Laura Schoenfeld wrote a guest post for my blog called “Is a Low-Carb Diet Ruining Your Health.” Perhaps not surprisingly, it caused quite a stir. For reasons I don’t fully understand, some people identify so strongly with how many carbohydrates they eat that they take offense when a suggestion is made that low-carb diets may not be appropriate for everyone, in all circumstances.
In these circles low-carb diets have become dogma (i.e. a principle or set of principles laid down by an authority as incontrovertibly true). Followers of this strange religious sect insist that everyone should be on low-carb or even ketogenic diets; that all carbohydrates, regardless of their source, are “toxic”; that most traditional hunter-gatherer (e.g. Paleolithic) societies followed a low-carb diet; and, similarly, that nutritional ketosis—which is only achievable with a very high-fat, low-carb, and low-protein diet—is our default and optimal physiological state.
Cut through the confusion and hype and learn what research can tell us about low-carb diets. #lowcarbdiets #myths #truths
On the other hand, I’ve also observed somewhat of a backlash against low-carb diets occurring in the blogosphere of late. While I agree with many of the potential issues that have been raised about low-carb diets, and think it’s important to discuss them, I also feel it’s important not to lose sight of the fact that low-carb diets can be very effective therapeutic tools for certain conditions and in certain situations.
With this in mind, here are 7 things I think everyone should know about low-carb diets.
#1: Paleo Does Not Equal Low-Carb, and Very Low-Carb/Ketogenic Diets Are Not Our “Default” Nutritional State, as Some Have Claimed.
Some low-carb advocates have claimed that most traditional hunter-gatherer societies consumed diets that were very low in carbohydrates. I’ve even seem some suggestions that nutritional ketosis was “the norm” for these cultures.
These claims are false.
The majority of studies have shown that traditional hunter-gatherer (HG) societies typically consume between 30–40% of their total calories from carbohydrate, though the range can vary between 3–50% depending on the population studied and the latitude at which they live. (2, 3) The only HG societies observed to eat fewer than 20% of calories as carbohydrate were those living at latitudes quite distant from the equator, often in marginalized environments where fruits, vegetables, starches, and honey were not readily available.
Yet even these cultures—such as the traditional Inuit—often made an effort to obtain carbohydrates from berries, corms, nuts, seaweed, and tubers whenever they could, as Richard Nikoley has recently detailed on his blog. What’s more, contrary to popular claims, studies have shown that it’s unlikely the Inuit spent much time—if any—in nutritional ketosis. Their high protein intake would have prevented ketosis from occurring. (5)
So, while ancestral diets were certainly lower in carbohydrate than the diet currently recommended by the USDA (45–65% of calories), they were not typically “very low” in carbohydrate (<15% of calories). With virtually no historical examples of human beings following ketogenic diets for any significant length of time, and few examples of very low-carb diets, it’s difficult to imagine how these diets could be considered our “default” nutritional state or the optimal approach for most people.
#2: Low-Carb Diets Are Incredibly Effective in Certain Situations
Lest low-carb advocates think that I am anti-low-carb, I’d like to reiterate that both the research and my clinical experience suggest that low-carb diets can be incredibly effective therapeutic tools for certain conditions.
These conditions include (but aren’t limited to):
- Overweight and obesity
- High blood sugar, metabolic syndrome, diabetes (both type 1 & type 2)
- Traumatic brain injury
- Epilepsy
- Parkinson’s disease
- Alzheimer’s disease
- Other neurological conditions
- PCOS
I have personally witnessed some remarkable transformations using ketogenic diets therapeutically in my practice. I recall an 84 year-old woman who came to see me complaining of dementia and early-onset Alzheimer’s. She was losing her memory and cognitive abilities at an alarming rate. After just two weeks on a ketogenic diet, this progression not only halted, it reversed: her memory returned, her mind was sharper, and she was far less confused and disoriented. Her family (and her doctor) were stunned, and could hardly believe the changes they were seeing.
Yet as impressive as very low-carb (VLC) and ketogenic diets can be in certain situations, that does not mean that these diets may not have some undesirable side effects over the long term—some of which we’re only beginning to understand. For example, as I discussed with Jeff Leach from the American Gut project in a recent podcast, some preliminary research suggests that long-term ketogenic/VLC diets may cause adverse changes to the gut microbiota. (6) In addition, a new paper soon to be published in the journal Cell by two Stanford microbiologists indicates that diets low in “microbiota-accessible carbohydrates (MACs)” contribute to modern, inflammatory disease. (7)
The phrase “microbiota-accessible carbohydrates” refers to the various fibers found in fruits, vegetables, starchy plants, nuts, seeds, legumes, and other foods that are poorly absorbed by us, but can be utilized as a food source by our intestinal bacteria. It’s worth noting that many of these fibers are found in foods with moderate to high carbohydrate content—foods that would typically be excluded on very low-carb diets.
It’s important to note, however, that the beneficial bacteria-starving effects of ketogenic/VLC diets can be at least partially offset by consuming non-digestible, fermentable fibers like resistant starch and non-starch polysaccharides that don’t count toward daily carbohydrate intake. This is something I recommend to all of my patients following low-carb diets)
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#3: The Fact That Ketogenic/Vlc Diets Work Therapeutically for Certain Conditions Does Not Make Them Appropriate in All Circumstances, for All People
This assumption is a basic failure of logic, but it’s remarkable to see how often it happens. A person has a life-changing experience with a VLC diet, so they assume that their friend will have a similar experience. Or a clinician that works primarily with people suffering from neurological conditions has great success with ketogenic diets, and then makes the assumption that all people (regardless of their health complaints) will benefit from them.
This is akin to saying that since people with hemochromatosis (a genetic condition that causes iron overload) need to limit their iron intake, everyone should consume foods that are low in iron.
The belief that “everyone” will benefit from one particular dietary approach—no matter what it is—ignores the important differences that determine what is optimal for each person. These include variations in genes, gene expression, the microbiome, health status, activity levels, geography (e.g. latitude and climate), and more.
When it comes to diet, there is no one-size-fits-all approach.
#4: Some People Do Better with Low-Carb Diets Than Others
If you understand #3 above, then this should not come as a surprise.
Some people may thrive on a long-term, low-carb diet. I have patients and even a family member in this category. And maybe you’re one of them too. But that doesn’t mean everyone will have this experience. If you talk to practicing clinicians who work with patients on a daily basis, or spend any amount of time in internet forums or the comments sections of nutrition blogs, you’ll find numerous reports from people who either experienced no benefit from or were even harmed by following a low-carb diet.
What blows my mind is that the “low-carb zealots” seem completely incapable of accepting these reports at face value. Instead, they’ll argue that anyone who doesn’t succeed with low-carb is either doing it wrong, cheating, or somehow imagining their symptoms.
What’s the more likely explanation here? That everyone who gets worse with a low-carb diet is either incapable of following directions, weak-willed, or delusional? Or that a low-carb diet simply does not work for everyone? You be the judge.
#5: If a Low-Carb Diet Works as a Therapy in a Given Condition, That Doesn’t Mean Too Many Carbs Caused That Condition in the First Place
This is another error of logic that is often made. Here’s an example:
“A low-carb diet is effective for treating type 2 diabetes. Therefore, eating too many carbohydrates led to this condition in the first place.”
This is like saying:
- Restricting iron is helpful in hemochromatosis patients. Therefore, consuming too much iron is what caused hemochromatosis in the first place.
- A low-FODMAP diet helps patients with Irritable Bowel Syndrome (IBS). Therefore, eating FODMAPs caused IBS in the first place.
- A low-histamine diet alleviates the symptoms of histamine intolerance. Therefore, histamine intolerance is caused by eating too many histamine containing foods.
Or, more ridiculously, since wearing a cast on your arm will help the broken bone heal, the reason you broke your arm in the first place is because you weren’t wearing a cast.
It’s true that VLC/ketogenic diets are effective for improving the metabolic markers associated with type 2 diabetes. But that doesn’t mean that eating too many carbohydrates led to the condition in the first place. It is certainly possible (and indeed likely) that eating too many refined and processed carbohydrates, in the form of flour and sugar, contributes to diabetes. But I have not seen a single study suggesting that eating whole-food carbohydrates (e.g. fruit or starchy plants) leads to diabetes or other metabolic problems. On the contrary, reviews of prospective studies looking at the relationship between fruit intake and diabetes have found that those with the highest intake of fruit had the lowest incidence of diabetes. (8, 9)
It is also worth pointing out that virtually all studies performed so far showing benefits of the Paleo diet in conditions like type 2 diabetes and obesity have used moderate carbohydrate (not low or very-low carb) versions of the Paleo diet.
#6: If a Low-Carb Diet Is an Effective Therapy for a Condition, That Doesn’t Mean It’s the Only Therapy for That Condition
There’s little doubt, as I said above in #2, that low-carb diets can be remarkably effective in certain situations. For example, there are numerous studies showing that low-carb and ketogenic diets can help with weight loss and metabolic problems. (10)
However, that doesn’t mean it’s not possible to lose weight and reset your metabolism through other means. Studies have also shown that calorie-restricted diets, protein-sparing modified fasts, and even low-fat diets can also be effective treatments. (11, 12, 13)
This means that it’s not necessarily true, for example, that everyone with type 2 diabetes should be on a low-carb diet. They may be able to reverse their condition by following a high-protein, moderate-carbohydrate, moderate-fat diet (such as the Paleo diet with 32% of calories from carbohydrate in this study), or any of the methods I just mentioned.
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#7: Whole-Food Carbohydrates Do Not Affect the Body in the Same Way as Processed and Refined Carbohydrates
This should be obvious to anyone with a basic understanding of nutrition and human physiology, so I’m amazed at how often I see experts talk about all carbohydrates as if they’re the same.
In #1 above, I referenced studies indicating that most hunter-gatherer societies consumed about 30–40% of calories from carbohydrate. These carbohydrates came from starchy tubers and plants, whole fruit, and in some cases, honey. We also have evidence of specific ancestral populations—such as the Kitava, traditional Okinawans, and Tukisenta—that consumed between 70–95% of calories from whole-food carbohydrate. (14)
Yet despite this liberal consumption of carbohydrates, these people were remarkably lean, fit, and free of chronic, inflammatory diseases like diabetes, cardiovascular disease, and neurological conditions. (15) If carbohydrates cause these conditions, regardless of their source, why don’t we see such conditions in these groups?
What we do see is that these cultures acquire modern disease when they adopt a modern diet and lifestyle, complete with the highly processed and refined foods that characterize it.
When it comes to macronutrients, quality is much more important than quantity for most people.
Final Thoughts
I hope this helps to clarify some of the confusion that has surrounded this issue. Low-carb diets are an effective therapeutic tool in certain situations and one that I (and many other clinicians) use in my clinical practice. That said, it’s equally true that low-carb—and especially VLC and ketogenic—diets are not appropriate in all circumstances, and they are certainly not our “default” or optimal nutritional state.
Sadly, it doesn’t seem to matter how much scientific evidence, clinical experience, and common sense is brought to bear on this question: those who preach and follow low-carb dogma will not be swayed. Ah, well. As they say: “You can’t fight faith with facts.”
Low carb worked pretty well for me for a while when I was fairly obese. I lost fifty pounds in six months. But toward the end of this time I became steadily weaker and sicker. I ended up in the hospital with bradycardia caused by a potassium deficiency. They put me on a high potassium diet (which had a lot of carbs in it) and I lost several pounds in just a few days.
Every time I have tried it since I have had some kind of health problem that has started up really quickly, thyroid issues, heart slowdown, kidney problems – plus my weight loss stopped. I am on the borderline between being obese and overweight now and I switched to a regular low-calorie diet and immediately felt better and resumed losing weight. Perhaps this sort of diet is really meant more for people with a lot of body fat, or people without some of the health issues I have. For the record, I never gained back any of the weight lost on the low carb diet, and it did appear to be all or mostly fat I lost. It was really hard on my health, though.
I too get low potassium so just wondering what kind of high potassium diet they put you on?
Interestingly, I am experiencing the similar situation. I have been on a no carb no sugar diet for almost 6 months now, and have lost 10kg. I seemed to be getting thinner despite doing high intensity interval exercise. I do however take a lot of vegetables, especially green leafy ones to ensure my body gets enough trace minerals.
I need to go into weight maintenance but most articles I find are really for weight loss rather than maintain.
I wonder the long term effects of being on this diet and if it is sustainable in the long run. My friends are already concerned with my drastic weight loss.
Jonathan, If you are trying to maintain, I suggest you start looking into carb cycling. There are many articles on the web and videos on youtube about it, and I believe it is the best way to maintain the weight while maintaining optimal hormonal health.
Props for your weight loss !
If you’re concerned about just maintaining, eat more food. And zero carb is not sustainable.
Just use Morton’s Lite salt. It’s 50% potassium. Buy it in any grocery store.
If you do low carb diets or keto, you need to take potassium supplements. I noticed I would cramp a lot when on low carb, so I started taking a potassium supplement and no more cramps.
One result of low carb, particularly if you are in ketosis is that your body will expel excess water like an open faucet. I’m not a Dr, but I do have years of experience with low carb. I think the fact that you are constantly expelling fluids you automatically deplete minerals, including potassium. This is one of the benefits of keto that I like, as it takes the puffiness out of my face and makes me look much leaner. Body builders will use low carb at times to get as cut and lean as possible. Try drinking more fluids too, although you will likely take lot’s more trips to the toilet as well. 🙂
If I don’t take a potassium supplement, I can’t function when really hitting ketosis hard, so this is probably a common problem for many that stay on low carb long term. With the supplement, that solves my problems and I just keep on trucking.
Over a month consistent, I think it’s a good tool. I feel like I have benefited from it in a lot of ways, but there have been some ongoing setbacks. Lower energy then when on carbs, and major constipation. Maybe it’s personal and not directly related I don’t know for sure. I think it’s good to cycle through a low carb diet. I would like to hope, and agree as long as the majority is essential good quality whole foods we should be bueno. Just try not to have those modern, refined, and processed foods in your diet. If you do, use it like a very occasional drug. Beast, feast, and fast
Very interesting site. I have been following a low carb diet for 2 years post breast cancer. This wasn’t intentional re carbs but felt better doing the blood group diet. I am blood group O positive. However the backlash was insomnia. Sometimes no sleep at all plus a gnawing empty (but not really hungry) feeling which although not painful was very discomforting. I always try to heal with food and my body said ‘eat more carbs!’ To all those people suffering insomnia, and there are many, please look at your carb intake, what type how and when. I sleep so much better have more energy despite previously having a text book diet of organic veg fruit nuts seeds and meat plus oats. I just wasn’t having enough carbs. Yes I’ve put 2lb on my permanent 9 stone 7 but I can modify that by gradually tapering the carbs to a suitable level. It’s all about a BALANCED diet and whoever said one size doesn’t fit all is so so right. You truly are what you eat and just stuffing any food down is not conducive to good health. Your body does communicate with you in different ways, listen to it ?
Hello Magsa,
I am on alow carbs diet ( eating only broccoli and meat ) and I am waking ip always around 1:00-2:00 am. I am thinking it’s because of my low carbs diet.
What carbs do you consume for dinner?
I am on a low carbs diet, high fat, high protein. eating broccoli and meat also. I wake up at about 2:00 on the dot every night, I thought it was due to my 4 year old waking me up. Or going to sleep way to early. Casein Protein before bed is recommended to help sleep. My joints have stopped cracking I have been doing heavy working out.. so I have not lost much weight as I gain muscle.
I couldn’t agree more with you. I used to be very scared of carbs, after having lost a lot of fat on a low-carb diet, I thought that just a few carbs daily would instantly make me fat again. But I’ve lost so many nights of sleep due to my stubborn diet. Today I eat a healthy balanced diet, low-carb in the morning and high-carb in the evening
I am gluten intolerant and consequently eliminated wheat products from my diet. I have never liked rice and potatoes so inadvertently, I have been following a low carb diet. After a whole I began losing my memory and my hair started falling out. I did some investigation and found memory loss can result from low carb intake and increasing my carbs restored my memory. I am hypothyroid but other than the hair loss, symptom free. I have just recently started increasing my carb intake so I will have to wait and see what it does for my hair. Here’s hoping!
Great site; new here. I’ve been eating a veggie, low-carb diet for 40 years. Originally lost 100 lbs and I haven’t looked back. I hike, ski and act crazy with my grandson. Life is good and my food is easy and crunchy. I grow much of it.
Thanks for your site.
I found this article facinating, not least because of my despair at being only able to lose a few pounds on a LCHF diet (I am over 60 years old). Since I started it about 2 years ago I have had two new medications for high blood pressure and also have a persistent cough, whilst my husband, on the same diet, has lost about 60 lbs, and no longer takes medication for diabetes or blood pressure. This article perhaps goes some way to explaining “what I am doing wrong.” What a pity it doesn’t tell me what would be right as I think I. have tried everything else, includinf fasting.
I think most of us at one point or another subscribe to a one-size-fits-all approach to nutrition. Seeing my roommate doing well on a super high protein, low fat, low carb diet, while working out twice a day and feeling great made me to decide to give it a go.
Adopting the same lifestyle felt great at first: started really leaning out (though I had a plenty health composition before), felt higher energy, and frankly had an air of pride around me for being disciplined.
After a couple weeks, I started to notice various symptoms: hands and feet were chronically cold, hair and skin looks and felt less elastic, scalp became noticeably inflamed, I had difficulty concentrating, I was irritable, zero libido (horrifying for a 20-something male) and my sleep quality was horrendous. It because unbearable, so I started ready Kresser’s and Roddy’s respective works.
I started testing my body and was alarmed to see my basal body temperature was 96.8 degrees on a good day and my pulse was in the mid-50s. the temp would slowly raise but never get to 98.6 unless it was right after a workout.
I readjusted my diet to include more carbs (including plenty of sugars) and instantly felt better. I even had some ice cream before bed and I can remember how deep a sleep – lucid dreaming and all. Now I’m doing roughly a 50% carb diet and it’s great. My abs aren’t chiseled anymore, but I *feel* good. I’ll never ignore my body’s signals ever again.
I get kind of tired of the, were our ancestors low-carb or not argument.
The fact is that almost all hunter-gathers, both the few that exist now and our paleolithic ancestors of 11,000 years ago and more, lived CYCLICAL, SEASONAL LIVES with periods of dry-season or winter, and periods of lush vegetation, fruit and water-logged roots and tubers.
They MOST CERTAINLY, therefore, lived through extensive periods of low-carb, where hunting supplied the mainstay!
The BEST thing that you can do for your health, regarding the percent of carbs is to re-enact that cyclical/seasonal life for yourself!
No true. Depends on latitude. Most of our ancestors lived close to the equator WHERE THERE ARE NO SEASONS. Also, significant portions of that time had much highly global temps, causing less seasonal affects.
Hey there,
can I gain muscle mass on low-carb diet? Is there anybody who already did this?
I am 185 cm tall and I weigh 70 kgs, so I am slightly underweighted. I have about 6 % of body fat on myself.
I want to gain like 5 kgs 🙂
Would you do this diet if you were me?
Thank you for your answers.
Absolutely you can!
Google and read about “Todd Kuslikis” for one. When he ate the “Standard American Diet” he could NOT gain weight no matter what, even when he spent a lot of time in the gym. When he switched to low-carb and isometric exercises, that fixed him right up!
Just to get off on the right foot, I am not against any way of eating that keeps people at a healthy weight, and is sustainable in that one can eat that way 80-90% of the time. I noticed that the blogger was really having a go at low carbers for their almost religious fervour, on low carbing> Well I read quite a few of these blogs, and you can bet their is someone on there who is a vegetarian or a low fattter who is decrying low carbs, loudly and clearly, as being from the devil, (almost). There is room for many types of diets, depending on our bodies, illnesses personal beliefs, etc. I have a cousin who is a vegetarian, I believe he eats fish, now that seems fairly reasonable to me. I think low carbers who eat only moderate protein high fat and high vegetables is also reasonable. Unfortunately some people through their belief system think vegan is the only sustainable way to eat, and maybe it is so, I don’t think so myself. 70-120g of protein is not a lot of fish or meat to get to that number, in fact dairy, beans, and whey or vegetable protein powder gets you there easily, without harming any animal, and can be done without feed lots, look at New Zealand, who are only now starting to build feed lots, through greed. the rest of your diet can be made up with either high fat/oils,and high vegetable/fruit intake. if you are a vegetarian you can add grains, if thet don’t cause harm. So lots of scope there without tring to put a downer on sanyone who is trying to beat the weight/metoblic/ any other disease that may stop them from putting on weight, or having their particular ailment. Cheers.
sorry about the typos, getting a bit blind at nearly 70 years of age Cheers
I’ve always lost weight on a low carb plans. As a vegetarian with T2 diabetes, a high fat – low carb diet works best for me on a long term basis, but I need my daily dose of “bread” made from coconut flour & psyllium husks, cream and plenty of calories from butter, eggs and cheese. If I go down too much in calories then I have no energy for my workouts and feel really bad. I can eat fruit and honey on cheat days, but only do so only on rare occasions. I use stevia instead of sugar and drink lots of water.
has anyone mentioned that carbohydrates cause tooth decay should we be eating something that feeds the plaque and whose acids corrode our teeth
What you’re saying is intuitive, but I think it falls under the “appeal-to-nature” fallacy. What paleo and low-carb advocates don’t acknowledge is that there is no perfect natural food. We humans are not perfectly adapted to our environment. We are acceptably adapted for survival.
That’s to say that it’s possible for a given diet to be the best for our teeth but not for our gut, or our metabolism, or our nails and hair. There is no one ideal diet for everything. Maybe very low carb diets are the best for our teeth but not for anything else.
John what are your qualifications, or where are you getting your superior knowledge from to say low carbing may be ok for teeth but not for anything else. Did you know that carbs are not an essential, macros? Water, protein, and fat are essential, without them we quickly die. Alow carb way of eating, can be anything from 20g net carbs, to 150g carbs, a very low carb diet is a “ketogenic” diet, so a diet with 30% carbs and 30% protein leaves 40% fat, now could I keep my gut health etc eating that way? me thinks yes. Cheers
There’s a lot of stuff out there on low carb, but no one seems to
stick with it. What do you guys think of this article? http://totalbodyblueprint.net/2015/10/17/why-paleo-fails
I have been on a low carb/ketogenic diet for almost 16 years. It is possible to stick with…very possible
Of course it is Mary, but you are just not allowed to tell everyone, it is the only way, only the vegans are allowed to do that. And I am happy for you keep it up. Cheers.
I totally agree….it is a lifestyle of eating. I have been on LCHF for 8 years. I have regained engird and youth. I also have lose over a 5 year period 80 pounds!
After 3-1/2 years on Paleo, AIP and a lot of money spent with a Functional Medicine doctor and a ton of supplements, I finally went Ketogenic. While I haven’t lost much weight, my mind is clear, I have tons more energy and my stomach issues are virtually gone – they come back as soon as I eat off-plan carbs (and I am saving a lot of money by ditching the expensive supplements). I’m not saying this is what everyone should do, though I’ve learned a lot in the process. We each have to find what works for ourselves. For me it is very (very) low carb. N=1!
i have been on a modified keto diet for over a year. it has helped anxiety and weightless form poorly prescribed meds that damaged me. i have mthfr and besides other mutations, my neurotransmiiters are mutated, filled with glutamate generally.
i take lots of probiotics but i am not a fan of vegies or now, meat. why have i lost my appetite? any ideas?
Three years a go i was diagnosed with PCOS and i have been in search to cure myself naturally ever since. Tried a lot, and finally started up a cycle of 90 days, then 60 and then 40. And then i fell of the wagon. In November I started eating Paleo, very low carb. I felt amazing and got my 40 day cycle back. The last three weeks my fatique came back, a long with pain in the ovaries. And im still waiting for my period, 50 days now. Two days a go i added back carbs. White rice, sweet potatoes and fruit, to a max of 150 gram. I stopped Intermittent Fasting and eat three to four times a day. I also started taking supplements, kelp, ginger, turmeric, krill oil and d-chiro inositol and boy did i feel different almost directly! My cystes are hurting for like a minute and then they dissolve in fluids. I think very low carb did help me get my hormones back on track. Lost weight too: about 8 lbs, now down to 142 lbs. And i believe that when my body was restored, it needed to get back to ‘normal’ eating. Let’s just hope i’m right, it is such a struggle!
You should eat low carb high fat and then your symptoms will resolve over time… I have PCOS and I do a so called Carbnite style diet… Through the week I eat moderate protein, high -ish fat, and lots of low carb veggies (greens, peppers…). If I’m hungry through the week I’ll eat one meal mid week with some potatoes for dinner. Then on weekends, I reduce fat intake to half of that on my weekdays for the day and eat up to 200g of carbs in the evening (late lunch, dinner, late snack)… I don’t go too crazy with calories. Plus take inositol + nac + folic acid…
I need help with a concern I have about being in Ketosis for myself. I’m not sure where to put it and this thread seems best and Chris has become my trusted source.
I have kidney damage from a baby. Doctor’s said I have about 60% use of my kidney function. I have a lot of other health conditions that I am unraveling and trying to get better from my younger life. One of them is obesity related to Hashimoto’s. With my change to all-natural living in the last 3 years I have found that the only way I lose weight is either pregnancy (and I’m done with that) or ketosis.
My concern is every time I’m in ketosis (for me organic, high-fat 130+g, mod-protein 90g, low-carb ie 25g net) I get low back pain, strange sharp phantom pains in my ankles and toes (worry about gout?), and heavy thirst and urination. I know the thirst and urination are norms in ketosis. I was under the impression the worries for kidneys in ketosis were if you ate high-protein. Yet, my gut instinct and anxiety make me wonder if I’m in trouble being in ketosis because of my original kidney damage. The idea of taking away this form of weight loss from me is so disheartening but I don’t want to end up hospitalized and feeling stupid either. Any thoughts?
I have one kidney with CKD, (lost the other to cancer) now at fluctuating 35%-28% function..not good, but I am 66…the best thing I can do is lose weight to unburden my kidney. So a <30 carb a day diet allowed me to lose 29 pounds in ~6 months, and I plan to stay eating <50-70 carbs for life. I gain quickly and am hungry if I try low fat. But I do well and am satisfied with ~100-130 gr fat, low protein at 40-50 gr at 1400 LCHF calories.
NO USDA trained RD will allow you to eliminate or reduce carbs, I just sat thru a lecture on eating bread and cereal for breakfast!!!!..of course this will kick me out of ketosis, and I WILL be hungry. So my choice is ALL fresh cooked foods, lots of veggies, SOME fatty meats- eggs, nuts, cheese- butter and coconut oil.. Carbs in veggies are ideal..the body knows what to do with them. Eliminating ALL processed foods/packaged stuff is best.
I found Hempseed protein is ideal- has all 8 essential amino acids needed..just like MEAT…without the strain on my kidney to process the ROS "wastes" of meat. for a kidney too much protein is as bad as too much sugar.
Find a LOW CARB RD to talk to..the rest are useless and are forced to promote 45-65% carbs a day. period. ANd they ALL believe butter causes heart disease..still..My Nephrologist, urologist and RD all stick to the party line.
You’re so right; you have to find someone who keeps up with things and believes in low carb solutions. The one nephrologist that I know who is a huge advocate of low carb and intermittent fasting is of course, Dr. Jason Fung. Best wishes..
while i don’t have an answer to your query i can sympathize, i had kidney damage from pregnancy (and this was 20 years ago bear in mind). i have tried ketosis twice now and both times have suffered similar symptoms to yours. what i found helped was just raising my carbs to just around the 50gs a day (some days i would still be under) and this cured the pains. i would be out of ketosis but only just and sometimes still registering on my blood meter
good luck
I would wager intellectually, that you are experiencing symptoms of mineral deficiency, especially magnesium. The frequent urination, which is good, is washing away your minerals / electrolytes , so they need to be replenished. You probably are also low in potassium since you need magnesium to regulate potassium.
Sorry I don’t have any insights on your ketosis quandary, and sorry to hear about the kidney damage, though it reminds me of the story of how the founder of Mountain Meadow Herbs healed her toddler son’s kidney damage with herbs. You might check out their kidney formulas (they are glycerine tinctures). He was about to need dialysis and then a kidney transplant when he was old enough for one, but she got his kidneys back to functioning well enough on their own with the herbs!
MACs = prebiotic foods??
Dr. Kressner, you are a life saver. I have been low carb since 2007 and initially I felt a miraculous turn around given that I couldn’t seem to break down carbs. At the same time my doctor prescribed dessicated thyroid which I couldn’t raise past 25mg. Two years later my health began to continuously decline until recently when I read some of your articles explaining that low carb shouldn’t be long-term and was not for everyone. I attempted to add complex carbs back into my diet while simultaneously raising thyroid medicine and I was finally able to raise successfully and significantly, thereby addressing my thyroid and I discovered that I was now able to tolerate carbs. After all these years and many doctors, none were able to make the connection between inability to raise thyroid and this low carb diet I thought I HAD to consume out of inability to break down carbs. Talk about a catch 22. You truly are a HEALER and I hope that more doctors in the medical community are enlightened by your true expertise. Thanks again for this life-changing information.
I’ve been doing low carb for 10 months. First of all lost weight felt great and thought I had cracked it. Was lean, alert, energetic. Recently, although I have not changed my eating habits, the weight has returned and so has my stomach bloating. I read recently that low carb diets slow your metabolism? I’m not sure how to kick start my weight loss to get the kilos off again? Thoughts?
I believe Low Carb can be very effective in achieving weight loss. I am living proof having lost nearly 20 pounds in the last year due mostly to following a low carb diet using a meal replacement shake the ensures I am getting my vital nutrients. And of course, exercise 🙂
I think it’s important to keep in mind that Paleolithic Man ate “Paleo” from birth, as did their parents.
There’s a distinction to be made between how we should be eating as a society (from birth) and how I should eat to RECOVER from (or attempt to reverse) conditions brought on by poor eating and a toxic environment combined with my genetics.
i have been a ‘low-carber’ for about 4 years and will be for life. Really, I’m low carb + red wine, I enjoy a glass or two of red wine daily and sometimes more. I am not slim, but I am lean for my height and weight and I feel fabulous. I lost about 40lbs initially, and now probably lose about 4 lbs a year. All of the health benefits that are described by the advocates of low carbing happened to me. My blood pressure went down from dangerously high to normal, no medication. My GERD disappeared virtually overnight (before I had lost any significant weight) I am now medication free and literally never have heart-burn / indigestion. My IBS, similarly, disappeared within a fortnight. I have never experienced any negatives, my skin glows, I have good energy. I have a small appetite (linked, I believe to prevention of the highs / lows in blood sugar / insulin levels) and I have never felt or looked better. So I eat real food, good quality protein, unrestricted healthy fats and salad / leafy green vegetables. And it’s brilliant. I do not know why the low carb diet attracts such negative attention, for me it has been a life changer / life saver!
Firstly congratulations!
I have been doing low carb for probably about a year due to pancreas issues and a diabetes scare! Initially I lost a lot of weight and now plateau which is fine I am happy with my eight but I am not feeling as healthy as I did a year ago? I constantly have tummy aches and feel so sluggish. I am afraid it’s dairy! I am guessing. The dairy has inflamed my gut. I don’t think I have too much dairy but now when I do think about it, all the sites that I get my low carb recipes from always use cheeses and creams .
I’m curious to know how much dairy you have?