Low mood and brain fog in a fasted strength training context

#1

Hello everyone,

A keto friend of mine (woman, 30s, 160lbs, mostly OMAD) has recently started working out again about 4 times a week. Not new to working out.

Twice a week she does interval training consisting of 30sec jumprope and 30sec bodyweight/strength exercises over the course of 1hr

The other two days a week, she does moderate strength training for 1hr. Not really heavy weight but usually lifts until failure.

On all four days, she works out in the morning fasted.

On the days she does strength training she notices considerable brain fog and low mood that gets worse as the day goes on. This does not happen on the days she does the interval training.

She consumes relatively equal amounts of electrolytes, calories and nutrients on all four days.

Any explanation for this brain fog or low mood on fasted strength training days? Is she using up all her glycogen stores during lifting which reduces what’s available for the brain (although from my understanding, the brain is usually given priority for glucose use)? Will it be better for her to do the strength training later in the evening after she has had her OMAD?

Thanks,

Mo

#2

Better yet, stop doing OMAD. Can’t work out right on an empty tank. You’re not going to mobilize fat fast enough to keep everything running. If she’s eating keto (assuming so?) she has little glycogen stores to being with so it wont take make to deplete them all especially doing what she’s doing. Lifting until failure is lifting to failure, I don’t care whats on the bar at that point.

She’s doing high intensity circuit training one day, lifting to failure the next. She needs to start fueling herself properly for her goals. We also have no idea what she’s actually eating on that one meal, very difficult to get everything you need at one sitting from both a caloric, macro and micronutrient standpoint.

(You've tried everything else; why not try bacon?) #3

How long has this woman been eating a ketogenic diet? Glycogen levels eventually return to normal in keto-adapted athletes, certainly by the two-year point, as Volek’s team recently showed.

Furthermore, Cahill demonstrated, by using a hyperinsulinaemic eugylcaemic clamp on his fasting research subjects, that ketones could feed the brain just fine in the absence of glucose. He drove his subject’s serum glucose down to levels that would normally cause coma or death, and they were fine.

Cahill’s estimate that the brain requires a minimum 150 g of glucose a day has been taken as Gospel since, but it has recently been challenged by Bikman, who asserts that the brain’s need for any glucose at all (given ketones of sufficient quantity) has never actually been demonstrated.

I suspect that your friend may have a condition that needs to be investigated.

(Michael - When reality fails to meet expectations, the problem is not reality.) #4

I agree with @lfod14. Running on empty doesn’t cut the mustard. There’s a limit to how much onboard stored energy one can access. Try to exceed that limit and you run out of gas.

#5

Thanks - good points. I think she is eating circa 1600 - 1800 calories a day. According to her, she has no issues with the interval training - she feels great doing that. It’s just on the days she does the lifting that things get a bit foggy, has difficulty concentrating and notices her mood dips considerably.

She is keto too, limits carbs to 20g and her protein varies but she says she goes as high as 120-150g most days. I have done weight lifting on keto/OMAD in the past with no issues so wasn’t sure how to advice her.

I’ll tell her to maybe try increasing her eating window like you suggest to see if that works.

#6

Thanks Paul

I was referencing the findings in the below video by Dr Nadir (around 17:00) regarding brain using ketones but only up to 60% of total energy needs for the brain. It seems like for the remaining 40%+ the brain seemingly prioritizes any available glucose for itself. So perhaps after the weight lifting, there isn’t even enough glycogen for the 40% needed for the brain? If so, what would fix that in a keto context? More protein?

https://youtu.be/jU50PyuJVOI

She does do her bloods regularly and her blood sugar is low but kinda expected for keto. By the way, she is about 2 years into the ketogenic lifestyle.

However, perhaps she has something new going on so will tell her to try to move up her tests.

#7

Who knows, maybe she is not eating as much as she thinks she is? Will also ask her to try properly tracking intake for a few days - thanks.

#8

I’d also work on the total calories! 1600-1800 for somebody working out that much? My 7yo literally eats more than that!

#9

@lfod14

She may need to. Her BMR is supposedly circa 1700 at a sedentary activity level.

She used to eat more than that but actually gained weight. She said the choice was either to increase her deficit or just increase her activity and she chose exercising. She also increased her protein and reduced fat intake a bit.

She is seeing results doing that just this issue on lifting days. Again, she is fine on interval training days but perhaps that’s because ketones are the main source of energy for that type of exercise?

It’s been a bit hard for her to consider eating more since she gained weight doing that previously but given that she is now working out again, that won’t happen and may be the solution to the issue.

#10

I’d choose that over more of a deficit as well, but that’s just a band-aid, if her RMR is that low she needs to work on that but also reverse dieting to get her metabolism up, not just crunching it by creating an exercised induced deficit. That will never fix the issue, only hold her where she is indefinitely.

I say this as somebody who had his metabolism right there as well, that was as a at the time 250lbs, lifting heavy 5-6 days a week and cardio most of those days. You do gain a little doing it, but it’s a must. Also needs to dump all high intensity cardio, that only makes it worse. I recently just got a DEXA scan and RMR test and came in at 220lbs, 11%BF with an RMR/TDEE set at sedentary in the 3400’s now! So while it sucks gaining here and there from doing it and finding your limits, more muscle, less fat and a higher metabolic rate in the end makes it very worth it. Far cry from when I gained fat eating the “normal” 2000 cals/day.

Good move, that helped me a lot!

Send her this if you think she won’t start eating more… worked for my wife and sister in law :grinning:

#11

Thank you. I have sent her the video.

She does want to do the reverse metabolism program but once she reaches a lower weight.

I think if the case was that she was stalled and not losing weight, she probably would give that more immediate consideration.

However, she is losing weight and feels great on days she does interval training. She just wants to solve the low mood and brain fog on lifting days. She is not even fatigued physically, it’s just those two symptoms.

She also seems to be struggling to understand how increasing protein/fat will help her solve the issue of brain fog and low mood on lifting days. Assuming the brain fog and low mood are resulting from depleted glycogen for the brain, will the extra fat or protein (since she isn’t increasing carbs above 20g) result in more glycogen to fuel the lifting?

For now, her working theory is that maybe 24 hours is just not enough time for her to replenish her glycogen levels, especially since she is OMAD eating sub 20g carbs. It doesn’t help that she also spends 8 hours a day doing work that is mentally tasking.

She is now leaving 2 days between workouts which means working out 3 days a week and I guess we will see if that works.

I actually want to try the reverse metabolism myself a increasing my RMR can only be a good thing - so will be watching. Thanks.

(Michael - When reality fails to meet expectations, the problem is not reality.) #12



Discussion:

#13

Protein will help her recovery and ability to build muscle, fat will help hormones and possibly the brain fog. When it comes to muscle glycogen only the carbs are gonna help that. People claim long term keto’r’s have the same amount of muscle glycogen… I call BS on that crap! You can fake (in a dudes case) you’re arms being an inch bigger after a hard workout with carbs in the system vs not. Doesn’t take scince for that, unless you consider eyesight or a tape measure science.

That’s why I went with a TKD/CKD protocol. I have preworkout carbs to fuel the workout and if there’s spillover it can go to muscle glycogen and once or twice I week I’ll up my carbs to fill up the stores so I can continue to have the performace of glycogen but without consuming enough to make it store as fat. Currently the leanest I’ve been in years, people deny it (I always did) but there’s definitely a metabolic bump as far as calories burned when you’re taking in some carbs. Just gotta be smart about it.

(Edith) #14

Have her listen to this. There is a portion of this podcast discussing how much protein we need in our diet. If she is working out as much as you say, she is definitely not eating enough and keeping herself at one meal a day, she may be sabotaging herself.

#15

Thanks Michael. Just a side question. Assuming there is a presence of adequate/high blood ketone levels, are there other factors that can affect ketone uptake by the brain e.g problems with the blood/brain barrier endothelial cells etc?

#16

Thanks again.

She is recovering ok physically (i.e no terrible fatigue/doms, pain etc) even with working out 4 times a day so she feels she is ok physically on protein. She also has quite a well controlled appetite - no hunger pangs etc so she thinks she is ok on fat.

Carbs may indeed be something she needs to increase and she may well consider that (increasing to 25g) plus maybe a bit more fat if spacing the workouts 2 days apart does not work. That will have a further effect of upping her calories too.

She is having a lifting session Wednesday morning so we will know by Thursday if the spaced out workouts is working or if she needs to try another recommendation in this thread.

Will update on her progress. Thanks.

#17

That is similar to what @lfod14 said as well so I’ll forward this to her too. Thank you.

(Michael - When reality fails to meet expectations, the problem is not reality.) #18

Anything is possible. Your friend may have some undiagnosed pathology that has only become noticeable due to the extra stress imposed by the exercise/fasting routine. Normally, the more ketones available the more ketones the brain will use. For the brain the primary criterion is availability. More available means more ketones get used. I think Ben Bikman talks about this. I might be able to find a video or paper about it.

(You've tried everything else; why not try bacon?) #19

Ketone bodies (acetone, acetoacetate, and β-hydroxybutyrate) cross the blood-brain barrier just fine. As mentioned above, there is some question whether the brain needs any glucose at all, but it is known that the liver is capable of synthesising glucose for those tissues that need it, in the absence of dietary glucose (i.e., carbohydrate). The primary glucose-burning pathway in brain cells requires insulin for proper function, but the ketone-burning pathway is independent of insulin.

Your friend might wish to investigate her electrolyte levels and her hydration on the days when she feels bad. It would also be interesting to know whether ingesting MCT oil or exogenous ketones would be of any help on such days.

(You've tried everything else; why not try bacon?) #20

“Weight” is an ambiguous term. Did your friend gain fat or did she gain muscle and/or bone? Both increase increase the number on the scale, but it is fat that she is trying to lose, surely, not lean tissue.