Low BG on LCHF diet

[Sirzy]

I've been on a LCHF diet for a week. I'm starting to slowly feel my energy returning (I just have quite heavy, easily tired legs now), but I'm having real problems keeping my BG levels above 4, especially in the evenings I'm fine in the morning as I tend to run at bit higher then anyway, so I'm staying around 5 - mid 5's after breakfast, but once I have lunch it starts to go down. I'm usually mid 4s before dinner, and then afterwards I start going down, until I'm mid 3s before bed. I've tried having less fat with my evening meal and more carbs, plus before bed I'm having some carbs (I had some banana last night ,which was 7.5g of carbs, and this didn't move my BG from 3.6.

I'm getting very frustrated as I really didn't think low BGs would be a problem for me on this diet, I thought I might end up craving something and giving in, or the low energy would eventually get to me (although I'm also finding this annoying too). Can anyone suggest anything I could do? I'm currently eating around 20g of carbs per day, 50g of protein and 125-150g of fat (I'm 5' 2 and weigh 7lbs 6). I'm also following a SIBO diet too, which is essentially a LCHF diet (started on Monday), so I can only eat every 4 hours and many of the starchy vegetables and high sugar fruits aren't permitted on this diet.

Sorry for the long post

 

[zand]

Do these low figures give you a problem? Do you feel ill when they are so low? I know there are some on this forum who get low BG's but they are fine with them. As long as you are diet only, it's rare to actually have a real hypo, though you might get something that feels like that. @AndBreathe might be able to help you here.

I would think that many of us have more carbs than you but still consider we are following LCHF. With your BG's nice and low all the time I think you could probably gradually introduce a few more carbs and see if this helps. Most of us would consider 50-60g still to be low carb and some manage to maintain good BG's on a higher level than that. it's all about trial and error until you find what is perfect for you. You have made a great start. I feel all that is needed is a bit of tweaking here and there.

Good luck

 

[AndBreathe]

Hello there. My comments are based on me. I don't take any medication, for anything, so my diet, exercise and my body are my management tools.

I spend quite a bit of time in the 3s, and routinely feel absolutely fine. Skipping through my records, I went to bed on 3.0 on Friday, without a care in the world, knowing my liver will dump some stored glucose if I go too low. Let's also not forget our meters can be +/-15%, so the numbers we record may not be absolutely accurate.

I rarely feel anything untoward unless I'm in the 2s, which doesn't happen so often. If I go to the 2s, or into the low 3s, before a meal, I sometimes just feel very hungry, but if I have a meal due, I'm happy to distract myself until my meal arrives, or if I'm too hungry, I might grab a cup of tea with milk, a cherry tomato or a couple of olives. Just something to take the rough edge off, then I can enjoy my dinner, as intended.

Provided you are not on any hypo inducing meds, and you feel fine, I would urge you not to be too influenced by the number itself. Again, provided you're not on potentially hypo inducing meds, please don't go grabbing glucose tablets or jelly babies. That'll just shoot you up high, you'll probably then drop quickly and end up in a glycaemic rollercoaster - quite unpleasant.

Really, how you move forward really depends how you feel and any meds in play.

 

[diamondnostril]

Hi Sirzy . . .

As has been said above, I think it's better to be guided by how you FEEL, rather than by any arbitrary definition of a number that represents "too low".

I find that I basically have a choice of high blood-sugars or low blood-sugars, compared to the standard definition of a "normal" blood-sugar range. I always set my target as the "normal" non-Diabetic blood-sugar range. On a Ketogenic (LCHF) diet my blood-sugar tends to stay below this "normal" range. On any other diet (even a standard low-carb diet) I am unable to stop my blood-sugar rising above this "normal" range.

I asked my Doctor: What is the "normal" blood-sugar range for a person on a Ketogenic (LCHF) diet? She said that she did not know, because there are so very few people that follow it. (And of those that do follow it who are Diabetic, it is difficult to take their results as denoting what is "normal").

I guess we should remember that this "normal" blood-sugar range has only been decided in the last 100 years, when Western diets had already started to be switched to be loaded with high amounts of Carbohydrates and unnatural foods. If we looked around the streets today we would decide that it is "normal" to be overweight, but of course in evolutionary terms it certainly is not.

Would be fascinating to be able to scientifically determine the HbA1c levels of Paleolithic man. My hunch is that it would be lower than what is currently accepted as a "normal, non-Diabetic" level in the modern era.

In any case, Sirzy, from me you get one confirmation that on an LCHF diet very similar to yours (<20g CHO, approx 55g PRO, >120g FAT) blood-sugars are generally low, and everything seems absolutely fine. No lack of energy, no problems with brain function, no other problems that I am aware of or have been noticed by any blood-tests or neurological tests.

Regards
Antony

 

[Sirzy]

Thanks so much for the replies everyone, this has really helped me feel better about whether or not I'm on the right track with this diet. I'm not taking any meds so there's no chance of a 'real' hypo. I think what's confusing me is that I'm not sure if I feel so tired and achy and lacking in energy because I'm still switching to ketosis or because my BG is in the mid 3s. As you both mentioned though, blood sugars in the 3s shouldn't automatically be assumed to be a problem. I'm not feeling shaky or hungry and I don't have a rapid heart rate when I have BGs this low, just headachy, like there's a band across my eyes, very very tired, and quite irritable, but again this could just be switching the ketosis.

I think I'm most frustrated by the sore legs and lack of energy as I'm usually quite active, but I haven't been able to manage much since starting the diet. This is something else that I'm concerned about, if I have BG levels in the 3s to 4s, how can a full hour of exercise be managed? Should I be eating something in particular before exercise, maybe more protein? Also, where is the liver getting it's glucose stores from when I'm eating such small amounts of protein and carbs?

S

 

[zand]

I am wondering why you feel ketosis is the right way for you? Is your weight 7 stones 6 pounds? I have looked at your BMI and it seems to be borderline low/normal. If you lose 3 or so pounds you will be underweight. Or is there a typo in your post? Just checking

For myself I feel I need to get into ketosis and stay there because I have several stones to lose.

 

[LittleGreyCat]

@zand has a good point - if you are not eating enough calories this could make your body go into defensive mode which may result in unusual BG readings.

If you have very little body fat but are trying to get your body to metabolise this for energy then this might explain your results.

Have you considered keeping your balance between carb/protein/fat but upping the amount you eat by, say, 10%?
This might keep you in ketosis but supply more slow release glucose.

 

[AndBreathe]

Thanks so much for the replies everyone, this has really helped me feel better about whether or not I'm on the right track with this diet. I'm not taking any meds so there's no chance of a 'real' hypo. I think what's confusing me is that I'm not sure if I feel so tired and achy and lacking in energy because I'm still switching to ketosis or because my BG is in the mid 3s. As you both mentioned though, blood sugars in the 3s shouldn't automatically be assumed to be a problem. I'm not feeling shaky or hungry and I don't have a rapid heart rate when I have BGs this low, just headachy, like there's a band across my eyes, very very tired, and quite irritable, but again this could just be switching the ketosis.

I think I'm most frustrated by the sore legs and lack of energy as I'm usually quite active, but I haven't been able to manage much since starting the diet. This is something else that I'm concerned about, if I have BG levels in the 3s to 4s, how can a full hour of exercise be managed? Should I be eating something in particular before exercise, maybe more protein? Also, where is the liver getting it's glucose stores from when I'm eating such small amounts of protein and carbs?

S

There are some excellent points in this thread.

Roughly how many calories are you eating a day? I understand that calories aren't critical in a ketogenic diet, but it's worthwhile paying it a little attention. Whatever you are eating, if it's not enough, you will both lose weight and your bloods will go down. We are built on a similar scale - I'm 5'3" and 49kg (7st 10lb) and to maintain, I'm on around 1800 calories. When overseas, I'm actually much more active, so getting a few more calories in me is going to be a challenge again; especially as we don't buy the local cream overseas, as it's just not very nice.

If you feel you want to eat more, try adding a bit more fat, by way of butter on veggies or cream in coffee (yuck, yuck, yuck), rather than milk.

 

[Sirzy]

I'm not looking to lose any weight at all, I'm actually trying to eradicate SIBO via the SIBO diet, which is largely LCHF. I'm only hoping to be in ketosis because the amount of veg/fruit etc allowed on the SIBO diet is so small, so the alternative energy source for me whilst on this diet seems to be fat. I don't know how many calories I'm consuming, I'm eating lots of fat (mainly olive oil and coconut oil, dairy isn't allowed on the SIBO diet for the first month). I'm not sure I could eat anymore fat, I'm already adding it to all my meals plus large amounts of coconut oil in my peppermint tea.

 

[Lamont D]

Just as a reference point as I'm not diabetic.
My fasting BSLs are never below 4.1 and never higher on my very low carb intake than 5.4 after 2 hours.
This my specialist describes as 'normal' for non diabetic.
He has describes a hypo as below 3.5 mmol.
Even after work, which is physical.

Hope this doesn't screw your findings and BSLs.

 

[Totto]

Thanks so much for the replies everyone, this has really helped me feel better about whether or not I'm on the right track with this diet. I'm not taking any meds so there's no chance of a 'real' hypo. I think what's confusing me is that I'm not sure if I feel so tired and achy and lacking in energy because I'm still switching to ketosis or because my BG is in the mid 3s. As you both mentioned though, blood sugars in the 3s shouldn't automatically be assumed to be a problem. I'm not feeling shaky or hungry and I don't have a rapid heart rate when I have BGs this low, just headachy, like there's a band across my eyes, very very tired, and quite irritable, but again this could just be switching the ketosis.

I think I'm most frustrated by the sore legs and lack of energy as I'm usually quite active, but I haven't been able to manage much since starting the diet. This is something else that I'm concerned about, if I have BG levels in the 3s to 4s, how can a full hour of exercise be managed? Should I be eating something in particular before exercise, maybe more protein? Also, where is the liver getting it's glucose stores from when I'm eating such small amounts of protein and carbs?

S

Glucose will be produced from protein mainly but also from fat so don't worry.

It can take a couple of weeks to get completely keto-adapted so don't give up.

You don't have any adrenal problems? It is very uncommon but lack of cortisol/adrenalin can in some instances lead to lower blood glucose.

 

[Sirzy]

Thanks Totto I don't have any adrenal problems that I'm aware of. I had a teaspoon of honey (6g of carbs) with my lunch, just to try and bump my energy up a bit. I only went up by 1 mmol/l, and I won't make a habit of it, but I have an exercise class tonight and I really feel like I won't be able to even attempt it feeling so tired, and I've paid for the course, which was quite expensive, so I can't not turn up. Honey is allowed on the SIBO diet (because it's absorbed high up in the small intestine), but I'm guessing it's not something I should eat often on a LCHF diet, even if it's part of my total carbs for the day?

 

[Totto]

I envy you, I love honey. A neighbour keeps bees.
Honey is mainly water and sugar and should of course be avoided. Nevertheless I think raw honey can have its benefits. It contains good bacteria for example.

You'll have to work it out for yourself but remember things might change along with your body getting adapted to ketosis.

 

[LittleGreyCat]

If you are running low BG numbers and honey doesn't spike you then I would think it is worth using it as an energy boost if this works.
Obviously it counts towards your total carbs, but if you are within that then I can't see the harm.

Having just Googled SIBO (I assume that you are suffering from this if you are on a SIBO diet) I see that some of the effects include malnutrition, malabsorption and weight loss.

Given that, I assume that your low BG readings are a sign that you are having at least some of these effects.

So it looks as though you may effectively not be (very?) diabetic at the moment because of other factors, so any advice aimed at diabetes and diet based on our personal experience could well be very misleading.
It may be worth checking how much honey you are allowed on your SIBO diet.
If you can absorb it high in the intestine and process it without spiking your blood sugar then it may be a very useful food for you.
In fact, I would be tempted to ramp up the honey, with testing, to see how much you can take without going too high in your BG.
Is there anything else in the carbohydrates/sugars that you are allowed?
I assume your diet is one designed to starve the overgrowth of bacteria in your small intestine without starving you as well.

Have you checked with your medical team?
If you are effectively starving they may wish to review your diet.

Cheers

LGC

 

[Sirzy]

Yes, the idea of the SIBO diet is to starve the bacteria in the small intestine, but without starving yourself too! I'm reluctant too eat too much honey as I'd prefer to be getting my energy primarily from fat as the amount of honey and fruit and veg allowed on the SIBO diet isn't really enough to rely on for energy from carbs, mainly because it's mostly very low carb fruit and veg that's allowed to be eaten, plus only small amounts per meal are recommended. I toted up my total calories for the day which are around 1500 -1600, which I think is fine for someone of my height and weight to maintain their current weight, so that's ok. It's just the lack of energy and mental concentration which is getting me down, plus the low BG levels have been worrying me, although they're not worrying me as much since reading AndBreathe and zands posts.

I just finished my exercise class and have to say that I struggled with really easy stuff that I could manage a week ago. I also felt a bit lightheaded and couldn't fully concentrate on the instructor. I'm really hoping this will improve over the next week or so once I'm fully acclimated to ketosis.

 

[Totto]

Do you supplement with vitamin B12? This might be a good idea.

 

[Sirzy]

I've tried B12, but unfortunately it triggers a flare with my irritable bladder, B vits are notorious for doing this. I think having to eat a diet which not only caters to my diabetes, but also my SIBO and irritable bladder is what's the causing me a lot of problems. One kind of food is allowed on one diet, but not on the other, it's very frustrating at times

 

[LittleGreyCat]

Jut to make the point again - if your SIBO is preventing you from absorbing nutrients (malabsorption) leading to malnutrition and weight loss, then counting calories in is surely not a good guide?

The calories you are taking may be O.K. for someone slim and of medium height when they are able to absorb all the calories from their food, but if your ability to extract energy and nutrients from food is compromised I would have expected that you would increase your total calorie intake to compensate.

From http://www.webmd.boots.com/digestive-disorders/small-intestinal-bacteria-sibo?page=2

"Bacteria in the small intestine, when present in large numbers, can compete with the human body for the food that is eaten. This can lead to malnutrition with vitamin and mineral deficiencies. In advanced cases of SIBO, the bacteria use up enough food, that there are insufficient calories for the body, which leads to weight loss."

I can't immediately find any figures for how much the bacteria steal from your food, but I would guess that even if it is only 10% you should be adding 10% to your normal calorie intake to compensate.

I can see, again from Google, that you have to avoid any fermentable carbohydrates which severely limits most food groups and is far more restrictive than normal LCHF. If you are having difficulty in increasing your fat intakes, how about increasing your egg consumption?

Hope this helps

LGC

 

[Sirzy]

Thanks LGC, that's a very good point. I could add a bit more coconut oil and another egg or two just to boost my calorie intake. I'm finding this easier to do as I've been underestimating how much coconut oil I've been eating (twice as much as I'd thought originally!) It's very hard trying to pinpoint which foods are actually causing me problems with SIBO, as foods need to be omitted, then reintroduced later, then omitted again if they're not suitable. I had scrambled eggs with a small amount of fried and mashed red pepper this morning and this has caused me to bloat up and to burp constantly, so it looks like red peppers are off the menu for a while now

 

[zand]

This is just my thought and may well not be right for you, but you will know if it is or not. Your SIBO diet seems very restrictive anyway and to me that is the most important health issue for you to address since your BG's are already excellent. Do you think a small amount of honey every day could help? This could help you increase calories a little quite easily, it looks as if your BG's would stand it. As LGC says it looks like you need more calories than most people your height and weight just to stay the same.

It's a shame about the peppers