I share some very personal information with the hope that you may be better informed and may avoid some of the innocent mistakes I made along the way.
Each year when I went to my doctor for my annual exam, I brought a list of complaints–conditions which manifest themselves in dozens of seemingly unrelated symptoms. Despite polite and repeated pleading, my concerns were never seriously addressed. Instead of my list getting shorter, over the years it grew. Ailments became chronic and spanned years, even decades. My doctor, as is often the case with women, waved away my worries. The signs of trouble didn’t seem to add up in his mind.
My litany of complaints:
- Chronic yeast infections
- Frequent urinary tract infections
- Hypoglycemic episodes
- Irregular heartbeat & fibrillation
- Frequent urination
- Blurry vision
- Chronic fatigue
- Tinea corporis fungus infections
- Bloating & intestinal gas
- Mood swings & depression
- Cognitive thinking difficulties
- Borderline hypertension
- Weight gain
- Loss of muscle mass, stamina & strength
- Joint pain
- Hay fever
Most doctors, I expect, would recognize this collection of maladies as a clear indication that I was becoming insulin resistant. Clearly, I was on the path to becoming diabetic, though I did not know it at the time. Somehow, these assorted markers for metabolic syndrome did not elicit concern from my doctors but I was extremely disturbed by them! My health was slowly deteriorating and I couldn’t understand why.
Since beginning menstruation at age thirteen, I’d suffered from chronic vaginal yeast infections. If you are female, you will appreciate the discomfort I endured! The itching and thick discharge was more than a bother. This should have been of significance to a gynecologist, but I never received attentive care. Topical creams did nothing to affect the source of the condition. I was unable to find a doctor who would take me seriously.
I began to have mood swings and become irritable easily. I became seriously depressed. We went to counseling. I went on Prozac, then Paxil, and finally Zoloft for a short period about 1992-93 in an effort to feel normal. I suffered some very unfortunate sexual side effects, which apparently are quite common, though I was not warned. With Prozac, I immediately lost all sensation upon initiating the drug. As I tried to explain to my doctor, it was like the nerve endings were severed. Orgasms were impossible, much to my dismay and the great disappointment of my husband. Switching to Prozac did little to restore feeling. My libido was extinguished. Years after being off anti-depressants, I am still dealing with these consequences.
During this period, Clark and I were known to our friends as “the original organic couple”. We were grinding our own grains with a stone grinder. Clark baked two loaves of whole wheat bread a week. We made our own yogurt. Clark created a signature dish made with this yogurt– clam fettucini. We’ve never been afraid of eating fat and never ate a low-fat diet by any means, but we did try to eat whole grains like brown rice, no processed food, no refined sugars or flours, and no red meat. Our meals were the epitome of the “healthy” Mediterranean Diet. As the years went by, I slowly gained weight and became more and more tired all the time. Hypoglycemic attacks were occurring with increased frequency. I needed to pee often and had sudden sugar cravings.
The heart palpitations were the most worrisome, at least for me. I remember one morning when an episode of fibrillation began. We were at a local dive shop buying SCUBA gear at their annual sale. I sat on the floor waiting for my heart to go back into normal rhythm. When it didn’t, Clark drove me to the internist’s office, where I sat on the floor in the waiting room until I could be hooked up to an electro-cardiogram machine. The doctor could see what was going on, but he merely told me that what I was experiencing was “normal.” “Everyone’s heart has irregular beats,” he said. “For hours on end?” I asked. As a result of this event, though it came after years of complaint, I was finally referred to a cardiologist for a complete evaluation.
The cardiologist had me wear a Holtor monitor for twenty-four hours and he scheduled a stress test with echo-cardiogram. From reading my copies of his records, I learned that he suspected a mitral valve prolapse with both premature atrial and ventricular contractions. He wrote “aortic insufficiency” as a diagnosis. No treatment or change of lifestyle was advised other than using a prophylactic dose of antibiotics prior to having dental procedures. His bedside manner left me cold and unsatisfied. I asked to have my records moved to a different doctor within the group when he told me outright, “I don’t have time to answer your questions.”!
Finally, my tolerance for the vaginal discharge of chronic yeast infections ran out (pun intended). I couldn’t travel anywhere overnight because of it. We were going on SCUBA trips and this aggravating symptom was really getting in the way. I bought a copy of The Yeast Connection and jumped into the recommended diet with both feet. This plan nixed anything fermented. I was not allowed to eat breads, cheeses, alcoholic beverages, processed foods, salad dressings, peanuts or peanut butter (mold contamination), etc. Amazingly, baked potatoes (being bland, I guess) were encouraged! “Stay away from sugar-containing foods,” the author advised. The text goes on to read, “An alternate: Use bananas and other fruits to prepare cookies, cakes and other sweetened foods.” It is recommended that the reader get a copy of the “all-natural, fruit-sweetened cookbook” by Karen E. Barkie entitled Sweet & Sugar Free. (I was very naive then.)
I restricted my foods to those that did not contain yeasts or molds. A banana and a large glass of orange juice accompanied my morning eggs. Lunches consisted of a large baked potato and an undressed salad. I remember that, at one restaurant, I had to send the salad back four times before they finally served it the way I ordered it. I felt better in the beginning (note that I was also taking anti-depressants at the time!) but it wasn’t to last. The diet was very difficult to stick to but I held strictly to it for over seven months. Then we went on a week-long SCUBA trip to Turks and Caicos where we were confined to the dive boat. The fare was spartan and not at all aligned with my eating plan, of course. I ate whatever was served to replenish the energy I was using. In the end, this strict regimen made no difference. The Yeast Connection diet did not eliminate the yeast infections or anything else. Should I have known? We were eating “healthy,” weren’t we? I know why it didn’t work– now.
I had a suspicion that glucose was behind the problems I was having. Clark and I shared three children between us, all boys, and we worked at feeding them “healthy” food. Sweet & Sugar Free (which I know now to be a ridiculous concept) instructed us how to prepare foods using “natural” sweeteners such as dates and rice syrup instead of white sugar. Ignorantly, we thought this to be healthier and so started cooking according to the plan. Naturally, the kids hated it because lots of foods were not allowed. A good effect of these experiences was that I became a dedicated label reader at the supermarket.
I entered peri-menopause at the end of the 1990s. Going through menopause, the severe hot flashes I endured were punishing, but the constellation of symptoms listed above were my main concern. I began hormone replacement when my periods ceased. The synthetic hormones (a patch) that my doctor prescribed caused numerous problems, not the least of which was severe pelvic pain and cysts, from which I had never before suffered. I eventually insisted upon natural estradiol and micronized progesterone. The cysts disappeared and the pain stopped. My list of symptoms, though, continued to lengthen. I continued to try everything I knew to get better.
In 2001, my weight topped out at 173 pounds, which is what I weighed in 1976 when I was nine months pregnant. Prior to the annual exam with my gynecologist, who was then my primary care physician, I spent hours doing research online. (The internet is a wonderful thing! ) The articles I found pointed to a metabolic problem dealing with sugar – insulin resistance – a precursor to diabetes. I decided to ask for a five-hour glucose tolerance test.
In the exam room, I read down my list while perched on the table dressed in thin paper. My doctor was dismissive. He made flippant comments such as, “You’ve never been this old before” in response to my complaints of fatigue, blurry vision and cognitive problems. He actually told me that I didn’t need to lose weight, saying, “You carry the weight well.” He said that if I lost weight, I would appear gaunt in the face and that the skin under my arms would waggle when I waved! How dare he!
The superior doctor prevents sickness.
The mediocre doctor attends to impending sickness.
The inferior doctor treats actual sickness.
— Huang Dee Nai-Chang (2600 BC)
I only become more determined. Conveniently, I had a huge tinea corporis (skin fungus) infection on my back. I raised the paper shirt to present it to him. “Hmmm,” was his response. I told him that I felt I had a serious problem that needed looking into. I said wanted a five-hour glucose tolerance test. He immediately told me there was no such thing, which is false. According to him, my blood work was good. My HDL was “high” at 86. He stated that my fasting glucose was “normal” (it was 98) and that I didn’t need a glucose tolerance test. I said I had lived in my body for over fifty years– I knew it pretty well. Something was very wrong. I told him I would not leave until I got a lab slip for the test. He huffed. I sat still. Finally, he wrote out a slip for a two-hour tolerance test. You have to be persistent.
Needless to say, the glucose tolerance test showed that I had indeed become insulin resistant. The normal range for blood glucose value at the end of two hours is between 70 and 110. Mine spiked to 173 from a fasting level of 93 (this number should also have raised flags), decreased to 168 at one hour, then down only ten more points to 159 at the end of the second hour. At the follow-up visit, the doctor gave me a lab slip for a Hemoglobin A1C test, admonishing me with the warning that if it came back with a value higher than 6.0, I would have to start medication. There was no discussion whatsoever about diet. Doctor handed me the phone number of a diabetes nutritionist and told me to call.
My understanding is that Type II diabetes takes decades to develop. Diabetes did not run in my family. How had this happened? Obviously, we had been doing something wrong. The Mediterranean Diet, avoidance of processed foods, refined sugars and refined flours, in other words “healthy eating” as advocated by the government, medical authorities, by virtually anyone and everyone, had made me sick.
I left a voicemail the nutritionist, went for the HbA1C test and an eye exam with an ophthalmologist (to establish a baseline for the inevitable retinal deterioration of diabetes). The diabetes dietitian did not return my call. Back at the doctor’s office, I was informed that my HbA1C was 5.9 and the doctor urged me to call the nutritionist again. He gave me another lab slip for another HbA1C to be done in ninety days after I’d adjusted my diet.
When confronted with a problem, I research. I filled my virtual cart with books on the subject of diabetes at Amazon.com. While I was perusing the available titles, I discovered a compelling one: Life Without Bread: How a Low-Carbohydrate Diet Can Save Your Life. This book by Ph.D. Christian B. Allan and M.D. Wolfgang Lutz joined three volumes on diabetes in the Amazon.com order.
The nutritionist never returned my calls but it didn’t matter. Within a few days of receiving the book order, I had determined how my diet needed to be changed. Life Without Bread was so illuminating and powerful, I recognized it as life-changing. I immediately understood why all our “healthy” eating had made me ill. The evidence was potent and undeniable. Dr. Lutz’s “diet” plan was exceedingly simple. We began the new way of eating even before I finished reading the book! Amazon.com accepted all the diabetes books back. They were wrong and dangerous– I knew that I would continue to travel the path toward full-blown diabetes if I followed the advice found in these books. Life Without Bread bought an exciting revelation and understood that I could, at long last, regain my health by changing to a carbohydrate-restricted way of life.
My dear husband said, “Tell me what we need to do and we’ll do it.” He was doing all the cooking and grocery shopping while working at home on our trimaran. I was very busy running a commercial studio photography business. At first, we continued to eat our regular foods but we counted the carbohydrates in each meal. Portion sizes of carbohydrate-laden foods were reduced to stay under Dr. Lutz’s limit of 72 grams of carbs per day. We increased our consumption of protein and good fats: animal fat, butter. Basically, the plan is to eat freely (no calorie-counting!) of foods that contain virtually no carbohydrates: meats, cheeses, fish, eggs, and butter. You are to restrict carbohydrates to 6 BUs (12 grams equals a “bread unit” or BU) per day. Permitted foods include moderate amounts of nuts, non-starchy vegetables and sensible amounts of unsweetened alcoholic beverages. These foods have carbs that are added into the daily allowance. That’s all there is to it!
“Restrict all carbohydrates to 72 utilizable grams per day.
Eat as much of any other foods as you wish.”
The following week was Thanksgiving. I wasn’t at all worried, my resolve to heal myself was strong, but my family was puzzled and couldn’t understand why I wouldn’t eat most of what was presented. It was a good thing that there was a lot of turkey! I had no doubts that I was on my way to optimum health. Happily, I turned down the créme bruleé at the end of the meal.
We gave away our rice and cereals, cleaned the cupboards of crackers and other carbs. Clark and I have always enjoyed vegetables. We just got rid of the potatoes and starchy stuff. We threw away the frozen fruit juices. Breakfast consisted of beef patties, pork chops, cheese omelets, sausage and bacon. I usually had a salad for lunch with meat of some variety. I snacked on cheese and nuts during the day. Dinner, as it is to this day, is a serving of meat or fish and a serving of a non-starchy vegetable, sometimes a combination of vegetables. Within just a few days, we both noticed that our cravings for sweets and other carbs had disappeared. Our energy levels soared. We both felt terrific!
Rather than dragging into the studio, I was bouncing down the hall. My mood brightened and I had lots of stamina. All my complaints – the 40-year-duration yeast infection, the heart arrhythmia, the frequent urination, the hypoglycemic attacks, everything – disappeared virtually overnight!
Clark lost ten pounds immediately– his very slight “middle-age middle” melted away. His muscle mass increased noticeably as did mine– all without exercise! He was amazed at how high his energy level had become and how it remained high all day long. This way of eating was just fantastic! I began to read as much as I could find on low-carb “diets”. I devoured information and read quite a lot of it aloud to Clark as he prepared dinner. We went through books by several well-known doctors– cardiologist Robert Atkins, epidemiologist Diana Schwarzbein, bariatric and nutritional physicians Michael and Mary Dan Eades. Low-carb cookbooks appeared in our collection– authors Fran McCullough and Dana Carpender being our favorites. Low-carbing was a such dramatic force in our lives, I admit that we became a bit evangelistic about it.
Ninety days later and twenty-six pounds lighter, I appeared in front of the doctor to hear the results of my latest HbA1C test. He said he didn’t know how I did it, but that my value was even less than his at 4.6 (normal). He was impressed with my weight loss too and asked what I had changed. I told him that the nutritionist had never returned my calls but that I was simply “restricting carbs.” This seemed to satisfy him so I did not elaborate. In other words, I didn’t tell him about the red meats and the fats we were now eating.
When I had my semi-annual consultation with my cardiologist, I told him that I had been diagnosed as insulin resistant by my ob/gyn, but that I had changed my diet. I was feeling really good. He naturally asked me what I had been doing– exercising? I practically scoffed because I do not exercise. Never have. When I told him we were eating red meat, butter, cheese, and lots of eggs, he recoiled in horror. You should have seen his face. He said, “You can’t lose weight eating like that.” “Really? Check the chart,” I said, “I’ve lost over thirty pounds since my last visit.”
In August of 2002, the cardiologist noted that my total cholesterol had risen to 234, but he dismissed it as being insignificant since the other values were spectacular– HDL 124, triglycerides 37, VLDL 7, and direct measure (not calculated) LDL 125. I had lost more weight and my HbA1C remained 4.6. He told me he was skeptical that I could be accomplishing these results while consuming all the things he taught his patients not to eat. He ordered some more detailed blood work (to be done prior to my next annual visit), including a high-sensitivity C-Reactive Protein (CRP). He obviously could not believe his eyes.
Months passed as we refined and adjusted our low-carb lifestyle. At the end of 2002, Clark and I had settled on the Eades’ Protein Power Lifeplan. We followed the Dilettante version. I continued to lose weight, which was wonderful, but I was infinitely more pleased that all my medical issues had been cleared up! They were essentially nonexistent.
The Drs. Eades recommend supplementing with magnesium citrate or malate. I started using this and, at first, didn’t experience any difficulties. I used a dose not nearly as high as they advocate. However, a serious incident happened one night in August 2003 as we were preparing to leave on a week-long coastal cruising adventure on a sailboat with another sailing couple. I began to have heart palpitations after Clark and I had retired to the V-berth. Initially, I thought it was just the anxiety of the impending offshore journey and the heart would go back to normal rhythm. I had not had any fibrillation for nearly two years. After a couple of hours, I started to feel worse and woke Clark, saying that I had to get up. The skipper was alerted (he is an optometrist) and we all decided that a quick visit to a nearby emergency room was in order. Clark drove. I didn’t want to stop at the emergency room first because I was having a gigantic urge to have a bowel movement. I barely made it to the restroom in the lobby of the hospital. I have never before or since experienced the gastric dumping that happened that night. I immediately began to feel better but figured I should get checked out anyway.
Once we entered the ER and I said “heart palpitations”, we were at the mercy of the staff. I was whisked away in a wheelchair. Overall, it was not a pleasant experience. The male nurse practitioner was unable to find a vein to insert a catheter and finally gave up. The physician on duty was brusque and rushed. The heart monitor showed some minor irregularity that went back to normal rhythm shortly after I had been hooked up. I was ready to leave but had to wait for the blood work to come back from the lab. Hours later, I was finally released. There was no evidence of a heart attack. Subsequently, I discontinued the magnesium citrate supplement.
At the cardiologist’s office in November 2003, I told the doctor about my short visit to the ER, providing him with all the lab results and paperwork. Magnesium citrate is used in connection with mitral valve prolapse and cardiac arrhythmia, he said. It plays a role in the electrical stability of muscle contractions. High doses (which I was not taking) can cause diarrhea. It was possible that this OTC mineral could have caused both the arrhythmia and the sudden onset of bowel problems.
At this visit, my lipid panel showed a total cholesterol of 308. Most people would gasp at this number (when I mention this to anyone, they do!) and I know that many patients would immediately be put on a statin drug to bring it down. Fortunately, I did not have to feud with this cardiologist because he understood that my HDL of 148 was phenomenal. The CRP test that he’d ordered gave him little cause for concern. The result was 1.0.
A year later, in December of 2004, after we’d completed and launched our boat, sold our house, and were getting ready to leave San Francisco Bay to embark upon a cruising life, I went to the cardiologist for a final visit. My weight had stabilized at about 132 pounds, I was feeling great, ready for whatever may come. My HDL of 151 had actually surpassed my LDL level and my high-sensitivity CRP level remained low. The cardiologist told me I was “too healthy” and that he could not help me. I needn’t come back.
We’ve been adhering to the low-carb lifestyle for over eight years at this writing. I keep carbs down around 10 to 20 per day. Most of those come from nuts– we’ve become quite fond of macadamia nuts. We try to eat fresh foods as much as possible. Processed foods of any kind are not acceptable– nor are polyunsaturated oils, which means virtually all industrial seed oils. Extra virgin olive oil, which is a primarily a monounsaturated fat, is wonderful for flavoring, but we cook mainly in butter or virgin coconut oil. When we can get fresh fats from naturally raised animals, we will use lard, suet, beef or chicken fat. We have increased our consumption of these extremely healthful fats. Our goal is to maintain at least a 65% level of fats in our diet, with 25% protein and 10% carbs. (edit: we now strive for 75-80% fat with no more than 15% protein) When I eat higher fat, I feel wonderful. It is much harder these days to get the fats our body needs. Our food supply has been so completely taken over by the low-fat, high-carbohydrate dogma that we find it difficult to find the unadulterated foods we need, those that our bodies prefer.
We both make sure that the amount of protein we get in each meal is adequate. We understand that it is reasonable to calculate the daily amount by multiplying 0.76 by your body weight. So for me, 90 grams of protein per day is plenty. It is okay to eat more on occasion but we shoot for at least the minimum. Fat causes virtually no response in serum insulin levels but protein does, even though it does not raise serum glucose levels. Excess protein can be converted by the liver to glucose through the process of gluconeogenesis. This can throw off fat-burning metabolism, which would derail our desired state of nutritional ketosis. Like glucose, circulating insulin is also harmful to body cells, so keeping both glucose and insulin levels in the bloodstream very low is our goal.
This may all sound too complicated and/or boring. Let me assure you that our meals are highly satisfying and interesting and very much worth the effort. The health benefits we reap are the sweet dessert! We don’t think this lifestyle is repetitious or lacking in pleasures. I can make a pretty mean low-carb cheesecake or flourless chocolate torte for special occasions. We still indulge in a bit of spirits or extra-dark chocolate now and then. Our food allows us to enjoy abundant health and the freedom to engage in our favorite activities without reservation.
In January, 2009, I completed my sixtieth year. I feel better now than I did at age twenty-five! So, if you are experiencing what you’ve been told is a “natural” slowing down, a “normal” feeling of tiredness, having “old-age” aches and pains, I am here to tell you that none of this is normal, natural or inevitable! Whatever age you are, take back your health. Start today.
My very best wishes for success in your journey,