Hey there. It's Dr. Susan Peirce Thompson and today I want to tell you about the glucose tolerance test and one possible way of navigating it in Bright Line Eating®. I just need to start off by saying I am not a medical doctor. I am Dr. Susan Peirce Thompson, but that's just because I have a PhD in brain and cognitive sciences. I'm a brain scientist. I'm a cognitive scientist. I'm an expert in addiction and weight loss and the dopamine dominant brain, in general. I am not a medical doctor. So, everything I'm going to be telling you today is based on my experience having navigated two pregnancies while doing Bright Line Eating. There might be some information here that you can take to your doctor if you get pregnant, or if you know someone in Bright Line Eating who gets pregnant you could refer them to this vlog or just tip them off about the information that I share here because it can make a real difference.
The glucose tolerance test is, and I'm speaking now as a lay person, not as a medical doctor, it's a test that they run on you, maybe at other times, but especially when you're pregnant in order to see if you've developed gestational diabetes. The thing is that during pregnancy people can develop diabetes when they didn't have diabetes before, when they never even had blood sugar issues before. The reason is that the massive surge in a variety of hormones during pregnancy results in cells not being able to process blood sugar as well and something like three times as much insulin being needed to handle it all. The pancreas sometimes just can't keep up with that load. So, diabetes can develop quite quickly during pregnancy because of the massive hormonal changes that are happening. And diabetes is terrible for the mother and for the developing fetus. It's really important that this get caught. The way they tend to catch it is by bringing the pregnant woman into the lab, having her drink a high glucose concentration drink. It's literally a very, very sweet, very, very syrupy liquid that is designed to knock the system out with a bolus of sugar and then they see what the system does with it. Like, okay, let's give you a bunch of sugar and see how you respond. If the insulin is able to pump out a lot, if the pancreas, sorry, is able to pump out a lot of insulin, if the cells are able to mop up that glucose, then they say, "Okay, good to go. You're all right." If blood sugar spikes and then stays high and doesn't come down showing that the system's not able to deal with all that extra sugar, then they know there's a problem.
I was pregnant for the first time. My first pregnancy was with twins and my amazing OB- GYN, whom I miss very much, Dr. David Gandel, rest in peace. He died suddenly tragically after he'd been my doctor for 22 years or something like that. I got a notice that he had died out of the blue. Anyway, he was still alive, obviously, and I was 33 years old, so, not young by pregnancy standards. I mean, I think risk of gestational diabetes goes up if you're over 25 and pregnant. So, I was quite old as far as he was concerned for this pregnancy and twins makes it a higher risk factor. All of the hormones are increased and it's just a high risk pregnancy in all kinds of ways, as mine ended up being. But anyway, that's for other reasons.
He told me one day that I was going to need to take this glucose tolerance test and I said, "What's that?" He described it and I said, "Oh, I'm not doing that." He said, "Well, you have to do that. I have to know if you're developing gestational diabetes." I said, "Dr. Gendel, I am not doing that." I was really, I mean, I wouldn't say uncharacteristically firm and confident and definitive because I can often be that way, but I remember at that moment just basically saying no, like my system was a no for that test and it was a standoff. I said, "I'm not doing it." He said, "You have to do it." I said, "I'm not doing it." And then as reasonable adults, we discussed it. I said, "Here's the thing. I haven't had any sugar in years.
My last relapse, the one in Australia where I went from a size four to a size 24 in three months and couldn't stop eating no matter what, it was horrific. I was absolutely clear that I was going to protect my Bright Lines at all costs. I said," I haven't had sugar in years, like none, not even a bit. I have no idea what it would do to my brain or my system to drink a deliberate shocking bolus of sugar like that. No, I'm not doing it." And he said," What if we did something else first? What if you came into the lab fasting and then ate the highest carbohydrate breakfast that your program allows and then I tested your blood sugar two hours later to see how your system had responded to that. And based on those lab results, if I see anything worrisome, I'm telling you, you have to take the glucose tolerance test." I said, "That's fair." I just had a feeling my system was going to pass that test, that it was going to be okay. Having that intermediate benchmark calmed me down. I said, "Yes, I agree to that." He said, "What's the highest carbohydrate breakfast your program allows?" I said, "Well, my breakfast is protein, grain, fruit." And I said, "For protein, I could have plain yogurt that's not Greek yogurt, like just regular plain yogurt, which has a lot of lactose in it. There's actually quite a bit of natural sugar in that." And I said, "For grain, I could have quick oats." Which are pretty processed actually. They're Bright, they're compliant, but they're way more processed than steel cut oats or whole rolled oats or something like that. So, I said, "I'll have quick oats and then for my fruit, I'll have a banana." He said, "That sounds great. Really high carbohydrate breakfast." And so, we scheduled the test.
I didn't see him on that day. I went into a blood draw lab and I showed up having fasted and I got my blood drawn at a baseline and then I ate that breakfast, which I'd packed and brought with me and then I waited for two hours and then I got my blood drawn again and then I went home. Now, I was pregnant with twins at this point. I was seeing him pretty often for checkups, just he was checking on me. I went back to my next checkup, and we were talking, talking, talking and then he didn't bring it up. I said, "Hey, Dr. Gandel, what happened with that test I did?" And he said, "Right." He said, "I've never seen anything like it. I can't believe I forgot to talk to you about that." He started flipping through his notes. He said, "It blew my mind." He said, "Where's the numbers? I want to make sure that I share it with you accurately." He said, "Okay, at rest..." I know, I think I got these numbers right. This was now 18, 19 years ago. Maybe I've told the story and I get the numbers a little different, but it was something like this. He said, "At baseline, your fasting glucose was 87 and two hours after eating your max high carbohydrate breakfast that your program allows, it had gone up to 88." He said, "I've never seen anything like it." He looked at me and he shrugged, he said, "Yeah, you do not have gestational diabetes. No way." He said, "You don't have to take that glucose tolerance test." And I said, "Awesome. Thank you." We did that for the next pregnancy as well and I passed again.
I have had two pregnancies, and I have never had to take the glucose tolerance test. So, I offer this to you as a potential workaround. Of course, this is something for you to discuss with your doctor, that maybe there's a way to get through a pregnancy and not have to take the full glucose tolerance test, that there's this kind of workaround that might make your doctor comfortable like it did mine. For what it's worth, that's the glucose tolerance test.
Now, I will say one more thing, which is I've always said that when it's prescribed for a medical reason, a drug tends to hit the brain differently. For example, I mean, the protocols keep changing, but typically the colonoscopy prep is sweetened because it's terrible and people have to be able to drink it. I think that the protocols are changing these days, but I've never seen anybody get triggered in their Bright Line Eating program by doing a colonoscopy prep. There's something about it being prescribed by a doctor for medical reasons that seems to make it hit the brain differently. Now, I can't explain how that happens. It's not unprecedented though. Expectations ready the brain in a different kind of way. In general, the placebo effect is powerful. So, when you're thinking it's medicine, it may get processed differently, like it's medicine, not a drug.
There's something about when you're looking for a hit or you're looking to get some relief from it that it gets processed in that way. So, it's possible the glucose tolerance test would be fine. Again, I've never done it so I can't speak to this, but also that's a lot of sugar. I mean, intentionally so. It's supposed to shock the system. I mean, if you Google it, it warns you that you might feel kind of sick and get lightheaded and it might be so much sugar that it sends your system for a loop and be sure to bring some protein with you because afterwards you might not feel well and need some protein to just be okay and it's supposed to be a whopper. That's the point. It's supposed to send your system into an emergency situation with so much sugar that it kind of doesn't know what to do with it all. So, that sounds worrisome to me as a food addict. I'm going to go to lengths to avoid having to do that. I wanted to say this at the end just to say it's possible that if you do the glucose tolerance test with the right expectation of I'm just doing this for the health of myself and my unborn baby, you might be protected from the addictive effects of it. And certainly, I recommend you do what you have to do to have a healthy pregnancy. But I also wanted to say that there might be an option. All right, that's the weekly vlog. I will see you next week.
