Replies

• Great Read! Thank you Nicholas Norwitz
  April 21, 2021

• I’m an Nurse Practitioner in Seattle and would love to create or join a group to review cases and support one another.
  April 19, 2021

• This is just fantastic! I feel like I’m having „Imposter-Syndrom“ or a „Wanna-Be“ Health Coach daydream, but the simple fact is - I am also one of those success stories. I have been on a Healthy Keto or LCHF diet for over 5 yrs and it has saved my life! I‘ve lost over 80 lbs and holding, all of my inflammation disappeared after just weeks of eliminating the „bad foods“ and incorporating more of the good foods. OMAD and extended fasting came automatically. My energy levels and cognitive strength are high & constant. I just feel great! Wish I knew about this 20 yrs, 3 surgeries, dozens of medications ago. Now I am med-free, pain-free and just free to enjoy life! Oh yeah and I haven‘t been sick a day the last 5 yrs. Thanks for planting a small seed of hope for the rest of the world. I am actually considering the Training provided in this article for myself. It would be a dream come true, maybe even my calling - to help others help themselves!! Become healthy people ... it‘s all in your hands, it‘s your life to live. God bless
  April 10, 2021

• That feeling of burn out do to not seeing positive changes in our patient's lives is devastating. Seeing blood pressures and A1C's going up instead of normalizing is very frustrating and it leaves you wondering if we, as providers, have failed them somehow. After embracing a low carbohydrate lifestyle and seeing the positive changes in my own life, it allowed me to see a different treatment option. I actually feel like I am making a difference again by improving and even reversing metabolic diseases using the SMHP guidelines. Thank you for sharing your story!
  April 7, 2021

• Very inspirational and mirrors my own path to ketogenic lifestyle and reversal of diabetes. Your story is important and your presence in the medical community will eventually lead to the change we are all hoping for. Thank you!
  April 7, 2021

• Michael, I agree that curated insights are very important. These newly-launched metabolic health research summaries might also be helpful. Curated research printable for NAFLD . https://research.nutrition-network.org/downloads/ It is from Nutrition Network's LC reference portal, which it recently made public. A volunteer, Sarah Rice, keeps it updated. (@sarah4info on twitter) She's also curated the strongest 30+ studies on liver function in her conditions of insulin resistance section. https://research.nutrition-network.org/metabolic-disorders/. You'll find a more exhaustive, searchable list of LC research in this Zotero research library https://www.zotero.org/groups/2384096/metabolic_multiplier/library
  March 30, 2021

• First a fasting insulin cannot be accurately interpreted in the absence of a simultaneous fasting glucose. From these 2 values a HOMA-IR can be calculated. This is the standardized measure of insulin resistance used in most clinical trials that require that information. I have been checking it on all patients in who I suspect insulin resistance for 2 years and have searched the literature for information on it use. I hope to publish an article soon but what I have found is that a HOMA-IR >1.0 shows some insulin resistance. By 1.7 one study found that 50% of subjects meet the criteria for metabolic syndrome. My patient's A1c's reach the prediabetic level (5.7%) by a HOMA-IR of around 3.5-4 and diabetes (6.5%) by a HOMA-IR of 8-9. You can calculate the HOMA-IR by multiplying glucose in mg/dl by the insulin in mmol/l then dividing the product by 405. There is a more accurate equation that require a sophisticated program you have to install on your computer called the HOMA2. Here's a link to a HOMA2 calculator https://www.dtu.ox.ac.uk/homacalculator/
  March 29, 2021

• Thinking about homeostasis and steady state dynamics, i think of the term metabolic recalibration as appropriate due to carbohydrate restriction healing.
  March 24, 2021

• I am not a physician but as an "educated" patient I can tell you the doctors I have consulted with are not operationally familiar with IR and much less with HOMA calculations. Most of the focus is on blood glucose which is elevated only in a fraction of patients and/or becomes sensibly elevated asa late sign. It has been hypothesized that it takes about a decade of chronic hyperinsulinemia/hyperglucagonemia before weight and blood glucose alterations become significant. It is still widely assumed that diabetes is a disease of hyperglycemia and not of hyperinsulinemia. Hence, most doctors do not measure fasting insulin because it is not a biomarker informing sugar status. I has taken redouble efforts for me to convince my endocrinologists to include fasting insulin among the markers to evaluate the status of my DT2. I wish we could have a continuous insulin tracking technology to better manage insulinemia.
  March 23, 2021

• Dr. Crofts and Kraft both mention that o ly 24% fall in pattern one. That the 2 hour GTT would catch 90% of patients. But I believe that the reason most docs don’t test is because they simply are ignorant to how to it’s used and why it even matters. Even my own sister(a fellow doc), when I asked her if she tests it came back to me and said “I don’t know how to use it” & “my patients wouldn’t do anything about it anyways” The lab values on the fasting insulin are ridiculous anyways. They believe it’s normal up to 25 anyways. We simply need to start educating our colleagues and teach them the value. But it’s concerning if we potentially could miss 76% of patients. Could it be that those patterns are inherent to our genetics? That the SAD diet would push them further to diabetes anyways? So everyone could benefit from a whole food diet anyway?
  March 17, 2021