A tale of four hormones

I am gradually getting my head around how and why LCHF works. It’s not enough for me to be told a diet has worked for loads of people, I need my brain to be involved & understand why I have to give up buckwheat pancakes & rye toast. So. Halle Berry does Keto and looks amazing. Bully for her in my view - unless you explain why it all works. Several people here have been enormously kind and generous of their time in sharing their understanding. I have done a little more reading and am going to play back my understanding.

There are 4 main hormones which control our food consumption & weight.

- Insulin: transports sugars from the blood into our cells (liver, muscles, fat cells). If there’s too much sugar for our day to day needs, the fat cells are the beneficiaries. If your body does not make insulin or enough, you have type 1 diabetes. Type 2 diabetes is when our bodies have stopped responding to insulin & too much sugar is left in the blood. We stop listening to insulin when we put too much sugar & carbs in over time, we have to produce a lot of insulin to cope & we generally wear out (not a technical term) the insulin function. It would seem that lots of people don’t have type 2 diabetes but have managed to muddy their insulin response by eating too many carbs. Well that’s all fine, but how does that affect my weight?

Ghrelin - is the hormone that stimulates appetite. It checks how much fat we have, gauges not enough, and calls for more. Leptin is its counterpart and restricts appetite if the fat cells are juicy enough. BUT, when we are producing high levels of insulin, the body stops being able to hear the voice of Leptin saying ‘step away from the pies, you aren’t hungry’. Instead the voice of Ghrelin saying ‘ooh pies’, becomes dominant. Moral, cut back on stuff that stimulates insulin ie carbs and sugar especially, insulin stops doing overtime, & Leptin gets its voice back.

I titled this four hormones though and have only mentioned three. The forth is cortisol. Cortisol is produced in our body in response to stress and lack of sleep. It stimulates the of insulin to get the energy ready to fight or run away. Accordingly the voice of our appetite hormone Ghrelin is boosted and we stuff our faces when we are stressed and tired. This would be ok if we were trekking several thousand miles away from an approaching ice age, but we’re usually sitting on our bottoms dealing with our stress. Then if you add in cultural messages about chocolate, cake and ice cream being comforting in times of stress, and pizza the thing to eat when everyone has to work late, then it gets even worse.

Below are my top tips from the science and also very personal experience:

- somehow anyhow remove yourself from deeply stressful situations

- get enough sleep even if it means other things falling apart

- if you are stuck in a stressful situation it’s extra important not to use carbs to get you through. They are about as helpful as cocaine. If the best thing in your day is a toasted tuna melt, and the next best thing is going to bed, you need to resign.

- never ever ever let anyone prescribe you mirtazapine as it stimulates Ghrelin & you’ll end up eating more than a starving golden retriever in a biscuit factory

- finally just don’t eat sugar, and just a few carbs.

Where all this logic breaks down is my sister. She is undergoing horrific stress, has been for 20 years, eats loads of carbs & is VERY thin, fall down a grating, everyone worried thin, I don’t know why metabolically. I wouldn’t swap my fat ar$e for her life though.

[Subtle_badger]

"never ever ever let anyone prescribe you mirtazapine as it stimulates Ghrelin & you’ll end up eating more than a starving golden retriever in a biscuit factory"

Jesus H. Christ! I remember saying to my doctor that the only thing antidepressants (I tried them all) did for me was make me eat carbs and pile on kgs......check medical record...

May 2015: weight 75kg

August 2015: mirtazipine prescribed (ongoing)

March 2016: weight 85kg.

🚬 🔫

(new gun emoji. Ugh!)

Note: going off the drug did not remove the weight.

As for your sister: acute stress kills my appetite. When I was younger, I always looked my best after exams (summer!) or a break-up (the best revenge!). This annoyed my friends who found solace in cake.

PS: I only got back to my 2015 weight last week.

[Hidden in reply to Subtle_badger]

Well done for making it back to 2015 weight. I got back to pre mirtazapine/stressful job weight in the autumn. The rest is too many carbs weight.

I was furious with the GP’s practice for not telling me about the side effect of appetite stimulation when they prescribed mirtazapine. I had to learn it from a friend - she really did need the drug. Post-natal psychosis, hospitalised for 6 months with a 24hr guard in her bedroom to make sure she did not harm herself or her baby.

When I raised the appetite issue with the GP practice I was told they prescribe it for old ladies in nursing homes who can’t be bothered to eat anymore & are wasting away.

And what was worse than the fat arse is that mirtazapine caused me bladder failure. It’s a pretty rare side effect & the urology surgeon concluded I had cancer & actually operated on me looking for it.

[ChubbieChops in reply to Subtle_badger]

Congratulations !!! I hate people who do seem to eat loads of crap and still stay thin!!

[TheAwfulToad Ambassador]

Ooooh, pies

Nice summary. Couldn't agree more about getting enough sleep and getting out of stressful situations. I notice a fair fraction of people who sign up in the NHS group appear to have dysfunctional home lives or toxic workplaces, and I think to myself: you're going to really struggle unless you fix that first. Or at least recognise that it's a problem and address it as part of solution.

One of the nice things about the LCHF group is that it's full of frighteningly smart people. I'm not sure what that's all about. Do you have to be smart to see the flaws in the Eatwell plate? Are you all just rebels who enjoy being contrary just for the sake of it?

Incidentally ... I'd say the main reason for avoiding antidepressants is that they simply don't work, in most cases. Some of them make things worse. If the patient is literally suicidal then there might be a case for using them, simply on the basis that anything's worth a try. But if the patient is depressed for a very good reason, then the primary objective should be to get them out of that situation. More than a few clinicians have noticed that when you remove a patient from a horrible environment, their symptoms magically improve.

[Aussie64 in reply to TheAwfulToad]

I think in reference to the use of antidepressants, they need to be considered on a person by person basis, along of course with other therapies dependent on the MH issues being treated. I agree that sometimes the issues can be situational, I've often said "Before you diagnose yourself with depression, first just check you're not surrounded by C*π#s.....😉 Mirtazapine is by far the antidepressant of choice, prescribed for little old ladies, often they're lonely and isolated and would benefit from social interaction rather than "Happy Pills".... Obesity is often oversimplified "Eat less move more" if I'd heard that one more time I was going to throat punch someone, I believe shift work, a highly stressful job and menopause all played a part in my 35Kg gain over the past 3 years, I can just feel the Cortisol coursing through my veins as I type this....

[Hidden in reply to Aussie64]

Ugh well that sounds very tough. Thank goodness you have found us lot now 🤪

[Hidden in reply to TheAwfulToad]

Well. It they can be helpful. I went on anti depressants when my first husband plucked off leaving me with an 11 week old baby & his new girlfriend told him to choose between her & seeing his son again. He chose her. I got post natal depression & the GP didn’t think I could look after my baby without antidepressants & went on a lovely serotonin booster, which made me happy and I lost 3 stone in 6 months (I did walk for 2 hours a day pushing the pram as well) . I got used to being a single mum and two years later took myself off them, gradually & I thought sensibly. And I was quite happy but found I had significant memory loss and concentration issues - signed off work, back on the happy pills. But... memory loss is also a sign of long term sleep deprivation & it too another 4 years to discover & diagnose that I had a sleep disorder caused by anaemia, rather than ongoing depression. Where it went wrong is that the happy serotonin pills were making the sleep disorder worse - at this stage I knew I had it but no diagnosis. So I was put onto mirtazapine instead & became little miss plumpy. It was all worsened by the fact I was in a horrifically stressful job. Fast forward 8 months. Out of the stressful job but tubby. I went on strike, & insisted the doctors treat me as a whole person - look at sleep deprivation thing and also depression. They did.

Sorry. Maybe too much information. Yes. Sometimes we can come out of stressful situations - such as leaving hideous jobs or leaving abusive relationships (what my sister needs to do). But sometimes we can’t - such as being unexpectedly a single mother of a tiny baby at a time when post natal depression is likely to be triggered.

[Hidden in reply to Hidden]

Eat well plate - it’s a good start for people who think crisps are a vegetable.

[Aussie64 in reply to Hidden]

You're correct, people need to be treated holistically, but Dr's have a 10 min window to make a Differential Diagnosis so often unfortunately a prescription is a quick fix. One of the better decisions made over here in recent years is to fund GPs and Practice Nurses to develop Mental Health Care Plans, because of the increased funding under the Medicare system they can make longer appointments, and refer on to Psychologists, everyone is entitled under this system to 8 free appointments with a Private Psychologist for free, reducing the strain on the public system... I too was on my own with 4 children under 6 and looking back I don't know how I did it, I just pulled my big girl panties up and did, it was lonely at times but I put myself through Uni (and cried a lot) 😂 No looking back now though Sista, you are strong and capable, an Independent Woman of the World... Sleep deprivation is awful though, no wonder it's used as a form of torture, it can cause symptoms of Psychosis too, auditory hallucinations, terrible stuff.

[Hidden in reply to Aussie64]

4 under 6! Respect!

I have remarried & can now delegate a lot of things, including Lego duty.

[Aussie64 in reply to Hidden]

I have Grandchildren now, we're at the Giant Lego stage still which is bearable 😉

[Dogpal in reply to Hidden]

😂😂

[TheAwfulToad Ambassador in reply to Hidden]

Can't really argue with that. I'm not saying antidepressants should never be used. It's just that 90% of them are prescribed either because the patient wants a pill, or because the doctor knows there's nothing else he can do. In a lot of cases it would be better if the doctor were able to refer people on for a good old talking session to help people figure out why things have gone so wrong and what they can do about it. But there are usually no funds for that. So a pill it is.

As you know all too well, life throws us curveballs and we get depression. I've been there (although not for the same reasons as you). The fact that the situation seems intractable is what causes the depression (depression is qualitatively different to extreme sadness - the depressed patient thinks that life is futile because, looked at from a certain angle, it actually is). Sometimes a pill can give you the motivation you need to realise that the situation isn't quite as intractable as you first thought.

Unfortunately, there's no way of really knowing which pill will have the desired effect, or whether it'll have any effect at all. Or whether (as in your case) it'll have unintended consequences. It's often a case of "try this and see what happens".

Life is a bit crap sometimes. And I guess in the case of lonely old ladies, maybe a daily happy pill is the lesser of several evils.

[Hidden in reply to TheAwfulToad]

Absolutely. In my experience, counselling was prescribed at the same time as the happy pills. And it was very helpful. But pills are more available than good counsellors i fear & cheaper as you say. My counsellor described antidepressants as the things that position you to receive help, rather than the help themselves.

Last summer an amazing GP said the only way to find out if you actually are depressed anymore is to take you off the antidepressants. So she did & I wasn’t.

Life can be a bit crap. But it can also pick up in ways we can’t imagine when we are in a slough of despond.

Anyway blah blah about my mental health. The point that matters is that the scale says I have dropped 2lbs in 2 days, and I am a bit off my grub. Looks like Leptin is putting Grehlin in his box.

[Onlymeandyou]

Oh no I take mirtazapine, could this be the reason for my lousy weight loss? I am sticking to the LCHF diet, lost 2lbs in the first week, then nothing in the following 2 weeks, I also take other drugs mainly for my fibromyalgia and I did wonder if this is the reason for not losing weight! Am I doomed to fail, I am so disheartened but really don’t want to give up now that I am comfortable with the eating plan

[Hidden in reply to Onlymeandyou]

Well I can’t comment on your situation and body specifically but mirtazapine is definitely an appetite stimulator. They give it to anorexics and old ladies in nursing homes who can’t be bothered to eat. I am FURIOUS they do not tell us about this side effect before prescribing. (I suggest) Stick with the LCHF eating plan as getting your insulin under control will help enormously. Mirtazapine will make this feel very hard I am afraid. Weight does not always drop off immediately with LCHF. I would stamp back to your doctor about this side effect. Other antidepressants are available - but they may clash with your other drugs., I understand the weight loss can greatly help with fibromyalgia, so it’s extra appalling they’ve not raised the mirtazapine issue for discussion at least. Thinking about it, I would not only stamp but to your doctor, but write to the head of practice to complain.

I should say it is possible to lose weight on mirtazapine - I lost 9lbs in 3 weeks by just not eating. I thought I was going to die, it was horrific & it was not a remotely healthy sustainable eating plan. But it shows it was possible. I then came off mirtazapine, are more healthily (lowER carb than my normal diet but not LCHF) and consolidated that 9lb starvation loss over the next 4 months.

[Subtle_badger in reply to Onlymeandyou]

My experience was not that mirtazapine caused me to put on weight while my behaviour was unchanged (like steroids can do) but it made me crave carbs. I would go back and back and back for more and more pasta, bread, rice. I was just inhaling them. I told my doctor, it's no mystery how I put on the weight, just why.

If you can stick with LCHF, then I think you may be OK. Stalling weight loss is natural. Don't panic yet.

[Onlymeandyou in reply to Subtle_badger]

Thanks for this, I was prescribed mirtzapine as a sleeping tablet, so obviously I take it at night, but knowing what I know now (thanks to you guys) this could explain why I wake in the night ravenously hungry and just can’t get back to sleep until I’ve eaten something (before starting this diet usually a bowl of Rice Krispies, for quickness and the lesser of a lot of other evils!?!? My tablets are 15mg but I only take half a tablet, I think now I will try and cut this down to a quarter and then come off them completely, I would appreciate any thoughts or comments on this. I have to say this forum is so helpful, Thank you all.

[cheritorrox]

Hope you don't mind, I've added this to my "Resources" post:

healthunlocked.com/lchf-die...

[Hidden in reply to cheritorrox]

Of course. I’m not professional, just trying to get it clear for myself!

[cheritorrox in reply to Hidden]

Which in turn helps the rest of us!

[Subtle_badger]

You forgot poor little Cinderella, glucagon! It's a very important part of this story, that I didn't know about a few days ago.

yourhormones.info/hormones/...

Glucagon’s role in the body is to prevent blood glucose levels dropping too low. To do this, it acts on the liver in several ways:

* It stimulates the conversion of stored glycogen (stored in the liver) to glucose, which can be released into the bloodstream. This process is called glycogenolysis.

* It promotes the production of glucose from amino acid molecules. This process is called gluconeogenesis.

* It reduces glucose consumption by the liver so that as much glucose as possible can be secreted into the bloodstream to maintain blood glucose levels.

Glucagon also acts on adipose tissue to stimulate the breakdown of fat stores into the bloodstream.

[Hidden]

I did. Which is ridiculous as it’s one that doesn’t work too well for me...