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Need advice on the Ketogenic Diet

Discussion in 'General ME/CFS Discussion' started by Prefect, Mar 15, 2018.

  1. Prefect

    Prefect Senior Member

    I need advice on the ketogenic diet.

    I want to try it NOT for weight loss but to see if it will help with my neurological symptoms and anxiety.

    1. Can a skinny guy go on the keto diet?
    2. If I'm to consume 20 g of carbs a day, is that 20 g of carb sources (say 20 g of bread) or the actual amount of carbs in that food? I mean even high fat plain yogurt has carbs. When I eat yogurt do I count that in?
    3. Same with protein. When I eat fish, do I just weigh the fish and that's my protein intake, or do I calculate the amount of protein in that fish?
    4. How does MCT oil work? Can I have a breakfast with MCT oil as a part of it and maybe an egg on the side, or do I just eat the MCT oil and that's my breakfast?

    Sancar likes this.
  2. AdamS

    AdamS Senior Member

    Personally I wouldn’t do it. Just eat a balanced, healthy diet.

    I tried cutting out carbs/sugar for 6-8 weeks myself when I first came down with ME. I thought it would solve everything but infact it made me much worse energy wise. It did however help some of my bloating/stomach issues.

    Others may tell you otherwise but i’ve had advice from a nutritionalist and a metabolic dietitian who both independently advised against trying such extreme measures...turns out they were right in my case.

    It may be worth trialling a low carb diet for a short period to see if you feel a bit better but be cautious. I hope you find some relief from your neurological symptoms and anxiety.
    Tammy likes this.
  3. pamojja

    pamojja Senior Member

    I'm skinny too and for years on a moderate low-carb diet. According to blood I am in ketosis when fasted and taking blood-test too. Had no ill effects.

    Use a software like to get a handle (its free after signup). 20g of bread isn't 20g of carbs. At one point I quit milk, because it provided the most carbs to my diet. You count every gram of carb in every food, except the fibers.

    Software like cronometer gives exact ratios of carbs, proteins and fats of each food, and add up the amounts of each consumed throughout the day. No natural food is just one macro-nutrient and you can't count it that way.

    Best always have a combination along as it come with natural food. You're eliminating foods with a disproportional amount of carbs, like grains. And reduce other with a still higher carb-content.

    Start slow and decrease gradually while you see how you're doing.
    Kenshin and Murph like this.
  4. Alexi

    Alexi Senior Member

    Last edited by a moderator: Mar 15, 2018
  5. ryan31337

    ryan31337 Senior Member

    South East, England
    Hi @Prefect,

    I went keto Oct 2016 and it was really, really good for me. I have since relaxed the fat intake and upped the carbs a small amount (~50gm). I am now what you might consider low carb, rather than very low carb, high fat (VLCHF ketogenic).

    As @AdamS mentioned ketogenic diet doesn't work for everyone. For some this is because they aren't strict enough with carb intake, or because they don't realise they also need to consume what seems like an insane amount of fat. If you don't do these things properly ketogenesis will not happen and you will feel terrible. On the other hand some unlucky people seem to do everything right but still don't enter ketogenesis, so perhaps there is a metabolic block present too.

    @pamojja covered your questions well but here are some general points so you know what you're getting yourself in for:

    - Forget any food that is remotely carby. It is challenging to keep under 20gm when consuming the low levels of carbs in green veg, yoghurts, nuts etc. There is little room for higher carb veg like peas & carrots, let alone potato, bread, grains, pasta etc.

    - I went from normal diet to VLCHF immediately. This gave me the 'keto flu' for about 4 days, feeling tired and incredibly weak. This is entirely normal and can be mostly mitigated with a lot of rest, fluid and electrolyte intake. Towards the end of the first week ketogenesis took over and it was like suddenly being turbo charged cognitively & physically.

    - You could drop the carbs gradually (and I recommend pretty much anyone with our constellation of issues to try at least low carb), but personally if you are aiming for VLCHF I would go cold-turkey and within a week you'll know if its good for you or not. The alternative is a long drawn out process where it'll be harder to ascertain the state of ketosis.

    Good luck!
    bertiedog, Ema, Bander and 4 others like this.
  6. Bander


    I've been on keto since August of last year and it has been the second most powerful intervention I have tried in the 25+ years that I have had cfs. For me I saw improvement within a week, as Ryan suggests. The biggest changes were increased alertness and energy. I had some keto flu, but that is long gone. I have found that staying under 20 grams matters. When I was eating closer to 30 or 35, it lost much of its effectiveness.

    For anyone who is interested, here is my standard daily diet:
    • breakfast: 4 slices of cheddar cheese
    • lunch: can of tuna with 4 tbsp of mayo, cup of macadamia nuts
    • dinner: 2 Angus beef patties with 2 slices of cheese and 2.5 tbsp butter, 2 hard-boiled eggs
    The spreadsheet I use says this is 2460 calories with 12 net grams of carbs and 206 grams of fat. I figure the carbs are actually higher because often something is listed as 0 carbs when it has some. Costco is a great source for frozen Angus patties and hard-boiled eggs.
    ChrisD, ryan31337 and sb4 like this.
  7. ryan31337

    ryan31337 Senior Member

    South East, England
    It's doable if you are dairy free like myself too, just a bit harder.

    I'm not a big fan of oils in salad etc. But I do roast aubergine in a couple of tablespoons of olive oil and add coconut oil to spiralised veg every day. I also up the egg count (though these are roughly equal protein to fat).

    I enjoy a coconut yoghurt that is 20g fat and 4g carbs. Peanut butter can be quite good just watch out for added sugar varieties. Macadamia nuts are great too for incredibly high fat with very low carb content.
    Bander likes this.
  8. ryan31337

    ryan31337 Senior Member

    South East, England
    Oh, and avocado.

    It's remarkable how much half of one at breakfast and lunch keeps you full all day :)
    Bander likes this.
  9. Ema

    Ema Senior Member

    Midwest USA
    Keto has been great for me as well.

    I would highly recommend getting a blood meter and testing at first though. It’s easy to be getting too many incidental carbs at first and a meter helps keep you on track.
    ChrisD and Bander like this.
  10. ryan31337

    ryan31337 Senior Member

    South East, England
    The urine dipsticks seemed fairly reliable for me too :)
  11. sb4

    sb4 Senior Member

    United Kingdom
    I have a theory on why eating so much fat can be disgusting if done wrong. I used to just have some meat and force done a ton of butter with it. This is disgusting and makes you feel sick however if you eat high fat cheese, sausage, or scrambled egg, it's perfectly nice.

    I think first of all, your gut has a hard time digesting oil on it's own. If it's emulsified in something like egg or part of cheese I think it is absorbed better. Also intestinal inflammation and endotoxin absorption can be very high with ketosis, perhaps emulsifying the fats helps this?

    Second, you need veg with it for the minerals and to produce SCFA and T regs to quell inflammation caused by high fat. Minerals will be low if your eating 200g butter with 100g of meat, so veg helps this.

    I think we are evolutionairly designed to not want to eat fat straight up on its own in the form of butter / tallow. So if you are like me and originally found eating this way to be a disgusting chore, then just scramble your fat with eggs and add some green veg!
    Bander likes this.
  12. ChrisD

    ChrisD Senior Member

    East Sussex
    I have been Keto since last summer (with a few slips back into carb eating just for one day at a time - ''carb refeed''), i would also say that it has been the greatest intervention in my recovery and would urge people to try it. It's no miracle recovery but I would say I have recovered from about 5% activity level to 15% which for now is enough to keep at it. In general it just make my quality of life so much better as I am able to go for a 45 min walk a day and go out for a few hours at a time with friends or family in the car with a less dramatic PEM crash afterwards, i.e. No or Less chest tightness, fasciculations, sleep disturbances.

    Adaptation can be tough and I had a few issues with eye problems, and skin rashes (still trying to resolve slight keto rash on head), but the benefits outweighed the negatives.

    If you are interested, I started a facebook community for people using Keto for ME
    bertiedog, Bander, sb4 and 1 other person like this.

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