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Insulin/Glucose Results & Hormones

Discussion in 'Hormones' started by jpredsoxdude00, Sep 18, 2017.

  1. jpredsoxdude00

    jpredsoxdude00

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    Hello-

    I am not much of a poster, but I do read many forums here and I was hoping to get some insight regarding some new test results. Last year, I was revealed to have low cortisol throughout the day, along with borderline elevated DHEA levels and elevated testosterone. I have recently suspected insulin resistance as a problem so we ran a GTT test with Insulin Response. My results were:

    Fasting: Glucose 90; Insulin 3.8
    1-Hour: Glucose 135; Insulin 19.4
    2-Hour: Glucose 90; Insulin 27.4
    3-Hour: Glucose 45; Insulin 2.7

    It appears as though I have a delayed insulin response, however the insulin levels never appear to elevate to an extreme level, but this pattern does appear to be causing reactive hypoglycemia. I am wondering if anybody is familiar with this pattern.

    One thought I had was that this could be an insulin resistant state, but the adrenals are lowering cortisol production and elevating DHEA as protection against hyperglycemia and increased insulin levels and that perhaps some underlying mechanism is causing an endogenous insulin resistance problem. In other words, possibly a masked diabetic state. My doctor attempted to treat me with some low-dose hydrocortisone (as it was only slightly below the range) but this ended up making me feel worse.

    Anybody have any insight?
     
    Last edited: Sep 18, 2017
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  2. Kati

    Kati Patient in training

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    Hi @jpredsoxdude00, what is your doctor trying to treat with low dose hydrocort? Low cortisol? i believe that science has not proven helpful in treating low cortisol with steroids. In my case, i had critical low reading of morning cortisol and a regular dose of cortef (20mg in AM and 10 in afternoon) did not raise significantly my Cortisol levels.

    However the hydrocort will worsen your insulin resistance problem if it is what you have (i cannot comment on your lab results, but i would suggest you bring them to a good endocrinologist so they can advise).

    Do make sure if you come off the hydrocortisone, that you do so very very gradually. You may end up feeling worse while you are weaning off them but it will stabilize. Physicians will advise on how to wean off and you may need to take on an even slower approach.

    Best of luck.
     
  3. jpredsoxdude00

    jpredsoxdude00

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    @Kati thanks for the response. Yes, he was suggesting a 3-month course of hydrocortisone (to be gradually weaned off of) to assist in what he said was adrenal insufficiency. I lasted a couple of days on it but realized it was making me feel worse. Being that I only took if for a couple of days, weaning off was quite easy (since it was also a low dose to begin with). Since my DHEA levels are slightly elevated and taking the cortisol made me feel worse, I have a feeling the adrenals are functioning fine and are not the cause of the low cortisol, but rather responding accordingly to another imbalance. To me, it seems theoretically possible that the body may respond to elevated blood glucose/insulin resistance by reducing cortisol and increasing DHEA, thus making the GTT seem more normal than it should, but I just don't know enough about these interactions to know if this can actually occur. I have read that insulin resistance can lead to hormonal imbalances, but most research specifically talks about PCOS, which is irrelevant to my situation as a 23 year old male.
     
    Last edited: Sep 18, 2017
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  4. Kati

    Kati Patient in training

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    I have a contact interested in these matters, i will ask her. Do you have a ME diagnosis? Do you have a lipid (HDL, triglycerides) problem as well and do you have weight issues?

    Of course, your best bet is seeing an endocrinologist. But i am interested in the topic and may have similar issues, though i never had 3hours GTT
     
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  5. jpredsoxdude00

    jpredsoxdude00

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    @Kati that would be much appreciated! I do not have an ME diagnosis, but a set of symptoms that have at times mirrored ME or CFS. My problems started with what seemed like a stomach infection (h. Pylori) and my GI has not been right since, but abdominal scans, a variety of top notch stool exams, Hydrogen Breath tests, food intolerance + allergy testing and other testing has revealed nothing of any sort of pathogenicity. Food elimination diets have not worked to relieve anything sand I have tried many, many different things for the GI problems, and I am beginning to think that the GI problems are a symptom rather than the cause. The abdominal pain is a burning sensation sometimes right above or below the belly button, which has made me begin to wonder if GI motility is to blame, and if so, what is causing it. Some of my first initial symptoms were hypoglycemic-esque and I am wondering if there is something that has been unfolding. About a year ago, a supplement with iodine created a whole host of issues. Later on, my doctor mentioned my T3 levels were a tad low, and tried Natur-Throid, but this created the same issues as the iodine. My thyroid hormones have been mostly normal since, but it seems as though my body does not respond well to thyroid stimulation. I have read that hyperthyroid states can unmask or aggravate blood sugar problems, since it revs up the metabolism.

    NutrEval revealed some low Krebs Cycle metabolites, zero lactate, elevated Suberic Acid, elevated 3-methylhistidine, and some other problems, but other blood tests have revealed no vitamin deficiencies. B-Vitamins seem to worsen my problems, and I have researched methylation quite a bit. Throughout this process, the stomach problems have come and gone, but now seem here to stay. Amongst the GI issues, I have a burning tongue, metallic taste in my mouth, hair loss, muscle pain, twitching, back & forehead acne, a burning feeling in my legs, headaches, fatigue, hot/cold flashes, periods of sweating, etc. The list goes on and changes all the time.

    My cholesterol panels are good and I am very average weight with a BMI of 21.7. History of T2D in my grandparents, but it was late onset in their 60's. If I do have insulin problems, it is likely genetic, but there is not a lot of info on the SNPs most relevant to diabetes.
     
    Last edited: Sep 18, 2017
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  6. Kati

    Kati Patient in training

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    @jpredsoxdude00 thank you for sharing this history, and I am sorry you are dealing with this so young in your life. How disabling are your symptoms? Are you able to work or go to school?
     
  7. jpredsoxdude00

    jpredsoxdude00

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    @Kati thanks for listening! I have actually been able to somehow power through it and finished my Master's degree this summer, all with the goal of figuring this mess out and joining the real world. I am a bit nervous to take a job when I have no idea what the day will bring for me, but I am hoping I am closer to figuring out the mess.
     
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  8. Isaiah 58:11

    Isaiah 58:11

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    A Sun-Scorched Land
    This is fascinating.

    I am female, but have essentially the same problems. I know this is typical of PCOS, but I have never been diagnosed with that as I don't seem to really fit the profile: I have had these problems while having children (all on the respective first attempt), having normal ovarian ultrasounds, and having a low-average BMI (currently 18).

    My prepubescent daughter has been having the same so I am trying to figure out if it is some sort of non-classic adrenal hyperplasia, but it looks unlikely as my random draw 17-oh progesterone, etc. were normal. I haven't had an ACTH stim test though, so who knows...

    I have been diagnosed with ME/CFS though.

    -----

    Edited for fuzzy brain spelling error.
     
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  9. jpredsoxdude00

    jpredsoxdude00

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    Hi @Isaiah 58:11 . Yes, my situation seems to have strange parallels to PCOS, but for obvious reasons, that is impossible in my case. It makes me wonder if is there may be some strange phenomenon by which insulin resistance may trigger hormone imbalance that somehow masks the condition and creates symptoms through these imbalances, unrelated to PCOS. This would imply that full-blown diabetes requires multiple mechanisms to fail in order for it to manifest, which we know to be true. It seems possible to me that insulin resistance may exist on a deeper level for genetic or other unknown reasons, but some people's bodies are better equipped to deal with it, perhaps by adapting and producing less cortisol and more DHEA, amongst other mechanisms. This would make things seem normal on the surface level in regards to typical diabetes markers and symptoms, but could manifest with symptoms not necessarily commonly associated with insulin resistance. I don't have enough knowledge about these hormonal interactions to back this up, but it seems possible, since there are many factors that lead to insulin resistance, most likely different for everybody. Most research is focused on those who develop T2D due to lifestyle and the mechanisms underlying may be drastically different versus those who do not fit the typical T2D risk factors. I am thinking perhaps some combination of busted genes. The rest of the body may be "healthy" enough to try and offset these imbalances, leading to atypical presentations. Interestingly enough, I have read things that suggest Metformin can lower both testosterone and DHEA, which is curious. Hopefully we can get someone with more knowledge on this delicate interaction to explain more in depth so that we may have some explanations.



    Have you had a GTT to measure glucose levels and insulin responses?
     
    Last edited: Sep 18, 2017
  10. Isaiah 58:11

    Isaiah 58:11

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    A Sun-Scorched Land
    @jpredsoxdude00 I may not have been clear, I apologize. I have not been diagnosed with PCOS even though I have the hormone imbalances. I do think there is something else at play that makes this a protective mechanism, but I have no idea what it is. I am certain, though, that it has to do with ME/CFS because this all started after onset. (And my daughter's TGFb1, cd57, etc. were just as bad as mine.) The closest thing I have found to this being a protective mechanism is related to PTSD, which I do not have. Though maybe the body reads physiological stress and psychological stress the same (neuropeptides and all that mind-body stuff) and we could have a purely physiological PTSD-like syndrome? That sounds pretty out there though. :rolleyes:

    I haven't had a GTT since my last pregnancy. It was normal. It looks like my last labs were about a year and a half ago with fasting glucose at 91 and fasting insulin at 5. Supposedly my HBA1c was just under the cut off so I was given a glucometer. I have tested all sorts of things with it and never see an abnormal reading according to the <140 hr postprandial standard, but I read somewhere that optimal is actually <100 after 2 hours and I would typically be over that. Today, however, I tested it 2 hours after eating a load of biscuits and gravy because I felt cotton-headed and it was only 84.

    I have been taking myo-inositol again which seems to be the most likely candidate for lowering my postprandial glucose as it is known to help with insulin sensitivity, but it didn't do anything the first time that I experimented with it. I have also been taking acetyl l-carnitine again and I suspect that may also have something to do with it as I don't seem to be able to metabolize fats or ketones at all without it. I have also been taking silymarin which, oddly, may have something to do with it in a roundabout way: http://forums.phoenixrising.me/inde...duction-in-exercising-rats.54440/#post-906233

    My lipids, like yours, are fine. How is your vitamin D? Mine is usually low and it seems like that could matter: https://www.sciencedaily.com/releases/2016/12/161221125439.htm

    I wonder if supplementing inositol would do anything to benefit you? (I am not recommending that you do.) You mentioned digestive problems and an altered microbiome seems to have a correlation with PCOS: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207627/ I am assuming this would explain the efficacy of treating PCOS with inositol, which is supposedly non-essential because it is synthesized by the (normal) microbiome. Maybe it is that lots of men have "PCOS" but are never diagnosed as such because #1 they don't have ovaries (they would certainly have to change the name!) and #2 most doctors are likely not looking for overly high androgens in a man?

    Have you seen the 800 calorie Newcastle Diet? It is supposed to reverse Type 2 diabetes (and prediabetes/insulin resistance) by losing fat inside the organs. I have wondered if that would fix my problem, but I am afraid of only screwing up my normal metabolism like is known to do with crash-diets. My doctor couldn't advise me on this as I am bordering on underweight anyway, but I don't think that is from a lack of fat and is instead from a body composition imbalance (I have lost muscle and bone).

    I hope this makes sense; my head is swimming now. :bang-head:
     
  11. Kati

    Kati Patient in training

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    Congratulatons on your master's degree, that is quite the achievement. And never ever give up, i believe we are moving forward in science. It is a matter of pin pointing the exact problem and finding treatments for that.
     
  12. jpredsoxdude00

    jpredsoxdude00

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    Thanks! The only way is forward. Please do let me know if your contact has any insight. Much appreciated!
     
  13. Kati

    Kati Patient in training

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    Will PM you
     

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