Ketosis and constantly activated Sympathetic Nervous System

[sb4]

I have POTS which results in vasoconstriction caused by my sympathetic nervous system being jacked up all the time. I think this has been giving me problems when trying to enter ketosis.

When I get in ketosis I notice my POTS is worse, particularly mornings and after meals. What I think may be happening is my sympathetic nervous system is constantly asking my liver for glucose and when it doesn't get it thanks to none been available in the liver it causes more of a stress response and tells my liver to start breaking down proteins to carbs to make up for it. This would fit with cortisol being high in the morning.

The solution may be to eat more carbs / protein but then no ketosis.

Has anyone else had this issue?

Also I have noticed the last 4 times I have gotten into ketosis has resulted in my brain stem feeling inflamed and like it's too small for my spine and massive headaches.
I understand the cervical spine inflammation can be an issue in these illness and indeed I have this normally anyway but why would it be so much worse during keto?
Perhaps the stress response from low glucose is causing trouble?
Maybe the increase in metabolism I notice on keto is causing my immune system to work better / harder such that it starts attacking things more vigorously?

 

[Mary]

@sb4 - I had trouble with doing keto and had to stop it. I think my situation is different than yours though perhaps similar in one way, though I really don't know! What happened to me was after a few days of doing keto with my carbs drastically reduced from before, I started crashing easier and crashes lasted longer.

What I think happened was my body had trouble breaking down fats for energy instead of carbs and so it went to breaking down protein (amino acids), and that this depleted my branched chain amino acids. And my branched chain amino acid supplement is what has given me a bit more energy AND cut the duration of my crashes by more than half. So doing keto caused my body to start gobbling up my BCAAs for fuel, depleting them and causing me to revert to the bad old days when crashes lasted close to 3 days, instead of one.

 

[sb4]

@Mary I think you're right regarding the BCAAs being to low for you on ketosis as I know you get a big benefit from them.

Interestingly I have been following a school of thought that BCAA contribute to obesity and lower metabolism.

When taking BCAAs I only noticed insomnia, no real boost in energy but who knows, perhaps keto lowered them to much.

My macros were / are:
Carbs 20g
Protein 50g
Fats 200g+

When I hit around 2500kcals I definitely noticed a metabolism increase. I was running hot instead of my usual cold miserable self. It got me thinking about if the increase in metabolism was causing the increased brainstem inflammation and If I just power through it maybe this improved metabolism immune system could sort out the problem at the brainstem.

Probably just wishful thinking though I have never really been high / normal metabolism since getting this illness. Only when going keto have I approached that. Maybe if I could correct my metabolism good things will happen?

 

[L'engle]

I've found high fat foods like butter, coconut oil and almond butter can affect my thyroid. The symptoms can be subtle but all over the place if the thyroid gets stimulated and then crashes. This might not be the case for others but my recent attempt at keto caused a thyroid type curve through high metabolism then flattening/crashing.

Also learned I hate avocados.

 

[Mary]

Interestingly I have been following a school of thought that BCAA contribute to obesity and lower metabolism.

Would not want that!

When taking BCAAs I only noticed insomnia, no real boost in energy

Actually the bigger effect I've had is my PEM duration being cut by more than half. The energy boost was mild. I don't take them after 2:00 p.m. I have read that BCAAs can cause insomnia if taken late in the day.

I hope you're able to get your issues with keto sorted out. A metabolism increase does sound like it should be nice, but not at the cost of inflaming your brainstem!

 

[Mary]

Also learned I hate avocados.

this is just sad! Have you ever had decent guacamole? I can eat it by the spoonful!

 

[L'engle]

this is just sad! Have you ever had decent guacamole? I can eat it by the spoonful!

Good gaucamole is probably really nice. Or little bits in sushi is ok. But If I buy an avocado and just have to eat the whole thing before it goes off, blech!

 

[SlamDancin]

Hey sb4 have you ever looked into BHB supplementation? I remember reading that it was the main factor in the benefits of the keto diet and that it supposedly can give the benefits of the diet by supplementing it along with normal diet. I know that the ray peat forum opinion on sugar is that it’s necessary to keep cortisol low.

 

[sb4]

Hey sb4 have you ever looked into BHB supplementation? I remember reading that it was the main factor in the benefits of the keto diet and that it supposedly can give the benefits of the diet by supplementing it along with normal diet. I know that the ray peat forum opinion on sugar is that it’s necessary to keep cortisol low.

Yeah I did a few years back. I remember them giving me gut issues. Perhaps those problems have been ironed out now as the supplements were relatively new back then.

One problem might be the BHB competing with BG leading to higher BG when taking them though I haven't looked into this.

I think I'm going to try upping the carbs and protein a touch and seeing if I can still get that increased metabolism.

I think the constant stress hormones / sympathetic activation is really doing a number on us. It makes increasing metabolism so much harder. The blood has increased FFA, BCAAs, Glucose because of this AND poor blood flow makes it even harder for cells to uptake these nutrients so insulin has to increase so we can dump them into fat cells.

 

[SlamDancin]

I think that’s well said.

just got a basic metabolic panel from my doctor and glucose was on the lower end of normal, but I consistently have high lipids in the blood.

I have stubborn high blood pressure so that’s a dead giveaway of chronic sympathetic activity. Telmisartan and Propranolol and it’s still not fully controlled

 

[sb4]

I've been thinking about this a bit more. Why some of us with POTS have gain weight easy and have trouble losing it.

With POTS you have poor circulation from whatever cause.
To compensate the body might increase sympathetic activation / stress hormones to cause vasoconstriction to help blood flow.
The stress hormones cause increased levels of Glucose and FFAs at a baseline constantly throughout the day.
The stress doesn't lead to exertion (lion chasing you) so the glucose goes unused. Not only that but you have less cells to use up the glucose as blood flow isn't getting to them fast enough.
The high glucose and FFAs leads to insulin being released.
The insulin shoves the glucose into fat cells to dispose of it.
When you eat a meal it has been shown that even in lean POTS patients excess insulin is released from a hormone that brings blood (vasodilation) to the gut. I assume extra levels of this are being released because of the poor blood flow.
This excess insulin shoves nutrients from your meal into fat cells preferentially.
This means your non-fat cells get less of there share of nutrients.
The brain then signals that you are still hungry.

So the root problem is the poor blood flow.
Regular people also struggle with excess Glucose and FFAs in there blood from whatever reasons (seed oils???) yet we might have that problem + constantly activated stress hormones and poor blood flow to compound it.

The stress hormones would explain why in ketosis my heart pounding / stress / adrenalin is worse in the mornings and after meals.
In the mornings cortisol is released requiring glucose yet also my body is flooded with stress hormones that demand even more glucose causing my body extra stress.
After eating insulin is released in higher amounts in me thanks to the pots so once again my body expects glucose yet there is non thanks to ketosis so cortisol etc is released to generate some making me feel like shit.

This also explains why I put on weight so fast with carbs.

Not really sure of the solution other than to treat POTS. Way easier said than done.

 

[SlamDancin]

This is a long shot sb but have you ever looked into the herb called Butcher’s broom? It can help with blood flow/POTS by activating alpha1/2 adrenergic and muscarinic receptors . It’s cheap, might be worth a shot. I take it whenever I’m feeling lightheaded

 

[sb4]

Yeah @SlamDancin I tried it way back when. I think the problem with POTS is that it's such a vague diagnosis and patients vary significantly in there symptomology, root causes, and treatments. Kind of like CFS/ME I suppose.

It overstimulated me. I was actually on Mirtazapine for a while and that has a similar mechanism of action, it helped me a bit when I was at my worst but overall it was too stimulating, made me more wired and masked depression. Also ruined my sleep.

If we can fix blood flow we could avoid this issue but that's essentially fixing POTS so obviously that would be idle.

The only other way of l can think is taking something like bromocriptine and calorie restriction as that would reduce that extra dose of insulin POTS patients get with meals.