After Keto - what then?

(Mike Leahy) #1

From the outset, I want to clearly state that I’m not “keto bashing”. Through following Keto, in twelve months I have: completely reversed type 2 diabetes, gone from 105 kilograms to 70, my waist has gone from 104 centimetres to 88, my HDL has increased from 1 to 1.9 while my triglycerides have decreased to 0.8. Actually, most of that was achieved four months ago and my markers have been pretty stable since then. Along the way I have learnt an awful lot about macronutrients, cardio vascular disease lipid panels and, of course diabetes. I should mention that three years ago, I had a quintuple heart bypass. The diabetes came along at the start of 2018. I’m over 70 and have been subject to the consequences of Ancel Keys’s flawed science for most of my life.

I have just reached the point where some re-evaluation is called for

The last three months have been the hardest. The heavy lifting had been done, health really good. My goals had been achieved, but I started to notice that my skin was starting to break out in a rash and my mental clarity started to get a bit wobbly. I became agitated, jumpy and unusually moody. I wondered whether it was just “old age” until two separate medical folk, knowing that I was following a ketogenic regime made the same observation: that my daily carbohydrate intake (between 15 and 21 grams) was too low to be healthily sustainable and that my body was responding to a lack of available glucose. Specifically, the MCT oil and fats in general had suppressed feelings of hunger, the brain was crying out for more glucose and my body rash was symptomatic of un-ease, inflammation.

Now, I’m not a doctor but I’ve learned to listen to professionals who suggest that Keto has done its job and it’s now time to reap the rewards of that. Keto has improved all of the environment factors so important to my heart - my weight, my glucose levels - and to the often-forgotten organs that support - the pancreas, liver and the system of internal tubes and valves which connects everything to everything else.

So I’m moving on from Keto to low-carb. I’m simply relaxing my level of carbohydrate restriction and telling myself that it’s OK to consume even over 50 grams of carbs per day, while holding to my overall 2100 calories and 90-odd grams of protein per day. This means that my fat intake will inevitably decrease (that will make my cardiologist happy!). Who knows how my diabetes will deal with the carbohydrates or my brain with the additional amount of glucose available to it.

The take-home message is that I started Keto in response to my diabetes and for the flow-on advantages offered to my heart. My fatty liver and pancreas are now much happier - in fact I carry very little fat along with me. Keto has done all that I have asked of it, so it’s time to increase the level of glucose a bit and hope that my brain, skin and nerves appreciate it!

Thanks for reading. I hope someone might find it useful

#2

Some people can still be in ketosis at 50g of carbs per day, some at even 100g. 20g isn’t the be all and end all of keto, it’s just a guaranteed level to follow to definitely get a person into ketosis. Now you just need to find your maintenance level.

I wouldn’t sweat it too much.

(John Pizzuto) #3

Do you measure blood ketone levels? George Cahill’s 1967 study showed the brain runs on 66% ketones in starvation.

Blood cells and some nerve cells have no mitochondria and must have glucose, so the liver and kidneys process and recycle things, producing 80 grams of glucose daily, even in starvation.

Dr. D’Agastino says ketones are the preferred fuel of the brain and heart, saying the hydraulic pumping efficiency of the heart is increased by 25% when fueled by ketones.

(squirrel-kissing paper tamer) #4

Congratulations on your successes. You’re heading into maintenance and it’s time to experiment on how many carbs your body can tolerate while continuing to feel good. Maybe you’ll have a few more some days and less on others. Good luck on your journey.

(Scott) #5

Play around with your diet and see what works for you. If you find improvement that’s great, if not it’s not like you’re throwing away the key. I seem to do fine at 50g carbs daily.

(Bunny) #6

I’m rather confused about this post (it makes no sense?):

Sounds like keto flu or somebody who is just starting out and in the beginning stages a ketogenic diet? (HPA-Axis dysregulation?)

You could have never been in ketosis or fully ketogenically adapted to begin with if that was truly the case?

Hope that does not include highly processed foods and refined sugars?

My troll troll alert alarm is really going berserker (but that’s just me I guess).

(Carl Keller) #7

I feel like my current WOE has improved my demeanor 100% and while I have felt myself become a little frazzled a grand total of two or three times in the past six months, I like to think we humans will never be completely immune to the effects of stress… no matter how ‘proper’ our diet is.

I think if you continue to eat intuitively and avoid processed foods, you’re going to be just fine. Congrats on your journey. Please do return and let us know how things are going.

(Windmill Tilter) #8

I think that’s a very healthy way of looking at it. Keto has been a wonderfully effective tool that helped you overcome a lifetime of SAD, and now it’s job is done. It no longer feels good for your body. If that’s the case, it’s time to try something else that does.

You might want to check out Dr. Fung’s new book “The Longevity Code”, about how to eat in order to stay as healthy as possible as long as possible. It’s caused quite a ruckus because Dr. Fung suggests that the diet designed to fix obesity/typeII diabetes is not the same diet that one should eat for longevity. I haven’t read the book yet, but apparently he’s more lenient with carbs that are lower on the insulin index like legumes and essentially advises low carb, high fat, moderate protein with a 50/50 split between vegetable and animal fats. Sounds kind of like what you’re thinking about anyway.

I’m not keto bashing either. I’ve lost 36lbs since the start of the new year and I feel fantastic. I’m in better shape now at 40 than I was a 30. I preach the gospel of keto to anyone who will listen. I give out copies of the Obesity Code like a Gideon. That said, when people talk about keto as a “way of life”, it occurs to me “that’s what vegan’s say!” and I get a little nervous. If keto stops feeling good, and it starts affecting your mental acuity, I think it’s completely appropriate to make adjustments to the composition of your diet that make you feel like the best version of yourself!

Good luck and let us know what works for you after a bit of experimentation!

(You've tried everything else; why not try bacon?) #9

I call BS. Ask them to name the known carbohydrate deficiency diseases. (Hint: there aren’t any).

Phinney and Volek have found that glucose storage in fat-burners on a ketogenic diet is indistinguishable from the glucose storage in carb-burners.

Since Type II diabetes is essentially a disease of carbohydrate intolerance, I question the logic of increasing the food that caused the problem, but you have to listen to your doctors, so good luck!

(Martin Worth) #10

Maybe I’m naive, but I didn’t pick that up at all. This sounds like someone who has had great success with a Ketogenic diet and now his body is suggesting that it might like just a little more in the way of carbs.

I don’t think for a minute that should be interpreted as turning to pizza, donuts and sugar sandwiches. I imagine he means including a bit more fruit and veg. He mentions increasing to 50g or a little over per day. This is still a very low carb approach and with the right GI any effects on IR and Insulin spiking will likely be negligible.

It sounds like where I am currently myself. 10kg long term reduction in weight, stable, great bloods and BP under control.

I’m not saying its the lack of glucose that is definitely the problem, but a quick foray up to 50g to see if it fixes the problem is in my mind a very reasonable experiment to try.

(Chris) #11

Should look into Mark Sisson’s keto reset - he talks about metabolic flexibility. If you can handle the carbs, there’s no reason not to experiment. There are still foods that should be avoided though, for the most part. Anything processed, seed oils (or seeds in general, including beans and nuts).

(You've tried everything else; why not try bacon?) #12

In my case, sugar and carbohydrate, since they stimulate an addictive response. :grin::bacon:

(Chris) #13

Oh, you!

(Lisa marie t) #14

Congrats on hitting ur goals and doing what’s best for you I don’t get ur keto bashing at all

(Lisa marie t) #15

Congrats to hitting ur goalsemphasized text

(KCKO, KCFO 🥥) #16

Cut out the MCT oil. See how you feel.

Some can tolerate higher carbs, up to 100 or so is not problematic for most people. (disclosure: in maintenance for almost two years now and eat around 50 grams per day) not everyone needs to stay at 20 grams. You just have to experiment and see how your body likes the additional carbs.

Good luck sorting yourself out.

#17

Is there anything you started eating a lot of that you didn’t use to? Skin rash sounds more like you are eating something your body disagrees with rather than not eating something.

Anyway best of luck. Like others have said you can still be keto at 50-60 grams of carbs.

Eating the ‘extra fats’ like the mct is a good place you can try and reduce to see if that helps. Sticking to whole 30 might improve some things if you are not already.

#18

I’m 68 and have been subject to Ancel Keyes propaganda via doctors for awhile too. :grin:
I hope you will track and return and tell us how you go.

I have reversed type 2 diabetes too but am not counting on that staying the case if I up my own glucose levels, so I am really interested in how you go and look forward to hearing from you again.

#19

Mike, you write beautifully.

It just sounds like a transition from strict nutritional ketosis with therapeutic goals to an experiment in low carb eating that may see you in ketosis, or sometimes not.

As you clearly state and observe you are not the same person now. You have changed metabolically and physically. It’s no surprise that what worked for you in a less healthy state is not working so well after the change. The way of eating probably needs to evolve with the changes in the being.

It’s not like you are saying that you are changing from therapeutic ketosis to eating cream cakes and chocolate milk every day.

You have some symptoms that you find less than optimal, so you are tweaking the inputs.

The current trend is to ditch the plant inputs when a low carb eater finds they have stalled or have immune system symptoms, like inflammation in the skin.

Equally it could be a reactive protein source.

An older trend was to ditch the dairy inputs because of the milk proteins that can be problematic in some people.

Maintain your curiosity and eloquence and enjoy the discoveries.

(Mike Leahy) #20

Thank you all for your comments.

I definitely do not intend to go back to bread (my personal trigger), processed/convenience foods, oils that have been hydrogenated, and all of the other things that I know to be nutritionally bad. I simply am going to relax the Keto regime so that it becomes low carb. Keeping a close eye on my blood glucose levels, lifting daily carbohydrates to 50 has had no impact. Keto has indeed healed things.

Yes, I measured for ketones - until I figured that knowing I was “in ketosis” mattered very little: the weight was coming off, the BGLs were low and stable as was my blood pressure. The results were clear and I gave up worrying about whether or not I was “in ketosis”. It seemed pretty academic, frankly.

Looking back, following Keto made achieving my goals easy: never hungry, never consciously “dieting”. But as I got into maintenance, it became harder - I had become “routinised” with a Keto mindset that has made “letting go” of fairly stringent macronutrient levels. We’ll see how it goes!

Again, thank you all. As requested, I will keep you posted on what happens.