Disappointed after 13 months

#1

Hi. I’m a 60 year old female, 13 months into my keto diet. My goals were to reduce inflammatory joint pain from arthritis (and probably other unknown causes), and to lose around 15 pounds that I’ve gained since menopause. I didn’t start out with any metabolic or cardiovascular issues of concern. Can’t say I’ve stayed in ketosis 100% of the time, but most days the pee sticks are at least a light hue of purple. I’ve eaten the occasional banana, but otherwise nothing that threw me out of ketosis too badly or for too long.

Honest assessment:
My pain is worse. I don’t know if this is a natural trajectory of joint degeneration that would have occurred anyway – I was on a downhill slope to start – but there is no way I could claim keto has helped. At the start, I thought I felt better, but now I wonder if that was not just placebo effect. I had great hopes so am disappointed.

On the weight loss front, I started out losing. Went from about 145 to 137 over 3 months, but have been at a plateau over the past 9 months and maybe more recently going up (now at 140). I realize the fluctuations might be water weight. Maybe the entire “loss” is water and I have not lost any weight at all. On the positive side, I was steadily going up as of last February and I did put a stop to that (hopefully!).

I’ve noticed many small benefits of the diet (skin, hair, digestion), and I do believe that low carb is the healthiest long-term diet, but it hasn’t been a miracle cure for me. I wanted to try carnivore for 30 days but realized I don’t like meat options enough for that. I would have ended up relying on cheese, which in excess is not a great option for me. (Love it but it causes constipation.) I am thinking about trying to be really strict about staying below 20 grams but am not feeling very motivated these days.

I’ve also thought maybe blood testing would help me better understand which foods I should or should not eat. Any ideas for me out there? Thanks in advance!

(Polly) #2

Hi Wendy.

Sorry you don’t see the improvements you were hoping for.

How tall are you? I am 5’ 8” and 140lbs would make me look like a survivor from a concentration camp. The closest I got to it was 142lbs when I was in my early twenties and it was not a good look.

I am in my mid sixties now and have been dabbling with carnivore since last summer. My inflammation and joint pain have been much improved since going grain free and zero carb certainly makes a lot of sense to me.

If I were trying to suppress pain and inflammation I think I might stop considering whether I enjoyed the food and just treat it as a fuel source. Give carnivore a 60 or 90 day trial and see where it took me.

(Gregory - You can teach an old dog new tricks.) #3

What does the majority of your food choices look like?

What are your eating times/habits like?

Where did you get your diet guidelines from before coming here? What do they look like?

Are you grain free? No grain/seed based oils?
These things are generally highly inflammatory.

(You've tried everything else; why not try bacon?) #4

  1. Don’t worry about the urine strips. After a certain point, they become unreliable for many people. If you are keeping your carb intake low, your liver is making ketone bodies.

  2. A ketogenic diet can help a lot, but it can’t heal all damage. These days, I notice pain in my knees and stiffness in my hands only when I have indulged too greatly in carbohydrate the day before. But I don’t think that my friends with worse arthritis would see it go away entirely, even though keto would probably help to some extent.

  3. As far as weight loss is concerned, the last 15 pounds of fat take a long time to lose, if we ever do. There is also the matter of what weight our body feels most comfortable at. I lost 80-85 pounds effortlessly when I began eating keto, but you’d never know it to look at me. I could stand to shed another 80-85 pounds of fat. If my goal were fat loss, I’d be quite distressed, but I started this way of eating for the metabolic benefits, which I have received.

    The question about how tall you are is relevant. When I met him (decades ago), my ex-lover had a strenuous role dancing in a big West End musical. He was 5’7" tall, and looked like a scarecrow at 140 pounds. When he ended his run, he gained ten pounds and looked a lot healthier. It may be that your goal is unrealistic.

    Another point to consider is whether you you are interested in losing weight at all costs, or whether you would like to lose fat while preserving muscle tissue and bone density. If the latter, you should know that there have been documented cases of people actually increasing their lean mass while shedding fat. So the scale is not by itself an entirely reliable guide to progress on a ketogenic diet. If your clothes fit more loosely these days, you have shed fat.

  4. Lastly, the inflammatory markers are white blood cell count, C-reactive protein, and ferritin, among others. If those numbers are now in the normal range, that is another sign that your ketogenic diet is working for you. I would also expect that your HbA1C would be low, and your ratio of triglycerides to HDL should be healthily low. And whatever your LDL is doing, it shouldn’t be a problem.

(Edith) #5

Could you give us an idea of what you’ve been eating? I’m almost 55, btw. I cannot eat dairy at all. It really makes my joints hurt among some other problems. You may want to try giving up all dairy. If a seasoning has whey powder in it, that is enough to cause me trouble.

The other problem I ran into was I was eating a lot of nuts and other oxalate containing foods when I switched to keto. Oxalates can also cause joint issues. We do have some threads here on the forum discussing oxalate, but you may want to do a little bit of research into that.

(Vic) #6

Go carnivore anyway, for at least 30days, no cheese, only water.
Not as a new way of eating. To reset your body.

Than you add in cheese, and now and then a plant to learn what is harming you. Oxalates are suspect but there are hundreds of nasty plant toxins.

Meat is not your favourite food, but pain is no fun either, in the name of science… its just a few months

(KCKO, KCFO 🥥) #7

Dropping grains worked well for my joint pains. I was older than you are now when I sent keto. I do take glucosamine supplementation, had for at least 10 yrs. before going low carb, which I had done during the menopausal years.

I still get some pain but nothing like the levels I used to get.

The smaller amounts of weight are harder to lose, adding regular fasting was what got me to goal weight. And keeps me where I want to be. I eat about 50 g. of carb now, occasionally going up to 100 g. But I also have days when I am zero carb as well. Mixing things up seems to help me.

Good luck sorting yourself out.

#8

Thank you all so much for this useful feedback!
@Polly1
I am 5’2". I don’t look overweight, but I definitely don’t look skinny. One reason I want to shed some weight is that it is very evident to me that even 5 extra pounds exacerbates my hip joint pain. (I’m reminded of this each time I try to carry my vacuum cleaner up the stairs.) My weight at my fittest (age 30) was 125.
@OldDog
I have been almost entirely grain and more recently nut-free. No seed oils at all but wondering if they still remain in my tissues from past years. But even pre-keto, I was using mostly olive or avocado oil for cooking. I’ve always been health-conscious about diet so I never ate many processed foods or desserts/sugar, but I think my pre-keto diet was high-ish carb anyway.
My main foods are eggs cooked in butter or olive oil, cheese, frozen applegate sausage, avocado, tomato, scallion, onion, garlic, assorted greens, cucumber, occasional bite of carrot, HWC or a bit of half and half in coffee – collagen too, beef, chicken, pork, occasional fish/tunafish, occasional berries and – like I said – banana (I know…), homemade salad dressing with olive oil and/or avocado mayo and balsamic vinegar (I know, carbs…). I occasionally try “bites” of non-keto foods made by friends or family but not often. I’m sure carbs slip into my meals and I doubt I am consistently under 20 grams.
@PaulL
I had chronic Lyme disease for many years but blood tests of “inflammatory markers” always came back normal. I don’t think post-Lyme syndrome is well understood but I’m guessing it is contributing to my pain. Although I am definitely a cholesterol hyper-responder, I am no longer worried about this after reading the science. Just did a CAC score which came back zero.
My clothes definitely still fit better (looser) and that is great. But I think my body type and joints would do better with 10 fewer pounds.
Side benefit: Although no one ever suggested I worry about my A1C level and I have not paid much attention, looking at my blood results since 2017, I see I was hovering 5.5-5.7 and now I am at 5.1, so that makes me very happy.
@VirginiaEdie
It’s possible dairy is a problem for me but I’m very reliant on it especially now. Coffee may also be a problem. Never used to drink it because it caused me anxiety/stress response, but lately I really enjoy it to start my morning. I do wonder about oxalates, because I eat tomatoes almost daily. It’s so hard to give these things up.
@Carnivoor
I think you are right that I need to at least try carnivore, just to see. Or at least, maybe try to achieve really low net carbs and not just hover around 20-30. I will continue to ponder how to do this. Fasting might also help. I notice less pain when I haven’t eaten, but I have not reached that point where my satiety allows me to go long without a meal.
@collaroygal
I have been on and off glucosamine for years but I guess I have never been convinced it helped so stopped. I tend to believe the randomized trials which don’t show a benefit so I guess I am trusting the science at this point.

Thank you again! No one mentioned testing blood glucose or ketones. Does anyone think that understanding which foods spike sugar might help me at least identify problematic foods? I am guessing that sugar spikes could exacerbate inflammatory pain.

(Edith) #9

That’s probably because you are reacting to something you are eating. If nothing else, try carnivore as the beginning of an elimination diet. Tomatoes for example are a nightshade. Nightshades are also known to cause joint inflammation.

(Gregory - You can teach an old dog new tricks.) #10

There is not much point in testing for ketones. If you are maintaining less than 20g carbs a day you will be using ketones for energy. and that is the benefit of a ketogenic diet.

A recent A1c test will be more useful than BG monitoring, but some monitoring can be useful.
Once again, if you follow a <20g carb diet the BG will fall into place unless you have other problems such as thyroid issues.

(Michael - When reality fails to meet expectations, the problem is not reality.) #11

@Wendy198 Lots of excellent responses so far and I hope you find at least some of them helpful. I might be an oddball or :unicorn: but I have a couple of observations. If you’re not consistently in ketosis, and by ‘consistently’ I mean 99+% of the time, you might not experience the full benefits of ketosis. Some folks will argue that ketosis is not the ultimate goal and that simply staying ‘really low carb’ is all you need to do. Or that you can ‘mix it up with carb days’. I disagree. Ketosis is a distinct metabolic state from which derive multiple health benefits that don’t derive if you’re not in it or in and out of it. For one, having your innards consistently awash in β-hydroxybutyrate is better than not. Our Pleistocene ancestors spent most of their lives in ketosis and in my opinion it is the natural metabolic state of humans, if there is such a thing and I think there is, and the state in which best health can be realized.

Second, it looks to me from your description that you eat a lot of plant-based foods. Maybe not in quantity (do you measure and/or weigh food portions?) but at least in variety. I suggest dropping it all for a while to see what happens. That includes both olive and avocado oils. If you must eat some veggies I recommend baby bok choy. Bear in mind, it’s a brassica and some folks respond negatively to brassicas. If you must have an ‘oil’ try MCT oil - but cautiously since it acts as a laxative for some folks.

Finally, drop the half&half and stick with (heavy) whipping cream. Cut back on chicken and pork. I’d replace chicken and pork with both oily fish (herring, sardines, anchovie, etc) and dry fish like tuna and semi-dry like salmon. If canned only buy packed in water!

You could accomplish this by going full-blown carnivore, or not. Best wishes.

#12

I’d use an app like chronometer and write everything down. Everything! It helps to see where hidden carbs are.

Also, as much as folks say calories don’t matter, perhaps they do when you’re only a few pounds above the weight you wish to have and you’re eating as many carbs as you do. You’d know if they matter for you if you’d write everything you eat down in the app and see how your weight behaves compared to the calories you eat and the carbs you eat.

I hope you reach your goals! It’s difficult to feel motivated when you don’t. Give it another chance, but writing everything down, at least for a while.

I also don’t see in me all the things others say they get from this WOE. I keep doing it, because I like it.

#13

Yes, these responses are very helpful! Thank you!

I think it’s true I may be going in and out of ketosis – since last fall, really. My energy level is not great like it was at the beginning when I was being a lot more precise in measuring carbs and keeping below 20. Also, the fact that I’m not feeling satiety a lot of the time, and that I’m often hungry when trying to fall asleep, makes me think that something is off. Maybe I’m eating more plant based foods (and carbs) than I realize… For example, I forgot to mention I eat a lot of pumpkin seeds. That is a source of seed oil not to mention carbs. And the olive oil I buy might not be pure since apparently most olive oils are mixed with other cheaper oils.

@Corals I was using the Lose It app but not as much lately. I agree I need to pay more attention. I will also check chronometer in case it is better.

I doubt I will be successful at full-blown carnivore, but I do want to aim for it (with minimal cheese!) and also make sure to keep carbs really low, like 10 grams or less.

Thanks so much for the encouragement!

(Edith) #14

Something else to consider:

I’ve posted this many times, but on a high fat diet, quality of food matters tremendously.
Say you are eating 1200 calories a day and 75% of you calories are from fat. (Fat has some vitamins, but not the much) That leaves you with only 300 calories of non fat (protein and carbs) to get in all the vitamins and minerals your body needs. If you are fasting, that is no vitamins and minerals.

You may be stressing your body with the low calories and fasting. I would try cutting back on the oils and adding in more protein.

#15

That is an interesting point that I’ve also thought about. How much of my micronutrient requirement am I getting from the fat in my diet? For me, carnivore would help with that issue, because I don’t eat (like) pure fat on meat so I would mostly be eating the protein part.

Thanks for the suggestion!

(You've tried everything else; why not try bacon?) #16

Thanks for the responses to everyone. It really appears that you are doing fine, despite your concerns. As others are saying, your numbers look really good.

I understand the desire to take more fat off. We are so used to using “weight” as a euphemism for fat that we forget other parts of the body weigh, too, which is why I always encourage people to look at as many measures of progress as possible, not just the number on that single device. The fact that your clothes are looser means that you are losing fat, regardless of the scale number, because fat is much less dense. So if we add lean mass while losing fat, we are still going to be skinnier.

I’ve had my own interesting scale experiences: I got a pair of khaki trousers for Christmas of 2017, that wouldn’t quite fit over my butt. By Christmas of 2018, while my weight remained unchanged, I was able to wear them comfortably. Also, the following year I suddenly noticed the scale reading 32 pounds higher than it had the previous day. Yet my clothes fit just the same as usual, so I don’t know what was going on, except it took four or five weeks for the scale to gradually drop back to the previous number.

A question that @Aqua_chonk likes to ask: Would you rather stay the same weight and look ten pounds lighter, or lose the ten pounds and still look the same?

#17

Thanks @PaulL
That is a very interesting story. Of course, I know you and others are right about not focusing so much on weight.

But really, it’s pain that is my most pressing concern, and in that area I’m not doing well. For example, pretty much every night I struggle to find a position that is pain-free enough to let me fall asleep. I have thought that a little excess weight contributes to my pain, but maybe it doesn’t.

I’m on this site mostly hoping to discover pain-relief “miracles”. I think I am convinced to at least try a closer to zero carb approach.

Again, thanks very much. I’m so grateful for this site and the practical knowledge you all have.

#18

Or not more than you realize but more than what your body likes… Some of us needs to go almost or exactly to zero. And going off keto easily may be a problem too, I am sure it’s extremely common. As far as I know, fat adaptation progresses with off times as well but it’s way slower that way…? And fat adaptation made huge changes in my satiation. But carbs are the most important. Vegetables and nuts mess things up. And it’s not just the carbs, certain items aren’t as satiation as others for most people. Even if you eat way more from some not so satiating food, maybe you won’t be nearly as satiated as using a little proper food, I experienced that.
It’s quite individual what works and what messes things up, I personally experimented a lot since I got more health-conscious and went low-carb (as that was quite obviously my way but it wasn’t enough).

You may try carnivore with more than usual eggs if eggs are fine for you. I came from vegetarian keto and it took me a lot of time to raise my meat intake (I liked meat but not in big amounts and I had supply problems too). I did it eventually and it’s much better as I eat less dairy now and it’s good for me… But I still like eggs and the variety they offer. I would be super bored with only meat unless I could afford a huge variety of high-quality meat but probably even then.
Our taste can change to some extent. Mine rarely does but I went from a huge veggie lover to a “veggie avoider” (not 100% but close to it most of the time), I simply don’t like them anymore (except a few which are wonderful with certain egg and meat dishes) and they surely aren’t good for me due to carbs. It was a surreal change but happened so who knows, maybe you can learn liking certain meats in certain forms…? It’s normal we don’t like it all.
<10g carbs is easy with carnivore :slight_smile: I do it every day now. And even my 19g carbs carnivore(-ish? but it doesn’t really matter) day felt fine. But it matters if it’s mostly sugar (lactose) or just liver and eggs… Oh, there are different styles, maybe you can find your own. Even if you just do it for a while. I surely couldn’t eat without enjoying it for 2 days (unless my life depends on it or something)… And anyway, if you don’t do it right, you won’t get the same benefits. Hopefully your taste and your physical needs won’t disagree.

(Robin) #19

Hi Wendy, I am 66 with significant arthritis in both hips and knees. Keto has helped me drop the weight, which puts less stress on my joints. On my doctor’s suggestion, I bought a rowing machine for my home. (Walking and biking put more wear and tear on your joints.) I row anywhere from 45 minutes (full steam) to 2-3 hours (zero tension or pressure while watching a film)6 days a week. My main goal is to be strong enough to be able to get off the floor! LOL. Secondary goal is just keeping those joints flexible. It has also helped the pain. And I can squat again! Sounds silly, but that’s a big freakin’ deal, right? My arthritis may not be improving and it might actually be progressing. But I think about my joint x-rays the same way I think about the scale. Who cares. Do what you can, keep moving, be patient. Even if you aren’t where you hoped to be… think where you might be if you had not gone keto!!! Anyway, good luck (think about a rower) and YOU GOT THIS!

#20

@robintemplin
Great reminder about importance of exercise for arthritis. Since the pandemic I hardly move. Rowing machine is a great idea!

Yesterday I started day 1 of carnivore with minimal dairy (just two tablespoons heavy cream in coffee). First observation is that my energy level this morning is off the charts high. Maybe a good sign? Will do my best to give this a 30-day try. it’s gonna be hard!