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Supposedly in ketosis, but still hungry and panicky

Answered on January 21, 2015
Created May 29, 2014 at 9:56 AM

Last year I tried paleo for 6 months, and basically gave myself 6 months of blood sugar swings and gradual body composition losses as my body insisted on cannibalizing its muscles instead of burning fat. Recently I decided to try a low-carb diet in hopes that I could jumpstart fat burning by getting into ketosis and then going gradually back up on carbs.

My goals are to see if fat-adaptation leads to improvements in energy and mental clarity, or if it helps with my chronic joint pain and heartburn. I don't want to lose weight -- I'm already skinny with low body fat and very low muscle mass, due to joint problems that prevent me from doing any kind of strength training (yes, *any* kind).

So, I'm now on week two of low-carb. Urine testing indicates that I'm consistently producing low levels of ketones, but I'm emotionally volatile and constantly hungry about half the time, and nauseous much of the rest. I frequently feel stressed, panicky, and angry, which is similar to how I was feeling when I was doing my previous run with paleo and gradually losing muscle mass. I don't want to go through that again! Does anyone have suggestions on how to hasten keto-adaptation / fat-adaptation?

Details on my diet: I'm eating moderate amounts of meat and eggs, lots of dairy fat, coconut, and olive oil, and some nuts. Some vegetables, but it's hard to eat much when I'm this low on carbs. Almost 100% grain-free, and no alcohol, artificial sweeteners, or other weird stuff. I'm getting 25-35g net carbs per day, about 80g protein, and at least 150g fat. I'm averaging just over 2000kcal total, which is a little more than I was eating before. I'm not highly active but I do walk 4-5 miles every day.

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I've been asked if I'm insulin resistant or prediabetic, but I don't think so. My regular diet is moderately high-carb, but pretty low GI and low on anything refined. I had my fasting glucose and insulin measured just before I started low-carb and they were 79 (glucose) and 2.4uIU/mL (insulin).

72cf727474b8bf815fdc505e58cadfea

on June 22, 2014
at 04:45 AM

I just couldn't get myself to consume Atkins induction quantities of meat, but I did take your advice and start eating more of it. It seems like that did the trick! Or possibly I just needed a little more time to adapt. Either way, thanks for your response.

72cf727474b8bf815fdc505e58cadfea

on June 03, 2014
at 04:57 AM

By the grain-free comment, I meant that I'm not eating any grains at all. I'm just not making a special effort to avoid trace quantities like I would if I were testing for celiac.

72cf727474b8bf815fdc505e58cadfea

on June 03, 2014
at 04:57 AM

Thanks for all the suggestions. I've made electrolyte solution at home before (a relative has electrolyte problems) so we already have the recipe and the potassium salt at hand.

I'll go ahead and track blood glucose. That should be informative! If that doesn't provide any leads, I'll look into the medical possibilities you've mentioned. I've had thyroid hormones tested before and they've always been normal, but who knows what might have changed.

72cf727474b8bf815fdc505e58cadfea

on June 03, 2014
at 04:50 AM

I've been sleeping well. For the first week I'd wake up at night because I was so hungry, but that's gotten better. I've been taking salt, magnesium, and potassium but don't have any idea of an appropriate dose.

I've been eating cheese, cream, and butter. I was also eating a small amount of high-fat greek yogurt, but I currently suspect that's one of the triggers for heartburn.

I was feeling too mentally exhausted to get any structured exercise, but I have a firm commitment to trying that several days this week.

76026e8ef496039d5075440ff731aa0d

(5386)

on June 02, 2014
at 11:30 AM

It's strange because you're numbers should mean that you're well on your way.

How is your sleep?

Also, are you supplementing salt, magnesium, potassium at all?

What dairy are you consuming?

The fastest for me to enter ketosis is 2 days of carbs at 20 net, with an hour of walking each day (though it might be longer for you since you're more conditioned to walking), the third day I do an hour at the gym to really deplete my stores. After that, it's 20 carbs net until I don't want to do it any longer.

72cf727474b8bf815fdc505e58cadfea

on June 02, 2014
at 05:23 AM

The calculator guesstimates my BMR at 2009kcal. It says net carbs should be <50g (mine are 25-35) and protein should be 68-112g (mine is 80-100), so for weight maintenance the fat target is 168g.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 30, 2014
at 01:22 AM

50 is the minimum. While that may be acceptable, I don't believe that it is optimal.

72cf727474b8bf815fdc505e58cadfea

on May 29, 2014
at 11:35 PM

That's really impressive. The "protein will knock you out of ketosis" lore is very prevalent, and I know it's not total fantasy. But it sounds like it's surely not true for everybody.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 29, 2014
at 08:16 PM

You need approximately 50 grams of carbs and 50 grams of protein to both prevent ketosis and preserve lean mass. The 50 grams of protein is nonnegotiable… the carbs are, but if you dip the carbs, you better have protein there to convert to glucose for basic needs. Not sure there's any reason to go into ketosis aside from a few disease states, shedding a few pounds is not a good reason.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 29, 2014
at 07:40 PM

I would assert that your body is cannibalizing its muscles because you are probably protein deficient. Cannot say 100% because of your joint problems (lack of stimulus also can cause muscle wasting).

That being said, when I conducted a ketosis experiment. I was not able to knock myself out of ketosis through protein ingestion. I got up to 300g (and that was me really forcing it down) while staying in deep ketosis so long as I remained low on carbs and at a slight caloric deficit.

72cf727474b8bf815fdc505e58cadfea

on May 29, 2014
at 05:34 PM

Thanks for the thoughts. My hypothesis is that on my previous go-round I went just low enough on carbs to feel awful, but not quite low enough to push my body to adapt. That's why I thought it was worth another try where I jump in the deep end. I do think that ultimately the more moderate kind of adaptation you're talking about is a more reasonable choice for most people, and it's where I'd like to end up.

72cf727474b8bf815fdc505e58cadfea

on May 29, 2014
at 05:29 PM

How would I eat that much meat and not end up really high on protein? I realize that protein isn't the worst thing, but I thought it tended to disrupt ketosis and fat-adaptation.

Be803dcde63e3cf5e21cc121097b8158

(529)

on May 29, 2014
at 12:23 PM

What was your original paleo diet like? Six months of bad results doesn't sound right!

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5 Answers

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0
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 29, 2014
at 12:39 PM

dairy fat, at least for me, is not very satisfying. I would suggest cutting the dairy all-together. Replace those calories with fish, meat and veggies (most veggies are not very high carb. Andy of the veggies on this list will work: http://www.atkins.com/program/phase-1/what-you-can-eat-in-this-phase.aspx). And I would not count calories or carbs for three weeks. After that check your levels and adjust from there.

72cf727474b8bf815fdc505e58cadfea

on May 29, 2014
at 05:29 PM

How would I eat that much meat and not end up really high on protein? I realize that protein isn't the worst thing, but I thought it tended to disrupt ketosis and fat-adaptation.

72cf727474b8bf815fdc505e58cadfea

on June 22, 2014
at 04:45 AM

I just couldn't get myself to consume Atkins induction quantities of meat, but I did take your advice and start eating more of it. It seems like that did the trick! Or possibly I just needed a little more time to adapt. Either way, thanks for your response.

0
A1cec3730960247be0465cffe92a97d3

on January 21, 2015
at 01:17 AM

Have you looked into other reasons your body could be reacting the way it is beyond the diet? I've been Paleo for over 6 months and have had some of your symptomns- specifically hunger, anxiety, blood sugar swings, and extreme weightloss over a short amount of time. I'm also hypoglycemic, have an autoimmune disease that effects my thyroid (and causes digestion issues and joint pain) and have adrenals that have been in a state of fatigue for over five years. Something is causing your body to waste away and its likely not your diet but an inability of your body to access the nutrients its taking in through your foods. Food intolerences can mess up your digestion so much food just passes through and your body will cannibalize to support its energy levels. Aand if it is this, you need to be completely free of those trigger foods for 2-3 years just for your stomach to heal properly. But it could be something else, like an over active thyroid which can lead to paniky feelings and weightloss.  I know people want to heal with food, but sometimes you need the right doctor and supplements too, especially seeing as your particular symptomns could be a sign of whole body problems. I hope you figure out your personal mystery because I know how frustrating the journey is to good health. It wont be overnight but you get a good feeling everytime you figure out a new piece of the puzzle.

0
3491e51730101b18724dc57c86601173

(8395)

on June 03, 2014
at 02:02 AM

Two questions:

1. What does "Almost 100% grain free" mean?

2. What dairy are you eating?

Your symptoms of anxiety, anger, panic can be related to several things. I feel that way when I'm dehydrated. Be extra certain you are drinking plenty of water AND have adequate amounts of potassium and sodium. Salty broth, potassium rich veggies (dark leafy greens and avocados are good sources, or sprinkle some potassium based salt substitute on food (but don't skip real salt, either)). Another easy way to get a good electrolyte balance it to get UNFLAVORED electrolyte water--WF carries it for about 99 cents a liter, it's the correct balance of sodium and potassium in plain water. It doesn't taste any different than water.

It does sound like you may be having blood sugar swings, which should NOT be happening with carbs that low. That makes me wonder if your carbs are really higher than you think--from dairy and from whatever grains constitute the "almost" in your description of being grain free. If you really, truly are low carb, I'd be very concerned if your blood glucose is not stable--that may indicate something else going on. Your description of blood sugar swings on Paleo heightens the concern--you may have an atypical diabetes--e.g. an autoimmune type which is interfering with beta cell production intermittently, or who knows what else. In any case, it would be useful to track your blood glucose--your fasting BG in the morning, at 1 and 2 hours after meals for a few days, and whenever your symptoms are particularly bothering you.

Your symptoms also suggest a thyroid issue should be ruled out. I think it would be a good idea to find an endocrinologist to help you sort things out if increasing your fluid and electrolyte intake does not make any difference.

72cf727474b8bf815fdc505e58cadfea

on June 03, 2014
at 04:57 AM

By the grain-free comment, I meant that I'm not eating any grains at all. I'm just not making a special effort to avoid trace quantities like I would if I were testing for celiac.

72cf727474b8bf815fdc505e58cadfea

on June 03, 2014
at 04:57 AM

Thanks for all the suggestions. I've made electrolyte solution at home before (a relative has electrolyte problems) so we already have the recipe and the potassium salt at hand.

I'll go ahead and track blood glucose. That should be informative! If that doesn't provide any leads, I'll look into the medical possibilities you've mentioned. I've had thyroid hormones tested before and they've always been normal, but who knows what might have changed.

0
76026e8ef496039d5075440ff731aa0d

on May 30, 2014
at 07:17 AM

http://keto-calculator.ankerl.com/

Can you punch in your numbers to the calculator and post them, it'd help.

I've been in deep ketosis (10-20 carbs net) for 6 months and have only recently started CKD to observe how I feel and the difference each can provide while training at the gym 3-5 days a week.

Other than your protein seemingly a little low, but since it's an individual thing (mine was 90 grams and it warns if it's lower your body will lose lean mass) my next big question..SALT..if you're not getting enough (3-5 grams/ day), brain fog and irritation were always a warning sign to me that it was time to drink some bone broth/ bouillon, and if your salt isn't good, there's a great chance your potassium is shot also..but I don't want to throw out random assumptions, so can you give a broader idea of what your diet looks like?

72cf727474b8bf815fdc505e58cadfea

on June 02, 2014
at 05:23 AM

The calculator guesstimates my BMR at 2009kcal. It says net carbs should be <50g (mine are 25-35) and protein should be 68-112g (mine is 80-100), so for weight maintenance the fat target is 168g.

0
Medium avatar

on May 29, 2014
at 10:15 AM

Usually the worst sufferers of this are those who cannot shun their preconceptions about fat being bad, and they don't get enough. It doesn't sound like this is the case for you - but if you think it could be then make sure you're getting plenty of saturated fat and plenty of protein. Also I don't find this to be the case with other people so much, but I really suffer when I'm not getting high quality meat. Sometimes when money or time is tight and I can't get to the butchers, I'll get a lot more supermarket meat, and my energy / mood suffers. Other factors like the quality and length of your sleep can also have an effect on body composition and energy, but it sounds like you have an active lifestyle and you're quite well read on all this. Even so, it's probably worth a mention. I went almost completely no carb for a while when I started the Paleo diet and it was really difficult. I was devoid of energy and moody for about 3 weeks. In my experience though, most people can build up their mitochondria and start burning fat more efficiently without going completely into ketosis. I've got friends who've turned to the Paleo diet and experience great energy now, despite never going zero carb. I've never heard of the Paleo diet having this affect as it did on your body, but I can't help but think that if it did you're probably not going to benefit from going low-carb.

72cf727474b8bf815fdc505e58cadfea

on May 29, 2014
at 05:34 PM

Thanks for the thoughts. My hypothesis is that on my previous go-round I went just low enough on carbs to feel awful, but not quite low enough to push my body to adapt. That's why I thought it was worth another try where I jump in the deep end. I do think that ultimately the more moderate kind of adaptation you're talking about is a more reasonable choice for most people, and it's where I'd like to end up.

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