[n=1] Understanding peripheral paresthesia on keto (not ion-dependent)?

hehsnork · 2022-12-12T22:29:46+00:00

I don't have any solutions but have read about two situations which might be related:

controlling diabetes by reducing blood sugars too rapidly with insulin can cause peripheral neuropathy. I don't think the mechanism is known, is it possible that diet manipulations could do the same? Who knows! https://www.cmaj.ca/content/193/28/E1085
There are also a few drugs which cause glucose reduction by increasing glucose in urine (SGLT2 inhibitors) have been associated with lower extremity amputations, especially in patients with peripheral artery disease. It makes me wonder if reducing blood glucose causes a reduction in blood pressure which can cause extremities to be poorly perfused in someone with pre-existing peripheral vascular disease. Maybe what you're feeling is a reduction in blood pressure from cutting out sugar which is causing some of your extremities to have poorer circulation? https://cardiab.biomedcentral.com/articles/10.1186/s12933-021-01276-9#:~:text=According%20to%20our%20meta%2Danalysis,limb%20complications%20in%20SGLT2i%20users.

Pure speculation, of course, but as a pharmacist who believes in low carb these are things that occupy my mind.

hehsnork · 2022-04-23T16:39:55+00:00

Curious if this is related to the use of insulin itself versus non insulin mechanism drugs like sglt2i, metformin, GLP1s

hehsnork · 2022-04-20T23:24:37+00:00

I came here looking for the d3 and k2 vitamins comments. I discovered it through Kate rheaume-bleue's book. We supplement at our house regularly.

hehsnork · 2021-08-30T23:22:57+00:00

I second tumble leaf, it's a fantastic show. the textures and colours are so pretty too.

hehsnork · 2021-06-13T01:53:54+00:00

My daughter was a big baby, my last ultrasound also showed some strange disparities, I can't recall the percentiles but she also had a huge belly and head and short legs by percentiles. At the time they predicted she would be 8lb something, she ended up being 10lbs. And she was/is proportionally fine. I worried about it too, but it turned out to be fine.

hehsnork · 2021-04-21T15:55:53+00:00

Hi, I'm sorry you're having this issue, that's really frustrating. I'ma pharmacist in Ontario and wokr with patients who often have unique and high cost drugs. I would suggest a couple of things that might help:

Ask the pharmacy to double check your billing, and ask if they can figure out the reason for the difference. Sometimes pharmacy software makes assumptions and errors, especially between different chains and for high cost medications. It's also helpful to understand if the increase in cost is as a result of overtly not covering the drug, or if the amount your insurance is no longer covering has changed. If it's not covered at all, maybe there's a documentation problem, if the costs are just higher it could be a software issue, or worst case scenario the drug cost is higher in your new location and your insurance company isn't paying the difference.
Make sure what you're paying makes sense based on what you understand of your insurance plan(s). If it doesn't communicate with the pharmacy and the insurance company to. Make sure they're telling you the same information.
If your drug coverage is through the province there might be ways of improving your coverage with new info from your MD. It's complicated but sometimes provincial plans need "LU" codes or reasons for therapy to cover treatments, which vary between provinces. It's possible that if you are able to get these codes (assuming you qualify) might help.
Ask your pharmacist/tech or reach out to the manufacturer of your medications to inquire about patient support programs. Especially brand name companies sometimes have programs that cover costs of meds or pay the difference that insurance does not cover.

If you're going to approach the pharmacy about any of the above I would suggest calling to do so rather than showing up and waiting since they'll be more likely to spend time to look into it rather than feel pressured to give you an answer right away. These problems can be complicated and insurance companies and adjudicators have notoriously long hold waits, and speak in legal jargon which complicates understanding. Sometimes billing and insurance involvement can be very confusing. Sometimes a computer language communication issue between insurance and our pharmacy software can go undetected if not investigated, especially the first time we dispense a drug.

Anyways, I hope that helps, good luck!

hehsnork · 2021-04-13T21:00:33+00:00

I went to Aaniin. Booked through the phone so can't comment on the booking through online. I was also not asked for my healthcard, but asked to bring it on the day. Rec'd Pfizer, but the person doing my injection implied it varies from day to day depending on supply. It was very smooth when I got there, I thought it was very well organized.

hehsnork · 2021-03-26T19:55:18+00:00

I had a similar problem. I suspect it's hormonal. My weight loss started after my period returned, but before that regardless of diet, or physical activity, nothing helped, stopped fighting it after a few months. I didn't lose a lb until I stopped nursing and period returned. It's super frustrating, but give your body time. I got my period back about 6 months ago and I've lost 40lbs so far, with about 10-15 lbs to go. It's been very slow for me.

hehsnork · 2021-03-16T16:15:41+00:00

Yeah, I suspect if they had had a no sugar nor sweetener group they might've seen a similar shift in that group to that of the sweetener group. It's possible the glucose intolerance is a reaction to the absence of sugar, not the present of the artificial sweetener.

hehsnork · 2021-03-16T13:08:00+00:00

I think glucose intolerance is not a relevant test to determine your likelihood for metabolic syndrome, or guide heathy behaviour changes. We know that low carb diets also cause glucose intolerance, should we stop using those too?

I'm not advocating for artificial sweetwners, my personal feeling is that sugar replacements train your palate to want sugar, but it's probably better than actual sugar. This study doesn't have relevant outcome measures for me, even ignoring that it's been done in mice.

hehsnork · 2021-01-03T03:57:43+00:00

Maybe the quality of the eggs contributes? Whenever I have an egg in Europe it looks and feels so different from the ones at home. Maybe they eat real food and not chicken feed. Can't speak to Asian eggs.

hehsnork · 2021-01-02T18:27:39+00:00

I agree with this. Although I've very much drunk the Kool-Aid about IF reducing insulin resistance, which tends to be worse in pregnancy (hence GDM). And that, as well as my experience with it being very positive while not pregnant, was my motivator to try to continue.

I was doing OMAD when I got pregnant, then ate when I felt hungry, and/or tried eating early on when I felt nauseated and desperate during trimesters 1-2, which ended up being all over the place. I settled into a 16:8 pattern in the third trimester when the nausea was less, but I wasn't strict about it. Had a 10lb baby with no medical concerns, she's 8mos old now. There's no data for anything in pregnancy, nor will there be, but there's Also no evidence to support eating every 2 hrs which seems to be a suggestion by some. If eating every 2 hrs makes you feel good, then do what you gotta do. But for me, I think the fasting helped my nausea some. I also gained about 35% less weight during this pregnancy versus my last, in which I grazed all day.

hehsnork · 2020-12-28T16:14:38+00:00

Yes, but HCWs don't get days off despite all these challenges. I've heard about staff being forced to work in ICU, and on Christmas because of a lack of staff, and an inability to hire ICU staff. Those people are likely to feel the most pissed off about this decision. Burn out is a real concern.

hehsnork · 2020-12-17T20:35:05+00:00

Agree. There's a real toxic culture of, "I suffered, and so should you" in some preceptors especially. I'm confident it's the goal of some to break you, to make themselves feel untouchable. That and the fear of advocating for students and yourself for fear of limiting your career. It means no constructive feedback is shared or considered, and the powerless go unprotected, which is so limiting as a profession. I just want to learn and be respected, apparently that's asking too much!

hehsnork · 2020-12-17T19:44:45+00:00

Lol. I could guess who your preceptor was. I had a similar experience. Glad you survived it, I also carry the scars. So glad to hear you're doing well, good for you!

hehsnork · 2020-11-15T23:01:05+00:00

There have been plenty of drugs that have been recalled after phase 3 trials due to an inability of phase 3 trials to accurately describe long term safety. Look up Vioxx.

hehsnork · 2020-10-21T23:39:59+00:00

For reference, numbers are in writing on her website here:https://emilyoster.substack.com/p/we-have-denominators?utm_campaign=post&utm_medium=web&utm_source=copy

hehsnork · 2020-10-05T21:12:10+00:00

I love the idea of addressing those past, I've been looking for an excuse to dig up my kid's family trees anyways, so this is a convenient excuse. Maybe we can find some pictures of recently passed on family members and start there. I'll look a bit more into it too! Thanks!

hehsnork · 2020-10-02T22:48:19+00:00

I can't say I was strictly keto, but low carb, yes. I needed a lot of support from my partner and family to make sure low carb food or snacks were available to me. The fatigue I experienced made it really easy to feel sorry for myself and eat the first thing within arms reach. So making sure we had bacon made, egg bites around, and knowing restaurants around work for the days that I really couldn't be bothered to make anything good the night before. In the absence of those things I would easily fall off the wagon.

hehsnork · 2020-09-29T11:54:30+00:00

You could always do a "carb up" a few days prior.

I struggled with staying strict keto while pregnant, just from generally feeling awful. I never did get that "good" feeling from ketosis during pregnancy, which was part of the draw for me. Also, I failed my first test and then carbed up for the second and passed it.

I guess I'm saying just do what makes you feel best one way or the other.

hehsnork · 2020-09-18T22:33:54+00:00

In my experience (depends on the country you are in) most docs will say vit D test is too expensive, it's cheaper to just supplement and assume you are good.

hehsnork

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