Trying to get into ketosis WITHOUT losing weight - please help!

(Clare) #1

Please help - I seem to be one of the few people who are attempting to follow a ketogenic diet without needing to lose weight and am struggling to stay in ketosis due to it being imperitive that I maintain enough calories (so no OMAD or fasting for me at the moment, however I only eat fat or meat juices for breakfast and don’t eat a substantial amount of protein until lunchtime). I am wearing a Continuous Keto Monitor at the moment, as well as a CGK to check what is going on. I am eating almost zero carbs (carnivore on a daily basis with a strictly keto meal when eating out with friends in order to look normal!). I cannot eat dairy - not even goat ghee. But despite my glucose being consistently low (4-5 millimole) and eating as much fat as I can (so far I haven’t reached my upper limit for tolerating fat), I can’t stay in ketosis for more than a few hours at a time. It never gets above 1.8 and usually hovers low at between 0.5 - 1 millimoles, and will often flat line for most of the day or most of a night at 0.1, and seems random when it arrives (though it is mostly after midday) and any meal containing enough meat to stop me feeling hungry, seems to put an end to ketosis. I am doing this for Hashimotos and mental health purposes. Depression in my case, but two of my siblings have severe bi-polar, OCD and Asperges, and so I was hoping to role model this to encourage them to do it too.
I started to go low carb in January and went ‘keto’ level low carb by April. I was relying heavily on dairy including butter and cream for the fat and calories. I then removed dairy as an experiment due to advice re Hashimotos triggers. I discovered that dairy was the cause of several physical health conditions which cleared up miraculously within a week and some of the mental health problems (agitation, rage, irritability). However, within a fortnight I had dropped 22 pounds (10 kilos) which seems impossible, but definitely happened. Since then I have been underweight and look like a skeleton with some muscles and ligaments attached. It ain’t pretty! I am desperate to gain weight, but haven’t been able to since April. In April I tested my ketones with urine strips for a month and I was showing definite ketone production, particularly in the afternoons and evening. I then gradually reduced my diet down to carnivore (for allergen/hashimotos triggers reasons) and spent the summer at sea on a boat with no access to any testing, and probably not enough access to calories as we don’t have a fridge on the boat so keeping enough meat can be a problem. (I had to make friends with tinned sardines). I was also dealing with my husband being angry at me for doing this and haranguing me at every meal. Thankfully he is now resigned to it. I have now doubled my meat intake and my fat intake and I think I am now hitting my protein target as recommended for my ‘ideal’ weight. I am usually around 70% fat and am near zero carbs, but find it hard to get enough calories to gain weight. I sometimes add olive oil, avocados and coconut milk/oil for the easy fat boost so am open to non-strict carnivore suggestions.
I am sorry this is a long post, but I needed to write enough for you to understand my situation.

I would welcome any advice on how to trigger and maintain ketosis for sustained periods of time, how to get the ketones higher, and how to get enough calories and nutrients into me to maintain / gain weight.
The good news is that whenever I am in ketosis, I can tell instantly - everything goes bright, my brain fog clears, I suddenly have motivation and can concentrate well and all my joint pain disappears. When I drop out of it, I can also tell instantly - I become heavy, sleepy, confused and unable to start new tasks without massive willpower… So I’d really like to master staying in at least low levels of ketosis for the majority of the time.
Thanks in advance for any advice you can offer me!

(Joey) #2

Welcome to the forum!

I regret that I can’t offer any actionable advice regarding diet tweaks beyond what you’ve already been discovering. This is because your situation is very specific and your body is going to tell you more than any one of us on the web can offer.

The proof of what’s best for you seems to be what you’ve already discovered … clarity of mind, energy levels, mood, etc. These are the markers that are probably most useful. Far more telling than (imperfect) blood monitors and urine strips.

No doubt you have physicians’ guidance involved given your medical conditions. If they are “keto-savvy” they should be of great help.

My only question would be: if your body’s natural tendency is to be super lean, perhaps you need to embrace that reality. And let your overall sense of well-being be the lighthouse for which you aim. Wishing our body types were different than they are is usually a losing battle, anyhow.

Embrace the lean? :vulcan_salute:

(John) #3

I’m with Joey on this and wonder if it’s worth stressing over those low numbers on your monitor; blood meters only show the leftover ketones floating around in your blood, falling right into the “meter trap.” Once you’re fully fat-adapted, your body and brain get so efficient at hoovering up those ketones for fuel that fewer are left lingering in the blood. And, of course, big protein meals can also cause a temporary insulin or glucagon shift that dips ketone production, which is totally normal.

Since you already know how amazing you feel when you’re in ketosis - with your brain fog clearing and joint pain vanishing - perhaps your subjective symptoms are a far more reliable guide than an imperfect gadget.

(Cathy) #4

I hear you saying that you feel best when you have lots of ketones in your system. You are having trouble eating in a way that facilitates that. I would suggest that you eat protein as your main focus and then add in fats as a secondary.

Try that for a few weeks and see if it makes a difference. I would be interested to know how you feel, your weight and then ketone responses.

I don’t know anything about a continuous ketone monitor but would think that like most things in the blood, ketones will fluctuate with many things and just because your meter doesn’t register ketones (or low ketones) doesn’t mean that you are actually out of ketosis. When you describe being out of ketosis, it may be that you not enjoying the high levels but are in fact still in ketosis.

I have been in ketosis for the most part of 17 years and do check blood ketones on occasion and I can say from my own experience, I have rarely exceeded 1.8 and am usually around .5 to 1. This is dependant of all sorts of things like how I slept, what kind of activity I had, what I ate, am I sick, did I take anything like a steroid or other meds that may interfere - and on and on. But getting that ‘high’ from ketones is a thing of the past. I do suffer from chronic depression that is alleviated by ketosis but even that effect has been muted in that I can have some depression but it’s not chronic and well within the norm.

Just really saying that ketones are not going to be linear. They are fluid like most things in human physiology.

(Clare) #5

Dear Joey,

Thank you for your kind words. And yes, I am actually just back to the weight I was at 18. I was very thin then, and got teased/abuse about it. And that was back in the day when all kids were skinny and there’d only be a couple of plumper ones in each class! I guess I was enjoying my middle-aged extra few pounds! So you’re right, maybe this is just me and I need to accept it. Now that I’m home and have access to more food, I am eating more. Since no one I know has heard of keto, let alone carnivore and I’m the trustee of a carbon reduction charity, I’m navigating a line of trying not to be accused of having an eating disorder, and the aggression that follows anyone who bucks the trend and is now eating more meat rather than less! I explain that I’m doing an exclusion diet to work out my Hashimoto triggers. They seem to accept that. Although no one seems to know about ‘autoimmunity’ often being a reaction to leaky gut etc. Anyway, it’s nice to be able to discuss something calmly with you in this forum, without all the overreactions and trolling that happens online. Having now discovered that the ‘bright’ alert feeling correlates with my keto monitor signalling that I’m in ketosis, I’ll be able to trust that feeling in the future.
Thanks!

(Clare) #6

Dear John,
Thank you for your supportive comment. It is useful to know that once fat adapted there are likely to be less ketones floating around to monitor in the blood. I’m still glad I tried this CKM though, as I didn’t know if I was even producing any ketones, so it has confirmed that the diet is having an effect, that I am producing ketones even though I’m having to eat more than people on a keto diet who are living on their own fat while losing weight, and it has confirmed that the bright alert feeling coincides with the ketone spikes. In future I’ll be able to trust that the food choices are likely to be having an effect on ketones and be able to trust my subjective body feedback. I put the CKM and CGM on in front of 2 friends who I’ve been trying to persuade to lower their carbs - they have become very interested and made me eat a piece of cake while I was there so they could see a glucose spike. Now if I get a spike from something, I send them a screenshot and been able to demonstrate the nightime low that can cause people to wake up suddenly, the dawn phenomenon, and the difference between protein rounded hummocks and the sharp carbohydrate spikes. They are subsequently sending me photos of their newly adopted low carb, high protein breakfasts! Meanwhile, my husband has been very anti over the past 9 months, refused to listen to a podcast to explain it, refused to listen to an article, won’t listen to more than a sentence or two about it from me, walks away if one of our friends asks for an explanation, and now suddenly, he’s fascinated by the keto and glucose graphs I’m showing him. He has a physics degree and maths background and he’s been on the computer googling ketones and getting interested from a chemistry perspective. So there have been some wins! I have made sure that he is not directly impacted by making him a separate meal every night exactly how he likes it and I haven’t expected him to change anything himself.
So thank you for your confirmation to me that I don’t need to worry about hitting certain numbers and that I can trust my physiological responses in the future. I think that this experiment has confirmed that I need even more fat than I was already having. At least this keto movement has vindicated me. All my life I have needed to eat high fat to feel even slightly okay and have suffered disaproving comments constantly about the thickness of the butter on my bread, or the instinct that made me eat all the fat on my meat instead of cutting it off like everyone else! I once cut out all fat for lent because social pressure said fat was bad. By the end of lent I felt terrible. Now I know why!

(Clare) #7

Dear Cathy,
Thank you for your helpful answer! I will take your advice about concentrating on proteins as priority.
It is amazing that you have been in ketosis for the best part of 17 years! I have only just found out about this approach for mental (and physical) health. I have never had a problem with insulin resistance, so maybe it’s been a concept more understood in those circles. It is also interesting that you feel that the ‘high’ effect of being in ketosis has worn off a bit. I’m glad you are finding your tendency to depression manageable with this approach.
I have been on anti-depressants for 20 years now. I kept trying to stop them, but 3 months in I’d be getting suicidal thoughts, crying, lack of motivation, and depression. I’d then have to go back on them. After listening to Dr Georgia Ede and Chris Palmer, I became determined to try the keto approach. I recognised that it would help. (Removing gluten and soy had resolved chronic fatigue syndrome in my thirties, so I realised that diet can have a huge influence). I titrated myself off my antidepressants last autumn so that I was already off them before starting the diet in January. It was a rocky road. By March I was pretty much keto and I spent a month testing with urine strips that confirmed high numbers in the afternoons. But I saw no noticeable good effects on either my body or mind or any let up in the brain fog. So then I removed dairy (completely expecting no response as I used to eat loads of dairy and never appeared to have a problem with it). Within 48 hours I was in a catatonic depression. I couldn’t move. I could barely speak. I’d done it while my husband was away so I wouldn’t have someone moaning on at me for doing it. A friend rang up and urged me to go out for a bike ride in the sun but I couldn’t even move or make myself pump the bike tyres up. I had some meat cooking in the oven, so I went to the oven and drained off the fatty meat juices and drank them. Immediately it was like a gate opening in my brain and suddenly I could think and move again and my mood lifted. I managed the tyre-pumping and bike ride. It was still very up and down. The following week, every morning I woke up angry, agitated and irritable. My husband and I argued all morning. By lunchtime I was fine and by evening my husband might be speaking to me again! Someone on a Thyroid forum pointed out to me that I needed to check if my Levothyroxine contained lactose. Lo and behold! Lactose in my medication that I took every morning. I went to my GP and had it written on my prescription that I have to have only lactose-free brands. (Unfortunately there are only two and the pharmacist has difficulty sourcing them). I am finding that any sort of dairy, the tiniest scrap including goat ghee, supplements derived from dairy even though they are lactose and casein free all give me the same bad mental health effects. 15 years worth of debilitating post nasal drip, constant allergic rhinitis and lung conditions also cleared up within a week. It’s like a miracle. So at least my husband is backing me on the dairy-free aspect!! Now I am feeling a lot better on this ketovore approach and hope to consolidate the progress while keeping my weight in a healthy range. I have been able to remain antidepressant-free and I hope that my digestion will heal enough for me to be able to add more variety back in.
Thank you for your encouragement and the confirmation that ketones will vary and that I don’t need to be trying to target high numbers and we don’t actually know whether the tests truly reflect what is going on a cellular level.
All the best with your own journey!

(John) #8

It’s great to hear about your improvements, Clare! In addition to my own physical health improvements, I’ve also experienced better mental health. My family has a history of depression (including a couple with very unfortunate outcomes :frowning:) and I’ve struggled a bit, myself. The most noticeable being my regular experience with Seasonal Affective Disorder, which I would go through right about this time of year every year. However, in the last 10 years, and especially the last 6 with essentially no carbs in my diet to speak of, I haven’t dealt with it in the slightest.

Just over 50 years ago the food industry began an anti-fat campaign and the consumption of animal fats has plummeted drastically since. At the same time, the number of cases of depression alone has doubled (or some such number). It’s not hard to believe that those two things are related. Chronically high blood glucose inhibits healthy brain functioning and ketones are how the brain operates optimally.

Happy to hear about your own success!

(Clare) #9

Dear John,

Thank you for sharing your story with me, it is very encouraging. I don’t know why it’s taken me so long to come across the whole keto movement. Now I’m going to be sticking with it. I only ever ate carbs because society wouldn’t allow me to only eat the meat and veg! Carbs never made me feel good. I remember the days in my childhood when you knew you had mice because they left little footprints in the frying pan of lard kept in the cupboard (young people would be horrified!!). Hopefully the tide is turning (though I’m not suggesting we go back to uncovered food for the mice to dance around in!).

I’m finding it hard to clear the final level of brain fog, but I’ve made a good start with everything else. I haven’t had to take a painkiller for anything since January. I used to take up to several a day and one to sleep at night due to the pain in my back. So lots of great things happening.

(John) #10

I know that you said you tried pure carnivore at one point but I also saw that you might sometimes include plant foods for fat more recently. How long did you experiment with eliminating all forms of plant from your nutrition? In my case, I’d say that it took me more than a few weeks to fully eliminate all plant-sourced foods and fully realize the benefits of zero (literally zero) carb nutrition.

(B Creighton) #11

Standard American Dairy can be very inflammatory. Since Covid, I’ve had to drop it completely if I want to be able to function normally. Standard yogurt got switched out for goat yogurt I either buy or make. If you tolerate this, it may help you stay in ketosis as goat yogurt has 2 x the MCTs as SAD dairy. I now use goat cheese as my “cream cheese” and either A2 cheddar cheese or imported sheep cheeses like pecarino. All full of proteins and fats.
When I do keto my weight will drop off 5 to 6 pounds as I lose glycogen, but I have found if I start supplementing with creatine this drop off is less noticeable. You might try that. At least 5 gr a day. Initially, I got down to my college waist size, but I can definitely gain fat much easier than I used to. I never got down to my college weight, because I think I put on more muscle since college.

(John) #12

I tend to prefer goat cheese but I’ve also found local dairies that produce A2 products. I think that if you were interested in reintroducing dairy, the important thing would be to determine what it is about it that causes the health issues. It could be the protein type, feed/diet, processing, lactose, or some combination perhaps.

(myketocalc) #13

One thing that stood out to me is that you’re already reaching nutritional ketosis more often than you might think.

Blood ketone levels of 0.5–1.0 mmol/L are generally considered nutritional ketosis. They don’t need to stay above 1.5 or 2.0 all day for ketosis to be occurring. Ketone levels naturally fluctuate, including after meals, because your body is both producing and using ketones.

But what concerns me much more is the 10 kg weight loss in just two weeks, especially since you’re now underweight and struggling to regain it.

With Hashimoto’s and such significant weight loss, I’d strongly recommend discussing this with your doctor and a registered dietitian familiar with therapeutic ketogenic diets. It’s worth checking whether your thyroid function, nutrient absorption, or another medical issue is contributing to the difficulty maintaining your weight.

I also wouldn’t recommend reducing protein further or fasting just to push your ketone readings higher. Getting enough nutrition and restoring your weight seems much more important right now.

Your improvements in mood and mental clarity are worth discussing with your healthcare team. There is emerging research on ketogenic diets for depression, but we don’t yet know what ketone level, if any, is necessary for those benefits.

I run a small educational keto website and have a guide explaining ketone testing methods and why readings fluctuate. It might help you interpret your monitoring data:

I hope you find a way to feel better without having to compromise your nutritional health.

(Edith) #14

I have to admit, I only skimmed through all the responses, so I apologize if anything I write is a repeat.

Like mentioned, ketones of 0.5 or above means you are in what is called nutritional ketosis, so don’t stress about that. Also, like mentioned in some of the replies below, ketones fluctuate throughout the day depending upon meal times, exercise, sleep, etc. You may also show lower ketones over time because your body adapts to its new fuel source and becomes more efficient at utilizing the ketones.

If you are losing weight, you are not eating enough. Period. You don’t have to intermittent fast on a ketogenic diet. If you need to eat three meals a day, that is fine.

I’ve been eating this way for over eight years. I was never really overweight, I started eating this way just to drop a few pounds, but I stayed for all the health benefits I received, including keeping psoriatic arthritis from rearing its ugly head. Dairy is a big trigger for joint pain and skin problems, so I follow a paleo ketogenic diet.

I did make mistakes, especially when I first started keto, though. I totally bought into the intermittent fasting hype, but because I am a petite woman, eating higher fat and only 1-2 meals a day, I developed nutrient deficiencies. I especially lost a lot of hair. Think of it this way… If you are only eating 1200 calories a day and over half of them are coming from fat (which doesn’t have a lot of vitamins or minerals in it) that only leaves 600 calories to get all the protein and micronutrients you body needs. It is not enough. I really think you are probably not getting enough protein.

Finally, yes, eating pure fat will most likely keep you in ketosis after eating, but secreting insulin after a meal is a natural process. Once your insulin and blood sugar drop after the meal, you will go back into ketosis. Eating meat does cause insulin to go up, but not nearly as much as carbs. Don’t fear protein.

(Clare) #15

Dear John,

Please tell me the changes you saw when you got to zero plants.
I am finding it difficult to navigate the diet wars. I turned to keto after listening to Chris Palmer and Georgia Ede. Georgia Ede is also a proponent of as near zero plants as possible - she was the first person who I heard say ‘plants are trying to kill you’. At first I found that extreme, but pursued normal keto, just dropping all carbs except some root veg. Then I heard various autoimmune points of view such as Mikaela Peterson and Anthony Chaffee and I began to cut out more allergenic food groups. Then I heard Sally Norton and read her book ‘Toxic Superfoods’ and panicked because a lot of the veg I was still eating were high in oxalate. I removed those and started oxalate dumping (stinging pee, tooth exploded, crippling joint pains etc). At some point I gave up dairy for my thyroid and had the depressive episode but lots of health conditions clearing up. (Recently I looked for the least allergenic type of dairy to try out - goat ghee. One teaspoon and I was very ill. Same if I accidentally take a supplement that is derived from dairy but contains no lactose or casein, so I seem to be ultra sensitive). Then I realised that most of the low oxalate veg left to me were goitrogens - not ideal. So then I just thought, ‘blow it, it’s my body, I’m going to choose what goes in to it’ and just dug my heels in and refused to allow everyone around me to make me eat veg and I don’t have any seasonings or herbs either except salt. However I’ve felt socially pressured into eating some veg approx once a week if we eat at a friend’s house or eat out. Plus just recently I’ve been trying to go down the keto route a bit more and added back coconut oil and the occasional avocado. I also often squeeze lemon juice on my meat because I crave some sharp and sour things and that seemed the least harmful. And I’ve just worked out how to make my own coconut yoghurt because I’m craving yoghurt. But don’t know if that’s good or bad. So I just feel a bit battered by all the food controversy and although some people are nice and say ‘find out what’s right for you’ - I just don’t know what’s right for me. I don’t feel right yet, just vastly improved (including suddenly having extra strong muscles, a pull up is easy peasy, I can do planks for ages, I cycle to work after not having been on a bike for 9 months and don’t even feel the hills etc). But I feel confused and frightened because every podcast tells you something different and they’re all convinced they’re right. And I’ve suffered from bad cramps in the night for months despite eating seasalt and using electrolytes. I’ve currently given up the electrolytes in case they were unbalancing me and am trying just salt with some improvement.
So I’m interested in your own story. What made you turn to carnivore, and what extra benefits did you see once you got to zero plants?

(Clare) #16

Thank you, Oton for your thoughtful answer. It is reassuring to know that there is probably more ketosis going on than registers on our various devices. I know that they have seen significant alleviation of alzheimers symtoms adding coconut oil and MCT oil to the diet, even when the person hasn’t yet removed carbs, so ketones floating about can even be helpful when the diet hasn’t changed much yet. So since I am almost zero carbs and have radically upped my fat intake, something positive is probably going on. I will definitely check out your website, thanks for letting me know about it! And yes, I guess I’m wavering between different keto dietary paths, while at the same time thinking I need to prioritise nutrition and gaining weight while being scared of losing ketosis. I need to make nutrient density my priority. Thank you for your helpful advice.

(Clare) #17

Dear Virginia,

Thank you for your helpful input. It is reassuring to hear that you have been eating this way for 8 years and are doing fine on it, maintaining your weight and keeping an autoimmune condition at bay. As you suggest, I have continued to eat whenever I am hungry as I want to stop my body consuming itself for energy! But the huge OMAD and fasting pressure has made me feel a bit guilty about doing that. My protein sources are all kinds of meat, fish, seafood and eggs. There is a lot of pressure in autoimmune circles to only eat beef and salt but I can’t seem to do it. I end up not wanting to face another bite of beef. I need to cycle around between the different meats. I know that eggs can be an allergen but I haven’t seen a difference when I avoid them for a bit, so I’m hoping I’m okay with them as they contain a lot of nutrients. I have recently returned to coconut oil, avocado and occasionally olive oil. But I’ve no idea if I’ve done the right thing. I don’t feel any worse at any rate. My body is generally good at telling me what not to eat. If it wasn’t for the autoimmune issue, I’d be happy to be a low oxalate ‘ketovore’ but I am wondering if I need to be stricter than that to give my body the space to heal?
What was your journey to ketopaleo? What did you have to do to get your hair back? What made the most difference to your health and what improvements have you seen?

(Clare) #18

Thank you, Scaperdude for your advice. Especially re: creatine. I have been thinking about taking it since it is advised for both mental health and gaining muscle with exercise, so I need to get on with that!

#19

Have you thought about trying to increase muscle mass? I’m very lean and have been actively cultivating metabolic flexibility. I have a carb containing meal (~ 30-40g carbs) on alternate days to activate mTOR which increases muscle protein synthesis (MPS) and it also stimulates bone. I cycle or walk immediately after the meal to rapidly clear glucose which quickly tops up muscle glycogen stores. The following day I use this glycogen to do resistance training. I’m at the stage where I can switch between fuels — glucose or fat. Last night 2.5 hours after the carb meal my BGL was 5.3 mmol and ketones 1.7. Fasting bloods this morning BGL was 5 mmol and ketones 2.9, so my body did its magic overnight. Plus exercise is great for increasing ketones independent of diet. The first time I did a carb meal after using fat burning for energy my body didn’t know what to do with the glucose , BGL shot up to >8 mmol. This is called adaptive glucose sparing or physiological insulin resistance. I’m been actively working towards challenging my metabolism to deal with different fuel sources and I’ve been able to maintain ketosis AND achieve higher ketones.

(Clare) #20

Thank you for your interesting advice. It is always helpful to know what other people are doing which works well for them. I have heard of this approach. At the moment I seem to be fairly well adapted as when I’ve tried to get some impressive glucose spikes on the CGM I’ve been wearing as an experiment to scare my friends into lowering their carbs, I couldn’t get it above 6 and it had dropped back down within an hour, and my ketones were still producing well, and I’m usually 4-5 mmol in the morning. I’d like to build muscle while I’m on land (in the summer I’m on a boat) - I cycle 30 mins to and from work, live in the mountains so walk and climb etc We don’t have a gym around here so I’m just doing push-ups and so forth. I will bear your advice in mind.