GH-induced insulin resistance already? Or simply too many carbs? Or both? Looking for input

[econ mba]

Hi guys,

I would like input on the possibility of getting GH-induced insulin sensitivity from three months of 4.8iu/day GH. Or could it simply be too many carbs? Or combination of both?

I've been on GH for over three years straight at 1-2iu daily, and my non-fasting glucose ranged from 63-118, with a three year average of 95. Hemoglobin A1C at 5.0 (normal). I stopped training in mid-2019.
In early July, I started heavy training again, went back to five meal per day diet (from two), increased to 4.8iu GH daily, and glucose has increased steadily on my last four blood draws. My A1C was 6.0 (prediabetes, the lab reference range is 4.0-5.6) on Friday. So, my glucose has gone up and I'd like input on if anyone else has run into this, and if so, what did you do to bring glucose back down. Obviously, the way to figure this out is to manipulate one variable at a time while holding others constant--which I will do--but while that takes time to see the potential effect, I'd like input from others who may have experience here.

Thank you for your time.

Some pertinent info:

49 years old
5'7, 218lbs
training on and off for 33 years
140mg Test/wk TRT
4.8iu GH/day

4/2018 - 2/2021 1-2iu daily Chinese generic GH from a long-time PM sponsor, IGF-1 bloodwork shows I get approximately 70 point increase in IGF-1 per iu.
2/2021 - 7/2021 1-2iu daily Norditropin flex pro (Rx from endo)
7/2021 - current 4.8iu daily Norditropin flex pro (Rx from endo)

Meal 1: 8oz ground turkey, 1 cup plain oatmeal/cream of rice
Meal 2: 8oz ground turkey or chicken breast, 1.5 cups white rice
Meal 3: (pre-workout) 50g whey isolate, 1 cup plain oatmeal/cream of rice
Meal 4: (post-workout) 50g whey isolate, 40-50g simple carbs (fruit, sometimes Gatorade)
Meal 5: 8oz protein (chicken, fish, steak, turkey), 1.5 cups white rice

Glucose (from recent blood draws)
04/21 94
05/21 87
06/21 90
07/21 103
08/21 124
09/21 131
10/21 152 (additional test showed 24hr average glucose at 125.5 [ref range 68.0-126.0])


I do 14-16 blood draws per year it's a little more than one per month
I have a phlebotomy about every six weeks to reduce hematocrit
blood pressure controlled
kidney function compromised (eGFR hovers in the 50s)

Thanks again, guys--I appreciate any insight you could offer.
S

 

[btails]

Hows your body composition? Pics?

 

[SouthernMuscle]

thats not a huge amount of carbs

if it were me i would discontinue the GH for two more blood draws and see what numbers you pull

 

[econ mba]

Hows your body composition? Pics?

Thanks--I started at 202 pounds in July, and have put on 16 pounds in the three months I've been back training. Not sure I could accurately guess my bodyfat percentage.

Hows your body composition? Pics?

 

[KillerStack]

I mean I think GH causes some insulin resistance from the first dose. Some of it is tied to the positive body composition effects of GH.

Of course fixing any blood glucose elevations is a good thing but you can't really escape the insulin resistance completely.

 

[econ mba]

I mean I think GH causes some insulin resistance from the first dose. Some of it is tied to the positive body composition effects of GH.

Of course fixing any blood glucose elevations is a good thing but you can't really escape the insulin resistance completely.

thanks--I'm willing to accept a higher glucose baseline than what I was before. Ideally, that baseline is still in the normal range.

 

[econ mba]

thats not a huge amount of carbs

if it were me i would discontinue the GH for two more blood draws and see what numbers you pull

thanks--that may be what I do

 

[KillerStack]

thanks--I'm willing to accept a higher glucose baseline than what I was before. Ideally, that baseline is still in the normal range.

Some would say, if health is paramount, that using Lantus, perhaps at night, would be a smart thing when running higher doses.

I'm sure you know about the metformin and berberine. At least pick up some berberine and see what it does for glucose. Buying a glucose monitor might be smart.

 

[econ mba]

Some would say, if health is paramount, that using Lantus, perhaps at night, would be a smart thing when running higher doses.

I'm sure you know about the metformin and berberine. At least pick up some berberine and see what it does for glucose. Buying a glucose monitor might be smart.

Thanks—Glucose monitor is good idea. Maybe that way I can make changes to carbs and see potential effect more readily.

Not up to speed fully on metformin or berberine so I’ll read today.

Also no experience with insulin so that’s another reading project.

 

[qbkilla]

Hows your body composition? Pics?

This. You added bodyweight and bodyfat, that is going to cause you to be more insulin resistant.

How many carbs per day? Definitely running gh and adding 16 lbs will hurt you. Possibly carbs but depends how many per day, do you use MFP to track calories?

 

[btails]

My reccomendation from the pics would be to outsource your diet to someone to get you shredded. Like stage ready. You're carrying too much adipose tissue imo.

If you do this you'll look far better and make much more progress in the future and your bloodwork should improve greatly.

 

[qbkilla]

My reccomendation from the pics would be to outsource your diet to someone to get you shredded. Like stage ready. You're carrying too much adipose tissue imo.

If you do this you'll look far better and make much more progress in the future and your bloodwork should improve greatly.

Agree with this. Or just carefully track calories and adjust downward to lose bodyfat which will help with increasing insulin resistance. Also reducing gh, reducing carbs will help as well. Maybe add metformin or berberine. Adding slin would just be putting a bandaid on a cut and ignoring the real reason bg is rising

 

[Kaladryn]

You were borderline before at 5 and A1C only went up 1 point to hit 6, that isn't a very big change.

Real cardio will make a big difference in this situation, that would be the first step if you aren't doing it.

Unfasted glucose really doesn't mean anything, you will peak and then go into a trough, so all those unfasted glucose numbers really don't mean that much.

eGFR doesn't really mean much, you need to get a more accurate GFR test, like a 24hour creatinine clearance with GFR.

You shouldn't need to donate blood that often, I would try to figure out what is going on if you are having to donate that often.

 

[econ mba]

My reccomendation from the pics would be to outsource your diet to someone to get you shredded. Like stage ready. You're carrying too much adipose tissue imo.

If you do this you'll look far better and make much more progress in the future and your bloodwork should improve greatly.

thanks--this is probably a very good idea. I have never been really lean so finding someone to help with the diet would allow someone with more knowledge to provide better results.

 

[econ mba]

Agree with this. Or just carefully track calories and adjust downward to lose bodyfat which will help with increasing insulin resistance. Also reducing gh, reducing carbs will help as well. Maybe add metformin or berberine. Adding slin would just be putting a bandaid on a cut and ignoring the real reason bg is rising

thanks--I like the idea of turning the diet over to someone who knows more than I do. Alternatively, I haven't used MFP in years so maybe I should track calories more strictly and make changes accordingly.

 

[econ mba]

You were borderline before at 5 and A1C only went up 1 point to hit 6, that isn't a very big change.

Real cardio will make a big difference in this situation, that would be the first step if you aren't doing it.

Unfasted glucose really doesn't mean anything, you will peak and then go into a trough, so all those unfasted glucose numbers really don't mean that much.

eGFR doesn't really mean much, you need to get a more accurate GFR test, like a 24hour creatinine clearance with GFR.

You shouldn't need to donate blood that often, I would try to figure out what is going on if you are having to donate that often.

thanks--I get symptomatic when my hematocrit gets high so doc orders phlebotomy when I complain or bloodwork shows high HCT. I saw a hematologist and he ruled out other factors so it looks like the exogenous Test is driving up HCT.

Totally appreciate the GFR suggestion! Unfortunately, I had kidney failure in 2015 after a surgeon made a mistake. I went on dialysis. My kidneys eventually came back somewhat but have never fully recovered. I gave eGFR as a basic barometer.

I don't currently do regular cardio. To change that and start doing it, what do you mean by "real cardio"? Would that mean 3x/wk of 20/30 minutes on stationary bike at moderate pace? More?

 

[econ mba]

I want to thank you guys who have responded because this has already given me much insight. This is one of the reasons I love this board--guys willingly give of their time to help someone like me.

 

[Kaladryn]

thanks--I get symptomatic when my hematocrit gets high so doc orders phlebotomy when I complain or bloodwork shows high HCT. I saw a hematologist and he ruled out other factors so it looks like the exogenous Test is driving up HCT.

Totally appreciate the GFR suggestion! Unfortunately, I had kidney failure in 2015 after a surgeon made a mistake. I went on dialysis. My kidneys eventually came back somewhat but have never fully recovered. I gave eGFR as a basic barometer.

I don't currently do regular cardio. To change that and start doing it, what do you mean by "real cardio"? Would that mean 3x/wk of 20/30 minutes on stationary bike at moderate pace? More?

If you lift weights, you already do a form of "HIIT" so I recommend doing some moderately intense stead state to compliment this, the key is getting up near your maximum aerobic heart rate and staying there. For most people, the stationary bike won't get your heart rate up efficiently or high enough unless you really push it. Something that recruits more total muscle like the stairmill or elliptical would be better.

 

[qbkilla]

thanks--I like the idea of turning the diet over to someone who knows more than I do. Alternatively, I haven't used MFP in years so maybe I should track calories more strictly and make changes accordingly.

I definitely think tracking calories is important. To me that is the number two thing anyone should do, with number on going to the gym. Counting calories is even more important than aas, and gh usage. Running a cycle without a proper diet is like taking a job without knowing how much it pays lol.

 

[b-boy]

START WALKING!!!!

It's THAT fucking simple. Take all the advice you want from whomever you want, the simple little task of getting outside and walking a few times a day will do WONDERS for your situation. Move more sit less!