Trying Keto Again, some tips please?

(Dan) #1

Hi All,
Just looking for some advice on how to make my second run at Keto more successful than my initial attempt. In March of 2018 I started the Keto diet and felt fine and lost about 8lbs in the first few days. At about day 5-6 I started getting the keto-flu symptoms and made some bone broth to try and combat. I can deal with the Keto- flu, but the issues which were disconcerting was that of systemic inflammation. As a person whom is highly active with running, lifting, biking, boxing etc we grow intimately familiar with our bodies. The type of inflammation I was experiencing was very rare and new. My right ankle started feeling tender after a run, and it never has before. My left knee also started to grow inflamed and I can’t articulate it well but it’s not a soreness, it felt almost like “gout” or an infection does where it’s warm and red and tender to the touch. A weird sensation. Next my right wrist started to get inflamed I noticed after doing pushups, and my right elbow and then my shoulder. So again, lots of joints affected and no change in my exercise regiments, basically everything was kept equal except the keto diet naturally.
All of this inflammation process forced me to abandon keto after I did a lot of research of why this stuff was happening. I’m not okay with becoming sedentary as a result of a diet. Evidently the higher purine consumption unmitigated by the lack of potassium, sodium, magnesium etc is responsible for the joint pain, higher uric acid which crystalizes in the joints or whatever.
Excuse the long-winded background please, but I want to try eating keto again and preemptively addressing the electrolyte issues to ensure I don’t have a repeat of the symptoms. My joints were tender for several weeks following cessation, but are all back to baseline now and pain-free.
I know anecdotally keto is said to reduce inflammation but clearly not for me. How might I embark on this eating program again and what I should specifically take to ensure there is no inflammation? Supplements, concoct my own beverage, etc?

Thanks in advance for your comments, I appreciate your time.

(Katie the Quiche Scoffing Stick Ninja ) #2

A lot of us here made Ketoaide. I did not experience any type of flu or muscle soreness whilst consuming this drink.

Hope this helps.

(karen) #3

When you tried keto last time did you add / increase things to your diet that you didn’t normally eat before? Maybe a food that is known to trigger gout or arthritis? According to the arthritis foundation red meat, organ meat, bacon :frowning: and shellfish can be triggers.

(Dan) #4

An increase in eggs and meat. But not a significant increase I don’t think. Nothing new was added. Just more of whatever I was consuming.

(Dan) #5

Thanks for the tip, I will look into making this for my next attempt.

(Bacon is a many-splendoured thing) #6

Another thought: go easy on the exercise until you are fat-adapted (usually takes 6-8 weeks). You are make a major change by trying to get your body to metabolize fat and ketone bodies in place of glucose. Give things a chance to settle before stressing your body in a second way. The good news is that once you are fat-adapted, you will most likely see an increase in your endurance.

(Dan) #7

It’s not exercise which prompted the symptoms though, it was just the keto. I can’t not exercise for that extended duration regardless, provided I’m not injured. I would rather die.

#8

I will echo @PaulL – suggest you lighten up on your exercise duration and intensity during your adaptation. He did not suggest you “not exercise”, just “go easy”. Also, I’d read The Art and Science of Low Carbohydrate Performance by Vokek and Phinney for specific advice on how to accomplish exactly what you are trying to do.

It was likely the exercise in conjunction with the keto adaptation that prompted your symptoms. Your athletic performance will be diminished during the adaptation period, which means you will be more susceptible to soreness and injury if you do not reduce intensity and duration.

Once you’re adapted, you will enjoy the benefit of bonk-free endurance. Just like it’s worth slowing down to recover from an injury, I think it’s worth slowing down to get through the adaptation. But, if you can’t, it’s very likely you will fail in your second attempt at Keto.

(Dan) #9

Thank you for the thoughtful response. I will look into the read. What was most disconcerting is the type of inflammation versus that there was inflammation. Like we all have those joints which can become problematic with overuse, etc. Things like my wrist and elbows and ankle flaring up, things which were never on the radar before. That’s bothersome. I think it’s all connected to the uric acid.

#10

@dannypage – I had totally forgotten about increased uric acid and gout – I did not experience it myself, but your post jogged my memory. You may have already seen this article by Phinney and Volek that speaks directly to this phenomenon during keto adaptation.

They found that uric acid levels more than doubled in the first week of ketosis, and did not return to normal until 8 weeks into adaptation. In the article, they discuss possible mechanisms. I’m thinking that if this what was contributing to your joint soreness, then the exercise probably wasn’t the driver I thought it was.

(Dan) #11

I think you’re right. Is it foolhardy to assume I can mitigate the potential inflammation with electrolytes?

(Dan) #12

Thanks for the article, a good read.

#13

@dannypage – I think the answer is, “whatever you do to prevent / mitigate gout - do that.”

Turns out, uric acid and gout are not addressed in their Performace book, but rather on in The Art and Science of Low Carbohydrate Living on pages 166 - 167. They describe the mechanism that drives serum uric acid level spikes and that it occurs both when entering and exiting ketosis (!) such that people who are predisposed to gout are cautioned to avoid cycling in and out of ketosis.

I just googled how one might treat gout, and I only have one thing to say - “ouch”. Gout is now officially on my Anti-Bucket List. I don’t know if minerals will make a difference, but perhaps sodium will help by increasing hydration.

(Bacon is a many-splendoured thing) #14

@dannypage Please have patience with your body while it readjusts to ketosis. Trust me on this, you really don’t want to cause yourself long-term problems when easing up over the short term could have prevented them. There is an enormous amount of collective experience on these forums, and we want you to do well. We are not trying to thwart you.

I don’t think you can control your uric acid level with electrolytes, and nutritional ketosis will eventually mitigate the problem. People in ketosis experience many benefits, including the “bonk-free endurance” Dave mentions. Isn’t it worth easing up just a tad now, for the sake of being able to resume and exceed your expectations later? There are people on these forums achieving amazing things in their exercise routines, but they had to get fat-adapted first, before these things became possible. In the meantime, just keep calm and keto on. God bless.

(Doug) #15

Gout since the year 2000. Yeah, amazing how painful a joint can be. Do think that keto and its’ giving the liver and kidneys a rest, in the long run, is quite valuable, despite the transient fluctuations in blood uric acid level.

(Dan) #16

Thank you for addressing my issues. Sounds like the collective word is that I cannot really do anything about the gout-symptoms and just have to deal with it. So on average what are people finding the time-frame to be until they can resume normal activity? Part of my issue is that I use exercise for mental welfare, I.e. it is my anti-deppresant when I should inarguably be on conventional medications. So I don’t say I need exercise to embellish, I need it to not drive myself crazy. Are you submitting that if I don’t do any exercise for several weeks the symptoms will alleviate? What if being in ketosis does the opposite and the gout symptoms persist even with a traditional non-keto diet?

(Dan) #17

So are you in chronic pain or are you expressing keto has alleviated your gout symptoms? Did gout come on during an altered eating regiment like keto, or just something which was predisposed and started progressively for you? Outside of keto eating, I have no gout symptoms thank goodness.

(Doug) #18

Dan, all good here. Keto has never given me a gout attack. I think fasting has come close (I could feel a big toe ‘getting there…’), but only a couple times among 20 or so fasts of 3 days or more.

My gout is a “plain vanilla” case, I think. No genetic predispostion to it, just a huge number of days of drinking a lot of alcohol (which leads to the body excreting less uric acid) and eating serious quantities of foods containing purines - the digestion of which leads to higher uric acid production.

Aside from diet, I take one little pill per day, Allopurinol, and that makes me excrete more uric acid and all is well - been that way for 18 years. And I still booze and eat big steaks, despite having gout and being convinced of the benefits of low-carb eating. I really do not have severe gout attacks anymore, no matter what.

Being more-or-less keto and fasting once in a while is beneficial for our livers and kidneys - my opinion but also backed up by science, especially when one is already compromised by eating too many carbs over time. I can only think that in the end it will help with gout.