Diarrhoea on new keto starter

(Tanvir Islam) #1

just started keto 4/5 days. mostly eating steamed veg like broccoli,cauliflower about the size of a bowl and 4 eggs, meat/fish. fat sources are ghee and coconut oil maybe 6-7 tea spoons daily.

I started keto with the hope to get better from ibs-d and hypersomnia. for ibs-d i usually took a spoonful of ispergul and that preveted diarrhoea. but since starting keto it is not working. even Imotil isn’t working. anyway to stop diarrhoea? if i get few times diarrhoea a day, i get anal fissure which is really painful.
for the hypersomnia i am using ASV and suspected narcolepsy meds such as mythyphene 10, Flurazepam 15. there are some improvements with the meds. hoping to get better with keto. i m 39 yrs old, 66kg, 5feet 9 inches if these info matters.

(Joey) #2

@Tanvir_Islam You’ve got a lot of moving parts involved (… sorry, not a digestion crack, which would not be cricket), so it would be hard to suggest specific adjustments given all the possible interactions.

As for the fissure issue, this likely has more to do with your external response to the bowel movement than its loose consistency. Constipation would seem to be a more likely culprit of what you’ve described. So try soft wipes, a bidet attachment, or other possible ways to not inflame those gentle tissues.

As for diet, there are many around this forum who can offer more insightful suggestions (e.g., salt intake, reactions to other foods, etc.) that may be helpful. But suffice it to say that you have a history of sensitive digestion functions and so changes in diet are likely to take time for adjustment. Your gut biome is likely going through a meaningful transition if your eating has drastically changed, too, and this may take time to evolve to your benefit also.

Sorry I can’t be more helpful, but eager to see what others may offer for your relief.

Congrats on starting out on a better course of eating. Best wishes!

(Robin) #3

I don’t have any knowledge about this either. I’m just part of the welcoming committee. I’m sure you’ll get some good feedback.
Happy New Year

(B Creighton) #4

Ulcerative colitis is the most common form of inflammatory bowel disease, and often causes diarrhea or bloody diarrhea. Anaerobic fermentation of the soluble fiber in Ispergul results in the production of short chain fatty acids, acetate, propionate and butyrate in the intestine. “Butyric acid is the preferred oxidative substrate for colonocytes and may be helpful in the treatment of ulcerative colitis.” This may be why Ispergul made you better. Even though you are eating steamed cruficerous vegetables, however, you may still be consuming less fiber than pre-keto. If so, the first thing I would try is to consume more fiber. You can use ground psyllium seed as a cheap source of relatively pure fiber. I do not count carbs from fiber as part of my daily allotment of carbs on keto because the fiber is being turned into beneficial short chain fatty acids in our gut, which are helping your colonocytes ie colon cells digest more fully. Again, if you have disrupted that balance by eating less fiber than you did pre-keto, I suspect that is the cause of your discomforts.

Whether you have ulcerative colitis or some other potentially worse thing going on is another question I cannot answer for you, and you probably should consider a visit to a gastroenterologist, if you have not seen a Doctor about it.

(Bacon is a many-splendoured thing) #5

Cut back on the salt for a bit. That will help the colon recover water from your stools and slow down the diarrhoea. Also knock off the added fat. The fat in your meat and the fat you cook with are probably enough. Once the diarrhoea settles, you can experiment to find out how much fat and salt you actually need.

You can eat your broccoli and cauliflower with cheese sauce, and that might help bind you up, lol! :grin:

I suspect that eating carbs did not help your narcolepsy, so a low-carb, ketogenic diet should help. I wouldn’t be surprised if you could reduce your meds, even if you still need them somewhat. I had a buddy with bad narcolepsy who worked with a chiropractor and was able to cut the Ritalin to a quarter of the dose he’d been on.

If you would like some advice, avoid sugar like the plague, because it is a metabolic toxin and does the brain no good. Watch your ketone levels, and try to keep them up. Poor nutrition can cause so many different brain problems, from motor-neuron diseases, to mental problems. Keto may not be able to reverse all the damage, but it can certainly keep it from getting worse.

(Tanvir Islam) #6

i actually have been suffering with lbs for about 20 years or more. numerous visits with gastroenterologist and endoscopy, colonoscopy, blood works, biopsies…all came ok hence doctors typed it as ibs-type d. Lots of medicines tried. Only imotil and/or ispergul powder that I take was able to stop loose stool. Although I had never taken hydrogen/methane based breath test to find out if I have SIBO, I highly suspect that might be one of the cause as I have seen whenever my stool or gas smells really bad taking Refaximin subsides it for a while. Unfortunately its keeps coming back.

As for fiber intake i am sure i am taking lot more fiber after starting keto as i am eating at least twice the amount of veggies thats I used to eat. I only suspecting that amount of fat that I have started eating might be causing the loose stool as stomach isn’t used to that much fat and doctor in traditional treat always suggests to conssume less fat and spices.

(Tanvir Islam) #7

Thanks you PaulL. I am not taking any extra salt only with cooked foods as per taste which is the same before starting keto. I will try to even lower it.

I was thinking the same you have mentioned about extra fats but wasn’t sure if I would reach ketosis if I dont eat those extra ghee and coconut oils. will follow your advice on this an see how it goes.

Additionally I wanted to know if HCL and digestive supplements would do any good for me? As I have gerd and heartburnrn issues as well.

And of course my biggest nemesis is the sleep proplem. I was managing ibs with other means but its the sleep proplem that put me to the fence. After spending so much money on sleep tests, CPAP, bipap and medication I have barely reached normal functional level hence trying my luck with keto as a last resort. Hope to get the best out of it.

Suger is of course out of the diet but still crave for it.but denying them so far as its been only 4/5 days and also yet to get a blood ketone meter. I have only VTrust TD-4279 and Freestyle Optimum Neo available where I live. Any suggestion which one would be better to purchase?

(B Creighton) #8

Sounds nasty. Personally, I would introduce a home-made reuteri yogurt to my routine. Perfectly acceptable on keto. You can also try just using Lactobacillus reuteri probiotic. Reuteri is often able to help with SIBO, because it can colonize the upper intestinal tract.

A few years back I got my digestive tract all messed up because I had to take an antibiotic. I used this:
https://www.lifeextension.com/vitamins-supplements/item02125/florassist-gi-with-phage-technology which is able to kill about 6 common bad guys which may be part of your SIBO. I found this to be the most economical source of bacteriophages. When I used the bacteriophages, I did notice a lot of unusual gas for 2-3 days, which I believe was the phages breaking down bad-guy biofilms. Unfortunately, this supplement does not have reuteri, so it has to be purchased separately. I have a probiotic which has L.reuteri, and I make my own yogurt with it to this day.

(Bacon is a many-splendoured thing) #9

As long as you are eating enough fat and have extra stored fat to get rid of, your liver will have an abundant supply of fatty acids to make ketones out of (ketones are to fatty acids as charcoal is to wood).

But what makes ketosis possible or impossible is the amount of carbohydrate in the diet. Too much carbohydrate, and insulin rises, which signals the liver to stop making ketones and signals the fat tissue to store fat. (When we eat too much carbohydrate the body needs to neutralise all the excess glucose that results.) A low enough carb intake allows insulin to drop, which signals the liver to start making ketones again and allows fatty acids to leave the fat cells and be metabolised.

(Tanvir Islam) #10

Thanks scaperdude.
sounds good. Will give it a try as well. To simply
I need to try Lactobacillus reuteri probiotics and FLORASSIST probiotic together? Is there a recommended time when to take them? With/without food , morning or before bed?

(Tanvir Islam) #11

So to lower carb and fat intake(to prevent diarrhoea) such as butter & coconut oil i can eat more proteins to feel statiated for now?
And once i get a ketone meter what level of ketone should I be targeting?

(Bacon is a many-splendoured thing) #12

You’ll have to figure out at some point how much salt and fat you need. Just give yourself a break from diarrhoea first.

Also, while I think of it, try
cutting out fibre from your diet. Many people with bowel problems (IBS, Crohn’s disease, diverticulitis, etc.) find that fibre is really detrimental to their intestinal health. Myself, I find, as a carnivore, that I really don’t need fibre at all. Getting enough fat and salt prevents constipation, and too much of either or both causes diarrhoea. And my diverticula don’t affect me as long as there’s no fibre to get into them and cause trouble.

As far as your ketone level is concerned, any level of serum β-hydroxybutyrate above 0.5 mmol/dL is certainly adequate. Unless you are trying to affect your brain chemistry (when treating epilepsy, mental illness, or a motor-neuron disease, for example) or to fight a cancer, there is no particular advantage to high ketones. Expect higher levels at the beginning, then lower numbers once your body has fat-adapted. The presence of measurable serum β-hydroxybutyrate is simply a convenient indicator that your insulin level is low enough to put you into a healthy metabolic state. Once we have a reliable home test for serum insulin, that will probably be the standard indicator.

That said, however, be aware that ketones have a lot of uses in the body, in addition to their value as fuel. For example, they have potent hormone-like epigenetic effects, and they also have positive effects on brain chemistry.

(Tanvir Islam) #13

Couple of months back I started carnivore. And had severe diarrhea for couple of days.so had to stop there. This time thinking that fibre might be helping keeping loose stool in check, started with keto. Though this time also having loose stool couple of times but its not that serious as last time.

(Bacon is a many-splendoured thing) #14

It seems that every change in diet has temporary digestive consequences. I remember my mother, who was a nurse, talking about this decades ago.

For me, the digestive upsets from going from keto to carnivore settled down fairly quickly. Before I stopped eating plant foods, I never worried about how much fibre I was getting, and now that I’m not getting any at all, I seem to be even more regular than before. But there were a few days at first when I was constipated, then a few days of diarrhoea, and now everything is right the way I want it to be.

If we are not getting enough salt, the colon works to recover it aggressively from the food passing through, and that over-dries the stool. Too much salt, and the stool is not dry enough.

Dr. Anthony Chaffee, a carnivore, says that for carnivores, it’s the amount of fat we eat that keeps the stool soft. He says that the liver makes enough bile for the fat we need, and any extra fat gets excreted. As far as I can tell, he’s on to something.

(B Creighton) #15

It is the particular Florassist GI that has the phage technology. There is a separate Florassist that has L. reuteri. You can find it here: https://www.lifeextension.com/vitamins-supplements/item01821/florassist-heart-health
Or you can find L. reuteri at most places which sell probiotics. Most probiotics do best if taken with either a raw dairy or some source of fiber.

#16

There is an individual factor too. My fat intake never seemed to change my stool at all. Or my salt intake. The variety (an average number, a single day probably doesn’t matter) wasn’t super varied (no way I could try low-fat from my own will even if I was super determined, for example… but I tried not to eat 300-400g fat either) but still there was some variance. Some human bodies just refuse to change their ways as far as the noticeable things go, it seems, my diet changes rarely caused any difference, I only noticed that a lot of carbs can make my stool a bit softer, usually still fine but I prefer the carnivore ghost wipe :wink: (And I prefer less carbs for other reasons as well, of course.)

But it makes sense many people notice changes when they change their woe or an important part of it. Just not all of us have that. Or not in the cases we ourselves have as we have some taste or instincts or something that keeps us in a range where the output is pretty much the same and looks good :slight_smile:

(Robin) #17

Many of us have issues with veggies. You might try cutting them back.

(Tanvir Islam) #18

Actually i tried carnivore couple of months back. First 2/3 days were ok. After that I had massive diarrhea kept me almost a day and night on the throne.

As a long term ibs-d patient, only thing that worked for me is powdered ispergul on regular diet. Didnt try ispergul while on carnivore though at that time. But tried it with keto at the beginning which hasn’t worked so far probably because of the high fat intake than usual diet. So now trying not to add extra fats in keto(using usual amount of fats that I consumed in normal diet) and observing.

#19

I wonder if this diarrhoea problem due to high fat typically happens to newbies (not only, sure but typically?)… It would make sense. And if it is, how much time and what approach one needs… Individual but still, probably there are good tips…

I always ate (very) high-fat so my actual fat intake is probably a reduced amount (I haven’t ever tracked on high-carb but have memories about my food and the fact I always, sometimes quite badly missed fat on low-carb points to that direction too though higher carb changes my need for fat and satiation in interesting ways so it’s hard to tell). But my body is pretty resilient too so who knows what could have happened without it? Still, it makes sense that if one is very used to using fat for energy as they did it all their life very seriously, things will go better…?

(Tanvir Islam) #20

suffering from long term GI condition probably makes it worse adapting to new diet, when even old diet was not working.