**sdepp**, a lean petite female doing keto for non-weight issues/optimal-health.. HELP PLEASE!

#1

Hi my fellow keto’ers,

I am writing this with dismay. I don’t want to offend anyone and I want keto to work for me so much, but I need help. Any help really, as I know some of you are so experienced and knowledgeable.

I have been eating the keto way for a bit over one month. I am doing this to better control my PCOS, restore my energy level and stay away from my disordered eating centered around health (orthorexia). I definitely have insulin resistance (I would get light headed and dizzy after eating sugar, I am thirsty ALL the time etc EDIT: maybe not insulin resistance but insulin issues, likely to be producing too much), I am not overweight, a bit underweight really. But I don’t want to put on a lot more weight (maybe 5 lbs) as my PCOS symptoms will get worse. My doctor also recommended low carb to me, which I have been since the summer of 2015.

So I have been eating a lot (to satiety), much more food than I am used to (EDIT: thought my body would need actually). I am generally doing two meals a day, and to give you an idea. One meal looks like : one avocado, 4 oz of beef grounded or other fatty meat/fish, 1 oz of some sort of hard cheese, 3 oz of leafy greens dressed with olive oil, all with a few fat bombs (mostly just coconut oil with coconut butter) or a lot of nuts (like 3 oz…). I roughly did the maths and my meal is averaged at 1200/1300 cals. So that is 2500 a day… and I am petite : 5’1 and 95 lbs female, with a desk job working from home, no exercise except weekly skating an hour. I would really like to gain some, better muscle of course.

Eating like this, my weight did not change, however, my skin is getting so clear and soft. My headache after meal is gone. I sleep well most of the days. My mood is better too. And much more metal sharpness. Life is better than before, definitely. Except I have a few new problems, making me doubting if this is working for me or actually killing me -

  1. keto rash : had three episodes of these already, saw my demo (his ointments don’t work) and also had blood tests done, showing my WBC is low and breakdowns are kind of wacky… indicating an infection. Both docs are sitting on it and want me to redo tests in a month.
  2. stiffness of right shoulder : i remember @richard said this means you are doing too much fat on one of the podcasts?! But this comes and goes too…
  3. a weird pump in my right eye corner : this is new and quite painful (“something in my eye” feeling all the time and esp. when blinking or eye is closed), and I looked at possibly being Pinguecula… scheduled to see my doctor. but if this is an accumulation of fat/excess protein. Does that mean I am eating too much of those?

It seems either I am in and out of ketosis too often and that is creating issues, since I suspect my nuts business needs to be fixed (I am eating so much)? Or is it me eating too much fat (and everything)? But I don’t want to starve, or restrict. Basically I don’t know how to adjust my macro? More fat, more protein or more carbs, and of course less of what?! So confused. My thyroid is normal

Any advice??? Anxiously waiting…

(Rob) #2

I’m not qualified to talk about PCOS. It have heard here that it takes a while to abate under keto and will slow progress. So that’s a KCKO :grin:

I never got the rash so can’t help there but the shoulder pain and eye twitch sound like low electrolytes so look at ketoade. It may help with the rash too.

I also don’t know about weight gain either (I wish I had that problem) but I think @Emacfarland definitely does as does @brownfat so maybe they can help?

Best of luck, congrats on the NSVs so far as KCKO.

(Tessy M.) #3

Do you track how much protein you are consuming? Too much can negatively impact ketosis.

#4

60-100 grams depends on the day, but mostly 70/80

#5

I can only imagine that your body is fat adapted, your meals are a great deal of fat - if true, then your body is burning that fat as part of digestion. For a person trying to lose weight this would be ideal situation.

Change things up, increase protein and reduce fat - as a way to gain weight while remaining in ketosis.

#6

There is little doubt from myself that I am fat adapted. I suspect my years of low carbing (50-100 grams of total carbs, no sugar) was beneficial. The only thing I did switching to keto is dropped brown rice and quinoa, less broccoli/cauliflower. More fat of course. Also I never got the Keto flu.

However I don’t know if my problem (the eye and shoulder in particular) is too much fat, or too much protein? I have a lot of both for someone my size…

(Todd Allen) #7

This is just my thoughts and I don’t value them enough myself in this case to be commenting except for the reference by @Capnbob.

I don’t see the connections between the collection of issues/symptoms you describe. Not saying there aren’t any but perhaps one or more are just coincidental and maybe not related to diet at all. It seems unlikely your diet is doing you major harm at the same time you are experiencing significant positive benefits such as better sleep, better mood, diminished headaches, etc.

Your diet as described looks good to me without any obvious issue. Perhaps there is a food in there that is either new to you or that you are eating in much larger quantity than before that is causing trouble? For example if you never ate much coconut before maybe try cutting out coconut for a week and see if anything clears up. And consider it might not be all coconut causing trouble but perhaps one product made with a particular preservative or processed in a plant that also processes something else to which you are allergic.

So I have been eating a lot (to satiety), much more food than I am used to.

Which sounds like maybe you were under eating before? If so, did you have blood work done before your most recent dietary shift? If not, I wouldn’t be quick to assume the low WBC or other results indicate an issue with your current diet. I think the doc’s approach of sitting on it and retesting is good though 1 month more is still a fairly short time frame. There is noise in the signals, they bounce around a bit in the short term so it can take some time for trends to be clear. It’s like the posts “Help! Keto is no longer working for me, I lost 2 lbs yesterday but gained a pound today!” illustrating that while a scale is useful on longer time frames it is next to useless day to day.

I would really like to gain some, better muscle of course.

As someone with a muscle wasting disease this has become a bit of an obsession for me. I think the experts on the topic are athletes and in particular body builders. And short of ingesting/injecting hormones and other dangerous substances the most potent thing is exercising/training the muscles. There’s lots of debate on what is optimal but most everyone agrees you want to periodically strain/over strain your muscles and then let them rest, recover and grow. The strain can be either metabolic, sustaining moderate tension in muscles as they tire until they fail. Or mechanical, loading a muscle high enough to create micro tears in the fibers which stimulate growth as they heal. Achieving high intensity in each type of strain speeds progress. The quantity and duration of training ought to be proportional to ones level/capacity for training. ie, If you don’t have a lot of muscle frequent long duration training probably won’t help much and could be counterproductive if you aren’t fully recovering between sessions. The biggest muscles of the body are in the legs, butt and torso and they should be a focus of training. And finally my personal belief is that the concern that women can lose their feminine appeal through excessive muscle is overblown. It’s rare and I imagine exceptionally rare that it ever happens without tremendous effort. I’m thrilled my wife has begun to show some interest in weight training even though I’m not yet as strong as she is and may never be, especially if she were to get serious with the weights.

(Richard Morris) #8

These would be typical for most people going keto. Congrats on those outcomes

KetoRash is a rare incidence, but it is definitely a significant one. I have not seen a compelling explanation for why it happens (couple of hypotheses like candida die off, but I’d like to see a clinical study). It usually abates tho.

It wasn’t me, I’m not sure what the mechanism could be for that. I have a stiff right shoulder because I have been using a mouse for 35 years and those micro movements have built up a callous in the supraspinatus tendon that goes through my shoulder joint from my shoulder blade to the top of my arm.

Hmmm I’ve not heard anything about that. One related effect to Keto is that we make less mucus, because we are sparing glucose for our brain and so we apparently make less glycoproteins than someone who is awash in glucose. For me that meant I lose a persistent cough that I’ve had since I was a smoker. For some people it can mean dry eyes because they don’t make as many tears.

It probably sounds unfairly cruel for me to just tritely say keep calm and keto on … but it sounds like you are in ketosis enough to get positive side effects, and the apparent negative side effects may be transitory or not related to the diet.

#9

While I have no specific suggestions other than get your thyroid checked, have them do the full panel, I will say that I also came to keto from moderate carb 75-150 per day but with a lot of trouble sticking to it and cheating, and while I did not have flu, I did have other weird symptoms. I came to keto to lose weight. They lasted about 3 months and came and went. I had a lot of rashes in places I often got rashes (which happens on Sad but not on moderate carb), I had not even heard of keto rash then. I had UTIs which I never get. I had what I thought might be gout and in general my eyes are a little dry but that is likely age. My sleep was also not great which took months to work out. Still the benefits and weight loss are great. I will say that as a TOFI managing your IR is more of a priority than someone who is heavy and can produce more fat cells

#10

Thanks for your thought reply, @brownfat!

No, not really. I was eating “slow” carbs along with my “main” meal (one avocado, 4 oz of beef grounded or other fatty meat/fish, 1 oz of some sort of hard cheese or sour cream), say a whole wheat bun or some brown rice. AND I was exercising a bit more (nothing crazy but maybe 1hr more of light cardio). But now I am swapping that with a dressed side salad, and SO MANY fat bombs and/or nuts to feel the same level of fullness. Dropped the cardio and would love to get into weight training bits by bits like you mentioned. It was just a comment how CICO does not work! At least not for me. Not sure exactly, but these two different meals must have a difference of 400/500 cals. I was more or less 1600 cals a day prior to keto, which is “appropriate” according to a lot of calculators on my size, and I was maintaining as well… Human bodies are just that interesting!

(Candy Lind) #11

I have never heard of these as symptoms of IR. If you’re thirsty, you might be dehydrated; you may also have an electrolyte imbalance. An imbalance may cause the dizziness, too. Do you track salt, potassium & magnesium? You should take all of them in well ABOVE the DV/RDA since you are eating high levels of fat. I myself have struggled with electrolyte balance.

This sounds like a Stye more than anything - warm compresses will help, and if it’s infected the doctor will give you an ointment.

I wonder, opposite of some other comments, if you are eating too much protein? I eat less than you do; my lean body mass is more than what you weigh, and I usually eat under 70g protein. If you try tweaking it up or down, keep your macro for fat proportional, meaning if you lower your protein, you might want to lose the nuts or fat bombs to keep fat in proportion (but still 70%, of course). Do you usually hit the macros pretty close, or are you more like 80% on fat? If so, maybe dropping your fat a bit will help your bothersome symptoms without dropping you out of keto. Just a thought!

Good luck to you! I am positive you should continue keto, you just need a little “tweaking.” We all do on occasion.

(Todd Allen) #12

The reason I asked about under eating is that low WBC is sometimes associated with malnutrition. Also you said you’ve only been keto for roughly a month so unless you had it tested shortly before going keto it seems reasonable to expect your WBC was probably low prior to keto.

Another group of people who have atypically low WBCs are the CRONies. CRON stands for “caloric restriction with optimal nutrition” and it’s why there is an app CRON-O-METER that many here, myself included, use to track the macro and micro nutrient breakdowns of our diets. These are people seeking longevity by minimizing metabolic load by restricting total calories, and especially the amino acids leucine and methionine, highest in animal sourced protein which stimulate growth promoting mTOR and IGF1, while seeking high intake of micronutrients. They like yourself are on the low end of the BMI scale due to having both low body fat % and modest lean body mass too. In general they are fitter and healthier than most and despite low WBCs tend to have very low levels of sickness, colds, etc. Although some of them also develop abnormal glucose tolerance and fail OGTTs as if they were diabetics. Perhaps your low WBC is more like their pattern and not caused by your current trial of keto?

There is a high correlation between PCOS and insulin resistance/hyperinsulinemia/type 2 diabetes and very low carb and keto diets are probably quite beneficial in those cases. That correlation is very strong for obese women but is weak for those of normal weight and you are slimmer than most. The symptoms you described high thirst and light headedness after consuming sugar sound like a sugar metabolism issue. Maybe it is hyperinsulinemia despite being thin? Other markers for hyperinsulinemia are elevated blood pressure, high triglycerides, low HDL and high fasting blood sugar.

There’s a term TOFI (thin outside, fat inside) for people who have impaired metabolic health despite being thin. They have a reduced ability to grow new fat cells. Blood triglycerides tend to be high and other tissues such as the liver and muscle accumulate more fat in the form of lipid droplets. Unfortunately it appears that the best place for accumulation and long term storage of lipid droplets is fat cells. In other tissues there should only be a modest amount with high turnover such that the fats stay fresh and healthy. Anyway, if you fall in this category I’d be concerned that fat bombs might contribute to a higher level of ectopic fat even if the scale doesn’t reflect it. Probably not a concern if your HDL to triglycerides ratio is good. Dexa scans would be another way to see if you have significant visceral fat and track how it responds to diet.

#13

What a huge bundle of valuable information!

OMG! CRON sounds exactly like me! I never get sick from colds or flus, never do the flu shot. My WBC has already been low ~4.5 and it is NOT my main worry (it was brought to my attention in the context of the rash thus linked to keto). I consider myself relatively fit, although I am not sporty per se. I am very conscious about what I put in my mouth, in the sense of “is this nutrition/calorie ratio good enough for me”? (As I mentioned, I had a history of orthorexia). I did not know about the CRONies having lower WBC.

So to your question on WBC vs keto, I had quite a few blood tests done around the time I switched to keto (dropping carbs dramatically from my previous diet). My pre-keto WBC was 3.8 to 4.5 depends, then it was 4.1 (might just be noise given how WBC fluctuates) 2 wks after keto, all good. But then it dropped to 3.1 while I got the rash, which is another week or 10 days… This is the problem, not only WBC is lower than my past mean, there are a few markers out of range, which is new: high MONOCYTES, high EOSINOPHILS, low ABS NEUTROPHILS, low ABSOLUTE LYMPHOCYTES, high ATYPICAL LYMPHS… My hemo ruled out lupus.

Regards to your other points, on PCOS and TOFI. I have more to read up on, but the sugar problem is there, either IR or hyperinsulinemia. But I agree it’s atypical for IR to experience what I was experiencing. My blood pressure is and has always been normal… 68/108. Triglycerides is 120 post-keto (super low at 40 pre), HDL is in the high 70s (stable). LDL nearly doubled since I went keto, 70 to 120. Not sure what to make out of all these, but my doctor seems to be ok with those numbers.

(Meredith Loring) #14

You definitely should try magnesium for the eye twitching - that should be solvable! Regarding the rash and the shoulder pain, what sweetener are you using? Some sweeteners can cause rashes. You are overdoing the protein - but not by much. I would have 3-4oz protein per meal (now you’re having 5+). Nuts you should limit to 2oz per day. Hope this helps.

#15

Hmm, it’s not twitching. It’s a little bump/growth. Idk, so hard to explain. I am having 300-500 mg of magnesium.

I don’t use any sweeteners. Fat bombs are just the natural sugar from coconut butter and cocoa powder, very little dark chocolate occasionally.

But you are probably right on too much protein, and too much nuts…

(Todd Allen) #16

Here’s a research paper you might find of interest discussing caloric restriction lowering WBC and in particular lymphocytes without compromising immune function. Note, high monocytes and eosinophils don’t correlate with the caloric restriction pattern.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993339/

(Michel Labelle) #17

You’ve received quite a bit of advice from those who are much more knowledgable than I above, but on the point of the right shoulder, I would recommend that you start a regimen of 2 Tsp of Apple Cider Vinegar (ACV) and 1 Tsp of Lemon juice in 8-12 oz of water (carbonated tastes best). You need to drink this before every meal, especially one that is heavy in fat. You can ALSO augment with Bile Salts if you are having trouble with the ACV mixture (some people can’t get used to it). (https://www.amazon.ca/Trophic-Digest-Aid-Salts-Count/dp/B00CP7RWMK/)

Right side/shoulder/neck pain (radiating as high as the top of the head) CAN be a symptom of gall bladder fatigue. Dry eyes, clogged tear ducts, skin issues, night vision blindness can also be a symptom of low Vitamin A, that is usually a symptom of low bile production or a gall bladder issue since Vitamin A is a fat soluble vitamin that is only extracted if you have a well functioning digestive system.

The “cure” for me has been an ACV/Lemon mixture that tricks your digestion a bit. What it does is it signals the stomach to stop requesting bile salts from your liver/gall bladder by raising the acidity of your stomach. There are other benefits from the mixture, but one of the most noticeable for myself was the elimination of almost 15 years of chronic right shoulder pain that no Physio, RMT or other specialist was able to resolve. Within 2 weeks of starting ACV 4-5 times a day, all my right side symptoms were gone. Over time, because you are not draining your gall bladder, you will allow it to fully restock and address the underlying issue/condition.

Dr. Berg has a page on Gall Bladder issues that is well written - https://www.drberg.com/blog/you-and-your-gallbladder

Thomas DeLauer has a number of mixtures that he recommends for use during fasting to rebalance electrolytes (to help those head aches), and for gall bladder support

I’d give that a try. It won’t hurt, and my wife and I are almost addicted to the mixture (it tastes really good when you get the quantities balanced right), especially with Soda water / Carbonated water. We drink so much that we replaced our fridge to take advantage of one that has an embedded Soda Stream maker.

Hope that helps, and PLEASE let us know if it does or doesn’t so that others can learn from your experience.

#18

Thanks so much! This is going to help me - already know. Read Dr Berg said, and I quote,

“I do remember at age 11, feeling weird lightheadedness after I would eat but it would go away if I ate something sweet, which I know now was the start of my blood sugar issue (hypoglycemia).”

This is ME now.

And all the other points! Thanks!!

#19

I will definitely pop in and update on my experience and progress. I am definitely sticking around as many of you had said and I agree that, the benefits outweigh the downsides, for now. Just searching for fixes.

My instinct so far is I added too much fat too fast, and I also restricted vegetables too much, as I wanted the net carbs to be as low as I can. (I was below 10g most of the days) I think I can benefit from having much more (to satiety of course) non-starchy vegetables, broccoli that kind of thing. Incorporated those in the past two days, rash stopped spreading. Shoulder pain is gone.

Not sure what’s up with the eye thing - not sure it’s related to keto to be honest. Maybe my contact lens were acting up.

Adding apple cinder vinegar starting today.

#20

Dr Berg refers to gallbladder issue as @Michel_Labelle linked. It fits well with my case. What do you think of that?

Also I use the mouse daily (programmer) but maybe with less years under my belt… Not sure that would create this come and go pain, vs a more constant one.