39. It’s my age. It was also my fasting blood glucose this morning. Dangerously low.
Let me backtrack a little bit. I’ve been playing around with a shorter term version of nutritional ketosis (NK) again, for a few reasons.
1. I’m part of a biggest loser style competition with some friends that ends a week from Monday and I found out I was 2nd and within spitting distance of first. And first is my husband. Yeah. I’m a pretty competitive person, so I decided to gun for him.
2. Before I quit my previous bout with NK, I had been reading some on the possible cancer fighting & cancer prevention aspects of a ketotic diet. It’s some interesting stuff, but it was looking like that would require a higher ketone level than I had achieved (at least since I was tracking it via a meter). I wanted to see if that was possible for my body.
3. I also was curious to verify some things I had suspected about how coconut fats affected my ketone levels.
But I wasn’t really going to blog about it here, because I’d like this blog to be more generally about eating a moderated sodium paleo diet and awesome recipes, not really my personal diet diary. And then this morning I woke up severely hypoglycemic. And I think this is something that should be discussed in public.
Basically, I had been doing something very similar to my eating through January and most of February. Around 50 grams of total carbs a day, 35ish net carbs (subtracting fiber), cutting back calories by 250 a day. Nothing extreme. And then after a few days of the normal plan, I was going to take 4 days and do a very high coconut version of this same plan… coconut custard for breakfast, coconut curry soup for lunch, a snack of dried coconut and then one of my normal dinners to see if that did anything extreme to my ketone levels. Wednesday was day 2 of the coconut plan and frankly I wasn’t very hungry that day, so I undershot my calories quite a bit (probably a 500-600 calorie deficit rather than 250), especially since it was a training day. I felt fine that evening, but Thursday morning I woke up and I was HUNGRY. I was in ketosis, but my body was clear that I needed MOAR FOOD (ketosis is not a magical hunger suppressor, if it was, humans wouldn’t be motivated to look for sufficient food and we would die). I ate more that day, but still kept my carbs down (31 net carbs) and that evening when I tested ketones it was the highest ever at 2.6. I was feeling a little off even before bed though. When I woke up this morning, I felt fairly sketched out and had a gut feeling to use up the last of my glucose test strips to test my fasting blood glucose. It read 39.
Yeah. That’s dangerously low. The recommendation for cancer patients who are trying to starve a glucose dependent tumor is 55-65. I was well below that. And it’s not like I had a day planned of lounging on the couch. I was going to take my son to the pick-your-own strawberry farm to see the Easter bunny and play on farm equipment, and then in the evening I had a trapeze class planned. It would have probably been unsafe for me to even operate my car when extremely hypoglycemic, much less run around in the hot sun hunting eggs. So I supplemented my coconut custard with a couple tablespoons of cooked rice and felt a little better. I waited about an hour and still didn’t feel totally right, so I mashed about 1/2 a banana into some full fat yogurt and slowly ate that over about an hours time. By the time I finished I was back to my usual self. I’ve carried on the rest of my day as planned foodwise, except I enjoyed a couple strawberries with my son, without a care for the extra carbs.
So what happened? Well, given my extremely poor reactions to super low carb diets in the past, and my adequate, but not excessive protein intake this round (average 82g a day), I hypothesize that my body is less efficient at most than converting protein to glucose. I haven’t been taking in enough carbs to cover my brain’s minimum needs, I’m not carrying any extra in my liver, and my body is doing poorly at making enough from the few extra grams of protein I have laying around. Now this isn’t a hypothesis I want to test in any way shape or form (unless someone can do it in the lab without me having to drop into hypoglycemia again) because frankly it just doesn’t feel healthy to keep messing with it. Chasing deep levels of ketosis is not for me. Dr. Georgia Ede has asked,
“For people without cancer or seizures, who are just using this diet to lose weight, improve function/performance, manage mood swings, or manage appetite, does the degree of ketosis matter?”
And I think for me, it doesn’t. I saw benefits from mild ketosis in the 0.5-1.2 range, and my body has problems higher than that. Today, I clocked in at 86 total carbs, 66 net, and after trapeze class I got a 1.1 ketone reading. That’s pretty reasonable, I feel fine, not hungry and not messed up in the head. I see no reason to chase higher ketone levels, I do not believe they are “therapeutic” for me.
I want to bring this up publicly because I may not be the only one out there who can have this kind of reaction. Yet I see many places people talking about how zero carb and very low carb diets are safe. They may work for some people but be unsafe for others. If I had been in Steve Phinney’s bicyclist study, I would have been pulled out of the study as an “adverse event” with glucose that low. My advice in this situation is not to avoid a reduced carbohydrate diet, nor to avoid ketosis at all costs… but if you are chasing ultra high ketones for a particular performance or therapeutic reason, please double check your blood glucose from time to time to make sure you’re not so depleted that you can’t keep your glucose in a healthy and appropriate range.
Incidentally, I have one Meniere’s symptom that varies a lot with my seasonal allergies, the “fullness” thing in my bad ear. It feels like an ear infection, but without the sharp pain… all the time. For me, this is actually more irritating than the tinnitus, since my brain has learned to tune out the tinnitus most of the time, whereas I can’t shake the uneven feeling when my ear feels full. My allergies have just started to act up this year and my ear was bugging me, within a couple days of popping back into mild ketosis the fullness diminished quite a bit. I think the changes in sodium metabolism that come with ketosis have the same effect on me as diuretics do, without dropping my blood pressure like the meds would. It’s handy to know for when the fullness gets out of control. The more control I have using my diet the happier I am.