Is it normal to have PEM / exhaustion in start days with ketogenic diet?

[MartinK]

Hi all!
Simple question for all with ketogenic diet experiences! Is it normal to have PEM / exhaustion in starts days with ketogenic diet? Im in ketosis shows measurements for 2-3 days (5 days on ketodiet counted).

Because of my frequent crashes /PEM I can't tell if it's a keto flu...but im pretty tired these days.

I increased the doses of electrolytes and PEM busters.

How long you have keto flu? Were they similar symptoms for that days?
Can it be alleviated or need to endure?

Thanks a lot!
Martin

 

[Hope4]

Hi, @MartinK. The time it takes to become keto-adapted is individual. The older one is, the more ill one is, the longer it takes. And some, such as Dr. Wolfgang Lutz, and Dr. Jan Kwasniewski, felt that dropping carbs too fast, was an unnecessary stress.

Here is a post at Dr. Michael Eades' blog which might be of help. It is common to eat more meat and fat when one starts a very low carb diet, if that is of any help.

If you made a great change to go on a very low carb diet, the adjustment could be dramatic. If one has been eating 200g/CHO per day, to drop to 20-40g/d is a shock to one's system. Dr. Lutz had people who were older or ill start at 90-100g/CHO/d, and stay there until they had adjusted. Some need weeks, some months, some never get adjusted. The adjustment is metabolic. If 90-100g/CHO per day is easy, then lower to 60-70g. That was Dr. Lutz's approach. He details this in his book, Life Without Bread.

In my opinion, unless there is a great need to be ketogenic, such as seizures, Parkinson's, migraines, etc., why not increase the carbs a bit, and find a protein level that makes you feel good.

The goal is to feel better, not to adhere to an external standard (unless that standard is a life-saving measure).

I have never measured ketones. I don't worry about them. My diet is structured so as to facilitate usage of FFAs.

Dr. Ron Rosedale has several very interesting talks at youtube on the purpose of a low carb diet, why FFAs are important, etc. He has his own website, too.

If staying at ketogenic levels of protein and carbs makes one feel crummy, why not increase them a bit?

If I feel stressed from staying at 50g/PRO and 25-30g/CHO, I just increase protein to 60 or 70g/PRO and carbs up to 45, or even 60gCHO/d. I adjust the amounts and contents to try to have the steadiest brain function, and energy levels, without increasing brain agitation or amine/salicylate/glutamate load. I used to count, weigh and measure everything, and sometimes do, now, to check.

Food planning is a bit of a puzzle and it takes experimenting for oneself to find what fits well.

If you don't mind posting them, could you post about your PEM busters? Thanks.

Best wishes to you.

 

[MartinK]

Hey @Hope4 ...thanks!
I made dramatic takeoff from carbs...from "classic" menu (healthy nutrition but not dramatically)...to maximum 20g carbs/day ...measuring on app, and my ketons on strips.
Maybe I was too angry with start of diet looks like!
When I ate some sugars or starches, I had some energy boost for 1-2 hour ...but that was false, unsustainable...

Looks like I'll try not to set it so strictly now...for few days... adaptation days for fats.

I also want to add some time to low histamine foods...overall to eliminate all possible inflammations in the body...because I feel inflammation 24/7 and it one of my main problems with fatigue...and think with previous infections is main trigger of my getting worse CFS.

Thanks for article! I will look on it!

PEM busters? HBOT makes me better everytime! Sure Im on BCAA, CoQ10 or sodium bicarbonate in bad PEM times, but with uncertain results. Good sleeping in the daytime is also good...and fresh air...some yoga on fresh air, but easily...Only stretching for push some oxygen to muscles and make lymph works. Ad sure...so stress that day...relax only and do well for yourself! ;-)

Martin

 

[Hope4]

@MartinK. I have been thinking about what I posted earlier. I think that the body adapting to burning fat instead of glucose is metabolic exertion. If any exertion causes PEM, it stands to reason that metabolic exertion could cause PEM.

Are you tracking protein, fat and carbs?

I get brain agitation with too much protein, especially ruminant meats, but even poultry or fish. I don't know if it is the protein, as such, or perhaps amines or glutamate. I do better with egg yolks or yoghurt as my last meal of the day, and the meat/fish earlier.

If it is possible you have functional hypoglycemia, or poor glucose uptake in the brain, then timing the P:F:C amounts from day to day can help a lot.

For example only:

Breakfast 25g of P: 45g of Fat: 8g. of CHO (carbs). from day to day to day.

This gives the body a rhythm, a schedule to follow.

Lunch, the same amount of P:F:C from day to day.

Supper, the same amount of P:F:C from day to day.

This idea comes from Dr. Richard Bernstein who specializes in helping diabetics achieve normal blood sugars.


Thanks very much for the PEM busters lists. I'll have to look up HBOT. ETA: I'm guessing that is hyperbaric oxygen tank.

All the best to you.

 

[BeADocToGoTo1]

Yes, it can take weeks to get used to it, with ups and downs. Withdrawal symptoms from heavy reduction of sugar and simple carbs is normal, but have you made sure that your calorie intake is at a healthy level still. On a macro-nutrient level, it is easy to to drop too many calories with keto initially. Also, when you are burning adipose fat, it can also release some built up toxins stored in your own fat, which can also make you feel tired and flu-ish.

By cutting down carbs it is also possible to cut out too many micro-nutrients that you were getting from fortified food, legumes, certain veggies, and grains for example. Have you looked at the micro-nutrient balance of the new diet? Adding some vitamins, minerals and phyto supplementation might help.

Perhaps, too obvious, but the quality of the food and water is very important. Adding healthy fats and proteins without adding chemicals, herbicides, pesticides, hormones from unhealthy versions. Drinking non-chlorinated, non-fluoridated water is important. Having a handful of nuts and seeds as an in between helped me a bit with extra calories.

20 carb grams is hardcore and really a temporary thing as a reset. You can try taking it up a little to see whether that also helps you feel better. 50-100 grams along with eating food within a 10-12 hour window can also provide light ketosis. It is often better to ease into these types of changes, especially when you are already ill.

 

[taniaaust1]

When I went to this kind of diet, I did not go through any bad patch at all and from the start of it actually felt much better.

Why not do it more gradually if it's causing you negative symptoms. I'd be worried about the added stress on the body with the ME if your body is struggling to cope with it.

 

[MartinK]

Hey all, thanks a lot! I really appreciate it!

@Hope4 - yeah, hard chamber - 2 hours in 15 meters dive.
Yes, Im tracking PFC...it helps me a lot make things under control.

But from now on I will not be so strict...looks like its really too much for my body. Im trying to lot of BCAA support and liposomal C + ALA + Glutathione...and LOLA for possible ammonia from toxins. Oh - gentle detox with all for sure!

Now I'm mainly on vegetables, eggs, some fish and BIO meat, meanwhile salted peanuts...and looot of filtered water and green tea, lapacho tea.
Virgin oils - coconut, hemp, avocado
Supplements are B-complex, E, D, K2, Curcumin + piperin, CoQ10, Seleno, Quercetin, electrolytes.
And Im on Buhner herbs for babesia (I've had it for a while)

Martin

 

[Hope4]

@MartinK I wish you well with your food plan. If you are not overly attached to the peanuts, any chance you could use a nut that doesn't have such high Omega 6? I suppose it depends on the amount. I try to keep the PUFA (polyunsaturated fats) very low.

I do notice, with lots of health challenges, that the wiggle room in the food plan is narrow.

I ran into problems with my food plan, that I could not solve by altering PFC ratios or total amount, and ended up on the Royal Prince Alfred Elimination Diet, which has cleared up some troubling symptoms.

I use butter and tallow for fats, and sometimes clarified butter. And I do better with egg yolks only, and toss the whites. I get allergic symptoms from the whites.

Another way to test foods is to rotate food families. Dr. Theron (Ted) Randolph's rotary diversified diet is the background for that. I have found that useful, too.

I wish you good health and joy.

 

[MartinK]

Thanks @Hope4 for tip with omega 6...I need to make more overview of everything!
Today was really bad day...massive long PEM, exhaustion...flu like feelings...
Hope I adapts on this diet fast...this start in so hard for me and my CFS!

 

[Hope4]

@MartinK. I wish you smooth and easy recovery. Please, please eat so that you feel well. Going low carb does not have to happen fast. For some people, the shock of going from a high amount of carbs, to ultra low can be too severe.

I don't want you to tax yourself too much by adhering to an arbitrarily set, external standard of carbs, or anything else.

I'm sending you good thoughts for health and joy and comfort.

 

[Mary]

Hi @MartinK - I tried the ketogenic diet last November with bad results. I was not a heavy carb or sugar eater to begin with. I've been strict about that for a long time. Here's a thread I did about my experience: https://forums.phoenixrising.me/threads/bad-experience-with-keto.62135/

Anyways, within 2 days I felt pretty bad. I assumed it was the 'keto flu" but then I crashed. There was no doubt it was PEM, which has a very distinct feeling for me. It's unlike anything else. I found I was crashing much easier (energy envelope cut in half at least), and the crash was doubling in length, like it had been 4 years ago before I started taking BCAAs. It was scary so I stopped the diet.

I believe it was Fluge and Mella who posited that women with ME/CFS tend to use amino acids for fuel. So I'm guessing that keto depleted my BCAAs (which I have taken religiously for over four years and I didn't stop with the diet), and that caused me to revert to how I was in the bad old days prior to BCAAs.

So this might have happened to you too. If I were to ever try it again, I would increase my BCAAs and hope they didn't cause insomnia - high doses cause insomnia for me.

 

[MartinK]

I think @ryan31337 have some to say with this crash/PEM in start of ketogenic, right?
I want to give it a few more days for adaptation....but, its hard. Today looks like little bit better, but still hard PEM.

@Mary Im sorry with your bad results from last November :-/
But yes, I using a lot of BCAA and electrolytes! ;-)
Hope it helps!

Martin

 

[ryan31337]

Hi @MartinK,

Yes, I experienced significant muscle weakness & fatigability (more than bad PEM) and very foggy/headaches (on par with bad PEM).

It didn't last that long for me. I think within 7-10 days I felt a lot better than before starting the diet. The keto-flu symptoms started 2 days into the diet and were at their worst in days 3-5 I think. After that it was upward trend, but YMMV. In my case I'm pretty sure I was also correcting gastric dysmotility and associated reactive hypo's, so I got a bigger benefit than most.

Stick with it and good luck!
Ryan

 

[MartinK]

Thanks a lot @ryan31337 !!!
I have it exactly the same as you describe...to the last dot! Yesterday was most bad (day5) - PEM, flu-like, headaches and feeling like fever - hot body inside. Today (day6) is little bit better.
My stomach is a little inverted now...at least I wash out bad things.

Thanks all for support!
Martin

 

[MartinK]

Hey all - good news!!!
Today first day better and its amazing - better than before start of ketogenic...today out for 1 hour...1km distance walking!! so amazing!!!
little bit tired now in evening, but nothing special to PEM or crash!
Thanks god!

Martin

 

[Hope4]

@MartinK Congratulations! I wish you continued success.