Hello Dr. Myhill. I am an endocrinologist in Syracuse, NY. I received your name from a patient of mine with CFIDS. She is adamant that she cannot tolerate any medications. She has very poorly controlled type 2 diabetes mellitus. Her hemoglobin A1c is over 15 and her blood sugars all run from 400-500. She tried one insulin in the past but states she cannot tolerate it and declines any others. Have you ever heard of any situations like this before? I have not found any information in the medical literature in relation to this. Any advice that you may have would be highly appreciated. Thank you so much in advance for your time. Jennifer Kelly
Gosh – no easy answers here!
Firstly your patient should do a ketogenic diet – see
That will greatly reduce the glycaemic load and MAY be all that is required.
What exactly does she mean by intolerant of? Allergic?
Does she have insulin resistance or is she insulin deficient? (ie what are her blood insulin levels). The point here is that insulin resistance may result from micronutrient deficiencies (eg B3, zinc chromium) or from inhibition by toxins (either endogenous from the fermenting gut eg alcohol, D lactate etc or exogenous such as heavy metals?).
Do get back to me if you get stuck
Good morning, I am forwarding to you the email I received from Dr. Myhill. Very informative and it was so nice of her to respond so quickly. You may want to try the ketogenic test that she mentions. If you’d like to have a fasting insulin test performed to further answer her question of insulin resistance, I will mail a lab script for you to have performed fasting some time at any lab. If there are other labs you’d like to have ordered, please let me know. I’m sure Dr. Myhill would be happy to answer any questions you would have also as her website was open to questions from doctors and patients. Keep in touch and have a nice weekend. J. Kelly
A web site says that the Keto diet is contraindicated if you have a “history of kidney failure.” I don’t know what that means. I have stage III chronic kidney disease as well as nephrogenic diabetes insipidus. Am I in or out?
I didn’t see any “ketogenic test.” Where is that?
Yes, I will do a “fasting insulin test” (fasting glucose test?). Please send script.
I would be inclined to try the ketogenic diet, but I would need help getting started. Would the Irish lass who met with me in February/March (?) be willing to take a shot at this? http://www.ketogenic-diet-resource.com/ looks like it might be helpful.
“. . . Intolerant of? (Allergic?)” I had undiagnosed ME/CFIDS and took antidepressants every day for 26 years. Antidepressants are contraindicated for ME/CFIDS. My theory is that the antidepressants on top of CFIDS for so long a time utterly broke down my immune system. The homeopaths consider this a major toxic load. I do not have classic allergies (I am not generating antibodies) but do have extremely severe hypersensitivity to all drugs.
I may only have tried “one insulin” [three times] but I also have tried many other medications for other things and I react to everything. There is no point in hospitalization to try new things. The history of my relationship with doctors is that they are always looking at the drugs and never looking at the patient. The question is not “What new drug can we try”; the question is “What’s wrong with the patient?” It is about the immune system; it is all about the immune system. (To be continued)