Yonason did you find any of the information you wrote in your book about weight loss helpful?
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It's stunning what not eating carbs does to a severe diabetic (type 2). When my brother was admitted to the ICU he was a breath away from death. The ICU doc told me, "His diabetes is raging out of control. His blood sugar is over 500 and his a1c is so high we can't measure it--it's off our charts."Originally Posted by Mark Rippetoe
When he got out (long story) I cleaned out the fridge and threw ANYTHING with sugar in it away. His a1c was just measured--by the same hospital--at 5.7. I utterly refuse to let him eat sugar. Now his fasting blood sugar is around 115 if he takes his metformin--130 if he (or I) forgets to take it. I haven't given him insulin in weeks. His blood sugar was 113 this morning. The docs can't believe it. Training with barbells has been a big part of his recovery. A big thanks to Rip for his advice as we passed through uncharted waters during this most tying time in my brother's (and my) life.
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Yonason did you find any of the information you wrote in your book about weight loss helpful?
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If you're eating over 2k calories a day with a diet that's 75%+ fat, you absolutely do not feel starved.
If you're hungry eating keto you're doing it wrong.
It sometimes feels kind of gross eating that much fat, but you definitely don't "feel starved".
So you're lifting for your health. And you won't stop eating carbs (which would improve your health) because it will affect your lifting.
Your priorities are not in order. Straighten out your priorities. Figure out what the most important goal is. Accomplish that goal. Then move on.
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You are correct that some people can do keto long term. Its effectiveness in weight loss is great (better than any other diet) for the first six months, but after one year the only real benefit is for diabetics to help them avoid high blood sugar.
However, studies have shown that the keto diet is hard to stick to long term for most people (including myself). I am not diabetic, and only borderline pre-diabetic with hA1c at a mere 6.0, and as such I have no "need" to diet or take meds for the purpose of lowering blood sugar. The primary reason I started metformin is because its weight loss success appealed to me, and since my endocrinologist recommends it for anyone with hA1c above 5.6.
In regards to my priorities, you are correct that if my priorities were based on my health needs, I would have to prioritize losing fat with serious four week bouts of keto+aerobics. But I am nearly 54 years old and after four years of weightlifting I am pretty damn close to reaching my potential strength. My current PRs are squatting 160kgX3 deadlifting 210kgX1 and benching 110kgX5. I think there's a chance I could reach 170-180kgX1 squat, 220-225kgX1 deadlift, and 120-130kgX1 bench. At my age, if I don't go for these numbers now, I never will be able to reach them. So I have set my priority to be gaining strength, at the cost of not being able to cut fat for the next year or so. That doesn't rule out taking a break here and there for cutting, but the above explains why cutting is not currently my top priority.
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Tov-tusch, you are a wiseguy. Since you have nothing of value to add to the conversation (which is about alternatives to metformin for improving insulin sensitivity without harming muscle building abilities), you took a low swipe with a personal insult. A chutzpah.
Mark Rippetoe has dedicated his life (and this website) to teaching people how to get stronger. Although only 9.3 percent of the total adult population has diabetes, an additional third of the entire adult population suffers from prediabetes. Metformin is the most common drug used for pre and type 2 diabetes. Metformin harms one's ability to get stronger, and as such this should be a topic of keen interest to Mark and many others on this forum; perhaps a third of the readers here.
The objective of beginning this thread is to spread awareness of the problem of metformin for weightlifters, and to search out better alternatives for improving insulin sensitivity. With the number of doctors and scientific minded people that use this blog I was hoping and expecting a better response than to simply cut carbs.
With world class contributors such as Jordan Feigenbaum (who is finishing or finished med-school), I was really hoping to bask in the intellectual enlightenment on these types of subjects that Jordan is so expert in.
Well so far my hopes have not been actualized, but at least I haven't been insulted yet by anyone other than you. Yes, I'm a fat dude who wrote a book on dieting for weight loss. The reason I wrote the book is because I struggled so much with weight loss and did so much research on the subject, that I became a world recognized expert. Dietitians and doctors have given my book rave reviews. There is no other book on the market that is so packed with helpful information on weight loss and fighting the metabolic syndrome.
Before I wrote the book, at the outset of 2013, I was 98kg, with 30kg body fat, and 68kg lean body mass, a waistline of 44 inches, and a body fat percentage of over 30%. By May 2015, I had my waistline down to 38.5 inches, my body weight was 92kg, and body fat mass was at 20kg, with my lean body mass at 72kg and fat% under 22%.
At that point in time I had knee surgery for a torn meniscus. How many people do you know that didn't gain body fat after knee surgery when beyond age 50? It is an inevitable fact of life.
Now in 9/2017, I have reached an estimated lean body mass of 78kg... an additional 6kg of muscle mass since my knee surgery two years ago. I have also gained 6kg of body fat in that time as well as 4 inches on my waist (now 42.5).
Compare where I was in 2013 (30kg fat, 68kg lbm) to now 2017 at age 53 (26kg fat, 78kg lbm) and you tell me if the info in my book didn't help. How many 50 year olds do you know that have put on 10kg of muscle without steroids?!!! That is an outstanding accomplishment. Where would I be now had I not hit the gym and learned how to watch my diet? I would likely have ten more kg fat while having probably lost close to a kg muscle instead of gaining ten, and I would like have serious problems with diabetes and heart condition.
But Tov-tusch, you are right; it's very funny that a dude with a 42.5 inch waist and 26% body fat has a book out on dieting and the metabolic syndrome. Now go back to reading comic books, and leave this forum for adults.
TMPHBITEU
I don't think Tovarisch has asked an unreasonable question. How is it that the author of a weight loss book is so unfamiliar with the physiology that he thinks there is a "natural insulin sensitizer" that works better than glycolytic exercise?
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With an A1c of 6.0, metformin is optional. Now the longevity community thinks it's a wonder drug, so there's a conflict there with the premise of this thread. I'm not convinced either way. You could try byetta (synthetic lizard siliva), which also helps people lose weight, but metformin is definitely cheaper and easier to take -- and byetta isn't really for "pre-diabetes." For most people, low to no carbs is the answer to insulin resistance, if they'll do it. Some people just can't do carbs, like at all.
The fundamental question is: "do people eat what they like? or do they like what they eat?" I think it's the latter.
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Anything that depletes glycogen reserves (aerobic exercise, anaerobic exercise, or cutting carbs), will naturally improve "insulin sensitivity". Despite that, there are loads of people lifting weights and watching their carbs that still need metformin.
Rip, as you are well aware, insulin is an anabolic hormone; it helps us build muscle and get stronger; it drives nutrients into the body cells (including muscle cells), and that includes glucose and amino acids and other nutrients that the muscle fibers need to rebuild and get stronger. Therefore, I would assume that any herb, mineral, or medicine that would improve insulin sensitivity would thereby improve the anabolic properties of insulin. In other words I had assumed that just as metformin aids insulin to more effectively direct the body to absorb glucose, that it would also more effectively absorb protein and thereby enhance the muscle building effects of insulin. But to my dismay, despite being an insulin sensitizer, metformin inhibits muscle recovery due to other effects it has, such as reducing testosterone. (I still haven't fully recovered my strength, 11 days after having stopped my six week stint on metformin).
Do you know why metformin helps people lose weight? After eating, blood glucose levels rise, the body releases insulin, driving the excess sugar out of the blood and into the muscles and organs. A person who suffers from insulin resistance, after eating his body also releases insulin, but it is not sufficiently effective in lowering the blood sugar levels; so the body releases more insulin, creating a state of “hyperinsulinemia” (too much insulin). What happens next is that after a couple of hours after eating blood sugar levels drop. Then the body releases catabolic hormones to release glycogen stores into the blood. However, the insulin resistant person is now in a state of hyperinsulinemia because the high levels of insulin take hours to dissipate. Insulin is an antagonist of the catabolic hormones. If insulin levels are high, the insulin will block the effects of those catabolic hormones, and blood sugar levels stay too low. So the person gets hungry and eats to get the glucose boost he needs. With metformin one's insulin is more effective in lowering blood sugar, therefore one doesn't come to the state of hyperinsulinemia, and therefore one's catabolic hormones prevent sugar lows abating one's hunger. Being less hungry aids in losing weight, hence metformin helps people lose weight.
The bottom line is that for the benefit of cutting fat, building muscle, and keeping blood sugar levels stable and healthy, insulin sensitivity is essential. Exercise and cutting carbs help but beyond that, for people who exercise and watch their carbs but still suffer from a lack of optimal insulin sensitivity, what herb or mineral or medication can improve insulin sensitivity without negative side effects, such that one can maximize getting stronger and leaner? I have seen studies that ginger, cinnamon, and magnesium can help. But it would be nice to get some feedback from someone like Jordan, who could put things better into perspective for a layman like me. What dosage is ideal, how effective are these supplements, are there more effective supplements?
Despite having authored a book on diet, I am primarily a religious scribe. Most of my day is spent writing with a feather quill on parchment. I study religious texts much more than physiology. For a self-taught layman I have a strong background in metabolism and endocrinology. But that’s still a far cry from the scientific background of an MD like Jordan.
I appreciate your attitude of pumping iron to solve all the problems of the world and not giving much of a hoot about nutrition and medicine. But that choice of direction is not sufficient for everyone. You’re smart; you know that. You know that some supplements (like Creatine) are worth knowing about. You know that many people on your forum would be interested in a better answer to my question than “there is no better insulin sensitizer than pumping iron.”
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Wow. That's interesting. Apparently it can only be taken through injection. If it could be taken orally, I'd consider trying it out for a week. Apparently there are loads of common side effects, and there aren't sufficient long-term studies on it. But very interesting to learn about.
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It's a subcutaneous injection, similar to insulin. But it's not insulin.
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