Keto: 2 Month Review and a New Plan

My Keto 2 month anniversary came and went 5 or 6 days ago.  It was without fanfare.  I’m fairly confident I was sticking to a high fat, low carb diet that should have been ketogenic.  Unfortunately, my Ketonix meter indicated I was producing only “small traces of ketones” every day.   I tried lots of different food combinations and timing exercise differently, but wasn’t able to get up to “moderate” ketone production, according to the meter.  I tried to not eat till later in the day.  I tried to eat 90% fat.  I went days at a time eating only egg yolks, oil, and olives, with a little meat here and there just to hush my hunger.  No dice.  Only “small traces of ketones”.  This resulted in very slow weight loss, and in the last few weeks, increasingly poor sleep.

I started getting tired of oily egg yolks, olives, and avocados.  I could have lived with it if I was losing body fat, pounds, or feeling better….I guess I was feeling ok most days, but it was tiresome eating weird food – and not too much of it – and not seeing much progress.  I only lost a few pounds in 2 months.

So a few days ago I started eating some carbs at night, and sleep improved right away.  The very first carbohydrate meal I ate involved about 3/4 cup of rice noodles.  Unfortunately the next day – Depression.  It’s as if I hadn’t JUST spent the last 2 months eating absolutely nothing starchy.  First time I have it again, the depression is back.  Poisoned again by endotoxin (aka lipopolysaccharides, aka LPS).

So I got to thinking about this.

For years now, whenever I eat lots of fiber or starch my monster of a gut pathogen dumps all over the place, screwing up my ability to think, reason, and get through the evening without yelling at someone.  It makes me depressed, irritable, tired, hopeless, and mean.  A while ago – I don’t know when – maybe after my 2nd round of antimicrobials last year that made no difference – I came to accept that this intruder was always going to be with me and I just had to work around it.  Never eat starch, and if I did, follow it with lots of activated charcoal.  I said to myself, I’ll just never eat raw fiber – I’ll accept that vegetables must be well cooked.  Say good bye to salads, apples, and most other things that normal people eat when they try to eat a nutrient-dense diet.  (Side note: I have no idea why I’m able to eat avocados. They have lots of soluble fiber in them.  Must not be what my pet pathogen likes to eat.)  I’d already said good bye to dairy, sugar, starch, polyunsaturated fats, most processed food, nightshades.  Not much left, but I was willing to do it.

But not if I’m getting no results.

Anyway, I’ve decided to refocus.  Stop worrying about weight loss (I took the scale out of my house, in fact), stop worrying about what I can and can’t eat.   My singular focus right now is on eradicating this endotoxin-producing gram-negative madness from my gut.  I think my gut is keeping me inflamed, hence my inability to lose weight.  Sure, it’s possible insulin is still playing a role (and I haven’t tested it again since 1 month into keto when my level was 20), but really…I just can’t believe that with exercise and LCHF it’s not come down to an acceptable level by now.

I saw some progress in my attempts to slay The Beast with my Great Garlic Experiment in 2014.  I was able to eat starches for a while afterward, without depression.  I think that it’s susceptible to the antimicrobial properties of garlic.  I’ve decided to do the garlic thing again.  In the meantime I’m learning everything I can about LPS, how to kill it, how to neutralize the inflammation it creates. There’s really no good how-to manual on this.  Nourish Balance Thrive had me take probiotics with lots of fibers.  Maybe that works for most people, but for me that turned out to be a very bad idea.

I’m going to kill this bitch.  Pubmed is going to help me.

High Fat/Low Cal – An Experiment

I got discouraged by high hunger and inability to reduce protein or calories, which was resulting in very slow weight loss.  So a few days ago I tried something new.  I ate fat all day long. And guess what – I can’t say the hunger disappeared completely, but it dropped so low I was able to keep overall calorie intake very low:

3-2-16 diet.png

I know peanut butter is not an ideal food – I make it a little better by pouring off the peanut oil and mixing in melted coconut oil.   But the point is I’ve struggled for years with reducing calories because of hunger.  Hence, my fatness.  Once I reduce the insulin-generating foods significantly (protein and carbohydrates) I’m able to eat much less. I did this 2 days in a row and lost 4 pounds (down a total of 6 now).  Here was day 2:

3-4.png

The last 2 days I’ve increased calories to over 2000 and haven’t lost any more, but haven’t gained anything back either.  I’m considering alternating 2 days of very high fat/low calorie with 2 higher-calorie days for a while.  Today is another high fat/low cal day.  All the while I’ll be continuing LCHF.

Now that I’m pretty sure it’s protein that’s been keeping me hungry I’ll be adding vegetables back into my diet.  Hey here’s a fun keto tip…Did you know that sauteed radishes taste a lot like fried red potatoes?

2016-02-29 14.32.58.jpg

I make them with a lot of butter or bacon grease (ideally from grass-fed beef bacon, if I have it), salt and garlic.  Fry them until they’re soft and some of them are browning (about 10 minutes).  I would probably cook them a little longer than the ones in the picture.

A 16-oz bag of radishes is dirt cheap ($1-2), has 72.6 calories, 3.1g protein, 15.4g of carbohydrates (7.3 of which are fiber), and 0.5g fat, and has the following micronutrients:

radishes

Obviously the macro/calorie load shifts when you add a bunch of fat to the pan.  And that’s what makes them so delicious.   Best of all I can eat a whole bag of radishes cooked up like this without noticeable endotoxin problems (e.g., depression) and without any impact on my blood sugar.  I can’t say that for potatoes.

Hey one last thing on the topic of eating straight oil and calling it a meal.  I have been feeling great on the days I do this – focused, high energy, great mood.  I’m not sure if it’s the MCT oil itself or the reduced brain fog from having lower insulin.  I’ve been smiling for no good reason.  When you catch yourself doing that it’s a wonderful thing.

 

Don’t put ghee in your BPC

For whatever reason, ghee is not a good substitute for butter when making Bulletproof Coffee.  It doesn’t blend well, and is like drinking an oil slick.  I regretfully had to dump the whole thing.

Macros for yesterday:

today

I stayed as low as I could on protein, and still 91 grams.  Fucking hunger.

I’m annoyed.

Keto – 1 Month Review

About a week and a half ago – 3 weeks into eating a LCHF diet – I added high intensity interval training (HIIT), as often as time permits, which isn’t much – I think I’ve had 4 sessions since I started.  I do 30 seconds of running uphill (5.5 mph, 6% incline), and then 4 minutes of slow walking (2 mph, 0 incline).  Repeat 4 more times.  So really I’m doing only about 5 minutes of hard work per week.  Since I started this I’ve lost 5 pounds and my fasting blood sugar has dropped from around 114, where it’s been stuck for 3 weeks, to about 102.  Post-prandial blood sugar (at 2 hours) is usually in the 80s.

I’m sleeping better, I have more energy, my mood is better than when I was eating carbs every day.

My usual diet:

  • Breakfast: eggs (1 whole egg plus 2 egg yolks cooked in coconut oil) and 1/2 of an avocado.  Sometimes a couple ounces of meat if I’m particularly hungry, but I notice ketones drop quickly if I eat too much protein.
  • Snack (because I can’t make it the 6 hours till lunch without one): bulletproof coffee (16 oz coffee with 2 Tbs unsalted grassfed butter and 2 Tbs MCT oil.  Yes, I’m using the actual, authentic mycotoxin-free upgraded coffee from Mr. Bulletproof himself).
  • Lunch: 1/2 avocado, 1-2 Tbs. homemade mayo, about 4 oz of chicken/fish/steak, a bunch of kalamata olives.
  • Snack – whatever coffee is still in my thermos, maybe some macadamia nuts
  • Dinner – a small-medium portion of whatever my family eats – last night it was cod cooked in butter.  I have been avoiding the veggies to see if it makes a difference one way or the other.

I’m hungriest in the morning, and have been eating till I’m not hungry anymore.  I might experiment with getting rid of that last egg white, and see if that reduces hunger by reducing impact on insulin levels.

Current supplements:

Medications:

  • Hydrochlorothiazide – 25mg/day (for hypertension)
  • Methyldopa – 250mg 3x/day (for hypertension)

I quit taking the Metformin.  It made my breasts stupid big and really sore and after 3 weeks it just wasn’t going away.  I figured I could manage without it eating Keto anyway.  So it’s gone.  Now, a couple weeks later, my bras still don’t quite fit.  Hot flashes are starting to come back as hormone levels return to baseline.

Marriage update:  Things are on cruise control.  It’s a real pain in the ass to split up.  For now, we’re just getting through the day to day, no movements in that direction.  He doesn’t want to split up and I’m not sure my life would be better if we did.  We get along well so it’s not painful.  Not the marriage I thought I had, but many things in my life are wonderful, so this is fine for now.

A request was made for my extremely easy homemade mayo recipe.  I have to admit it’s not MINE, exactly, because I got it from here.  I did tweak it a little so I’ll share the recipe as I make it:

Coconut Oil Mayonnaise

Equipment:

  • 1 glass jar with a mouth wide enough to accommodate a stick blender. I’ve used Vlasic dill pickle jars and 16-oz wide mouth Mason jars.  Both are great.
  • A stick blender (I use this one).

Ingredients:

  • 1 egg
  • 1 cup of fractionated coconut oil (the kind that is liquid).  I use Carrington Farms, which is available at Walmart.
  • 1 Tbs lemon juice (more if you like it a little more sour)
  • 1/4 tsp salt

Instructions:

  • Put everything in the jar.
  • Get the stick blender and put it in the jar, resting it on the bottom of the jar.
  • Hold on to the jar.  (<– Once I didn’t do this and the jar spun right off the counter onto the floor.  A serious waste of good ingredients).
  • Turn on the blender for 20-30 seconds, moving it up and down a little to incorporate all of the liquid into the emulsified mayo.
  • Done!  Refrigerate for up to 2 weeks.

Some info about fractionated coconut oil is here.  Apparently it is liquid at room temperature because the long-chain fatty acids are removed, along with some of the health benefits of coconut oil.  I made the mistake of trying this recipe with regular (melted) coconut oil once and found myself with an unacceptably solid final product.  The fractionated oil works well for this recipe, and still has the health benefits associated with MCT oil, without the PUFAs found in other liquid oils.

I’ve tried this recipe with other oils.  Olive oil (“extra light”) tasted good but even good olive oil is 12% PUFA.  The same is true for avocado oil, though I never tried that one.  I tried it once with regular olive oil (not the “extra light”), and it tasted way too strong.  I tried making it in a bowl once, rather than in a glass jar…it didn’t emulsify.  It needs to be in the narrower container to come together.  I already mentioned my foibles with using regular coconut oil and letting the jar spin out of control….Ok, I guess that’s it. The recipe and instructions above has never let me down.

Oh and speaking of PUFA…check this out.  Michael Eades, a long-time leader in the low-carb community seems to be turning his attention away from blaming sugar and towards the evils of PUFA.  Very interesting.  And score one for Ray Peat.

Keto – 2 weeks in

I started eating a LCHF diet 2 weeks ago.  I’m down only a couple pounds, which doesn’t surprise me really.  I’ve learned that for me it takes a little while for my insulin to drop enough to utilize body fat for fuel…at least, that’s what I suspect is going on.  Last time I kicked the carbs out of my life it took about 2 weeks to see anything measurable on the scale.  The scale is so passe anyway…all the cool kids are doing circumference measurements anyway.

Other than weight, I feel so much better now that I’m not eating stuff that feeds my endotoxin-prone gut.  Mood is better, energy is better, everything is better.  It’s easy to accidentally trigger that though – a raw salad or other gut-irritating foods and I’m right back there again, irritable and tired.   (Tried that yesterday so it’s fresh in my mind).   Generally things are going well.

I mentioned the metformin I started taking a few weeks ago is causing hormonal changes, as evidenced by the disappearance of my hot flashes a few days after starting it.  I guess that’s why it’s prescribed to treat PCOS.  I can’t tell what hormone changes exactly, but it’s making my breasts sore and bigger.  They didn’t need any help in that area, and I wish they would stop it.  I’m considering stopping the Metformin if this doesn’t go away.  I googled it and I’m not the only one with this symptom.  Apparently it’s not an increase in estrogen, or I would expect there to be a correlation with breast cancer in the literature…and there doesn’t seem to be.  The opposite, actually…Metformin may have an ant-cancer effect.  So maybe it increases progesterone or behaves like progesterone in the body?

Dunno.  Research for another day.

Insulin

Well, I fucked up.

Last year when I was eating low carb, I was doing it all wrong.  I think I was scared of all macronutrients except protein, and instead of following a diet plan that was ketogenic – allowing for the production of ketones to provide fuel to the body – I was following some random Atkins-esque plan.  I was losing weight (at first) so it seemed like the right thing to do, but when my weight loss stopped and my labs looked terrible and I started feeling tired and bored with my meat-and-vegetable diet I gave up.  I now realize that my focus was misguided.  I was targeting carbohydrates (keeping them low) when I should have been targeting insulin.

Thanks to my brilliant commenters I now realize that diet was actually fairly insulinogenic, and with all that insulin it’s impossible to use body fat for fuel.  I lost 15-20 pounds eating that way, which probably represented a reduction in my previous Peat-inspired insulin level of 27.9 two years ago.  I wonder if this is why people stall on low-carb diets…they manage to reduce their insulin level enough with their meat-and-veggies-only diet, but because the meat is actually insulinogenic the weight stops at the point that the insulin stops dropping.  So Atkins had it right up to a point…and for some people that’s enough.  Their insulin isn’t so chronically high, or their body isn’t so quick to toss insulin all over the place, and just cutting the carbs is enough to drop insulin low enough that their body can release stored fat for fuel.  I’m not one of those people.

For years I’ve had to be very careful of what I eat because everything seems to make me desperately hungry.  Coffee, rice, gigantic salads containing many ounces of skinless chicken – always with the ravenous hunger 1-2 hours later. 10 years ago I could eat a “low carb diet” of meat, eggs, and veggies and never feel hungry.  Now my blood sugar is much less stable than that, probably because insulin resistance has advanced and therefore insulin output has increased. When I was eating meat/eggs/veggies for 6-8 months last year I would have what seemed like a giant breakfast of steak and eggs – seriously, like 800-1000 calories, and I would be hungry 2 hours later.  I figured I was just broken and kept eating more and more to make the hunger go away.

When I originally started with Nourish Balance Thrive I met with their diet specialist, Julie, and she recommended a paleo diet that was 60-65% fat.  I think for most people that would probably work well.  I eliminated all starch and sugar from my diet and figured I was probably in the ballpark as long as I was eating fatty meats.  I really should have Cronometered it, because looking back I was probably getting only about 50% of my calories from fat…and that was not enough.  So I was putting myself in a state where I had no carbohydrates for quick energy and no ketones due to high insulin.  It’s really no wonder I stayed hungry, weight loss stopped, and I got tired. It seems the goal shouldn’t be low blood sugar – it should be low insulin, as discussed by Dr. Fung in Christopher Kelly’s podcast and Woo all over her blog (though, ironically the latter considers the former to be a menace who must be stopped).

So I’ve been learning over the last couple of days about insulin – how to lower it, how to keep it low, and how to fuel the body while doing that.  My goals, of course, are to lose body fat and improve metabolic markers (reduce blood sugar, cholesterol, triglycerides, blood pressure) while not starving and being irritable all the time.  I came across the Optimising Nutrition blog discussing an “insulin index” – much more useful to me than a “glycemic index” since my goal is shifting from low blood sugar to low insulin.  Contrary to my previous belief, carbohydrate density and insulin demand are not perfectly correlated.

The author states:

“The chart below [see it here] shows the relationship between the glycemic load and insulin index from the testing undertaken in healthy people.  Reducing the glycemic load does not guarantee a low insulin response, particularly when it comes to high protein foods.”

This graph, which is based on the data in this thesis: Clinical Application of the Food Insulin Index to Diabetes Mellitus (Kirstine Bell, September 2014 indicates that raisins create about as much insulin as cheddar cheese.

I know, right?

Click here and scroll down for a chart of Least Insulinogenic Foods along with their Food Insulin Index.  Suddenly my seemingly-random and incredibly-annoying hunger makes so much sense.   I was eating too much meat, and my insulin was too high.

So for the last 3-4 days I’ve been following these charts and eating things that are much less insulinogenic.  The steps I’ve taken:

  • Eliminated all dense forms of carbohydrate again (rice, sugar in all forms, etc) limiting carbohydrate intake to just vegetables
  • Drastically reduced meat intake to probably 4 ounces per day
  • Eliminated egg whites
  • Added high fat dairy including cream cheese, sour cream and mozzarella cheese (no milk), as well as olives, homemade low-PUFA mayonnaise, and raw macadamia nuts

The results so far: hunger has dropped about 80% and when it’s there it’s not the gnawing painful type. Irritability and fatigue are gone, unless I accidentally eat too much protein.  I learned today that egg yolks (not just the whites) contain a certain amount of protein and 3 of them – even without the whites – is really too much.  I’m still working out the details, but Cronometer tells me that even a seemingly high ratio of fat to protein+carb is not high enough to avoid the irritability and hunger that suggest too much insulin was generated.  For example, this morning breakfast was 3 egg yolks cooked in coconut oil with half of an avocado.  Here’s the macronutrient breakdown of this meal:

fat

So this meal had a ratio of about 2.6/1 fat to carb+protein.  About 90 minutes later I had that familiar hunger/irritability.  So I’ll be looking for more of a 3/1 or 4/1 ratio which translates to about 75-80% of calories from fat.  I ate a couple ounces of macadamia nuts and felt much better.

Further experiments to follow.

I feel really happy.  My mood has improved 100% since giving up the carbs again, and it happened on day 1.  This is probably related to discontinuing the eating of foods that cause endotoxin.  I hope I’m on the right track now.

A side note – taking the Metformin is going well.  My hot flashes went away a few days after I started taking it.  Things are looking up.

Overdue Update

Well I’m definitely overdue for an update.  Several things to report.

1.  Neither I nor my daughter have Pyroluria.  I guess this is a good thing.  Nothing to fix.  I was hoping there would be something to fix.  But really, this is better.

2.  I’ve begun taking iodine again.  My last experience trying to supplement with it didn’t go well, and I concluded that maybe I didn’t have enough of the cofactors in my system (selenium, B vitamins, magnesium, vitamin C, and sea salt) to support the Bromine detox that showed up.  So I supplemented with just those for the last couple of months and I’m restarting Very Slowly.  I’m following Grizz’s advice in this thread, and taking only a fraction of a drop of Lugol’s 2% every day.  Basically I filled a 16-oz water bottle with water and added a drop of Lugols.  Then every day I measure out 2-oz of the water and drink it.  So basically I’m taking 3mg of iodine a week.  A week.  How crazy slow is that?  Anyway I got through a week with no significant depression, acne, or throat issues so I think I’m on the right track.  Starting today I’ll double the dose – so 1/4 drop a day.  Maybe I’ll keep it there for a couple weeks.  Those detox symptoms completely kicked my ass.

3.  I’ve been doing DDP Yoga every day for almost a month now.  I can tell I’m getting stronger because the moves are getting easier and I’m becoming more flexible.  I’m proud of myself for this one.  I’ve been wanting to be someone who does yoga for about 15 years.  It’s about time!

4.  A week ago I started doing Nutritional Ketosis.  Basically it’s a high-fat, moderate protein, low carb diet designed to get the body into a state of ketosis (fat burning and producing ketones for energy).  I was really inspired by Jimmy Moore’s N=1 with nutritional ketosis.  What I was doing (low carb/paleo) wasn’t working and I was starting to feel really frustrated.  I’m down a few pounds doing this approach already.  I’ve ordered ketone blood test strips – not cheap, but I think worth it. This Canadian pharmacy had the best price I found (thanks to Jimmy Moore for the link).  These are different than the ketone urinalysis strips that you can find at any drugstore.  The advantage to monitoring blood ketones is greater accuracy with measurement.  Also, according to Volek and Phinney who wrote The Art and Science of Low Carb Performance (and who coined the term “Nutritional Ketosis”), you can stop producing ketones in urine after a while even if you’re still in a state of Ketosis.  Blood monitoring is always more accurate.  While I’m waiting for the test strips I’ve been using the urinalysis strips though.  They’re better than nothing.

So basically I’m shooting for a diet in the area of 1600 calories at 85% fat, 15% protein, and 5% (or less) carbohydrate.  I find it pretty easy to get to 80% fat, and pretty challenging to get it up to 85%, so typically I’m somewhere in the middle.  After one week of doing this, here’s what I notice.  I do get hungry sometimes but that’s because I’m doing this with an eye toward keeping calories low.  Jimmy Moore didn’t watch calories, and Volek/Phinney say “eat to satiation” – not low cal.  I know if I ate to satiation I’d eat way too many calories, and I need to see some results.  I think for ME (maybe not for everyone) but for ME calories matter.  So I’m watching them and trying to stay about 500 calories below what my body needs given my current activity level.

Another thing I’m noticing – when you eat this way you’re never really full – there’s none of that feeling like you ate too much.  Fat just doesn’t take up much space in your stomach I guess.  But I do find that I’m completely unaware of the effect of food on me 90% of the time.  I feel light and energetic and there are no ups and downs.  Just sustained energy for hours at a time.  The purpose of eating this way is to turn the body from a “sugar burner” into a “fat burner,” which can take weeks.  After fat adapted, the body can use excess body fat for energy.  Well, I’ve got lots stored.  Have at it, body!

Another advantage to eating this way: it’s cheap.  I’m eating full-fat dairy, eggs, a little meat here and there (but not much), butter, coconut oil and coconut butter, and some veggies here and there.  It’s been interesting finding ways to make almost pure fat taste like regular food.  One day when I have more time I’ll share the recipes that I’ve been relying on (and that I’m soon to discover).

So generally things are going great in my world.  Still waiting for 23andme results. Will update as things come up.