Medical basis for myself being in ketosis.

[Lamont D]

Spent most of yesterday rummaging through the medical websites.
Though most really disagree and and dispute the evidence of continuous ketosis, that it does harm, well this sort of medical evidence is abound in most medical websites.

I have copied this from a conglomeration of medical websites, it is not my words.
Sorry, no links as this would be general knowledge throughout the medical industry.
I could never in a million years, choose these words!
This describes the evidence that we actually don't need carbs to be well, as the source of glucose between glucose derived from carbs and sugars and glucose derived from being in ketosis.

'Although the cells can use other fuels, neurons depend on glucose as a source of energy, unless the person is in ketosis, they do not require insulin to absorb glucose, unlike muscle and adipose tissue, and they have very small internal storage of glycogen. Glycogen stored in liver cells can be converted to glucose and released into the blood, when glucose from digestion is low or absent, and the glycerol backbone in triglycerides can also be used to produce blood glucose.'

For someone who has a condition that reacts to carbs and excessive insulin, this gives me my attitude towards not having to digest the so called good carbs, for me carbs are carbs and not conducive to my body and how it works.
Reducing insulin in the blood, will also help so many other conditions as well, mainly T2.
That's why reducing your carbs will help with insulin resistance.

 

[DavidGrahamJones]

That's interesting. By coincidence I've recently had a simple urine test done (depending on how steady you are achieving sample collection mid flow when half asleep or is it half awake?) providing a comprehensive profile.

I have high beta-hydroxybutyrate suggesting Ketosis (must be doing something right) but interestingly I have been tinkering with my fat intake (GP said I didn't eat enough, most people talk about LCHF as opposed to my usual LCLF or LC?F) as I'll try anything once. The report says that there is a metabolic block preventing the fat from being converted into ATP for muscle energy and is being diverted and stored as fat. I feel that I've had a eureka moment, it explains a lot, including the elevated BG I've been getting.

 

[Oldvatr]

Spent most of yesterday rummaging through the medical websites.
Though most really disagree and and dispute the evidence of continuous ketosis, that it does harm, well this sort of medical evidence is abound in most medical websites.

I have copied this from a conglomeration of medical websites, it is not my words.
Sorry, no links as this would be general knowledge throughout the medical industry.
I could never in a million years, choose these words!
This describes the evidence that we actually don't need carbs to be well, as the source of glucose between glucose derived from carbs and sugars and glucose derived from being in ketosis.

'Although the cells can use other fuels, neurons depend on glucose as a source of energy, unless the person is in ketosis, they do not require insulin to absorb glucose, unlike muscle and adipose tissue, and they have very small internal storage of glycogen. Glycogen stored in liver cells can be converted to glucose and released into the blood, when glucose from digestion is low or absent, and the glycerol backbone in triglycerides can also be used to produce blood glucose.'

For someone who has a condition that reacts to carbs and excessive insulin, this gives me my attitude towards not having to digest the so called good carbs, for me carbs are carbs and not conducive to my body and how it works.
Reducing insulin in the blood, will also help so many other conditions as well, mainly T2.
That's why reducing your carbs will help with insulin resistance.

I see from other posts you have made, that you are running with a Very Low Carb diet (<20g.day). I can understand why someone with RH would want to run their metbolism like this, but I am not so sure if it is a good idea for T2's (or others) to follow a 'continuous ketosis' diet. The justification you quote in this post is I think an oversimplification of the processes involved, and not very helpful.

Firstly, what it says is true. Neurons cannot get their energy from any other source except from glycogen or ketones in the blood. Neurons must have glucose or ketones, or our brain, and respiratory systems fail, and we die. So our body has learnt to adapt to protect these most vital of bodily functions. Ketosis is one such mechanism, but it is a backup protection, and not the primary means of living.

Then there is gluconeogenesis, by which glucose is made from proteins during ketosis, but for this to occur, our bodies need to be in ketosis, and with low glucose levels. This glucogenesis can also synthesise glucose from fats, but it only does this when there is low protein around. This is very close to starvation mode, and is the last ditch effort to provide glucose for the brain. It is the Last Chance Saloon.

If we run with continuous ketosis, which is what I think you are trying to justify here, then this will lead to (a) glycogen stores depleted, and not recharging easily, and (b) fat stores depleted by ketosis. So we are already on emergency rations. Add some extra exercise or exertion, and then we rely on gluconeogenesis working flat out to support it. If you are also restricting fat and/or protein, then the body may start to struggle to maintain functions since gluconeogenesis is a very inefficient process and slow to react.

I think this is why medical people feel that ketogenic diets carry some risk, since we choose to force our bodies to run in emergency mode for prolonged periods, and we deliberately run down our backup batteries. I hope we get a full discussion going here, since not everyone reading these posts will be experienced or informed.

 

[KevinPotts]

Interesting stuff chaps. I wonder how the traditional aboriginal ndiets of the antipodes, north American, Canada Inuits for instance, all of which have been clinically observed and researched and managed on perpetual ketogenic diets, whilst watching their protein intake and consuming 65% + fat. They still appeared to thrive on this lifestyle eating approach.

 

[Oldvatr]

Interesting stuff chaps. I wonder how the traditional aboriginal ndiets of the antipodes, north American, Canada Inuits for instance, all of which have been clinically observed and researched and managed on perpetual ketogenic diets, whilst watching their protein intake and consuming 65% + fat. They still appeared to thrive on this lifestyle eating approach.

Agree that these peoples survived on a largely keto diet, but if you take,say, the Inuit, then their livers have adapted to their diet, and they eat completely different meats to us. High in Omega-3,low in Omega-6 Blubber supplies most micronutrients they need, and they eat a lot of fat and rancid fish oil. Not the sort of thing we buy in the Supermart today. It is not a good idea for those of us accustomed to a modern processed diet to suddenly embark on a continuous keto diet since the fats we have here are not the same as those that are available to the peoples you mention. It is not like for like.

Remember, a diet of rabbit kills us because it is too lean and we overdose on protein, as the trappers in Canada found out.

 

[KevinPotts]

So funny, " Not the sort of thing we buy in the supermarket today".

 

[KevinPotts]

Have you seen cereal killers 2, where Steve Phinnney, works with the husband and wife long distance endurance athletes. They did the Pacific crossing rowing in a 2 person boat, fully keto adapted, admittedly they were only rowing was it 60 days? But their entire lifestyle was totally ketogenic and has been for quite some time and all their numbers, BP, hba1c, lipid and subfraction particles, kidneys, liver adrenals all appeared to be operating optimally. Are you aware of ant RCTs long term? I know of comments from doctors with patients keto adapted for 3 years +

 

[chri5]

I really don`t pretend to understand a lot of the technical discussions on this and similar subjects but surely, isn`t the very fact that anyone does live in ketosis proof that it is both possible and possibly even beneficial in some cases? We assert time after time on this site that we are all different and one size certainly does not fit all, it`s one of the few things most of us here agree on! Well maybe this is one of those things which works for some, but not others.

 

[Lamont D]

I have been in ketosis for over two years and my health has turned around exceptionally, I am fitter and stronger, have more energy and my body has more or less self healed itself, so that the only thing that is medically or physically or psychologically wrong with me is my imbalance of insulin. Which I don't need when in ketosis or very little, I should say. I have lost over five stone in weight.
Everybody comments on how well I look and how I can continue to work full time and look after the house and shopping, cleaning, cooking, etc.
I have every reason to be in ketosis, because of my insulin problem.
I don't want to feel ill, just because some well informed specialist says so, when even he says to be on a very low carb diet.
Meanwhile, I do eat some carbs, you just can't get away from them. It seems that the salad I have every day is sufficient for me. I don't need supplements or vitamins, I don't need to exercise as my work does enough, I eat the fat of meat, I have some dairy at night, but I eat mostly fresh meat and salad veg. And lots of eggs!
There is a new thinking in extreme sports, that being continually in keto, helps with performance and recovery, and it is generally thought that drinking fructose (sports drinks) when just simple straightforward water will suffice and the likes of carb overloading and carb recovery is having adverse effects on future health of ex professionals.
Ketosis doesn't suit everyone, I don't recommend it for those that can eat as normally as possible. The reason for the post was to post certain information that we can live full functioning lives without the amount of carbs that our health care system tells us.

 

[KevinPotts]

Thanks Nosher - excellent first hand testimony.

 

[Bluetit1802]

Indeed, excellent first hand testimony Nosher, and well done for all you have achieved.

 

[Munkki]

I see from other posts you have made, that you are running with a Very Low Carb diet (<20g.day). I can understand why someone with RH would want to run their metbolism like this, but I am not so sure if it is a good idea for T2's (or others) to follow a 'continuous ketosis' diet. The justification you quote in this post is I think an oversimplification of the processes involved, and not very helpful.

Firstly, what it says is true. Neurons cannot get their energy from any other source except from glycogen or ketones in the blood. Neurons must have glucose or ketones, or our brain, and respiratory systems fail, and we die. So our body has learnt to adapt to protect these most vital of bodily functions. Ketosis is one such mechanism, but it is a backup protection, and not the primary means of living.

Then there is gluconeogenesis, by which glucose is made from proteins during ketosis, but for this to occur, our bodies need to be in ketosis, and with low glucose levels. This glucogenesis can also synthesise glucose from fats, but it only does this when there is low protein around. This is very close to starvation mode, and is the last ditch effort to provide glucose for the brain. It is the Last Chance Saloon.

If we run with continuous ketosis, which is what I think you are trying to justify here, then this will lead to (a) glycogen stores depleted, and not recharging easily, and (b) fat stores depleted by ketosis. So we are already on emergency rations. Add some extra exercise or exertion, and then we rely on gluconeogenesis working flat out to support it. If you are also restricting fat and/or protein, then the body may start to struggle to maintain functions since gluconeogenesis is a very inefficient process and slow to react.

I think this is why medical people feel that ketogenic diets carry some risk, since we choose to force our bodies to run in emergency mode for prolonged periods, and we deliberately run down our backup batteries. I hope we get a full discussion going here, since not everyone reading these posts will be experienced or informed.

I am sometimes worried about going on an extreme diet, as my previous low-sodium diet really was not the magic solution I hoped it would be. So, what diet do you recommend for people with diabetes? Low carb, but not so low that we are in constant ketosis?

 

[KevinPotts]

Munkii, I totally agree, that's why I find LCHF so palatable (excuse the pun).

No calorie counting, full and satisfied all the time by simply, cutting the carbs, moderate protein and more fats, preferably good ones. you'll only experience an adaptation to ketones if you drop to 20g per day, which arguably is the state that translates you to fat burning. But you could ease in if your concerned, by dropping to say 120g a day, like the low carb program promoted through diabetes.co.uk

 

[Oldvatr]

Munkii, I totally agree, that's why I find LCHF so palatable (excuse the pun).

No calorie counting, full and satisfied all the time by simply, cutting the carbs, moderate protein and more fats, preferably good ones. you'll only experience an adaptation to ketones if you drop to 20g per day, which arguably is the state that translates you to fat burning. But you could ease in if your concerned, by dropping to say 120g a day, like the low carb program promoted through diabetes.co.uk

I started my LCHF journey with 120g per day, and that did lower my bgl and my weight. But my lipids increased, and the improvements plateau'd. I have now reduced to around 50g per day, and believe I am getting intermittent keto state. My weight loss rate has now increased, and I am having to up the fat to compensate for this.

I am wondering how my lipids are doing but have another 3 months before GP will authorise a full panel test. IMO, I think that the good lipids come when the fat is burned up either by exercise or during keto, but stay bad in the presence of carbs. So I may need to drop my carbs again and experiment with extended keto mode. For me this is still a concern since I am not 100% convinced about the fluffy LDL and nasty sdLDL and lowered mortality with a higher TC count. As an old Vart I may just get away with it, but I am not sure yet. I have had surprising luck so far.

 

[Lamont D]

I am sometimes worried about going on an extreme diet, as my previous low-sodium diet really was not the magic solution I hoped it would be. So, what diet do you recommend for people with diabetes? Low carb, but not so low that we are in constant ketosis?

Yeah, more or less!
But it has to suit you!
I haven't had the chance to look at your history, but reducing your carbs is the first step and finding out what you can tolerate that doesn't spike you.
If you feel comfortable and losing weight and your blood glucose levels are dropping, then a moderately low carb diet will suffice.
You just have to find out what works for you!
Control is the key to unlock better health.

 

[Robbity]

Our bodies can only store limited quantities of energy from carbohydrates, but much more in the form of fats. So why would nature perversely design us to run on limited (carbohydrate based) energy resources when we can store and use huge quantities of fats instead? That makes no sense at all to me!

Ketosis is actually a perfectly normal state - breastfed babies are naturally in ketosis - and what can be be better proof than nature starting us off in our lives this way?? (http://realmealrevolution.com/real-thinking/ketosis-key-to-human-babies-big-brains and other Google sources) When I was a child (1940s) it was also a given that parents should give young children only full cream milk to drink as it was considered a necessary part of their diet for healthy growth.

When you're keto-adapted your body can switch in and out of ketosis using whichever energy resources are currently and easily available for it to use, so easy carbs first then fats when you've emptied your short term carby larder. (http://www.ketotic.org/2012/05/keto-adaptation-what-it-is-and-how-to.html, https://www.reddit.com/r/keto/comments/1jqgav/in_ketosis_vs_ketoadapted/). I use a Ketonix and it shows me that I'm definitely switching in and out of ketosis regularly as needs be.

My general health has improved, and my glucose levels have come right down and tend to be much more stable since I started eating an LCHF/Ketogenic diet just over 2 years ago. But more importantly my long term (over 6 years or more) brain fog suddenly cleared very soon after I started eating this way, and the incidence of lifelong chronic migraines has dramatically decreased, both of these are adequate proof to me that my brain is now using a preferred fuel and it's certainly no longer carbohydrate based.

Johns Hopkins University has used a ketogenic diet as a long term treatment for epileptic children since the 1920s (http://www.hopkinschildrens.org/hig...-control-seizures-is-safe-over-long-term.aspx), and to quote:
The evidence is based on a study of 101 patients ages 2 to 26 years treated with the ketogenic diet for a minimum of 16 months and for up to eight years at Hopkins Children’s between 1993 and 2008. At the time of the follow-up, patients were off the diet anywhere between eight months and 14 years....

Researchers caution it is possible that some effects may not show up for decades. However, the evidence, especially among patients who were off the diet for more than 10 years, suggests no long-term harm.

So as far as I'm concerned a ketogenic diet is actually perfectly natural and harmless - and although I eat more (but <50g) carbs than he does, like @nosher8355 I'm a happily ketogenic creature.

Robbity

 

[JohnEGreen]

Ketosis has never been an aim for me nor do I expect ever to achieve it though I don't think it unsafe in fact my physiology tutor went to great pains to point out to us that a diet exclusively of fat was perfectly sustainable long term.

I know it's been mentioned before but I am a little unclear as to below what level of carbohydrate intake you feel you would need to go, in order to achieve it and maintain it?

 

[Indy51]

If anyone wants to see the "consequences" of living full time in ketosis, check out videos of Dr Dominic D'Agostino. I gather he's pretty much been in ketosis since around 2008. The dude is extremely muscular as well as being the ultimate science nerd

 

[JohnEGreen]

Ah so according to ruled.me calculator this is what I should be doing to get into Ketosis and lose weight.


1389 kcal Daily Calorie Intake
20 g Net Carbs (6%, 80 kcal)
89 g Protein (26%, 357 kcal)
106 g Fat (69%, 951 kcal)

Might even give ago when I get out of the hospital.

 

[pleinster]

Very interesting and highly informative thread which is helping me get my head around all things ketone related. I have been told that serious problems with ketone issues are much less of a concern for Type 2s generally due to the fact that some insulin is still being produced by the pancreas...but I am still concerned. I have been on a very low carb diet for maybe six months or so (with the odd bit of cereal creeping in form time to time), mostly under 50g maybe as low as 20g...and I worry that ketones might build up and cause issues. This is of particular concern to me as I am a year post renal transplant (my diabetes induced by steroids post op). I'm still not totally clear on ketosis, but this thread is helping. I find @KevinPotts words that I need only be concerned if I am eating less than 20g of carbs a day very encouraging. Also, as my background is in anthropology and archaeology along with ancient history, I find the info on the peoples referred to very interesting too. Thanks..keep chatting pleeease. Paul