Autoimmune Thyroid Disease

An Unfortunate and Lengthy Adventure in Misdiagnosis

Archive for May 2005

The porker diet update

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A Brief History of alienrobotgirl’s Diets

The Standard Western Junk Diet

I ate any old crap: pizza and pasta were regulars, curries every two weeks or so, I ate a couple of bowls of sugary breakfast cereal a day, drank frequent large lattes, and sugared my tea and coffee. I never ate bread because I couldn’t digest it at all (yes, I do tolerate pizza, pasta and cereal better than bread!). I was vegetarian, pasty and anaemic-looking, allergic to everything (including my clothes), had eczema, asthma, was chubby, bloated, cross and stressed all the time. I tried calorie reduction diets and Slimfast and felt so hungry I couldn’t bear them, and I never lost a pound. I tried exercise at the gym and always felt so hungry and shaky that I could faint afterwards and always ended up pigging out. I lost about four pounds through exercise only to regain it plus a couple more pounds when I gave up from exhaustion. Then I went on warfarin for a blood clot in my leg and it completely destroyed my already terrible health. I was utterly worn-out, stressed, dreadfully hypoglycemic, and just about at the end of my tether.

The Atkins Diet

I went on Atkins, lost two and a half stone (dropping from ten and a half stone down to seven stone twelve pounds) and felt great for about a year! I ate about 1,800 calories per day. I usually ate between 100-120 grams of protein, 20-40 grams of carbohydrate and 120-150 grams of fat. Things were wonderful and I was very slim. Then I started to regain some weight. I started to feel exhausted all of the time, particularly after meals when I would get sweet cravings. I was unable to cope with stress and had redeveloped the eczema I had struggled with before going on a low-carb diet. I was eating nothing but natural wholefoods, but something was still wrong with my diet! So I thought I would experiment.

Phase I – The Porker Diet Experiment

In Phase I, I ate between 2,700 and 3,000 calories for five days. I kept my protein at about 70 grams, my carbohydrate at about 40 grams, and my fat at about 220 or more grams. I lost three pounds! I felt pretty good, not as fuzzy or as tired between meals and my eczema visibly improved in a very short space of time.

Phase II – The Less Porky Diet Experiment

In Phase II, as I planned, I reduced my calories to about 2,500 and kept my protein and carbohydrate grams the same for three days (protein 70 grams, carbs 40 grams, fat about 150 grams). I felt atrocious. I was tired, irritable and confused. I put back on the three pounds that I lost!

Phase III – The Ketogenic/Optimal Diet Experiment

I went for all-out ketosis, reducing my protein to between 50-60 grams, carbohydrate to less than 20 grams and raising my fat to 180-200 grams with an overall calorie count of about 2000 per day (I physically could not eat a higher proportion of fat than this!). I felt atrocious for the first three days (headaches, weakness and other low blood sugar and ketosis symptoms), then I woke up with a massive energy rush and a clear head. I dropped from a worrying 9 stone down to 8 stone 9 pounds (five pound loss!) in about five days!

Fuel and Efficiency – The Second Law of Thermodynamics

Obviously the weight I lost and regained in Phase I and II is only water weight. The body stores between 1,600 and 2,000 calories of glycogen – a starchy carbohydrate – in water at a ratio of 1:3, and the first 3-4 pounds of weight loss on any diet is glycogen, which must be depleted before real fat loss takes place. Furthermore the body stores minerals such as salt in water, in fact people with poorly functioning thyroids are particularly prone to excessive amounts of salt storage, and this balance can sometimes change when someone starts dieting depending on the state of the thyroid. So, I either I lost my glycogen when I increased my fat consumption (in spite of not changing my carbohydrate consumption) and regained my glycogen on the slightly lower-fat, lower-calorie diet (without increasing my carbohydrate consumption), or my metabolism sped up on the high-calorie diet and slowed down on the slightly lower calorie diet, and I regained both glycogen and water and salt due to my body burning less calories. I lost the most weight on the ketogenic diet, by lowering carbohydrates and calories, though on 2,000 calories per day I was still consuming more calories than modern medicine says I should burn in a day. I didn’t exercise. Even on a glycogen-depleting, thyroid-stimulating diet like this, 5 pounds is pushing it for mere water weight, and according to my body fat monitor, I seem to have lost some fat too.

To understand this apparent paradox, you need to get your head around the laws of thermodynamics: most people don’t understand them because physics is complicated stuff and we don’t really get taught it in school. People assume there is only one law of thermodynamics; “energy can be transformed but not destroyed”, i.e. a calorie is a calorie is a calorie; energy in equals energy out. A physicist will tell you there are three laws of thermodynamics (at least, possibly more, you know what physicists are like for inventing more stuff). There are numerous essays on the internet alluding to the importance of the second law of thermodynamics in biology and weight loss; “in any transformation of energy from one form to another, ‘useful’ energy is lost.”

The example I’ll give is that of a car. A lot of non-useful heat is generated in overcoming friction, as well as the forward motion of the wheels. Calories in calories out, sure enough, but a portion of calories is going to waste as heat rather than forward motion (arguably heat is not actually wasted and is valuable when produced in the human body but we’ll get on to that when we talk about the thyroid). Another example I’ll give is fuel. A diesel engine will run a lot more efficiently on diesel than it will on petrol, and vice versa, though they’re of a similar calorific value! Note: if anyone intends to take me to task on this I’ll tell you now, diesel is 16,000 kcals per LB and petrol is 14,700-15,400 kcals per LB, the important factor is the octane rating – diesel has a high octane rating and self ignites, where petrol is designed not to. Each type of fuel causes havoc in the wrong kind of engine, like supplying the human body with the wrong kind of fuel.

Thyroid Function

In the car analogy, the thyroid is like a gear stick. Imagine you’re riding a bicycle: it’s very difficult to get up a hill in a high gear, but much easier in a lower gear. Do you think you expend the same amount of energy getting up the hill in a low gear compared to a high gear? No, in a high gear you’ll be hot, sweating and probably start going backwards! Running burns more calories than walking the same distance. The thyroid controls how fast the body “runs” internally, so it is possible to expend more energy doing the same task (keeping you alive), depending on what gear your metabolism is in.

A doctor will tell you that hypothyroidism leads to weight gain and hyperthyroidism leads to weight loss. Someone with a sluggish thyroid can eat the same amount of calories as someone with an over-active thyroid, and they will gain weight whilst their friend loses weight. This is due to thermogenesis. Do you have friends who either sweat all the time or complain of being cold all the time? If you are cold all of the time your thyroid is under-active and you’re storing energy instead of burning it to heat up your body. If your body is too cold, it shuts down numerous enzymic reactions that it would usually use for maintenance and repair tasks. You’re stuck in a low gear.

The opposite is true if you’re hot under the collar. People with hyperthyroidism are often battling weight loss. Many things affect thyroid health, such as mineral deficiencies (which can be caused by a high-fibre diet), fat soluble vitamin deficiencies (usually caused by a low-fat diet), thyroid inhibitors (goitrogens) such as isoflavones and phytoestrogens found in plants like soy and many beans and nuts, and the macronutrient composition of the diet. Calories too are important for your thyroid. More calories stimulate your thyroid to burn more and hotter and turn on all of those enzymic reactions. Less calories pushes your body into starvation mode, cools you down and switches off all those chemical processes that keep you healthy, as your body struggles to cling to its fat reserves in order to keep you alive for longer.

Fat composition is important. Animal fats are around 45% monounsaturated, 47% saturated, and 8% polyunsaturated. Vegetable oils are largely polyunsaturated apart from olive oil, which is largely monounsaturated, and tropical fats such as cocoa butter and coconut oil which are largely saturated. Saturated fat is essential to thyroid health. The fat around the heart is highly saturated as it is the preferred food of the heart, this is a special reserve the heart draws on in emergencies. The lungs cannot function without saturated fat, which forms the protective surfactant that also helps to prevent asthma and emphysema. Saturated fat is so essential to the body in general that if the diet contains inadequate amounts of saturated fat, the body starts producing it from glucose. Thus, any very low-fat diet is actually a high-saturated fat diet – but without the benefits of fat-soluble vitamin consumption. Don’t believe me? These are the words of Mary Enig PhD, one of the world’s leading experts on fat.

Insulin and Pancreatic Function

In terms of weight loss, insulin is like the body’s brakes. Insulin pushes energy into the body’s cells, but it also signals to the body to turn excess carbohydrate into fat and store it instead of burning it. The physical shape of your body may cause you to produce more insulin. People who have fat stored around their bellies are frequently insulin-resistant, that is, the fat cells in this area reduce the number of insulin receptors on their surfaces, which means that the body has to output extra insulin in order to push energy into them. Imagine your pancreas having to shout louder so these cells can “hear” your pancreas speaking. So if you have weight around your middle, you’re at a serious disadvantage when it comes to weight-loss. Depending on how much insulin you have circulating in your body, you’ll gain or lose weight regardless of the composition of the diet. Thus some people are more likely to gain weight than others. We know this because poorly controlled diabetics with very high blood sugars tend to lose weight regardless of how much they eat, whilst diabetics who inject industrial amounts of insulin to cover their high-carb ADA diet get fat very quickly even on controlled-calorie diets. People who have higher insulin levels have a tendency to put on weight instead of heating up and burning their food. Carbohydrate i.e. sugar, is what stimulates insulin production. Protein stimulates insulin production too, but in smaller quantities. More insulin is like stepping on the brakes; it slows your energy burning down and causes you to store fat. The less insulin you have circulating in your bloodstream, the more likely you are to be able to burn off the energy you consume, plus a bit more. The only ways to reduce your insulin levels is to reduce your carbohydrate intake and control your protein intake, or exercise.

By eating this high-quality high-fat diet I’ve been stimulating my thyroid and lowering my insulin levels. I think the reason I got away with eating so much on The Porker Diet is simply to do with proportions. Fat lowers the glucose index and glucose load of any food (this is the speed the glucose passes into your bloodstream), and fat also increases ketone production, which in turn stimulates fat burning. I ate so much animal fat that I managed to keep my insulin levels down in spite of the extra carbs, keep my ketones up, and keep my thyroid stimulated, and I was able to burn the excessive amount of calories I gave to my body, probably on numerous much needed repair tasks.

Phase III – The High-Calorie Ketosis Experiment

Having recovered then lost my health again in phases I and II, I decided to try something new: going for all out ketosis. Ketosis is a kind of soft metabolic switch, when the body burns fat primarily for fuel instead of glucose. Imagine if your car could run on both petrol and electric at the flip of a switch, and the two could be mixed to different proportions to produce different effects. Ketones are the substances produced when the body breaks down fat (dietary or body stores) for fuel in the liver. It’s a dimmer switch, we all produce ketones all of the time, though those of us on a high carbohydrate Western diet don’t produce very many. Our ancestors who lived during the ice ages and ate mammoth fat probably produced a lot of ketones. We usually have a higher ketone level in the morning, after an overnight fast.

The more fat we eat in relation to carbohydrate and protein, the more ketones we produce for energy, though even low-fat calorie restricted diets produce small amounts of ketones – it would be a biological impossibility to lose weight without producing them, as they are simply the by-products of all fat burning. Ketones only appear in significant amounts when insulin is lowered to a critical point. The body seems to prefer to operate either in the presence of insulin, or the presence of ketones, which bypass insulin. It does not operate more efficiently in the presence of both, as insulin suppresses ketone production. The body actually runs more efficiently on ketones than it does on insulin, as demonstrated by numerous studies available in PubMed, including the body’s heart function and brain function. If you hear that ketones are “dangerous” in the media or from your doctor or nutritionist, their information is out of date and based on a misunderstanding of what diabetes is and what it does to the body.

A ketogenic diet restricts protein to the RDA amount, restricts carbohydrates to less than twenty grams, and makes the rest of the diet up with fat. This comes to 80-83% of calories from fat, about 10-13% from protein, and barely 3-5% from carbohydrate. This diet is similar to the diet recommended by the longest living type I diabetic, Dr. Richard K. Bernstein MD. It’s also very similar to The Optimal Diet recommended by Dr. Jan Kwasniewski, when adapted for weight loss.

I’ve been eating about 2000 kcals a day and I have reduced from a frustrating scrape with the nine stone mark down to eight stone nine in less than a week. I am aware that this is mostly water weight as my experiments are too brief for anything else, and that I will probably need to add some aerobic and anaerobic exercise to this to continue to lose weight because of the quantity of calories I am eating.
I don’t want to cut back on calories at the moment as I feel I need to support my thyroid to continue to experience good health
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Ketosis is a subject of controversy. It hasn’t been studied very much, and the web is full of misinformation and contradiction. A copy of the best paper I’ve found so far is Ketones: metabolism’s ugly duckling, though even this contains some confusion about how much protein gets converted to glucose towards the end.

I’m surprised by the numbers of doctors who write rabid rants about ketosis based on the few meagre facts they learned at medical school about diabetes and the dangers of ketoacidosis. Ketoacidosis is a condition suffered only by diabetics who have very low or non-existent insulin levels. It is accompanied by very high blood sugar levels because there is no insulin to push glucose into the body’s cells. The body goes into overdrive in trying to protect itself both from the high blood sugar and the inability of the cells to get energy and produces an excess of ketones to compensate. Ketones are acidic. Under normal circumstances, a body in ketosis is still able to maintain a very narrow PH band, but not in ketoacidosis, where the diabetic is overwhelmed by the acidity and quantity of ketones, along with the high blood sugar. This state leads to death if untreated with insulin.

On the other hand, ketosis in a normal body is rather different. In normal quantities, ketones protect the body from the neurologic degeneration and the mitochondrial abnormalities associated with diabetes. A common myth you will hear is that the brain runs solely on glucose: it does not. The brain also runs on ketones, and in fact it runs 25% more efficiently on ketones than it does on glucose. The heart increases its efficiency by the same percentage in the presence of ketones. However, in ketosis, the body will reserve glucose for the places that need it most, like the brain.

Medicine has known since ancient times that fasting reduces the frequency or even eliminates epileptic fits. It is ketones which protect the epileptic’s brain from dysfunction due tothe changes in gene expression they cause as the body adapts to the ketogenic diet. Scientists are now discovering that ketones protect sufferers of Parkinson’s and Alzheimer’s too, and one wonders what other brain diseases they might help. In the 1920s, the ketogenic diet was devised to produce the beneficial effects of fasting whilst nourishing the sufferers of epilepsy. The diet is designed to get the blood concentration of ketones as high as possible. This means fluids are restricted (due to the possibility that the body would wash excess ketones away), carbohydrate is restricted, and so is protein. The diet has been rediscovered in recent years and is used in patients unresponsive to medication and appears to be particularly effective in children. There are claims that the diet is less effective in adults, but I have not found the scientific source of this claim. J. suffers from Juvenile Myoclonic Epilepsy, and we have both observed a lessening in his symptoms over the last year or two since the changes to our diet.

The thing about my appalling health is that I go through periods of hazy exhaustion, dumbness, spaced-out-ness and irritability, and then I have startling patches of clarity and energy. I’ve always had a tendency toward this, but ever since the warfarin treatment I consider my pancreas to be a dysfunctional idiot and even wonder whether I would be better without it. Many times in the last couple of years I have seemed to become trapped in some sort of low blood sugar ADD state in which I am unable to concentrate on the simplest programming task and have been entirely unable to face writing anything creative (anything at all!). Whilst protein and low GI carbohydrates keep my blood sugar more stable, based on my experiments, they also appear to make me gain weight and feel foggy and tired.

Those first two weeks on Atkins were the most unbelievable for me, and I’ve been trying to recapture them ever since. I had more energy than I knew what to do with, no neck pain, no cracking joints, no drowsiness or confusion, and I could cope with a much higher amount of stress. This feeling has slowly faded and only re-emerged in patches, such as how I felt in Spring in France last year (eating all that fatty French food). This last week I have felt better than I have done in all that time, since I was a child in fact. My tiredness after meals is gone. I have been able to concentrate on work and I’ve been very productive. I’ve actually been able to write again and I’m charging through the chapters of my book! I feel completely blissed out and inspired to do things. I have been able to work on my feet in and around the house for hours without sitting down.

The other week, however, I fell off the bandwagon by eating a (homemade) Passanda curry that probably only had about 15 grams of carbohydrate in it, mostly as onion, and lo-and-behold, by lunchtime the next day I felt awful, my back was all stiff and I was tired again.* I’ve slipped a few of times since then and these relatively minor slips have caused havoc the following day. Ten or fifteen grams of carbohydrate is enough to cause the gain of a pound or more of water. This seems a physiological impossibility, but it really happens, I bloat and swell up like a balloon. I’ve gone out and bought a blood glucose monitor as I’m starting to wonder whether my extreme reactions to diet mean I’m getting closer to diabetes than I am to hypoglycaemia. Type II diabetes is characterised by an initial slow reaction to high blood sugar, followed by an overkill of insulin that can send blood sugar plunging. My tiredness after meals might be down to high blood sugar. I’ll let you know the results when I’ve plucked up the courage to use it.

Carbohydrate and Weight Loss

The overall proportion of fat in our diet has decreased by all of five grams in the last thirty or forty years (it’s impossible to feel full or enjoy food without it). The amount of saturated fat has gone down. By contrast the amounts of refined carbohydrate and thyroid-blocking polyunsaturated and trans-fats in our diet have rocketed through the roof.

The only way to lose weight in the presence of insulin is to eat a diet so low in calories and so low in fat that you create a deficiency and the body is forced to mobilise stored fat reserves in the presence of insulin (a physiologic contradiction that results in the unpleasant headaches, cravings and wild blood sugar swings one experiences on weight watchers and slimfast diets). One does not have to use one’s brain to know that starvation diets damage the thyroid and insulin mechanism. If you want to lose weight you need to lower your insulin levels, and the only way to do that is to cut the amount and change the quality of carbohydrate in your diet.

GI and GL are respectively glucose index and glucose load. They represent the speed at which glucose enters the blood stream and its overall impact on blood sugar and insulin levels. Carbohydrate varies in quality from largely low GI/GL natural wholefoods to largely high GI/GL ultra-processed store foods. Dr. Atkins has always insisted that people who want to lose weight need to stick to low GI/GL foods to help level out their blood sugar, but was also very specific about the quantities and types of food that could be eaten (only green vegetables for the first couple of weeks, then a few berries and nuts). Since Dr Atkins has passed away, Atkins Nutritionals Inc. has started to ditch the “net carb count” concept in favour of a more complex glucose-load based “net Atkins count”. This hasn’t been going down very well amongst Atkinsers who use low-carb messageboards. The general consensus is that Atkins Nutritionals Inc. has been selling out on Dr. A’s established health and weight loss methods in order to flog more low-carb frankenfoods. Dr. Atkins was very specific about which foods could and could not be eaten on Induction, and there are numerous stories of weight loss stalls after eating these low GI/GL frankenfoods like high-protein bars, Splenda and other artificial sweeteners, soy foods, glycerine and other additives due to multiple factors that haven’t been accounted for with mere GI/GL, from food allergies to goitrogens to glycerine, to the wrong types of fat. Dr. Atkins himself appears to have been unaware of the goitrogens contained in soy and other food, and perhaps through lack of knowledge or even hoping to avoid confrontation, was vague about the types of fat that were best for weight loss.

More recently a plethora of half-baked GI/GL diets have come onto the scene, claiming to be the ultimate answer to weight loss when really they’re just a repetition of old ideas put forward by various early 1980’s diabetes researchers, without the controversy of actually overtly low-carbing (or indeed high-fatting), so they can be marketed to mainstream doctors.

My problems with GI/GL diets is firstly their generally hazy stance on both the types and quantities of fat in the diet. Fat is a substance that lowers the GI/GL of any food, but which these diet gurus would rather limit to miserly food-pyramid proportions because they haven’t bothered to critically study any research papers on saturated fat and cholesterol. One minute these people are praising nuts and seeds for their “good fats and minerals”, the next they are telling you to limit your fat to 25% of calories (less than the amounts in the typical Western diet!), exposing you to potential blood-sugar swings and hunger, and always ignoring the fact that fat has a GI/GL of zero and actively lowers the GI/GL of any food it is consumed with, and furthermore it is the most satiating food you can eat!

Secondly, on a low GI/GL diet, yes glucose enters the blood stream more slowly causing less of a surge of insulin, but the glucose still goes into the blood stream and still gets taken up by insulin, which is still outputted in the presence of carbohydrate. Certain types of foods produce a greater insulin output for the same GI/GL than others: for example white bread has a higher insulin index than white rice for a similar GI/GL; this suggests that other factors are at play which have not been accounted for. GI/GL diets do cause weight loss, it’s just that the weight loss stalls long term leaving the dieter stuck on a permanent plump plateau. You will never be Jennifer Aniston or Renee Zellweger (the 106 pound version) on a GI/GL diet, the insulin mechanisms of us Westerners are simply too damaged by years of abuse.**

Thirdly, the GI/GL diet can be bad for your health. Take for example peanuts. Peanuts have a very, very low GI/GL, far beyond what should be expected from the proportions of macronutrients in them: there’s something else in peanuts that slows down their GI/GL. Peanuts, along with a very many other low GI/GL nuts, beans and grains, contain enzyme inhibitors, goitrogens (thyroid inhibitors), and polysaccharides (particularly amylopectins, cellulose etc.) that slow down the digestion by taxing the digestive system leading to unpleasant symptoms of gas, constipation and even diarrhoea, and you’ve guessed it, the goitrogens in them also slow down your thyroid, exactly what you don’t want when you’re losing weight. These foodstuffs are the mainstay of low GI/GL diets. The types of carbohydrates in low GI/GL grains like rye and whole wheat (certain polysaccharides), proteins (gluten), and lectins are irritants that cause digestive problems.

Insoluble fibre consumption actually increases the risk of colon cancer as it scrapes its way along the delicate lining of your gut and fosters the growth of unpleasant bacteria, whilst mineral-rich beans and nuts are also high in phytates that block the absorption of said minerals by the body! Whole nuts, seeds and grains need to undergo some labour-intensive processing before they are fit to be eaten in any quantity. Like beans they need soaking overnight in salty water. Then they need baking in a low temperature oven to complete the neutralisation process of the enzyme-inhibitors, and this still does not neutralise the polysaccharides responsible for IBS and flatulence (see The Specific Carbohydrate Diet for more information on bacterial growth and polysaccharides). How many GI/GL diet gurus will tell you that? Why don’t they tell you that? Because they don’t know anything about food!!! Put that in your pipe and smoke it Dr. Gillian McKeith and Dr. Patrick Holborn.

I’m sorry (I have two friends currently experimenting with GI/GL diets, to whom I am apologising) these diets are for people who want trendy low-carb advantages combined with an unchallenging world view, and are afraid to take risks with “dangerous artery-clogging” fat. Ultimately these diets are orthodox food-pyramid low-fat diets and doctors have been recommending those since the eighties with some success on the general population’s eating habits; however we’ve yet to see the nation slim down or stop having heart-attacks as a result of these changes, in fact quite the reverse.

Protein and Weight Loss

The body requires protein at a ratio of about 0.001% of body weight per day in order to maintain protein mass. That is, if you weigh 50kg (110 pounds), you will require 50 grams of protein to do the necessary maintenance and repair to your system. Protein makes up about 20-30% of the weight of raw red meat (the rest being water and a roughly equal quantity of fat), so your entire protein requirements for the day will be satisfied by the equivalent of a six ounce steak. Any excess protein you consume in a calorie/carbohydrate deficient diet will be converted to glucose at approximately 56% of its weight through a process known as gluconeogenesis. So if you consume an extra 20 grams of protein, you’ll get a net result of an extra 10 grams of glucose entering your bloodstream, albeit so slowly it won’t raise your blood sugar above normal. You don’t get a much lower GI/GL than protein, which like fat does not raise the blood sugar above normal at all, though unlike fat it does cause insulin release. The net result of protein consumption is that it lowers blood sugar by causing insulin release faster than any excess protein can be converted to glucose.

Gluconeogenesis is the synthesis of glucose from non-carbohydrate precursors such as lactate, glycerol, pyruvate and certain amino acids. Approximately half of the amino acids found in meat are glucogenic. Gluconeogenesis occurs predominantly in the liver and can also occur in the renal cortex. It has a key role in the maintenance of blood glucose levels during certain stresses e.g. prolonged starvation. After about 24 hours of fasting, glycogen reserves are depleted and the body reverts to gluconeogenesis to supply glucose for tissues with an obligatory dependence e.g. the brain.

Considering the average Atkinser can consume 100 grams or more of protein per day, this may add up to an extra 25 grams of glucose going uncounted, and a deal more insulin too. I believe the proportion between the overall net insulin release and fat consumption, along with individual metabolic insulin and thyroid differences is the reason why some Atkinsers suffer unexplainable weight-loss plateaus even when counting calories, whilst others have never felt better and fat is melting away. Jst check out low carb forums and you’ll see what I mean. Imagine a see-saw with insulin on one side and fat-burning hormones on the other side. Some people have a different “weight” (insulin output) on the see-saw to other people, and they have to go to different extremes to lighten their load on the see-saw to cause weight loss. It may be that all they have to do is reduce calories, whilst others must reduce calories and GI/GL, whilst others have to also lower overall carb consumption, and others still have to lower protein consumption and fat-fast their way to weight loss. All this of course presuming that thyroid function and metabolism is equal!

The ketogenic diet is very specific about keeping protein consumption down to the bare minimum RDA to keep gluconeogenesis and insulin under control. The longer a body does a task, the more efficient it becomes at it. I believe the reason I only lost weight very slowly when I went back on Atkins Induction earlier in the year was that my body became extremely efficient at burning fat and converting excess protein (and other factors such as glycerol and lactate) into glucose, that I was eating too much protein, and therefore my insulin levels didn’t drop down to the necessary levels required for rapid weight loss. Gluconeogenesis can be quite taxing to the body, and as protein causes a moderate insulin output it forces the body to perform gluconeogenesis from protein in order to keep the blood sugar stable. I believe this may be part of the explanation for my former exhaustion after eating meals.*** Whilst most orthodox low-carbers would probably pooh-pooh this as some sort of evil establishment anti-protein-ism, I would ask them to explain why I had to cut protein in order to get into ketosis, and why my eczema has now cleared up! The problem was not calories, because I had also reduced them, to no avail.

Dr. Atkins has always said that protein is a “free food” but that as one becomes less hungry in ketosis one should reduce the amount of protein one eats. This is vague. Atkins is very vague about the proportion of protein to fat that should be eaten. The problem is, if one has a body that is particularly good at converting protein to glucose (as in someone who has eaten excess protein in a low carbohydrate context for months or years), and that body is very eager to output insulin at every given opportunity, one is going to find it much harder to get into ketosis and get hunger under control. J is still eating in the way that I used to eat – lots of meat, moderate carbs, not much added fat apart from buttered vegetables. I am fascinated by how much greater his hunger levels are compared to mine.

We probably all know of someone who went on Atkins and “got kidney pains” or “had a painful big toe and thought it might be gout” and was scared off. Silly ex-Brooksider Claire Sweeney went about flogging a diet book of her own the other year, after claiming to develop a kidney infection after going on Atkins. “I was snacking on packaged ham all the time. […] After three or four weeks I started getting pains in my lower back and my kidneys. Then I got a temperature, then I got uncontrollable shaking. I never miss a day’s work, but suddenly I was bedridden for two days with a kidney infection.” Sweeney says the diet made her lose energy. This would only happen if she never got into ketosis. Obviously if she was snacking on packaged ham “all the time” she hadn’t actually read the book. But Atkins is open to interpretation because he doesn’t give specific ratios of macronutrients. Some people do go all out for lean meats like ham and chicken and fish, and they suffer ill health and can’t stick to the diet as a consequence. I mentioned “Rabbit Starvation” in the previous posting: if one eats nothing but lean meat, one gets very ill very quickly. If you drink alcohol, restrict calories and fail to drink enough water to let your kidneys process all the protein you have eaten, you downright deserve to get kidney infections and gout for grade-A stupidity. Perhaps if Atkins was more specific about limits, people like Sweeney wouldn’t have an excuse to abuse the diet and then swan about making cash out of its apparent failure.

Fat and Weight Loss

If you want a really dangerous diet, try The Zone or South Beach. The Zone requires caloric ratios of 40% carbs, 30% fat, 30% protein. The Zone is actually a low-fat high-protein diet, because even the Western diet contains more fat than this (about 35% fat). Considering that by weight, red meat contains over twice as many calories as fat as it does protein, you are forced to live on fish and chicken, and you can’t butter your greens. South Beach is Atkins without the animal fat: low-fat white meats are complimented by olive oil – the very fat your body most likes to store. Protein digestion requires vitamin A, which is only found in animal fats, not vegetable oils. Both of these regimens induce vitamin A deficiency, and therefore symptoms of headaches, weakened immune system, fatigue, blurred vision and thyroid problems. Vitamin A is also essential to the health of the thymus gland, which regulates the immune system. You may have a friend or two who is very tall and gangly, possibly with round shoulders and an undershot jaw. If you find out what they ate as a child, you may be astonished to discover their diet was very lean and they probably have a particular addiction to carbohydrates as a consequence of the lack of fat in their diet. These are the symptoms of vitamin A deficiency on growing children: uncontrolled, precocious growth and frequent infections.

I tried going back on Atkins Induction before by reducing my carbohydrates to less than 20 grams a day. The weight loss has been very slow and has reversed almost immediately that I increased my carbohydrate consumption again. The reason I increased my carbohydrate consumption again is that I never got through the cravings the whole time I maintained Induction (very strange, they usually disappear within a few days). I’ve tried going back on Induction and also adding coconut oil to my diet. I managed to lose 5 pounds in about 3 weeks, not bad you might say, but hardly the whopping stone in two weeks I managed the first time around on Atkins. Again, I stopped because of the cravings, and because coconut oil is disgusting, and because if I forgot or was unable to take it, I’d get the shakes pretty quickly, and I don’t like being dependent on supplements.****

This time around I’m losing weight and I have absolutely no carbohydrate cravings so no desire to stop. I’ve finally managed to flip the switch properly. I am amazed that I have had to go to such extremes. I have been taking coconut oil, but if I don’t take it I’m not getting the shakes as I did before. The reason I am succeeding is because of fat.

Fatty acids are simply chains of carbon atoms with hydrogen atoms filling the available bonds. Saturated fat is the most stable fat, as all available bonds are saturated with hydrogen. It’s inert. Monounsaturated fat has one hydrogen atom missing, and polyunsaturated fats have many hydrogen atoms missing. There are many ways of classifying fats. Saturated fat is the fat least likely to oxidise. Monounsaturated fat is good too. Polyunsaturated fats should be avoided completely with the exception of the EFAs found in cod liver oil and evening primrose oil, as they interfere with the prostaglandin pathways necessary for good health and weight maintenance. Polyunsaturated fats are sticky and reactive because their carbon bonds are not filled – vegetable oil will stick to and stain a metal pan in a way that saturated fat will not. Aside from having a disgusting taste and greasy feel, polyunsaturated fats also stick to the lining of your arteries. Scientists have known for decades that by far the major fat found in atherosclerotic deposits is polyunsaturated. It makes you wonder how the lipid hypothesis was ever formed. Trans-fats (hydrogenated vegetable oils found in pastry shortening, vegetable suet, margarines and most processed foods) are even worse, a metabolic poison, one of the main factors in the development of heart disease, and should be avoided at all costs. This has been done and said before in better ways by countless other people. Know your fats!

What seems to be quite important with regards to weight loss is more the length of the fat chains than anything else. The body prefers to store the longer-chain fatty acids found in olive oils and polyunsaturated vegetable oils, and it prefers to burn the shorter-chain fatty acids (coincidentally these are saturated) found in butter, cream, coconut and palm oils. This is because longer-chain fatty acids require L-Carnitine (an amino acid) to push them into the cell mitochondria, the powerhouses of cells, whereas shorter-chain fatty acids enter by passive diffusion. L-Carnitine production is inhibited by insulin production, and it takes several weeks for a healthy body to adapt to produce enough L-Carnitine after one begins a low-carbohydrate diet. Production of L-Carnitine will never fully normalise so long as one is producing excess insulin (i.e. if you have belly-fat).

Coconut oil (sometimes called MCT oil) is mostly made of a medium-chain fatty acid called lauric acid. Amongst other things it has anti-microbial properties and helps to bolster the immune system. Lauric acid is too short for the body to store as it enters mitochondria by passive diffusion (without any help from L-Carnitine). If the body wants to store lauric acid, it has to go to the effort of joining it up with other triglycerides to make longer chains, so it would rather burn lauric acid as this is a more efficient thing to do. Therefore coconut oil is highly thermogenic. Coconut oil is also thermogenic because it is
ketogenic
, breaking down easily into ketones. Remember what I said about cranking up the gear stick? Coconut oil helps people to lose weight by satisfying their hunger, providing quick energy, stimulating the thyroid and heating up the body’s temperature. It helps sick people recuperate and normalise their immune systems for several reasons, including its antibacterial properties, and also that many enzymic reactions essential to health are switched back on and speeded up when the body is warmed properly. A few months ago I talked about fever therapy as an alternative cancer therapy! People with poor thyroid function are known to be at a greater risk of cancer than those with good thyroid function, and coconut oil can correct poor thyroid function.

Unfortunately as virgin coconut oil tastes pretty awful it’s hard to eat off the spoon. Coconut based curries like Korma and Thai curries are a good way to eat it, though they make it harder to count the carbs. When coconut oil is added to a ketogenic diet it allows the dieter to ease off on the ratio of non-fat to fat, allowing more protein and carbohydrate into the diet because it bypasses the requirement for L-Carnitine, which is dependent on lowering insulin levels.

Dairy fats like cream, butter and cheese are moderately thermogenic as they also contain a higher proportion of lauric acid to other fats, but more long chain fatty acids too. I find that dairy fats agree with me more than coconut oil, which actually burns so fast and so hot in my body that I am hungry again after a couple of hours.***** Dairy fats keep me full for longer.

Monounsaturated olive oil and polyunsaturated vegetable oils are not terribly useful for weight loss. The length of their chains are long and this encourages fat storage. The major component of adipose tissue is oleic acid, also the major component of olive oil (55-85%). Oleic acid is also found in animal fats (about 45%), along with shorter-chain saturated fatty acids.

Ketosis

Ketosis – proper ketosis – not the half-assed kind of popular diets, has some slightly uncomfortable symptoms. They should not be confused with symptoms of low blood sugar.

Symptoms of Low Blood Sugar******

These occur within the first three to four days of the diet and will probably be highly unpleasant.

  • Weakness and exhaustion
  • Irritability
  • Confusion, woolly head, poor attention span, lack of focus
  • Apathy and depression, moodswings
  • Headaches
  • Palpitations
  • Blurred vision

Symptoms of Ketosis

  • These occur after the first few days when the body adapts its metabolism.
  • Energy rush
  • Feelings of bliss and calm
  • Thirst
  • Fruity odour to the breath (only if inadequate amounts of water are drunk. Fruity breath fades as the body becomes more efficient at utilising ketones)
  • Mild, occasional stomach discomfort
  • A lack of constipation (unlike high protein Atkins or Zone style diets, a ketogenic diet will keep you regular)

Severe Ketosis

If you experience the following symptoms, you need to ease back on the coconut oil or eat a few carbs!

  • Severe stomach pain
  • Diarrhoea
  • Nausea
  • Throat tightening or palpitations (caused by adrenaline surges as your body struggles to raise blood sugar)

What Happens After Getting into Ketosis?

During the first couple of weeks of ketosis, the body mainly lives off ketones, reserving glucose for the areas of the body with obligatory requirements such as the brain. The body adapts further during this time as insulin lowers and it learns to produce L-Carnitine, becoming more efficient at fat processing until the muscles no longer require ketones for energy and these too are reserved for the brain and other obligatory organs. At this point the muscles burn fatty acids directly (with the aide of L-Carnitine), negating the need for ketones. The diet takes about two weeks to adapt to, and changes will still be occurring as much as six weeks after the diet begins: this is a strong reason to stick with the diet and give your body chance to adjust, as you may experience many strange and unpleasant symptoms and cravings that are only temporary. No one really has a genetically “fixed” or “natural” diet with regards to macronutrients (much as some people are eager to believe in metabolic typing and blood typing, I am afraid it is unscientific bunk), though we may have minor genetic quirks with regards to micronutrient and mineral requirements or our own particular tolerance levels of various macronutrients. Unfortunately the people who need a low-carbohydrate the most (people with mood disturbances, insulin-resistance, belly-fat, diabetics, hypoglycemics, hypothyroids, alcoholics, and particularly stressed, irritable or nervous young women*******), are the people who will experience the most problems, and these people should focus on the use of coconut oil and L-Carnitine supplements.

The Ketogenic Diet

This has been my routine for the last week or so:

Supplements

I consider the following supplements essential to good health and weight loss, particularly the cod liver oil and dolomite. I have not experienced any leg cramps and I believe this is because of the combination of fat-soluble vitamins and calcium/magnesium supplementation.

  • 1 tbsp cod liver oil (essential to thyroid health and rich in vitamins A, D and omega 3s)
  • 2 tsp wheat germ oil (source of vitamin E)
  • 1200mg dolomite (source of calcium and magnesium, calcium is essential to thyroid health and magnesium is a regulator of other minerals, balancing calcium)
  • 1 gram vitamin C (this is the only vitamin for which I haven’t been achieving RDA, mainly through laziness rather than carbohydrate restriction, I must point out that the vegetables and fruits highest in vitamin C are also the lowest in carbs, such as broccoli, red peppers and blackcurrants)

Breakfast: 2 egg yolks, 1 whole egg, slice of butter, slice of lard or dripping, heaped tbsp crème fraîche, salt & pepper. Scrambled lightly in a saucepan.

This is a seriously fortifying breakfast, I defy anyone to eat this and be hungry before one o’clock. The idea is to eat as many calories as early in the day as possible. All of the animal fat in this breakfast will help you to absorb the nutrients from your supplements.

Mid-morning: decaf coffee with a good glug of cream

Lunch: 1 tbsp coconut oil melted in water with small amount of salt and cream added to help disguise the flavour (optional). 2-3 ounces of chicken liver pate or 1 ½ ounces unpasteurised camembert cheese and 1 ½ ounces Parma ham or2 ounces of smoked salmon, balanced with a spoon of sour cream or crème fraîche (fish, even “fatty” fish is extremely low in fat and will not control hunger unless additional fat is added to the meal). Salad leaves or ½ red pepper or ½ avocado or 1 ounce lacto-fermented cabbage or sauerkraut.

Note that it helps to consume “live” lacto-fermented products on a daily basis for intestinal health.******** Protein should be of highest quality (i.e. meat) and should be consumed either raw, or as organ meats, to achieve the most benefit from the smallest quantities.

Mid-afternoon: decaf coffee with cream.

Tea: 1 tbsp coconut oil melted in water with small amount of salt and cream added to help disguise the flavour (optional). 3-4 ounces cooked weight of lamb, steak or pork chop (these contain approx equal weight of protein and fat) or 2-3 ounces cooked weight of chicken in homemade (i.e. no MSG or additives) curry made with coconut milk (chicken is lower in fat and higher in protein, the coconut “balances” it, fish would have to be cooked in a similar way). Seasonal green vegetable such as broccoli, cabbage or spring greens.

If you’ve eaten according to plan for more than three days, you will not need to snack in the afternoon and probably won’t be hungry at tea time. You shouldn’t drink anything but water between meals to allow your body to rest. If you are hungry, then another decaf coffee and cream should be enough. Don’t skip a meal because you aren’t hungry, it is better to eat at tea time than feel hungry just before bed time. The body burns fat stores during the overnight fast, eating before bedtime will scupper this to some extent.

Evening: decaf coffee with cream.

The Results

Originally when I went on Atkins I noticed the following changes to chronic symptoms, some of which have reemerged during the last few months as my health has deteriorated again:

  • My eczema cleared up (it reemerged again a year later).
  • My blood sugar evened out and I stopped being hungry all the time.
  • My asthma cleared up and didn’t return, even during hayfever season.
  • I still got hayfever during the height of the season, but all of my daily allergies reduced to nothing. I am barely allergic to cats and dogs anymore.
  • I used to come up in all manner of mysterious rashes and itches on a daily basis and these went away.
  • My skin stopped being so greasy and so dry.
  • I have otis externa in my right ear, it’s an eczema-like inflammation I’ve had since I was about nineteen. Sometimes the pain would be unbearable and I used to have to put cream in my ear every day for years. It still gets inflamed sometimes, but it doesn’t really bother me anymore since Atkins. I still have to wear hats when it’s cold though.
  • My regular migraines went away and so did my terrible back and neck ache.
  • I was no longer ready to fall asleep after meals and didn’t feel tired in the afternoons anymore.
  • I actually had some motivation to do things in the evening rather than just watch television.
  • I stopped getting flashes of anger and experiencing panic and irritability. I stopped being whiney and sighing and being indecisive.
  • I stopped getting depressed.
  • I stopped feeling crap all the time and stopped coming down with colds every couple of months.
  • All those mysterious aches and pains went away.

Since making the changes in my diet I’ve noticed the following changes to my body. I’ve tried to be as scientific and objective as possible about this. Fortunately I’m pretty self-aware with regards my physical state and how it relates to what I have eaten.

  • As of two weeks of being on the diet, the eczema on my face has completely cleared up. I noticed prior to this period that any deviation from the diet caused it to reappear.
  • I was previously experiencing the occasional skip in my heart beat rhythm, as often as once a day. I now hardly experience this at all. I think I might have had one last week, and that was after eating additional carbohydrate.
  • My physical endurance is much greater. I endured an entire day – 9am till 5.30pm, on my feet walking and standing when I went to Alton Towers last weekend! I didn’t get irritable or tired at all and hardly sat down, and in spite of being in a socially stressful situation I was even able to make friends. I credit my survival to the packed lunch I took with me of Camembert, Greek yoghurt, pistachios and foie gras! I felt completely normal the next day (unheard of!).
  • I no longer feel tired, foggy and apathetic after meals.
  • My symptoms of low blood sugar have changed. They only appear when I drop out of ketosis from deviating from the diet (anything over 20 grams of carbs). Before, I would get irritable, panicky, confused, blurry eyes, I would sigh a lot, and couldn’t be bothered to prepare something to eat. Now I don’t seem to get these symptoms, or get them only mildly. Instead I’m overcome by a strange draining sensation of weakness where I feel like I have to sit or lie down before I collapse and I can’t do anything. I usually stay like this for about ten or twenty minutes, and then I have enough energy to get up and do something – whilst these symptoms are equally as disabling as the confusion and apathy I was experiencing before, I am able to rescue myself because my mental and physical endurance is greater, and I seem to be able to get up and keep going in spite of feeling weak. I think this may have something to do with gluconeogenesis – before I would have been making excess protein into sugar where now my body is relying more on fat for energy. I think gluconeogenesis may have kept my blood sugar more stable but was having detrimental effects on my health due to it straining my body and making me grumpy.
  • My mucous membranes all over my body seem to be regulating themselves better, not too dry, not too wet or greasy. My skin is not too dry any more, in fact I don’t really bother using moisturiser at all now.
  • I am more content and laid back and more able to cope with social situations that previously made me anxious.
  • My driving lessons have been much better. I am more alert and have been doing some quick thinking.
  • I actually feel like doing some writing again and getting on with my book! Before I found the thought daunting.
  • My varicose veins aren’t as bad.
  • I am warmer and don’t seem to get cold hands or feet nearly as much.
  • My joints and back have stopped feeling stiff and clicking, though if I eat sugar I start clicking again the next day. It feels like my whole body has started relaxing. If I bend over or stretch and I’ll get unexpected crunches that feel different – as though my joints are loosening up properly instead of staying stiff.
  • I stopped what I call “carping”, that is, carb-craving for sweet things after meals. Fat is stopping me craving carbs!

Where Next?

Over the course of the last few weeks, the diet has changed. I eased off on the coconut oil as for a couple of days I had all of the severe ketogenic symptoms, including stomach pain, nausea, diarrhoea, and throat tightening and palpitations. I have ceased to take the coconut oil at all now (too disgusting) and have stopped deliberately indulging in fat when I am already full (grin). This has put an end to these symptoms, which were entirely of my own making. They did not bother me terribly at the time as the energy rush and feelings of bliss and calm I experienced (and continue to experience) made them absolutely worth it. Even the three days of hell I went through to get into ketosis were worth it!

At the moment my plan is to continue as I am. I think my weight loss is going to slow down so I will start to exercise as soon as we get the builders out of our hair (we’re having our house renovated, and it would be too embarrassing to jump up and down on a rebounder with builders popping in for a cuppa!). I’m going to test my blood sugar, however I am at risk of a false negative because I’m on a diet that practically cures type II diabetics. In spite of all this excitement about weight loss, I went on the diet primarily with the intention of trying to fix my fibromyalgia and eczema and that’s what I’m prioritising. Some time in the future when I am feeling happy and healthy, I’ll try increasing the carbs so my diet is more like Kwasniewski’s Optimal Diet. If it works out I’ll stick to that, if it doesn’t I’m going to try to stay in mild ketosis for the forseeable future, stopping weight loss with extra fat, as anything that feels this good simply can’t be bad for you.

Notes from October 2007

As you can see from the breakdown of what I was eating daily, my diet was still quite high in food chemicals. I do not believe I really reduced food chemicals, I just changed my macronutrients in a way which helped me to cope with food chemicals. At the time I didn’t even know what food chemicals were.

* As you can see I blamed a food chemical reaction caused by a curry on carbohydrate. I was stuck in this mentality for a long time. This is because I DID have reactions to pure carbohydrate and I felt fine for most of the time that I avoided carbs. Salicylates were the ultimate cause of my hypoglycaemia, but there’s more than one way to skin a cat, and low-carbing negates hypoglycaemia too.

** Caused by additives and alcohol more than carbohydrates.

*** I still believe that excess protein was causing my exhaustion, not merely the consumption of amines/glutamates. Excess protein makes ammonia, and some people, particularly autistics, have problems processing ammonia.

**** Here I am complaining again that coconut oil gives me the shakes!

***** Was this really true? Or were the polyphenols in it affecting my insulin output?

****** These really are symptoms of low blood sugar, not just food chemical sensitivities.

******* Stressed young women – the stereotypically food chemical sensitive! I knew I was seeing something but I didn’t know what to name it.

******** I refute this now. There’s no actual evidence you need lacto fermented foods in your diet, if you’re eating properly. You might need lacto ferments if you eat too much starch.

Written by alienrobotgirl

11 May, 2005 at 7:41 pm

Posted in My History

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I was very desperate in the autumn of 2004, fatigued and suffering from worsening eczema in spite of trying everything under the planet to fix it, from pharmaceuticals to vitamins and minerals to numerous elimination programs and radical changes in diet. My eczema seems to be closely related to blood sugar fluctuations and has gotten worse over time as I fail to keep my blood sugar in check in spite of rigorous dietary control.

Notes from October 2007

This is from an irrelevant post that I’ve since junked – but I thought it was worth keeping this snippet just to remind me how bad my fibromyalgia became after I returned to the UK. My face itched all the time. I was constantly fatigued. I was ashamed to leave the apartment because my skin was so bad. During the autumn I was in floods of tears over little tiny things. I could no longer face doing any programming work because I couldn’t concentrate at all – I was deep into ADD. I wanted to write, but I couldn’t write because the thought of writing filled me with dread. I couldn’t make a simple phone call because the thought made me so nervous.

What was I doing differently?

  • I was ordering vacuum packed organic meat of the internet, that was dispatched by overnight carrier. It wasn’t kept cold enough, and always smelled slightly sulphurous – it was full of amines and glutamates.
  • Because this meat made me hungry, I ate more of it. My protein consumption rose from about six ounces a day to eight or ten ounces. I’ve since learned that extra protein makes me very tired.
  • I ate in a slightly calorie deficient way in France. I always had energy as a result. But back in the UK I couldn’t keep it up.
  • I think I really needed some sunlight.
  • I was happy and I felt like I was ‘on holiday’ when I lived in France. Back in the UK it was like being flung back into my old depressing life again.
  • I stopped taking vitamin E and replaced it with vitamin K1.
  • In a desperate attempt to cure myself I had tried all sorts of things like B vitamin megadoses and eating lots and lots of liver and fermented products – the Weston A. Price Foundation’s fault – I blame the crying on those. I was eating kefir and sauerkraut most days. I got a juicer and started making green juices because I thought I needed some vitamins that maybe hadn’t been discovered yet.

Poor me. I started putting weight on, and putting weight on, and I couldn’t figure out why. I was very scared that there was something seriously wrong with me. There was – fibromyalgia is very serious. Unfortunately it’s very difficult to get genuinely trustworthy information about it on the internet so I tried all kinds of crank cures. I had no idea I was being affected by food chemicals. Though I certainly felt poisoned by something.

Written by alienrobotgirl

3 May, 2005 at 12:32 pm

Posted in My History

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