circular wrote:First a comment as an aside for the benefit of newer readers new to ketogenic diets (if any are reading this thread): You mention being in "mild ketosis" at 3.3. I have thought .5 - 1.5 or 2 or something is mild. Someone can go to 5 or 6, maybe especially if they have epilepsy or brain cancer or are doing extreme fasting/exercise such as our rockstar George does. But I think these should be considered outliers rather than the standard next to which 3.3 would be considered mild. Let's not forget that Stephen Cunnane thinks we only need about .5 to feed our brains. In that case 3.3 is a pretty hefty dose of ketones! Just thought it good to keep these numbers in perspective for the forum as a whole. Maybe this should be its own thread.
I know that Julie already addressed the matter of what mild ketosis means, but I just wanted to add that in The End of Alzheimer's
, Dr. Bredesen says on p. 180: "Aim for about 0.5 mM to 4 mM betahydroxybutyrate." He does use the term "mild ketosis" on the preceding page, so I'm assuming this is his range for mild ketosis. However, what Julie wrote about Dr. Cunnane's recommendation makes a lot of sense to me. If I had edited Dr. Bredesen's book (having worked as a technical editor for 13 years; oh my, what a pleasure that would have been!), I probably would have requested clarification on what he considered the range to be for mild ketosis and when someone should aim higher versus lower.
That comment dovetails with another observation with all the talk about extreme fasting ... namely that we begin to easily suggest a standard that may be completely unnecessary for many to achieve an excellent healthspan and lifespan and that could make lots of readers feel unaccomplished when they undershoot it. Therein lies your good question about how necessary the long fast and very-low animal protein intake are for you. I'm with listen to your body.
Thanks for this advice. Given what you and Susan have suggested, I think I'm going to listen to my body on a day-to-day basis. If one day, I feel great and not particularly hungry, I'll aim for 14 hours; but if I start feeling too hungry, I'll just go ahead and eat. If on another day, I wake up ravenous, I'll just make sure I make it to 12 hours. Every day is different.
I also have the issue of not getting enough calories in during a smaller eating window. My stomach feels full quickly. If I push it I get reflux, so I eat to comfort and then whatever I got in is not going to carry me 16 or more hours every day (although occasionally I easily go 15 hours for whatever reason, and I always welcome and enjoy these days). My practice is to fast in the morning until I've felt good and hungry for a while, but not ravenous or where I can't accomplish anything because my brain is offline. I don't see the point of being ravenous when I know I can't make up the calories and then sleep through the next night without hunger.
If I go past a certain point of fullness, I'll get reflux as well. It will interfere with sleep, perhaps for hours. It's just not worth it. And if losing concentration is your signal to eat, I'd say you're doing your body good by listening to that. An offline brain isn't particularly helpful.
I'm wondering if you don't notice cognitive benefits because you've been generating ketones a long time. I remember when you first started testing and were surprised to find you were already generating ketones. Maybe you're just used to their cognitive benefit?
The cognitive benefits I've experienced came before I went into ketosis, as I implemented the Muses Labs protocol. I would like to see more cognitive benefits. My ability to sustain attention is a significant issue, as is mental fatigue. And my memory for details is definitely not what it used to be.
Dr. Gundry said my IGF-1 was perfectly good at 118 ng/mL (<130, while the lab reference range was 60-217) and that was while eating more than his prescribed 20 gms animal protein/day, probably more around 60-90 gm but I wasn't counting. It's not what I consider high protein, but not very low either, being his 20 gm target everyone talks about. He said if I wanted to push it lower and be in the centenarian camp, I could do so by eating less animal protein. Being a centenarian isn't high on my list though. I'll be thrilled to advance my healthspan from whatever baseline I'm at at any given time.
Could you possibly elaborate on the connection between IGF-1 and protein intake? A year ago, my IGF-1 came in at 46 ng/mL. I asked my endocrinologist at the time what that meant. She said it was because my fasting insulin was so low (due to being in mild ketosis). She wasn't concerned about it. Here's the reference range from my results, but this make it appear I'm in my 70s (though I'm 57).
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ApoE 4/4 - When I was in 7th grade, my fellow students in history class called me "The Brain" because I had such a memory for detail. I excelled at memorization and aced tests. This childhood memory helps me cope!