Keto adaptation lost for not apparent reason


#1

Hey everyone,
I’m new here, but not new to keto. I’ve been on and off for 3 years, and, the current unbroken streak is over 10 months long. I have been doing it for health benefits, not weight loss, my weight is fine as is.

While I was adapting last year, it was quite hard on me. Had all the usual stuff - greasy stools, horrible smelling breath, felt dizzy and almost fainted a few times, but persevered and got there.

While I was adapting, my blood ketones were around 3-4, urine strips were deep purple, blood glucose was about 2.5-3 mmol/l.

After my adaptation was complete (couple of months in), blood ketones were at 0,6 to 2, urine strips detected no ketones, blood glucose was at 4-5 mmol/l. I felt great.

Two weeks ago, for no apparent reason, my adaptation was lost and I am back to my “keto flu” again. Greasy stools, horrible breath, waking up several times at night with my heart pounding, etc. Measured my levels yesterday, blood ketones are at 3,9 (with no exercise that day!), urine strips say I am near ketoacidosis, and blood glucose is critically low at 1,9.

My weight was stable, but now I am rapidly losing it (almost 4 kg in 2 weeks) which I do NOT want to happen since I am at the low edge of normal as is.

Anyone had experience with something like this? Why does it happen? Any advice? Thanks!


(Allie) #2

That stuff is not considered usual.

“Keto flu” is an electrotype imbalance so can happen anytime they’re out of whack. Nothing at all do do with adaptation.


#3

It was usual for me, happened every time I was adapting. But, this time it happened more than 10 months into eating around 10 g of carbs/day on average, which is unexpected.

Also I don’t think keto flu is just an electrolyte imbalance. I did a screening blood test of important blood component levels (including electrolytes) when I was adapting and had these symptoms, everything was fine except low blood glucose.


(Allie) #4

Those tests are useless TBH as the body will always get what it needs to function by leeching it from the bones etc. so blood results always show normal.


#5

Hi NOD

Welcome.

You appear to be at a different level of ketosis. As you describe with your blood results. The deeper ketosis for you seems to create some unpleasant effects. So, moving back into the more optimal range, for you, will hopefully sort it out.

It would be great to know what you are eating and if anything changed about 2 weeks ago.

Changes include eating, drinking, physical activity, sleep, work, play, obvious stress etc.


#6

Hi Franko and thanks for the warm welcome!
From what I learned from my own experience and scientific articles along the way, blood ketone levels drop as you adapt, and they disappear from the urine completely since the body learns to use them efficiently and stops overproducing and wasting them as a result. So yeah I am in a deep ketosis, but the reason for this seems to be broken adaptation and inability of my body to use them effectively.

I don’t think anything has changed except physical activity. I am used to having a long and fast walk every day, but somewhere in the second half of August I have injured my foot and was forced to decrease the distance and speed of my walks. But I had periods of inactivity before, and it didn’t break my adaptation then…


#7

Yes, I agree. We adapt. The mitochondria are able to switch between fuel sources easily. The ketones aren’t ‘wasted’ as much. I’m down with all that.

It is really interesting to see that your ketones are near 4 and blood glucose at 2. That is therapeutic ketosis levels with a GKI, glucose ketone index of 0.5. Many people have to work very hard with a strict diet to achieve those levels. That’s why i call it therapeutic because most people are seeking that ratio to fix an illness. The 1.9 glucose is low but your ketosis will stop you from passing out. Ketoacidosis only occurs in the presence of high blood glucose and much higher blood ketone levels.

These numbers, like yours, seem to occur when people include extended fasting in a low carbohydrate nutritional ketosis regimen. Are you experimenting with fasting?

I think the obvious solution to test is to have some wholefood carbohydrates to raise your blood glucose and drop the blood ketones and see how you feel.

Yes, the answer could be that your body has suddenly rejected ketones and fatty acids as a fuel source. I just can’t think of why that would happen without a big change in eating or lifestyle.

Hopefully a smart person will be along presently to help us out. @PaulL @brownfat


#8

I am not fasting. Eating just like I always was, 3-4 times a day, with two of those meals being rich in fat - butter or salo (pork fat). Around 1500 calories per day, which was enough to maintain a stable weight for months.

Don’t want to start eating carbs again (just a little bit was enough to crumble my willpower in my first attempts of keto lifestyle), but if it doesn’t get better I will be forced to add some to maintain quality of life.


(Bacon is a many-splendoured thing) #9

This is a puzzling situation. The keto or Atkins “flu,” which is the dizziness, headache, and lightheadedness many people experience when changing to a ketogenic diet is from lack of sodium. It is completely preventable if we eat enough salt. In my case, low salt is often accompanied by migraine auras and constipation. Of course, too much salt causes messy stools. It is not diarrhoea, but it is the opposite of constipation, for sure!

@NOD If you are willing to share details of what you’ve been eating lately, we might be able to spot something that could be the culprit. Otherwise, I wonder if you might possibly have some medical condition that has suddenly flared up, because the symptoms you describe are not usual for people on keto.

If your urine strips consistently show a high ketone output, you might want to get checked out for Type I diabetes. (It’s not likely, if your glucose is low, but still.) Type I is an autoimmune condition that can happen at any age and is not related at all to diet. I only bring this up because of a recent interview with Dr. Robert Cywes, a bariatric surgeon who treats his patients with a ketogenic diet, in which he said he had recently encountered a number of patients whose Type I diabetes had mistakenly been diagnosed as Type II. (I suppose it is possible that their pancreas had started to fail but was still producing insulin at the time of diagnosis.)


#10

on and off a keto plan and then you are ‘all in’ and no deviations and I have to ask…what changed? You are doing something different or ya got a ‘real medical issue’ that needs addressing, but I would ask first, what are you doing very different? What changes or little experiments you might be trying?

If none, then I would do a Dr visit to be safe cause if you are ‘all in’ and holding keto plan tightly now, then 10 months doing so well big changes came, hmmm, but those changes I see listed are more like…adaption after eating up crap and getting back on plan vs. someone holding plan tight for 10 months. SO??? I gotta give this a big ???

what is different 10 months in on good Keto that is in any way diff. then what you have done before?

just asking cause I just don’t know what you are dealing with at this point.

Agree with Paul in his post that something has changed…your eating or trying new diff. approach or it is a real med condition that might need to be addressed?

I got alot of ? here LOL am I am sorry for that but there is an abnormality here that I ain’t reading in your posts that gives me all the questions.


(Todd Allen) #11

I think you and @Shortstuff have made good points. I’d add that the rapid weight loss in someone without a lot to lose and isn’t trying to lose weight is concerning. It might be mostly water so far and could bounce back but the low blood glucose, higher ketones, greasy stools and other symptoms suggests the possibility of something serious. I think your suggestion to try adding in a little better quality foods with carbs is a good first step but unless there is a dramatic change in trajectory I’d be very focused on finding answers. I hate hearing so frequently “consult your doctor” as so many people have awful doctors but dietary tweaks aren’t sufficient to diagnose and treat every health issue.

Good luck to the OP I hope you are able to find the answers you need and understand this forum is a place for ideas but you need to work at finding your answers.


#12

Thank you for your responses everyone.

@PaulL My diet is pretty boring and it hasn’t changed in months. I usually eat an omelet in the morning (fried with olive oil) with pork fat mixed into it, then meat or smoked salmon with a salad (mostly leafy greens) for lunch, and cabbage based vegetable mix in the evening, adding some cheese with butter later on. If I feel hungry before sleep (happens every other day or so), I eat more salad and salo.

Come to think of it, my greasy stools might be pointing to the actual problem and not just be a symptom of keto flu. My appetite has been quite bad recently, I have to almost force myself to eat, and often have stomach pains and bloating after eating. If my body isn’t properly digesting the food I am eating, I might be missing out on most of the energy I am consuming.

@Fangs and @brownfat I think I might need to visit a doctor to solve this. Already made an appointment, although I am not looking forward to it. My GP was against the idea of keto in the first place, and she will probably treat my issues as an “I told you so” moment. I will see if I can test the autoimmune diabetes theory and get my digestive system looked at, as well as see what my GP suggests.


(Todd Allen) #13

I’d be surprised to see low blood sugar in a type 1 diabetic who isn’t taking medications to lower blood sugar. A gut issue seems more likely although finding a doctor good at diagnosing and treating gut issues is challenging.


(Michael - When reality fails to meet expectations, the problem is not reality.) #14

May as well start at the beginning.


#15

Usual for the way you’re going about it sure. Years ago with Atkins and the beginning of keto we accepted all that as “usual” too, then we figured out WHY it was happening.

Right, but then what were you comparing those blood tests too? The lab range? Those are 100% pointless in our case. The ranges on those labs are geared towards “normal” people that have all their salts limited because of the water retention that the carbs would cause along with them. They’re NOT geared towards the person that realizes we need at lest 2-3x the RDA to begin with and which on top of being in a diuretic state where we’re literally pissing out salt at a ridiculous rate. Curiosity, were you tracking your salt/salts intake at all during this?


#16

Interesting… I was aware that I needed my salt intake to go up, but I didn’t track it. I just added more than usual and followed my salt cravings in general. I have allowed myself as much salt as I wanted, but didn’t force myself to eat more than than I felt like.

My salt cravings are up now as well. Probably because I am rapidly losing weight. I will try eating more salt and see if it helps with my sleep.


(Bacon is a many-splendoured thing) #17

So would I. I was going by the high level of ketones in the urine, however, and thinking that perhaps the condition is only beginning to develop.

That sounds like a really good approach.