3

votes

3 months strict zero carb - can't induce ketosis. What to do?

Answered on September 12, 2014
Created August 18, 2012 at 3:32 PM

Hello All,

I???ve been trying to get into ketosis for 3 months, and I can???t seem to do it. I???m someone can give me some insight on what???s happening and how to induce ketosis in stubborn adaptors like myself.

I???m a 43 year-old male, 5???7, 94 kg. I???ve been on a strict zero-carb diet for 3 months. Almost immediately on going zc I found that joint and muscle aches and pains that I???d had for years disappeared. I???ve also suffered from depression, and my depression is in remission. Which is amazing.

However, after a full three months of being super careful zero carb, I am still not in ketosis, and I???m utterly exhausted most of the time.

For the first month, I ate a wide variety of foods but kept my carb intake to as close to zero as possible. I was not in ketosis after a month, so I transitioned to an all-beef diet for 6 weeks. Over time I found that I was gradually feeling worse and worse ??? I simply had no energy, and each day was a long struggle just to do basic things.

About three weeks ago I started reintroducing other food ??? cheese and eggs, at first, and then butter. This helped somewhat with brain clarity, but the low energy continued. A week ago at the suggestion of some of the great folks on the ???zeroing in on health??? forum, I stopped drinking caffeine and increased my intake of eggs. When I started zc, I was drinking up to a gallon of coffee and tea per day. Cutting caffeine also seemed to help with brain clarity.

I also had a major realization, which was that I was not at an 80/20 fat/protein ratio. I started tracking on fitday, and I found that I had probably been way out with regard to the ideal ratio.

So I made adjustments and I???m now on my 8th day of eating a 80/20 fat/protein ratio. My diet is butter, eggs, ground beef, beef roast and a little liver ??? sometimes some chicken. I???m supplementing with magnesium, a multivitamin (no iron), vitamin E, a probiotic and 10000 units D3. I???m also taking 5-6 spoonfuls of coconut oil each day. In the last couple of days, I???ve brought down my caloric intake, too.

At the beginning of zc, I had good days followed by 1-2 day long energy crashes where I couldn???t do anything. Now I have a constant ongoing low level of energy, and I feel crap most of the time. Sometimes I seem to get small windows of feeling good ??? an hour or two at a time ??? but the dragging-ass state comes back. Mornings have been really rough for the past few days. It???s a struggle just to get up and go through the day, and I???m finding it hard to think. Evenings have also been quite low energy.

I got some ketostrips and I???m using them. So far, no ketosis during the day. I see mild ketosis when I test my pee in the middle of the night. Blood glucose is ranging from 100-110. I did blood tests about a month ago. Almost everything was normal, but my cholesterols were up a bit. In addition, my TSH was a bit high 5.82 (5.5 -0.35 normal range). I???ve been high in the past, and it has come back into the normal range, so I don???t know if this is an exception or a sign of something to check. FT4 was normal, testosterone was a bit low but in the normal range.

My recent food numbers are as follows: Date F/P Ratio Calories: 17/08/12 75/24 1731, 16/08/12 73/26 2810, 15/08/12 76/23 2427, 14/08/12 81/19 2820, 13/08/12 75/23 3022, 12/08/12 79/20 2136, 11/08/12 80/20 1859

So??? I???m wondering if you have any idea what might be going on with me. Why can???t I get into ketosis? I seem to be stuck in some kind of no-man???s land. Gluconeogenisis is working well, but I have almost zero energy reserves, and I still can???t get into ketosis. What do I need to do to induce ketosis? What might be blocking me from getting into ketosis? Any resources I can turn to to help crack this problem?

Thanks,

Daniel

886436139cec4c2fbf30d26a40a0fc06

(219)

on November 24, 2012
at 12:47 AM

hey, i'm hypothyroid . .i find that muscle aches, brain fog, and fatigue are common whenever my TSH is above 3, even if the T3 and T4 is normal. Who knows why? Some people are not so sensitive and do fine a the higher end, you may not be one of those people -- were you ever a vegetarian or vegan before? if so, lack of zinc/selenium may be impeding your thyroid function, and this should correct with good paleo eating. otherwise, you should consider a second opinion on thyroid medication .. .i admire your tenacity

10f6f47a7cfd16e24b9ba5d6bb44ec64

(60)

on September 14, 2012
at 10:11 PM

Get off your high horse, I'm not retarded. Maybe no fruit, but applicable veg., yes. Anyway, this person can think for themselves and this was a suggestion.

61f9349ad28e3c42d1cec58ba4825a7d

(10480)

on September 14, 2012
at 05:47 PM

For ketosis? No.

5bc61961126827414874d0af0b4e33cd

on September 02, 2012
at 01:13 AM

I should also point out that ketosis may be hard to detect on the sticks after a while. If you truly are in fat-burning mode, from what I understand you excrete ketones for a while, then a more efficient mechanism kicks in. You still excrete some byproduct but it isn't ketones in your urine. Your urine will smell funky, but it is a different funky. I'm still looking for the source of that information.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:51 AM

Thanks, David. Very helpful response. Yes, I'm seriously considering adding in some carbs to see how I do as a vlc/lc.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:47 AM

Thanks, Monte. Much appreciated.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:46 AM

Thanks, Man With a Middle. I'm going to consider your strategy - may well be a better option for me.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:45 AM

Great link. Very useful. Thanks, VB.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:45 AM

Thanks, ThinnerStrength!

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:44 AM

Thanks, Maria Anna.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:44 AM

Thanks all for the very helpful comments!

F5a0ddffcf9ef5beca864050f090a790

(15515)

on August 19, 2012
at 09:59 AM

Oh, thanks! I do not eat eggs and do not use iodized salt. Which fat worked for you because I cannot seem to find a fat that my system can handle?

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on August 19, 2012
at 09:35 AM

I can't imagine your all meat diet provides enough nutrition, as it stands. Your not eating nose to tail, and your not eating a wide variety of different meats. TBH its easier to just eat some veg and fruit IMO. Whatever your goal is, chances are you can at _least_ fit some non-starchy veg in there! (And id suggest a bit of carb may be a good idea as I advise above, especially if your low energy is accompanied by a lower heart rate)

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on August 19, 2012
at 09:26 AM

If your getting an advantage from being lower carb, Id still recommend - a bit of fruit, some low-starch vege, and some salmon or brazil nuts occasionally for selenium (or lamb).

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on August 19, 2012
at 09:24 AM

What your heartrate like? is it a bit low?

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on August 19, 2012
at 09:18 AM

I agree this diet may be causing hormonal changes, partly because its too rapid, partly because of all those eggs. TSH isnt a very good indicator tho. Free t3 and t4 are the cornerstones.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on August 19, 2012
at 09:16 AM

I guess carb intake may factor into that too. But I suspect its equally about the introduction of more fat. Either way, if your radically changing your diet, your better to vary as much as possible, and not rely on "staples", lest the some nutrient goes into overload...

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on August 19, 2012
at 09:13 AM

^ did the opposite for me, all the zinc and iodine in the food triggered hyper. Seems to be better now ive lowered my iodine. But its well understood that if your initially on a low iodine diet, that a high iodine diet can trigger hyperT (or more rarely hypo). Eggs are very high in iodine. Id actually recommend people dont go from very poor diets, onto diets with lots of fish, eggs or iodised salt, because the thryroid quite is sensitive to dietary changes.

1c67bc28f4e44bbb8770b86df0463df3

(6719)

on August 19, 2012
at 01:39 AM

yes, you should take a day where you eat little fat and a ton of carbs, drink lots of water that day too.

1c67bc28f4e44bbb8770b86df0463df3

(6719)

on August 19, 2012
at 01:37 AM

Your IN KETOSIS, the longer you are in Ketosis the less ketones in your urine. You need to stop NC/VLCing it as you are screwing up your hormones which are screwing up your Thyroid hormones and god knows what else. Start consuming carbs and stop eating so much grain fed processed fat!!!

6120c989fd5b69f42a0834b69b87955b

(24553)

on August 18, 2012
at 04:34 PM

The nudge upwards in cholesterol also points to reduced thyroid function.

6120c989fd5b69f42a0834b69b87955b

(24553)

on August 18, 2012
at 04:30 PM

Your lab is using an outdated range for TSH. The new standard is .3-3.0. You are well into hypothyroidism. I know all this because I had the same thing happen when I was initially tested about 10 years ago, and my TSH was 5.6 and I couldn't concentrate well enough to drive and had to sleep 12 hours per day, but supposedly everything was "normal". Your energy levels would likely benefit from a prescription for Naturethroid or Armour (avoid Synthroid if at all possible, it makes the labs look better, but many report that their symptoms continue on it.)

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10 Answers

4
43f469552cfd3be73fc88a9821b14986

on August 18, 2012
at 03:49 PM

Buy a glucometer like Abotts Precision XTra. It measures blood sugar and blood ketones. Urine ketone strips are worthless.

Excess protein (over circa 120g on no carb, or 60+g in moderate carb) turns to sugar.

To induce ketosis, eat a low carb diet, moderate protein and high fat diet.

So lower your protein, raise your fat and check your blood glucose after eating. If it goes up significantly post eating and is above 100 2 hours post meal, lower your carbs an protein.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:45 AM

Thanks, ThinnerStrength!

3
E8fbc8067e64d0994aa70171601e68fd

(297)

on September 14, 2012
at 06:46 PM

I am astonished that a major component of this question hasn't been addressed -- that you shouldn't actually care whether you're in ketosis, because that's an unreliable gauge of whether you are producing ketones.

Ketosis is the state of having EXCESS ketones.

Ketogenesis, meanwhile, is the state of generating ketones. You can be in ketogenesis but not in ketosis.

Most people get into ketosis (producing excess ketones) and then, after a period of days or weeks, stop producing excess as the body learns how much it needs.

THe important thing to realize here is that you can't use ketone strips to test whether you are in ketogenesis.

3
Medium avatar

on August 18, 2012
at 04:06 PM

Have you considered 'fat fasting'?

1c67bc28f4e44bbb8770b86df0463df3

(6719)

on August 19, 2012
at 01:39 AM

yes, you should take a day where you eat little fat and a ton of carbs, drink lots of water that day too.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:44 AM

Thanks, Maria Anna.

2
F5a0ddffcf9ef5beca864050f090a790

(15515)

on August 18, 2012
at 06:36 PM

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:45 AM

Great link. Very useful. Thanks, VB.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on August 19, 2012
at 09:13 AM

^ did the opposite for me, all the zinc and iodine in the food triggered hyper. Seems to be better now ive lowered my iodine. But its well understood that if your initially on a low iodine diet, that a high iodine diet can trigger hyperT (or more rarely hypo). Eggs are very high in iodine. Id actually recommend people dont go from very poor diets, onto diets with lots of fish, eggs or iodised salt, because the thryroid quite is sensitive to dietary changes.

F5a0ddffcf9ef5beca864050f090a790

(15515)

on August 19, 2012
at 09:59 AM

Oh, thanks! I do not eat eggs and do not use iodized salt. Which fat worked for you because I cannot seem to find a fat that my system can handle?

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on August 19, 2012
at 09:16 AM

I guess carb intake may factor into that too. But I suspect its equally about the introduction of more fat. Either way, if your radically changing your diet, your better to vary as much as possible, and not rely on "staples", lest the some nutrient goes into overload...

2
E35e3d76547b18096a59c90029e7e107

(15613)

on August 18, 2012
at 04:29 PM

I think you were right to lower protein (insofar as your goal is simply reaching ketosis by any means necessary). Protein can be (and will be) turned into glucose by your body. There's little point worrying about 5g carbs here or there, if you're eating an excess 30g protein (from the standpoint of ketosis). Protein is specifically mentioned here in this connection. 1.5g per kg (lean bodyweight) per day, is suggested.

I would also strongly suggest intense exercise (not easy when you feel weak and exhausted, of course, but I often find it possible to do a few minutes worth of short bursts of weight-lifting however tired I am). If you look at this table, you'll note that post-exercise ketone levels were comparable to people who've been totally fasting for 48 hours.

3-months-strict-zero-carb---can't-induce-ketosis.-what-to-do? http://healthcorrelator.blogspot.co.uk/2010/04/ketones-and-ketosis-physiological-and.html

Anyway, if zero carbing, low protein, as much coconut as you can eat, intense exercise and fasting don't get you into ketosis or improve your position at all, it's probably time to give up on ketosis. It's probably worth seeing if adding back in some paleo acceptable carbs (vegetables, fruit, potato) don't make your position worse. On the broader question of low energy, you might be lacking salt and potassium on this diet- I've sometimes found that they perk me up when I've been low carbing (I find low sodium 'potassium salt' is the easiest source, so long as it has an appropriate ratio).

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:51 AM

Thanks, David. Very helpful response. Yes, I'm seriously considering adding in some carbs to see how I do as a vlc/lc.

2
6d64cd6dc98d6ab763bd03678a317964

(2177)

on August 18, 2012
at 04:28 PM

During the first weeks of ketosis, approximately 75 grams of glucose must be produced (the other 18 grams of glucose coming from the conversion of glycerol to glucose) to satisfy the brain???s requirements of ~100 grams of glucose per day. After approximately 3 weeks of ketosis, the brain???s glucose requirements drop to approximately 40 grams of glucose. Of this, 18 grams are derived from the conversion of glycerol, leaving 25 grams of glucose to be made from protein. Since 58% of all dietary protein will appear in the bloodstream as glucose (3), we can determine how much dietary protein is required by looking at different protein intakes and how much glucose is produced (table 1).

Table 1: Protein intake and grams of glucose produced *

Protein intake (grams)                Glucose produced (grams)
50                                                     27
100                                                     58
125                                                     72.5
150                                                     87
175                                                     101.5
200                                                     116

* Assuming a 58% conversion rate

Assuming zero carbohydrate intake, during the first 3 weeks of a ketogenic diet a protein intake of ~150 grams per day should be sufficient to achieve nitrogen balance. Therefore, regardless of bodyweight, the minimum amount of protein which should be consumed during the initial three weeks of a ketogenic diet is 150 grams per day. After 3 weeks of ketosis, as little as 50 grams of protein per day should provide enough glucose to achieve nitrogen balance. The inclusion of exercise will increase protein requirements and is discussed in chapter 9.

From "The Ketogenic Diet" by Lyle McDonald

You may be in ketosis. The urine levels don't tell you much. You could be using all the ketones and not peeing them out and so they won't show in your urine but your are definitely in ketosis. Best bet is to log your food daily to see how many net carbs you really are ingesting AND how much protein your taking in. After three weeks your requirements go down and you may be kicking yourself out of ketosis even on zero carb!!!

You may also want to supplement with "ketogenic amino acids". See: http://perfecthealthdiet.com/2011/02/ketogenic-diets-i-ways-to-make-a-diet-ketogenic/

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:47 AM

Thanks, Monte. Much appreciated.

1
7bf306ada57db47547e9da39a415edf6

(11214)

on September 14, 2012
at 06:26 PM

You have been in ketosis. What the strips show are excess ketones that weren't burnt in the urine; you have been burning them as fuel rather than throwing them away in the urine.

The first thing to do, rather than imagine a dire situation with your thyriod and start gobbling down carbs, is eat more fat and possibly reduce the amount of protein you eat at any one sitting. Too much protein at once can interefere with ketone production, so can not eating enough, and, of course, carbs cheats will shut it down too.

I spent a lot of time in a situation where I wasn't getting enough of any one fuel source, and since I binge too easily on carbs, more of them wasn't the answer. Eat more was the answer. I was too much in the habit of dieting to lose weight, and while in ketosis, I just didn't feel hungry.

1
10f6f47a7cfd16e24b9ba5d6bb44ec64

on September 14, 2012
at 05:41 PM

Please add some vegetables to your diet, and some berries/fruits!

61f9349ad28e3c42d1cec58ba4825a7d

(10480)

on September 14, 2012
at 05:47 PM

For ketosis? No.

10f6f47a7cfd16e24b9ba5d6bb44ec64

(60)

on September 14, 2012
at 10:11 PM

Get off your high horse, I'm not retarded. Maybe no fruit, but applicable veg., yes. Anyway, this person can think for themselves and this was a suggestion.

1
5bc61961126827414874d0af0b4e33cd

on August 18, 2012
at 03:55 PM

Is your objective fat loss? Are you losing weight on this diet currently? How are you determining ketosis?

Some people do very poorly on zero carb. I did it for a while and had a similar experience as yours.

You might consider very low carb. Experiment with how many grams it takes for things to work out. Adding a few carbs occasionally actually got me over the hump and I get into ketosis rather easily.

I have settled on an intermittent fasting routine, one meal a day in the evenings. My carbs come in the form of vegetables and the occasional potato. I get into ketosis pretty regularly simply due to the calorie restriction and a few grams of carbs doesn't seem to hurt me. I am doing about 1500 calories per day, carbs generally less than 40 g (some days zero, some days all 40).

If your energy is bad, something needs to budge. Fat burning ketosis should make your energy good and steady once you have adjusted to it.

C82b0ef3aa73b4b7329643113b28ec10

(18)

on August 20, 2012
at 05:46 AM

Thanks, Man With a Middle. I'm going to consider your strategy - may well be a better option for me.

5bc61961126827414874d0af0b4e33cd

on September 02, 2012
at 01:13 AM

I should also point out that ketosis may be hard to detect on the sticks after a while. If you truly are in fat-burning mode, from what I understand you excrete ketones for a while, then a more efficient mechanism kicks in. You still excrete some byproduct but it isn't ketones in your urine. Your urine will smell funky, but it is a different funky. I'm still looking for the source of that information.

0
07ff38ef327592624872a4d2c44bf920

on November 24, 2012
at 12:30 AM

You are taking in too much protein. I solidly disagree with Lyle McDonald on this one. If you are having some metabolic dysfunction (which you appear to be having), your body is creating glucose from all of that protein. This will keep you out of ketosis for sure.

Ketostix are almost useless. Get a blood ketone monitor and aim for between .5 and 3 mM. Pick up a copy of "The Art And Science of Low Carb Performance" by Voleck and Phinney.

And... there is really no evidence that low carb diets affect your thyroid, even tho that is the popular consensus. Check Jimmy Moore's site for more info on that topic...

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