Going in and out of ketosis

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Going in and out of ketosis


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Old 11-24-2019, 01:55   #1
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Default Going in and out of ketosis

For a number of reasons I decided not to focus or care much whether I was in ketosis or not. My record-keeping is more along the lines of carbs plus 1/2 protein for bolusing and assumed I was outside of ketosis because my carbs ticked up as I focused singularly on my bg range and maintaining as flat a line as possible.

Got some labs back that showed ketone in urine, was surprised, and dug out my old Precision Xtra ketone meter and the strips I had bought a few months back. Just tested 1.3 so minimal. Looking back at rusty values I used to live more in the high 2's-high 3's.

Recall some discussion back then that it wasn't healthy/good/optimal to go in and out of ketosis, something I suspect I'm doing, but don't recall why or if that's accurate?

Input on pros/cons of ping-ponging? Or it doesn't much matter healthwise?

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Old 11-24-2019, 21:18   #2
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Interesting! I found a bunch of ketone test strips with a 2012 date on them and for the heck of it tried one vs tossing outright. It worked and matched the new ones.

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Dx'ed Feb 2011 w/ BS > 600
A1C: . . . . . . . . . . . . . . . Other Stuff
2/13/11 .. 14.7 . . . . . . Trig/HDL ratio .. 5.5 to 2.2 in 6 mo
5/23/11 .. 6.2 . . . . . . . Low-carb/high healthy-fat diet
9/8/11 .... 5.6 . . . . . . . No meds, No statin
2/24/16 .... basal/bolus insulin 2-3 days/wk due to steroids

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Old 11-24-2019, 23:20   #3
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An occasional cheat isn't going to do much damage to someone solidly in ketosis. But it's best to keep it to a minimum: one slice of pizza, not half the pie; a handful of french fries and skip the sugared pop with it; a glass of dry red wine rather than an umbrella drink; etc.

There are studies that indicate that even one cheat day or a big cheat meal causes unexpectedly high levels of damage to blood vessels. But IIRC that study used 75g of carbs as the cheat. It's possible to cheat on far fewer carbs than that.

If you're slipping out of ketosis by just a few carbs (or higher-quality ones like too much protein or you went overboard on tomatoes or keto cookies), even that level of damage may not be a serious consideration.

Of course, at higher levels, there's the "keto flu" to deal with. That may not be the days-long ordeal it was when you first went keto, but it may leave you feeling a little dragged out or give you some digestive issues as your body processes carbs it hasn't seen in a while.

Personally, I'm finding fewer cheats worth paying the price of slipping out of ketosis for even a day. But that's me.

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Old 11-25-2019, 02:25   #4
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Just going in and out ketosis may not be a big issue. Most people tend to slip in and out every day, unless they eat so often they have no fasting periods that allows fat burning or they have enough insulin in circulation that it keeps ketosis shut down.

The study above was conducted on 9 men over 7-9 days. The damage mentioned is hardly what I would think would be a direct result of a keto diet, especially based on it only being 7 days of keto. I'd have a hard time believing they were much in ketosis, much less adapted.

I don't think it's good to do "cheat days" where you just go hog wild with carbs, but have nothing to base that on but some testimonials I read by those that had done them. They said they felt like total crap when they did and it was harder to get back in ketosis each time.

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Old 11-25-2019, 22:14   #5
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The thought that comes to my mind when thinking about all of this is, not that going in and out of ketosis is harmful (I don't think there's any real evidence of this) but that it could keep someone in a state of low energy and brain fog - not having enough carbs, nor fully utilizing fats. (I think this is where I live )

Based on what I've read on this forum over several years from some folks who do the research and are, IMO, experts on the subject of the keto adapted state (i.e.: smorgan), it is my understanding that even one "cheat" meal could very well knock one out of ketosis. The problem with is that once that happens, one has to begin again at the beginning to become keto adapted - 2-3 weeks probably - during which time one can suffer again to degree the low-energy, etc., of the road to being keto adapted. If one want to maintain keto adapted then one must "do" keto consistantly at all times. And, while it may take 2-3 weeks to return to ketosis, it can take another month to become *fully* keto adapted.

Trying to reach a state of ketosis takes a real commitment. Something I don't seem to be able to reach or maintain.

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Old 11-26-2019, 02:00   #6
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I was hoping @smorgan would see and weigh in on this thread.

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Think I've had this since 2003. Told I was Type 2 lean on 2/13/12.
a1c 8.8 (8/2011) 5.4 (10/2018)
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Supplemental vitamins and electrolytes
64 YY Love the LCHF diet. The cheese goes well with my whine

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Old 11-27-2019, 17:36   #7
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Thanks all for your input. The good news is that I've not had a really high carb day since dx and while I did things like years ago try a beignet in New Orleans (remember that well!), I've remained low-carb. Some days higher yes, really high no.

I don't feel motivated to stay in deep ketosis and if it's not harmful I'm okay with drifting in and out, if it's not harmful, which is where I suspect I am. From curiosity, I've been measuring ketones and am consistently in the 1.1-1.6 range, not deep as I used to be. Definitely affects how I bolus because I need a lot more for protein than I had anticipated.

Yes, it was Salim's posts on this I remember but obviously not well enough! Good point VeeJay about energy, will have to pay attention to that.

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Dx'ed Feb 2011 w/ BS > 600
A1C: . . . . . . . . . . . . . . . Other Stuff
2/13/11 .. 14.7 . . . . . . Trig/HDL ratio .. 5.5 to 2.2 in 6 mo
5/23/11 .. 6.2 . . . . . . . Low-carb/high healthy-fat diet
9/8/11 .... 5.6 . . . . . . . No meds, No statin
2/24/16 .... basal/bolus insulin 2-3 days/wk due to steroids

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