Ketogenic Diet

Oh, and one more question. When you first started, did you have a few days of bad headache (withdrawal from carbs, etc.)?

Thanks again,
Reama

Hi Reama,
I'm probably not the best role model for the ketogenic diet because I did not count grams of anything, but I will tell you how I did it. Yes there is lots of variety and at the end of the day you will find what works for you and what you like to eat. Though it sounds very restrictive, this diet is awesome and actually quite freeing, both food-wise and headache-wise!!!

I had a bigger problem in the beginning not with reducing carb, but with adding fat. If you don't eat TWICE as much fat as protein (easier said than done), then you will have trouble staying in ketosis. It took me about 2 weeks to fully adjust to the diet. In retrospect, I should have started the way bodybuilders do, where you eat a keto meal for dinner, go to bed wake up and exercise THEN eat a keto breakfast. This jumpstarts the metabolism into ketosis. You know you are in deep ketosis if your saliva tastes a little metallic. It still happens to me whenever I exercise.

In those first two weeks I still had headaches, and I don't think they were worse than normal. But I did get keto "flu" symptoms. In the first few days especially, I had trouble telling how often to eat because my cravings went away, and as a result I waited too long for lunch. I'd eat lunch, and then my body would run out of energy because of the lack of carbs and kind of shut down. I immediately had to take a ~20 minute nap and then I'd wake up feeling totally fine. Over time this improved, and in the two times I've fallen out of ketosis since, I've known because of these flu-like symptoms + headache.

On days where I do eat more carb than usual, like if I have a meal at a restaurant and accidentally eat too many carbs, I will get a headache. Usually drinking water, taking a triptan, or eating a good keto meal will fix this.

When I started I tried to stick to the ratio of 65% fat 30% protein 5% carb. Though I didn't count fat or protein, I did try to be mindful of my carbs, and stay below 20. One important fact is that 20g carb=20g NET CARB. Net carbs are carb content - fiber. So 1 serving of pecans have 5g carb but 4g fiber so that is only 1 net carb. In the beginning I printed off the Atkins Net Carb list of most common food types and used that as a reference when making meals.

Ex. In a large salad I would add 1 stalk celery (1 net carb), lettuce (1 net carb), 1/4 bell pepper (1 net carb), some olive oil/tahini/yogurt dressing (2 net carbs). 5 carbs in 1 meal is totally acceptable!
If I snack on nuts, I'll have a handful, and that's 1-2 net carbs.
If I eat some cheese for snack, thats 0 carbs.
For dinner tonight I made lasagna with homemade egg pasta, ricotta, tomato sauce, and ground beef. The pasta was made with 6 eggs, water, and 1/3 c flour, and I only had a fraction of that (so ~1 carb from the flour + 1 from the sauce). I also had mashed cauliflower which is an excellent keto staple that I highly recommend you try! (Just google, keto mashed cauliflower; it is the keto replacement for mashed potatoes). I had 2 servings so probably 3 carbs there.

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Some general rules to follow as you try this:
1. add fat to everything, and make sure you are following the 65/30/5 ratio. Before you eat ANYTHING ask if it follows the ratio.
2. all carbs should come from vegetables. In the beginning I limited my veggies to very low-carb ones (kale, cabbages, mushrooms, spinach), but over time I expanded this to 1 serving of anything that grows above ground. Root vegetables are discouraged, but if I'm tempted I'll have a spoonful of mashed potatoes with lots of cream and butter (~5 net carbs).
3. If you can eat a vegetable raw, you should. Onions, peppers, squash, mushrooms all increase net carb when you cook them, so if you do reduce portion size.
4. Follow your taste buds. Your sense of taste will dramatically change. In the first few weeks, everything tasted so rich and fatty, but now things that aren't fatty lack substance. Carbs are heavy, filling, and sweet. After the perfect keto meal, you will feel pleasantly full and able to function
5. Cheating is discouraged, but I allow myself to have 1 bite of anything on occasion. Usually I am disappointed
6. Eggs and avocados are your best friend. I eat ~14 eggs a week, and up to 1 avocado a day.
7. Savor smell. As your taste changes and foods you used to love become grotesquely sweet, start to smell things and enjoy them that way. You'd be surprised how easy it is to pass a bakery and not indulge.
8. Though fruits are a big "no", berries are the lowest-carb fruit and allowed in moderation. If craving something sweet, I would eat 5 raspberries/blueberries/blackberries in a bowl with cream, coconut flakes, and nut pieces, ~3 net carb. (1 small strawberry = 1 net carb.) Over time I lost my taste for berries because they became too sweet. I now make very bitter flourless chocolate cake and eat that with cream

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Resources that got me started: "The Migraine Miracle" By Dr. Josh Turknett. This dr only has a page on the ketogenic diet, but he basically describes the same thing in his own 6-step diet guide. He suggests <100g carbs for migraine reduction if you have a few headaches a month, and <20g carbs if you have more. I went for <20 b/c my headaches were daily. I highly recommend this book to anyone interested in reducing their headaches via carb reduction!

For keto specifically: http://keto-calculator.ankerl.com/ to calculate how many grams you should each of each.
If you like reddit, this has a lot of info, mostly from people trying to lose weight http://www.reddit.com/r/keto


Best of luck!
CG

Thank you very much, ConcordGrape, for such detailed explanation. I've been reading a lot of his website after reading your recommendation...he's got a TON of info there. Still seems pretty hard to reduce carbs to less than 20 gm (even if it's net carbs), but so worth it if it really works. I'm going to first concentrate on getting below 100 gm net carbs (actually, I've outlined a rough menu I think I can live with that's about 60 gms a day net carbs) and see how I do with that, then go lower if necessary.

Thanks for the tip on the fat to protein ratio. I read somewhere else (don't remember exactly where) that excess protein is metabolized into glucose, so too much protein ups the carb count, too. There's also a link to a German website I found, on this forum but from back in 2010. I can't read German, so it's not helpful to me, but I'll update that thread so anyone else may be able to benefit from it.

Thanks again!!! I'll post in a couple of weeks a follow up on my results.

Reama

Sounds good, I can't wait to hear how it goes!

My trick to getting carbs down was eliminating entire groups and figuring out how to substitute in ways so I wasn't unsatisfied. No grains, legumes, baked goods, or packaged/processed foods. I eat sandwiches or burgers wrapped in lettuce or without the bread. (lettuce wraps=great workaround for many cuisines). Indian is my favorite food to eat out; I usually get a creamy dish and don't eat rice or naan. Breakfast is by far my favorite meal: sausage/bacon, eggs, avocado, and cheese will hold me over for 5+ hours. Quiches are great to mix it up and can be vegetarian or have meat.

When in doubt, look up some keto blogs and you will find good recipe ideas. I really like cheese, so I've tried many new kinds over the past few months and this has been a good way to add variety to my menu.

Good luck!

Thanks again! Wow, I haven't eaten cheese in something like 20+ years as it's always been a reliable migraine trigger. Your menu sounds delicious....

Reama

I finally got around to making bone broth. Had a cup this morning and will have one again tomorrow then will have to make more. I cooked it 20 hours in the crockpot on low. It was tasty and easy so will likely be on my menu at least several days per week. Not sure if it will do anything for the migraines but it is supposed to be good for IB and maintaining bone strength. I used marrow bones that the store had in the meat case. Maybe next time I will ask if they have chicken necks or something.

ConcordGrape wrote:I started a ketogenic diet 4 months ago and within 2 weeks I had a significant reduction in headache hours. I went from daily constant migraine to daily intermittent migraine and EVEN had 1 headache-free day.

In addition, I had a LOT of other positive effects, and so I will not go back to eating carbohydrate unless I have to.

These included...

improved memory!
no more tremor!
no more GI/bowel/intestinal issues. cramping, bloating, gas, all GONE!
no more food cravings, and my mental health is more stable
lost 15 lbs

but most importantly, a raised migraine threshold! Prior to the diet, I couldn't do anything for a migraine except take medicine and cross my fingers/suffer through. But now, I can drink water or eat a meal, or take a triptan and the headache will go away.


I waited to share this until now because I still did have headaches fairly often, and so was not completely satisfied with the diet. But I found the missing piece......bone broth!

Not the kind of stock or soup you buy in a can, homemade, bones boiled in water for a few hours with veggies and seasonings. Since I started drinking 1 bowl of broth a day (~2 cups) I have not had a migraine! It is incredible. I am still in shock. I guess it is all the micronutrients + electrolytes + super hydration from the broth. All I know is it works, and I really hope it can help others too!

feel free to ask me anything about keto or the broth! I will gladly share my recipe as well
xox

Hi,

Please see my post on the leaky gut thread.  Bone broth is highly recommended by the Weston Price Foundation.   The main reason is that it contains gelatin - a colloid which has the effect of homogienising  the chyme (partly digested food in your stomach)  and therefore making it  easier to digest.  Thus,  it may have a positive effect on leaky gut syndrome.  Bone broth also contains many minerals and trace minerals and beneficial glyconutrients.  However,  according to Dr. Jean Seignalet,  bone broth should be avoided because it has to be brought to a boil initially and then simmered for a long time.  According to Seignalet,  this alters the molecular structure of the proteins,  and this can damage the gut lining because these altered proteins are not digested properly.  Personally,  I think Japanese dashi (stock) is the answer.  You can buy kombu,  dried shiitake mushroom and bonito flakes online.  You can make dashi from one, two or all three of these together.  Kombu contains many minerals and trace minerals (like bone broth) and also contains agar agar which is a colloid  just like gelatin.  Kombu also contains some very active anti-cancer micronutrients.   Unlike bone broth,  dashi is made by very gently heating at below a simmer,  which means that the proteins are not damaged.   Shiitake mushrooms have a fantastic beneficial effect on the liver and can even reverse some forms of hepatitis.  (There is definitely a connection between a toxic liver and migraines - look it up on pubmed).  So all in all, dashi does all the great things that bone broth does,  without the drawbacks.  Also,  it is much quicker and easier to make.  In 20 minutes at below a simmer you are done.  If you use bonito flakes,  put them in already boiling water for just a few seconds.  See my post on the Leaky gut thread.

Cheers Chris

I have found on a low carb, no grain diet that I must add a good bit of salt to my food to avoid leg and foot cramps. Just a suggestion to those that may be trying the very low carb diet.

I just wanted to check in and see how everyone is doing.

I continue to do well on the diet--which really is an understatement. Now that I have extended headache-free periods, I started socializing and made new friends where I live now. Even though I still bring my little "migraine-pack" with me everywhere, I rarely need it (emergency meds, tiger balm, ear plugs, face mask). I am slowly building up tolerance for continuous activity. I can now do one task for 2-3 hours without getting a headache, as long as I drink enough water.

This past week I did have 6 or so days in a row of headaches, but it was not 24 hrs/day and I ended up kicking it by drinking extra broth and upping my salts.

I am slowly converting my diet over.  I've found that it's easy enough to cut out foods with more than 20g of net carbs - pastas, breads, most cereals.  On the days when I eat fewer carbs, my appetite is lower and I don't get crazy hungry.  This diet would be very good for weight loss.  I don't want to lose any weight but I have dipped down to 104lbs!

On the days when I have eaten a lot more carbs, such as eating out, it does seem like my headaches are worse.  I have not had any no migraine days yet.  I guess I must continue to lower my carbs and see if they actually reduce in frequency.

I tried making beef stock - yuck!  I will stick to chicken stock.

I have had one issue. I've started to have difficult falling asleep, extremely rare for me, and small muscle twitches all over my body. Looking it up I feel this is probably magnesium deficiency. A great source of magnesium is cereals which I used to eat daily and of course I have now cut out. I still eat foods with magnesium such as my daily coconut milk, and I love dark green veggies and dairy which supposedly has magnesium but I guess it's just not enough for me. I ordered a supplement yesterday and will see if that solves the problem.

When i started the diet I was taking magnesium supplements (as requested by my neuro ages ago). I stopped a few months in and was okay for a while but muscle twitches and cramps starte coming back. I started taking the supplement again and eating more salt in general and it seems to help. I think I still need to find the right balance of micronutriets in the foods I am eating.

I also noticed my headaches seemed worse when I ate too many carbs. The good thing is these headaces do respond to triptans. I have also heard from others that after about 2-3 yrs tolerance for carbs will stabilize and I will only have to eat keto 1-2 days a week, while still maintaining control over the headaches.

As far as the weight loss goes--you will drop ~5lbs of water weight quickly but this may stabilize and you could gain it back as lean muscle. I started exercising again and can't believe how quickly my strength is improving!

Beef broth: i agree its not the best alone. I use it more as bases for soups or turn it into gravy. This week I made some pho and that broth is good enough to drink alone. You could try cooking it w cinnamon, cloves, and star anise for ~45 mins and see if the flavor improves.

Hi all, thought I'd update again:
Still following a keto diet and have not fallen out of ketosis since I first started.

My migraines are now down to ~2-3 a week and my threshold is much higher. I have more tolerance for activities that in the past were guaranteed triggers (exercise, car-rides, schedule changes, working long hours, or missing a meal.) I take triptans + an NSAID when I do get a headache--usually from the weather--but my med consumption has decreased dramatically, and it seems that the medicine works better when I take it. I am still getting botox, but I was a month late for my last appointment and saw no significant increase in M's during this time. I just got botox again so I will see if the headache-free time continues to improve.

My only complaint (which has been mentioned before) is the muscle cramping and twitches. It seems to be getting worse. I now take 3-4 slow-mag pills a day and still get daily cramping. I drink salty broth when it is available and add salt to my food, but it never seems to be enough. I think I will have to start supplementing with more salts, or commit to eating 1-2 bullion cubes a day of broth.

xo CG

Concord I am having the same issue with muscle twitching, especially in my eyes, and I have not gone to an extreme low carb diet yet. I found that magnesium made no difference. Still searching for which vitamin might help.

Potassium can help with muscle spasms too, but magnesium can help some people with migraines, so taking either/both can help

Seaine: I had twitching in my eye when I wasn't taking magnesium, and when I started again it went away. Are you taking enough? Or maybe try a different kind? I have heard that chellated magnesium is the best to take. Slow-mag is also good.

I have book on the diet, "The Art and Science of Low Carbohydrate Living", and there is a whole section on minerals. This is what they say:

-Potassium/Magnesium: there is a lot in meat, so if you eat meat regularly you shouldn't have to supplement. BUT you have to cook it in a way so you save and eat the drippings--all the minerals go into the juice and will be lost if you grill/boil. Homemade broth is a great source of this.

-Sodium: When you are on a low-carb diet, your kidneys change the way they function and you will lose water weight (and associated salts). To save sodium, the kidneys get rid of potassium in exchange. It is important to consume extra sodium so you have enough of both minerals. The authors recommend taking 1-2 grams of sodium a day as bouillon. **If you have very high blood pressure, you should consult your dr before doing this**

-Zinc: Deficiency here is rare, but if you are anemic and taking iron supplements, there is a chance you will be deficient in zinc (they are both absorbed the same way and cannot be taken in together). The solution is to alternate 1 month of iron supplement, 1 month of zinc chloride, 50 mg.


This is from someone who successfully followed a keto diet to lose weight:

"Keep your electrolytes high; for us keto'ers its main 3 are: Sodium, Potassium, and Magnesium. Put salt on all of your foods, go overboard, we need like 5000mg of sodium a day (i know it sounds crazy but you have to throw all of that old conventional sh*t you've heard from doctors for the last 50 years out of the window) and even if you salted all your foods you don't get there so don't be afraid to do so, go crazy! our liver expels sodium like crazy because of this diet so we need alot of it to replenish it, personally I down 2 teaspoons of morton's table salt in a 4 cups of water 2x a day to get to my numbers, others drink something salty like chicken bouillon with their foods. For potassium, I eat a lot of spinach, and also down 1 tbsp lo-salt substitute with more water to get my 2500mg of it, and lastly for the 400mg of magnesium we need I take a supplement of it, 400mg exactly in a pill...oh and by the way, if you are waking up in the middle of the night with bad leg cramps, or cramping anywhere in your body, it's because of the lack of exactly these things, these electrolytes, I suffered from these cramps and it wasn't until I was downing that salted water that they went away..."

One of my issues with magnesium is that I can't take it in pill form. Doesn't matter what form it's in, and doesn't matter the dose. Even if I get it in the best form, and in a powder, and take 1/8 of the dose that's recommended, I can't tolerate it (diarrhea). If I continue the tiny dose it gets worse over time, not better. Believe me I have tried all the different forms it comes in. I don't know why I simply can't tolerate it, because if I eat it in food form I have no issue at all.

So that being said, I have had to just try eating a lot of foods with magnesium but it makes no difference in the twitching. I don't have any muscle cramps at all, only twitches.

Maybe it is potassium, because I've noticed that eating a LOT of spinach seems to help. I can also make chicken broth again to see if more sodium helps. I need to find a multivitamin in it with zinc as well. I'm confident I'll be able to solve this, because I never had this issue before low carb so it must be a vitamin that I normally got when eating cereal every morning...

Try bananas. A very good form of potassium and it's helped others with this problem.

Seaine--even in slow-release form? (Mag64 or Slo-Mag) This is the type recommended in the book specifically for people who are sensitive and get diarrhea. Otherwise you can try eating more seeds and dark leafy vegetables, especially spinach. Cashews are also another good source.

Thanks everyone. Unfortunately bananas are out because they don't fit in the low carb. I love cashews though, and have some in my house right now. I also just ordered a new multivitamin with more in it than my current one.

Update, twitching problem solved!

Cashews, while delicious, did not do anything to decrease the twitching even though I ate a lot of for several days in a row. They have iron, phosphorous, magnesium, zinc, copper, and manganese in them.

My new multivitamin came in. I had been unsatisfied with the kind I could find in the store and it didn't help the twitching so I looked around online for a brand that had more kinds of vitamins in it - NOT easy to do when you can't consume additives like food coloring and artificial sweeteners. I finally did find one though, and it stopped ALL the twitching within 2 days.

The additional vitamins in this brand, which are not in my old brand are:
Thiamin
Riboflavin
Calcium
Iron
Magnesium
Zinc
Manganese

SO, using elimination, it's not the same vitamins as are in the cashews since those didn't help. Remembering that eating a lot of spinach helped, I looked up the two B vitamins and Riboflavin, or B2, is in green leafy vegetables. Even though muscle twitching doesn't seem to be listed as a symptom of deficiency, I have found that vitamin B2 solved the issue!