Ketogenic Diet - Powerful Dietary Strategy for Certain Conditions

[aragorn]

Re: Ketogenic Diet - Path To Transformation?

This podcast might be of interest:

_http://livinlavidalowcarb.com/blog/do-low-carb-diets-lower-thyroid-function-lets-ask-the-experts/15305

If you’ve been paying attention in the low-carb and/or Paleo communities over the past year or so, then no doubt you’ve heard the popular meme promoted by certain Paleo diet advocates that zero-carb and very low-carb diets (ketogenic) lead to lower thyroid function, among other issues. They claim that this leads to a diminished capacity for T4 to be converted into T3 thyroid hormone because of the lack of glucose consumed by low-carb dieters. This concept has been heavily promoted by highly-respected practioners like Chris Kresser who sees patients from what he describes as “the dark side of Paleo and low-carb” dealing with hair loss, cold extremities, feeling horrible and other such negative manifestations of experiencing a low thyroid function.

However, two of the top low-carb nutritional health researchers in the world — Dr. Stephen Phinney and Dr. Jeff Volek — say this phenomenon with low thyroid while on a low-carbohydrate diet promoted by people in the Paleo community like Kresser and Paul Jaminet is “a myth” and has not manifested itself in any of the research subjects in their numerous studies of people who are properly following a well-formulated low-carb diet with adequate calories over the past three decades. Dr. Phinney believes the primary point of contention revolves around consuming an adequate amount of calories with your low-carbohydrate nutritional intake in order to normalize thyroid and metabolic function without the necessity for consuming added sources of dietary glucose. Dr. Volek concurs stating that it’s calorie-restriction that brings on this low thyroid effect, not limiting carbohydrates.

I haven't heard this particular version yet, but I believe I have heard all of the material while listening to the podcasts in the series. In this instance I am inclined to favor Phinney & Volek over Kresser, based upon the sum of my own experience. For me the key seems to be keeping the carbs fairly low, adjusting protein to make things work, and topping off with fat, and I have a wacky endocrine system. I did raise carbs for a while (staying usually at or below 50g/d), partly to test this idea, and I am back down to 30 now and planning to go lower. It does appear that a very occasional hi-carb "jolt" could help to break out of "stuck" situations. For me, "high" means 70 grams in a day, not hundreds, and "stuck" means truly stuck. I have only tried it once so far.

I don't think now that the problem I was having was was thyroid, and I don't think that people should avoid a ketogenic diet because it might cause thyroid problems. You have to stay with it until you figure it out, backing off when required (due to severe symptoms) and trying different things, as I was suggesting earlier.

Yes, this thyroid thing keeps coming up in many paleo discussions. When listening to the latest 'ask the low carb experts' with Phinney, with the Q:s and A:s I was a bit surprised by the fact that Phinney didn't mention the relation between thyroid problems and adrenal exhaustion, or leptin. He just said that people often self diagnose them having thyroid problems, and taking thyroid supplements is a very delicate matter that should be supervised by a health care professional. Those are wise words, no doubt, but I would have expected him to elaborate quite a lot - adrenals, stress, leptin etc.

Another thing that bothered me a little was Phinney's response to the question of intermediate fasting. He repeated that "he's not a big fan of fasting" and that the human body needs consistency in energy input. And that was that! He probably knows a lot more details than he was telling in this program, but somehow I got the feeling that he's stuck in his old ways, not that innovative, if you get what I mean. But I could be totally wrong.

I mean, e.g. Gedgaudas and her colleagues emphasise strongly that thyroid problems are commonly just the symptom of an underlying problem, and most often it's about adrenals and stress, and leptin. And that you should always start at the top (leptin, adrenals) when trying to resolve thyroid problems, NOT start supplementing with thyroid hormones right away.

Maybe these people who experience thyroid problems, when going paleo, are in fact under a lot of stress? I know some folks who's sole reason for going paleo/LCHF is to get slim and look good/perfect - and they get SO stressed with getting results that they finally give up because they feel so miserable (thyroid problems?).

 

[seek10]

Re: Ketogenic Diet - Path To Transformation?

This podcast might be of interest:

_http://livinlavidalowcarb.com/blog/do-low-carb-diets-lower-thyroid-function-lets-ask-the-experts/15305

If you’ve been paying attention in the low-carb and/or Paleo communities over the past year or so, then no doubt you’ve heard the popular meme promoted by certain Paleo diet advocates that zero-carb and very low-carb diets (ketogenic) lead to lower thyroid function, among other issues. They claim that this leads to a diminished capacity for T4 to be converted into T3 thyroid hormone because of the lack of glucose consumed by low-carb dieters. This concept has been heavily promoted by highly-respected practioners like Chris Kresser who sees patients from what he describes as “the dark side of Paleo and low-carb” dealing with hair loss, cold extremities, feeling horrible and other such negative manifestations of experiencing a low thyroid function.

However, two of the top low-carb nutritional health researchers in the world — Dr. Stephen Phinney and Dr. Jeff Volek — say this phenomenon with low thyroid while on a low-carbohydrate diet promoted by people in the Paleo community like Kresser and Paul Jaminet is “a myth” and has not manifested itself in any of the research subjects in their numerous studies of people who are properly following a well-formulated low-carb diet with adequate calories over the past three decades. Dr. Phinney believes the primary point of contention revolves around consuming an adequate amount of calories with your low-carbohydrate nutritional intake in order to normalize thyroid and metabolic function without the necessity for consuming added sources of dietary glucose. Dr. Volek concurs stating that it’s calorie-restriction that brings on this low thyroid effect, not limiting carbohydrates.

I haven't heard this particular version yet, but I believe I have heard all of the material while listening to the podcasts in the series. In this instance I am inclined to favor Phinney & Volek over Kresser, based upon the sum of my own experience. For me the key seems to be keeping the carbs fairly low, adjusting protein to make things work, and topping off with fat, and I have a wacky endocrine system. I did raise carbs for a while (staying usually at or below 50g/d), partly to test this idea, and I am back down to 30 now and planning to go lower. It does appear that a very occasional hi-carb "jolt" could help to break out of "stuck" situations. For me, "high" means 70 grams in a day, not hundreds, and "stuck" means truly stuck. I have only tried it once so far.

I don't think now that the problem I was having was was thyroid, and I don't think that people should avoid a ketogenic diet because it might cause thyroid problems. You have to stay with it until you figure it out, backing off when required (due to severe symptoms) and trying different things, as I was suggesting earlier.

thank you Megan for the link.
I was trying to try to understand this topic for last couple of weeks. As I mentioned I am having low thyroid issues (TSH 7.85), low blood sugar issues ( after 2hrs of heavy paleo diet it reaches 65 to 75 max ) and very low iodine levels ( 20 - healthy limit is 100 or so ), cortisol levels at lower end of healthy range. I went to a natural doctor associated with this author of the book "Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal" by Dr. Kharrazian. This natural doctor thinks I should increase my carbs or do heavy exercise. I did tried sweet potato to test it still less than 30 grams carbs, it does increase blood sugar to normal level . I tried stopping carbs then blood sugar drops again. It raises interesting question. exercise or IF seems to have not made much difference. I will increase the bone broth more and see whether that will heal this condition.

what are the healthy levels of blood sugars ? some say 65-100 , some say 80-100 and others more. the doctor I visited says 80-100. After 2 hr meals 100-140

what should be healthy blood sugar levels after zero carb paleo diet ( after 2 hours)- Does it still needs be above 100 ?.

If cortisol is responsible for balancing the blood sugar, Is it adrenal fatigue is not creating cortisol to balance blood sugar ? . This is a loop.
Or is it low calorie food, responsible for not converting the enough T3 from T4? I haven't tested inactive reverse T3 to check that. It is quite possible I haven't put enough calories in the past.
Quite a lot of controversy regarding impaired T4 to T3 conversion with a paleo.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

Yes, this thyroid thing keeps coming up in many paleo discussions. When listening to the latest 'ask the low carb experts' with Phinney, with the Q:s and A:s I was a bit surprised by the fact that Phinney didn't mention the relation between thyroid problems and adrenal exhaustion, or leptin. He just said that people often self diagnose them having thyroid problems, and taking thyroid supplements is a very delicate matter that should be supervised by a health care professional. Those are wise words, no doubt, but I would have expected him to elaborate quite a lot - adrenals, stress, leptin etc.

Another thing that bothered me a little was Phinney's response to the question of intermediate fasting. He repeated that "he's not a big fan of fasting" and that the human body needs consistency in energy input. And that was that! He probably knows a lot more details than he was telling in this program, but somehow I got the feeling that he's stuck in his old ways, not that innovative, if you get what I mean. But I could be totally wrong.

I mean, e.g. Gedgaudas and her colleagues emphasise strongly that thyroid problems are commonly just the symptom of an underlying problem, and most often it's about adrenals and stress, and leptin. And that you should always start at the top (leptin, adrenals) when trying to resolve thyroid problems, NOT start supplementing with thyroid hormones right away.

Maybe these people who experience thyroid problems, when going paleo, are in fact under a lot of stress? I know some folks who's sole reason for going paleo/LCHF is to get slim and look good/perfect - and they get SO stressed with getting results that they finally give up because they feel so miserable (thyroid problems?).

There are several things going on in this discourse. First of all, Kresser wins over Phinney on looks, I think. If only Kresser had a voice to go with his looks. But more importantly, Kresser is a licensed acupuncturist while Phinney is an MD (one trained in nutrition!), and they have rather different worldviews, it would seem.

To hear him tell it, Kresser sees some rather sick people, and these may be people that Phinney & Volek would exclude as test subjects. We already know that ketogenic diets can present a challenge for people with significant damage. So they might be talking about different segments of the population.

You can see here some of what I meant earlier about the value of listening to the sources (and viewing them when possible) -- the researchers themselves, including Phinney & Volek here, and also Rosedale (I think someone posted a link to one of his presentations earlier). It can give you a better sense of their strengths and biases.

My impression at this point of the endocrine system, having struggled all my life with what would appear to be a damaged one, is that it is not hierarchical but circular. Mess with part of it and you will see effects all around. Low thyroid, in the absence of observable disease, doesn't necessarily mean "bad thyroid." And low adrenal hormones (my big issue) don't necessarily mean bad adrenals. (I actually examined my adrenals, in a CT scan, in consultation with a specialist. They looked fine! It's really weird to look at your own insides.)

If there is any unifying issue in endocrine problems, I suspect that it is inflammation, with gut and brain inflammation being the most common forms. Endocrine "imbalances" may actually be correct, compensating responses, but when you don't remove the original cause there is only so much the body can do. Stress is also a factor, though I have to wonder if proneness to stress might arise from inflammation as well.

Your remark about Phinney's view of IF goes with mine about the way he favors "consistency." There, I just think he's wrong. "Variation" is a central theme in living systems, for a good reason I think. Consistency, not so much. Consistency is more critical at the lower levels of the "life system" because so many layers depend upon it. At higher levels we see reproduction with variation. Lots and lots of different experiments. And that is what I find that I need to do too. Phinney might be right at some level, but wrong in terms of the big picture.

 

[aragorn]

Re: Ketogenic Diet - Path To Transformation?

Another thing that surprised me with Phinney in the podcast was that he didn't mention food sensitivities, at all! Maybe, as you say Megan, he's just so focused on his area of expertise that he's not seeing the forest from the trees?

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

thank you Megan for the link.
I was trying to try to understand this topic for last couple of weeks. As I mentioned I am having low thyroid issues (TSH 7.85), low blood sugar issues ( after 2hrs of heavy paleo diet it reaches 65 to 75 max ) and very low iodine levels ( 20 - healthy limit is 100 or so ), cortisol levels at lower end of healthy range. I went to a natural doctor associated with this author of the book "Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal" by Dr. Kharrazian. This natural doctor thinks I should increase my carbs or do heavy exercise. I did tried sweet potato to test it still less than 30 grams carbs, it does increase blood sugar to normal level . I tried stopping carbs then blood sugar drops again. It raises interesting question. exercise or IF seems to have not made much difference. I will increase the bone broth more and see whether that will heal this condition.

what are the healthy levels of blood sugars ? some say 65-100 , some say 80-100 and others more. the doctor I visited says 80-100. After 2 hr meals 100-140

what should be healthy blood sugar levels after zero carb paleo diet ( after 2 hours)- Does it still needs be above 100 ?.

If cortisol is responsible for balancing the blood sugar, Is it adrenal fatigue is not creating cortisol to balance blood sugar ? . This is a loop.
Or is it low calorie food, responsible for not converting the enough T3 from T4? I haven't tested inactive reverse T3 to check that. It is quite possible I haven't put enough calories in the past.
Quite a lot of controversy regarding impaired T4 to T3 conversion with a paleo.

First of all, be careful with measurements. Some of these readings can vary quite a bit from one sample to the next. That can be due to natural cycling in your body, margins of error in the tests, or a lab tech having a bad day. There is often the possibility that a single reading is not significant.

If you have your own low-cost glucometer for glucose measurements, you can calibrate it by taking a reading both with a high-quality instrument and your own device at the same time. Then you will know about how much to correct the reading. ("Reading error" rears its head once more!) This idea comes from Chris Kresser; at least that is where I saw it.

Next there is the matter of "healthy ranges." When you receive back a test report, the ranges presented may be "lab ranges," which reflect what is "normal" for the lab. You might well guess that the people submitting the samples tend on average not to be the healthiest people in the world, and that "normal" might be skewed toward unhealthy.

Another common kind of range or threshold is that provided by pharmaceutical companies. They choose their thresholds so as to sell lots of product. So what, really, is a healthy range? I don't know. Dr. Cate says that fasting glucose of 125 is the standard level for diagnosing diabetes, but that if she sees a level of 89 or higher she recommends a low-carb diet (100 g/d or less), because that is the level she observes in her medical practice where the trouble seems to start. Mine last reading was 104, but then I am on a <50 g/d diet, and I don't worry about it.

I wish I could remember this better, but while the glucose reading needs to be taken while fasting, there is another measure that needs NOT to be taken while fasting. I don't remember which -- part of the lipid panel, perhaps. But all the readings are commonly taken at the same time, so there is a potential source of error right there.

If you really want to feel some confusion over thyroid readings, have a look at
_http://raphaelkellmanmd.com/health-issues-we-treat/the-thyroid-autism-connection/

You can skip down below the symptom list. The discussion of accuracy of thyroid test starts one paragraph after that.

Sorry if this seems to make things less clear, but it's better to be aware of it. I just keep thinking about our (presumably) healthy paleolithic ancestors with no access to lab tests, pre-screenings, or any sort of medical technology and doing pretty well without it. It can be helpful, or it can get in the way. Part of our lessons, I guess.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

Another thing that surprised me with Phinney in the podcast was that he didn't mention food sensitivities, at all! Maybe, as you say Megan, he's just so focused on his area of expertise that he's not seeing the forest from the trees?

Westman, Phinney, and Volek, the authors of The New Atkins for a New You, are low carbers with a medical perspective. Westman and Phinney are MDs if I remember correctly (Volek is a PhD). You shouldn't be too surprised. They are not paleo/primal advocates. They do give a token nod to elimination testing in the book, but OMG some of the foods they suggest you eat.

 

[monotonic]

Re: Ketogenic Diet - Path To Transformation?

Citric acid, like found in lemons and limes, also has more useful mineral salts, and is more feasible than lactid acid (ha...). Surely it will be better than vinegar. Is it forbidden to squeeze a lemon into the bone broth? Citric acid can also be bought in pure form. On another note, I just realized apple cider vinegar has a mix of malic, lactic and citric acids, which only makes sense since apples "especially green" contain malic acid which is broken down to lactic acid. However the main component still appears to be acetic acid. A mix of lactic, citric and malic acids seems ideal which may be one reason cider vinegar has so many reported benefits - but for dissolving food minerals acetic acid seems questionable.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

Citric acid, like found in lemons and limes, also has more useful mineral salts, and is more feasible than lactid acid (ha...). Surely it will be better than vinegar. Is it forbidden to squeeze a lemon into the bone broth? Citric acid can also be bought in pure form. On another note, I just realized apple cider vinegar has a mix of malic, lactic and citric acids, which only makes sense since apples "especially green" contain malic acid which is broken down to lactic acid. However the main component still appears to be acetic acid. A mix of lactic, citric and malic acids seems ideal which may be one reason cider vinegar has so many reported benefits - but for dissolving food minerals acetic acid seems questionable.

If you are concerned about cooking bones with vinegar then you can leave the vinegar out. It isn't required.

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

Citric acid, like found in lemons and limes, also has more useful mineral salts, and is more feasible than lactid acid (ha...).

monotonic,

I don't quite understand why you are going on about lactate. I really think that this is a non-issue for all of us.

Lactate is only produced under very specific conditions (lack of oxygen to cover immediate metabolic needs), which only happen in extreme circumstances. One of these would be cardiac arrest, where the oxygen supply is interrupted and the cells switch over to anaerobic glycolysis for a little while. So this is a backup mechanism to give the body the means to survive a little bit longer ... That is also the reason that the brain is happy to utilize lactate - to enable it to survive a little longer in the absence of oxygen (only works for a few minutes).

Vigorous exercise also produces some lactate, but it is cleared very quickly from the blood and metabolised to bicarbonate. I don't think that this is contributing to our basic energy needs at all.

To sum it up - lactate is a last-ditch metabolic pathway only used in extreme situations ...

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

Phewww .... just caught up with this thread - it was moving so fast that it took me days to get up to speed.

As previously mentioned my current regime is the following:
- Normal day:
* Breakfast as usual (pork belly and lard plus bone broth)
* Dinner with bone broth and some meat and a little bit of veggies
* Workout before dinner (eccentric resistance training)
- Off day:
* Breakfast as usual (see above)
* bone broth only if I feel hungry (which usually is not the case), other than that fasting until next breakfast
* no workout

After having hit a wall with loosing weight I have now started to shed pounds again. I will continue the above regime until I have reached my lean weight. Then I will adjust the meals accordingly to stabilise my weight. My energy levels are relatively ok, some bone pain and heavy legs on my days off. Ketone strips usually in the dark purple range.

One of the problems I have is to find a source of bacon without nitrites. Here in Australia it is illegal to sell cured meat without nitrites (nanny state!). This is the reason I use pork belly, but for convenience I would really love to have bacon. Has any of the Ozzies had any luck of sourcing some nitrite-free bacon?

The other problem is that I will have to go overseas for 4 months for professional reasons and will most probably not have access to bone broth. My plan is to fully cold adapt (as the place I'm going will be very cold) and just eat whatever is available (meat/ veggies) and top this up with butter/ ghee. My main focus will be to maintain my body in ketosis. I don't see any other way of doing this - but if anyone has a better suggestion I would be very happy indeed.

 

[Iarrthoir Firinne]

Re: Ketogenic Diet - Path To Transformation?

One of the problems I have is to find a source of bacon without nitrites. Here in Australia it is illegal to sell cured meat without nitrites (nanny state!). This is the reason I use pork belly, but for convenience I would really love to have bacon. Has any of the Ozzies had any luck of sourcing some nitrite-free bacon?

Hi Nicklebleu

I'm not sure where in Oz you live, I am in Sydney. My local butcher sells nitrate free bacon and ham. Would they be of interest to you?

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

One of the problems I have is to find a source of bacon without nitrites. Here in Australia it is illegal to sell cured meat without nitrites (nanny state!). This is the reason I use pork belly, but for convenience I would really love to have bacon. Has any of the Ozzies had any luck of sourcing some nitrite-free bacon?

Hi Nicklebleu

I'm not sure where in Oz you live, I am in Sydney. My local butcher sells nitrate free bacon and ham. Would they be of interest to you?

I live in Darwin, but will be in Tassie soon - is he producing that himself? Or is it one of the bigger brands sold all over Oz?
Wonder how he gets away with no nitrates ...

 

[Carl]

Re: Ketogenic Diet - Path To Transformation?

The other problem is that I will have to go overseas for 4 months for professional reasons and will most probably not have access to bone broth. My plan is to fully cold adapt (as the place I'm going will be very cold) and just eat whatever is available (meat/ veggies) and top this up with butter/ ghee. My main focus will be to maintain my body in ketosis. I don't see any other way of doing this - but if anyone has a better suggestion I would be very happy indeed.

Well usually where there's meat, there's bones. Why do you think you will not have access to broth?

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

The other problem is that I will have to go overseas for 4 months for professional reasons and will most probably not have access to bone broth. My plan is to fully cold adapt (as the place I'm going will be very cold) and just eat whatever is available (meat/ veggies) and top this up with butter/ ghee. My main focus will be to maintain my body in ketosis. I don't see any other way of doing this - but if anyone has a better suggestion I would be very happy indeed.

Well usually where there's meat, there's bones. Why do you think you will not have access to broth?

... because the food is all pre-packaged and "tidied up" to reduce transport costs! Also access to a kitchen might be a problem, even if there are bones around.

 

[Ollie]

Re: Ketogenic Diet - Path To Transformation?

For the last week I’ve experimented with Intermediate Fasting, even though I was in ketosis – to see the effect, if any. I did it for two spaced out days in the week.

On a normal day:
Breakfast - pork sausage patties and lard plus diluted bone broth (quarter broth plus salt) and butter (plus prostate and digestion supplements)
Lunch – meat or fish and lard and butter (plus prostate and digestion supplements)
Workout before tea-time (type depends on where at during week – resistance training, sprints, walks or rest)
Tea-time – cold meat or fish and butter (plus prostate and digestion supplements)
Evening – supplements before bed

Intermediate fast day:
Breakfast - pork sausage patties and lard plus diluted bone broth (half and half plus lard and salt) and butter (plus prostate and digestion supplements)
Lunch – diluted bone broth (half and half) (plus prostate and digestion supplements)
Workout before tea-time (walk or rest)
Tea-time – diluted bone broth (half and half and salt) (plus prostate and digestion supplements)
Evening – supplements before bed

In addition, I’m taking cold baths twice week - not on the fast day

The only noticeable effect has been runny stools on the day (post-breakfast) after Intermediate Fast days. First time I put it down to taking HCl with the broth, so on the second day I cut this out, so it must be something else, possible because of the ‘diluted’ broth, rather than full. Otherwise there was no noticeable effect, energy levels just the same as before (full ketosis). The most interesting part was a lack of hunger through the day of the fast. And, as Laura says ‘It's definitely a cheap way to stay nourished!’ It just goes to show that it is possible to ‘survive’ on a very low ‘food’ input. :)

In the future I may continue with Intermediate Fasting either one day a week or every two weeks, or as the mood takes me. :)

It was also the week that I started doing resistance training (twice) and sprints, well that was a real revelation! :D A lot more is required to get into the 'zone' with these (especially pull ups ), although there was no noticeable after effect, other than a few stiff abdominal muscles the next day.