First time in remission with ketogenic diet

Messages
22
Likes
37
I'm cautiously excited and have been wanting to write this post to all of you, but I first wanted to make sure it really wasn't a fluke.

I've been in remission or near remission for over a week now. I've never had any symptom improvement for more than a couple of hours for 5.5 years, and before 1.5 weeks ago my entire time having ME was slowly getting tragically worse.

For those of you who don't know my story, I got sudden onset ME in January 2013. In hindsight there were some earlier signs, so accurately I would call myself gradual + sudden ("straw broke camel back") onset. It was a very severe shock and I didn't know what was going on for 6 months. Went to doctor after doctor helplessly and the only hints they found were large and hard lymph nodes in neck and groin, huge EBV/CMV/HHV-6 titers, and evidence of 800 heart PVCs/day (which I was feeling constantly in my chest the moment I got sick).

As with most of us, all the specialists those first 6 months had no idea what was going on and how to help. So in August 2013 I started trying to figure out online what might be going on since my life was falling apart and that's when I found PR and literally cried because my symptoms and experience where exactly what was going on with so many of you.

I went to see Dr. Susan Levine in NYC, she did a full evaluation and battery of tests and after those came in confirming everything we started on Valcyte + Famvir + LDN, supplements, sleep aids.

I've had very classic ME. It was the worst in the beginning and through the first year, and like you know in the beginning you have more reserve to try to fight the disease process. Then very slowly during the second year my body kind of stabilized and I thought (mistakenly) that the antivirals etc were doing it. But during the second year, which I didn't realize it until later, the stabilization was just moving from the acute phase to the chronic phase. Since being in the chronic phase for the last 3.5 years or so I've been very slowly getting worse.

As many of you know from my posts over the years, I've literally tried most everything. NOTHING ever worked. Thanks to all of you for posting all the different and interesting things to try, trust me it was worth it to try and have some hope of improving. Probably in my third year I really stopped posting much and stopped trying new things. I just said to myself nothing is working so all I can do is dig in, stick with the few medications which I think might help and just try to manage every day and keeping tabs on latest research.

I've had mild severity ME until more recently, though always going to moderate severity in a crash. I've worked at my job through it all but it's been absolute hell and a herculean struggle with lots of missed days and vacation time spent to try and recover. Fortunately, working didn't cause a sudden severe worsening I heard a lot of people get, for me it's just been a very slow deterioration.

Last year I would say I noticed that my worsening condition was more apparent. When I was mild severity I had symptoms constantly but could still work and would crash usually once per week and then could recover. The crashes very slowly started become more frequent and took longer to recover from, and the constant symptoms became more intense. It wasn't until this summer that I fully started having moderate severity ME. Everything flipped, I was crashed most of the week with terrible symptoms and I would only get out of it for two days before crashing again. I wouldn't be able to leave the house or do much of anything other than lie in bed. I've had to take extended time off work this summer.

I've had a rare form of psoriasis since I was a teenager, and after getting ME it made the psoriasis much worse, harder to control, and ME and psoriasis flare ups went together. The last two years I started progressing to psoriatic arthritis, which is common for psoriasis sufferers that have had it a long time.

The beginning of this year my rheum + derm begged me to try a newer biologic. In the past, I've taken other DMARDs (such as older biologics) and they didn't work very well or caused me serious side effects, plus having ME I was really worried to go back on one in case it would trigger a viral reactivation. Still, I decided since I was indeed getting worse with ME and autoimmunity that I needed to give it a shot. So I started with guselkumab (Tremfya), the newest and most targeted anti IL-23 biologic available.

Guselkumab significantly improved my psoriasis and psoriatic arthritis symptoms and reducing flare up severity. But it did absolutely nothing for my ME symptoms. Something that was very striking to me was that my ME could make my psoriasis and PSA break through the Tremfya, which is a powerful drug. It made me think that my ME was being driven by something else entirely and it would cause an immune activation which strongly impacted the psoriatic process.

During these years I've kept up with research always hoping for a breakthrough, in particular going through the Valcyte and Rituximab sagas. Then last year I think all the groups doing metabolomics (Davis/Naviaux/etc Stanford, Norway, Australian groups, Myhill UK, etc) published their findings showing similar metabolic issues at the cellular level, in particular the block with the glucose PDH route into mitochondrial cellular respiration and the extensive use of glycolysis producing lactate. These findings really struck a chord with all of us I think because it explained our symptoms more closely than I believe other previous hypotheses.

These last couple months I started seeing people, in particular on PR, leveraging those findings and either trying dichloroacetate (DCA) + supplements or using a ketogenic diet since these treatments in theory it would unblock or circumvent, respectively, the above cellular metabolic issues. There have been quite a few people who've had major improvements or remissions.

So sorry, long story short, I was basically losing all I had left these last two months and 2 weeks ago I said I need to push hard as I can to give one more try at something. Two things I hadn't tried where DCA or ketogenic diet. I read as much as I could about both and ordered everything I would need to to get either one started.

Since DCA is potentially more toxic I decided to start with the ketogenic diet first. I was in the middle of a crash in bed and said ok I'm starting with a 48-hour fast, only drinking water and eating small amounts of ketogenic food, e.g. almond butter, olives, and celery (don't ask my why they were the only keto things I had in the fridge at the time). I lied in bed not able to move, so I slept, watched TV, and only ate those things

After the fast I received the necessary starter things to do a ketogenic diet properly. Since I have ME, I knew that I need to be in strong therapeutic ketosis in order to see if this will work as a treatment. So I knew I had to take it much more seriously than a healthy person trying to lose weight or lower their lower blood sugar. I knew it had to be done with the same rigor as a cancer or epilepsy patient.

I've had an absolute 180 deg turn with this disease, going from moderate severity in a crash all the time 1.5 weeks ago to now in a remission. I'm still in shock from how things have changed. Just off the top of my head, here are some of the major symptom improvements I've noticed in just 1.5 weeks:

No more muscle tremors
Fewer neurological problems
Balance problems are greatly reduced
No more visual blurring
No more tinnitus
Far reduced joint and muscle aches
No more ME flabby muscles
Hair stopped falling out so much
Sleep much improved
Cognition is like night and day
Energy levels are really good
Virtually no fatigue
No PEM (though I need to test this by pushing harder)
I am slowly working again
No crazy pre-crash hunger

I haven't gotten a chance to really push myself outside physically and/or mentally yet, but I will keep posting how things go.

For those of you would want to try this, it's very important to do the following:

1. Try to do the 48-hr initial fast (if you can)

This will help jump start you into ketosis. It's not a water fast (which is really hard). You can eat maybe ~700 calories/day from food with almost no carbs and mostly fat. You can also buy exogenous ketone powder and drink that.

2. Purchase a ketone and glucose blood monitor and strips (I would recommend Keto Mojo) and always measure your glucose ketone index (GKI)

You will never really know if you are in therapeutic or high ketosis if you don't do this. Ketone pee strips and breath analyzers are inaccurate and totally worthless. You need to measure both ketone and glucose at the same time to know if your are in ketosis.

GKI = glucose / ketone (each in same unit of mmol/L or mg/dL; blood monitors give in same unit)

GKI Degree of ketosis Degree of dysfunction
--- ------------------- ----------------------------------------

<1 Therapeutic ketosis Epilepsy; cancer; ME/CFS
1-3 High ketosis Type 2 diabetes; obesity; ME/CFS
3-6 Moderate ketosis Insulin resistance
6-9 Low ketosis Optimal health; maintenance; weight loss
>9 No ketosis


Here are my readings from this morning:

Ketones = 4.4 mmol/L View attachment 28127

Glucose = 3.8 mmol/L View attachment 28128

GKI = 3.8 / 4.4 = 0.86

So far I've typically been between GKI 1 and 2. I think that is fine for ME/CFS. Other people who respond to it might not need so a high level, I'm sure it depends.

3. Purchase an app on your phone for completely managing your ketogenic diet (I would recommend Keto.app)

Apps such as this make it so much easier to do day-to-day. They take in your personal data and tell you exactly what calories from carbs, proteins, and fat you should follow in the ketogenic way, i.e. 75% fat, 20% protein, 5% net carbs (carbs - fiber). You don't do more than 25g net carbs per day, and you don't do more than 1g protein per kg of body weight. You will fill up the rest of you daily calories with healthy fats, which is actually really easy to do.

People screw up this diet all the time. For example, people eat too much protein thinking it's just another low-carb diet like Paleo. Protein beyond what your body needs will just be turned into glucose by your liver (gluconeogenesis) and just defeats the purpose.

These apps have huge databases of food and you can scan UPC codes on labels to locate the product.

4. Monitor your food intake accurately and RELIGIOUSLY.

You cannot guesstimate, cheat, get lazy, or anything like that. Everything must be counted, weighed, measured, calculated from the nutrition label and serving sizes, you get the idea. With UPC code scanning it gets easier. If the diet could work for you then it won't have any possibility if you don't follow it in every detail.

At first it's a pain in the neck, you just want to eat and it takes like 20 minutes get everything into the app correctly. You have to have your phone and put things in before you start eating which initially takes time. But as time goes by all of the things you eat or in there and you can copy them. It becomes more streamlined and less of a hassle. It actually becomes like a fun game. Eat out is very difficult to impossible.

5. Make sure you are getting your electrolytes.

Magnesium, sodium, potassium are very important in a ketogenic diet. You will pee more when not eat a lot of carbs and if you are deficient in electrolytes you won't feel well. Read more about this on keto info sites.

6. Drink baking soda (sodium bicarbonate)

Ketones lowers the pH of your blood. Drink a glass of water with 1/2 tsp of pure baking soda in between meals 1-2 times per day (I would recommend Bob's Red Mill Premium Quality Baking Soda, available at Whole Foods and other organic markets). Baking soda alkalizes your blood, helps to prevent any kidney stones, and there is some evidence that it could dampen immune activation. Since it could interfere with digestion it's important to drink it well in between meals.

-------

Your brain takes the most time of all your organs to utilize ketones. In fact it's the only organ that cannot totally use ketones exclusively. Even in maximum usage your brain will take 70% of it's energy needs from ketones and the rest must be from glucose. The 25g net carbs you eat will provide that glucose, plus your liver will make glucose from fatty acids.

For the above reason, I believe because having ME our brains might not ever back to pre-disease performance using just ketogenic. Whatever is blocking PDH is still doing it. But my brain has definitely "woken up". ME makes your senses like the volume has been turned from 10 to -1. When I went into full ketosis I had this very immense and insane reaction where my brain could suddenly utilize energy much better and could actually function again. My brain and body were not used to it becuase its been so long. It was almost overwhelming and totally felt like I was high.

I've seen a number of posts on S4ME and PR where people said they tried this diet and it didn't work or they felt terrible. I think first make sure you did all the above, that's important. Also initially on the diet you don't feel well but I found once I kept going all that just went away. For example, I had keto diarrhea for two days which is very common. I didn't get what is called the "keto flu" that healthy people get, I think because having ME and being in a crash when I started, and ME is 100x worse than most anything so a little keto flu didn't come up on the radar.

I think too if you have a lot of ME-related food sensitivities or gut issues it could be hard to do it. Also if you had your gall bladder removed then it would also be difficult.

God I have so much more I could say.... Those of you who know me and my background know I'm not messing around. I've had this disease for a fairly long time, was doing really terribly and on a trajectory of being totally housebound and this was my last ditch effort to try and improve. This has been no placebo effect and is not a spontaneous remission. I'm sure if I go off the diet my ME will come raging back. I was an athlete before getting ME and only gained a minimal amount of weight due to the disease. I do not have prediabetes or anything like that.

I am definitely part of the possibly major subgroup that has glucose cellular pathway blocked and eating carbs actually contributes to the symptoms because your body’s cells cannot use it efficiently so it likely just causes inflammation and immune activation which reinforces the disease.

Finally, I've formulated and written this entire long post without any ME symptoms coming back due to the exertion. That would of been impossible just a couple weeks ago...


DO you think it is possible it is a gluten free and or grain free diet which helps heal gut dysbiosis vs just Keto diet? similar response to a GF diet for me at first!
 

Mary

Moderator
Messages
8,117
Likes
16,933
Location
Southern California
@sb4 - keep us posted how it goes with the potassium citrate! I think it's encouraging that it apparently (and the mirtazapine) helped with your sleep last night. BTW, low potassium can also cause insomnia. I have to be careful with citrate anything at night because there is some connection to msg in all its manifestations, which causes severe insomnia for me. e.g., magnesium citrate worsened my insomnia instead of helping. I do well with potassium gluconate and magnesium glycinate.
 

cigana

Senior Member
Messages
1,069
Likes
898
Location
UK
@Mary I don’t know how many stories I’ve read where people say they were eating a low-carb diet for a long time and when they finally got around to doing blood measurements they weren’t in ketosis at all.

ketogenic diet != low carb
I just wanted to point out to @Mary that when @leokitten uses the symbol != it means ketogenic diet is not the same as a low carb diet, as that may have confused her. Those of us who code know what != means!:)
 
Last edited:

bertiedog

Senior Member
Messages
1,360
Likes
2,348
Location
South East England, UK
I am trying to understand the issues many of us with this illness have related to ketosis Does anybody know of any reason as to why several of us with ME/CFS find it very difficult if not impossible to get into ketosis even though we keep trying. It's a definite for me at the moment and every time I have tried I experience killer migraines which are triggered often from the overnight fast of 12 hours. They will go on daily and if I get rid of it say at lunchtime on the second day, then it will start up on the opposite side the following day and the pattern goes on.

I have read of many others who experience intractable migraines and others who experience weakness and feel so much worse they have to stop. Please excuse me if I am being a bit ignorant here but would it be to do with the energy blockage that several researchers talk about?

It would seem that people who don't have our illness get on with Keto fine and no real problems.

Doing very low carb with more fat has raised my steps up to almost 10000 a day according to my Fitbit since this second attempt at Keto so I am obviously getting benefits but still get PEM if I don't rest enough between doing stuff. However I don't think I am in ketosis because my body still needs a top up of say seeds and nuts following 30 minutes walking my dog (this always includes a 5 minute sit-down). I just cannot not have a top-up otherwise I am extremely dizzy and week and nil energy. Also on waking quite quickly I really want to eat and always have some seeds with homemade whole milk yoghurt next to my bed so that I can eat this before getting up. I think that shows that I cannot be in full ketosis although my OAT test showed I had a very high reading overnight. My ketostix certainly don't show this.

I would love to be able to fast for a few days to see how I feel but for me it's out of the question. As I have mentioned several times I do wonder if I find it so difficult to get into and stay into ketosis is because of adrenal insufficiency plus hypothyroidism and my reliance on Prednisolone and NDT. I guess I just want a better understanding of the difficulties many of us face.

Pam
 

cigana

Senior Member
Messages
1,069
Likes
898
Location
UK
I am trying to understand the issues many of us with this illness have related to ketosis Does anybody know of any reason as to why several of us with ME/CFS find it very difficult if not impossible to get into ketosis even though we keep trying. It's a definite for me at the moment and every time I have tried I experience killer migraines which are triggered often from the overnight fast of 12 hours. They will go on daily and if I get rid of it say at lunchtime on the second day, then it will start up on the opposite side the following day and the pattern goes on.

Pam
I've often wondered about this from a different perspective.
Whenever I try water fasting (going without food, drinking only water) for a few days, I become extremely ill - I can't breathe. This is not normal, humans are supposed to be able to water fast with no problem because during our evolutionary past there were many long periods of food shortage, and religious fasting has been very common in the past. I've spoken to a couple of doctors who help patients water fast and it's very rare that patients can't do it. So it seems to me something interesting is going on with us.
 

bertiedog

Senior Member
Messages
1,360
Likes
2,348
Location
South East England, UK
I've often wondered about this from a different perspective.
Whenever I try water fasting (going without food, drinking only water) for a few days, I become extremely ill - I can't breathe. This is not normal, humans are supposed to be able to water fast with no problem because during our evolutionary past there were many long periods of food shortage, and religious fasting has been very common in the past. I've spoken to a couple of doctors who help patients water fast and it's very rare that patients can't do it. So it seems to me something interesting is going on with us.
Thanks for posting your experience even though it is very unpleasant just like my migraines which just shouldn't happen when one's blood sugar is in a normal range and not having eaten anything for 12 hours. I was in a terrible state once in the 80s when I had limited carbs all of a sudden at a so called health farm. It made me so ill and I hadn't developed full blown ME/CFS but undoubtedly I was a bad way metabolically speaking and no way was I well either.

Pam
 

leokitten

Senior Member
Messages
725
Likes
2,199
Location
Maryland
DO you think it is possible it is a gluten free and or grain free diet which helps heal gut dysbiosis vs just Keto diet? similar response to a GF diet for me at first!
Hi @sar88 - in the first year I had ME (2013), before I even knew I had ME (which I didn't find out and have diagnosed until 8 months after having it) I tried two different diets separately 1) gluten + dairy free and 2) vegan. I remember strongly that I trialed these interventions, in the middle of going to different specialists to desperately figure out what was going wrong, because I felt that diet and metabolism might be a major driver.

I did each diet for 1 1/2 months and neither did anything to improve my ME symptoms. Now the only asterisk I can put on this is that I was in the acute phase of ME when I did these interventions. Who knows, maybe that was a factor negatively influencing the outcome. Since then, I did no dietary interventions until early this year when I randomly started intermittent fasting (IF, 24hr only), which improved my symptoms like clockwork every time until after eating again. This gave me one early clue that maybe I should try a ketogenic diet as an intervention.
 

leokitten

Senior Member
Messages
725
Likes
2,199
Location
Maryland
Yeah I noticed that my BP is a lot higher on ketosis which made me think electrolytes. I had tried magnesium 2 nights before but perhaps it made me worse. This heart pounding at nigh has been consistant the last 3 nights and ruined my sleep for 2 of them.

I have purchased some potassium citrate which I intend to experiment with. Interestingly I was having the night heart problems last night and I took a decent amount of potassium citrate and switched my mirtazapine dose back to night time and I slept ok.

Will be able to test the high BP stuff better today as I recieve k citrate.

Interestingly my hair mineral analysis shows low Na, K, and Mg. I am also fairly adverse to salt. Like bacon now tastes pretty bad and I'm sure it's the salt in it, when I have it in reasonable quantities. I think that the hair minerals test could be right in that I am deficient in all 3 which means whenever I raise one of them too high I end up flushing more of the other 2 out in pee.
@sb4 a couple other good ways to get electrolytes:

1) A high quality BHB exogenous ketone powder drink mix, which comes as BHB salts (sodium-BHB, maganesium-BHB, calcium-BHB)
2) Electrolyte drink powder mix (e.g Emergen-C Electro Mix sachets)
 

sb4

Senior Member
Messages
1,137
Likes
1,815
Location
United Kingdom
@Mary So I have been taking K citrate for the last 1.5 days and I still have high BP which I suspect is causing me problems (making my heart more uncomfortable, pinching/stabbing pains in left heart occasionally, heart pounding making it very difficult to sleep).

The K+ doesn't seem to have made much of a difference so far. I think switching mirtazapine to night helps me sleep thanks to the anti histamine effect but I wake up latter in the night with a weird differen't type of palpitation that prevents me from laying down for 30-60mins (I took an aspirin so maybe that helped).

I have been taking around 2g x2/day. Perhaps I should increase although it fails the taste test (tastes repulsive so perhaps my body is signalling it doesn't need it ala salt, or maybe it doesn't work this way). I even did some nebulized Mg sulphate last night but didn't seem to affect BP.

Really unsure what is causing this. I now turn my attention to B2 as I had a test last year showing low B2 and this could be a big problem, if it's true, on a ketogenic diet.

It could also be that for months I had been taking B1/3/6/7 but stopped them dead around 3 weeks ago. I didn't notice any difference the first 2 weeks, then I started ketosis diet 1 week ago so perhaps it's taken a while for my body to become "depleted" in them again. If the B2 doesn't make much difference today I shall add the other b vits tomorrow.

Any one have any other ideas what could be causing my increased BP?

In other news, after 2 disastrous attempts at making keto desert, I made a decent one. The secret? Actually following the instructions from online recipes and using the same ingredients, instead of just saying I don't have that so I will use something completely different instead.

Although I have found that the keto deserts aren't that necessary to make high fat do able if you use dairy. This could be a problem when I try to do the clean version of just meat, fat, and veg though.
 

Mary

Moderator
Messages
8,117
Likes
16,933
Location
Southern California
Hi @sb4 - I'm stumped. :confused: Too bad the potassium didn't solve the problem! you're taking 4 grams which is a healthy dose and seems like it would have made a difference if low potassium was the problem. Maybe @leokitten might have some ideas here. I'm holding off starting the diet for a few weeks, hoping to be able to get into the pool where I live a few times before summer is over. I have no idea if low B2 could be a factor, am not very familiar with it, though I take several other of the Bs.

In other news, after 2 disastrous attempts at making keto desert, I made a decent one. The secret? Actually following the instructions from online recipes and using the same ingredients, instead of just saying I don't have that so I will use something completely different instead.
:lol:
 
Messages
1,002
Likes
729
@sb4 I had worsened autonomic symptoms last time I was transitioning into keto. No idea why. It lasted 3 weeks. :(
High cortisol is a possibility, I think??? Switching primary fuel source is much more a stressor than it ought to be (for pwme) is my educated guess. ;) Also B1 can become depleted on a keto diet so you might want to make sure your B's are covered as a precaution.

Not sure what else to suggest. But yeah...if all else fails, follow the recipe. lol ;)
 

sb4

Senior Member
Messages
1,137
Likes
1,815
Location
United Kingdom
@sb4

Could you be having low blood sugar? High cortisol?

Are you taking biotin?
It is possible. I do have a glucose meter but the sticks for it are really expensive and I'm out. I was taking biotin previously.

I intend on pulsing the bvits for 1-2 times a week starting today. I think I had a very moderate success with B2 or maybe it was just random.

I had worsened autonomic symptoms last time I was transitioning into keto. No idea why. It lasted 3 weeks. :(
High cortisol is a possibility, I think??? Switching primary fuel source is much more a stressor than it ought to be (for pwme) is my educated guess. ;) Also B1 can become depleted on a keto diet so you might want to make sure your B's are covered as a precaution.
Very interesting that it took you 3 weeks. Last time when I had big problems with POTS and keto I pushed myself to 2 weeks and couldn't go any longer. This time I'm only at 1.5 so hopefully it will change in the coming week or so. I'm going to take an allithiamine along with a b-complex this morning.

AFAIK B5 is highly needed to digest fats (see link in my sig for Kerbs cycle)
Thanks, lets hope this b complex helps!
 
Messages
22
Likes
37
@sb4 I had worsened autonomic symptoms last time I was transitioning into keto. No idea why. It lasted 3 weeks. :(
High cortisol is a possibility, I think??? Switching primary fuel source is much more a stressor than it ought to be (for pwme) is my educated guess. ;) Also B1 can become depleted on a keto diet so you might want to make sure your B's are covered as a precaution.

Not sure what else to suggest. But yeah...if all else fails, follow the recipe. lol ;)

I feel like some of this may be endocrine but I am convinced the worsening is endogenous opioid like withdraw. Since majority of us most likely have gut dysbios more gets through to our brain and gut dysbiosis also inhibits DPP enzyme?? DId you kick all grains at once?
 
Messages
22
Likes
37
Hi @sar88 - in the first year I had ME (2013), before I even knew I had ME (which I didn't find out and have diagnosed until 8 months after having it) I tried two different diets separately 1) gluten + dairy free and 2) vegan. I remember strongly that I trialed these interventions, in the middle of going to different specialists to desperately figure out what was going wrong, because I felt that diet and metabolism might be a major driver.

I did each diet for 1 1/2 months and neither did anything to improve my ME symptoms. Now the only asterisk I can put on this is that I was in the acute phase of ME when I did these interventions. Who knows, maybe that was a factor negatively influencing the outcome. Since then, I did no dietary interventions until early this year when I randomly started intermittent fasting (IF, 24hr only), which improved my symptoms like clockwork every time until after eating again. This gave me one early clue that maybe I should try a ketogenic diet as an intervention.

Yes the first year is hard. I couldn't make many connections that first year. I did not see many results until at least 8 weeks off Gluten because of that withdrawal effect. I also wonder if a lot of this could also be a result of immune cell shifting and regeneration that has been studied to occur with fasting? I t is interesting and great that you are feeling better regardless! Keep us posted! Maybe the variables will become more clear over time.
 

Gondwanaland

Senior Member
Messages
5,002
Likes
4,138
I wonder if anyone ever felt the need for silica to cope with all the high salicylates in olive and coconut oils in Keto and LCHF diets. Here where I live the soil is very poor in silica and high in aluminum. I have a great need for silica, but can tolerate a supplement anymore, but high silica tea helps me imensely with collagen synthesis and salicylate intolerance.

Not eating grains lowers silica intake to close to zero.
 
Messages
1,002
Likes
729
I feel like some of this may be endocrine but I am convinced the worsening is endogenous opioid like withdraw. Since majority of us most likely have gut dysbios more gets through to our brain and gut dysbiosis also inhibits DPP enzyme?? DId you kick all grains at once?
I do eat some rice, spelt, quinoa and amaranth when not ketogenic. I probably went from around 150 - 200 g carbs per day (which isn't a lot really) to 20 g to achieve therapeutic ketosis.
I'm not using a ketogenic diet all year round. I worry I'm not getting enough fibre so I try and take a seasonal approach. It should be easier than it is though to transition. Interesting thought about the opiods. I had also wondered if it might be microbiome related.
 

Crux

Senior Member
Messages
1,185
Likes
922
Location
USA
Here's an excellent article from the Diet Doctor's website that explains some causes for elevated glucose with the ketogenic diet.

This happens during the initial stages when the body adjusts to needing less insulin, etc. There will be some insulin resistance.

One cause that's brought up with some folks is the 'Dawn Phenomenon' , when glucose is elevated in the morning because of elevated morning cortisol. Many here would say that their morning cortisol is low, but also, adrenaline raises blood glucose.

Anyway, it looks like a good idea to measure insulin as well as glucose to get a more accurate assessment of ketosis.


https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher