I would argue that not every person is the same and some may not react well to low-carb diets.
My son spikes into the 300s when eating 0-carb meals and we have no idea how much/if to bolus. With 50-grams of carbs from a bowl of oatmeal, I just bolus for the carbs and he goes up to 140 and then gently drops down. We have found he really does not do well with a ton of saturated fat and that fiber intake is highly correlated with how sensitive he is to insulin for hours afterwards. So I started cooking with olive oil and making sure all his meals had at least 10 g fiber and āpoofā ā the negative effects of the high-fat meals went away. (But he is of partly Indian descent, where plant-based diets have been ancestral for a long time. Other people may be genetically predisposed to thrive on a more animal-heavy diet. )
Obviously, YDMV and everyone is different, but there are a number of studies showing that high-fat, low-fiber diets can induce insulin resistance. I think they overstate things but I wouldnāt completely toss those studies out. Iām guessing for some people, low carb works well because they have minimal effect of dietary intake of fat on insulin resistance, but for others, the increase in insulin resistance and inflammation winds up drowning out the impact of reducing the carbs.
Personally, Iād try to increase my intake of fiber from foods like broccoli, leafy greens, artichokes, etc., eating them before the more caloric foods. Those donāt have many carbs, but do have a lot of fiber, and they often help people feel fuller. So at the least you may be eating fewer calories overall.
And with any weight gain, Iāve never had success removing it unless I tracked every piece of food that went into my mouth. Itās a super bummer but it really was key for me.
Thanks for all the experiences and advice! I do have Gravesā disease which Iām currently taking medication to treat. It would not surprise me at all if the medication, or just my thyroid going out of whack in general, had something to do with the most recent weight gain, as it started a month or two after I was diagnosed. My thyroid levels have been in range for several months now, though, so I would think any weight gain from thyroid fluctuations would have stopped.
Iām going to start tracking my food in detail to see how many calories and how much protein Iām eating. Maybe itāll take restricting one or both of those to get things moving.
Interestingly, after thinking about exercise yesterday (I was trying to think of things that I know make me run low and use less insulin), I exercised for an hour last night instead of half an hour. Today Iāve been low and eating all day non-stop despite lowering my basal rate by 0.1 units and hour and even running a -70% basal rate for two hours (which would normally send me high without fail!). So maybe increased exercise will help a lot in cutting back on insulin as well, which will hopefully help with losing weight.
You could be on to something as the timing coincided with your diagnosis as Graves can also cause weight gain. Is it possible to get in to see you doctor to see if your condition and treatment could be the source of the weight gain? Perhaps they could modify your treatment to help.
@Jen, another thing I just thought of is that Graves and the ensuing hyperthyroidism can cause insulin resistance. Is it possible that now you have gotten treated you become more insulin sensitive? Is it possible that you basal is too high? That could cause weight gain as well.
I just saw my endocrinologist in late August and my thyroid levels are perfect according to him. He was a bit surprised at the weight gain. He says most people with Gravesā disease lose weight, but I didnāt. He says the weight gain may be because my metabolism was on hyperspeed and I got used to that, and then it was slammed back to normal when I got treated. Iām not sure I had time to get used to Gravesā before I was diagnosed, but I do think the medication may play a role (maybe itās a side effect). My doctor says that my medication is fine unless my thyroid level drops too low, which so far it havenāt. If Iām still gaining weight when I see him next Iām going to ask if I can cut back the medication dose even if my thyroid levels are in the normal range. Iām just nervous if I do that Iāll go back to hyperthyroidism, which I donāt want.
A few months after I was diagnosed, as my thyroid went from high to normal, my blood sugars went crazy and I had to adjust all my pump settings. Things have settled down pretty much back to normal since my thyroid levels have been normal. I adjust my basal settings a lot (the actual levels, not necessarily the overall āprofileā shape) and try to keep them so that my blood sugar stays steady overnight and between meals. If I notice that Iāve been treating lots of lows throughout the day I will lower my basal.
Most doctors treat to the blood tests, instead of paying attention to the symptoms. You may find http://www.stopthethyroidmadness.com (hereās more on graves) to be a useful resource for finding a good doctor, or at the very least arming yourself with enough information to work with your current doctor and get the treatment you deserve.
I have heard that a lot of doctors just test TSH and thatās it. My doctor has been testing TSH, Free T4 and sometimes Free T3. So itās not just guessing based on the TSH level, both my TSH and my thyroid hormones are coming back within the normal range. My TSH is at the same level it had been at for years prior to diagnosis. Aside from weight gain (which is actually less now than when my thyroid levels were higher) I havenāt had any other symptoms of hypothyroidism, which is why Iām thinking maybe a medication side-effect rather than a thyroid hormone issue.
That is frustrating, Jen! You donāt mention your TDD (total daily dosage) of insulin, but here are a couple of suggestions. Ultimately your body needs what it needs, but if your TDD is more than, say, 40-45 units a day, you may be insulin resistant. Some Type 1ās actually benefit by taking a Type 2 medication such as Glucophage or Metformin to help with the insulin resistance, then make adjustments to the pump to reduce the amount of insulin needed. Insulin is a fat-storing hormone, so the more you take, the more you hang onto weight. Another medication to consider is Symlin, an injectable synthetic form of amylin, which is another hormone that Type 1 typically destroys in the pancreas. It is not a necessary hormone, but it is helpful because it makes you feel really full after just a reasonable amount of food, like standard people! Talk with your doc to see if either or both of these might be worth trying.
Unfortunately, to my knowledge we never have gained access to Symlin in Canada. My guess is that the company just didnāt even bother trying to get it approved, since itās such a small market (only a subset of Type 1s). I do, however, plan on asking my doctor about metformin, originally for the recent studies about protecting the cardiovascular system of Type 1s, but now possibly also for weight loss. According to Diasend, over the past week I used an average of 43.7 units of insulin, which has dropped a lot from the average of 56.4 units it was over the past two weeks, so perhaps things are starting to move in the right direction I also think Iām limiting carbohydrates more, since it dropped from an average of 79 grams to an average of 52 grams. So maybe I wasnāt eating quite as low-carb as I thought initially. Iāve also found more exercise has dropped my basal even more, and Iām trying to head off my weekday lows around 4:30 (that do not happen on weekendāIāve fasted through that period) instead of eating food.
My guess (as a registered dietitian) would be that despite eating low carb, you are still exceeding the number of calories your body needs during the day. Iād say take a look at your protein sources. They could be contributing a lot of calories and therefore weight gain. Leaner meats, like chicken and certain cuts of pork and beef, might be the way to go. Also, increasing your intake of veggies and other low carb options in place of higher calorie meats could be helpful.
Realizing this may have supposed to be added to Type 2, perhaps a little additional Type 1 experience could be helpful? I was very low carb, high protein since 2012. During that time, I lost a significant amount of weight. Now in 2016, I started to put some of it back on even though I continued low carb/sugar free. My carb intake is usually below 20g a day.
Realizing calories were now an issue and metabolism was not as good as it used to be, I decided to do something unusual and join a clinic for a new diet. This diet consists of about 600 calories a day or so, only 7oz of protein a day and only carbs found in iceberg or romaine lettuce and what is in 2 servings of fruit a day at 6 hours apart. Zero fats, no breads and no dairy (fats of course).
Yes, very restrictive however my basal is down to 10u and bolus is about 5u per day. I do still have to continue the Symlin and 150mg of Invokana due to insulin resistance. I also realize this wonāt be sustainable forever so no clue what the maintenance will be yet. Regardless, Iāve lost 15lbs in 3.5 weeks. My goal is another 15 then call it good.
To summarize, not only does metabolism change but the body becomes adjusted to low carb/high fat and calories become an issue (maybe not everyone). What I hope happens with this diet is kind of a āshock to the systemā to get things back on track and I will go back to low carb/sugar free.
Jen, your post is getting old, and you might not see my reply, but just in caseā¦
I changed from animal insulin to synthetic insulin in the mid 1990s. I started gaining weight, even though I had not changed my way of eating. I reduced my carb intake and increased my exercise, but I still gained weight. My internal medicine doctor diagnosed insulin resistance in 1998 because I had been using an increased amount of insulin while I was gaining weight. I had gained 57 pounds by the year 1998. My doctor prescribed Avandia, which was not very effective, but I did lose 30+ pounds during the next few years.
I saw my first endo in 2007 to get approval for using a pump, and asked about using Metformin. She approved, and I started with 2000 mg per day of Metformin ER (extended release). About 18 months later, I had lost all of my 57 pounds, and more. I stopped the Metformin for almost a year. I was averaging 130 carbs per day at that time. I started gaining weight again, and resumed taking Metformin, 1000 mg per day. Metformin works very well for me. I am currently three pounds below my āidealā weight, eating 150-160 carbs per day, and using an average of 34 total units of Humalog each day with my pump.
I have four relatives who are/were type 2. I am thinking that I may have inherited the ātype 2 geneā and the weight gain triggered my insulin resistance. I have seen several type 1 people post that they have insulin resistance, and they are using Metformin.
Do you have any type 2 relatives?
As an update to everyone else, I cut back my carbohydrates a bit more last week and cut out all the low-carb ātreatsā and found that I did lose a couple of pounds. Back up to eating more carbohydrates this week, though. So, I think if I could keep my carbohydrates really low and exercise, Iād be able to continue losing weight. Iām finding lunch is my biggest carb-heavy meal, because I eat a piece of fruit with it. When people talk about lowering carbs and protein and eating more fat, what are they eating? Maybe itās because Iām not able to eat dairy (butter, cheese, cream, etc.), but Iām finding that really hard. I could use more coconut oil and such, but that doesnāt really seem filling at all.
One nice thing about being low-carb is that it has made my cycle much easier to detect with its effects on my blood sugar. A few days ago I started running higher at night, and ran high most of yesterday, so I put all my pump settings up fairly aggressively (basal rate by 0.15 units an hour, carb and correction ratio down). I woke up this morning at 14.6, having spent all night high, so will be putting things up more aggressively still. Before eating low-carb a number like this would be something I would see fairly regularly, but with low-carb I have not been in the teens in weeks, so itās definitely more unusual and caught my attention.
Hi @Jen!
Good to know you had some results last week!
Just to answer your question, I am LCHF, and unlike you I do rely a lot on dairy for my daily carbs.
No fruit or breads / starches at all.
Protein and fats, plus veggies. I have 4-6 oz of half and half in my coffee every morning. This is where I get most of morning carbs.
So Iām sorry I cannot be of much help to you. Just wanted to say you were right; someone like me is relying on butter, cream cheese, cheeses, sour cream and high fat milk products (no yogurt: too many natural sugars in it) for the sated feeling these products give me.
Hey Jen, if I gain weight I use a calorie counting program to keep track of nutrition. https://www.caloriecount.com allows me to not only track calories, but I can pick the diet I want (mine is ādiabeticā and also low-cholesterol). It tells me what the nutritional value is of each food I log, and overall what Iām lacking. Because of this program, for instance, I realized I get nowhere near enough potassium and fiber. You can do custom values on the diet plan, changing the number of carbs or fat the diet calls for.
It doesnāt do the work for you, of course, but if youāre like me, a visual of where Iām at really helps. I log my weight, activities and foods, vitamins and water, and then get an overall picture of my health.
I wonāt lose weight if Iām not getting enough protein and fiber, so this helps clock that. It also shows me how many calories I burn with certain exercises.
I also have a thyroid disorder and got used to that amped up metabolism that came with a dying thyroid. When that ended, I was used to eating 3,000 calories a day and running around like a little kid hyper on sugar. By the time I hit 35, things changed and I had to be far more careful.
Maybe having everything on one screen, weight, goals, food intake broken down into carbs, fat or protein, exercise etc. would help?
No dairy would make low carb very challenging, IMHO. Some options that come to mind are avocados (as are or as guacamole or even as pudding with cocoa powder and stevia), coconut cream (so good), veggies, protein, SF jello, peperoni sticks, bone broth, herbal tea with coconut oil, nuts (although I think a lot of people have trouble with nuts as an allergy or weight loss staller). If I think of more Iāll let you know!
