Low ketones, diabetes, carnivore. low omega-3 - no progress?

#1

I’ve been 98% carnivore for over a year, trying to manage diabetes with diet and exercise. I test my blood sugar and ketones every day, as well as weigh myself. I am about 40-50 pounds overweight, 65 years old, female. Diabetes runs rampant in my family, and I know that even a few carbs will shoot my blood sugar up. Blood sugar runs from 104-146, mostly in the teens and low twenties, but I do have some good days under 100, but not nearly enough. My A1C is a teensy bit high, but not enough that my doctor is pushing meds hard (and she knows I don’t want to take them). Ketones are usually .2 to .7, with occasional days over 1.0. Given that I hardly eat any carbs, I don’t understand why those numbers aren’t higher. Cholesterol numbers are through the roof, but triglycerides are well under 100 - like 77 on my last test. I’m not nearly as concerned about the cholesterol as I am about the blood sugar.

I exercise 5-7 times a week, walking 2 miles on my treadmill. Sometimes I have problems with that, because I have a herniated disc injury and a back surgery to fuse those lumbar vertebrae. The main thing the surgery did was to leave me with nearly constant back pain, low level on good days. Some days are worse than others, and even on good days I push up on the side rails of my treadmill to stretch out the back while I’m walking. I also have an issue with low level migraines, and those sometimes get in the way. I do notice that on days where I don’t exercise, the blood sugar numbers are generally higher. Also with a bad sleep night, which happens more often than I’d like.

I eat when I’m hungry, my first meal usually around 1:00 or 2:00, and my last meal before 6:30. I do have coffee with cream in the morning, because it helps to manage the headaches. I didn’t use to drink coffee, but my doctor told me after I had those 4 thunderclap headaches in one day - and then had those months of follow-up migraines- that caffeine would be my best friend. And the coffee helps keep the headaches down.

I recently paid Function for a full blood panel. Everything is fine, except for the slightly high insulin markers, and low omega-3 levels. I’m also showing signs of low-level inflammation, which I assume is from the back. That was the first time that I’d heard about the low O-3s. The clinicians review said that the low levels could have an impact on inflammation, among other things.

I guess I’m going to eat more sardines (not a big fan, but okay). I have also started an omega-3 supplement.

My question: Why can’t I budge my weight? I know that if I lost some pounds, the sugar would regulate better. Could the low omega-3 levels be a part of the problem? I know to expect plateaus, but holy cow, this has been well over a year…

UPDATE: including info from my summary –
You have a mix of positive results and areas to work on. Your results show clear signals of heart risks with high cholesterol measures. Although your metabolic markers are mostly within a healthy range, a slightly elevated insulin level suggests that your body is working harder to manage blood sugar. Your immune markers indicate low-level inflammation and a lower white blood cell count (WBC), along with low Omega-3 levels that support cell health and brain function. …
Your heart findings are a top priority, with increased cholesterol and inflammation that can affect your arteries. While your Type 2 Diabetes is well controlled, the slightly high insulin level hints at the need for tighter blood sugar control to better optimize your metabolic health. The immune and nutrient results suggest low-level inflammation and indicate that increasing your Omega-3 intake may help reduce inflammation and support overall well-being. Additionally, while your stress-related hormones are balanced, your blood counts show a higher-than-expected red blood cell count and slightly lower hemoglobin levels, which may affect oxygen delivery.
Your blood test shows that your red blood cell (RBC) count and hematocrit are somewhat higher than the typical range. This may indicate an increased concentration of red blood cells, … Meanwhile, your mean corpuscular hemoglobin concentration (MCHC) is slightly below the reference range, suggesting that your red blood cells might have a lower concentration of hemoglobin,…
Your high high-sensitivity C-reactive protein (hs-CRP) level of 1.4 mg/L suggests low-level inflammation that may gradually increase the risk of arterial damage. Your apolipoprotein B (ApoB) level of 161 mg/dL indicates an increased number of cholesterol-carrying particles that can contribute to plaque buildup in your arteries. A total cholesterol level of 332 mg/dL is significantly high, meaning that an excess of cholesterol is circulating, which can promote hardening and narrowing of the arteries. The calculated low-density lipoprotein cholesterol (LDL-C) at 234 mg/dL, often referred to as “bad” cholesterol, is elevated and may contribute to cholesterol deposition in artery walls.

A total cholesterol to high-density lipoprotein (HDL) ratio of 4.2 is above optimal levels, suggesting that the protective effects of HDL might be insufficient. The non-high-density lipoprotein cholesterol (non-HDL) value of 252 mg/dL further indicates that a substantial amount of harmful cholesterol is present. An LDL particle number of 2409 nmol/L shows that you have an excessive number of cholesterol-carrying particles, which is an important risk indicator beyond standard cholesterol measurements. Elevated small LDL particles of 273 nmol/L are concerning because their size allows them to more easily penetrate arterial walls, and the higher level of medium LDL particles at 392 nmol/L adds to this risk. Additionally, an HDL large particle count of 6363 nmol/L is lower than recommended, indicating that there are fewer protective particles available to help remove cholesterol from your arteries.

These findings point to a combination of low-level inflammation and an excess of harmful cholesterol particles, factors associated with an increased risk for cardiovascular issues…

(Bob M) #2

You know, omega 3s are kinda an unknown for keto folks. All the studies done on them are for high carb folks.

Do you know which markers of inflammation were higher?

Poor sleep will raise blood sugar, as it messes with a lot including cortisone.

I also have low ketones, and have had them for years. Some people can increase ketones by eating higher fat and lower protein, though I can’t say that’s true

#3

What an excellent amount of information to comment on. It may take a few attempts to cover the whole of it and tie it up in a bow. But there are areas for consideration in the first quick read through.

The best part is that you are obviously intelligent and well versed in low carb.

My first note is the exercising almost everyday. I’m getting the gist that you have the dietary factors mostly dialled in, > 80% compliance. The exercise part may be a factor at maintaining stress hormones that stimulate prolonged elevated blood glucose and a consequential insulin response. Adapting to a physical activity routine that incorporates days of recovery, rest and relaxation will mitigate the stress hormone response. Keep being physically active, absolutely, but tweak it to 3 times per week, or some schedule that suits you.

There are more things to consider in your report. But that one grabbed my attention to start.

I think people will advise the director feedback tool of a Continuous Glucose Monitor (CGM) in working out what works best for you. You may have mentioned it, as I only had an overview read scan. But a CGM will signal your interstitial glucose response to physical activity, foods, and rest.

#4

Dialing back the days is something worth trying. I do notice that my blood sugar is higher the day after I fail to do cardio. Maybe I’ll try fasting those days I’m not exercising, but I’m already OMAD some days. Maybe do 1 mile instead of 2, or break the two miles into smaller pieces, reducing the stress on the back (and my general system). Thanks for the suggestion, I’ll see if that helps.

#5

Weight loss is an ok goal but body fat loss is the real aim.

Back to basics is a low insulin level is required to stop storing blood glucose as fat, and start using stored fat as fuel. The signal for low insulin is ketone production.

If the low carb diet is dialled in well, then other areas of lifestyle need attention to lower insulin and blood glucose to start losing body fat, in particular inflammation- producing deep body fat around internal organs ( search visceral fat, or ‘how to get rid of visceral fat.’ ).

If you are so close to being full carnivore, then try to go full carnivore for 5 days. If that can be done OMAD or 2MAD with a good balance of animal fat (e.g. butter), then the blood glucose should drop markedly and insulin with it, while correspondingly measurable ketones rise.

Take a face photo before starting that experiment, and then another face photo at the end of day 5. Also take photos of your hands and feet with unpainted nails to note any changes.

Add in 8hrs sleep per night with the aim of 1 hr deep sleep (glymphatic health), 4h 30m core (resting), at least 1h 30m REM (dreaming, fat loss and memory consolidation). I know that only adds up to 7hrs but the aim is to exceed those targets, especially core and REM sleep. Those things are measurable on an Applewatch, or Aura ring, and probably other wearable monitors.

(Bean) #6

Are you taking any antihistamines? Also, keep an eye on the dairy. It can be inflammatory for some.

#7

No medications - I try to avoid them. I am taking the occasional methylated multi-vitamin, Vitamin D3 on days where I don’t get outside, magnesium (leg cramps and general health), and now omega-3 supplements.

#8

Getting a good night’s sleep has been a problem for my whole life, for as long as I can remember. I do have some muscle relaxants, left over from my surgery. On bad days, I take half of one at bedtime and it helps. If I take a full one I’m groggy for half the next day. I try not to take meds, because I don’t want to become dependent on them, but maybe I’ll try the half pills for a few days in a row and see what happens. I’ll just have to adjust to groggy(er) morning wake-ups. I’m not a morning person. My hubby could tell you all about that. :wink:

(B Creighton) #9

I am not carnivore and don’r promote it. Your very elevated cholesterol is why. With your somewhat high blood sugar, I believe that to be a long term risk factor. Some people, esp lean mass hyper-responders need some carbs to clear cholesterol out of the system - just once per day would be enough. You can do things to promote higher ketones. I use a salad dressing with MCT oil, balsamic vinegar and herbs. I also have goat yogurt every morning which may give me about a half ounce of MCTs. I find it gives me good energy. Those MCT fats will go straight to ketones.

Do whatever you can to wean yourself off of coffee. The caffeine keeps your cortisol higher, which interferes with fat loss by keeping your body more in “fight or flight mode.” Try taking a brisk walk for about an hour in the morning if you can.