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Ketosis: Friend or Foe?

9/3/2014

13 Comments

 
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Ketogenic diets are getting a lot of attention these days and along with that attention comes a great amount of debate as to whether or not this metabolic state is ideal for individuals to purposely put themselves in. The information available is constantly growing and can be extremely confusing to a newcomer.
The good thing about disagreement is that it is one of the best ways to fuel growth and progress. While there are some remarkable things people are doing to improve their health through ketogenic diets, there is still a lot we have to learn about it and the common misunderstanding of this metabolic state is what I intend to address in this post.
For the sake of keeping this blog post short and sweet, keep in mind that this is a topic I will continue to build on. Ketosis, and all the dynamics associated with it, are so complex that it would be impossible to write about it all in one post. So where I post links to other, more thoroughly written articles, make sure to take action and read through them to better understand this subject.

What does it mean to be in ketosis?

The body can run on either glucose or fat (ketones) for fuel. Because the standard American has been told to fear fat and encouraged to consume a diet of at least 65% carbohydrates, it's safe to assume that a majority of the population are using glucose (aka sugar) for fuel. However, there is an alternative to this. It's called being in a state of ketosis which is when the body burns ketones (a byproduct of fat metabolism) to fuel the body. The most important thing to remember is that both are completely normal and mankind has been using both forms of fuel since the beginning of time to get us to where we are today. Without the ability to store fat on our bodies, and later tap into those fat stores during times of famine via ketosis, we would have been extinct long ago and cease to have existed at this very moment. Here is a quick read on ketosis that I recommend written by Mark Sisson, here. For a more science based and in depth look at ketosis, check out Dr. Peter Attia's blog post on ketosis, here.

How do you get into a state of ketosis?

Most people hear about ketogenic diets and think it simply means low carb, however it's a bit more complicated than restricting carbohydrates. Reason being is that low carb diets are sometimes also high in protein and protein is capable of converting itself into glucose (via a process called gluconeogenisis) when you consume more than your body needs. The amount the body needs is dependent on each individuals lean body mass and their activity level. Pair that with varying carbohydrate tolerances (some people can only have 20g per day while others can consume upwards of 75-100g), which again is dependent on each individual and their activity level, and you've got yourself one hell of a moving target. So it's nearly impossible to Rx an equation to someone who is learning how to eat in a way that will shift their bodies into a state of ketosis. The only way to know is through your own personal trial and error. The most important thing to remember is that ketogenic diets are first and foremost high in fat and LOTS of it. So if you're not getting the majority of your food from things like grass fed butter, egg yolks, fatty cuts of meat, avocados and coconut oil, then you're missing the entire point. 

What are the benefits of Keto diets?

The number one thing you will probably hear most about is weight loss, and while this is a very appealing reason to try out this kind of diet, the benefits go far beyond dropping some pounds. Reason being is that people are using ketogenic diets to manage chronic disease. While the use of ketogenic diets for managing epilepsy (seizures) is nothing new (read more about it here), ketogenic diets have received some recent attention in the media for those who have used it to manage their Multiple Schlerosis. MS is an autoimmune disease characterized by the body attacking it's own brain and spinal chord nerves leading to numbness, impaired muscle coordination, blurred vision and severe fatigue. Jack Osbourne recently shared how he is managing the effects of his MS through a nutritional approach of a Paleo ketogenic diet, here. In the case of Dr. Terry Wahls, her MS had progressed to the point that she was wheel chair bound and on her way to becoming bed ridden. Within a year of using a Paleo based ketogenic diet, she was riding a bicycle for up to 18 miles! See the pictures and read her remarkable story for yourself, here. Other reported health benefits of being in ketosis include appetite suppression, higher levels of energy and improved fasting blood glucose levels. 

What are the concerns with keto diets?

One of the biggest health concerns with ketogenic diets right now is thyroid function. The concern is that carbohydrates (specifically glucose) are needed to convert T4 to T3 (thyroid hormones) in the liver and in the absence of carbohydrates may cause dysfunction of these hormones. This will present itself with signs and symptoms such as irritability, menstrual disruption, hair loss, fatigue and low body temp. There is a great article written over at Paleo For Women that explains it in better detail, find that here. On the other hand, there is another really well written article by The Wellness Mama (found here) that explains why lowering carbs more slowly could avoid any thyroid dysfunction all together. Regardless, paying attention to your body gets the last word and if you're feeling worse by lowering your carbs, reevaluate and adjust your macros (fat/protein/carbs) accordingly. 

So whats the verdict?

Here's the fun part where I get to interject my opinion. So keep in mind that this is merely all it is, an opinion. Do your own research, starting here, refer to the links I've included in this post, experiment if you chose to do so and make sure to reevaluate how you feel. If at first you don't succeed, try another way. 

I think ketogenic diets are a fantastic option for individuals trying to tame insatiable appetites, manage chronic disease and lose some weight. I also believe that they are not for everybody. The biggest reason I feel they are not for everybody is due to operator error and the fact that not everybody knows how to properly follow them. Do your homework. I cannot stress it enough about something like this. As natural of an occurrence that a ketogenic state may be, shifting from a lifetime of primarily burning glucose to burning fat is no easy task when you do so unguided. I just finished reading the latest book by Jimmy Moore, called Keto Clarity. I cannot recommend it enough. Being someone who thought they knew quite a bit about this subject and who had already read several books on it, I still learned a lot from this book. 


The biggest argument I hear advising against ketogenic diets is that they cause hypothyroid symptoms such as intolerance to cold, hair loss, menstrual disruptions, brain fog and fatigue. My guess is that one of two things are happening. One, the person isn't eating enough fat. If you aren't ready to purchase stock in Kerrygold butter, you probably aren't eating enough of it! But seriously, eat the fat. And lots of it. Your body needs fat to produce several hormones in your body and keep them well regulated. If you come into this thinking low carb is a good add on to a low fat diet then you're going to put unnecessary stress on your body. Two, calories are way too low. Yes, I know calories don't matter as much as quality of food, but the body still needs fuel to keep all the systems running in tip top shape. So don't short change them. This happens when people make the mistake of thinking low carb and low cal are a good idea. I don't even want to think about those who do low fat, low carb and low cal. What a hot mess that more than likely results in. It also often happens by mistake because getting into a ketogenic state has a very powerful appetite suppressing mechanism to it. This makes it easy to go hours without even thinking about food. Pair that with an increase in energy or desire to hit the gym and you've got a pretty hefty caloric deficit. Is it any coincidence that the signs and symptoms of thyroid disfunction due to very low calorie diets are menstrual disruptions, irritability, intolerance to cold, brain fog and hair loss??? Read more on this topic in this article, here. 

All in all I believe ketogenic diets to be a friend and an excellent tool to use to aid in fat loss, as well as an ideal lifestyle to manage chronic disease. While I don't personally intend to follow a ketogenic lifestyle and maintain a state of ketosis forever, I don't miss the low fat/high carb days of unstable blood sugar levels and insatiable hunger. I believe an ideal metabolic state for myself will consist of my body cycling in and out of ketosis, playing with the durations as I go along. I'll learn more about what works for my body during my keto experiment this month and I encourage you to do your own to figure out what amount of fat, protein and carbs is right for yours. Last but not least, listen to your body. It's your body, and yours only, that gets the indisputable last word. 

Now I would love to hear from you! Have you ever tried to get into a ketogenic state? What was your experience? Good or bad, lets chat about it in the comments below.

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13 Comments
Erin
9/9/2014 12:31:53 pm

Hi Alex,
So I started following you on Instagram when chad meketarian added you on my phone! I'm glad he did because I am super interested in nutrition and a certified specialist. I also have lost a ton on weight in my life. So my question is...in bringing your body into ketosis, have you lost any weight yet? Is that the goal?

Reply
Alex
9/10/2014 12:44:18 am

Ha! Too funny, glad he made the introduction :)
I have lost weight in the past, quite remarkable because it came off so easy! But if you note in my next blog post, I've had some severe digestive issues, unrelated to ketosis, that needed attention. So I put all weight loss efforts, including stressful workouts, on hold until my body healed up. I did end up gaining back some weight, but my habits have upheld pretty well that its been easy to start this back up again. The goal is to lose weight, yes. The experiment I'm currently on is to figure out what my personal tolerance to carbs and protein amounts are, since that plays a vital role in getting your body to primarily burn fat for fuel.

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Dan link
9/11/2014 02:44:21 am

Great post! I too read Keto Clarity and have attempting to take a ketogenic approach to life and I love it. I am fighting a possible hypothyroid situation (although I do not experience symptoms--found a trend of increased TSH levels on blood tests), so I will be interested in seeing if/how this affects my thyroid hormones. Great post, and will follow you on Twitter ;)

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Alex
9/12/2014 01:45:53 am

I highly recommend that read to others and glad you already have it. They cover this topic in that book as well. I'm a big fan of treat the symptoms/person/patient, not the labs/numbers, etc. If you're not having symptoms then thats a great sign. But definitely use caution if you're concerned about your TSH levels. I would love to hear a follow up about your test results :)

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BJJ Caveman link
9/18/2014 08:27:35 pm

I too experienced an increase in my TSH while doing strict ketosis... so I experimented with adding carbs back in and rechecked my thyroid panel periodically. If you're interested you can see my post here:

http://bjjcaveman.com/2014/05/12/carb-back-loading-thyroid-hormone/

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CENK KIRAL link
9/11/2014 06:13:13 pm

hello Alex, how about having a ketogenic diet as a vegeterian? does vegeterianism fall in conflict with ketogenic diet? and how about juicing? I am a huge fan of green juicing. does juicing fits well with this dietary model?

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Alex
9/12/2014 01:41:41 am

It may pose a challenge but I imagine it is doable. Some of my favourite Keto foods are macadamia nuts, coconut oil and avocados! As long as the juice is part of a bigger meal that includes fats and comes from low sugar greens then you should be fine. Adding MCT oil to the juice may help to even out those macros, too!

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CENK KIRAL
9/14/2014 06:56:52 am

what about juice in the manner of fasting? is not compatible with ketogenic diet?

Lisi link
9/11/2014 10:11:53 pm

Hi Alex..... I LOVE this article !! I like how you made this topic very easy to understand. This will definitely help lots of people !! Thanks for taking the time to write this amazing piece !!!

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Alex
9/12/2014 01:38:43 am

Thank you for that feedback! It's what I was going for so I'm glad thats what you got out of it :)

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BJJ Caveman link
9/18/2014 08:23:36 pm

Nice, very well thought out post. Seems like you reached the same conclusion as I did... that cyclic keto is more appropriate for our bodies than strict keto.

If you don't mind my asking... what were you missing doing strict keto that improved when adding in carb refeeds?

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Alex
9/19/2014 12:35:57 am

As of now this is simply my hypothesis. Im just looking at it from all angles of how our bodies were designed to function, how active I intend to get and the fact that I just simply love carbs! But I know that finding the correct balance is key and thats what this experiment is all about. How about you? What improved when you started to cycle them in?

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Mike Gopsill link
5/4/2015 06:54:15 pm

Great introduction to ketosis! I agree that the main promoted benefit of ketogenic diets is weight-loss (which is great) but I have found the neurological benefits of it a ketogenic diet even more impactful. Stable energy and moods is a welcome change to sugar highs and lows.

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    :::Author:::

    I'm Alexandra; blogger, paramedic, and eater of fat. 
    I eat bacon daily, take my coffee with heavy cream, eat the yolks and consume coconut oil by the spoonful. Because of this, I have never been healthier or happier in my life. Welcome to my blog, where I intend to abolish the fat phobia that plagues us and give dietary fat the healthy reputation it deserves.


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