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Medical basis for myself being in ketosis.

If anyone wants to totally geek out on this stuff, there's a recent very long interview between biology researchers Drs Rhonda Patrick and Dominic D'Agostino. There's quite a long discussion about metformin as it relates to the recent stuff about longevity, cancer protection, etc. later in the interview.

Beware the largest manspread in history though, lol

 
Great to here from you Paul.. My only note of caution as a T2, is if you are medicated. If so you will need to consult with the Dr or nurse just to ensure the meds get tapered gradually as your body adapts from being a sugar burning machine to a fat burning machine. Kevin
 
I don't test my ketones, perhaps I should start. I just assume I am in ketosis by looking at 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. It is difficult to describe better than that. I have been on up to around 30g carbs a day for quite a while now. Previously it was just clear and colourless. I do drink a lot of water. It isn't of concern to me as long as my bloods all come back normal and I feel well.
 
I was having problems with most LCHF advice coming from blogs and Guru's to the point that it seemed to take on an almost messianic feel. Although there were some RCT's on the periphery of the study of the diet, there seemed to be no actual trials on the diet itself. Some of the evidence I reviewed was compelling, but there seems to be a common zeal which makes me suspicious of bias. I refer to the Sidakis lectures, the South African Seminars, the Ireland Seminars and others referenced by dietdoctor.com.
I know the diet works for reducing bgl and weight loss, and is effective in my life too. But then so does Atkins, South Beach, Paleo, et al. But when I try to evaluate the safety and long term effect of LCHF, most of the info is anecdotal, so I have to become the Devils Advocate to try to examine the data and isolate what is important in the long run.

Thankfully I have finally unearthed a study report that covers some of my concerns. It also has viable source references, and has actual data that can be reviewed and debated.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/

I am very mindful that while this forum has discussions on LCHF, the other forums I visit do not support LCHF, and are often anti LC in any form. The Diabetes Association is apparently against ketogenic diets, and DUK also does not seem to advocate it. This site is a flagship, but is it ShippyMcShipface by being before its time?
 
According to the Newcastle Diet study (and some other related research) each of us has a carb intake level below which we can get into ketosis, and it seems to vary between 20g and 50g and is an individual thing. Dietary ketones are not the same as those from ketoacidosis, and are actually beneficial, and not considered a danger.
 
@Oldvatr

Have you come across the work by Voleck and Phinney? They have written some books about low carbing, and have been studying it for decades. I like their work because they calmly discuss the pros and cons, providing excellent references, although it is rather tragic seeing the unprofessional mess that so called scientists have approached the subject.

My next purchase of their stuff will be their endurance athlete book. Not that I have the slightest interest in athletic endurance.

The problem with most of the studies of LC are that no one agrees on what low carb actually is (you need to check this with every single thing you look at. Sometimes they call 150g carbs 'low carb' and then say the diet is ineffective, ***!), and they rarely specify whether their 'low carb diet' consists of 6 tonnes of leafy green veg, or 10 slices of white bread a day. Any researcher who does not distinguish between low sustainable ketones (aka nutritional ketosis) and ketoacidosis is too ignorant to be taken seriously.

The horns of the dilemma, for me are very simple (probably helped by the fact that as a reactive hypoglycaemic, carbs make me feel ill).

If I eat over my personal carb tolerance, I feel permanently sluggish, leaden limbed, get indigestion, have erratic high and low blood glucose, my joints ache and I get inflammation, my HbA1c rises sharply, my brain fog returns and my attention span shortens to compete with gnats. I feel seriously CR%P.

When I get down below my personal carb tolerance all those symptoms disappear, my brain returns to full function (although that is always subjective, isn't it?), inflammation recedes, I get more energy and feel sooo much better. I am not in ketosis all the time, but I AM fat adapted.

So, as I said, my decision is basically to trundle along in Fat Adaptation and feel WELL. Or blunder along burning glucose and feel CR%P. The difference is so obvious and clear cut for me that I don't consider it a choice, and the health questions about long term ketosis strike me (personally) as absurd. I would rather live for 15 years feeling well due to fat adaption than live 30+ years in an aching body, brain fog, and a grey half-life.

Gosh. What a difficult decision!

I would suggest that only people who feel such benefits ( people like me and @nosher8355 and all those gloriously zealotous bloggers) actually NEED to be fat adapted.

The rest of the world just needs to find their own personal sweet spot, balancing their lipid profile, their carbs, their HbA1c and their CR%P v WELL seesaw.

I have also said, many times, that the fewer people who embrace ketosis, double cream and fillet steak, the better. All the more for me.

Edited to add: I am, however, one of the lucky ones that has optimal Cholesterol ratios on VLC, which is pretty awesome considering my chaotic hormonal situation.
 
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Brunneria, what an excellently balanced view. Oldvatr, thanks for the useful link.
 


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Excellent post as always @Brunneria!

After living in my own personal hypo hell for longer than I can remember. Which was over a decade, I know, where and how I would rather be! Not that I can remember that much!
I was so ill, I don't know how I got to the point of diagnosis, never mind the absolute ******** of so called medical practitioners telling me to lose weight on a supposed healthy diet, when it was obviously not working and adding weight, the reluctance to refer me to a specialist, then first specialist for my NAFL, not having a clue what was going on, tablets, didn't work, diets not working, continuous anxiety, do I need to go on? I was in a hell of a state.
Then hypo in GPS office, then hypo after second referral because of that first hypo.
Which led my second specialist to take me through so many tests and saving my life!
He advised me on diet, on so many things including this site!

So if I come across as a bit of a low carb rebel, I won't apologise!
I try to see both sides and the one thing that I've really took on board is that no two RH ers are the same, no diabetics are the same, and each due to personal tastes, environmental and budgeting can have a distinct difference in how we treat all our medical problems.
 
Thanks for the interesting discussions. I can say that the less carbs I eat, and when I moderate my proteins, the better I feel. Brainfog is gone, my immune system is rock-solid, I am strong and fit. I have one concern, though, and this was the reason why I stopped low-carb before my type II diagnosis, when I was still prediabetic. Back then, now 1.5 years ago, my period stopped, did not really pick up again until, interestingly, it returned to a normal level when I ate a lot of yoghurt last autumn, and gained weight too. Is my body too stressed, or am I just not eating enough fat?
 
The reason for my outburst was that this last week there have been 'reports' that a new study has apparently established a link between the onset of hypothyroidism and ketogenic diets. My mother was T1D, and she went on to develop hypothyroid. My wife is non diabetic, but she already has hypothyroid. I do not seem to suffer it (yet). The concerns are that I may be about to trigger this in my life, and secondly am I putting my wife at further risk since she is sharing my diet.

I have spent most of today researching this study, but all I seemed to find were blogs and guru's spouting that ketosis is safe and that it is an urban myth. None referenced this purported study. Nor did they provide anything apart from anecdotal stories

However, I did find a reference to an RCT that establishes that the thyroid hormone T3 is reduced by a ketogenic diet. Now the blogger I got this from jumped to the conclusion that low T3= hypothyroid and thus is v.bad. It may be the other bloggers picked up on this and relayed it out.
After further research, it would appear that low T3 is only bad when TSH is elevated due to disease, but on its own it is in actuality beneficial. There is nothing in the original blog that ketosis raises TSH.

I have not found the referenced RCT report.

So I think this nonsense can be put to bed.
 

Hi Kevin, I'm on a lot of meds to prevent rejection of my new kidney (one of these is the steroid which brought on my diabetes - and it has now been cut right down) and others for blood pressure etc. I came off my diabetes meds (Gliclazide months ago due to success on the low carb diet). Also, as for fat burning...obviously I have fat...but I have never had a problem with weight really (currently under 12 stone at 6 foot tall). I value your help, Kevin - thanks.
 
Pleinster, defo one for the medics before you proceed forward. All the best.
 
Thanks, Oldvatr.
 
KevinPotts said:
Pleinster, defo one for the medics before you proceed forward. All the best.
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So far my renal specialists are happy and they set up an appointment with a daibetes consultant who was really on the ball - happy with my diet (which I had broken down into a list of average daily intake over a week (carbs, calories, fibre, protein, fat etc). This one actually sees LCHF as THE way forward for most Type 2s. No-one has mentioned reducing meds further, but then - I need them at the levels determiend by relevant blood levels. My blood and urine is tested every six weeks (including test for ketones) as they have to keep my levels balanced...progress in post trenaplant success is alrgely due to how meds are monitorted and altered or tweaked for the individual in response to minor changes. That said, I like to be as informed as I can, so everything I read helps. Thanks again, Kevin. Paul
 

Before I found our forum, I looked at the (original!) Atkins diet information (as recommended by my GP for weight loss) and the good doctor Atkins recommended 20g carbs a day for a couple of weeks (mainly from veggies but no fruit or nuts at this level) to be absolutely sure of kick starting nutritional ketosis, and then under 50g carbs a day for maintenance. Which is more or less what I've been dong ever since, and at this level it's sustainable long term.

Robbity
 
Thanks for the link John.
 
Good article, clear and succinct!
 

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?
 
Munkki said:
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?
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Diabetes 101 by Jenny Ruhl. Was a major factor in me taking up LCHF and was at a readable level with just a hint of techgeek that provided a bit of backup. I got mine thru that Amazing online emporium.
 
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