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I have a few questions I need answered, I have been

struggling with insulin resistance, mild...
I have a few questions I need answered, I have been struggling with insulin resistance, mild fatty liver, and elevated GGT (119) ALT a little high, (72) just recently had a thyroid test done, Calcium 9.7, Parathyroid 42.5, T4 Free 1.13 T3 5.37 (elevated) Vitamin D 39.6 low end of normal, Vitamin B 12 304, low normal, amylase and lipase normal, Cholesterol 188, HDL 24, Triglycerides 637, and Direct LDL 53, I had an ultrasound of my liver done a year ago, it was mildly fatty, I have noticed, my blood sugars will rise over 200 (IF) I grab some fast food, usually eating a balanced diet, it never goes over 140 (150) sometimes, last night it went over 200 again after eating a McDonald cheeseburger and nuggets, this was after waiting 2 hours, I immediately drank 20 grams of protein, and my sugar lowered to 94 in about an hour, and I felt so much better! Can you please explain to me what's happening? This is very scary, I am active and quite fit for my age 39, 5ft 9, 180lbs, also fasting insulin level is 14.30mlU/ml
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Answered in 38 minutes by:
3/15/2018
Sohaib K
Category: Endocrinology
Satisfied Customers: 5,337
Experience: Consultant at King Faisal Specialist Hospital
Verified

Hello and thank you for the question.
I am Dr. Sohaib, a practicing Internal Medicine Consultant with over 13 years of experience and I will do my best to help you today.
Let me review your question for a minute and I will get back to you.

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What were your HbA1c levels?

Are you obese? Do you know your BMI?

Waist circumference?

Any treatment you are on?

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Customer reply replied 4 months ago
HbA1C 4.7, 31 waist, no current treatment

Thank you.

Can you clarify you TG levels? 637?

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Customer reply replied 4 months ago
Correct, usually if I drink any kind of alcohol, which isn't often, they can rise as high as 1,300

This is sky high. No one started any treatment for that?

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Customer reply replied 4 months ago
No, because I was taking apple cider vinegar and lowered them to 261, unfortunetly I was diagnosed with H Pylori, and had to stop the apple cider vinegar until my stomach healed, was trying to avoid meds

I believe you have metabolic syndrome; insulin resistance, dyslipidemia and fatty liver.

You should be on drug treatment for very high TG levels, because you already have fatty liver and also this much high levels pose you at greatly increased risk for pancreatitis, and atherosclerosis leading to heart disease.

Secondly, you should be started in treatment as per Metabolic Syndrome, which includes life style modification by intensifying weight management and increasing physical activity; and to treat the cardiovascular risk factors if they persist despite lifestyle modification; such as high cholesterol/TG levels.

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Please note that the best treatment for insulin resistance is exercise, 30 minutes of aerobic exercise daily, with diet control. The next step is starting metformin or pioglitazone, as drug treatment, which help reduce insulin resistance, and also help delaying the onset of overt diabetes.

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Customer reply replied 4 months ago
Why did the apple cider vinegar lower my triglycerides then? Can you explain that to me?

There are many natural agents which can affect the cholesterol/TG levels, but the long term beneficial effects + any possible side effects are not studied/validated by any large medical cohort studies/research, therefore we can not recommend any such agent like apple cider vinegar as the sole management of any problem. Though I am not against them but this should not be the only treatment you should be taking.

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Customer reply replied 4 months ago
You never answered my question as to why the protein lowered my sugar from 200 down to 94 so quickly

Its not the protein, its your insulin that bring down the sugars. This is the effect of high insulin already in blood which was bringing down the sugars and your inference in not correct that protein brought down the sugars.

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Customer reply replied 4 months ago
Also, one last question, can this metabolic syndrome cause constipation? I have had constipation problems since all this started a few years ago

No, this doesn't cause constipation. And this is also not considered a part of metabolic syndrome. Mostly constipation is related to kind of diet (refined and less fiber diet) and physical inactivity.

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Customer reply replied 4 months ago
you were very helpful and thank you for being kind, I am also getting a HidaScan of my gallbladder to make sure I don't have any issues with bile flow either, this is very scary for me

Good luck and my sincere wishes for your good health.

Please do not forget to Click and Give 5 Star Rating (at the top of screen) to my service as this is the only way I get credit for my time and expertise on your question.
If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.
Kindest Regards.

Sohaib K
Category: Endocrinology
Satisfied Customers: 5,337
Experience: Consultant at King Faisal Specialist Hospital
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