I have wished for a higher metabolism my entire adult life. Once my lifestyle "settled down," the fat also settled...on my stomach, hips, thighs... I have watched my husband eat like a horse (his serving size for Twinkies is 2-3 at a time, for example) over the last 12 years and not gain a pound. He is still under weight. I however, can think about chocolate (obsess really, but that's another conversation) and gain weight. I am 40 pounds heavier than I was at age 21. A good 30 pounds overweight.
Now I am starting to wonder if a high metabolism is really such a blessing though. I mean, I am sure it would be great for me, but it is not beneficial to the men in my life, my hubby and son. The first time I heard that your body can metabolize your medications was last year, a couple months after my husband began getting remicaid infusions for his ankylosingspondilitis. The first couple months were great. The pain was down significantly over his previous medication, which had just stopped working after several months. But after 2-3 months on the new medication, it began loosing effectiveness as well. His rheumatologist immediately asked him about his eating habits. My husband, god love him, survives on a Coke diet (at least 6 cans) up until dinner. He eats nothing during the day and then eats dinner and doesn't stop eating until midnight or later. So, the obvious question is, what will his body burn to make energy when it runs out of calories from the Coke? Ah, it will burn his medication. Ding, ding! That's a problem. Getting him to eat is a problem too. For a few weeks after this revelation, he ate pre -packaged peanut butter crackers and cliff bars, several a day. But soon these two foods got tiresome and he fell back into his pattern of being too busy at work and on job sites far from food and not eating again. He had actually put on about 15-20 pounds during his high-calorie phase but had lost it all again by the time he went back for his last doctor visit six months later.
Mia's wonderful comment on my last post, mentioning metabolism, triggered a revelation. If my husband's body is burning his medication when he doesn't eat or eat enough, can't Luke's little body be doing the same thing to his Concerta? Could that be why his Concerta loses effectiveness after a few weeks? Even more so, could that be why he got a bit more time out of the higher dosage, because I was feeding him extra calories for the first few weeks? Could a sustained, high-calorie diet maintain stimulant function? I immediately turned to my trusted, wise advisor...google.
I have been googling for answers and insight on this for two days now. I have to say, google let me down this time. It turns out there's an entire science, pharmacokinetics, on how the body metabolizes drugs. All drugs are metabolized. What I am searching to know is if the body will metabolize the drugs faster than it should in the absence of food to create the energy it needs, thus lessening the desired effect of the drugs. I even read the entire drug study for Concerta online to see if it mentioned this sort of thing but it did not. It did detail the pharmacokinetics of the drug but most of the lingo was over my head. It also mentioned that they had no instances of "drug dumping." That means there aren't food interactions that would cause an increase in the release of the drug and subsequent toxicity or overdose. Not what I was looking for, but good to know.
So I have no answers to my theory. I am going to once again push calories for Luke, and his dad. I will watch closely to see if that makes a difference. I am going to try to keep food diaries for all of us but I can't promise anything. Life is so hectic. We are set to visit a nutritionist soon too and I definitely plan to discuss this with her and get suggestions for adding calories fo the boys, definitely not for the girls. This is likely the only kudos I will give to Blue Cross Blue Shield or any other health insurance company in my lifetime but they cover 6 free dietitian visits per member, per year in our insurance plan. I am hoping she will help me drop a couple pounds, put several pounds on Luke and daddy, and teach Emma to eat better. The poor woman is in for a real challenge.
If you know more about any of this, please share it with us.