I just recently had a full blood profile done, and it states that my glucose is 90, with the normal range being 75-110mg/dl. My question is this: for 8 weeks prior to this I had been adhering to a very strict keto diet, with my only carbs coming from 1 serving of macadamia nuts and 1 cup of cottage cheese (15 or so carbs daily) with a carb-up every Saturday until 4pm or so. Now, the blood test was given on a Friday, and in addition I had been fasting since 6pm the preceding evening, in which I only had 1 cup of cottage cheese with 1tbsp. of flax oil. So, what exactly is this telling me? Is my blood glucose unusually high for someone that has followed a moderate-high protein intake and high fat intake? Or does this mean something entirely different? The reason that I ask is when I had it tested roughly a year ago I was eating close to 40/30/30-like, and my glucose was 79. Can someone please explain?
Any keto experts out there? This is something that I am really concerned about? Can someone offer an explanation?
Dude, you’re fine. Your levels are normal, your glucose won’t be below 50 or 60 unless your taking insulin or have a beta cell tumor.
According to CKD guru Lyle McDonald, “To achieve sufficient glucagon concentrations for ketogenesis/lipolysis, blood glucose levels must drop to around 50-60mg/dl and insulin must drop almost to zero. This drop in insulin can occur with below 30 grams per day (which I clearly had been doing). Within about 3 days of carbohydrate restriction, blood glucose will fall below 60mg/dl, insulin levels will drop to zero and glucagon levels will increase causing an increase in KB formation.” What do you think about this? Is this why some people do well with CKD diets and others don’t? Where is my blood glucose coming from?
Racer: I can’t explain but I can add fuel to the fire. I am an insulin dependent diabetic, living in UK. Our units of measure are different to yours so I’ll quote mine with approx U.S equivalents in (). Now normal is say 4 (90) and Ketosis is in theory at 2 (50). When I go low-carb, I go ZERO CARB and I mean virtually ZERO. Max 5-10g per day. At that to maintain a “Normal” level of 4(90) I need to take about 16iu at night and 12iu in the morning of slow acting insulin. What does this tell you. It means as you correctly state, that the glucose is coming from somewhere else, ie the Liver. OK. How do we stop it? The theory is Metformin. Well the theory is fine but read the label on Metformin and it says that it “only works in the presence of insulin”. Thus if the body is not producing insulin then Metformin don’t work. Now note the logic. With modest insulin being produced and the liver not producing glucose guess what? Thats right, your blood glucose levels plummit. I have the greatest respect for both Dan Duchane and Lyle McDonald, but on this point, they both have it wrong. Is this important? Well, yes and No. Take the Metformin (you really must do this). If your sugar levels don’t drop then your not producing insulin and guess what? your possibly diabetic. If your levels drop, then BINGO. In my case it can be made to work like this. When on a low calorie diet, I have no problem keeping the sugar level low, I just add more insulin to the Metformin dose as reguired. On a low-carb mass gain diet, it don’t work. Probably due to excessive insensitivity. The high fat levels slow down the insulin to a virtual standstill. Quite honestly, whilst on high fats, say 300+ g per day, I could pump in insulin all day and it would have no effect. How’s that. Reply if you wish to discuss further. For now, get the Metformin, Ketosis (or even low blood sugar) won’t work properly for anybody without it and if you hav’nt got low blood sugar, you are only kidding youself if you think you are burning fat. Really, when you are at 2(50), you will feel absolutely whacked out. Lyle is correct on this point. How he rode his bike, I will never know.
Graham
Last time I checked Lyle was not an endocrinologist. Your glucose will not fall below 60 no matter how much you lower your carbs because glucagon will be secreted and raise your glucose above that level. Your glucose is higher because you have less insulin in your system causing a reflex increase in your glucagon levels which then will increase your blood glucose into normal levels. Enough said.
JJ and Chris S: Thanks for the input and the help on this matter! It is good to know that this board is alive with quality people who care!
Graham: I just read your post and now I am really hoping that I am not diabetic. Do you have any other explanations for how anyone manages to get into ketosis without the use of metformin and slow-acting insulin? How about the glucagon theory by JJ? It sounds pretty logical to me, as it is what I thought may be happening? Give us some more feedback. You seem to know your stuff.
Racer. JJ is absolutely correct. He is in fact saying the same as I am. The subtitiles are as follows. What the Liver holds is glucagon, as JJ says. This is the bank supply of energy, what the body uses to convert into glucose to keep a more or less consistent blood sugar level of 4 (90). If you follow Dan and Lyle’s argument as follows. In reverse order, at the friday workout, by using extreem high reps etc we are trying to drain the last drops of glucagon from the body as the prelude to the carb-up. Fine. But this assumes there is already glucagon there, else why would be need to drain it. If there is glucagon there and we don’t use Metformin to stop the conversion to glucose, how can we be burning fat. We can’t. So either, you use Metformin, or you run, or exercise a lot and use up the glucagon very quickly. Problem with that is, you may lose muscle as well. Keep the questions coming. I’ve often wondered if this subject is worthy of a paper for T-mag. What does Chris, TC think? Graham
Another thought on this one. (1).Bill Roberts, on a seperate post a few days ago, hinted that in his opinion, using less than 100g a day of carbs was low enough to produce Ketosis even though it did’nt show on the Ketoxtix. Well I don’t agree!!! Dangerous ground here boys. Well, in my HUMBLE OPINION, and I’ve done all the tests on myself you do need to go low carb.
By using 100g per day you will be secreting insulin and you will still have a storage potential unless you are using all the energy up.
(2) If you use say Clenbuteral, again as I have done to help the fat loss, you will induce additional insulin insensivity, ie more insulin will be required to keep the blood sugar level low and guess what. More insulin means more possible storage. In dieting for fat loss, you do not want storage of any sort. Mass gain is a totally different senerio. Graham
One last point Racer. Don’t go away with the impression that you may be diabetic. There are various degrees of this condition. Like me, some people don’t actually produce any insulin at all, some people produce some, but most produce the heap. Of these, the principal problem is insensisitivity to their own insulin. That degree of insensisitivity can be anything you like. A perfect individual would be so sensitive that their blood glucose levels would be virtually ststic at say 4 (90) whilst others would see it wander about all over the place. The way to check is this. (1) When you return to a normal diet wait a day or two then do this first thing in the morning. Take a blood sugar reading when you get up. Mix 75g of pure glucose in a glass of water and drink it down. Take readings every 30 mins for 2 - 3 hours and look at the results. IF the readings shoot up quickly and continue to rise you are like me. If the reading rises slowly then flattens and falls slowly, you have a degree of insensitivity. If the reading is constant, you are perfect. Only if the reading exceeds 10(250) would you need to see a doctor. How’s that? Graham
Graham: Have you heard about the new drug glucovance? It is made by Bristol-Myers Squibb and combines glucophage(metformin) and glyburide together in one pill. These two drugs work together to improve the different metabolic defects found in type 2 diabetes. Glyburide lowers blood sugar primarily by causing more of the body’s own insulin to be released, and metformin lowers blood sugar by helping your body use your own insulin more effectively. They claim that it is proven to lower blood sugar better than anything else on the market. What do you think?
This is getting interesting, but hellish dangerous. Correct me if I’m wrong here, but are we advocating that it is necessary to drive down our blood glucose levels by external methods in order to really guarantee that we enter fat burning mode. If that is the case, surely we are treading on extreemly dangerous ground. John Reynolds
Being that I too am a diabetic, on insulin continuously, I agree with most of what Graham is saying. However I have certainly not taken it so far. Could Graham elaborate further on the risks associated with his suggestions and are these risks (if there are any that is), the same for diabetics, non-diabeticas and those in-between.
I do agree that this is a change of direction in the forum and is a change from the usual stuff on anabolics. Maybe Graham should do a full article on the subject. What about mass gain, what are the principals there?
Graham, the liver holds glycogen not glucagon. You have the terms mixed up. Glucagon works the opposite of insulin and is important for the mobilization of proteins/amino acids. The aminos are then converted to glucose in the liver via gluconeogenesis. This is necessary because the liver glycogen is already depleted while in ketosis. Also, ketones are produced when consuming less than 100g of carbohydrates. This is fact, and I have stated it many times on this board. If you produce ketones you are in ketosis.
John U. is partially correct. Without getting bogged down in the medical issues here, it is glucagon which stimulates the rise in blood sugar levels. Remembering the many and varied feedback loops within the body, there are many ways in which the body will want to continue burning glucose for energy before it has no option but to burn fat. Remember, that most of us take 4 or 5 days to get anywhere near Ketosis the first time, this is valid. Referring back to Lyles well documented diaries, he rode his bike something like 25 miles a day. Why do you think he did that? Check the medical sites for info on glucagon secretion, but the fact is that both it and adrenalin cause rises in sugar levels. The critical issues are
(1) Check your sugar levels regularly. If you are over 50, then you are not burning fat. PERIOD. That does’nt mean your not loosing weight, but we are taking fat burning here.
(2) If you are showing Ketones on the stix, then that speaks for itself.
Racer, any further comments. Why not ask me how to bulk up using similar methods of insulin misuse?
Graham: I am really interested on what you think of the comments I posted about the drug glucovance and if it would be more beneficial to establish ketosis. Also, since you mentioned it how does one bulk up using similar methods of insulin misuse?
If your blood glucose levels are over 50mg/dL IN ketosis, you are still burning fat. The idea that it must be under a certain value is absurd. If ketones are produced the body is mobilizing triglycerides from fat stores. I think Duchaine propagated this false statement when he said that blood glucose levels must be under 50 to achieve ketosis. In Lyle’s literature he has even stated that his levels didn’t fall below 50. I think it is important to note that during the first 3 weeks of ketosis the brain is running primarily on glucose, the rest of the body’s organs use primarily ketones for energy. This is why the body needs to maintain a higher blood glucose concentration. After this 3-week period in time the brain switches to using ketones as its primary source for energy. Blood glucose levels will drop and hence the body is using ketones more efficiently. While it is true that the body is utilizing ketones more efficiently at blood glucose concentrations under 50, it is not true that it must be to burn fat. The issue about glucagon increasing blood sugar levels is true, though it does it in an indirect manner. This is the opposite action of insulin and is used to stabilize blood glucose concentration levels. Also ketostix are really useless, unless you are diabetic. They can show you that ketosis has been reached by spillover into the urine, but not that you have not reached ketosis. The ketones spillover just means that the body is not using them for energy and needs to expel them to adjust blood pH. Using a drug that stimulates insulin production or insulin itself to achieve ketosis is an EXTREMELY DANGEROUS practice. Sure you could drop glucose levels faster but you can also die. There is no need to get in ketosis that fast unless you are on a CKD so you can lose more fat during the week. This is pointless because lengthening the low carb days can rectify that.
Racer: On the subject of glucovance, I know little of it. I live in the UK, and although I know trials are proceeding in USA, there is no word of it here. There is no doubt that if you can justify by the tests I detailed previously, that you are insulin resistant (ie Type 2 Diabetic) it may be of assistance. However , if you are not, exercise caution, as exteeme low blood sugars could occur, similar to insulin. The beauty of Metformin is that it is virtually safe. ie Take too much and you might get a sore stomach, constipation, the trots etc but it won’t kill you. It is the sensible way to go.
The subject of mass gain was dropped in more or less as an asside. This is an extreemly dangerous practice that many pro body builders use, some of them not waking up the next day. I do it, as do many others. Do I want to discuss the methods, I'll have to think about that. Its playing Russian Roulette you know. You will need strength of character and a lot of common sense to do it with success. Graham
Well, I contacted Lyle himself and he responded within a couple of days. Here is a copy of his message:
"well, as someone else said I'm not an endocrinologist so take this under that heading.A blood glucose of 90 might be a little high in ketosis but maybe not. Blood glucose doesn't get as low as most people think and the body is really good at keeping blood glucose in the normal range (except for diabetics). Yeah, I might expect it to be a little bit lower if you were in ketosis but what's the big deal? 90 is normal, even after an overnight fast. Also, for a lot of folks blood glucose tends to go up in the mornings. I don't think it's anything to worry about."
Lyle
So basically what he is saying goes along with much of what John U. said. Does anyone else have more to add? I have learned quite a bit from this one post and I thank all that have contributed to it. Now if Cy would only chyme in with his .02 then it would be complete!