This is a weird one. I have been eating paleo for the past five years and ketogenic paleo for the past year. I've had psoriasis all my life and about 5 years ago was diagnosed as pre-diabetic. I've had great results eating this way, specifically the ketogenic diet clearing up my psoriasis by about 80% and keeping my blood sugar down without the need to be on any medication. I was recently diagnosed with Cushing's disease which causes an excess of cortisol to be present in my body at all times. Since that diagnosis I have not been able to maintain ketosis. I asked my endocrinologist about that and he said it makes perfect sense since cortisol causes gluconeogenesis. I will have surgery at some point in the next few months to remove the tumor that is causing the excess cortisol but in the mean time, I am trying to figure out what best to eat to keep my body from packing on every possible pound. I've been so high-fat/ultra low-carb focused for the past year and loving it so it's hard to re-wrap my head around something new again. If I can't be in ketosis do I need to suddenly start counting calories? Do I need to go low-fat/slow carb? Chicken breasts and brocoli for every meal? Oh dear. Thanks for any advice/speculation you might have.
asked byusagi (55)
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on March 23, 2017
at 03:53 PM
Cortisol stimulates gluconeogenesis (the formation of glucose), and if it's too high, the excess glucose will signal insulin, and insulin prevents fat cells from releasing their stores, and instead instructs them to store glucose as fat. That's what you're seeing.
Look into Holy Basil (aka Tulsi) tea, and phosphatidylserine supplementation. Additionally to holy basil, a good PS stack would be (this comes from Sara Gottfried's recommendations):
- Fish Oil (Omega-3): 1,000 – 4,000 mg/day
- Phosphatidylserine (PS): 400-800 mg/day
- Rhodiola: 200 mg once/twice per day
Consuming some carbs would normally lower cortisol and shut down gluconeogenesis but not if there's a tumor causing it.
Meanwhile supporting your adrenals is necessary, so drink some water with a teaspoon of sea salt each morning and take plenty of Vitamin C. (You can squeeze a lemon or two into the salt water)
You do need some carbs, more specifically fiber for your gut bacteria, especially if you're on a ketogenic diet. BTW, a ketogenic diet isn't ideal here as it will stimulate more cortisol. So you want to stay low carb, but not very low.
Maybe 50-100g/carbs/day and don't count any fiber a carb calories. i.e. leafy greens, veggies such as cellery should be counted as zero carbs. Starches such as carrots, sweet potatoes, batatas, yams, etc. should be counted instead.