Hi, At the risk of getting no replies at all, I'm making this long post because i) I can't explain any quicker and ii) I'm desperate.
A month before I completed a 12 week transition (starting at HbA1c 47) into a ketogenic diet, I wrote:
Hi, I'm 73 yo, male with T2D since late 2013 diagnosis, diet controlled but only just, BMI 22.5 and don't need to lose weight. BP controlled to less than 140/80 by 5mg Amlodipine and cholesterol controlled at 4-5 by 20 mg statin; lifelong asthmatic, controlled well by drugs.
I get plenty of exercise, in excess of 5 x 30 mins strenuous sessions per week.
Why did I go keto? To reinstate myself firmly into the low prediabetes HbA1c range, preferably better, and to be a credible, live example, to my son and D-in-Law who have a T1D teenage daughter, that BG can be controlled (maybe not till she's out of the headstrong teenager stage and definitely at the cost implied by recognising she can't eat just what she likes and maintain stability with (mis-)calculated gobs of insulin).
It's 17 weeks after I went keto (I was ketotic from at most day 4, when my urine strips arrived).
A, B, C, D, E below are included for completeness, but can be ignored unless you are someone who is interested in unremarkable experiences.
A) I stuck very well to a limit of 30g net carbs and less well to a limit of 125g protein. I was surprised when I made a graph of protein limit breaks that there had been so many. BUT there were only 4 days when I was not in ketosis, maybe because the breaks were caused by pre-bedtime binges (biggest binges: +50% over the protein limit and, sometimes even that has not stopped me registering ketosis before breakfast.)
B) I do not feel any better than before keto (actually worse, see below). I still crave more food, but that may have improved somewhat and doesn't matter too much (normally, I was a grazer, always waiting for my next snack, and didn't eat regular meals, but I've kept to the keto discipline). (I used to have 2 guaranteed' ways of making myself feel good. Both involved shortening my usual endurance exercise by a considerable amount and then 'going for it'. When I finished my shower I would feel refreshed, clear, sharp, just great. This is how I interpret people's feelings of well-being from keto. It would be a wonderful bonus.
C) Cholesterol has doubled. Not prepared to worry at the mo' and I'm trying to get tests to clarify whether my LDL is as bad as conventional medicine would say it is.
D) My self-monitored BP has certainly not improved. It may have deteriorated slightly.
E) At times, I have suffered from quite a lot of nausea, unpleasant and demotivating/debilitating exercise-wise, but that seems to have been fixed several weeks ago by giving up avocados (200g - 500g/day with very low net carbs and protein; but they contain a fair amount of Omega-6 and maybe that was the villain - it's warned about in soybean oil by Steve Phinney (SP)).
A detailed breakdown of diet plus 2 Boots A-Z multi-vits, magnesium citrate tablets, (salmon and) Omega-3 capsules against the RDI/RDA plus SP recommendations re minerals, convinces me my pretty much unvarying menu satisfies the requirements (wholefoods for sure, minimal microwaving and frying with olive oil/butter. It's hardly what you would call cooking as such, and very boring for most, but it works for me (?)).
Very importantly, my HbA1c is reduced to 42 - much, much better (and disproves over-optimistic readings I got from both Abbott CGM and A1CNow - they were mutually consistent but my SD Codefree was right!).
The following add up to an inability to continue the diet without help.
Despite ensuring I get at least 10g Salt (4+g sodium) and 3-4g potassium spread throughout the day, but usually including a substantial boost before exercise, I more often than not cannot exercise strenuously or, since I just feel **** as soon as I get on the treadmill, at any worthwhile energy level at all. Sometimes it works for a couple of days and then I'll be back to giving up for a couple of days. This matters a lot to me and is a deal-breaker.
In fact, I maybe did better in the earlier weeks (4g - 6g/day and when I was expecting keto flu) than now, despite not making the effort to increase salt and potassium wholeheartedly until about 6-7 weeks ago. Depending on which publication you read by Steve Phinney (SP, below) and/or which video of his you watch, you shouldn't really increase your salt if you have hypertension, should compromise on 7g salt fir hypertensives, or go for at least 10g.
Prior to keto, maybe a few times a week at most, I would register faintness for a few seconds when suddenly getting up from a chair or from doing up my shoelaces ('postural hypertension', maybe). That now happens every day, lasts longer sometimes and sometimes merges with/develops into (?) the following feeling.
I get a feeling that, at its mildest, feels like a light covering has been placed gently over the whole of the top of my skull. At the time, you might think that it was nothing much but that it would develop into a headache (it doesn't). However, even if I don't have it to start with, if I go out and do some very light gardening for 45 minutes (e.g. some gentle weeding), when I (straighten up and) walk back to the house, it will be noticeably worse and I don't feel good. Unless it improves, and often it doesn't, I won't even attempt 'proper' strenuous exercise (because I would feel rubbish, demotivated and fatigued before a few minutes had elapsed). I have very good powers of concentration, so if I get into doing purely brain work (like writing this) it doesn't bother me (but it's still there). And it doesn't deteriorate if I go for a walk.
Conclusion: I cannot tolerate feeling rubbish and being unable to exercise strenuously and will have to give up keto if I need to. It will be a very big blow if I do, but I must try to regain my fitness - at least for next year's holiday if I can't go this year, and I can probably keep down to a mid-40s HbA1c by (guess) a 130g carbs/ 200g protein diet. (But what about my grandchild?).
Maybe in due course my GP would be able to help if I can persuade him that his other patients could benefit from keto, but not till Covid-19 subsides.
Maybe you have good suggestions (please)?
If you've read this far, wow!
TIA, John
post edited By moderator for language In accordance with forum rules
A month before I completed a 12 week transition (starting at HbA1c 47) into a ketogenic diet, I wrote:
Hi, I'm 73 yo, male with T2D since late 2013 diagnosis, diet controlled but only just, BMI 22.5 and don't need to lose weight. BP controlled to less than 140/80 by 5mg Amlodipine and cholesterol controlled at 4-5 by 20 mg statin; lifelong asthmatic, controlled well by drugs.
I get plenty of exercise, in excess of 5 x 30 mins strenuous sessions per week.
Why did I go keto? To reinstate myself firmly into the low prediabetes HbA1c range, preferably better, and to be a credible, live example, to my son and D-in-Law who have a T1D teenage daughter, that BG can be controlled (maybe not till she's out of the headstrong teenager stage and definitely at the cost implied by recognising she can't eat just what she likes and maintain stability with (mis-)calculated gobs of insulin).
It's 17 weeks after I went keto (I was ketotic from at most day 4, when my urine strips arrived).
A, B, C, D, E below are included for completeness, but can be ignored unless you are someone who is interested in unremarkable experiences.
A) I stuck very well to a limit of 30g net carbs and less well to a limit of 125g protein. I was surprised when I made a graph of protein limit breaks that there had been so many. BUT there were only 4 days when I was not in ketosis, maybe because the breaks were caused by pre-bedtime binges (biggest binges: +50% over the protein limit and, sometimes even that has not stopped me registering ketosis before breakfast.)
B) I do not feel any better than before keto (actually worse, see below). I still crave more food, but that may have improved somewhat and doesn't matter too much (normally, I was a grazer, always waiting for my next snack, and didn't eat regular meals, but I've kept to the keto discipline). (I used to have 2 guaranteed' ways of making myself feel good. Both involved shortening my usual endurance exercise by a considerable amount and then 'going for it'. When I finished my shower I would feel refreshed, clear, sharp, just great. This is how I interpret people's feelings of well-being from keto. It would be a wonderful bonus.
C) Cholesterol has doubled. Not prepared to worry at the mo' and I'm trying to get tests to clarify whether my LDL is as bad as conventional medicine would say it is.
D) My self-monitored BP has certainly not improved. It may have deteriorated slightly.
E) At times, I have suffered from quite a lot of nausea, unpleasant and demotivating/debilitating exercise-wise, but that seems to have been fixed several weeks ago by giving up avocados (200g - 500g/day with very low net carbs and protein; but they contain a fair amount of Omega-6 and maybe that was the villain - it's warned about in soybean oil by Steve Phinney (SP)).
A detailed breakdown of diet plus 2 Boots A-Z multi-vits, magnesium citrate tablets, (salmon and) Omega-3 capsules against the RDI/RDA plus SP recommendations re minerals, convinces me my pretty much unvarying menu satisfies the requirements (wholefoods for sure, minimal microwaving and frying with olive oil/butter. It's hardly what you would call cooking as such, and very boring for most, but it works for me (?)).
Very importantly, my HbA1c is reduced to 42 - much, much better (and disproves over-optimistic readings I got from both Abbott CGM and A1CNow - they were mutually consistent but my SD Codefree was right!).
The following add up to an inability to continue the diet without help.
Despite ensuring I get at least 10g Salt (4+g sodium) and 3-4g potassium spread throughout the day, but usually including a substantial boost before exercise, I more often than not cannot exercise strenuously or, since I just feel **** as soon as I get on the treadmill, at any worthwhile energy level at all. Sometimes it works for a couple of days and then I'll be back to giving up for a couple of days. This matters a lot to me and is a deal-breaker.
In fact, I maybe did better in the earlier weeks (4g - 6g/day and when I was expecting keto flu) than now, despite not making the effort to increase salt and potassium wholeheartedly until about 6-7 weeks ago. Depending on which publication you read by Steve Phinney (SP, below) and/or which video of his you watch, you shouldn't really increase your salt if you have hypertension, should compromise on 7g salt fir hypertensives, or go for at least 10g.
Prior to keto, maybe a few times a week at most, I would register faintness for a few seconds when suddenly getting up from a chair or from doing up my shoelaces ('postural hypertension', maybe). That now happens every day, lasts longer sometimes and sometimes merges with/develops into (?) the following feeling.
I get a feeling that, at its mildest, feels like a light covering has been placed gently over the whole of the top of my skull. At the time, you might think that it was nothing much but that it would develop into a headache (it doesn't). However, even if I don't have it to start with, if I go out and do some very light gardening for 45 minutes (e.g. some gentle weeding), when I (straighten up and) walk back to the house, it will be noticeably worse and I don't feel good. Unless it improves, and often it doesn't, I won't even attempt 'proper' strenuous exercise (because I would feel rubbish, demotivated and fatigued before a few minutes had elapsed). I have very good powers of concentration, so if I get into doing purely brain work (like writing this) it doesn't bother me (but it's still there). And it doesn't deteriorate if I go for a walk.
Conclusion: I cannot tolerate feeling rubbish and being unable to exercise strenuously and will have to give up keto if I need to. It will be a very big blow if I do, but I must try to regain my fitness - at least for next year's holiday if I can't go this year, and I can probably keep down to a mid-40s HbA1c by (guess) a 130g carbs/ 200g protein diet. (But what about my grandchild?).
Maybe in due course my GP would be able to help if I can persuade him that his other patients could benefit from keto, but not till Covid-19 subsides.
Maybe you have good suggestions (please)?
If you've read this far, wow!
TIA, John
post edited By moderator for language In accordance with forum rules
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