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

[mike]

I use a combination of Lite Salt that has potassium especially

Circ, Lite Salt has potassium chloride, which I've been told is not a great form - instead Potassium Citrate or bicarbonate is safer...

[xactly]

Just did Rhonda Patrick's new comprehensive genetic report. Found this genetic gem, which might help explain why I feel better with higher amounts of carbs in my diet. If anyone else feels worse on keto or just not getting the results you expect, there might be a genetic component. It's one gene whose research I plan to watch.

Thanks for posting this. I'm heterozygous for that SNP. It's interesting to read that exercise seems to offset the effect by boosting FGF21 production.

I really, really wish someone would put together an AI program that would enable us to load all of this genetic information plus lab test results and updated research. (For instance, thanks to Tom Dayspring and Peter Attia, I now know that ApoB and LDL-P are really important but fugeddabout LDL-C.) We could use this program to put together a comprehensive set of nutrition and lifestyle recommendations.

Some things I know are unchanging regardless of genotype/phenotype: get lots of exercise, plenty of sleep, and do your best to minimize stress. Everybody should probably fast and/or engage in time-restricted feeding. But there are so many genetic variations that combine to reinforce or offset one another that it's difficult for the owner of a genotype to figure out how to run the darned thing.

I love reading my results from Rhonda Patrick's program; however, my SNPs seem to range from "yay! you're going to live to be 100!" to "you are going to die in a car wreck tomorrow " If the latter is the probable outcome, I'm going to find a chocolate cake and eat all of the icing off it right now. And, I'm going to blame it on the rs838133 SNP.
/rant

[circular]

Just did Rhonda Patrick's new comprehensive genetic report. Found this genetic gem, which might help explain why I feel better with higher amounts of carbs in my diet. If anyone else feels worse on keto or just not getting the results you expect, there might be a genetic component. It's one gene whose research I plan to watch.

FGF21 rs838133

Susan do you have one or two Ts? I have one T there. I don't have any trouble going in and out of ketosis, and spend most of my time at .5 - 1.5 mmol, randomly going higher or lower. It's not due to exercise offsetting the effect of FGF21, since I haven't't gotten much exercise in the last year for a plethora of reasons. I almost certainly have some insulin resistance at my baseline diet before keto, based on symptoms, although my A1c would come in below or right near prediabetes. I know that's too high. I haven't checked A1c in a long while and while mostly in mild keto.

[SusanJ]

Susan do you have one or two Ts?

Just one T. And I don't check ketones.

I will say that with pretty low carb (50 grams-ish), and I just didn't feel my best and it was impossible to stabilize my weight. And that was after many years of low carb, gluten free, dairy free, healthy eating - not keto flu for sure.

I'm up to somewhere in the neighborhood of 150 grams (some days more) and I feel much better. My last A1c was 5.2. About 2 years ago, the 150 grams yielded me about 5.6, so it might be related to gut work, PC (maybe improving fat absorption?) and creatine (improving methylation). Lots of moving parts, as you well know, to just point at just one snp as the culprit.

But I'm with xactly, 'cause I have a lot of hetero longevity genes (thanks Mom), and ones that aren't so nice, so if I'm going down, bring me the chocolate cake and icing.

[apod]

I use a combination of Lite Salt that has potassium especially

Circ, Lite Salt has potassium chloride, which I've been told is not a great form - instead Potassium Citrate or bicarbonate is safer...

I use potassium chloride as well -- I'm curious to hear more about citrate / bicarb being a better option. The last time I bought Lo Salt, I grabbed a 3-pack, so I've got a ton of the stuff.

I did just recently see Potassium Bicarb in the SeekingHealth shop. I asked them about taking it outside of a meal (since to me, it seems like you wouldn't want to alkalize your stomach while trying to digest food), but they responded back with a sort "whatever you do, don't take it on an empty stomach" sort of stance.

[mike]

Chloride is a mineral salt, and potassium in food is usually organic salts like citrate, bicarbonate and malate. It is harder for potassium chloride to get into the cells, and can lead to too high blood levels. Also, Citrate, and not Chloride form seem to help insulin sensitivity and blood pressure

https://www.ncbi.nlm.nih.gov/pubmed/272 ... XCzqX-mIa4

That being said, after you asked, I went looking, and probably found as many keto sites saying to use the chloride form. I guess my worry would be that it is easier to get too much when doing chloride form. I currently take 3 gram of citrate in powdered form - seems most cost effective. I take it in one swallow in the morning with enough water to create suspension, but I hear others need to dilute it and take over the day.

[TheBrain]

Just did Rhonda Patrick's new comprehensive genetic report. Found this genetic gem, which might help explain why I feel better with higher amounts of carbs in my diet. If anyone else feels worse on keto or just not getting the results you expect, there might be a genetic component. It's one gene whose research I plan to watch.

A study in FGF21 knockout mice (missing the FGF21 gene) showed that these animals did not respond well when
fed a ketogenic diet. The mice had impaired glucose tolerance, weight gain, triglyceride accumulation in the liver and reduced ketone formation. The authors propose that FGF21 action is needed to utilize fatty acids as the primary fuel source. Individuals with the T allele may be less suited to a ketogenic diet due to decreased expression of FGF21 which plays an important role in ketogenesis, however, more evidence to support this idea is still needed.

FGF21 rs838133

Anyway, if you're looking to tweak your diet or supplements, then Patrick's comprehensive genetic report might give you some places to look.

I find this fascinating. I'm AA on rs838133. So I'd presumably have a significant issue with a ketogenic diet, if what's described here is supported in further studies.

In my case, I'm losing weight on a ketogenic diet. My massage therapist says I have no fat on my body. Of course, that can't be true, but according to my scale, I am 8 % body fat. I'm down to 95 pounds, so definitely getting too thin. I do create ketones, but my ketones appear to be highest in the morning when I'm at my hungriest. So is my body actually using the ketones I'm creating?

The ketogenic diet does not stave off hunger or improve my cognition. However, I am no longer hypoglycemic; based on the timing of that shift, I give the ketogenic diet credit for that.

I don't know what to think. I sometimes wonder if I should go off the ketogenic diet because of my weight loss, but I don't handle carbs well.

[Robhypno]

Have you measured your ketones with a meter whilst on the keto diet?

I found that I went beyond the nutritional ketosis for a period, ie past 3. I was 3,5 and even higher at times. My weightloss was staggering at this period but it wasn't optimal or particularly healthy

When I adjusted and tweaked my diet by increasing veggies therefore raising carbs slightly, everything changed. Brain fog and energy levels

By making this statement, I wasn't climbing the walls like a higher active child or had the mental ability of Prof Stephen Hawkins. However, when I applied myself I noticed the change. 12-14 hour shifts destroyed me in energy, motivation and mental focus. This has completely changed and as a result, my time off is better as I know longer am exhausted, mentally and physically.

I had to adjust the keto plan, only slightly but it has worked better than I hoped. It took a little while to get keto adapted but I noticed the huge difference

[Robhypno]

I should add, I upped my fat in take as well when my ketones were too high. I lost so much body fat - my body and brain fed on the ketones produced but obviously my fat in take wasn't high enough and why the ketone demand was high. Raising fat quenched my hunger as well as sustainable body fat loss, energy levels etc

[TheBrain]

Have you measured your ketones with a meter whilst on the keto diet?

I found that I went beyond the nutritional ketosis for a period, ie past 3. I was 3,5 and even higher at times. My weightloss was staggering at this period but it wasn't optimal or particularly healthy

When I adjusted and tweaked my diet by increasing veggies therefore raising carbs slightly, everything changed. Brain fog and energy levels

By making this statement, I wasn't climbing the walls like a higher active child or had the mental ability of Prof Stephen Hawkins. However, when I applied myself I noticed the change. 12-14 hour shifts destroyed me in energy, motivation and mental focus. This has completely changed and as a result, my time off is better as I know longer am exhausted, mentally and physically.

I had to adjust the keto plan, only slightly but it has worked better than I hoped. It took a little while to get keto adapted but I noticed the huge difference

I should add, I upped my fat in take as well when my ketones were too high. I lost so much body fat - my body and brain fed on the ketones produced but obviously my fat in take wasn't high enough and why the ketone demand was high. Raising fat quenched my hunger as well as sustainable body fat loss, energy levels etc

Hi Robhypno,

Thanks for your response. It's great that such a simple change, increasing veggies, made such a big difference for you, especially with your energy levels.

Yes, I measure ketones with a meter. I used to regularly test my ketones. Now, I do spot checking. I have gone into the 3's, but I don't recall ever going higher than that. The other morning, I checked my ketones and BG before breakfast after 14 hours of fasting. I was ravenous. My ketones were at 1.9. My BG was at 77. I didn't retest after my low-carb breakfast, but based on past testing, my ketones almost certainly dropped significantly, maybe as low as .4 or .5. Maybe that's a normal response, but I don't understand it. How can I suddenly use up my ketones as I eat meals?

I aim to have at least 2 tbsp of fat at every meal (three meals a day) and almost always achieve that, often more. But I do think I'm hypocaloric. I have many food sensitivities and after recently learning I have hydrogen sulfide SIBO, I'm on a low-sulfur diet. That removes all the cruciferous veggies and alliums (garlic, onions, leeks, etc.) from my diet for the time being. Evidently, it's often just one or two high-sulfur foods that cause problems for people (the #1 offender being garlic), so hopefully I'll get back most of these veggies. But as you can imagine, my veggie options have been greatly reduced.

And being on a ketogenic diet, I can't go crazy with some of the low-sulfur veggies (like winter squash). The nutritionist on the clinical team I'm working with is recommending I add pseudo grains, lentils, and cassava root flour—all of which are carb heavy. Actually, I should look into whether cassava root flour contains a lot of resistant starch; if so, it could be a good option.

Maybe as my gut heals, I'll be able to tolerate more carbs. I'd actually like to cycle in and out of ketosis with higher carb days twice a week. For now, that would spike my glucose too much.