9

votes

Stuttering/clouded mental state on very low-carb diet?

Answered on September 12, 2014
Created June 16, 2011 at 10:11 AM

Before I ever heard anything about "Paleo" I tried Atkins and lost about a hundred pounds. It made sense to me because as a Native American I saw how the modern diet affected people I know and how historically a high-carb diet was simply unpractical (almost impossible) for my ancestors. During this time a typical lunch for me was a few ounces of smoked-canned salmon and I drank the oil along with it. I'd also have something like a small handful of celery sticks and a couple of ounces of almonds and cheese. I really wasn't hungary at all. But during this time I lost a lot of lean muscle mass and was significantly weaker, I'm 6'3" and in highschool I was about 310 and could deadlift almost 700lbs. I didn't lift during this time but I played in a basketball tournement and got pushed all over the court, something that had never happened to me before. I grew up sleeping with my window wide open year round and was the kid who wore shorts and t-shirts in winter. But after losing all that weight on Atkins I was always cold and I noticed my thinking was foggy at times, and I found myself occaisionally stuttering, which was abnormal for me. My Dad told me that he had noticed problems with my speech after gorging myself on Halloween candy as a very young child.

I know that glucose is a preferred energy source for the brain and that ketones will also work, but I am a take-charge kind of guy in my work and stuttering or stammering is unacceptable. I'm reluctant to take that risk again. I've been trying to do Paleo for the past two or three years and have only been able to maintain my HS weight (I'm in my early 30's now). I've never had a "six-pack" and have tried calorie-counting, running up to 50 miles a week, and the whole whole-grain thing extensively. The idea of "paleo" makes sense to me on an intuitive level but the weight-loss has been hard and I've had to settle for not gaining anymore weight. I also think that my previous experiences have kept me from fully committing to a VLC approach to Paleo. Any suggestions or similar experiences?

Edit 12/16:

Wow, reading my first PH post is a little embarrasing now--seems rambly and unfocused. I no longer have the problems I brought up but I also don't practice VLC/ZC for the most part. That seems to be the solution for me. I do try to achieve ketogenic states for short periods to aid in weightloss but I don't continue it for the durations that led to my previous issues. I'm still curious about the cause but am content to think that the exact reason may never be known. I'd still appreciate any insights.

7841848bd0c27c64353c583fb7971242

(7275)

on November 11, 2012
at 08:07 PM

I just wanted to update and say that B-vitamin deficiency (especially thiamin and cobalamin) have been implicated in stuttering. I ran across an interesting study the other day, but now I can't remember where I found it. Sorry for the lack of citation.

34b560c8b9ce660d7839fb7e29d7be89

on December 19, 2011
at 01:00 AM

When I look back people who had known me for a long time often said "wow, you've really lost a lot of weight" they didn't say "wow, you look great."  I still think I could stand to drop a few lbs. but I also feel I've struggled with a bit of orthrexia.  Now nearly a decade later I feel the initial 100lb loss was way too much and I'd be better off at a lean 255-265 and was probably a sickly looking 220.

34b560c8b9ce660d7839fb7e29d7be89

on December 19, 2011
at 12:59 AM

The hair thing is interesting as well. During my lowest adult weight, which was also the period I experienced the problems, I now think I was undernourished. During that period I noticed that a strand of my hair would vary in thickness which I wonder about now.

34b560c8b9ce660d7839fb7e29d7be89

on December 19, 2011
at 12:47 AM

Thanks Raydawg! I've considered that ketones may not be adequate for full brain functioning. Mostly because periods of intense concentration feel especially draining, more so than extreme physical activity. I'm also intrigued by the power law concept. I've interpreted it as varying my diet seasonally to some extent i.e.-more carb less fat at one extreme as well as HFLC say during winter's coldest months. I need to vary food sources more but that is harder as I try to rely mostly on locally harvested meat/fish sources.

96440612cf0fcf366bf5ad8f776fca84

(19413)

on December 17, 2011
at 01:16 AM

I know you're saying to avoid it, but I'd like to point out one thing, agave syrup is almost all fructose, more so than high fructose corn syrup, so if you're someone who thinks HFCS is bad, you should be really afraid of agave. Me, I'd rather drink tequilla than go near agave syrup (and I do drink it!)

34b560c8b9ce660d7839fb7e29d7be89

on December 17, 2011
at 01:10 AM

Yeah it does seem to be during periods of extreme weight loss (not the case with gradual weight loss though) interesting.

3b7e6c77a5412587152c9e3f22b41c2a

(434)

on December 17, 2011
at 12:56 AM

Interesting details! Thanks for sharing.

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 16, 2011
at 11:26 PM

Is the stuttering and brainfog most pronounced during periods of weight loss? Heavy metal toxicity could be involved then, and not from what you are putting in your mouth now, but from what you had stored in the adipose tissue in your body. Also, if you have the Apo E4 genotype, your brain won't be good at clearing those heavy metals and some gentle chelation therapy could be good. Paging Dr. Grace for more info on this.

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 16, 2011
at 11:22 PM

I read recently that high O6 (from conventional meat and the veggie oils they are cooked in) can depress the thyroid, and cause every symptom you've mentioned.

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 11:16 PM

I'm from a confederation of bands in the plateau region (eastern WA), I've also (since originally posting this) learned that camas bulbs and bitter-roots were much more prevalent than they are now. In my personal experience the yeild from an afternoon of root digging pales in comparison to the historic harvests of salmon. But I took a class this fall and learned that camas bulbs where also abundant and that they were traded to coastal tribes.

9d43f6873107e17ca4d1a5055aa7a2ad

on December 16, 2011
at 10:48 PM

What tribe are you from? A lot of plant foods have been lost from the knowledge of many tribes.

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 10:37 PM

I seem to recall some reference to stuttering on a low carb discussion forum somewhere but can't recall where that was. I decided I like sweet potatoes and rice seems to agree with me so I've traded easy weight loss for feeling better in several aspects.

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 10:23 PM

Well not quit exactly but as I mentioned in another answer I cycle it for short periods to jumpstart weight loss.

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 10:21 PM

Good info! In my case the problems arose after about 6 months during which time I had resorted to the atkins induction phase ad it was the only way to keep the weight loss going. In retrospect I was probably malnourished. I lost a lot of fat and a lot of LBM. I still experiment with ketogenic periods but tend to cycle them.

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 10:16 PM

Thanks, I'm not sure what the cause was specifically but I've quit VLC/ZC and that seems to be the key. It also seems to happen only after extended periods of time on such a diet. Weight loss is harder now but I guess that's where discipline comes in.

3b7e6c77a5412587152c9e3f22b41c2a

(434)

on December 16, 2011
at 04:29 PM

P.S. If you are losing fat mass then you should effectively count that as part of what you are burning for energy. So, if you're eating a half a pound of protein and half a pound of fat per day, that looks like you're running on 50% protein, but if you are *also* burning off another half a pound of stored body fat per day, then you're really running on 33% protein. At least, that's what Volek and Phinney say.

34b560c8b9ce660d7839fb7e29d7be89

on June 16, 2011
at 10:18 PM

Thanks, I'll try doing a stricter version and see what that does for me.

34b560c8b9ce660d7839fb7e29d7be89

on June 16, 2011
at 09:21 PM

As for fat I had some coconut oil that I used for cooking but I ran out and have been greasing pans and such with bacon fat. I rarely trim the fat from any meat (even grain-fed beef) but I eat venison almost weekly and it's really lean. When I get serious about complying with a decent diet I start to lose fat but then the brain-fog sets in. I usually resort to sweet potatoes or sneak a little rice at that point, then the weight loss stops.

34b560c8b9ce660d7839fb7e29d7be89

on June 16, 2011
at 09:19 PM

Mostly just meat and veggies. If I eat breakfast or lunch on a typical work day then it is convienience food I admit. Sausage-egg muffin sans the muffin, sometimes a breakfast burrito to which I admit to eating the flour tortilla. Lunch can be a couple of dollar menu chicken sandwiches without the buns. Poor choices I know but I generally don't eat anything before 2pm. Grilled venison, beef, chicken, and fish are staples. I often have a big salad with mixed spring greens and tuna, chicken, or steak.

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6 Answers

6
3b7e6c77a5412587152c9e3f22b41c2a

(434)

on December 16, 2011
at 03:56 PM

A bunch of athletes who were put on a ketogenic diet by Phinney had worse performance for 1 or 2 weeks before they became keto-adapted and their performance returned to roughly the same levels as before or perhaps even better on endurance [Phinney-2004-???Ketogenic diets and physical performance???].

Also, according to Volek and Phinney's book "The Art and Science of Low Carbohydrate Living", if you get more than a certain amount of carbs per day then your liver won't do the job of converting fat into ketone bodies. They use the number "50 grams" for this, but I suspect this number varies a lot among individuals. They also say that this process of keto-adaptation also involves your brain and muscles adapting to become more proficient at burning ketones and fat (and lactate) respectively.

Therefore, if you want to give the ketogenic diet a good try, you should go at least three weeks, and make sure to limit your total carb intake as low as possible. There's no need to include any carb in your diet for at least the few weeks of the experiment. The brain-fog may be what people on this site call "low-carb flu", but if it is actually a temporary condition during adaptation, like the reduced performance of those athletes was, then it should instead be called "adaptation flu".

Be sure to get plenty of fat (ideally from fatty meat), water, and salt. Since you don't want to lose lean mass, you should make sure to get plenty of protein and calories. Now, I would tend to assume that this will happen naturally if you're eating primarily meat and you're eating as much as you desire, but you said you lost weight, had foggy thinking, and felt cold, which makes me wonder if you accidentally had a deficiency of fat, protein, or calories.

I'd suggest you eat at least 2 grams of protein per day per kilogram of your body weight, at least for the duration of the experiment [Elango-2010-???Evidence that protein requirements have been significantly underestimated???]. That "2 g/day/kg" takes into account that your liver might be converting some protein into glucose ("gluconeogenesis") to fuel those tissues such as brain and blood cells that require some glucose. If you were adding mass I guess you'd want even more protein; I don't know a lot about body building. A lot of people, including Volek and Phinney, warn not to eat more than about 1/3 of your total calories from protein, but I haven't yet found hard evidence that this would actually be a problem, so I don't know.

Good luck! It sounds like you are quite a specimen of a man. What sort of American Indians were your ancestors? I've learned a little bit about the traditional diets of a few different tribes, but I find contradictory information and I don't have time to study it as much as I would like.

3b7e6c77a5412587152c9e3f22b41c2a

(434)

on December 16, 2011
at 04:29 PM

P.S. If you are losing fat mass then you should effectively count that as part of what you are burning for energy. So, if you're eating a half a pound of protein and half a pound of fat per day, that looks like you're running on 50% protein, but if you are *also* burning off another half a pound of stored body fat per day, then you're really running on 33% protein. At least, that's what Volek and Phinney say.

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 10:21 PM

Good info! In my case the problems arose after about 6 months during which time I had resorted to the atkins induction phase ad it was the only way to keep the weight loss going. In retrospect I was probably malnourished. I lost a lot of fat and a lot of LBM. I still experiment with ketogenic periods but tend to cycle them.

3
7841848bd0c27c64353c583fb7971242

(7275)

on December 16, 2011
at 05:21 PM

Wow, thanks for posting this. I've been noticing a bit of a stutter in myself lately and had no idea what was going on. I've never stuttered before. But lately, it's like I'll either forget what word I was saying, or I'll get stuck between two words and not be able to pick just one, so I end up on the first phoneme for a while. It's subtle, but definitely something my husband and I have noticed. I've also been mentally foggy for a few months. And lately I've been losing really simple words. Like many people, I have always occasionally forgotten a word here or there, but lately it is happening a lot. And they are really common words, like the "clock" part of "alarm clock".

For what it's worth, I eat half a pound of grassfed ground beef, about half a cup of sweet potatoes (I wasn't doing well on 50g carbs, so I added the root veggies to bring me up to about 80g carbs), a cup or two of kale, and some sauerkraut or spirulina, for breakfast and again for dinner. Lunch is typically a salad with half a can of salmon, apple cider vinegar, and coconut oil. Sometimes I'll add a carrot to my salad. No snacks. Maybe once or twice a week I'll have a cup of green tea. And about once a week or two I'll have a bar of chocolate. I've started making water kefir at home and have been drinking that most days. And every night I have a cup of Natural Calm.

When I plug my food into cronometer, I usually come up low in thiamine, and a little low in folate. I've been getting about twice the omega-3 as omega-6: 5g omega-3 to 2.5g omega-6. However, I'm not sure what nutrition I'm actually taking in because I'm still struggling with celiac disease (only 5 months in, and I read it can take 6 months to heal).

I get about 8 hours of sleep each night, but feel like I should get a little more.

I'm certainly not eating very low carb at 80g carb per day, so I'm not sure what's going on. I tried a day eating high carb (250 g), to see if that helped, but I didn't notice an improvement.

If I make sense of any of it, I'll update with my experience. But even though I haven't uncovered any clear associations with it, at least you're not the only one experiencing this!

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 10:37 PM

I seem to recall some reference to stuttering on a low carb discussion forum somewhere but can't recall where that was. I decided I like sweet potatoes and rice seems to agree with me so I've traded easy weight loss for feeling better in several aspects.

7841848bd0c27c64353c583fb7971242

(7275)

on November 11, 2012
at 08:07 PM

I just wanted to update and say that B-vitamin deficiency (especially thiamin and cobalamin) have been implicated in stuttering. I ran across an interesting study the other day, but now I can't remember where I found it. Sorry for the lack of citation.

2
96440612cf0fcf366bf5ad8f776fca84

(19413)

on December 17, 2011
at 03:04 PM

Sounds like you guys aren't generating enough ketones to keep your brain functioning at 100% - maybe not fully in ketosis either from too many carbs, or maybe something is preventing the process from working fully (not adapted to burning fats instead of carbs, or working out too hard and have depleted glucose levels). Or maybe, you're just not generating enough to keep the brain and the muscles going.

I'd say take some coconut oil a few times a day as the MCTs are readily converted into ketones to make up for the difference, so it's not necessary to add carbs - if you want to stay VLC.

Of course, if you do go VLC/ZC, then you may experience cortisol issues from stress as it sends signals to convert protein into glucose, if this happens to you, going VLC might not be a good idea as the damage caused by chronic cortisol is worse than the benefits of VLC. Symptoms of that are anxiety, rapid pulse (though coconut oil causes rapid pulse too, this is higher), and noticing hair falling out.

Probably alternating between periods of zero carb and some (but not high) carb intake is ideal. When in zero carb, we become a bit insulin resistant to spare glucose for red blood cells and some brain tissue, if we add a lot of carbs at once, that would be a problem. So as you go from zero to some carbs, say after a big workout, do it very slowly, and then back off slowly. The point of alternating is so as to be able to stay insulin sensitive and reset any insulin resistance you might have. This is of course not applicable to everyone as your sensitivity varies (it is very much applicable to me, as I very easily gain weight from carbs.)

Overall, I'm a fan of Art De Vany's ideas on fractal/power law ways of working out, but you can apply those to your food macros as well (within tight limits - i.e. I'd want the carb side of the graph to be far less frequent.)

By varying both macros and actual foods themselves, we also vary the metabolic pathways and stay flexible, and we can avoid overflowing with the same toxins.

It seems to me that on a SAD diet, you tend to hit the same pathways all the time (high carb, toxic seed oils, etc), and then it becomes hard to adapt to anything else (i.e. VLC, MUFAs, sat fats), so there's transition pain.

So, once adapted to a paleo diet, and at the ideal body composition, by alternating between different kinds of macros on a power law scale, selected towards your goals (for me heavier on the fats, lighter on the carbs with some alternation, and alternating more on proteins), you can stay metabolically flexible.

i.e. one week at a lot more eggs, another eat mostly lamb, another beef, another bison, another fish, chicken, and so on. Ditto with the veggies - alternate between cabbage, spinach, kale, asparagus, Brussels sprouts, mixed greens, etc. Rarely throw in a sweet potato or carrots or parsnips (usually after 1-2 hours after heavy work outs.) Not saying eat just one or two foods for the whole week, but rather eat somewhat more of one food that week, but still mix it up with other foods.

I do this by buying food in bulk, and cooking. One week I made soup from bison marrow bones and oxtail with some meat. The next week I made mesquite pork ribs. The next roast leg of lamb. The next was bison burgers and steak. I still had some left over ribs and lamb the week that I had burgers and stake and had a few meals of each of those too.

Hope these ideas are useful.

34b560c8b9ce660d7839fb7e29d7be89

on December 19, 2011
at 12:47 AM

Thanks Raydawg! I've considered that ketones may not be adequate for full brain functioning. Mostly because periods of intense concentration feel especially draining, more so than extreme physical activity. I'm also intrigued by the power law concept. I've interpreted it as varying my diet seasonally to some extent i.e.-more carb less fat at one extreme as well as HFLC say during winter's coldest months. I need to vary food sources more but that is harder as I try to rely mostly on locally harvested meat/fish sources.

34b560c8b9ce660d7839fb7e29d7be89

on December 19, 2011
at 12:59 AM

The hair thing is interesting as well. During my lowest adult weight, which was also the period I experienced the problems, I now think I was undernourished. During that period I noticed that a strand of my hair would vary in thickness which I wonder about now.

34b560c8b9ce660d7839fb7e29d7be89

on December 19, 2011
at 01:00 AM

When I look back people who had known me for a long time often said "wow, you've really lost a lot of weight" they didn't say "wow, you look great."  I still think I could stand to drop a few lbs. but I also feel I've struggled with a bit of orthrexia.  Now nearly a decade later I feel the initial 100lb loss was way too much and I'd be better off at a lean 255-265 and was probably a sickly looking 220.

2
724ba4f39f7bbea7f74b45c0a79615f2

on December 16, 2011
at 04:19 PM

Huh, the brain fog and stammering is a little worrying actually. Those are the same symptoms that vegetarians have when they have a B-12 deficiency, but of course, it doesn't sound like you do, but plenty of other vitamin deficiencies/imbalances/overloads can cause neurological symptoms. Or it could be heavy metal toxicity or something like that.

It may be that when you cut back on carbs you also tend to be cutting back on something else that you're not getting from your food or that you're replacing the carbs with too much of something toxic, or that throws your balance off. I doubt that low-carbing is sufficient to cause those kinds of symptoms. I understand the whole "carb flu" business, but it doesn't sound like you're really eating sufficient carbs for it to be that.

Or it could be H. Pylori or something, since that lives off of the sugar in your gut, and so you actually feel better when it's being fed sugar, but it's doing you damage in the long run. (This is what I hear, I've never had it).

I'm not a doctor, I don't know anything about this, but I just think that it's something you want to get a handle on for its own sake, weight aside. Feeling low/tired/sad/blah on a low-carb diet is relatively common, and just means you're not someone who can deal with that. Stammering sounds more like a neurological symptom of something, though, and that's when you want to make sure that you're not doing yourself accidental serious damage by eating too much/little of something.

Maybe see someone (naturo/homeopath, functional doc, etc.) or just go run some blood really extensive blood panels, just to make sure you're in the clear.

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 16, 2011
at 11:26 PM

Is the stuttering and brainfog most pronounced during periods of weight loss? Heavy metal toxicity could be involved then, and not from what you are putting in your mouth now, but from what you had stored in the adipose tissue in your body. Also, if you have the Apo E4 genotype, your brain won't be good at clearing those heavy metals and some gentle chelation therapy could be good. Paging Dr. Grace for more info on this.

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 10:23 PM

Well not quit exactly but as I mentioned in another answer I cycle it for short periods to jumpstart weight loss.

34b560c8b9ce660d7839fb7e29d7be89

on December 17, 2011
at 01:10 AM

Yeah it does seem to be during periods of extreme weight loss (not the case with gradual weight loss though) interesting.

34b560c8b9ce660d7839fb7e29d7be89

on December 16, 2011
at 10:16 PM

Thanks, I'm not sure what the cause was specifically but I've quit VLC/ZC and that seems to be the key. It also seems to happen only after extended periods of time on such a diet. Weight loss is harder now but I guess that's where discipline comes in.

1
26b7615ef542394102785a67a2786867

on June 16, 2011
at 01:16 PM

Could you give us an idea what you are eating these days? When you say you've been 'trying' to eat paleo, what does that entail? Just meat and vegetables with almost no carbs? And how much fat do you get?

I don't function well mentally on VLC/in ketosis either (same issues with persistent brain fogginess, stumbling over my words). It definitely is not for everyone. You might very well be able to reduce your body fat without going VLC.

Maybe try a 30-day 'challenge'; ditch the grains and sweeteners and eat animals, seafood, natural fats, and vegetables - including tubers and roots for a fairly nutrient-rich source of glucose.

34b560c8b9ce660d7839fb7e29d7be89

on June 16, 2011
at 09:21 PM

As for fat I had some coconut oil that I used for cooking but I ran out and have been greasing pans and such with bacon fat. I rarely trim the fat from any meat (even grain-fed beef) but I eat venison almost weekly and it's really lean. When I get serious about complying with a decent diet I start to lose fat but then the brain-fog sets in. I usually resort to sweet potatoes or sneak a little rice at that point, then the weight loss stops.

34b560c8b9ce660d7839fb7e29d7be89

on June 16, 2011
at 09:19 PM

Mostly just meat and veggies. If I eat breakfast or lunch on a typical work day then it is convienience food I admit. Sausage-egg muffin sans the muffin, sometimes a breakfast burrito to which I admit to eating the flour tortilla. Lunch can be a couple of dollar menu chicken sandwiches without the buns. Poor choices I know but I generally don't eat anything before 2pm. Grilled venison, beef, chicken, and fish are staples. I often have a big salad with mixed spring greens and tuna, chicken, or steak.

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 16, 2011
at 11:22 PM

I read recently that high O6 (from conventional meat and the veggie oils they are cooked in) can depress the thyroid, and cause every symptom you've mentioned.

0
48e51a7af3adc13503c37f4385ac19f2

(105)

on June 16, 2011
at 11:50 AM

First of all, major congratulations for what you have been able to achieve so far. You don't say what you do for exercise and nutrition now, but the three approaches you mention (cutting calories, running 50 miles/week, whole grains) will not get you a six-pack. At the same time, if you do not feel good on very low carbs, don't do it. "Paleo" really is about making the choices that work for you in the context of eating non processed foods. My opinion would be to go very strict for 30 days - that means NO grains at all, no legumes (beans, peanuts, soy), absolutely no sugar or derivations (honey, agave, certainly no corn syrup, and extremely minimal fruit - maybe a handful of berries now and then) and absolutely no industrial seed oil. Do all your cooking in olive oil or coconut oil. I also would consider cutting all your dairy for 30 days. Beyond that, keep it simple. Eat a good hunk of quality protein with every meal, eat some veggies and lots and lots of good fats to keep you full (avocado, coconut, occasional macadamia nuts). You can bump up your carbs in the post-exercise window with a yam or sweet potato with a little protein after you work out. Lift heavy weights, go for hikes with a heavy pack, sprint once a week. The key is to be extremely strict with yourself, not in terms of calories at all but the quality of what you eat. Don't cheat at all for 30 days and see how you do. Good luck!

34b560c8b9ce660d7839fb7e29d7be89

on June 16, 2011
at 10:18 PM

Thanks, I'll try doing a stricter version and see what that does for me.

96440612cf0fcf366bf5ad8f776fca84

(19413)

on December 17, 2011
at 01:16 AM

I know you're saying to avoid it, but I'd like to point out one thing, agave syrup is almost all fructose, more so than high fructose corn syrup, so if you're someone who thinks HFCS is bad, you should be really afraid of agave. Me, I'd rather drink tequilla than go near agave syrup (and I do drink it!)

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