Hello I have been on keto now for about 5 weeks. My fasting Blood sugar numbers have been much improved from 140 to 95 to 110 most morning. My blood pressure have all come down to under 120 over 80 and I have lost 17 pounds. So all that seems great to me.
Now the bad part I am currently being treated for High Blood pressure and take 2 meds for that. High cholesterol and Lipitor for that. Chronic Kidney decease and one med for that stage 2. Some signs of Cornary Artery desease found from Cath. Also had Heart Ablation 2 years ago for Tachacardia. Also suffer from sexual problems. Also type 2 diabetes and on metformin for that. So tired of all these meds but afraid to stop them. My last Doctor visit was in February and A1c was 7.5. I figured I needed to do something. Next doctor visit end of May. Should keep on keto or am I killing myself with all this fat? So confused. Please any insight is needed.
Am I making my health worse?
I canât speak to any of this (via personal experience or research). But MANY here will have some good input for you. You arenât alone. Hang onâŚ.
Hello, friend.
Your fasting blood sugar, blood pressure, and weight have all improved dramatically - great work!
Is there a reason why youâre concerned that youâre killing yourself with fat? Has something happened? Or is it a fear from a lifetime of being told fat is bad for you?
If youâre worried, are you able to check in with your doctor before May and ask what they think about the improvements youâve seen, and whether you need any medication adjustments due to them?
No, you are not killing yourself with all this fat. The principle behind the ketogenic diet is that excessive carbohydrate intake elevates blood sugar, forcing insulin to rise, in order to force it out of the blood stream. Some of the glucose goes to muscle to be burned, but the rest goes to our fat tissue, to be stored as fat. The elevated insulin prevents that fat, once stored, from leaving the fat tissue. By switching to a low-carb diet, we eliminate the need for a high insulin level. As we adapt to a low-carb ketogenic diet, our muscles switch from burning glucose to burning fat, so our fatty acid metabolism actually increases.
Dr. Stephen Phinney, one of the big researchers in the field, has data to show that even though we eat more fat on a ketogenic diet, the amount of fat we burn actually increases so much that we not only go through all the fat we eat, we also burn off some of the extra stored fat that has accumulated. This is why people often lose weight on a ketogenic diet.
Not only that, but lowering insulin has a number of other beneficial effects, since elevated insulin causes a number of problems in the body, not just fat storage.
Insulin interferes with the mechanisms that keep blood pressure low, for example, so as you go along, you will probably need your doctor to reduce the amount of your blood-pressure medicine, especially if you start to feel dizzy or light-headed. (You donât want to start collapsing from low blood pressure!)
The research surrounding cholesterol is not as conclusive as the statin manufacturers would have us believe. Yes, statins do lower cholesterol, but the benefit of lower cholesterol has been seriously called into question by some large, well-funded studies, along with the idea that cholesterol is even the cause of heart disease (at best, certain cholesterol number might be markers of disease, but not the cause). Given that statins achieve their cholesterol-lowering at the cost of some pretty serious side effects in many people, a lot of us on these forums arenât keen to take them.
If you have coronary arterial blockage, your heart muscle will probably do better on a ketogenic diet than on a high-carb diet. Ketones are partially-metabolised fatty acids, so they require less oxygen to metabolise, and thus the heart muscle tends to do really well on them. And avoiding carbohydrate greatly reduces the damage caused by constant glucose metabolism.
Dr. Phinney feels that metformin is a drug that is very safe to take, so in the company where he is Medical Director, they keep their patients on metformin after all other prescriptions are no longer necessary. This is not to say you canât do away with the metformin, just that itâs not as much of a concern as other drugs are.
I would suggest not worrying about your blood work until you have been at least six months on a ketogenic diet. Doctors often get freaked out by the early cholesterol readings, for example, and other numbers also often take a while to settle, as well. You will have a much better picture at the six-month mark, so try to get your doctor not to stress at the readings before then. At six months, we can propose some strategies for approaching your doctor, if some markers arenât what he or she thinks they should be.
THank you so much this helps with my concerns. I guess maybe i read to much at what is out there on the internet. This forum has been very helpful hearing the personal concerns of real people. Thank everyone for that. At the same time I have been trying to research the internet and have watched many of Dr Berry and Berg and Ekhert and Dr Fung very informative. At the same time some top Cardiologist are saying quite the difference and say Keto is killing us. I have many problems that even with medications donât seem to make things better and I guess maybe worse. That is the reason I am trying keto. I guess after 5 weeks I am seeing some results. I know everything takes time. I will wait until the end of May at my next Doctor visit and see what the numbers say. It takes that long to see a differnce in A1C. I will be interested to see what Kidney tests show along with Cholesterol. Hopefully my HDL has increased which now stands at 30. I will hold off on making any self adjustments to meds until Doctor. I have a feeling he is not in favor of keto but maybe numbers will convince.Maybe getting off some of these meds will help in a very personal and sensitive department.
I might mention that I am 72 years old but do not consider myself as OLD. I try to stay very active.
I have been on most of these meds for years.
Thanks for the help to everyone and words of encouragement
I think one of the problems is unrealistic expectations. Keto is biochemistry not magic. I suspect those of us who do well easily eating keto tend to feed into these unrealistic expectations. If I wax poetic about how natural, normal, healthy and EASY keto is for me, then others expect the same when they do it. And maybe, because of genetic differences, extent and degree of previous metabolic damage over the years, they donât get there as soon or as easily as they were led to think by those of us who did. So they mistakenly conclude keto is nonsense or just doesntâ âwork for meâ, etc.
The evidence is that humans evolved over the course of millions of years living predominantly in the metabolic state of ketosis and itâs only in the last few thousand years that the mere possibility of anything else developed. Thus, keto is the normal, natural and healthy state for humans and thereâs nothing âunhealthyâ about keto. The problems some people experience can be due to their specific genetics, whether or not they were breast-fed or had high carb formula as an infant, and what and how much damage they suffered subsequently eating the standard diet for years and/or decades prior to adopting keto.
I donât want to hijack Davidâs thread, but PaulL mentioned something that Iâve been wondering about lately. When I last saw my doctor, which was after less than two months on a keto diet, she was so impressed by the drop in my A1C that she took me off metformin. I had noticed that Dr. Phinneyâs company measures success by getting patients off medications other than metformin. Since I stopped taking it, my morning fasting glucose readings have gone up, although everything else is fine. It leaves me wondering whether perhaps my doctor jumped the gun a bit. Perhaps it wouldnât be so bad having metforminâs help in suppressing gluconeogenesis. I doubt it matters much, but Iâm curious whether PaulL or anyone else has a citation to Dr. Phinney or one of his colleagues discussing why metformin is safe. I realize that I have Google and could look for it myself, but if you had a particular source in mind it would give me a head start. Back to Davidâs issue, anyone who is losing weight, lowering glucose levels, and improving blood pressure is much more likely to be doing good than harm. I would stay the course until my next appointment at least.
Actually, your A1c should come down very quickly, before even weight loss. And you may have to get off some drugs only because you could get low blood pressure or hypoglycemic episodes.
If it makes you feel better, after 5.5 years low carb/keto, I got a coronary arterial calcification scan done, scored zero (very low chance of heart disease in the next 10 years).
It can take a while for HDL to come up. It took me a few years to go from <40 to mid 50s.
Thatâs because they are stuck in the paradigm that saturated fat causes heart disease.
The researcher who claimed that, Ancel Benjamin Keys, did a study involving twenty-two different countries, but he reported it as the Seven-Country Study. He did that, because the data from those seven countries, when analysed, showed a correlation between saturated fat intake and coronary heart disease. He also noted a correlation between sugar intake and heart disease, but he dismissed that out of hand. Interestingly, when people went back and re-analysed the data, they found that when all twenty-two countries are included in the analysis, the correlation between saturated fat and coronary heart disease vanishes, but the correlation with sugar remains.
(It may or may not be relevant that Frederick Stare, founder of the Department of Nutrition at the Harvard School of Public Health, was at the time taking money from the sugar industry to play down problems with sugar and play up problems with fat. At least, this is according to internal memos from the Sugar Association at the time.) [Note: I originally mentioned Walter Willett, but it was Stare I was thinking of. Ancel Keys and Frederick Stare both received money from the sugar industry in the 1950âs and 60âs. Stare also put together the industry presentation to the FDA that persuaded the agency to put sugar in the category of foods âgenerally recognised as safe.â]
In any case, several large studies, funded by the U.S. government, including Keysâs own Minnesota Coronary Study, actually showed that low fat intake or blood cholesterol levels (depending on the study) actually correlated with more heart disease. This so disappointed Keys that he had his name removed from his own study.
But the dogma that fat/cholesterol is bad for us remains firmly entrenched.
Possibly, possibly not. I firmly believe (though I have no evidence) that leaving the body alone to manage itself is, in general, better than messing with processes we donât fully understand. We have another topic, debating whether higher glucose on a ketogenic diet is a good or a bad thing. At least one doctor feels that a higher average glucose, if the levels stay within a narrow range, is much better for his patients than a lower average, but with large peaks and troughs. Iâm not saying heâs necessarily right, but the fact that an experience physician feels this way from clinical experience is at least food for thought. (His name is Paul Mason, and heâs an Australian sport medicine physician who does lectures available on the Low Carb Down Under YouTube channel.)
I canât help with your question as I donât even know which numbers mean what (I never go to the doctor and feel healthy) but I wonder how much fat do you eat that it seems so much for you? Though itâs probably due to your past low intake⌠I dropped my fat on low-carb, actually as I truly overate fat on high-carb so itâs very different for me. Anyway, fat feels life and love and everything to me. My body wants it. It needs it. I have doubts about things but eating much fat never was one of them. What else would I eat, carbs? I tried that and not only the typical clearly super unhealthy way and nope, it was definitely not my way. A health-conscious high-carb woe may be the way for others, we are different.
If you donât see any warning signs or donât have some condition that clearly screams for low-fat or something, I would give keto some more time and see what happens. But again, I am totally unfamiliar with health problem things so⌠Probably donât listen to me. I just wouldnât want you to be scared without a good reason⌠Too many people fear fat while eating clearly bad things galore, more fat very possibly could help them and itâs so sad.
Define âall this fatâ.
For me, the simple definition of keto is âMinimal carbs, adequate proteins, fats as needed (for satiation).â
You do need to target a minimum amount of protein (in grams), primarily based on your lean body mass, but after that, it should be whatever additional proteins and fat you need to satisfy your hunger.
Sounds good just not used to all the butter and bacon and olive oil. I appreciate all of your input.
As long as youâre seriously restricting your dietary carbs, you need to fuel your bodyâs energy needs from somewhere. Thereâs only so much protein that can be tolerated (or is healthy) ⌠the rest must necessarily come from (healthy) fat sources.
Oneâs sense of satiety is how you get the best indication of how much fat is the âright amount.â Too little and your metabolism will begin to wind down in starvation mode. Too much, and youâll feel stuffed beyond appetite comfort.
Listen to your bodyâs signals. Itâll likely take some time to adjust so bear with it and be patient with yourself. 
Iâll admit to using my fair share of butter when I cook some vegetables, but most of the bacon I eat is crisp, so much of the fat is gone. I donât use olive oil at all because it gives me gastric issues.
So the only time I really add fat purposefully is cooking those veggies.
Blood sugars down, losing weight (fat), sounds like the right track. I say nothing wrong with Keto diet. 5 weeks? Really? Give it at least a year. Its too early to worry. It would be crazy to go back to what was killing you.
And besides, protein, under normal circumstances, is not used as a source of energy. Including it in the calorie count is a holdover from 150 years ago, when all they could do was count calories. They barely knew the difference between carbohydrate, fat, and protein, much less what they did in the human body.
We should be measuring foods by how much ATP they produce, anyway; not how much heat they release when burnt.
Fair enough. Although I understood it to be a minor source of dietary energy. And, in a pinch, oneâs body can cannibalize stored proteins to produce energy to keep the metabolic lights on.
But without dietary protein, we wouldnât last long. As such, itâs an âessentialâ macro-nutrient (we must consume). Moreover, thereâs a healthy range outside of which we find ourselves in nutritional trouble.
Didnât want to leave it out of the dietary mix given the context of the conversation.