. And that’s where things have started picking up!

I started by taking 5-HTP, 50 mg between meals. Maybe I’ll write a post about it later, in short it is a serotonin precursor. Since carbs lately were improving my mood substantially, and carbs raise serotonin, it seemed worth a shot. I also reordered my old favorite, GABA, to help with anxiety. “The internet” suggested that taking it before bed could help with my insomnia and …. I think it is actually helping. Last night was the third night in a row where I slept (most) of the night through.

Maybe I am jinxing myself by with my silly title, but I feel like I am making progress. I finally hauled my cookies back to the doctor to get a prescription for test strips and am testing my blood glucose multiple times a day. I registered for a professional conference that should be a great learning experience (who knows maybe I’ll meet a future employer too). I even worked up the courage to make Oopsie Rolls (aka low-carb hamburger buns) for our Memorial Day cookout. Plus I am back to terrorizing the household with my off-key, goofy singing. The jury is still out on whether or not that is improvement. :)

Wish me luck in keeping hold of my rediscovered motivation!

I encourage you to watch this Ted talk, Allan Savory: How to green the desert and reverse climate change. It is only 20 minutes and is easy to follow with lots of compelling before and after pictures of how his group has helped restore grasslands across the world.

Here is my understanding of his key points:

• Land deteriorates into desert when it is bare and not covered with vegetation. The soil is then unable to retain water and rainfall either evaporates or washes away (with topsoil).
• When grazed incorrectly, livestock does increase the rate at which grassland turns to desert. So does modern farming…
• When livestock are grazed in a similar pattern to how they would graze in the wild, e.g. in large herds which move constantly to avoid predators, they actually restore the grassland. He explains why in the video, in short “manure + urine + trampled grass = fertilizer and compost”.
• If the majority of our grasslands adopted these livestock techniques we would be able to a) feed more people and b) capture enough carbon in the ground to bring down our carbon levels to pre-industrial era levels. This would help combat climate change.

It is an interesting perspective and is heartening to learn that using these techniques they have helped restore previously barren land, giving the indigenous people a way to sustain themselves without foreign aid.

One of the first things I hear from others about their experience with a ketogenic diet is usually that they aren’t hungry. Suddenly many are able to cut out snacks entirely or even eat just 1-2 meals a day. It saddened and drove me crazy that I was NOT one of these lucky people!

Well I think I may have finally figured out why I was still hungry even on a ketogenic diet! Before I share, I’d like to start from the beginning.

Over Christmas, I decided to eat some desserts that contained gluten. Well one meal turned into a few more… you know how it goes and by New Years, my digestive system was seriously pissed at me. I was in a ton of pain and things were not working right in the poop department. :) So I decided to give my guts a break. My husband had recently brought home a protein powder that tasted very good so quite arbitrarily I started a protein shake “reset”.

The first day I had 2 shakes, each shake is 12g carb / 27g protein / 52g fat, about 600 calories. I was hungry and cranky in between meals but I was ready to do whatever it took to get my digestion back in working order. The second day, I had my first shake in the morning and then lunch rolled past… and I WASN’T HUNGRY!

By the third day it finally sunk in that something about my silly reset had completely nuked my constant gnawing hunger, cravings and thoughts of food. I was eating 2-3 shakes a day with maybe a small snack of bacon or some faux chocolate mousse. In total it has been between 1,400 – 1,700 calories a day. Which is a huge reduction from what I have been doing lately, which has been around 2,200 (all the while still hungry I might add!). This was absolutely NOT originally a diet attempt. I was simply suddenly not hungry and this just happened to be how much I felt like eating.

I have been trying this for 2 weeks now and am still experiencing the same freedom from the constant hunger. As I have been transitioning from the shakes back to normal food, I think I know why the shakes were so successful. With the shakes, I am 100% confident that I know exactly how much carb/protein/fat I was eating. There just isn’t that much variation in either the powder or the heavy cream I was mixing it with.

The same can’t be said about what I usually eat, e.g. deli ham, pork shoulder, beef brisket, pork chops and ribeye steak. All are considered high fat foods and according to my food logs, I was getting at least 75% of my calories from fat when eating these foods. But really there is a lot of variation, sometimes I get a great piece of meat, well marbled and it’s amazing. Other times, maybe it’s leaner or when I cook it, much of the fat renders and is lost. What I am saying is that I am not nearly so confident in my macronutrient ratio when eating “real food”. I would not be surprised at all if the amount of fat is much lower and the protein much higher than expected.

My theory is that I was hungry because despite my best weighing, counting and logging efforts, I wasn’t really eating as high fat and low protein as I am currently with these shakes. Which could also explain why I was having such a hard time getting above the mythical 0.5 ketone reading….

I am not perfectly sure if that is really what is going on but for the moment I want to just bask in the glory of not being hungry for the first time in months. Oh dear lord what a difference it makes to be able to have my stomach shut up and get some peace and quiet. It feels absolutely wonderful and I am just hoping like crazy that I can figure out how to replicate this with real food.

Someone recently asked me how they could increase their ketones and after typing out an epic comment, I decided to turn my reply into a post.

When it comes to ketones, there are a couple things to look at:

1. Are you measuring using a blood ketone meter or a urine strip? If you are using a blood meter, it usually registers highest in the evening and lowest in the morning. If you are using the strips, it’s the opposite, higher in the morning and lower in the evening.

2. How long have you been eating a ketogenic diet? It can take weeks for your body to adapt and make an adequate amount of ketones. If you are measuring using a blood ketone meter, the range is 0.5 – 5.0.

3. How much protein are you eating? Your body can convert a portion of the protein you eat into glucose. Have you tried calculating your suggested protein and seeing if you are within range? Try to find an amount that keeps you satisfied, as I’ve found going too low while it may raise your ketones, causes me to be constantly hungry! :–)

4. How much fat are you eating? When doing a ketogenic diet, please don’t try to go low-fat! Make sure you are getting enough healthy fats (saturated and mono-unsaturated, like avocado, pastured eggs, butter and animal fats). When doing a ketogenic diet, the majority of your calories will come from fat.

If you are “doing everything right” and have given yourself enough time, you may want to try eating more coconut oil or MCT (medium chain triglyceride) oil as they are converted to ketones easily. Another idea is to switch up when you test. For example, since I have diabetes, my blood sugar rises quickly in the morning and that causes my morning ketones to read very low. However after eating breakfast, they rebound nicely.

One more thought is to ask yourself why you want higher ketones (assuming they are at least registering). Is it because you are feeling tired or experiencing poor blood sugar control? Or is it because you believe that higher ketones will result in better weight loss? If it’s the former, then keep tinkering and hopefully you will find what works best for you. If it’s the latter, I wish you the best of luck but must caution that I and a few others have found that there isn’t a great correlation between high ketones and weight loss.