Type 2 Nutrition #404: “If you’re feeling signs of sleepiness…”

In his magazine, “The Good Life,” Dr. Oz’s Rx of the Month (March ‘17), is, “If you’re feeling signs of sleepiness, pull over and take a nap – it’ll help.” D’ya know what would help even more? Don’t eat a carb-loaded lunch!

Dr. Oz’s suggestion is based on the assumption that the driver in his set-up piece is sleep-deprived. We’re a “chronically sleep-deprived nation,” the article says. “Skipping even a few hours of sleep nearly doubles your risk for an accident,” according to an AAA report cited. But you know what produces “signs of sleepiness” as much and much more frequently? Answer: a metabolism that has crashed because of a low blood sugar.

If you have Insulin Resistance, as you likely do if you meet the criteria for Metabolic Syndrome, or have been told you are either pre-diabetic or a type 2 diabetic, you have a chronically elevated level of insulin in your blood. In that case, your chronically elevated blood insulin level will block access to energy from body fat which a healthy metabolism would have between meals. Your blood insulin level remains elevated as your pancreas continues to make insulin in an attempt to overcome the resistance to the uptake of glucose from your blood.

Without that access to energy from your body fat, your metabolism will have to slow down to maintain energy balance, called homeostasis. Among other things, you will feel “signs of sleepiness.” You’ve crashed. And you will soon be hungry again…for more carbs. Yes, it’s a vicious cycle. By continuing to feed your body carbs by mouth, you deny it the body-fat fuel it needs to be “energized” and in balance at a higher metabolic rate.

Of course, you do have an alternative: You can gain access to your body fat reserves to give your body the energy it needs to maintain a stable, high metabolic rate. That is, to remain in energy balance (homeostasis) but at a normal, high metabolic rate. Your body will not need to slow down and “crash.” How? Listen up!

Most people in the U. S. eat their evening meal between 6 and 8pm. Digestion of carbs and fat starts almost immediately and is usually complete within an hour or two. Protein takes longer, up to 4 to 5 hours. Then the body rests (and we sleep), and while we sleep it runs on sugar in the blood and stored in the liver. When the “sugar” stores are nearly exhausted, it enters ketosis, where it naturally breaks down body fat for energy.

This is a normal process. It is called the overnight fast. We all do it. And survive. And we wake up in the morning feeling refreshed from the rest and the fast! And then we eat “breakfast.” Get it? “break-fast.” The problem began when we began to create a cycle of carbohydrate addiction: we started by eating a breakfast loaded with carbs, starting with fruit juice. Pure sugar water! Then we ate toast or a muffin or worse, a bagel. Pure “sugar” glucose! Then we ate cereal or oatmeal. All carbs (glucose)! And in 2 hours we’re hungry again.

Suggestion: Try 2 eggs, any style, even hard boiled if you don’t have time to prepare them in the morning. If you do cook, fry them in bacon grease (enjoy a bacon ‘side’). This “break-fast” is all protein and fat. No carbs!

Or, if you’re not hungry (like me), just have a cup of coffee. I have mine with heavy whipping cream (a ‘fat bomb’) and pure powdered stevia (not in packets of stevia combined with maltodextrin or dextrose – other words for sugar). If you do this, you are in effect extending your fast. You will be surprised at how your energy level, and your blood sugar, will remain stable all morning long. I’ve been skipping breakfast for a few years now, and I often forget to eat lunch. Or don’t think about it until 2 or 3 or even 4 in the afternoon. Really!

I think it’s a red herring to attribute “signs of sleepiness” to sleep deprivation. I know that many families have to get up early and stay up late and that sleep deprivation is a problem for some. But “signs of sleepiness” are much more likely to be attributable to a metabolism that slowed down because access to its own fat stores for energy was blocked by a chronically elevated blood insulin associated with pre-diabetes and type 2. If you are overweight and are developing insulin resistance, that is most likely why you get tired after a carb-laden meal.

Type 2 Nutrition #403: Denial is not a river…

When someone says their A1c is 6.1% and they’re doing nothing about it – not even taking Metformin – I think, what are they thinking about! Are they waiting until they’re told, as Tom Hanks was, “You’ve ‘graduated’ to full-blown, type 2 diabetes.” As though, after observing “high-normal” blood sugars for 20 years, his doctor was congratulating him! And what is their doctor thinking about? I mean, folks, denial is not a river. I know, it’s an old joke, but that behavior is just bizarre, unless, that is, the Standards of Medical Care – which to be paid by insurance for his or her services a doctor must follow – doesn’t offer a better solution.

That’s what it amounts to, though. Metformin is not generally prescribed to pre-diabetics, although in my opinion it should be. Currently, it’s occasionally  prescribed “off-label,” meaning “used in a manner not specified in the FDA’s packaging insert.” But putting pharmacotherapy aside, what else can a pre-diabetic do to “delay” the onset of frank type 2 diabetes, or as demonstrated in so many recent trials, to proactively REVERSE incipient type 2 diabetes and put this modern lifestyle scourge into complete remission?

Well, the first thing you have to do is acknowledge that you are pre-diabetic. What does that mean? It means that 1) you have a genetic predisposition, 2) you’ve eaten, per nutritional guidelines, a diet unnaturally high in carbohydrates in order to avoid eating saturated fat and cholesterol, and 3) your body has “expressed” an intolerance for so many carbohydrates. Being “pre-diabetic” means you are now carbohydrate intolerant. The condition, Insulin Resistance (IR), is a continuum. And the sooner you address it, the easier it is to manage.

Insulin Resistance is part of Metabolic Syndrome, a constellation of symptoms that put you at much higher risk of heart disease (CVD and CHD) as well as several other chronic diseases of Western Civilization, including Alzheimer’s disease (“type 3” diabetes) and many types of cancer. But Insulin Resistance can be managed by lifestyle changes. You modify your diet so the pancreas does not secrete too much insulin. The only way to do that is to restrict your dietary intake of carbohydrates.

The object of self-management of your Insulin Resistance is to keep your blood insulin level low. There is not a common lab test to measure blood insulin, but a good surrogate is your blood sugar level, either fasting (FBG) or A1c. And there is no drug to lower blood insulin although anaerobic exercise can help.  If you’re Insulin Resistant, the consitent way to lower your blood insulin is to restrict carbohydrates. It is not a “therapy” that will enrich Big Pharma, or Agribusiness, so you’re not likely to hear about it from them. And to avoid financial penalties and sanctions, your doctor is not likely to go against what the Standards of Medical Care dictate.

So, self-management of your pre-diabetes is just something you’re gonna have to do yourself. Perhaps that’s why you’re surfing the web and how you came across this site. If so, we hope you’ll come back. We encourage you to try carbohydrate restriction on your own. Test your blood before and after a meal and see how much it improves when you eat fewer carbs. Do it for 3 months and see your A1c improve and your weight plummet!

Or…here’s an idea. Forget about how much carbohydrate restriction will help your pre-diabetes or type 2 diabetes. Don’t even think about asking your doctor for “permission” to go on a carbohydrate restricted diet to help control your pre-diabetes or type 2 diabetes. Ignore the fact that type 2 diabetes is a dietary disease.

Instead, if you would like to lose a few pounds, and you think your doctor would like that as well, ask if he or she thinks a carb-restricted diet would be a good way to lose weight? Safely! I’ll bet you that you’ll get a “yes.”

Better yet, don’t ask. Help your doctor avoid the risk of financial penalties and sanctions from Medicare. And then, when you next have bloodwork done and your weight and cholesterol – especially triglycerides and HDL-C – and blood pressure and inflammation have all improved, it’ll just be our little secret how you did it. 

Type 2 Nutrition #402: IGNORANCE is the biggest problem…

I was at a gathering recently where I was having a tête-a-tête with Dr. Eric C. Westman, co-founder and medical director of the Heal Clinics. I’ve been a diagnosed type 2 diabetic for 31 years, eating Very Low Carb for the last 15 and writing about it here for the last 7, so when Dr. Westman asked me what I thought was the biggest problem in type 2 diabetes today, I responded, simply, “Ignorance.” He nodded his head in agreement.

I told Dr. Westman that I started this WOE after my doctor had read Gary Taubes’ July 7, 2002, New York Times Sunday magazine cover story, “What If It’s All Been a Big Fat Lie?” My doctor wanted me to lose weight, so he tried it himself first to see if it would be safe and effective. When he lost 17 pounds, he suggested that I try it too, to lose weight! As he walked me down the hall to schedule my next appointment, he said, “It might even help your diabetes.” He had no more than a vague notion about that. Turns out, he was spot on!

My doctor told me to start Atkins Induction after he returned from vacation so he could monitor me closely.

He had my blood sugar “under control” (FBG: 155mg/dl!!!) with 3 classes of oral hyperglycemic meds. He knew, however, that by this standard he would soon have to refer me to an endocrinologist to start an insulin regimen, probably a basal injection once a day and maybe mealtime bolus injections, 3 times a day, as well.

Like so many other clinicians, my doctor believed that my morbid obesity (I weighed 375 pounds) was a CAUSE (frequently hedged as a “risk factor”) of type 2 diabetes. But Taubes had not yet written his ground-breaking magnum opus “Good Calories – Bad Calories” (2007), in which he dispels that notion. In fact, in the Epilogue (page 454) he says, “As I emerge from this research,” 10 “certain conclusions seem inescapable to me.” Today, ten years later, every one of his conclusions is still right on point – as true today as the day he wrote them.

In #5 Taubes says, “Obesity is a disorder of excess fat accumulation, not overeating, and not sedentary behavior.” If this first part sounds like a tautology, it is not. It is fully explained in #6 thru #10. You really should read all 10 “certain conclusions” in the above link. I’ve read it a dozen times over the years.

6.      “Consuming excess calories does not cause us to grow fatter, any more than it causes a child to grow taller. Expending more energy than we consume does not lead to long-term weight loss; it leads to hunger.

7.      Fattening and obesity are caused by an imbalance – a disequilibrium – in the hormonal regulation of adipose tissue and fat metabolism. Fat synthesis and storage exceed the mobilization of fat from the adipose tissue and its subsequent oxidation. We become leaner when the hormonal regulation of the fat tissue reverses the balance.

8.      Insulin is the primary regulator of fat storage. When insulin levels are elevated – either chronically or after a meal – we accumulate fat in our fat tissue. When insulin levels fall, we release fat from our fat tissue and use it for fuel.

9.      By stimulating insulin secretion, carbohydrates make us fat and ultimately cause obesity. The fewer carbohydrates we consume, the leaner we will be.

10.  By driving fat accumulation, carbohydrates also increase hunger and decrease the amount of energy we expend in metabolism and physical activity.”

Gary Taubes’ hormonal explanation of the metabolic science of fat synthesis and breakdown totally refutes the “calories-in, calories-out” (CICO) hypothesis. CICO sounds so logical that it is now “accepted wisdom” without evidence. It’s like that other “truism” of establishment dietary thinking: “Eating fat makes you fat.”

Taubes’s “certain conclusion” #1, “Dietary fat, whether saturated or not, is not the cause of obesity, heart disease, or any other chronic disease of civilization,” deals with that. Of course, he backs up this statement, and all his other conclusions, with 460 pages of convincing research and analysis, 45 pages of links to his sources, and a 66 page bibliography. “Good Calories – Bad Calories” is a bit of a slog, but it’s worth it.

Type 2 Nutrition #401: “Improve your A1c with a non-insulin option”

Have you seen this diabetes drug commercial on TV? It always makes me laugh. I’ve been a diagnosed type 2 for 31 years, and my last A1c was 5.2%. That was a big improvement from 5.8% eight months ago. The only diabetes medication I took eight months ago and I take now is Metformin. I improved my A1c with another “non-insulin option.” I control my diabetes with Metformin, and I improved my A1c by eating Very Low Carb.

Of course, the TV ad had a different “fix” in mind for you. It was playing on the dread people have for the drudgery of daily insulin injections. Most insulin-dependent type 2s inject a slow-acting basal dose of insulin once a day and then many (most?) inject a fast-acting bolus with each meal. Thus, with this 1 to 4 injections-a-day routine, if you are very careful to avoid hypos, you can achieve “good” blood glucose control. It’s an onerous path to follow.

It doesn’t have to be this way. I weighed over 300 pounds in 1986 when an internist diagnosed me as a type 2 with a high fasting blood sugar (FBS). He started me on an oral anti-diabetic drug of the only class then available in the U.S., a sulfonylurea. Seven years later an endo gave me my first A1c test. It was 8.9%. My FBS was 197. Nine years later (2002) I was maxed out on both the sulfonylurea and Metformin and had started on Avandia.  My FBS was 81, so my doctor had my “progressive” diabetes under control with drugs. But we both knew that when the 3^rd class of drugs was no longer effective, I would “graduate” to insulin. I weighed 375 lbs.

So, my doctor now turned his attention to my weight again. He had tried before. I had seen his staff dietician who advocated a “restricted-calorie, balanced diet and exercise.” It didn’t work. I lost weight but promptly regained it. Then, in July 2002 my doc read the New York Times Sunday Magazine cover story, “What If It's All Been a Big Fat Lie,” by the science writer Gary Taubes. He tried the diet described himself, and it worked. When he came back from vacation in September, he asked me to try it too. He wanted to monitor me closely.

The diet was Atkins Induction, which is VERY low carb, just 20 grams a day. On the first day I had a hypo. I called him, and he told me to stop taking Avandia. The next day I had another hypo and he told me to cut the other two drugs in half.  Later that week, when I had yet another hypo, he told me to cut them in half again. So, in just one week, by strictly following a VERY LOW CARB diet, before losing more than a few pounds of water weight, I had dramatically reduced my diabetes meds. My type 2 diabetes had gone into remission.

A year later, in August 2003, I had lost 60 pounds and my A1c was 5.4%. A few years after that, I regained 12 pounds over the summer, so I started on Richard K. Bernstein’s 6-12-12 program for diabetics (30 carb grams a day). Over the course of a year or so, I lost that 12 and another 110 pounds, reaching 205 pounds at the end of 2008. That was my weight when I completed Army Basic Training in 1960! And my A1c was still 5.4%.

Now, 15 years after beginning to eat Very Low Carb, and plenty of “misadventures” (“cheats” with ups and downs), I celebrate by dropping below 200 pounds (186 last week) for the first time since I was in my teens. And although 15 years ago, in 2002, my doctor’s motivation was to get me to lose weight, NOT to treat my so-called “progressive” type 2 diabetes, I have “improved my A1c with a non-insulin option.” Furthermore, I have forevermore avoided progressing to becoming an insulin-dependent type 2. AND MY LATEST A1C WAS 5.2%.

To his credit, although he suggested it to help me lose weight back in 2002, my doctor did have an inkling that eating VERY LOW CARB might help my type 2 diabetes. He said, as he walked me down the hall to schedule my next appointment, “Dan, this diet might help your diabetes too.” Boy, was that an understatement!

Would that more doctors had a similar understanding of the basic relationship between dietary carbohydrates and blood sugar regulation. Type 2 diabetes is, after all, a dietary disease, and the best treatment is self-management by carbohydrate restriction. Your doctor can’t write a prescription for that, BUT YOU CAN!

Type 2 Nutrition #400: “Not half the man I once was,” my wife quipped

As you can tell from the number above, I have been posting a long time. I have also been a diagnosed type 2 diabetic for 31 years and probably pre-diabetic for a decade or more before that. At my doctor’s suggestion (to lose weight), I’ve been eating Very Low Carb since 2002. About 8 months ago, I added Extended Fasting.

In 2002 I started and stayed on Atkins Induction (20g/day) for 9 months and lost 60 pounds. Four years later I regained 12 and started and then stayed on Bernstein (30g/day) for a year and lost 100 pounds. Later I lost another 20+, reaching 205 in 2008. I regained some later but recently returned to 205 using consecutive 2 and 3-day fasting. This was possible because, while fat-adapted on VLC, I can easily go 2 or 3 days without hunger.

My weight has not been below 205 since I was a teen ager, maybe pre-pubescent! I’m 76 now. But, feeling as healthy and energized as I do, I am going for a new goal: To be half the man I once was. I began in September 2002 at 375. My goal is to get to half that weight, to 187, by end of September 2017, 15 years later. Here goes. (N.B.: If you want to skip the messy parts, don’t bother with the Weekly details; just jump down to Results.)

Week 1: I start this challenge at 207, so I need to lose 20 pounds in 8 weeks. The 1^st 4 will be easy. I gained them overnight, literally, so this week I expect to lose at least 6, leaving 14 for the remaining 7 weeks, or 2 pounds a week. That’s very doable. Result: lost 5lb, after regaining 3 Sat. FBG aver: 81mg/dl. Wk 2 goal: 5 lbs.

Week 2: Three restaurant meals this week, including a birthday. Fasting only Mon & Wed. Result: took 3 days to lose the 3 pound gain, and the glucose shot up after the b-day; alas, I lost only 1 pound. FBG aver: 97mg/dl.

Week 3: Starting the week 2 lbs behind, but have no excuses. Should be a good week. Goal: lose 4 lbs to reach 197; Plan: fast Mon-Tue-Wed. Result: lost 5, then regained 2 Sat to 198, net lost 3 pounds. FBG aver: 82mg/dl.

Week 4: Starting week just 1 lb behind. Goal: lose 3 lbs to reach 195. Fasting Mon-Tue-Wed. Result: Small cheats every day, but I lost 3 lbs and reached goal of 195, a 180 lb total loss from 2002. FBG aver: 82mg/dl.

Week 5: Eight pounds to go in 4 weeks, 2 lbs per week. Goal 193. However, gained 4lbs both Sun & Mon, so strict fasting this week; I need to lose 10 lbs. Result: Lost 11, fasting 4 days; net lost 3 lbs. FBG aver: 79mg/dl.

Week 6: Now 1 lb. ahead, but goal is still 2 lbs. Eating ‘normally’ Sun & Mon (company); fasting thereafter. Results: Relaxed a bit and just lost 1 lb to 191, on target. 4 pounds to go, 2 each week. FBG aver: 71mg/dl!

Week 7: Doing a modified fast Mon-Tue-Wed, then Fri and/or Sat if required. Thurs: dining with visiting ‘kids.’ Results: Missed the mark; lost just 1. Too much fat, a little cheating, poor choices Thu. nt. FBG aver: 88mg/dl.

Week 8: Final week of challenge with 3 pounds to go. Very doable with a little discipline. Let’s see if I have it.

Results: A feast on Sunday added 4 lbs. to the challenge, but I “fasted” until I lost NET 4. FBG aver: 79mg/dl.

Results: Well, I did it! These words recall for me the line “We did it!”that Elle Woods squeals in her graduation speech at the end of one of my favorite films, the chick-flick “Legally Blonde.” Except in this case, I did it, all by myself! In the last 8 weeks, using a combination of Very Low Carb on days that I ate “normally,” and Very Low Carb on my so-called “fasting” days, I lost 17 pounds. That was my goal: to get to be “half the man I once was,” at 375 pounds, when I first discovered Very Low Carb in 2002. My doctor suggested I try Atkins Induction (20 carb grams a day) to lose weight. It’s been a long journey, with lots of ups and downs, but I finally reached my goal. Along the way, my health improved greatly, and I feel great. It’s wonderful not to always be hungry.

Next week my wife and I are taking a vacation. We’re going up to the Shaw Festival at Niagara on the Lake. Plans include dinner every night in a nice restaurant and one lunch and a tour of one of the many wineries in the area. When we return, I will begin one more weight loss challenge: To lose another 15 pounds (plus what I gain on vacation) to get down to 171. And then, THE FINAL CHALLENGE: to maintain the 200 pound loss. I will keep my weight between 171 and 175 by a combination of OMAD (VLC), plus Extended Fasting as needed. 

Type 2 Diabetes, a Dietary Disease #399: WebMD and Walgreens, a new collaboration

While waiting in my wife’s doctor’s office the other day, I picked up a FREE magazine, “WebMD diabetes, at Walgreens.” I’ve been a type 2 for 31 years, and treating it as a dietary disease for 15, so I didn’t expect that the magazine would have much to offer me, but…was I in for a surprise! It was loaded with material for my blog!

The featured article was “Savor Summer,” with a recipe section: The subtitle was “New ways to bring sweet corn to your table” (my emphasis). But to a carboholic, the added emphasis is unnecessary. The brain sees “sweet” and translates it to “SWEET.”  And the food photography was great! Really mouth watering stuff!

“You can almost taste sunshine when you bite into a freshly picked ear of corn,” the article begins, adding, “It’s also nutritious” because it’s “chockful of Carotenoids.” (No mention of sugar.) But then, unabashed, it says, “It’s also a starchy vegetable, easily rounding out your plate with more fiber than a refined grain.” Okay, so it’s not a refined grain. That’s good. But corn is starch. It is pure sugar and starch. For a diabetic, that’s just as bad as a refined grain. The sugar alone is 62% glucose (the rest is fructose) and the starch is 100% glucose.

And if that wasn’t enough, 2 of the 3 corn recipes added honey! Added honey, for diabetics! As if corn wasn’t sweet enough! The recipes had all been reviewed by the WebMD medical editor, an MD, and she could do it with a clear conscience because, by the U. S. Dietary Guidelines “MY PLATE, a healthy meal plan for everyone, even diabetics, – includes ¼ starches. Corn certainly fills the bill. But should a magazine for diabetics, intended to help both type 2 diabetics and pre-diabetics make healthy food choices, suggest and feature recipes that will assure that the pre-diabetic progress to diabetic and the diabetic remains in a diseased state? C’mon!

 Why would the medical community and Big Pharma encourage people who have “presented” with evidence of Insulin Resistance, which equates to Carbohydrate Intolerance, suggest, recommend, and even encourage people to eat a diet comprised three-quarters of carbohydrate (¼ starch and ½ non-starchy vegetables)? Why? One size fits all!!! For 37 years the “Dietary Guidelines for Americans” have ordained that one-size-fits-all. The Guidelines have gone through various iterations, from various food pyramids to today’s “My Plate,” but they all have one thing in common: by following them, you, the diabetic, most assuredly will get sicker and sicker.

Who benefits from this whack-a-mole recommendation? I know, I know. It’s easy to conclude it’s the doctor’s and the pharmaceutical industry, including retailers like Walgreens. And they certainly do benefit. We all get sick, and they take care of us. But that’s their business. They’re just doing what they are in business to do. Altogether, the 23 page Diabetes magazine included 4 pages of corn recipes, 8 pages of other content, and 11 pages of ads, 4 for Walgreens products and 4 for diabetes meds from Lilly and Pfizer, available at Walgreens.

But that’s not where the problem lies. It originated forty years ago when the U. S. government got into the nutrition business. In 1977 a U. S Senate select committee convened and held hearings. So-called “experts” testified. Later, the lay staff of the Committee produced the “Dietary Goals for the United States.” In 1980, and every five years after, HHS has produced the “Dietary Guidelines for Americans.” It’s been a disaster.

The Nutrition Coalition has proposed that the Guidelines be reformed. They say, “Americans have followed the Guidelines, but their health has not improved.” “The Guidelines have not always provided the best dietary advice.” “The science is not settled and in some cases has been reversed,” and “(T)he process of drafting the Guidelines needs reform.” I certainly agree. I have signed their petition and ask you to consider adding your name to the growing community of people like us who are in-the-know. We need Guidelines based on sound scientific evidence. And there will still be plenty of ways in which WebMD and Walgreens can collaborate. And then my wife’s doctor won’t have the shame of having this awful magazine in his waiting room.

Type 2 Diabetes, a Dietary Disease #398: My Supplements

I haven’t written about supplements since…wow! I just did a search of almost 400 posts and discovered I have NEVER written about my supplements. I guess it’s because I consider it personal, not in the sense of private – I am transparent about my health – but in the sense of “individualized.” I think it is also because I have read so much about how none of them are necessary or even helpful, like I’ve just been duped or sold a bill of goods.

So, why do I take supplements when there’s no real way to prove that they have helped me? A well designed experiment is impossible; there are just way too many confounding factors. I guess the best answer is that they are “insurance;” besides, most of them are vestigial, that is, I began them before I was initiated in the ways – or the concept anyway – of eating a low carb diet of whole, real food…and I just continued with them. That’s my construct anyway. Besides, some of them I do believe in. So, which would I eliminate and why?

I am prompted to write about this now by a presentation made at Keto Fest in New London, CT last July by podcast meister Ivor Cummins, the “Fat Emperor.” Near the end – maybe his very last sentence – as though it were a hurried, throwaway line, he said: “Don’t forget to take supplemental magnesium and potassium.” No time for an explanation. It was just a given, like everyone knew! Fortunately, I do take them both.

Here’s a complete list of my current supplements. Bear in mind, I am/have been a Type 2 Diabetic for 31 years and eat a Very Low Carb (VLC) or LCHF (Low-Carb, High-Fat) or Ketogenic Diet, with frequent full-day fasting.

With COFFEE with HEAVY CREAM and POWDERED STEVIA, early in the MORNING

●     1g fish oil, containing 300 EPA and 200 DHA, and 5 IU of vitamin E

●     1 tablet high potency men’s multi-vitamin, with vitamin D3, lutein and lycopene

●     100mg capsule of CoQ10, the active form (Ubiquinol)

●     200mg magnesium glyconate, chelated for absorption

●     200mcg of elemental chromium (chromium picolinate), with 18mg L-leucine + 2mg vitamin B6

●     100mg biologically active R-Lipoic acid (alpha lipoic acid), with 150mcg D-Biotin

In addition, I take 2 prescription meds: 750mg metformin Hcl and 25mg HCTZ, a diuretic (for hypertension)

With 6oz RED WINE & 8oz SELZER, about 12 hours later, if FASTING, or with FOOD (my supper meal).

●     1g fish oil, containing 300 EPA and 200 DHA, and 5 IU of vitamin E

●     200mg magnesium glyconate, chelated for absorption

●     99mg potassium, a multi-source blend

●     1 capsule homocysteine modulators: 50mg B6, 400mg folic acid (B9), and 500mcg B12

In addition, I take 3 prescriptions: 750mg metformin Hcl, and 20mg Enalapril & 240mg Verapamil (BP pills)

Candidates for deletion: 1) chromium picolinate, 2) R-Lipoic acid and 3) homocysteine modulators.

Possible additions: 1) a small (250mg) Vitamin C tablet with supper, to help with protein uptake, and a calcium supplement, to help with magnesium uptake. First I need to learn more about their interactions.

My labs are very good. My last A1c was 5.2%. My Vitamin D and B12 are high and very high respectively. My TC is below 200mg, my HDL-C is averages about 80, my LDL-C averages about 100 and my TGs still average around 50, even though I don’t eat a can of sardines for lunch any more. When I do eat lunch, I prefer a can of kippered herring in brine. It’s fewer calories and much less fat, and I’m trying to burn endogenous fat, not exogenous fat! My fasting intake is about 300kcal/day and my feasting intake paradigm is still about 1,200 (15g carbs, 60g protein and 100g fat, mostly saturated/monounsaturated). Finally, my inflammation markers are very low. Now that I have laid it out for everyone to see, what do you think? I invite comments.