Working on a diagnosis

I am 42f. I have been having some blood sugar issues the past few months. Through blood sugar testing, I found I could keep my fasting blood sugar below 100 and postprandial at or below 140 by eating 15g of carbs or less per meal.

I am underweight (5’1” and 93 lbs) and have always had PCOS and relatively high cholesterol.

After staying on the low carb diet since July, I just had blood work with levels as follows:
Fasting glucose 94
C-Peptide .75 (low)
Total cholesterol 231 (high)
LDL 141 (high)
Fasting insulin 3.4
A1C 5.0
Estradiol (low)
Testosterone (low)

Everything else was in normal range and my Chol/LDL ratio was 3.0, which is still considered good.

Would starting LADA treatment benefit my lipids or other hormones? Is there any benefit to starting insulin while I can still control glucose levels with diet?

You might be happier with Insulin. Probably your low carb diet includes a lot of protein and hence higher cholesterol.
Weather or not you are eating a lot of animal products, I just started taking plant sterols. Cholestoff. I got 2 bottles for 10 dollars at cvs.
I’ll get another test soon. I can’t take statins so this Is my only hope. My cholesterol is not terribly high but I had one high test.
It might be worth a try.

Thank you for the suggestions! I will talk to my doctor and see if we can figure this out. It’s scary to think I may have to start insulin shots!!

I didn’t know protein can raise cholesterol. Can you send me where you read this info?

Animal protein contains cholesterol. It’s widely accepted.
Veggie protein like tofu satan etc do not.

Here is a good list. https://www.ucsfhealth.org/education/cholesterol-content-of-foods

Cholesterol is only found in eating animal products. Your liver also makes some cholesterol.

The sure fire way to know if you are a type 1/LADA diabetic is getting blood tests for antibodies done too. An antibody test if positive is a sign of type 1, although some type 1’s don’t have antibodies but don’t make insulin and they don’t know why. That’s also where a C peptide test tells the rest of the story. C-peptide is a measure of the insulin your body is making. Low or low normal C peptide points to type 1 as they are slowing or have stopped production of insulin and high or high normal points to type 2 as they make plenty of insulin they just don’t use it well.

LADA is type 1, it’s just a term for adult slower onset. Eventually you stop making insulin. We call that time the honeymoon period which literally can take years before you completely stop making insulin. So some can get away with diet changes or medications for a while before they need insulin. But at some point you have to have insulin.

You mentioned LADA so I’m not sure whether you had the antibody test yet? When you start insulin it is decision that’s usually made with needs to control blood sugar levels. Your levels aren’t bad right now, if you want to add more carbs you might need insulin. But adding insulin when you don’t need it can make you fall to dangerously low levels of blood sugar. You would not take it just to change other hormones.

PCOS can be the precursor sign to both type 1 and type 2 diabetes. PCOS really messes with hormone levels, or I guess people that have PCOs have messed up hormones. But their different hormone levels can vary in how they are messed up? Also commonly type 1’s have a problem with their thyroid and the antibodies attacking it. And it is considered the primary signaler to other hormones. I know I had a heck of a time with menopause until I got my thyroid into more normal levels. The thyroid sends out signals for other hormones and it’s tricky because the major test they do can show normal levels, yet it’s not actually okay. And add to that the doctors groups have different levels they deem okay. You need a full panel of thyroid tests to know. They keep a close eye on mine as mine was functioning at normal levels, but the other tests showed my thyroid isn’t actually okay. I control it with natural supplements right now and if I stop taking them for a while my thyroid tests start going askew and I start getting major Dawn Phenomenon, which is a hormone release. Plus PCOS can also cause insulin resistance.

I am including a description of the blood tests for type 1/LADA because if you are a type 1, you will have no choice but to eventually be on insulin.

https://www.jdrf.org/t1d-resources/about/diagnosis/

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A little more on cholesterol. Here’s my understanding. A large majority of cholesterol is produced by the liver. The liver will change its output based on the amount of dietary cholesterol it senses. If dietary sources decrease, the liver puts out more and if dietary sources increase, the liver puts out less. Reducing dietary cholesterol has little effect on cholesterol overall since the liver will just make up the difference.

Do you remember when the mainstream medical advice recommended avoiding eggs since eggs are high in cholesterol? That was when doctors and their professional associations thought dietary cholesterol played a larger role than it actually does. More recently the medical warnings about egg consumption have gone quiet.

This is due to what we’ve learned about the liver’s primary role in cholesterol levels. I consider eggs to be one of nature’s perfect foods; it contains all the nutrients needed to grow an entire animal!

By the way, the liver also plays an important role in clearing cholesterol from the body. Sometimes it is this function that is not working properly. Statin drugs enhance the liver’s ability to clear cholesterol – but not without creating other concerns.

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@Terry I don’t believe that. I watched several customers cholesterol fall when they went vegan. We used to provide information for them to easily do so. Plus everyone else in my family except for me had heart issues. I being a vegetarian for 53 years and a vegan for 36 years have never had an issue. My HDL has always been between 70-95. My oldest sister has always had a very healthy diet and eats very limited meat and lots of whole grains, fruits and veggies. She has a heart issue, but it’s only a mild prolapse issue. She was probably born with it.

Everyone else had heart issues. My Dad had his first major heart attack at 54 and was lucky to be within a few minutes of a major cardiac center and lived. Years later he ended up with bypass surgery. My brother wasn’t so lucky and died at the age of 56 of his first major heart attack. Both relied on meat as a mainstay to their diet, in my brothers case lean meats and he belonged to 2 gyms. 3 of my grandparents died from heart issues as did my Mom. My second sister has heart issues. It does not escape me that eventually it might be an issue with me, but hopefully it will be when I am much older.

I eat absolutely no cholesterol and yet I have always stayed in normal ranges. I believe we do inherit propensities and my family has had cholesterol issues, but I do not and I am the only vegan.

You can find doctors that say all sorts of different things. But Dr Neil Barnard, Dr Dean Ornish, Dr McDougall are very respected in the health industry I was in and all either limit meat or promote veganism.

This is an interesting article published recently in JAHA Journal of the American Heart Association. It talks about eggs and red meat consumption.

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What influence do you think any of the companies and interests cited in the referenced article played in the analysis of this article’s various authors?

Disclosures

Professor Spence is a consultant to Amgen and Orphan Technologies and an unpaid Scientific Officer of Vascularis Inc. Professor Jenkins has received research grants from Saskatchewan Pulse Growers, the Agricultural Bioproducts Innovation Program through the Pulse Research Network, the Advanced Foods and Material Network, Loblaw Companies Ltd, Unilever, Barilla, the Almond Board of California, Agriculture and Agri‐food Canada, Pulse Canada, Kellogg’s Company, Canada, Quaker Oats, Canada, Procter & Gamble Technical Centre Ltd, Bayer Consumer Care (Springfield, NJ), Pepsi/Quaker, International Nut and Dried Fruit Council Foundation Inc., Soy Foods Association of North America, the Coca‐Cola Company (investigator‐initiated, unrestricted grant), Solae, Haine Celestial, the Sanitarium Company, Orafti, the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Soy Nutrition Institute, the Canola and Flax Councils of Canada, the Calorie Control Council, the Canadian Institutes of Health Research, the Canada Foundation for Innovation, and the Ontario Research Fund. He has received in‐kind supplies for trials as a research support from the Almond Board of California, Walnut Council of California, American Peanut Council, Barilla, Unilever, Unico, Primo, Loblaw Companies, Quaker (PepsiCo), Pristine Gourmet, Bunge Limited, Kellogg Canada, and White Wave Foods. He has been on the speaker’s panel, served on the scientific advisory board, and/or received travel support and/or honoraria from the Almond Board of California, Canadian Agriculture Policy Institute, Loblaw Companies Ltd, the Griffin Hospital (for the development of the NuVal scoring system), the Coca‐Cola Company, EPICURE, Danone, Diet Quality Photo Navigation, Better Therapeutics (FareWell), Verywell, True Health Initiative, Institute of Food Technologists, Soy Nutrition Institute, Herbalife Nutrition Institute, Saskatchewan Pulse Growers, Sanitarium Company, Orafti, the Almond Board of California, the American Peanut Council, the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Herbalife International, Pacific Health Laboratories, Nutritional Fundamentals for Health, Barilla, Metagenics, Bayer Consumer Care, Unilever Canada and Netherlands, Solae, Kellogg, Quaker Oats, Procter & Gamble, the Coca‐Cola Company, the Griffin Hospital, Abbott Laboratories, the Canola Council of Canada, Dean Foods, the California Strawberry Commission, Haine Celestial, PepsiCo, the Alpro Foundation, Pioneer Hi‐Bred International, DuPont Nutrition and Health, Spherix Consulting and White Wave Foods, the Advanced Foods and Material Network, the Canola and Flax Councils of Canada, the Nutritional Fundamentals for Health, Agri‐Culture and Agri‐Food Canada, the Canadian Agri‐Food Policy Institute, Pulse Canada, the Saskatchewan Pulse Growers, the Soy Foods Association of North America, the Nutrition Foundation of Italy, Nutra‐Source Diagnostics, the McDougall Program, the Toronto Knowledge Translation Group (St. Michael’s Hospital), the Canadian College of Naturopathic Medicine, The Hospital for Sick Children, the Canadian Nutrition Society, the American Society of Nutrition, Arizona State University, Paolo Sorbini Foundation, and the Institute of Nutrition, Metabolism and Diabetes. He received an honorarium from the US Department of Agriculture to present the 2013 W.O. Atwater Memorial Lecture. He received the 2013 Award for Excellence in Research from the International Nut and Dried Fruit Council. He received funding and travel support from the Canadian Society of Endocrinology and Metabolism to produce mini cases for the Canadian Diabetes Association. He is a member of the International Carbohydrate Quality Consortium. His wife, Alexandra L. Jenkins, is a director and partner of INQUIS Clinical Research for the Food Industry, his 2 daughters, Wendy Jenkins and Amy Jenkins, have published a vegetarian book that promotes the use of the low glycemic index plant foods advocated here, The Portfolio Diet for Cardiovascular Risk Reduction (Academic Press/Elsevier 2020) and his sister, Caroline Brydson, received funding through a grant from the St. Michael’s Hospital Foundation to develop a cookbook for 1 of his studies. Sievenpiper has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of Health Research, Diabetes Canada, PSI Foundation, Banting and Best Diabetes Centre, American Society or Nutrition, INC International Nut and Dried Fruit Council Foundation, National Dried Fruit Trade Association, National Honey Board, International Life Sciences Institute, The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), and the Nutrition Trialists Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received in‐kind food donations to support a randomized controlled trial from the Almond Board of California, California Walnut Commission, American Peanut Council, Barilla, Unilever, Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods, and Nutrartis. He has received travel support, speaker fees, and/or honoraria from Diabetes Canada, Dairy Farmers of Canada, FoodMinds LLC, International Sweeteners Association, Nestlé, Pulse Canada, Canadian Society for Endocrinology and Metabolism, GI Foundation, Abbott, Biofortis, American Society or Nutrition, Northern Ontario School of Medicine, INC Nutrition Research & Education Foundation, European Food Safety Authority, Comité Européen des Fabricants de Sucre, and Physicians Committee for Responsible Medicine. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Wirtschaftliche Vereinigung Zucker e.V., and Inquis Clinical Research. He is a member of the European Fruit Juice Association Scientific Expert Panel and Soy Nutrition Institute Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the Study of Diabetes, Canadian Cardiovascular Society, and Obesity Canada. He serves or has served as an unpaid scientific advisor for the Food, Nutrition, and Safety Program and the Technical Committee on Carbohydrates of International Life Sciences Institute North America. He is a member of the International Carbohydrate Quality Consortium, Executive Board Member of the Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes, and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His wife is an employee of AB InBev. Dr Srichaikul has no disclosures to report. Additional information is available from the corresponding author on request. [my emphasis]

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If it had only been one or two companies I would have been more suspicious. But it is several, lots more than I even bothered to keep reading who. Some of which even sell meat products. To me that is a plus. I would not expect to see a pure meat/egg company subsidizing research that shows anti reasons to eat it.

I would bet a lot of money that there are genetic individual differences in what type of diet is optimal re cholesterol, and that for some, eating dietary saturated fat (likely the issue more than cholesterol for the people where it is an issue) is fine and for some not so much. So there probably isn’t one answer for all people, it’s mostly about trying stuff and seeing what works for you.

Maybe the one thing we can all agree on is that hydrogenated fat is bad, though.

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