Ketones when new vs fat adapted

(Bob M) #42

I think the body does that. I’m not sure why the ketones go down even for the same number of days. I should see if I have blood sugar for those times, too. Maybe my blood sugar was higher for the later fast? But the question would then be, why? Especially since one would think that 4.5 days of fasting would equalize at least the blood sugar. But I don’t know.

(You've tried everything else; why not try bacon?) #43

Sorry, I just saw these questions. My Internet connection was out for a week, so I’m busy catching up.

You can still get high ketone readings, but it is more difficult. The therapeutic ketogenic diet is extremely high in fat and low in protein. For some people, it is deficient in protein., and they need more than “allowed.” Fasting promotes ketosis as well.

Fortunately, newer research has shown that diets involving a better balance between fat and protein can still have an excellent therapeutic effect. But every body is different, so responses can be idiosyncratic.

Also, you really need to be monitoring glucose and ketones around the clock in order to see the real picture. For example, glucose is higher in the mornings (the so-called “dawn effect”) and drops throughout the day. Ketones are lower in the mornings and rise throughout the day. This is the way the body is designed to operate.

A caloric deficit signals to the body that there is a famine going on, to which the body responds by husbanding its resources. Fasting–a complete absence of calories–causes the body to simply swith from dietary fuel to stored fat. That is why it is so important to not eat at all when fasting, and when eating, to eat abundantly.

Your carb tolerance is highly individual. The problem is that we don’t know what it is. Research has shown that the threshold for serum insulin is just under 25 μU/mL, but there is no way to measure insulin at home; it requires a radioimmunoassay, which requires lab equipment. So we use the presence of ketones in the blood as a proxy for a low insulin level. The body will not produce ketones if insulin is at 25 μU/mL or higher.

But how long it will take for your pancreas to calm down and stop pumping out vast quantities of insulin at the least sign of dietary carbohydrates is anyone’s guess. You can experiment, if you are really keen to know what your actual carb tolerance is.

Myself, however, I discovered that there is a level of carb intake for me that starts to cause my joint pain and skin problems to return, even if it’s still low enough for me to be in ketosis. When I stick to 0-carb/carnivore or very low-carbohydrate keto, my joints and skin are fine.

(You've tried everything else; why not try bacon?) #44

This is a really good question, but I’m not sure about the assumptions behind it. I’m speaking generally, this is not a personal criticism, and I’ve been wondering for a while now just how high ketones need to be in order to be therapeutic.

Some random data:

  1. The therapeutic diet for epilepsy was developed a long time ago, and it was not based on a scientific understanding of brain chemistry, but was developed empirically, by treating patients and observing what seemed to work best. It was believed that the fat content of the diet was what was treating the seizures, so the diet was extremely hight in fat and deficient in protein, to the extent the growth of some of the children was stunted because they didn’t get enough protein during the pubertal growth spurt. This (and diabetic ketoacidosis), is why a high-fat, low-carb diet is still considered likely to be dangerous. Fortunately, more recent research has shown that a higher-protein, lower-fat diet can still be therapeutic.

  2. Dr. Chris Palmer at Harvard has seen remarkable results from ketogenic diets in mental patients who weren’t trying to keep their ketone levels elevated. One man embarked on a keto diet simply to lose weight, and everyone around him was amazed that his schizophrenia improved and eventually cleared up. Matt Baszucki, the son of the founders of the Baszucki Foundation, which funds research into mental health treatments, is on record as describing how he controls his bipolar disease by maintaining a ketogenic diet. He makes no particular mention of trying to keep his ketones elevated.

So these sorts of anecdotes make me wonder whther it is possible that whatever ketone levels the body produces naturally on a low-carb, high-fat or carnivore diet might not be sufficient to treat most conditions that we worry about. It is even possible that the therapeutic effect results more from the absence of dietary glucose and fructose than from the presence of fat, Who knows?

(Diana) #45

Thank you so much for the time on your reply. Interesting finding. I’ll need to test both glucose and ketones later in the day. The last 2 days I’ve tested only first thing in the morning. So maybe that’s the issue…

Okay I’ll pivot back to resuming omad. That did work really well for me. To be honest I’ve been trying to get back to omad for a while and look back at how easy it used to be, but since I’ve been eating twice daily it feel impossible. I know it’s a habit and more mental than anything. And yet I keep caving.

(You've tried everything else; why not try bacon?) #46

Forgive me for advising you, but I would suggest considering whether your hunger might mean that your body needs the food.

(Diana) #47

I came for input so shoot away :slight_smile: it could be….but I keep reflecting back I’m eating the same amount of fuel (calories), I’m very weight stable yet I used to be able to do omad with ease and now I can’t get to it. This is why I feel like it’s just a mental hurdle. Or I need to increase the fat and lower the protein a bit.

(KM) #48

I recently started up an old hobby, after a long period of what in retrospect seems like depression, or at least a very flat patch where nothing but food seemed particularly interesting. I find myself now easily able to skip lunch, whereas before I felt lunch was the highlight of the morning. Are you going through a similar low patch, perhaps?

(Diana) #49

Yeah. Possibly just using it to pass time…

(Diana) #50

Earlier it was more a theoretical question, but I just got my blood work back and am a bit worried. My AST and ALT are both elevated, could this be due to excess protein consumption for my body? Mainly trying to reassure myself that it’s not a bigger problem. My cholesterol is also high but I’ve read all about those topics so am not worried as it seems this is to be expected esp if I’m on the leaner side.

(Robin) #51

How elevated are your ALT and AST? Mine rose significantly after surgery and anesthesia can affect your liver too. But should go down soon.

(Diana) #52

No surgeries, no exercise pre blood test, perhaps I didn’t have enough water (I read that can impact it)….

AST= 55 IU/L (notes say moderately high)
ALT = 52 IU/L (moderately high)

Keep in mind I’m a healthy 40 year old always have perfect labs. So I know this won’t seem a big deal to most but genuinely it’s freaking me out that I’m doing something wrong. I couldn’t sleep last night I was panicked. I’ve been eating about 1g/lb of protein, but I don’t really work out (walking and Pilates) so I’m just hoping for an easy answer that maybe this is too much protein for my small frame.

Please understand not trying to create fears, I’m just looking for some reassurance for my situation. I know no one here is a doctor but I feel like regular docs mine included the advice she sent was go on low fat diet and recheck labs in 3 months and we’d go from there. I don’t even know what to eat today frankly…

(You've tried everything else; why not try bacon?) #53

Not likely. It has more to do with glucose (carbohydrate) and fructose (sugar) consumption. Fructose is a metabolic poison and is one of the big contributors to fatty liver disease. Too much glucose also causes metabolic damage, but at a slower rate. In the case of glucose, it is the insulin response that causes a lot of the additional problems; fructose has no effect on insulin.

(Bob M) #54

Relatively speaking, I eat a lot of protein, and my ALT/AST are usually around 20. This is from last year:

image
image.png774×39 4.77 KB

The first set is from whenever I got the last results and the second set are the previous results (on 07/06/2023).

I’d guess it’s unlikely that protein is causal.

(Diana) #55

Well now I’m worried. I was hoping to find something I can implement to fix it. I mean my minor carb creep couldn’t possibly be doing that much damage.

(Diana) #56

My numbers are now worrisome.

(Robin) #57

My numbers were 48 and 64. My doc said those aren’t in the scary zone. So he’s not concerned yet. There are several factors that could have impacted my numbers, invasive surgery, new drugs, anesthesia. All of those were in play for me.
He wants me to wait 2 months and test again.

If they are still that high then he will order a sonogram.

If you don’t have any other concerns, and if your doc isn’t freaking out, I would wait a month and retest.
But if you simply can’t stop worrying, ask for a sonogram now.

(Bob M) #58

Personally, I wouldn’t stress and just retest in a while. The tests are relatively reasonable, and you can pay yourself. You can get a test for $10 here:

(Diana) #59

Oh 100% planning to retest. Trying to figure out what could be the cause and if I need to change anything I’m eating….and giving enough time before the retest