Within about 4 to 5 days I saw some of my best post meal blood levels (in the low 80s) and fasting (low 100s) Since then they have all started to climb up again. Todays fasting # was 113.
Still on keto diet eating less then 15 carbs a day.
My journey so far with low testosterone.
- Thread starter CSI007
- Start date
Within about 4 to 5 days I saw some of my best post meal blood levels (in the low 80s) and fasting (low 100s) Since then they have all started to climb up again. Todays fasting # was 113.
Still on keto diet eating less then 15 carbs a day.
Fasting morning blood sugars take much longer to bring down than post-meal. You say you were getting fasting (morning I presume?) blood sugars in the "low 100s" and today's was 113? That's just not materially different and within the range of accuracy of your meter (+/- 10%).
Most adult males won't get a clinically significant and lasting reduction in post-meal and fasting blood sugars at your dosage. I was typical. No significant effect until 1500 mg./day and best result at 2000 mg./day (extended-release formulation).
I planned to increase my dosage if I saw no differences after week 4. Will increase by 500mg each month.
My pressing issue at this point though is my hormones. Something has changed. I mixed the new HCG since my last mixed bottle was about 6 months old. If I still feel like crap in a few weeks I will have to increase my T I guess.
Added 500mg of metformin in the morning for a total of 1000mg/day. After the first week on 500mg values slid back up. Interesting side note: yesterday I had a high carb meal fried chicken, mashed potatoes, baked apples, diet cola mixed with a little cola, 2 biscuits with butter and jam. Yeah, not a good meal, but it was time for a cheat day. Anyway, post meal 1 hour I was at 167 (same as my wife who is not diabetic or insulin resistant). 2 hours I was at 95. 3 hours I was at 95. I think that is pretty darn good drop. Lunch time yesterday after low carb, 1 hour it was 120, 2 hours it was 81.
I think my hormones have stabilized again. The newly mixed HCG might be having an impact? Will have to see how the extra 500mg metformin affects me over the next 2 weeks or so. ED on a scale of 1 to 10 is about a 6 at the moment with 1 being terrible an 10 being perfect. Libido still very good.
I think my hormones have stabilized again. The newly mixed HCG might be having an impact? Will have to see how the extra 500mg metformin affects me over the next 2 weeks or so. ED on a scale of 1 to 10 is about a 6 at the moment with 1 being terrible an 10 being perfect. Libido still very good.
CSI007,
Good to see you are working at trying to normalize your blood glucose.
The meal you described was definitely very high-carb, but even so, a blood glucose level of 167 mg/dl one hour thereafter is still very high indeed, indicating an inadequate first-phase insulin response (with an albeit still-working second-phase response). Some doctors would diagnose it as indicative of diabetes. Those who have truly normal blood sugars typically would not experience a blood glucose in excess of 120 no matter what they ate (see this, e.g.).
Blood sugar control with Metformin, like TRT, is a journey requiring patience and dedication. You have to move Metformin dosage up slowly to give side effects a chance to subside. I took two months to get to max dosage and almost another month to stabilize and really feel its full effects. 1000 mg/day of Metformin may be borderline in terms of producing significant, consistent results in an adult male, even when on a low-carb diet. I saw real results when I got to 1500 mg/day, even better at 2000mg/day (which is where I have remained). YMMV. Once you stabilize on Metformin you can see if you get better results if you take it at different times of day, with meals or fasted, etc.
It's also key to hold to a low-carb diet when trying to stabilize blood sugar with Metformin. A meal such as you described needs to be a very rare treat (your birthday, etc.), not a routine cheat. To achieve normal blood sugars with Metformin, you'll probably need to consistently keep carbohydrate intake at or below 50 grams/day.
Well,
I'm not terribly concerned about the 167. My wife pulled the same BG that I did and she ate less then me. She is definitely not pre-diabetic either. Her numbers are fine. I read mixed things on post meal glucose levels for non-diabetics with some graphs showing spikes over 180! Non-diabetics should be below 140 in 2 hours and it seems it really depends on the amount of carbs one eats.
"For someone without diabetes, a fasting blood sugar on awakening should be under 100 mg/dl. Before-meal normal sugars are 70–99 mg/dl. “Postprandial” sugars taken two hours after meals should be less than 140 mg/dl."
The study you linked does not mention the amount of carbs consumed (unless I missed it?) for the study.
I am always skeptical of medical studies. The report talks about mortality rates in the groups over 33 years. I mean come on, people DIE all the time. It doesn't even say what they died from. They could have been run over by a car.
Maybe it's buried in the actual study and not reporting in this article.
My goal here is to improve my insulin sensitivity and get off metformin in a year or so. We'll see, I read many forums where DIABETICS have gotten off insulin and metformin in a year with diet and exercise modification and are able to maintain their BG in healthy range.
I'm not terribly concerned about the 167. My wife pulled the same BG that I did and she ate less then me. She is definitely not pre-diabetic either. Her numbers are fine. I read mixed things on post meal glucose levels for non-diabetics with some graphs showing spikes over 180! Non-diabetics should be below 140 in 2 hours and it seems it really depends on the amount of carbs one eats.
"For someone without diabetes, a fasting blood sugar on awakening should be under 100 mg/dl. Before-meal normal sugars are 70–99 mg/dl. “Postprandial” sugars taken two hours after meals should be less than 140 mg/dl."
The study you linked does not mention the amount of carbs consumed (unless I missed it?) for the study.
I am always skeptical of medical studies. The report talks about mortality rates in the groups over 33 years. I mean come on, people DIE all the time. It doesn't even say what they died from. They could have been run over by a car.
Maybe it's buried in the actual study and not reporting in this article.My goal here is to improve my insulin sensitivity and get off metformin in a year or so. We'll see, I read many forums where DIABETICS have gotten off insulin and metformin in a year with diet and exercise modification and are able to maintain their BG in healthy range.
That is what the ADA says. They also say that any A1c below 5.7% is acceptable (that's an average glucose level of 117 mg/dl or more). But thorough population studies demonstrate that those who are truly euglycemic and euinsulinemic (completely normal and robust blood sugar regulation throughout life) have fasting glucose levels of 70-92 mg/dl, A1c in the high-4% to low-5% range, and almost never go above 120 mg/dl after meals -- no matter what they eat (and even after drinking 75 or 100 grams of glucose during an oral glucose tolerance test).
Don't believe it did, but in one sense the amount of carbs consumed is irrelevant. That is, what counts is the serum glucose level. Complications and damage aren't caused by carbs; they're caused by high blood sugars. If you have truly normal blood sugars you can eat all the carbs in the world and you'll never get diabetic complications and damage because you never have high fasting blood sugars or high post-meal spikes. Conversely, if you are a full-blown Type 1 diabetic (few or no remaining beta cells), you can eat a nearly zero-carb diet, exercise religiously and be thin as a rail, but you'll still sustain diabetic complications and damage if you don't control your blood sugar carefully with exogenous insulin.
I am always skeptical of medical studies. The report talks about mortality rates in the groups over 33 years. I mean come on, people DIE all the time. It doesn't even say what they died from. They could have been run over by a car.
A longer study is actually more meaningful because weak associations tend to disappear over time. When you're talking about large epidemiological studies and control for all other variables, a difference in all-cause mortality over 33 years of 76% between the group with the lowest (although still high) post-meal blood sugars and the highest is quite statistically significant (i.e., extremely unlikely that it was due to chance). It's true that this isn't a randomized, controlled trial (you couldn't do one of those ethically), but it is good evidence for the proposition that high post-meal blood glucose spikes (especially at one hour) correlate directly with morbidity and mortality.
Some patients with blood sugar issues are able to modify their diets and exercise and achieve normal blood sugars. I hope you are one of them. I found that my blood sugars improved with diet and exercise but I had to add Metformin to achieve normal blood sugars and that if I go off Metformin my blood sugars will rise.
Not sure what is the healthy range of blood glucose that is being used for reference, but for diabetics who are type 1 or full-blown type 2 (fasting glucose above 125 mg/dl, post-meals above 180 mg/dl, A1c above 6.0%), achieving and maintaining truly normal blood sugars (as described above) without drugs is uncommon.
I wish you good luck.
Blood sugar is a funny thing....
I decided to do a little experiment tonight for dinner. Had a Cheeseburger with ham on it, lettuce, tomato, mayo, ketchup. 2 fried chicken strips with about a tablespoon of sweet BBQ sauce, about 25ozs od diet coke with a little regular coke mixed in, a medium order of standard french fries.
I honestly do not eat like this on a regular basis. I am just experimenting and it's deviating from my low carb and has probably knocked me out of ketosis but I was curious!
55 minutes after said meal my blood glucose was 111. I will check in another hour and see where it's at.
Counting everything up it had to be darn near 100 carbs in that one meal. It was the only carbs I have had the entire day though. No lunch and breakfast consisted of 2 fried eggs (maybe 2 carbs?) and 4 strips of bacon.
Oh and my FBG this morning was 100 on the dot. The lowest I have recorded since using Berberine (which I stopped about 5 months ago)
dnfuss,
Seems that many studies show that non diabetics can have 1 hour post meals exceeding 160 but most are not in that range...most seem to fall below 140. I think I have about worn my brain out on this blood sugar stuff though, There is sooo much stuff out there and sooo many opinions from so many different viewpoints. Some say low carb high fat, some say all veggie (high carb) and low fat diets etc. etc. Enough to make your head spin.
I decided to do a little experiment tonight for dinner. Had a Cheeseburger with ham on it, lettuce, tomato, mayo, ketchup. 2 fried chicken strips with about a tablespoon of sweet BBQ sauce, about 25ozs od diet coke with a little regular coke mixed in, a medium order of standard french fries.
I honestly do not eat like this on a regular basis. I am just experimenting and it's deviating from my low carb and has probably knocked me out of ketosis but I was curious!
55 minutes after said meal my blood glucose was 111. I will check in another hour and see where it's at.
Counting everything up it had to be darn near 100 carbs in that one meal. It was the only carbs I have had the entire day though. No lunch and breakfast consisted of 2 fried eggs (maybe 2 carbs?) and 4 strips of bacon.
Oh and my FBG this morning was 100 on the dot. The lowest I have recorded since using Berberine (which I stopped about 5 months ago)
dnfuss,
Seems that many studies show that non diabetics can have 1 hour post meals exceeding 160 but most are not in that range...most seem to fall below 140. I think I have about worn my brain out on this blood sugar stuff though, There is sooo much stuff out there and sooo many opinions from so many different viewpoints. Some say low carb high fat, some say all veggie (high carb) and low fat diets etc. etc. Enough to make your head spin.
CSI007, Congratulations on your good results. I am hopeful that you will continue to see improvement. Stick to your plan of low-carb eating. Eat plenty of protein and don't be afraid of the fat that accompanies it. Enjoy lots of low-carb vegetables: some of my favorites are salads with oil and vinegar or other low-carb dressing, cauliflower mashed up like potato with butter and sour cream, yellow squash and onions slow-sauteed in olive oil, cole slaw with home-made mayonnaise, home-made sauerkraut, and broccoli with real butter and salt. Try to cheat only in a conscious way (i.e., avoid carb-creep). Keep up with your exercise and of course continue on metformin, increasing it if necessary up to the maximum prescribed dose after consultation with your physician. If you give it time, as with TRT, I think you will be pleased and have a very good chance of achieving normal blood sugars.
Afraid we will have to agree to disagree about post-meal blood sugar spikes. My view, shared by a great percentage of the scholars and clinicians who have reviewed data regarding continuous serum glucose monitoring of euglycemic and euinsulinemic populations, continues to be that post-prandial serum glucose levels in those with truly normal blood sugars are almost always below 120 mg/dl and never above 140 mg/dl -- no matter what they eat. Those clinicians would generally consider a regular post-prandial blood glucose of 160 mg/dl to be consistent with pre-diabetes.
OK, so I switched to metformin ER about 3 days ago. Before that my fasting and post meal numbers were looking fantastic. FBG was in the low 100s almost to the point of dropping into the 90s.
The DAY AFTER I switched to 1000mg metformin ER my FBG JUMPED up to 115, then the next day 112 and today 111. This stuff does not seem to work as well as the regular metformin.
Also, since I started metformin my libido is now completely gone. ED is back with a vengeance too. I think since increasing the dose to 1000mg that my T may have even dropped further from the last test. I will confirm in a few weeks (this testing is getting expensive!!)
So if it is, The only thing that has changed is I am taking metformin now. Do I increase my T to compensate or do I stop the metformin. Ugh. I never thought this whole process would be this difficult.
The DAY AFTER I switched to 1000mg metformin ER my FBG JUMPED up to 115, then the next day 112 and today 111. This stuff does not seem to work as well as the regular metformin.
Also, since I started metformin my libido is now completely gone. ED is back with a vengeance too. I think since increasing the dose to 1000mg that my T may have even dropped further from the last test. I will confirm in a few weeks (this testing is getting expensive!!)
So if it is, The only thing that has changed is I am taking metformin now. Do I increase my T to compensate or do I stop the metformin. Ugh. I never thought this whole process would be this difficult.OK, so I switched to metformin ER about 3 days ago. Before that my fasting and post meal numbers were looking fantastic. FBG was in the low 100s almost to the point of dropping into the 90s.
The DAY AFTER I switched to 1000mg metformin ER my FBG JUMPED up to 115, then the next day 112 and today 111. This stuff does not seem to work as well as the regular metformin.
Also, since I started metformin my libido is now completely gone. ED is back with a vengeance too. I think since increasing the dose to 1000mg that my T may have even dropped further from the last test. I will confirm in a few weeks (this testing is getting expensive!!)
CSI007, While metformin half-life is not as long as that of testosterone cypionate, it is not fast-acting in all of its effects. Any time you make any change, such as going from regular metformin to ER, you need to give it at least three weeks to see how things may settle out, maybe longer. Remember, you're interfering with hepatic glucose production and glucose uptake at the cellular level. These are hormonal processes that are complicated and interactive. Patience and careful observation are required. Perhaps you will conclude after giving it some time that you indeed see better results from regular metformin than from the ER version. But as with TRT, rapid and/or multiple protocol changes based on subjective feelings or short-term lab values are to be avoided. Also note that many patients feel that they react quite differently to one brand of generic metformin versus another, and find that switching generic brands can sometimes bring improvement in glucose regulation and side effects.
Not necessarily so. Give yourself at least three weeks on this drug and dosage to get a better idea of how it will affect your blood glucose levels. Also important to adhere to a low-carb diet; metformin will not be very effective otherwise.
Hey everyone,
Been a while since I posted. Life gets in the way. Well I had my latest labs done. Good news, great news (I guess) and some concerns.
The labs:
Since starting the metformin it has had a significant impact on my T levels. My latest test 6 months after my last test has proven that my total T levels have dropped over 100 points (and maintained) (mid 600s) , free t has dropped and maintained about 10 pts. (Mid to upper teens) E2 has dropped and leveled off at around 35 to 40. My A1C has maintained at 5.7 so I am pretty certain that the metformin is still having little if any affect on my FBG but its pretty clear that my pre metformin value of 5.7 was not an aberration and the T has been helping with my blood glucose! Which is awesome news!
My PSA has risen yet again and now sits at 1.0. When I started the injections I was at .6 or .7. This has me a bit worried. I know it's not a lot but I have almost doubled my PSA value in a little over a year and it has not stopped climbing.
My hematocrit has dropped and maintained at around 50. RBC is still slightly elevated but just barely.
I have continued with 200iu of HCG twice per week.
How I feel?
Right now I feel between good and awesome most of the time. No hot flashes, no aches and pains (aside from getting old), I continue to build muscle mass and strength. My mood and attitude has been really good. Libido runs in cycles. Some weeks better then others but I generally want to have sex more then 3 time per week. Since my serum levels of T and E2 have dropped my ED has been much better. Erections are more frequent and firmer (and last longer too) without the use of the generic Viagra. I am still using it though (40mg) - I feel like its giving me the edge I need to extend sessions. Without it I could probably go to completion but it would be rushed. Sensitivity on a scale of 1 to 10 is about a 6. Some times its a 7 or 8 especially when first starting out, then it quickly begins to slip back to a 5 or 6.
The only significant "issue" of I can even call it that is my brain function. Since my T dropped I feel like I am having a harder time again with words but no where near what It was 2 years ago.
My dosage of T is EOD for a total of about 105mg per week.
Oh one more thing. I had a bit of a cancer scare a few months ago. My lymph node in my neck when I had the biopsy done 20 years ago enlarged one night after I strained the area somehow during sleep. Then the swelling subsided within a few days. Then it happened 2 more times. It forced me to see my oncologist who I had not seen in almost 20 years.
Just wanted to post this to keep followers up to date and reading the front page, man so many poor guys getting bad treatment with such high dosages. I am proof that less *could* be better for *some* men.
Been a while since I posted. Life gets in the way. Well I had my latest labs done. Good news, great news (I guess) and some concerns.
The labs:
Since starting the metformin it has had a significant impact on my T levels. My latest test 6 months after my last test has proven that my total T levels have dropped over 100 points (and maintained) (mid 600s) , free t has dropped and maintained about 10 pts. (Mid to upper teens) E2 has dropped and leveled off at around 35 to 40. My A1C has maintained at 5.7 so I am pretty certain that the metformin is still having little if any affect on my FBG but its pretty clear that my pre metformin value of 5.7 was not an aberration and the T has been helping with my blood glucose! Which is awesome news!
My PSA has risen yet again and now sits at 1.0. When I started the injections I was at .6 or .7. This has me a bit worried. I know it's not a lot but I have almost doubled my PSA value in a little over a year and it has not stopped climbing.
My hematocrit has dropped and maintained at around 50. RBC is still slightly elevated but just barely.
I have continued with 200iu of HCG twice per week.
How I feel?
Right now I feel between good and awesome most of the time. No hot flashes, no aches and pains (aside from getting old), I continue to build muscle mass and strength. My mood and attitude has been really good. Libido runs in cycles. Some weeks better then others but I generally want to have sex more then 3 time per week. Since my serum levels of T and E2 have dropped my ED has been much better. Erections are more frequent and firmer (and last longer too) without the use of the generic Viagra. I am still using it though (40mg) - I feel like its giving me the edge I need to extend sessions. Without it I could probably go to completion but it would be rushed. Sensitivity on a scale of 1 to 10 is about a 6. Some times its a 7 or 8 especially when first starting out, then it quickly begins to slip back to a 5 or 6.
The only significant "issue" of I can even call it that is my brain function. Since my T dropped I feel like I am having a harder time again with words but no where near what It was 2 years ago.
My dosage of T is EOD for a total of about 105mg per week.
Oh one more thing. I had a bit of a cancer scare a few months ago. My lymph node in my neck when I had the biopsy done 20 years ago enlarged one night after I strained the area somehow during sleep. Then the swelling subsided within a few days. Then it happened 2 more times. It forced me to see my oncologist who I had not seen in almost 20 years.
Just wanted to post this to keep followers up to date and reading the front page, man so many poor guys getting bad treatment with such high dosages. I am proof that less *could* be better for *some* men.
DragonBits
Well-Known Member
Why do you want to get off metformin, it seems useful beyond blood glucose and doesn't seem to have many negatives that I know about. And it's not expensive.
It might be interesting to experiment to see how your BG behaves without metformin, but even if that experiment is successful, why get off?
Vince
Super Moderator
DragonBits
Well-Known Member
Blood glucose levels are for sure a funny thing.
If you have been on a true keto diet and in ketosis for longer than 3-4 months, your fasting BG can start to rise to 100-110.
Your reaction to a high carb meal can send your BG to over 160 for I believe everyone diabetic or not.
It's all about "physiologic glucose sparing" Your muscle refuse glucose causing your blood glucose to rise especially fasting BG. They have adapted to burning ketones. Even your brain can adapt to burning ketones. However, it seems a few tissues still need glucose which your liver supplies via gluconeogenesis.
However, even people who are not a diabetic will react this way. Your insulin levels during this time while on the keto diet remain low. If you do a HOMA-IR test/calculation, you should be insulin sensitive. Meaning very low insulin with a little higher FBG.
It takes 1-3 days of consuming carbs at about 100-150 grams to switch back over to adapt to glucose.
However, I think a lot of people "believe" they are on in ketosis, but you need to be very strict about consuming high fat, enough protein and really low carbs, or test using keto strips / meter to be sure you really are in ketosis.
Blogs say this sort of higher than expected BG while in ketosis is healthy, I haven't tried to find scientific evidence that this is true, but it seems like it often happens.
Higher Fasting Glucose on Ketogenic Diets: Reason to Worry?
Long Term Ketosis, Insulin Resistance & Physiologic Glucose Sparing
Hey everyone,
It's been a while again. Just got my bi-annual blood work completed. Looks like I have some more modifications to make to my protocol. Any comments are more then welcome.
Some background over the past 8 to 10 months. So after being diagnosed with sleep apnea I started to use a APAP machine. Been hell dealing with it. It started out well enough but then nights I started to throw the mask off repeatedly. Then I got a cold and stopped using it because I couldn't breath through my nose. Been eating like crap again a couple of times a month (around 100 carbs/day) and not eating lower carb like I should be. Been feeling bloated a lot when I eat too (Metformin causing this?) Of course I have also not been able to lose any more weight either. Cholesterol is starting to look terrible IMO. Never had issues with that.
Still dragging butt (sleep apnea?) falling asleep mid day, no energy and now a new thing has cropped up - I have a lot of muscle weakness in legs and arms.
So, I am trying to re-acclimate to the APAP machine and am going to try to keep the mask on at night and get a good nights sleep. Most nights I am lucky if I can get 4 to 5 hours of sleep if that. Sleep has been a HUGE struggle since I started TRT (about a 8 months in problems started with waking up multiple times at night, not being able to fall asleep etc.)
Meeting with my Doc Friday to discuss getting the T levels back where they were when I stabilized in late 2017. When my levels were in the mid 700s/ free in the low to mid 20s I seem to have felt so much better then I do now. Also will discuss increasing the Metformin to 1500mg
I am going to start supplementing vitamin D again and see if that has any effect on my skin, muscle weakness and fatigue
On a positive note, ED has been handled very well with 40 to 60mg of generic Viagra. In spontaneous situations I can some times get by without it.
The bottom line here though is I just can't figure out why my T and free T continue to slip. No changes in amounts or protocol. All the while my red blood cells have risen a bit (yes I drank a lot of water before the test) and my estrogen has stayed the same.
Not sure if I should do a theaputic phlebotomy or not with these RBC and hematocrit levels.
Again, any comments are greatly appreciated!
It's been a while again. Just got my bi-annual blood work completed. Looks like I have some more modifications to make to my protocol. Any comments are more then welcome.
Some background over the past 8 to 10 months. So after being diagnosed with sleep apnea I started to use a APAP machine. Been hell dealing with it. It started out well enough but then nights I started to throw the mask off repeatedly. Then I got a cold and stopped using it because I couldn't breath through my nose. Been eating like crap again a couple of times a month (around 100 carbs/day) and not eating lower carb like I should be. Been feeling bloated a lot when I eat too (Metformin causing this?) Of course I have also not been able to lose any more weight either. Cholesterol is starting to look terrible IMO. Never had issues with that.
Still dragging butt (sleep apnea?) falling asleep mid day, no energy and now a new thing has cropped up - I have a lot of muscle weakness in legs and arms.
So, I am trying to re-acclimate to the APAP machine and am going to try to keep the mask on at night and get a good nights sleep. Most nights I am lucky if I can get 4 to 5 hours of sleep if that. Sleep has been a HUGE struggle since I started TRT (about a 8 months in problems started with waking up multiple times at night, not being able to fall asleep etc.)
Meeting with my Doc Friday to discuss getting the T levels back where they were when I stabilized in late 2017. When my levels were in the mid 700s/ free in the low to mid 20s I seem to have felt so much better then I do now. Also will discuss increasing the Metformin to 1500mg
I am going to start supplementing vitamin D again and see if that has any effect on my skin, muscle weakness and fatigue
On a positive note, ED has been handled very well with 40 to 60mg of generic Viagra. In spontaneous situations I can some times get by without it.
The bottom line here though is I just can't figure out why my T and free T continue to slip. No changes in amounts or protocol. All the while my red blood cells have risen a bit (yes I drank a lot of water before the test) and my estrogen has stayed the same.
Not sure if I should do a theaputic phlebotomy or not with these RBC and hematocrit levels.
Again, any comments are greatly appreciated!
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