muscle wasting/protein deficiency
After being un/misdiagnosed as a type 1 LADA diabetic, I was hospitalized 3 times in the month of April. My blood sugars from Jan- April were 300-400. I had been type 2 for many years but always kept them under 120 eating very low carb. They shot up over night and wouldn't come down. I did not respond to oral meds and had sudden severe weight loss and muscle wasting during this time. I am 5'8 and currently 117 which has been my normal weight for years. I was down to 97#'s and my Dr's weren't doing a thing. After my hospital visits I was diagnosed with severe muscle wasting, protein deficiency and malnourishment. I seriously thought I was dying s slow death. Shortly after being on insulin most of my weight and health have been restored. I started with 8-12 units per meal and 5 basal at night. I'm happy to say I take 1-1.5 with meals now and 4 basal and my BS is good and stable (under 120)
My question to you is that after such a severe illness, do my protein requirements stay the same or should I be eating more? I eat about 60 g pure protein a day, sometimes up to 75. I feel good but don't want to overeat it but at the same time, I need to make sure I'm getting enough to rebuild and maintain the muscle I do have. Your suggestions will be greatly appreciated
Kristin
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Support Staff 1 Posted by Ken on 18 Aug, 2014 06:58 PM
Hi Kristin
Sorry to hear that you have had a rough go of things. This type of thing happened to one of my in-laws at the age of 32 and it was hard for him to adjust.
• Do you remember what your daily fat & protein intake had been prior to being hospitalized?
• I would use a bit of caution and try not to over compensate with the amount of protein intake. Your body will only use a certain amount of protein at any given time and too much will mess with your insulin/sugar levels.
• For your height 48g – 52g is a doable amount of protein. This thought is based on what I have learned over the past couple of years. Whether you need more per day to get your health back I can not really say with certainty. Hopefully your doctor will be of help.
• Don't forget good fat intake.
Kristin these are only my thoughts and I do not speak for Dr. Ron or other staff members here on the Help_Line.
Keep us informed of how things are going for youSure wish you the best ..
Ken
Support Staff 2 Posted by Ken on 18 Aug, 2014 07:32 PM
For those that are not familiar with LADA diabetes
Wikipedia
3 Posted by Kristin Nagel on 19 Aug, 2014 01:55 PM
Ken,
Thank you for responding and I understand what you’re saying. However, seeing as I was hospitalized 3 times in April with severe muscle wasting and protein deficiency (literally skin and bones) I am curious as to whether my protein requirements change for awhile. Same concept as they change for the very sick, elderly, pregnant etc.
As far as it messing with my insulin/sugar levels, I don’t produce my own insulin so it doesn’t effect that and I take the insulin based on my carbs. I am on EXTREMELY low doses of insulin. My breakfast dose is the largest even though it’s my smallest meal. I have 10g turkey on a piece of romaine and a couple bites of celery and take 1.5 units of insulin. My lunch is 22g of usually salmon or tuna on a wrap and a cup of steamed broccoli and I take 1 unit. Then dinner is usually 25-35 g fish again with a power green salad and some cold veggies and take 1/2 unit. I obviously am most insulin resistant in the morning and always have been. I do exchange the fish sometimes for roast beef/turkey or bison burgers. I snack on hot dogs or hard boiled eggs or nuts. Protein and fat are the only things I can snack on without having to dose insulin. They only raise my BS a tiny bit. I eat plenty of healthy fat and always have. I actually do have a little fat around my middle which I am thankful for now. After 2 months on insulin my weight came right back to my exact normal weight and stopped and remained there. Funny thing is, everything that effected me or how it effected me still does. When 1st diagnosed they had me eating 20-25g carbs per meal and I don’t eat grains/ starch or sugar so I was eating large meals of mostly veggies but each had 2 small bites of sweet potato or hummus. Ditched all that and back to my normal protein fat and veggies and smaller meals. Since then my insulin needs are much lower and that I am happy with.
I had been doing the Rosedale/Paleo/ Blood type diet before all this happened and was eating around 45g protein and that’s when I started losing muscle (this was PRE diagnosis) so I don’t think that’s enough for me. 60-70 SEEMS to be a better fit.
Are you still eating your 13-15g salmon/1 cup kale and 1 tsp oil? That is certainly not enough food for me. I need more fat than that and more veggies, as well as a little more protein. I don’t need a snack between BF and lunch but between lunch and dinner I do. That’s usually a hard boiled egg/or 1/2 hot dog and some nuts/nut butters.
Kristin
Support Staff 4 Posted by Ken on 19 Aug, 2014 03:29 PM
Hi Kristin
Glad you are improving and are establishing your personal diet that fits you, this is what I have done and every so often I re-evaluate it.
At the present time I have upped my protein (salmon) to 15g to 18g per meal (@ 3). I concentrate on keeping my total protein 52g to 56g per day, this includes the protein from vegs. I haven't had Kale for awhile now, been using Mustard Greens & Spinach for the past few months. As far as fiber carbs (I do around half a cup per meal) - total daily fiber carbs = 6g to 8g. My oil varies, depending on how I feel the need. However, the Salmon has around 15g (total fat per day) in it - I am fairly active and there are times I up that with olive or coconut oil as needed. For the time being I no longer set a certain amount of supplemental oil, only as I sense the need.
Kristin I am so glad that you are doing better and sincerely hope that things will only get better for you.
Ken
5 Posted by Kristin Nagel on 19 Aug, 2014 11:13 PM
Ken, do you realize without the added fat, your meals only come to less than 400 calories? Even if you do have A LOT of extra fat on your body, I can’t see how that’s enough calories to maintain anyone. And I’m sure you are not eating LOTS of additional supplemental fat. I am certainly not a calories in calories out person but I do believe anything under 800 even of the highest quality calories is on the very low side. I do think there is something to be said for using calorie restriction but 400 seems extreme. I’m not telling you what to do as I find it hard to eat enough calories on low carb/ moderate protein and fats. For me I have to eat nuts as well as olive oil on salads to get enough but sometimes I really don’t want all the nuts but have a hard time finding other foods to make up the deficit. Doing my math with 65 P, 15 C and 2 T oil + 15 fats in my protein, I’m still only at 600 calories so I do supplement with nuts. Sometimes I just gorge on them though which is no good, LOL. I do try to keep my meals on the lower fat side to not keep my BS out too long and so the insulin sops up some of the protein that turns to BS. If I eat too much fat at a meal the blood sugar from protein is delayed and my insulin takes me too low 1st and then there’s none left when my protein gets there, hence he fat snacks in between meals. Again, I am by no means telling you what to do, I would just hate to see anyone with muscle wasting and protein deficiency as protein is needed for so many body functions. I think you know I do the Blood Type diet in conjunction and as an O I need more protein than other blood types and this seems to be true. However, I am total agreement that excess is not good either. It’s just hard to know what excess is as everyone is different. I just NEVER want to go back to muscle wasting etc so I guess for me I’d rather error slightly on the high side rather than the low. I do tend to over eat protein when we go out (LOVE chicken wings) but shaking things up once in awhile is OK too.
Also, it is not that your body does not use extra protein for maintenance and repair, because it will BUT too much protein, especially at one time will convert to some excess blood sugar and there is always the mTOR pathway which is exactly why I space it out. Just my take on it... hopefully will hear good DR!!!
Support Staff 6 Posted by Ken on 20 Aug, 2014 12:20 AM
Hi Kristin
I haven't really done calorie counting. For about 3 months now I have let my body tell me how much fat to ingest, it's been interesting. I had a little extra layer around my middle so I thought I would try and see if I could get that down a little - mainly thru diet.
I did up my protein a little, a couple lab work back my plasma protein was 6.1 (on the low-side) - this past lab, after I upped my protein, plasma protein was 6.7.
I began this little adventure with wearing a 30" waist size pants. I haven't tried yet but I believe I can get into a 28" waist pants. My weight is holding pretty steady between 142# and 145#. I am fairly lean now. At 5' 10" in height with a medium
frame.
The main thing I keep a close watch on is my protein. When I feel a bit hungry if drinking a glass of water does not take the edge off I'll down a table spoon of coconut oil. Eventually the waist line will run out of it's storage and I will need to compensate with olive or coconut oil. It appears that using the storage of fat around the middle is a slow process, which is okay, I am not in a hurry.
I guess-ta-mate another 3 to 5 weeks will be sufficient. I must admit that there is loose skin but I am not bothered by that - I may live long enough for it to shrink some, only time will tell. While it is true that I have lost some muscle mass but I am not concerned about that either. Minus the loose skin I am about the size I was in my late teens.
It is my understanding that the body tries to hold on to a certain percentage of fat and when that gets depleted is when you start having problems.
I think sometime next month I will go to the department store and see if I can comfortably fit into a 28" waist relaxed fit jeans - maybe Santa Claus will bring me some new stuff for Christmas :-)
If nothing else comes to mind to experiment with I will have some kind of a maintenance routine figured out by end of this year. For now I am keeping an eye on how my body responds to the fiber & protein intake from Mustard Greens and Spinach.
Take care & wishing you the best.
• I forgot to mention that I have been off and on using a pat or two of full fat butter instead of coconut oil to see how it works to take the edge off in times of a hunger sensation when the water doesn't quite do the trick. Seems to work okay - a little cheaper than coconut oil.
Ken