Questions re: Metformin, Inflammation, Meds & Weight
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Questions re: Metformin, Inflammation, Meds & Weight
Hello there! Well, my labs keep coming in and there are some big surprises! I've been a Type 2 Diabetic since 2006, and was doing well on Metformin. I stopped the Met (and my other meds) and began a Paleo-style diet in November 2015 when the big D started and I found out I have autoimmune thyroid (Hashi's). Ultimately I received my diagnosis of LMC in April 2016. The reason I'm writing is that my A1C, which had been 5.3, 5.5, etc. even as late as 3 months ago, has now jumped up to 6.9!! Yikes!! I'm about 12 pounds heavier than I should be after my 8 weeks on Budesonide, but with the small amount of eating I'm doing and all the edema in my face, etc., it seems to me some of this must be inflammation?
For months, up until about 2 months ago when I started taking the antihistamines and digestive enzymes, which most thankfully have greatly reduced the D, my weight was about 10 pounds under my norm, due to everything going right through me.
Questions: Has anyone else experienced this phenomenon of weight gain while going through the healing the gut process? In my case, it's quite likely the extra weight that's causing my A1C to be higher, so that's not good. Also, in my research here and elsewhere, I haven't been certain whether Metformin is okay to take with MC? And, is it safe to take the combination of Metformin and Cholestyramine (which I haven't started yet)? Are there any contraindications to this/these meds with digestive enzymes or antihistamines?
I'll see my doctor in another 1 1/2 weeks; I just wanted to get your valued feedback and opinions before my appointment, in case she wants to put me back on the Metformin.
Thank you so much!
~ Holly
For months, up until about 2 months ago when I started taking the antihistamines and digestive enzymes, which most thankfully have greatly reduced the D, my weight was about 10 pounds under my norm, due to everything going right through me.
Questions: Has anyone else experienced this phenomenon of weight gain while going through the healing the gut process? In my case, it's quite likely the extra weight that's causing my A1C to be higher, so that's not good. Also, in my research here and elsewhere, I haven't been certain whether Metformin is okay to take with MC? And, is it safe to take the combination of Metformin and Cholestyramine (which I haven't started yet)? Are there any contraindications to this/these meds with digestive enzymes or antihistamines?
I'll see my doctor in another 1 1/2 weeks; I just wanted to get your valued feedback and opinions before my appointment, in case she wants to put me back on the Metformin.
Thank you so much!
~ Holly
2015 Hashimoto's, MTHFR
2016 LMC, Malabsorption
2017 Lymphocytic Dermatologic Vasculitis
"I strive to live in my heart, not in my head!"
2016 LMC, Malabsorption
2017 Lymphocytic Dermatologic Vasculitis
"I strive to live in my heart, not in my head!"
Oh dear ... doing even more reading from older posts here, I see that Metformin is one of those drugs that can cause MC, especially if one is genetically pre-disposed to it. I took Metformin from 2006 to when the MC started (late 2015). My suspected drug that set me off is the course of NSAIDs that my sports medicine doctor put me on following an extremely painful back injury in late 2013. He had me on the max dose of Motrin (800mg 3x day - yikes! if I only knew then ...) plus morphine and hydrocordone. I weaned myself off the opiates as quickly as possible, and tapered down on the Motrin a few months later. To this day I have pain (waiting for those magnesium levels to come up!) but just live with it. I have Tylenol in my back pocket if I really need it.
Another possible drug that may have caused my MC is Simvastatin, which I also took (low dose, 10mg day) for 10 years prior to my MC.
Brain fog, sorry for the rambling. My question is back to the Metformin. Since it was successful for me in the past at keeping my A1C down, and since I already have developed T2 Diabetes and MC, if my doctor wants me to re-start it now that my A1C is up, would it be a good idea to start it or could it prevent me from optimum MC healing? It's only been a couple of months since I've been off the Budesonide and really started to understand ALL the foods I need to eliminate, but I haven't been able to get my weight back down and my A1C has risen alarmingly.
Again, thank you for any input. I'm anxious to start the Cholestyramine (wonder if that might help in any way?) and want to make the best decision about re-starting Metformin. Like all of us, I'm trying to find the best and least amount of supplements and meds that are most effective!
~ Holly
PS ... I did find a few studies that showed Cholestyramine can reduce A1C levels in humans and rats (and I feel like a rat today!!!)! Polly and all, have you heard of this? Maybe taking the Cholestyramine would work for both MC and lowering blood sugars, without the Metformin! That would be so lovely.
Another possible drug that may have caused my MC is Simvastatin, which I also took (low dose, 10mg day) for 10 years prior to my MC.
Brain fog, sorry for the rambling. My question is back to the Metformin. Since it was successful for me in the past at keeping my A1C down, and since I already have developed T2 Diabetes and MC, if my doctor wants me to re-start it now that my A1C is up, would it be a good idea to start it or could it prevent me from optimum MC healing? It's only been a couple of months since I've been off the Budesonide and really started to understand ALL the foods I need to eliminate, but I haven't been able to get my weight back down and my A1C has risen alarmingly.
Again, thank you for any input. I'm anxious to start the Cholestyramine (wonder if that might help in any way?) and want to make the best decision about re-starting Metformin. Like all of us, I'm trying to find the best and least amount of supplements and meds that are most effective!
~ Holly
PS ... I did find a few studies that showed Cholestyramine can reduce A1C levels in humans and rats (and I feel like a rat today!!!)! Polly and all, have you heard of this? Maybe taking the Cholestyramine would work for both MC and lowering blood sugars, without the Metformin! That would be so lovely.
2015 Hashimoto's, MTHFR
2016 LMC, Malabsorption
2017 Lymphocytic Dermatologic Vasculitis
"I strive to live in my heart, not in my head!"
2016 LMC, Malabsorption
2017 Lymphocytic Dermatologic Vasculitis
"I strive to live in my heart, not in my head!"
Holly,
You won't find any research on this observation/opinion (at least I couldn't find any), but from what I know about magnesium deficiency's tendency to cause insulin resistance, I'll bet a GF cookie that the increase in your A1C level is due to an increase in your magnesium deficiency caused by the malabsorption problem associated with MC and other IBDs. The fact that you are gaining weight when there is no logical reason why you should be is further evidence that that my theory is correct.
Most people believe that increased adiposity increases the risk of insulin resistance, and that's generally true. But it's also true that the reverse can happen — increased insulin resistance (due to magnesium deficiency) can compromise the way that nutrients are transported to cells, and the increased insulin resistance would surely boost A1C levels.
IOW, I suspect that your A1C increase is due to increased insulin resistance because of a magnesium deficiency problem. Here's a quote from page 25 of my Pancreatic Cancer book (to be published in August, I hope). But note that this page number and this text may change before I finish the final edit.
24.Takaya, J., Higashino, H., & Kobayashi, Y. (2004). Intracellular magnesium and insulin resistance. Magnesium Research, 17(2), 126-136. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15319146
25.Sircus, M. (2009, December 8). The Insulin Magnesium Story [Web log message]. Retrieved from http://drsircus.com/medicine/magnesium/ ... um-story-2
But fructose is the main problem associated with weight gain, because fructose is metabolized differently form other sugars and it skips the insulin-signaling step. I have highlighted in red why fructose causes weight gain. From pages 49–50 of the PC book:
54. Ancira, K. (n.d.). What is the differene between sucrose, glucose & fructose? Healthy Eating [Web log message]. Retrieved from http://healthyeating.sfgate.com/differe ... -8704.html
Tex
You won't find any research on this observation/opinion (at least I couldn't find any), but from what I know about magnesium deficiency's tendency to cause insulin resistance, I'll bet a GF cookie that the increase in your A1C level is due to an increase in your magnesium deficiency caused by the malabsorption problem associated with MC and other IBDs. The fact that you are gaining weight when there is no logical reason why you should be is further evidence that that my theory is correct.
Most people believe that increased adiposity increases the risk of insulin resistance, and that's generally true. But it's also true that the reverse can happen — increased insulin resistance (due to magnesium deficiency) can compromise the way that nutrients are transported to cells, and the increased insulin resistance would surely boost A1C levels.
IOW, I suspect that your A1C increase is due to increased insulin resistance because of a magnesium deficiency problem. Here's a quote from page 25 of my Pancreatic Cancer book (to be published in August, I hope). But note that this page number and this text may change before I finish the final edit.
Here are references 24 and 25 from that quote:But this leads us to the magnesium connection again.
As mentioned in the previous chapter, magnesium deficiency plays an important role in the development of insulin resistance and type 2 diabetes. Researchers have shown that both hypertension and type 2 diabetes involve low intracellular magnesium levels.24 In the research article cited, Takaya, Higashino, and Kobayashi (2004) concluded that because magnesium is necessary for the proper utilization of glucose, and it's also used for insulin signaling, an intracellular magnesium deficiency may alter glucose availability and contribute to the development of insulin resistance.
Magnesium and insulin are co-dependent.
One cannot function properly without the other. And this is a 2-way street in many regards. Not only does a magnesium deficiency cause insulin resistance in the cells of the body and reduced insulin production by the pancreas, but there is a reciprocal effect. Insulin is responsible for the transport of nutrients to locations where they can either be immediately utilized or stored for future use. When the availability and effectiveness of insulin is compromised, extra magnesium in the blood cannot be properly stored, so most of it may be wasted instead.25
This can dramatically increase the odds that diabetes patients may develop a magnesium deficiency. And of course as the magnesium deficiency becomes worse, insulin resistance may increase and insulin production by the pancreas may decline even further.
24.Takaya, J., Higashino, H., & Kobayashi, Y. (2004). Intracellular magnesium and insulin resistance. Magnesium Research, 17(2), 126-136. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15319146
25.Sircus, M. (2009, December 8). The Insulin Magnesium Story [Web log message]. Retrieved from http://drsircus.com/medicine/magnesium/ ... um-story-2
But fructose is the main problem associated with weight gain, because fructose is metabolized differently form other sugars and it skips the insulin-signaling step. I have highlighted in red why fructose causes weight gain. From pages 49–50 of the PC book:
Here is reference 54 from that quote:Contrary to advertising claims made by certain industry interests, including their paid lobbyists in Washington, D.C., all sugars are not equal. The contention arises around the differences between the ways in which the body processes glucose fructose.
Sucrose, fructose, and glucose are all simple sugars. Sucrose (aka common table sugar) contains a 50–50 combination of glucose and fructose. By contrast, high fructose corn syrup (HFCS) contains a higher percentage of fructose, and the amount can vary over a wide range depending on the individual product specifications. When analyzed for their specific properties, they all provide the same amount of energy per unit of mass. But despite the fact that they contain equal amounts of energy (calories), the ways in which the body utilizes these sugars varies dramatically.
Glucose is the most important sugar (as far as energy production in the body is concerned) and it is also called blood sugar because it's the type primarily used by both the body and the brain as fuel. It can provide all the energy the body and the brain need (although when necessary, both the body and the brain can operate on the conversion of fat into energy).
It's important to note that glucose is the only sugar that triggers an insulin response.
Insulin is produced in response to an increase in the blood glucose level, but an increase in the blood fructose level does not cause an insulin response.54 This results in a completely different way of handling fructose metabolization.
Fructose can only be metabolized by the liver and the process requires the enzyme fructokinase. Insulin allows glucose to pass from the blood into the muscles where it can be immediately burned as fuel. But because fructose does not prompt the release of insulin, it will not have the opportunity to be burned as fuel, and because of that important difference, fructose digestion tends to result in the formation of more fat deposits.
Another important difference is the production of leptin.
Leptin is a hormone produced by fat cells and used by the body to regulate energy balance (read that "prevent overeating") by suppressing hunger whenever energy levels are already sufficient. Glucose stimulates the production of leptin, but fructose does not. Obviously the failure to promote the production of leptin creates an increased likelihood of overeating.
54. Ancira, K. (n.d.). What is the differene between sucrose, glucose & fructose? Healthy Eating [Web log message]. Retrieved from http://healthyeating.sfgate.com/differe ... -8704.html
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
- Gabes-Apg
- Emperor Penguin
- Posts: 8332
- Joined: Mon Dec 21, 2009 3:12 pm
- Location: Hunter Valley NSW Australia
Further to Tex's info about Magnesium
there is also a link between Methylation cycle and Diabetes
This highlights not just the importance of magnesium, but B12, B9, B6. (and in some cases other aspects of the methylation cycle)
http://www.news-medical.net/news/201602 ... betes.aspx
there is also a link between Methylation cycle and Diabetes
This highlights not just the importance of magnesium, but B12, B9, B6. (and in some cases other aspects of the methylation cycle)
http://www.news-medical.net/news/201602 ... betes.aspx
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
The prescription vitamin mix that I've posted about many times (Metanx) consists of the active forms of vitamins B-12, B-9, and B-6. Metanx was originally developed to treat the peripheral neuropathy that's often associated with diabetes. The active forms of those vitamins are used to treat metholation issues. Obviously that's additional evidence that diabetes is commonly linked with methylation issues.
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Holly - Weight gain itself does not cause an increase in A1C. Instead both weight gain and an increase in A1c are a result of the same disturbed metabolic processes namely hyperinsulinemia or high insulin levels which leads to insulin resistance. For me the key to keeping my blood sugar under control has been to eat a very low carb paleo diet. There's a lot of good diabetes info at the site dietdoctor.com. It is worth listening to a number of the videos there by Dr Eric Westman, Dr Sarah Hahlberg, Dr Jason Fung among others. I have always been able to adapt any dietary advice to the limitations in diet imposed by MC. I have supplemented with magnesium glycinate for years as well as the B vitamins but the foundation of my diet is very low carb. Since I have got my MC under control my weight has dropped 50 pounds without any real effort on my part other than sticking to my low carb paleo diet while avoiding all the foods to which I am sensitive.
Jean
Jean
Thank you so much to all!
Tex, I appreciate the information on magnesium and fructose, and how they relate to the blood sugar levels/weight gain. As I mentioned in a previous post, it appears from my latest magnesium lab that many months of the topical magnesium oil have not even begun to impact my critically low magnesium levels. So, I've just started the Re-Mag at the lowest dose, and will slowly work my way up to amounts that will hopefully begin to reverse this long-time deficiency. I've also ordered Doctor's Best Chelated Magnesium Glycinate, so will continue that important process. I know my body is starved for magnesium; I honestly thought I'd been treating it well for some time now. Live and learn, and move forward!
I may look into the Metanx vitamins. Thank you for that reminder. I do take the methylated B's, and feel good about the amounts and kinds I've been taking. (Thorne Methyl Guard Plus; Thorne 2/Day, and Metagenics B Complex)
Gabes, thank you for that link, which I found extremely helpful! Reinforces everything about the methylation cycle, magnesium, and puts it in context with my A1C/diabetes question.
JFR, thank you for your post and the link to the dietdoctor.com website! Very informative! You're absolutely right, I appreciate that it isn't the weight gain itself that causes the rise in A1C, rather it is the process of insulin resistance. (It's just been easier for me to think of it that way; the less of "me" there is, the more effective the smaller amount of insulin my body produces will be. That was before MC, and all the changes that have impacted my metabolism!) I appreciate what you're saying, and your encouragement about being able to stabilize weight and minimize insulin resistance/A1C through diet and managing my MC.
It seems I've been quick to panic again, and thank this wonderful group of people yet again for helping calm me, as well as providing knowledge and tools to figure out how to move through this instead of getting stuck in it. Now that I know my previous magnesium protocol wasn't enough, I'm trying these other forms recommended here, plus it's still not been long since my EnteroLab results and implementing a different diet plan based upon those results. With my Vitamin D and B levels high, plus the new forms of magnesium and diet, I'm hopeful that my insulin resistance, weight and A1C will drop naturally over the next few months. And when I see my doctor (endocrinologist), I'll tell her that.
Plus I have the cholestyramine at hand. My thought is to get my magnesium levels up first, then try the cholestyramine. The trouble with adding more than one thing (be it food, vitamin, supplement, medication) of course is that if symptoms develop, it's harder to know the cause. If any of you see a potential flaw in my "plan" or thought process ... PLEASE let me know!! I can tell my body is still highly inflamed because of the edema under my eyes and the belly bloat. If I'm understanding things correctly, both the magnesium and the cholestyramine help de-toxify the body?
~ Holly
Tex, I appreciate the information on magnesium and fructose, and how they relate to the blood sugar levels/weight gain. As I mentioned in a previous post, it appears from my latest magnesium lab that many months of the topical magnesium oil have not even begun to impact my critically low magnesium levels. So, I've just started the Re-Mag at the lowest dose, and will slowly work my way up to amounts that will hopefully begin to reverse this long-time deficiency. I've also ordered Doctor's Best Chelated Magnesium Glycinate, so will continue that important process. I know my body is starved for magnesium; I honestly thought I'd been treating it well for some time now. Live and learn, and move forward!
I may look into the Metanx vitamins. Thank you for that reminder. I do take the methylated B's, and feel good about the amounts and kinds I've been taking. (Thorne Methyl Guard Plus; Thorne 2/Day, and Metagenics B Complex)
Gabes, thank you for that link, which I found extremely helpful! Reinforces everything about the methylation cycle, magnesium, and puts it in context with my A1C/diabetes question.
JFR, thank you for your post and the link to the dietdoctor.com website! Very informative! You're absolutely right, I appreciate that it isn't the weight gain itself that causes the rise in A1C, rather it is the process of insulin resistance. (It's just been easier for me to think of it that way; the less of "me" there is, the more effective the smaller amount of insulin my body produces will be. That was before MC, and all the changes that have impacted my metabolism!) I appreciate what you're saying, and your encouragement about being able to stabilize weight and minimize insulin resistance/A1C through diet and managing my MC.
It seems I've been quick to panic again, and thank this wonderful group of people yet again for helping calm me, as well as providing knowledge and tools to figure out how to move through this instead of getting stuck in it. Now that I know my previous magnesium protocol wasn't enough, I'm trying these other forms recommended here, plus it's still not been long since my EnteroLab results and implementing a different diet plan based upon those results. With my Vitamin D and B levels high, plus the new forms of magnesium and diet, I'm hopeful that my insulin resistance, weight and A1C will drop naturally over the next few months. And when I see my doctor (endocrinologist), I'll tell her that.
Plus I have the cholestyramine at hand. My thought is to get my magnesium levels up first, then try the cholestyramine. The trouble with adding more than one thing (be it food, vitamin, supplement, medication) of course is that if symptoms develop, it's harder to know the cause. If any of you see a potential flaw in my "plan" or thought process ... PLEASE let me know!! I can tell my body is still highly inflamed because of the edema under my eyes and the belly bloat. If I'm understanding things correctly, both the magnesium and the cholestyramine help de-toxify the body?
~ Holly
2015 Hashimoto's, MTHFR
2016 LMC, Malabsorption
2017 Lymphocytic Dermatologic Vasculitis
"I strive to live in my heart, not in my head!"
2016 LMC, Malabsorption
2017 Lymphocytic Dermatologic Vasculitis
"I strive to live in my heart, not in my head!"
- Gabes-Apg
- Emperor Penguin
- Posts: 8332
- Joined: Mon Dec 21, 2009 3:12 pm
- Location: Hunter Valley NSW Australia
you probably are taking great amounts, the thing with magnesium, the body will 'get by' on minimum amounts. once you start taking it, and the levels increase, the body sort of wakes up and starts doing all the functions that it needs the magnesium for, so the demand gets higher (does this make sense)I know my body is starved for magnesium; I honestly thought I'd been treating it well for some time now. Live and learn, and move forward!
Cell health and body healing takes weeks /months - if you break a bone it is 8 weeks healing time (longer if you are older or unwell)
(it is early days for your healing journey, you joined us just over 4 weeks ago)
what I see from the discussions on the forum (and from my own experience) we are healing years and years of inflammation, leaky gut, and nutritional deficiencies, toxin build up etc. the healing and rebuild journey is months and years
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
Yes, this makes sense. My magnesium blood lab last week showed 1.4 (at 1.6, the ER infused me, so I know it's critical); ref range 1.8-2.5 mg/dL). I've had all kinds of magnesium deficiency symptoms for the past 25 years, and was basically diagnosed with severe depression. My MC symptoms began in November 2015, and first came my Hashimoto's diagnosis, then in April 2016 my LC diagnosis. EnteroLab results just came in late July 2016. So yes, it's definitely early in the game for me, I know that. You and the people on this board have helped me immeasurably, and I can never express my gratitude enough.
I hope I don't come across as expecting everything to get better overnight. I do understand it is a long and individual journey for healing the leaky gut, toxic buildup, inflammation, et al. And that we have to try different things sometimes to find out what works best for each of us.
~ Holly
I hope I don't come across as expecting everything to get better overnight. I do understand it is a long and individual journey for healing the leaky gut, toxic buildup, inflammation, et al. And that we have to try different things sometimes to find out what works best for each of us.
~ Holly
2015 Hashimoto's, MTHFR
2016 LMC, Malabsorption
2017 Lymphocytic Dermatologic Vasculitis
"I strive to live in my heart, not in my head!"
2016 LMC, Malabsorption
2017 Lymphocytic Dermatologic Vasculitis
"I strive to live in my heart, not in my head!"
- Gabes-Apg
- Emperor Penguin
- Posts: 8332
- Joined: Mon Dec 21, 2009 3:12 pm
- Location: Hunter Valley NSW Australia
no, you are sounding the same as many people here, i think of it like 'Alice in Wonderland' type journey at first you think you have landed in a strange land and things are very different and people are borderline bonkers, and then it all starts to makes HUGE amount of sense, and the lightbulb moments happen, as you read posts and you relate it to your symptoms and various events over the past 5-10 years, you relate to the people here and make friends. Then you get excited about finding answers, and even more enthused and motivated about reading and learning that you can fix things, and improve your wellnessI hope I don't come across as expecting everything to get better overnight.
You are entirely bonkers, but I will tell you a secret, all the best people are
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama