Posted by Sherry on November 19, 2000, at 16:10:16
In reply to Re: No, but it should not be ignored., posted by SLS on November 17, 2000, at 22:49:23
Hi Scott,
Thank you for completing the homework assignment so throughly. You get an A+ from me.
Diabetes runs in my family, and I definitely fall into the treatment resistant category. In fact, I can not take most of the antidepressants because they disable my cognitive abilities even worse than the depression. I too, am going to give the glucophage a trial, and I can only hope and pray that it improves my capabilities. I have a very hard time following the intellect on this site sometimes, eventhough it is within my abilities. Very, very frustrating.
Here's an excerpt from a book describing insulin resistance:
Today, each of the stages in the progression of Insulin Resistance Syndrome has been described and studied, and though you might not be a scientist, if you are addicted to [carbs], chances are you have experienced some of these stages firsthand. The cells in your brain and the rest of the nervous system appear to be the first to become insulin resistant. In order to protect you from a flood of insulin, your body simply closes these cells down (that is, it makes them resistant to insulin). Unfortunately, when the doors to the cells in your brain and nervous system close to insulin, they also close to the blood sugar that insulin ushers in and that would normally nourish them. The First Stage of Insulin Resistance Syndrome [IRS] In this first stage of [IRS], you may find that within two hours after eating high-[carb] foods, you feel light-headed, irritable, or unable to concentrate. In addition to craving high-[carb] foods, you may gain weight easily as an increased quantity of the food energy (transformed into blood sugar ) is channeled through the liver, turned into blood fat, then stored in your fat cells. The Second Stage of Insulin Resistance Syndrome [IRS] If hyperinsulinemia continues, a second stage of [IRS] may occur, and the postmeal cravings, tiredness, light-headedness, irritability, or inability to concentrate that you felt before may become more noticeable. Your muscles, liver, and other organs will likewise begin to block insulin's entry and, in doing so, will also close off their ability to get nourishment from blood sugar. As muscles experience a decrease in blood sugar fueling, you may experience a decrease in your desire or willingness to be active or to exercise. You might feel less inclined to do very much except what is absolutely necessary. If you do feel motivated to be active or find you must be active, you may lose your desire to continue activity or find that you tire easily. In this second stage of [IRS], weight gain is almost inevitable, as food energy (in the form of blood sugar transformed into blood fat) is channeled increasingly into the fat cells for storage. In addition to weight problems, in particular abdominal obesity, the second stage of [IRS] can herald a wide variety of noticeable heart disease risk factors, including an increase in risk-related blood fats, increases in blood pressure levels, and more. During both the first and second stages, insulin is able to continue to usher some blood sugar into the cells of many organs, but if no corrective action is taken, these cells will grow more and more insulin resistant, closing the doors (or sites) through which blood sugar had previously entered. The liver, sensitive to these high levels or insulin and blood sugar in the bloodstream, transforms the excess blood sugar into blood fat so that it can be removed from the blood, and the blood sugar (now in the form of fat) is stored in the fat cells. In the first two stages of [IRS], then, as insulin resistance grows, insulin has transformed your body into a fat-making machine. As the cells of many organs throughout your body become insulin resistant, your fat cells become the preferred storage site for blood sugar. The Third Stage of Insulin Resistance Syndrome [IRS] In the third stage of [IRS], brain-related low blood sugar swings can become severe, and your muscles may literally be starving for nourishment. At this stage you may experience extreme mood swings, irritability, inability to concentrate, tiredness, muscle shakes, depression, headaches, and foggy thinking. You may gain weight more easily than you ever thought possible and find that cravings for starches, snack foods, junk foods, and sweets has become uncontrollable. Much of the weight you gain may be deposited as abdominal or tummy fat. Most likely, you find that you prefer frequent snacks rather than typical mealtimes, and when you do snack or eat a meal, you may continue to eat even though you are uncomfortable and/or no longer enjoy the food. The Fourth Stage of Insulin Resistance Syndrome [IRS] Chances are, as you enter the fourth stage of [IRS], you will no longer be able to ignore or deny the physical changes that have sprung for your body's insulin imbalance. At this stage even your fat cells can become insulin resistant and close down to insulin and to the blood sugar/blood fat it brings along with it. Many of the symptoms you experienced at earlier stages in the progression reach a peak in the fourth stage, with the significant exception of low blood sugar and weight gain. Two of the signs of [IRS], rising blood sugar levels and weight gain, reverse in the fourth stage. At this final level, even fat cells closedown. Now insulin, blood sugar, and blood fat are caught with no place to go. They cannot leave the bloodstream and remain blocked there. So in this final stage, rather than channeling the energy into fat cells, leading to weight gain, your body may no longer be able to channel energy into your fat cells, and your weight may suddenly drop a bit (though usually not to normal levels). In the same way, the low blood sugar swings that you might have experienced when blood sugar and blood fat are being channeled into your fat cells in the third stage will disappear and be replaced by high levels of blood sugar. At this point, as blood sugar is trapped in your bloodstream, unable to enter the organs or to be converted and then stored as fat in your fat cells, you may be said to have adult-onset diabetes."-------------
I can actually feel food work on my mind. Every doctor I have been to, I told them when I eat that my ears begin ringing, my vision blurs, and my mind goes blank. I had to do the research myself and demand the tests. Then and only then, did I get a referral to an Endo. I guess you could say that I'm just a little disappointed in the medical camp.
Enough already of my babbling. At least in my case, the answer to you're question is, yes. *Every* AD I have tried has caused weight gain and I'm definitely treatment resistant. In fact, every AD I have tried has made many of my symptoms worse. But, I have a really screwed up system.Have a great Thanksgiving.
Sherry
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> > That's what I have--insulin resistance. It is apparently a vicious cycle---insulin resistance leads to weight gain leads to more resistance, etc. Also, then, insulin resistance leads to hormone changes leads to more depression, menstrual irregularities, acne, infertility, etc. I have to start taking glucophage to break the cycle, although I know that increasing exercise has also been known to help a lot. But I guess my endo is worried about the diabetes developing.
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> Diabetes is also a disease displaying a positive-feedback loop. High concentrations of blood glucose kills the insulin-producing cells of the pancrease known as the beta Islets of Langerhans.
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> fewer islets - > less insulin - > higher blood-sugar - > fewer islets - > less insulin - > higher blood-sugar - > fewer islets...
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> The higher and more chronic the elevation of blood glucose, the faster the insulin-producing cells of the pancrease die. I do not believe that these cells divide. There is but a limited number of beta-cells that you will depend on for the rest of your life. Therefore, controlling glucose can be a matter of life and death. I lost a cousin to diabetes, but not before she lost both legs.
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> Just thought I would mention it.
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> ------------------------------------------------
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> I hope I got at least a C on my homework assignment.
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> The research took me 3-4 hours. I don't mean to be facetious, but I don't remember coming across a single abstract on Medline devoted to reviewing *all* the diverse mechanisms that account for the weight-gain associated with the major classes of psychotropics. I am often amazed at how little attention is often paid to the most obvious and relevant of issues and phenomena.
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> It was somehow a let-down to see my 4 hours of research reduced to a few sentences. I tried to make the post as organized and concise as possible, as I thought it would be more informative and understandable that way. (Who am I trying to convince, anyway)?
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> The real reason for this post is to pose a question for others to follow-up on. It occurred to me that there might be an association between the atypical paradoxical weight gain produced by the SSRIs and treatment-resistance and/or specific symptomatic presentations. I can't help to consider the population of Psycho-Babblers to be skewed in the direction of treatment-resistance. In addition, atypical depression may be overrepresented. Perhaps SSRI-induced weight gain is a marker of treatment-resistance and possibly a criterion to use when choosing therapies.
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> Any thoughts?
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> - Scott
poster:Sherry
thread:48867
URL: http://www.dr-bob.org/babble/20001115/msgs/49079.html