Would you help me crack my code?


#1

Hi. I’ve been eating very low carb for almost 2 years. And I only feel one of the positive things others do.

Very low carb is anything between 0 a day and about 30, or 40 g, net carbs. I don’t have a keto mojo, but I still see a change in color on the urine stick when I use one.

Also, I do mostly OMAD, sometimes 2 meals, but my stomach is empty for most of the day. Even when I used to eat carbs, I was a kind of OMAD person.

I’ve tried carnivore for about 3 months, a little over, I think. I wanted to get my BG down.

FBG: 111 mg/dL
C-peptide 0.544 nmol/L
BG 0, 30 min, 1h, 2h: 110, 198, 157, 84 mg/dL
A1c 5.7

Triglycerides 48 mg/dL
HDL 93.9 mg/dL
LDL 134
Non-HDL 145
Cholesterol 238

Potassium 4.7 mmol/L
Sodium 139

Urea 53 mg/dL
Creatinine 1 mg/dL
CKD-Epi 65

I’m worried about my kidneys and the high potassium and FBG.

I started keto because of one test giving a FBG of 102 mg/dL. Now, it’s 111.

I’m convinced it’d be much worse if I wasn’t doing very low carb.

I was looking at kidney “friendly” diets and they’re high carb. I don’t want to go high carb, of course. So, I’m doing an adapted kidney diet, that’s very low carb. It means there are very few foods I can eat. I’m losing weight, because I eat very little of them to keep carbs very low. My doctor seems to think everything is fine, except LDL. This is the least of my worries.

I’m afraid of not eating right now and end up in dialysis, or diabetic. Diabetes is one of the main causes of kidney disease.

I’ve never been diagnosed with any illness. If I’m healthy, all I want is to eat in a way to continue being healthy. Therefore, keto.

But now I’m worried about my kidneys. I’ve checked my old exams and the creatinine was already high. Before keto. So, I’m not thinking keto caused the bad number. But I’m afraid it may make it worse IF I don’t eat the right foods.

For kidney patients, they say low protein, sodium, potassium and fats. What’s left? Carbs. But carbs cause diabetes and diabetes causes kidney disease. So, what to do?

If you have knowledge in these things please, share. What do you eat that keeps low BG and is good for your kidneys?

Because I don’t experience any of the wonders ketoers do, sometimes I wonder if I have something wrong in my cells and keto isn’t for me. At the same time, I can’t see myself eating a high carb diet, because I don’t want high BG.

I’ve gone carnivore for over 3 months and it did nothing for me. I enjoyed the simplicity of the food, but didn’t feel energy at all and none of the good things 0 carbers do.

What is wrong with me?

What I eat before kidney diet: chicken, fish, shrimps, liver, porc, cheese, a portion (max a cup) of the lowest carbs veggies and butter. Lots of salt. Occasionally, 86% chocolate. Not everyday and small pieces.

Kidney diet: the same, but less butter, no salt, proteins up to 30g a day. Therefore, I’m starving myself, which can’t be healthy.

I’m losing weight, because now I’m very low cal, with the kidney-keto version of diet.

Any help is appreciated. But no youtube videos, please, unless really relevant. I work very long hours and I can listen to a podcast on my way to and from work, but not watch videos.

I think that if I’m not careful, I’ll end up with diabetes and kidney failure.


Should I use a Blood glucose monitor
(Take time to smell the bacon) #2

Two things I noticed are that your ratio of triglycerides to HDL is stunningly low, which means you are at very low risk of cardiovascular disease. Also, your HbA1C is not as high as one might expect from your serum glucose reading, so that’s encouraging.

As for your protein intake, my understanding is that the standard medical advice to limit protein to fix kidney problems may not actually be the best idea. There is a video by Dr. Paul Mason, the Australian sports medicine doctor, on this very topic, in which he goes through the studies and points out their flaws. Unfortunately, I don’t seem to have bookmarked it, but you might be able to find it on YouTube. You might try a higher-protein diet for a month or so, while cutting the carb intake somewhat, just to see what happens. Cutting salt is probably not necessary, either, but I don’t really know about that.

I’m sorry not to be of more help. Perhaps some other of our members have more experience that would be useful.


#3

Do you work out? Lift weights? run a lot or losing weight? In any of those situations higher than range (within reason) creatinine is fine. It’s also not a real indication of anything, even crap hydration will raise that number on a lab. Have you checked your eGFR? That’s the one that matters if you’re worried about kidney function.

No, carbs don’t “cause diabetes”, that’s hitting keto dogma level. People who eat excessive crappy carbs above what they should while having a constant high blood sugar over a long period of time get diabetes. BIG difference.

We’re all the same, you just haven’t found what works for you because it seems you’re stuck to extreme versions of things only. Keto, OMAD, Carnivore then you only mention high or low carb. Do you think there’s nothing in between all of that?

Also, protein hurting kidneys has been debunked a million times in all but people with known existing damage, even then it’s not required to eat so little protein that they lose all their muscle and bone mass.


#4

I can’t say anything smart regarding the right diet for your kidney… I just know NOT everyone gets the usual keto benefits. I got none beyond fat adaptation, carnivore is better but much energy? :smiley: I probably never will have that. Or only if I do everything right for longer term.
If you eat low-cal, no wonder you don’t have much energy.
And as I said, I know about nothing about the right diet for you BUT no way 30g protein is the best. It’s so low I am not sure you can live long with it but you surely can’t keep a decent amount of muscles that way. And it must cause other problems. It’s simply INSANELY low, no matter how I look at it. And if it causes starving, it’s quite bad (fatal, eventually), there must be something better! Isn’t there some info about low-carbers with kidney problems?
I heard about people who needed to eat low protein but that was 60g, not 30g. Still very low but still LOADS better, I can imagine one can survive with that amount. Protein is needed for many things, it simply can’t go super low without serious consequences.


(Bob M) #5

Could you explain what this means? Is this after eating? What did you eat?


(Take time to smell the bacon) #6

Carbs cause diabetes by elevating serum insulin and thereby stimulating the release of insulin. Over time, this leads to insulin-resistance, which is what diabetes really is. We just don’t label it diabetes until the resistance becomes so bad that the glucose starts getting out of control. If we were to switch to Dr. Joseph Kraft’s method of diagnosing diabetes by the pattern of insulin response during an oral glucose tolerance test, we’d see an alarming increase in diabetes diagnoses.


(Bob M) #7

This is Paul Saladino type of logic: eating honey sometimes does not cause diabetes.

Does meat cause diabetes?
Does protein cause diabetes?
Does fat cause diabetes?

If not, what does? Carbs.


#8

Sure… IF they’re over consumed, IF they eat more than their bodies will deal with, IF their blood glucose stays high, IF their serum insulin stays high, which doesn’t happen to hundreds of millions of people. Not everybody over does it, not everybody is or becomes insulin resistant.

You can’t change the context to automatically equate carbs with candy and Twinkies and make the assumption that everybody that eats carbs also over consumes that, that’s not real life. There’s no shortage of people that never become diabetic and never have insulin resistance from them.

Since reversing my Insulin resistance and going to CKD/TKD my A1C is still below 5 most of the time, my inflammation is still low, my blood glucose is usually in the 80’s fasting vs the low hundreds I used to be in, my cholesterol better, my actual LDL breakdown is better, my LP-IR went from 36 to only showing <25, and that’s at around 100-150g/day when I’m lifting. Where’s the diabetes? Where’s the precursor to diabetes? It’s not there. Because the carbs I eat are when I should eat them, in appropriate amounts,

As every Keto’r already knows, a Calorie is NOT a Calorie! It does matter where it comes from, even within the same macro. Nobody has an issue saying Fat is good, but PUFAs are bad… they’re both fats right? The difference is one and one only, it’s ok to have that opinion in the keto world on fat, but if you say not all carbs are equally as evil, that’s insanity. Except unless you eat a cauliflower crust pizza, then it’s OK again.


(Take time to smell the bacon) #9

We are probably arguing semantics, here. It is definitely true that the dose makes the poison, no question. A small enough quantity of arsenic doesn’t do enough damage to kill us, and formaldehyde is fatal when ingested in quantity, but the body actually makes it for certain purposes. Hell, even water can be fatal, if we drink enough. So no, that one Twinkie isn’t going to give you diabetes overnight, but enough Twinkies, over enough years, will.

All carbohydrates except sugars are composed of glucose molecules linked in various ways. If we have enzymes to cleave the bonds, the carbohydrate is digestible; if not, the carbohydrate is indigestible, and we call it fibre. But even fibre is made up of glucose molecules linked together, we just are spared having to deal with them. But the glucose molecules in digestible carbohydrates are all liberated in the small intestine and go straight into the blood stream, and the pancreas neither knows nor cares whether the source was a “healthy” carbohydrate or an “unhealthy” one—it just knows that there is too much glucose in the blood, and it had better do something about it.

Now, if we add sugar—sucrose—to the mix, we are not only increasing our pancreas’s glucose burden, we are also burdening our liver with fructose, which is itself toxic to the liver over the long term, if we eat too much of it. And fatty liver disease is nothing other than insulin-resistance of the liver, which contributes to insulin-resistance in other cells in the body, making the pancreas have to work even harder to clear all the extra glucose out of the blood (at least we don’t need to worry about gluconeogenesis at this point, because the insulin response has shut it off).

So it is in this sense that I say that glucose (i.e., carbohydrate) causes diabetes. Now, can we eat a low enough dose of glucose to avoid this problem? Sure. How little must we eat? Well, as you point out, that depends, not only on our individual biochemistry, but also on how insulin-resistant we happen to be. In the same way, how much arsenic or formaldehyde someone can tolerate without sickening or dying will also vary from person to person.


#10

Thank you for all the replies.

I’ll look for the video, @PaulL. I’ve found a paper where they tested outcomes in the treatment of kidney disease (or failure? Can’t remember) and, indeed, low protein diet didn’t help. I’ll increase my protein again, @Shinita. I weight about 60 kg, 164 cm. Estimating my lean body mass at 70%, it’s 42kg. 1 g per kg would make it only 42g of proteins anyway.

@ctviggen
That BG 0h, 30 min… was after ingesting an amount of liquid with sugar (75g of sugar). They call it OGTT and it is a test to see if one has diabetes. I’ve done it when I did my last blood test. They also gave the fasting c-peptide, which is an indirect measure of insulin. Mine was within limits, but I need to dig in it to understand it better.

@lfod14, the eGFR, I understand is the CKD-EPI. Mine is 65. I’ve seen on the internet that it indicates stage 2 kidney disease. Above 90 it is stage 1. Below 60, stage 3. So, I’m very close to stage 3. It means my kidneys have some mild damage. I found the math equation for the estimated GFR and it only takes into account gender, age and creatinine. I’ve read creatinine is due to the breakdown of creatine and muscular people may have it higher. I’m a runner, swimmer, climber, hiker, mountain biker. I’ve exercised since I was a toddler. However, I’m not super muscular. My legs are super strong, for an old lady. But my arms are weak. I do body weight exercises, but not like someone whose creatinine would be high due to exercise.

I get what you say about the carbs and I totally get it. But I was making the sentence short. Of course it is excess carbs that are bad, mainly if of the bad kind, which I don’t eat. However, my elevated BG shows I have some level of insulin resistance. Therefore, it’s like my kidneys: I’m already not 100% healthy in that part, so I want to be careful so as not to become worse.


#11

I’ve found this paper interesting. There were others such as this. So, c-peptide is produced at the same time and quantity as insulin. So, it is a measure of insulin. And following the conclusion in this paper, it is one predictor of mortality. As we all believe, high insulin is a bad thing and indeed, people on the high c-peptide quartiles have worse outcomes. I’m on the second quartile (1 is better and 3 and 4 are worse).


(Bob M) #12

Did you get insulin tested at the same time? If not, it’s relatively useless. Here are my results. They were supposed to take values at 1 hour but did not:

This is what my blood sugar looked like (multiply by 18 to get US units):

Unfortunately, this software will only list the values when you download the data. I wanted to download the data (and take a pin-prick blood sugar also) at one hour, but I literally fell asleep. I could not keep my eyes open. Mine is at least 180 (10x18), it’s hard to tell.

My 2-hour insulin is slightly high, according to a podcast with Dr. Ben Bikman.

Blood glucose is only part of the story. See this for instance:

Kraft Test

My 2-hour insulin is slightly above the “normal” range.

But I had been lc/keto for 4 years at that time. I did not eat carbs before the test. Some say that you will get a better score if you are keto and eat carbs the week or so beforehand. My doctor at the time was Cate Shanahan, who did not agree with this.

Edited: Cate, not Kate. This doctor:

She also really did not say anything about my results, so maybe she thought they were fine?


#13

At your activity level I wouldn’t have an issue seeing high creatinine at all! You’re super active! The sports you’ve listed are known for more muscle breakdown than others, you’re doing TONS of activity that requires beating the crap out of yourself, (and a lot of strength) but you do so much of it (endurance) that the muscle stands no chance at surviving (breakdown) endurance is a never ending cycle of damage and repair, just without the growth. In weightlifting it’s exactly what we deal with when we over train.

My understanding of CKD-EPI is it’s a GFR guess based on creatinine, but if you have high creatinine which is explainable that would effect that number as well. Honestly not sure how they come up with eGFR when it’s listed that way on labs.


(KCKO, KCFO) #14

40 net carbs is low carb, not very low carb. Pee sticks tell you how hydrated you are, not necessarily your ketone levels. Even the Adkins group says not to use them to determine your ketones, and they were the ones who original said to use them.

Check into the fructose levels of any carbs you do consume. There are FOD map apps that can help you with that. it is also good to limit the sugar alcohols or half what the label says the food contains. Company play fast and easy with nutrition labeling.

Has your dr. spoken with you about your chances of getting kidney disease? And if you have used dna testing for health issues do you have snps that might make you more prone to getting it? This article lists the ones associated with that:

I hope you get yourself sorted out.


#15

I don’t think there’s a definition but people have their individual definition anyway. Low carb is (below) 80g net for me, 150-160g for others (I call that moderate). 20g is extreme low-carb for me (I must do carnivore to go that low or carnivore + 1-2 tiny bites), 40g is very low-carb in my books (and keto for me) :slight_smile:


(Take time to smell the bacon) #16

Strictly speaking, any diet that puts us in ketosis is a low-carb/ketogenic diet, whether the person’s amount of carbohydrate can be as high as 100 g/day, or needs to be below 10 g/day. Some people make a distinction between “low-carb” and “keto” such that the former typically means a higher level of carb intake, and the other a lower level.

“Keto” advocates typically advise a lower limit, because it means success for a greater number of people. For example, these forums recommend a limit of 20 g/day, especially when starting out, because it’s a level that works for just about everyone, except for those people who are exceptionally insulin-resistant. We advise staying at that level until one is fat-adapted, at which point it might make sense to see if one’s body can tolerate a bit more carbohydrate than that and still remain in ketosis.

To me, the main distinction is whether carb intake is low enough for ketosis or not. I don’t worry so much about the label. But to nutrition researchers, “low-carb” often means a level of carb intake that those of us on these forums would consider unhealthily high and impossible for allowing ketogenesis to occur.


#17

@ctviggen, I already know I suffer from insulin resistance, so I don’t need to know how much insulin was necessary to lower my BG. It is a good test to know that, at my present condition, if I should consume more carbs, my body could still produce insulin enough to get it elsewhere than in my blood stream. It doesn’t mean I should, because I don’t want my insulin resistance to become worse.

@lfod14, I’m active, but really nothing like a bodybuilder. I’ve been reading and only if you are really very muscular, or like lifting a lot of weights, would that change your creatinine much. However, it is a fact that it varies during the day. If you eat a lot of meat, for a few hours it could also push it up, but I had fasted over 12h. I am hoping it is lower next time. I just don’t want to ignore a problem if it is there. Suppose it is 0.8 instead of 1. It is still not ideal. The math formula to calculate the eGFR is pretty simple and I’ve checked it. It fits with my creatinine level and age. I want to get it really measured, as opposed to calculated. I’ll look after it when I’m back from another cycling trip that’s coming up soon.

@collaroygal, 40g is very low when I have that much. I walk 2h and run 1h. I could have 100g and it’d still be ok. I won’t, but I could. When I don’t need it, I’m lower on the carbs. Let’s suppose I need 1500 KCal per day. 40g will be supplying small part of it. Where is the rest of my calories coming from? Surely a part from fat, no? Don’t forget by now I should be fat adapted, whatever that means. I’ve even been carnivore months this year. Nothing changed. If there’s an easy source of energy like the 40g of carbs, it’s going to be used by your body when you exercise.


(Kirk Wolak) #18

Your last couple of sentences confirmed what I was going to tell you.

Your glucose may be high due to stress. your inflammation and insulin resistance and high BG can all be by stress.

I recommend getting your doctor to get you a Freestyle Libre Continuous Glucose Meter. You will need it for 2 cycles (about 1 month).

I want you to track your readings against what you were DOING/EXPERIENCING.

It was wearing these that showed me how Stress was de-railing me. And even “GOOD” stress can be bad. Watching too intense of a movie can spike my glucose. Getting bad news gave me a 50pt glucose spike. Dealing with a deep emotional issue in public, triggered massive cravings 45 minutes later. When I got the readings, I had a MASSIVE Glucose spike, and then a hard drop (a sign that my body used INSULIN to control the spike). That lead to the drop and the CRAVINGS.

How certain I am, that these were NOT food related? Because I was fasting!
Holy COW… I can swing my glucose almost 20 points just by focusing intently on a difficult programming task. And stop, and wait 20 minutes, and have a much lower glucose number.

And LIKE YOU my A1C wasn’t as bad as my BG implied it should be. It was all DEMAND (Stress) driven.

Dr. Boz did a video about a gal who discovered that playing her favorite video games was jacking up her glucose and ruining her diet.

For what it is worth… Working long hours is stressful.
I would start with the CGM.
I would add an OURA Ring and track your sleep and your heart rate.
I would practice Breathing exercises.
I would simply eat CLEAN (no processed foods)

Once you see your patterns. then practice what you need to do, to de-stress yourself.
Walking for breaks during work. Parking REALLY Far from the door, so you WALK IN,
and WALK OUT far enough to get a break. Small changes can really add up.

Remember to cut yourself some slack, show yourself some grace, and love yourself through this process… You are asking an incredible amount of your body… Listen to it. Hear it. Feel it.

Good Luck!


#19

Thank you! I’ll do it. I’ve found out yesterday, by coincidence, that now I can buy a CGM without a prescription. It wasn’t possible last time I’ve checked.

I’ve been working very hard through a burn out. I’m feeling better now, but until a few weeks ago, I was still going through the bad patch.

Covid restrictions mean I can’t see my elderly parents who live in another continent. Flying there is a complicated affair. I’ve decided I’ll lose my job if I have to, but I’ll go to see my parents. Once I’ve bought the ticket, I cried like a baby. It was weighing on me just really bad.

And now that I feel better, though not ok yet, my BG has been low.

So, I think what you said makes a lot of sense in my case.


(Kirk Wolak) #20

Remember, this too shall end. This is just a crazy season.
I see Omicron Spreading like Wildfire, and KNOW that it is inoculating us from 90% of Covid, making it an OLD story quickly.

Can’t tell if sanity will return. Based on the FACISM I see daily, I am not sure. Vaccinating people who have HAD The disease has NEVER, EVER, EVER Been a thing. We’ve gone looney.

good luck to your parents. Vitamin D3 is important. Especially if you have inflammation!

allow yourself to EMOTE and deal with the emotions (we usually bury them in food, which causes the deeper problems we have)!