Help! I'm going under

[Lindy]

Hi Lindy, Like many of us pursuing the goal of full-time mild ketosis, I have struggled with maintaining my weight, passing through "Wow, you look great!" a few months in to "Are you okay?" a few months later and a few lbs lower. I also was asking myself that in the mirror since though I felt great I was looking very thin.

Floramaria, that is exactly what I do. My mirror is brutally honest and although I tell people who think I'm thin that I feel great, never better, I sometimes wonder if feeling OK is enough.

Here in the US, we have a really skewed idea of what a healthy person looks like since most people are overweight. So family members who are really concerned about me (and are also overweight) don't realize that people could actually be fine at this weight. The self-questioning may partly come from the fact that our points of reference are off.

From notes I took of an online town hall meeting with Dr Bredesen, he answered a question regarding a person with BMI of 19 who was struggling to maintain weight. His recommendation was for that person to cycle in and out of ketosis, allowing one or two days a week where dietary restrictions are liberalized. And though I couldn't find it in notes today, I have also heard him say on forums that people who are concerned with prevention can be more lenient than those who are already experiencing cognitive decline and trying to reverse it.

I hope I'm still in the prevention phase - anyway, coming from him, this is encouraging, thanks!

[Stavia]

A few thoughts:

OMEGAS
An omega 1:1 ratio is almost impossible if one is eating nuts. And you need nuts for the calories. What I recommend is stop tracking it, avoid industrial seed oils, supplement a gram of omega 3s, and stop worrying about it at this stage.

SUGARS
Youre exhausting yourself tracking these and your target us too low. 2 servings fruits a day. Non-refined veggie carbs as you are doing. I would petsonally recheck your HbA1c in 6 months.

Blood glucose is a very inaccurate marker and varies over every few minutes. Insulin secretion is pulsatile. 76 is just fine. I think you are worrying unnecessarily and you have overreacted unnecessarily. My waking blood glucose is in the 90s but my HbA1c and insulin are excellent. Its the overall picture that matters. Not just one isolated marker that is known to be non-specific and have a large variability.

This is not medical advice, just my general thoughts. Please discuss with your doctor.

And yes I get brain fog when I cheat more than a certain amount. Like eat a pizza.





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[McGido]

From notes I took of an online town hall meeting with Dr Bredesen, he answered a question regarding a person with BMI of 19 who was struggling to maintain weight. His recommendation was for that person to cycle in and out of ketosis, allowing one or two days a week where dietary restrictions are liberalized. And though I couldn't find it in notes today, I have also heard him say on forums that people who are concerned with prevention can be more lenient than those who are already experiencing cognitive decline and trying to reverse it.

This is kind of what I'm gearing towards. Allowing myself a few days of a more liberal diet. Indian food and Sushi are usually my go to's. I do have a keto-mojo, and have tested my blood sugar after these meals and it's not spiked, and I also am right back in ketosis the next morning. Still testing the boundaries.

[Jafa]

Haha Lindy, You sound like a much more clever version of myself. I get bogged down in detail too and the sat fat is a real bogeyman when you have spent your entire previous life (BF - before forum ) minimizing it. That and rabbit hole tangents (of which there are many on this forum) often mean a long and winding journey to answer a question. But hey, it’s an education isn’t it? Can’t be bad for the brain.
Thanks Susan, Slacker and Stavia, for your wise words as always.

[floramaria]

Haha Lindy, You sound like a much more clever version of myself. I get bogged down in detail too and the sat fat is a real bogeyman when you have spent your entire previous life (BF - before forum ) minimizing it. That and rabbit hole tangents (of which there are many on this forum) often mean a long and winding journey to answer a question. But hey, it’s an education isn’t it? Can’t be bad for the brain.
Thanks Susan, Slacker and Stavia, for your wise words as always.

You are pretty clever yourself, Java. “BF”....that is great!!!

[circular]

Lindy, add me to the club.

I feel full fast, I fast at least 12 hours, but I usually start getting hungry right at 12 and go ahead and eat what's usually a light breakfast (2 eggs, a shot glass of goat kefir, some nuts). If I'm not hungry yet I keep going, but I find that if I'm getting hungry and don't eat I get really angry, and it's not my personality. I really become someone else. The same thing happens even if I'm not fasting past 12 hours and eating as much as I feel I can, but I add in decent exercise. The only way I've been able to avoid this anger problem is eating at the 12 hours and not doing too much exercise. But it doesn't seem to be insulin resistance, because this happens while I'm in ketosis. And the problem is, the first sign that I'm way too hungry isn't hunger, it's a burst of anger. I have never been like that. In any case, rather than do ratios or calories or percentages, I just check on my ketones in the afternoon. They usually run .3-1.5. If they're getting down to .3-.5 then I deliberately avoid carbs until they're back up. Sometimes I'm quite surprised at my ketone level, when it's either higher or lower than I expect. I'm going to try higher levels of ketosis and see if the anger thing gets better. It sounds like hypoglycemia but I've been doing this a long while with ketones. I would think I'm adjusted? Or maybe need higher levels?

I have skinny stick legs yet a bit of fat at my waist. My waist inches and waist to hip ratio are still in a safe zone, and the fat is subcutaneous rather than visceral. I don't worry about it. I like that it helps keep my BMI where it is. I'm 5'6", 120 lb, and have BMI of 19-20. I wouldn't mind it higher, but not if it adds more fat at my waist. What works best for me for weight gain are nuts, green bananas and resistance training/muscle building. I honestly think if you're getting enough calories, with whatever diet works for you, that muscle building is the way to keep being low BMI from being frailty, and I'm learning -- if I'm not being misguided -- that for muscle building we need more protein and leucine than we think. It's one reason I've been on this protein riff lately, because of the many who are in keto and complaining about difficulty keeping weight on and feeling robust. I'm beginning to suspect that many are going too low on protein, but I really don't know enough about this for anyone to rely on my statements.

I wonder about your energy levels being lower. You could also try not forcing such a long fast. Maybe spreading your food out over a longer period will feel better. It might be worth a try before exiting keto altogether, so you won't wonder if that adjustment would've helped. I occasionally wonder whether I'm missing out on such magic regenerative elixir by not fasting 14-16 hours, but I've got to have stability and listen to my body too. Maybe at higher ketone levels it will come more easily. I think some of the fasting benefits don't kick in until three or four days, thus the rise in people doing extended fasts. Until I'm in a place to do that I'm not worried about most of my fasts being only 12 hours.

[circular]

This is kind of what I'm gearing towards. Allowing myself a few days of a more liberal diet. Indian food and Sushi are usually my go to's. I do have a keto-mojo, and have tested my blood sugar after these meals and it's not spiked, and I also am right back in ketosis the next morning. Still testing the boundaries.

This is why I'm still a finger pricker ( Susan). I also allow myself sometimes to venture out of my home-base diet at restaurants (Indian and sushi two of my preferences as well) and then check the reaction. Those are sometimes the times my ketones go down to .3-.5. Once I had a small gluten free pizza, ate it all, and stayed in ketosis. I guess the thin crust helped. Have no idea what it was made of. Usually at restaurants though it's salad and protein with my down oil and vinegar dressing.

[Lindy]

This is kind of what I'm gearing towards. Allowing myself a few days of a more liberal diet. Indian food and Sushi are usually my go to's. I do have a keto-mojo, and have tested my blood sugar after these meals and it's not spiked, and I also am right back in ketosis the next morning. Still testing the boundaries.

McGido, this points out something I'm missing (like Susan). No keto-mojo because I am deathly afraid of hurting or infecting my fingers, which are essential to my work. It sounds like your keto-mojo is providing enough data that you can make some rational choices as you go along. I am starting to think about whether I should get one along with all the paraphernalia that goes with it. Lots of internal resistance. How are your fingers feeling?

[Lindy]

A few thoughts:

Thanks, Doctor (or maybe I should say Professor at this point?), the advice on omegas (nuts) and sugar tracking is great and I've removed the sugar limits from Cron-o-meter, given that I have had 0 consistently in the "added sugars" category for four months. I will ask HbA1c to be rechecked in a couple months.

Re: the exceptionally fine blood glucose level I had a couple of months ago after starting the protocol - my doctor was extremely impressed and I was pretty heartened to see such positive feedback to my switch in diet (76 was 20 points lower than my previous "best" level from the past two decades, which was 97 - my "usual" was 100-120, with a "oh-no-I'm-going-to-die worst" at 169). So although one test isn't dispositive or maybe even indicative, at least this one lent a psychological boost to my otherwise demoralizing sugar ban, and helped cement it into a confirmed habit.

And yes I get brain fog when I cheat more than a certain amount. Like eat a pizza.

I would say that is the best closing statement ever. I will not inquire as to when you last ate a pizza.

[Stavia]

A few thoughts:

Thanks, Doctor (or maybe I should say Professor at this point?), the advice on omegas (nuts) and sugar tracking is great and I've removed the sugar limits from Cron-o-meter, given that I have had 0 consistently in the "added sugars" category for four months. I will ask HbA1c to be rechecked in a couple months.

Re: the exceptionally fine blood glucose level I had a couple of months ago after starting the protocol - my doctor was extremely impressed and I was pretty heartened to see such positive feedback to my switch in diet (76 was 20 points lower than my previous "best" level from the past two decades, which was 97 - my "usual" was 100-120, with a "oh-no-I'm-going-to-die worst" at 169). So although one test isn't dispositive or maybe even indicative, at least this one lent a psychological boost to my otherwise demoralizing sugar ban, and helped cement it into a confirmed habit.

And yes I get brain fog when I cheat more than a certain amount. Like eat a pizza.

I would say that is the best closing statement ever. I will not inquire as to when you last ate a pizza.

About 6 weeks ago.
When I get overwhelmed and exhausted and there is no food at home and I've been working for 12 hrs straight for days I fall off the wagon. Blue cheese and caramelized onion pizza. Made me feel better for exactly 10 minutes

We are human honey. Its impossible for most of us to be perfect all the time. (Except Tincup lol but he does really enjoy the tracking)

I've aimed at getting to a place where my diet is within a range of parameters and I don't track anymore. Its not a rigid range. I believe that we are evolved to thrive on a wide range of macronutrients. Also within reason, micronutrients. I believe that so-called "daily requirements" of micronutrients are unnecessarily specific and often the number chosen is arbitrary and without sufficient evidence (like the 1000mg calcium a day. When you see a round number, its gotta be inaacurate and arbitrarily chosen because its nice and neat). I believe that worrying about meeting these likely inaccurate for me and reductionist numbers on CronOMeter is unnecessary worry and a waste of my energy. Obviously I'm not silly and I don't ignore obvious stuff. But for instance I have great bone density so I ignore my calcium intake of about 600mg a day being "under target". My Blood Pressure is excellent at around 90/60 and my renal function normal so I ignore that CronOMeter says my potassium intake is too low. There are two really important principles here - we say in Medicine - treat the patient not the (blood test) number. And its always, always about context. This is where (no disrespect, members have done an awesome job of learning biochemistry and often know more than my colleagues) laypeople go wrong in googling. They don't have the training or experience to interpret bloodwork numbers in the context of the whole picture. So they worry unnecessarily about a number that is slightly out of range of an arbitrarily chosen "normal" value which is honestly probably often only valid for 95% of healthy people.


And I don't beat myself up when I cheat, because I know I bounce back. This way I'm not obsessing about details of food, and can spend energy on other healthy and fun things like excercise, reading, learning piano, hanging with family n friends etc.



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