Is Metformin Contraindicated In Congestive Heart Failure?

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Congestive Heart Failure (cont.)

What Causes Congestive Heart Failure? Congestive heart failure (CHF) is a syndrome that can be brought about by several causes. Congestive heart failure is a weakening of the heart caused by an underlying heart or blood vessel problem, or a combination of several different problems, including the following: Weakened heart muscle (cardiomyopathy) Damaged heart valves Blocked blood vessels supplying the heart muscle (coronary arteries), which may lead to a heart attack (This is known as ischemic cardiomyopathy. If there are other, noncoronary causes, these are collectively termed nonischemic cardiomyopathy.) Infections, commonly viruses, which for unknown reasons affect the heart in only certain individuals High blood pressure that results in thickening of the heart muscle (left ventricular hypertrophy) Congenital heart diseases Certain genetic diseases involving the heart Prolonged, serious arrhythmias A variety of less common disorders in which the heart muscle is infiltrated by a disease process There are over a hundred other less common causes of heart failure, which include a variety of infections, exposures (such as radiation or chemotherapy), endocrine disorders (including thy Continue reading >>

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  1. Azrael

    Hi All,
    Firstly thanks so much for everyone who posts on this forum. I have been a lurker for around 5 weeks which is the length of time I have been doing lazy keto.
    I don't feel hungry anymore - this has been a revelation and a blessing that I am very grateful for since starting keto.
    From the 2 keto dudes podcast I remeber the frequenbt refrain "if you aren't hungry, don't eat"
    I have been eating at the normal times I usually eat but I'm not sure that I'm always hungry and have just eaten because I feel I should do to ensure I get my macros. It has occured to me that this is the perfect time for me to keep a copy of the hunger scale and actually workout what hungry is for me because I have spent so long emotionally eating.
    However, I have ingested alot of information on keto and I have smatterings of half digested ideas floating around in my head. If I didn't eat in the next 2 days would my BMR drop? Is low calorie ok as long as I don't spike my insulin with carbs? I am not sure how to proceed.
    Apologies if this has been covered ad nauseum but when I have searched some posts say there is no such thing as starvation mode and others refer to it.


  2. BillJay


    If I didn't eat in the next 2 days would my BMR drop?
    This would be considered a fast and metabolism can actually increase during a fast, but will not likely decrease.

    Is low calorie ok as long as I don't spike my insulin with carbs?
    Chronic low calorie is the problem because at that point the body begins to predict that calories will continue to be limited and will down-regulate the metabolism to be conserving through what it thinks is an impending famine.

    actually workout what hungry is for me because I have spent so long emotionally eating
    Yeah, this is part of my problem too and why I track everything in MFP so I can at least review the information to detect patterns and associate them with how I feel.
    Using MFP, I noticed that my IF was actually being combined with calorie restriction and although keto does seem to naturally reduce calories, I was just too low considering how I felt.
    I find it best for me to restrict carbs to under 20 grams, protein between 70 and 100 grams and eat fat until I feel full and some days that means eating very little and some days I eat a lot (and I really mean a lot) and I've been hovering around the same bodyweight for a couple of years. I have problems when I try to increase calories using carbs or protein.
    I would recommend against eating just to get your macros unless that is based on empirical evidence that eating too little of something consistently results in feeling cold or hungry, etc.. This is taken from personal experience because I noticed that feeling cold correlated with eating too little in general and specifically too little fat as well as eating too little protein was associated with more soreness and slower recovery from activity and exercise.
    In other words, spend some time eating what you want and evaluate the results. In your case and mine this can be scary knowing that we have a history of eating for emotional reasons so it's constantly second-guessing whether or not the hunger is real.
    I've used the information I log to find out what works for me and review it weekly to see if I'm drifting too high or too low and I will occasionally correct with an extra fast or skipping a fast and eating more in the next couple of meals.

    That's probably not very helpful, although you're not alone when it comes to really understanding hunger and eating to satiety, and I will say that I have gotten much, much better at understanding real hunger and eating appropriately because there are now many more times when I've eaten to satiety and spontaneously fast which is something that never happened before keto.

  3. Azrael

    Thanks so much @billjay that is so helpful.
    I have never felt satiated before or had so much stable energy and it isn't something I wish to lose see through my ignorance.
    I know it's silly but I think I'm worried that if I don't eat consistently I will get caught short and end up eating carbage and fall back into the carb cycle.
    I've decided to keep some mini cheeses, avocado and preserved meat with me and listen to my body. From your story and other people's I have faith I will even out.
    Thanks again Azra

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