Extended my extended fast.

[Tamarillo]

I completed a ten day fast. *Phew*.
I was aiming for five days but I felt so well on days four and five I just kept going...and assessed things day by day.

I felt fatigued on day 3 which is typical for me with the liver emtying it's glycogen stores and ketones needing to come more robustly to the party.
I hit another patch of fatigue on days 7 and 8. Then days 9 and 10 I've felt like fuel is getting to the cells again. I was able to get quite a lot done on the garden, cook for my family and go for a walk on the beach. Looking at my numbers, on days 9 and 10 my ketones went higher than the glucose number, putting me into therapeutic ketosis. IE: GKI of less than 1.

I had one cup of black coffee in the morning each day and until day 6 I added a couple of teaspoons of C8 mct oil to my coffee.
There was no good reason for the mct oil, I just had the last of a bottle to use up.
Other than that, I drank water, electrolytes and a teaspoon of apple cider vinegar here and there (1 or 2 x per day) in a glass of sparkling water. As well as electrolytes I took a B complex, extra thiamine and extra magnesium. I crunched up a bit of flaky sea salt any time I felt the need. It's amazing how much better you feel when you need salt and you get it!

I felt hungry between mid-afternoon and around 7pm the first few days and transiently once or twice at other times, but most of the time I wasn't physically conscious of not having eaten.
I did find myself watching a LOT of cooking videos in the evenings while I sipped my 'apple cider bubbly'.

I tested blood glucose and ketones each morning around 6.30 am.

October 31st Glucose 4.5, Ketones 0.8 *Started fast at midday
November 1st Glucose 4.6, Ketones 0.9
November 2nd Glucose 3.8, Ketones 1.1
November 3rd Glucose 4.2, Ketones 0.9
November 4th Glucose 4.4, Ketones 1.8
November 5th Glucose 4.0, Ketones 1.8
November 6th Glucose 4.1, Ketones 2.3
November 7th Glucose 3.8, Ketones 3.4
November 8th Glucose 3.5, Ketones 3.8
November 9th Glucose 3.4, Ketones 4.2
November 10th Glucose 3.4, Ketones 4.3 *Ended fast at midday. Had some beef bone broth and later matcha tea. Then apple cider bubbly in the evening because it seems I've formed a habit....er I mean I've grown fond of it.

I'd hoped to get to the 'therapeutic ketosis' point sooner than day 9, but two days in that zone is better than none and if I play my cards right I might be able to remain there another day or two while re-feeding.

Made some celeriac soup with bone broth for tomorrow and have things like avocado and yogurt on standby.
Will post the next few days numbers here while I get back up to speed with eating and digestion.

 

[EllieM]

Hi @Tamarillo thanks for a very interesting post.

I've got to ask, how do you manage regaining the weight lost due to a 10 day fast? (Not getting at you at all, it's just that you look pretty slim in your photo, and am guessing that if this is your prediabetes maintenance regime you don't have a lot of weight to lose)

 

[Tamarillo]

Hi @Tamarillo thanks for a very interesting post.

I've got to ask, how do you manage regaining the weight lost due to a 10 day fast? (Not getting at you at all, it's just that you look pretty slim in your photo, and am guessing that if this is your prediabetes maintenance regime you don't have a lot of weight to lose)

Hi Ellie, actually I have 11 or 12 kg I could lose to be the weight I was before I had children, and I lost around 3 kg on my fast. My metabolism is slow (due to illness and relatively low activity). Other people would likely lose a good bit more than that!
I expect I will put some of that weight back on over the next week or two.
I wouldn't recommend a long fast to anyone without some spare fat to burn.

 

[Pipp]

Wow, 3 kg in 10 days, then the possibility of regaining some of that, makes me wonder if it is worth the effort. Would Intermittent Fasting be of any use to you, @Tamarillo ? Less drastic and more sustainable, particularly as you have children keeping you busy.

 

[Tamarillo]

Wow, 3 kg in 10 days, then the possibility of regaining some of that, makes me wonder if it is worth the effort. Would Intermittent Fasting be of any use to you, @Tamarillo ? Less drastic and more sustainable, particularly as you have children keeping you busy.

Hi Pipp, weightloss wasn't the reason I was fasting. 3 kg is only a 'best guess' because I only thought to weigh myself on day 4, and then weighed again on day 10. Prior to that it was at least a month before I'd got on the scales.
I expect other people might lose a lot more weight than I did, depending on their level of insulin resistance maybe?

Sorry I ought to have mentioned in my original post. I was trying a longer fast to see if a low GKI might help with neuro and autoimmune issues....that's specifically why I was hoping to attain a ratio of less than 1.
I am also still quite insulin resistant so with what I originally planned to be a 5 day fast I was expecting it might have some impact in that area.

Yes I've been an intermittent faster quite a while. Previously I'd only done a 5 day extended fast but I've done a number of 3 days. 10 is a bit drastic I admit , but not something I plan on doing often at all. I felt perfectly fine to cook most days, plus make school lunches and all the other fun stuff.

 

[Tamarillo]

Just an update for November 11th (I'm from the future, if you're in the UK).

My numbers this morning were spectacular.
Glucose 3.2, the red light/alarm went off, and Ketones 5.3. GKI of 0.6.
I wish it was easier to attain that ratio. I was able to for a while on a carnivore type diet but my liver did not like the amount of saturated fat I was eating. I feel better with some monounsaturated fats and some fibre containing foods.

 

[MrsA2]

How do you cope/resist when cooking for others and/or they are eating around you?
I think maybe I could manage in isolation on a desert island but whenever I try at home habit (hubby eats by the clock, no exceptions) or aromas mean food goes in my mouth, often before I'm aware I've eaten it

 

[Tamarillo]

How do you cope/resist when cooking for others and/or they are eating around you?
I think maybe I could manage in isolation on a desert island but whenever I try at home habit (hubby eats by the clock, no exceptions) or aromas mean food goes in my mouth, often before I'm aware I've eaten it

It's mindset and experience partially. I've been intermittent fasting (conservatively) for years and when the kids were younger, eating more often and dependent on me for preparing everything there were indeed times a piece of cheese or whatever would be in my mouth before I remembered I was fasting!

For an extended fast it really helps me if I have things set aside or in mind for when I know I can eat again. For example this time I ordered a box of goodies from a free range pig farm, with a few extra keto friendly treats in there just for me.
It's also physical! That's where the magic in fasting is. It's my experience that when I'm in a deeper level of ketosis I phyically feel like I'm fed all the time - from my body fat, and there is no immediate or urgent desire to eat anything I encounter. If it looks good I'll tell myself I'll have some after my fast, but any physical "need" for it then and there is literally extinguished.

By my numbers, I can see I didn't get comfortably to the point of being well fueled by fat until day 4 and that ties in with how I felt energy-wise too.

I don't usually eat with the family when I'm fasting, although on a couple of occassions when they ate outside this week I sat out there too with my sparkling water.
The hardest thing this past week was the smell of pizza cooking! I made the dough and everything. I feel like I still have a hankering for bread, for whatever reason.
It's also difficult for me to guess when seasoning a dish and not being able to taste for adjustments.

 

[Stephen Bond]

I had a weird thing happen this evening... i have been having 1 meal a day (dinner) mostly for the last 3 weeks.This evening felt really tired so went for a nap. Just before checked my keto level with a pee strip. A few days earlier it was in the 1.4 -4.0 range.... This time it was off at the highest level 16! I did not dwell on it and took a nap... 15 mins later Blood sugar alarm on Libre3 went off as it had dropped to 4.2. i immediately took some carbs and sugar.
Is that keto level concerning, it seems very high???

 

[Tamarillo]

I had a weird thing happen this evening... i have been having 1 meal a day (dinner) mostly for the last 3 weeks.This evening felt really tired so went for a nap. Just before checked my keto level with a pee strip. A few days earlier it was in the 1.4 -4.0 range.... This time it was off at the highest level 16! I did not dwell on it and took a nap... 15 mins later Blood sugar alarm on Libre3 went off as it had dropped to 4.2. i immediately took some carbs and sugar.
Is that keto level concerning, it seems very high???

Ketones should rise nicely to compensate when your blood sugar drops, so long as the blood glucose drop has occured as a result of carb restriction. There is another more worrying condition called ketoacidosis. I'm not sure what leads to that..I think it may apply more to type 1's?

I am only familar with blood ketones (have never used the pee sticks) and one of the fasting gurus says up to 7.2 is fine but anything over that should be supervised by a doctor. I've never measured higher than a 6.0 personally.
4.2 is absolutely fine for glucose if you are in some level of ketosis. I have been as low as 2.6 and I felt just fine because my ketones were up at 5 at that point.

Your Libre3 will not take any state of ketosis into account when it sounds an alarm. Hopefully future monitors will be able to measure both, and and only alarm you if there is true cause for alarm! You need to worry if you feel dizzy or shaky of course and you might need to apply caution if you're on blood sugar lowering meds.

 

[Tamarillo]

Posting food intake a day after breaking my fast here:

Coffee.
Beef bone broth.
Celeriac soup x 2 mugs. (Soup was thinned out 50/50 with more of the bone broth). This was so good!!
Matcha tea.
Lotsa water.

*Looking forward to some real food! Just got to take it easy a bit while the liver, pancreas and goodness knows what else 'wakes up'.

 

[Stephen Bond]

Ketones should rise nicely to compensate when your blood sugar drops, so long as the blood glucose drop has occured as a result of carb restriction. There is another more worrying condition called ketoacidosis. I'm not sure what leads to that..I think it may apply more to type 1's?

I am only familar with blood ketones (have never used the pee sticks) and one of the fasting gurus says up to 7.2 is fine but anything over that should be supervised by a doctor. I've never measured higher than a 6.0 personally.
4.2 is absolutely fine for glucose if you are in some level of ketosis. I have been as low as 2.6 and I felt just fine because my ketones were up at 5 at that point.

Your Libre3 will not take any state of ketosis into account when it sounds an alarm. Hopefully future monitors will be able to measure both, and and only alarm you if there is true cause for alarm! You need to worry if you feel dizzy or shaky of course and you might need to apply caution if you're on blood sugar lowering meds.

Thanks for the advice.... I am on Ozempic as far as meds go, and have been following a very low carb diet and no sugar for the last 4 weeks. I feel fine now at 5 am! I felt very tired yesterday evening and my glucose level was very low, that is why i did the Ketone pee test. I did not feel dizzy, just tired. I thought perhaps the pee testers were rubbish so my wife and son also tried one... My wife was around 6, she is also doing the low carb no sugar, but not as strictly as me, my son came up at 0.5... So the test sticks are correct. have just done another pee ketone test and it is still at the maximum 16 level, despite eating a load of sugar and carb snacks?? I will call my doctor once it gets to a reasonable hour! I feel fine so am not rushing off to hospital as some of the info on the net advises!

 

[Tamarillo]

Thanks for the advice.... I am on Ozempic as far as meds go, and have been following a very low carb diet and no sugar for the last 4 weeks. I feel fine now at 5 am! I felt very tired yesterday evening and my glucose level was very low, that is why i did the Ketone pee test. I did not feel dizzy, just tired. I thought perhaps the pee testers were rubbish so my wife and son also tried one... My wife was around 6, she is also doing the low carb no sugar, but not as strictly as me, my son came up at 0.5... So the test sticks are correct. have just done another pee ketone test and it is still at the maximum 16 level, despite eating a load of sugar and carb snacks?? I will call my doctor once it gets to a reasonable hour! I feel fine so am not rushing off to hospital as some of the info on the net advises!

Good idea to call and have reassurance. Hopefully your doc is reasonably 'low-carb literate' so they can put your experience in context. Haha yes well the advice on the net is often written by people expecting you to be following a 1990's (sponsored by Big Wheat) food pyramid diet or similar. If you were doing that, then your blood glucose number might actually be concerning! Best of luck getting some professional insight anyway.

 

[Jaylee]

Ketones should rise nicely to compensate when your blood sugar drops, so long as the blood glucose drop has occured as a result of carb restriction. There is another more worrying condition called ketoacidosis. I'm not sure what leads to that..I think it may apply more to type 1's?

Hi,

Yep, Keytones present normally coincides with high BGs regarding mismanaged diabetes.. https://www.nhs.uk/conditions/diabetic-ketoacidosis/

However
Nutritional ketosis (which can occur whilst fasting.) on the other hand is fine if BGs are in range.

On the subject of using a sensor to interpret BG readings. It’s advised to back up & reference any seemingly errant scans (or alarms.) with a BG meter.

Hope this helps..

 

[bulkbiker]

I had a weird thing happen this evening... i have been having 1 meal a day (dinner) mostly for the last 3 weeks.This evening felt really tired so went for a nap. Just before checked my keto level with a pee strip. A few days earlier it was in the 1.4 -4.0 range.... This time it was off at the highest level 16! I did not dwell on it and took a nap... 15 mins later Blood sugar alarm on Libre3 went off as it had dropped to 4.2. i immediately took some carbs and sugar.
Is that keto level concerning, it seems very high???

Odd as a level of 4.2 mmol/l is totally normal for most people and to be desired.

What units are your pee sticks (a notoriously poor measure of ketones) reporting in?

And more to the point why are you taking medication for pre diabetes especially one that can over stress your pancreas?

 

[Stephen Bond]

Odd as a level of 4.2 mmol/l is totally normal for most people and to be desired.

What units are your pee sticks (a notoriously poor measure of ketones) reporting in?

And more to the point why are you taking medication for pre diabetes especially one that can over stress your pancreas?

The pee sticks are measured in mmol/l

The medication is what the doctor advised. My weight gain had been very sudden and without a change in my diet, so i guess he thought there was something wrong that needed fixing.

 

[Stephen Bond]

Hi,

Yep, Keytones present normally coincides with high BGs regarding mismanaged diabetes.. https://www.nhs.uk/conditions/diabetic-ketoacidosis/

However
Nutritional ketosis (which can occur whilst fasting.) on the other hand is fine if BGs are in range.

On the subject of using a sensor to interpret BG readings. It’s advised to back up & reference any seemingly errant scans (or alarms.) with a BG meter.

Hope this helps..

The constant BG kit i am using is the Freestyle Libre3, if i get a high or low reading i double check it with a meter that uses blood on a small strip. The one i use is supposed to be the most accurate for home use and is accurate to 9%.

 

[Stephen Bond]

Good idea to call and have reassurance. Hopefully your doc is reasonably 'low-carb literate' so they can put your experience in context. Haha yes well the advice on the net is often written by people expecting you to be following a 1990's (sponsored by Big Wheat) food pyramid diet or similar. If you were doing that, then your blood glucose number might actually be concerning! Best of luck getting some professional insight anyway.

All seems good now. I spoke to my doctor this morning and he said as I am losing weight it is not surprising that the ketone level was high.
Regarding the BG level, he thought it was ok, but maybe take a little more carbs as part of my weekly diet.

 

[HSSS]

4.2mmol is a perfect blood glucose level - especially as a prediabetic and ozempic is not a hypoglycaemic medication. The alarms are intended for those that need to take action to avoid hypos they may be rushing towards as a result of medication onboard in excess of need at that specific point in time. So I’m confused why you felt the need to take both carbs and sugar. Even more confused why your dr thinks they need to be higher considering you are reporting 4.2 as being particularly low for you so I assume they are often higher. Could he want to make sure he can continue medicating you. (Where in the world are you?)

ketones of 16, even whilst losing weight, sound excessive, and for your wife even reaching 6 whilst merely low carb and not keto also sounds unlikely - so I’m guess I’m saying I doubt the accuracy of your strips.

 

[HSSS]

My weight gain had been very sudden and without a change in my diet, so i guess he thought there was something wrong that needed fixing.

So he’s fixing the unexplained weight gain by giving you drugs to remove the symptom (weight) without knowing why you gained it in the first place (cause). How is this fixing the something that went wrong in the first place?