Re: question for Theodora

[Guest guest]

Hello Theodora - Im hoping that you would give me your thoughts about symptoms that could be some sort of glucose intolerance/insulin resistance but fasting glucose has come back normal - Ive had dizziness for years and its getting worse hence visited GP and done a number of bloods all normal (though I dont know results as only spoke to receptionist). along with the dizziness I often get palpitations and last week after eating some jelly babies my heart rate went through the roof and kept me awake for ages! memory/concentration problems are the most concerning as I worry about my job!Im undergoing a behavioural approach to insomnia, diagnosed as psychophysical following on from hypoT, my memory and concentration are

poor - much improved on zopiclone and also mucuna pruriens (L Dopa). Ive got high BP but its under control at the moment. Im due to have an ultrasound next week as Im getting pains that appear to be kidneys, along with a right upper abdo dull pain (gall bladder removed 20 years ago) and symptoms of wee infection but no infection found, did calm after trimethoprim but now 3 weeks and still peeing more frequently but no cystitis or bladder pain.tall order I know but Id be grateful for your thoughts and suggestions for further investigation and hope you dont mind my asking. many thanks,Gill Moderator

[Guest guest]

intolerance to gelatine or some other ingredients?

>

>

> Hi Gill,

> Sorry for butting in - but in particular your description about eating

> jelly babies and getting palps which kept you awake, rang some bells...

[Guest guest]

Hi thanks for this - I hadnt thought of this, thanks very much for troubling to respond.Gill

intolerance to gelatine or some other ingredients?

e

[Guest guest]

I'm on my Vitamin D hype at the moment - have a look at the post I have just

done on it.....

Vicky

>

> Hi - thanks so much for taking the time to respond - its not butting

in when its on the forum so its very much appreciated.  I have looked into this

before and dont think this is the cause, but Im open to offers!  I will revisit

this, thank you.  Im suffering from insomnia and on a behavioural regime of

staying up later and getting up at the same time every day and its starting to

get better - I was sceptical but it is working amazingly well and might be part

of the answer to brain fog, memory problems etc - I will share this when I know

more!

>

> thanks very much,

>

> Gill

>

OLDER POSTS DELETED BY MODERATOR...

[Guest guest]

Hi Vicky, thanks a lot, I will do.Gill

I'm on my Vitamin D hype at the moment - have a look at the post I have just done on it.....

Vicky

[Guest guest]

Hi Gill

Thanks for waiting patiently for my reply!

You raised a few points that I'll do my best to cover:

A)Dietary influences on hormonal balance.

The key hormones affected by dietary choices are insulin,cortisol and adrenalin

and they seem to interact in an immediate and direct feedback system.These

hormones,in turn,impact on thyroid hormones,sex steroids and others.High

glycaemic load diets not only increase insulin resistance but also shift HPA

axis towards sympathetic overactivity which increases

cortisol,ACTH,catecholamines and decreases heart rate variability.Symptoms such

as dizziness,fatigue,feeling tired but wired,headaches,palpitations and

tachycardia,cravings for sweets(hypoglycaemia),mental fogginess or trouble

concentrating,non-restorative sleep and sleep problems,etc are all symptoms of

adrenal dysfunction.

Any harmful foods(ie gluten or other allergenic foods in susceptible individuals

,see jelly beans) or altered gut flora(dysbiosis) can trigger damage to the

intestinal mucosa impairing nutrient absorption and leading to ie B12 and D

deficiencies in addition to upregulating the gut-associated lymphoid

tissue(GALT) which leads to oxidative stress and hormonal

imbalances(thyroid).Inflammation may ,in turn,affect nuclear PPAR receptors

through TNF-a and increase insulin resistance.

Symptoms and Signs of Insulin Resistance

Sugar cravings

Hypoglycaemia(night sweats,irritability,palpitations,dizziness,fatigue relieved

by eating)

Post-prandial fatigue post carbohydrate meals

Chronic fungal infections

Fatigue

Central obesity(waist to hip ratio>0.8 in women,and 0.9 in men)

PCOS or infertility

Hypertension

A single fasting blood glucose cannot diagnose insulin resistance.

Suggested laboratory testing for Insulin resistance:

75 gr insulin tolerance test(raised fasting insulin and /or raised 2 hr BS and

insulin)

ferritin(raised)

fibrinogen(raised)

hs-CRP(raised)

homocysteine(raised)

liver function tests(elevated AST,ALT and gGT)

serum magnesium(low)

NMR lipid profile(assessment of lipid particle size):small LDL and HDL particles

and large VLDL particles.

total cholesterol,HDC-C,LDL-C,triglycerides:(all high,high triglyceride/HDL

ratio)

uric acid(high)

Obviously keeping insulin low as advised previously-see file on insulin

resistance and measures against it-helps with such symptoms.Further

investigations for gut dysbiosis(stool analysis,sIgA,Candida Abs)and IgG4 food

allegies and /or tissue transglutaminase for coeliac disease would help

eliminate sources of harmful stimuli to GALT-as explained above.

B)Autonomic nervous system dysfunction.

Some of the symptoms you mentioned-dizziness,heart racing,bladder

symptoms,hypertension-may be linked to this pathophysiology.

The autonomic nervous system has complex interactions with organ systems and

changes in the activity or tone of its sympathetic or parasympathetic component

can lead to imbalances ie in patients with inflammatory arthritis or myofascial

pain there is heightened sympathetic activity which may result in high blood

pressure.Fibromyalgia pain may be attributable to a sympathetic hyperdynamic

state and seems to respond favourably to manipulation.

some genitourinary disorders have been shown to have a structural basis as above

mentioned;the pelvic floor fascia and muscles provide mechanical support to the

lower urinary tract and work with the somatic and autonomous nervous systems to

coordinate sphincter and bladder activities.It has been long established that

pelvic floor exercises can be useful in minor stress

incontinence.Furthermore,interstitial cystitis(which sounds likely from your

sysmptoms)and the urethral syndrome may also respond to myofascial therapy aimed

at the pelvic floor;in a study of 52 patients

with some form of urgency-frequency symptoms,more than 70% experienced

significant improvement after treatment with manual trigger point therapy to the

pelvic floor muscles.

Finally,it is important to say that decreased physical activity for whatever

reason and increased caloric intake can further complicate these problems and

create more imbalance between the sympathetic and parasympathetic nervous

systems.

Reference:Weiss JM,pelvic floor myofascial trigger points:manual therapy for

interstitial cystitis and the urgency-frequency symptoms,J urology

2001;166:2226-31

F,Heller PH et al:Altered autonomic function in patients with arthritis or

chronic myofascial pain,Pain 1989;39:77-84

ez-Lavin M,Vidal M et al:Norepinephrine -evoked pain in fibromyalgia,a

randomized pilot study,BMC Muscul Disord. 2002

I hope the above helps.

Best wishes

Theodora

>

> Hello Theodora - Im hoping that you would give me your thoughts about symptoms

that could be some sort of glucose intolerance/insulin resistance but fasting

glucose has come back normal - Ive had dizziness for years and its getting worse

hence visited GP and done a number of bloods all normal (though I dont know

results as only spoke to receptionist).   along with the dizziness I often get

palpitations and last week after eating some jelly babies my heart rate went

through the roof and kept me awake for ages!  memory/concentration problems are

the most concerning as I worry about my job!

>

> Im undergoing a behavioural approach to insomnia, diagnosed as psychophysical

following on from hypoT, my memory and concentration are poor - much improved on

zopiclone and also mucuna pruriens (L Dopa).  Ive got high BP but its under

control at the moment.  Im due to have an ultrasound next week as Im getting

pains that appear to be kidneys, along with a right upper abdo dull pain (gall

bladder removed 20 years ago) and symptoms of wee infection but no infection

found, did calm after trimethoprim but now 3 weeks and still peeing more

frequently but no cystitis or bladder pain.

>

> tall order I know but Id be grateful for your thoughts and suggestions for

further investigation and hope you dont mind my asking.

>

> many thanks,

>

> Gill

> Moderator

>

[Guest guest]

Hi Theadora, thanks so much for your comprehensive and knowledgeable reply. I need to read and digest!some of these I can go with and some I doubt - the insulin resistance I think is the most likely really as Ive never had any symptoms of candida or food allergies and the jelly babies incident was the most extreme case Ive had but had similar when i drink coffee - pretty sure that;s the sugar rather than the coffee and the reason I only have coffee on rare occasions as I can drink tea without sugar! Adrenal dysfunction - I have done the adrenal questionnaire and come out low on that and did try NAE in the past which didnt seem to do anything, although the dizziness was worse on it, but I will give that another try I think.the ANS - that doesnt feel like me at all and the bladder symptoms must have been some sort of bug or virus

that didnt show on the test I think as they have more or less gone now, but I did feel poorly/buggy at the time.I will use what you have said to think and consider what to do - am seeing GP on Tuesday so will see how that goes!thanks again, much appreciated - have you been able to arrange any clinics outside London yet? For those of us 'up North' its really an overnighter to get to London!Gill x

A)Dietary influences on hormonal balance.

The key hormones affected by dietary choices are insulin,cortisol and adrenalin and they seem to interact in an immediate and direct feedback system.These hormones,in turn,impact on thyroid hormones,sex steroids and others.High glycaemic load diets not only increase insulin resistance but also shift HPA axis towards sympathetic overactivity which increases cortisol,ACTH, catecholamines and decreases heart rate variability. Symptoms such as dizziness,fatigue, feeling tired but wired,headaches, palpitations and tachycardia, cravings for sweets(hypoglycaemi a),mental fogginess or trouble concentrating, non-restorative sleep and sleep problems,etc are all symptoms of adrenal dysfunction.

Any harmful foods(ie gluten or other allergenic foods in susceptible individuals ,see jelly beans) or altered gut flora(dysbiosis) can trigger damage to the intestinal mucosa impairing nutrient absorption and leading to ie B12 and D deficiencies in addition to upregulating the gut-associated lymphoid tissue(GALT) which leads to oxidative stress and hormonal imbalances(thyroid) .Inflammation may ,in turn,affect nuclear PPAR receptors through TNF-a and increase insulin resistance.

Symptoms and Signs of Insulin Resistance

Sugar cravings

Hypoglycaemia( night sweats,irritability ,palpitations, dizziness, fatigue relieved by eating)

Post-prandial fatigue post carbohydrate meals

Chronic fungal infections

Fatigue

Central obesity(waist to hip ratio>0.8 in women,and 0.9 in men)

PCOS or infertility

Hypertension

A single fasting blood glucose cannot diagnose insulin resistance.

Suggested laboratory testing for Insulin resistance:

75 gr insulin tolerance test(raised fasting insulin and /or raised 2 hr BS and insulin)

ferritin(raised)

fibrinogen(raised)

hs-CRP(raised)

homocysteine( raised)

liver function tests(elevated AST,ALT and gGT)

serum magnesium(low)

NMR lipid profile(assessment of lipid particle size):small LDL and HDL particles and large VLDL particles.

total cholesterol, HDC-C,LDL- C,triglycerides: (all high,high triglyceride/ HDL ratio)

uric acid(high)

Obviously keeping insulin low as advised previously-see file on insulin resistance and measures against it-helps with such symptoms.Further investigations for gut dysbiosis(stool analysis,sIgA, Candida Abs)and IgG4 food allegies and /or tissue transglutaminase for coeliac disease would help eliminate sources of harmful stimuli to GALT-as explained above.

B)Autonomic nervous system dysfunction.

Some of the symptoms you mentioned-dizziness ,heart racing,bladder symptoms,hypertensi on-may be linked to this pathophysiology.

The autonomic nervous system has complex interactions with organ systems and changes in the activity or tone of its sympathetic or parasympathetic component can lead to imbalances ie in patients with inflammatory arthritis or myofascial pain there is heightened sympathetic activity which may result in high blood pressure.Fibromyalg ia pain may be attributable to a sympathetic hyperdynamic state and seems to respond favourably to manipulation.

some genitourinary disorders have been shown to have a structural basis as above mentioned;the pelvic floor fascia and muscles provide mechanical support to the lower urinary tract and work with the somatic and autonomous nervous systems to coordinate sphincter and bladder activities.It has been long established that pelvic floor exercises can be useful in minor stress incontinence. Furthermore, interstitial cystitis(which sounds likely from your sysmptoms)and the urethral syndrome may also respond to myofascial therapy aimed at the pelvic floor;in a study of 52 patients

with some form of urgency-frequency symptoms,more than 70% experienced

significant improvement after treatment with manual trigger point therapy to the pelvic floor muscles.

Finally,it is important to say that decreased physical activity for whatever reason and increased caloric intake can further complicate these problems and create more imbalance between the sympathetic and parasympathetic nervous systems.

Reference:Weiss JM,pelvic floor myofascial trigger points:manual therapy for interstitial cystitis and the urgency-frequency symptoms,J urology 2001;166:2226- 31

F,Heller PH et al:Altered autonomic function in patients with arthritis or chronic myofascial pain,Pain 1989;39:77-84

ez-Lavin M,Vidal M et al:Norepinephrine -evoked pain in fibromyalgia, a randomized pilot study,BMC Muscul Disord. 2002

I hope the above helps.

Best wishes

Theodora

>

> Hello Theodora - Im hoping that you would give me your thoughts about symptoms that could be some sort of glucose intolerance/ insulin resistance but fasting glucose has come back normal - Ive had dizziness for years and its getting worse hence visited GP and done a number of bloods all normal (though I dont know results as only spoke to receptionist) . along with the dizziness I often get palpitations and last week after eating some jelly babies my heart rate went through the roof and kept me awake for ages! memory/concentratio n problems are the most concerning as I worry about my job!

>

> Im undergoing a behavioural approach to insomnia, diagnosed as psychophysical following on from hypoT, my memory and concentration are poor - much improved on zopiclone and also mucuna pruriens (L Dopa). Ive got high BP but its under control at the moment. Im due to have an ultrasound next week as Im getting pains that appear to be kidneys, along with a right upper abdo dull pain (gall bladder removed 20 years ago) and symptoms of wee infection but no infection found, did calm after trimethoprim but now 3 weeks and still peeing more frequently but no cystitis or bladder pain.

>

> tall order I know but Id be grateful for your thoughts and suggestions for further investigation and hope you dont mind my asking.

>

> many thanks,

>

> Gill

> Moderator

>