Continuing to harp about the medication you are taking and combining that with a VLC diet...it is the Farxiga side effects that worry me.

Losing 18 pounds of water weight is possible with a diuretic diet plus a dehydrating medication..and that can lead to problems. Now you see the concern about adding Farxiga and staring LC the same day, one example, passing out while driving, or even walking through HD.

The Caution sticky has suggestions what LC doctors generally do. Dr. Westman is clear in the video that for most cases medications doses are reduced by half before even starting to cut carbs. https://www.dietdoctor.com/lchf-dia...dr-eric-westman Starting around minute 20, he has examples of Clinic patients dropping all meds within a week. (Patients on medications are given a 24 hour phone number to have dose adjusted anytime). Your doctor should be aware that a ketogenic diet is powerful medicine all on its own. Maybe he doesn't expect patients to actually comply with keeping carbs under 20g, but if they do as you have, Farixga and even common BP medications may be too diuretic.

Edit ps: some of the side effects for Wellbutrin sound diuretic too...frequent urination and constipation. Maybe not the best idea to start 2 meds and a new diet the same day

Actually I started the Wellbutrin about a month ago. Today my fasting glucose was 121 when I woke up and just now it was 115 two hours after breakfast.

My doctor suggested two years ago that I go on a low carb diet, but like a fool I ignored him and tried - somewhat - to follow the ADA recommended diet (but I still ate a fair amount of jasmine rice and pasta). That may be the reason he prescribed the medication, thinking I would not follow through. I will drive down there first thing Monday morning and see him and I will probably discontinue the Farxiga.

I have also read that the Metformin is "somewhat" natural. Many folks drink Mulberry tea which is where the Metformin comes from - do you think I should discontinue that too or is the Metformin OK to continue to use?

Bill

You should ask your doctor, but Metformin is at least not a danger by causing too low blood sugar or dehydration or kidney damage or worse. Like any drug, Metformin has some side effects, often digestive, so if you can control your BG without it, I'd consider dropping it.

However, Any of the SGLT2 inhibitors are much more of a problem, please read all of page 4 of the Caution thread to see current warnings. http://forum.lowcarber.org/showthre...93&page=4&pp=15

Jey100

The past couple of days I have been feeling very tired and weak. I had to force myself to exercise again today so I am going to cut my Farxiga dose in half until Monday and see what happens. I am already on the lowest dose, 5mg, so I'll have to cut the pills in half and see what happens.

Bill

The "tired and weak" could be "induction flu", a side effect from the diet, read here https://www.dietdoctor.com/low-carb #5. Be sure to drink enough water and add salt to your diet, easiest is 2 cups of boullion a day. *. But since you also take dehydrating medication, and tiredness is a common side effect of that drug too, water and salt may not be enough.** Skip exercise until you can talk to the doctor. Have a list of what you have been eating, show your commitment to very low carb eating and good BG readings.

You first wondered if you would ever have "normal" BG under 100.
You have been there, done that and can be successful without medication.

* Dr Westman's Clinic Diet as in back of great book, Why We Get Fat
http://www.kostdoktorn.se/wp-conten...starch_diet.pdf The limit on cream and mayo is really 2T, not 4T, but minor misprints..not enough to change the effectiveness of the diet.

**seriously, why is this drug even on the market? (http://forum.lowcarber.org/showthread.php?t=477213)

Yes I did read about "induction flu" and that is probably what I am experiencing, (I do feel better today).

It seems that "99" reading was maybe a fluke. My readings have been ranging from 114 to 140 for the past two days, (which is still a HUGE improvement over what I was averaging on the ADA diet, 250-275 with spikes over 300).

My doctor told me that if I stuck to a low carb diet, I would not need the Farxiga for over a month - so that was sorta the plan form the beginning that I would not be on the medication long term. I have also noticed that my feet don't hurt any more when I walk - and there is no numbness, just "tingling". I did read all the warnings and also read some of the blogs and while I know there are risks, I don't think the risks are significant in the short term - less than a week so far, that I have been taking it.

Bill

Bill, how are you feeling today?

I'm feeling a lot better, I think I'm pretty much over the "atkins flu" - and actually, I don't think I've felt this well in years!

I was tempted today to "reward" myself with a couple of peaches, but I managed to resist So far I have not cheated at all, even once.

We have this peach tree in our yard that produces the most sweet, juicy peaches you ever tasted - nothing like what you can buy in the supermarket. This year it was literally LOADED, the lower branches were bending all the way down to the ground - none broke fortunately. As always, we gave most of them away to friends and neighbors but how I would LOVE to just sit down and gorge myself on them! lol

Bill

I know the feeling! I hate it when there's a bumper crop of something I can't eat. Now I'm remembering peaches & cream. Maybe someday!

Glad you are feeling better! Did the doc adjust your meds? BG still good and coming down?

You can dry pack peaches without sugar and freeze them. Maybe save them for some LC holiday treats? I started LC in August and my first attempt at any dessert or muffins made with sweeteners like Swerve was the holidays. Can see a cheesecake with peach topping As you know, eating higher carb foods with fats is one way to moderate the BG rise.

Jey100 -

I knew you were going to ask me that

I saw my doctor yesterday and we decided to keep my medication levels as they are - for now.

As I mentioned earlier, I seem to have leveled off with my BG readings between about 115 - 140 with occasional low readings of about 100 and occasional high readings of 150... "not great" but way better than it was. Also the rapid weight loss seems to have stopped - for the past few days my weight has been hovering between 272-273. I have been trying to get in a small amount of aerobic exercise once a day to get my heart rate up, which right now, is 15 jumping jacks and I notice that my BG is predictably at its lowest about 1 hour afterwards. I have noticed this consistently for the past 3-4 days. Those are the only times I have had a BG reading in the 100 range.

What I kinda don't understand is why, if I am eating less that 20 carbs a day, where is all this blood sugar now coming from?

I read somewhere that I am not supposed to skip meals and snacks - I have been skipping the snacks for the most part and sometimes eating when I don't feel hungry just because I'm not supposed to skip meals.

I am thinking going forward maybe I'll start eating only when I am hungry?

Also I am thinking doing my aerobic exercise 2 or 3 times a day?

What other things might I do to keep my weight and BG readings going down?

My doctor said not to think about decreasing the meds until I can get my BG down into the 100 range, consistantly. I think the aerobic exercise might be the key - walking just doesn't seem to be cutting it.

about those meds.

That whole don't skip meals and snacks idea is part of a high carb diet. You eat some LF yogurt with sugar, and then to "get ahead of hunger" as your blood sugar starts crashing, you eat a snack. Don't need to do that on Low Carb.
Quote from the Duke Clinic diet:



If you are only hungry for one meal day, Dr Westman is OK with that. He's not a fan of extended fasting, though Dr Fung is. All info on that here: http://forum.lowcarber.org/showthread.php?t=472377 I do some extended fasts for the possibility of cancer recurrence prevention, and my BG dropped to never before seen levels and I felt great..tons of energy. Low levels in the 80s remained even after the fast. Aerobic exercise may bring down BG, but for how long? I think fasting is a longer term solution to clearing out the stored energy and reducing BG levels. https://intensivedietarymanagement....arb-fasting-26/
If you slog through the first thread linked you will find examples of many members here with success lowering BG.

Have you read Dr. Bernstein's book yet? If not, get cracking. You might be able to find it at your public library - 2nd hand copies are very cheap online. Dr. B will explain everything to you!

Don't eat snacks. Period. You don't need them. You have to go at least 4-5 hours between meals to let your insulin get back to normal. If you are eating every couple of hours - it doesn't matter what - your bg & weight will go up.

Too much protein will increase bg, too much anything - even low carb foods - will do it.

Exercise is good. You aren't doing much, so more exercise - 20-30 minutes of brisk walking, for example - would help. Exercise can, short term, increase bg, but in the long run, it helps reduce bg. Jumping jacks aren't too good for your knees.

OK guys,

#1 when I say "snacks" I don't mean carbs - just so you know. I am counting carbs and keeping them below 20 per day, religiously, no cheating at all. I keep a bowl of boiled eggs in the fridge and have 100% natural peanut butter, (no added sugar, only peanuts), that I sometimes put on one stick of celery. That is what I mean by snack. I only did that for the first few days anway - like I said, I have been skipping the snacks, I could also easily skip breakfast.

My vice is coffee, I have a cup of hot black coffee every morning and there are mixed reviews on that, but as long as I have my coffee I'm not hungry in the morning - I may start skipping breakfast.

from the Atkins page on induction:

"1)Eat either three regular-size meals a day or four or five smaller meals. Do not skip meals or go more than six waking hours without eating."

https://www.atkins.com/how-it-works...es-of-induction

I'll try to figure out some other aerobic exercise that will get my heart pumping

EDIT: Yes, at my weight, no doubt jumping jacks are hard on the joints - whats more, my PJ's are loose now, I think most of the weight I have lost so far has been in my waist, and all that fat flopping around when I try to do them combined with my bottoms trying to fall off... LOL - I'm just glad no one can see!

"1)Eat either three regular-size meals a day or four or five smaller meals. Do not skip meals or go more than six waking hours without eating."

Hi TucsonBill,
When I first started Atkins I had to debate with people about this but I think this was the secret to my success in the beginning. I think it kept me satisfied and on the low-carb track.
I also think low carb snacks are fine.

You're doing great Bill, keep up the good work!