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.

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.

Beginnings and Endings

My time for writing has become very limited.  I apologize to anyone who has emailed me for not responding quickly.  I’m fatigued and not feeling well, and most hours of of my day are spoken for.  I work full time and then play Mommy for 4-5 hours every night.  At that point I’m usually ready for bed.  The only time I have for myself is [ok, seriously?  As I was typing this my daughter woke up, came out of her room, and climbed onto my lap.  Apparently the only time I have for myself is never!].

So we’ll have to get to the point.  No time for dilly dally.

Bye bye Ray Peat.  My high blood sugar, high blood pressure, high cholesterol, high triglycerides, low energy and low libido are just not that into you anymore. Thanks for the progesterone and the anti-PUFA information.  I’ll take that with me.  My body doesn’t handle all these carbohydrates well, and it’s about time I faced that.  I’m dealing with constant bloating and fatigue whenever I eat any dense source of carbohydrate now.  I can’t say that eating a Peat-inspired plan caused this, but it didn’t prevent it or fix it.  I suspect Peat is right about a lot of things, but I don’t think he addresses gut health adequately.  No carrot salad is going to clear this up (I’ve tried it).

I’ve moved on to something else. I’ve found a functional medicine practitioner to work with (or rather, she found me).  I’ve started working with Amelia Luker through Nourish Balance Thrive.  She’s an RN who studied the Kalish Method, which is apparently a respected functional medicine approach.  I’ve already had my initial consultation with Amelia and my nutrition coaching session with Julie Kelly, and testing supplies are on the way.  They routinely do the testing I’ve wanted to do for a while, but money got in the way, as well as my inexperience with interpreting results.  I have the money now, and these guys seem to be good at the second part.

So far I’ve been very impressed with the Nourish Balance Thrive team.  They’re professional and tech savvy, they seem very personable and competent in their areas of expertise, and everyone’s on time.  When they say they’ll call me at noon, they call me at noon.

Anyway, I’m back to a low-carb nutrient dense diet, avoiding everything that bothers me, which is most carbs.  In the meantime I’ll be getting tested with an Adrenal Stress Profile, an Organic Acids Urine Test (to test for nutrient deficiencies), and stool problems.  Amelia and Julie will help me develop a diet and supplement protocol based on the results.  So far I feel good low carbing again.  Blood sugar swings have lessened considerably.  I’m not constantly needing to eat.  Appetite is dropping.

I’ll report as things go on.

Unrelated but interesting.  My daughter suddenly decided she doesn’t want to drink milk anymore.  So she’s been off milk for a week.  Suddenly the constipation she’s had since she started drinking milk a year ago is gone.  Amazing.  She’s eating cheese with no problem, which suggests to me that it’s the lactose in the milk (as opposed to the casein) that’s the problem for her.  I ordered some Lactase drops in case she wants milk again.  I’m reluctant to discontinue dairy completely because a) she loves cheese, and b) it’s got lots of calcium, and I don’t think I can get her to eat enough dark leafy greens to make up for it.  So this is the plan for now.  The Peat folks always like to say try different kinds of milk till you find one that works for you – Well, we’ve tried many different kinds and never found one that didn’t constipate her.  Conventional, organic, grass fed, lactose-free, goats milk.  We don’t have access to raw milk and I’m not sure I’d give that to her anyway.  I guess it’s weird that lactose-free milk didn’t seem to make a difference.  Anyway, we never found an acceptable milk and she never developed the appropriate enzymes to deal with drinking milk (if that is, indeed, the problem).  Probably because there’s a gut issue that’s unaddressed.

I’m rambling now. Time to go be Mommy.

Upswing

Ok, I’m feeling better again.  No more!  No more crazy anything!  I’m just going to accept that I’m fat and get about the business of feeling better.  Forever.  No more deviations from the plan. I’ve been eating a lot of garlic, trying to make the endotoxin die down.  I think I’ve managed to poke enough holes in my intestine now from various experiments (let alone my unhealthy pre-Peat life), and now I accept that I don’t EVER get to eat starches and I don’t EVER get to eat fibrous fruits and veggies.  For at least…oh, a year or so.  Then MAYBE once a week or once every 2 weeks I can have an apple or a serving of potatoes.  But now, NO.

I recovered my energy and my mood by eating non-fibrous whole fruit, juice, meat, and lots of dairy (all forms).  Not gonna fuck it up again.  NOT GONNA.  YOU HEAR ME ENDOTOXINS?  YOU SUCK.

On another note…

One of my favorite bloggers in the entire world, Ray Medina, has moved his website to here.  I was poking around his site and came across this excellent article called Ulcerative Colitis and Dietary PUFAs.  I don’t have UC so I would normally have skipped right by it, but for some reason I decided to read it.  He discusses a mouse experiment that really makes a great case for avoiding omega 3 fatty acids.  In fact, I’ve never really understand the Peatarian assertion that Omega 3s only APPEAR to be good for you by “suppressing the immune system.”  This article explains it really well.  In essence, if you eat a diet high in PUFA, adding some Omega 3s (or fish oil) will make your labs look better.  BUT YOU’RE ALSO MORE LIKELY TO DIE SOONER.  hahahaha.  Good stuff.

Go read it.  And then stop eating salmon.

The end.

Rough Day

I felt terrible yesterday.  I attribute it to taking NAC the day before. Nothing else was different.

Why did I take NAC?  Well I decided to take N. Acetyl Cysteine for several reasons.  First, I had a bottle of the stuff I got a while back.  I don’t remember why…I think I was concerned about detoxing estrogen more quickly or something, so I got this as well as DIM and Calcium D-Glucarate, in the interest of helping my liver to function more effectively and eliminating excess estrogen. Well, my “enlarged spleen” is no longer enlarged most days, but I noticed it was back to being enlarged on Monday.  Monday was Day 14 of my cycle – estrogen was probably at its highest and maybe my liver was having trouble detoxifying everything.  I really have quite the fantasy life about processes I know little about.

Anyway, I decided to take NAC on Tuesday.  The next day (yesterday) my lymph nodes were swollen and I became very depressed…just like the pre-garlic days!  Awesome.  I  guess maybe I stirred things up and increased endotoxin in the blood stream or something.  Anyway, it was a complete waste of a day.  I got no work done, I did almost nothing productive, my concentration was terrible and I managed to delete the text of a file I needed for work, I had massive food cravings…just a mess all around. In the midst of my feeling like a squashed bug yesterday I entered “cysteine” into the search box on Ray Peat’s site.  Guess what!  Cysteine, like tryptophan, is anti-metabolic and anti-thyroid.  NICE TO KNOW!

I feel better today but won’t be taking NAC again.  In fact, you know what else?  I won’t be taking ANYTHING again that Ray Peat doesn’t explicitly recommend (exception: dill pickle with liver gets to stay). I’m going full-on Ray Peat Groupie.  Peatarianism.  I’m gonna be a devoted cult following, light-bathing, orange juice guzzling PEAT FREAK. When I do what he says to do I feel great.  When I start second guessing it because of labs or because someone on the internet has some great idea, I lose my footing and feel like crap again.

All you non-Peat internet people, I’m not listening to you anymore!!!

Edited to add….

Ok, I just remembered Ray Medina’s work has been immensely helpful to me as well.  Ok, he’s the only non-Peat internet person who is an exception to my new rule.  Basically if your name isn’t Ray, your authority is suspect!

Recent Wins and Fails

Hm….It seems it’s been a week since I’ve written anything!

Time for an update post.  This will be disjointed and possibly rambling.  I just haven’t been struck by the literary genius lately.

  • Depression is still gone.  Yay for garlic!  If I wouldn’t have been screwing around with starches (a la the Perfect Health Diet and the Resistant Starch craze) I wouldn’t have needed it. But I did. So I did.
  • I’ve eliminated starches again…not because I have to but because I want to.  It’s time for me to get serious!  I can’t be dilly dallying around any more!  Ray Peat says starches aren’t optimal food, so I’m done with them for a while. Plus someone on the internet told me he fixed his high triglycerides by eliminating starches…and I believe everything I read on the internet.  So I’m in!
  • I’ve increased my magnesium supplementation from 200mg/day to 600mg/day in the last few days.  My blood pressure has dropped 10 points.  I’m going to keep increasing and see if it improves further.  I figure I’ll get up to 1g a day, and if things aren’t better I’ll drop back to where I am now.  Blood pressure today was 138/88.  Yesterday it was 132/76.  Crazy low for me!  I took it 3 times to make sure it was right.  By the way, I stopped taking my blood pressure medication 5 days ago.  I’m done with it.
  • Still taking niacinamide and aspirin 3 times a day.  I find it very relaxing.  My pulse dropped into the 70s from the 80s when I started that.  I attribute that to reduced stress hormones (thanks, niacinamide).
  • I’ve had some real culinary FAILS lately.  I tried making liver pate using beef liver.  So awful.  I tried making pancakes out of 1 banana and 2 eggs…cuz I saw it on the internet. It tasted like a flat hot banana.
  • A culinary WIN today.  This video:

I never liked fruit much (and perhaps this contributed to my current state of poor health).  But through sheer will and determination I’ve found a few items I can tolerate.  Watermelon is one of them.  I actually really like it.  OJ also….excellent.  Grapes can be good too.  The rest of them…ok in a smoothie, and that’s about it.

  • Another culinary WIN, learned today.  I figured out how to eat liver without gagging.  For a while there I was eating it raw.  Sounds gross, but actually much easier for me than chewing it cooked. It was the perfect way to avoid both the taste and the texture of liver. Then I learned that there are some pathogens (e. coli, for example) that can survive being frozen, so I stopped eating it raw.  The last couple of weeks I’ve just choked it down.  But today I decided to eat it with pickles.  Crunchy, strong-tasting Vlassic dill pickles.  Every bite of liver has a pickle companion.  Like this:

pickle

The pickle completely kicks the liver’s ass!  The crunch and sharp pickle taste overpowers the liver’s ick!  I’m not afraid of you anymore, Liver!

Hm….what else…I guess that’s about it.  No starches, yes fruit and honey.  Yes magnesium.  Yes pickles and liver.  I guess that about covers it.

Till next time!