Ketogenic diet made me ill

[Anonymous]

Hi everyone

Following some advice on the approaches to managing blood glucose on this forum, I decided to try a very low carbohydrate diet, where my intake didn't go above about 70 to 80 grams per day. I am on Metformin which I take morning and night. It is not the SR version.

At first, I did feel much better as my blood glucose levels started to come down. Then, something started to happen to me. Following my breakfast of cheese and meats, I go to work or go out to play and at about 10am, I started to slump. In fact I felt quite unwell on a regular basis, and this always happened mid-morning.

Recently, I travelled to Ashford in Kent for a meeting with my boss and when I arrived at Ashford Station, I just had to sit down. I now recognise what was happening to me - I was hypoglycemic.

At the kiosk, I bought a small coffee and a sugary snack (a flapjack). Within minutes of eating it, I felt much better and had more energy. In fact, I felt fine. Even my boss noticed, as she noticed I looked pasty when I arrived, but had more colour in my cheeks later on.

I have tested myself in this state, and get a reading of about 4.5 mmol/l. I wake up with a high BG level, but with the carb-free breakfast and the metformin, this level drops markedly.

This means that a change of strategy may be called for and I am thinking of two options:

1. remaining on the same lo carb diet with no metformin in the morning; or,

2. maintaining the same medication regime, but upping my carbs slightly and, maybe, have a snack if I need to, and having the bulk of the carbs in the morning and easing off by lunchtime.

I do find that almost completely eliminating carbs from my diet can make for a quite boring eating regime anyway, but I would appreciate some feedback.

Many thanks

Dave

 

[hanadr]

Dave,
I'd go with the reduced Metformin option, since I always like to minimise medicines. Also add in a LITTLE carb in the morning. Perhaps a piece of fruit?
I personally eat much less than 70/80grams carb per day and take 2 x 500mg Metformin. I don't seem to make ketones though.
Hana

 

[borofergie]

Eating a low-carb diet will not make you hypoglycemic (unless you are also taking more powerful medication than metformin). In fact, the reverse is true, as you start to produce ketones to reduce your brain's glucose requirements your blood glucose levels will stabalise.

What you describe sounds like a "false hypo", which is a withdrawal symptom, as your body gets used to operating at (more) normal blood glucose levels. You should embrace it, it's a sign that you're starting to get your diabetes under proper control.

You didn't mention how long you've been on a low-carb diet, but it takes at least a coupe of weeks to adjust first time you try it, during which period you'll also experience the symptoms you've described above, often known as the "low-carb flu".

I think that sweating it out is a better idea than increasing your carbohydrate intake, but that's your decision. Good luck.

S.

 

[Anonymous]

Hi Boro

I have been doing this for a couple of months now, and it has only recently started to become a problem. I appreciate your point, but the trouble for me is that I have to be in a fit state to do my job properly (which I love by the way!) and just can't do things right if I'm feeling ill.

It's telling that it only occurs in the morning though.

Dave

 

[xyzzy]

Good to hear from you again Dave. I'd say either way is valid. You need good levels but need to function. Good levels include not being low as well as not being high and peoples "too low" indicator does seem to vary quite a bit but your too low value is quite high if that makes sense . I'd suggest try doing what Hana suggests which is what I do and eat a small amount of fruit at breakfast. I find this gives me a kickstart for the day. Small amount for me is a few defrosted strawberries or similar berries mixed in some Greek yogurt with some strawberry yogurt added for extra kick and taste. Just get the quantities right for yourself with your meter.

 

[Anonymous]

Yes, sorry I've not been on here much. I have a new job (promotion), which takes me all over the world now, so I spend much time on planes, trains and automobiles, in addition to traipsing all over our factories in far away places doing quality audits!

I will certainly try that option. I'm considering reducing my metformin to an evening dose only. I'll see my GP first though (she's fantastic).

Dave

 

[borofergie]

If it makes you feel ill (consistently) that's a pretty good indication that you shouldn't be doing it...

 

[Patch]

From experience, I know that Met SR and VLC/HF/Keto doesn't mix. I'd cut the met, and stick with the diet. You MAY (may...) want to go back to regular met in a smaller dose and see if that helps.

I really didn't get on with SR - they'd go through whole, if you know what I mean... :sick:

 

[Anonymous]

I really didn't get on with SR - they'd go through whole, if you know what I mean... :sick:

... or as my Grandmother used to say: "In one end, out the other!" :lol:

 

[KetoLiving]

Hey Ursus,

I'm not familiar with the medications and their interactions, but the majority of the symptoms your describing sound like the typical ketogenic transition issues due to lack of mineral content excreted by increased urination. In order for your muscles and brain to use the energy provided while expelling the excess glucose from your body, it needs additional sodium, potassium, and a bit extra magnesium as these get expelled in large quantities along with the processed glucose. Here is an excerpt from my guide on how to start on Ketogenic diets (www.facebook.com/KetoLiving) - bear in mind that the direction of the article is geared towards weight loss but the science still applies to anyone who adapts ketogenically:

3) Hydrate! Especially when you withdraw from carbs, you will expel a LARGE amount of water weight initially (your body is expelling the excess glucose in your system in the absence of insulin). This is the reason why you lose so much weight initially. YOU WILL GAIN THIS WEIGHT BACK!!! People think that this lifestyle doesn't work because they regain the water weight under ketogenic conditions, and they completely plateau for a week, maybe 2. This is completely normal.

4) Supplementation. This is a bit of a gray area, but a lot of evidence shows that people benefit on a muscular level (especially through the transition phase within the first month of cutting carbs) to supplement with extra sodium, potassium, and magnesium. Failure to do so WILL very likely result in lethargy, brain-fog, and mood disorders. You need these electrolytes in your system to keep your muscles and brain functioning normally (especially potassium).

 

[Sid Bonkers]

Hi Dave,

Taking meter readings is only ever useful if you are using it to find out what portions of carbs you can eat. By taking readings and adjusting the carb portions till your 2 hour postprandial readings are no more than 2 mmol/L higher than your pre meal readings is the right way to test. Do this and your base levels/fasting levels will come down on they own. Many times I read people saying not to let your postprandial readings go above 7.8 or some such nonsense, and why is that nonsense? Because how is that possible if your pre meal readings are 9 mmol/L or higher which is quite common for the newly diagnosed diabetic, it just shows how little some people here know when they make such unachievable statements.

If you are feeling weak or tied mid morning then you need to eat more carbs with your breakfast as your energy levels are obviously low, you are not adjusting :roll: you are feeling the affects of a lack of energy. And carbs = energy, you dont have to pig out, just eat enough to fuel your mornings activity, a mid morning carby snack may help too especially if you can only eat small portions at one time.

Eat some carbs and test 2 hours after you finish eating them, if you are more than 2 mmol/L higher than ypu were before breakfast either reduce the portion or try some other type of carbohydrate.



Eat to your meter, thats all you need to do, you dont have to eat less than x amount of carbs you just have to eat the portions that are right for you, as an individual.

Its a shame that those who choose to take the very low carb approach cant accept that not everyone can eat that way or wants to eat that way, especially as it is not essential.

 

[anna29]

Hi All.
I have cleaned this thread up and would prefer less arguing or getting personal
over own preferences of 'how' things 'should' be being done .
Try helping the OP with more choices of suitable food options for example?
As the OP 'does' raise this question to you all in his opening topic post...
Threads that keep going off topic, landsliding into petty arguements into who is right and who is wrong aren't acceptable.
Anna.

 

[Dillinger]

Hi Dave,

I'd go for option 1 and reduce/drop the Metformin in the morning.

Depending on how long ago you started dropping the carbs you may well be having the false hypos - I'm not sure how long it would take for your body to reset to a low carb regime but it could be a couple of months.

Obviously you need to do something though, but hopefully it will be a passing problem and soon you'll be feeling good with the massively added bonus of normalised blood sugars.

Best

Dillinger

 

[Jude]

Patch

What are you saying exactly about Metformin SR? Are you saying that Metformin clashes with LC or are you saying that we do not know whether or not we get the drug as it appears to go out of our system in the same state it went in?? I am on 1gSR which I take breakfast and evening meal but I am also on Humalog with breakfast and evening meal and more recently Sitagliptin with evening meal. I have been trying to reduce my carbs for some months now but not very successfully mainly I think because as you say you are a "recovering carboholic" I still am one!!
Are you LC and if so how low? I do not think I could manage VLC but I have been making a big change from what I used to eat on the days when I can stick to it .
I have wondered in the past whether or not I am actually getting the Metformin due to the makeup of the tablet and I also have IBS (I go too much) and often I am sure the pill is out of my body before it could possibly have done any good!!
Any advice gratefully received thankyou. :clap:
Judith

 

[Anonymous]

Well, the thing is, that I've learned a lot about eating this last few months. I'm beginning to find that a very low carb diet isn't right for me, and I'm beginning to wonder if it really is a wise choice.

The problem for me is that low carbing is terribly boring - there is only so much meat and cheese you can eat before you think: "Oh, sod this Where's the cake!" Ultimately, it's not very satisfying at all.

I am finding that a low GI diet suits me better because it does mean that I can enjoy more foods and feel satiated for longer. I'm finding also that my BG levels are stable and don't fall too low.

In fact, I've discovered that my ideal BG range is between 6 and 7 and generally, I can keep it pretty much in this range. It's a bit tight but I can manage it.

 

[xyzzy]

Diet wise just do what you think is long term sustainable for yourself. If you can keep your BG's in safety and have found a regime you can continue with then the amount of carbs is immaterial. Just don't let it become a slippery slope i.e in another 3 months don't start saying to yourself well my low GI diet is boring and I'm ok between 8 and 10 cos it won't be ...

 

[borofergie]

The problem for me is that low carbing is terribly boring - there is only so much meat and cheese you can eat before you think: "Oh, sod this Where's the cake!" Ultimately, it's not very satisfying at all.

If you want to eat cake, then maybe the "big syringe full of insulin diet" is the one for you...

 

[Patch]

What are you saying exactly about Metformin SR? Are you saying that Metformin clashes with LC or are you saying that we do not know whether or not we get the drug as it appears to go out of our system in the same state it went in?? I am on 1gSR which I take breakfast and evening meal but I am also on Humalog with breakfast and evening meal and more recently Sitagliptin with evening meal. I have been trying to reduce my carbs for some months now but not very successfully mainly I think because as you say you are a "recovering carboholic" I still am one!!
Are you LC and if so how low? I do not think I could manage VLC but I have been making a big change from what I used to eat on the days when I can stick to it .
I have wondered in the past whether or not I am actually getting the Metformin due to the makeup of the tablet and I also have IBS (I go too much) and often I am sure the pill is out of my body before it could possibly have done any good!!
Any advice gratefully received thankyou.

Literally - the tablets (and those SR's ar big bloody tablets!) would pass through whole. I really don't know if it's the interaction with Lo-carb foods that does it. But I do know this - the REGULAR metformin causes LESS of an upset than the SR ones...

For anyone worried about lo-carbing (especially those who think they won't manage) I'd say this - DO TWO WEEKS on Atkins induction. I gaurantee (and I know borofergie will back me up on this) the feeling you get after that 2 weeks will be the BEST motivation you ever had for going lo-carb. You will feel more alert, have more energy and, incredibly, your motivation/get-up-and-go will return in abundance.

It will literally change your entire outlook on diabetes. Any more Q's - just PM me, Jude! :thumbup:

 

[Anonymous]

What are you saying exactly about Metformin SR? Are you saying that Metformin clashes with LC or are you saying that we do not know whether or not we get the drug as it appears to go out of our system in the same state it went in?? I am on 1gSR which I take breakfast and evening meal but I am also on Humalog with breakfast and evening meal and more recently Sitagliptin with evening meal. I have been trying to reduce my carbs for some months now but not very successfully mainly I think because as you say you are a "recovering carboholic" I still am one!!
Are you LC and if so how low? I do not think I could manage VLC but I have been making a big change from what I used to eat on the days when I can stick to it .
I have wondered in the past whether or not I am actually getting the Metformin due to the makeup of the tablet and I also have IBS (I go too much) and often I am sure the pill is out of my body before it could possibly have done any good!!
Any advice gratefully received thankyou.

Literally - the tablets (and those SR's ar big bloody tablets!) would pass through whole. I really don't know if it's the interaction with Lo-carb foods that does it. But I do know this - the REGULAR metformin causes LESS of an upset than the SR ones...

For anyone worried about lo-carbing (especially those who think they won't manage) I'd say this - DO TWO WEEKS on Atkins induction. I gaurantee (and I know borofergie will back me up on this) the feeling you get after that 2 weeks will be the BEST motivation you ever had for going lo-carb. You will feel more alert, have more energy and, incredibly, your motivation/get-up-and-go will return in abundance.

It will literally change your entire outlook on diabetes. Any more Q's - just PM me, Jude! :thumbup:

I am concerned about the guarantee you made in your post above. You cannot make such statements because different people react in different ways. This type of eating regime made me ill, yet there are others on this forum who have been on an Atkins/Newcastle type diet who swear by it. My best advice is this: try it, and if you find it doesn't suit you, then try carbs with a low GI. I won't go into it here as there is plenty of advice about the Glycemic Index on this site. Even then, you will still need to reduce the amount of carbs consumed

 

[borofergie]

For anyone worried about lo-carbing (especially those who think they won't manage) I'd say this - DO TWO WEEKS on Atkins induction. I gaurantee (and I know borofergie will back me up on this) the feeling you get after that 2 weeks will be the BEST motivation you ever had for going lo-carb. You will feel more alert, have more energy and, incredibly, your motivation/get-up-and-go will return in abundance.

It will literally change your entire outlook on diabetes. Any more Q's - just PM me, Jude! :thumbup:

I am concerned about the guarantee you made in your post above. You cannot make such statements because different people react in different ways. This type of eating regime made me ill, yet there are others on this forum who have been on an Atkins/Newcastle type diet who swear by it. My best advice is this: try it, and if you find it doesn't suit you, then try carbs with a low GI. I won't go into it here as there is plenty of advice about the Glycemic Index on this site. Even then, you will still need to reduce the amount of carbs consumed[/quote]

I think Pat is talking about the "epiphany" moment of getting your BG under control for the first time, after months (or even years) of hyperglycemia. I still remember how it felt as, from behind the clouds of Atkins Flu type headaches, I suddenly felt relaxed and lucid for the first time in years. I still feel great, but it's that transition from the tense and stressed feeling of hyperglycemia to the beautiful lucidity of norm BG. I can also feel when I'm in ketosis, because I feel more alert and lucid than ever.