Almost there — the last few pounds

Cmoney

Cmoney

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Female, 41 — 42 in April

5.7 (3/4)

Start weight 238.8

Now 143

1st goal 138 (that's the -100lbs mark)

Target 125 lbs

This last hurdle is 5 lbs, which should be gone by the next cycle.

Not sure I'll reach 125 by my birthday. A new symptom has cropped up: severe light headedness. It's been an on-off thing all my life. I catch it and bend over and I'm fine. Then, the Friday before valentines, I blacked out for the first time in my life — and not gracefully. I was here one moment, then woke on the floor with no memory of how I got there. Then the pain hit. Jaw dislocated, front teeth knocked loose, lip split open, a knot on my cheek bone, plus bruising on chin, elbow and shoulder and a scraped, bruised knee. It frightened me badly. My best guess was dehydration — stacking gf triz/reta, going without food, high stress, no sleep, that whole set. So I ate, refed, and drank plenty of water with sodium coloride. Some rest and it settled. But jeez, I can eat at any hour, and I can't sleep at any hour. And with water I just feel unthristy. I'm so close, and I look skinny fat — a sack of bones, honestly. I bought 2 of my favourite protein powders, plus BCAA, creatine pre work out and collagen. My thinking: get to that goal and force protein into building muscle.. Gear crossed my mind but I wouldn't know where to go and learn about it.. bloods are good, no issues. Shame there's no local gym bro to help me sort it out. Open to advice. Pics in 5 more lbs! If anyone's nearby and wants to team up and knock it out, say so. McKinney TX
 
Since you mentioned your jaw was dislocated, did you actually have a doctor look at it? And did you tell them about your medication and what took place?

What you're describing makes it seem like fainting is a serious possibility for you, but anterograde amnesia isn't typically something a faint causes — the part about not recalling how you ended up there doesn't quite fit. The collapsing, the injuries, and the memory gap sound more consistent with a seizure or a concussion brought on by passing out. That's only a guess on my part, though, since there isn't enough information.

Postural hypotension after losing a lot of weight is extremely common, and you clearly have it, but if a doctor hasn't evaluated you yet, it could be worth doing, and it really does sound like you should slow down a bit, pay attention to staying hydrated, eat on a regular schedule, take care of yourself, and perhaps have your electrolytes tested.
 
From the perspective of a GP, this raises red flags for me.

Fainting with zero prior signals is EXTREMELY worrying.

It could be any of the items on your list, but something different might be going on.

When there are no warning signs, things like cardiac issues need to be excluded.

You ought to book an appointment with a doctor; you don't sound well, and being skinny fat isn't healthy. Proper food and movement need to be given to yourself.

In my view, we must also keep in mind that not every symptom can simply be blamed on glp-use (or the other peps).

Frequently I come across posts and think, this might not be connected to glp at all.

Illness can happen to us.

Go see your doc. And update us on how you're doing. 😎
 
miss-sanne said:

From the perspective of a GP, this raises red flags for me.

Fainting with zero prior signals is EXTREMELY worrying.

It could be any of the items on your list, but something different might be going on.

When there are no warning signs, things like cardiac issues need to be excluded.

You ought to book an appointment with a doctor; you don't sound well, and being skinny fat isn't healthy. Proper food and movement need to be given to yourself.

In my view, we must also keep in mind that not every symptom can simply be blamed on glp-use (or the other peps).

Frequently I come across posts and think, this might not be connected to glp at all.

Illness can happen to us.

Go see your doc. And update us on how you're doing. 😎
Click to expand...

I really do appreciate that your concern came without any judgment. It means a lot to me, genuinely. To give you the background: the day before everything happened, I pushed my doctor into ordering a full panel. Let me try to remember the names, and please excuse me if I get any of them wrong. CBC, BMP w/Diff, the thyroid and hormone tests, A1C, T3/4 and Fettrin? <something close to that. Everything landed within range except Potassium and Calcium, which were a little above normal. Full disclosure: getting myself to drink water has honestly required an act of god since around May last year, and it has steadily gotten much worse. My intentions are good — my Stanley sits full of ice and my favorite sparkling water is always within reach. Following through is the hard part. I just get distracted. I have experimented with a few of the things I suspect could be behind it. At first I figured dehydration. So for a few days I loaded up on water and sodium chloride, and there wasn't much difference. Then I stopped taking any glps for a week and a half, since I was heading out on a work trip and needed to be at 100%. I made myself eat breakfast, lunch and dinner, and I had no issues at all. I dropped glps to 1/3 dose, kept eating, and was fine. Again — could it be a stack? Yes. But Reta helps me eat. Sitting here now, the past few days have been moderately bad, though I haven't been eating adequately or drinking fluids the way I should. Since the blood work is good, I think a few things need to happen: a blood sugar monitor, a water drinking reminder app, cut the stack down and just pick one, and really dig deep on the force feeding. As for the memory not returning right away, and not remembering my fall — I have no personal or family history of seizures. And I'm so mad my cameras didn't catch it so I could be sure. Even so, I'm in underwriting for a life insurance policy. Once it's issued I'll dig much deeper. But which doctors do you think would be most helpful? Endocrinologist comes to mind. Maybe cardiologist too? I'm not dismissing anything, because tbh I'm too busy to accidentally die right now. lol I know how weird that sounds but it very true. You would think my blood would've showed something, right? Ugh the battle for vanity.
 
My knowledge of the US is limited, but here in Denmark the first stop is the GP, and if something more is needed the GP sends you on to a specialist.

Should eating be impossible, PLZ reduce the dose or take a break.

'Force feeding' isn't something we're meant to do — that isn't what glp's are for. Balanced meals are what we need, roughly every 3 hours. That means 3 main meals plus some snacks.

Staying under TDEE is all it takes, and that can be done.

For 1 week, I'd eat above what I'd normally eat for losing weight.

Mechanical eating is your friend. 😎

If you underreat, what is an endocrinologist even able to do for you?

Were I your GP, though, at minimum I'd order an ECG and ask more about what happened etc, plus a clinical examination of course. That's how you decide what comes next.

No, blood tests wouldn't automatically reveal anything — they sound fine.

Get better ! And eat ! 🙂
 
This exact thing hit me today too. My son, fresh out of med school, put it this way:

[[Q1]]". A whole lot of elaborate terminology just to convey "hydrate more". At least in my case. (Your Medical May Vary, see rules and restrictions, Terms and Conditions apply).

Blood sugar wasn't the issue for me. I'd had sushi 2 hours before.

Here's a check he did on orthostatic vitals with my BP monitor. Sitting is on the left. Standing on the right, taken within a minute of getting up, after 5 min's of sitting. Amazing!

So right now I'm having a glass of water or 2...
 
That's really intriguing. Sorry about the fainting spell, and I hope you get everything sorted out quickly. Until now, though, I'd never come across the idea that skipping fluids could make a person feel faint. Passing out isn't something I've experienced, but standing up and feeling lightheaded happens to me pretty regularly, so this might describe my situation too. Fascinating. I'll start paying closer attention to those symptoms.
 
A solid nudge to keep an eye on your ps & qs (protein, water and electrolytes.). If it comes to it, take the week off — a couple of pounds is not worth your health. Look after yourself.
 
Seems as though a portion of those problems has been dealt with, at least in part—but yes, a proper evaluation is still needed, and the American version of a GP is the place to begin. Ruling out more dangerous possibilities is something that genuinely ought to be done.

Since what you describe points to postural hypotension, getting a blood pressure monitor is likely sensible; they are pretty inexpensive on amazon and sufficiently accurate. Taking several seated readings plus several while standing, then jotting them all down, is simple enough. That gives you some picture of what your bp is up to and gives the doctor helpful information once you are evaluated. Also repeat this across different days so you can see how much it varies and get a solid average. Before you think about doing anything to correct the postural hypotension, you probably need to establish that your blood pressure is not elevated.

Usually, electrolytes come from food, frequently with salt added. If eating consistently is not happening, then clearly reducing the GLP dose or pausing it for a while makes sense. However, if your blood pressure is low and getting back to better eating is taking time, salt tablets could be a sensible short-term measure. Sodium chloride for sure, if your potassium is on the higher side. Because of that, be extremely cautious about—or simply avoid—any electrolyte products containing potassium. Alternatively, just put extra salt on your food, though you may require several grams per day for any effect, and use the blood pressure device to check whether it lessens the drop in pressure upon standing, or the symptoms themselves. Do not do this if your blood pressure is above 120/80. Ideally the medical workup would come before you consider this. Compression stockings are another thing that may help. More salt will most likely make you thirstier. You need to drink more, but plain water alone may not do much, because without enough salt to hold the water in, you just urinate it back out.

Before I lost weight I had high blood pressure, and now it is on the low side—especially during weight loss, but it is still that way now, almost 3 years afterward. My vision tends to grey out a bit when I stand, so I have to be careful about how fast I get up and make sure I can respond if it happens so I do not faint. The only research on this issue comes from after weight loss surgery, where nearly 50% of people have long term postural hypotension after massive weight loss, and nearly 50 kilos certainly counts as that. What occurs is that the veins in your legs and gut previously had fat pressing on them, which created pressure pushing blood back toward the heart; that pressure is gone now, so on standing, the return of blood to the heart is reduced and your bp falls until your system readjusts.
 
deluge said:

This exact thing hit me today too. My son, fresh out of med school, put it this way:

[[Q1]]". A whole lot of elaborate terminology just to convey "hydrate more". At least in my case. (Your Medical May Vary, see rules and restrictions, Terms and Conditions apply).

Blood sugar wasn't the issue for me. I'd had sushi 2 hours before.

Here's a check he did on orthostatic vitals with my BP monitor. Sitting is on the left. Standing on the right, taken within a minute of getting up, after 5 min's of sitting. Amazing!

So right now I'm having a glass of water or 2...
Click to expand...
Yeah, I picked up a blood pressure and blood sugar monitor, and those readings are fine. So it's definitely water. Ugh, water and sodium tablets until my blood builds back up.
 
Cmoney said:

Female, 41 — 42 in April

5.7 (3/4)

Start weight 238.8

Now 143

1st goal 138 (that's the -100lbs mark)

Target 125 lbs

This last hurdle is 5 lbs, which should be gone by the next cycle.

Not sure I'll reach 125 by my birthday. A new symptom has cropped up: severe light headedness. It's been an on-off thing all my life. I catch it and bend over and I'm fine. Then, the Friday before valentines, I blacked out for the first time in my life — and not gracefully. I was here one moment, then woke on the floor with no memory of how I got there. Then the pain hit. Jaw dislocated, front teeth knocked loose, lip split open, a knot on my cheek bone, plus bruising on chin, elbow and shoulder and a scraped, bruised knee. It frightened me badly. My best guess was dehydration — stacking gf triz/reta, going without food, high stress, no sleep, that whole set. So I ate, refed, and drank plenty of water with sodium coloride. Some rest and it settled. But jeez, I can eat at any hour, and I can't sleep at any hour. And with water I just feel unthristy. I'm so close, and I look skinny fat — a sack of bones, honestly. I bought 2 of my favourite protein powders, plus BCAA, creatine pre work out and collagen. My thinking: get to that goal and force protein into building muscle.. Gear crossed my mind but I wouldn't know where to go and learn about it.. bloods are good, no issues. Shame there's no local gym bro to help me sort it out. Open to advice. Pics in 5 more lbs! If anyone's nearby and wants to team up and knock it out, say so. McKinney TX
Click to expand...

Update* Figured I'd share where things stand. Work has kept me slammed nonstop. Saw a cardiologist, redid all my bloodwork, had a heart monitor on for a month, plus an echo with bubbles. Turns out I'm healthy as a horse.. though the Doc says it's a sub type of POTS — when I stand, BP and HR jump 40+ points.. his take is my Brain may be playing catch-up with the weightloss, and it could be extreme strain on my body from the past year, possibly long term. Won't know until I've held a steady weight for a year or so. In the meantime, a low dose beta blockers to shut down the spikes and make daily life better.
 
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