Ketogenic Diet: Transitioning, Experiences, Reasons, Cautions ...

[circular]

I recently tried to achieve mild ketosis. I've stopped the experiment for now. I wasn't prepared for the transition and need to think about this some more. On top of there being no long-term RCT trials to show it will help prevent AD for E4s or 3/4s, if I'm going to try again, I need to to have a trustworthy electrolyte management plan ready (not too many not too few), as well as be well stocked with exogenous ketones to ease the transition.

For now I am wondering …

I think it was at the conference in NY about diet and Alzheimer's that a speaker gave a range to shoot for, maybe 1-2 mmol ketones? I remember Stavia and others being excited because it was so doable. I can't find the thread. Can we revisit this? How is it doable?

I have a lot of questions, but if people could share their ketone target and what it was like getting there and how they managed the transition I'd appreciate it.

One of my worries is being thin already and having low normal blood pressure and how to balance electrolytes without doing so 'blindly'. I think the conference speaker said thin people should use exogenous ketones, but I don't get enough from coconut oil, or I am afraid of ingesting too much of it if I'm not keto, and supplements like Ketoforce require citric or other acidic medium which I don't tolerate.

During my *very* brief experience with mild, mild ketosis, a different person was emerging. I could see the light and at moments felt a couple decades younger but these moments were interspersed with the keto flu. I wasn't prepared for the roller coaster adapting, and not knowing if adapting would take me just a couple more days or a month.

The electrolyte issue concerned me because of my lowish blood pressure. I took in so much salt I retained water around my belly and couldn't evaluate if I was gaining weight due to the extra fat calories or not. (Also upped magnesium but had no potassium supplement on hand and for various reasons couldn't get to the store to get some lite salt.

I had to up my animal protein and that ups the histamine issues, and avocados, a fat staple of keto dieting, are high in tyramine if not also histamine and I'm homozygous on MAOA. I seem to react to them along with umpteen other foods.

Anyway, having taken myself out of the very mild ketosis I was in, I'm back to my old feel horrible self, at least for today. My circadian rhythm, which seemed to have corrected immediately even in the mildest keto (unless it was a4-5 night aberration or due to some other cause), fell apart just as fast.

I'm definitely in a no woman's land at this point. There seem to be good and bad in both directions and I'm now at a crossroads. I wonder, as an 3/4, if something as extreme as a keto diet is going too far. IF my apoe4 wants keto (we all know the jury's out on that!), what does my apoe3 want and need?

One voice says mild keto's the way to go, another - coming from fear I think - is that it's too extreme and I should be fine on a low carb diet with some coconut and MTC oil to tolerance (which is low for capric acid).

This is quite the complex arena!

[LG1]

Circular, hello.

I use http://www.amazon.com/Jigsaw-Health-Ele ... B014X0MHQC on occasion. You might check it out. Pretty sure I first heard about it from a Jimmy Moore Podcast.

I don't lose weight on keto unless I also restrict calories or IF. Right now that is exactly what I am doing.

I think IMO your weight loss on keto will level off after a short time. You might see how you do and then experiment with going out of ketosis on a schedule to allow for more weight gain, if that remains an issue.

Good luck and I am really interested in seeing how you do.

Laura

[circular]

Thanks Laura. I checked out the supp. It has some things I can't take, like methyl versions, and other things I already take another way, so I think maybe that one is too much of a cocktail for me. I wonder if just drinking water with electrolytes added is enough to counteract the keto water loss?

I'm interested in seeing how I do too haha! I think if I can cross the rubicon I will do better. It's a doozy to wrap one's brain around.

Juliegee mentions eating fat at about 65%, which is lower than what I keep reading keto is, but I know she does mild ketosis. My biggest mistake the first day was I actually *under*ate carbs while trying to ensure enough fat intake. Since I wasn't adapted I got no energy, or so I think. Any my electrolytes fell off. Not good.

I want to find my sweet spot for mild keto, through diet and/or supplements, but I think in large part diet.

[apod]

In the past, I've tried a ketogenic diet and really enjoyed the way it felt. Unfortunately, I didn't measure cholesterol / lipids, a1c, glucose / insulin, or ketones during this time (I stayed in this state for close to a year straight.) I wasn't measuring food intake, but I was somewhere in the 3,000kcal ballpark with very minimal carbohydrates outside of some post-prandial zucchini and tomato for some potassium (consistent 30-50g carbs per day.) At this point in my nutritional studies, I wasn't against fried foods / animal meats / saturated fats, so I was drinking MCT before workouts, coming home to packs of bacon and large fatty ribeyes cooked in ghee, and snacking on balls of cheese, bars of extra extra dark chocolate, cups of macadamia nuts, and having soups with layers of coconut oil on top. This felt fantastic.

I then transitioned toward a low-SFA diet (<15g per day @ <7%) with periods of very high carbohydrate refeeding -- much less energy here both at a caloric surplus and caloric deficit, but the food was delicious having avoided the taste of sweetness or fruits for so long and I hit my all-time high ratio of lean mass:body weight. Eventually this hit a pretty extreme zone where I was eating bowls of rice, several potatoes, and going through entire bunches of bananas and fistfuls of dates in single sittings. Once I started measuring post-prandial glucose, I dialed way back.

Now, I'm somewhere around the mediterranean levels (7.5-10% SFA @ 45-55% fat and 2200-2400kcal.) Measuring carbohydrates, I seem to eat around 100-175g net (~150g/d divided by 2 meals), with fiber intake up around 60-100 grams per day, where my total carbohydrate intake might be up around 225g some days. Ketones between breakfast and dinner seem to raise up to around 0.4-0.6mmol/L of BHB, which is similar to the levels I measure before breakfast. Before bed and after exercise, I believe I'm closer to 0.2-0.3mmol/L. This seems to be a sensible range of mild ketosis, moderate carbohydrates, moderate fats, and moderate protein with moderate periods of fasting without going too far off the deep end. It feels good, but not quite as nice as 3,000kcal per day with tablespoons of MCT and massive amounts of coconut oil / butter / bacon / ribeyes.

I tend to have low blood pressure as well. I usually add salt or something salty to most things I eat (even if I make a protein shake -- salt is added.) If I don't do this while eating two meals a day, just eating 1 meal relatively straight-up drops my sodium intake by ~50%, or almost completely if I do this again at dinner time. BP lately has been measuring around 90/60 with resting pulse around 43, despite a pretty good coffee habit and occasionally drinking salt water. Lately, I'm supplementing magnesium as Magnesium Creatine Chelate. Potassium intake is no issue at my current carbohydrate intake, but it was an issue for me at strict ketosis levels.

[circular]

Thanks apod! I wonder if the recommendation out of the diet conference was actually a range under 1 mmol? I've been understanding that to be a fairly non-therapeutic background level per Phinney and his bud (Vole?).

I hope more chime in with their details WRT this...

[LG1]

Apod has a good point. You can add salt, I hear Himalayan salt is a good one? You can add a daily supplement of potassium and magnesium in the form that suits you. Lots of water! Chicken broth or bone broth is good.. sure, electrolytes in water, perfect.

I'm not sure what your reasoning is for wanting to be 'in mild ketosis'. Is it that you have some medical concerns about it or are you worried you won't find it palatable? IMHO, over 1.0 will give you the best benefits of ketosis. Mild ketosis, assuming it means making ketones around .5 to 1.0, is still terrific!

You could definitely start at 65% fat and see if that makes ketones for you, then up tweak it as necessary. Would you do protein at 20% and carbs at 15% or 25%/10%?

If you do go forward with it, you should strongly consider the Precision Xtra glucose and ketone monitoring device. The ketone testing strips are expensive but extremely motivating and you can taper off their use once fat adapted.

Be careful not to over eat protein. Even though I knew this, I did not realize I was doing it. Especially easy to forget that milk has protein in it... I love my Kalona Whole Milk! My favorite foods right now are brussels sprouts with bacon and toasted pine nuts and scrambled eggs finished with cream cheese and greens sauteed in grass fed butter, yummy.

[hill dweller]

For keto diet, I don't count fat grams or protein grams. I limit only carbs (try to stay under 20 - 30g/day). This is basically Atkins.

Lots of greens cooked in coconut oil, handful of nuts daily, lots of garlic & spices, shrimp, eggs, fish, pork, chicken, goat cheese. Usually half a piece of fruit for dessert (orange or apple). Again, I don't count out anything but carbs, and since my husband isn't doing keto, much of what I eat depends on his meal choice. Since I've been doing this, he has voluntarily cut out rice and pasta, and of course, he loses more weight than I do.

What really does the trick is stopping all eating at least 4 hours before sleep. And then no food (coffee, tea, bone broth -- ok) until 17 - 18 hours after that last meal. So, if I finish dinner by 6 pm, lunch is at noon the next day. That's doable for my schedule.

Generally, I'm not that hungry at lunch, but I eat a good meal. Then, I'm really NOT hungry by 5:30, so that meal is pretty light. That 18 hours fast sort of cuts the calories for me.

[hill dweller]

Oh, almost forgot. Beverages are tricky. No milk (one cup has about half of the daily carb ration). That leaves water. And unsweetened teas and herbal infusions like rosehip, peppermint, chamomile. I usually just go with water.

[circular]

Thanks, it's so helpful to read others approaches. The three things I'm most worried about, the first only requiring habits:

1. Getting my electrolytes out of whack. Along with my low normal BP I live in the desert and need time outdoors in the sun. It's very easy to get dehydrated even without being on a diet where you regularly lose a lot of water and electrolytes. So this is probably just new habits, but I don't like not knowing if I'm oversupplementing one or another electrolyte or adversely affecting their ratios?

2. I'm worried about weight loss. I'm already very skinny. Was just at the doc and had lost two pounds to 117 at 5'6" since dropping my carbs.

It's confusing because I do have some fat accumulated around my middle (although my proportions are preserved) and other signs of insulin resistance. However my glucose measurements are very decent in the scheme of things (when not in ketosis). I was sometimes dx with PCOS and other times docs said no. I'm beginning to think that was a correct dx with mild presentation. I have a study that women with PCOS and normal glucose levels hypersecrete insulin after meals. Dr Kraft's insulin assay could determine if that's happening with me. PCOS is known to involve insulin resistance and respond favorably to lower carbs. A small pilot study showed improvement in PCOS symptoms on a ketogenic diet. Most women with PCOS are overweight but not all.

In short I seem to be "skinny fat" and a good candidate for mild keto independent of ways it *may* benefit e4, but at the risk of weight loss. I need to lose the belly fat (I think it was spurred by a raise in estrogen dose) but not overall body weight. The answer is to build more muscle which I need. Keto seems to give me better stamina and energy for that, but it will also burn more calories, and I have early satiety and trouble consuming enough during the day without night time hunger even when I'm too unwell to exercise much. I can fast 12-14 hours, but it starts when I eat before bed so I can sleep through the night. Not ideal but required.

3. No long-term RTC studies in e4 and/or PCOS.

I think keto will straighten out a lot of things but may also introduce problems. Will just have to see.

Bought Morton's Lite Salt with electrolytes today and can focus on using bottled water with electrolytes added.

[LG1]

IMO: The use of electrolytes should only be temporary as you lose water at first... also a reason you saw -2 lbs. You might consider quitting your supplements that contain the potassium and magnesium for a few weeks if that is what you are worried about regarding using the electrolytes? You can just add them back once you are fat adapted. The only way to see if it works is to try it... for a month I would say. I was adapted within a few days to a week. I would assume you would be too... so just wait and see if all things including weight loss even out after you adapt.

Adding weight training is a fabulous idea!