Hi everyone. I’m following up from my first post here Help me figure out what's wrong
Basically feeling physically and mentally fatigued after I’m certain I’m keto adapted (4.5 months now)
I have been trying to work through possibilities and at first was working on electrolyte deficiency supplementing with up ample sodium potassium and magnesium as per the numbers I have seen mentioned (5000,3000,400).
Not much resulted from this and I was bothered by the fact that anecdotally most people did not seem to be chugging 10grams of salt a day. I then had a day where I had some lambs liver with onions and felt back to normal the next day. I thought maybe this could point to a lack of b5 as I would feel particularly crashed after meals and b5 plays a role in metabolism. I started eating 100gm lamb liver every day but was still having mixed results. Also I eat meat and get 100gm a day protein average so that deficiency doesn’t make heaps of sense
Finally I thought I would try introducing some carbs deliberately. I’m doing this in the form of 5gms carbs from one flat white (coffee with about 120ml full cream milk). This has been like flipping a switch on this fatigue I’ve been experiencing and for the past couple of days I have felt back to normal
I’m getting a blood test next week but in the meantime I’m hoping this is the answer. I see occasionally that some people don’t function as well below 20gms carbs but I can’t seem to find out why.
Is it to do with my livers ability to generate glucose?
Does my body need extra carbs to hold onto more electrolytes?
Is it just prolonged adaptation?
Would love to know others thoughts on this whole process.
Why might some people need more carbs?
Carbs are not by any stretch of the imagination an “essential” nutrient. No one has ever, in history, died because they stopped carbs or were “deficient” in them. However, one’s addiction to carbs can be difficult to get over, and when adapting away from them it’s very easy to feel bad and take that as a sign that one needs more. It’s simply not true.
You’re prob not fatigued any more because of the fat in the coffee not the carbs.
To avoid assumptions, I would experiment. Try swapping the flat white with a bulletproof coffee (with coconut oil, butter, or MCT) that gives you the same amount of fat and caffeine as the flat white would. See how you feel - if you feel just as good, it’s the additional fat that’s making you feel good. 
Please report back!
If you have a glycolytic type workout, lots of anaerobic activity, burning through glycogen, and do it regularly enough, go ahead and add some carbs back in. Liver and onions has glucose in it and I’d wager that’s why you felt better after eating it.
Your liver can replenish glycogen stores on its own slowly and only up to a point if you’re eating ketogenic. Gluconeogenesis is a thing but the exact rate is up to you.
I will say that I feel AWESOME on a fat fueled diet, I am certain that my metabolism (though I do not have diabetes or prediabetes, or any sort of hormonal disorder, or any sort of neurological disorder) is better suited to fat burning. I am completely willing to accept that some people are better at carb burning.
I feel you’re reading me wrong. In the 4 months I have been keto I have experienced an amazing amount of energy and I agree with you that carbs are not an essential nutrient. When I became fatigued it was at least 4 weeks of trying other things before I tried carbs. To be clear I am talking about 5-10 extra grams of carbs which is not taking me out of ketosis. I might be wrong but that’s why I’ve sought out some more opinions. The title of that post may have been poorly worded:frowning:
Thanks. Feel like I ruled that out as I usually have something like this when I was fatigued. In this state no amount of caffeine would help. My instinct is that it might have something to do with my ability to retain electrolytes
I am doing a lot of exercise. 5 days a week. What do you mean the exact rate of gng is up to me? Is it possible that your glucose demand can outstrip your livers ability to generate it?.. This may change further into adaptation?..
Theres no glory in trying to be as low carb as possible. If you can find your sweet spot with 35 g carbs a day vs 25, and that will result in long term compliance with a healthier diet, than you should definitely eat 35 grams a day.
Have you considered that you might have actually contracted the flu? It is going around pretty hard and fast currently.
Yes, that’s what I’m getting at, especially if you’re going anaerobic exercise at that rate.
Be careful with the liver. It is possible to overdose on it because it is such a nutrient dense food. Some nutrients are harmful in excess.
Personally I choose not to eat it more than once a week.
I will pop back later and post a couple of links on the subject.
Edited to add
Here you go:
That is why I switch to high carbs e.g. eating fruits (natural sugars) etc. then back to keto (a fasting state is what it really is i.e. autophagy); that said, looking at the raw information on the history of fasting from non-modernized technical terminology of what this term “Ketogenic Diet” actually is? and really means? To put it simply and plainly, it is a fasting state (carb reduction, extended fasting and intermittent fasting) and giving the body a chance to recuperate from constantly burning glucose!
Neo-refined and highly processed sugars is the other part of the problem and trying to avoid it! Biological exposure to food refining processes, toxic insecticides and forage killing chemicals, antibiotic and GMO treated agriculture and livestock including poultry are fairly new threats and alter our biological processing mechanisms including suppression of natural gene expressions!
I try not to get lost in the paradigm that I must only subsist in a Ketogenic state, that would be a set up for failure and dissent! That is what culminates nay sayers, because they fail to really think? Going into this thinking they must remain exclusively in Ketosis, then midway into this, some negative health variables come into play and then they quit midpoint before they can experience the benefits of being fully keto adapted (after 6 months when things metabolically return to normal)?
What I am discussing here is what is lacking in the research about the efficacy and sustainability of both (low-(high fat/low fat - high carb/low carb) dietary methodologies!
Human beings are nutritionally & metabolically nomadic!
Being tired tends to be low electrolytes, or high insulin, or body is in gluconeogenesis. If you have high fasting insulin it will block the body from accessing fat stores. The person feels hungry all the time and has to eat every couple hours. Gluconeogenesis happens when the person has stopped eating, glucose is decreasing, but they are not in ketosis. Generally, it takes a couple days to get into producing a lot of ketones. During that time, the body is making glucose from proteins. This will produce a lot of urea that builds up in the kidneys. A person will feel tired when this happens.
Ah good, my plan for once per payday pound of liver is a good rate then!
I’d add to that that selenium is used in the detoxification of mercury, I believe on a molecule by molecule basis. It was either Dr Nasha or Dr Cate that has that in their book. Once I learned that, I stopped worrying about my brazil nut and sashimi intake. (2 brazil nuts per day and one or two sashimi dinners per week is my MO)
But to the OP, shellfish are a good source of just pure glucose. My Friday lunches are at a place that does 1/2 wings and raw oysters so depending on workout load (how low I feel) I may get a 1/2 dozen or full dozen oysters to replete the stores. I have no idea the precise level of glycogen I’m at or what the tank is. So we’re all going on how we feel.
It’s a very targeted glucose intake in my stategery, not a habit. I still prefer to be as low carb as I can be otherwise.
I try to stay under 20 grams of carbs per day, but I’m often around 30 or go up to 50. Simply because I workout a lot and I have many food allergies. I still loose weight and get into ketosis. So yes, you might need some more carbs. But feeling tired is probably due to something else. I would suggest checking in with the doctor and not forget that your body is constantly adapting. That can make you tired too, hope it helps!
This most likely would be from spike in insulin and drop in blood sugar. Even after 4 months you are still going to be insulin resistant if you were before you started.
I don’t think it would be from added carbs but from possible the mct’s in the cream or just the increase in calories from adding the full cream it to your diet.
[quote=“Hungerob, post:9, topic:30187”]
Is it possible that your glucose demand can outstrip your livers ability to generate it?
[/quote] High insulin levels will increase the demand for GNG since insulin with drop your blood sugar. IF you are crashing during a workout then you need more energy. If you crash after a meal you just may be spiking insulin.