Meeting the Endocrinologist

Finally, I had my first appointment with an endocrinologist, who was friendly and warm. He quickly noticed skin tags on my neck, a common sign of insulin resistance, which I had assumed were merely moles. He suggested that I might have been dealing with insulin resistance for a long time, possibly as far back as three decades.

He explained insulin resistance using a metaphor about a door with rusty hinges. Although my insulin levels, tested previously, were just below the normal range, he indicated that they were still concerning. The possibility of hyperinsulinemia—a condition characterized by excess insulin—was brought up, which would explain my blood sugar spikes followed by rapid declines.

My glucose readings don't show a smooth pattern; rather, they are characterized by sharp rises and falls. Each time I eat, my blood sugar spikes, prompting my pancreas to release insulin, which then causes my levels to drop significantly.

Despite my lab results indicating that I am mostly within the normal range, my weight and skin tags led the doctor to consider prescribing Ozempic for insulin resistance. However, my A1c of 4.8 and fasting blood sugar of 81 meant that my insurance would not cover it.

Gathering Information

I arrived at the appointment with a prepared list of concerns, stemming from my extensive research online. My cortisol levels have been fluctuating, with some readings indicating low levels that led to an emergency room visit and a hydrocortisone shot. Other hormone levels also showed borderline deficiencies.

After sharing my concerns, including episodes of fatigue and low blood pressure, I learned that I have an adenoma on my adrenal gland and a partially empty sella, which could be linked to secondary Addison's disease. My doctor assured me that he would order tests to assess the function of my adrenal glands.

Facing Dietary Changes

During our discussion, the doctor advised a drastic dietary change: a zero-carb diet. He argued that eliminating carbs would prevent my blood sugar from spiking and crashing. While I was skeptical, he suggested I could eat animal protein, broccoli, and leafy greens, essentially a keto-like diet.

The idea of following such a restrictive diet raised concerns for me, especially as someone with a history of disordered eating. I sought recommendations for resources that would guide me through this process without the pressures often associated with diet culture.

Despite my hesitations, the doctor spent considerable time explaining the science behind my condition and the potential benefits of dietary changes. He also prescribed additional continuous glucose monitors to help me track my blood sugar more effectively.

Making Adjustments

After our appointment, I went to Red Lobster with my family, where I opted for shrimp and Brussels sprouts, and my blood sugar responded positively. I also purchased a book aimed at helping me manage my blood sugar through diet. While I found it hard to commit to a keto diet, I began significantly reducing my carb intake.

In the days following my appointment, I discovered that keeping my blood sugar levels between 80 and 140 made me feel my best. Additionally, I learned the importance of eating protein first to help stabilize my blood sugar.

I am committed to understanding my health better and finding a sustainable way to manage my blood sugar levels while ensuring my overall well-being.

Shaunta Grimes is a writer and educator residing in Northwestern Pennsylvania with her family and pets. She is the author of several novels and a newsletter, where she shares her insights and experiences.