Need help understanding Keto 60 days in, low BS, high insulin -Help

(LAURA) #1

Hey all,

Been keto since 28 June 19. Start insulin 20 (way to freaking high). Not diabetic, insulin-resistant. My blood sugars are fine, fasting under 90. However, after losing 30 pounds and being keto for 2 months, my insulin has gone up to 22? I’ve been doing 18/6 IF for the last 2 months. I haven’t cheated, I use CM to track my macros, I’m under 20 carbs per day and yet my insulin keeps going up. I’m confused. I thought IF was supposed to help reduce the insulin load, but it’s making mine worse. What gives? Any support is appreciated.

(Bacon is a many-splendoured thing) #2

Welcome to the forums!

Fasting insulin is variable, but your report is a bit surprising. What is the normal range, as shown on the lab report? (Sometimes it varies from lab to lab, depending on their procedures—and in any case, I have no idea what it should look like!)

Did they do a fasting glucose at the same time? Do you have a home meter for glucose/and or ketones?

Having a low insulin/glucagon ratio is a good thing, even if the absolute levels are fairly high. However, I don’t imagine your doctor asked for a glucagon test. So if your ketone numbers have been good, then it’s likely your glucagon was also up, to offset the extra insulin, and there would be nothing to worry about in that case, because the ratio is more important than the absolute values. If your ketone numbers don’t look good, on the other hand, then you probably want to look more closely into what’s going on. If you’d like, you could post what food you’re eating, and we could look for hidden carbs and such.

Knowing your HbA1C would also be helpful.

Lastly, with lipid numbers, it often happens that things don’t settle down until people have been keto for six months or so. I’m wondering if that might not also apply with insulin.

(LAURA) #3

Thank you PaulL for the kind words. From what I understand, my numbers should be between 5-7 for healthy insulin levels. My doctor was super surprised as well that my insulin levels were so high, especially since I’ve been losing weight and under 20 carbs a day. According to the tests, normal is 2.6-24.9 ulu/ml and I’m coming in a 20/22 I’ve been consistently in nutritional ketosis for the last 2 months, never dipping below .5 and not going over 3.0. So, I am able to achieve ketosis daily. It doesn’t look like he checked my A1C this time because he says that’s just an average of blood sugars over the last 90 days and my BS have been fine. My fasting BS is 91. The last time I tested in April, prior to keto, my A1C was 5.6.

But, my insulin keeps going up/staying high. I know I need to give it more time, but now he has me doing IF for 20/4… and that’s hard while raising 3 kids!! It just doesn’t make sense that my BS are good but my insulin is high. I’m not sure how the science works on this, but I assume they work off each other.

(Cancer Fighting Ketovore :)) #4

I have been doing keto for a little over a year, so my numbers will be very different.
Here’s what my last fasting insulin was, with the reference range:

image

And I assume that you were at least 8 hours water fasted when you did the blood work for insulin.
Also, what time of day are you testing? That could effect things. As far as being in ketosis, I assume those numbers to be with a blood tester, correct?

If the IF isn’t working for you, then maybe you can try something else?

(Marianne) #5

Welcome.

I’d be interested to see that as well. If you have lost 30 lbs. in two months, keeping your carbs low, you must be doing something right. Are you getting enough calories?

(LAURA) #6

Yes, I was fasting. No food/water for over 12 hours. 60 days of strict keto and my insulin was still 20+. My test was first thing in the morning.

Ketosis are Keto Mojo blood tests.

IF doesn’t seem to be working but my doctor wants me to push to go dinner to dinner fasting. It’s no way to live that’s for sure.

(Cancer Fighting Ketovore :)) #7

Maybe try having your next test a different time of day?
I’ve heard that fasting insulin can be extremely variable.

(LAURA) #8

Eating one meal a day, no, I’m not getting enough calories. I try, but it’s hard to get them and keep my carbs down. I’m 20 total carbs, including veggies, so I’m not getting a whole lot of veggies. Mostly meat and fat. If my doc let me do net carbs, I would think I could get more veggies in I’m not sure how to with 20 total carbs.

(Cancer Fighting Ketovore :)) #9

Why won’t he let you do net carb?
I’ve found that a cup of heavy cream (or even a half cup) can give 6 (or 3) grams of carbs, depending on the brand and 80 (or 40) grams of fat. That’s what I use with some MCT powder to keep my fat up, and I do one meal (dinner) and can usually hit under 20 neg grams (I personally choose to ignore the carbs from the cream).

(Marianne) #10

One thing, sounds like you have a great doctor who is educated about this WOE and who is partnering with you in your health journey. Most other docs would severely chastise us for eating so recklessly and “causing” this.

I am at a loss, although what Paul said made sense. I would encourage you to keep doing what you are doing until you get to a point where you can sustain OMAD -comfortably. I think it’s important to find what we can live with long term. If you’re not there yet, don’t do it. Are you eating clean food?

Again, I am not an expert but just throwing out possible scenarios. Maybe if you give it a little more time and consistency and after you know you become fat adapted, you will see a marked decline in your glucose.

I hope so, and I hope you don’t get discouraged; please keep us posted.

(Bacon is a many-splendoured thing) #11

So your insulin is high, but still in the normal range. It’s understandable that your physician is concerned. It certainly bears watching. If you are staying in the blood ketone range that you posted, then it would seem that your glucagon must also be high, for you to be doing that well in ketosis.

And I beg to correct your doctor. Your HbA1C functions as a three-month average of your serum glucose, but that’s because the average lifespan of your red blood cells is 90 days. What it really measures, however, is how glycated your haemoglobin is, and that is useful to know, regardless of your glucose levels. Yours was borderline pre-diabetic at last measurement, and I would guess that it’s come down a bit, but is still not great. Once you’ve been eating ketogenically for six months, however, I would expect it to be a really good number, unless you are severely insulin-resistant.

Do you have any recent measures of your inflammatory markers (white blood cell count, CRP, ferritin)? This would tend to tell something about your degree of insulin resistance, which I am guessing is still fairly high, hence the high fasting insulin. Your glucose is so nice, because your insulin is pushing it down. But it’s taking a lot of insulin to do so, is my guess.

Tell your doctor to stop bugging you, until you’ve been ketogenic for another four months, at which time he should retest, and get all the numbers I’ve mentioned. It’s far too soon to be making course corrections yet. If your insulin resistance fully resolved, you would see it from really nice inflammatory markers, HbA1C at 5.0 or below, a lower fasting insulin, and glucose levels below 90. Note that after fat-adaptation, glucose tends to rise somewhat, while HbA1C stays low. This is normal and not a problem.

You can tell your doctor from me that he shouldn’t be obsessing about transient variations in your blood work, and that if he really wants to know how insulin-resistant you are, he should order an oral glucose tolerance test (OGTT). (Be sure to tell him I was smiling as I wrote that.) :grin: And no, I’m not a doctor, but I’ve learned a fair amount from hanging around with smart people.

No, and you probably shouldn’t be attempting one meal a day, this early on. Once you find yourself skipping meals because you’re not hungry, or especially if you keep forgetting to eat (“accidental fasting”), then it’s time to think about fasting on purpose. Till then, listen to your body.

P.S.–It’s great that your doctor wants you in ketosis and fasting, but listen to your body. Too much too soon is counter-productive. Tell him that for me, too!

(LAURA) #12

Thank you for the support. I guess I need to just give it more time and just keep working “the program.” I know this is a way of eat, that I will have to do for life. I was just pretty upset that my numbers went from 20 to 22 vs going down after 60+ days of this way of eating. I know all my numbers are high and that is why I’m trying so hard. I have a heart test tomorrow to see what kind of damage the high insulin has caused. I didn’t have any issues until I had my 3d child 13 years ago and then my whole system went whacky. So, I suspect I will be told I have heart disease too tomorrow. What’s crazy, if I’ve eaten well my whole life. I’m not a junk food person. I love veggies, fruits, meats, fish etc. I have never been into sugar or a carbaholic. So, when I started gaining weight after my 3rd child, it really kicked my butt and now, well, now, I have to face it head on and get these numbers down. I have to admit, I’m scared for the test tomorrow, but I know I need to see how bad my heart looks.

(Marianne) #13

Maybe not so much!

:thinking:

Well, at least you’ve found a great place to get guidance and encouragement.

(Marianne) #14

Good luck; I hope you are pleasantly surprised.

(LAURA) #15

Actually, my doctor is SUPER supportive. He’s the one who told me Keto was the way to go. He just wants me to do hardcore IF so that I can see results. He was just as shocked as I was that the numbers went up. He said it can happen in some people, and that is why he wants me to go longer without eating. He has put some feelers out to other “keto friendly” doctors to find out what can be done when someone doesn’t respond to 18/6 and Keto…

(Bob M) #16

I wouldn’t get too excited about those values. Here are my insulin values:

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I’ve heard some people say that if they had one blood test, fasting insulin would be it, but based on my results, fasting insulin is pretty useless. My fasting insulin went up while my HbA1c went down?

As you can see, I’ve fasted quite a bit. I’ve fasted at least 4.5 days many times, 3+ days many times, usually two meals a day, fast 36+ hours at least once a week now, etc. My fasting insulin is still somewhat “high”. Fasting insulin is just one marker. Don’t get freaked out about it.

The 1/20/18 test was an OGTT with insulin.

(LAURA) #17

Still, your insulin numbers are really low compared to mine. But you’ve always been doing it a lot longer than me. You all have offered so much support and I feel less freaked out. I just don’t understand how my daily blood sugars are low but my insulin is high when I am not eating but less than 20 total carbs a day. I guess it just takes time for insulin issues to go away.

So that brings me to my next question, carbs vs net carbs. What gives? Lol

(Susan) #18

Basic Keto is:

20 grams or less of net carbs a day, NO Sugar, try to eliminate sugar substitutes as well if you can as they can cause insulin spikes, stalls, and other issues, adequate proteins, healthy fats, get enough calories, enough water and adequate Electrolytes/salt =).

Keto is very basic and if you follow those basics, you will be doing great =).

(LAURA) #19

You say 20 net carbs but my doc said there truly is no such thing as “net carbs” and to count total carbs. I guess he went to Ketocon and spoke with a Dr. Fung or someone, and he told my doctor not to do net carbs. So I get really confused. I do put a bit of Stevia in my coffee. I checked, it didn’t make my blood sugar go up, so I’m not sure if I have an insulin response to artificial sweeteners or not. So much to learn!

(Susan) #20

Many of us try to go as low carb as possible, and focus more on proteins, fats, getting the carbs we do eat from above ground veggies, because they are lower in carbs =). You seem to be on track with your losing weight though =). So best wishes with the rest of your journey and don’t worry too much.

I Mentioned the sugar substitutes as an issue why your sugar might be going up, because others have mentioned it does for them is all.