On a low carb or ketogenic diet my fasting blood sugar is 90-120. I think it may get higher the lower carb I go. Most internet sources say don’t worry about it, worry about your Ha1c. Is this insulin resistance? Anyone have better information? If I do a water fast my morning blood sugar will go down and down each day, til it reaches about 50 in 4 days. But as soon as I start eating it pops right back up.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
For example, in trained people and athletes who eat a low-carbohydrate, high-fat diet (not to be confused with a low-carbohydrate, high-protein diet), a large amount of fat burning can take place at intensities well above 80 percent maximum oxygen utilization (VO2 max) – allowing for very-high-intensity or long efforts with low calorie intake and also allowing for use of fat fuel stores during long steady-state exercise, even at a relatively fast pace (so much for the “fat burning zone” giving you the best bang for your buck). With high-fat, low-carb intake, you can go hard and still burn tons of fat. In addition, this means that more carbohydrate stores will be available when you really need them, such as for an all-out, 100%, maximum effort.
Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.

First, it’s important to understand how keto may help you lose weight. The purpose is to kick your body into ketosis, a natural metabolic state that forces your body to burn fat rather than carbs. This happens because, on the keto diet, you’re usually taking in 50 grams (g) or fewer of carbs per day, says Deborah Malkoff-Cohen, RD, a nutritionist based in New York City. While several types of the keto diet exist, the standard approach to this plan requires you to take in about 75 percent of your calories from fat, 20 percent from protein, and 5 percent from carbs.
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People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.

A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.

Checking your ketone level is one way to know if you’re in ketosis. This metabolic state usually kicks in after three or four days of restricting your carbohydrate intake or going through periods of intermittent fasting. You don’t have to visit a doctor to measure your level. Pick up a ketone urine test from a nearby drug store, or use a blood sugar meter that’s capable of measuring ketones.


The Gatorade Sports Science Institute (GSSI) is widely considered one of the world’s top go-to resources for cutting-edge exercise and nutrition science advice – which is probably why Gatorade vending machines dot the campus here, and the majority of the kids seem to be walking around campus with a never-ending big gulp-sized cup full of sports drink.
Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18]
The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]
Urine test for diabetes: What you need to know Urine tests for diabetes check for protein, ketones, and glucose. They are frequently used for diagnosing and monitoring diabetes, and to assess people who are experiencing symptoms, such as fatigue or nausea. Depending on the results, recommendations may be given about medication or lifestyle changes that could help. Read now
On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell's mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[57] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[56]
Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)
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Might not be nutritional. Could be a training issue. Could be fascial. Could be neurotransmitter. If you're taking 1 serving of UCAN perhaps you need two. Not sure of ht, body wt, etc. I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
If you want to make some enemies very quickly, just jump on to social media and say "the keto diet stinks." Because there are certainly a number of people who swear by the keto diet. Some of them will even swear at you if you say anything bad about the diet. Supporters of the diet claim that the keto diet will help lose weight relatively quickly, clear your mind, make you feel better, and even clear up your acne, because you no longer are taking in carbohydrates that "cause inflammation." People who question the diet have raised concerns about whether maintaining such a high fat diet is effective and healthy in long run. After all, high fat diets could raise the risk of various chronic medical conditions such as heart disease and cancer.

To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet. That’s what’s called optimal ketosis.
Keep in mind that if your crotch begins to have a very unusual smell, whether or not you are on the keto diet, you may want to see your doctor. Don't just tell everyone on Reddit about how much your crotch smells. Regardless of your gender, an unusual smell could be a sign of an infection or some other condition that needs proper medical attention. Even if you don't have a medical problem, your doctor can tell you what kinds of smells are normal and not normal. In other words, he or she could lower your concerns about what's going on in the lower part of your body.
I was shocked at how easy it was (using the new supplements and methods outlined below that have been developed since my initial foray into ketosis) to get into ketosis without extreme carbohydrate restriction, without excessive, diarrhea and “diaper-moment” inducing amounts of MCT and coconut oil, and without the inflammation, triglyceride and hormonal issues, or social discomfort I outline above. I was also able to achieve a much more immediate and deeper level of ketosis than I ever achieved in previous experiments sans these newer strategies you’re going to learn about.
Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[19]
There are many misconceptions about ketosis. The most common is mixing it up with ketoacidosis – a rare and dangerous medical condition that mostly happen to people with type 1 diabetes if they don’t take insulin. Even some health care professionals tend to mix up these two situations somewhat, perhaps due to the similar names and a lack of knowledge about the distinct differences.
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%.[9][31][32] The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy, and tuberous sclerosis complex.[9][33]

But sadly, whether due to government subsidy of high carb foods like corn and grain, funding from big companies like Gatorade and Powerbar, our sugar-addicted Western palates, or the constant (unfounded) fear mongering about saturated fats and heart disease, the type of research that shows these fat-burning and performance benefits of carbohydrate restriction simply get shoved under the rug.
^ Bechtel PJ (2 December 2012). Muscle as Food. Elsevier Science. pp. 171–. ISBN 978-0-323-13953-3. Retrieved 19 May 2014. Freezing does stop the postmortem metabolism but only at about −18ºC and lower temperatures. Above −18ºC increasing temperatures of storage cause an increasing rate of ATP breakdown and glycolysis that is higher in the comminuted meat than in the intact tissue (Fisher et al., 1980b). If the ATP concentration in the frozen tissue falls below ~ 1 µmol/g no contraction or rigor can occur because they are prevented by the rigid matrix of ice.

Therefore, more people experiencing "keto crotch" need to visit doctors to determine what's really happening. It could be that some of the people claiming "keto crotch" are instead detecting smells that are not related to their diets. Many different smells could emanate from your crotch, some are normal, some are not. Conversely, who knows for sure what a drastic change in your diet may do to different parts of your body? There is still a lot unknown about the links between nutrition and your various bodily functions. You are a complex system with many unknowns. The keto crotch could be a real phenomenon, but more scientific evidence and studies are needed.

Similar to the BHB salts and MCT’s from the KETO//OS I discuss above, powdered forms of ketones are excellent if you don’t want to completely eliminate carbohydrates or protein (which can be gluconeogenic when eaten in excess) or eat copious amounts of fats, but want to simultaneously maintain high levels of blood ketones. It may also be used to ease the transition into a ketogenic state, because it can help alleviate the fatigue and lethargy some  people experience while making the transition from a glucose metabolism (carb burning mode) to ketone metabolism (fat burning mode).
Wow! Amazing article. I don’t read blogs regularly, but I’ll be reading more of yours. I am on day 11 of a fast to get me into ketosis; 7 days bone broth and now on day-4 water only. Intentions are weight loss (10# down, 15# more to go) and immunity improvement/gut help. Planning 9 days of whey water, fermented veggies and mad probiotics when the water days are done (day 14?). After this fast I want to stay fat adapted, start training again and get down to 8% body fat. I believe you have cut that journey significantly with this article. Thank you.
Other research further supports the potential benefits of this diet. For example, preliminary studies link following the keto diet to reduced symptoms of Alzheimer’s disease. (4) Previous research suggests it may also help reverse metabolic syndrome, manage Parkinson’s disease, has been proven to help control seizures in children with epilepsy, and, according to the results of a small pilot study, may potentially even improve symptoms of polycystic ovary syndrome (PCOS). (5, 6, 7)
Fuels and feeds your brain: Ketones provide an immediate hit of energy for your brain, and up to 70% of your brain’s energy needs when you limit carbs.[6] Fat also feeds your brain and keeps it strong. Your brain is at least 60% fat, so it needs loads of good fats to keep it running.[7] Essential fatty acids such as omega-3s help grow and develop the brain, while saturated fat keeps myelin — the layer of insulation around the brain — strong so your neurons can communicate with each other.
I’m missing one key-step in this whole process … I understand (vaguely) how to get into ketosis via diet, starvation, or supplementation. But, my confusion really is with the supplementation method (such as XCT Oil, for example). If I supplement with these to get into ketosis quicker, but haven’t significantly altered to a high-fat diet, won’t I just shift back into glucose-use as soon as I burn out the supplemented ketones?? like within minutes / hours?
The concentration of ketone bodies may vary depending on diet, exercise, degree of metabolic adaptation and genetic factors. Ketosis can be induced when a ketogenic diet is followed for more than 3 days.[34] This induced ketosis is sometimes called nutritional ketosis.[35] This table shows the concentrations typically seen under different conditions[1]
Cyclical keto diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes.[9][10]  Learn more here about how carb cycling works.
As a matter of fact, from a pure biology perspective, lauric acid should actually be considered a LCT, because unlike C8 and C10 forms of MCT, lauric acid gets processed by your liver. This matters because your body metabolizes MCT’s differently than LCT’s: unlike LCT’s, MCT’s get very quickly converted into ketone energy to fuel your brain and body instead of requiring a pit stop in the liver for processing.
Might not be nutritional. Could be a training issue. Could be fascial. Could be neurotransmitter. If you're taking 1 serving of UCAN perhaps you need two. Not sure of ht, body wt, etc. I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
Fascinating stuff and I am quite curious how we know for certain one is actually in ketosis i.e. using ketones as primary fuel source BECAUSE we do know that glucose has a shorter metabolic pathway to burn and under most conditions, given the presence of glucose, that is what the body will default to which is why high fat and high sugar together in diet is so detrimental. So if we use one or more of the above “boosters” and show high levels of blood ketones but also highish levels of glucose (during initial transition) will be mostly burning ketones or still defaulting to glucose? 
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