Medical Questions I'd Like Answered...

Whipstitch · Post by **Whipstitch** » Thu Jun 27, 2019 2:32 pm

re: "one neat trick" advice that doesn't always work for everyone

One thing that's made things easier for me is doing away with the old "3 squares a day" dogma. There's some indications that intermittent fasting has health benefits and even if it doesn't there's not much hard evidence that you'll ruin everything forever by being more flexible with your schedule and only eating when you're hungry and avoiding food when you're not. Embracing that helped me a lot because my Achilles' heel has always been portion control at meal time rather than a steady stream of snacking. Basically, I don't overeat because I'm hungry all the time, I overeat because our modern world surrounds me with delicious things all the time and it's hard to stop once I've started. So I might eat less than a thousand calories today, but that's not because I'm starving myself. It's because I had a Rodeo King cheeseburger combo yesterday and that bad boy's nutrition label just says "bad idea" followed by a bunch of numbers over 100%.

Captain_Karzak · Post by **Captain_Karzak** » Fri Jun 28, 2019 3:13 am

I suffer from a "brain fog" most of the day and I really need to make it stop. I believe it's related to recent dietary changes.

I've been eating a low carb diet for about 2 weeks, and combining it with 18 hour intermittent fasting (skip breakfast, eat 2 meals in a 6 hour window, no snacking).

I usually don't start feeling clearer headed until about 3 hours after eating my first meal of the day.

I saw a nutritionist and she told to eat 600 more calories per day and get more calcium in my diet. I implemented those changes about a week ago. Still foggy. Maybe less so? Hard to tell.

I believe that I eat close to 50 grams of carbs per day. The lack of hunger has just been amazing, and I find it easy to keep to my fasting schedule. But this brain fog, I can't even...

I don't think I have any obvious nutritional deficiencies. Bloodwork results from just before going low carb + fasting were all normal (lipid panel, various vitamins, cbc, T4, Chem7/BMP).

Another recent development - I think I may also be experiencing very mild orthostatic hypotension (slightly dizzy when I get up from lying down). As a baseline - Fitbit tells me my heartrate at rest hovers a little under 60 bpm and my last BP reading from recent doctor's office visit was 117/78. Usually my diastolic is around 81 (stage 1 hypertension). I'm not bothered by this hypotension, but the timing of this development is suspicious to me.

Thanks for reading all of this.

Maj · Post by **Maj** » Fri Jun 28, 2019 5:26 am

None of my doctors would blink an eye at your blood pressure. They would say the top's below 120 and bottom's below 90, so you're fine. I have no idea what the current guidelines are, but a diastolic of 81 is easily within that range.

That being said, I'd second your nutritionist's advice on calcium, but I'd extend it to all the alkaline ash minerals: calcium, sodium, potassium, and magnesium. And make sure you're drinking/eating plenty of liquids. But this is because I personally have brain fog as my first symptom of dehydration, and if I'm not getting enough salt, I'm not keeping the water in.

Username17 · Post by **Username17** » Fri Jun 28, 2019 5:30 am

I believe that I eat close to 50 grams of carbs per day.

That's quite close to the absolute minimum you can get away with, and it wouldn't surprise me if you were going into Ketosis for part of the day, which is characterized by:

Nausea and vomiting
Abdominal pain
Weakness or fatigue
Shortness of breath
Fruity-scented breath
Confusion

Or you might be having difficulty maintaining blood sugar levels, leading to Hypoglycemia, which is characterized by:

An irregular heart rhythm
Fatigue
Pale skin
Shakiness
Anxiety
Sweating
Irritability
Tingling sensation around the mouth
Crying out during sleep
Confusion
Inability to perform routine tasks
Visual Disturbances

Anyway, while a ketogenic diet will lead to weight loss, ketosis is still a disease state and I consider it similar to the "cancer diet" or the "e. coli diet." There are many disease states that will cause weight loss, and that's not actually a good thing. If you want to lose weight (and many people in the west including me could do with doing so), my strong suggestion is to find a way to do it that doesn't involve nail polish remover building up in your blood.

BTW, the difference between a diastolic of 78 and a diastolic of 81 is insignificant. Those are readings you'd get on the same person if you measured their BP five minutes apart. Diastolic pressure of 80 is classically normal, and values between 75 and 85 aren't meaningfully different from that. Diastolic pressure near 100 is problematic (and above 100 is a big problem), but pressure "about 80" is normal.

-Username17

Maj · Post by **Maj** » Fri Jun 28, 2019 5:52 am

You sound like you're describing ketoacidosis.

Blade · Post by **Blade** » Fri Jun 28, 2019 9:31 am

I've been exercising steadily for some time and clearly gaining muscle without getting additional mass. Since I'm quite skinny, I decided to eat more in order to get some mass. I don't want the muscles I'm working on to build up by draining the other muscles.

I've switched my breakfast to something more nutritious, with more fat and proteins. I've added a mid-morning protein snack, I've been increasing the size of my lunch and since the start of the heat-wave I've also started eating more ice-cream.

When I started I was a bit under my usual weight, and it raised in a few days. But then I reached my usual 50kgs and it's been stuck there for a week. I do poop more though.

Whipstitch · Post by **Whipstitch** » Sat Jun 29, 2019 6:02 am

In general I'm super suspicious of any diet that flips out if you dare eat an apple and a banana in the same day.

Count Arioch the 28th · Sat Jun 29, 2019 9:33 am

I dropped keto for that exact reason. It worked but one screw-up ruined it.

Frank's list of hypoglycemia symptoms sounds like my general condition in life for as long as I can remember.

Meikle641 · Post by **Meikle641** » Thu Jul 04, 2019 11:35 pm

So, bout a month ago I got referred to a fat loss doctor (my doctor ignoring all the indications I have hemochromatosis), which sucked. Anyway, I'd lost a few pounds by then and the fat doc prescribes me some sort of appetite suppressant. Expensive as fuck, but since they were implying my life was in immediate danger I went with it.

So, last week I started Saxenda, and things have been going well after the initial side effects. The meds make the altered diet a cakewalk, and I'm down 5% of my bodyweight, being 288 lb yesterday.

My issue is this: the prescription says to keep upping the dose at weekly intervals, but the base dosage is doing great. I'm honestly not seeing what is gained by continuing to increase the dosage since it is doing the trick and now I'm having some insomnia and worsened nausea, the runs, etc. What also worries me is the whole 'connected to getting tumours, cancer, and other organ problems' thing.

Tried to talk to the doc, but the nurse gave that a hard no. Looked at me like I was an idiot for even asking about staying at base dosage. What do?

Josh_Kablack · Post by **Josh_Kablack** » Wed Jul 10, 2019 4:48 pm

So yesterday I rode a century, and pushed to achieve a personal best time (still really slow compared to serious cyclists) So for the back half or so I was riding in a position that put strain on my left hand and wrist. I figgered it would all be okay after I got off the bike....sadly not so. Even after a nap last evening and then a full night's sleep, I'm having a consistent tingly, pins-and needles prickling, much like a "my foot fell asleep" feeling in my left hand, wrist, and partway up the forearm. I'm also having notably reduced grip strength in my left hand.

So is this just a case of I gotta wait it out? Did I manage to give myself carpal tunnel with a few hours of strain? Is there anything I can do to speed recovery or mitigate symptoms?

erik · Post by **erik** » Wed Jul 10, 2019 4:59 pm

If it’s inflammation/strain then anti inflammatory may help alleviate it some. Can see if takin it easy plus NSAID and icing it helps any, assuming you don’t have something that precludes use of something like naproxen/ibuprofen.

Maj · Post by **Maj** » Wed Jul 10, 2019 6:37 pm

Magnesium and a B complex vitamin. Ibuprofen, as mentioned, if you need it. This happens to me about twice a year, and makes me freak out because I have a diagnosis of MS on my record. But every time, it's just a case of a weird position I put myself in. It has taken anywhere from two days to a week to recover.

That being said, if it doesn't go away in a week, I'd see someone about it.

tussock · Post by **tussock** » Sun Jul 14, 2019 11:48 pm

Oh, and too late for this, but there's a lot of recommendations around endurance exercise now that probably anti-inflammatory drugs are hurting the healing process.

The studies I've found are actually from taking them during events, but the recovery times there are longer, as there's more damage done for the lack of cushioning provided by the inflammatory response, and taking them after is believed to increase the likelihood that you'll further strain the problem area.

But, obviously, if you need to move the problem area for work or whatever, can't really rest it, then anti-inflammatories with a support bandage are a better option to reduce strain.

--

And for me, resting on my arms too hard is generally lack of food, end up locking elbows for non-muscle support rather than holding everything up on my legs and core. Still working on being able to eat enough during though, after years.

Count Arioch the 28th · Mon Jul 15, 2019 4:21 pm

So, is red-light therapy a thing that works, or is it bullshit? My gym has a red light booth and the trainer was extolling its virtues. My first impression was that it sounds like nonsense, but I don't want to discount what she was saying just because she was young, attractive, and female.

Maj · Post by **Maj** » Mon Jul 15, 2019 4:54 pm

There's not really a lot of evidence out there about this particular kind of light, but light clearly has an effect on the body. If it doesn't cost you extra to use, try it. And if it does something for you, who cares what scientists tell you? Even if it is a placebo, there is power in knowing how to make that psychology work for you.

Username17 · Post by **Username17** » Mon Jul 15, 2019 6:28 pm

Count Arioch the 28th wrote:So, is red-light therapy a thing that works, or is it bullshit?

Unclear. There are some scientific studies that show benefits but to the best of my knowledge we are also talking about really low sample sizes.

There is a legit theory behind it, so I don't wholly discount that it might be helpful. Broadly speaking, being exposed to the sun is a double edged sword. It is good for hte complexion and stimulates vitamin D metabolism. But the high energy light of the sun also damages DNA and causesskin cancer. So the thinking is that red light, which has a much lower energy per photon and essentially can't break DNA bonds might have some or all of the benefits of going outside while not giving you skin cancer.

Does it actually work? I dunno. It wouldn't surprise me if some of the body's benefits of sunlight exposure were frequency specific and we could minmax our light exposure somehow. And it's obviously true that the dangers of ultraviolet light are not shared by red light on the other end of the spectrum. But the evidence isn't in, and of course there wasn't any possible way to get a whole lot of red light exposure without simultaneous ultraviolet light exposure during most of the last two hundred thousand years - so there are no population based natural experiments either way.

-Username17

Josh_Kablack · Post by **Josh_Kablack** » Mon Jul 15, 2019 8:02 pm

tussock wrote:Oh, and too late for this, but there's a lot of recommendations around endurance exercise now that probably anti-inflammatory drugs are hurting the healing process.

From what I've read, it seems to depend on the type of anti-inflammatory and the degree of inflammation.

However, I'm pretty sure what I did to myself was more about constricting blood flow than it was about muscular inflammation. There was no swelling nor muscular soreness.

phlapjackage · Post by **phlapjackage** » Tue Jul 16, 2019 12:56 am

Josh_Kablack wrote:However, I'm pretty sure what I did to myself was more about constricting blood flow than it was about muscular inflammation. There was no swelling nor muscular soreness.

When I ride long-ish distances (long for me, anyway), I find that if I hunch over a lot I also get the numb,pin-and-needles feeling in my wrists/hands. I've been trying to have a more upright posture while riding to keep pressure off my wrists and so far it seems to help...

Count Arioch the 28th · Mon Dec 09, 2019 7:02 am

So I had a physical at work and they did a battery of tests in order to harvest and sell personal information allow me to track my health for a bonus to my HSA harvest and sell my personal information and one of the tests was way out of whack. Most were good, or out of range in an expected way, but my Gamma Glutamyl Transpeptidase was 204. Dr. Google was less than helpful (unsurprisingly). Is this something I need to bother my doctor with? My previous doctor said specifically that she couldn't diagnose anything else with me since I'm fat and diabetic so I'd rather not waste everyone's time (and more importantly my money) just to have another doctor thow up their hands and give up.

Orca · Post by **Orca** » Mon Dec 09, 2019 8:14 am

A quick google gave me "Elevated levels may be due to liver diseases, such as hepatitis or cirrhosis, but they may also be due to other conditions, such as congestive heart failure, diabetes, or pancreatitis. They may also be caused by alcohol abuse or use of drugs that are toxic to the liver."

It mentions diabetes as a possible cause which you say you have so I guess the obvious answer is that you have some sort of liver problem caused by your diabetes. If you know about that fine, if not you probably do want to talk to your doctor.

Count Arioch the 28th · Mon Dec 09, 2019 8:24 am

Well, shit. I was hoping to avoid having to do repeated tests that cost me thousands of dollars each to be told they can't give me a diagnosis or recommend any sort of treatment. I'm supposed to be getting MRIs every six months for my !notsarcoidosis (the doctor gave me that diagnosis but took it back real quick when I wanted a note to give me an extra break at work), but I can't swing 2 grand twice a year, especially when there's literally nothing that can be done about it.

Grek · Post by **Grek** » Mon Dec 09, 2019 9:10 am

GGT is an enzyme in your liver. Any time you stress your liver, the level of GGT in your blood goes up. But GGT by itself doesn't mean very much since having high GGT could just mean you stressed your liver doing something non-worrisome, like drinking or smoking or taking tylenol. It's also elevated in people with diabetes or a history of heavy drinking.

If your other liver enzymes are also elevated, that's worrisome. If you have a bunch of symptoms of liver disease like fatigue, nausea, gut pain, jaundice, dark urine or pale poop, you should be very worried. But if none of that is the case, it's probably just due to you being diabetic.

Count Arioch the 28th · Mon Dec 09, 2019 9:18 am

I have none of those symptoms, and all my other enzymes are at good levels. So I'll ask at my next checkup but I won't treat this as an emergency.

Username17 · Post by **Username17** » Mon Dec 09, 2019 10:53 am

Weird side question: if your GGT is up and your ALT and ALP are normal, is your PSA up?

-Username17

DrPraetor · Post by **DrPraetor** » Mon Dec 09, 2019 2:31 pm

PSA = prostate-specific antigen, not public service announcement

.

Gamma-glutamyltransferase gets into your blood when cells turnover - most often these are liver cells, but prostate cell turnover (which also releases PSA) dumps GGT into the blood as well.

If you're curious about all the tissues that GGT activity can come from:
https://www.genecards.org/cgi-bin/cardd ... expression