Keto Un-Clarity
I thought that I MUST be in ketosis. I was eating lots of fat, lots of protein and cheating only intermittently. I’d been doing my version of a ketogenic diet for about nine months.
It wasn’t as if I’d prepared for it. I didn’t read any book or even check out any websites. I simply dropped all grains (which tended to put me to sleep), almost all starches (ditto) and all sweets (left me shaky) and ate lots of proteins and vegetables. I’d discovered a new appreciation for the pleasures of fats.
No ketosis (?) (!)
It was true that I hadn’t had the progress that I’d hoped for. I’d hoped for a health revolution and had settled for feeling a bit better. My sugar cravings had disappeared — that was good news even if I wasn’t getting great results. At least I was on a better diet and I was going to stay on it. I’d had enough of those depleted feelings I associated with starches and sugars.
I dipped my ketone test strip into my urine and waited for it to turn the reddish color indicating the moderate ketosis I was sure I was in. Instead I got tan — indicating nothing…no ketosis at all. I doubled down on the fats and proteins over the next couple of days, and I made it into low ketosis (dim reddish purple) and then poof I was back to tan — no ketosis.
I was out of my depth — so, after Lori presented her keto diet success on Health Rising, and recommended Keto-Clarity, I picked it up. Boy, did I need clarity and boy, did I get some.
Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet — A Review
If you’re the kind of person who needs studies to validate a treatment this book may not be for you. Written by a patient and a doctor, the book contains numerous “Moments of Clarity” blurbs from well-known doctors and ketogenic professionals that provide tips. A quick flick through the research section suggested that the pickings were pretty slim. If you’re going to act on the recommendations from this book you’ll have the take the word of patients and doctors who apply the techniques.
That was fine for me. I found the book to be an easy, informative and entertaining read. It’s not a complete guide — you’re probably going to want to get a recipe book — but it appears to cover the major issues, and most importantly, the most common mistakes people make on these diets make.
If you’re not aware of what ketosis is, it is a metabolic state that occurs when we consume a very low carbohydrate, moderate protein, high fat diet that causes your body to switch from using glucose at its primary source of fuel to running on substances called ketones. Ketones are produced when our bodies burn fats; i.e. your body is using fats for fuel instead of sugar.
Why make the switch from being a sugar-burner to a fat-burner? Because, the authors assert, our muscles, heart, liver and brain actually do better when they’re running on energy derived from fats. Plus, since your body is now burning fats, even though you’re eating fats, the fat just melts off some people on ketogenic diets. (The author of the book lost 180 lbs in one year.)
Readers should know that many medical providers are not fans of a ketogenic diet. They associate ketosis with a condition called ketoacidosis — a potentially life-threatening condition that can occur in people with Type I diabetes. The authors argue that this condition simply doesn’t apply in people with other diseases.
In fact, proponents of ketogenic and paleo-type diets assert that the American dietary guidelines are backwards. Carbohydrates including whole grains, beans and potatoes are something of a historical aberration. Humans evolved eating lots of fatty substances, meat proteins and vegetables — not grains.
The low-fat kick the health profession has been on decades is similarly backwards. Sugar, not fat, they assert is the big problem in the modern diet. Enormous sugar consumption (in combination with sedentariness) has caused the recent explosion of diabetes.
The authors assert that eating lots of fats is only problematic in the context of a high carbohydrate diet. In the context of a low carb diet, they assert that focusing on fats can make the pounds drop away and improve a legion of diseases from autoimmune disease to Crohn’s disease to chronic fatigue syndrome/fibromyalgia to diabetes. Metabolomics studies in chronic fatigue syndrome (ME/CFS) suggest that ketogenic diets might indeed be helpful.
A ketogenic diet that works for one person, though, might not work for you. A 60 gram carbohydrate and 110 gram protein diet might send one person into ketosis and leave another burning carbs instead of fats for fuel.
Protein is Not Necessarily Your Friend
The idea that a ketogenic diet is synonymous with a high protein diet is simply wrong. In fact, a high protein intake is a no-no on a ketogenic diet (!). Eat too much protein and your body will convert it to glucose (via “gluconeogenesis”) — exactly what the ketogenic diet is trying to avoid.
Too much protein will kick you out of ketosis.
(Chris Armstrong has stated that gluconeogenesis might be enhanced in ME/CFS. We won’t know until more testing is done but it’s a possibility.) In fact, the possibility that gluconeogenesis is occurring increases when on low carb diets; i.e. people on ketogenic diets need to be careful not to eat too much protein. A common reason for not going into ketosis is eating too much protein.
One doctor suggested eating no more 140 grams of protein a day (and no more than 30 grams per meal) or to consume 1 gram of protein per kilogram per day of your ideal body weight, and then subtracting 10 percent.
Another suggested having 5-10% of your calories coming from carbs, 10-15% of your calories coming from protein, and 75-80% of them coming from fats.
Fat – Yummy, Saturated Fat – Is Your Friend
The author has butter with EVERY meal….
Contrary to accepted wisdom, the doctors associated with this book state that saturated fat is good. The author of the book eats butter with every meal. Some fats are better than others: mono-saturated fats (butter, coconut oil, avocados, olive oil, red meat, cultured ghee, MCT oil — easily convert to ketones — and, the author says, are anti-inflammatory as well.
Plus, fat is a hunger fighter. If you’re feeling hungry – eat fat! Eating fat is what propelled me through the “keto-flu” stage that some people go through as their bodies go into a ketogenic state. Plus, fat is extraordinarily good at turning off hunger pains.
Time Required
It takes time — from four days to six weeks — to become “keto-adapted”. For most people it takes 3-4 weeks for them to start making energy from fats instead of from carbohydrates.
Warning
For people with Type I diabetes or gall bladder problems, a ketogenic diet could be dangerous because of the possibility of ketoacidosis.
Although the author doesn’t say so, ketogenic diets just don’t work for some people. Always follow your body.
As your body transitions to ketosis, some people experience symptoms of the “keto-flu” (fatigue, headaches, cough, irritability, nausea, lightheadedness, etc.) which can last from several days to several weeks.
- See one website’s tips for avoiding the keto-flu here, here and here.
- Check out some videos on starting out on a keto diet here.
Testing for Ketosis
If You Can — Test, Test, Test
The number one reason for failing on a ketogenic diet is not testing for ketones. People (like me) think they must be in ketosis if they’re on a low carb, high fat diet but it’s not necessarily so. Some people need to tweak their diet further and testing for ketones is the only way to do that.
Avoid
Urine ketone strips
- Pluses – cheap and easy.
- Minuses – they only measure one kind of ketone — and not the most critical ketone produced; they could state you’re not in ketosis when you are…
The Gold Standard
Blood Ketone Testers
- Pluses – incredibly accurate, plus the ketone testing tool is affordable for most.
- Minuses – ketone strips are very expensive; $2-$6 dollars per strip — so not very affordable after all, plus you need to prick a finger.
Blood ketone monitors
- Precision Xtra (Abbot) (called FreeStyle Optium in Europe and Australia) — preferred for its greater accuracy.
- Nova Max Plus.
Best Overall (???)
Breath Ketone Testing
Ketonix – (Swedish manufacturer) measures acetone in breath — which correlates to levels of the key ketone, beta-hydroxyl-butyrate
- Pluses – accurate and affordable for most; no ketone strips needed — but see this review for possible accuracy issues.
- Minuses – have to blow into device from 10-30 seconds; (not as accurate as blood ketone testers?)
Create Your Own Breath Ketone Analyzer (???)
In 2013, a Swedish engineer created a home-made ketone breath meter (the Ketosense) for about $30 and provided instructions here. The author tried it out and said the results were “remarkably close” to the readings he got on his blood ketone tester.
If You Can’t Afford a Blood or Breath Ketone Tester (or Even If You Can)
Use ketogenic ratio calculator on the Low Carb Flexi Diet (www.flexibleketogenic.com) website to determine how ketogenic your diet is.
Another Idea: Use a Glucometer to Keep You Blood Sugar Low, Low, Low
When your blood sugar goes down blood your blood ketones should go up. Keeping your blood sugar low, of course, is a key aim of a ketogenic diet. Plus, it should result in reduced hunger pangs.
The Gist: use a glucometer to monitor which foods send your blood sugar levels up and which keep them low.
The Author’s Story
The author was severely overweight prior to going on the diet and it sounded like he may have been verging on ME/CFS. Exercise for him was “disastrous” — he would experience dizziness, nausea, fatigue and even black out. It would take him from 7-10 days to recover from a weight-lifting session.
The author’s description of his own ketone testing was highly enlightening. He’d been on a ketogenic diet for 7 years and improved greatly but had never tested. When he found out that he wasn’t in ketosis at all he was floored. In truth he wasn’t far from being in ketosis but testing him allowed him to find his optimum balance of fats, carbs and proteins.
After only a couple of months on the diet his ability to exercise increased dramatically. Ultimately he was able to work out without experiencing any dizziness, blackouts, fatigue, etc. He said it took him completely by surprise. He also lost almost 80 lbs. the first year of being in ketosis. He also finally got good sleep.
Tests at the doctor’s office revealed that being on a ketogenic diet significantly dropped his blood sugar levels, reduced levels of bad fatty acids and increased levels of good ones, and reduced inflammation. Plus, despite being on a very high saturated fat diet, a CT scan revealed no build-up on his coronary arteries.
Conclusion
Metabolomics and anecdotal evidence suggests that ketogenic diets may be helpful in ME/CFS and FM. “Keto-Clarity” is a well-written and enjoyable book that will help keto beginners to transition to ketosis. It explains the basics of ketosis and ketogenic diets, and more importantly, explains why some people on “ketogenic diets” may not be entering ketosis. The book also provides a helpful 21 Day Kickstarter Menu and some recipes that can get a new ketogenic dieter started. An avid ketogenic dieter will probably want to purchase a separate recipe book.
The Free Online Keto Summit is On…
The Keto Summit presentations beginning on June 15th can be viewed free on the day of the presentation for all who register. If yo’d like to view the presentations at your leisure you can buy the Summit.
Some of the things you will learn include:
- Simple, easy ways to test whether or not your body is burning fat and ketones.
- Things you MUST do properly on a Keto Diet in order to avoid common problems.
- Supplements that can help you get into ketosis (and feel better).
Many Summit presentations provide practical tips for ketogenic dieters including “Practical Keto”, “How to Interpret Your Blood and Lab Tests”, “Why Water is Critical”, “What to do if Your Keto Diet is Not Working”, “Ketogenic Diet Pitfalls”, “The Myths and Facts of Supplement”, “When to Use or Not Use a Keto Diet” and others. (Health Rising is a Keto Summit affiliate).
Resources
- Lori’s Chronic Fatigue Syndrome / Fibromyalgia Ketogenic Diet Success Story
- Starter videos For Ketogenic Diet Beginners
- How a Ketogenic Diet Boosted Courtney Craig Out of a Relapse
- “Wired to Eat” – the Best Diet for ME/CFS and Fibromyalgia
- A Ketogenic Diet Menu
- Ketogenic Diet Resource Page
- Dorothy Walls and Paul Jaminet Talk on Ketogenic Diets
- Using Cronometer to Create A Mitochondrially Supportive Diet
I’m curious, Cort. Haven’t we humans been eating grains, wheat, etc for thousands of years? So wouldn’t our bodies have adapted and evolved to this way of eating?
Also, when I first got sick, after gettin pericarditis at 26, I started with terribly swollen glands, fever, the whole CFS thing that a lot of us go through. Lasted for years. I don’t think any change of eating habits could have helped me . And I was always a very healthy, low carb type eater anyway. I think the pericarditis , for me , ushered in whatever CFS turns out to be.
Good question. I’ve wondered about that as well. Grain-based diets have obviously worked wonders for many people over the ages. I wonder, though, if ketogenic diets – because of the metabolic issues in ME/CFS and FM – might be better suited for at least some of us (???)
Interesting. Hard to track if this helps people as probably not many with CFS have tried it. It would take a pretty high functioning CFS person to be able to prepare the food and put
this diet into their lives. Someday this maybe part of the treatment as it might, as you said, help with the metabolic issues, even in the very sick. I can’t say it would be a cure, but you’re not saying that either . But a way to address some of the things that have gone wrong with us.
IMO the ketogenic diet is best for fat people and athletes; those of us underweight folks will have a tough time, as I did. I only made it two weeks and hated the diet and got tired of steaks, eating in the local French restaurant, etc. Really. Jimmy was a really fat guy so is a true believer. He minimized IMO the nasty likelihood of constipation with no fruits or grain fiber. I ended up in the Er with unbelievable intestinal hassles. There is also the fact that, for many of us in chronic pain, there are few enjoyable aspects of life left and ice cream, chocolate, pastry, etc. are mine. I found no positive effects from being off gluten and sugar for those two weeks, though I was only in ketosis, tested via blood test strips and meter, for less than a week. I understand that sugar feeds cancer cells and that many fighting cancer are on Keto but, at the moment, I will stick to my omnivore diet.
As an aside, humanity has not really been eating grains all that long compared to our history, starting only after farming became the norm during the Agricultural Revolution. In fact, health then greatly declined for the masses on cheap grains, as opposed to animal protein and fat from hunting previously. Read Sapien for a great sociocultural history of evolution and food. Hunter gatherers lived pretty good lives nutritionally, culturally, and socially. When we became tied to land farming, we got many more social and nutritional problems.
I too have wondered if fat people do better on this diet although I think Jimmie might be aghast at the idea of eating a lot of steak. I also thought that my protein intake should be increased but after I read this book I realized that that’s not so and eating a lot of protein can actually kick you OUT of ketosis.
Grains may have helped increase population sizes but they certainly don’t work for me now…That problem and my problem with other carbs, in particular sweets, suggests to me that ketosis type diets might be the way for me to go.
Who knows??? One can hope (:)) and time will tell!
Watch “What’s with Wheat?” on Amazon. Helped me understand that question and so much more.
The eight to ten thousand years that humans have been eating grains are nothing–repeat, NOTHING–on the timescale of evolution. We are the same creatures that spent millions of years eating no grains or bred/farmed foods at all. Ten thousand years is not even close to the length of time required for significant change–not visible, insignificant change, but basic change in the type of creatures we are–to take place. This is the reason many of the people who don’t understand evolution have that problem–the sheer lengths of time involved for it to happen are not understood.
Thanks for pointing that out Phaedre. Very interesting!
I’ve been eating a strict Autoimmune Paleo Protocol since November when I got a positive ANA test back. It is low carb and higher fat/protein. It has really seemed to help my inflammation levels, but I feel like I traded lower inflammation for lower energy and much higher “anxiety” and hunger.
Then I had a cortisol test done a few months back and my levels were literally off the charts. Quite scary to see. After reading about what factors lead to high cortisol, starvation comes up frequently.
So I think I either have to go farther into the fats, or add some carbs back in. I’m guessing that lowering carbs as far as I have without doing everything else to get into ketosis has left me in sort of a middle starvation state, with no real source of energy for food.
Is it true that your body can only burn either carbs or fat for energy, but not both at once?
But I feel conflicted, because while the antecdotal evidence is compelling, the truly high fat diets seem so extreme, and honestly so completely unappetizing.
And I find myself wondering if one extreme after the other is really the best solution for me. The search process is exhausting, in and of itself.
I know in my gut that so many of the problems I’ve suffered from over the years can be at least partially attributed to being given almost zero medical care for so many years when I was so sick and in so much pain, including undiagnosed severe POTS. I know my nervous system has been re-wired through that process to be in chronic fight or flight, which requires far more energy to operate. And I don’t think it likes me messing with its energy source the way I recently have been.
So, I keep toggling back and forth, thinking maybe I need to give true ketosis a try, and then talking myself out of that, thinking maybe what I need even more is to give my system everything it should have been given the very first day that I got sick: compassion, kindness, the benefit of the doubt, sleep, rest, lots of water, pain relief, stress relief, a really healthy balanced diet, a slow steady increase in exercise, fun things to do every day, etc….day after day after day. So that it has everything it needs to heal, all in one place. And no more extremes.
But that’s just me pondering…
I am certainly no expert but one thing I gathered from the book was that a low carbohydrate diet without a quite high fat intake is a recipe for hunger pangs, weakness and problems. One issue is that proteins get metabolized into glucose.
My guess is that they would suggest increasing your fat intake and seeing what happens. I wonder if you could quickly tell if it was working
Hi Martha – it’s been two years but wondering how you are going with your diet? Your post here is exactly where I am at now. Could’ve written your post myself.
Dr has me eating less carbs, more fat and protein, but my energy is worse and I’m getting worse in general. I feel exactly how you do here in that I’m so unsure about going Keto (Dr says I’m not ready anyway), and feel I’m now in limbo land – not keto, low carb and not getting any energy from food.
I just started Wahls Paleo Plus version of keto; this is day 3. I’m in mild ketosis as of this evening, which is where I want to be.
I’m consciously eating at least 25 grams of fiber daily, and keeping protein moderate (40- 50 grams a day). To simplify fats, I use a can of coconut milk daily, for everything.
Brain fog cleared up right away, which is stunning and great. I’ll see if it also helps with energy and sleep.
Congratulations….
This is great to hear. I am trying to implement Wahls Paleo Plus now but keep falling off the wagon. Going to her conference in August
Good luck!
Good write up. My only concern here is the massive amount of evidence from tens of thousands of studies linking cardiovascular disease to saturated fats. I know that people argue this by supplying alternative studies, However every one of those studies I’ve read have conflict of interest payments/funding from either the Meat industry , Dairy industry or Pharmaceutical industry. Sometimes if I can’t find that conflict of interest I’ll look further and I find the funding conflict was given to the same researchers in a later trial or to a lesser known member in that research team. Hardly anyone reads the conflict of interest or let alone digs deeper.
So its risky to ignore the magnitude of existing studies linking fats to cardiovascular disease and stroke.
I see in the blog one man on a high fat diet states
“despite being on a very high saturated fat diet a CT scan revealed no buildup on his coronary arteries.”
That’s one man, the smallest sample size ever! It’s not thousands.
I’ve read plenty of other studies showing cardiovascular disease was a problem long BEFORE the low fat, high sugar eating epidemic.
And other studies showing plenty of increased cardiovascular disease in zones around the world where animal products are consumed. That’s just a correlation, but it’s a big one. There’s also evidence that there maybe something the body is ‘rejecting’ either a protein or fat from animal products that is triggering inflammation of the lining of the blood vessels, That inflammation is the start of cardiovascular disease.
However some research has shown this blood vessel inflammation doesn’t happen with plant fats and proteins.
But the jury is still out on whether that will prevent cardiovascular disease. So there should still be a big precautionary warning on increased risk of cardiovascular diseases like stroke and heart attack from a ketogenic diet.
Yes you can achieve the same ratios of plant fats, proteins and low carbs to suit the ratios of a ketogenic diet. So that maybe the safer option. But I would recommend those that try any ketogenic diet whether from plant or animal sources to have regular CT screenings for plaque build up.
Good idea on the idea of the screen – which the author did. I think their argument is that high carbohydrate, high protein diets are a) inflammatory in nature and b) that carbs get translated into fatty deposits. If you’re in ketosis, on the other hand, the situation is different; the fats are translated into ketones (instead of fatty deposits) (I hope I got that right). Because the hunger pangs and cravings for carbohydrates are gone you actually eat fewer meals and fewer calories overall – and lose weight. Plus the authors believe a ketotic diet is anti-inflammatory in nature.
That’s an interesting point on if one is in ketosis that it could well be mopping up the left over fat and reducing deposit build up.
I wonder how easy or hard it is to get a regular carotid ultrasound, surely if our doctors are aware their patient is on the diet and if the patient has benefited from the diet, then the doctor maybe more willing to allow more regular screenings. Maybe even fibbing that there’s a family history of stroke would make the doctor more willing to order the scan.
“carbs get translated into fatty deposits”
If I get the science right, glucose only gets converted into fat (mainly triglycerides) when blood glucose levels rise too high (as a protective measure). Somewhat trickier to get a good view on it, fructose (and other sugars) (less well controlled in blood) mainly converts into fat when it peaks in blood too.
So getting these levels of blood sugars somewhat flatter *may* deliver some part of the advantages of a low-card diet whilst being a lesser change.
Over a year ago I started a kethogenic diet. I did not test and still consumed really small quantities of bread (1 small slice a day) and milk (less then 40 ml a day) in order to not risk losing hard to replenish good gut bacteria. So I have no way to know for sure if I did reach kethosis.
It mainly noticeably reduced pain levels, but did not help with fatigue. Then I returned to a diet in between “normal” and “kethogenic”. The pain advantage remained. Also, total cholesterol levels remained somewhat similar before (normal diet or better said diet with very low fat levels) and after (halfway diet) but the ratio of HDL to LDL improved somewhat. I attribute this to the fact that a person produces it’s own cholesterol if he has insufficient. I seem to produce only “bad” one myself so I can better eat a mixture that contains more HDL. The main difference: triglycerides dropped from 150% of allowed level to 75% and remained so while eating twice as much fat as before. Glucose levels dropped only a bit.
I believe that eating smaller portions of carbs, better spread over the day, prevent the glucose spikes that turn on the conversion mechanism from glucose to triglycerides. Having lots of veggies slows absorption and hence lowers the spike.
Fruit is a tricky one. I prefer to consume only small portions and only those with lots of fibers to prevent fructose spiking. I also do not eat it before resting as it seems to need immediate combustion (no storage possible, only conversion to fat or consumption). Avoid quick-absorbers such as fruit juice.
Reduce sugars a lot. Your body can get glucose with lesser spiking from many carbs. Avoid corn sugar (cheap, used very widely) at all cost: it’s not glucose so too tricky.
Reduced spiking also avoids massive conversion from glucose too glycogen back and forth. That consumes/produces lots of water causing strong variation in hydration that partly spills over to variations in blood volume. I’d think we can mis that. That likely is another advantage of kethogenic diet. As “bad gut bacteria” and candida thrive on carbs if I get it right, eating lower levels of it helps slowly restoring gut microbiome too.
Going full kethogenic may add other benefits, but going in steps and checking blood chemistry and body reaction may be wiser.
Hardly any studies of the effect of fat are conducted on people who are fat adapted i.e. have eaten a keto diet and become fat adapted. Furthermore most studies of high fat are high fat and high carb .i.e. Hamburgers and cake.
FredcKumnerow, a researcher at U of Illinois at Champaign Urbana says it is trans fats that clog the arteries. He died earlier this year aged 103, and worked past his 100th birthday. This an article about his work when he was alive. There are obituary articles about him now, too. I think a lot of the saturated fat articles are like people quoting the PACE trial, an invalid study in the first place, my view, yet so often quoted I articles & by doctors. https://www.google.com/amp/www.chicagotribune.com/news/ct-102-year-old-professor-archives-20170311-story,amp.html
There is alsoba whole lot of evidence that the original studies done that got us all afraid of fats due to cardio risks were funded by the statin industry. Perlmutter’s Grain Brain has great info on this.
Only problem with a CT scan is it involves quite a bit of radiation.
Two things–make sure to read both for your safety!
1. The ultimate ketosis diet is a water fast–read the book by Dr Joel Fuhrman–something like “Fasting for Health.” He explains ketosis, its benefits in healing, and why eating while in ketosis (especially fatty protein) is very hard on your body. The pure Atkins Diet can be dangerous.
2. I did a week long water fast annually for five years, which eliminated my inflammatory arthritis symptoms. Last summer I had a rather minor surgery, which may have sparked my severe case of ME/CFS, but my first symptom (blurry vision) appeared in September WHEN ON DAY 4 OF A WATER FAST!!! My symptoms continued a slow and vicious march after that. Was it just the surgery, or did ketosis put me over the edge?
Ketosis puts your body under physical stress, and throwing a bunch of protein into your body while in ketosis is even harder on your body–see Fuhrman’s book.
Water fasting can be amazing, but maybe not for our delicate systems.
Be careful!
This book made it very clear that high protein intake is contraindicated in this diet. It’s a common fallacy that protein intake is increased on these diets. (I made that mistake). In fact one of the chapters focused on explaining how proteins retard going into ketosis. Instead, the vast majority of calories on come from fats.
I gathered from the book that The Atkins Diet is not the same as a ketogenic diet. This is because Atkins focused on low carbohydrates and largely ignored how many calories came from proteins and fats.
I don’t know anything specific about the ketogenic diet, but ketosis is ketosis. Ketosis saves muscle and burns fat and flushes out other junk. You must be on virtually zero carbs to get there. But, if you exercise while in ketosis, your body will jump into muscle-burning mode, and you don’t want that. Anyway, I’m jumping around a bit (brain not fully operational at this time of day!).
I would still highly recommend reading Fuhrman’s book on water fasting before trying to get into ketosis. Water only during ketosis allows your gut to heal. You must rest or you can hurt yourself.
I was a big fan of water fasting and it changed my life for the better, but am concerned the physical stress pushed me over the edge into ME.
Best wishes, Cort, and thanks for this site–helps me maintain my sanity!
Just read an article from Scientific American that said that evidence shows humans have been eating grains for at least 100,000 years .
True, and they were known to be making porridge at least 30,000 years ago after several stone artifacts and bowls were found to have deposits of oats ground into the porous surfaces of the grinding stones. Archaeologists said that they have been looking at the wrong things all these years by arrogantly assuming paleo people mostly ate animals because they were mainly looking for bones and tools. Turns out that most dig sites were layered with all types of edible plants. One archaeologist went as far as saying we were just blindly chucking away all this evidence of paleo people’s plant based diets.
Crazy, but funny too, haha
I want to bring up the subject of resistant starch for those concerned about intestinal health/constipation issues that might be an issue with an all fat and protein diet. It’s my understanding that the body’s enzymes are not able to digest these particular starches and so travel to the large intestine where beneficial bacteria break them down into fatty acids which benefit the intestine and are also absorbed for fuel. Info. is readily available online that goes into great detail about the process. Cooked and cooled rice and beans are 2 sources I use and I can personally attest to elimination of pain I was feeling in my intestines almost immediately after making this a regular part of my diet.
I do question whether all of a resistant starch is bypassed by regular digestion or if some is digested into glucose in the upper gut. This would be important to know regarding a ketogenic diet so if anybody reading this has some expertise regarding this I’d appreciate a response.
Thank you, Cort, and everyone contributing. Hopefully enough of these lifestyle clues can be pieced together to help make our lives more livable.
Yes the heating and then importantly the cooling of carbs/starches creates resistant starch which is then able to make it to the lower intestine. I know that works as my IBS vanished, however I fart much more… epically so!
🙂
I have CFS/fibromyalgia & have found that I have multiple food sensitivities (worst offenders gluten/corn/eggs). If I have an accidental exposure to any of them I’m bed ridden & in terrible joint pain for days. Staying clear of these food items (identified through the Paleo autoimmune protocol elimination diet) is what gives me the greatest relief from CFS/FMS.
HOWEVER being in ketosis is wonderful – extremely hard for me to achieve & maintain but well worth the effort. The mental clarity, energy, elevated mood feels like a “cure”. BUT it takes tremendous willpower & determination. I have to eat a diet that is 90% fat, keep protein to 35gm or less per day & carbs less than 20gm. Even though it feels so fabulous I find myself cycling in & out of low to high ketosis (never completely out of it). I feel best when my ketones are between 1 & 3 or 4. However sometimes I am tempted to overeat carbs & protein driving my ketones lower than 0.5 – when I do this I don’t feel the clear headedness & well being but as long as I don’t eat any of my out of bound foods I also don’t have any fibro pain.
Andrea, I’m glad to hear that you feel so much better in ketosis and that you can manage the diet. But I’m wondering – what in the world are you eating to get to 90% fat?
I’m not Andrea, but I took a look at my log on MyFitnessPal. I don’t keep it all the time, but here’s a day with almost 80% fat:
Breakfast: bullet-proof coffee (my version) – coffee, heavy whipping cream, coconut oil, butter – 364 cals (37+ gr fat)
Lunch: macadamias, macro cakes (low carb pancakes – cream cheese, eggs, protein poweder), butter – 556 cals (61 gr fat)
Dinner: salad (lettuce, cucumber, mayo, 4% cottage cheese, salted sunflower seeds, tomatoes, Italian vinaigrette) and burger (grassfed, plus slice of swiss cheese on top) – 641 cals (51 gr fat)
Snack: Ghiradelli chocolate square (dark/sea salt) – 50 cals (4 gr fat)
Total macros for the day, 1611 calories, 23 grams of carbs, 154 grams of fat, 65 grams of protein. (5% carbs, 15% protein, 80% fat).
I usually shoot for around 1750 calories, but will go anywhere from 1500 to 2200. I don’t keep track all the time.
I thought I should clarify: fat has 9 calories per gram, carb and protein 4 calories per gram. The 80% by fat is calories.
Shelby just today I got an email from Dr. Fuhrman talking about fasting and plan to read that book. I tend to agree with Michael Pollen who says “Eat food. Not too much. Mostly plants.” Our body does not seem to be made to eat what carnivores do – ie very long intestinal tract, no ability to catch prey and rip it up with our teeth and eat raw etc etc. From what I’ve read/heard studies do show that those who adhere to a plant based diet have less cancer, virtually no heart disease and live the longest….
Hi Betsy! I like Pollen’s advice. You’ll like Fuhrman’s book, but like I mentioned, it may be too much stress for our delicate bodies. I firmly believe that my last fast pushed me over the edge into ME, particularly because my symptoms began in the middle of it.
I’ve thought about trying to contact Dr Fuhrman and ask him if he’s heard of this happening to fasters. Maybe my surgery last summer teed me up for ME, and fasting was the “driver” that sent this mess in motion.
I just hope they find a cure soon. My heart goes out to all who have dealt with this for years.
Best wishes.
It actually takes a very long time to adjust to a ketogenic diet. It takes between 5 days and a month for your liver to adjust and produce ketones that your brain can use to be able to think. It apparently takes 2 to 6 months for your muscles to adjust and be able to use fatty acids for energy for exercise.
MCT oil can help quicken the time it takes your liver/brain to adjust.
I’m up to week seven of which the first 3 weeks were very difficult. I have noticed a significant initial dip in energy and then a very slow build back to something close to pre-keto diet levels. I hope the slow build continues past my previous baseline. I’m planning to continue with it for 3 months and then evaluate.
The diet has been scientifically studied by Dr Veech, Dr Dom Dagostino and Dr Volek.
I have watched a few sessions of the keto summit. Two out of the three I watched stressed that keto diets are not a way of life, but rather are something to dip into and out of as it is still unknown what effects they can have on our bodies. One presenter spoke of certain results being able to be interpreted in two different ways, and the harmful way can’t be checked out. He loves a keto diet and feels better on it but only stays on it for a month at a time now. He said three months maximum at any one time.
This was a bit disappointing for someone who had only started a keto diet a few weeks earlier!
I’d be interested to hear from other people.
Hi Cort! This might be offsubject but I am deeply thankful for all the work you do to help others. I am french speaking, my english vocabulary is limited but I just want you to know you are great! Thanks for being this little light in the dark.
Well said. I agree . Cort is a jewel!!
🙂
Thanks Nathalie 🙂
No. Thank YOU 🙂
Hi Nathalie, sorry to hijack your post but I had to ask if you live in France? I am english but have lived in France for 9 years and have not met anyone else here with M.E!
I agree with you though, I too am very grateful for Cort’s hard work and the quality of this site.
I received an “autoimmune” cook book for Xmas and started using some of the recipes. More like keto to than paleo, saturated fats were the focus and I started feeling better. While my labs can still be a train wreck, I am not getting as sick as I have in the past. I had blood fat levels checked and they were down so this approach is worth trying. I hope you like bacon and coconut.
I do and mayonnaise and avocado’s and walnuts 🙂
I have just been listening to Prof. Kieran Clarke on the keto summit. She has developed a keto supplement, a keto ester, at this point for elite athletes, that puts them instantly in ketosis and gives them an energy boost. My ears pricked up at this. I wonder if it could be adapted for people with ME to give us instant energy.
They have also thought about it for dementia but the studies involved are too great. They have also tried it on a few Alzheimers’ patients but the ester tasted too bad and they would not drink it as they could not understand the reason.
She has also just said that it stops your muscles aching. It sounds very promising. However, they need about a million pounds before they can start producing it commercially.
Sorry for all the messages. I have been writing them as I listen. Right at the end she said there is a website for anyone who is interested. It’s a spinoff from Oxford University.
http://www.tdeltas.com/site/how_it_works999.html
Last night I emailed Prof. Clarke about this and received a reply today to say that a group in Oxford wants to conduct its own preliminary study before applying for a grant. Very exciting! I have contacted the professor concerned to register my interest and to say I can give details of my local support group if they need volunteers.
Hi Cort –
Thanks for encouraging me to tell my story…and I’m interested to know how you’re doing and how you’re changing your way of eating based on any new information you’ve picked up through Moore’s book, but also the keto summit information.
If you’ve got the time for it, I recommend you also delve into Phinney and Volek’s book which I included on the recommended reading. It is quite technical, but it has a lot more on what types of studies have actually been done and what they actually mean – not always what we’ve been told they mean.
It simply isn’t true that there isn’t science to back the benefits of a ketogenic diet for a great deal of the general population, and its a shame that scientists and dieticians and medical professionals who have hung their hats on poorly interpreted study results refuse to acknowledge new information. We have the internet to thank for access to an alternative viewpoint. (Thank you!)
My best to you for your continued journey – Lori
Thanks Lori…As usual I missed the Keto Summmit (I miss ALL the summits) but am going to use the information in Wired To Eat (see Remy’s post here – https://www.healthrising.org/forums/resources/wired-to-eat-the-best-dietary-guide-for-me-cfs-and-fibromyalgia.440/ – to find my personal carbohydrate level)
Thanks for telling your story!
After reading Lori’s story and this post I have decided to try and do the ketogenic diet, but I am quite scared of doing damage. I normally avoid extreme diet plans like the plague as I am a firm believer in eating healthily, plenty of veg, nothing processed, all as close to nature as possible and everything in moderation, definitely not cutting out complete food groups unless absolutely necessary (ie because of known intolerances).
My diet before getting ill 25 years ago was definitely not good, but I was young, thin (too thin and desperately wanted to put on weight and never could) and felt healthy. Since getting ill I have made sure I eat healthily, have tried at various times cutting out dairy, or wheat, etc etc, none of which has ever helped my symptoms other than digestive ones to some extent but not completely. I have eaten fairly low carb for a long time now, then last year I did an elimination diet trying to track down more of my intolerances. This was even more low carb as it cut out all wheat and grains and I lost a stone without trying (I was only a little overweight and am now exactly the right weight). I don’t know if I reached ketosis or not but I have now ordered the blood testing kit. I am wary though because it doesn’t sound super healthy, I am happy with my diet as it is now as it is v low carb but lots of veg and is balanced well. However the recent research is making me want to give this a go, I just don’t want it to mess me up at all as my system (like most of us) is very sensitive. Scared but hopeful without wanting to get my hopes up too much as the disappointment is always too hard to bear, but I can never help hoping!
One of the worst pieces of advice with CFS is to go low carb and high protein. (Although the article is clear this isn’t the intent of the diet). If you think about it… protein takes alot of stomach acid and energy to process – two things we don’t have. Undigested protein is like poison – hence alot of CFS symptoms like arthritis. Protein requires a strong gut immune system – something we don’t have either. CFS is a neuro superstorm- the brain prefers glucose to operate. There needs to be a shift in CFS thinking to diets that factor in things like ease of digestibility and times of day. I.E Eat complex carbs, but earlier in the day so they don’t affect night time blood sugar and keep protein serves under 20 grams and before 4pm when you have the most energy to digest it and undigested protein can’t cause sleep issues either. Keep night time meals to something with simple sugars and easily digestible, like good old bananas. High fat in the diet is very good too (as the article suggests). CFS diets should be more like Stomach Flu (BRAAT) diets not “I’m gonna get ripped at the gym” diets.
WARNING: Please, please, learn from my mistake…If you have cfs/me only go on a ketogenic diet with the supervision of a knowledgable nutritionalist/dietitian.
I stopped doing the ketogenic diet 5 weeks ago and I’m still very, very ill from it.
I too was amazed at some of the success stories of people on ketogenic or low carb diets. But, after the initial ‘keto-flu’ I found I couldn’t keto adapt. I could make ketones fine (tested with Ketonix), I’m just not sure I could use them (only felt ok after having protein each day).
Also, high ketone levels started to increasingly give me tachycardia (no digestive issues with fat though) and that would also keep me awake in the night (as well as being quite scary).
When I stopped the keto diet 5 weeks ago, that’s when the trouble really started. It’s like my body can’t use ketones or fat as a fuel and now can’t use carbs very well either. I’m stuck in no-man’s land.
So going back to carbs my muscles suddenly became incredibly weak and shake with the slightest of effort, like holding a mug or trying to stand. Pushing through this even slightly gives me a terrible cfs crash.
I’ve gone from being housebound but could walk, say, from the carpark to the doctors office if I had to, and just about able to keep a clean-ish home before I went keto, to now where I am bed-bound about 95 percent of the week and can only really walk to the toilet and back. Even that leaves my muscles shaking and weak-feeling for hours. I can’t wash properly or cook for myself now and my partner has to do everything for me, even wash my hair.
Don’t get me wrong, I still think the ketogenic diet has such potential to help people. I was just naive in thinking that if it didn’t work for me, at least I couldn’t do any permanent harm to myself!!!
Ironically, I’m now having to eat much lower fat than I did before I went keto. I’ve just started to see a nutritionalist that specialises in keto and paleo diets, hopefully she will have the knowledge to help me undo some of the imbalances I’ve caused in myself and find the best diet that works for me.
So, I’m not saying don’t go ketogenic, just, if you are unwell, don’t do it without professional supervision. I hate the idea of other people jumping into this without realising what a mess they could potentially put themselves in.
Wow…So sorry to hear that this happened to you and thanks for passing on the warning…You’re the second to report that you’ve gotten stuck in a kind of limbo state. Good luck with getting out of it.
Thanks Cort 🙂
Did you ever consider a zero carb diet? Hope you get the help you need.
Hi Cort, I see the blog on “Lori’s story” still starts with:
The metabolomic findings in ME/CFS and reports that high carbohydrate foods have a sapping effect suggest that ketogenic diets – which increase fats AND PROTEINS and severely limit carbohydrates – may make sense in ME/CFS and fibromyalgia
Maybe it would be better to remove the “and proteins” part following this blog?
Kind regards,
dejurgen