It's no secret that I am one of many people out there that finally found a safe, effective & non-addictive medication to treat a rare form of intractable insomnia. My insomnia is a result of metabolic issues combined with your typical life stressors, which makes it difficult to treat and pretty much chronic.
For the past twelve years, I have struggled with various treatments for my insomnia in a desperate attempt to find those illusive zzzzz's. What I didn't know, was that while I was so hyper-focused on falling asleep that I didn't realize that the sleep I was getting was very poor.
After a string of ineffective, short-term medications whose side effects were worse than their cure, a new doctor I was seeing decided to try me on Remeron. Within days, I was sleeping like I had never slept before. I slept heavily those first few weeks, finding it difficult to wake up and get going in the morning. But, after I adjusted I started sleeping normally for the first time in years.
But, I (like many others) made a big mistake when I first started taking Remeron.....I ate. The doctor's will warn you that there is a risk of weight gain (mine said about 6-7 lbs), but what they should tell people is that the risk is actually reality and that most people end up putting on large amounts of weight.
I personally gained about 16 lbs, which, given my frame, is a pretty large weight gain. And, like many others, despite how much I exercised the weight kept piling on.
For weeks and weeks I was tormeted by the weight gain, as I exercised more and more. I tried to change my eating habits by not eating out, watching calories and being more aware of what I was putting in my mouth. But, the fact was that I wasn't a person who ate poorly, but was now a person who could not lose weight.
So, I started taking a hard, scientific look at Remeron and why it causes so many people to gain weight. I read up on the methods of action, the studies that link Remeron to a reduction in stress hormones (specifically cortisol) and how all of that could be connected to what was happening to people's bodies.
Here's what I noticed: I couldn't seem to build and maintain muscle mass. If I took a single day off of exercise, the fat would pile back on. After months of exercise, I had barely made a dent. But, then I also noticed that certain exercises seemed to create a bigger effect than others (more on that later) and that some days I could barely walk down the street because I felt so heavy and others I seemed to move faster and easier.
Not surprisingly, the research on Remeron talks alot about the weight gain, but, specfically, about the change in body composition. On Remeron, people tend to gain this layer of fat, or that's how I describe it. I call it the immovable layer of lard. It comes out of nowhere and is very stubborn about leaving. Walk all you want, hit that eliptical all you want....it won't move. It makes you want to give up on the drug. To hate it. To return to insomnia, if that's what will make the weight go away.
But then I happened upon some like that lead me another link. And, that's when I put together the cortisol + insulin connection.
This is how it goes: Remeron supresses the stress hormone cortisol. This is one of the reasons it helps people sleep. It basically 'powers down' your brain and slows your metabolism a bit. But, more interestingly is the relationship between cortisol and insulin. Apparently, cortisol counteracts insulin. Insulin basically grabs sugar from your bloodstream and stores it as fat. Your body needs cortisol to counteract and balance this effect of insulin, in addition to helping processing lipids (fats) and proteins.
So, as Remeron is supressing your cortisol it is also contributing to some of the effects of high insulin, specifically hypoglycemia or low blood sugar. When people say that can't stop eating carbs on Remercon, this may be why. Unabated, the insulin is grabbing sugar out of your blood, which leads you to think that you are carb depleted. So, you eat more carbs.
That's problem number one.
Problem number two comes from simply supressing cortisol. Because optimal levels of cortisol are neccessary for processing all macronutrients, having too little of it a night could drastically effect your body's conversion of these nutrients into energy. This could cause weight gain and would explain why people gain weight on Remeron so quickly.
That's problem number two.
So, when I rethought all of this, I actually decided to try a little experiment: To eat a 'Zone' diet that focuses on balancing fats, proteins and carbs, to increase my B-Complex vitamins, add Omegas and incorporate more muscle building activities, such as weight training.
The diet gets rid of the carbs that the Remeron are making your body store as fat. The B vitamins help metabolize macronutrients and convert them to energy, omegas can help balance fat levels and muscle building exercise burns glucose and taps your fat reserves.
Three days and I lost 4 lbs.
So, there is hope. I am going to try and keep this up over the next week and see what happens. But, so far there has been a significant difference. And, given that losing ANY weight on Remeron is almost impossible, I am hoping that this actually works.
Keep ya posted....
For the past twelve years, I have struggled with various treatments for my insomnia in a desperate attempt to find those illusive zzzzz's. What I didn't know, was that while I was so hyper-focused on falling asleep that I didn't realize that the sleep I was getting was very poor.
After a string of ineffective, short-term medications whose side effects were worse than their cure, a new doctor I was seeing decided to try me on Remeron. Within days, I was sleeping like I had never slept before. I slept heavily those first few weeks, finding it difficult to wake up and get going in the morning. But, after I adjusted I started sleeping normally for the first time in years.
But, I (like many others) made a big mistake when I first started taking Remeron.....I ate. The doctor's will warn you that there is a risk of weight gain (mine said about 6-7 lbs), but what they should tell people is that the risk is actually reality and that most people end up putting on large amounts of weight.
I personally gained about 16 lbs, which, given my frame, is a pretty large weight gain. And, like many others, despite how much I exercised the weight kept piling on.
For weeks and weeks I was tormeted by the weight gain, as I exercised more and more. I tried to change my eating habits by not eating out, watching calories and being more aware of what I was putting in my mouth. But, the fact was that I wasn't a person who ate poorly, but was now a person who could not lose weight.
So, I started taking a hard, scientific look at Remeron and why it causes so many people to gain weight. I read up on the methods of action, the studies that link Remeron to a reduction in stress hormones (specifically cortisol) and how all of that could be connected to what was happening to people's bodies.
Here's what I noticed: I couldn't seem to build and maintain muscle mass. If I took a single day off of exercise, the fat would pile back on. After months of exercise, I had barely made a dent. But, then I also noticed that certain exercises seemed to create a bigger effect than others (more on that later) and that some days I could barely walk down the street because I felt so heavy and others I seemed to move faster and easier.
Not surprisingly, the research on Remeron talks alot about the weight gain, but, specfically, about the change in body composition. On Remeron, people tend to gain this layer of fat, or that's how I describe it. I call it the immovable layer of lard. It comes out of nowhere and is very stubborn about leaving. Walk all you want, hit that eliptical all you want....it won't move. It makes you want to give up on the drug. To hate it. To return to insomnia, if that's what will make the weight go away.
But then I happened upon some like that lead me another link. And, that's when I put together the cortisol + insulin connection.
This is how it goes: Remeron supresses the stress hormone cortisol. This is one of the reasons it helps people sleep. It basically 'powers down' your brain and slows your metabolism a bit. But, more interestingly is the relationship between cortisol and insulin. Apparently, cortisol counteracts insulin. Insulin basically grabs sugar from your bloodstream and stores it as fat. Your body needs cortisol to counteract and balance this effect of insulin, in addition to helping processing lipids (fats) and proteins.
So, as Remeron is supressing your cortisol it is also contributing to some of the effects of high insulin, specifically hypoglycemia or low blood sugar. When people say that can't stop eating carbs on Remercon, this may be why. Unabated, the insulin is grabbing sugar out of your blood, which leads you to think that you are carb depleted. So, you eat more carbs.
That's problem number one.
Problem number two comes from simply supressing cortisol. Because optimal levels of cortisol are neccessary for processing all macronutrients, having too little of it a night could drastically effect your body's conversion of these nutrients into energy. This could cause weight gain and would explain why people gain weight on Remeron so quickly.
That's problem number two.
So, when I rethought all of this, I actually decided to try a little experiment: To eat a 'Zone' diet that focuses on balancing fats, proteins and carbs, to increase my B-Complex vitamins, add Omegas and incorporate more muscle building activities, such as weight training.
The diet gets rid of the carbs that the Remeron are making your body store as fat. The B vitamins help metabolize macronutrients and convert them to energy, omegas can help balance fat levels and muscle building exercise burns glucose and taps your fat reserves.
Three days and I lost 4 lbs.
So, there is hope. I am going to try and keep this up over the next week and see what happens. But, so far there has been a significant difference. And, given that losing ANY weight on Remeron is almost impossible, I am hoping that this actually works.
Keep ya posted....
Comments
What you said really hit the nail straight on the head: I have these cravings for things like Smucker's jam and chocolate. I eat and eat and eat until I am sick and then I recover and eat more! I was wondering what the hell was wrong with me, until I read this. Thanks so much for writing.
Now, tell me, how has this diet been for you? Any further success? I would try it, but I don't know how I'd fare; I think I'd eventually give in after a short time and go back to my Smucker's jam jar and just spoon it out... :-/
Would love to hear from someone who has success,
Francos@westnet.com.au
Thanks
I noticed that people are still reading this and that it has seemed to make sense to people.
Many of you have asked for an update, so here goes:
I stopped taking Remeron in 2009 because I was able to change my life to accomodate the insomnia. Apparently I have an annoying combination of DSPD and anxiety (probably acquired over years of fretting about sleep). Naturally my body will fall asleep around 2-3am and I only have problems if I know I have to get up in the morning. That's when the anxiety kicks in and make the whole thing worse - leaving me with almost no sleep.
Unfortunately, my life has switched back to getting up early and struggling to get a good night's sleep. Stupidly, I didn't revert back to Remeron immediately and saw a few doctors who went with the benzos. Everyone who has dealt with long term insomnia knows how that pans out.
I'm headed back to the doctor tomorrow, sadly, to talk about tapering off the Restoril/Xanax. I'm both frustrated and embarrassed that I let a fear of gaining weight put me in this predicament.
I will ask to go back on the Remeron and, hopefully, take some time off from work to adjust to it.
As far as the weight gain, yes, the balance of proteins, fats and carbs works. Think about it, anyone who binges on carbs will gain weight whether they are on Remeron or not. Sticking to a high quality protein diet with good fats is not only a great way to eat but it will help curb the weight gain from the drug.
If any of you ended up trying the lower-carb approach, let me know. We'd all like to hear how it went with you.
Here's to a good night's sleep.
I don't think hypoglycemia is a contributing factor though. When I was in college, studying biochem, people that used to smoke pot said they got the munchies from low blood sugar. I tested their blood and never found hypoglycemia to be the cause of 'getting the munchies'. Also it doesn't matter what my blood sugar is - it could be 60 mg/dl or 400 mg/dl - I crave carbs no matter what. Honestly carbs or not, I just crave food.
my Diet: I don't eat tons of carbs, just oatmeal in the morning... So I'll let you know how my testing goes... Next week I'm going to go back to just weight lifting and jumping rope to see if I start losing weight again.. I'm also in pray on this as well.. The Lord is amazing and a few pounds is nothing to him, if anyone can help me he can :-)
I initially gained about 25lbs in the first few months because those sugar/carb cravings are indescribable! I have always tried to follow a low carb diet, so decided to get very strict with myself and last month I ate very low carb (only 40-50 grams per day) and did cardio five times a week. I lost 13 pounds in 1 month!
Needless to say I am very pleased and will continue on.
I would like nothing more than to stop taking it all together, but fear going back to sleepless nights and constant anxiety.
Low carb and lots of exercise is the only way.
About 15 years ago I had extreme anxiety and insomnia that rendered me pretty much useless. I was put on every possible SSRI but they all had horrid side effects. Finally, the doc tried Remeron and it was a miracle. Within a week I felt 100% better. At the time I was very thin, 104 lbs, but gained about 35 lbs in 4 months on it. The weight gain leveled off after that. I was on it for a year and safely came off of it and all meds. I never lost the weight, and gained 40 more over two pregnancies, but it was worth every lb gained to get my life back with this drug. After 15 years I am now having similar problems with anxiety but I weigh 178 lbs, so my doc doesnt want to put me on Remeron due to weight gain. He tried Lexapro, which is EVIL stuff, at least for me. I simply cannot do SSRI drugs of any sort. I would happliy diet and exercise to stave off the Remeron weight gain but I am not sure that will help. I am a bit disheartened because I know this drug works so well but I dont want to create other health problems with being morbidly obese.
Im in the UK where remeron is called mirtazapine, i have been on it for about 18 months.
Like everyone here I initially had massive carb cravings resulting in mass carbiside. I ballooned despite training and competing in triathlons.
Last year i went on a very low carb [ketogenic] diet; this diet definitely helps with symptoms of depression but also helps with weight management; what it hasn't done [yet] is get rid of the belly and i still feel like i have a layer of fat all over my torso. Lifting heavy weights has helped with body composition but i think that as soon as spring comes and this winter weather has gone that i will continue the ketogenic diet as this appears to be my magic bullet, but not the pills; sure they helped with some issues but they have also given me some issues...catch 22 really!
I did not know about the cortisol suppression; why are we not told the full story by the pharmaceutical companies i will never understand.
Feel free to check out my twitter feed for lots of low carb and ketogenic information @colin__matthews
I know this post is oldish but I can't tell you how good it makes me feel. I have been on Remeron for about 4 months. I knew it caused weight gain because it had in the past when I had been put on the drug-- however I had rapidly asked to stop as a result. This time, my depression was so bad, the doctor wanted to try anything that works at all, so they pulled Remeron out. Well..
In the past 4 months I have gained over 30 pounds. I have always had a thin frame and am tall but have also always been slightly inclined towards thinking skinny is better. Never had an eating disorder. Never been a stress eater-- if anything I am one who doesn't want to eat when depressed or upset. At first I thought I must be doing something wrong, so I exercised more. Then I thought maybe I'm eating something wrong, so I saw a nutritionist. However after over 2 months on a strict diet of 800 calories a day and 2x serious cardio a day, I still weighed more-- and not in a muscle type of way, in a fat around my belly that I have never had before type of way.
I have been off this medicine for about a week and have already lost 4 pounds. I hate that I am going to have to work off this weight but will do it because I can't imagine going through life like this.
My doctor subbed in another antidepressant and I know that it takes time to ramp up/get the effects of the drug, but I would rather deal with the ramp up time and sleep loss and other side effects than not be able to look in the mirror when I'm getting out of the shower because it is so shocking and disturbing.
I have an excellent doctor and when I hesitated on the Remeron because of past weight gain, she convinced me that it was better to be fat and alive than skinny and not. I agree with that. But if the choice isn't life or death, if it's milder than that, then I would strongly suggest anyone going on this medication do some reading. Doctors don't seem to be anywhere near as aware of this issue as this post.
Thanks again for helping me understand I am far from the only one who has experienced this bizarre rapid weight gain and insatiable appetite!
For the past 2 years I have taken 120 of Remeron for Major Depressive Disorder and Generalized Anxiety Disorder. It has done great to help me manage both mental illnesses. I actually have not had a depressive episode for the past 9 months. It is so great to be living in a "normal" state vs being depressed for years at a time.
But the negative body image caused by the weight gaining effects of Remeron are taking its toll on me. My joints ache from the weight. I'm embarrassed to be seen by anyone or to go out in public or parties.
I don't know what will happen to my mental illnesses if I go off Remeron. I also take other antidepressants and mood stabilizer meds.
I'm going to try the weight training and low carb approach as well as asking my psychiatrist if I can start to come off Remeron. Hopefully I will be able to come off it and start to lose the 100 pounds I've gained from it.
I'm grateful to be alive and hope to see if I can live a good physical and mentally healthy life without Remeron.
So from the day I started with Remeron I also started a rigorous diet. I have upped my protein intake, but am still getting 50% of my energy from carbs, though they are natural, unrefined "good" carbs. Same with fats. Only unrefined, natural, healthy fats.
So far I have lost 1.2 lbs. I'll see what the next weeks will bring. I am trying to find a balanced calorie level that works for weightless. Right now I am going with 1500 cal with a 200 cal up or down bandwidth.
I have also added an OTC fibre product (PGX) to my diet to even out blood sugar levels and curb hunger. It's working pretty well so far.
I'll be happy to report back in a few weeks how things are going.
I have been on Remeron 30 mg for a year and half and I am currently diminishing the dose to 15 mg. I am taking it because my other AD (Effexor) doesn't let me sleep but is otherwise effective.
My latest depression/anxiety episode has been major so I changing meds is not an option for me.
Since I'v been feeling better, I gained 10 kg in around 1 year but I was not looking at what I ate and was only working out once to twice a week.
For the past 3 months, I have been following a Low Carb Diet and working out 4 to 5 times a week (cardio and weights). My weight has plateau but I haven't lost a pound and while I gained muscle, I still look like a pregnant man. I know that the choice of going back to my 'Crisis' state and living like this is a no-brainer, but still, I would appreciate if someone found a way to limit this side effect of this otherwise cool medication.
Cheers
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How are you getting on on the Remeron/ Mirtazapine now? I, like you am on Venlafaxine 225mg and added in Mirtazapine 2 days before you (only a 1/4 of the prescribed 15mg tablet as I'm so sensitive to meds).
I'd been feeling really great on only that dose (3.75mg), but the last couple of days my depression has reared it's head again .... Not sure whether to up it to half a tablet (7.5mg) or ride this out as a blip on the road to recovery. PMT might not be helping either!
Hope you're still feeling less depressed on it.
Take care.
X
So the trick may be to raise cortisol. Caffeine is one way (you can see a rise on my test, though still below base level, an hour or so after consuming). However, another way is licorice root (not, not the candy which has anise). I do caution that this could be a dangerous way of going about it because it can drop your potassium levels quite low. I've taken it in the past when a doctor recommended it per the testing that revealed low levels. I went out west shortly after to rock climb, which is what I do regularly where I am. Ten pounds came off. Now that could be due to elevation as well.
So, I'm going to give it a shot while carefully monitoring my cortisol. I'll let you know in a few weeks.
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I have been eating LCHF (Low carb/ High Fat ) for 1 1/2 years (check it out on line). Recently Menopause hit me with a vegence. At 56 it WAS bound to happen sooner or later. My last period was 3 month ago. Everything happened at once. Severe Anxiety and Unstoppable Insomnia. Then came the panic attacks (from 4 nights of no shut eye). I was raving mad. A lunatic. Wailing and crying. My husband stayed home from work for two days to hold me. I had heart palpation's that I was sure was a heart attack. AFter two ER visits and visits to countless doctors I was declared fit as a fiddle! Being a Fitness Professional for 25 years has definitely been a contributing factor. So the imbalance of hormones is the cause. Bio-identical hormone treatment (look that up!) is the cure. In the meantime, till I get all that sorted out I turned to our local psychiatrist for pharmaceutical help to sleep. And not happily I may add. Terrified of side effects. I began with Zolof, BAD BAD BAD. Made the aniety and insomnia even worse. He switched me to Remeron. The first three night were like having been under anesthesia! I slept so deeply and so soundly. Woke up in a daze. Took all day to snap out of it. Thankfully that past. I haven't craved grains or sugar (carbs) at all for over a year. But after taking Remeron, I suddenly became ravenous. Looked it up and yup. Munchie! OMG. Thank G-d I have been low carb, other wise it would have been pig out city for me!!! I ate some protein with good healthy fat. Then went to bed. Now that I am fully aware of the metabolic changes going on, I am being even more vigilant in keep my diet very low carb. 50 grams a day. Part of me just wants off the drug. The thought of gaining weight is so unappealing. But I can't go back to that crazy gal of last week. Couldn't leave the house. Could not work. I am banking on LCHF to see me through until hormones get balanced and I can get weaned off the stuff. (Which, from what I read is NOT easy). I urge you all to learn about Low Carb eating. Tons of info on the internet. IT's solid science. You can manage your weight eating this way.
it's Shelley!
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Everything you need to know. It works!! I NEVER Crave sugar or carbs. That is until i began Remeron!! But I am very strict low catb. So i can ovecome the cravings by eating good fats and small amount of protein
I noticed that, too. Depleting almost all carbs from my diet combined with weightlifting really let my muscles explode. I was surprised. Thanks to your post I now know why this is happening. And I tried so much different methods in the gym with no results for years. Regarding food: For example, I have 5 scrambled or fried eggs for breakfast and therefore no longings for any carbs till lunch time. Remeron helps me to get at least 3000 kcal in per day. I take 15mg and this has always been the most difficult dosage for me as my cravings for sweets were on its maximum. The higher the dosage the need for sugar decrased but 15 mg is all I can tolerate. I gained 40 lbs after all, but luckily my body fat is quite low, after I figured out how to handle the one and only real heavy side effect of Remeron. I used to be very slim so fat or muscles, either way is not very convincing, but muscles are much more acceptable. When you try to stay slim, it requires more discipline to manage. But when you can handle this side effect, it can really support you fixing your life.
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If you can get switched to something else that would work for you, I recommend that you do it right away. Despite all the exercise (avid rock climber and distance runner) and extremely healthy diet, it's hard to take off the weight. I am now down to 5mg and just want the drug out of my life. Spend time on PubMed and search on why Mirtazapine -- it affects leptin (consequently glucose) and TNF-alpha factors (I'm wondering now if that is contributing to my arthritis nodules that popped up this year). I put on 20lbs in 6 weeks when I started this and managed to get 8 off, but it's a struggle.
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So first of all this forum was SO helpful. I am a 24 year old female. I have only been taking Remeron for a few weeks but I adjusted my diet and I am excited to say that I haven't had any weight gain (which CAN be easy for me). In fact I have leaned out and lost fat!
So as recommended above I do a high fat low carb diet. Specifically I do a ketogenic diet, staying under 20g of carbs a day. I don't exercise like I used to, I used to lift weights 5+ times a week. Now it's yoga some mornings and skateboarding some days and I still have had great results.
I was originally supplementing 250MG of Magnesium, I upped that to 500 MG. Also 2 weeks before starting the Remeron I started using Fit Tea. I can't say that the fit tea helped me loose size, but it definitely helped control my appetite which is a problem,I've heard with Remeron (munchies).
Another thing that I started doing almost 6 months ago, was intermittent fasting. So for me I don't eat for 2 hours after I wake up no matter if that is 8 or 10 AM. The idea is to increase your "fasting state" before breakfast. So for me? I don't eat before 11AM (sometimes I wait until 2pm) and again Fit Tea helps with hunger. And then I try not to eat after 9PM. I am pretty lax about that last one though.
The beautiful thing about the ketogenic diet is, you eat until full and then because your diet is high in fat, more calorie dense, you'really generally not as hungry. And that has been my winning combination.
I hope this helps.
Have you had your vitamin levels checked? That might account for your junk food craving.
Mirtazapine (under various brand names here in Australia) has changed my life and helped me balance full-time work as a classroom teacher and co-parenting two rugrats without succumbing to the 'black dog'. I am a runner, recently did my first half marathon, and couldn't work out why my weight was going up and up, rather than down and down, same weight as when pregnant with #2 but okay with energy levels and stamina. Argh!.
Now super keen to chat with psych and also a nutritionist and *FINALLY* make a plan.
I want to offer suggestions that might help. I take L-theanine (with inositol) in the morning before eating. It seems to counter any anxiolytic effects from the coffee I drink. I've made sure my B and D3 levels are optimal, and I take ZMA at night. I'm down to 5mg of mirtazapine, and when needed, a small dose of ambien. I'm a big fan of Now Foods because they're high quality, if you want to use what I do. Would still like to lose that 10lbs that lingering and all the cardio, body weight, weight lifting, jumping isn't getting me there. =-(
I have just been prescribed Mirtazapine so I am yet to fully experience side affects/ positives/ negatives. I have read a lot about weight gain- which I am very anxious about. I haven't exercised in a while- because of the anxiety and the whole 'get up and go' loss. But, I eat pretty well and if the meds work for depression- Im hoping it gives me the boost to want to work out.
Will definitely be checking back on this blog as its been super helpful and hopefully I can share my own positive experience over the next few weeks :)
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I was quite disgusted with weight gain and when I left rehab, or more accurately got kicked out because I used drugs and ended up street homeless, I ended up using opiates. I was then prescribed buprenorphine to replace my opiate addiction and was housed in a hostel, and I lost a considerable amount of weight even though I was still on mirtazapine. This was definitely a side effect of the opioid medication I was on.
Soon I was getting too skinny so I then made a conscious effort to gain weight through weight training and a high protein diet, but to my surprise I put on quite a lot of fat as well as muscle, which shouldn't happen on this this kind of diet & exercise regime. For about a year I have been trying to trim down, and I go weight training 6 days a week and often cardio on top; while I haven't gained wait over the last year, I haven't lost a pound, which is really frustrating . I am not in bad shape, but I'm not comfortable even with being muscular + normal fat; if I'm going to have muscle I would like to be very lean with the low body fat percentage, because I don't like looking meaty.
I think I have useful tips. Eating a very high protein diet, at least 150g or one gram of protein for every pound of body weight per day, and if you crave something sweet or indulgent, there are some incredibly delicious gooey chocolate protein bars that use sugar alcohols and othersweeteners and have far more protein than carbohydrate.
To be quite honest this post talks of losing 4lb in a matter of days on a carbohydrate controlled diet. You would be very naive to think this was body fat loss. 4 pounds of body fat contains 14000 calories, or seven days worth of calories. It is very well known that low-carb or carb restricted diets, and also a high protein diets for different reasons, cause a lot of water loss in the first week or so. This is due to a loss of glycogen, and glycogen is stored carbohydrate; for every gram of stored carbohydrate there are two grams of water. The body on average contains 500 g of stored carbohydrates, which equates to 1.5 kg, or about 3.3lb, of glycogen. Protein also causes additional water loss because of the extra nitrogen excreted by the kidneys, so probably most if not all of the weight you have lost has been from water. You have not given an update on the weight loss has continued and I know that the truth will probably be that it stalled or perhaps even you gained.
I am of the view that a very high protein diet is superior to a low-carb high fat diet because high protein intake stimulates muscle protein synthesis independently of exercise, which means more lean body mass which has a much higher metabolic rate than fat mass full stop hi protein intake has been shown by countless studies to improve body composition by, i.e. to increase the ratio of lean body mass two fat mass, although it is unclear if this is the same when you are taking ramaron (mirtazapine).
I have never heard of Mirtazapine decreasing cortisol levels and actually cortisol is responsible for fat gain and a decrease of muscle mass. It is glucagon, not cortisol, that opposes the action of insulin. Cortisol can actually increase insulin levels because it frees up stored carbohydrates increasing blood sugar levels. I therefore find your science a bit spurious and I think you ought to cite credible research studies. Eplanations I have heard have tended to relate to the histamine/H1receptor activity.
I've never had this kind of weight problem. I feel very lethargic and craving carbs big time. Ive had to buy a whole new wardrobe after the rapid weight gain.
Needless to say I've thrown out those evil pills and back to square one.
I'm wondering whate these diëts are. Low carbin? So I don't eat it any more or do I need to eat les carbs? And how much vitimins and omega do i have to eat?
A little background: I've previously been diagnosed with Bipolar II and have successfully been on Lamotrigine for a bit now. It's been fantastic in so many ways, especially with major depressive episodes. However, Lamotrigine doesn't help with anxiety nor the insomnia I've dealt with most of my life.
After talking to my head doc we decided to try adding Mirtazapine (7.5mg). We discussed the potential for weight gain, but I'm happy to have found a blog with suggestions to mitigate it. We also discussed that if this side effect is severe, the weight gain could create a body image problem that negates the positive impact of the drug. Self esteem is a particularly big factor in my struggle with Bipolar.
With that said, thank you for all the replies! I'm hopeful that starting Mirtazapine with a game plan for weight gain might make all the difference. As always, looking for silver linings in this fog. Cheers!
It says here that Remeron has no influence on blood sugar regulation?
https://www.ncbi.nlm.nih.gov/pubmed/16649829
"CONCLUSION:
The antidepressant therapy with mirtazapine was associated with a significant increase in body weight, body fat mass, and leptin concentration. In contrast to other psychotropic medications inducing weight gain, such as some second-generation antipsychotics, mirtazapine treatment did not influence the glucose homeostasis."
I was prescribed it today but I am so hesitant because of the weight gain, I am on a keto diet so that gives me hope but then the snippet I just posted has confused me, don't know what to do!
Hi there, I just had to come back to this blog to thank everyone for posting about eating a low carb diet, while taking Mirtazapine.
I have GAD and PTSD. I successfully came off Citalopram over a 14 month taper. It was horrible. I managed three months off medication before having a massive relapse, which ended up putting me on a psych ward for a few days. The doctors wanted me on Mirtazapine and I was in no state to argue. It really helped me. Within three days I started to feel so much better. As soon as I came home I started to research Mirtazapine, and I came across this blog almost immediately, as I was looking for solutions to the weight gain side effects. I had gained four stone in weight when I was on Citalopram, and couldn't afford to gain a single pound more! When I was on Citalopram, I tried a low carb diet but it didn't work. However, I found this post and thought as I was on a different class of medication, perhaps I should at least try it. So I sent my husband off to the butcher's and hit low-carb HARD. I've been taking Mirtazapine now for three months. Started on 15mg, up to 30mg (that made me mean)so now back on 15mg. I am happy to replace that not only have I not gained any weight, I've lost two stone!!!!!
Over Christmas I didn't want to miss out on all the goodies, so on Xmas Eve, Xmas day and boxing Day I ate carbs. OMG, I ate and ate. I gained half a stone in three days. I was mortified. So, started back on the low carb and it's taken three weeks to loose that half a stone, and I've had to be ruthlessly strict. I supliment with quality minerals and vitamins. Drink loads of water, and take laxatives and/or enemas. It's very hard, and you have to be very strict. It seems that ANY carbs my body gets it clings onto and converts to fat while I'm on Mirtazapine. But if I don't eat any.......then it can't do that. I don't go to the gym, I don't have an eating disorder, I'm half way through the menopause, taking Mirtazapine, yet I'm still loosing weight. I have no cravings and feel as fit as a fiddle. That test at Xmas told me everything I needed to know. I hope it helps someone else out there.
It's not easy, you really can't cheat and have to do a lot of research into how to do this safely. Make sure you balance your electrolytes and mineral supplements. Make sure they are good quality and bio available. Have regular bloody tests and seek advice from professionals if your new to low carb eating.
But after all is said and done, it works. Simple as. So thank God I found this blog before my journey with Mirtazapine began.
Gosh, I am really feeling all of these responses. I've been on Mirtazapine since June, and I've gained 20 lbs (9 kilograms) since then. I've been a healthy eater, and very active (cycling, weight training, walking, hot yoga), but nothing seems to make any difference. In November, I even switched to a whole-food plant-based diet, and I've gained weight. Forks over Knives purports that such a diet that avoids oils and highly processed foods will stimulate weight loss without counting calories. I still counted calories. Each day for over 2 months, I had at least a 300 calorie deficit and still held onto the fat.
After reading this thread, I've gone through my regular diet and found that it's incredibly carb-heavy (sweet potatoes, lentils, black beans, chick peas, bananas, farro)-- basically my whole diet is a carb frenzy. So, this is low-carb idea is making sense to me. A low-carb diet that is also entirely plant-based is pretty tricky, so I'm going to have to try to work in some greek yogurt and eggs here and there. In addition to that, I started taking Glucomannan supplements about a week ago. It's a root extract that expands in your stomach, promoting the feeling of fullness, so you eat less. It really does work (when I remember to take it 20 minutes before I eat).
I just saw my doctor who also wants me doing intense cardio every day... yuck. But I'm desperate to get the weight off. I'm suddenly so uncomfortable in my own body; I have only 2 pairs of pants that fit, I can barely cross my legs anymore, and bending over makes me feel like I'm going to choke on my own body fat. It's awful. I got so fed up with the weight about a month ago, that I asked my psychiatrist to start tapering down. With her blessing, I tapered down for about 4 days before I called back frantically, saying it was a mistake. My mental health took such a nose dive that I had to decide: Fat or Dead. I chose Fat.
My new plan of action is to try this low-carb thing, but I feel like I need to also watch the fat too. So I can't go full Keto. I'm going to increase weight training because building muscle is supposed to boost metabolism, do at least a little cardio each day, keep taking my supplements, and drink Matcha tea. Good God... so much work just to get comfortable in my own skin.
I'll be back to report on my progress. Thank you all for contributing to this thread!
Yes, plant based low carb is going to be very difficult for you. If it helps at all, I don't count fat, fats don't seem to make any difference to my weight loss. It's only carbs that contribute to my weight gain (over Xmas). I also take very dark chocolate every day, two or three chunks. 85% Lindt, the benefits are amazing. Flavonoids and magnesium.
What I try to bear in mind is this: I'm staying very low carb to loose the weight. But once it's stabilized, I don't have to be as strict. Then I can stay in Mirtazapine. I've recently had my bloods done and my doctor was very surprised by how low my cholesterol was, compared to before. So the low carb option is having other good effects on my system. I do eat some green and red veggies, but 80% if my diet is fat and protein. I don't have any cravings at all. But any white carbs, rice, potatoes,bread,pasta......you get the picture, they can effect my weight overnight. Good luck, I think it can be managed, but it's very very difficult. I suggest that this time, I just got this will power from out of nowhere, determined to tackle the weight gain. Like a switch was flicked in my head and reality hit. Probably because of that, and the experience at Xmas, I'm finding it easier every week. My body also seems to have adjusted to the diet and I no longer have to take laxitives. But that's taken over three months. Sometimes I think, just a slice of toast, what's the harm? But then my scientific brain kicks in and I know the harm, so I just eat dark chocolate instead. I have no real idea as to Mirtazapine reacts to carbohydrates,it's just personal experience.
Hope you find a way to do it on a plant based diet. If you struggle, maybe fish could be a temporary option for you.
Best of luck
Trish XXX
It's only been 3 days, and I'm already down 4 pounds, and I FEEL soooo good-- so much less fluffy and bloated. I'm definitely bending the rules on being fully plant-based, and I'm 100% okay with it. Greek yogurt, eggs, cream, and cheese are my friends right now :) I missed them. Fish and shrimp, too!
I'm finding this diet surprisingly non-restrictive. I'm not really counting calories or fats, but I'm getting all the things I love. Dark Chocolate, hell yes. Red wine, absolutely. This has been the first time I've seen any progress at all in 7 months, so I'm feeling SUPER motivated to stick to this diet. Like you said, I know the harm of piece of bread or some pasta, so I think I can easily look at them as total enemies rather than seductresses.
Thank you, again, and I will report back soon with more progress, I hope!
Cheers,
Lisa
Going to a 50th Birthday party on Saturday and I'm taking a Tupperware container loaded with cheese. I don't care, I really don't. A girls gotta do what a girls gotta do.
The more fat you eat the better. They say 1-4 protein to fat, but that's just nasty. I recon I'm about 2/3.
Best wishes
Trish
Thanks
During my little stint in hospital because of PTSD, I had the chance to talk with a pharmacist at length about Mirt; She said that—as you alluded to— Mirt is a drug in which the side effects decrease at higher doses. My psychiatrist doubled my dose about a month ago, and I absolutely notice a difference in my appetite. I’m not constantly hungry and craving carbs. Better yet, I’m able to drop weight (albeit very slowly), I’m still sleeping well, and my mood is stable. No change in my mood at all from the lower dose. I had a metabolic test done, and I’m right where I should be, so keep in mind that while Mirt may affect your metabolism and cortisol-insulin relationship, the weight gain is primarily from eating too much :/
Hope this helps, and best of luck!
Lisa
Can anyone else comment on appetite decreasing when your dose was increased?
Thanks again - Buck
I’m also not sure if anyone has mentioned the fact that insomnia in of itself can be linked to weight and other health issues. So for me, there is that added stressor of going off of the mIrt.
J
As for your anxiety over the insomnia, I get it. My psychiatrist advised me to replace my usual dose of mirt with Benadryl. It helped a bit, but I still had trouble falling asleep and staying asleep, so I put 5mg of melatonin on top of that. I’m not sure if that’s advisable, but it helped a lot. I’m also very sensitive to melatonin.
In all, I was still able to sleep; it was just restless sleep for about a week, and it got better as the week went on. Then I was back to normal with the occasional brief wake-up.
I’d also like to add that I lost 15lbs in a month and a half after getting off. Hell yeah.
Hope this helps!!
I am still low carb and keeping my weight at 128. FYI I am 5 ft 3 and take 7.5 mgs of mirtazapine for insomnia. I have not seen the side effects decrease with time. I am 71 years old. I take it with a trazadone and still wake up frequently but it works for me and don't intend to ever stop. I still think mirt increases hunger but I have figured it out with low carb eating . I am pretty active trying to walk 2 miles a day and hiking whenever I can but not in pouring rain
I haven't changed my dosage for 3 years.
Trish here with an update a year on. Since posting last year I can reliably report the following:
Exercise is healthy but doesn't help weightloss on Mirtazapine.....at all.
ANY carbohydrates go straight onto your belly, and they take weeks to get rid of again, so not worth it!
Fat, protein, kefir,yoghurt,dark chocolate,nuts,eggs,mayo,cheese, fish and decaf....CAN keep a human alive and healthy (me).
Watch your sodium, potassium and magnesium as you won't be getting any from veg anymore. I have two Epson salt baths a week (magnesium sulfate X3 cups 30-40 mins), potassium in the dark chocolate and use a quality salt for sodium. Happy to report that still managed to maintain healthy weight and still on Mirtazapine.
But!!!! Every single time I give in to carbs, I PILE it on and it's more trouble than its worth to get rid of it again.
How does low carb work fighting weight gain on Mirtazapine?? I have zero effing clue, ziltch, nada,niente. But it just does 😃.
Is it easy existing without carbs? No, it's bloody awfully hard. But is it worth it? Depends on you. For me, it's given me my life back. So on a sliding scale, no carbs is doable. Mind me though, no carbs means exactly that. This is some strange wierdness going down, it's chemistry, you can't cheat. Good luck everyone. Keep strong. It CAN be done.
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