Functional Medicine/insulin resistance
QUESTION: Hi Steven,
I have insuin resistance ( high FI), but my fasting BS is OK, I eat a low carb diet, exercise daily,low BMI, cholesterol, trigly., but hi free fatty acids and hi hsCRP, and no-one can figure out why! I take 1000mg Metformin x2/day, and yet every am after a low carb, hi-protein, mod. fat breakfast I still feel more tired than when I got up, and get a bad headache. Normally I never get headaches. Meals later in the day are fine, but I cannot survive breakfast! If I don't eat for sev. hrs, I feel even worse, with the same symptoms. I eat a v. anti-inflammatory diet-v.low sugar and gluten free( as the gluten made me feel drugged and I was literally falling asleep after breakfast, so eliminating that helped tremendously. I have no idea why this is suddenly happening. Up until 3 yrs ago my hs CRP was less than 1-now it fluctuates between 3 and 6, for no apparent reason! Do you have any ideas please-they would be so appreciated! Thank-you for your time, Tina
ANSWER: Sorry, I had composed a lengthy answer but my computer locked up and I lost all the work.
I'll have to run some scans. I'll get back to this in a day or two. But dont worry, your issues are fixable!
I do suggest you go to a site called drugs.com and look up all the side effects for Metformin (not just the common ones). As I recall, some people do get increased inflammation from it.
Let's see if I can send this.
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QUESTION: No worries- look forward to your reply as and when convenient:-)
I finally caught my breath again. I've been trying to get a bad journal publication retracted, which is like trying to unring a bell!
I hope you were able to find some info on Metformin. I have seen inflammation and headaches as part of the side-effects people get. In truth, most docs don't pay much attantion to side effects. Mostly, patients have to communicate them. So did the headaches start around the time you started the Metformin, or after a dosage chage? Maybe the higher inflammation as well?
Here are some thoughts on the other things in your question (I have to remember what I wrote):
The hs CRP value is a concern, especially if it continues over a long period, say several months or longer. A good level is 1, maybe 2 max. Mine was less than .05 a few years ago. A level of 3-6 is high, and the inflammation can damage organs or trigger auto-immune or other serious problems (see link below).
The BMI without body fat percent number is not very useful. I always tell clients we need to include body fat percent, whci is a more reliable number. Here is a link to a body fat calculator you can use:
You mentioned low-carbs and I assume you mean "low refined carbs" like sugar, soda or wheat-based products (cookies, crackers, cakes, muffens, pasta, etc.). You also mentioned gluten free which is often produced with rice flour, potatoe starch an dother grains, and those are often bad for glucose levels. I stopped eating wheat and most sugar years ago. I don't miss any of it! But as a health coach, I know how to find substitutions.
You may not realize it but most veggie oils are inflammatory. Oils like corn, soy, safflower, canola, etc., are all reined, high omega-6 oils (and often found in salad dressings and many processed foods/meals/snacks). Those can trigger inflammation, just like refined carbs do! EVOO or some coconut oil can work better n dbe less inflammatory. EVOO is actually anti-inflammatory.
How many slow carbs do you have daily (veggies like broccoli, cauliflower, brussels sprouts, beans, asparagus, etc.) Or fruits like berries or grapes in modest servings can also offer slow carbs. I mention those because they don't tend to spike blood sugar and sometimes, too little glucose can also trigger headaches. I'm thinking of that because you said you feel worse if you don't eat.
Also, have you had your 25-hydroxy vitamin-D checked? it's critical for blood sugar, bone health and your immune system. Vitamin D3 is really a pro-hormone, not a vitamin. It helps to regulate many systems, including the immune system/inflammation. I try to help clients reach 40-50 ng/ml. Most docs will think that's too high (they think 30 is enough).
Here is a post I wrote on Inflammation:
I also wonder why you are taking Metformin? It sounds like you've had a type-2 diabetes diagnosis, which is often treatable and curable with lifestyle interventions.
In truth, the body is like a unique puzzle (no two people are the same). To be complete, all the pieces need to be connected in the right place to make a picture of health! And most docs are terrible at that part!
I hope those thoughts are helpful!