I’ve been on a keto diet since the end of December 2017. Testing shows I’m making ketones (low in the morning, 0.5 – 1.0 or higher as the day progresses) but over the last few weeks I’ve become exhausted all the time, and dizzy and a bit disoriented – sort of removed from myself. I’m finding it hard to function and work. I think maybe my brain is just not getting enough gas somehow – a kind of energy starvation.
I sure would appreciate your suggestions on how to troubleshoot this. Keto is very good for me for several issues (see below) and I sure want to keep up this WOE.
I’m 48 years old, male, 169cm / 5"7 height, total weight 195lb / 88kg, lean body weight 150lb / 69kg.
My current known issues are:
• Hashimotos, with Thyroid Peroxidase (TPO) at appx. 800 IU/ml. I’m working with a functional medicine guy and now testing various thyroid / adrenal supplements.
• Chronic fatigue for almost a decade
• Anxiety / panic attacks.
• I’m currently not exercising. That petered out 2 years ago as energy levels dropped. If I have a good day, I’ll do a walk.
I transitioned to keto in December 2017.
It was a hernia that pushed me into ketosis. The hernia starting about a year ago and was extremely painful. I had surgery that helped for 6 months, and then failed. I was in severe pain and went back to my surgeon, and he told me there was nothing he could do.
So I figured the one thing that would help would be to lose weight. And the one sure way to do that was fasting.
So I read a bunch of Dr. Fung’s stuff and watched some extended fasters on youtube and did a fast for 37 days:
• 2 weeks of salt + water
• then 2 weeks of bone broth with fat
• then the remainder with slowly increasing protein (meat).
Towards the end of the fast, I started to feel fairly unwell. I think there was an electrolyte imbalance, but I wasn’t able to figure it out, so I came off the fast into a zero carb diet.
That didn’t work well, so after about a week I settled into a keto diet.
My current macros in cronometer: appx. 23% protein, 73% fat, 4% carb.
That’s give or take 110g protein, 20g net carbs, and 160g fat.
I’m also testing higher carb levels to see how I do at 10g intervals, taking each level 3days at a time. E.g. 20g, 30g, 40g etc. Blood testing shows I’m still in ketosis.
Total calories consumed daily is appx 2300kcal.
These number vary from day to day, but I’m strict and not cheating. I’m preparing all my own food, not eating out, and no keto frankenfoods.
Note: Over the past week or two my calories have gone up – sometimes doubled – as I have been trying to find some kind of food that will turn into energy. Most of the extra has been fat, and I have gone as high as 87% calories from fat. I also started carb cycling last weekend – 2days carbs (up to 100g), followed by a fast day, then the rest of the week keto – again, trying to find energy. I also dropped my protein to 1gm/kg lean body weight.
Blood ketone measurements are low in the morning, then rise throughout the day to 0.5 – 1.0 by early evening.
It’s a fairly limited diet – steak / ground beef, beef fat / sheep fat, egg yolks, and a variety of leafy greens, avocado, and low carb veggies. Some cheese, nuts and blueberries. I tried an orange but that seemed to trigger an anxiety attack.
I’m supplementing with vitamin D, C, K2 and I’m taking digestive enzymes – they seem to help me with fat digestion. In the last couple of days, I’ve significantly increased the amount of enzymes I’m taking, again to try to find energy.
So the good news:
• After some refeed weight recovery, I lost 8kg and put my hernia into remission.
• My weight was stable for several months, lately it has started to come back.
• My anxiety is in remission – instead of 3 panic attacks a day, I have had 3 panic attacks in the last 3 months.
• I no longer need starchy carbs – I can get through the day with leafy greens and low carb veggies only.
The bad news:
• 10 days after ending the fast – at the end of Jan 2018 – I got a winter flu. I was sick for months – hacking and coughing up phlegm, poor sleep, and with low energy.
• Near the end of April, I thought it was behind me. I seemed to recover for a couple of weeks – I even had a day where everything was awesome – I got more done in 24h than in the previous 3 months. Then things settled into moderate energy levels.
• And then at the start of May I got sick again – I felt sick for a week, and then that passed, and I have been left with heavy exhaustion and brain fog. So bad it’s been hard to function.
In the last month, I’ve had a three short periods where I felt absolutely amazing – for a day, and twice for half a day. Good energy, good mood, a feeling of wellness.
I hope that is the keto at work, underneath this current exhaustion. But I can’t seem to fully shake the tiredness, and I can’t seem to get to a place where my energy levels and mood are consistent.
As I mentioned, I’m now upping the amount of enzymes, and upping electrolytes as well – drinking salt water and supplementing with a little potassium and some magnesium. Also trying various carb levels, dropping protein to 1gm/kg lean body weight and carb cycling.
So the bottom line is 5 months in ketosis, blood ketone tests show that I’m making ketones, but I am at very low energy – just getting going in the morning is a success at this point.
Any suggestions on how to troubleshoot this exhaustion would be most welcome. Have you heard of something like this? Tweaks to consider? Possible solutions?