Cypionate Crushing my Potassium Within 36 Hours of an Injection?

Pharma TRT
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New update:

Well it seems my mineral and vitamin deficiencies last April up till now is because of the use of Protonix, a proton pump inhibitor not only lowers potassium, but also vitamin C as well as iron and many others!

Does a proton pump inhibitor cause hypokalemia?

Proton pump inhibitors (PPIs) act only in the stomach, although the proton pump, H(+),K(+)-ATPase exists and contributes to H(+) and K(+) homeostasis in the kidney. We encountered two hypokalemic cases receiving omeprazole. These cases were women ages 69 and 80 years old. Their serum potassium levels decreased with accelerated urinary potassium excretion with the use of omeprazole, and recovered by potassium-supplement and the discontinuation of omeprazole. Because inhibitory effects of PPIs on H(+),K(+)-ATPase are exerted only in acidic condition, hypokalemia is not generally introduced by PPIs alone. However, in extreme alkalosis or impaired K(+)-recycling system, PPIs may cause hypokalemia unrelated to hypomagnesemia.

Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications

A recent review by McColl highlights a detailed understanding of the effect of PPIs on vitamin C absorption. Humans are unable to synthesize vitamin C and thus must rely upon obtaining adequate concentrations of the water-soluble vitamin from dietary intake. PPIs affect its bioavailability via lowering its concentration in gastric juices as well as the proportion of vitamin C in its active antioxidant form, ascorbic acid. The ascorbic acid that is in turn secreted by the gastric mucosa directly affects the concentration of nitrite and iron in gastric juices.

There is additional evidence that PPIs lower serum vitamin C concentrations.

If members ever wonder why I hate doctors so much this is why, because they keep you in a disease state and have been in a disease state for almost a year, last April I have vitamin C, iron, potassium and vitamin D deficiencies!

Iā€™m so enraged right now, Iā€™ve been have GI issues since March. Iā€™ve been dealing with unabsorbed vitamin C in my GI tract causing horrible bloating for months. I was at a wedding on Saturday and days earlier I was told to double up on Protonix, I took Protonix and right after the meal I started feeling nauseous and bloating.

I have been fighting to keep potassium and vitamin C elevated and now I know why.

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I donā€™t think you need to be.

The study refers to two elderly women who had problems. Thereā€™s no legitimate reason to have anticipated you having a similar reaction.

From that same study: "Conclusion

PPIs have revolutionized the therapy of numerous upper gastrointestinal tract disorders, while posing a very minute and largely theoretical risk of adverse effects based upon data from mostly small retrospective trials. The overall benefits of therapy and improvement in quality of life significantly outweigh potential risks in almost all patients." [emphasis mine]

They do not. They use tools and information at their disposal to treat symptoms and issues as they occur.

Do you have, like, any personal responsibility in your own healthcare? You werenā€™t healthy long before TRT or other meds came into the mix. Youā€™ve been significantly overweight for a very long time, at one point a few years ago stating you were ā€œunable to lose weight by diet changes for 20+ years.ā€ Thatā€™s 100% on you, because that type of non-progress is basically unheard of.

But youā€™ve spent almost three years here on the forum and never once asked for help with your training or nutrition, because you were so overfocused on your TRT - a typical and unfortunately common problem I see a lot of guys fall into.

Not trying to pile onto you, man, because it does seem like youā€™re dealing with several medical issues at once and thatā€™s gotta suck. But blaming doctors is not the answer.

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But it is easyā€¦

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PPIs arent the source of your deficiencies, vitamin C doesnt bring people out of an unconcious state and a couple of hundred mg of potassium doesnt correct severe hypokalemia.

You are living in denial, craving for attention.

You need to work together with your physician to get your diabetes under control. You wouldnt be the first one that is not surviving an acute epiosode diabetic ketoacidosis

Wake up man!

ā€˜Sudden death from diabetic ketoacidosis (DKA) is common and nonalcoholic fatty liver disease (NAFLD) is a frequent finding in patients with diabetes mellitus and impaired glucose toleranceā€™

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Doctors are humans and like many humans some arenā€™t worth a shit.

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I take full responsibility for the low testosterone and diabetes diagnosis, but the doctors also must take responsibility for their actions or lack thereof.

As a result, PPIs can modify the bioavailability and absorption of essential vitamins and minerals both in the stomach and duodenum, which may also affect more distal absorption. Recent case reports and retrospective literature reviews have posited a potential adverse association between both short- and long-term PPI utilization and vitamin and mineral deficiencies.

This is more than good enough for me, I only just started taking the Protonix again, except this time doubling up on the doses and experienced the same exact symptoms when I was taking it in April, however things progressed more quickly this time around.

My experience and these papers is strong circumstantial evidence and itā€™s not even considered flimsy. I havenā€™t been dissolving food laterly, it just sits in their and bloating occurs, then the cramps and diarrhea is not too far behind. You need gastric juices to break down food and this medicine decreases gastric juices.

If it walks like a duck and quacks like a duck, itā€™s a duck.

My doctor saw my 6.6% A1C and said I donā€™t really need the diabetes medicine, he wanted to stop the prescription, but I told him I feel better when taking it and he cancelled my prescription.

When I mentioned this to the ER doctor, he stated he would want his A1C <5.0 if it were him.

I became complacent, I should have researched the medicine right when I started taking it. The sick care system wants you to remain in the disease state they are creating a consumer of health problems and if my experience tells you anything, they have been milking my insurance company causing more healthy problems.

The sick care system is a multi-billion dollar business with big pharma greasing the wheels. My medicine cabinet has stuff in it I never needed, in fact since I joined Kaiser my prescription count is climbing and all I have are mineral deficiencies that can be corrected by mineral and vitamins.

In fact when I started having these Gerd issues, doctors never even ran a mineral or vitamin panel until after things got worse.

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Well shit man.

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Talked to a colleague of mine at work who is a physician specialized in endocrine disorders

He said that EDKA/DKA is not too common in type 2 diabetes and when it develops it is a clear indication for insulin therapy. Its termed ketosis prone type 2 diabetes or also type 1b diabetes, somewhat a transition state between type 2 and type 1 characterized by an insufficient insulin production.
When one sees a gradual decline in serum electrolytes over weeks/months it speaks also for a low level of chronic ketosis going on. It is the ketosis that leads to a gradual decline in electrolytes which in tern causes abdominal cramps. Thats also the differentiation between DKA seen in type 1 vs type 2 diabetes. Type 1 is rapid onset du to eg a failing insulin pump whereas type 2/1b is more gradual and at some point the body is not able to compensate anymore.

Glipizide (glucotrol xl) should specifically not be used in any patients with a recent history of ketoascidosis. The initial therapy of choice is insulin.
Only after exclusion of the presence of beta-autoantibodies and monitoring of beta-cell function by measuring c-peptide and keton bodies the insulin can slowly be withdrawn.

For whatever its worth.

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I have no idea whatā€™s going on but I will say, daily injections are definitely not more anabolic.

Secondly, I just looked over a few years worth of my labs, and regardless of T levels, from normal range, to off the Richter scale, my potassium is always dead center of normal range.

However I do find it hard to believe that only your potassium is being affected in isolation. So supplementing with only potassium may cause an imbalance.

I have water filters at home, and so I worry about not getting the natural balance of minerals/electrolytes in water. So, much of the time I will add this to my filled water bottles. It has 72 minerals in their natural occurring ratios. Itā€™s made by concentrating sea water and then removing most the salt, and itā€™s inexpensive.

You might want to maybe try supplementing all your minerals and then maybe also boost your potassium if necessary.

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Any chance the rash looked like this

acanthosis-nigricans-neck

If yes this is called acanthosis nigricans, if present in a subject with diabetes its typically a sign of severe insulin resistance

Your problem is your diabetes, everything else is a consequence. The PPIs and the multi billion pharma are not to be blamed.

Some further reading

https://www.diapedia.org/other-types-of-diabetes-mellitus/41040851292/insulin-resistance-syndromes

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The use Glucotrol XL lead to a quicker depletion of minerals and vitamins and didnā€™t do anything for glucose levels, initially there was a reduction in glucose levels, but it was very short lived. I went from needing 400mg potassium to 1500mg whenever my metabolism increased whether itā€™s TRT, Glucotrol XL or simply going to the gym.

I have been experiencing an ongoing battle with keeping potassium and vitamin C from dropping below range, my teeth have turned yellow a couple of times this past week, restoring potassium turns teeth white again.

I have labs going back pre-TRT, there is gradual decline in potassium (vitamin C, iron, vitamin D) and an sharp decline which first occurred in April when my body was creating ketones. I am struggling with keeping levels elevated and I feel if I donā€™t get treatment soonā€¦

My doctors are unconcerned and state I donā€™t even need diabetes medicine.

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So does your fridge. Diabetics donā€™t eat bagels or drink orange juice like itā€™s water.

Are you taking those minerals and vitamins from a combination of supplements and whole foods?

As Iā€™ve told family members, just because a doctor brings up the idea of prescribing meds doesnā€™t mean you have to take them. There are always options, the biggest of which are drastic lifestyle and nutrition adjustments. Though admittedly, with your snowball of issues, the options and waiting time may be getting limited.

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With a HbA1c of 6.6 you are clearly diabetic, not badly controlled diabetic but diabetic. So you need the diabetes medication.

Anyhow, blood glucose levels dont give you the full picture in your situation.

If I was in your situation I would get a hand held ketone meter to measure the levels of ketone bodies in your blood.
Monitor, keep track and discuss with your doc.

But be careful, hugh Vitamin C levels interfere with the test.

For example this one here
Freestyle optium Neo Blut Glukose und Ketone monitorring System for about 80 $

Further reading

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As far as blood keytone meters go I have the ā€œKeto-Mojo blood keytone meterā€ and it works great. The strips are quality and one of the best things is you can also get glucose strips and use the same meter. Check it out

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There are multigrain bagels, I need orange juice otherwise Iā€™ll become vitamin C deficient and canā€™t find supplements in 35mg, believe me Iā€™ve looked. I only need 3 ounces of orange juice which equals 35mg of vitamin C.

The vitamin C dosing is very finicky, a little bit in either direction produces symptoms. It took my the better part of 5 months to figure it out, when I went from 4 ounces (45mg vit C) to 2 ounces (22mg vit C) OJ, I went from an excess to a deficiency in about a week.

When it comes to potassium, I keep finding potassium below range everyday and am adding a little in food as well because my gut needs to function correctly be not relying solely on supplements.

I hear that healthy kidneys can handle supplementing 1500mg potassium daily in addition to potassium in food, would you say that someone suffering from a deficiency can handle a little more? My seems to be starving for potassium.

Thank you Chris.

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Youā€™ve been very helpful and I want to thank you and for relaying for what your physician stated, I will take this to my endocrine appointment in a month.

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Nutritionally, this doesnā€™t really matter much. Bagels are carb-bombs, extremely inappropriate for diabetics.

OJ isnā€™t the only source of vitamin C in the world. And you need exactly 35mg, no more and no less? Iā€™ve never heard of a condition requiring that precise dosing of a water-soluble vitamin, but if thatā€™s where you are, I believe (as Iā€™ve said before) that a consulting with a specialized dietitian is the best course of action. And keep a detailed daily nutrition log in the meantime.

However, it took me about 25 seconds to find that half a kiwi delivers about 30mg vitamin C (plus fiber and potassium) and I found a liquid ester-C delivering about 30mg per quarter-teaspoon and basically zero sugar. Either of those, along with other alternatives, would be better than your current solution. Iā€™m phenomenally skeptical that daily orange juice shooters are the best idea in your situation.

From what Iā€™ve read, itā€™s about 4,500mg per day total. I havenā€™t seen it broken down food vs supplements.

If your body has a deficiency, itā€™s either not getting enough in the first place (nevermind handling more) or itā€™s having a problem assimilating it/balancing with other minerals.

Try having beans, legumes, nuts, and avocados daily.

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My pleasure.

One more thing that I can only highly recommend: Inositol

(In addition to what we have discussed not as a substitute!)

Inositol has been demonstrated to reduce blood glucose levels in diabetics by lowering insuline resistance. It has been shown to be effective in anxiety/panic disorders and through its insuline sensitizing effect helpful in NAFLD.

Try it, it wont hurt you and you could immensely profit. Start with 2x 0.5g per day and work your way up to 2x3g per day.

Further readings
https://www.researchgate.net/publication/309024573_The_Effectiveness_of_Myo-Inositol_and_D-Chiro_Inositol_Treatment_in_Type_2_Diabetes

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He is in a disease state. A diabetic ketoacidosis is a serious thing.

Nutrition has a huge impact - no disagreement here, but I am afraid that his diabetes is too advanced to be treated ā€˜onlyā€™ with food. Its like pouring water into a sieve, you have got to fix the holes first.

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Iā€™m definitely not saying he should try fixing it ā€œonly with foodā€. Iā€™m saying he should stop pouring gasoline on the fire.

Heā€™s mishandling his nutrition which is worsening the underlying problem, exacerbating symptoms, and making the downward spiral steeper and steeper.