talk about spending pounds to save pennies

Anecdotally over the years in many diabetes newsgroups and forums I have seen the same pattern emerge so often that I truly can’t understand the controversy any more.

My trigs are a tenth of what they are and my HDL doubled between the Healthy High Carb Low Fat diet (which isn’t) and my current low carb WOE.

There is often the downside that LDL increases – BUT my GP appears to agree with you, and others, that this is non-lethal in the absence of the trigs and low HDL. Curiously since starting to add more saturated fats my HDL has increased and LDL has decreased by about the same amount, so there are obviously non-simple things occurring.

My next plan will be to drop my simvastatin for a month prior to my next lipid panel to see what my actual unmedicated numbers come out to, but I suspect I may need to continue it as it’s the only thing I’ve found so far to knock down the LDL, to half what it was. Maybe some individuals actually DO benefit from statins, just not nearly as many as they are marketed at?

Meanwhile here in the UK we are currently being bombarded with this

http://www.nhs.uk/Change4Life/Pages/default.aspx

sponsored by Kelloggs Tescos and Unilever, so no bias there obviously

There is no doubt that statins will reduce LDL levels – that isn’t in question. The question is, so what? A lower LDL doesn’t translate into lower all-cause mortality. If you are a female, statins don’t help irrespective of your age; if you’re a male, they only help (and then only minimally) if you are under 65 years old and have had a heart attack. If you are over 65 they don’t help, and if you are under 65 and haven’t had a heart attack, they don’t help. And just having elevated LDL levels IS NOT the same as having had a heart attack.

One thought on the carb addiction front: since I started Topamax a couple of years ago, not only have I gained a terrifying alcohol tolerance, but virtually all of my prior binge eating habits have disappeared. While I haven’t been very good on the diet front, I’ve still managed to lose about 35 lbs since mid-August, which isn’t so bad for doing it half-assed. Only about 130 left to go.

I tested the alcohol thing once for kicks, and it took 9 shots in an hour to get me only sort of buzzed – I now have to ask what’s in a cocktail, as I fear for my poor abused liver.

It’s interesting how poking around on the intarwebs can change your whole perspective – a few years ago, I was going to school as an English and linguistics major, and thanks to protracted illness and new priorities, am going back in biochem and mathematics. This stuff is just so cool.

Would never have gotten here without your book, doc. My favorite physician ordered me to go out and pick up a low-carb diet and nutrition book (just not that Atkins!) when I was 13 and newly diagnosed with PCOS, and it reinforced every instinct about food I ever had, and made science class that much more interesting.

Got some sauerkraut fermenting in the kitchen right now – tasty, real food, good for you, and a biology experiment, all in one cute little glass jar!

Thanks for the work, doc.

Also, one of the many modes of action of the atypical antipsychotics is an antagonist effect on the 5-HT2C receptor. The ones that are the most potent antagonists are the worst as far as causing diabetes.

So, I’ll shut up now and go back to undecorating the Christmas tree. Happy New Year, and all the best to you and M.D.

He has noticed that the atypical antipsychotics (Risperdal, Zyprexa, Seroquel, and Abilify) *increase* carb cravings to the extent that patients often become diabetic as a result. I haven’t checked the mechanism of action, nor has he, but it might offer a clue about the brain chemistry involved.

Actually, in my experience (which is an “n” of one), it does. If you don’t mind my asking, how did you prescribe the 5-HTP? As a daily dose? PRN for “comfort”? And how much did you recommend?

Along the same lines, I expect that you occasionally prescribe SSRIs. Do you notice that any of the SSRIs increase or decrease carb cravings?

Well, you said it: you are an ‘n’ of one. Which doesn’t mean that it doesn’t work for you or that it won’t work for others. I’ve just found in my experience that it didn’t work as well as I thought it should. But it did work here and there, so I felt it was worthwhile trying if patients were fighting carb cravings. I usually prescribed it as a 100 mg dose daily at about 5 PM.

I have used SSRIs. I found that Zoloft seem to have a little carb-craving blunting effect, but, again, not a whole lot. It didn’t seem to me that the other SSRIs worked as well as Zoloft.

http://www.diabetes-book.com/articles/method_of_treatment.shtml

It looks like Dr. Bernstein has what is called a use patent, which means that he has a method patented for using commonly available substances to reduce carb cravings. If someone tries to exploit this method by trying to sell an alternating schedule of these substances, Dr. Bernstein could challenge them with his patent and either force them to quit or to pay him a royalty. In the case you described, in which an individual alternates supplements to decrease his/her own carb cravings, said individual isn’t really violating the patent because he/she isn’t selling the method. However, if an individual does use this method successfully, it would be a friendly gesture on his/her part to send ME a check. All such checks will be cheerfully accepted.

I’d also guess that part of the allure of carbs is that, at a basic biochemical level, the body adapts to using carbs–rather than fat and protein–as fuel. Once you’ve low carbed for awhile, your body begins to re-adapt to using proteins and carbs as fuel, and so they lose some of their allure. I don’t dispute their allure to opiate receptors, though.

Yes, one of my comments was captcha’d. When it sees a mismatch, your captcha widget generates an error message converts the comment to “\.” Evidently someone’s “\” got published upthread.

Sorry for the hassle. I didn’t realize there was a captcha feature on the comments. I just upgraded a couple of days ago to the latest version of WordPress, and the captcha must have come along with it.

I agree that the tryptophan/insulin/serotonin situation is part of the carbohydrate allure, but I’m not sure it’s the entire reason people bolt for the carbs. Taking 5-HTP (a precursor of serotoin that doesn’t require insulin to get into the brain) doesn’t seem – at least in my experience – to strongly blunt cravings for carbs. Maybe a little, but not as much as would be expected if increased serotonin were the primary driving force behind relieving carb cravings. I suspect that carbs have a more opioid effect, which gives them their addictive nature.

It accepted this one. Did you try previously without success?