There is no going back. Damage to your nerves by neuropathy is a one way street. Start treating your diabetes while you still can prevent the worst of it.
The journey into becoming a diabetic is one that most of us join without knowing the consequences of what we’re doing. There are a lot opinions out there, even among doctors, as to what actually “causes” diabetes, but pretty much everyone I read knows that diabetes is highly related to obesity and carbohydrate overconsumption. And when I was diagnosed, more than twenty years ago, the information I was given was faulty and at the very least incomplete.
What no one ever said was that if I continued to eat what I thought of as a “normal” amount of carbohydrates and sugar every day, by the time I retired my life would be severely circumscribed, with many symptoms of diabetes and other metabolic syndrome related diseases causing continuing pain, physical exhaustion and emotional distress. I also suffer from chronic fatigue and despite having lost some weight, am still fighting the good fight doing intermittent fasting three days a week for 36 hours.
So what should I have been taught as a younger person, that might have protected me from getting full blown diabetes and other metabolic syndrome diseases.
Eat less carbohydrates. A lot less. On my current low carb high fat diet I keep my carbs below 150 grams a day. Eat even less added sugar. I try not to eat anything with added sugars, and when I do offend I eat very small portions of any sweet at all. Mind you, my appetite for sweet things has pretty much disappeared since I started avoiding them. Stay away from booze. Period. Lots of doctors and dieticians say that a one or two drinks a day is okay. I don’t believe them. Alcohol does similar things to the liver as carbohydrates, without the redeeming quality of providing me with any energy.
Always seek to reduce the amount of starch and sugar, and fill up on natural food if you are going to eat carbs. Eat fruit in season, in your area, and don’t overindulge even in fruit and vegetables.
Try not to get depressed because you can’t have any “real” food. Try to redefine what constitutes a meal, and understand that the meat and vegetables are really enough.
Rain Coast Review Blog author
It turns out that the best advice anyone can give anyone about diabetes is really simple – eat less carbs, fast intermittently, and exercise moderately as much as possible.
I have been afflicted with Type 2 Diabetes for more than twenty-five years. Perhaps even longer, since my partner reports that she saw symptoms of it even in my late twenties and early thirties. But despite diagnosis in the 1990’s by my doctors, and a referral to an endocrinologist who worked out of St. Paul’s hospital at the same time, the seriousness of the disease and its potential consequences were not really taken into account until relatively recently, when some of the symptoms started to become more pronounced.
Truthfully, until the summer of last year, I didn’t really feel like it was even possible to have any real impact on my diabetes. After being put on insulin, nearly fifteen years ago, with steady weight gain and gradually increasing problems related to my diabetes, I think I didn’t really believe there was anything I could do about the decline in my health, and probable premature death from diabetes related conditions and disease.
On my birthday last year, my middle son gave me a copy of a book by Dr. Jason Fung, on which I have written a lot in this blog in the past. Reading his book, The Diabetic Code, taught me that I need not be doomed to continual decline as a result of diabetes, but in fact could take control of my lifestyle, and thereby forestal future declines in my health, and even, perhaps, recaptures some of the vigor of my earlier years.
From July until the present I have been working towards a better life. I’ve lost a bit of weight, about 30 pounds down from my weight last summer, although I’m back up 10 pounds more or less since November, as a result of failing to maintain my lifestyle changes over the Christmas break.
Starting last night I am back to doing my intermittent fasting for three days a week, thirty-six hours for each day. During November I went from strictly obeying the fasting hours, and not eating anything, to eating Keto foods which are not supposed to break the fast. Whatever I thought I was doing, what was really happening was that my fasts became shorter and far less effective.
Fasting now until I reach my net goal of reaching 15 BMI during the current calendar years is my objective, for now, until I get my weight down from 222 pounds down to 167 pounds for a total weight loss of 55 pounds over the next 12 months. It doesn’t sound too daunting, having to lose between four and five pounds a month to reach my goal. But of course my goal isn’t really so much about losing weight as it is about gaining control over my blood glucose levels, and wrestling my metabolic syndrome to a point where my health doesn’t continue to decline, or lead to ever more serious consequences of my diabetes.
It is discouraging losing weight by changing your lifestyle, in many different ways, but intermittent fasting and eating a low carb diet is probably the least difficult method. All it requires of me is to pay attention to what I eat when I’m not fasting, and to fast long enough and for enough days, to ensure that my liver gets a reboot, during this process. Even when I reach my targeted goal it will not be the end of managing my carbohydrate and sugar intake. A healthy lifestyle for a diabetic (or former diabetic, which is what I’m trying to achieve) should be one that avoids carbohydrate and sugar in one’s diet, on a day to day basis.
Of course, all people need some carbohydrate and sugar in their diets, but it should always be extremely limited since it has proved to be so problematic to long term health. I’m recommitting to changing my lifestyle to a healthier and strong future. This recommitment includes reasserting my plan to get out and walk an average of 4,000 or more steps, at least four or five days out of the week. With serious neuropathy in my feet this isn’t always easy, but it is nonetheless critically important, to build and maintain a healthy cardiovascular system.
It’s currently two o’clock in the afternoon, and I haven’t eaten anything since about eight o’clock last night. My next meal will be tomorrow morning about eight o’clock, when I’ll have breakfast. My next fast will start tomorrow after dinner, at about eight o’clock tomorrow night, and will continue until 8:00 am on Thursday morning.
Hang in there with me, folks. I may not be changing the world, but I’m certainly changing my world.
At the end of another week of three 36 hour fasts, I’m contemplating how much my life has already changed, and how much it may still change, as I continue my fasting and attack on diabetes.
Changing your lifestyle is the first key to beating diabetes
First of all, I currently weigh about 30 pounds less than when I started on the low carb high fat program. Fasting started about two weeks later, after I took the time to consult with my endocrinologist about how to manage my blood sugars during my fasting. We had already switched to two different types of insulin, long acting and fast acting, and I’m using the new meter that tests all day long, so he felt that the risk of a dangerous low could be managed.
Secondly, I now know that fasting isn’t really all that hard, for me. I suspect that motivation is a huge part of this, but fasting seems pretty straightforward to me now. Take care of my insulin and blood glucose levels, otherwise just don’t eat. Anything. Instead of it being hard, it’s been pretty easy, and the results so far are gratifying.
Weighing myself every day has become a lifetime habit. Getting my weight to a better levels is one of the keys to improving my diabetes, blood pressure, arthritis, and many other inflammatory problems and diseases.
I made the change to my lifestyle on July 10, and began fasting near the end of the month. It’s now the end of the first week of September so I’m approach two months into the program. My insulin levels are lower than ever as are my glucose readings. I take half of the prescribed dose of long acting insulin these days, and no fast acting insulin at all on my fasting days, and about three quarters of the previous prescibed dose on my non fasting days.
The biggest concern is keeping my blood sugars high enough not to end up in a coma from hypoglycemia from having too much insulin in my system and lowering my blood sugar too much. In more than 20 years of trying to manage my diabetes low blood sugar was never ever a remote possibility, even after being on insulin, as my blood sugars were always higher than desireable.
I recently made two new holes in my belt to keep my pants from falling down, after moving from the last belt hole at the other extreme. I didn’t measure my waist when I started because I was too embarrassed to admit how big I had become. Now I wish that I had because I’m shrinking fast.
When I started this fast, I told myself that I would stay the course for three months, and then re-evaluate where I’m at then, from a health perspective as well as general feeling perspective. I also said that I would be happy if I were to get my weight under 200 lbs or 90 KG by the end of the 90 days of fasting. Today I weigh 217 lbs, down from 244 lbs on July 10th. I believe that I will achieve both goals, at which time I will commit to the next phase of this program.
I wish I could say that there have been no negative effects of fasting. It’s a little early to make that statement. What I can say is that there haven’t been any, so far.
I am currently on a fasting program outlined in the Diabetic Code by Dr. Fung. Here are some reviews by other, professional doctors and experts, who might be better qualified to give a review. From my point of view what Dr. Fung does extremely well is combine recently discovered truths, and rediscovered nutritional wisdom from the past, in a readable and applicable book. It inspired me to change my life.
DONALD B. WILSON BA MAOM, author of the Rain Coast Review, a recent blogger on diabetes and health.
“By understanding the underlying cause of the disease, Dr. Fung reveals how [type 2 diabetes] can be prevented and also reversed using natural dietary methods instead of medications. This is an important and timely book. Highly recommended.”
MARK HYMAN, MD, author of Food: What the Heck Should I Eat?
“With rich scientific support, Dr. Jason Fung has sounded a clarion call to re-evaluate how we view and treat diabetes. Considering that roughly half of all adults worldwide are diabetic or on their way (pre-diabetes), The Diabetes Code is essential reading.”
DR. BENJAMIN BIKMAN, Associate Professor of Physiology, Brigham Young University
“In The Diabetes Code, Dr. Fung lays out the case for eliminating sugar and refined carbohydrates and replacing them with whole foods with healthy fats. Dr. Fung gives an easy-to-follow solution to reversing type 2 diabetes by addressing the root cause, diet.”
MARIA EMMERICH, author of The 30-Day Ketogenic Cleanse
“In this terrific and hopeful book, Dr. Fung teaches you everything you need to know about how to reverse type 2 diabetes. It could change the world.”
DR. ANDREAS EENFELDT, author of Low Carb, High Fat Food Revolution
“The Diabetes Code should be on the bookshelf of every physician and any patient struggling with blood sugar control.”
CARRIE DIULUS, MD, medical director of the Crystal Clinic Spine Wellness Center
“The Diabetes Code is unabashedly provocative yet practical . . . a clear blueprint for everyone to take control of their blood sugar, their health, and their lives.”
DR. WILL COLE, leading functional medicine practitioner and educator at drwillcole.com
“With his trademark humor, Jason Fung exposes the secret that type 2 diabetes can be reversed with the right combination of diet and lifestyle—you can reclaim your health and vitality. Dr. Fung will teach you how.”
AMY BERGER, MS, CNS, author of The Alzheimer’s Antidote
“The Diabetes Code clears the fog around type 2 diabetes and underscores that for most people, it is preventable or reversible.”
DR. KARIM KHAN, MD,British Journal of Sports Medicine
There can be no time more suitable than the present to make
better choices for my future health and well-being. New choices mean reviewing and carefully
considering alternatives not previously pursued, or if previously pursued,
inadequately. In some respects, this
analysis reflects a continuing and necessary re-evaluation based of my current
state of health, not as a snapshot, as it were, but rather as a streaming and
changing set of conclusions and actions based on them. However, this analysis is specifically about
now and the immediate future, with a clear understanding that nothing is ever
completely settled in these issues, and there is new information available on
an ongoing basis.
More simply put – This self-analysis is about resetting how
I go about living my life with due consideration to what I have learned about the
conditions and diseases that currently plague me. How to do better and improve my health for
the future – this is my object.
Much of what will be expressed here rests on certain
persisting patterns of behavior which require significant modification. In other words, I must change if there is to
be any real improvement in my health reality. And based on what I know about
achieving anything of consequence in my life, it will need to be outlined in a
program of specific steps, which depend upon my own actions rather than on
others. My physicians can only provide
me with information and treatment within what I’m willing or able to do
myself. My partner, as supportive as she
has tried to be over the years, is not responsible for any part of this,
despite my tendency to try to lay responsibility at her door particularly for
my dietary habits and lack of blood sugar control.
Frequent urination – especially at night,
interrupting my sleep.
Poor sleep – several things wake me up at night,
variously including frequent urination, frequent cramps in my feet and calves, pain
my shoulders and hips, dry mouth and nasal congestion, sleep apnea, hay fever, and
difficulties breathing.
Chronic pain during waking hours – moderate to severe
pain in my feet, neuropathic pain as well as mechanical distress, including
pain caused by walking on supersensitive soles of my feet, as well as my
toes. Also… periodic moderate pain in my
back and shoulders, and more serious pain in my lower back and hips when
walking more that 1,000 to 2,000 steps.
Periodic breathing problems – mild to severe
asthma on a continuing basis, almost always somewhat symptomatic but much worse
when exercising or physically stressed.
Sometimes exacerbated by emotional stress or conflict.
Chronic physical exhaustion and fatigue – comes and
goes during the day but is worse during periods of relative inactivity (sense
of exhaustion) and during periods of exercise (weakness and muscle fatigue)
Dizziness upon standing – it is sometimes acute
and sometimes minor
Mental fatigue and a sense of a loss of acuity
and sharpness – I am finding it difficult to concentrate on mental tasks which
require the application of my intellectual skills and professional skills. I still feel capable of creative work for
relatively brief periods, but fatigue quickly overtakes me, and I must put
things aside, while I attempt to recover my energies and focus.
Forgetfulness and feelings of anxiety regarding
memory
Visual deficiencies – lately I can only read or
work on the computer for a certain period before my eyes begin to become less
effective, making it necessary for me to interrupt my work or reading, and brake
completely from work that require visual acuity. Eye fatigue contributes to my overall sense
of fatigue and exhaustion. Note: I probably need new glasses, something
I will discuss with my ophthalmologist on Friday when I next visit her.
Rain Coast Review Blog author
Conditions and/or diseases
Diabetes
Slightly elevated cholesterol
Sleep apnea
Asthma and bronchitis (borderline COPD)
Diabetic Neuropathy
Evidence of diabetic damage to my eyes
Fatty liver
Obese
Arthritis in hips, hands, shoulders, lower back
Tendonitis in hands and wrists
Eczema
High and low blood pressure
Allergies to a broad band of common allergens
including pollens, animal dander, dust and others. Anaphylactic reaction to Cipro and Penicillin
I have had recent visits with my family doctor, my Endocrinologist
and my Respirologist (Pulmonologist), plus an upcoming CT Scan in early June at
Burnaby General, and an eye exam this Friday.
I’m clearly a heavy draw on the medical system with all these frequent
appointments to deal with various ailments.
Clearly I’d like to see less of them, and they would like to see less of
me. All we have to do to accomplish this
feat is to improve my health sufficiently so that they wouldn’t need to see me
so often.
Diabetes blood sugar and neuropathy management
Endocrinologist
My most recent visit with my Endocrinologist, as usual, thorough,
with a significant discussion about changing my medications, in particularly,
moving to two different types of insulin every day, with a long acting insulin
injected in the morning with design purpose of bringing my premeal and fasting
insulin down to ideally 7.0mml or below and then having me take fast acting
insulin with each meal, dividing up the insulin between the meals, more or less
based on the prorated amount of food being ingesting at each meal.
In order to manage this much more intensive insulin regime,
it will be necessary for me to check my Blood sugar levels first thing each
morning, as well as 2 hours after each meal.
The goal of the fast-acting insulin is to return my blood sugars to
10mml or below within the two hours.
In order to maintain such a frequent reading of my blood
sugar levels, I need to have a new form of monitor with a patch blood reader
that sends the information to a monitoring device, either my iPhone or one that
comes with the patch. I submitted the
request to Blue Cross two weeks ago and am currently awaiting approval. Note: I
should follow up with them before Friday to make sure they are working on this.
The Endocrinologist wrote me prescriptions for the insulin
and the device, as well as had his assistant prepare the forms for Blue
Cross. Once I have approval, I will need
to deliver these forms to the Pharmacy for processing.
The Endocrinologist and I had a fairly long conversation
regarding various aspects of my diabetes including the need for me to have my
eyes re-examined, thus an appointment this Friday with Chui Luca, my Ophthalmologist. We also discussed my weight gain since being
diagnosed with diabetes with him expressing some thought that while weight loss
would be desirable many type two diabetics in my circumstances find it very
difficult to lose weight while taking insulin.
Not only does insulin contribute to weight gains, but so do Jentadueto
and Invokana my other diabetes treatment medications.
In addition, gabapentin, which has been prescribed for my
neuropathy due to diabetes, also leads to weight gain along with other symptoms
I am experiencing.
The more common side effects
of gabapentin include:
abnormal eye movements that are continuous,
uncontrolled, back-and-forth, or rolling
clumsiness or unsteadiness
constipation
diarrhea
difficulty speaking
drowsiness or tiredness
dry mouth
nausea
vomiting
Talk with your doctor about
precautions you can take for side effects from gabapentin:
Ask your doctor for advice on diet and
exercise to help manage your weight if you are concerned about possible weight
gain from gabapentin.
Don’t drive or operate heavy machinery until
you know you can function normally while taking gabapentin.
Talk to your pharmacist about
over-the-counter medications that can help relieve some of the more common
digestive system side effects.
Gabapentin side effects may
make you want to stop taking the drug. However, don’t stop taking it without
first talking to your doctor.
Stopping gabapentin suddenly
can cause serious problems, such as withdrawal symptoms or the return of
seizures. Your doctor will help you stop taking the drug safely.
Medically reviewed by Lindsay Slowiczek, PharmD on December 20,
2016 — Written by University of Illinois-Chicago, Drug Information Group
Other diabetes
Medications
In addition to the two new forms of insulin, and the
gabapentin for treatment of the diabetic Neuropathy I also take two other
diabetes medicines.
Jentadueto
2.5/1,000 MGs – taken twice daily prior to morning and evenings
meals.
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
08/28/2017
Jentadueto (linagliptin and
metformin hydrochloride) is a combination of two 2 oral antihyperglycemic drugs
indicated as an adjunct to diet and exercise to improve glycemic control in
adults with type 2 diabetes mellitus when treatment with both linagliptin and
metformin is appropriate. Common side effects of Jentadueto are:
cough,
sore
throat,
sinus
pain,
stuffy
nose,
upset
stomach,
weight
gain,
pancreatitis,
diarrhea,
and
low blood
sugar (hypoglycemia).
Get medical help immediately
if you have severe side effects of lactic acidosis (symptoms include muscle
pain or weakness, numb or cold feeling in your arms and legs, trouble
breathing, dizziness, lightheadedness, tiredness, weakness, stomach pain,
nausea with vomiting, or slow or uneven heart rate.
Jenadueto is available in the
following strengths: tablets containing 2.5 mg linagliptin and 500 mg metformin
hydrochloride or 850 mg metformin hydrochloride or 1000 mg metformin
hydrochloride. The maximum recommended dose is 2.5 mg linagliptin/1000 mg
metformin twice daily. Jenadueto should be taken daily with meals, with gradual
dose escalation to reduce the gastrointestinal side effects due to metformin.
Invokana
300 MG – taken once daily prior to the morning meal.
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
11/12/2018
Invokana (canagliflozin) is a
sodium-glucose co-transporter 2 (SGLT2) inhibitor used to control blood sugar
in people with type 2 diabetes mellitus, in addition to diet and exercise.
Common side effects of Invokana include:
urinary
tract infections,
increased
urination,
yeast
infections,
vaginal
itching,
thirst,
constipation,
nausea,
fatigue,
weakness,
skin
sensitivity to sunlight,
hypersensitivity
reactions (including skin redness, rash, itching, hives, and swelling),
bone
fractures, and
kidney
problems.
The recommended starting dose
of Invokana is 100 mg once daily, taken before the first meal of the day. Doses
may be increased to 300 mg in patients who are able to tolerate Invokana at 100
mg doses. Invokana may interact with rifampin or digoxin. Tell your doctor all
medications you use.
Asthma and Bronchitis Medications and treatments
After spending 10 days in the hospital in 2016 with severe
pneumonia, when I was discharged my Respirologist at Centrio Medical Centre diagnosed
me with COPD and prescribed three different inhalers to treat the disease.
Spiriva 2.5 mg
Spiriva 2.5 mg – two puffs with morning medications
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList 2/12/2018
Spiriva HandiHaler
(tiotropium bromide) Inhalation Powder is an anticholinergic drug used to
prevent bronchospasm (narrowing of the airways in the lungs) in people with
bronchitis, emphysema, or COPD (chronic obstructive pulmonary disease). Common side
effects of Spiriva HandiHaler include:
Tell your doctor if you have
any serious side effects of Spiriva HandiHaler including:
difficult
or painful urination, or
fast
heartbeat.
The recommended dose of
Spiriva HandiHaler is two inhalations of the powder contents of one Spiriva
capsule, ONCE DAILY, with the HandiHaler device. Spiriva may interact with
atropine, belladonna, cimetidine, clidinium, dicyclomine, glycopyrrolate,
hyoscyamine, mepenzolate, methantheline, methscopolamine, propantheline, or
scopolamine. Tell your doctor all medications you use. During pregnancy,
Spiriva should be used only when prescribed.
Symbicort
Symbicort 200 mg – two puffs with
morning medications and two puffs with dinner medications
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
1/22/2018
Symbicort (budesonide and
formoterol fumarate dihydrate) is a combination of a steroid and a long-acting
bronchodilator used to prevent bronchospasm in people with asthma or chronic
obstructive pulmonary disease (COPD). Common side effects of Symbicort include:
headache,
throat
irritation,
nausea,
vomiting,
stomach
upset,
diarrhea,
back pain,
stuffy
nose,
muscle or
joint pain, or
changes in
your voice.
Tell your doctor if you
experience unlikely but serious side effects of Symbicort including:
white
patches on tongue or in mouth,
signs of
infection (such as fever, persistent sore throat),
mental/mood
changes (such as nervousness),
trouble
sleeping,
vision
problems (such as blurred vision),
increased
thirst or urination,
muscle
cramps, or
shaking
(tremors).
For patients 12 years of age
and older, the dosage of Symbicort is 2 inhalations twice daily (morning and
evening, approximately 12 hours apart). Symbicort may interact with
antibiotics, antifungal medication, MAO inhibitor, antidepressants,
beta-blockers, or diuretics (water pills). Tell your doctor all medications you
are taking. During pregnancy, Symbicort should be used only when prescribed.
Budesonide passes into breast milk. It is unknown if formoterol passes into
breast milk. Consult your doctor before breastfeeding.
Salbutamol
Salbutamol 100ug – two puffs as required
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
2/7/2019
Ventolin HFA (albuterol
sulfate inhalation aerosol) is a bronchodilator used to treat or prevent
bronchospasm in people with reversible obstructive airway disease. Ventolin HFA
is also used to prevent exercise-induced bronchospasm. Ventolin HFA is
available in generic form. Common side effects of Ventolin HFA include:
nervousness,
shaking
(tremor),
palpitations,
headache,
mouth/throat
dryness or irritation,
cough,
hoarseness,
sore
throat,
runny or
stuffy nose,
nausea,
vomiting,
dizziness,
sleep
problems (insomnia),
muscle
pain,
changes in
taste, or
diarrhea.
Seek medical help immediately
if you have rare but serious side effects of Ventolin HFA, including:
chest pain
or
irregular
heartbeat.
The dose of Ventolin HFA for
adults and children for treatment of acute episodes of bronchospasm or
prevention of symptoms associated with bronchospasm is 2 inhalations repeated
every 4 to 6 hours. More frequent administration or a larger number of
inhalations is not recommended. For exercise-induced bronchospasm, the dose is
2 inhalations 15 to 30 minutes before exercise. Ventolin HFA may adversely
interact with diuretics (water pills), digoxin, beta-blockers, antidepressants,
MAO inhibitors, or other bronchodilators. Tell your doctor all medications you
are taking. During pregnancy, Ventolin HFA should be used only when clearly
needed. Discuss the risks and benefits with your doctor. It is unknown if this
medication passes into breast milk. Consult your doctor before breastfeeding.
Other Medications Prescribed or recommended
Tecta 40 MG
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
10/24/2018
Protonix Delayed-Release Oral
Suspension and Delayed-Release Tablets (pantoprazole sodium) is a proton pump
inhibitor (PPI) used for short-term treatment (less than 10 days) of
gastroesophageal reflux disease (GERD) and a history of erosive esophagitis in
adult patients.
Common side effects of
Protonix include
injection
site reactions (redness, pain, swelling),
headache,
nausea,
vomiting,
abdominal
or stomach pain,
diarrhea,
gas,
dizziness,
joint
pain,
weight
changes,
drowsiness,
tired
feeling, or
sleep
problems (insomnia).
The recommended adult dose of
Protonix is 40 mg once daily. Protonix may interact with atazanavir,
nelfinavir, ampicillin, blood thinners, digoxin, diuretics (water pills),
ketoconazole, iron, or methotrexate. Tell your doctor all medications and
supplements you use. Protonix is not expected to be harmful to a fetus. Tell
your doctor if you are pregnant or plan to become pregnant during treatment
with Protonix. Protonix passes into breast milk and may harm a nursing baby.
Consult your doctor before breastfeeding.
APO-atorvastatin 40 mg
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
4/23/2019
Lipitor (atorvastatin) is a
statin used for the treatment of elevated total cholesterol, LDL,
triglycerides, and to elevate HDL cholesterol. Side effects of Lipitor include:
constipation,
diarrhea,
nausea,
fatigue,
gas,
heartburn,
headache,
and
mild
muscle pain.
Contact your doctor if you
experience serious side effects of Lipitor including:
muscle
wasting and muscle breakdown (rhabdomyolysis),
confusion
or memory problems,
fever,
dark
urine,
increased
thirst or hunger,
drowsiness,
loss of
appetite, or
yellowing
of the skin or eyes (jaundice).
The recommended dose of
Lipitor is 10-80 mg daily. Erythromycin (E-Mycin), ketoconazole (Nizoral),
itraconazole (Sporanox), cyclosporine (Sandimmune), indinavir (Crixivan) and
ritonavir (Norvir) decrease elimination of Lipitor. Lipitor increases the
effect of warfarin (Coumadin) and cholestyramine (Questran) decreases the
absorption of Lipitor. Lipitor should not be taken during pregnancy because the
developing fetus requires cholesterol for development, and Lipitor reduces the
production of cholesterol. Lipitor passes into breast milk and could harm a
nursing baby. Breastfeeding while taking Lipitor is not recommended.
Ramapril 10 MG
Ramipril side effects
Ramipril oral capsule doesn’t
cause drowsiness. However, it can cause other side effects.
More common side effects
If these effects are mild,
they may go away within a few days or a couple of weeks. If they’re more severe
or don’t go away, talk to your doctor or pharmacist. The more common side
effects that occur with ramipril include:
dizziness
or faintness due to low blood pressure
cough
dizziness
chest pain
nausea
vomiting
diarrhea
weakness
or tiredness
Serious
side effects
Call your doctor right away if
you have any of these serious side effects. Call 911 if your symptoms feel
life-threatening or if you think you’re having a medical emergency. Serious
side effects and their symptoms can include the following:
low blood
pressure. This is more common when you’re starting the drug or increasing
doses. Symptoms include:
dizziness
lightheadedness
allergic
or hypersensitivity reaction (angioedema). Symptoms include:
swelling
of your face, lips, tongue, or throat
trouble
breathing
stomach
pain with or without nausea and vomiting
liver
problems (jaundice). Symptoms include:
yellowing
of your skin or the whites of your eyes
stomach
pain
fatigue
swelling
(edema). Symptoms include:
swelling
of your feet, legs, or hands
low white
blood cell count. Symptoms include:
sore
throat
fever
purple
spot on your skin caused by internal bleeding (purpura)
fast or
abnormal heart rate or palpitations. Symptoms include:
feeling
like your heart is fluttering
high
potassium levels. Symptoms include:
weakness
arrhythmia
(irregular heart rate)
worse
kidney function. Symptoms include:
nausea and
vomiting
decreased
urine output when urinating
fatigue
loss of
appetite
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Senior dosage (ages 65 years
and older)
As you age, your kidneys may
not work as well as they used to. This can cause your body to process drugs
more slowly. As a result, more of this drug may stay in your body for a longer
time. This increases your risk of side effects. Your doctor may start you on a
lowered dose or a different schedule. This can help keep levels of this drug
from building up too much in your body.
Special considerations
Kidney problems: 1.25 mg once
per day. Your doctor may increase your dose to 5 mg taken once per day if
needed for blood pressure control.
Renal artery stenosis or
dehydration: The starting dose is 1.25 mg taken by mouth once per day. Your
doctor may change your dose as needed.
Dosage to reduce the risk of
heart attack, stroke, or death
Adult dosage (ages 18–64
years)
2.5 mg taken by mouth once
per day for 1 week. Then 5 mg taken once per day for 3 weeks. Your doctor will
increase your dose as tolerated to 10 mg taken once per day.
I have not been diagnosed with fibromyalgia, at least not yet. However, the development of chronic pain has paralleled my diabetes over the past twenty-five years. For most of these years I have taken metformin or other compounds including metformin, which may have been providing some mitigation of the numerous forms of pain I have battled with over the years.
So, in addition to the pain potentially caused by “dysfunction within the brain’s small blood vessels” caused by insulin resistance, as noted in the report on this study, I think researchers should also study the link between inflammatory diseases and diabetes, to determine any causality, either way.
Having had a lifetime of inflammatory issues, starting with chronic allergies to a multiplicity of substances, arthritis, tendonitis, asthma among other painful inflammatory symptoms have laid the groundwork for neuropathy and muscular inflammation. The pain in my feet and hands has nearly become disabling from a combination of pain from neuropathy, arthritis and tendonitis.
In the meantime, my medical practitioners have their hands full trying their best to assist me in dealing with the symptoms, as well as with the underlying issues related to diabetes. My muscle and skeletal pain issues are largely untreated while I struggle with diabetes, as an insulin dependant diabetic.
From this report, among other studies I’ve read, it is clear that there is little that can be done to reduce my experience of chronic pain that does not also improve my A1C levels on an ongoing basis.
Three things need to change in order for there to be a significant reduction in both – a substantial reduction in my current weight, exacerbated by using insulin, better A1C blood sugar management, which may be a result of changing the form and administration of insulin to a much more intense dose management more closely related to my blood sugar levels and meal times, and a more appropriate combination of reduced caloric intake with a physical exercise regime which focuses as much on increasing flexibility of my skeletal and muscular systems, as on weight loss or caloric output.
I think, from my own experience, that the cited report offers some valuable clues to fibromialgia, its causes and some potential treatments. But I also think that these relationships are more complicated that they appear on the surface, and may require much more than a magic bullet to help deal with the pain.
Rain Coast Review 