Archives for April 2019

The ineffectiveness of the HbA1c test when a patient has active inflammation

April 28, 2019 By Sue Moseley

As I mentioned in my last blog post, I went undiagnosed for a long time as a diabetic due to having normal HbA1c readings. However I also have rheumatoid arthritis, which wasn’t in remission at the time, so I had active inflammation, which in turn meant that the HbA1c test results could not be correct. Here’s why:

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New red blood cells are created in the bone marrow, and when you have inflammation in your body, for example, caused by one of many inflammatory autoimmune diseases, then the production of new red blood cells slows down. In addition to this, you have what is called rapid red cell clearance, which means the red blood cells that you are generating aren’t living as long as they should; they are getting killed off by the cytokines released by inflamed tissue. Red blood cells contain about 70 percent of the body’s iron, which is why when you have a lot of inflammation in the body you also struggle with chronic anaemia, as you have many fewer red blood cells than normal.

Glycation

Haemoglobin, the iron-containing protein found in red blood cells that transports oxygen, becomes bonded with glucose in the bloodstream. This bonding is called glycation, and this process forms harmful new molecules called advanced glycation end products, or AGEs for short, which is apt since they cause, among many other things, cell dysfunction, blood vessel stiffness and damage to the collagen and elastin in the skin, producing the effects we associate with ageing.

How does the HbA1c test work?

The HbA1c test measures the amount of glycated haemoglobin in the blood. Red cells normally live in the body for about 3 months and the HbA1c test reflects a person’s blood sugar levels for about the past 2 to 3 months. So, if you are anaemic and don’t have sufficient haemoglobin, or are inflamed, and so the red cells are not living as long as they should, then the HbA1c test cannot produce a true assessment of recent blood sugar levels. Picture this, the HbA1c result gives a reading based on the glycation created over 3 months, now imagine your red blood cells are only actually living for 6 weeks (just a random figure for illustrative purposes), in that case, the amount of glycation could be double the actual test result given, meaning that blood sugar levels were much higher than the test indicated.

The alternative

If you have any inflammatory disease, such as cancer, kidney disease or autoimmune diseases, or you are anaemic, and you’ve been told you’re not diabetic based on a normal HbA1c reading, even though you suspect you have diabetes, then you need to get rechecked using a fructosamine test. The fructosamine test gives a result based on the last 3 weeks rather than 3 months and is much more likely to be accurate for people whose red cells are dying off faster than normal.

Despite the inaccuracy of the HbA1c test in my case, doctors have continued to give me one regularly and when compared to the fructosamine tests, my endocrinologist noticed that as my inflammation came under control then the test results from the HbA1c and fructosamine tests became more in line with each other.

What is diabetes?

April 26, 2019 By Sue Moseley

There is more than one type of diabetes and although they carry the same name they have very different causes and/or outcomes.

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Type 1 diabetes

Type 1 diabetes is an autoimmune disease where the body attacks the islet cells in the pancreas that produce insulin, resulting in the body not producing enough insulin. Because there is not enough insulin to control blood sugar, blood glucose levels can rise very high. Without injectable insulin, these patients will die. Currently, there is no cure for type 1 diabetes, but there is ongoing research into stem cell transplantation, which looks promising.

Type 2 diabetes

In type 2 diabetes there’s an abundance of insulin present as the body tries to compensate for high blood sugar levels by pumping out more insulin to try, unsuccessfully, to pack the excessive amounts of blood sugar into cells that are already saturated with sugar. This inability of insulin to get sugar into cells is known as insulin resistance. When insulin levels are high the body will not burn its own fat for fuel, this results in weight gain, increasing visceral fat levels, a fatty liver and fat in the pancreas. The fat in the pancreas prevents the hormone-producing cells from functioning normally. Unless this pattern is interrupted, there will be an inevitable decline in health over time as every part of the body is subjected to sugar damage. Treating type 2 diabetes with insulin does nothing to deal with the root cause of the problem. What is needed is not more insulin, but less, so that the body can lose the fat that is causing the abnormal hormonal response to food. In order to have lower insulin levels, there needs to be a lower intake of sugar or foods that turn to large amounts of sugar once eaten, in other words, sugary foods and high-carb foods such as starchy vegetables, grains and some fruits. Refined and processed foods are often among the worst offenders.

It is possible to be type 2 diabetic for years and not be aware of it, meaning that sugar would start causing damage to your body long before you have symptoms bad enough to make it obvious there’s a problem. You can also be in a prediabetic state for a long time – not quite full-blown diabetes, as determined by the guidelines given to doctors, but still, high enough levels of blood-sugar to be causing long-term damage. So, even if you’ve not been diagnosed diabetic there is good reason to be aware of the damage that can be caused by eating a high-carb diet. If you are gaining weight steadily and find it hard to lose weight, you need to pay attention to your blood sugar levels, because you could be prediabetic or even diabetic without knowing it. Visceral fat is the real problem as far as weight gain goes and it is possible to have high visceral fat levels while looking slim on the outside, and it is also possible to look obese on the outside but have normal visceral fast levels – so weight gain should be taken as a warning rather than proof of diabetes. Blurred vision was one of the first symptoms that made me think I had diabetes. I also realised other things were happening, like massive weight gain and oedema, but I went undiagnosed for a long time because I had normal HbA1c readings. It is apparently not common knowledge yet among medical staff that inflammation causes an abnormally low HbA1c result, which does not accurately reflect blood sugar levels during the previous 3 months, which means that many patients with inflammatory diseases are quite possibly undiagnosed and therefore untreated diabetics. My next blog post will be about this dilemma because I find the situation quite upsetting. By the time I was diagnosed, I already had retinopathy and peripheral neuropathy (I was initially told that was just a trapped nerve – obviously it wasn’t, as it spread to all four limbs). There is no excuse for not disseminating crucial information like the ineffectiveness of the HbA1c test for patients with active inflammation to medical staff when so much is at stake for the patients affected.

Symptoms of type 2 diabetes

There are a few symptoms, which are potential indicators for type 2 diabetes. Obesity is generally considered a cause, not a symptom, but I disagree. It’s a chicken and egg argument, but in my opinion, the early changes (long before diabetes would be officially recognised) start the cycle of weight gain, and therefore obesity should be regarded as both a symptom and a cause. Other symptoms can include weight loss, blurred vision, needing to get up in the night to urinate, feeling tired, impotence, weight gain around the middle (again generally referred to as a cause, not a symptom). Many of these could easily be mistaken for general problems with ageing, but that’s because many older people have a problem with blood sugar control and are unaware of it. Type 2 diabetes is most common in the middle-aged and the elderly, so these aren’t symptoms of ageing, they’re symptoms of type 2 diabetes. Cure their diabetes and these problems will go away.

Type 3 diabetes?

Researchers at Warren Alpert Medical School at Brown University, in Rhode Island, USA, have found that insulin resistance can happen in the brain, leading to speculation that Alzheimer’s disease is actually type 3 diabetes. It’s already known that type 2 diabetics are at a 50% to 65% increased risk of developing Alzheimer’s disease (source: www.diabetes.co.uk) and that many type 2 diabetics have amyloid beta in their pancreas, similar to the amyloid plaques found in the brains of Alzheimer’s sufferers. There is currently no solid proof as far as I’m aware that Alzheimer’s is type 3 diabetes, but given what is known for sure, maybe it’s time to take a much stronger stance over sugar, starches and processed foods if we want to hang on to our minds in old age.

Further resources

An excellent resource for diabetics is www.diabetes.co.uk This has input from Doctor David Unwin, a British GP who has been using a low-carb diet, very successfully, with his diabetic patients. A side note: David was originally banned from the site because he was ‘handing out advice like he was a doctor’ – he responded ‘but I am a doctor!’ They were surprised that a doctor would take an interest in what they were doing. Of course, once they knew who he was, they welcomed his support on the site.

What’s the plan?

April 24, 2019 By Sue Moseley

Given that I’ve managed to get rheumatoid arthritis and asthma into remission, stopped acid-reflux permanently, reversed retinopathy and made an almost complete recovery from peripheral neuropathy, you might think it strange that I’m going to start the blog off by devoting the coming weeks to something I haven’t yet been successful with – curing type 2 diabetes. I’ve made some progress, learning how to maintain good blood sugar control, but I still sometimes fall off the wagon dietary-wise, and it’s not a cure; I still don’t have a normal hormonal response to food.

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So why am I doing this?

Right now my health needs are to focus on losing weight and curing diabetes. I will be making a lot of changes, so I might as well document these as I go, along with the outcomes of these new life choices, and hopefully, this will help others facing metabolic diseases. I’m mentally ready to do this now; it will take an enormous amount of discipline and self-control and I feel able to commit to this now.

Sticking to a plant-based diet and daily time-restricted eating has been critical for conquering my RA and pain has been the motivator that kept me on track. I would have caved in to my cravings for cheese many times if it wasn’t for the fact that I knew I’d be in extreme pain if I ate even the tiniest amount. Having something that keeps you on track when you feel like caving in makes the difference between success and failure, so going public with my plans to cure diabetes will bring accountability that will hopefully provide the motivation I need on the days when I just want to cave in and eat. Those days will inevitably come, they always do; tiredness, emotional upset, running out of the right food, just not fancying a green vegetable juice, not feeling in the mood to cook, all sorts of things will heckle from the sidelines and try to get me to quit the race. Photographing everything I eat, knowing that people will see absolutely every bit of food I consume will force me to stick with this plan and keep going until I have reached my goal. My goal is a complete cure from type 2 diabetes (determined by a normal blood sugar response to eating a high-carb, processed meal), a BMI of 24 or less (currently 40.7), a body fat percentage of 30 or less (currently 55.5), a waist circumference of 89 cm (35 inches) or less (currently 116 cm), a visceral fat level of 9 or less (currently 13) and a skeletal muscle percentage of 30 or more (currently 20.7).

Metric	Current – May 2019	Target – October 2019
BMI	40.7	≤ 24
Body fat %	55.5	≤ 30
Waist circumference	116 cm	≤ 89 cm
Visceral fat	13	≤ 9
Skeletal muscle	20.7	≥ 30

I know that it’s entirely possible to get type 2 diabetes into remission and maintain it with a low-carb diet and fasting, the work of many low-carb doctors, endocrinologists and fasting experts have demonstrated that, but the work of Professor Roy Taylor, of Newcastle University in the UK, demonstrates that a complete cure is possible for some patients by using a radical reduction in calories for a period of time, resulting in a rapid 10% decrease in body weight. It is of course still possible for the patient to get type 2 diabetes again in the future if they increase their visceral fat levels. Monitoring weight regularly and taking swift action when there is weight gain will prevent this from happening.

How do I know I’m in remission?

April 22, 2019 By Sue Moseley

The DAS 28 mathematical model

My rheumatologist used the DAS28 mathematical model to assess the level of disease activity in my body. The data used for the model consisted of assessing the number of swollen joints, the number of tender joints, ESR and CRP levels, and feedback from me about where I would score on a level of well-being (pain, stiffness etc) between very good and very bad. A high score of 5.1 or greater will qualify you for treatment with an anti-tumour necrosis factor therapy in the UK. A score of less than 3.2 is considered to indicate low disease activity and a score of less than 2.6 indicates the disease is in remission. My score was 2.16, so well inside the remission range. You can read more about the DAS28 score here:
https://www.nras.org.uk/the-das28-score

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Here is a clip from a recent hospital letter

5 years plant-based

Since adopting a plant-based diet 5 years ago my CRP levels have at times fallen into the completely normal range, which considering I never achieved a normal CRP reading while on 2 DMARDs and an anti-inflammatory over more than 2 decades, is incredible. During the time I was on 2 DMARDS and an anti-inflammatory my CRP was most often in the high teens or low 20s. The normal range is below 10.

Remission

I did get into remission once back in my early 30s, with the use of drugs. I was so well that I asked my rheumatologist to cut the dose of the DMARD I was on at the time, 3 grams of Sulfasalazine. The dose was cut back too much (to 1 gram) and I went into a massive flare. I had to return to the high dose of Sulfasalazine, plus start on Methotrexate as well before I got any real improvement. I never got back to how well I’d been before the cut in medication though and it took two years to get the flare under control, during which time I needed to wear splints on my wrists. At the end of the flare, I was left with fused and immobile wrist joints. To this day I have difficulty writing, playing musical instruments, racket sports and doing some other tasks because of the damage to my wrists from that flare. If I’d known then what I know now I could have got the flare under control in 7 days and not suffered long-term damage. Medically supervised fasting followed by a plant-based diet for those in extreme flares would be a more effective, faster, less damaging and cost-efficient way for the NHS to treat RA patients. This could be managed at the patients own GP surgery if they have phlebotomy services there. I hope I will see that become a reality.

Backed by science

Fasting followed by a plant-based diet for RA patients is backed by a scientific study published in the Lancet, demonstrating a reduction in CRP and ESR levels, and improvement in pain scores and numbers of sore joints after a 7 to 10 day fast, the benefits of which were still present a year later. You can read the abstract here: https://doi.org/10.1016/0140-6736(91)91770-U In my opinion, hanging onto the remission after fasting depends on finding the right diet and maintaining a daily time-restricted eating and intermittent fasting regimen. My experience of drinking milk and eating a slice of dry toast after obtaining remission with a fast was that extreme pain and disability set in within 30 minutes of breaking the fast. Nowadays I like to break my long fasts with steamed broccoli, which tastes out of this world when you’ve not eaten for 7 days and does not cause me any pain. Fasting and a plant-based diet work for me, you can try this yourself and see if it helps you. Freedom from pain might just be a week away. I have seen another study that claims to contradict the study in the Lancet, but they only fasted patients for 3 to 5 days on 3 separate occasions. That will not work, you need at least 5 consecutive days before the results start to appear, and if you’re in a severe flare it could well take longer than that. With my last severe flare, I did a 7-day water fast, after which time the pain had subsided. but I was still feeling unwell, so after a 2-day break, I followed that with a 5 day fast, after which time I felt completely fantastic. If you try it, then exercise caution in reintroducing foods, as the wrong foods (in my case animal products) will take you straight back into extreme pain and you will lose all the benefits you gained from the fast.

My next challenge

I am not as well as I was in that first remission back in my 30s, but that is due to other conditions I have developed as a result of stress, the effects of inflammation from the RA and diabetes I developed, partly from following the wrong diet guru. With more dietary changes I have also been able to reverse conditions related to diabetes and get my blood sugar under control. I plan to reverse diabetes completely and I’ll cover that in the next post.

First things first..

April 9, 2019 By Sue Moseley

I’ve been planning to write a blog documenting my journey to recover my health for quite a few years now. Every time I felt ready to launch, something would happen to knock my health for six and make me question everything I thought I’d discovered about nutrition, health and fasting. On top of those issues, there was a confusing array of information from those promoting a low-fat, plant-based lifestyle, and those promoting a high-fat, high-animal-protein-based lifestyle.

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Much of this on each side outright contradicts the other side and both sides are subject to biases and agendas other than wanting the best for people. To add to the confusion, many of those who have benefited from a particular diet have become filled with zeal, claiming science to back up their every argument, while rarely actually reading or understanding the research for themselves. They have based their opinions almost entirely on what they’ve been told by people in authority and they attack anyone who disagrees with them with a disturbing degree of fervour that smacks more of religion than science. Science is evidence-based and does not need irrational, frenzied fanatics to defend it, the facts speak for themselves. Some of the authority figures in the respective nutritional movements are guilty of this behaviour themselves and incite hatred against and personal attacks upon the ‘opposition’, dragging what should be reasoned scientific debate into the playground. I’d like to put them all in detention and make them sit and think about what they’ve done because while this is going on and they are feeling smug about themselves and jostling for the upper-hand in the debate, people are dying for want of correct nutritional information. One of those who died was a friend of mine. Dead, in my opinion, because he followed the incorrect advice of one of these authority figures.

Science is not just another opinion

I’ll discuss why science matters and what constitutes valid science in other posts, along with why you should look at the research for yourself and not just take anyone’s word for it just because they sound confident or come with medical credentials. Don’t take my word for any of this either, just look at the research. Sure, listen to people’s experiences. I love listening to how others have recovered their health, or learning from their mistakes so I can avoid them myself, but it is dangerous to make life-changing decisions that will impact your health without fully understanding potential complications. I’ve made this mistake twice, both times with serious consequences.
The diet I have found to transform my health might not be the best diet for you and I’m merely documenting what I’ve done, the good and the bad, along with my reasons for doing so. What you take away from this is your responsibility. Look at the research, decide for yourself. What I will commit to, is that the message I’ve heard from doctors, that ‘diet makes no difference‘, in terms of controlling autoimmune disease, is flat out wrong.
I recently received a letter from my rheumatologist at hospital confirming that my rheumatoid arthritis is now in remission and being controlled with a plant-based diet and fasting, along with a small weekly dose of Methotrexate. It’s no fluke that I have been able to come off anti-inflammatories and another DMARD (disease modifying anti-rheumatic drug), while substantially lowering my CRP level (C-reactive protein – an indication of how much inflammation there is in the body). I have been systematically working my way towards this goal for about 10 years. Maybe others will be able to use what I’ve discovered to get themselves into remission within weeks or a few months. My current diet and fasting work faster than the drugs that I’ve been on, in terms of controlling flares (now occasionally triggered by eating tiny amounts of animal products inadvertently), and the only side-effects have been good ones. Obviously discuss any experimentation you plan to do with your doctor before-hand, as some of what I do in terms of fasting and eating large quantities of vegetables could be life-threatening in patients with certain conditions. My long-term hope is that the NHS in the UK will put nutrition and fasting on the front-line of medicine, that both subjects will be taught in medical school, and that the nutrition advice given to doctors will be correct.
Having the correct diet and lifestyle for you, including regular fasting can have a massive impact on the likelihood of you developing one of the UK’s 5 biggest killers: coronary heart disease, respiratory disease, stroke, liver disease and cancer, as well as autoimmune diseases and type 2 diabetes. Once you’ve got one of these diseases getting the diet and fasting right might just save your life.

Stoicism, fighting and quitting

April 4, 2019 By Sue Moseley

To be, or not to be: that is the question. Whether ’tis nobler in the mind to suffer the slings and arrows of outrageous fortune, or to take arms against a sea of troubles, and by opposing end them? To die: To sleep; no more; and by a sleep to say we end the heartache and the thousand natural shocks that flesh is heir to, ’tis a consummation devoutly to be wish’d. To die; to sleep; perchance to dream: ah there’s the rub; for in that sleep of death what dreams may come when we have shuffled off this mortal coil, must give us pause.
(Shakespeare, Hamlet, Act III, Scene I)

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Suffering the slings and arrows in silence

You might not be familiar with Shakespeare, but if you’ve ever contemplated suicide due to the overwhelming onslaught of chronic illness and trouble in your life, then you will be familiar with this mental battle. To exist or not exist? Am I better off alive or dead? Is it the stronger, right thing to do, to suffer in silence and take it all on the chin? The Stoics among us would have us believe it’s shameful and embarrassing to confess to our difficulties in coping with constant pain and fear.

At a family dinner where I was physically unable to open my mouth to eat, a family member complained that my inability to eat was attention seeking and embarrassing. When I tried to explain that my jaw had locked from the Rheumatoid Arthritis a relative of an in-law of mine piped up with how her husband never once complained about how much pain he was in when he had cancer and how wonderful he was for doing that. She said this while looking at me with utter contempt and disgust. It’s odd how those who have never had to live with intolerable pain are so quick to shame those who do, what makes them qualified to judge? No wonder her husband didn’t feel safe enough to share his fears and pain with her. No doubt he expected criticism, and that would make the pain so much harder to bear. I’ve done that too. Better to bottle it up, suffer alone and imagine that someone cares, than to share and be treated with contempt and find out for sure that you really are alone. The selfishness of those who feel entitled to an existence unruffled by the awareness of your suffering boggles my mind, and the manipulative tactics they use to ensure your compliance with their selfish whims is truly the antithesis of the nobility they presume to possess and seek to educate you on.

Opposing the sea of troubles

So, if we don’t want to suck up the pain and suffer in silence, what else can we do? Can we stand and fight and put an end to it that way? If so, how do we arm ourselves? How do we stand up to an overwhelming tsunami of sickness and pain and the myriad of circumstantial and relational troubles it gathers in its wake? How can we defeat something supposedly incurable and relentless? Do we even believe we can win?

Shuffling off this mortal coil

If we don’t believe we can win and can’t face the pain and forced isolation demanded of us by those who think everyone but them should be stoic about their problems, what other way out do we have? Death? Anything to make the pain stop looks inviting, even when non-existence is the price to be paid. Is that a way out, or a path to something even worse? There’s the rub.

Believe!

So, we can bottle it up, fight for a better life, or quit and die. Let’s fight! We must arm ourselves with knowledge, don’t accept the prevailing ‘truth’ that there is no hope and it’s all downhill from here. Just because something hasn’t happened before doesn’t mean it’s not possible, and just because there’s no supporting research yet doesn’t mean it’s not possible either, unless there is research confirming the contrary.

Research for people over profit

Until people are looking for a humanitarian return on their investment, rather than a financial one, no one will be carrying out the scientific studies necessary to prove the efficacy of diet and lifestyle changes in improving chronic illness, or bringing about remission. We have to study the existing data and see what we can deduce from it that applies to our health and wisely and safely experiment, with our doctor’s knowledge, to see what improvements we can make to our health. I am doing this, and I’m achieving the allegedly impossible, though of course, it was never actually impossible, people just believed it was, because no one had done the research to show that it wasn’t, because there is no money to be made from getting people off medication and keeping them well without it.

Let’s talk about health!

So, don’t quit and check out of life, don’t bottle everything up in isolation, and kick the Stoics to the kerb. Let’s talk about health and what we’re doing to restore it. Let’s pool our knowledge and experiences. Let’s choose not to believe there is no hope, and let’s find a way to make it happen. I stopped wearing my wedding ring decades ago because my fingers would swell and I lost count of the times I woke up with my finger turning purple from the swelling. I have refused to get it enlarged because to do that is to accept that I will never be well. I have no intention of conceding defeat, ever. I have already achieved the impossible and choose to believe that I can make this happen. I hope you will fight for a better life too.