A Failed Attempt at LCHF - Anyone Else?

I was diagnosed as diabetic by a GP in November 2014 and started taking Meformin (500mg once a day). I then went through additional examination by an endocrinologist who found GAD antibodies through another test. So, I was diagnosed as T1 in March 2015. Although my HbA1c was not too bad (40), he put me on Lantus (6 units in the evening) and NovoRapid (2 units before main meals). I think it was a sound decision since my post-prandial BS would spike to 9 without insulin.

I started reading about diabetes and found a lot of info on LCHF. I thought it makes sense and tried it. Unfortunately my medical team does not endorse LCHF and advised me to "eat normal" - others will probably have the same experience.

I went to eating about 90g of carbs daily and later reduced that to 50g. I stopped taking NovoRapid as my BS was excellent with low carb. I would still take Lantus. I experimented decreasing Lantus to 3 units and my fasting BS went up to 5.3, so I continued with 6 units. I would wake up with BS around 4.7.

As for my BS, everything went pretty well. However, I could not figure out how to gain or at least maintain weight (I am not overweight by any means). As far as I was concerned, I ate quite a bit of fatty foods (butter, cheeses, oil, jhigh-fat yoghurt, etc.). I started feeling quite weak and I also started feeling a strange pain or rather discomfort at the bottom of my neck. At some point I started having breathing difficulties and at that moment I decided to quit LCHF.

I went through a medical examination and just a deficit of potassium was found. Not sure if this was related to my problems. I also think I had sufficient intake of salt and liquids when on LCHF.

In any case, I quit LCHF for now and I eat about 50g of carbs per meal (a total of 150g per day) and resumed taking 2 units of Novorapid. I started feeling OK again. Perhaps I should also mention that I switched from Lantus to Levemir.

Even though I started eating carbs again, the combination of taking NovoRapid and being careful about my carb intake per meal helps me maintain a relatively good BS levels, even after meals. For instance: I found lentils are really good. After eating about 200g of cooked lentils (ca. 50g of carbs) my post-prandial BS is around 6.5 or even less. With other types of carbs (e.g. pasta), my BS would go a bit higher (above 7) and stay there for quite a while, so I try to limit pasta in my diet (unfortunately). Potatoes create a little spike in the first 30 minutes (e.g. 7.3) but then my BS goes down pretty quickly, e.g. to 5.4 wihin an hour from eating. I think these numbers are not too bad and I am aware that I can only achieve them thanks to the fact that I still have my own insulin. As my endocrinologist tells me, this is just temporary and I will have to face much higher insulin intake to compensate for the carbs.

So, I would prefer to go LCHF once this happens but am quite confused about the effects the first, failed attempt at LCHF, had on me.

Has anyone had a similar experience going LCHF? And any ideas how to overcome the initial difficulties?

Ian DP said:

I wonder if you weren't eating sufficient fat. Any idea of your carb/protein/ fat ratio? (Mine is 5%carb, 15%protein, 80%fat) . I use the app myfitnesspal to work out the ratios, but there are other apps. I had a problem maintaining weight (BMI 22), until I upped my fat content. my weight has been constant now for a year, since I have been around the 80% fat level.
Eating; real mayonnaise, bullet proof coffee, double cream, cheese, butter, nuts, fatty meats and fish all help..... And my cholesterol has improved.
Most 'healthy fat' experts seem to recommend around 80% fat, 15%protein and 5% carbs.

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Hi Ian,

Thanks a lot for your advice. You are right, I was probably not eating sufficient fat. I think that was part of the problem. I tried to eat a lot of cheese, nuts, butter but then got a bit disgusted and also found I could not digest as quickly as I would like. Also, I found it is hard to go ketogenic if one's medical team does not support you along the way (my case). I actually cannot complain about my medical team but they urge me to eat normal and certainly not high fat.

I wonder if by taking small steps, I can arrive at a low carb diet - though perhaps not ketogenic.

msmi1970 said:

Hi Dave,

I think most people have some sort of reaction in varying degrees when going LCHF. You do need to be extremely diligent.

It's not only conquering the fear of fat but also the lack of carbs (& the supposed impact on the brain), the consumption of additional salt (& the supposed detrimental effects on your blood pressure & kidneys) and the rise in serum cholesterol (which actually is happening to me).

Despite wholeheartedly embracing fats & going cold turkey on my carbs, the issue of salt was a little more daunting as my blood pressure had recently hit 160/100. I went on medications for about 2 weeks before starting LCHF whereupon I stopped taking the meds to see if the diet alone would work.

Two months into LCHF, I began to suffer palpitations, in spite of consuming what I thought was sufficient sodium. My blood panel showed me within "normal" range of sodium & potassium levels. I held my nerve and began increasing my sodium intake. Later, I added a dose of potassium every 2-3 of weeks & daily magnesium as well.

About 2 weeks after increasing sodium intake, my palpitations started to recede. What I realise is that, "normal" ranges tend to apply less in relation to LCHF particularly when your kidneys start excreting rather than retaining sodium. This electrolyte imbalance can cause issues with heart rhythms but for the most part can be avoided with adequate supplementation.

10 months into LCHF, I have lost a considerable amount of weight. My blood pressure without medication is now 120/75. No more issues with palpitations. If I feel my heart skip even a single beat, I just add a little extra salt at my next meal.

I am doing this with the blessings of my cardiologist who agreed after seeing my risk factors plummet within the first two months (apart for my cholesterol, which is an entirely separate discussion in itself) so I do think it would be best if you continue in consultation with a medical professional if you go back on LCHF.

Hope this helps. Good Luck!!

Mo

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Hi Mo,

Thanks a lot for sharing your experience. I can only agree going LCHF can be hard for some people. You are lucky having your medical team support you in going LCHF.

An update: I still could not figure out how to go below 50g carbs per meal. When I switch to eating low-carb meals, I very soon start feeling weird: restless and with breathing difficulties (quite scary, had never experienced this in my pre-diabetic life). I have no idea how to prevent feeling like that when eating low carb... Drinking more water and taking in more salt does not help.

So I finally made it and managed to go below the magic 50g carbs per day. It has been roughly a week now that my body produces ketones (1+ mmol).

Besides this forum, two books by Volek and Phinney helped me quite a bit:
- The Art and Science of Low Carbohydrate Living
- The New Atkins for a New You (this is a very practical guide for anyone starting a LCHF diet)

4ratbags said:

Its great to hear you have managed to get below 50g carbs per day. How are you feeling, are you still having breathing difficulties ect or has it all settled down.

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Thanks! It has mostly settled down, I wonder if it was part of the keto-adaptation process. I will know for sure in a few weeks time I guess. On the whole I feel pretty much OK. I just cut down on sports activity a bit this week. The muscles are still not adapted prefer to burn glucose. I read that it takes threee to four weeks for the muscles to get adapted.