The Elusive Ketosis.

[Remy]

So around Christmas, I decided to get serious about my diet again. I'd followed a low carb diet for most of my late 20s and 30s but fell off the wagon when I got sick about 6 years ago. And I not only had the intractable weight gain of illness but it was compounded by my medium carb diet.

I didn't really eat badly so I figured it was fine. Mostly carbs in the form of baked starchy veggies with some rice or pasta or bread thrown in for the periods when I was not gluten free. I ate very few processed or fried foods and no alcohol for years. Yet the weight kept piling on.

So ketosis was my goal and I learned a lot in the 3 months it has taken me to regularly achieve that state. Yes, you all read that right. Not 2-3 days or a week but 3 months of eating induction level carbs of <20 g/day.

First, I tried protein shakes. I thought I had low carb protein powder but was horrified to discover that each shake (and I was drinking 3-4 a day!) had nearly 20g of carbs each. Lesson number 1...it's really helpful to actually read the label and not just assume.

So I found a different brand of protein powder. And then another and another as I struggled with the taste and texture. The only ones that whipped up nicely like a shake and not a gloppy slushy mess were filled with carbs! Finally I discovered that I could add a bit of glucomannan powder and that would help gel it up and solve a few of the texture problems.

Then I re-discovered Think Thin bars. And man, were they tasty. So tasty that soon I was abandoning the protein shake for a delicious bar. Until I realized that maltitol has approx the same impact as straight sugar. Whoops. No wonder I still wasn't getting into ketosis...some nerve that company has selling those suckers as low sugar though.

So by this point, everyone in their right mind is saying, Remy, why don't you just eat some real food instead of trying all this crap food? And they would all be right...except I do not like food all that well. I especially do not like food that is not carbohydrates. In my younger years, I was perfectly happy drinking my calories in wine and living on Diet Coke and Marlboro Lights. Unfortunately, in my 40s this no longer seems like a workable solution.

So after 6-8 weeks of utter frustration, I gave in and resigned myself to lettuce, eggs, bacon and blue cheese dressing.

I also discovered I liked Bulletproof coffee in the morning. It was easy to add some of the collagen powder to it for a little protein too and it keeps me full well into the day. I've now modified the recipe to ditch the whipping cream for coconut cream and replaced half the coffee with Dandy Blend (dandelions!) which tastes surprisingly like actual coffee. Mixed in with cinnamon and maca and the like and it's a slam dunk.

But still, in and out of ketosis on my blood meter...and never strongly in ketosis. Usually I'd measure around .5-.7 instead of the 1-1.5 people talk about as the sweet spot. I was so frustrated! And frustrated because weight loss was so so slow.

So I had some labwork done...and discovered that my insulin was about 3 times higher than it should be and my leptin about 4 times higher than it should be. So I was/am severely leptin and insulin resistant. The only way out of those states (that I know of) is a low-carb diet, so I carried on (and bought every supplement I could find that purported to address those resistant states).

So here we are now, almost 4 months after I left all the carbohydrates behind. I'm having one cheat day a week now on Friday where I have a little bit of rice with sashimi. I'll probably get tuna poisoning next from mercury but at least it is tasty! Mmmm, spicy tuna roll!

I'm staying in ketosis better now. My meter usually reads over 1.0 no matter if I've had a few tomatoes or not on my salad. I'm still basically just eating chicken and salad...and watching my protein consumption much more strictly too.

And now I'm starting to finally see some weight loss. It's not to the point where I think it should be after what I've eaten (or not eaten!) for 4 months, but it's pretty significant. I can't say how much because I refuse to weigh myself until my old, pre-sick clothes fit again but it's enough that when I saw pictures of me running in the creek with the dogs over the weekend, I didn't want to throw up immediately. So, that's a win!

The best part though is how much better I feel. I resisted diet for so long because carbs were really my only source of pleasure after I got sick and removed everything else I liked from my life, including my own independence. I was NOT going to give up the potatoes too!

But someone asked me, not too long ago, if I knew the reason behind feeling better lately...and the answer was surprisingly simple - it's the diet. It was the right way for me to eat in my 20s and it's right for me still.

Most of you all probably know by now how much I like to try supplements and meds and gadgets, but changing my diet was the best thing I've done since I got sick. I just wish I hadn't waited so long now. And I hope that the effects are sustained and buildable and not just a function of feeling mostly better in general.

Here are some great podcasts on ketosis if you're interested and they address why such a diet may be so beneficial for our population as well given our myriad of metabolic issues.

Intro to Ketosis...by Dr Sarah Hallberg

Ketosis Grad School by Dr Richard Veech (student of Professor Krebs! Yes, that Krebs) on Bulletproof Radio

Ketosis for those who like the work of Dr Terry Wahls... @San Diego?

http://www.phoenixhelix.com/2015/06/06/episode-20-ketogenic-diets-with-terry-wahls-and-paul-jaminet/

 

[Who Me?]

Congrats on your long awaited success! I will not give up my Think Thin bars! I prefer to believe (delude myself) that manitol is better than regular sugar like in other bars.

 

[bobby]

@Remy awesome you found a diet that works for you! It takes some time and trial&error but when it works, you can feel it right away. For me diet is one of the things that have worked best in terms of symptom relief.

Have u tried and seen a difference with low carb low fat diet and ketosis?

I've tried that for a while but I felt so weak and had more cravings than ever. Low carb low fat, that's too many skipped food groups imo. No grain high fat, that has consistently kept me in ketosis for a few years with symptom relief. But diet is such a personal thing. And also, I've noticed that my food sensitivities are always changing. That's why I try to take an intuitive approach, which has worked well for me so far.

 

[Tigerlily]

Thanks Remy very interesting and thanks for the videos.

I would go ketogenic if it wasn't for my thyroid but last tsh seems fine though a little raised since IAP for three months.

My HbA1c has gone down from last year 7.2 to 6.3 and am now taking chromium and cinnamon and less carbo's. Hope to get there one day.

 

[Remy]

Thanks Remy very interesting and thanks for the videos.

I would go ketogenic if it wasn't for my thyroid but last tsh seems fine though a little raised since IAP for three months.

My HbA1c has gone down from last year 7.2 to 6.3 and am now taking chromium and cinnamon and less carbo's. Hope to get there one day.

The thyroid problems seem to mostly be related to low insulin levels so if you are insulin resistance, ketosis should not be detrimental to thyroid.

Have you tried vanadyl sulfate as an alternative to chromium? I switch back and forth.

Good luck!

 

[Tigerlily]

Thanks. I have hashis so it's autoimmune. A few weeks since l found that cutting carbs right down slowed my thyroid but this time it seems to be surviving it. Thanks l will try that. My post prandials have gone down a bit on chromium.

 

[Remy]

@Remy
Have or do u test blood ketones instead of urine ketones. Just read its more accurate??

Im still reading up on it but a guy called jimmy moore has mentioned this and has a few utube videos. He did mention not only cutting carbs but also protein to increase ketosis. I recall dr atkins mentioned this in a book but cant quite recall how to do this. I remember atkins would say to do this for only a few days and recall people using diet jelly and cream as a food source as its low in carbs and protein. Not sure what else one could eat but maybe one could replace a low carb meal with a jelly and cream meal once a day??

Now off to research it abit more.

I have a Precision Xtra meter. The meter itself was less than $20 but the strips are like gold unfortunately. I ended up getting them from Canada so maybe they will be less expensive in AUS too?

Atkins has a lot of ideas for induction level meals. Basically for me it was egg yolks, bacon and lettuce. Most of the protein in eggs is in the white and bacon is pretty low protein as well. The Bulletproof coffee with the collagen also worked out well for me since a scoop only has about 8g of protein vs the 15-20 that is in a normal protein powder.

MCT oil like Brain Octane will also help boost ketones. I wish I'd used it more in the early days.

 

[bobby]

@Strike me lucky Atkins Fat Fast? It's not without risk though... http://www.ruled.me/using-fat-fasting-technique/

some options for a single meal:

• 1 Oz. Macadamia Nuts
• Macadamia Nut Butter with 2 Oz. Cream Cheese
• 1 Oz. Chicken with 2 Tbsp. Mayonnaise
• 2 Egg Yolks with 1 Tbsp. Mayonnaise
• 1 Cup Coffee with ¼ Cup Heavy Cream
• 4 Slices bacon (be careful with this, as it dwindles under 80% calories from fat)

• ¼ Cup Heavy Cream whipped with Da Vinci Flavored Syrup
• 2 Oz. Sour Cream with ½ Cup Cucumber
• ½ Serving of Sugar-free Jell-O with ½ Cup Whipped Cream

 

[Remy]

do need to look for a cheap source of mct or maybe just coconut oil??

I think the best one is Brain Octane. Coconut oil isn't helpful for ketosis.

 

[Remy]

@Strike me lucky Atkins Fat Fast? It's not without risk though... http://www.ruled.me/using-fat-fasting-technique/

some options for a single meal:

Yup! That sounds like Atkins induction! MMMmmmm...not! Thankfully it's only for a short time typically.

 

[bobby]

so really something id use for 2 days then revert back to normal low carb food

from what I've been reading though it seems like we need 3 days to get into ketosis?

also, that atkins fat fast sounds like eating mayo straight out of the jar for every meal! yikes!

 

[Remy]

from what I've been reading though it seems like we need 3 days to get into ketosis?

It literally took me 3 months to get regularly into ketosis. My body was very resistant for some reason that I suspect is related to chronic illness. 3 days would have been like a miracle.

 

[Remy]

From what i have read, if you have been low carb for awhile your body gets better at using ketones as fuel so it may not show up in testing. But if that'sthe case i should be a lean mean machine but??

I think for us cfsers activity is an issue with increasing metabolism and also increases muscle cells insulin sensitivity. Rock and a hard place?

I think that's the rationale for why urine ketones don't show up as well after a while on low carb. But most of what I've been reading says urine strips are utter rubbish and it shouldn't be an issue anyways with the blood meter.

I do think it's a rock and a hard place but just don't give up after 3 days.

Tornado sirens tonight.

 

[bobby]

I think for us cfsers activity is an issue with increasing metabolism and also increases muscle cells insulin sensitivity.

From what I've seen online everybody says dietary fat + exercise is the golden combination. So that's where we get into trouble...

I think that's the rationale for why urine ketones don't show up as well after a while on low carb. But most of what I've been reading says urine strips are utter rubbish and it shouldn't be an issue anyways with the blood meter.

another way to know if you're in ketosis is the smell of your sweat... reminiscent of cat pee or ammonium

 

[Upgrayedd]

@Remy - you are speaking my language. I've been a devotee of a ketogenic diet for over a year. Most of the time, I'm pretty strict with what I eat. I haven't had pasta, bread, grains, most fruits or starchy veggies in all that time.

I think overall, I feel better than when I was eating more carbohydrates, but it hasn't been the magic switch that cured me. I still struggle with a lot of the usual CFS/ME problems. And, contrary to so many articles on the subject, a ketogenic diet has not greatly improved a lot of my blood markers. My trigycerides came down a bit to a normal range, but my cholesterol is still very high, and my fasting blood sugar and a1c are what the docs call borderline pre-diabetic. I can't for the life of me figure out how my insulin and blood sugar are not lower when I eat almost no sugar or carbs of any kind most days.

I think the ketogenic diet helps, and when I do hit ketosis, I have moments of clarity and feelings of well being that make me almost believe I'm normal again. But it is hard to maintain those moments. I think our systems are just so dysfunctional that it takes a long time to change them, or maybe one day cure them.

For the time being, I plan to keep the carbs to a minimum and keep eating as much healthy fats as I can, which for me include animal fats, eggs, avocado, fish and fish oil, evening primrose oil, olive oil, MCTs.

 

[Remy]

figure out how my insulin and blood sugar are not lower when I eat almost no sugar or carbs of any kind most days.

I think this almost has to be related to HPA axis dysregulation, specifically cortisol and adrenaline problems.

When those two are too high, it's almost impossible to stay in ketosis or keep blood sugar low no matter what the diet.

It's very frustrating.

 

[Remy]

http://www.questnutrition.com/protein-powders/coconut-oil-powder/?utm_source=Going KETO Pt 3 - FLEX&utm_medium=Going KETO Pt 3 - FLEX&utm_term=Going KETO Pt 3 - FLEX&utm_content=Going KETO Pt 3 - FLEX&utm_campaign=Going KETO Pt 3 - FLEX

Just of interest as i never seen coconut oil powder and they also make a mct oil powder. Apparently easy to use with protein drinks.

Well I'll be.

Probably good to mix into cream with diet jelly for fat fast low carb/protein stint??

It's all about the C8 if you want help with ketosis though and neither coconut oil nor MCT oil will provide that in sufficient amounts. If you just want a healthy fat, sure, have at it. But if you want a ketosis bump, the only thing out there is Brain Octane oil right now. Hopefully that will change in the future because more options usually means lower prices.

 

[San Diego]

I went on Wahl’s ketogenic diet about a month ago. I produced ketones on day 2, so apparently I easily slip into ketosis. (maybe due to my Scandinavian heritage???)

The trouble began after about 2 weeks. I became progressively weaker to the point of fatigue unlike any I’ve known before (and I’ve been bed bound a significant portion of the past 4 years)

I’ve added back plenty of carbs, but am still in ketosis. In one month, I’ve dropped 10 pounds. Yikes.

All that to say, I think having 1/3 cup canned, full fat coconut milk in my coffee twice a day put me into ketosis and kept me there regardless of what I ate the rest of the day. Could that be??? Or does it just take time to get out of ketosis? Or maybe my system is so messed up that I was going in and out of ketosis but never checked until recently?

Needless to say, I dropped the coconut milk. It’s really scary being so fatigued I struggle getting the restroom.

 

[Remy]

I went on Wahl’s ketogenic diet about a month ago. I produced ketones on day 2, so apparently I easily slip into ketosis. (maybe due to my Scandinavian heritage???)

The trouble began after about 2 weeks. I became progressively weaker to the point of fatigue unlike any I’ve known before (and I’ve been bed bound a significant portion of the past 4 years)

I’ve added back plenty of carbs, but am still in ketosis. In one month, I’ve dropped 10 pounds. Yikes.

All that to say, I think having 1/3 cup canned, full fat coconut milk in my coffee twice a day put me into ketosis and kept me there regardless of what I ate the rest of the day. Could that be??? Or does it just take time to get out of ketosis? Or maybe my system is so messed up that I was going in and out of ketosis but never checked until recently?

Needless to say, I dropped the coconut milk. It’s really scary being so fatigued I struggle getting the restroom.

It sounds like you may have been producing ketones just fine but that your body never adapted to using them as fuel hence the extreme fatigue. It takes time to switch fuel sources. In my case, it took months.

Coconut milk is great but I think you need more fats like butter and C8 oil.

Ultimately, I found it extremely worthwhile to persevere even though it was frustrating at the time.

 

[San Diego]

It sounds like you may have been producing ketones just fine but that your body never adapted to using them as fuel hence the extreme fatigue. It takes time to switch fuel sources. In my case, it took months.

Coconut milk is great but I think you need more fats like butter and C8 oil.

Ultimately, I found it extremely worthwhile to persevere even though it was frustrating at the time.

So I shouldn’t necessarily give up? I guess the trick is finding the highest carb level that still allows ketosis? Were you fatigued during the months of adjustment? (months! yikes!!!)

What is C8 oil?

Thanks.