The Levers of Power (What to Measure, What to Control) to avoid stalling/stalls

(Kirk Wolak) #61

Yes, I am openly admitting to a pathology here. It happens. And for my doctor, the proof was that I ended up with tachycardia as my body panicked while my glucose dropped because my brain was literally refusing to use the available ketones. (Now, we don’t know to what degree. I can function “normally” in some regards on ketones. But NOT with low serum glucose levels).

So, it IS a pathological case. And one that I was NOT AWARE of until we teased it out.

My next tests will involve PSMF approach to see if “any” fresh calories help the symptoms, or if it is literally requiring a certain Serum Glucose. I need a decent “Mental Test”. An average speed at sudoku, or the like…

Also, Michael, there are some brain functions that might REQUIRE glucose (ie, cannot be done with ketones). I remember Bret Scher or someone mentioning this, and saying “it’s a really small amount”… But it clearly implied 100% ketone utilization was not truly an option…

(Butter Withaspoon) #62

Not to mention that there will always be a blood glucose level, zero blood glucose is consistent with death. There are other cells that can ONLY use glucose (red blood cells for example).

There are a few studies and case reports now where giving ketones to people with dementia has a large effect of increased brain function almost immediately, so this suggests that the average person retains the ability to utilise ketones in the brain.

Adapting to lower glucose intake for someone cutting carbs is a roller coaster of blood glucose going too high, plummeting down low, ketones are probably going up and down too. It’s a bit of an uncomfortable mess until you get smooth glycemic control- then nothing feels better than this

(Bacon is a many-splendoured thing) #63

The estimate for how much glucose the brain needs comes from the work of George Cahill on fasting, published in Starvation in Man in the 1960’s and considered definitive. Yet Benjamin Bikman has questioned whether the brain needs any glucose whatsoever. So apparently there is some question about the issue. If Bikman is right, then 100% ketone utilisation ought to be an option, but at the moment, the standard thinking sides with Cahill.

What we do know for sure is that the brain can utilise both glucose and ketones, that it needs insulin in order to be able to absorb glucose to metabolise, and that ketone metabolism can still function even when the brain’s glucose metabolism is damaged, which is why patients in the early stages of Alzheimer’s disease can show a distinct improvement when put on a ketogenic diet. (Researchers into Alzheimer’s disease are now calling it Type III diabetes, because it appears to be basically a condition of insulin-resistance of the brain.)

(Ivy) #64