Lack of chatter about the Ketogenic Diet

Gondwanaland

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Serum is BS, celltrend I appreciate, RBC tests alike.
When I was desperately low in magnesium and hadn't found magnesium oxide yet (the only form I tolerated), I tested for it and the results were:

Serum Mg 2.2 (1.6 - 2.3 mg/dL)
RBC Mg 5 (4.3 - 5.7 mg/dL)
Urine Mg 4.7 (7.3 - 12.2 mg/dL)

For this and other electrolytes I noticed that when serum levels are high it can mean that mobilization is high and needs are increased (n=1).
 

Hip

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From the discussions on this thread, here is a list of things you can do to help your ketogenic diet go smoothy, and hopefully avoid the side effects that can be experience on the ketogenic diet.

Avoiding the Side Effects of a Ketogenic Diet

➤ Drink sufficient water, as ketogenic diets can be dehydrating.

➤ Take electrolyte (mineral) supplements including sodium (salt), because you can become short of electrolytes on the ketogenic diet. Electrolyte shortage can cause the symptoms of: fatigue and dizziness, headaches from sodium loss (a quarter teaspoon of salt in a glass of water may fix these headaches if they occur), constipation, muscle cramps due to a loss of magnesium (taking more magnesium may fix this), heart palpitations or a racing heart (this may also be caused by taking too much medium chain triglyceride oil).

According to this article, in a ketogenic diet, electrolytes can be supplemented at the following doses:

Sodium: 3-5 grams (= 1 heaped teaspoon of salt) in addition to the sodium which occurs in food
Potassium: 1 gram in addition to the 1-1.5 grams of potassium which occur in food
Magnesium: 300 mg supplement

➤ A multivitamin tablet may be useful, since as you will be cutting out grains (like wheat) which contain B vitamins, you may be short on these.

➤ With all the meat you eat, ketogenic diet may be slightly acidifying, so it may be an idea to take an alkalizing agent such as small amount of sodium bicarbonate with it (e.g., ⅛ or ¼ teaspoon of sodium bicarbonate daily on an empty stomach).

➤ It is a good idea to potassium citrate to reduce risk of kidney stone formation from a ketogenic diet. Potassium citrate is also good for alkalization, and so if you take this, you probably will not need the sodium bicarbonate (in other words, potassium citrate can kill two birds with one stone). See this paper.

Carnitine supplementation (eg 500 mg twice daily) may help: this paper says: "Medium-chain triglycerides do not require carnitine for mitochondrial transport. However, new data suggest that carnitine may play a role in their utilization."

Co-enzyme Q10 supplementation may be useful as well, as it helps promote the transition to a fat-burning metabolism on a ketogenic diet.

Stomach acidity boosters like betaine hydrochloride (or alternatively one or two tablespoons of vinegar) and digestive enzymes like bromelain may be helpful for digesting all the meat, especially in ME/CFS patients who have low stomach acid levels.

➤ Prebiotics like inulin 5 grams daily should help keep the friendly bacteria alive (the lack of prebiotic foods in the ketogenic diet may kill of your gut friendly bacteria, but taking prebiotic should help prevent this). Inulin contains around 1.2 kilocalories per gram, which is pretty low, since ordinary carbs contain around 4 kilocalories per gram. 1

➤ High fat foods like diary products and meat can be pro-inflammatory, and since ME/CFS patients may suffer from chronic inflammation, it may be an idea to take anti-inflammatory herbs and supplements to try to counter any pro-inflammatory effects from the ketogenic diet.

➤ A small amount of carbohydrate and protein just before bed may fix the insomnia that some people experience on the ketogenic diet. The insomnia may be due to low blood sugar and low serotonin, and a snack which contains both protein and some carbohydrate right before bed should increase both.

➤ Taking antihistamines may also help any anxiety and sleeplessness symptoms that can appear on the ketogenic diet: low carb diets are higher in histamine containing foods, and some people react to higher intake of these foods with anxiety and sleeplessness.


Reference: Low Carb Diet Side Effects


It may also be an idea to use medium-chain triglycerides (MCTs) from coconut oil (50% of coconut oil is MCTs) in your ketogenic diet, as this has the following advantages:
Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic.

A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.

Source: Ketogenic diet - Wikipedia
 
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Crux

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Thanks @Hip ;

The ketogenic diet, technically is not high protein. It was originally designed to be moderate or adequate in protein.

Depending on what someone's reasons for implementing it, though, protein intake may be adjusted.

I would guess that folks with ME/CFS may want to try a higher amount of protein if their energy doesn't improve.

I have more energy now, being more fat adapted, and I've recently increased protein to about 65 gms. daily.

That's not high, but, in past years, I was undereating it. Other people I've read about are having over 100 gms. daily, depending on needs, activity, etc. They are still in ketosis.

The emphasis on electrolytes can't be overstressed. The 'keto flu' can be miserable. Looking back, I realize that I needed much more salt. ( sodium chloride) The sodium would have helped the dizziness, and the chloride would have helped the nausea.
 

Hip

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Depending on what someone's reasons for implementing it, though, protein intake may be adjusted.

I would guess that folks with ME/CFS may want to try a higher amount of protein if their energy doesn't improve.
From the discussions in this post, if you are adding protein to a ketogenic diet, it may be an idea to use more of the ketogenic amino acids and less of the glucogenic amino acids, as the ketogenic amino acids can still be converted to energy in the mitochondria even when the pyruvate input into mitochondria is partially blocked (Fluge and Mella found the pyruvate input is partially blocked in ME/CFS patients).

The blocked pyruvate input to mitochondria acts to prevents the glucogenic amino acids from being used for energy, but the ketogenic amino acids will still be fine as fuel sources for mitochondrial energy production, because they do not rely on the pyruvate input.

The ketogenic amino acids are: leucine, lysine, isoleucine, phenylalanine, threonine, tryptophan and tyrosine.
 
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Crux

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The blocked pyruvate input to mitochondria acts to prevents the glucogenic amino acids from being used for energy, but the ketogenic amino acids will still be fine as fuel sources for mitochondrial energy production, because they do not rely on the pyruvate input.
I've read about these amino acids as ketogenic, but haven't tried them for that purpose.
Andrew Scarborough, who healed his brain tumor with keto, et.al, was taking leucine some months ago.

I may experiment with some whey protein or such.
When I first started Keto, it was with having more beef. Having had a negative reaction, it helped me discover that it wasn't the protein causing trouble - it was the iron.

Now I'm trying to increase protein without iron.

I bring this up because I've read that iron overload can disrupt pyruvate dehydrogenase production.
 

Crux

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I would also bring up that deficiency of micronutrients can happen with the ketogenic diet, as with any.

I realized I had a copper deficiency because I wasn't eating copper foods, even though there are a good many that are low carb. Mushrooms are great. Nuts are carby, but they are so nutritious, it's worth the count.

Also, I realized I had an iodine deficiency - again. Wasn't eating seaweed or much seafood. ( worse fatigue, hair loss )
 

Hip

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@Crux
Have you considered the MCT version of the ketogenic diet, which uses a lot of medium-chain triglycerides (which you can get from consuming coconut oil)?

The MCT ketogenic diet seems to offer a lot of advantages over the standard ketogenic diet:
Compared with the classic ketogenic diet, the MCT diet allows more calories, more carbohydrate, larger portion sizes, more fruits and vegetables, and a wider range of food. For these reasons, it can be useful for picky eaters or children with large appetites. The diet is more balanced, so children need fewer vitamin and mineral supplements. Children taking the MCT diet are also less likely to have side effects such as kidney stones, low blood sugar, constipation, low bone density, and poor growth. Their ratio of “good” HDL cholesterol to “bad” LDL cholesterol tends to be better than with the ketogenic diet.

Source: Medium-Chain Triglyceride (MCT) Diet
I think I will try to do the MCT ketogenic diet if I decide to experiment with a ketogenic diet.
 

frederic83

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The ketogenic amino acids are: leucine, lysine, isoleucine, phenylalanine, threonine, tryptophan and tyrosine.
I've read about these amino acids as ketogenic, but haven't tried them for that purpose.
Andrew Scarborough, who healed his brain tumor with keto, et.al, was taking leucine some months ago.
According to this, only leucine and lysine are ketogenic. The other amino acids are both keto and glucogenic or glucogenic only.
 

Hip

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According to this, only leucine and lysine are ketogenic. The other amino acids are both keto and glucogenic or glucogenic only.
Yes, leucine and lysine are the only two amino acids that are exclusively ketogenic, whereas isoleucine, phenylalanine, threonine, tryptophan and tyrosine can go through either the glucogenic or ketogenic routes.

So to be safe, you might stick to supplementing with just leucine and lysine.

I am not too clear on what happens if the glucogenic route is blocked via a blocked pyruvate input to the mitochondria, as it appears to be the case in ME/CFS. Do these dual-route glucogenic & ketogenic amino acids then divert to the ketogenic route? I don't know.
 

Crux

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@Crux
Have you considered the MCT version of the ketogenic diet, which uses a lot of medium-chain triglycerides (which you can get from consuming coconut oil)?

The MCT ketogenic diet seems to offer a lot of advantages over the standard ketogenic diet:


I think I will try to do the MCT ketogenic diet if I decide to experiment with a ketogenic diet.
Yes, I tried MCT oil a couple of years ago. I became wired and had some neuropathy.
But ! I may be of a small minority, because may folks do well with it.
I have wild sensitivities right now, can't tolerate even coconut products, or salicylates.
The only fats I can tolerate are animal ones, and, I tolerate them very well.
 

Crux

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The Ketogenic diet is being utilized for weight loss and other health issues. This reddit forum is extremely active and worth a visit because many health issues are addressed.

This link first gives an overview of the diet. Just click on the 'new' at the top, and you will find the threads. There is also a 'keto gains' sub, as well as a 'keto science' sub.

https://www.reddit.com/r/keto/wiki/faq
 

Gondwanaland

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I have wild sensitivities right now, can't tolerate even coconut products, or salicylates.
Watch out for uric acid mobilization and high purine foods! Coconut oil and products caused this to me back in 2014 and the solution to get away from the salicylate sensitivity was magnesium oxide, B5, and I have read that niacin (not nicotinamide) might be helpful, but niacin can cause kidney stones and hypothyroidism (since it put breaks into methylation).
 

Crux

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Thanks @Gondwanaland ;

I plunked some links for you in a uric acid thread.

Since the keto diet reduces elevated insulin, and hyperinsulinemia is associated with many diseases, it may reduce uric acid, along with the tendency to over absorb iron, among other things. ( increased insulin tends to increase iron absorption)
 

Gondwanaland

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Thanks @Gondwanaland ;

I plunked some links for you in a uric acid thread.

Since the keto diet reduces elevated insulin, and hyperinsulinemia is associated with many diseases, it may reduce uric acid, along with the tendency to over absorb iron, among other things. ( increased insulin tends to increase iron absorption)
I don't have hyperinsulinemia or high iron - have been low-carbing long enough. My problem was a high protein diet - I am having purine intolerance.
 

sb4

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Keto diet and improving circadian rythm where huge for my health before I got ill. Now gastroparesis has made me go high carb. If that went away I'd go right back to keto...
 

Gondwanaland

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Well, not everyone responds to the ketogenic diet.
Well, I did respond to it - got hyperthyroid by coconut oil and lost weight I couldn't afford to. I am all for keto diet, as long as one has issues to resolve like NAFLD, hyperinsulinemia, high ferritin, which I do not... Looking back, I have always been sensitive to purines, rather than to carbs.