Disease, Physiology

Ketogenic diet – a remedy for Diabetes?

So far, diabetics have had to resolve to getting insulin through multiple injections daily (or through a insulin pump). All diabetics have been taught to eat a “heart healthy” low-fat diet, with a lot of carbohydrates and they learn to adjust the amount of insulin needed to keep their blood sugar within reasonable limits. They never get to the same blood sugar control as a person with a functioning pancreas of course, but with practice many get really good at keeping it in check.
Having diabetes also automatically raise the risk for comorbidity – that is having other diseases. The most commonly associated ones are cardiovascular diseases – i.e myocardial infarction, micro-vascular dysfunction that leads to kidney failure, poor eye sight because of bad circulation in the retina and poor leg circulation leading to difficulties healing wounds and sometimes needing to amputate toes, feet or a whole leg because of ischemia (oxygen deficiency).  These diseases occur because sugar have tendency to react with proteins and make them dysfunctional. The more of the changed proteins you have, the more inflammation, because that’s how the body tries to deal with them. Inflammation is good when it’s kept in check, but it is also damaging for the tissues.

Of course, not everyone with diabetes will succumb to these diseases, but the risk a lot higher than for an average person without diabetes.
It’s pretty easy to understand that having a normal regulation of blood sugar is the pivotal point here. If you don’t have diabetes or any problems with blood sugar regulation you never have to worry about what will happen to the sugar, your body just handles it. But when having diabetes you have to become your pancreas and figure out just how much insulin is needed to get the sugar into the cells, but not lower it too much, a tricky balance.

I find it really interesting that diabetics are told to eat a diet high in carbohydrates and low in fat, since it is the sugar that is the problem. It doesn’t matter if you eat a spoon of sugar or a “low-GI” carbohydrate, it will all become glucose in your blood.
There is a bunch of different versions of insulin for injections, and they all have their different profiles of how they affect blood sugar. Most of the ones taken with a meal are fast and short acting, with an effect that lasts for two to five hours. It can be tricky to know just how much insulin is needed to end up in a good range.

A case study (that is one person has been studied) has been published in the International Journal of Case Reports and Images (1). It shows how a young 19-year old man, newly diagnosed with diabetes, goes from a standard, conventional diabetes diet – 6 meals daily, containing about 240 grams of carbohydrates. He had a hard time keeping his glucose levels in check, fluctuating between 68 to 267 mg/dL (normal is considered below 140 two hours after a meal, but most healthy people are lower than that).
20 days after being diagnosed he shifted to a low carbohydrate diet, in this case a paleolithic ketogenic one. He consumed meat, organ meat, fish, fowl, eggs and fat and very small amount of vegetables. He did not eat oils of plant origin, milk products, sugars or artificial sweeteners.
From the first meal he discontinued insulin, because his glucose levels never went high enough to take it! As he continued the diet the pancreas seemed to restore it self and insulin was continuously being produced. This was measured through a protein called C-peptide, which is cut of from the insulin as it is released into the blood stream and it correlates to insulin levels in the body.

He had been on a ketogenic diet for 6,5 months when the report was published, and he was still doing well, with low/normal glucose levels and he was not experiencing any side effects.
When having diabetes in a young age, there is usually auto-antibodies, directed towards the cells producing insulin in the pancreas, and so was the case for this man as well. It seems his diet has not only kept him of insulin but also halted the auto-immune process, because the levels were unchanged four months after starting the diet.

This is a case study and you can’t draw to many conclusions from it when it comes to looking at the whole community of diabetics. Some might not have any insulin production left for example.
From my clinical experience and from other observational studies, it seems that lowering the carbohydrate intake does help people with diabetes to manage their blood glucose levels and also get off blood sugar regulating drugs and lower their need for insulin.
And that’s all we want in the medical profession. We want our patients to have a well regulated blood sugar and with as little insulin as possible, because we know that’s how they can stay healthy for as long as possible.

I actually have a type 1 diabetic patient in my clinic that just have made the shift from a standard diabetic diet to a low carbohydrate one, and she’s experiencing some amazing results! How about getting of insulin completely three days into the diet, after being on both a long- and short-acting one for 25 years?
Keep a look out on my blog for more about her!

I think we are moving towards a big shift in how we look at diseases like diabetes. There is so much more that can be done than just resorting to insulin injections!
Hopefully this and other case studies will push the science towards a more open mindset and allowing individualized treatment that might, or might not contain insulin or other drugs.
I am convinced that what we eat affects our bodies, and cases like this make it pretty apparent.

From my perspective it also feeds my conviction that we all are best of with as little sugar (that includes all carbohydrates) as possible in our diets. Type 2 diabetes is on the rise, and it is seems to be connected with our high carbohydrate, low fat and no exercise life styles.
I’m not going to wait for the medical community to catch up. Do your own research, read up on the human physiology and it will speak for itself!

1) Tóth C, Clemens Z. Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet. Int J Case Rep Images 2014;5(10):699–703. http://www.ijcasereportsandimages.com/archive/2014/010-2014-ijcri/CR-10435-10-2014-clemens/index.php

Disease, Medication

Hypothyroidism – being on the backburner.

The thyroid is a very important player when it comes to regulating our metabolism and as a result our energy levels. To read more about what the thyroid does, go here.

Thyroid issues is very common in the industrialized world and an increasing health problem, and about 90% are women. A recent study suggests that up to 10 % of women over 60 suffers from hypothyroidsm, which translates to low levels of Thyroid Hormone (TH).  There are also the opposite, hyperthyroidism, with too high levels of thyroid hormone, but it usually ends in a burn out of the gland and a hypothyroid state.
The focus of this article is on hypothyroidism, the causes, symptoms, measurable blood work and treatment.

The most common underlying cause for thyroid hormones is Hashimoto’s thyroiditis, an autoimmune disease where antibodies from our own immune system attacks the cells of the thyroid. The antibodies are directed towards Thyrosine Peroxidase (TPO), an enzyme that makes iodine biologically accessible for the thyroid cells.
Hashimoto’s has been associated with other autoimmune diseases as Chron’s disease (an autoimmune disease that affects the bowels) and Reumatoid Arthritis (RA). Autoimmunity is more common in women than men, and it is believed to have a connection with the fact that women’s bodies are meant to conceive and carry a baby (in this case a foreign object). So the immune response is tuned in a little differently between men and women.

Symptoms of hypothyrodism:

  • Chronic fatigue
  • Difficulty concentrating
  • Slow speech
  • Feeling low or depressed
  • Hair loss
  • Loss of apetite
  • Easy weight gain
  • Constipation
  • Infections
  • Inability to tolerate cold
  • Muscle weakness and cramps
  • Heavy periods and painful premenstrual periods
  • Discoloration of the skin, a yellow-orange color. Dry, saggy, old looking skin.
  • Goiter (swelling of the thyroid gland)

As you can see, many of these symptoms are pretty unspecific, meaning that they can be attributed to many different conditions and they can also be fluctuations in your normal state. Since none of the symptoms directly points towards a certain disease, ea they are not pathognomonic, it’s important to address if there has been a lasting change. Did you notice a difference 2-3 months ago? Has it continuously stayed the same or become worse? Do you have many of the symptoms? Then that makes hypothyroidism more likely.

TH is crucial for the body to keep it’s systems going and keeping up the metabolism. Without it you will be put on the back burner, and your life tends to be lived in a shade of grey.

Diagnosis
When you go to your doctor with these complaints, some blood samples will usually be drawn. Namely T4, T3 and TSH (for more info about them go here), the main actors on the stage. If the results indicate hypothyrdism – low T4 and/or T3 and high TSH, some additional testing might be done, to look for TPO-antibodies or other antibodies that also might be the culprits of thyroid dysfunction.
Sometimes the results will come back within the range and you will be told that there is no problems with your thyroid and you might even be given antidepressants, because they symptoms are pretty similar. It is important to remember that the blood tests won’t tell us everything. The “normal” ranges that laboratories use is the average of all the tests that they have been doing, and since many people that are being tested have a disease or anomaly, the ranges will be skewed. There are many levels where TH levels can be affected and some of them don’t show up on your tests.
If you have trouble converting T4 to the active T3 in your cells this won’t show up on your normal tests, and sometimes your doctor will  measure reverse T3 (rT3), an inactive version of the T3 hormone. If that is above normal and the other tests are within range, the issue might be on the cellular level. That brings us to the next important point. This hormonal system does not operate as a sovereign entity in the body, it collaborates, is influenced by and influences other organ and hormonal systems in the body. That’s what the body does, balances for all it’s might to keep all of it’s systems in that sweet range of healthy and excellence.

Another system that heavily influences the thyroid is the Hypothalamus Pituitary Adrenal (HPA) -axis. The adrenals are glands situated on top of your kidneys and they secrete, among others, a  stress hormone called cortisol. Cortisol inhibits the conversion of T4 to T3 and pushes it direction of rT3. Another hormone in this same axis, CRH (that stimulates the release of cortisol) inhibits the effects of TSH on the thyroid and through that lowers he amount of available TH. So if having symptoms of hypothyroidism the adrenals should be addressed as well.

Treatment:
The common treatment in modern western medicine today is to add what is missing, in this case thyroxine or T4. Depending on your doctor you’ll be prescribed different versions of the same thing.
Sometimes this is enough to get the symptoms to go back, but the real issue, the dysfunction of the thyroid, haven’t been addressed.

There are many things that can influence the health of your thyroid, including gut issues, high inflammation, very low blood sugar, high amounts of fluoride or other toxins to mention a few. Iodine and Selenium are also two very important elements for a healthy thyroid.
So the most important thing is to make sure you live in a way that supports your body. Eating a nutrient dense diet, giving you all the nutrients you need without a heavy toxin load. This means getting away from processed food, cooking from whole foods, preferably organic and locally grown/produced. Stay low on the sugar/starches, moderate on high quality protein (grass fed beef, small fish, shellfish, pastured chicken etc)  and get a lot of good fats (butter, coconut oil, olive oil, avocado oil). Be sure to use salt with iodine. Drink enough of clean, filtered water.
Make sure you get to exercise and use your body daily, get fresh air and sunlight if possible. Clean up your life, make sure you do what you want to do, make room for silent moments and time to heal. Meditate, do yoga, do some kind of inner work. Let your self relax and have fun. As you could read earlier in this text, your thyroid is heavily influenced by the stress level in your body. Get enough good sleep.

Eating good food, low in sugars, drinking enough water, enjoying the outdoors, exercising, sleeping enough, being mindful, relaxed and having fun can take you a long way and help you correct minor thyroid imbalances and prevent thyroid issues in the future.
And even if you need to use drugs, giving your body what it needs will keep you as healthy as possible, even with your disease.

There are discussions if substituting with Iodine and Selenium could be beneficial or even have healing effects on hypothyroidsm, but I haven’t found any clear data or recommendations on this. It’s an interesting thought to keep in mind, and I’m sure there will be a blog post on that pretty soon.

If you have symptoms of hypothyrodism or know you have it, I highly recommend you work with a professional, an MD or a naturopathic physician that is willing to discuss both the medication and life style changes as well as supplementation that you can make. Sometimes medications are necessary, so having a health care provider that you trust and can discuss with is of uttermost importance for your optimal health.
Don’t be afraid to ask and discuss with your doctor, it’s your life and you deserve to have the best life you can possibly imagine!

Recommended reading:http://chriskresser.com/?s=thyroid
http://blog.cholesterol-and-health.com/search/label/Thyroid
http://www.saragottfriedmd.com/adaptogen-herbs-to-heal-your-thyroid-and-boost-metabolism/

Please tell me your story, post your questions, or just tell me what you think in the comments. I’m looking forward to hear from you!