Is it bad to float in and out of ketosis?

AngInCanada
AngInCanada Posts: 947 Member
edited November 2024 in Social Groups
I've had major issues with head pressure and dizziness the past month or so. I do feel better when i have a bit more carbs. Blood work and tests all good so doctor suggests bumping my carbs up to get out of ketosis but low enough to reep the benefits of low carb (she suggested 75-100g a day). I'm wondering though, some days i feel OK so is it OK to some days be in ketosis levels of carbs and some days to be higher or is it just better to keep my levels consistent? I haven't been able to find any pattern for the dizziness...I just know that a small amount of healthy carbs makes it go away

BTW I do use salt liberally, use lo salt for potassium, take natural calm for magnesium, drink a lot of water etc.

Replies

  • GaleHawkins
    GaleHawkins Posts: 8,159 Member
    It should not be a health issue based on anything I have read. In fact Dr. Peter Attia did it daily at one point in time when he was testing only eating once a day. His protein level would knock him out of nutritional ketosis. You can google his name for more details.

    I try to say into nutritional ketosis for the health benefits but from time to time I will get kicked due to carbs going over 50 grams from time to time.
  • wabmester
    wabmester Posts: 2,748 Member
    I think low sodium is the most likely culprit.

    More carbs will cause you to lose less sodium, and with lower carb intake, you'll lose more sodium. The more sodium you lose, the more you need to replenish.

    Failure to replenish = headache, dizziness, light-headedness, or fatigue.

    Salting your food with a salt shaker provides surprisly little sodium.

    If you add salt with a shaker, that might account for something like 10% of your daily sodium intake.

    Eat salty foods. Soup works well, but so do a lot of other foods.
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    edited November 2015
    I would think as long as you feel fine there's no reason you couldn't be right on the border, going in and out.
    But, I really think sodium is the most likely explanation. Whenever I see "I drink a lot of water" it's a clue. Drinking excess water is only flushing out more sodium. It could be that all the salting and efforts to get extra sodium are being countered with too much water. It's fine to drink all the water you want, but drinking "a lot" means you need even more sodium since you're flushing even more out.
  • lithezebra
    lithezebra Posts: 3,670 Member
    edited November 2015
    I'm in ketosis when I eat 100 grams of carbs a day, according to the ketostix. I assume that I'm relying more heavily on fatty acid metabolism now that I'm under 50 grams a day. It's a continuum, not an either/or, and the main point is whether you are getting the health benefits that you are seeking, from eating a particular way.

    @wabmester , as you suggested, salt helped my keto flu. Thank you!
  • AngInCanada
    AngInCanada Posts: 947 Member
    I have only ever been in ketosis as per urine sticks ONCE even at 20g a day
  • lithezebra
    lithezebra Posts: 3,670 Member
    edited November 2015
    I have only ever been in ketosis as per urine sticks ONCE even at 20g a day

    Urine testing can be wildly inaccurate. You can measure the actual ketone level in your blood, if it's important for you to know. Here's a link about glucose meters that take ketone test strips.

    http://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html

    P.S. Congratulations! Your before and after pics are looking great.
  • KnitOrMiss
    KnitOrMiss Posts: 10,103 Member
    edited November 2015
    You aren't tracking your sodium...do you know how much you're getting daily? I find that I generally take a pinch of salt crystals (the kind you put in the grinder) every other time I refill my water bottle. That way, if I'm drinking a ton of water, I'm taking in a ton of salt, too.... I just drop the salt in my mouth, let it sit enough for my taste buds to realize it, then swallow it down like pills...

    Oh, and I find as my carbs are fluctuating more nowadays, I need even more salt to balance things out. I'm back up at 4000+ mg as my daily aim...
  • AngInCanada
    AngInCanada Posts: 947 Member
    KnitOrMiss wrote: »
    You aren't tracking your sodium...do you know how much you're getting daily? I find that I generally take a pinch of salt crystals (the kind you put in the grinder) every other time I refill my water bottle. That way, if I'm drinking a ton of water, I'm taking in a ton of salt, too.... I just drop the salt in my mouth, let it sit enough for my taste buds to realize it, then swallow it down like pills...

    Oh, and I find as my carbs are fluctuating more nowadays, I need even more salt to balance things out. I'm back up at 4000+ mg as my daily aim...


    I salt EVERYTHING so I assume I'm taking enough.
  • KnitOrMiss
    KnitOrMiss Posts: 10,103 Member
    edited November 2015
    KnitOrMiss wrote: »
    You aren't tracking your sodium...do you know how much you're getting daily? I find that I generally take a pinch of salt crystals (the kind you put in the grinder) every other time I refill my water bottle. That way, if I'm drinking a ton of water, I'm taking in a ton of salt, too.... I just drop the salt in my mouth, let it sit enough for my taste buds to realize it, then swallow it down like pills...

    Oh, and I find as my carbs are fluctuating more nowadays, I need even more salt to balance things out. I'm back up at 4000+ mg as my daily aim...


    I salt EVERYTHING so I assume I'm taking enough.

    I salt my food and still have to take salt in between my water... I find that if I've drunk water within the hour and I feel thirsty/starting to get dry mouth, it's usually because my salt is low. I've had days where I had 100-130 oz of water but I was dehydrated because I hadn't had enough sodium.

    I'm not saying that is you at all, just sharing my struggles. I'd gotten back down to the 2000-3000 range, then started struggling badly with dehydration stuff... I'm still fighting my way back... (I even had a 2000 day followed by a 1200 day and another 2500 or so day, by that third day, I was MISERABLE!!)
  • Unknown
    edited November 2015
    This content has been removed.
  • wabmester
    wabmester Posts: 2,748 Member
    KnitOrMiss wrote: »
    You aren't tracking your sodium...do you know how much you're getting daily? I find that I generally take a pinch of salt crystals (the kind you put in the grinder) every other time I refill my water bottle. That way, if I'm drinking a ton of water, I'm taking in a ton of salt, too.... I just drop the salt in my mouth, let it sit enough for my taste buds to realize it, then swallow it down like pills...

    Oh, and I find as my carbs are fluctuating more nowadays, I need even more salt to balance things out. I'm back up at 4000+ mg as my daily aim...


    I salt EVERYTHING so I assume I'm taking enough.

    It's an easy experiment to see if you're right. Double your sodium, and see how you feel. :)
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    I feel like the water consumption may be the explanation for both the low sodium and the fact you didn't get positive ketone tests.
    Again, it's ok to drink all you want but the sodium balance is highly influenced by the water you're consuming. So is the presence of ketones on the urine tests. You were no doubt in ketosis if you were at 20g consistently. I suspect you're water is diluting everything.
  • nvmomketo
    nvmomketo Posts: 12,019 Member
    My guess is that if you are keeping carbs under 100g then you are still in ketosis, just a lower "level" of ketosis. As I understand it, ketosis is not just an on or off thing. It's a gradient. At only 100g of carbs, your body is still making some ketones for energy but not as much as at 20g of carbs. KWIM?

    My guess is that as long as you feel good (meaning healthy) then you are doing the right thing for you.... A sort of unscheduled, minor carb cycling. ;)
  • auntstephie321
    auntstephie321 Posts: 3,586 Member
    I bounce in and out all the time. I got a lot of advice back in the beginning about that. I would feel good then crappy then good. I remember someone suggested it was low carb limbo. @wabmester disagreed and suggested it was a sodium thing. He was right. You should be fine hovering in and out, since even below 100 you're not really out you're just producing less ketones. The only issue I have with that is carb creep, I'm easy peasy around 30 a day, the higher I go the harder it is for me to stay under 100. Just be mindful not to let it go out of control.
  • ladipoet
    ladipoet Posts: 4,180 Member
    wabmester wrote: »
    I think low sodium is the most likely culprit.

    More carbs will cause you to lose less sodium, and with lower carb intake, you'll lose more sodium. The more sodium you lose, the more you need to replenish.

    Failure to replenish = headache, dizziness, light-headedness, or fatigue.

    Salting your food with a salt shaker provides surprisly little sodium.

    If you add salt with a shaker, that might account for something like 10% of your daily sodium intake.

    Eat salty foods. Soup works well, but so do a lot of other foods.

    Ditto this bigtime!!
  • camtosh
    camtosh Posts: 898 Member
    I bounce in and out all the time. I got a lot of advice back in the beginning about that. I would feel good then crappy then good. I remember someone suggested it was low carb limbo. @wabmester disagreed and suggested it was a sodium thing. He was right. You should be fine hovering in and out, since even below 100 you're not really out you're just producing less ketones. The only issue I have with that is carb creep, I'm easy peasy around 30 a day, the higher I go the harder it is for me to stay under 100. Just be mindful not to let it go out of control.

    This is me, too, especially lately since coming back from 2 weeks of holiday ... I have never been really strict, and that made losing weight much slower. But eventually got down to maintenance weight. I often feel carb flu, so then drink broth or eat salty stuff.
  • nicintime
    nicintime Posts: 381 Member
    wabmester wrote: »
    KnitOrMiss wrote: »
    You aren't tracking your sodium...do you know how much you're getting daily? I find that I generally take a pinch of salt crystals (the kind you put in the grinder) every other time I refill my water bottle. That way, if I'm drinking a ton of water, I'm taking in a ton of salt, too.... I just drop the salt in my mouth, let it sit enough for my taste buds to realize it, then swallow it down like pills...

    Oh, and I find as my carbs are fluctuating more nowadays, I need even more salt to balance things out. I'm back up at 4000+ mg as my daily aim...


    I salt EVERYTHING so I assume I'm taking enough.

    It's an easy experiment to see if you're right. Double your sodium, and see how you feel. :)

    So - unless one is measuring your sodium intake you would not be able to "double " your intake.

    I have been eating a pinch of Himilayan sea salt and for kicks and grins decided to weigh "a pinch". It was nowhere near a gram.

    Anyway, this mini ramble is a simple plea to not ASSUME you are getting enough salt because you salt your food heavily. As with so many other things in eating guestimates don't work.
  • lithezebra
    lithezebra Posts: 3,670 Member
    edited November 2015
    lithezebra wrote: »
    I have only ever been in ketosis as per urine sticks ONCE even at 20g a day

    Urine testing can be wildly inaccurate. You can measure the actual ketone level in your blood, if it's important for you to know. Here's a link about glucose meters that take ketone test strips.

    http://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html

    P.S. Congratulations! Your before and after pics are looking great.

    What I actually should have said, to be accurate, is that urine testing is an inaccurate guide to the ketone levels in your blood. For example, if you're using ketones for fuel, efficiently, the ketones in your urine will be lower. Your stix could be defective, outdated, or damaged. So, even if you are getting negative results with Ketostix, but you're eating less than 50 g of carbs a day, you are almost certainly in ketosis.
  • wabmester
    wabmester Posts: 2,748 Member
    lithezebra wrote: »
    lithezebra wrote: »
    I have only ever been in ketosis as per urine sticks ONCE even at 20g a day

    Urine testing can be wildly inaccurate. You can measure the actual ketone level in your blood, if it's important for you to know. Here's a link about glucose meters that take ketone test strips.

    http://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html

    P.S. Congratulations! Your before and after pics are looking great.

    ... but [if] you're eating less than 50 g of carbs a day, you are almost certainly in ketosis.

    There's no "almost" about it. If you're not making ketones at that level, you're dead.

    In terms of sodium intake, I don't believe you need to measure precisely. Just keep eating salty food until you're either sick of the salty taste or until your symptoms are relieved.

    If salt still tastes good to you, that's probably a good sign that your body wants more sodium.
  • baconslave
    baconslave Posts: 7,042 Member
    This may or may not be helpful to anyone, but I've been doing keto for over a year, and I've yet to ever use a Ketostick or test my ketone levels.

    If you are at a carb level where you feel lousy, change it. I read that some people carb cycle within the ketosis range during the week, like a 5:2 of carbs between 20g for 5 days and 50 for 2. Or vice versa. Some even switch between keto and lower carb. Watch your carb level on days you feel yucky. Is it workout days or non-workout days? At what level do you feel best or worst? Analyze what's going on. Figure out the configuration of carb up days and down days that help you most. Some people bounce in and out all the time, but not everyone feels good doing it. You might, Ang. At some point we all have to experiment and tweak to find our sweet spot. Do the new configuration for a few weeks. If you are feeling better, stay. If not, try something else for a few weeks. But you need to stick out whatever change you make for at least 3 weeks before switching again to see the full scope of its effect. Otherwise, you'll only hop around and learn nothing. And make yourself crazy. Unless you feel so flipping terrible you can't stand it. That's a pretty good indication it isn't a good fit.

    And track your electrolytes to make sure. Once I get adapted, I don't need as much sodium. But if I have a cheat and get bumped out again, for about a week I have to bump them way up there again. And sometimes, if I'm not paying attention, they dip really low, too low even for my more-adapted state.

    HTH.

  • AngInCanada
    AngInCanada Posts: 947 Member
    Yesterday I felt horrible. Dozziness, head pressure, brain fog, headache. Ended up binging on popcorn and had some rice cakes for a snack earlier in the day. Carbs were at 99 TOTAL for the day. Woke up this morning and i feel amazing. Energy, no dozziness. I've felt dizzy and exhausted consistently for the last 5 days straight. First day in a while I've had drive and ambition to do something. Also whooskhed 3 lbs overnight. So I'm going to stick with 100 total carbs for right now and see what happens. Do I still need to really watch electrolytes at that level?
  • wabmester
    wabmester Posts: 2,748 Member
    You will lose some sodium at any carb intake below around 150g/d. But the more you restrict carbs, the more sodium you lose.

    There's a lag of about 4 days between intake and when your kidneys dump excess sodium, but the carb/ketone level may alter that independently. What that means is that it may be hard to predict your sodium needs, so just eat more if you feel lousy.

    A "whoosh" may be a sign that you've lost water, which is a sign that you've lost sodium.

    Personally, I felt great at 100g/d carbs, and I only needed extra sodium when exercising.
  • gsp90x
    gsp90x Posts: 416 Member
    edited November 2015
    Not to hijack this post, but this totally answered the question I was going to post today. I was looking for alternate ways to get enough sodium. I struggle with that and some days just cannot stomach yet another cup of soup broth. In like Knitormiss's suggestion of just taking a pinch like medicine and also to add it to my water maybe.
    Thanks!

    And @AngInCanada glad you got some respite from the lousiness and are feeling better! It's all about what works for you, as we all know. And I'm sure we all know that lousy, low energy feeling too! And none too soon I'm sure. With the farm, I'm sure there's extra work to be done this time of year! Glad you're feeling better!
  • lithezebra
    lithezebra Posts: 3,670 Member
    edited November 2015
    wabmester wrote: »
    lithezebra wrote: »
    lithezebra wrote: »
    I have only ever been in ketosis as per urine sticks ONCE even at 20g a day

    Urine testing can be wildly inaccurate. You can measure the actual ketone level in your blood, if it's important for you to know. Here's a link about glucose meters that take ketone test strips.

    http://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html

    P.S. Congratulations! Your before and after pics are looking great.

    ... but [if] you're eating less than 50 g of carbs a day, you are almost certainly in ketosis.

    There's no "almost" about it. If you're not making ketones at that level, you're dead.

    There's gluconeogenesis too. A person could, conceivably, be making glucose from protein. That just seemed like an unlikely scenario.

    @AngInCanada - I'm glad that you're feeling better!
  • wabmester
    wabmester Posts: 2,748 Member
    lithezebra wrote: »
    wabmester wrote: »
    lithezebra wrote: »
    lithezebra wrote: »
    I have only ever been in ketosis as per urine sticks ONCE even at 20g a day

    Urine testing can be wildly inaccurate. You can measure the actual ketone level in your blood, if it's important for you to know. Here's a link about glucose meters that take ketone test strips.

    http://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html

    P.S. Congratulations! Your before and after pics are looking great.

    ... but [if] you're eating less than 50 g of carbs a day, you are almost certainly in ketosis.

    There's no "almost" about it. If you're not making ketones at that level, you're dead.

    There's gluconeogenesis too. A person could, conceivably, be making glucose from protein. That just seemed like an unlikely scenario.

    Very unlikely. Ketosis evolved specifically to spare protein. It's what allowed us to survive periods of famine.

    As long as there's body fat available, GNG just makes up the difference between carb intake and the 40g/d of glucose our brain needs. So at 50g/d carb intake, the need for GNG is close to 0.
  • lithezebra
    lithezebra Posts: 3,670 Member
    edited November 2015
    wabmester wrote: »
    lithezebra wrote: »
    wabmester wrote: »
    lithezebra wrote: »
    lithezebra wrote: »
    I have only ever been in ketosis as per urine sticks ONCE even at 20g a day

    Urine testing can be wildly inaccurate. You can measure the actual ketone level in your blood, if it's important for you to know. Here's a link about glucose meters that take ketone test strips.

    http://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html

    P.S. Congratulations! Your before and after pics are looking great.

    ... but [if] you're eating less than 50 g of carbs a day, you are almost certainly in ketosis.

    There's no "almost" about it. If you're not making ketones at that level, you're dead.

    There's gluconeogenesis too. A person could, conceivably, be making glucose from protein. That just seemed like an unlikely scenario.

    Very unlikely. Ketosis evolved specifically to spare protein. It's what allowed us to survive periods of famine.

    As long as there's body fat available, GNG just makes up the difference between carb intake and the 40g/d of glucose our brain needs. So at 50g/d carb intake, the need for GNG is close to 0.

    It wouldn't be unlikely on a high protein diet. People use protein readily as fuel. I didn't think it was likely that Ang was on a high protein diet.
  • wabmester
    wabmester Posts: 2,748 Member
    lithezebra wrote: »
    wabmester wrote: »
    lithezebra wrote: »
    wabmester wrote: »
    lithezebra wrote: »
    lithezebra wrote: »
    I have only ever been in ketosis as per urine sticks ONCE even at 20g a day

    Urine testing can be wildly inaccurate. You can measure the actual ketone level in your blood, if it's important for you to know. Here's a link about glucose meters that take ketone test strips.

    http://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html

    P.S. Congratulations! Your before and after pics are looking great.

    ... but [if] you're eating less than 50 g of carbs a day, you are almost certainly in ketosis.

    There's no "almost" about it. If you're not making ketones at that level, you're dead.

    There's gluconeogenesis too. A person could, conceivably, be making glucose from protein. That just seemed like an unlikely scenario.

    Very unlikely. Ketosis evolved specifically to spare protein. It's what allowed us to survive periods of famine.

    As long as there's body fat available, GNG just makes up the difference between carb intake and the 40g/d of glucose our brain needs. So at 50g/d carb intake, the need for GNG is close to 0.

    It wouldn't be unlikely on a high protein diet. People use protein readily as fuel. I didn't think it was likely that Ang was on a high protein diet.

    I knew you were going to bring that up. :)

    OK, you're right. If she were eating 50g/d carbs and 200g/d of protein, she might not have to make any ketones.

    There is a limit to how much glucose we can make via GNG, but with fat and 50g/d carb intake, you might be able to make enough glucose to avoid ketosis.
  • lithezebra
    lithezebra Posts: 3,670 Member
    edited November 2015
    wabmester wrote: »
    If she were eating 50g/d carbs and 200g/d of protein, she might not have to make any ketones.

    And it seems way more likely that a dude would be doing that, at least some of the dudes I know, not just any dude.

This discussion has been closed.