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Carbohydrate Intolerance / Insulin Resistance

Carbohydrate intolerance/insulin resistance are terms often used interchangeably because they usually go hand-in-hand. Carbohydrate intolerance is when a person doesn’t tolerate carbohydrates very well, usually gluten containing products or simple sugars. They typically crave sugar but it may give them a headache, feeling of weakness, or make them irritable, edgy, unfocused, or angry. Insulin resistance is a term used to signify that the body’s cells have become resistant to the insulin produced by the pancreas resulting in a rise in blood sugar. In a normal person, about 40% of consumed carbohydrates are converted to fat. In a person with CI, that number increases to 50-60%. The excess insulin can cause blood sugar to drop too quickly, and then the adrenal glands must kick in to get the blood sugar back up. Not only will this cause more stress on the adrenal glands, but usually too much glucose is released, further causing the pancreas to produce more insulin. Around and around it goes. Eventually, the body must produce more insulin to metabolize the same amount of glucose. CI is caused by a number of factors; some of the more common reasons include increased stress hormones, a diet containing hydrogenated fats, a food allergy (milk is the most common as it has been shown to attack the beta cells of the pancreas – this is why children under 1 year old are advised not to consume dairy), a high carbohydrate diet, and caffeine. Insulin resistance can cause the following:





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  1. Suzanne Johnston permalink


    I have started the two week test and I was wondering is it ok to have Mozarella cheese as I know this is quite milky cheese?

    I see you told someone they could have decaf coffee is it ok to have decaf tea?

    Thank you


    • The cheese should be fine, though I wouldn’t go crazy on it.

      Either coffee or tea, decaf or regular, is fine.

  2. Suzanne permalink


    Thanks for the information. Are there any type of cheese which should be avoided apart from the processed cheese?

    Also I have been having problems eating tomatoes. I seem to be ok on fresh tomatoes but having a problem with tinned tomatoes. Could there be something in the tinned tomatoes giving me problems? As soon as I eat tinned tomatoes I am in agony pain and bloated instantly.

    Thank you.

    • No on the cheese. Could be so many problems with the canned food from the BPA, preservatives, concentration, pesticides, etc.

  3. Dave permalink

    I get hyper, anxious, when I consume any type of carbs and i can feel it instantly. I lack focus and it always seems foggy. I’m super sensitive to any types of carbs and I’ve been like this for as long as I can remember, although its gotten worse I think in the past 5 yrs I think. Iare there any other explanation for this? Is my only option to cut carbs?

    • It’s never your only option – as the post discusses hormones have a lot to do with it. Gut issues (dysbiosis) can cause sugar handling problems too. Cutting carbs is rarely a bad idea though.

    • It’s never your only option – as the post discusses hormones have a lot to do with it. Gut issues (dysbiosis) can cause sugar handling problems too. Cutting carbs is rarely a bad idea though.

  4. mona permalink

    I was diagnosed with PCOS when I was 15 -31 years ago. I never understood what it all entailed. I struggled with my weight but played sports and ran to keep it under control. when I was 30 I was in a motorcycle accident and am now a t-4 paraplegic. I have had the worst time keeping the weight off! I then when to see a nutritionist and he told me it was from IR. put me on metformin, I wrote everything down I ate eating 50% protien, 30 fat and 20 carbs and exercised (water jogged int he pool) this helped me lose the weight. I became sensitive to the metformin and couldnt take it any longer. I started wondering why I have such a hard time keeping weight off and why all medicines bother me. and pretty much have had to unravel the puzzle myself. I had a revelation the other day that I am allergic to carbs. I googled just that phrase and well, now I know. the whole list of symptoms is spot on. my questions are is there a natural alternative to metformin? could my carb intolerance be a symptom of my adrenal glands or lacking something in my diet? what causes carb intolerance? Thank you for your wisdom! I wish I would have found this site eons ago. by the way my fasting insulin level was 58 a month ago. she put me on junivia and it is at 34 now. still way too high! help; and my daughter has the same issues.

    • Hi Mona, thanks for the comment. The “natural alternative” to CI is diet and lifestyle. The only food “supplement” I recommend to a non-patient since there’s no harm in taking it is UNrefined sesame seed oil. You can get this at pretty much any health food store. Make sure it is unrefined. It’s great to use on salads – do NOT cook with it. Using around 1TB a day can help with inflammation caused by insulin resistance.

      I put my patients on the Paleo-Type diet, and for those with gut problems then the FODMAPs Diet – which is very similar.

      Fasting insulin should be <15 - ideally <10.

  5. mona permalink

    Thank you for the response! I have already started the TWT. What is your view for the TWT on turkey bacon and burger? I was reading the ingredients last night and noticed the hidden MSG. Should I continue the metformin while doing this trial (I just started the stuff anyway)?

    I would love, love, love to have a consult. sigh, only if insurance would cover it. Thank you again for your wisdom!

    • Turkey stuff is fine as long as there are no hidden sugars or additives, including MSG. I can’t advise you to take or not to take a medication; sorry!

  6. Diana permalink

    Hi. I have reactive hypoglycemia and find that when I eat a diet with carbs (even healthy carbs) in it then I need to eat a lot of fat and I have hypoglycemia symptoms. When I go to a high protein diet, then my carb tolerance falls to zero and I feel the effects of the carbs immediately (as well as getting hypoglycemia symptoms). The immediate symptoms I have when I eat a carb (even vegetables) are that I feel weak in the middle of my body, have difficulty breathing, and need to eat fat to stabilize myself. Then depending on how much I ate or other factors, I may be our of commission for the next several hours. Right now my diet consists of meat, fish, eggs, nuts, butter and olive oil. Have you ever heard of this? Thank you very much!

    • Yes and you may have something else driving your carb intolerance. Too much stress, past (or current) injuries, food allergies – just some of the things that can cause this problem. Also, it depends what you consider “a lot”. I’d say most people do best on a diet well over 50% fat.

      • Diana permalink

        Thank you for replying. Do you have any ideas of what I can do to help it? I’ve cleared my food allergies multiple times with elimination diets, TBM and NAET. As for stress I’ve not worked now for over a year and have no real obligations – so I don’t know how to reduce it any more! I’m interested that you have heard of others with the reaction I have since I haven’t been able to find anything else on it yet on the internet. Is there anything written anywhere that describes my particular reaction that you can recommend to help me understand it better? I’m about to start breathing exercises and I’m hoping that will help. Do other people have the exact same reaction or just something similar? When you say injuries do you mean physical or emotional? Thank you again.

        • You’re welcome but really hard to say too much more since it’s so individualized and that’s impossible for me to say w/o seeing you. You might try the FODMAPS Diet I discuss on this site as the dysglycemia could be from a gut issue.

          By injuries in this case I was referring to physical.

    • Lisa permalink

      I have no idea how old or new this thread is, but I stumbled upon it. I have the same symptoms you have Diana. The ONLY time I feel ok is if i eat one moderately sized meal a couple of hours before bedtime and eat absolutely nothing, not even a crumb during the day. Of course this is very hard to do, so I don’t do it often. However, I am fed up with feeling light headed, irritable, fatigued after I eat, so I decided am going to stick to this “eat only at night” plan. I have to put up with hunger pangs all day, but the trade off is I have no irritability, no mood swings, no fatigue. I’ve talked to my Dr. about it and the basic response I get is “it’s all in your head, your lab results are fine, get over it”. Anyway..just wanted to share my story. Good luck Diana.

  7. Kris Vasquez permalink

    Is there an explanation for why my body can handle oatmeal, beans, and honey and not handle refined sugars? Does this mean I am not carbohydrate intolerant, but maybe more sensitive to insulin responses?

    • Well it just means you’re more sensitive to higher fructose or sucrose foods and not those that are more complex carbs. Honey is kinda the exception but generally well tolerated because its natural & unprocessed (hopefully!).

  8. Jennifer Wallace permalink

    Hi – I am curious about CI, and I am thinking that I probably have a pretty severe reaction to carbs. For the last 4 years doctors have been trying to figure out what is causing my fatigue, inability to lose weight (I exercise 5-6 days a weeks ranging from yoga, running, HIIT and weights, etc) I thought I ate pretty well, I don’t eat processed foods/fast food or sugary foods. I recently did a challenge where all these people were losing weight, and I lost nothing…maybe a couple inches. I didn’t eat any wheat/bread products but I did consume a ton of fruit. Would that mean I am really CI? I would love to lose the last 10 pounds, but no matter what I do nothng works. I tried doing a TWT a while ago, but maybe my re-introductions wasn’t correct? However, for me, I strongly believe that I can’t have any forms of wheat/rice/potatoes/fruits/etc….I just don’t know how to get enough carbs in my diet then? Thanks for reading!

  9. mona permalink

    Just finishing up my TWT- first off I feel fabulous! I went to get weighed today and have lost 4 lbs in the 2 weeks. I know it isn’t much but I am paralyzed t-7 so have no large muscle mass to help burn the calories. I swim (more like a modified water jog). I am starting to introduce carbs today, I am going to try some fresh fruit and see how it goes. I also had my blood drawn this morning to see what impact it has had on my fasting insulin- started at 50ish, went to 32 a month ago and now hopefully even lower! Thank you for all your wisdom on this!!!!!!

    • Hey nice work Mona. Would love to hear what that insulin level is. <15 would be great; <10 superb.

      • mona permalink

        thought I would update you: received my fasting insulin results today from the test last thursday. WOOHOO it is going down baby! not perfect but getting there. 20.6. why oh why must my body be so rebellious! but at least all of the hard work is paying off.

        Thanks again! ( I was serious about the alaska halibut offer)

  10. Jennifer Wallace permalink

    Thank you! I do feel better when I am sticking to a lower impact routine such as yoga and light running, but I love the thrill of the intensity. How can I maintain muscle if I back off from anaerobic training? Will eliminating most carbs, other than veggies allow me to keep my muscle mass as my protein levels will be higher? I know I have a lot of the ‘over training’ symptoms…thanks again for reading!

  11. Jennifer Wallace permalink

    I agree, I know it doesn’t deplete muscle…but I haven’t noticed in the past that when I don’t keep up with strength training I quickly lose any definition I have? Other question, if you’re not eating carbs wouldn’t your body burn fat no matter what exercise you are doing? Thanks again for reading!

    • No – your body will quickly break down protein (from your muscles) into amino acids and use that to make glucose to fuel the body. So you burn muscle and hang onto fat.

  12. Diana permalink

    Thank you again for replying, Dr. Gangemi, and for all the other answers on your site – really very much appreciated. So I guess I’m already doing FODMAPS since I mainly only eat meat, eggs, fish, nuts, butter and oils – but I could could try to reduce the nuts and I will cut out the almonds and hazelnuts. I started the sesame oil today. But since I can’t eat any carbs (every now and then I can eat a vegetable) I just read on your site that I won’t switch to fat burning and I’m concerned about that :( Also if I goof anything up during the day (miss a snack, don’t eat enough at a meal – or the other day I ate organic pork that somehow didn’t register to my body as having eaten anything) then I can’t sleep at night and I need to get up eating and it’s hard to get enough to eat (I’m still awake at 4:30 am too hungry to sleep after two chicken legs, 2 eggs, 3 tsp sesame oil, 2 tsp olive oil and a bunch of almonds) … Also my brain fog hasn’t improved at all since I cut out the carbs – maybe because I haven’t switched to a fat metabolism? Maybe I could eat more fat. Thank you for any more advice you can give!

    • Make sure your protein and fats are plentiful in your diet; you shouldn’t need to eat every few hours if they are. Hopefully that helps you; sometimes there’s more to it than diet – hormonal balancing, lifestyle factors, food allergies…

  13. Diana permalink

    Thank you very much! I must be eating too much protein/not enough fat. So I’m going to switch to 50g or so of protein daily and an equal (or more) amount of fat like you say. Only problem is the nausea from eating fat so I guess I have to start to increase the fats slowly. Do you have any other ideas for the fat-induced-nausea problem? Thank you again, as I think this is going to help a lot. Then I will need to figure out the food allergy, hormones, lifestyle, stress, etc. factors too.

    • Nausea from fat can be due to a gallbladder problem. I often recommend 1g of protein per kilogram of weight (so a 125 lb person would be eating around 55g protein). But typically 1.5g per kg is better and 2g or more for athletes.

  14. Diana permalink

    Well…that won’t work since it’s no where near enough calories. I had read though that around 50g of protein is what is good, but that would mean I’d have to eat around 150g or more of fat which doesn’t seem right. Unless I’m calculating it wrong…

  15. Diana permalink

    Ok. I will try 1-1.5g per kg of protein and 2.5-3.0 g per kg of fat (that’s more than 50% of fat, but I don’t know how else to do it to get enough calories – is that ok?) and see if that helps. And see what I can do for my gall bladder in the mean time. Thank you!

  16. Diana permalink

    Ok, then I will aim for that too. Thank you again. Do you have any suggestions for heartburn at night, though? I need to eat right before bed and frequently need to get up once or more at night to eat (or I can’t sleep, get RLS, etc.) and eating fat at night can cause me to get heartburn (and I don’t think that protein alone will get me through the night). Sorry to be so much trouble! Thank you.

    Also the reason I want to restrict my proteins as much as possible (45-55g per day) is to make sure I go into ketosis (I thought that would get me through the night better and relieve my brain fog) and so I don’t want to be turning excess protein into glucose. If I do the 1-1.5 g of protein per kg body weight would that interfere with ketosis? (I already do zero carbs.) Again, thank you. I hope these questions help someone else too.

    • There is no reason to always be in “ketosis” as in it showing up in your urine.

      That is not necessarily healthy over time. If the fat causes the heartburn then that’s a gallbladder problem.

  17. Diana permalink

    Oh. I thought that if I switched to ketosis – fat as my main fuel for my brain and other organs – then I would be more steady. Now if I go a little too long in between meals (I have 6 small ones a day) then my blood sugar drops and I can’t sleep at night and as I said need to eat several times at night in order to fall asleep. I would like to not have that problem anymore! I thought I was eating too much protein and so I was still prone to hypoglycemia even though I had cut out the carbs.

    For gallbladder I’m thinking that the solution is to do a gallbladder/liver cleanse. Is that what you would do? (something with epson salts, olive oil and lemon juice…)

    • You can try the flush, sometimes they work sometimes not.
      If you have to eat 6 meals a day you’ll never correct your CI. All you’re doing is supporting habitually high blood sugar levels. If you eat enough protein and fat 3-4 meals a day then it’s close to impossible to be able to eat 6X a day. You won’t be hungry and you won’t have sugar-swings.

  18. Diana permalink

    What else can you do for the gallbladder if a cleanse doesn’t work?

    Ok. I will try the 3-4 meals with enough protein and fat. If you have the 4th meal is that a meal or snack? And is it between lunch and dinner or after dinner or whatever you are hungry for? How long can you go between meals? (Sorry to be so scientific – but I don’t always get hungry, and then the only way I know I’m hungry is that I get RLS during the day, and then by that time I’ve gone too long without eating and that causes me to not be able to sleep unless I get up to eat several times at night.)

    I’m confused though because all the hypoglycemia diets call for 6 small meals. I suppose hypoglycemia and CI are not necessarily the same thing, just related. Any clarification would be helpful.

    What do you consider a “high blood sugar level”?

    Thank you, again – very much.

    • Sorry, I can’t spend so much time giving you such detailed advice. That’s not the idea behind the website. Thanks for understanding. A lot of the questions you’re asking can be found on this site – you can always use the search tool. I can go 6-7 hours easily w/o feeling hungry and even longer w/o symptoms.

  19. Jennifer Wallace permalink

    What are your thoughts on the blood type diet? According to that, it says that I should be a vegetarian….I have been trying to find what works with me, yet there is so much out there and everyone has their own opinions which makes everything all the more confusing as to what truly is factual based science. Thanks in advance for your time!

    • I think people get better from the blood type diets because they preach general principles of health – no trans fats, no HFCS, no artificial sweeteners, etc.

  20. Jennifer Wallace permalink

    Thanks! I was just curious because I have been doing really well with the ‘paleo’ type diet, lost 6 pounds in 10 days, which is good as I only wanted to lose 10. However, I have a friend whose I bodybuilder and suggested the blood type diet. I looked into it, and figured it had been two weeks, I could add in some carbs. I had cherries and some GF oatmeal, and literally gained my weight back over the course of 3 days! I think one of the reasons why I played into it was because it said type A’s benefit from yoga, which I believe is true for me. I just wish there was a clear cut path as to what is good for me, it’s all so frustrating!

    Thanks again!

  21. Jennifer Wallace permalink

    This actually makes sense, thank you!

  22. Jennifer Wallace permalink

    Quick question, how do you know if you should start with the FODMAPS diet, or if you should start with the SIBO diet? What symptoms call for taking it one step further and starting with the SIBO first?

    After reading about both, I strongly agree that this is what has been troubling me over the past 4-5 years. I had a c-section almost 5 years ago and shoulder surgery last year, both of which caused some severe bowel changes, among various other symptoms, it all makes sense now.

    Thank you for all that you do, it’s a breathe of fresh air knowing there is an end in site…it’s just getting there now!

    • Just go with FODMAPS – I think it’s better – more comprehensive – than SIBO diet.

  23. mona permalink

    I was facinated that you list hands and fingers falling asleep at night and when exercising. Why does it do that with CI and when can I expect it to stop. it is very annoying. I have always thought it was because of my injury line T-7 intersting it probably doesn’t have anything to do with my SCI.

    • It is because of the relationship of the biceps and triceps with blood sugar handling issues and how those muscle can impinge some of the nerves off brachial plexus.

      • Nancy permalink

        I actually found this page because I was doing a Google search trying to find out why my hands stopped falling asleep at night immediately after I started avoiding HFCS. Dr. Gangemi, could you please explain a little more about why this happens? Also, is there any relationship with sleep apnea? That improved for me as well.

  24. SLalley permalink

    Are alpha and bean sprouts okay on the TWT

  25. nancy permalink

    I am beginning to think I’m intolerant of dairy. I never used to be, or at least not that I’ve noticed.

    After losing lots of weight, I started to add dairy and carbs back in to my diet. I’ve gained 15 lbs recently (I needed to though. I was too thin) and I was blaming on the carbs (I do only healthy cards mostly) in spite of the fact that I run 42 miles a week and lift weights twice a week.

    Every morning, I have a Greek yogurt with berries and two eggs. After breakfast, I get extremely tired and feel weak and get palpitations.

    Lately, I’ve been getting a lot of water retention. My feet and ankles swell. I thought it was because I quit smoking, and it very well could be, but it’s been a month since I quit smoking. This morning, my feet and ankles got puffy after breakfast.

    For lunch I had an eggplant parm that I made. The ricotta cheese I put in it didn’t affect me like breakfast did.

    Do you think it’s the eggs or the yogurt? I’m not sure which to cut out first. Thoughts?


    • Fatigue after eating is a common sign of a food sensitivity or carbohydrate intolerance. I’d cut the dairy out first since that’s more common (as an allergy) and it also has sugar (lactose) whereas the egg doesn’t.

      • nancy permalink

        I’m eliminating all dairy, effective immediately. Thanks for your advice.

        Assuming I am sensitive to the dairy sugars/carbs…does this make me pre-diabetic?

        • Anyone who is insulin resistance is in essence “pre-diabetic.” You can check your Hemoglobin A1C level to get a good reflection of your average blood sugar levels over the past 3-4 months measured in a percentage in which they have affected your red cells.

  26. Jen Mullen permalink


    I had a hair test done and it showed carb intorance. I have been sugar and carb free for 2.5 weeks. I have only lost 3 #s and I am very tired and thirsty. I have had issues with being tired for years, now I feel exhausted. I do drink a lot of water normally but noticed that I am very thirsty for that past 4 days. I emailed my doctor (acupunture and natural medicine) and he sent me an article regarding candida die off. I am confused bc I am not doing that diet. I have spent alot of money at different physicians offices as well as doing the acupunture and natural healing. I was hoping that this would take care of the issues but I feel Im still at square one. I cannot work out as my heart rate goes very high with very low impact. Any suggestions?
    Also, I have been taking my blood sugar for the past 3 days and it stays between 71-99. My friend said I should test that to make sure ketoacidtosis was not an issue.

    • High HR when exercising and carb intolerance are both closely related to hormonal imbalance – specifically adrenal gland problems. Lots of info on both site (use the SEARCH tabs). If you are carb intolerant that doesn’t mean you get rid of all carbs/sugars to fix the problem; actually it can make it worse because you stress your adrenals out more.

  27. Ann permalink

    Should I avoid onions when cutting down on carbs?

  28. Jyothi permalink

    Dr.Gangemi,I’m extremely thankfull to you,I live in INDIA and nobody could diagonose my problem,after reading your article I have brought changes in my diet and lifestyle.I feel better now.I will try the two week test and keep you posted.Thanks again.

  29. Julie permalink

    I have fibromyalgia and take metformin for insulin resistance…however, I have never had high blood sugars…on the contrary I have often been hypoglycaemic and have fainted in the OR when scrubbed up before only an hour after eating and my BM was 2mmols.
    I understand fibro people can have a reactive hypoglycaemia …can you tell me if this needs treating differently than insulin resistance..I must add I have most of the symptoms including a change in where body fat is stored. I changed within months of beginning tricyclics for pain.

  30. Lori permalink

    I have been a type 2 diabetic for years. I take Metformin, Amaryl and Levemir long acting insulin. However, for the past several months, no matter what I do, if I consumer ANY kind of carbs, my blood sugar goes through the roof. It doesn’t matter if it’s milk, fruit, or whole grains. I just can’t seem to get my numbers under control. Could I have such a severe case of carbohydrate intolerance??

    • Yes you sure could but there’s a lot more to regulating sugar than just insulin.

      • Lori permalink

        So are there any tests that can be done to determine if I am that severely carbohydrate intolerant? Do you have any advice on learning how to eat with that kind of intolerance and still get enough proper nutrition? or advice in general about this?

  31. Randeep permalink

    Hi, I have been on a low carb diet for almost 2 and half weeks and the only carbs I consume are vegitables and fruit. I have high levels of protein along with these low carbs, I was wondering would pins and needles in my fingers hands arms and feet have anything to do with this ? I also feel majorily thirsty ! Thanks

  32. SteveL permalink

    I have insulin resistance and have been managing it through diet having started with your TWT. Does caffeine have any involvement in insulin resistance and blood sugars? Thanks!

  33. P J Masulla permalink

    My doc is pushing me to begin a statin. I don’t like what I’ve read about statins regarding their side effects. Also, I’ve heard that they aren’t recommended for many women. Here are my lipid numbers: Total 263; HDL 72; LDL 173; Triglycerides 90; Lipoprotein (a) 232 nmol/L. I exercise frequently, eat lots of fruits, vegetables, and healthy fats. I am taking blood pressure medicine, and it is now under control. Would you recommend that I take a statin?

    • I cannot give you such advice. Check out my cholesterol article for more on the subject.

  34. Lyn permalink

    I am 46, female (family history of diabetes on maternal side)

    Have been struggling with low blood sugar, insulin levels are high, at times cortisol levels low

    the dr first said insulin resistance and then suspected an insulinoma. tests found this not to be the case

    a homeopath has diagnosed adrenal fatigue. I discovered your site and think that I may have carbo intolerance although I do not crave sweet things more like salty things.

    any advice??

  35. Abtin permalink

    As I was surfing the web I ran into your perfect website and decided to give you a full description of my situation for better diagnosis.
    Last year in June my weight was almost 110 kgs and I decided to on a diet to lose wight under supervision of a dietician.After two months with the help of diet and tennis( three sessions a week) I lost more that 15 kilos,by the way my height is 188.Then I started bodybuilding and couldn’t resist the temptation of having a fit chisle-cut body ,so started using Whey protein and amino acids.worst of all, i added Human Growth hormone to develop six-pack abz. I started with 2 units a day and after 6 months i reached the dose of 4-8 units a far every thing was good but after 2 months since the time i started using HGH i felt terrible bloating immediately after eating in the morning!i visited doctors and ran some blood tests and UBT test ,they diagnosed me with helico bacter pylori! I ran through eradication but it was of no avail the bloating returned a week after discontinuation of the medications.i ran through endoscopy and was diagnosed with windpipe- stomach hernia!they told me this hernia would be the culprit for reflux! But ,to my surprise, i have never had problems with reflux or burning feeling at the top of stomach! during the endoscopy, they said your h.pylori was back. For two times my doctors ran eradication prescribing heavy antibiotics . After almost four months they said every thing was ok! H.pylori was gone! And you are good to go! But no sooner than two weeks gas returned and again I visited another doctor he told about IBS and GLUTEN intolerance! But nothing helped me until 3 months ago! I finally decided to surf the web and google my condition.surprisingly i found many people like me that after using a lot of antibiotics suffered from gas and bloating!they thought candida were the culprit! Interestingly the symptoms matched with mine! Such as sweets craving( before that i never loved sweets but until recently i had too eat a lot of puff creams , and sweets at around 9-10 pm)
    Second symptom was rectal itching ,third:decrease in libido,fourth:bloating after consuming rice,potato,bread,sugar,…whatever containing glucose!,chronic fatigue and high uric acid which was because of dead candida!
    In my blood tests the only anomaly was uric acid,slightly more than normal!
    Then I decided to follow a special diet which i found online!
    Following this diet,i dont have any problem with gas but the only problem is weight loss
    Because i have to avoid starchy food sweets rice…
    Now my weight is 86 not good for my height! And still start bloating as soon as I have some rice or bread or cake!
    I also asked one of my friends who is a lab assistant to check my ear mucus for candida infection because i suffer from foggy head too! And a strange noise some time there! The result after culture test was positive!
    This was the whole story.any comments would be highly appreciated.
    Tx for the time
    Abtin Zangeneh

  36. IntrepidTea permalink

    I’ve been diagnosed with insulin resistance and PCOS. I’ve been given metformin multiple times, but I can’t seem to continue taking the pills when I get them. My best bet in this case, is to lose weight and change my diet. Part of what I’d like to do is start the Paleo diet, but the issue is I’d like to greatly increase my consumption of bananas since they are filling and full of fibre and vitamins. I wanted to have up to four bananas, and a serving of lean meat for my lunches or breakfasts (one of the two per day), but this would be a lot of carbs. It’s exceptionally healthy for most people, butwould it be healthy for me?

    • I don’t know when 4 bananas would be healthy for anyone, even throughout the day, let alone all at one meal.

  37. SteveL permalink

    What morning blood sugar levels should a person be shooting for? I’ve put myself back on the TWT and after nine days on the diet the last few days have been 99, 85, 77 and this morning 85 and that’s from an average of say 108 prior to starting the TWT again.

  38. Disa permalink

    Hi! Could insulin resistance cause tinnitus, rashes, nasal congestion and water retention? I’m following the paleo diet but haven’t been low carb and I’ve been dealing with these symptoms daily. I don’t have any allergies and most diseases that can cause these symptoms have been ruled out. I’m always tired after eating and now I’m wondering if this could all be because I’m carbohydrate intolerant?

    Looking forward to hearing from you

  39. Barbara permalink

    I have found more answers to more questions on this site than I have in the last five years of searching. Thank you so very much. I have a relatively rare genetic condition, AFAP, and 7 years ago underwent a subtotal colectomy to avoid the inevitable colon cancer. Not long after, I began having severe digestive issues; the doctor who diagnosed my disease suggested I take Imodium but I was convinced the problem was dietary – Abdominal pain, gas, bloating, excessively loose stools. All doctors and nutritionist I consulted were thrown by my lack of colon. I eventually found a nutritionist who suggested something very similar to the TWT; after successful completion and total symptom relief, I went on the Paleo diet and have to stuck to it for nearly three years. I have added some things into my diet (cornmeal, for example) and “cheat” occasionally, but have been mostly diligent. I eat meat, vegetables, eggs, nuts, and fruit; no dairy, no grains, no rice, no potatoes, no legumes. I drink coffee with a very small amount of sugar, water, tea; no soda, no fruit juice. For a treat, I will eat a small amount of dark chocolate. I lost about 25 pounds when I first went on the diet, but have gained back much of that in the past year.

    Unfortunately, my symptoms have returned in the last few months. At first I thought it might be stress, but life has smoothed out and the symptoms have persisted.

    A recent endoscopy showed inflammation in my esophagus and I now take ranitidine daily. More recently, a sigmoidoscopy showed inflammation of my small intestine; a biopsy was performed and I was told it wasn’t cancer. When I asked what would cause the inflammation, the answer was a shrug.

    I have been doing some research and now wonder if I should be taking probiotics. I’ve started over and am back on the TWT as of yesterday and have eliminated all fruit from my diet – I was eating watermelon daily.

    I am otherwise very healthy and am active – biking, rowing, walking. But the digestive problems are debilitating, both physically and emotionally, and I would like to find a doctor or nutritionist who can help with a diagnosis and diet.

    Interestingly, I have a 45 year old niece who has also been diagnosed with AFAP; she had only a small portion of her colon removed whereas I had all but 7 cm removed. We have the same dietary and digestive problems and both of us suffered from infertility as well.

    Can you refer me? I live in Florida and am very willing to travel.

  40. Teri permalink


    Starches literally put me to sleep. I’ve gone to the doctor and had all the tests, but they said that I am not diabetic or have insulin resistance. I’m at my wits end! I love pasta and I love bread! Can you suggest anything?


    • I don’t understand what more confirmation you need. Even if you’re not insulin resistance you clearly have a carb issue and most docs don’t have a clue how to diagnose insulin resistance anyway.

  41. Petr permalink

    What is a role of liver in insuline resistance?
    I did a liver flush a year ago and my IR symptoms were much worse after the flush. Do you think that liver flush can make IR worse?
    Is liver flush/liver cleanse recommended for IR?

    Thank you.

    • The liver is where you store sugar (glycogen) and it’s also the organ the makes sugar from other substances (like proteins).

      I wouldn’t recommend the flush for IR.

  42. Debbie permalink

    Hello Dr. Gangemi,
    Last year October, I suddenly gained 22lbs in one month. In spite of all my efforts to lose weight, nothing worked. I walked, and minimized carbohydrates, but nothing changed. For some months, I was on a strict regime of nuts, minimal carbs, fish, quinoa, and fruits, but I did not lose any weight. Since this year July, I noticed that once I ate carbohydrates, I gained weight immediately, and my bust would swell up and become very painful. This is unprecedented. I need help to understand what is really going on inside my body, as doctors keep telling me that all the hormone and other tests return normal results.
    I look forward to reading back from you.


  43. Milly permalink

    3 years ago was put on 2 courses of antibiotics for a dental issue.
    Months after I had: brain fog, dizziness, faintness, metal taste in mouth,
    Coated Tongue.
    Consulted a general nutritionist who recommended a Candida Cleanse kit.
    I did the cleanse. On the last day of the cleanse I had a physical crisis after taking a grape-fruit extract (part of the cleanse). Pulpitation, Severe Problems breathing, extreme anxiety, Fast pulse, Cold all over my body. It took 6 hours of bed-rest before my body returned to normality. I felt drained.
    After this episode, a pattern emerged: Hypoglycemic LIKE symptoms, Needing to eat every 2 1/2 hours, Had to eat plateful of food (snacks would only lead to a huge hypo), ALL MEALS had to contain MEAT PROTEIN (My body wouldn’t accept DAIRY PROTEIN).
    Saw a Nutritionist. Tests revealed I had a SIBO (Small Intestinal Bacterial Overgrowth and Malabsorption).
    I was put on ADP to cleanse the infection. Probiotics, a host of multivitamins and continued a protein/carb/fibre/fats diet.
    My absorption improved. The SIBO was clear.
    The only improvement was – I was able (till today) to go as long as 4 hours without eating before on the onset of Hypo symptoms.
    Had Blood Glucose Tolerance Tests and my levels were normal. Therefore i’m not considered to be Hypoglycemic. And still I’m not able to consume Dairy protein as an alternative to meat. So eat meat 4 times a day!
    It’s over 3 years now and for the most part I’m still the same. What could be causing this continued pattern? And what other tests could I possibly have and be checked for?
    Really appreciate any advise and suggestions you have.
    Many thanks

    • I’d suggest you find a holistic doc who can help you figure this out. I’m also happy to do a consult.

  44. Taylore permalink

    Hi Dr. Gangemi,

    I am in a bit of a pickle. I was recently diagnosed with reactive hypoglycemia. I also read about your 2 week test and tried it out. I felt so much better after cutting carbs out of my diet. However, I am reading a bunch of online advice for hypoglycemia and many doctors and websites recommend I keep low glycemic carbs in my diet.

    I ate beans in chili last night and felt absolutely awful today. But when my blood sugar is low I need carbs to raise it.

    Which diet should I follow? What should I eat when my blood sugar is low?

    Thank you,

    • See what works best for you. Though many people do not eat enough healthy fats to stabilize their blood sugar. Check out my article on the Paleo Diet.

  45. bre permalink

    I do have a question. I have high cortisol from Cushings. My blood sugar drops most days, rises too high sometimes too, but mostly drops. I was told I had insulin resistance earlier. Is it possible that my body or somewhere in my body was producing TOO MUCH insulin which is lowering my blood sugar, but the excess insulin also caused insulin resistance, which is raising it?


    • Yes that could be possible as hormones don’t sensitize their receptors over time where there are excess amounts.

  46. Monica permalink

    So grateful to you for providing this information freely.
    Thank you.
    Monica : ]

  47. giulia permalink

    hi, I do have a craving specially i cannot control most in the evening, a friend suggested to take a supplement Ortho Molecular – Diaxinol that supports liver and pancreas health, blood sugar levels e Supports cardiovascular health. i don’t have any issue beside I’m hypothyroidism. do you think I can take this supplement to help my craving? most my diet is gluten free, no deary and just recently I add organic chicken and fish.
    thank you for your advice.

  48. Petr permalink

    Hi Dr. Gangemi,

    would you recommend intermittent fasting for insulin resistance?
    I saw couple of youtube videos where fasting was recommended for IR.
    I would love to hear your opinion.

    Thank you very much.

    • Depends on the person but typically no. I’d go with a Paleo Diet first. Three big meals a day.

  49. acordemann permalink

    Mozarella Cheese if made properly should be Buffalo Milk.
    Goat Cheese either hard like (stars with M), there are a few. Delicious.
    Or goat cheese, crumbled, rolled, etc. Soft are great for salads and
    must be goat cheese.
    Many cheeses can be found without cows milk, so you have to know which way you want to or can go. There is a book, All the Cheeses of the world, I have this and it is very, very informative. Where they are made, how, fermentation etc.
    At the moment, Fermentation is the next big buzz word. However, I think what we need to know is what does YOUR BODY like. Not any particular diet, by any person. But, your own test.

    Elimination is similar to a babies introduction to food. First, rice cereal, for a few days. Than, you begin to try and add a food. I always picked a protein egg for myself. And, a bread – rice bread is my best one.
    And, a piece of fruit. That is it for a few days.
    Than, I go to a sweet potato. Great to eat and works well with other items.
    Once, you do this – with your Doctors consent, and consultation with a local nutritionist. Not off the web. Your Body, will tell you what is ok and what is not.
    For me, wheat sometimes, bothers me. Other, years no. It is a constant change, and I generally go for the craving. Sauerkraut, or a Steak or an avocado and sprout sandwich. Whatever, I am craving is generally found in the food. Once you become in tune to your body’s food requirements,
    you will just know what to enjoy for dinner. Strawberries, Mixed greens, Pecans and a protein. With a balsamic vinegarette – for me that is a great treat.
    Enjoy a great fantastic creamy cauliflower, or spinach, or butternut squash soup. No cream, no flour, just add for each item 1 cauliflower, 1 or 2 chicken of veg broth, steamed chopped onion (1), , flavoring – up to you. Cauliflower picks up any flavour. (ie: If you make a chicken pot pie, simply use the cauliflower soup with sage, parsley, rosemary and add your ingredients), or add Baharat,spicy etc. The richness of the rice that has cooked with the vegetable and than put through the blender twice is amazing. 1 cup = 10 carbs approximately. And, I make a whole group and freeze to use as a flavouring for salmon – [poached salmon on a base of spinach puree soup, with roasted pine nuts) theres more, but you get the idea.
    Changes in diet can be assisted by changes in how and what you cook for dinner.
    I hope this helps. Check all labels, check all ice tea and new natural drink labels. All are high in carbs, from added Sugars.

  50. Vanessa permalink

    Found this while searching Why do I fall asleep after eating bread.

    Which I do, it doesn’t matter how much or of what kind I always fall asleep I’d say within 15 mins of eating bread. Where as yesterday I had 5 nectarines (not a common occurrence they were just starting to go bad…) around 11 am and was up and going all day with a ton of energy. That confuses me since one of the resonances to this was about fruit doing the same thing to a person as gluten.

    My diet is about 85% raw vegan 14% cooked vegan and 1% sushi XD I do yoga, swim, and few other exercises my knees will let me do but I don’t seem to loose any weight.

    I’d say between July 2014 through Feb 2015 I was sleeping almost all day every day till late in the evening then I’d be up till about 3 am and then the cycle would start all over again. That stopped when I stopped eating any kind of bread and upped my vitamins, and veggies. But still if I eat a piece of bread I’ll be out and stay out for hours.

    • Robert Berman permalink

      I had a similar problem — whenever I ate berries or coconut milk, i was terribly fatigued. This was solved by taking pro-biotics. (I had taken 2 or 3 rounds of anti biotics)

  51. Robert Berman permalink

    Whenever I eat carbs/sugar, like sweet potatoes, my calfs, ankles and feet become bloated. Might this be a symptom of carb intolerance? Are there enzymes I could take?

  52. Dana Williams permalink

    When i eat i feel like im high afterwards! Meaning it makes me feel like i took something like a lortab! I have frequent headaches i cant sleep most days and every now and then i see those silver dots? What could be wrong with me?

  53. Dana Williams permalink

    When I eat i feel like im high afterwards! Meaning it makes me feel like i took something like a lortab! I have frequent headaches and I can’t sleep half the time. I also see those silver dots sometimes.

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