Medical basis for myself being in ketosis.

[Indy51]

Thanks for the video. I find it a bit too specialised, but on the other hand, many books out there are too simple (e.g. How not to die, Eat fat get thin). Is there anything in-between you can recommend?

Volek and Phinney - either their book The Art and Science of Low Carbohydrate Living or there are a lot of their videos online.

This is a good interview and good explanations of LCHF:

 

[KevinPotts]

That book Indy51 is the best I've read. I'm gong through it for the second time. Written to help doctors get a better understanding, it still remains accessible with just a little concentration.

 

[SugarPossum]

Excellent discussion Now I understand Ketone (to some extent) but I won't know if it will help me for a while, if ever.
Last HbA1C was 6.3% in April (down from 6.8% Jan 16) hopefully due to < 100g carbs/day.
Next check due end July.
However. My weight may have decreased but only slightly. Should I be expecting an ever increasing loss or do I need to go into ketosis?

 

[SugarPossum]

Oops! Forgot to watch this thread

 

[friendlyfish]

...the colour of my urine, which rarely varies during the day after my first one. It's a colour I can only describe as fluorescent yellow, but clear.

Do you take a vitamin tablet? The vitamin Riboflavin B2 can turn urine fluorescent - because it is water soluble any excess comes out in your urine, and produces this amazing colour.

https://en.m.wikipedia.org/wiki/Riboflavin

 

[Bluetit1802]

Do you take a vitamin tablet? The vitamin Riboflavin B2 can turn urine fluorescent - because it is water soluble any excess comes out in your urine, and produces this amazing colour.

https://en.m.wikipedia.org/wiki/Riboflavin

Thanks. I take no supplements at all. I have read about excess B2 and other vits causing this, but it can also be a sign of ketosis when the kidneys flush out the excess ketones. It is an amazing colour, you are right! I really must get some ketostix.

 

[Oldvatr]

Excellent discussion Now I understand Ketone (to some extent) but I won't know if it will help me for a while, if ever.
Last HbA1C was 6.3% in April (down from 6.8% Jan 16) hopefully due to < 100g carbs/day.
Next check due end July.
However. My weight may have decreased but only slightly. Should I be expecting an ever increasing loss or do I need to go into ketosis?

Ketosis is not essential for weight loss or bgl reduction. Just restricting carbs will force your body to raid your internal energy stores for glucogen, and this will also release stored water. When your internal stores are depeleted, then this is the time when ketosis can occur, and this starts to use up the fat stores instead of the glucose stores. This in turn helps weight reduction, and starts to reduce tummy bulge too. Depending on what your diet actually consists of, you should reach a sort of equilibrium wrt weight. Then you can use fat to control weight without changing your bgl levels. Increase fat to add weight, lower fat = lose weight.

 

[SugarPossum]

I used to be 34" waist, it's now 40 (down from 42 ) Braces for me soon then.

Fat. Confusing. I'd come round to believing that "fat doesn't make you fat" .
Now you're saying it does?
If that really is the case what is the "HF" in a LCHF diet?
Or. Do you mean only in ketosis?

My daily carbs are averaging <50, occasionally just 50+.
Four days a week small amounts of roasted several root vegetables using olive oil.
If I attempt to decrease my carbs, how will I know when ketosis kicks in?

 

[KevinPotts]

You may have to hit a max of 20g per day to transition to Ketosis, or fat burning as we also loosely describe it. 20g is basically all you'll get from your greens and normal protein ie. no more carbs in addition. It took me a couple of weeks to adapt with a few symptoms ( constipation and light headed ness) sorted the first with at least 8 glasses of water a day and 2-4 grams of added salt. I new when I was in Ketosis b using some Ketone sticks - not terribly accurate, but enough to know if you have ketones. Thereafter, the weight will come off (1-3lbs per week) and sometimes slower or faster, but as Oldvatr has said you will then eventually reach what they call your Personal Fat Threshold over time. I'm now 30" waist again - first time since I was n my early 20s, I'm now 54. So don't give up, just press on and I am sure you'll make progress. But your right, fat does not make you fat.


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[Oldvatr]

I used to be 34" waist, it's now 40 (down from 42 ) Braces for me soon then.

Fat. Confusing. I'd come round to believing that "fat doesn't make you fat" .
Now you're saying it does?
If that really is the case what is the "HF" in a LCHF diet?
Or. Do you mean only in ketosis?

My daily carbs are averaging <50, occasionally just 50+.
Four days a week small amounts of roasted several root vegetables using olive oil.
If I attempt to decrease my carbs, how will I know when ketosis kicks in?

I did start a thread in Discussions titled what is the HF in LCHF, so this might be worth a peek. Basically, I am using fat to control my weight, and carb + protein to control bgl. The two controls are pretty much independant of each other.

Like anything, if you intake more fat than you burn up (i.e.use) then it gets stored as fat. If you are in ketosis (fat burning) then this takes firstly blood lipids, then it raids the fat stores, thus reducing FAT. hence a mechanism to control weight and also can reduce adipose tissue (body fat)

It sort of works like this even if not in ketosis, just in LC mode, but to get full effect then really I think you need to be keto. Otherwise I suspect the cholesterol rises unless you exercise a lot.
Its a balancing act. I have been eating butter and olive oil and cheese for most of my life, but now I add double cream to coffee and snack on babybels when I want to put on a kg or two, leave it off if I go over my optimal weight. Seems to work ok for now. I can see my toes! and still only 67kg,

 

[Oldvatr]

If I attempt to decrease my carbs, how will I know when ketosis kicks in?

This is a difficult one, and one I struggle with. As Kevin says, you can buy some Ketostix or similar. They are not accurate, but give an indication of sorts. They only apply to the moment of test, so do not tell you how long keto lasts. Mine also tell me other things like protein in wee, blood in wee, infection (UTI), and a few other things beside.

I find my wee has a chemical smell that is different from normal. Bit like popcorn.

When i looked at how my bgl averages were going, there was a sudden drop soon after I dropped my carb level from 50 to around 30g/day. i believe this to bedue to ketosis, and not a strip change in my meter since I use 2 meters in parallel.

Some on the forum say they get more energy suddenly. I have not noticed this effect myself. I have no other symptoms either way, and feel no different. All I can say is that I used to become hypo aware at around 4.0 mmol/l, but now it starts around 3.5 mmol/l, but this could be due to other factors.

 

[SugarPossum]

I'll follow your link and see what comes up.
However, being a lazy person, do I need (yet) to monitor all those other levels you speak of?

Another (growing) concern about ketosis, or not knowing when it occurs, is danger of hypoglycemia. Not that in itself can be a danger except it can happen without warning which may happen at some critical juncture.

 

[Oldvatr]

I'll follow your link and see what comes up.
However, being a lazy person, do I need (yet) to monitor all those other levels you speak of?

Another (growing) concern about ketosis, or not knowing when it occurs, is danger of hypoglycemia. Not that in itself can be a danger except it can happen without warning which may happen at some critical juncture.

I test myself 4 times a day, and when I take an average across all 4 sets of readings, I get a result that is close to my HbA1c. The 4 readings I take a (a) fasting (FBGL) before breakfast, (b) Pre-meal (just before my major meal (c) 2 hour PP (2 hours after eating to see how the sugar and simple carbs have spiked me and (d) 4hr PP (4 hours after eating to see how proteins and fats have affected me. This is also generally how I will remain for most of the night due to the way my meds work)

Recently, to save strips for dealing with hypo's, I have dropped the FBGL since it is now fairly static.
This testing regime allows me to see how my meals affect me, and allows me to tweak ny medication and foods.

I also use 2 meters in parallel in each test, and this gives me confidence in how true my meters are. It can detect a false reading or a misread, it can detect the inevitable change when changing to a new batch of test strips, and recently it detected when one of my meters started reading high due to a flattish battery.

You can organise how you want to test. There are no fixed rules. I discussed my regme with my GP and the DSN, and they agreed to fund one of my two meters. I self fund the other.

As regards hypo's, most people get indications when their bgl drops too low. For me it is visual disturbances, and crabby demeanour (see my Avatar). There is a very good hypo awareness course online and free . Go to DCUK main menu and look for it. I completed it and on the very same day I bought some glucotabs in Boots, and promptly had my first ever hypo.
While hypo can occur even in 'normals' it is only really a concern if you are on either insulin or a drug like Gliclazide. Metformin alone is much less likely to give any serious concern. As a T2 on orals, which I assume you are, then even if one occurs, it is unlikely to be a major event, and the body is very good at finding ways to protect us. The night before last I had a reading of 3.6, which is technically in hypo land, but I had a cracker, went to bed, and woke up with reading of over 5.8 I have only once had to use a glucotab to deal with a hypo condition, and that was only bcause the DVLA insist that my bgl is over 5.0 before I attempt to drive, and I had an emergency that needed me behind the wheel

 

[bulkbiker]

I'll follow your link and see what comes up.
However, being a lazy person, do I need (yet) to monitor all those other levels you speak of?

Another (growing) concern about ketosis, or not knowing when it occurs, is danger of hypoglycemia. Not that in itself can be a danger except it can happen without warning which may happen at some critical juncture.

Hi SugarPossum
Unless you are taking meds to artificially lower your blood sugar in my admittedly limited knowledge it is highly unlikely that you will have a hypo. Your profile says you are diet only so that is the case with you I think. When I fast, last time 4 days, I'm pretty sure I was in ketosis but only got down to 4.1 (just before eating on the fourth day) and even then I felt fine.. In fact had just swum 50 lengths (1.25 km).

 

[Lamont D]

I'll follow your link and see what comes up.
However, being a lazy person, do I need (yet) to monitor all those other levels you speak of?

Another (growing) concern about ketosis, or not knowing when it occurs, is danger of hypoglycemia. Not that in itself can be a danger except it can happen without warning which may happen at some critical juncture.

Hi, you are not on meds, if your information is right.
You should not have a hypo, unless something else is going on.

Take a look at the hypo awareness test, it is very good!

 

[Robbity]

Another (growing) concern about ketosis, or not knowing when it occurs, is danger of hypoglycemia. Not that in itself can be a danger except it can happen without warning which may happen at some critical juncture.

As far as I understand it: when you're in ketosis, because you're not entirely relying on glucose, you're less likely to have hypos and they'll be less severe.

An old (mainly type 1) discussion on this topic here: http://www.diabetes.co.uk/forum/threads/how-do-you-hypo-on-a-ketogenic-diet.66536/. I thought I'd actually seen another similar thread more recently but couldn't find that one.

Robbity

 

[KevinPotts]

Robbity, I am fairly sure any T1s and T2s who are medicated should get GP support with monitoring and gradually reducing insulin/meds in view of greater likelihood of hypos on a ketogenic diet. With T1s they also have to be careful of developing ketoacidosis. I am sure those more adept and able will correct me if I'm wrong.


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[robert72]

Robbity, I am fairly sure any T1s and T2s who are medicated should get GP support with monitoring and gradually reducing insulin/meds in view of greater likelihood of hypos on a ketogenic diet. With T1s they also have to be careful of developing ketoacidosis. I am sure those more adept and able will correct me if I'm wrong.


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As a T1, you are not likely to get ketoacidosis if you have sufficient insulin and therefore normal blood sugars. The risk is when you have ketones and your sugars are in the teens, meaning you don't have enough insulin to stop the ketones rising to dangerous levels. It's quite OK to follow a ketogenic diet as a T1 (I have for almost 3 years) as long as you understand what you are doing.

 

[KevinPotts]

Thanks for the helpful clarification Robert.


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[Oldvatr]

Robbity, I am fairly sure any T1s and T2s who are medicated should get GP support with monitoring and gradually reducing insulin/meds in view of greater likelihood of hypos on a ketogenic diet. With T1s they also have to be careful of developing ketoacidosis. I am sure those more adept and able will correct me if I'm wrong.


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I will not correct you on that. It is the correct way to approach it. I am a maverick sometimes, and I do tend to act first then tell the GP after, but I have kept my GP in the loop on this important matter. I have now officially reduced one of my meds, and my GP is aware that I get low bgls on this diet. He is aware of what ketosis means, and is happy for me to continue,

I am aware of the DVLA requirements regarding low bgl levels,and also the legal requirement to report any intervention events if they occur.