I. Am. So. Frustrated!


(Ron) #24

I would say that most all of us have 90% of our diets in common - avoid processed junk foods, avoid added sugars, eat as healthy as possible,etc. It’s the last 10% that varies.

For me, I believe weight loss / weight gain is hormonal. Insulin present in the blood will lock away food as fat and prevent the body from accessing fat stores. When insulin is low, fat for fuel is accessible for energy. I am sure calories have a part to play but I do not believe in strict CICO. The body will adjust to what you are doing if you make a routine of it.

The reason why I really believe in fasting for health and weight loss is that it is simply the best way to improve insulin sensitivity. Even ketogenic foods, especially protein, cause some insulin response. All foods cause at least a minimal insulin response. So it is quite possible for there still to be enough insulin present on a low carb moderate/high protein diet to cause a weight loss stall.

There are studies that show that TDEE will decrease and compensate for low calorie diets over time. They will work short term but stop working long term. Similarly, there are studies showing TDEE not being affected or even increasing when fasting.

If the problem here is that yayhowfun’s TDEE has decreased to match her lifestyle, there are several ways to get total energy expenditure to go back up. One is eating low carb, high calorie for a week or two to reset leptin and increase metabolism. Another would be alternate day fasting, or an extended fast.

In the end different things work for different people and there is no one right way to do things. My best advice would be to change things up if what you are doing isn’t working to your satisfaction for whatever reason. There’s lots of different things to try. :slight_smile:

(Richard Morris) #25

Ted has fasting insulin of 2 mIU/l … which explains why his way worked for him, but it doesn’t work for everyone.

My fasting insulin is 13.7 which is sufficient to inhibit healthy fat releasing their cargo even when I eat nothing.

There is a reason for that, but it’s not a reduction in calories in forcing the body to get energy from storage to make up for the arrears.

The only thing that appears to budge my insulin is fasting for around 48 hours and then it drops because it has to. Interestingly my normal physiological range for ketones are very low like 0.3-0.8 … yet 2 days into a fast they will jump up around 2.0. Which supports my speculation about basal insulin dropping after 48 hours.

A simple hypocaloric diet wouldn’t do anything for me - except cause hunger and lethargy (ie: Lower MBR because stored energy was still blockaded). I could fast for 1 day and it wouldn’t do anything. It is specifically lowering insulin which releases the block on release of energy from adipose tissue.

But there is good news. 6 months ago my fasted insulin was 19.8 mIU/L and a year ago it was 29.3 mIU/L - so time at a lower level of insulin is how someone like me who makes a LOT of insulin learns to become more sensitive to it, so we can make less.

If you restrict your caloric intake and immediately lose weight then you are probably safe to try a higher protein low carbohydrate diet. If you do and you feel like someone just unloaded a tonne of bricks on you then you might want to try a lower protein higher fat diet for a while to expose you to less insulin to get your basal insulin down.

100 days of Keto
(What The Fast?!) #26

I think I’ll go get a fasting insulin test. Maybe that will give me some insight.

(Richard Morris) #27

it cost me an extra $40 on my regular quarterly draw but I wish I had done it from the get go … cos my fasted insulin when I had an HbA1c of 11.2% must have been up around 200.

(What The Fast?!) #28

I would pay literally any amount of money to get the results I want.

(Richard Morris) #30

I’d probably have to be 5 day fasted and riding about 3 hours on the bike and at altitude to see a 5.7 mmol/l ketones.


One tip, if you have total cholesterol over 6 you can apparently get a lipid subfraction analysis done once every 6 months on medicare (no charge). It’s “LDL subfraction” on the pathology request. The lowest my total cholesterol has been since I went off statins in 2014 was the week I tried @DaveKeto’s protocol eating 2 cups of macadamias a day for 3 days prior … 6.2 … SCORE.

(Richard Morris) #32

ouch. It’s only $100.

And to be honest I think it’s really only useful to get a GP brandishing Statins off your back.

Trigs below 1.0 for me is just as good a guideline for cholesterol being pattten A (non atherogenic).

But when it comes to convincing your GP on a course of action, it’s nice to have a colourful chart and a path lab analysis that confirms pattern A LDL.

(Deb) #33

Thank you for posting that chart! So many people don’t seem to understand that you can eat too much fat!

(Richard Morris) #34

That calculator also assumes you can use all the body fat you have, and gives you a number of calories that that body fat can release every day. If for any reason your body fat can’t release any energy then that would additionally restrict the energy it can contribute to your total daily energy expenditure (TDEE).

For example if you have more than about 13 mIU/L of Insulin at any point then body fat is not contributing any energy.

So what makes insulin go up?

  1. eating carbs
  2. eating protein (but only 50% as much as carbs)
  3. making glucose to keep your brain alive (which you kind of have to do)
  4. stretching your stomach

But what makes it REALLY go up is being insulin resistant and doing any of the above

That chart is a popular meme on Facebook trying to encourage people to eat more protein, but it also explains succinctly why people who are insulin resistant have similar access to stored energy as people who are lean - namely they have access to very little energy from body fat.

It also nicely refutes Ted Naiman’s hypothesis that obese people are always protected from Rabbit starvation on a PSMF that lean people would be at risk of.

Obese people with low basal insulin? Then yes, I would agree that body fat protects against rabbit starvation.

However people with insulin resistance are overwhelmingly in the majority among the obese population. So for the majority of people who are obese, for those who are insulin resistant, a protein sparing modified fast would be just so much metabolic jackass.

So the question for someone who is insulin resistant should be - how do I lower my basal insulin so I can access body fat?

There is an acute method, extended fasting. If I fast longer than about 36 hours all of a sudden I experience a rush of energy as my insulin finally drops low enough to allow access to body fat - and then it’s party time until I stop the fast, and a few hours after breaking the fast I am back to making no ketones and becoming hungry when I don’t eat sufficient fat to fuel my day. Obviously fasting isn’t a long term strategy but it does provide a metabolic window of being almost normal during which I can do prodigious amounts of fasted exercise.

There is a chronic solution too tho. Time. We become insulin resistant over time exposed to higher levels of insulin. So the longer we can function producing the least insulin we can, the more sensitive we become, and the less we need to produce in response to our basal glucose levels that we MUST have to keep our brains alive. This involves eating as little carbohydrate as you can, and the minimum amount of protein to support your normal lean mass maintenance … AND once a week depleting muscle glycogen to give your body a sink into which to pour insulin.

Here are my results from the past 18 months

That shows my fasted insulin for the past year, now this is year 2-3 into a ketogenic diet in which I have already lost 40 kgs and you can see that last April my insulin when I wasn’t eating anything for 12 hours was 29.3 mIU/l (202 pmol/l). By August 2016 I had almost gotten it down into the range where I would get reasonable access to energy from body fat (that cyan zone of Normal range insulin).

Late in 2016 a doctor told me that I couldn’t claim to have reversed my diabetes because in his opinion my glucose would go back up to 10+ as soon as I went off metformin. So I went off metformin for 3 months to make a point. My glucose stayed pretty stable, but my fasted insulin took a hit.

I regret not having a fasted insulin test from when I was really diabetic and my fasted glucose was over 20 mmol/l (350 mg/dl). That would have been interesting to know.

But since I have a year of fasted insulin and fasted glucose it is worth looking at a year of my insulin resistance and pancreatic beta output

Going off metformin makes me more Insulin resistant, but interestingly my beta output remains consistent. That implies I am under the threshold at which I overload my pancreas, so I am slowly improving it’s insulin (beta) function.

(Tom Seest) #35

Great stuff. Can you pass me a couple of sticks of butter?

(What The Fast?!) #36

This seems like a good possibility for the reason I have not lost even an ounce of weight since starting keto 3 months ago, even though I’m also working out, doing IF, and a few EF’s. …but I don’t want to jump to conclusions. My typical ketones are under 1.0 (usually 0.4-0.8) and my BG is usually around low 70’s in the morning.

Does insulin resistance tend to affect these numbers - I.e. Is it possible to be IR with these averages? I’m going to find a doctor that knows keto and ask to get my basal insulin tested.

Is the only way to test in a doctor’s office?


Two things strike me as something to investigate - insulin as Richard mentioned and cortisol. If you want to test cortisol go for the saliva test kit that takes 4 samples during the day and analyses the same (i.e. doesn’t lump into one average reading). Stress will have an impact on weight loss as will inflammation. Chances are your body has hunkered down a bit these last few months with the stress it has been under. You add to that the fact that you could easily be where your body wants to be weight wise. Richard has discussed this before on a podcast - your body is more interested in being able to hunt, run and fight when it needs to and also go without food for a few days. To do that it needs a min amount of body fat which will vary from person to person.

As to @akirby83’s suggestion to lower fat - I think you know what I think about that and it is likely the same as you. CICO indeed is the first thing that comes to mind. The lower fat school of thought as he puts it still suggests higher fat at maintenance and you are at or near that. You could potentially wring a few pounds out this way but could you sustain it? Doubtful. So what would be the point?

If you have some money to put into testing, I would do that. I would be looking at insulin, adrenals/cortisol, thyroid, an iron panel inc B12 and folate, D. There could easily be something going on on the inside that is holding you back.

Re all those adaptation markers - I haven’t had any of the big hits either really. I have noticed all round improvement, especially with migraines and depression. I am not sure that we all get those highs and buzzes. We are all unique after all.

(Tom Seest) #38

In the US, you can probably order the test from RequestATest.Com

(Tom Seest) #39

I was an endurance cyclist prior to starting my Keto journey, and I gained 4 pounds in my first three months. Then, the weight just started to drop off.

It’s possible that maybe something effects the deepness of the adaption of the endurance athletes differently; I don’t honestly know. I find it interesting. The irony at the time was that I was only really looking to do long rides without having to eat all the time. The weight loss was an nice bonus.

I hope you figure it out.

You may also want to have some basic thyroid function testing done, as that can effect weight loss too. Might be something hormonal happening there too.

(What The Fast?!) #40

Do you or @richard know which test to order off this list? There are three insulin related ones.

(Tom Seest) #41

I would think it would be http://requestatest.com/insulin-free-and-total-test but I don’t honestly know. By the time I started doing more frequent blood testing, I didn’t feel I was insulin sensitive again and didn’t feel the need for the test.

@DaveKeto might have a better idea, as he orders blood testing all the time.

(Richard Morris) #42

$159 is expensive. I think that’s more for type 1s to determine how well they are using insulin. I wouldn’t know how to read a free and total diagnostic.

I think this one is more like it http://requestatest.com/insulin-testing

That is $49. I pay $40 Australian (roughly $30 US) so that is likely to be the one.

(What The Fast?!) #43

@DaveKeto let me know!

(What The Fast?!) #44

Thanks @Daisy!! I’ve had thyroid, cortisol, etc tested. Thyroid and adrenals are a-okay, cortisol (vía saliva test) was high. I’m buying the insulin test and will report back.

(Dave) #45

Hi Andrea -

I would start first with a close look at what you’re eating before looking at blood work. If you aren’t already, I strongly urge you to track everything you’re eating and share back here for advice.

With regard to blood work, I see there’s a lot of context throughout this thread that I was having trouble reading through – can you summarize real quick what you’re looking for?