Insulin resistance or cell satiety?

(charlie3) #1

The presenters I’ve listened to on Youtube refer to “insulin resistance” without regard to cells need to restore depleted energy. If I’m sedentary and my cells energy levels are topped off it’s predictable that they may decline to absorb more. In that situation the glucose goes to fat cells unless those too have reached their limits. Then the glucose spends too much time in the blood and damages things. Isn’t the solution to deplete muscle cells and fat cells of energy so they are receptive to absorbing glucose when it appears in the blood stream? If insulin resistance means not absorbing glucose even when energy stores are depleted wouldn’t that create critical medical conditions. If cells are only resistant to absorbing glucose when they are already full of energy why not call it glucose resistance instead of insulin resistance?

I am not sedentary. My BMR is 1400-1600 calories per day. My typical activities and exercise burn another 600-800 calories per day. 75% of those calories is walking. The other 200 is burned from alternate days of of cardio and strength training. I imagine my muscle cells are restoring stored energy most of the time so when glucose appears in the blood stream it is cleared rapidly by cells that need it.

I’m upping net carbs from 20 to 50 grams to see if there is an effect on exercise intensity and on my perpetual light headedness that is not an asset at work.

I’ve been doing 20 net carbs for 5 months. May be that’s too low for someone doing my level of activity. I’m not getting stronger or bigger under the bar and I’m tired of sluggish legs and a fuzzy head.

Am I missing something?

#2

Do you get enough salt? On the rare occasion when I feel slightly lightheaded…I put a little rock of salt under the tongue and all is good again.

(Bunny) #3

Your probably using ketones for energy and very little glucose so would it not be more logical to increase the fat intake if your looking for increased energy rather than the carbs and/or sugars if your not looking for speed but endurance?

For example it may work something like this:

1 hour of simply walking (at a normal steady pace), you will burn up all the glucose you just (immediate in the blood) ate for energy?

2 hours of walking, you start burning up all the glycogen stored in muscle tissue for energy?

Then what?

3 hours of walking, then you start burning body fat (for weight loss) or dietary fat for energy?

Or something to that effect/affect?

(charlie3) #4

Do I get enough salt? Cronometer says I averaged 3,000 mg in the previous 7 days. My potassium seems to meet the British standard but not US. Crono says magnesium and calcium are okay.

Should I just eat more fat? Losing weight has become easier than gaining. That needs to be addressed because my body fat is 11-12%. That’s wonderful but it must not go lower, at least not for now. For N=1 I’m going to increase net carbs target in Cronometer from 20 to 50 and BMR by 150 calories in Cronometer from 1400 to 1550. That will hide the increase so I’m more likely to eat the extra calories. I maintain weight by eating 300 surplus calories 6 days a week in 2 meals with no snacks then eat nothing one day a week to zero out the excess. I’ll continue to do that but actually be eating 150 calories more than before.

My reason for starting keto was to keep blood sugar normal. May be I can accomplish that just the same with higher carb intake because of the exercise and may be I need more carbs to sustain the exercise. I don’t mind eating 20 net carbs at all. It’s a satisfying diet. What I mind is sluggish workouts, too little progress, and being light headed every waking hour.

I’m still curious, is “insulin resistance” really just predictable glucose resistance because the resisting cells have all the stored energy they need? If yes does that mean there are two ways to address high blood sugar, reduce the amount of glucose going into the blood stream, and/or consume the energy stored in the cells until they want to replenish the supply and aren’t resisting?

#5

I find your question interesting. Sorry I have no science for you, but I’d like to throw out a few thoughts. Feel free to correct me if they don’t correlate with your question.

I thought they call it insulin resistance because the insulin and insulin receptor are not working properly. I thought insulin receptors and insulin production both get up-regulated and then maxed out. This would be in response to chronic hyperglycemia. It would also result in continued or worse hyperglycemia. Otherwise, it may not make a difference what you call it?

“Cell satiety”- If you have lost weight; sounds like mostly fat. I would think it would be hard to reach any significant cell satiety, until those fat cells have replenished their previous energy. If you consume carbs they would try to replenish liver and muscle stores and if those are full then be converted to fat and stored in the same cells which you had previously lost fat from.

I’m curious if you’ve calculated your degree of “insulin resistance” with say a HOMA-IR score.

I’m also curious if you have a high or low insulin level. I wonder bc you say your in it for the blood sugar control. Could it be possible that you have depleted pancreatic b -cells with chronic hyperglycemia and are reaching an insulin deficient state more like progressing to Type I diabetes. In this case you may have been insulin resistant previously; but would now be more insulin deficient.

Thanks

(Brian Chandler) #6

This sounds similar to a bout of lethargy I had around the 5-6 month mark. I took it as normal adaptation. Part for me was potassium/magnesium needed to be increased. Part, I suspect, was the fact that my weight was stabilizing so my body didn’t want to use it’s own reserves as much. In retrospect, I probably should have also gotten a pulse on my Vitamin D with the doc around this time. I kept an eye on my potassium, magnesium, and toyed with my fat to protein ratio a bit while waiting it out. About two months later it passed for good and my body seems much more adaptable to my eating habits. I’ve never been able to go above 35g of carbs without it affecting my ketosis. I’m doubtful 50g will not muddy feedback for you unless you are doing high-intensity exercise and carbing up a bit right around the workout so you are sure to burn them quickly. Personally, I don’t carb up.

(Bob M) #7

I think “insulin resistance” is a multi-faceted term. Fatty pancreas and fatty liver both cause insulin resistance, without any input from fat cells. Gary Taubes tends to concentrate on insulin resistance at a cellular level, between fat and muscle cells, but this is only one aspect of “insulin resistance”. If you perform intermittent fasting, for instance, you could change your fatty liver and fatty pancreas, which will provide an improvement in “insulin resistance” likely without much change in fat/muscle insulin resistance.

Also, if you want an intense review of theory about what happens at a cellular (fat cell) level when you eat different types of fats, read the “Protons” posts here:

I think “insulin resistance” is a combination of these.

Then throw in the fact that if you’re in ketosis for a while, you likely have physiological “insulin resistance”, meaning that your body is saving its blood sugar for what needs it, which ostensibly means if you eat carbs, you would have a different insulin response to carbs than you would if you ate a higher level of carbs to kick you out of ketosis, and then ate the same amount of carbs.

(charlie3) #8

When this alleged resistance to insulin by cells is supposed to be happening is there any effort to check the energy status of the resistant cells? If not may be the problem is simpler. Cells that aren’t asked to do very much have all the energy they need and decline to take more. Then we eat too much glucose and it spends too much time in the blood stream doing its damage. So may be there are there two approaches of equal merit, either consume less carbs or deplete the cells of energy so they won’t be resistant to new glucose entering the blood stream from digestion. Finally, best of all, do both.

(Bacon is a many-splendoured thing) #9

Insulin resistance is a multi-faceted term. It generally, however, has to do with the down-regulation of insulin receptors, requiring the pancreas to produce more insulin to get the same effect. By the time our blood sugar starts to rise, we have already been insulin-resistant for years.

The liver becomes insulin-resistant when it has produced more fat (say from too large a load of fructose) than it can dispose of, and fat has started to accumulate within and between the hepatic cells. Muscle cells get insulin-resistant when they have already burned or stored as much glycogen as they can handle. Past this point, glycogen/glucose then gets converted into intra-muscular fat. Insulin resistance of the brain is even more serious, since several essential processes depend on the proper level of insulin.

When the adipose tissues contain as much triglyceride as they can hold, they down-regulate their insulin receptors, and any additional fat intended for storage has to be crammed in wherever it can fit (resulting in ectopic fat)—unless the body is capable of making new fat cells, in which case the crisis can be staved off for a while. In fact, some researchers think that the ability to make new fat cells is what accounts for the percentage of people who are obese yet metabolically healthy.

Another factor in insulin resistance is the health of the mitochondria. Handling too much glucose causes them oxidative stress beyond their ability to repair themselves.

Now, each of us has an individual carbohydrate threshold below which we need to stay if we want to keep our insulin low, enjoy the benefits of ketosis and fat-adaptation, and regain our insulin sensitivity. What your threshold is, I couldn’t tell you: I can tell you, however, that whatever it is you don’t want to exceed it, so eating more carbs is not a great idea. Try eating more protein instead, and see if that helps.

Lightheadedness is generally a symptom of low sodium, and recent studies show that we need 5,000 mg of sodium a day for maximum health, which translates to 2.5 U.S. teaspoons of salt (this amount includes the salt naturally present in food, BTW). Of course these studies were done on people eating a high-carb diet, which means that people on a ketogneic diet need even more salt, but how much more is the question. In any case, unless you have high blood pressure, it is safer to err on the side of too much salt rather than too little.

#10

I agree about the sodium with the same blood pressure or heart disease concerns if you have that condition. Assuming you are healthy and blood pressure or CVD is not an issue, then when you feel lightheaded try a bit of salt. Try to get good quality salt if possible, I find if I need salt is tastes ok to me. If I have had too much salt then it startes tasty too salty but the first test is try to see if you feel better after having some salt

While I am not sure I understood, you say you are non sedartery athlete who excercises several hours a day but you eat less than 1800 calories a day and have 12% body fat and feel like you are losing too much weight? Have I got that right? While this is not about CICO, at some point if you are low on body fat you need to feed your body something. It sounds like you are not eating enough which is not a big deal if you are keto with 30 extra lbs but will cause lethargy if you are not eating enough and have no extra fat. While I neither exercise nor have low body fat but I have read enough posts from people who do that say if you must carb up, it should be right before exercise

This may answer some of your questions https://idmprogram.com/tag/insulin-resistance/

start with the earliest post and keep reading.

(Charlie Kathopoulis) #11

Hi Charlie3,
I think you might have the cart before the horse - or the glucose before the insulin :wink: I normally explain glucose, insulin, resistant states and diabetes by using the following analogy.
Your body can run as a nuclear reactor or really efficient on solar. Glucose is like uranium. Great energy source but has a lot of bang in the wrong areas. As such any time, you have a sugar/carbohydrate/starch, it is broken down eventually into glucose. The body releases insulin as a means of taking this glucose and it forces the glucose into our cells to burn for energy. Think of insulin as your friendly neighbourhood uranium door salesman. It knocks on the muscles door and offloads the glucose for the muscle to burn. If you continually take in sugar/carb/starch the pancreas has to continually produce more door to door salesman (insulin) to meet the upsurge of free-flowing uranium (read glucose). The muscles who already have a decent supply start to get ticked off with their doorbell chiming off as the insulin clad sales force keeps hammering on their doors. As such the muscle turns down the chimes on its doorbells ie it becomes ‘insulin resistant’ as a means to stop taking in or limiting the amount it takes in, of glucose. This is the beginning of what we formally called adult-onset diabetes or Type 2 diabetes.
At the same time, the pancreas has had to do a stellar job in meeting the demand of producing and managing an ever-increasing sales force of insulin. It keeps working away tirelessly. But as the muscles become more resistant to the insulin, the pancreas has to increase its production. If one salesman did not do the job, then maybe two might, or three door knockers etc Eventually the ß cells in the pancreas are working so hard they literally burn out from exhaustion. If this continues the bodies ability to produce enough insulin to meet it basal metabolic requirements cannot be met and we have the real possibility of becoming a type 1 diabetic (there are other causes as well such as autoimmune issues but I like my simple story).
So the long and short is insulin resistance is simply where your bodies cells have become resistant to insulin, by tuning down their receptors to insulin, to slow down the intake of glucose.

As to your fat percentage and exercise. I am 178cm and 82 kg. My body fat is a little higher than yours. My caloric intake is between 1800 to 2500 per day (i track but depends on how hungry I feel) and I aim for around ≤ 55 grams of carbs (I have no issues and below this threshold, I do well), and 130 grams of protein. I CrossFit 6 hours per week, still play soccer and soccer train as well, plus I love hiking and hunting. Not bad for an old fella really. On 1400-1600 Calories per day I would starve and I would struggle. My salt sits between 3 to 5 grams (and I supplement with magnesium).

Just my two bobs and I hope that all made sense.

(charlie3) #12

I’m eating 25-2800 calories per day. I aim for 300 surplus per day because on saturday I’ll eat nothing and that will be an 1800 calorie deficit. The goal has been to maintain. My exercise in calories averages 800 per day. Walking is 75% of the calories. Alternating days of cardio and lifting account for the other 25%. Now that the weather is cooler I’ll go back to a cup of bullion for the salt. I’ve reset crono for 50 grams of carbs instead of 20.

Am I doing too good a job of depleting glycogen? Does the liver convert enough fat into glucose, then release it to the blood stream, sufficient for muscle to replenish glycogen for my level of activity and 20 grams or even 50 grams of carbs per day? I don’t see how my cells are going to be insulin resistant if they are chronically depleted of energy.

(Charlie Kathopoulis) #13

Cool - sounds like you have a handle on it. I know when I’d started keto I saw a drop in power, found I was sucking and gasping air like a fat carp out of water, and my heart rate sounded like it was hosting a rave party in my chest. I scaled back my heavier weights, increased my salt (I have bone broth tea with a teaspoon of ghee each day, especially in summer and I sweat a lot), did HIIT 3 days per week and the other days focused on slowly building my endurance (I used a primal method technique - 180 - age for maximal heart rate). It’s taken a while, including some hiccups, but the strength, intensity and focus have come back. Note though I’m not after size.

If you would like more size then possibly a small amount of carbs, supplemented with creatine phosphate, and a decent protein source straight after training might help (please chime in anyone else with more experience). Insulin does have an anabolic effect, coupled with protein (need a positive nitrogen balance and protein does also cause an insulin spike) for muscle growth, and creatine to assist in energy production (also increases cell volume by pulling in water) associated with high intensity might all assist in the growth your after.

Please remember keto as a way of life is to assist us in preventing a lot of disease states. If some have been metabolically damaged, through years of misunderstanding, it can take a long time for the body to respond. I’ve been keto 6 years and each year I surprise myself. So by all means increase carbs a bit, add more salt and experiment. Nothing here is an exact science so half the fun is having a go and seeing what works.

(Raj Seth) #14

Your body will go where it wants if you feed it right. 1400-1600 BMR seems very low. You may just need to ingest more (not carbs) and allow the body to do its thing.

On a Ketogenic diet, the skeletal muscles feed directly on free fatty acids. Ketones are a byproduct to fuel 80% of your brain and some other things. Glucose via gluconeogenesis is produced by the liver for those parts that cannot use FFA & ketones.

(charlie3) #15

Sorry for the long delay in responding. On week days I’m buried by work and diet/exercise. I don’t want my body to “go where it wants”. That would be back to 25 pounds more fat.

BMR is calories at rest. Mine is lower than most because the estimate considers age. I’m 69. Never the less I’ve overridden crono’s 1430 calories with 1550 and I’ll eat those extra calories and if that’s not enough I’ll raise it again.

I got a bluetooth scale to make sure daily weights are recorded so may be I can spot trends sooner and so far either weight is holding steady or declining. I’m done with weight loss so may be calories will go up yet some more. I’ve also upped the carb budget to 50 grams with the apple-a-day approach. My workouts are low energy and very slow progress. There needs to be a fix for that.

What makes me impatient with all this is the perpetual light headedness, even after 5 months of what I believe is a “well formulated” keto diet (20 net carbs, 90 grams of protien). I’ve noticed others complaining about being light headed for long periods so it’s a keto thing. Well what is it exactly? What is the mechanism?

As for salt, Cronometer says I averaged 3185 mg of salt per day for the preceding 7 days. Okay, I’ll figure out a way to add 2000 more mg but I’m doubtful that’s the issue. One of my successes in this process has been reducing BP. I got a cuff in January. The highest I recorded was 160 over something. Recently almost all measurements are below 120 and the lowest was 102, no medications involved. The exercise got that done with may be honorable mention to keto. This really is all about life style.

#16

by what mechanism would a “lack of carbs” create light headedness? its not likely you have low blood sugar unless you are a type 1 diabetic as blood sugar is spared by ketones a fatty acids.

additionally, study after study (muscle biopsies) show muscle glycogen is replenished just as effectively on low carb/ketogenic diets as on a diet replete with carbs. your “low and slow” workouts are not likely glycolytic anyway.

in all likely hood this is a blood pressure issue, spurred on by too low of a salt or magnesium (or possibly, water) issue or a kidney disorder, or even a heart issue.

(Charlie Kathopoulis) #17

So when you get into ketosis you lose glycogen - every gram of glycogen is bound on average to 3 to 4 grams of water. Hence, initially, we see a significant weight loss as we cut carbs as we lose a lot of retained water. Correspondingly as we enter ketosis, the water loss also accelerates the loss of sodium, potassium and magnesium. The result is a drop in blood pressure and I believe a drop in heart rate volume. So when we stand suddenly we get an initial drop in blood pressure (gravity working here) and it takes a little while for the heart to build enough ‘revs’ to counterbalance this drop in blood pressure (hence why some get a racing heart rate when starting a ketogenic diet). This does settle over several weeks usually and the body, in turn, has an increased need for Na+, K+, and Mg++ as well.

1 teaspoon of salt = 5 grams of salt = 2.3 grams of Na+ - it is normally recommended that we have 5 grams of Na+ (Sodium) and more so if you are undergoing heavy, strenuous exercise.

https://blog.virtahealth.com/sodium-nutritional-ketosis-keto-flu-adrenal-function/

That’s your systolic value. You need the other number as well (diastolic value) and please see your doctor and get your heart tested … not trying to be an alarmist just that most are not doctors here and if you have had the dizzy spells for so long it never hurts to be safe. Also given your age (not being rude) a systolic pressure of 102 mmHg though still in the normal range, is in the lower end of the spectrum.

(Bacon is a many-splendoured thing) #18

Firstly it is protein that the liver converts into glucose, and it does so only in the absence of glucose (i.e., carbohydrate) in the diet. Sufficient dietary glucose inhibits gluconeogenesis by raising insulin secretion.

What the liver makes from fat is ketone bodies, and again, a high enough insulin level inhibits ketogenesis. When they are fat-adapted, the muscle cells burn not only ketone bodies, but also fatty acids, which they tend to prefer to ketones, thus sparing the ketones and the glucose from the liver for those organs that need them (the brain prefers β-hydroxybutyrate; the red blood cells must have glucose, because they lack mitochondria). When you are fat-adapted, your muscles have no need of glucose/glycogen, except for explosive power; for endurance they have fatty acids and ketone bodies.

ETA: I agree with Charlie’s post, immediately above. If adding more salt to your diet has not cleared up your light-headedness, then see your doctor, soon.

(charlie3) #19

“explosive power” is relevant to my resistance training and where I’m feeling frustration. After 5 months progress is far too little. (I was a dedicated hobby lifter years ago for about 10 years so this is not new stuff. My exercise walking and steady state cardio have progressed acceptably.) Currently I’m doing 3 whole body lifting sessions a week, about 60 minutes each, on my pretty good 80’s era home free weight setup.

(Raj Seth) #20

I think to super hydrate and up salt - a lot. There’s plenty evidence that our sodium intake should be 2-3 x USRDA. Target 8000 mg sodium a day. It will up your blood volume too as hydration increases to keep body salinity in line. Might help.
Years of hypertension and the CW to lower sodium (like the low fat dogma) has biased our food supply to be lower sodium. On keto, with heavy exercise you need a ton more electrolytes.
Of course, it could be something else too - so if Na and H2O don’t fix it - see your PCP