After Keto - what then?

#21

If your medical professionals actually said that you needs more carbs to be a sustainable woe, I’d be looking for new professionals lol. There are no essential carbohydrates. Your body will make all the glucose it requires thru gluconeogenesis. More than likely if you go back to eating carbs you’ll slowly revert back to your old eating habits and regain your old unhealthiness. Keto is a perfectly acceptable woe that can be done for as long as you wish. If keto has done so much good for you why fix what isn’t broken?

The only cell that absolutely needs glucose are erythrocytes/red blood cells. This is because they don’t contain mitochondria.

#22

Hmmm… my first thought would be to make sure you are getting enough of all your salts, keeping in mind some sources of salts don’t absorb into the body very well (Magnesium has been a hard one for me, as most the available/cheap suppliments are Magnesium oxide, which doesn’t absorb well despite high amounts). That wouldn’t explain a rash though as far as I know.

But, let’s say your doctor is right about the glucose deficiency to the brain, since the brain does need glucose:
I wonder if whatever controls gluconeogenesis for you isn’t working as well as it should, and so you aren’t turning protein into glucose as much as necessary for some reason (assuming you are eating enough protein, and not accidentally eating so much pure fat that you left out the needed protein amounts)?

As far as I know, that’s largely in the kidneys and liver, and the pancreas is involved with some of the trigger hormones, so if any one of those are falling behind there could be a real problem getting enough glucose for the brain, I would think. If any one of those is having a problem though, that’s probably an important problem to know about, as those organs do a lot of other stuff too.

That’s just a thought. I don’t think 50g of carb is enough for the brain either though when not in ketosis (I was under the impression it used closer to 120g of glucose a day anyway, which I imagine requires more than that of carbs since some carbs are not completely glucose). It might be enough to suppliment a brain in ketosis that isn’t making enough glucose otherwise though (don’t know).

(You've tried everything else; why not try bacon?) #23

Interestingly, some of the experts take this for granted, some challenge the notion. Dr. Phinney asserts that while the brain does need some glucose, it thrives on β-hyrdoxybutyrate for most of its needs (not to mention that the β-hyrdoxybutyrate appears to help clear the amyloid plaque and neurofibrillary tangles that many suspect to cause Alzheimer’s disease). Dr. Ede says that certain parts of neurons need glucose, because they are too long and narrow to contain mitochondria. Prof. Bikman challenges the notion entirely, saying that he’s never seen any study showing that the brain needs glucose at all, and asking for references to such a study.

My speculation is that the notion that the brain needs glucose may very well come from the incontrovertible observation that in people accustomed to eating a high-carbohydrate diet, hypoglycemia is a serious problem. However, it has been noticed, both in anecdotal experience and in at least one clinical trial, that people on a well-formulated ketogenic diet can, with no ill effect, see their serum glucose drop to levels that are customarily taken to be hypoglycemic.

#24

Phinney and Volek and others did study the brain on a ketogenic diet though, and did find it still needs glucose. About 1/3rd of the glucose, but still needs some, which I referred to a bit above (though kinda vaguely I suppose).

It doesn’t require external glucose, certainly, as the body can normally make enough for the brain itself from other sources, but there is still some glucose requirement as far as the research I’ve seen has ever indicated.

If someone can find something that indicates the brain is able to operate at full capacity without any glucose at all, that would be quite the interesting find, but I’d have to see that reproduced a few times and reviewed first.

EDIT: I’ll be fair after looking a bit into some of the literature I could find, I suppose it’s possible the brain could survive without the glucose, it just hasn’t been observed to do so since the body will make the glucose for it. Why the body has a process for making unnecessary glucose for the brain is a huge question if it’s not needed, but I suppose I haven’t seen any paper yet that studied what would happen if they artificially blocked all glucose from making it to the brain (and in humans, this would seem to be pretty unethical given the risks of anything going wrong when messing with someones brain). Nor have I seen anything studying people dying from gluconeogenesis failing. That said, if there isn’t glucose making it to the brain, all the evidence I’ve seen thus far indicates something is likely wrong with other organs.

(Alec) #25

Seems to me this is all very normal: success on keto, then slight relaxation to low carb when you’ve hit your targets. Wish I was there to do the same!!

But some points:

  1. I would be very wary of any doctors telling you to eat more carbs. In my experience, 99% of doctors just toe the CW line, and frankly know little about nutrition.
  2. I would recommend that if you have been T2D or close to it, that you regularly measure your BG level or better get your hba1c tested to make sure you are not travelling back to poor health. Sugars can be very sneaky, and they are addictive.