I have been following the Zone Diet, and very successfully, for several years. I lost over 100 pounds and defeated high trigly, high bp and high blood sugar. A few months ago I had my gall bladder removed with only 20 or so pounds to reach my target weight. Since recovery, I have had difficulty staying awake, after lunch in particular. I have tried removing any glycemic triggers and have reduced my carbs to a 2p, 1c, 2f ratio and still no success. I have regained about ten pounds over the past few months following surgery and am at my wits end. I simply can not figure out what I am doing wrong. Suggestions are welcome. Hoping for help from Sue.

Thanks.

Matt

Hi Matt,

Congrats on your 100 pound weight loss and other health accomplishmets! As you're finding out, the body can change. After major surgery it can take a number of months to fully heal and during those months it usually wants to hang onto the status quo and sometimes even add some extra weight.i've experienced this myself and have had discussions with Dr. Sears about it. I have a few thoughts for you. Stick with a the Zone diet with most of your carbohydrates coming from non starchy vegetables. For your fruits choose berries (blueberries, raspberries, strawberries and blackberries). The 2P and 1C balance is taking the P/C a bit out of the range of the Zone, which is P/C from .6 to 1. Dropping 1C from a 3 or 4 block meal will work, but with 2 block meals try 1.5 C. Afood diary can also be helpful. Stay hydrated and you might also consider adding a little more monounsaturated fat to help control the entry of carcobhdrate into you bloodstream. Hang in there because it can take some time.

Sue:

Thanks for the response. What concerns me most is that I am both sleepy and gaining weight, regardless of what I eat. I eat no starchy vegetables at all - only cruciferous (broccoli, cauliflower, asparagus and brussel sprouts), cucumbers, red peppers and spinach. My protein comes largely from boneless, skinless white chicken meat oven roasted in olive oil and egg beaters (I make a frittata for lunch every week). For breakfast I have protein from soy milk, soy powder and greek yogurt. It is the only meal that I have fruit and it is berries only, and mostly strawberries. I have tried .75 to 1 ratio of protein to carbs and started reducing carbs because I was sleepy (like clockwork) 2 hours after eating lunch and dinner every day and noticed weight gain. This has gone on for 2 months now and I have gained about ten pounds back. Surgery was more than 4 months ago.

For example, for dinner this evening I had 4 blocks of chicken on a plate of fresh mixed greens topped with 3 TBSP Guacamole and an English Cucumber (Which I estimate at about 2 blocks of carbs). This should have been a 4P 3C and ??F meal. I was drowsy almost exactly 2 hours after eating. VERY frustrating as cucumbers and salad should be extremely low glycemic index.

You said "Afood dairy can also be helpful". Did you to avoid dairy?

Lastly, I have been measuring my blood sugar on and off over the past two months. My breakfast smoothie meal results in a peak blood sugar of about 110 after 2 hours and is the only meal that does not cause me to become drowsy after eating. Lunch usually is a 4P frittata and a Red Pepper and 1C block of cruciferous (as mentioned above). Peak blood sugar 1-2 hour after eating is usually 85-95 and settles back down to the low 80s after two hours. So, my blood sugar number don't lead me to believe that I am going out of the zone and should not be resulting in weight gain.

Please let me know if you have any additional thoughts based on this information. I thought that after 4 months I would not still be facing any weight gain from the surgery.

Thanks.

Matt

That was a typo, should have been diary.

I would call the chicken and cucumber meal 4P, 1C, 3F. The greens contain negligible amounts of carbohydrate and it takes 4 cups of sliced cucumber to yield 1C block. It looks like you are short on carbohydrate in the frittata meal also (4P, 1.5 C). Insufficient carbohydrate could be causing ketosis, though I don't know if ketosis involves feeling sleepy. Remember to double the fat blocks you add to the frittata meal, since eggbeaters are fat free. Are you ever hungry?

4 mos. is still within the realm of possibility for it to be your body recovering.

Sorry, Sue. One last time. Avoid dairy? Or don't avoid dairy?

I do sometimes get hungry after meals. Nearly always sleepy and sometimes hungry. Curiously, when I eat Dr. Sears food, I am nearly always sated and almost never sleepy as a result. My recollection is that ketosis is not associated with drowsiness.

Thanks again.

Matt

a food diary (a food journal)

It can help track trends making it easier to figure out symptoms. Note everything you eat (specific foods and amounts of each), what time you eat, how you feel 4 hours after eating, and any exercise you do (type of exercise and time spent performing it). Some people also like to note how much water they drink.

A little extra monounsaturated fat could help.

Ahhh, a diary. I misread that several times. Yes, I can do that. Honestly, there is little variety to what i eat because pre-surgery so many foods were giving me gall bladder issues that i had whittled my diet down to 5 or 6 items. I have since added some things back, but since I have been having problems being drowsy, i stopped adding new foods and concentrated on what I am currently eating.

As for additional fats, I probably underestimate how much avocado, olive oil and guacamole I eat.

But I will keep a food journal and let you know what I find. thanks again for the help, Sue!

Matt

So, is there an iPhone app that anyone uses for food journaling that they like? Thanks!

Matt

My pleasure, Matt. Some more info, my additional fat suggestion is not based on the fat amounts included in your posts, but on the fact you are feeling sleepy. Keep experimenting. Also, some people do better when they include a little unfavorable carbohydrate. Others find they need a mix of carbohydrate densities in every meal. This is where a food diary will really come in handy. If you feel sleepy and/or hungry after a certain meal, change one thing in the meal the next time you have it. Keep working on that meal by changing one item at a time until the meal works for you (lack of hunger, with good mental focus and energy). If it just never works out, simply scratch that meal altogether. Good luck!

Today's Lunch:

4.25 oz baked chicken breast (boneless, skinless) - 4P
1 large english cucumber - 1C
1 Red Pepper - 1C
3 campari tomatoes (golf-ball sized) - 1C
4-6 TBSP Guacamole - 4-6F

Blood sugar after 1 hr - 80
Blood sugar after 2 hrs - 86
Sleepy after 2 hours.

Try using this current block guide for determining amounts of foods in carbohydrate blocks. http://drsears.com/ArticlePreview/t...fault.aspx

Looks like had about 2 C blocks in that meal. Also, knowing you blood sugar readings is not going to give you info about how much insulin you are producing to achieve those readings.

Update: Almost 2 months later and no positive changes for me - I am up over 25 pounds now. I continue to gain weight and I continue to fall asleep after every meal, as I did when I was not following the Zone and my sugar was out of control. My blood pressure is pre-hypertensive again. I have used a food diary and found myself to be following the diet perfectly most days, a couple of extra blocks on some days and sleepy after eating on all days. I saw the doctor today to be tested for Hypothyroidism. Reading/research seems to indicate that this is a strong possibility. If it's not Hypothyroidism, I am totally out of ideas as to why the same diet I followed for 5 solid years and used effectively to lose >120 lbs now simply does not work for me anymore. Very frustrating.

What worked for you 5 years may need to be changed a little bit simply because the body changes. Your inflammation levels are probably higher the they used to be, which signals your body to store fat. It's happened to me and I successfully reversed it with adjustments. BTW, I have hypothyroidism. You may or may not discover a diagnosis that provides some answers, but in the meantime you can adjust you Zone diet and lifestyle to get a better response. Sleepy after eating indicates too much carbohydrate in relation to protein in the meal. If you'd like to post a few days of your actual meals and snacks here I'll be happy to make suggestions.

Until then these steps should make a difference:

1. Recalculate your current protein requirement (block requirement) with the Zone Body Fat Calculator and stick wit it, no extra blocks (excess calories increase insulin levels).

2. Take Omega Rx and Polyphenols XT daily; you can take the AA/EPA test to find your most appropriate fish oil dose, find it at Zonediagnostics.com

3. Drop one block of carbohydrate from each meal.

4. Eat non-starchy vegetables for all you carbohydrate.

5. Drink a minimum of 64 oz. water daily.

6. Don't more than 5 hors without a Zone balanced meal or snack.

Sue:

I eat much the same every day, especially during the week. Here's a sample:

Breakfast 7AM:
20 oz smoothie (4P, 4C) (Soy milk, greek yogurt, kefir, sea health plus, whey protein powder, frozen strawberries, frozen mixed berries)
1 hass avocado (8F?)

Lunch 11:30AM:
1 Frittata (96/4 lean beef, egg beaters, very little cheese) (4P)
1 red pepper (1/2 - 1C)
9-12 spears asparagus, over roasted in EVOO (1C, ?F)
3-4 heaping T Guacamole (4F)

Afternoon snack 4PM:
1 cocoa crisp zone bar

2nd Afternoon Snack 6PM:
2.5 oz over baked chicken breast in EVOO (2-2.5P, ?F)
1.5C cooked spinach (1/2C?)
2 baby cucumbers (size of a kosher dill pickle) (1C?)
3-4T Guacamole (4F)

Dinner 8PM:
2.5 oz Oven Baked Chicken Breast in EVOO (2-2.5P, ?F)
1-1.5C Shaved Brussel Sprouts sauteed in EVOO (1-1.5C, ?F)
2-3T Guacamole (2-3F)

Bed Time Snack 11PM-12AM
1 Zone Bar


This is pretty much my diet all week long. I find that I am not sleepy after breakfast, and alert until lunch. I am nearly always sleepy by 2PM. I often eat a piece of string cheese at 2PM, which perks me back up, but leave me really hungry for my snack at 4PM. I am often drowsy after my 4PM snack, I am often drowsy after my 6PM snack. I am nearly always flat-out sleepy after my dinner and will fall asleep on the sofa like I did before I was zoning. I am very confused by this because my lunch meal is half the carbs the diet recommends, my whole food snacks are less carbs than recommended, and yet I am sleepy and gaining weight. I have an elevated BUN at this point from the P/C ratio I have been eating.

Additionally, it should be noted that throughout February and March I worked out daily in the morning after eating 1/2 of my breakfast (and finished breakfast immediately after my workout). The exercise routine consists of stretching for my lower back issues for about ten minutes, 20 minutes of cycling on my stationary bike (5.8 miles in 20 mins ~17. mph, heart rate 130) and 20 minutes walking 3mph on my treadmill at a 1% incline. I performed this routine 6 days a week. By early April, I have found myself too tired to get out of bed for the morning workout and am now doing it on the weekends only.

My weight has increased from a low of 210-215 to 238 as of yesterday. All of my weight gain is abdominal. Blood pressure had been 115/65, and is now 130/85. I feel like I have all of the markers of someone who is hyperinsulinemic and over inflamed, despitre following the zone diet closely daily. It should be noted that I don't cheat on the diet or go off the diet ever. There are no days when I just grab a burger or have a pizza. I *always* eat within the diet.

Also, my daily supplements:
4 Omega RX
2 eico Rx
1 capful of Sea Health Plus
1 Polyphenol capsule
4000 IU Vitamin D3
90 mcg Vitamin K2 (MK7)
2000 mg Cinnamon

I also take
600mg Ibuprofin twice daily for back pain
Flonase
Pataday
Zyrtec

So, based on all of this, what do you recommend? I have already dropped carbs. I have recalculated my P requirements. I take and have been taking polyphenols. I tried adding 2 more omega RX caps per day, but for two weeks I have diarhhea and reduced back down to 4 omega and 2 eico. Not sure what else I can do. And really frustrated with the weight gain. My clothes no longer fit.

Hi, on my way out at the moment and will give you my thoughts later. One qn., what is your LBM?

Matthew,

From what you posted on your diet intakes (and I didn't go and calculate everything..) I think you are doing well with your food choices. You admitted, though that you are pushing your P/C ratio to the point of having too little carb, and I think that it is possible you are too far into that range. I am also concerned about your BUN. The Zone Diet should not affect your BUN. If you have an elevated BUN, you could be suffering from dehydration or ??? Your sleepiness may be because you are not getting enough carbs for adequate brain function, or maybe you are dehydrated (again noting the BUN).

Another thought is about your vitamin D. I would recommend stopping that, or dropping it down to 1000 IU per day, see what happens when you cut back. Vitamin D is a fat-soluble vitamin, and people can become toxic on it by taking supplements.

Go see your doctor. Get a full work-up, including a metabolic panel. Specifically look at your BUN, creatinine, electrolytes and calcium levels.

Hi Matt,

Just a quick note, if you doc isn't concerned about you bun, I wouldn't give it another thought. Mine is always elevated, which my docs have no concern either and have all explained it's due to the protein I eat (which is not in extreme amounts).

Vitamin D toxicity (too much vitamin D in the bloodstream) is very rare. Vitamin D is considered to be one of the safest substances around and D3 is the best form to supplement with. If you're concerned about you D3 supplementation, you can ask you doctor to do a D test to assure blood levels are not too high. My guess is that you doc might even routinely order vitamin D levels annually, as many docs now do.

I have a busy weekend, and will get back to you soon with the rest of my thoughts.

Thanks Cranberry and Sue.

Cranberry:
I drink a TON of water; typically 6 or 8 16oz glasses a day. Again, I am not a new Zoner, I have been following the diet for years, so I know the general rules and have had great success for the past several years. My current P/C ratio is out of whack *because* eating the right ratio was causing me to be sleepy. My point in my last post was that despite lowering the P/C ratio to a level I know is out of the Zone, to the point where I am way protein heavy, I am still sleepy after eating as if I were eating too many carbs (and gaining weight, too). Also, I totally agree with Sue on the Vitamin D. There is little evidence that it can even be toxic. My D levels were checked at my last doctors visit when I was tested for Thyroid and tiredness and weight gain. D levels were 40, which is "great for the winter time" according to my doctor. Thyroid was also VERY normal, by the way. I appreciate your input.

I really have tried all of the normal adjustments like eating fewer carbs like a 4/3/4 ratio, or adding fat to a 4/3/5 or 4/3/6 ration, etc. I have tried 2-block meals. I have added water. I have eliminated all starch and the only fruit I eat is berries at breakfast. I think there's more at play here, but I am confounded because of how well this exact diet (some of my meals have been the same for 5 years) has worked for me in the past, and now it's as if I am not zoning at all.

Sue:
My stats are:
Body Fat %: 38
Body Fat Weight (lbs): 91
Lean Body Mass (lbs): 149

6'1", 238 lbs, 7.25" wrist, 48.5" waist at umb.

That should put my protein requirement between 14 (low activity) and 17 (moderate), which is hard to judge, but as I mentioned, I had been doing 40 minutes of 130 bpm exercise 6 times a week (cycling and walking) until about a week or two ago. My doc didn't say anything about my BUN, but it is at about 30. My sister, a Paleo dieter, indicated that it was too high and was a bit concerned. A few years back on my last blood work up, my BUN was 21. So it's definitely elevated and likely because of the excess protein.

I look forward to your input. I also e-mailed Dr. Sears asking for some guidance, but go no response.

Matt, just to let you know, I'm also checking with some people at work/Zone Labs about this, so I may not get back to you for a few days. I'd also suggest getting the AA/EA test (find it at Zonediagnostics.com). I'm thinking the Eico may be causing you spillover, increasing your inflammation and setting you up for what's going on currently. Hang in there. We can figure this out.

Typo...that's AA/EPA test

Hey, Matt

I am glad that my concerns from the previous post are not likely issues for you. Hopefully your doctor checked out the full metabolic panel, too. You do not seem to be dehydrated, if you are drinking all of that water. Are there any other concerns with your electrolytes? How is your sodium?

I think you have a good handle on your food choices and you are trying to do everything in the right way and right order. However, you mentioned that you are getting "1/2 of the carbs that the diet recommends" You may not be getting enough carbohydrate to your brain in order to support brain function, which may be contributing to your sleepiness. It is interesting that your first meal is probably the highest in glycemic load, and closer to the appropriate Zone ratio, and this is the one meal that you commented made you feel your best. I would like to see you get your carbs closer to the appropriate Zone ratio. And, you could probably back off from the fat and just take the recommended amount. Too much fat may be contributing to the weight gain. Yes, it is fine to increase fat when decreasing carb, but since I am suggesting upping the carb a bit, you would want to decrease the fat, too. If you are not comfortable with decreasing the fat, then at least try to nail down those items with the questionable amounts. It is really easy to overdo the fat (I sometimes overdo it when I make omelets LOL). Too much fat may also take you OOZ and cause weight gain.

Sue:
Thanks. I am looking forward to hearing back.

Cranberry:
As I mentioned in my previous response, the reason many of my other meals have lower carbs is because I already dialed them down in response to sleepiness following meals. I started out with normal Zone ratios and removed carbs in an attempt to keep from being sleepy.

There is the possibility that I am getting too much fat, but I do find that a little hard to believe, as the amount of fat I am eating has not changed much from before when the diet was working for me. I *strongly* suspect that there is something wrong internally, and what I am hoping for is a clue to follow in order to get back on track. I don't think the diet is broken, and I don't think my implementation of the diet is broken (since I am largely doing exactly what I have been doing for the past 5 years).

I think something *in me* has changed and now the diet is no longer working. What I can't figure out is what the change is. It's not thyroid. Could it be that my pancreas is malfunctioning? Or something is causing incredible inflammation that 6 fish oil caps and 6 advil a day can't manage? Based on the amount of weight I have gain in the time I gained it (nearly 35 pounds in 30 weeks) makes it seem like I am not dieting at all. My caloric intake is 1800-2200 calories per day and I (had been) working our 6 days a week, until just two weeks ago. My doctor did not do a complete blood work up. I came in complaining about fatigue and weight gain and she ran tests based on that.

So, I am very interested to hear what Dr. Sears says - perhaps a few things to follow up on. My doctor has recommended visiting two different specialists, one of whom is an endocrinologist. I have not made that appointment yet because I am not ready to do battle with the endo about diet vs mediciation - I am sure the first thing I will be told is to start taking Metformin, following a Glucose Tolerance Test, which I will no doubt fail miserably. But if the Zone folks think that would be beneficial, that's what I will do.

Sue:

Also, I'll take a look at the AA/EPA test today.

My most recent blood workup showed (non-fasting) glucose of 96 (I test myself, and it's typically in the mid 80s to mid 90s 2 hours after eating, as I mentioned several posts ago, back in Feb).. My A1C was 5.4, an increase from my last read of 4.6 a few years ago. Sodium (142) and potassium(4.9) are normal. BUN was 31 (normal is 8-22), but creatinine was 0.8, normal. Vitamin D was 49. TSH was 2.07 (normal) and FT4 was 1.3 (also normal). My Testosterone was low and the doctor recommended a Urologist. Follow up with Uro showed T levels of 200 and Est levels of 33 (normal-high). The Uro wants to treat me for low T, but I am concerned that the Low T is a symptom of some other issue, and not the cause. I am also interested to hear what the Zone folks have to say about that. Not thrilled with TRT because of the potential side effects. But again, if it will help, then clearly that's what I'll do.

Matthew,

I hear what you are saying... From what I have read about you, and what you have posted, I have no doubt you have spent a lot of time tinkering and trying to get this to work for you. I am just thinking that possibly your fatigue might have to do with TOO LITTLE carb. Perhaps you are pushing the threshold of P/C ratio too far into the direction of Atkins-ism. Obviously, in the Zone literature, it is stated that the fatigue comes from too many carbs, but you really can't push things any further in that direction. So, I am making an assumption that perhaps you are not getting ENOUGH and that is why you are fatigued (but read further, I have some other ideas).

I appreciate you posting your recent labs and I feel better about it than previously, other than the BUN being elevated, everything else looks fine. You and your physician have obviously ruled out other causes, and so this is obviously due to high protein intake.

I do agree with you that the low T is probably a symptom and hopefully you can work it out once this mystery is unraveled. I am generally not one to be in favor of using medications unless absolutely necessary, so if you can fix that issue by getting the Zone to work better for you, then hopefully no other treatment will be necessary. But, this might actually be WHY you feel less energy and you are gaining weight. And, it also might explain the elevated BUN levels (if you are losing muscle mass--I don't know if you have said this or not). So, it might be worthwhile to at least consult with the urologist to see what the treatment is. Most urologists will want to do a work-up and many will look at lifestyle changes before heading towards medication. I read somewhere that about 90% of men actually have this condition--its the "male menopause" (I don't know how old you are though LOL).

In any case, you might really be in a catch-22 where perhaps you are thinking that the fatigue and weight gain is from not getting in the Zone, thus pushing the P/C threshold. But, in reality, it could be the T level causing the whole thing, so maybe you need to ignore the fatigue as a Zone symptom and get back to correct Zone ratios, and then see where that takes you. Sounds like you have the ability to monitor your blood sugar, so you should be able to get in the Zone and not overdo the carbs by monitoring your post-meal blood sugars. I do this all the time. I am considered "pre-diabetic" and will flunk miserably on the glucose tolerance test. However, my A1C remains in a good range because I follow the Zone Diet. I only have problems with my fasting sugars, the rest of the day is well-controlled.

And, don't be afraid of the medication. You obviously want to manage this without medication, but sometimes we just need to allow our physicians to treat things. Maybe you just need a little help to get things back to a point where you can get the weight off and then perhaps you will then be able to eliminate the medication. I am the same way, I would resist the urge to take the meds, but sometimes it is just necessary to reverse things to a point where we can finally jump in and manage ourselves. I would not recommend someone with high blood pressure to not treat it, either.

Hope that this all is helpful for you!

Cranberry:

Thanks for the thoughtful reply. You seem adamant about me consuming more carbs, but I think you keep missing what I am saying. There was a time when I *was* consuming more carbs. And doing so left me sleepy after meals. That is why I reduced the number of carbs. When i eat more, I am sleepy. So I am really quite confident that adding more carbs alone will not be the fix for what ails me. I have experimented with this significantly.

I have done a fair bit of reading about Low T. There is a lot of influence between T levels and diabetes. Diabetes can adversely effect T and vice versa. So, it's not clear cut as to whether my low T is a cause or a symptom. My age is 43, so andropause is a possibility, but seems to be a bit early. Perhaps it's accelerated based on my underlying sugar issues? Perhaps not. It's not clear. I have likely lost some muscle mass. Can't be a ton based on my measurements for BMI for the purpose of the Zone diet. I come out quite regularly as a 14-block male (assuming low activity) and have every time I've done the measurement in the past 3 years. It was a bit higher when I weighed a LOT more.

As I noted in previous posts. my post-meal sugar levels are fantastic (85 to 95). But I still fall asleep after meals after 2-2.5 hours. Sue indicated that, while my sugar is good, it says nothing of my insulin levels. And therein lies my concern. Sugar levels don't tell you if you're in the Zone. Insulin response does. My sleepiness was what prompted me to buy the sugar tester in the first place, and I have not found my sugar to be out of whack. But my rising A1C tells another story.

I will see what the Uro has to say - I see him today. TRT has unpleasant to very bad side effects including prostate enlargement, possible prostate cancer, gonad atrophy, etc. There are good reasons to be wary of meds, especially those that tweak your hormones. I am also not a fan of taking medication and avoid it where I can. This is why I am hoping for Sue to bring some advice from the Zone professionals. Have they seen other Zoners with the same issue as me? Do they think the low T is a symptom or a cause? Do they have ideas for other avenues to investigate for causes, etc. For example, would Metformin help control my insulin sufficiently such that my T levels return to normal and I start losing weight again? Metformin has far fewer side effects than TRT.

Thanks again.

Matthew,

I read your history, and I know you dropped carbs because you were sleepy. You stated "I am very confused by this because my lunch meal is half the carbs the diet recommends, my whole food snacks are less carbs than recommended, and yet I am sleepy and gaining weight." I am interpreting this to mean that you have dropped your carbs below the P/C ratio that is recommended by the Zone. Dropping it too far down (as well as having too many) will have an impact on your energy levels. At one time prior to the Zone, I tried Atkins. I got myself to a point where I was mentally not focusing and just lacked energy to do anything. And, I didn't lose any weight.

You stated that you calculate 14 blocks (for low activity). Your menu sample that you posted has about 16-17 blocks. Are you consistently taking in 16-17 blocks? Are you supporting this with a higher activity level? Just asking--Sue had posted awhile back that eating too many blocks would not keep you in the Zone, and if you are eating more than you need, that could also explain some of the problems you are going through. Just an observation...

As for the low T levels, I was leaning towards this being the culprit, as well, because everything else just iwasn't adding up and I tend to look outside of the Zone for things when things don't add up in the Zone (just as I did previously with the BUN/dehydration and the Vit D supplementation). Please keep us posted on what the urologist has to say...

I think you should proceed with asking for a fasting insulin level. You stated that you have good blood sugars, but your risk factors are weight gain, BP increasing, rising A1C (although your practitioner may argue that your current level is still within an appropriate range). If it isn't too late to ask for it, you should try to get the fasting insulin level. A level of 5 would be a good place to be in the Zone, 5-10 is OK but over 10 is heading towards hyperinsulinemia. If you do that test and you are at a good level, then I think you can be assured that the Zone is working for you, and that we need to look outside of the Zone for a cause of your problems.

My history, I am pre-diabetic, have been since I gave birth to all 3 of my children, having had gestational diabetes. I have ALWAYS had elevated fasting blood sugars and have miserably failed every glucose challenge test that I have attempted--even after pregnancy. However, my glucose levels for the rest of the day have always been perfect. My A1C is perfect. My fasting insulin levels have always been 5 or less. And, yet I was still struggling in the Zone, having early onset of hunger and mentally unfocused at times. My symptoms were not always lack of energy, but I would not be able to concentrate on a task (unfavorable carbs DO put me into a coma, though). So, being "carb sensitive", I dropped carb and added fat. That seemed to help with the hunger and mental focus/ability to concentrate, but weight loss was still slow. At times, I had contemplated dropping the carb lower, beyond what was recommended for Zone ratios, and I have toyed with that, but each time I had tried it, I got into this phase where I could not easily complete a bike ride because I felt like my energy was just crashing. So, for me, dropping the carb further than recommended just did not work.

And, I am not advocating that you start medication. I just wanted to say that if you really needed to start it to "temporarily" get things back in order, its OK to do that. Kind of like taking an antibiotic to get over an infection that our bodies just can't fight off alone. I understand your concern about taking TRT. I would definitely be wary about it, until all of the facts are considered.

Other thoughts, How much do you use the Flonase?