Aldosterone and insulin resistance.

Via the Yahoo PA group, this really great article just came my way, addressing the relationship of aldosterone to insulin resistance. I’ve been saying this all along, but this is the first time I’ve found Actual! Scientific! Evidence!! to back it up.

The adverse effect of excess aldosterone on insulin metabolic signaling (Figure 1) has generated increasing interest in the role of hyperaldosteronism in the pathogenesis of insulin resistance and resistant hypertension. This association was initially described more than 4 decades ago in individuals with primary hyperaldosteronism and impaired glucose tolerance (34). Increased plasma aldosterone levels are associated with insulin resistance independent of other components of the metabolic syndrome (35-37). In patients with primary hyperaldosteronism, resection of aldosterone-producing tumors and pharmacologic treatment both decrease blood insulin and glucose levels, which indicates an improvement in insulin sensitivity (37,38).

I’m happy to be able to report that now, nearly a year and a half after my adrenalectomy, I continue to no longer show ANY signs of insulin resistance. When my illness first became apparent in my early 30s, I thought the sudden weight gain concentrated in my midsection was due to approaching middle-age. When this was followed by abnormal labs showing IR and borderline high fasting glucose, I thought I was not only doomed to a typical apple-shaped middle-aged body, but to the diabetes that runs in my maternal family. This all seemed terribly incongruous to the lifestyle I was living – unlike my maternal relatives, who smoked like chimneys, drank like sailors, and lived in the suburbs planted on their butts in front of the TV or in their cars, I lived in the city and walked everywhere, was (then) a vegetarian with a textbook-perfect diet, practiced yoga, went hiking, rarely drank, and had smoked a cigarette exactly once in my life. It didn’t seem fair. Hell, it wasn’t fair.
But. The tumor is gone, and so is the weight gain, the abdominal obesity, the worry that I will have to face diabetic foot in my lifetime (warning, extremely graphic Google image search). And I say this all the time, but I have to say it again – I am so, so incredibly grateful to everyone – the doctors, the hospital staff, the friends who saw me through this journey – that I have this second chance.
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I get stupid thankful about this, just about every day of my life. After seeing a most amazing gig last night with a dear friend, I was already bordering on the stupid-emotional side. He asked me, as he does from time to time, how I was doing health-wise. I’m not a crier, but I came thisclose to bursting out in tears. That I am doing okay – that I am doing damn fine, even – that I have friends who remember what I’ve gone through and who care enough to check in about that, is just something that overwhelms me almost every single day. Sometimes that fact that I am here, and well, is the thing that doesn’t seem fair nowadays, since every day that I check into the Yahoo group it seems that there is yet another person who is NOT doing well at all. I realize life can be, in general, a matter of luck – I’m lucky to live five minutes from a research hospital, I’m lucky to be a trained researcher myself who can read articles like the one linked above, I’m lucky that my disease was caught before it did any real damage. And the fact that not everyone afflicted with this condition has equal access to the resources I do absolutely pains me.

Gluten cross-reactivity?

This article came across my radar the other day, giving me a proverbial lightbulb moment. Suddenly, everything is starting to make sense to me about this whole eating thing: why so many things that I “shouldn’t” react to make me so gosh-darned sick, and why my symptoms seem to be so random and caused by… nothing and everything, really. I’m not going to get into the science of it – the author of the article is a scientist after all, and she can do that far better than I can – but it answers so many of the questions I’ve had since I started seriously trying to trouble-shoot this thing.

In short, since my celiac diagnosis in 1999, and my fructose-intolerance diagnosis in 2003, I have tried OH SO MANY approaches, all with mixed success. Eliminating gluten was the big one – within a matter of days the symptoms I had lived with for years had diminished greatly. Diminished, but not vanished. Once the fructose part of the puzzle was solved, things improved considerably, but again, not 100%. And last year’s dairy ban helped as well. But things got better, then they got worse.

Per the article linked above, these are the foods that cause cross-reactivity. I’ve bolded the ones I know I react to:

  • Rye
  • Barley
  • Spelt
  • Polish Wheat
  • Oats (2 different cultivars)
  • Buckwheat
  • Sorghum
  • Millet
  • Amaranth
  • Quinoa
  • Corn
  • Rice
  • Potato
  • Hemp
  • Teff
  • Soy
  • Milk (Alpha-Casein, Beta-Casein, Casomorphin, Butyrophilin, Whey Protein and whole milk)
  • Chocolate
  • Yeast
  • Coffee (instant, latte, espresso, imported)
  • Sesame
  • Tapioca (a.k.a. cassava or yucca)
  • Eggs

Up for debate still are rice and eggs. Since I started following my quasi-autoimmune protocol experiment, I haven’t eaten rice. I have continued to eat eggs, 2 a day every day (along with an entire avocado, my favorite breakfast as of lately), and have not had any symptoms save for once following a misguided attempt at eating kale. (I love the stuff – LOVE it – but I know full well it doesn’t love me back, and I paid for it, for two days straight. I’ll leave it at that.) Eggs and rice have always been my “safe” foods, but at this point I’m not so sure about rice.

I already knew full well that I can’t tolerate most grains and dairy. But since starting my AI protocol experiment, in addition to rice, I’ve avoided soy (legumes) and potatoes (nightshades), two things I never really gave a whole lot of thought to before. I’ve also been diligently avoiding nuts – I had a small spoonful of my beloved almond butter a week or so into this, and didn’t feel so great a few hours later – so now I wonder if there is some sort of cross-reaction going on there as well.

As for coffee – yeah, I’m addicted to the stuff. Per the article, it was instant coffee that caused reactions – something I would never consume in the first place. I’ve gone off coffee twice in recent memory, under the care of two different doctors at two different times, both of whom actually recommended that I keep one or two cups a day in my diet because I functioned so poorly without it (both intellectually and biologically!). I’m pretty sure that my two cups a day of organic free-trade coffee isn’t causing any problems. Okay, maybe three cups a day.

So what am I eating? Mainly spinach, eggs, avocados, wild-caught and grass-fed proteins, sweet potatoes, butternut squash, brussels sprouts, cauliflower, broccoli, and all things coconut. (Speaking of which – if you haven’t tried coconut butter yet, what are you waiting for? Almond butter ain’t got nothin’ on this stuff!) And aside from the aforementioned kale experiment, I’ve felt absolutely great. Zero malabsorption symptoms. Zero. While it makes going out to eat even more challenging than before, it’s otherwise pretty sustainable.

The bottom line, I’m learning, is really, nobody knows much about this stuff except for those who have lived through it. Conventional wisdom, and the American medical profession in general, doesn’t give a whole lot of thought to the huge role that diet plays in one’s wellbeing. Rather ironic, considering it was Hippocrates who said, “Let food be thy medicine and medicine be thy food” – while it’s impossible to know precisely what he meant by it, I’m sure he didn’t mean “go ahead and eat that fake soy-protein filled processed food, then take a pill for it when you don’t feel so well.”