Just started keto. This is day 3 (I'm probably not in ketosis), and I've got some newbie questions

newbies
#1

I’ve been diagnosed with a range of medical problems, including type 2 diabetes, fatty liver, and COPD. I hope that this is going to be a good way to eat for me. I am trying to lose weight, and I’m about 6 feet tall and about 350 lbs, but I understand that this is not going to be a magic bullet.

I have been sent to dietitians and nutritionists that have had me on a variety of calorie-restricted diets and none has felt as satisfying as this and the one other time that I tried Atkins about 10 years ago (I was told to stop because of my cholesterol levels, which, if I recall correctly, were just a bit over 300 with a slight increase in the “bad” cholesterol). I’ve also tried being a vegetarian, which had horrific effects that accounts for the last 40 lbs of my 350 lbs. I’ll admit that I could have had some success with calorie-restriction, but I was eating 1600-1800 calories a day and feeling very lethargic and hungry with minimal weight loss in a few months.

So, with all that said, I’ve only been eating a ketogenic diet for three days, and I’ve had some ups and downs. I believe that I have reached a state of ketosis, or rather, in a position where my body can begin to start using some of the ketones for energy, but I’m presuming that I am primarily breaking down glycogen given urine strip readings of something like 80 - 100 mg/dl. After talking with my doctor about it as well as reading on some of posts on the forum, I feel that I can continue eating in this way, but I’ll be careful to keep hydrated. I’ve lost about 10 lbs so far, but that seems like a ton of water over three days and makes me think that I have not supplemented my water intake during this process.

I’ve got some newbie questions:

  1. Am I in ketosis? Can I be sure that ketone production (urine stripes) = ketosis?

  2. I was exercising a few times a week, but I tried exercising yesterday and I was totally worn out after 30 minutes of cardio (I was doing about 60 minutes and some weights prior). Should I be making an effort to put some carbohydrates back into my diet prior to a workout? Is it just too early to say given the relatively small amount of time that I have been eating this way?

  3. How do I snack? I’ve been trying to eat nuts, but I can only tolerate a small amount without having some digestive issues. Also, I’ve tried eating things like salami and cheese, but have found that I feel flushed and worn out after eating these items.

  4. I’m taking metformin and glyburide. How long should I wait before talking to my doctor about adjusting the levels to some of these meds? Or rather, how long will it be before my body starts relying primarily on ketones for fuel (and my glucose and ketone readings start to level)?

Thanks to the community for the help.

(Ellie) #2

Hi,
Welcome and congratulations on making the decision.
I’ll try to answer your questions.
1 - yes if you have ketones reading on the sticks then you are in ketosis. The next step is becoming fat adapted which means you are using ketones efficiently (simplified view). This can take 6-8 weeks.
2- no extra carbs needed, but don’t be surprised if you find exercise difficult until you become fat adapted.
3 - it is best to avoid snacking. Eat enough in each meal (mainly fat) to be satiated and to keep you going until the next meal. Each time you eat, insulin is released and this is something to minimise.
4- I’m not diabetic so I can’t advise on this but someone far more knowledgeable will no doubt be along soon.

Stick around here and read lots. Also listen to all the 2ketodudes podcasts.

#3

  1. You might be in ketosis. When you’re starting out, urine strips can be useful for checking to see if you’re in ketosis, but as you become fat- and keto-adapted, they will likely show that you’re not in ketosis even when you actually are. Blood testing is the way to go if you want to know for sure.

  2. It’ll be hard, but try to exercise without taking in additional carbs. Doing so will help you become fat adapted. Once you are fat adapted, you’ll be amazed at the amount of energy you have without having to take in additional food.

  3. Don’t snack. Not snacking will help to bring insulin down and will also help you to become fat adapted. If you find that you need to snack to avoid hypoglycemia, that’s a sign that you probably ought to cut back on your meds for controlling blood sugar. Also, as you get further into it, you might try skipping breakfast to extend your overnight fast.

  4. Are you taking daily blood glucose readings? If so, you should be able to use those numbers as a guide for figuring out whether you still need your diabetes medications. You should definitely talk to your doctor about it…

#4

Ketone strips are not a reliable way to determine ketosis mainly because the ketones in your urine are being flushed out of the body unused. If you burned the ketones, they wouldnt appear in your urine. If you want to monitor Ketosis based on ketones, you should get a blood ketone meter. They are not too terribly expensive but much much much more reliable than urine strips.

  1. After 3 days of eating keto its unlikely youre in ketosis especially if you have never been so before and have not experience any symptoms of the flu or noticeable change in urine/breath smell or other factors. Youll get there though! Your body has to burn through the stores of glycogen in the liver first which can take up to a week or so.

  2. No you do not need to carb up for workouts on ketosis. I ran a triathalon in ketosis without using any carbs or sugars to give me a boost. You just have to allow your body adjust to your new metabolic fuel and it WILL take a month or so. I work out about 4-5 times a week and I had to slow down a lot when I first transitioned into ketosis. Your body doesnt have the enzymes and metabolic pathways well greased to burn fat efficiently so youll feel a bit sluggish; thats fine! Just slow down and let your body make the transition fully. :slight_smile:

  3. When I first started Keto i felt the same odd sensation that you did that I felt feverish and tired after eating foods. It was almost like the food was having the opposite effect; I felt drained instead of energized. While I cant explain why this happened, just know that its likely temporary. The transition sucks but you WILL FEEL NORMAL AGAIN!! I promise!!!

Snacks I like:

  • Salty nuts (mixed nuts or just almonds whicever you like best)
  • Cheese sticks!! Colby jack cheese sticks or the classic string cheese.
  • I mix 1/4cup of Whipping cream with 1/2C Almond milk plus some sugar free chocolate syrup for chocolate milk if you want something sweet
  • I buy Club Soda and mix in the MIO drink flavors (or similar sugar free brands)
  • I have make some fat bombs that i keep in the fridge or freezer if I want a snack
  1. This one I cannot help but Im sure there are smarter people than me on here. But in general, I would keep your doctor up to speed on your diet and get a check up in a couple months to test your blood levels to see if your medications need to be adjusted.
(Running from stupidity) #5

What everyone else said, pretty much. Avoid snacks, pull back the exercise level (rather than carb-load) for a bit while you train your body to burn a different fuel.

Also, for ketosis checking, I’d recommend a cheap breathalyser from eBay. It registers the breath ketones, which is a more accurate (and FAR CHEAPER) way to check on ketosis. I have one and barely use it after a few months, but it’s a really good system. There’s a huge thread in here about them, but it just says what I did in a huge amount more detail :slight_smile: