Keto Notes
tcunbeliever
Posts: 8,219 Member
My Notes on Keto. There's more here than I realized and hopefully it's not confusing, but if anyone wants all the crazy details, here they are. More information from others is always welcome
I didn't cite any of the studies because anyone can find them with google.
***
Things to know for all types of keto:
1 – salt and water – you will likely lose water on a keto diet, and you will lose water soluble nutrients with that water. Salt will help you retain your water and water soluble nutrients. 3,000-5,000mg/day is recommended. Your body is a saline system, not a freshwater system, salt is an essential nutrient, don’t skimp. You may be more thirsty than usual, if so, have extra salt with your extra water.
2 – hypoglycemia – if you have hypoglycemia, which you can definitely have and not know about, then you may experience symptoms of low blood sugar as you adapt to keto. Shakiness, dizziness, headache, sweating, fainting, lightheadedness – watch for these and keep hard candies or a sugar cube on hand if needed. This is not a “normal” side effect of keto, but many people who eat all the time don’t even know they have this until they aren’t eating all the time. Once you get through adaptation this should no longer be an issue, the low insulin response of a keto diet will resolve reactive hypoglycemia, which is the most common type.
3 – adaptation – this is the time period where you are eating keto but your body isn’t quite accustomed to this keto thing yet. You may feel increased fatigue with physical activity. You may have trouble sleeping. You may have muscle cramps or nausea. This will clear up in as little as a few days or as long as 6 months, it varies a great deal based on your individual body, your current health level, and your prior eating habits. Average adaptation time for first time keto seems to be 2-3 weeks.
***
Types of keto:
Weight Loss – keto for weight loss is the simplest version. Keep carbs at a maximum gram level. The average person will go into ketosis if carbs are kept under 50g. Keep protein above a minimum gram level sufficient to retain lean body mass (aka muscle), for the average adult woman this is 100g, for the average adult male this is 150g. The more active you are the higher your carb levels can be and remain in ketosis.
Type 1/2 Diabetes (T1/2D) – same as Weight Loss protocol. There is some evidence that consuming your carbs early in the day (breakfast and lunch) and eliminating carbs later in the day (dinner) may help with controlling BG overnight and counteract the Dawn Phenomenon as well as providing an overall reduction to A1C even beyond what is seen with just lowering carbs. Diabetics on insulin need to be concerned with ketoacidosis (DKA), it’s very dangerous caused by high levels of glucose and high levels of ketones, know the symptoms and make those around you aware since one of the primary symptoms is confusion and you may not realize what is happening. Other symptoms are extreme fatigue, nausea/vomiting, excessive thirst and excessive urination, abdominal pain, and difficulty breathing.
Ratios – keto ratios are the ratio of fat to other macros (fat:carbs+protein). This is the only version of keto where protein is likely to be limited, and it is specifically designed to treat various neurological disorders by controlling more precisely the level of ketones to glucose circulating in the bloodstream. The higher the ratio, the more restricted the food, and the more difficult to sustain long-term. Children should not be on a ketogenic diet unless they pediatrician is aware of it and monitoring their growth and bone density. A ketogenic diet in children is definitely related to a reduction in bone density – which may be less dangerous than whatever else you are treating, but should be monitored, particularly in the higher keto ratios. Children with epilepsy are generally taken off the keto diet after two years and switched to a standard low-carb diet. This is because after two years there is no return of symptoms. I have not been able to locate any studies regarding the permanence in adults or with regard to other conditions in children.
1:1 Keto
Autism – there have been at least two studies (one in Crete, one in Hawaii) regarding children with autism and keto. In both studies about half of the children had dramatic improvements in behavioral symptoms, the other half only slight improvement or no improvement. The theory is that at least part of the problem with autism is also mitochondrial inefficiency, and that part at least keto can help with. It’s possible that autism has more than one root cause, and keto can only help in some cases, but when it helps it seems to help in a big way.
Depression – many studies have indicated that keto may be at least as beneficial as standard anti-depressants in treating depression. Most of these studies revolved around the “weight loss” model, so I’m putting this under the lowest ratio since that’s the easiest to follow while still creating a high level of ketone production.
2:1 Keto
Recommended start for migraines/headaches – increase the ratio in the absence of symptom reduction. Reduce the ratio once symptoms are controlled for at least 3 months. Increase the ratio if symptoms return.
3:1 Keto
4:1 Keto
Recommended start for epilepsy – Reduce the ratio once symptoms are controlled for at least 3 months. Increase the ratio immediately if symptoms return.
Alzheimer Disease (AD) – recent studies have shown a close link between AD and epilepsy, since keto is only recently being used for treating AD, there isn’t really an established protocol, but given the link between the two, it makes sense to follow the epilepsy treatment path.
Amyotrophic Lateral Sclerosis (ALS) – studies with ALS generaly start at this ratio, and it is recommended not to drop below a 2:1 ratio. Sadly, while studies do show massive improvements in motor skills and cognition, they do not show any improvement in mortality rate or any extension in survival time. So, this does not appear to be a cure, but it may help an individual to retain a higher level of functionality as the disease progresses. I was also not able to find any studies where this intervention was used early in treatment, so it’s possible that results may be better with earlier intervention, but there isn’t any data available at this time.
Cancer – there has been some documented success using keto for brain tumors. However, those results are also at rates similar to using calorie restriction as a treatment. Given the naturally appetite suppressing effect of keto, it’s difficult to determine if the success is due to being in ketosis, or simply due to not eating as much overall. The studies are very inconsistent, some types of cancers and tumor seem to respond well, others do not seem to be impacted by keto. Additionally most of the studies are keto used in conjunction with other standard treatments, and sometimes severe calorie restriction, which only complicates the results. This is the ratio used for treatment, generally no changes are made over the course of treatment, the ratio is maintained. In the end, there is certainly no evidence that keto can harm your treatment plan, and it may help, but this is definitely something that should be discussed with a medical professional. For further information on natural cancer treatments (keto and others) search for your specific cancer here: https://www.cancertutor.com/
Multiple Sclerosis (MS) – there was only one study I could find for MS and it used the standard epilepsy protocol. Reduction in symptoms was noted (both in conjunction with fasting, and without fasting) as well as reduced inflammation. More studies are necessary but it does seem to offer improved quality of life at the very least.
Neurotrauma/Brain Injury – there is a high risk of epilepsy following brain injury. Several studies have shown a dramatic reduction in risk with a keto diet immediately post-injury though in some studies this is in conjunction with fasting, so it’s difficult to determine which is the greater contributor to success. In animal studies there is a greater degree of recovery when the keto diet is employed pre-injury, but we don’t go around bashing people on the head for science, so there are no studies of this nature in humans.
Parkinson – no one seems to be sure yet if keto is helpful because it’s neuroprotective, or if the success in treatment is due to the anti-inflammatory nature of keto, but for the most part early trials are following the AD protocol and seeing positive results.
Stroke – There are no studies for humans. However, in animals being keto pre-stroke shows a huge reduction in brain damage/inflammation even after a stroke. Additionally, keto in conjunction with calorie restriction shows a huge improvement in brain recovery post stroke. There are anecdotal cases you can google where individuals have used keto to recover from their stroke and in all the cases I located the fat intake was very high, so I’m putting this under the highest ratio.
***
Do calories matter with keto:
If you are trying to lose weight calories always matter. For many people with metabolic issues the reduced insulin response on keto will naturally reduce cravings and hunger and result in a reduced calorie intake even in the absence of tracking.
***
Exogenous Ketones, what the heck:
Your body makes ketones from fat, either ingested or stored in adipose tissue. You can also ingest them, either in the form of actual processed ketones or just high fat oils which your body will quickly convert to ketones. If you are trying to lose weight you want to metabolize the fat stored in adipose tissue and you don’t want to ingest extra. On the other hand, if you are trying to maintain a fat intake ratio, these may help. Also, endurance athletes or heavy lifters sometimes use these to aid in having energy for workouts, particularly in the adaptation phase. The average person, probably has no use for them unless your wallet is simply too fat and you are desperate to spend a bunch of money.
I didn't cite any of the studies because anyone can find them with google.
***
Things to know for all types of keto:
1 – salt and water – you will likely lose water on a keto diet, and you will lose water soluble nutrients with that water. Salt will help you retain your water and water soluble nutrients. 3,000-5,000mg/day is recommended. Your body is a saline system, not a freshwater system, salt is an essential nutrient, don’t skimp. You may be more thirsty than usual, if so, have extra salt with your extra water.
2 – hypoglycemia – if you have hypoglycemia, which you can definitely have and not know about, then you may experience symptoms of low blood sugar as you adapt to keto. Shakiness, dizziness, headache, sweating, fainting, lightheadedness – watch for these and keep hard candies or a sugar cube on hand if needed. This is not a “normal” side effect of keto, but many people who eat all the time don’t even know they have this until they aren’t eating all the time. Once you get through adaptation this should no longer be an issue, the low insulin response of a keto diet will resolve reactive hypoglycemia, which is the most common type.
3 – adaptation – this is the time period where you are eating keto but your body isn’t quite accustomed to this keto thing yet. You may feel increased fatigue with physical activity. You may have trouble sleeping. You may have muscle cramps or nausea. This will clear up in as little as a few days or as long as 6 months, it varies a great deal based on your individual body, your current health level, and your prior eating habits. Average adaptation time for first time keto seems to be 2-3 weeks.
***
Types of keto:
Weight Loss – keto for weight loss is the simplest version. Keep carbs at a maximum gram level. The average person will go into ketosis if carbs are kept under 50g. Keep protein above a minimum gram level sufficient to retain lean body mass (aka muscle), for the average adult woman this is 100g, for the average adult male this is 150g. The more active you are the higher your carb levels can be and remain in ketosis.
Type 1/2 Diabetes (T1/2D) – same as Weight Loss protocol. There is some evidence that consuming your carbs early in the day (breakfast and lunch) and eliminating carbs later in the day (dinner) may help with controlling BG overnight and counteract the Dawn Phenomenon as well as providing an overall reduction to A1C even beyond what is seen with just lowering carbs. Diabetics on insulin need to be concerned with ketoacidosis (DKA), it’s very dangerous caused by high levels of glucose and high levels of ketones, know the symptoms and make those around you aware since one of the primary symptoms is confusion and you may not realize what is happening. Other symptoms are extreme fatigue, nausea/vomiting, excessive thirst and excessive urination, abdominal pain, and difficulty breathing.
Ratios – keto ratios are the ratio of fat to other macros (fat:carbs+protein). This is the only version of keto where protein is likely to be limited, and it is specifically designed to treat various neurological disorders by controlling more precisely the level of ketones to glucose circulating in the bloodstream. The higher the ratio, the more restricted the food, and the more difficult to sustain long-term. Children should not be on a ketogenic diet unless they pediatrician is aware of it and monitoring their growth and bone density. A ketogenic diet in children is definitely related to a reduction in bone density – which may be less dangerous than whatever else you are treating, but should be monitored, particularly in the higher keto ratios. Children with epilepsy are generally taken off the keto diet after two years and switched to a standard low-carb diet. This is because after two years there is no return of symptoms. I have not been able to locate any studies regarding the permanence in adults or with regard to other conditions in children.
1:1 Keto
Autism – there have been at least two studies (one in Crete, one in Hawaii) regarding children with autism and keto. In both studies about half of the children had dramatic improvements in behavioral symptoms, the other half only slight improvement or no improvement. The theory is that at least part of the problem with autism is also mitochondrial inefficiency, and that part at least keto can help with. It’s possible that autism has more than one root cause, and keto can only help in some cases, but when it helps it seems to help in a big way.
Depression – many studies have indicated that keto may be at least as beneficial as standard anti-depressants in treating depression. Most of these studies revolved around the “weight loss” model, so I’m putting this under the lowest ratio since that’s the easiest to follow while still creating a high level of ketone production.
2:1 Keto
Recommended start for migraines/headaches – increase the ratio in the absence of symptom reduction. Reduce the ratio once symptoms are controlled for at least 3 months. Increase the ratio if symptoms return.
3:1 Keto
4:1 Keto
Recommended start for epilepsy – Reduce the ratio once symptoms are controlled for at least 3 months. Increase the ratio immediately if symptoms return.
Alzheimer Disease (AD) – recent studies have shown a close link between AD and epilepsy, since keto is only recently being used for treating AD, there isn’t really an established protocol, but given the link between the two, it makes sense to follow the epilepsy treatment path.
Amyotrophic Lateral Sclerosis (ALS) – studies with ALS generaly start at this ratio, and it is recommended not to drop below a 2:1 ratio. Sadly, while studies do show massive improvements in motor skills and cognition, they do not show any improvement in mortality rate or any extension in survival time. So, this does not appear to be a cure, but it may help an individual to retain a higher level of functionality as the disease progresses. I was also not able to find any studies where this intervention was used early in treatment, so it’s possible that results may be better with earlier intervention, but there isn’t any data available at this time.
Cancer – there has been some documented success using keto for brain tumors. However, those results are also at rates similar to using calorie restriction as a treatment. Given the naturally appetite suppressing effect of keto, it’s difficult to determine if the success is due to being in ketosis, or simply due to not eating as much overall. The studies are very inconsistent, some types of cancers and tumor seem to respond well, others do not seem to be impacted by keto. Additionally most of the studies are keto used in conjunction with other standard treatments, and sometimes severe calorie restriction, which only complicates the results. This is the ratio used for treatment, generally no changes are made over the course of treatment, the ratio is maintained. In the end, there is certainly no evidence that keto can harm your treatment plan, and it may help, but this is definitely something that should be discussed with a medical professional. For further information on natural cancer treatments (keto and others) search for your specific cancer here: https://www.cancertutor.com/
Multiple Sclerosis (MS) – there was only one study I could find for MS and it used the standard epilepsy protocol. Reduction in symptoms was noted (both in conjunction with fasting, and without fasting) as well as reduced inflammation. More studies are necessary but it does seem to offer improved quality of life at the very least.
Neurotrauma/Brain Injury – there is a high risk of epilepsy following brain injury. Several studies have shown a dramatic reduction in risk with a keto diet immediately post-injury though in some studies this is in conjunction with fasting, so it’s difficult to determine which is the greater contributor to success. In animal studies there is a greater degree of recovery when the keto diet is employed pre-injury, but we don’t go around bashing people on the head for science, so there are no studies of this nature in humans.
Parkinson – no one seems to be sure yet if keto is helpful because it’s neuroprotective, or if the success in treatment is due to the anti-inflammatory nature of keto, but for the most part early trials are following the AD protocol and seeing positive results.
Stroke – There are no studies for humans. However, in animals being keto pre-stroke shows a huge reduction in brain damage/inflammation even after a stroke. Additionally, keto in conjunction with calorie restriction shows a huge improvement in brain recovery post stroke. There are anecdotal cases you can google where individuals have used keto to recover from their stroke and in all the cases I located the fat intake was very high, so I’m putting this under the highest ratio.
***
Do calories matter with keto:
If you are trying to lose weight calories always matter. For many people with metabolic issues the reduced insulin response on keto will naturally reduce cravings and hunger and result in a reduced calorie intake even in the absence of tracking.
***
Exogenous Ketones, what the heck:
Your body makes ketones from fat, either ingested or stored in adipose tissue. You can also ingest them, either in the form of actual processed ketones or just high fat oils which your body will quickly convert to ketones. If you are trying to lose weight you want to metabolize the fat stored in adipose tissue and you don’t want to ingest extra. On the other hand, if you are trying to maintain a fat intake ratio, these may help. Also, endurance athletes or heavy lifters sometimes use these to aid in having energy for workouts, particularly in the adaptation phase. The average person, probably has no use for them unless your wallet is simply too fat and you are desperate to spend a bunch of money.
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