Carbohydrates and weight control

[Brixhamhampster]

Just to recap I was diagnosed with PMR in June 2016 and started on 20 mg prednisolone. I took advice from this forum and have reduced my carbohydrates dramatically and not put on any weight during this time. I am now down to 3mg and wondering at what point I could introduce a few more carbs. I don’t mean cakes and biscuits just maybe the odd jacket potato or roast parsnips! I was thinking not until I reached zero mg that I could have a few more carbs but the colder weather has found me being a little more tempted to comfort foods. What do the more seasoned contributors think. Love to hear your thoughts.

[Ollanda]

Hi , I started on 15mg in February and now I am on 7.5 going down to 5 (half way there). I eat carbs and didn’t gain any weight. But every day I check my weight, if I gained weight, I immediately have a “diet” day. Works very well for me. Al together I eat less but I still enjoy comfort food from time to time. Maybe this method works for you as well, good luck!

[Rimmy]

Well you truly are a 'stoic' and I can't see why a few carbs can't be introduced now you are at a low dose of Pred. Everyone would also agree (well maybe not 'everyone') that carbs are part of a balanced diet and there is no reason why you should not include at least some. A humble baked potato or parsnip is something you should eat anyway now and then - and I certainly do and cake occasionally - as I think life is too short. I initially lost 12kg on a low carb diet - have maintained that - well almost that and have been eating carbs more under 13mg with no bad consequences yet. I know we are all different but there is also 'quality of life' to consider - and what about pumpkin soup (for example) you an't deprive yourself forever !!

Best wishes

[SheffieldJane]

I am jealous of your self discipline! Unless you are disposed like me and it seems you are not then I would gradually introduce the carbs you suggest. Me, I'd be falling on the cake by now and therefore remain pleasantly rounded.

[Brixhamhampster]

Ollanda Rimmy and Sheffieldjane thank you all for your lovely replies and I am taking your advice. First treat a jacket potato done in the oven and lovely crispy skin. Bliss. Just one more question. What about carbs and raised sugar levels. Does that go down too at lower levels of prednisolone ?

[PontesburySapper]

What works for me is a full length mirror and accurate digital scales in the bathroom.

Stand on scales, look in mirror daily. Not a pretty sight I assure you, but very effective. However be careful with the carbs, I lost 42 pounds in a year with near zero carbs, but with the colder weather, I've had some carbs and have now put on 10 pounds, so as above, mirror - scales - daily.

Good luck

[Brixhamhampster]

Pontes bury sapper that is really brave!! I don’t know that my mirror is ready for that! But agree about regular weighing. It concentrates the mind!

[Soraya_PMR]

Was reading the other day that severe calorie restriction appears to limit the conversion of T3 from T4, which is undesirable for hypothyroidism. Studies suggest a very low carb ketogenic diet may have a similar effect because of the way it mimics starvation or fasting, therefore the body may be trying to preserve energy. However, moderate low carb diets are likely safe. So that’s a good reason to include some carbs in your diet 😉

When combined with this... “Glucocorticoids inhibit TSH* secretion from the pituitary, alter transfer of thyroid hormones from plasma into peripheral tissue and inhibit the conversion of T4 to T3” our thyroid glands are potentially having a hard time of it (one of many causes of fatigue with pred??)

Personally I have cut out all simple sugars, and my carbs are now of the whole grain variety (which I halved portion size). After 3 weeks I have lost 5lbs, which was not the intention! I wanted to prevent further weight gain (after a loss pre diagnosis) but don’t particularly want to lose weight. So back to normal portions of whole grains, but still leaving out the simple sugars as they are the ones that will bounce my insulin around and cause energy dips. I do feel better without them.

Enjoy that baked spud Brixhamhamster, you deserve it! Lashings of butter and cheese are essential 🙃

*TSH=Thyroid Stimulating Hormone

[Soraya_PMR in reply to Soraya_PMR]

My predictive text wanted that to be a naked spud 😮 I’ll leave that choice up to you BH 🤔

[Brixhamhampster in reply to Soraya_PMR]

Soraya-PMR thank you for that really interesting post. I agree that we should not cut out all of any one food type. Like you I do have some carbohydrates but the whole grain variety and only a small portion. I am really looking forward to my potato ( with butter and cheese) in about half an hours time. 😋

[Brixhamhampster]

Soraya-PMR. which has to be naked the potato or me?

[DorsetLady PMRGCAuk volunteer in reply to Brixhamhampster]

Depends if you live alone or not!

A few carbs won’t do any harm- enjoy! Just finished Pilates and you’re making me feel hungry!

[Soraya_PMR in reply to Brixhamhampster]

BH that’s what I was unsure of, so your choice 😀

[PMRpro Ambassador]

You can just try adding in small amounts of extra carb until you find you go up a bit and then cut back a bit. That's what Atkins does I think - the original low carb diet! I have always eaten the odd carb when I fancied it, just didn't make a habit of it and if I did have a pizza, I was really strict the next day! I only do roast spuds/parsnips about once every couple of weeks in winter (when I roast a chicken) - but it satisfies the needs...

I don't know at what point pred no longer leads to the release of spikes of glucose by the liver. Your GP should have been checking your Hba1c every 3 to 6 months while on pred - that shows what the overall blood sugar levels have been like.

I don't like the spud particularly - it is the skin I want. So I do one for us both, scoop the middle out for him (he hates the skin) and loads of cheese and butter - which are carb-free anyway..

[Brixhamhampster]

PMR pro it was thanks to your timely advice at the beginning that I have managed to keeep my weight off and I now don’t even miss the refined carbs. Thank you for your advice about spikes of glucose by the liver. I did have a diabetes test recently (not by my GP) and was ok but don’t want to become blasé at this stage. I will try for an Hba1c test. Watch this space!