So yesterday I saw a bariatric/obesity specialist/menopause physician. He went over my labs and I’m slightly low in testerone, low in B12, prediabetic with fasting glucose and A1C, and my “bad” cholesterol is slightly high. He says I’m still ovulating and my estrogen and progesterone are good. So no perimenopause. My symptoms he says are from being insulin-resistant.
So here’s the plan:
I’m to follow a keto diet. This involves low carb, high fat and moderate protein. I’ve done the Atkins diet before in my early 30s and lost 35 lbs. This diet has me on slightly more carbs, which is more sustainable for me. Of course, I’m more overweight than that now so I am hoping I can lose even more. He is more concerned with measuring portion sizes than calories at this point, but of course I could have too many calories and not lose weight so I’ll have to be careful about that as well.
He says walking right now is fine, exercise is good but my goal is only 30 minutes 2-3x a week. I think he set the goal lower than ideal because of how little I exercise right now. His main goal at the moment is focusing on my nutrition.
The last 2 weeks before my appointment I had made some slight changes in my diet. Just ate more consciously and it resulted in my losing 2 lbs. Which isn’t a lot but I thought that was pretty good considering I was still eating more calories than ideal. I just stopped eating like shit and made healthier choices.
The other part of this weightloss strategy is weekly Vitamin B12 and semaglutide injections. The Vitamin B12 is for energy and mood and the semaglutide is for the insulin-resistance and will act like an appetite suppressant. Frequently he uses an appetite suppressant that affects dopamine levels but he doesn’t want to give that to me because it could make me manic (I have bipolar disorder).
He says that the B12 injections could help my depression and I told him that my Rexulti I take for depression is known for spiking blood sugar levels. So now I’m wondering if I should stop the Rexulti and see how the Vitamin B12 works. I’ll give my psychiatrist a call to see what he thinks. The doctor says being on Rexulti will make keeping my blood sugar down slightly harder but it’s doable with diet changes so I don’t know. Let’s see what my psychiatrist says.
It’s really difficult with these medication side affects. I didn’t have dental problems until I started taking Lamotrigine for mood stability, it can cause gum disease because it dries out your mouth, and some mild weight gain. And I didn’t have high blood sugar until I started taking Rexulti. My Rexulti makes me really drowsy at night, which is great because it ensures that I sleep so that is something to keep in mind. I can’t go without my Lamotrigine. It keeps me from becoming suicidal. I’m on a high dosage.
So, yeah, taking psych meds is a mixed bag but I need to be on them. You have to decide what’s more important to you. I know with the Lamotrigine I need it to live so that’s a no brainer. Without the Rexulti I have low motivation; I feel tired; I isolate. So let’s see what my psychiatrist says.
I ate breakfast this morning and I don’t usually. And now I’m really hungry unlike usual and have a headache. I’ve been doing keto for about 24 hours and I believe I am starting the “keto flu,” which is a series of negative symptoms you get when your body first adjusts to burning fat in your body for energy instead of glucose in your diet.
Last night at bookclub I had grilled shrimp and zucchini. Normally I’d have potatoes or rice or pasta with it, and an alcoholic drink and dessert. I had unsweetened iced tea. It was delicious but I left hungry, I think because I didn’t eat enough fat.
This is a learning process. I have a carb app that tracks my micronutrients. I will be receiving my meds in the mail in a few days. I get to stick myself with needles. Wahoo!