Karim's Extended Fast Tracker - come along for the ride


(Karim Wassef) #722

Day 7 of phase 3 adaptive fasting - fasted day

So GKI just under 3 this morning. I’ll fast until I get under 1, then eat again.

Interesting how that’s influencing my thinking…

Now that I have a measurable goal, I’m thinking of all the things I can do to get my glucose as low as possible and ketones as high as possible as fast as possible.

Am I hungry? No
Do I miss food already? No - actually need a fasting day to recover.

But something about a target just triggers me to solve… :smiley:


(Karim Wassef) #723

Thanks for sticking through this with me for the last 48 days … only one more week left (total 55) before the reverse fasting carnivore phase 4 that will last an equivalent 55 days.

I’m wondering if I should continue to document my journey here since it’s not a fast any more. It’s still part of the larger experiment though… with DEXA and RMR comparisons, etc…

It would be an accountability thread… until the next big fast in two months.

What do you all think? Keep it going?


(Little Miss Scare-All) #724

I say make it a new thread, so that that phase will be more easily serachable for content.


(Karim Wassef) #725

Hey there lurker! You’re so quiet most of the time so it’s nice to hear you peep up (ha ha Easter joke).

Ok. One vote for starting a carnivore thread.

Anyone else?


(Empress of the Unexpected) #726

I agree. Even though most of it is over my head I enjoy following along and seeing your GKI numbers.


(Karim Wassef) #727

Well you know my carnivore thread would have GKIs too! And DEXA and RMR.

My wife wants me to start keeping count of the cost … let’s see $160 each session x 5 sessions so far + 5 tests per day x $1.5 x 210 days ~ $2400 without counting food and supplements and time doing excel…

So… I’m just going to forget she asked and see when it comes up again. I’m not avoiding the issue- just calculating the risks … :laughing:


(Empress of the Unexpected) #728

The RMR is where you lose me :rofl:. I find the vegan aspect of keto pretty interesting, I have to admit. I was a vegetarian for years but couldn’t imagine taking the vegan plunge. Last few days for me have been just meat and onion.


(Karim Wassef) #729

RMR is just the calories I use in a day.

I breathe into a device that measures how much O2 and CO2 is in my inhale and exhale. Nick can probably explain this better. But it determines what I likely use doing nothing or if I exercise.

This is actually my best evidence that CICO doesn’t really work unless you measure continuously and accurately.

The only way I can fast and not lose fat is that my metabolism dropped too far and my food intake was higher than I thought. The drivers must be hormonal.

I gave it more thought and my suspicion is that my body was really optimizing whenever I wasn’t lifting. Whether it was sleep or just reduced energy for some blocks of time, I think it would throttle down my metabolism any chance it got to stretch the duration that my refeed calories would last.

This is why my extended fast was so much more effective. It basically takes more than 5 days for my body to run out of options… it’s just that efficient.

When I fast, even fat adapted, it still found any lean mass I wasn’t using & cannibalized it. So darn efficient.

I think this is why keto worked better - it was slower but it was less stressful so my hyper efficient body was more willing to access the fat.

The cyclic fasting was stressful with more cortisol but not long enough to force it to dig into the fat.

Also, the Leucine is anabolic and even though it’s transient, it keeps my body from my own fat usage. That’s why I gained muscle, lost no fat, and saw a drop in energy.


(Karim Wassef) #730

@Don_Q I asked them about the RMR machine and they said it costs $60k. It’s a pretty big machine with oxygen tanks, etc…

Didn’t take a pic though. Felt too much like spying.


(Karim Wassef) #731

Two votes to start a carnivore thread
No votes to keep it all here…


(Little Miss Scare-All) #732

:joy: Cute joke!! I like it.

A lot of the stuff is way over my head and I’m jealous of your ability to focus on a goal so rabidly. Often, all I’m good for in a thread like yours is pointing out something silly and irrelevant, or a sarcastic/crude joke. :grin:


(Karim Wassef) #733

We need more of that around here. I feel like the professor on Gilligan’s island … wait, maybe that’s Nick since he’s got the fancy equipment and I’m the skipper… you can be Gilligan or not-ginger (what was her name?)… LOL

Just kidding. Ok - everyone name your character!

I’m claiming the professor (just cause)


(Alec) #734

@Karim_Wassef, @Don_Q,
I have some questions for you on ketone measurement. Pls forgive me if this has been asked and answered in your logs, but I am still working my way through them. I think both of you are working on GKI measures and you hold store by them. Clearly this means you trust your ketone measures… what is your confidence level in the accuracy of those ketone measures that you get?

I have frequently thought about starting to measure GKI, but I do a bit of thinking and research and get discouraged by whether the ketone readings are accurate enough to mean anything.

Do you know what exactly the blood ketone monitor is measuring? Is it measuring spilled or spare ketones, or ketones in the blood that are on the way somewhere to be used, or something else? This is the bit I don’t understand. I am not currently a ketone measurer, but if I had a bit more faith in the accuracy/efficacy/usefulness of GKI, I might go there.

Your thoughts on blood ketone measurement accuracy? Do you know/think whether the level of fat adaption or time spent in ketosis/on the keto diet makes any difference here? For example, I have read that some people just have low blood ketone readings because they have been keto for 2 years, and the body just makes enough for what the body needs and no more, and thus their measured ketone level is low(ish).

I am not challenging the excellent tracking and analysis you guys are doing here, I think it is fantastic! But any thoughts on my questions would be welcome.


(Little Miss Scare-All) #735

Mary-Anne!! I’d rather be her, than Ginger anwyay lol.


(Karim Wassef) #736

ok… so ketones are like glucose. The level of glucose in the blood is based on the body’s homeostasis (equilibrium) based on the expected need of the body for energy as well as the processes trying to control it.

Ketones are similar and the body does adapt over time, but the BLOOD ketone measure is always meaningful.

So let’s take a journey from a SAD to a fat adapted body.

We start out as glucose burners. Depending on our level of obesity and insulin resistance, the body tries to maintain a glucose level around or under 100. With insulin resistance, the blood glucose rises and the insulin rises as the fat cells become overstuffed. I bring this up because understanding glucose is just as important as understanding ketones in the big picture of GKI. Glucose levels indirectly signal insulin. This metabolite (glucose) to hormone (insulin) relationship is important because it’ll come back later.

Insulin, by the way, is made in the beta cells of the pancreas. Glucagon, it’s “nemesis”, is made in the alpha cells of the pancreas. They’re both part of the critical balance of metabolic hormones and they are intentionally in opposition based on the body’s metabolic feedback loops. One goes up, the other comes down.

Then we reduce or stop eating carbs and glucose drops… and insulin drops… and then we go through the keto flu, losing electrolytes and water… until the pancreas starts releasing glucagon and the body starts to access fat. First, it turns it into fatty acids. Lipid molecules are made of a glycerol backbone and three very long chains of fatty acids. The glycerol is converted to glucose (gluconeogenesis) to support the cells that have to have glucose. The fatty acids are transported (in cholestrol) to those cells that can use them directly. These aren’t ketones, they’re literally fatty acids.

If you maintain low carb intake, the body moves to the next stage where it starts to make ketones, but it has some challenges - how much to make? how to get the cells that are carb burners to use them?

ketones are made after fatty acids and the cells slowly adapt to using them. The liver is the master controller and without a history of ketone usage, it goes into super-life-saving mode. This means that it’s going to generate SO much more than you could possibly use. It’s literally relearning how to live.

This is where ketones are made, and glucose is made from protein, lactic acid, and fats… and there is a surplus because there’s no history… you cannot be allowed to lose consciousness, so burn, baby, burn…

In this brief window (maybe a couple of months), you will lose more fat than ever as the body literally doesn’t care about waste. It’s focused on survival. During this time, you will have ketones in the blood, urine, breath, sweat… you will be oozing ketones…

Then… the liver starts to “get it”. It knows what you need for energy. It knows how many cells have switched over to using ketones vs. glucose. It knows when you’re going to eat and what you’re likely to eat… and now, it starts to adapt.

It starts to limit the ketones and plays around with your metabolic rate to try to zero in on what you actually need so it stops being so wasteful. This is fat adaptation. You become a fat burner and an efficient one at that. At that point, urine ketones stop.

Breath ketones continue because it’s a measure of what you’re using, but it’s also all over the place based on your actual energy usage.

But blood ketones now reach their own homeostasis… just like glucose.

So insulin and glucose are one side… and glucagon and ketones are on the other side. Your body can now go from sugar to fat burning… and this is where you come in with a tester.

When you measure both, you’re really looking at whether your body is a fat burner (glucagon dominant) or a sugar burner (insulin dominant). That’s why GKI is meaningful. It’s an indirect measure of your hormonal balance.

When you’re glucagon dominant, you’re most likely burning external and internal fats. This is a very catabolic (breaking down) state. When you’re insulin dominant, you’re most likely burning external and internal sugars. This is a very anabolic (building up) state.

If the ratio drops below 1, then you’re in a glucagon land … and you’re in autophagy - heavy fat and even old lean mass being broken down. If you’re over 1, you’re in different balances between the two and you can go from being in ketosis (1-6), to being way out (9+).


(Karim Wassef) #737

for completeness… there are actually three kinds of cells in the pancreas: alpha, beta and delta

http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/anatomy.html

The delta release a third hormone called Somatostatin that is considered the anti-growth hormone and basically silences both insulin and glucagon.

I’ve been trying to learn more about Somatostatin but the literature here is very technical. I’ve come across it while trying to understand the effect of Leucine while fasted:


(Karim Wassef) #738

I think ginger was misunderstood … but hard to love as a character. LOL

I think living on an island would have been a very keto way of life… coconuts and seafood. :smiley:


(Little Miss Scare-All) #739

I often fantasize about being left on a desert Island for like 3 months. I’ve watched enough Survivorman to know how to quasi build a shelter. I know how to make water out of pee, and even salt water.

Only catch is, I’d need to know that I had someone returning for me, else I’d be sore unhappy. But I’d come back tan and fit. :metal:


(Karim Wassef) #740

Here’s an example. After eating for three days, my GKI went over 6 and I decided to fast. I started to weaken a bit and decided to check midday to see if I was making progress.

I wasn’t. I was at 83G, 0.6K = 7.7GKI.

Basically, even though I was technically in ketosis at 0.6, my glucose was running so high that I was still feeding off my last meals and glycogen and remaining glucose.

I’ve noticed this effect where most of my cells prefer ketones, so if there’s an abundance of glucose (I hit 100 last night after my protein binge), they’ll continue to work down the ketones and the glucose drops very very very slowly…

Even with plenty of exercise, sunlight, fresh air and fasting … my cells were drawing down the ketones and my liver and pancreas weren’t making any more with all that glucose floating around. So I had to wait… long enough for the glucose and insulin to drop enough for my liver to trigger glucagon again…

Basically, after three days of food - it was like “he’s gonna eat… just wait for it…”…

I didn’t eat dinner and now a few hours later, my blood metrics are 68G, 1.4K = 2.7GKI… basically my metabolism got the message that there will be no feast today… so glucagon needs to go now and we have got to build up the ketone reserves. That only happens when ketones drop enough and the ketone users have to consume glucose and bring it down fast.

This is because the number of glucose users is a small % of all cells. Red blood cells, some parts of the brain and internal kidney cells. They have no mitochondria and need glucose.

So they use it, slowly…

But once the ketones drop enough, the rest of my body start using glucose and it’s like a big drain opens up.

Now ketones are low and glucose is dropping fast… and my super optimizing adaptive liver basically accepts that we’re going to have to switch modes. And GKI goes from >7 to <3 in a few hours…


(Karim Wassef) #741

I’m big on nature survival too… even if no one is likely to be coming… I’d totally go Robinson Crusoe.

Coconuts are not easy to open by the way. Neither is starting fire. There’s always a perfect rock in the movies or someone has glasses … or there happen to be glass bottles and straws to make a still… nature can be unkind… lol