Dr. Amy Nett: Yes of course it does. I would say you’re not an anomaly. I would say that’s actually pretty common. And especially 10 years ago when a lot of us were still doing the healthy whole grains and super-low-fat diets, of course we would have blood sugar swings. We were doing super-low-fat, high carbohydrates, and our insulin and blood sugar was probably going all over the place.
So I don’t know if your low blood sugar issues were because of a healthy whole grain diet or if they were because of cortisol issues. So the only place I would advise some caution in terms of suggesting that patients start with intermittent fasting and adding the fats and proteins to try to decrease meal frequency, I would only advise caution in the setting of pretty significant cortisol dysregulation. So I think it’s worth a try, but it might be worth looking at the cortisol profile before you make that recommendation.
Let’s see here, so yes, individual experimentation, understand their cortisol curves. If the HPA axis looks like it’s functioning normally, then I agree. I wouldn’t hesitate to suggest the strategy. I think it’s a great strategy for blood sugar problems. If there are issues, particularly with really high or really low cortisol, but cortisol dysregulation, you might need to do HPA axis work first before you can get to like a two- to three-meal per day frequency.
You can also have patients do glucometer testing and that can be a way. Especially because some patients get really uncomfortable with those symptoms of hypoglycemia, you might want to have them do glucometer testing as a way to monitor how does that work for them. But yeah, that’s great that you were able to make those changes and amazing that it was after only one week. And probably does suggest that some of it was diet-related rather than HPA axis-related.