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Your thoughts please

2K views 5 replies 5 participants last post by  Taso 
#1 ·
I recently had to see a new doctor (my former has gone on to practice in mental health) because my prescriptions had run out. I've fallen off my wagon for several months. Fasting was 267 three weeks ago. Back to lifestyle changes so down to 200 - 225 fasting now. I am mad at myself for agreeing with the doc to begin Metformin today. Feels like I have either failed or was not strong enough in resisting.

I have always been "a bad patient" meaning that I do a lot of health research and resist many doctor recommendations. Their goal clearly seems to be getting you on more and more medicine. They do not listen to lifestyle success or recommend those type of changes.

This new doctor probably is just very thorough but she seems to order unnecessary things. When I first saw her, she ordered a heart ultrasound when looking at my ankles (they were NOT swollen). I have no heart symptoms, angina, shortness of breath, etc. When I asked her yesterday what she saw in my legs to warrant the test, she just said I should know the health of my heart.

I noticed on my blood results that the ALT was 60 (high range is 29). She said it was not very high and then ordered a blood test to rule out hepatitis. When I read online, high ALT is hard to define and even liver diseased patients can have perfect readings.

I am to see her in 2 weeks and full blood work again in 3 months. I forgot to mention to her yesterday that I will not take the prescribed statin.

Three years ago, in 3 months time I dropped my bg from 270 to 105 with low carb and treadmill alone and ALL other numbers fell to within normal range. I did this, I lived it, but the doctor just passes over it and even stated "I don't think those are going to do it". That negativity makes me angry.
 
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#2 ·
I do think it's important to have a good working relationship with our doctor, but it's not always easy to find. And even when we do, our doctors can be wrong or we can disagree about our course of treatment.

Medication can help us get back on our feet when we've gone off program, and I put metformin and insulin in that category. You did it before with diet if I read you correctly, and most likely can do it again. But it doesn't hurt to get a boost from metformin, which is the only oral med I'd personally be willing to take. Alternately, you could decide not to take it for a couple/few weeks, stick closely to LC/HF, and see what results you get.

Agree on the statin! Be prepared for resistance, but I've successfully rejected them without being combative, and have agreement from my docs that we won't run lipid labs as I'm not prepared to do anything with the results.

In the next two weeks, sticking with LCHF, you will likely have great results to show your doc, and that does tend to change things. Then - in 3 months - your A1c will have improved significantly.

In your shoes, I'd give the doc a chance until after the 3 months. If I didn't then see progress in communication, or acknowledgement of my point of view, I'd probably start looking around for another one.
 
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#3 ·
Hi Lavendar -

I'm sorry your doctor doesn't listen to you, I know it's frustrating, especially when you had obvious success when you were first diagnosed.

When I was first diagnosed, my doctor and I wanted to get my numbers down by diet and exercise alone and when I followed LCHF, it was starting to work. And I was adamant that I would not go on any meds.

Fast forward as I've wobbled up and down (mainly up) and recently even with going back to LCHF, I was not able to get my numbers down.

I've done a 180 on medicine (at least Metformin and insulin) - they've totally changed how I view diabetes management and I consider them additional tools to help me control my sugar. That said, ideally I'd love to get off the meds, but I feel like these are giving me some breathing room, while not continuing to do damage to myself.

I'm also never upset when the doc orders various tests - I like to have a baseline, helps to see if there are any noticeable changes down the road. But that's just me.

Bottom line, though - luckily you have the control over whether to take the statin or metformin. So maybe you keep on with the LCHF and exercise and see where it goes from there?
 
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#4 ·
Hi Lavender!

It can be frustrating trying to find a doctor that works well with you. Even though their first instincts may not match yours, I try to focus on if they listen and are willing to let you "drive". For example, if you are interested in trying low-carb for say 3 months and only taking Metformin if diet alone doesn't get you to your goals, and your doctor is willing, then that may be a doctor worth sticking with a bit longer.

You said that you've managed to bring your fasting blood sugar down from 267 to 200 with changing your diet. How long have you been at it and what does your daily diet look like? We can help with suggestions or recipes to try.
 
#5 ·
About the ALT. Those liver panel values can be used to find hepatitis, but I've found them also to be a good surrogate for if you currently have NAFLD (non-alcoholic fatty liver disease). When I'm off the wagon, my liver numbers are all elevated and when I am being good, eating low-carb, they are in the normal range. It is something to monitor over the years because like diabetes, it NAFLD doesn't really get cured, just under control.

A very low-carb diet works well for many people to get NAFLD under control. I've read studies that Metformin is safe to take when you have NAFLD. It does help reduce insulin resistance, and while it doesn't improve your liver numbers all by itself, can help you lose weight and get your blood sugar a bit more under control. Basically, Metformin doesn't help with NAFLD but it doesn't hurt either. :D
 
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