Tips & tricks for starting (or restarting) low-carb Pt II

In the last post we discussed ramping up the fat intake as the single best way to hurry the low-carb or keto adaptation along.  I didn’t mention it in the previous post, but another little secret is to keep an eye on the protein intake. Too much protein will prevent the shift into ketoses because the liver will convert some of the protein into glucose – this glucose will then be used first and slow down the ketogenic process.  Which, if course, prompts the question, how much protein is too much?  As long as you’re getting your protein from meat, especially fatty cuts of meat, you’re probably okay.  If you go for the extremely lean cuts of meat, say, skinless chicken breasts, or if you are supplementing your diet with low-fat protein shakes, you could have a little more trouble low-carb adapting.  If you’re going the shake route, I would recommend you add some coconut oil to the shakes for a couple of reasons.  First, you’ll hasten the keto-adaptation, and, second, the fat it coconut oil will help remove the fat from your liver (which I’ll discuss more later in this post).

A glass of Tinto de Verano pictured at left. A great way to hydrate. (See note at bottom of post.)

As I said, you need to really crank up the fat intake to push yourself over the adaptation divide as quickly as possible.  If you don’t like fatty cuts of meat, you can add a little medium-chain triglycerides (MCT) to your diet.  MCT are absorbed more like carbohydrates and are used quickly by the body.  They are almost never incorporated into the fat cells, so they burn quickly, and any extra that might be hanging around are converted to ketones.  So, MCT will drive the ketone production process.  And so will coconut oil if you prefer that.

You can find MCT oil at most health food or natural grocery stores.  It has never bothered me, but some people can get a little nauseated if they take too much of it, so if you decide to give it a try, start out slowly.  Or go with the coconut oil.

Aside from the occasional carb cravings, which we’ll deal with later, the most common symptoms experienced by those getting started on low-carb diets are fatigue, headaches, light-headedness or dizziness, and cramping.  I would say these four symptoms probably comprise 98 percent of the complaints we get from our patients we put on low-carb diets.  Not everyone experiences these symptoms – especially those who do what we tell them – but of those who do have symptoms, these are almost always the ones they have.  Let’s look at what to do to avoid them or treat them should you already be experiencing on or more.

Electrolytes



The most common cause of virtually all the symptoms listed above is an imbalance in electrolytes.  Following a low-carb diet results in a rapid lowering of insulin levels, which – though a good thing – can create problems in the early days.  We’ll address the electrolytes in the order of importance.

Sodium

When you are overweight and insulin resistant, you have a lot of insulin circulating in your blood most of the time.  This excess insulin does a number of bad things to you.  Gary Taubes wrote an entire book about how excess insulin makes you store fat in your fat cells.  But the story doesn’t end there.  Excess insulin also drives the kidneys to retain fluid, which is why many obese people retain a lot of extraneous fluid and experience pitting edema in their lower legs.

What is pitting edema?

If you push your finger into the tissue in the front (or just to the side of) your shin bone and your finger leaves an indentation – almost a finger print – that takes a while to fill back in, you have pitting edema.  Most overweight people experience this phenomenon late in the afternoon and/or at night after being on their feet all day.  The excess fluid pools around the lower legs and seeps into the soft tissues. In the morning, after the body has been horizontal through the night, the fluid redistributes, and the pitting edema goes away but then reoccurs as the day goes on.  Even people who aren’t all that overweight but who do have elevated insulin levels will have some degree of excess fluid accumulation even if they don’t experience pitting edema as evidence of it.

One of the first things that happens when people go on low-carb diets is a rapid improvement in insulin sensitivity.  Because the low-carb diet starts to quickly banish the insulin resistance, insulin levels fall quickly.  And as insulin falls, the stimulus to the kidneys to retain fluids goes away, and the kidneys begin to rapidly release fluid.  One of the common experiences at the start of low-carb dieting is the incessant running back and forth to the bathroom to urinate this excess fluid away.  Which is both good news and bad news.

The good news is that it’s great to get rid of the excess fluid but it comes at a cost, which is the bad news.  As the excess fluid goes, it takes with it sodium an extremely important electrolyte.  When sodium levels fall below a critical threshold (which can happen within a short time), symptoms often occur, the most common being fatigue, headache, cramps and postural hypotension.

Postural hypotension happens when you stand up too quickly and feel faint.  Or even pass out briefly.  It’s a sign of dehydration.  So if you’ve started your low-carb diet, made your multiple runs to the bathroom, and jump up off the couch to answer the phone and feel like your going to faint (or actually do pass out momentarily) and have to sit back down quickly, you’ve got postural hypotension.  It’s really easy to fix – you simply need to take more sodium and drink more water.  Salt your food more.  Increasing sodium is just another one of the many counter-intuitive things about low-carb dieting.  Just like eating more fat to lower your cholesterol.  You’ve got to start thinking differently.  The low-carb diet is one that absolutely requires more sodium.  A lot more sodium.

If you’ve got the brutal headaches that some people get when starting on a low-carb diet, add sodium.  And drink extra water.

Even if you don’t have pitting edema, postural hypotension or headaches, you still need more sodium if you are starting out on or following a low-carb diet. It’s critically important that you get extra sodium.  I can’t make this case too strongly.

An easy way to get extra sodium along with magnesium and potassium (a couple of other electrolytes we’ll discuss in a bit) is by consuming bone broth.  Unfortunately, you typically have to make the good stuff yourself because it’s difficult to find commercially.  You can get chicken broth and beef broth at most grocery stores, but it’s not nearly as good as the broth you can make yourself.  At the end of this post I‘ll give you a spectacular recipe that we have for a great bone broth we made at our now-defunct restaurant.  It is beyond good.  It requires a little time, but you can make a bunch and freeze it in small containers and keep it forever.

Short of making your own bone broth, you can use commercially available bouillon, which contains plenty of sodium and makes a nice hot drink.  Plop a cube in a cup of hot water and throw it back. Many patients have reported that drinking a cup of hot bouillon helps them get through carb cravings.  It’s easy and convenient, but can’t compare in taste to the real bone broth you make yourself.

In addition to broth, get some Celtic Sea Salt, Himalayan Salt or one of the other grayish, pinkish kind of grungy looking salts and replace your normal salt with these.  And don’t use them sparingly.  These salts have been harvested either from ancient sea beds or obtained by evaporation of sea water with high mineral content and contain about 70 percent of the sodium of regular salt (which has been refined, bleached and processed until it is pretty much pure sodium chloride, often with anti-caking agents added).  The other 30 percent of the volume is other minerals and micronutrients (including iodine) found in mineral-rich seas.  Consuming these salts is not just following a Paleolithic diet using modern food, but, depending upon the origin of the salt, it is consuming the same food your Paleolithic ancestors ate.  I much prefer these salts taste-wise to regular salt, and I salt the heck out of all my food with it.

Magnesium

The low-carb diet doesn’t really cause a massive depletion of magnesium like it does with the sodium and potassium (the next electrolyte on the list), but most people who are overweight, insulin resistant and/or hypertensive or diabetic are deficient in magnesium.  Even people with lipid problems are often magnesium deficient.  In fact, even people who don’t seem to have health problems can often be magnesium deficient because most people don’t get enough.   The last I read on the subject, about 70 percent of people don’t even get the minimum recommended daily intake of magnesium (which isn’t all that high).  So, in my opinion, it’s important to supplement this vital mineral.  Good magnesium levels help regulate potassium as well, so keeping your magnesium adequate helps with your potassium as well.

Nature has designed us so that approximately 300 plus of our enzymes require magnesium as a co-factor to make them work properly.  Which tells us that we evolved in a time when magnesium was readily available, otherwise the forces of natural selection wouldn’t have made such wide use of it.

Where did it come from?  I would bet most of it came from the water.  Most natural sources of water have a high magnesium content, so when you drink bottled water and softened and treated water, you get short changed.  Magnesium salts in water are one of the substances that tends to make deposits on your water pipes and makes it difficult to get a good lather with soap.  This problem is solved with water softeners, but the process gets rid of the magnesium.  In the old days when we all drank well water or stream water, we got a lot more magnesium.

Since magnesium is used in 300+ different chemical reactions in the body, a shortage of magnesium can cause problems.  One of the most common ones is an increase in cravings.  Often simply replenishing magnesium gets rid of many of the food cravings people have.

The best way to get magnesium is from supplements.  Get a good chelated magnesium supplement and take 300-400 mg per day.  We’ve found it best to take these supplements in the evening because magnesium is relaxing and taking it in the evening helps you sleep.  About the only problem people ever have with magnesium is loose stools, i.e., the milk of magnesium effect.  If that happens – and it is unwelcome – simply reduce your dosage until your stools normalize.

Purchasing magnesium supplements can be a little tricky because of the way they’re labeled.  First, a chelated magnesium supplement is one that ends with an ‘-ate,’ as in magnesium aspartate or magnesium citrate or magnesium citrimate.  The -‘ate’ ending tells you the magnesium is chelated, which means it’s attached to another molecule (the chelating agent..aspartate, citrate, or whatever) that helps with absorption.  Second, with magnesium supplements, the manufacturers sometimes list the dosage of both the magnesium and the chelating agent combined.  Since the chelating agents are a lot heavier than the magnesium, this labeling often ends up saying the dosage of each pill is, say, 1000 mg of magnesium aspartate.  This isn’t the amount of magnesium you’re going to end up getting because the magnesium is only about 15 percent of the weight of the total pill.

About the only way you can really tell how much actual magnesium your getting is to look on the label on the back and see how much of the RDI (Recommended Daily Intake) the dose is.  The RDI for magnesium is 400 mg per day so if you find the dose of the supplement you are considering contains 50 percent of the RDI, then you know each dose contains 200 mg of magnesium irrespective of what the dosage is on the front of the bottle.  As I say, I recommend 300 to 400 mg of magnesium per day.  The only downside of magnesium is loose stools.  Doesn’t happen to everyone, but does to a few.  For many people the magnesium seems to offset the constipation that some experience when starting a low-carb diet.  If you do experience loose stools, simply back off your dose of magnesium until things unloosen.

Magnesium is natures relaxant.  It makes many people sleepy, so we always recommend taking it at bedtime.

Potassium

Potassium is linked to sodium.  If you lose a lot of sodium through the diuretic effect of the low-carb diet, you’ll ultimately lose a lot of potassium as well.  Keeping your sodium intake up as mentioned above will help preserve your potassium as well.  And keeping your potassium levels up helps to ensure that you don’t lose a lot of lean muscle mass during your weight loss.  Plus, just as with sodium, adequate potassium prevents cramping and fatigue.

You can replace your potassium by taking potassium supplements.  In our clinical practice, we gave all patients starting the low-carb diet a prescription for potassium.  You can get the same dosage by taking four to five of the over-the-counter 99 mg potassium supplements you can purchase at any health food or natural grocery store.

There are a couple of prescription medicines that you’ve got to be aware of if you markedly increase your potassium intake, so if you’re on blood pressure medicines, ask your doctor if it’s okay for you to take potassium.

Before we move on to other supplements we can use to help with low-carb dieting, I want to address the subject of dehydration.

Hydration



A few years ago, I learned the lessons of adequate hydration the hard way, so take this as a cautionary tale and benefit from my painful experience.  I had always pooh-poohed the notion of drinking a lot of water in addition to coffee, tea and other non-caloric beverages because I always figured (and probably have even written in the pages of this blog somewhere) that coffee, tea, etc. are nothing but water with a little flavoring in them.  I mean, if you start out with a glass of water and put tea bag in it, the water doesn’t go away.  It’s still there; it just becomes tea-flavored water.  Well, turns out that’s not actually the case.

My daily ritual was as follows: Get up, stagger to the refrigerator and take a big gulp or two of sparkling water.  Then make my way to the espresso maker and crank out a cup of Americano.  Followed by four or five more Americanos over the course of the morning and early afternoon, interspersed with a gulp here and there of sparkling water.  A snort of Jameson in the early evening, maybe a glass of red wine with dinner and a decaf Americano after dinner.  If I watch a movie or read a book, I usually nurse another glass of Jameson.  I typically take my supplements at bedtime, so I throw back another half glass or so of sparkling water then.  Plenty of liquids, right?

Well, not exactly, as it turned out.

I began developing severe cramps in my hands and feet that I had a hell of a time massaging out.  That was just the beginning.  I started being awakened at night with brutal leg cramps, requiring my springing from the bed and walking them out.  My potassium is too low, thought I, so I started taking potassium.  No change in the cramping situation.  In fact, if anything, it got worse.  I was complaining to a friend who told me calcium had helped his cramps.  So I downed calcium at bedtime.  No improvement.

Another friend told me that tonic water had helped her with cramps, but I only half believed it, so didn’t really try.  Then MD and I had family visit us in Tahoe for skiing.  I upped my booze intake, kept the coffee intake about the same, and probably decreased my consumption of sparkling water (or water of any kind, for that matter).  The cramps increased dramatically.  And what was worse, they stopped limiting themselves to the night.  When MD and I were driving over to Napa one day, the cramps were so severe I could hardly drive.  I had to keep the seat back as far as I could get it so I could straighten my leg when one hit me.  Then my hands started cramping just holding them on the steering wheel.  I pulled off the freeway and made a beeline for a convenience store and grabbed a one liter bottle of diet tonic water and proceeded to chug the entire thing as I drove down the road.  Miraculously, my cramps subsided.  So, I figured tonic water (quinine) was the solution.

One night – after being out of tonic water for a few days and being failed by my bride in resupplying – I had another brutal night of cramps.  The next day I was scheduled for blood donation.  After going through the long list of questions that must be answered verbally (and fighting down the impulse to tell my interrogator that I had recently paid for sex while imprisoned in Africa – those who have given blood lately will know what I mean), I was sent to actually have the blood taken.  The phlebotomist couldn’t find my vein, which had never happened before because I usually have rope-like veins in my forearms.  She asked if I was dehydrated.  I told her I didn’t think so since I had had my normal four of five cups of coffee that morning along with my gulp of water.  She brought me a couple of 16 ounce bottles of water that I drank, and, bingo, there were my veins.  Big and robust as usual.

It finally occurred to me that my cramping problem might be due to dehydration and that the diet tonic that solved the problem did so not because of the quinine but because I was drinking all the water the quinine was dissolved in.  And it occurred to me that the cramping was worse in the middle of the night because a lot of water is lost through the breath at night. (See my second post on the Anthony Colpo Smackdown to read more about this.)  You can lose a couple of pounds during sleep simply by breathing water vapor away, which was, I’m sure, what was happening to me.  I was barely hydrated enough to prevent cramping while awake, but when I slept and my fluid level fell due to my breathing water away, I hit some critical threshold of fluid that kicked off the cramps.

I started rehydrating first thing in the morning and throughout the day.  Now I get up, drink anywhere from 16 to 32 ounces of remineralized water (more about which later) first thing.  Then I head to the espresso maker and start my daily Americano regimen.  But I consume at least 8 ounces of sparkling water after each cup of coffee.  And I drink water after each shot of Jameson and/or glass of wine (or any other alcoholic libation),* and I’m proud to report that I have been cramp free since upping the water.

My brush with cramping misery inspired me to hit the medical literature to read about hydration.  And I learned many wonderful things. For example, I learned coffee is a diuretic (which I already knew but had chosen to forget), but that some acclimation occurs over time.  Still, due to the diuretic effect, you don’t get the full fluid from a cup of coffee that you would from an equal amount of water.  Same with alcohol.  Once I started calculating how much fluid of that I drank throughout the day I was actually retaining, I was amazed that cramping was the worst that happened to me.

I learned that water has a lipolytic effect (fat burning).  I read this in a number of papers that had studied it, and the data clearly showed that those who took in a lot of water had increased lipolysis.  I didn’t deny the data, but I couldn’t figure out the mechanism (and apparently neither could any of the authors because none described it).  I thought on it a while and finally came up with what I think is a plausible scenario.

When you drink water, especially cold water, you require some increase in caloric burning to bring the water to body temperature, but that increase doesn’t amount to all that much (the authors did describe this phenomenon), but you also dilute your blood for a bit until the water equilibrates with the fluid in all the tissues, and effect that takes some time.  During this time, while the blood is more dilute, the concentration of the various substances carried in the blood decreases.  Which would mean that insulin levels would fall.  The typical blood volume is about 5 liters, so drinking a liter of water would increase the blood volume temporarily by about 20 percent, which would mean the concentration of insulin and other molecules in the blood would fall by about 20 percent.  A 20 percent drop in insulin levels would allow fat to escape the fat cells and would facilitate its transfer into the mitochondria for burning.  At least that’s my explanation for the lipolytic effect seen in numerous studies of subjects increasing water intake.

Those starting a low-carb diet are prone to dehydration because excess ketones are gotten rid of via the kidneys along with a lot of fluid.  So, when you start your diet, consciously increase your fluid intake.  Do like I do now and come up with some sort of regimen that ensures you consume plenty of water throughout the day.  You’ll feel better; you’ll avoid cramping; and you’ll actually burn a little more fat.  And don’t make the mistake I did and assume that drinking a lot of coffee, tea, booze or other diuretic fluid is a replacement for water intake.

Since I drink either bottled water or water that comes through our RO filter, both of which are depleted of minerals, I always remineralize my water by adding a pinch of Celtic Sea Salt or one of the other such salts to each bottle.  I add enough so that the water just barely hints of a salty taste.

Supplements



Every patient whom we started on a low-carb diet left our clinic with six supplements:  lipoic acid, CoQ10, Vitamin E, magnesium, a good multi-vitamin and a prescription for potassium. (Now I would add a substantial dose of vitamin D3 to the list, a dose based on vitamin d levels and sun exposure.) We’ve already dealt with the potassium and magnesium, so let’s consider the others.

First, the good multi.  I’m a believer in getting most of what’s needed vitamin- and mineral-wise from food.  And I’m also a believer that I’m an excellent driver.  Yet I always purchase car insurance.  I see a good multi-vitamin as the same thing – cheap insurance against any kind of deficiency.  I would rather have my patients urinating away fifty cents worth of vitamins a day than risk that they have a deficiency in one.  And I feel the same way about myself.  So, find a good multi-vitamin without iron and take it.  Based on the experiences of my own patients, I can almost guarantee you’ll feel better. Why without iron?  Because most people on low-carb diets get plenty of iron in a very absorbable form.  And too much iron isn’t a good thing, so don’t take it in your multi.

Alpha lipoic acid (ALA)

ALA is, next to magnesium, just about my favorite supplement.  It acts as both a fat-soluble and water-soluble anti-oxidant so it can pretty much weasel its way in anywhere in the body and stamp out inflammation.  It protects fatty membranes and even acts as a cellular nutrient.  It also helps the body deal with blood sugar, which helps the whole low-carb adaptation process along.  Many studies have shown an improvement in blood glucose levels and insulin sensitivity with ALA supplementation.  ALA can rejuvenate other anti-oxidants, and has so many virtues that entire books have been written about it.  My standard dose is 300 mg per day for patients starting low-carb diets.  There is a newer, more potent version of ALA available now called r-alpha lipoic acid.  The standard stuff is a combination of the r and l varieties, and since the r isomer is the active one, a supplement made entirely of the r variety is going to be more potent.  And more expensive.  If you use the r-ALA you can take 100 mg a day.

CoQ10

Another superstar supplement, especially for those who have been on or are on statins.  Statin drugs interfere with the body’s synthesis of this important nutrient, and those who have been or are taking statins are usually depleted to some degree.  If you’ve been taking a statin, I would take 300 mg per day of CoQ10.  If you haven’t, 100 mg per day should do.

Vitamin D3

I would also add at least 1000 IU per day of this nutrient.  You need to have your levels checked at some point to make sure you don’t overdo it, but at 1000 IU per day, this is unlikely.  If you do test and find you’re deficient, I would take 5,000-10,000 IU per day until 25 (OH) vit D serum levels are up to at least 50 ng/ml.  Along with all the other benefits vitamin D3 provides (which I have written about elsewhere on this blog), there is some evidence that it even boosts weight loss a bit.

5-hydroxytryptophan

The last supplement I’ll mention is one I’ve had much success with in treating people who tend to have carb cravings late in the day.  5-hydroxytryptophan (5-HTP) is the precursor to serotonin.  Most people who have carb cravings have them because their serotonin levels fall.  Taking 5-HTP will bring them back up.  It also helps with sleep.  Best time to take it seems to be about 4 or 5 PM for those who go to bed at the standard 10-12 PM.  You can move the dose around to find a time that helps the most with your carb cravings yet doesn’t make you sleepy other than when you want to be.  I usually recommend 50-100 mg.  It’s available at most health food stores and natural food grocers.

Fatty liver



The last bit of advice I’ll give is that you need to work to defat your liver as quickly as possible.  The good news is that you can do it quickly on a low-carb diet.  Studies have shown major improvement in just 10 days or so.   It’s important to defat your liver to help you lose weight more quickly because the liver breaks down insulin.  If your blood sugar goes up, the pancreas makes and secretes insulin to drive it down. It does so by driving the glucose into the cells.  At the same time, insulin drives fat into the fat cells and keeps it there.  As long as the insulin is in the circulation, it’s going to be preventing fat from leaving the fat cells.  The liver is the organ that breaks down and gets rid of the insulin.  And a healthy liver does it a lot better than a liver full of fat.

One of the liver’s most important jobs is detoxification of harmful substances.  We all (at least I) consume medications, food and drink that is toxic.  We (I) drink coffee, tea and alcoholic beverages.  The caffeine and alcohol are toxins.  They don’t really hurt us in the quantities that most of us ingest, but they are toxic nevertheless.  The liver detoxifies them.  Same with many drugs – both prescription and over-the-counter.  Tylenol puts a major detoxification burden on the liver.  When you drink coffee, tea, and/or alcohol and take OTC meds, you occupy much of your liver’s detoxification capacity.  Which means it can’t get rid of insulin as well and can’t regulate metabolism in general as well as it does when it isn’t busily detoxing toxins.

So, if you really want to hit it hard in the early phases of your low-carb diet and reach low-carb adaptation at warp speed, I would recommend avoiding – or at least limiting – coffee, tea, alcohol and OTC meds.

I am a huge lover of coffee and alcohol (coffee more so than alcohol despite my constant talk of Jameson) so I know this is a sacrifice.  One way to have it both ways is to switch from caffeinated coffee to decaf espresso.  Decaf coffee to me sucks taste-wise.  But decaf espresso ain’t so bad.  If you don’t want to go completely cold turkey, you can switch from coffee to espresso since espresso has double (or triple) the taste of coffee yet only about half the caffeine.  My favorite way to drink espresso is as Cafe Americano.  I love it so much that I even made a video of how to make it to send to people.  Take a look if you haven’t seen it yet.  It’s the best cup of coffee you’ll ever have. (I have one on the table next to me as I write these words on the patio in Cuenca, Spain.)

That’s about a wrap on my tips and tricks for kicking off a low-carb diet.  I’m sure many of you have tips and tricks of your own.  Please feel free to share them in the comments section.

The bone broth recipe below is from our defunct restaurant I wrote about here.  We had this going on the stove all the time and used it as a base for about half the dishes we served.  It is absolutely spectacular.  I would eat is as a soup (we didn’t serve it that way) and take home bags of it and freeze it.  You can do the same.  I’ll provide the restaurant-sized version so you can either make a large amount in a big stock pot and freeze a bunch of it in individual packages.  Or you can cut it down to a smaller recipe.  If you do, just make sure to cut all the ingredient amounts proportionally.

Terrific Bone Broth

This is the restaurant recipe for massive quantities, so you can reduce accordingly.  Just make sure you reduce all ingredients proportionally.

2 oz roasted garlic (weight)
10 oz roasted red onions (weight)
4.5 gallons water (volume)
22 oz tomato paste (weight)
4 oz cilantro with stems
2 pounds chicken back bones (weight)
16 oz tomato pulp (weight)*
6 oz salt (weight) I would use Celtic Sea Salt or other such salt here
1 oz black pepper (weight)
1 oz olive oil (volume)

Roast onions and garlic in olive oil for approximately 15 to 20 minutes.

Add all ingredients to water, chicken and tomato paste.

Let simmer over medium fire until cooked.

Approximate yield is 640 ounces or 5 gallons.

*We used a ton of diced Roma tomatoes in the restaurant for just about everything.  We removed the pulp from these tomatoes before dicing them.  We saved the pulp and used it in the stock.

A note of interest: I wrote the first part of this post flying between San Francisco and Dallas.  The middle part during a flight from Dallas to Atlanta.  And the last part (along with the words I’m typing now) over the Atlantic on a flight from Atlanta to Madrid.  I’ll transfer it to WordPress, put in all the links and photos when I get to the hotel in Madrid.  So you’ll end up with a post that was written about halfway around the world.

Another note of interest: I’m finishing this post in Cuenca, Spain (including some of the edits I made above) because the internet connection in our hotel in Madrid sucked.  The hotel was great, the food was pretty good, but the internet was abysmal.  I kept getting kicked off, so I abandoned all but the most necessary internet functions (email, mainly) until I got to more reliable service.  Here we are in Cuenca where the hotel sucks, the food really sucks but the internet connection is great.

One housekeeping note: Since the internet has been so unreliable, I have been unable to deal with the 100 or so comments that have accumulated.  I’ll get to them as soon as this post is up.  I did perform one of my most-hated tasks last night and went through the spam filter to fish out legit comments that had gotten snared before deleting the zillions of spam comments.  So if you’ve been waiting a long time for a comment to appear, it was probably one of the handful that I rescued from the sea of spam.  I’ll get it up as soon as I can. Just bear in mind that I’m headed for my next stop, Zaragoza, as soon as I hit the ‘Publish’ button on this post and will be on a forced march for a bit. So, be patient with me on the comments.

*Here in Spain I have discovered a wonderful way to drink wine and stay hydrated.  They have a drink called Tinto de Verano (see photo at top), which is half fruity Spanish wine and half sparkling water poured over ice with a slice of orange and slice of lemon thrown in.  It’s kind of sangria lite.  Each time you drink a glass of it, you get half wine and half water, so you rehydrate the water lost from the little alcohol in the half glass of wine.  It’s tremendously refreshing, and I’ve drunk my weight of it since arriving.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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482 thoughts on “Tips & tricks for starting (or restarting) low-carb Pt II

  1. Dr. Eades, I’m perplexed by your assertion that “[t]oo much protein will prevent the shift into ketos[i]s.” Even though I realize fat is more ketogenic than protein, I have understood that the bottom line determinant of ketogenesis is lack of carbohydrate. In the past I have quoted you in saying that unless your body is not working properly, you will not create via gluconeogenesis more glucose than needed by the body. And in personal experience, I have never gone out of ketosis just because of a particularly lean day, even if protein came in at 65% of calories and over 300 grams. Is this something that only comes into play during adaptation, or have I fundamentally misunderstood something?

    • It’s an individual thing. It’s not that the protein drives gluconeogenesis, it’s that protein stimulates the release of insulin, which, depending upon a given person’s sensitivity, can shut down or prevent the ketogenic process.

      • Dr. Eades I have just recently foundyour blog. I have been eaing low carb for over a year wih amazing results. I am at 23% BMI now at age 40, however, I have begun to gain weight back over last week. Is there a time to readjust the carb or fat intake when the body reaches a goal weight? I consume alot of nuts, was wondering if the fat intake should be scaled back now? I am inersted in your thoughts.

      • Dr. Eades,
        This is confusing to me. I seem to be unable to maintain ketosis (as tested by the strips) for any length of time. One or 2 times I have seen a light purple, but most often in the am or not, I get nothing to trace amounts. I keep carbs very low, with the exception of fiber. My usual is under 35g plus 35 or more grams of fiber either as a supplement or in a Quest bar (18g). Could the fiber be the problem? I am losing weight, but at a very slow rate. <1-2 lbs./week. I keep calories at around 1500-1800/ day and I weigh 212 lbs. I have tried upping fat content like you suggested, but without much success. I work out 4-5 times a week. Bootcamp 3x per week and jog 2-4 miles once or twice a week. Any suggestions??? Really want to make this work better.

    • “In the past I have quoted you in saying that unless your body is not working properly, you will not create via gluconeogenesis more glucose than needed by the body.”

      What else are you going to do with excess protein? You can only build muscle so fast; after that, there’s really nothing you can do with it other than convert it to glucose. I’m not 100% sure, but I would be very surprised if it were possible to achieve and maintain ketosis while consistently consuming enough excess protein to meet the brain’s glucose requirements through gluconeogenesis.

      • Elimination. We’re operating under the assumption that the body uses 100% of what it takes in. If that were the case you would never poop. It could just be that what we don’t need for muscle repair and gluconeogenesis is simply not used.

    • I eat a zero carb (meat, eggs, and water only) diet. I eat between 24 and 32 oz of fatty meat per day plus 2-3 eggs on some days (that’s around 170-230 grams of protein). I test my my ketone levels via breathalyzer unit morning and evening everyday. My readings are ALWAYS in the moderate to high range every single time. I should mention, though, that the meats I eat are VERY fatty–chuck roast, ribeyes, oxtail, beef cheek, NY strips, dark meat chicken WITH skin, turkey drumsticks, bacon, pork belly, baby back ribs, etc. And I cook all my meats and eggs in butter, bacon grease, or beef tallow. I also eat lots chicken and beef liver, but I cook it in large amounts of butter since it is a leaner meat. I always avoid “lean” meats.

        • So based on the fact that he ate butter daily, his death was caused by butter consumption? If that’s what you are implying, you could be a journalist. That’s the sloppy thinking they use all the time.

          • I think it was his excessive air consumption that did it. 100% of CAD victims were breathing shortly before they died.

            The numbers don’t lie.

          • I didn’t say it was the cause, I was just suggesting it may have played a role.

            I’m well aware of the saturated fat phobia that exists in our culture. My question is why is it, that every time I try to increase my saturated fat intake, I develop leg cramps or ‘restless leg’ type symptoms? The circulation to my feet also decreases — every single time.

            ???

  2. Hi Dr Eades,
    My last comment on Part 1 was a bit too late after comments closed for the post so it got stuck in the awaiting moderation queue. I figured I’d get in nice and early this time :-) I have just started reading PPLP and am reading through the very well written simple explanation on insulin in chapter 2. I am yearning to jump ahead but figured I’d read through the science first.

    Most of the folks on here are focussed on weight loss. I actually want to put on weight weighing in at under 160 lb at 6ft1. The problem is I just cant seem to put on any weight on this diet but it has helped Tremendously with my brain fog and digestion issues in just a couple of weeks. A couple of areas that trouble me are insomnia (waking up too early in the morning) and a lower libido. Googling low-carb and these two throws up a bunch of people facing similar issues – would you have any additional tips on dealing with these ? I currently take fish oil and vit-c but plan on upping my supplements per your post – thanks, ed

    • Try some 5-HTP at night to see if it helps you sleep a bit longer. Don’t know your age, but you might want to check your testosterone levels re the libido issue. It’s not a complaint I’ve heard often in many years of practice. I’m not aware of any mechanism that could bring this about. I would bet it will normalize in time.

      • Thanks Dr Eades. I will try 5-HTP. I was initially thinking of using L-tryptophan. I’m a 32 yr old male. Total testosterone before I started pplp was 774 which is within range. My fasting glucose was 100 and vit-d at 33. Other than glucose, the numbers which I was hoping to improve were my LDL (161), HDL (50), 4.7 ratio of total to hdl, Triglycerides (121) and WBC count was a bit lower at 3.9. I’ll measure after 6 months on this diet and hope the numbers improve.

        I know you came down hard on fruit juice on your post with the Ozymandias poem :-) Vegetable juicing is touted as being a good source of minerals. Do you have any thoughts on using vegetable juice versus mineral supplements ?
        Thanks,
        Ed

        • Fruit and vegetable juice is fine, as long as you can figure a way to extract the carbs from it. But even then, I doubt that you’ll get enough of the minerals you need while in the early stages of a low-carb diet.

        • Dear Ed,
          I cannot help but notice that virtually all of your problems
          seem to be connected to hypomagnesemia. I recommend that you read Dr Carolyn Dean’s excellent book on magnesium (“The Magnesium Miracle”). Even before that,
          start taking magnesium daily orally or as topically as magnesium oil. Good luck, ZP RPh

  3. Thanks for the great info Mike. You’ve mentioned hydration numerous times in the past. I’ve heard it stated that most Americans are dehydrated most of the time. I, too, get cramping and have for years, even before going low-carb. Sounds like something I need to consider.

    I’ve been a “salt vampire” (cf. Star Trek) most of my life, but it looks like I should switch over to sea salt.

    My potassium was a hair over normal last time (more like a high normal) and my endocrinologist suggested not taking the potassium supplement. Everything else was normal, including magnesium, and he advised not taking that either.
    I’ve stopped both of them, but when I had taken them I don’t recall any negative side effects.

    As far as cravings, my only major one is for crusty Italian or French bread, which I resist.

    Bon voyage, keep up the good work and I look forward to the next post. Jim

    • Hey, Jim–

      Getting a normal magnesium reading on a blood test tells you nothing. The body governs blood levels of magnesium very carefully and to keep blood levels in normal range it will steal magnesium from your cells and bones. (Osteoporosis, anyone?) Most of the body’s mag stores are in bones and cells, and you can reach serious levels of depletion long before it shows in blood chemistry.

      There are some tests for magnesium that test for actual levels in cell tissue, but these are not yet widely accepted and doctors seldom order them.

      It takes ages to replenish the body’s magnesium stores, as single maegadoses mostly flush through as diarrhea. Many experts claim it takes 12-24 months to fully restore mag levels.

      Magnesium also absorbs through the skin. Epsom salt baths work well, as does so-called “magnesium oil” (actually just a saturated mag chloride soultion in water) rubbed or sprayed on the skin.

  4. Thanks for sharing the bone broth recipe! It looks great… we’ve made bone broth, but I’ve never added the tomato, I’ll have to try it!

    So much great info… I’m going to pass this on to clients who have trouble with cravings, dizziness, etc during the low carb transition! Thanks!

  5. Slam dunk of a post, thank you!

    I didn’t see the segment about how coconut oil helps remove fat from the liver, though I do understand the urgency in getting rid of it. I had NAFLD for several years which disappeared after 6 months of a calorie-restricted dietitian-prescribed diet, though I gained all that weight back (but have now lost it again, plus a couple pounds so far thanks to Atkins…). Haven’t had my blood checked since before starting Atkins so I might want to get on that soon…

  6. I’m no doc, so take everything I say with a grain of (Celtic sea) salt–but based on my reading between Whole Health Source and Healthy Skeptic and Chris Masterjohn’s writings, these are supplements or foods I would add:

    1. Liver, dessicated liver powder/tabs/capsules, or seriously increasing egg yolk production. Dr. Mike, remember when you wrote in your 6-Week Cure book that you thought egg reduced liver fat because of the cholesterol? Turns out it may be the choline. Beef liver is the number one food source, and egg yolk the second-best. Anyone who has to eat CAFO meat for whatever reason should stick with beef liver rather than chicken if they like liver; chicken livers from CAFO operations have tested positive for arsenic.

    2. Menatetrenone, or vitamin K2 analog mk-4, OR any of the foods it comes in–organ meats, fish eggs, grass-fed dairy (especially the fat portion, which works out nicely for low-carbers). You can get it in liquid form and take it as drops. Unlike the mk-7 analog in natto, menatetrenone crosses the placenta in a pregnant woman, and the vitamin is vital for skeletal development in a fetus. Also, it’s used to make osteocalcin, which is metabolically active–it causes fat cells to release a substance called adiponectin, which has the nice effect of increasing insulin sensitivity all over the body. I suspect part of the link between diabetes and tooth decay has to do with a lack of this vitamin, at least as much as with the direct effect of carbohydrates on teeth.

    In fact I consider A/D/K2 sort of a holy trinity of vitamin supplementation, and would prioritize those over almost anything else, since thanks to our current overall animal husbandry practices and dietary mythology that have seized this country, they are harder to come by.

    I can’t stand liver but it’s possible to score desiccated grassfed liver powder in gelatin capsules from Swanson’s. It’s been defatted but that’s about it–otherwise it’s freeze-dried so everything else ought to still be there. I just ordered some and it will be interesting to see if I feel any different. I realize I am not eating enough eggs daily to meet my choline requirement, my B vitamin supplementation is spotty, my beef consumption is not consistent and I do sometimes get betaine (one of the reasons choline’s important but not the only one–it converts to betaine) from spinach… But it’s all inconsistent. So having that everyday dose will help, I think.

  7. Consumption. Egg yolk *consumption.* Like anybody here is going to start suddenly laying eggs. *facepalm* I have a hard time keeping my words straight when someone starts talking to me in the middle of writing a comment. Sorry.

  8. I read your tweet of last year saying that caffeine in espresso was helpful for NAFLD – I’m not sure now if that’s still the case? (I love my coffee too but am not such a purist that I can’t drink decaf.)

    I had about 5 months of menorrhagia which cleared up within 5 days of your 6 week cure for the middle aged middle diet last year (I’m peri-menopausal). I also lost 7 pounds in about 10 days – yay! I’m about to embark on the diet again this week as it came back and am hopeful that it will work again. Ultrasounds show nothing going wrong like fibroids, but I suspect that I’m drinking too much alcohol, getting too chubby and drinking too much coffee. Will report back on the results.

    My question to you is – I’m currently on prescribed iron supplements and would like to drink something containing vitamin C to enhance absorption. Is it acceptable to drink a bit of orange juice or would a vitamin C supplement be more appropriate? Any other suggestions?

    Thanks so much for your work.

    • The orange juice will prevent ketosis, so I wouldn’t recommend that. You could take it with tomatoes, which also have vitamin C and are acidic. If you are eating plenty of meat, you should get a good deal of very absorbable iron. You could take it with vitamin C supplements.

    • Have you tried using cast iron cookware? Cooking meats and veg in cast iron can increase the iron content of said foods. This could solve your problem while allowing you to follow your diet.

  9. Dr. Eades, although your posts on a low carb diet are comprehensive, they are missing, as are all the low carb diet books I own, a really good explanation of reactive hypoglycemia.

    I experienced this phenomena in spades when I began low carbing, and it almost scared me into abandoning the whole idea. It took me a good two months of gradually lowering my carb intake to be able to do a 20-30 carb day without having a reaction. I have often wondered why all of my favorite low carb docs (The Eades included) don’t mention this more often.

    • Typically, a low-carb diet will fix reactive hypoglycemia. You can’t really have ‘reactive’ hypoglycemia if you don’t have a big carb load to react to. What happens is that a large carb load runs up insulin, which then tends to overshoot and run blood sugar too low. A few people have hypoglycemia at the start of a low-carb diet because they don’t efficiently slip into gluconeogenesis to make the sugar they need. It helps for these people – a minority – to increase protein intake so that they have plenty of substrate for glucose synthesis.

      • Isn’t there such a thing called false hypoglycemia, which is not from low blood sugar, but a sudden drop in blood sugar. If blood sugars are typically high and then drop quickly – could be from drastic change in diet – although still in normal range, could cause hypoglycemic symptoms, hence the term ‘false’ hypoglycemia.

        I also had difficulty adjusting to a low carb diet with hypoglycemic type symptoms while never having low blood sugar readings. I remember resorting to drinking a lot of water because I remember reading once that sometimes heart related symptoms such as palpitations could be helped by hydrating. It did help quite a bit.

        Tips: I do find that eating too much protein or eating too much at one time, can raise insulin levels. And exercise may be necessary for those that are insulin resistant but want to avoid medication. Check blood sugars to make sure they are in optimal range. Don’t assume they are good just because you are following a low carb diet. Numbers under 120 may be considered normal by your MD but anything above 95 can cause symptoms of insulin resistance and negatively affect your health.

        • I have had hypoglycemia symptoms forever, and thought it was because of low blood sugar, but I recently tested when I had symptoms and found out that my blood sugar is not low. This was puzzling, so your explanation of “false hypoglycemia” is very enlightening. I’ve been on a low-ish carb diet for a long time, but have trouble with bread cravings. The knowledge of false hypoglycemia may help me be able to stay off bread and other carbs that call out to me, and stabilize my blood sugar levels.

          • @Maxmilliana I found that once I got to 10-20 net gms of carb per day, I lost all cravings.. maybe you need to drop down more than the low-ish you are at now to find that place where bread doesn’t call out to you anymore. I will say that after a lifetime of fighting with myself over constant food cravings, the complete relief from them is the “magic” of it all for me. The low fat /high carb community would have us all believe that food cravings are some sort of mental health or emotional problem.. I can’t tell you how angry this makes me. I wasted so many years beating myself up over my “issues” with food when carbs were the problem all along. Will I eat more carbs at some point..maybe a few more as long as cravings don’t return, but I tell you, eating a satisfying meal and then forgetting about food for many hours at a time (10 hours is common for me) has been life altering for me! And.. well over 100 pounds gone too.

  10. “You can get the same dosage by taking four to five of the over-the-counter 99 mg potassium supplements you can purchase at any health food or natural grocery store.”

    Morton’s No-Salt is cheaper. Lite-Salt (50% NaCl, 50% KCl) is even cheaper. Taste takes some getting used to, but I use a liberal amount in my protein shakes.

    • My favorite potassium supplement is Alacer Corps “ElectroMix.” You just mix it into water to make a tasty, bubbly beverage. No carbs, no calories. 1 packet provides:

      Calcium 100 mg
      Magnesium 120 mg
      Manganese 2 mg
      Chromium 20 mcg
      Potassium 408 mg

      Hydrates you, provides balanced electrolytes, and beats swallowing 4 99 mg potassium pills.

  11. There is another supplement that I have tried, and had some remarkable results — my hearing suddenly and dramatically improved. It is B12 (2500mcg sub-lingual). I initially tried it because of a book on the subject (which I reviewed on my blog: http://guestdietblog.com/2011/05/could-it-be-b12/ )

    B12 is really cheap and has no known toxicity even in enormous quantities. B12 deficiency is not particularly rare (especially in people following a superstition-based diet *cough* veganism *cough*), and can cause severe and typically misdiagnosed problems. Even sub-clinical deficiencies can lead to problems which, incorrectly treated, lead to major health issues. My problem was certainly not due to a superstition-based diet, since I eat plenty of eggs and red meat, but evidently, my B12 level was not optimal.

    • Some people have a genetic component to whether or not they absorb B12. B12 may be plentiful in the diet but they may only benefit from it to a limited extend, or not at all. My grandmother was one of these and so is my sister (perhaps I’d better get checked out…). They require(d) shots of the vitamin every 3 months to prevent symptoms of B12 deficiency.

  12. Loved all the info on water and rehydrating. Something to think about first before the supplements. Tinto de Verano looks tasty!

  13. “failed by my bride in resupplying”?! *Massive eye roll*

    Would soaking in an epsom salt bath on a regular basis be just as good as taking a supplement for magnesium?

    • Hey, she’s the Quartermaster (mistress?) of our house. Whom else should I blame?

      I suspect there is some absorption of magnesium from epsom salt baths, but I’ve never seen any studies showing exactly how much, so I really don’t know. I play it safe and take magnesium.

      • Thanks for the wonderful post! I’m glad I saw it! I actually take Epsom salt orally – about a teaspoon a day dissolved in water. This spurred me to do a little searching and I found this:

        “One tablespoon of Epsom salt contains approximately 35 g of magnesium sulfate, which is 3.4 g (287 mEq) of elemental magnesium.”

        If my math is correct, I’m getting over 1000 mg of magnesium. I should probably go with half a teaspoon, shouldn’t I?

  14. Hi Dr Eades,

    I am only in my 30’s, not overwight or with high blood pressure or high cholesterol or anything, but was proscribed statins after getting a carotid stent due to a pseudoaneurysm.

    I’ve been on the statin for a year now, first at 40mg day but after constantly harassing my doctor, got it reduced to 20mg day. So far I have had no side effects of any kind, and my doctor has agreed to take me off the statin in september, providing blood flow through the stent looks good and there is no evidence of plaques.

    I am also on 75mg aspirin, which will be for life as a blood thinner. I was taking plavix for about 6 months after stenting, but was taken off that once I got through the most risky period of clotting after surgery.

    I am concerned the statins are unnecessary and are being prescribed under the false impression that cholesterol causes plaques. And so I am conserned they are doing more damage then good. I want to take Co-enzyme Q10, but on the packs they always say they should not be taken with any blood thinning medication. I have discussed this with my pharmacist and doctor, but they think I am making a meal out of nothing, and that I am fine taking what I am taking.

    I know you can’t offer drect medical advice to someone you don’t know a full history of, but I’d appreciate any advice you would be able to give. Its very frustrating when every medical practitioner you talk with seems to be completely oblivious to any potential downsided of statins.

    Thanks in advance for any help you can give

    • I am traveling right now with limited internet availability and don’t have access to all my literature that’s at home, so I can’t give you a definitive answer, but I don’t really recall any adverse effects from CoQ10. Your body makes it in fairly large amounts, but statins interfere with that process, so people on statins need extra CoQ10. I recommend at least 300 mg per day for those who are on statins or who have recently been on statins.

      • You recommend a lower dose for those who have never taken satin; what is the reasoning for this?
        I am on very limited income and can’t afford all the supplements you recommend, which ones would be the most critical?
        I’m type 2 controlling w/o meds.

      • Dr Mike – I have been off statin for 5 years – I quit taking CoQ10 about 3-4 years ago (because of espense). Do you normally have non-statin users take CoQ10 (I am 63 btw – in case that makes a difference).
        Thanks

    • Why do doctors sometimes ignore medical evidence?

      “Stents are often inserted after a heart attack (myocardial infarction), and the general view is that the sooner they are inserted, the better. Back in 2006 a study was published which showed that, as a rule, stents inserted more than 24 hours after a heart attacked produced no benefits for patients compared to usual care based around drug treatment. The following year, the American Heart Association and similar groups used this research as the basis for advice to doctors to desist from stenting patients more than 24 hours after a heart attack.”

  15. Love bone broth! You might also recommend CSA (Community Support Agriculture) and local farmer’s markets for additional resources. I get mine from a CSA and I absolutely love it! Local farmers might very well be open to making this if the demand is there.

    Tinto de Verano sounds fabulous! Thanks for a great post :)

    Namaste,

    Liz

  16. Loved this post. I’m a coffee and Jameson lover too! Irish? Just began making Americano for myself with the easiest, cheapest espresso maker, ever. Aero coffee press, about $25 on Amazon. Easy to travel with also. Been using Celtic sea salts for a long time too but will begin to add them to my glass water bottle. Read that they help with Adrenal support. And another discovery to have my wine and water too! Lillet Blanc (French appertif made with wine, herbs and fruit) with Perrier lime or other sparkling water. Delicious Thanks for all of the other helpful information also.

  17. Dr. Eades,
    Reviews and studies I’ve read a while ago (below) list other *potential* adverse effects associated with low carb diets. I am curious whether:

    (a) Are there any recent reviews (or studies) demonstrating – or arguing – that these issues are minor?

    (b) I am primarily concerned about the potential renal acid load of high fat consumption and kidney stones (it is known that children using ketogenic diets to control epilepsy are more likely to develop them)

    (c) Vegetarians, such as myself, can have serious difficulties in meal planning when on CR / VLCKD (very low carb ketogenic) diets

    (d) From personal experience (I do intermittent fasting ~ 36 hours, two times per week), ketosis feels good once one gets accustomed with it

    Thanks in advance for clarifying some of the above, if you have time.

    =============

    Westman et al note (pages 480-481): “Potential Adverse Effects. Adverse effects that may occur, but have not yet been observed in monitored clinical trials, include kidney stones, electrolyte deficiencies (hypokalemia and hypomagnesemia) if a large water loss occurs, elevated fatty acids, and gout (if too much protein is consumed) [10,64,65].”

    Westman, E., Mavropoulos, J., Yancy, W., & Volek, J. (2003). A review of low-carbohydrate ketogenic diets. Current Atherosclerosis Reports, 5(6), 476-483.
    http://www.ncbi.nlm.nih.gov/pubmed/14525681

    Concerning carb restricted diets, Sjogren et al conclude (p. 967): “adherence to a CR dietary pattern appeared
    to increase mortality in elderly Swedish men”

    Sjogren, P., Becker, W., Warensjo, E., Olsson, E., Byberg, L., Gustafsson, I.-B., et al. Mediterranean and carbohydrate-restricted diets and mortality among elderly men: a cohort study in Sweden (Vol. 92, pp. 967-974).
    http://www.ncbi.nlm.nih.gov/pubmed/20826627

    • In my opinion the issues raised in the two papers you cited are non-starters. At one point I was going to do an entire post dissecting these two papers – both of which are crap – but the time passed, and I hadn’t thought of them again until your comment. They are both slanted, skewed observational studies that mean nothing.

      I’ve taken care of thousands (as has MD) subjects using low-carb diets. None developed kidney stones under our care, so, given the patient-years we have seen, I’m doubtful that kidney stones are a major problem. Especially not if one hydrates properly and keeps electrolytes in balance.

      I used to be a sort of believer in the renal acid load notion, but not so much any longer. Even if it is true, it’s easy to counter balance by taking out carbs in green leafy and colorful vegetables, which provide a base to buffer the acid.

      • Thanks for your reply! In fact, I did some more research on the issue. The below (especially the second one, addressing directly renal function) may be interesting. All the best

        Westman, E. C., Feinman, R. D., Mavropoulos, J. C., Vernon, M. C., Volek, J. S., Wortman, J. A., et al. (2007). Low-carbohydrate nutrition and metabolism, American Journal of Clinical Nutrition (Vol. 86, pp. 276-284).

        Brinkworth, G. D., Buckley, J. D., Noakes, M., & Clifton, P. M. (2010). Renal Function Following Long-Term Weight Loss in Individuals with Abdominal Obesity on a Very-Low-Carbohydrate Diet vs High-Carbohydrate Diet. Journal of the American Dietetic Association, 110(4), 633-638.

      • I’ve been doing Atkins on & off for 15 years. 6 years ago, I went back to a carby western diet. I got kidney stones and gallstones approximately 3 year later. I’ve since had my gallbladder removed.

        I started a low carb diet again 6 months ago. I have been occasionally weak willed & cheated. I noticed that whenever I cheat, several hours later I get bad pulsing pains in my kidney and some time later I pass small grainy stones.

        Is it possible the kidney stones are caused by switching rapidly between the 2 fuels or do you think it’s purely a coincidence?

        (I love your blog, it’s fascinating!)

        • It’s really difficult to say without knowing a whole lot more about what’s going on. I would guess it’s more of a coincidence, but, as I say, difficult to say for sure.

  18. Hi Mike –

    What about ditching dairy as a low carb, fat boosting method? I recently shed 15 pounds ditching dairy and upping my fat intake. Truly an amazing boost.

    And how bad is it to eat the Celtic salt that contains iodine if you are diagnosed with Hashimoto’s thyroiditis?

    Great blog post BTW and we’re making a pitcher of that wine tonight! And did you find any good restaurants in Barcelona?

    • If you ditch dairy and don’t replace it with other fatty calories, you’re bound to lose weight. I’ve heard many times that dairy causes weight gain, but I would have to see it proven in a RCT before I believe it fully.

      I doubt there is that much iodine in Celtic Sea Salt.

      Enjoy the Tinto de Verano. I drank at least a quart of it myself today. Haven’t gotten to Barcelona yet, so don’t have any recommendations.

      Last night in Zaragoza I had pulpo (octopus) salad and manitas de cerdo (pig’s feet) that were absolutely delicious. Talk about a dish that gives you plenty of fat and gelatin…manitas de cerdo do the trick. A lot of work to eat, though.

  19. Dr. Eades, the way I see it you just experienced what Dr. F. Batmanghelidje discovered many years ago and has been talking about in all of his books (ie: Your Body’s many Cries for Water) and on his website http://www.the watercure.com, and he got nothing but ridicule then and now. You seem to have proven his findings. Water and the right kind of salt are very crucial.

      • No kidding. “Dr Batman” thinks everything up to and including AIDS is caused by dehydration.

        On the other hand, upping water intake to the levels he advocates has no downside (especially since he suggests adding salt).

      • I had a serious problem with cramping in the first weeks of the 6WC and almost quit. My hips and legs would ache and twitch during the night so that I couldn’t sleep and then it started happening in the day time. I finally went to the chiropractor (couldn’t think of anything else to do). He told me that dehydration was causing my muscles to tighten and shorten. I started pounding water and the cramps disappeared. One night I started having painful cramping in my arms–got up and drank about 16 oz of water–pain gone within half an hour. Hydration is key! I wish this had been in the book but glad to know I’m not the only one.

  20. I have been struggling with a low carb diet for about 5 months now. I started on a “medically” supervised, very low calorie protein drink based diet. I quickly lost about 15 pounds of water, but then slowed down considerably. Once I got tired of the assumption that I MUST be cheating, which I was not, and was still not really in ketosis, I found and read Protein Power. I tried to combine the two plans into something that would work for me. Still, slow weight loss, and not in ketosis at all according to the strips in the am. I assumed that since I have never had an issue with blood sugar despite being quite overweight, this diet just did not work the same on me. It is working enough that I am unwilling to change, however. After reading this post, I hope I have found part of the problem. I still consume mostly very low fat drinks, and tend to shy away from too much fat in my protein. I am hoping if I try more high fat protein sources, I may see better results and burn more fat. Could you provide a list of your favorite high fat protein sources to include, and also some resources for cookbooks for this diet? I trust your logic so much and am frustrated that I have not figured out how to make it work best for me yet. I have lost 50 pounds over 5 months, however, so I am not giving up any time soon. Thank you in advance!

    • Fat contains about 3500 kcal per pound. 50 pounds of fat loss over 5 months is about 1200 kcal per day. Even if only 35 pounds was fat, it’s 800 kcal per day that you’ve burned from fat stores, which is still about as good as you can expect on any diet. Keep up the good work – you’ll get there eventually!

    • Try bacon and eggs. I scramble the eggs in the bacon grease and them mix in a LOT of cheddar cheese. I finish the meal off with a cup of coffee with heavy cream. Make prime rib; you can eat off of it for days. Fry pork chops in bacon grease. Top a hamburger patty with bacon and cheese. Dip the bites in ranch or blu cheese dressing. I make a “taco” salad with fried ground beef sprinkled with taco seasoning. I put it on top of shredded iceberg lettuce, cheddar cheese, and sour cream. Grill some chicken thighs. Make chicken wings and for the sauce melt butter and mix in hot sauce. For veggies a simple side salad with a huge amount of full fat dressing is the easiest. Other tasty veggies include grilled zucchini with ranch dip, sautéed broccoli with butter, roasted tomatoes, or grilled asparagus. The secret to good vegetables is adding fat, butter, bacon grease and coconut oil are my favorite. Cheese sauce made with heavy cream also makes vegetables disappear. Good Luck!

  21. Dr. Eades – you are a mind-reader. ;D I just had the time to check my email and found your two-part articles on “restarting” the program. By last Fall I’d lost & maintained 30 lb loss for over 2 years – and enjoyed eating the lo-carb way. Then…. had minor surgery followed by major infection and 3 1/2 months of PICC line & oral antibiotics. In late Fall, 3 weeks of “healthy hospital food” of sugars, breaded objects and sweet fruit drinks seemed to “set me off and running. I have been snarfing down every carb in sight and am totally frustrated. Eating correctly, my Triglycerides had plummeted, my cholesterol was down to healthy again – and now it’s all out of sync again (plus an antibiotic induced IBS/colitis thing). I NEED to get back on the good Protein Power eating plan and have been failing like crazy from the out-of-control cravings for carbs (which NEVER exist once I get past the first month or so). Your posts have really encouraged me – especially since, from experience, I KNOW you and the Mrs. are SO right! Thank you for your determination to keep these truths in the spotlight… and for reminding us of the basics again.

  22. Great series of articles, and very timely, as I pointed family to these articles who are just starting out with LC and looking for advice.

    Reading labels on supplements/multi-vitamins and knowing if you are getting what you need is rather confusing. Especially when they are listed as magnesium citrate or magnesium oxide or a half dozen other forms. Do you have recommendations for specific brands or websites to buy from? I’m totally lost and overwhelmed just looking through the inventory at GNC.

    • For what it’s worth, avoid a supplement with only oxides in it because those are cheaper and inferior forms of minerals. Aside from that, in my opinion, Pure Encapsulations and Standard Process are really good. Although your aren’t likely to find them at GNC or Vitamin Shoppe because there a “doctor” brand. For the commonly available brands Rainbow Light, Megafoods, Garden of Life, and New Chapter are really good top tier brands to pick a multi from.

      But really, nothing beats logging your food on FitDay for a week and seeing what nutrients your lacking. That way you can intelligently adjust your real food intake to cover the Macros and the Micros.

      • People knock Mag Oxide and Mag Chloride, but the fact is that in areas where people are all adequate in magnesium, the main source is Mag Oxide and Mag Chloride in the local water.

        True, it isn’t as well absorbed as, say, amino acid chelates. But it’s also cheaper than dirt.

  23. Thanks for a very informative post. I’d definitely like to see you go into more depth about the excess protein/insulin rise business as it’s something that’s definitely a problem for me (I’m an aging woman and have to limit my protein intake to my PP minimum). It’s one of those things that often causes flamewars on low-carb forums between smaller, older women who have to limit their protein intake vs. young, healthy bodybuilder guys who will go absolutely ballistic at the very idea of someone having to limit their protein. Would be great to have some solid info on this to show that it’s not a myth–some people genuinely can’t eat huge amounts of protein without it raising their insulin levels too much.

  24. I found this post very interesting as it is similar to the recommendations of veterinary nutritionist, Dr. Kellon, for treating Insulin Resistant horses. Insulin Resistance has also been linked to Laminitis. My husband has been on a similar regime and along with loosing weight his blood pressure, cholesterol and triglycerides have all become normal. Reducing fruit also has had a positive impact.

  25. That alcohol, coffee and even diet sodas will dry you out especially in the heat. When I was hand grinding and welding in the 100 degree plus heat I got cramps in my hands so bad they closed up and I couldn’t pick up anything. I lost 7 pounds that day.

    One cure I found is water with cider vinegar, potassium chloride (Morton’s salt substitute) magnesium chloride and Iodine if you need that. A cup or two a day does the trick along with plenty of other fluids and salt. In the heat water alone isn’t quite enough. Also in the heat you tend to eat less so you get less minerals.

    • A few days ago in reply to Dr. Eads’ Twitter post re the low salt intake lie I posted this link to an excellent little article from Ed & Patricia Kane’s bodybio.com site about the biochemistry of muscle cramps & dehydration.

      They too are explaining that humans need sodium to ensure strong & powerful heart muscle contractions & circulation, and they also examine the current pickle juice fad for resolving cramps & why it only solves half the problem. In short, pickle juice is acetic acid, as is vinegar, which displaces sodium in the blood stream but does nothing to add magnesium & potassium which is necessary for the relaxation half of muscle contraction.

      For the full story go here http://www.bodybio.com/content.aspx?page=elyte-electrolyte-101 and for the pickle juice story look under “More” at the end of the article.

      • Uh, sorry, but that’s not really accurate to say “pickle juice is acetic acid”.

        Most, even ‘sweet’ pickles, also contain sodium. And dill pickles are loaded with sodium. It’s both the acetic acid and the sodium that makes pickles or pickle juice to be effective for muscle cramps.

  26. Great blog post, thanks. Comment on supplements. I am T2DDr. Bernstein noted in the second edition of his book that since he started taking R-alpha lipoic acid as an insulin mimetic he reduced his insulin 1/3. He recommended taking it combined with Biotin which I found at amazon.com as Insulow (each capsule: 100 mg R-ALA, 750mcg Biotin). I also found the antioxidant form of CoQ10 aka Ubiquinol (from lef.org) to be effective to stabilize fasting glucose levels.

  27. I’ve been eagerly awaiting this post and it exceeded expectation. Thanks so VERY much for taking the time to share all this info.

  28. Gotta be careful which “sea salt” you use. I tried the pink “Himalayan” sea salt for a while. I started getting stomach aches. I think what was happening was that there was a fair amount of just plain rock in that stuff…

    Because I switched back to one of the French gray sea salts, and have had no problem since. The French sea salts also are usually moist when you buy them. I dry it out in the oven before sticking some in my spice grinder.

    There are several brands of French sea salt, and the ones I’ve tried are quite good. In addition to the Celtic sea salt brands you have in your picture, there are some such as “Le Paludier.”

  29. Is it possible to lose too much weight on a low-carb diet and have to stop? I’m 5’11” and about 150 (down from 175). My body fat percentage is about 8. I’m still as strong and energetic as ever. But I keep getting leaner. Is it possible to be too lean?

    P.S. I really love your Sous Vide cooker.

  30. Hi Dr. Eades,

    I have a couple questions,

    1) How do you define low carb?

    2) What brand of water filter do you use in your home?

    3) Have you seen the recent scientific literature that’s come out regarding synthetic folic acid? A lot of supplement companies have switched to a different form.

    Thanks.

  31. Re: your recipe for chicken broth,
    I make massive amounts periodically, (thanks for the tomato idea), but don’t salt it. When highly reduced, which I often do, it gets too salty, if salted. I salt it when I make the final dish.
    As far as everything else, been there, done that, down 40+ pounds of fat, up at least 15 pounds of muscle, and at 66, I’m gaining on Art De Vaney!!!

  32. Dr. Mike, it’s nice to have you back. I would love to try Insulow but I am taking Levothroxine for hypothyroid. Would I be messing up my thyroid? How soon should I have a thyroid profile if I do begin Insulow?

  33. Pig’s feet are great. I regularly eat pig skin alongside a meal of fatty meat.

    The problem with water intake is that many people drink too much which comes with its own set of problems. Too much water can cause one to flush out the same vitamins and minerals you mentioned.

    One very common complaint i hear from low-carb’ers is incessant leg twitching, especially of the calves. There doesn’t seem to be any consensus as to the cause. Some say to increase calcium, others emphasize magnesium, while others emphasize vitamin e, iron, potassium, and sodium, or all of the aforementioned. What do you think is the main culprit?

    • My restless leg syndrome got much better after adding calcium, magnesium, and potassium supplements. But the thing that made it vanish completely was the elimination of all soda pop, including diet soda pop. My suspicion is that the culprit was phosphoric acid.

  34. Taubes cites references that show carbs cause sodium retention, which or course, causes water retention. No doubt a large portion of the weight loss when going low carb is due to that. (The other portions due to reduction of excessive glycogen and the water attached to all that excess fiber in the gut; my theories.)

    With all due respect, I disagree on needing supplemental sodium, ever. Especially true if one is eating much cheese or brined foods (pickles, olives, sauerkraut, etc.) A look at sodium and potassium levels of all natural foods we might eat on paleo show low levels of sodium and always much higher of potassium. Hint, hint……. In fact, your dehydration might well be caused by the high salt intake you suggest, no?

    I live in Florida and without A/C by choice. I work outside, currently painting the house, and ride my bike a lot. I drink a pot of coffee every morning, some diet tonic water, sometimes a “bit” too much of alcohol. I’m never dehydrated, especially if cramping is the criteria.

    I’ve played around with furosimide diuretic, especially after high salt intakes. Yes, I will get calf cramps during the night if I do, and it’s obvious why.

    Salt substitute is pretty bitter, I found that mixing a tsp in with a glass of Low Sodium V8 Juice works great. The 99mg gluconate capsules are worthless. I used to do salt substitute once or twice a day to try to get that sodium/potassium ratio more natural. Now, I just don’t care, simplify, simplify.

    I am always excited when I see your mail in my inbox! I just can’t agree with your salt comments this time around.

    Sorta PS, despite lots of internet research I cannot find why one loses water weight after drinking heavily (so I hear!) “Everyone” says alcohol is a diuretic, but I have no need to urinate more, so that’s not the right term. Does the alcohol take water with it during breathing? Inquiring minds want to know.

    • “Everyone” says alcohol is a diuretic, but I have no need to urinate more, so that’s not the right term. Does the alcohol take water with it during breathing? Inquiring minds want to know.

      Try researching Alcohol’s effect on ADH (anti-diuretic hormone) It’s a hormone triggered in the brain when alcohol is consumed. This hormone actually tells the body to urinate more.

      • You answered your own question. ADH causes the body to urinate more, i.e., when you drink alcohol, you pee more.

        Inquiring minds? sigh…

    • “With all due respect, I disagree on needing supplemental sodium, ever.”

      Speaking as someone who once went into convulsions because my sodium levels were too low…well, you’re just plain wrong.

      Hyponatremia (low sodium) kills quite a few highly fit athletes every year. Sweat is mostly water and sodium. Loss of other electrolytes in sweat is negligible.

      • Well said David.

        Not everyone holds their sodium well, due to many different issues. In fact, I would argue that with all due respect, Dr. Eades was drinking way too much water (not to mention coffee), and thus washing out his electrolytes, which then caused the cramping.

        Plus, it should be noted that the person who said we should never use ‘supplemental sodium’ also was eating a lot of high-sodium foods like cheeses and olives.

        We’re all different. What works for one, may make others a lot worse.

    • Paleo man most likely consumed whole animals, including the sodium-rich blood. Today, animals are bled and with that blood goes the salt.

  35. awesome! I’ve cured my dehydration problem by keeping two cups of ice cubes at my desk all day. It slowly releases water while I suck on cold ice cubes like candy, people think I’m crazy but it works, not too much water at one time and it lasts all day. My family all do it also, my kids are hooked on it, it also helps them relax before going to bed, Scotty Bowman (coach of the 9 Stanley Cup winning teams) did the same during a game, it helped control his temper.Thanks Dr Eades.

  36. Thanks for yet another interesting article! I’ve always been on the fence regarding water intake. One of my pet peeves is seeing people sucking on water bottles all day long. Also, I can’t imagine our Paleo ancestors drinking the equivalent of a gallon or more of water a day. That said, I’ll give it a shot. Maybe I’m usually dehydrated because whenever I start drinking more water, I’ll gain a couple pounds and it takes forever to get it off again. Maybe if I kept it up things would balance out.

  37. Very informative blogpost! I did have cramps in feet and calves in the beginning, but they subsided after a while. Somehow I didn’t suspect electolyte balance.

    Questions:
    1) Is a higher sodium intake required even after the starting phase of low-cal diet, or just during the start? And if so why?

    2) Some seem to have issues with sleep, they wake up during the night after a few hours of sleep, could this be because of electolyte balance or do some just need more calories to sleep better?

    Thank you.

  38. My questions are these. Is Kosher sea salt an OK salt to use or should I get some of the ones mentioned. I know that once I switched to Kosher salt away from processed salt I did much better but I am willing to get the others if there is a difference.

    Second, sometimes I am so thirsty and the more water i drink, the worse the thirst. It does not abate until I eat something. What is up with that?

    Last, would drinking the pellegrino water, the sparkling mineral water on a regular bases be a good thing or is plain water, filtered, be adequate for hydration?

    thanks for your time Doc Mike!

    Ressy

  39. Hi Doc

    Fantastic post, about 2 year’s worth of university level physiology! Just a couple of questions.

    1 I read that ketones make the liver insulin resistant. Am I misunderstanding something, can you comment?

    2 Does the consumption of saturated fat help the liver to burn the fat in it?

    Thanks. You have been truly been a blessing to us by your kindness in taking so much trouble to answer our questions.

    Martin

    • He isn’t particularly warning against drinking too much water while low-carbing, but instead against drinking too much water.

      His evidence is one anecdotal case (his own).

  40. Love all that you write and particularly enjoy your breakdowns of scientific processes. I am leery of supplements because I too agree that we can and should get all of our nutrients from the food we eat. I find fatty meat to be the most nutrient dense food available, that’s why I eat it as 90% of my diet. It is important to me that you explain why we aren’t getting something from our food that we should be like when you explained the demineralized water we drink.

    What I would love to see addressed is what we miss out on because we no longer take in the blood from the animals we eat. I am not about to drink blood, but I do believe I’ve read that the nutrients in raw milk are nearly identical to those in blood, save the lactose, right? since only infants need lactose, not adults, Logic would tell us that something in the cream of the breast milk replaces the blood of the animals infants cant yet eat. So, would that mean wholeunpasteurized non-homogenized cream would provide the nutrients missing from blood to adults as well?

  41. Dr. Mike,

    I believe in telling like it is, maybe you aspire from our generation..but you make me smile eveytime you say ” “that sucks” or “it sucks”. Lets me know how you really feel about it!..Enjoy reading the reading the truth. We all need to get back to that and away from the politically correct crap!

  42. I’m in my mid 40’s, a heavy drinker, am about 50 lbs over my ideal weight, and have high blood pressure and cholesterol. Aside from that, I feel great 😉 I’ve been trying to keep my carbs down for some time now, and that alone has been helping my weight, but will the alcohol I consume negate any health benefits from this diet? My typical drink is vodka and soda, and I have 7-10 strong drinks per night. I know I should slow down or quit altogether, but even if I don’t, is it worth it to try this, or am I just a lost cause?

  43. Hi Dr. Eades,

    It’s week 4 of LC/VLC for my 30y.o. sugar-induced, big-bellied husband and he’s still miserable. While the withdrawal headaches and leg cramps have diminished, his bowel function normalized, his blood sugar stabilized and his cravings reduced, all with noticeable weight lost!, none of his osteo-arthritis or nerve pain has diminished at all. On top of this usual pain, he’s developed very annoying leg twitches (RLS?) for the first time in his life which we’ve figured out are lessened by sex/orgasm before bed, but return by morning. Could the fact that he drinks 9 cups of coffee, takes 3x hydrocodone5/500MG acetaminophen and 40mg citalapram during the day and 10mg prazosin + ambien at night simply be too much for his liver and kidneys and needs his medications adjusted? Does he need more carbs? He doesn’t feel “great” or “full of energy” or any of the mood changes people report after going low carb. He’s miserable and frustrated and just wants to know when he can have a potato. As per your recommendations I’ll add in ALA and 5-HTP to his current supplements (he’s doing everything else according to PPLP). Thank you.

  44. Dr. Mike: Thank you, thank you for another excellent post (and recipe). I’ve subscribed to your reports for years and feel you are a beacon in the wilderness of the conflicting (and misguided) information which is all over the place. Your analysis of murky clinical studies over the years has been invaluable, along with your sharing of your medical practice experience and reading finds, are all greatly appreciated.

  45. I read the section on hydration and it left me a bit skeptical. I’m not a medical doctor, but…when you talk about hydration increasing blood volume by 20% to 6 litres, has anyone actually measured blood composition in those circumstances? If the blood volume increases by that amount, what does it do to blood pressure? Has anyone measured that?

    I suspect that it doesn’t increase blood volume to an appreciable degree, but sloshes about in the stomach and bladder, otherwise we’d see older folks going into congestive heart failure and drowning in fluid.

    Have I misunderstood what you were saying?

  46. hmmm, maybe I should try drinking “Scotcho de Verano” instead of scotch on the rocks… half scotch, half sparkling water, add bit of lemon and maybe even some ginger…

  47. What suggestions can anyone offer for someone who has done well with low carbing, losing an effective amount of weight and improving lipid health, but after eight to 10 months has reached a weight loss plateau where the remaining weight (midriff fat) doesn’t seem to want to go away, or perhaps has even increased a bit over the past few months? This is despite a consistent low-carb diet?

  48. Pingback: Fatty liver
  49. Be careful, because in some parts of Spain, Tinto de Verano is made with red wine and lemonade! (i.e. contains sugar).

  50. Thank you, Dr. Eades, for this post! I, too, have been eagerly awaiting it. Such an enjoyable read – who else but you could make reading about electrolytes and boiled chicken backs fun?

  51. A note about magnesium–I thought I would never be able to take magnesium supplements because every one gave me very loose stools, usually with no warning. But then I discovered that it was magnesium oxide that was the problem; any other type with the -ate on the end does not. I especially liked magnesium malate, as it seemed to do more for my muscles, but it’s harder to find in stores. And Celtic sea salt actually relieved the edema in my lower legs and ankles.

  52. I don’t think the problem with protein is due to the conversion of protein into glucose. Rather I think it’s due to the effect protein has on glucagon, which in turn causes more glycogen to be converted into glucose then dumped into the bloodstream.

    I forgot the details but I remember one researcher a while back who did a presentation during one of the low carb cruises (I wasn’t there, I just heard about his presentation) had found out that blood glucose, when it does not come from dietary glucose, comes not from direct conversion of protein into glucose, but rather from the conversion of some substances (i.e. protein, glycerol, etc) into glycogen first, then into glucose from that. This lends credence to the idea that the effect protein has on blood glucose is not first order, but second order.

    However, in practice, it doesn’t make much difference, the effect on weight loss and ketosis is probably the same.

  53. I’m on a brutal. almost forced march, schedule while I’m in Spain for the next few days. I’m going to put the comments up as they come in without answering all the questions because I simply don’t have time. I would rather get the comments up and generate a discussion than hold them in moderation until I get the time to deal with them. I read them all as I approve, but just don’t have the time right now to deal with each individually.

  54. One caveat about tonic water… it is possible to drink too much. For years I had kept some diet tonic water around because I have been prone to leg cramps for my whole life.

    I would guzzle tonic water. It seemed to stop leg cramps in their tracks. I would even sometimes drink some before going to bed.

    But it is possible to drink too much. You can get cinchonism from that (overdose). Quinine comes from cinchona bark.

    What happened to me was that I got visual disturbances called scotomata… wavy lines which would start pulsating on one side, then they’d get bigger, then they would subside after a while. It was not fun to attempt to transcribe medical reports while in the midst of one of them.

    I have been off tonic water for a long time now, but I got a scotoma the other night (surprise!). I think I may also get them from the strain of staring at a computer screen for too long.

    I’m drinking a lot of bone broth and using a lot of French gray sea salt. It helps, but I still sometimes get breakthrough leg cramps. Not fun to wake up to them.

    Sometimes by just waiting, the cramps will ease. Sometimes it helps to just drink plain water.

    • Thought I’d just chime in since I had very similar experiences. I drank gin-and-tonics for years with a variety of tonic waters – Fever Tree was by far the best – and never had any problems. However, when we started making our own homebrew tonic using cinchona bark I started getting scotomata symptoms – i.e. ocular migraines. (actually, the first occurrence was a real migraine, subsequent ones were only the ocular component).

      I’ve only had 1 occurrence since ditching tonic. I’ve also correlated these with dehydration, so that may be something to watch.

      • Thanks for your comments. I am staying away from tonic water from now on. Have never heard of that brand of tonic water, and now I won’t attempt to brew my own either!

        I did not have migraine headaches per se while getting scotomata, luckily. As a teenager I was a veritable walking headache.

  55. Well, Dr. Mike, thank you and Dr. Mary Dan for taking the time from your busy lives to post on your blogs. I enjoy your writing.

  56. Hi, Dr. Eades, Hello from Provence, where I now live and where I happily bought some nice, fatty barbecued ribs at the market this morning. I have been a HUGE fans of yours; am certain I would be diabetic without “Protein Power,” which I discovered over 10 years ago. Two years ago I lost weight on “The 6 Week Cure.” But then I gained it back, and I would like to blame the gain on the anti-depressants I started taking. It seemed that while I was on the meds I really couldn’t control my eating like I would have liked to. Perhaps I just imagined this?? Any studies on this? I am off the meds, and back on a very low carb plan. Merci.

  57. Great article, really cleared some things for me, especially about hydration.

    However, I can not underline enough one supplement that you missed – vitamin C.

    1. Lean meats are poor source of vitamin C. It is mostly found in adrenals, eyes, and brain. Those are the organs people typically do not eat. Vegetables contain some small amounts, paprika probably is the best source. Fruits too, especially rose hips and acerola, however, fruits are not an option on lowcarb and most fruits don’t have enough vitamin C, especially genetically altered.

    2. Carnitine is limiting factor in beta oxidation. C is required for its synthesis. You could use carnitine supplementation tho but you miss some of the many other benefits of C. I would probably take both during weight loss.

    3. If moderate exercise is included in weight loss regimen as it should (not because it burns calories, but because of hormonal changes and antioxidant machinery boost), C helps recovery and makes probability of injury less which is the very important thing. Injury leads to even more sedentary behavior then before exercise. Also, exercise, at least acutely can bring immunity down. Vitamin C helps with immunity a lot, but we all know that. Exercise will also rise cortisol levels which is good thing as it brings insulin down, but C is used in synthesis and pumped in the blood in parallel. On the negative side, there are some notes about reduced efficiency of exercise with antioxidant supplementation, but nothing conclusive, most in animals, and not something I would be concerned about at this moment.

    4. Vitamin C reduces stress by the same pathway as in exercise. Stress can lead to overeating for some people (for some it can lead to loss of appetite). Better to supplement then to guess.

    5. Vitamin C will help detoxifying hard metals and other poisons from the body once those are released from the fat tissue. You could be storing poisons there for decades ….

    6. Saturated fats rise LDL and HDL. Rising HDL is a good thing, rising LDL might not be a good thing for some people (i know… cholesterol hypothesis sux). Better to be safe then sorry again. Boost C, as it will boost E, glutathion and friends….

    Those are at least 6 reasons to supplement C, there are bunch more. You mentioned ALA and that is another one. Also, there are some claims that ALA can bring mercury from amalgam into the brain (its chelator besides its AO role) so C can help with that too as it reduces mercury poisoning. I recommend dosses from 2 – 10g per day as promoted by Linus Pauling and friends.

  58. Love your posts. Too few and far btwn.
    Epsom salt baths are a good recommendation. Some parents of autistic kids finds this helps and alleviates symptoms. Epsom is Mag Sulfate. The Mg is absorbed through the skin and the sulfate, which is deficient in plants that the vegetarians push (both because plants are low in the sulfur containing aa’s and the soils they are grown on are deficient) is the activating factor for proper ops of cholesterol in the human body and brain. Cholesterol-sulfate deficiency in exacerbating or causing DOC’s is the hypothesis of Dr Stephanie Seneff, MIT.

  59. I feel bad getting all this information for free! But since I’ve bought your two books and am still struggling through ‘good calories, bad calories’ I feel a little better! :) Thank you for not buckling under the establishment!! I appreciate your work!

  60. Very interesting post. Lots of information as usual. I’ve been drinking Gerolsteiner’s mineral water lately because it claims to have a good ratio of calcium and magnesium. If we take a magnesium supplement, should we increase calcium also? FYI: I like tonic water and thought it was a good alternative to having an alcoholic drink, but looked at the label one day (of a major brand) and saw HFC. So no more tonic water for me.

  61. I like all sorts of bone broth a lot but currently my favorite is fish broth. A local fishmonger sells halibut or other large ocean filleted fish carcass for less than $1 per pound. I fill a 5 gallon stock pot with the bones (about 12 pounds), cover with water, add a half cup of vinegar and simmer it for a couple of hours, then remove the solids and reduce the stock by about 1/3rd. That’s leaves more than 3 gallons of very rich broth, plus lots of delicious meat scrap and softened bone which I share with the dogs and chickens. I’ve been drinking about a cup per day of this broth with no seasoning except a little tarragon. It is plenty salty without any added and is extremely filling.

  62. Great advice. I always feel better when I up my fat content.

    Thanks for the video on how to make an Americano. I had a double Americano today instead of 3 cups of filter coffee and found it very satisfying.

    Hope you find time to enjoy Spain in spite of your gruelling schedule.

  63. Anybody have any suggestions for low cost vitamins/supplements that can be purchased online? I just ordered about a 1-2 mo. supply of magnesium citrate and potassium, but I don’t want to spend that much every month or two (in addition to the expenses I incur trying to eat so much meat)

    • Try iHerb.com and use coupon code FAK738 for a discount. I’ve purchased many supplements from them and have always been pleased with both the product and service.

  64. I made the bone broth today. It’s absolutely delicious. Being married to a chef by trade, I didn’t expect it to be anything far removed from other bone broths he’s made. However, it was indeed very different. Very smooth and flavorful. I could see it as the base for a hearty soup too. A nice dish to have when IF needs to be broken early. Good for extra fluids too. Was great to have all that salt in there too! Thanks so much for sharing!

  65. Why the push on sodium?

    The Paleo Diet I want to follow says to AVOID SALT (Loren Cordain).

    Now I’m really confused.

    • Having just watched a YouTube lecture given by Loren Cordain, I’m not surprised you are a little confused. I noticed quite a few contradictions in his messages.

    • Low-carb is based on science.

      “Paleo” is based on speculations about what our ancestors ate. Despite what Cordain and others say, dietary evidence from the Paleo period is all over the board.

      Many of our ancestors lived on coastlines with high intakes of seafood and sea vegetables. That means more salt.

      Many animals seek out salt. Our ancestors may have as well. And many researchers now believe that trade existed in the Paleolithic. Salt trade is certainly one of the most ancient forms of exchange.

      “Paleo” is interesting. But it isn’t science.

  66. Doc, this was your most fascinating blast of concentrated education (imho) since I first read PPL. Thanks for all the fascinating info, and please keep it coming.

    Question: could ALA cause some insomnia? I began experiencing some difficulty getting to sleep a while back so I decided to subject my supplements to a process-of-elimination test to see if anything effected my sleep. And ALA seemed to. In fact I realized that the sleeping problems began about the time I increased dose from 100 to 200 mg/day. Coincidence?

    • Todd, do you have any amalgam fillings ? If so, you may want to replace them before you start to take that much ALA.

      Otherwise, that dose (200mg/day) is not that big, for (diabetic) neuropathy doses are from 300 to 600 mg.

        • Hey.

          First, let me tell you that this is controversial topic and is promoted by Andy Cuttler, who is very much qualified to do such sort of research.

          The problem is that ALA is also a chelator. Doctors are prescribing it as antioxidant ignoring its chelating properties.

          I wrote about this on vitamin C forum, check it out:
          http://www.vitamincfoundation.org/forum/viewtopic.php?p=24528#p24528

          In short, if you have amalgam you have constant shower of mercury vapor from it, every day, all day. Eating and chewing gum makes it worst. Now, you add ALA, and its metabolic product binds inorganic mercury which can not pass blood brain barrier, and now it can since it has a vehicle. If it drops from the vehicle there, it is trapped in the brain and can not exit.

          Now, I am not an expert, and I know that some other mercury experts didn’t share this concern with Cuttler, however, that doesn’t mean he is not right and when you read the theory behind it seems to me that it is better to just remove those amalgam fillings (u need to wait 3 months after that from mercury to be removed from the blood) then to create some nasty problem, especially more so since ALA is fantastic antioxidant.

          Let me say that some people seem to tolerate mercury better then others (genetics [for instance levels of MT protein], sex [testosterone seems to make things worst], etc…) and might not have any problem with it. If you choose 2 use ALA with amalgam I strongly suggest you using bigger doses of C and selenium (brazil nuts) as those will help in mercury removal from the body.

      • Can you post links to peer reviewed research that shows amalgam fillings are a problem together with Ala

  67. I have been trying to get an answer to a glucose question from you for a few weeks, still haven’t found the answer so I am still trying. I have been following the diet for 5 weeks, my glucose levels are remaining high (despite insulin injections and pills) I don’t have ups and downs in my level anymore, but it’s hard to get it much less than 200mg/dl. I am consuming less than 20 grams of carbs a day, and I’m not fudging on that count. I have lost 7 pounds but none for a few weeks now.

    Is the elevated blood glucose keeping me from losing? I am in ketosis most of every day, at least a trace amount and usually more than that

    When I treat the high glucose with insulin is this driving my insulin levels high and keeping them there? I am actually having to take large amounts of insulin to get my glucose level to budge.

    Is all of this normal? If it isn’t, how do I break through this cycle?

    I have read your books and am working on others you have recommended. I have obtained all the supplements and take them everyday. I’ve bought the special oils and am reading the labels. Not one carb has crossed my lips other than what might actually be in a serving of a vegetable. Why are my sugar levels still high and what can I do to thurn this around?

    • Jody,
      As one diabetic to another I feel your pain!

      I wonder if you are eating alot of protein…which does break down into sugar but at a slower rate.

      Is your insulin in the bottle still good? Are you fighting an infection?

      I try to avoid taking more insulin that I need. I try to use exercise to bring down a high level and low carb to keep the insulin needs low. I also don’t snack so that I can give the insulin a chance over 4-5 hours to bring down the number.

      hth

      Ressy

    • Jody, Please realize that Dr. Mike is not your diabetes doctor, nor is he still in practice treating people for weight loss. He’s not going to provide diabetes advice to an individual he has not seen and cannot see. Jimmie Moore has a low-carb-friendly doctors list on his Livin’ La Vida Low Carb site — see if he has one listed in your area who can help you with your very high blood sugar levels — because you’re not going to be able to get the kind of help your asking for here! And I’d say you need to get help with those levels because they are so high!

      • Ressy: Thanks for your answer. Yes, I am eating a lot of protein, about 90 grams a day, which by calculations is what I should be eating. Yes, the insulin is good, I’m going through a new bottle about every 2 weeks with still these high numbers and no carb consumption to speak of. I suppose there could be an illness, but there are no symptoms of one. I’ll try to cut back on the protein and see if that helps.

        Elenor: I don’t expect Dr Mike to be my doctor, I am closely followed by my own. Unfortunately, my doctor isn’t as familiar with all the details of a low carb diet, he just gave me permission to “give it a try”. My question was does Dr Mike see this problem in some people where the glucose level is hard to decrease even though they are eating minimal carbs? After 5 weeks, I would expect to be seeing a different outcome by the information I’ve read in his books.

        • Jody, try some exercise, your liver is insulin resistant so pancreas keeps pumping it -> high blood sugar, high insulin, low fat burn. Exercise will fix that.

          Walk, 1 hour per day fast, or do some high intensity exercise couple of time per week for 30 minutes or so.

          Also, add some fish oil & cinnamon to your diet

          • Majkinetor: ( And Reesy, too)

            Thanks for your suggestions, I will give them a tryl Yes, I am slowly increasing my exercise. I have trouble due to some bad discs and back pain limits some exercises. Yet another reason to lose weight!.

            Good news today! I have had a breakthrough with a glucose level of 132 this afternoon. Looks like something finally kicked in. I did just start an ALA supplement the day before last, perhaps that is the reason. I just ecstatic to see things going in the right direction.

          • Jody, water aerobics is great increasing exercise without putting stress on joints/articulations.

          • Re: Vitamin C

            I remember reading that C is needed to process carbs, so if you’re eating low-carb, you need less C.

          • Its opposite actually – glucose competes with oxidized C for GLUT transporters, and C is needed for beta oxidation, i.e. fat burning.

          • Oh, thanks. So if glucose competes with C, then if you’re eating low-carb, you need less C because it is competing less (more gets through)? Just want to be sure I’m understanding.

          • I am a pre-diabetic. I found exercise has the maximum effect in bringing down the blood glucose to normal levels. Now a days I try to exercise after every meal or at least twice a day after meals, which sometimes bring down the BG level to 83 with 2-1/2 hours of bicycle riding. One hour walking after meal usually brings down by BG to 113 level.

        • What kind of meat are you eating? Is it fatty meat or the lean stuff like chicken breasts and filet? If you aren’t already eat very fatty meat. Every person I know who struggles with this way of living can’t let go of the “lean meat is good for us” mantra. They think lean meat and a salad with dressing is the answer. it’s not! choose the fattiest cuts and eat all the fat along with the meat. Eat the skin, eat bacon. Eat mayo. Eat butter. Pretty soon, you’ll rarely be hungry because your blood sugar will be stable at fasting rates and your cells will be nourished. It’s nirvana, trust me.

        • Jody, it’s unfair to ask a physician to give a diabetic a medical opinion over the internet, and it would be unethical for him to reply. If you don’t think your doctor is knowledgeable enough, it’s your responsibility to find another doctor.

          Do not attempt this without your doctor’s direct supervision, but the following extremely strict diet completely normalized blood sugars in diabetics in 7 days, and reversed diabetes in most of the trial subjects in eight weeks:

          http://www.telegraph.co.uk/health/8594293/Crash-course-diet-reverses-Type-2-diabetes-in-a-week.html

          This is the paper:
          http://www.diabetologia-journal.org/Lim.pdf

          In the paper, it reveals that the diet protocol was 510 calories of Optifast shakes/day + 90 calories of non-starchy vegetables daily.

          My hunch is that you would do even better with the shakes from the Eades’ 6-Week Cure, but the study was done with the Optifast powder.

          • Tom:

            I haven’t asked anyone to give me medical advice. I don’t think I am being unfair by asking a question about a metabolic process! I would imagine that I am not the only diabetic person following this lifestyle that has had trouble getting their glucose levels down and was asking if he has seen this before in OTHER diabetic patients that he HAS treated. And, if so, what physiology seemed to be the cause. It seems to be a catch 22 situation that I wasn’t sure that would resolve itself or not. It doesn’t matter anymore, I have broken the cycle and my sugar level is coming down. I guess whatever made it happen is a result of
            a combination of all the good information that I have found by reading Dr Eades books.

            I think I’ll pass on the 510 cal starvation diet. In fact, I’m pretty sure I read something in the good doctors book about starvation diets being very unhealthy and detrimental to a person’s optimal metabolisim.

            Oh, and by the way, just because I read that in one of his books, it doesn’t mean that he’s responsible for my decision not to try it. In the end, it boil down to my own choice.

          • Sure you are. You’re not asking about a metabolic process in the abstract. You’re laying out your personal situation, explaining your insulin dosing, and asking him to recommend an action to further lower your blood glucose.

            If he replies, he’s practicing medicine…without examining you. That’s certainly unethical, possibly illegal (not sure), but definitely insane from a liability standpoint. Why should he risk his life’s work to render an opinion to an anonymous commenter?

            There’s a reason he’s approving these comments without weighing in. My guess is he’s weary of asking people every ten minutes to respect boundaries that are not of his making.

          • Tom:

            **SIGH*** My understanding of asking for medical advice is asking a doctor to tell you something specific such as asking if you should or should not take a medication and/or how much. I wasn’t asking him if I should or should not take medication. I didn’t ask if I should or should not follow this lifestyle.
            I’ve read back over my initial blog. Perhaps I should have turned the “I” statements into something more like “when someone” I don’t dispute that I laid out my scenario. I thought it was pertinant to demonstrate the situation I was asking about. I have read his books and believe me, if he had touched on this subject, I would have already had my answer and not had to be subjected to your lecturing.

            You are correct, he has been approving these comments. I assume by that, I must have some validity to my inquiry. He doesn’t need to weigh in if he can put it out there and others like Andrea and Reesy are willing to share their similair experiences to help answer my questions. I see thismore as a good conservation of his time and energy and less of a demonstration of being “weary” of me.

            In the end, I think I have gleaned the answer to my questions in relation to “someone” who is diabetic: Yes, it is possilbe to have continued elevated glucose levels without the consumption of carbohydrates and yes, when you have to inject insulin, it will be a struggle to burn fat for fuel.

            As for you, I can’t figure out if it is your intention to be obtuse or if you are merely a bully. The man wrote a book(s) about all of this. He’s a expert about it. I had some questions and I asked them. If you expect an apology, it’s not coming. Now, please leave me alone.

          • Oh, please. When you repeatedly ask a physician questions that they can’t answer without getting sued, you are imposing.

          • Jody, low calorie diets are not necessarily unhealthy.

            – It has to be CRON – calorie restriction with optimal nutrition, which means you have to take a lot of supplements.
            – CRON prolongs life in most animals, and promotes autophagy probably as a consequence of protein restriction (probably MET).

            As for taking weight off, I don’t think its a good idea.

            So, I would start with 30 minutes exercise ala jillian michaels 30 day shred every second day and 30-60m fast walking ASAP, tones of vitamin C, and normal mode for vitamin D, Mg, carnitine, ALA, chromium, policosanol, CoQ10, fish oil. I wouldn’t introduce that 1 by 1, but would start ALL of it, tomorrow. The problem is to find good supplements with good dosages. Also, very cold shower might help, 10-20 minutes a day.

          • Thanks, Majkinetor!
            I am taking most of those supplements. I still need to start: CoQ10, krill oil and selenium. It’s been a bit of a challenge finding quality supplements at an affordable price, but it is on my to do list. I haven’t heard of poliocosanol before in any of my readings.

            I also haven’t read anything about a very cold shower, brrrrr.

            I’m trying to get off my rump and move, but still having trouble with fatique even at 5 weeks in. I figure this is because of the glucose levels and will pass when I get eveything nailed down. Someone else had mentioned water aerobics and that sounds pretty appealing.

            Im going to lower my calorie intake a bit, probably by cutting the protein just a smidge. I’ve been able to stay LC mostly because my appetite is low eating the protein and fats. There have been days I have had to force myself to eat trying to get my recommended grams of protein satisfied. That’s a new one for me, I’ve never had trouble eating before!

          • Im going to lower my calorie intake a bit, probably by cutting the protein just a smidge.

            Yes, just a bit…that’s the ticket! Pay no attention to the study I found for you that REVERSED DIABETES in ALL SUBJECTS in just EIGHT WEEKS.

            Because it might cause you to feel PECKISH.

          • For CoQ10 u need to find liposome encapsulated one, like Jarrow Formulas Q-Absorb. For selenium just use brazil nuts, 1 has around 50mcg.

  68. I had always thought that the best source of magnesium (and calcium) was green leafy vegetables and that the widespread deficiency problem was due to people not eating their greens. Not so?

    Best,

    Steve

    • Bioavailability is the problem. Sure, it’s in there, but it’s there to be had by the herbivores that have 4 stomachs to get to it. We get very little of the nutrients locked up in cellulose. We just end up with colon issues. Let the herbivores do the digesting and accessing, then eat one of them. Much easier.

  69. Steve wrote: “I had always thought that the best source of magnesium (and calcium) was green leafy vegetables and that the widespread deficiency problem was due to people not eating their greens. Not so?”

    I tend to eat one shell of a hard-boiled egg daily, which is perhaps the finest source of utilizable calcium.

  70. Hi, Dr. Eades,

    I know your plate is full, but if you were moved to write about the recent study about diabetes reversal with 8 weeks of a 600 calorie diet, I’d love to hear your thoughts on the paper.

    Link to paper:
    http://www.diabetologia-journal.org/Lim.pdf

    Head author:
    http://www.ncl.ac.uk/biomedicine/research/brc/profile/Roy.Taylor

    Article in the Telegraph:
    http://www.telegraph.co.uk/health/8594293/Crash-course-diet-reverses-Type-2-diabetes-in-a-week.html

    Thank you.

  71. Totally off topic. I assume you heard about Amazon terminating their Associates Program for California-based participants due to recent CA passed legislation expanding the definition of nexus for online retailers. Does this affect you? Comments?

  72. Jody & Ressy
    I too have experienced high blood glucose on VLC diet strictly adhered to (with plenty of exercise, fat, salt and water as well). My a.m. readings were always above 140, which drove me nuts. However, over the past several weeks I am having mostly non-diabetic readings, even in the a.m. It took about 2 months on VLC. So maybe it is a matter of time. But also: I discovered my body was pumping out high cortisol at night – possibly the cortisol raised my blood sugar. If you have one endocrine issue (diabetes) you may want to get checked out for impaired adrenal and thyroid function – both extremely common and rarely well diagnosed or treated…. I have been hypothyroid since age 3 but it was undiagnosed till I was 47. I have not lost much weight yet, but expect it will happen as my adrenals and low thyroid are finally being treated properly – and I am committed to VLC eating, which gives me so much energy.

    Dr. Mike – apologies if this comment was off topic. I am curious if you’ve observed that hypothyroid patients have trouble losing weight even on LC. Your LC info is the best. (I even saw Dr. Atkins in person several times in NYC in the late 1970s, and he had no answer for why I did not lose weight on his diet.) Thank you for everything you share with us here and in your books etc. You have given me a lot of hope and now with my blood sugar running 117-125 in the morning (instead of 140-170), I am really excited to keep going.

    • There are people who can’t loose weight on LC as described in GCBC by Taubes in charpter about reducing diets. I also encounter infrequent reports on various forums. There are various other reasons for why you can’t loose weight on LC, among most probable are malnutrition and dehydration.

      Since you are hypotyr and have higher cortisol levels at night, I would add selenium, idoine and vitamin C ~(250mcg, 1mg, 10g) to your regeime. This will help both your adrenal and tyroid gland function properly.

      Make sure you also have good input of choline, carnitine and fish oil, deficiency of each can slow or stop weight loss.

    • Very interesting post. One supplement I personally take “religiously” is Lysine. First thing in the morning vitC & Lysine and (god forbid) ibuprofen. I am 68yo, somewhat overweight, but haven’t been “sick” in decades.
      Lysine can be used as a sacrificial amino acid for glycosylation reactions. A lot of the damage done by elevated blood glucose levels, is due to glycosylation. Google AGE (advanced glycation end products).
      Just my $0.02 :)
      Namaste

  73. Andrea,

    thank you for your comment, I find it encouraging to see that I am not alone in my struggles.

    I, too, am hypothyroid. My thyroid crapped out 2 years ago and it was at the time that I had to start taking insulin. It all happened at once and had been a slow downward slide into obesity and poor glucose control since that time. It’s been a snowball effect. I have committed myself to a low carb lifestyle and I really do not have carb cravings and have a newfound sense of pride that I made this decision for my life. I love that I don’t feel like I’m starving all the time.

    I suppose I was just looking for a little afirmation that perhaps it is harder for a diabetic to get glucose control initially, but with a bit of sticking it out, things would eventually change. I’m looking forward to the day that I might be able to get off all these meds once and for all. From what I’ve read in the books, I’ve come to the conclusion that I’m not going to be able to reverse my insulin resistance until I am able to decrease and stop my need for insulin injections. Hopefully, it happens sooner rather than later.

  74. There’s another tip that Dr. Eades won’t talk about here because he doesn’t “hard-sell” his products, but I will: found the Eades’s Metabosol product really helpful in losing those stubborn last 10 pounds. I know everybody’s skeptical of “weight loss formulas,” but I needed a boost. Low carb alone got me from 135 to 129 in September 2010 but I just couldn’t get below that. Starting June 1, 2011, I made another run at it, same diet but with Metabosol this time, and in 31 days I went from 129 to 121.5 – within 3.5 pounds of my goal weight. I’m 52 and post-menopausal, so I can be considered a tough case.

    I kept detailed records of what I ate and my pounds and measurements. My diet approach for weight loss is around 70% fat, 28% protein, and 2% carb (about 6g per day), following the 6 Week Cure schedule. I tried 60%-38%-2% and couldn’t see a lot of difference, probably because it’s still pretty high fat. I did a couple of 49%-49%-2% days and stalled afterward, but I didn’t do it often enough to rule out coincidence.

    Question for Dr. Eades when you’re off the road: I have a trick I’ve discovered with Metabosol, where I get up and take it at 4 a.m. on an empty stomach and then go back to sleep for four hours. When my sleep is really deep and restful, I get up and find that I’ve lost .5 to 1.5 pounds between 4 a.m. and 9 a.m. (It stays off, too!) Is there any medical basis for this?

    Needless to say, I’m very happy about the way I look and wearing clothes I haven’t worn since 2002.

  75. @ Majkinetor — re: vitamin C

    I’ve experienced electrolyte issues now that summer is here and I’m sweating much more. To combat this — I’ve been using one packet of Emergen-C Lite plus additional Celtic seasalt in water. Et Emergen C contains magnesium, calcium, potassium in addition to 1,000mg of vitamin C. The sweeterner used is 2 mg of “purified fructose derived from corn.” Any thoughts as to how damaging purified fructose is? I like the convenience of the electrolytes all in a convenient pac but if I have to, I’ll start mixing up my own to avoid this fructose stuff. Thoughts?

    • I really don’t think 2mg of fructose is a concern, it might even be better for bioavailability of C since it uses mostly GLUT5 transporters, not GLUT4 as C which doesn’t make them compete (which is the case with glucose). One problem with fructose tho, is that it doesn’t rise insulin and rising insulin rises level of GLUT4 transporters (in metabolically healthy individuals). Perhaps adding some protein to the mix would be good idea (protein shake or taking stuff after protein meal).

      Emergen-C looks like a really nice product, I don’t use it but I am judging from the nutrition info on its site. I do think however, that 1g of C might be too low, you may want to double the dose at least and still fall inside ‘safe’ mainstream dose (UL for C is 2g). I would suggest to try more C for few months (for instance daily dose of 4-8g in pure ascorbate acid form dissolved in good carbonated water which contains magnesium) to see if it makes any difference for you. Generally, stevia or xylitol are the best sweetener for C if you need any.

      • @majkinetor

        Thank you for your helpful reply. I actually like the taste of pure ascorbic acid but only started using the Emergen-C Lite product because it contains electrolytes — sodium, potassium plus magnesium, calcium and some vitamins. I’ll try to find a good magnesium water and make my own drink. Thank you again.

    • 2 mg of fructose is nothing at all–purified or not.

      Are you sure is isn’t 2 grams? (even that isn’t all that much…)

      • Hi David,

        You are correct. I just checked the box again and it’s 1 gram listed under sugars and since fructose is the first ingredient it must be 1 gram of fructose.

        I see this company (Alacer) also has a pure electrolyte replacement drink that is stevia sweetened. It has no vitamin c though — and more calcium, magnesium, chromium, potassium — no salt. I might try this one and add salt and swallow with vitamin c capsules.

  76. @Tom You seem to have too much invested in being right and protecting Dr Eades. It does seem like bullying making Jody defend herself to keep her credibility on the site. You, however, with your right fighting are rapidly losing yours.

    • It does seem like bullying making Jody defend herself to keep her credibility on the site. You, however, with your right fighting are rapidly losing yours.

      We’re two anonymous posters, so I’m not sure we have a whole lot of credibility to defend either way.

      I’ll admit it ticked me off that she called me a “bully” after I went to the trouble of telling her about the Newcastle study.

      But I guess that must have been “bullying” too.

      By the way…I am right. All anonymous posters are. :-)

  77. Jody–How much protein vs. fat are you eating? As Dr. Eades says in this post, it is possible to get too much protein if the excess is, for you, inducing gluconeogenesis (sp??), which is causing excess protein basically to be turned into glucose (I think that’s right). I’ve been VLC for a month, and after initial weight loss woosh, I was at a stall. I changed up my protein vs. fat, and the weight has started coming off. I basically switched my fat & protein ratios: I now eat around 60 grams protein/125 fat/20 carbs. (I’m 49, female, 149.8 lbs.). I was at 155.2 lbs. the day I started. I, too, have BG issues, although not to the extent of yours. But, I think this might help you.

    As for the fats I’m eating: avocados, coconut oil, olive oil, butter, almonds (also where some of my carbs come from). Try one of the websites with a nutrition tracker where you can input your daily diet, and it will calculate the nutrients for you. I eat 1400-1500 cals/day, and am rarely hungry between meals. The fat is so satisfying.

    • By the way, it is SO surreal to me that, every day as I plan my food on my nutrition tracker, I have to FIND extra sources of fat, or fatty meats. The fact that I have to say…ooh, I NEED an extra tbsp. of butter today, or I better make it TWO tbsp. of olive oil on my salad. Or EXTRA avocado!!! Or the fact that yesterday, my bacon burger came out with “wobbly” bacon (love that word Dr. Eades!), and I didn’t send it back. I ate my wobbly bacon without the fear of the bacon fat causing my zipper to explode.

      I sleep SO much better: the entire night, no sinus issues, no more Breathe Right strips needed.

      Also, I had been diagnosed via an upper endoscopy with oeseniphilic (sp.?) esophagitis, basically inflammation which was causing me to choke on food. I, at times, was having to stop eating and regurgitate to get the food out of my throat. Ever since starting VLC, I’ve had zero problems getting food down. Inflammation being eased by no grain carbs? Seems like it.

      I just can’t understand why Dr. Eades isn’t being asked by Dr. Oz to share all of this. Sigh….shakes head in disgust….

    • Pam,

      I had read on in one of these blogs for protein power where Dr Eades told a writer to “eat more fat”. Since reading that, I’ve made a concentrated effort to up that and lowered my protein a bit. I noticed when I did that, my ketone strips were a darker purple. Still I am wondering, since the body can break down fat into glucose…. When you must inject insulin to keep blood glucose in normal range, and insulin is the key to storing fat…..aren’t you just making your body do just that? At least I can say this, it is a relief that I’m not gaining weight while consuming a high fat diet/

      But to answer your question: I estimate my ratio to be 40% protein 55% fat, 5% carb.

      I’ll keep working at it, I know eventually it will all work out.

  78. I just can’t understand why Dr. Eades isn’t being asked by Dr. Oz to share all of this. Sigh….shakes head in disgust….

    Because Oz has written best-selling diet books that place him firmly in the low-fat camp.

    At this point, he can no longer act as if low carb doesn’t exist, true. And he did recently have Gary Taubes on. But Taubes was there as a kind of stalking horse.

    What you will never see on Oz’s show is more than one low-carb expert in any given group. Because then viewers might be confused into thinking that low carb was something other than the wacky fringe alternative.

    And we can’t have that! 😉

  79. I’m not new to Low Carb, but am new to Protein Power, so I am really appreciating these last two posts about restarting. I’ve just finished reading the book and have a question about the proviso on page 97 that suggests if one suffers from allergies, asthma, arthritis etc one might want to avoid red meat and eggs because of their arachidonic acid content. (I’ve noticed mucosal issues after doing Very low carb.). When I look at sites with AA content on them http://wholefoodcatalog.info/nutrient/arachidonic_acid/foods/c/3/ however, I don’t see a large difference between red meat and other things (Per 100 grams I see values for Ham at 67, Chicken thighs at 78, and Shrimp at 70. Eggs seem to be the worst at around 120, while some of the beefs are in the 30mcg per 100 gram category.) So what I don’t understand is why one should reduce red meat if chicken is about the same. Are there other elements in the non-red meats that produce the Cox2/ “good” eicosanoids, or if one is sensitive to AA does this mean this diet is going to be a problem in terms of a PP diet? I’ve searched the site and haven’t found an answer to this question.

  80. majkinetor,

    I do thank you for your patience and helpful suggestions.

    I just wanted to let you know that I did read the link you supplied about cold water. I couldn’t find additional links to the studies that support this

    I say this because I am an emergency room nurse and we use body cooling in post cardiac arrest patients that we have been able to get a heart rhythm on after CPR. It is a system that has pads that wrap around the core of the body and the extremities. This system cools the body core temperature, slows heartrate and respirations and decreases the body’s oxygen needs. I can’t tell you how low the body temp is suppose to go because they are shipped to the ICU and rewarmed the next day, I believe the end goal is to prevent reperfusion injury to the heart. It is because of this that I was surprised that the article said that being exposed to such cold makes the heart rate speed up as well as the respiratory rate. Warmth, on the other hand (such as when someone is running a fever) does makes a person’s heart beat faster and breath faster in the effort to cool the body.

    I don’t mean to offend, just found this a bit confusing

    Thanks, Jody

    • Jody, its entirely different mechanism.
      First, its not that long, and temperature should be lower with showering I guess. You typically shower not more then 10 minutes.

      Then, as water is cold it promotes peripheral vasoconstriction which increases blood pressure and brings ‘ more circulation ‘ to inner organs which promotes nutrition and detoxification (the more detoxing variant is contrast shower, but for weight loss cold only is better).

      Also, you practice thermogenesis by activating brown fat cells – BAT – which dissipate energy as heat (when you stop shivering, your BAT cells take over). Cold water will speed up the metabolism in order to keep the internal body temperature in place.

      Cortisol is secreted as it is mild stress, which brings insulin down which is good thing. If you shiver, lots of little muscles that keep body hair up use some energy for its work.

      So, its healthy, if done in the morning wakes you up like nothing else, is good for skin, immune system, tyroid/adrenal function, improves depression etc.

      About papers, see:
      “Human Skeletal Muscle Mitochondrial Uncoupling Is Associated with Cold Induced Adaptive Thermogenesis”

      See also:
      http://green.wikia.com/wiki/Cold_showers

      • majkinetor.:
        Thanks for the comment. I’ll read up on it. I do recognize BAT, newborns have a lot of it at birth, adults have very little. It’s one of the reasons why a newly born baby has trouble regulating it’s body temperature (and blood glucose)

        I get the concept of vasoconstriction and rerouting the blood to the major organs. (This is called shock). But I can see why shivering would generate energy when trying to get your body temperature back up.

        And Cortisol… Well, let me tell you I’m beginning to think that this little hormone is behind a lot of my problems. I’m probably pump massive amounts 24/7. And on top of this, I’m a night shift worker. Lots and lots to consider.

        Thanks again.

        • (G’morning Dr Mike, sorry this is so long; hope it’s okay anyway…)

          Hi Jody, Mark Sisson, over at Mark’s Daily Apple has a lot of info about shift work and cortisol, and managing both.

          I also recommend VERY highly checking out the website “Stop the Thyroid Madness” — I know “allopathic” medicine looks askance, but thousands of folks have found themselves described oh-so-accurately — and then helped mightily — there. (Because allopathy just doesn’t get it!) (Sorta like they don’t low carb, eh?)

          I used to ascribe my stiff neck on arising, my all-over aches and pains, my hyper-sensitivity to light and sound, my dry hair and skin, my sore feet, and so on to being an old, fat sedentary woman. Once I treated my adrenals: All (All! ALL!!! YAY!) of that went away! Allopathy (mostly) doesn’t recognize adrenal fatigue, only adrenal failure; but when you actually check out what *thousands* of folks have found to WORK, you begin to see what allopaths usually refuse to. I’m still treating my thyroid — but OMG — having my adrenals healthy/functioning again is like a miracle!

          My thyroid doc — one of the few who (mostly/partially) actually “gets” it — said that you can be doing diet and exercise EXACTLY PERFECTLY, and if your thyroid/adrenal axis is messed up, you will not lose an ounce! (He was oh-so-right!) I DID go in the first time with what I wanted from him: prescribe Armour (back then; then Erfa Thyroid from Canada; Armour has gone-to-hell) and physiological doses of cortisone (Isocort, the OTC version, wasn’t helping/enough), on this dosing schedule suggested at STTM. He was (amazingly) willing to let me try what I wanted; he agreed to the scrips and the schedule.

          (For the past several years (after testing for reverse-T3 according to STTM), I’ve switched to T3-only, which takes more careful management than the T3-and-T4 dessicated thyroid. My body is not making much (if any) T4 now — (the non- or mal-conversion of T4 is what led to the reverse-T3, which blocks (“real,” active) T3 uptake by the cells — the T3-only suppresses my thyroid’s output. Anyway (you know this from your training, others may not so I’m writing it), T4 is the storage form and since I’m not getting or making much T4 , it means I don’t have a circulating batch ready for conversion (assuming my body can and will convert it correctly to T3, not reverse-T3; the original problem). So I have to (and am willing to) manage my T3 levels more closely and do without the storage form. Most folks (again, learning from STTM) go back on dessicated (T3 and T4) after a while on T3 only. Others (including me), willing to do the work, stay with T3-only.

          It takes a lot of reading and work to figure out what you need — but it’s SO worth investigating!

          • Eleanor, I have been on natural thyroid replacement from my Dr. for about one year. Went to him about three months ago and said that I am sure I have adrenal fatigue. My head hits the desk at about 3PM everyday! and the thyroid you gave me has helped me feel better. I’m also on bio-identical hormones (Wiley protocol). I had the reverse T3 situation where-by on most tests I look like I have normal thyroid levels. Anyway, he prescribed Cortef (hydrocortisone) and Cytomel (pure T3) What a difference! I feel reborn and have energy throughout the day and weight is dropping without much effort. I am going to go on Dr. Eades 6 week Cure with gusto on my return from vacation in 1.5 weeks. It all makes so much sense in my gut. I am celiac and have been off gluten for 3 years but still show inflamation. Got to get off ALL the grains…….Thanks to all and Dr. Eades for this forum….

  81. I just came across your 2007 post about Jane Brody and her travails. It’s the first I’ve heard her evil name mentioned in connection with this way of eating. But she’s been on my mind a lot. Ten weeks into my wonderful low-carb life, bursting with energy, pounds dropping off, etc etc et I keep thinking about the time in the early seventies when I had about ten pounds of post-pregnancy fat to lose. I told my Dad, a wise old time midwest general practitioner, that I planned to eat “healthy complex carbohydrates”, as Ms Brody recommended. He nearly went through the roof. But of course who can argue with the New York Times? And it was the “modern way”. I bought not one but TWO of her cookbooks and struggled with weight for the next forty years. I could wring that woman’s neck!!! (And now Mark Bittman is preaching from the same platform that a vegan diet is “obviously” the optimal diet for the entire planet. Fool me once…..)

    • Polly, your post gave me a chuckle. Jane Brody’s gravitas paved the way for people like Gina Kolata, Bittman of course, and Dr. Oz to foist their schtick on the unsuspecting public.

      I read somewhere (maybe here on Dr. Mike’s blog) that when the lowfat diet first came out, the AMA denounced it as a “fad diet.” For once they were right on the money.

  82. I have read most articles and posts on this site with great interest, but I am a little frustrated that after 6-7 weeks of low carb eating not a single pound has come off! I do feel great and other symptoms (bloating, gas) are gone (yay!) but I would really like to drop about 10 lbs (154 lbs now; 144 would put me in the range I was in my 20s). I was around 140-145 lbs in my early 40s but I was dieting and restricting my calories a great deal. I am 46 and not pre-menopausal yet and fairly physically active (cycling, walking, weight training). I do not know what my daily carb intake is exactly but I would say it’s less than 70 g. Am I too impatient?! Has anyone been there who could offer suggestions?

    • Valerina, I had to dial my carb consumption down below 50 grams per day to see any weight loss. It really depends on the individual and how much damage you’ve had to your insulin receptors over the years. When I reach goal weight, I’ll slowly increase my carb consumption until I find the sweet spot that puts some variety in my diet without making me gain weight.

      Although Dr. Mike doesn’t recommend tracking what you eat, I found that using a program like fitday or the USDA site helped me find the hidden carbs in my diet. Try it – the results might surprise you.

      • Thanks Lacie, I will check out those programs and try to shoot for as little carbs as I can manage to reach my goal weight. Not eating baked goods, ice cream, fruits and other sweets is really no problem for me as those things never appealed to me, but gving up bread and chips has not been easy–I have indulged in a couple of bites (only one or two!!) once in a while so that may be what is holding me back…

        I have to say that despite the lack of weight loss, the freedom gained with low carbing (i.e., not having to eat every 2 hours because of the sugar spikes) and the disappearance of stomach “issues” has converted me for life!!

    • If you are only 10 pounds off the weight you were in your twenties, then I would say you aren’t doing too badly. Maybe you are at the weight your body “wants” you to be at this time, especially if you are keeping hunger at bay with the low carbs.

      When I got down to the lowest weight I have so far achieved on low -carbs in 2009 (I started in late 2007 / early 2008), I was still at least 14 pounds above my weight in my twenties, and maybe more like 20 pounds. It seems we all get more insulin resistant as we get older, almost whatever we do (and I was about 14 years older than you are now), so it just gets a bit harder.

      Sadly, I put on at least 15 pounds from my 2009 low, and am trying again, with my main target to be that 2009 low that I achieved before. Of course, if I can get closer to my 20s weight after all, that will be a huge bonus.

      A few thoughts I had:

      – You could try zero-carb for a while, just to see what happens (i.e. meat and/or fish and fat only). It’s perfectly possible to survive without vegetables (and also not be constipated without them – plenty of fat and water can help here). I’ve done this for months and never had scurvy. I’m assuming you already are not eating fruit.

      -Remove potential “problem foods”, like cheese, in case you already haven’t.

      What I’m partly talking about here is simplicity and reducing the number of variables in your “experiment”.

      -Although I’m not that big a fan of Dr Jack Kruse, I do like his idea (see the leptin fix on Jimmy Moore’s forum) of eating within 30 minutes of getting up, and at least 50 grammes of protein (and of course plenty of fat). No snacking and maybe get down to two meals a day, but only when you are ready, and leave at least 4 hours between your last meal and bedtime. Both he, and Dr Eades are quite big fans of coconut oil, and I concur with that as well.

      • Thanks Mike that is really helpful! Giving up cheese is also a bit of an issue as I love it more than anything else and maybe I have indulged too much since starting the low carb lifestyle.

        I started taking coconut oil two weeks ago and I love the taste so it’s not hard to incorporate it in my diet. The one thing I am still unsure of is when to take it exactly, between meals or after eating?

        Also, how do people feel about coffee? I have always taken mine black and I don’t think it makes me hungry so I still have a cup or two in the morning–one of my few indulgences!!

    • Back in 2003, lowering my carb consumption to 50 gm or less did the trick as far as weight loss, but now I have to keep my carb consumption to less than 20 g/day, otherwise I would inevitably start gaining weight again. Age seems to play a role in your sensitivity to carbs.

  83. This is off topic, but I really need advice – Dr. Eades, or blog readers – can you recommend a low-carb doctor in San Francisco Bay Area, preferably East Bay? I lost 40 pounds relatively easily following Atkins diet three years ago, but allowed myself to regain in the last year. This time, following the book to the T, I did not lose a single pound in a full month. My thyroid function in normal, I am 46 years old, 184 pounds, not menopausal, and frustrated.

  84. ATTENTION DR.MIKE,

    I just got my blood work results today from a recent check-up, and I was alarmed when i compared some of these numbers to the results of the check-up i did November of 2010. Before i get into the details, I am an active male in my 20s with leaness and decent musculature as evidenced by six-pack abdominals, vascularity, etc.. I have been following a low carb, moderate protein, high fat diet for approximately five years. When i got my blood work taken in 2010, I was eating (with the fat) chicken, pork, meat, eggs, and duck, along with leafy greens, black coffee, and alcohol from beer and red wine. In addition, everyday, I was eating from 100-300 grams of 72-85% dark chocolate. So, in essence, my daily carb intake ranged from roughly 45-100 grams, mainly from the sugar in chocolate and the carbs in beer and red wine, and my daily calorie intake ranged from 1800 – 3500 calories.

    Since my last health check, I’ve lost 9 pounds, mostly of which seems to be fat judging by my appearance in the mirror (increased vascularity, more definition, etc.), though i made no conscious effort to lose weight. My eye sight has improved slightly. Furthermore, my fasting blood glucose decreased from 86mg/dL to 78. However, my total cholesterol, HDL, LDL, and triglyceride numbers changed for the worse, and in some cases, terribly. My total cholesterol went from 206mg/dL to 271. my HDL went from 86mg/dL to 62. My LDL went from 113mg/dL to 172. And my triglycerides went from 33 to 181. So my triglyceride/HDL ratio among other things has shot to s**t (pardon my French).

    At this stage, you must be asking what has changed in terms of my diet. Well, it was the same in that it was low in carbs, moderate in protein, and high in fat. One thing I did was I stopped eating dark chocolate (because i thought i was eating too much sugar). To make up for the loss in fat and calories that i previously got from chocolate, i consumed whole natural cream, something which i only did on occasion before. For some meals, I have also been consuming more eggs since the last check-up. I used to eat approximately 2 daily. Since then I have been eating from 2 to 8 daily, eating eggs instead of meals of meat here and there. Alcohol intake stayed roughly the same. Calorie intake was pretty much the same as before.

    So, basically the only big difference between how i was eating then and now is that my carbs decreased greatly, as well my chocolate intake, while my intake of cream and eggs increased.

    Sorry for the long message, but I am perplexed, and wanted to give as much detail as possible. I would have assumed that reducing sugar/carbs from chocolate would have improved my bloodwork across the board, but this doesn’t appear to be the case. Also, the intake of cream and eggs seems to have affected my numbers negatively, too. What am I supposed to make of this? This appears to be contrary to what is said about low-carb dieting. I definitely do not want to stop eating this way, but i also don’t want my numbers to continue to worsen.

  85. Dr. Mike,

    I’m trying to gain some muscle mass while lossing fat. I’m 206, 5’11 looking to be about 175. What amount of protien on a low carb diet would you recommend for this?

  86. As a follow-up to my comment about the fish broth, I found that on the days I drank it, I ended up having brutal carb/alcohol cravings in the evenings and going face down in the carbs three nights in a row. Since I usually am successful at staying low carb/paleo-ish I was mystified by this. I did a bit of searching and found this: http://raypeat.com/articles/aging/tryptophan-serotonin-aging.shtml. In a nutshell (according to the article) bone broth is high in glycine and proline, low in tryptophan. It suppresses the production of serotonin. Voila, cravings for stuff that increases serotonin.

    At this point I reread your post and decided to 1) back off the fish broth a bit and 2) implement your 5-HTP recommendation. I’m now taking 50mg (compounded with B6 and C) and I must say it is working very well to combat the evening carb/alcohol cravings. 5 days so far alcohol, potato and nacho free with only one glass of wine at day 3, which was more or less forced on me by my wine-snob father, and which I only drank under the duress of knowing he’d opened an expensive bottle, and that if I didn’t drink it he would, and he shouldn’t since the rat poison his cardiologist has him on nearly killed him a couple of weeks ago. But I digress. That’s the longest I’ve gone without 2-3 glasses of wine in the evening since I did the 6 Week Cure a couple of years ago. It also seems to be making it easier to eat smaller portions in general.

    I do have a couple of reservations about the 5-HTP however. In that article, Ray Peat is really down on tryptophan and serotonin in relation to aging and degenerative disease. He does say _excess_ serotonin. I’m guessing I’m probably deficient or possibly serotonin-resistant, if such a thing is possible. So I wonder how one goes about increasing one’s serotonin production to normal levels without supplements. Is it simply a matter of precursors (I could eat more poultry, for example, though I don’t care for it), and are there important co-factors? More protein in general maybe? Also, if people use 5-HTP should they cycle it to prevent tolerance or other problems?

    Anyway, I wanted to let you know how that is working for me and thank you for the tip. Even if there is a downside to supplementing 5-HTP I’m sure it’s preferable to continuing a higher level of carb and alcohol consumption than is good for me.

  87. Hi there Dr. Eades,

    Hope you are enjoying your stay in Spain. I am here with my family too, at Cabo de Palos, Cartagena. I find it very easy to eat here, since all the great sea food they have, the simple and tasty ways they prepare them and the salads. May I ask you what you and MD eat for breakfast while here? I just seems to me an overdrive of breads and cakes of all sorts. I even saw children breakfasting at toasted bread with melted butter sprikled with, I kid you not, not few tablespoons of pure sugar… and having a glas of oj with that!

    Un saludo,

    Renata

  88. Salute Mr. Eades

    I’d like to know your opinion on using the Dead Sea salt the same way you recommend using the Celtic Sea salt and other salts in supplementation and water remineralization and if it is dangerous in any way.

    Thanks :)

      • No, no, it is not a brand, it is as you’ve said a salt composite obtained by evaporation of water from the Dead Sea lake between Israel aj Jordan. You know, the one in which you stay afloat and cannot sink because it is so damn salty. :) It’s mineral composition is extraordinary among all the salts I’ve managed to dig up on the internet, just look over here http://en.wikipedia.org/wiki/Dead_sea_salt#Mineral_composition. Other salts including the celtic, himalaya, etc. can stick it. The salt alone, I have to say, is useless as a food taste additive, because it really ain’t tastin’ all that good even after getting used to it :D, still salty though :D, and potassium in it gives your tongue a nice crackling sensation if you put a solid piece in your mouth and let it dissolve. It is apparently used for detox, but since I’ve first posted my question in this post, I’ve been drinking this salt, about 5 sips every other day from a bottle of dechlorinated tap water with an average dead sea salt content of 5mg of salt solids per liter of water and after a few initial detox episodes I’m breathing and feeling good, maybe better (but that is hard to say because being hooked on paleo and herbalism makes me feel good 99% of the time), but I’d like to see some studies done on this, because I smell potential here.

  89. Dr. Eades, I was under the impression that 5-HTP was a downregulator. True? Any cause for concern? Any issues with the stopping of taking it?

    Thank you,
    Sarah

  90. There’s some things I wanted to ask the people of this blog: How come, if we supposedly evolved to eat meat and a high protein diet, then we evolved over the course of maybe a couple hundred thousand years or so? My understanding is that biologically, modern humans are maybe a half million years old at best. We wouldn’t have had time to evolve for such a drastic change. Also, how would it be beneficial for humans to evolve to eat a predominately carnivorous diet? I don’t see how your site explains that (an FYI, I am technically not a vegan/semi-vegetarian but am pretty close to it).

  91. Thank God for the Doctors Eades. I had 3 MI’s in 1999. 2 stents in 2000. AF in 2007 and ICD fitted in 20007. I have Hashimoto’s disease. Osteoporosis. Familial Hypercholesterolemia. Allergies (from blood tests) to gluten and milk and brazil nuts (even tho I don’t eat them) I am not a hypochondriac. I want to be in full health and want to live to see my gorgeous grandaughter get married (She’s 6) I am 70.I have taiken 75m of asprin, 50mg of Losartan Potassium, 20mg of Rosuvastatin, 50mg Atenalol, 150mcg Thyroxine.All for 11 years. Since starting the prog in January I have dramatically improved my blood profile and my blood pressure is reduced. My GP is supportive and has allowed me to reduce statins by half. I want to leave all the drugs off – Is this possible. I felt so well on the 2 weeks without them. Help.

  92. Dr Eades –
    I’ve had extreme edema in lower legs/ankles which only got worse after I was put on BP meds and hydrochlorothiazide (water pill) in 2008 – obviously effected by my lack of taking care of my diet and health (working long hours as sole provider, lots of sleep deprivation).

    LC is the only thing that has helped reducing the edema (at worst, my ankle was nearly as thick as my calves, left leg always worse). local doc keeps saying ‘wrap it, elevate it’ – which only made it lumpy and hurt. 3 weeks on LC/PP and swelling is down 70% – water intake is at least 128 oz, often more, plus other fluids (unsweetened iced tea, 1 – 2 diet rite cola).

    Any ideas for getting these lower legs back to normal? I did wind up in the Jimmy Moore/Kent Altena 400 club, so that’s my starting point.

    I’m finally back on low carb using your recent book (the 30 day low carb diet solution) and found Slow Burn from Jimmy Moore’s podcasts, starting that this week. I’m down 5″ on waist in the first 3 weeks which lines up with improvement in lower legs (water loss + fat loss).

    Any advise is welcomed – its very difficult to find any information about this online. Blood work always comes back great and EKG’s have been fine (I live in Alaska, eat lots of salmon, halibut, cod which I think has helped my heart).

    And huge thanks to you, Mary Dan and Fred Hahn – I’ve been fans of yours for years – PP is EASY to follow, you take the work out of it and the online resources are a godsend. Most of all – I love your frankness in responding to the naysayers!
    Protein Power helped me lose 50# + a decade ago, I fell back into old habits and

  93. Dr. M, you just get better and better. Don’t know if you’ll have a chance to read this article from The Guardian, but it’s worth a glance, if for no other reason than to offer a taste of the future of health care in this country if we don’t get a handle on obesity — preferably the one you have! As long as the medical establishment is in charge, there’s not much hope – so please, keep on with the wonderful work.

    The url for the article (Obesity and the NHS (National Health Service): ‘People here are in big trouble’ (wonderful play on words, btw) is:

    http://www.guardian.co.uk/society/2011/jul/11/obesity-nhs-people-big-trouble

    Check it out. And thanks again, Dr. Mike, for all your great work!!

  94. Cramping …I too had severe cramping to the point that I was drinking more water than before but still cramping. I started taking potassium but it didnt subside. I started searching all I could find on what I was eating and drinking and found out the my BELOVED EARL GRAY had a propencity to block the absorption of POTASSIUM!!! and I was drinking it every day and all day up to about 3 pm each day…after I stopped it for two days the cramping stopped. I just re-started my earl gray habit after being off it for a months and after a week my symptoms were back….so from now on I will drink more water then only have an Occassional Earl Gray (1) and then none for weeks….Hope this helps and if you want the links let me know. Great site!

  95. Re iron-free multivitamins: I read Protein Power years ago, and based on the advice therein, I switched from a regular multivitamin to one without iron. Despite being a heavy consumer of red meat, I was diagnosed with severe iron deficiency anemia two years ago. I was astounded. I had a thorough workup, but the only source of blood loss was through menstruation, which I never perceived as particularly heavy.

    The quality that has been restored to my life by supplementing with iron has been astounding. When I was anemic, my heart raced constantly. I was so tired, I never stood if I could sit, and I never sat if I could lie down. Just thinking was tiring. Once I got my iron level back up, it was like being brought back from the dead.

    I would like to suggest that all premenopausal women should have their ferritin checked before switching to an iron-free multivitamin. Maybe my case is unusual, but then again, maybe it’s not.

  96. Dr. Eades, six weeks ago,I was shocked to find out I gained 20+ lbs. since last summer (I wasn’t weighing myself). I was also surprised to find out in an exploratory ultrasound for abdominal pain (for which no cause was found) that I have a fatty liver.

    This gave me the motivation I so needed to get back on my low-carb diet. I was relieved to see you write about fatty liver here because I thought I was one of the few who must have this. Apparently not. And my gastroenterologist told me, as you have confirmed, that this is easily reversed—and not to be ignored, as it can lead to fatty liver disease with permanent liver damage. I surely don’t want this!

    I want to add, for your consideration, that in the past year I have been eating large amounts of beef with fat and pan-frying it in coconut oil. My observation is that you can put on a lot of fat and water with a low-carb diet if you ignore portion size and use coconut oil too liberally. Low-carb has a metabolic advantage, to be sure, but I’m not sure you can’t gain fat by wildly exceeding caloric needs.

    If I’m not mistaken, you have claimed it’s not possible to gain weight, though you may stop losing. Would be great if you could expand on this.

    Oh, one other thing, in the interest of truth. There were times, to be sure, during the past year, when my low-carb diet was interrupted by periods of everything-goes eating. I am left to wonder what my body will do if alternating low-carb with anything-goes. Is it easier to gain weight during periods of letting my guard down? I don’t mean I went wild, I do mean I imbibed during the holidays and other times liberally.

  97. Please, this not for posting, I just need to share my gratitude towards you today. My husband of 15 years died six days ago. (Heart attack — maybe/probably related to heat stroke? after mowing the lawn in the HELL that is Georgia.) (He was only 60; I’m 56. He’d actually been ‘mending’ his diet after all my discussion of this stuff, and reading to him from your book(s) and Gary’s…. He’d had been treating his angina — seemingly successfully — with something (chelation?) called Angioprim. He was very pleased that in our morning walks he wasn’t even having twinges anymore.)

    Of course, right now, I’m not hungry. Food doesn’t appeal in the slightest. But I am very conscious of the necessity to stay fueled and as healthy as I can. Every morning, a couple hours after my Americano (thank you), I make my 6-Week Cure shake (and again). I’m putting four egg yolks in it right now instead of one, plus 3TBS cream and 3 TBS of MCT oil (and some sucralose syrup). (Oh,and leucine.)

    I think the shake makes a sound basis for me to get through the day. It’s keeping me”fed” without making me force myself to eat “food.” I did make myself a hamburger, somewhere in there, but I can’t remember when. (Mostly at night I seem to default to a handful of cashews and some swiss-style cheese — I had DROPPED them just two weeks ago on your (generic) advice to try to lose weight… but when Michael died, I bought some because it’s at least semi-nutritious and takes no effort.

    Yesterday, our ‘every-friday-Japanese steakhouse’ comped me a full meal, including oddly enough, a group prayer before I left. (Ah well, you eat at the mission, you have to listen to the sermon. {eye roll}) Well, the staff there loved us both: we went every Friday for six years, and now I can’t afford to go back. (And they sent me how with two days’ worth of leftovers, so nice food with no cooking…)

    Anyway… I’ll quit rambling on. I am SO grateful that you published the 6 Week Cure, and that I acted on it, so I had the shake-system all down and ready to do without thinking. Our “steakhouse chef” (we always came in same time, same table, same chef) is buying my full-sized SVS, but I’m keeping my fantastic blue baby-SVS! (yeah, I know, you call it an adolescent…To me? It’s my BABY!)

    So, thank you. For all you do. For providing, all without knowing, a way for me to get through this horrible time with decent nutrition and little work. I’ll actually get to meet you and Mary Dan on a couple weeks. Michael had gotten me tix (first class!) out to CA for the symposium, and I’m staying with my mom (so, dual-purpose trip; right about now I need a small dose of my mommy, and I get to attend this symposium.)
    Elenor (Snow)

    p.s. I actually handed one of my “go here, read these blogs” card (on which your name comes first) to the CORONER!!! over Michael’s body in the hospital. He and I were discussing depression, and I explained how I attributed Michael’s recovery from suicidal depression to the fish oil I had gotten him to start taking years ago “for his heart” — he never knew about the effect it had in healing his brain! But I did and all our friends did.

  98. Has anyone on this site ever had a PROBLEM with supplementing Magnesium? It makes me VERY VERY cranky, and my temper flares.

    Is this a sign of too much magnesium (overdose)?

    History: I started with a very small amount of mg citrate in hot water, and increased the dosage until I was at about half of the recommended dose. Yet, crankyness came and went. Then started to get tired in the mornings and was foggy when at 1/2 of “normal” dose. I eat “primal” (no grains, no sugar, no dairy, no canola oil), and have a history of anxiety/depression that is very much helped by the primal diet.

    • Same symptoms as you! I tried a powdered magnesium drink called “natural calm” before bed and found it had the opposite effect. I couldn’t sleep, I was cranky, foggy, etc etc. I’d suggest forgoing the supplements and try to get all your nutrients through food.

      Just keep a food log (cronometer, fit day, myfitnesspal, etc etc) and adjust your intake to meet your needs. Worked for me. :)

  99. Dr. Mike, are your blog posts Part l and ll printable? I’d love to have them in hardcopy form to keep handy in my bag for quick reference. Would you give permission to copy/paste into a document for my personal use?

  100. Dr. Eades,

    First off, interesting post. . . as always.

    My query isn’t about the topic of this particular blog post, but about the recent attention to fat accumulation in the absence of insulin.

    Having read your many entries and responses, I understand that when eating a high-fat, moderate-protein, and very low carbohydrate diet (sub 30g/day), calorie restriction is more important if weight loss is desired. However, gaining actual body fat is much harder, and almost impossible for some by virtue of the ‘limited insulin’. I understood this in the context of individuals suffering from obesity or just high body fat levels who claim to have consumed in the region of 4000 kCals without gaining any weight. I’ve even seen comparisons to the Type 1 Diabetic model in order to support this view, although I don’t quite understand how Type 1 Diabetics can be fully compared to normal individuals who will always have some basic levels of insulin present in their systems. Nevertheless, it is still easier to comprehend the idea that someone who is significantly heavy would not gain more weight from gorging on such a diet since their maintenance calorific requirement will be much higher.

    This gives rise to an important hypothetical scenario for some of us because it would be interesting to know how such a maintenance approach – eating a high fat diet without calorie restriction, even going into the 3500 kCal range – would affect someone who is already very low weight and of very low body fat composition (120 lbs and around the 6% body fat range). I realise that this isn’t a very simple cut-and-dry science. However, going by a rough estimate, how many calories could one of very low mass and body-fat composition over-consume on such a diet without the any fat gain?

    Furthermore, given the rise in ‘organic meat vs. grain-fed meat’ debate, would one still be able to maintain their lean weight and good cholesterol eating the cheaper grain-fed meat?

    Your thoughts on the above would be greatly appreciated.

    Cheers,
    Kade

  101. Just curious about this diet and muscle building. I love pumping iron as part of my exercise routine and am trying to get back to my previous body weight before the tortures and stress of pharmacy school. Any suggestions about modifying it for someone trying to build more muscle?

  102. I am just one more progressive human body out there expressing my UTMOST gratitude for this article in lament’s terms making it so easy to grasp the explanations of all my symptoms. I was experiencing word for word everything you described. I had no idea by going low carb would require proper nutritional support and that too much protein may be what’s contributing to my insulin resistance. Being ill warned and jumping into meat buffets (no fish) for months has elicited PCOS, an increased appetite and an extremely puffy face.

  103. I see your recommendation on Coconut Oil. What are your thoughts on it? It seems like there are two spectrum’s, either it’s evil or it’s the magical HIV cure… so what’s the truth. I’ve been using it with Whey Protein and Glutamine trying to build muscle and increase metabolism on a low carb diet. (Work out 5 days a week, alternating cardio and strength training).

    How much is to much and should we REALLY not count those calories like many people say we shouldn’t?

  104. BTW If blood volume was increased 20%, insulin (and other) concentrations would be decreased by approximately 16.7%.

    Thanks for another helpful post! :-)

  105. Last summer the evening after biking 40 miles in 90+ degree weather I fell and pulled my achilles while running about 20 yards calling my dog (long story not worth going into hear). It was like the exertion sent a message to my calf-quick cramp now so this crazy woman won’t keep running! That night I read about hyponatremia, salted myself up and had very few cramp problems after that. I ride horses and my instructor is always bemoaning how tight I am. Recently I had been thinking most of my exercise issues had to do with being low carb but I’m wondering if its related to my sodium still being too low and my blood volume being correspondingly low especially with the heat outside and the AC indoors. Now I’m suspecting the reason my running goes so much better the day after I have popcorn is not the glycogen but the sea salt I lavish on it. Today for lunch I’m trying better than bouillon and chicken thighs and will run later and see if that improves my performance. It would be wonderful to find a way to stay low carb and not be exhausted partway through a workout.

  106. Hi, Dr. Eades.

    I hope all is well.

    Anthony Colpo is at it again. That charlatan is among the worst , if not the worst, on the Internet.

    He is accusing you of lying about Dean Karnaze’s diet. I challenged him on my blog and gave a link to Dean saying he eats the Neanderthal Diet most of the time,except during races.

    I would challenge that charlatan, Dr. Eades. It is HE who is the scammer. I want the public to know. And I made it known at my blog. I have your back on this. Many, many people have been bamoozled by Anthony Colpo – including me.

    I want everyone to turn up the pressure on him for his self serving claims.

    He takes a lot of uninformed people and makes them believers.

    Take care, Dr. Eades.

    Raz

  107. I´ve been here in Spain myself since July 1 and have had the chance to stay in 3 different households. What’s amazing is the vast quantities of carbohydrates that are consumed, but at the same time the relative absence of obesity. The amount of bread, rice and potatoes that they eat here is considerable, but almost none of the grossly overweight issue in the US.

  108. Dr. Eades,

    This is off-topic on this thread, but I just got done reading “The Vegetarian Myth” and was stunned by the section on soy. The whole breakdown of her book on the impact of BigAg was frightening, but the soy… Are there any other good sources on the effects of soy? Thankfully I’ve always stayed away from it but I have plenty of vegetarian friends who eat a lot of it.

  109. You may want to inform readers,of the possible dangers of 5-Hydroxytryptophan.

    Possible risks or side effects

    Because 5-HTP has not been thoroughly studied in a clinical setting, possible side effects and interactions with other drugs are not well known.
    Administered serotonin has been shown to increase the risk of heart valve disease in animals.[19][20] 5-HTP has not been subjected to this test. Oral 5-HTP results in an increase in urinary 5-HIAA, a serotonin metabolite, indicating that 5-HTP is peripherally metabolized to serotonin, which is then metabolized. This might cause a false positive test in tests looking for carcinoid syndrome.[21]
    5-HTP can cause hypertension by increasing plasma renin activity, when not co-administered with a peripheral aromatic L-amino acid decarboxylase inhibitor, such as carbidopa or benserazide.[22]
    Direct and indirect evidence for possible yet unproven risks and side effects associated with 5-HTP when overdosed:
    Heart valve damage or disease (cardiac fibrosis).[19][20]
    When combined with MAOIs or SSRIs, 5-HTP can cause acute serotonin syndrome.[23][24]
    When combined with carbidopa (as a treatment for symptoms of Parkinson’s disease), 5-HTP causes nausea and vomiting; however this can be alleviated via administration of granisetron.[25] As mentioned above under pharmacology, cases of scleroderma-like illness have been reported in patients using carbidopa and 5-HTP.[26]
    5-HTP may cause eosinophilia-myalgia syndrome, a serious condition which results in extreme muscle tenderness, myalgia, and blood abnormalities. Some think this could be caused by a contaminant in most 5-HTP products.[27]

  110. Now I know why I was getting those weird sensations in my legs. It wasn’t the tea I was drinking. It was from the lack of sufficient water Ithat I wasn’t drinking.

  111. What is the difference in other beverages like coffee, tea, herbal tea which has water & you wine mixed with water? Also, does adding cream to herbal tea affect the water hydration aspect?

    • Coffee, tea and alcohol have a diuretic effect, so they’re not particularly good as hydration beverages. You can drink them but you need to supplement with plain old water to get good hydration. I start every morning off by drinking 16 ounces of water before my first cup of coffee.

      • I keep hearing “plain” water. I’m wondering if stuff like Crystal Lite hurts the hydration issue.

        I’m 70, diagnosed Type II diabetic at 60, discovered “Dr. Bernstein’s Diabetes Solution” and tried to follow it, then fell off the wagon. The I discovered “Protein Power” and climbed back on the wagon, incorporating some of Dr. Bernstein’s comments about fruits and vegetables. On the low carb diet again some of the cognition losses that occur in people my age have reversed, my, head is clearer and memory works better than with higher carb intake ‘though not as well as when I was 20 (and I’ve never been very good at retaining what I hear, better with what I see).

        But I’m having trouble with the hydration question. I still don’t like “pure” water, much preferring water contaminated with flavoring like coffee, Cabernet Sauvignon, diet sodas, etc. Per Bernstein I avoid the products with Maltodextrin and other -oses and -ols because on the FDA label “sugar” refers mainly to sucrose which isn’t the only substance that can send a Diabetic’s blood sugar rising quickly.

        Thank you a lot for your insight and leadership.

        Ned Dodds

  112. Oh, so much information…so little time. I want to share how magnesium has helped me…perhaps even saving my life. I have been a low carber for nearly 10 years. Through my diet I have rid myself of migraines. However, I continued experiencing the everyday-run-of-the-mill-garden-variety headache. Fortuneately I read Dr. McCrealy’s book, “The Brain Trust Program” and learned the importance of magnesium in our diet. Headaches are symptoms of low magnesium levels. When I read this, I began taking magnesium for my headaches which worked as well as any OTC pain reliever.

    About a year ago, I was diagnosed as pre-diabetic. So I had to do some detective work as to why. I thought a low carb diet was all I needed to prevent full-blown diabetes. I began to suspect that low magnesium might be the cause because I was also aware that headaches can also be a symptom of insulin resistance. So I put on my Sherlock Holmes hat and discovered the elementary possible cause to my pre-diabetes … magnesium deficiency. I had to search for the “right” magnesium, one that did not cause diahrea. So I know that all magnesiums are not created equally. I like the ionic magnesium which is well absorbed and it helped to lower my blood glucose. I believe that it might also be the key to those who experience the dawn phenomenon.

    Thank you,
    Mary Titus

  113. Thank you so much for this post!
    ive been starting high-fat/low-carb diet almost for a year now, and i have some headaches and dizzyness throughout the day, especially after my workout
    i thought i exercised too much or still have some jetlag (im studying aboad, and came home just for vacation)
    after i read this, i had two cups of water with a few drops of mineral concentrate and i feel less dizzy!! haha this is great

  114. Dr. Eades,

    Thank you for sharing about dehydration issues. I was a Paramedic for 14 years, ER RN for 5 and now I am a Vascular Access BC RN. I would like to offer a couple simple things your reader’s can do to check their hydration status easily. First, when one pee’s the color should be clear or very slightly yellow (vitamins will make the urine bright yellow but you can easily tell the difference with hydration and dehydration color). Another trick is to hold your hand up in the air looking at the veins on the back of your hand until they are flat (not standing out). Then lower your hand below your waist and count how many second’s they take to stand out again. If one is well hydrated they should quickly 2-3 sec’s fill back in. If the veins take longer to fill in, then one is dehydrated or fluid volume low and hydration is needed. This also work if one has too many fluid (CHF pt.). If you are holding your hand up and it takes more than 2-3 sec for the veins to flatting then you have too much fluid. While there can also be other factor’s that will influence these tricks, for the most part they are good indicator’s without getting to the cramping stage.

    I also agree with your thinking about the blood volume and concentration of blood products in the lipolytic effect. The more concentrated our blood the more the body ‘hold’ water and sodium to prevent death. When we are hydrated well, the body release’s the enzymes, etc to allow cellular activity….so when we break down fat the body needs a median to transport the ‘waste’ – which is the water.

    Thank you for your posting. I have just started the low carb weight program – medically supervised, so it was with some relief to see how this works. I was not too sure about the whole low carb idea, but am excited to reach my goal. Lucky I am aiming for 20 pounds, but want a better healthier lifestyle. =)

  115. Hi Mike,

    I read Protein Power Back in the late 90’s and it laid the foundation for a complete change to my high-carb, gluten damaging diet. As a 16-20 year old I was training a lot and eating 14+ serves of damaging complex carbs per day (wheat/corn) as per what Conventional Wisdom (such bad science) was saying at the time.
    I have been a ‘blood-type-zoner’ at about 6-8% body fat for well over a decade but it is now time to go keto!
    I’m dropping the 6-8pieces of fruit per day (150 grams of carbs; I’m an exerciser (weights and low level cadio) at 5ft6 and 140lbs) and will be eating more vege’s and fat.

    What is your stand nowadays on Arachidonic Acid from saturated fats? Back in PP I believe you mentioned to minimize it (it looks like it is not much of an issue now?)

    What’s the go on AA Mike?

    Thanks

    PS. Thanks to you and Mary for publishing PP all those years ago. It sparked my research into ‘evolutionary eating and living’. I now live in a strong, fit, disease free body that serves me everyday.
    Cheers

    • Back when I wrote the section in PP about AA, I had fallen under the evil influence of Barry Sears. Later research has shown that AA isn’t all that big a deal, especially when one is consuming a low-carb diet. If I rewrote PP today, I wouldn’t include the AA caveats.

  116. Dr Eades: I have had metabolic syndrome for a couple of years now. My doctor controlle it with the standard meds. I recently decided to go on a low carb diet. I have diabetes insipitus. I take chlorothiazide and desamopresson to try and retain water. I also take 20 Meq of Kcl. How do I keep from loosing too much water on a low carb diet?

  117. Thanks Dr. Eades for all your help. 9 years and going strong on low carb with my wife, a Type 1 diabetic, and now my 20 year old daughter. Still love the meat, fats and oil and eggs, which I had to chuckle about when reading about PRES Clinton’s quote on cnn.com that he has “No meats, eggs or oils” under the Ornish diet.

    http://www.cnn.com/2011/HEALTH/08/18/bill.clinton.diet.vegan/index.html?hpt=hp_c1

    Sorry Prez, nothing like my grilled ribeye (fat and all) with freshly grilled garden tomatoes and yellow squash! Haven’t gone +or- 5 pounds off my teenage weight of 173 for the last 8 years and at age 57 I feel GREAT.

    THANKS AGAIN DOCTOR EADES!!!

  118. Very good blog Dr. Eades,

    I’m actually a fitness professional who takes part in bodybuilding competitions, and train many figure athletes as well.

    I use carbohydrate cycling to get them to body fat % you cannot stay at for long periods of time.

    Recently, I just had a VEGAN bodybuilder interested in this type of dieting. Its very hard to get down to contest levels with a low carb vegan diet.

    Have you ever come across this? What types of protein do you recommend besides some vegan powders. Beans/Lentils etc. still have carbs in them. I would be very interested to hear what you have to say.

  119. I have gained about 6 lbs since starting the low carb diet two weeks ago. I am eating the 5 oz three times daily (female 5’9 starting weight 212, now 218) and taking 2-3 T coconut oil per day. I am having two eggs for breakfast and an ounce of cheese. Also some whole milk kefir. Eating only low carb veges now, and a small piece of fruit daily. I feel like I am just blowing up. I finally took out wine to see if that helps. I believe I am having fewer than 80 grams per day of carbs and wonder how much more weight I will gain before I start losing. I am disappointed because I thought this was really the answer for me, but is it possible that some people do not lose weight on this plan?

  120. Dr Eades, I’m very curious as to your opinions about the “need glucose to make the decision to stick to a diet” theory in the book “Willpower” that’s been getting a lot of press lately.

  121. I discovered Protein Power on July 30 and have been (fairly) faithful to the low-carb induction (phase 1) diet since then. Initially, the diet did wonders for both my waistline and my LDL/HDL levels. Total cholesterol plummeted from 300+ to 180, HDL was around 45. Extensive business travel forced some minor deviations but by and large I have stuck with the very low carb gram amounts recommended. Despite all this my cholesterol has now jumped back up to over 300 and HDL has stayed the same (44). I do enjoy the occasional beer and consume about 2-3 alcoholic beverages 2-3 times a week. Is the alcohol the main culprit behind the raised TC and HDL values? I have also started eating low-carb bread (13 grams of carbs per slice with 12 grams of fiber).

  122. Hi Dr. Eades,

    I stumbled upon an interview you might find interesting. It’s with a cardiologist named William Davis.

    http://www.bodybuilding.com/fun/against-the-grain-how-wheat-wrecks-your-health.html

    It’s a pretty interesting read as he advocates that the biggest marker/threat to Heart Disease is the size of the LDL particles and not the total cholesterol number. Low-carb advocate too, but his biggest villan is wheat. He makes the point that if you had a choice between two slices of whole wheat bread and a Milkyway bar, that he’d take the Milkyway bar.

    Curious on your thoughts about his take on wheat, but thought you might find it heartening to see a cardiologist that thinks small LDL particle size is the real threat to heart disease.

  123. Hi Dr. Eades,

    I have a couple of questions regarding supplementation:

    1. In cases where opportunity for dietary potassium consumption is drastically reduced (i.e. IF with a small eating window) can the dosage you recommend of supplemental potassium be doubled or tripled? I currently take 1800mg of potassium (3 x 600mg tablets) in slow-release form, but I worry about the small intestine ulcer horror stories I read about, and I would like to switch to a different form of tablet.

    2. What is the MINIMUM amount of potassium (dietary and supplemental combined) that is required on an ongoing basis? I sometimes feel like I am overdoing potassium with my 1800mg/day current dose, since most other tablet dosages are so low!

    3. I am currently also taking a calcium supplement that includes magnesium. Does the magnesium in this supplement “count” towards the recommended dose of magnesium per day, or should I be supplementing 400mg of magnesium on top of that which is included in my calcium supplement?

    Thank you kindly for your time!

    • The adult RDI for potassium is almost 5,000 mg/day so your not really all that close with your supplements. But are you sure you’re taking 600 mg potassium tablets? The highest dose that can be legally sold in the US is 99 mg. If you really are taking 600 mg tablets, I would probably back it off to one. You will still get plenty of potassium in any fruits and vegetables you eat.

      As I said, the RDI is almost 5,000 mg/day (4,700 to be exact), so you can use that as a guideline to check your own intake. I don’t have a clue as how much potassium you’re getting in your diet.

      Yes, the magnesium in the calcium supplement counts toward your total.

  124. I find most of your suggestions compelling, but your advice for patients to consume 4 to 5 potassium supplements a day is very alarming. I consume as much potassium as I can (through foods), but there is a reason the supplements are required to be 99mg or lower. In the clinical trials I am aware of, large dose potassium supplementation led to mortality (whereas there has been no similar link found with potassium derived from food sources). It is irresponsible to reccomend consumption of 600mg of potassium supplement a day.

    • Can you post a link to some of the trials showing increased morbidity taking potassium supplements?

      What food would you eat to get large doses of potassium without a lot of carbohydrate?

  125. Hi Dr. Eades,

    I have a question about taste buds:

    I’m not used to meat!! i eat the occasional cheeseburger, but until i started HFLC i hated bacon and i couldn’t stomach gristle from my stake. I’m better now but, I’m still having a hard time actually enjoying my food. the only boost I’m getting is that I’m losing weight, but the food is still unappealing, any advice??

  126. Great blog! You always seem to get me thinking in areas I never had before. After reading your scenario on increased water consumption and its effect on weight loss, I began to wonder. If drinking a liter of water reduces the concentration of insulin by 20% what effect does this have on counting carbs? For example, say I am doing a low-carb diet with a target range of <=60 grams carbs per day. Say I eat my entire 60 grams of carbs in one meal followed by downing a liter of water, (probably not feasible, but play along if you will). Given the 20% precedence, wouldn’t the effect on insulin levels be the same as if I had only consumed 48 grams of carbs? Then I could eat 12 more grams of carbohydrate and still stay in my target range.

  127. I learned about potassium the hard way. This is my second time around with a ketogenic diet. The first time I lost 40 extra pounds and my blood sugar, triglycerides normalized and my reflux and mild arthritis went away. I didn’t experience any symptoms of hypokalemia then.

    This time around I experienced extreme thirst, dizziness, and palpitations. It was the later, the feeling my heart was going to jump out of my chest, that caused me to investigate, and self diagnose. Eating 2 bananas eased the palpitations somewhat, but due to their high carbohydrate count, I knew they couldn’t be part of my diet, at least in the early stages.

    I was supplementing, or so I thought. My multivitamin didn’t contain any potassium and the magnesium-potassuim supplement only contained 3% x 2 of the RDA.

    So I went to the drug store and read the supplemental potassium, and each tab only had 3% RDA. What?!?! So now I eat spinach, avocado, and pistachios every day and feel much better.

    • While I advocate eating whole foods to get your nutrients…you can go to any grocery store and buy a salt substitute that is 100% Potassium Chloride. A half teaspoon on your food would have given you all you needed for the day.

  128. This is also why it is VERY important to log your food for at least a week over at Cron O Meter to see what nutrients you are getting. That way you can adjust way before problems like yours start.

  129. I am excited I ran across your Website. What you shared about Restarting/Starting Low Carb really Hit home for me. I have Orthostatic HypoTension due to Exactly what you said. I have very low BP and I have been diagnosed with PreDiabetes recently. EVERYTHING you are talking about is ME. Fatty Liver, Etc. I am Opposite of alot of people, as I am NEEDING TO GAIN WEIGHT, as I have around 8 pounds to my Goal. It is really tough to get enough foods in to Gain weight. I also have Gluten issues, however, I CRAVE Sugars, bagels, and Not much meat eating. I am REGROUPING as I do NOT want to be Full Blown Diabetic. I have a wonderful MD who is a Diabetic Herself, however, she is really in the Minority with helping me be free of Grains, roots, Fruits and Liquid Dairy right now. I will continue to read your Posts and If anyone has any ideas, for how to get in around 6-8 feeding Opportunities a day, I WOULD GREATLY LIKE TO HEAR. Thanks again for your wonderful post and for all who responded.

  130. I am pretty new to Eating Low Carb. One reason Is I am Prediabetic and Just got Cholestrol results of Total 240 it shouldn’t be over 200. I dont want to be on any Medications. The strange thing is I am underweight and needing to add at least 7 pounds to my Frame. Reading a few posts about eating way more fats than protein and really making sure Everything eaten is Highest of Fat, like meats, dressings. Having the Hi Cholestrol I would think I should Lower all the Fats. I eat More Carbs than proteins of course, that is why I am Pre Diabetic. IS THERE ANYWHERE I CAN READ ABOUT EATING HIGHEST IN FATS TO LOWER EVERYTHING, EVEN WEIGHT, BUT I DONT NEED THAT PART. Pretty Desperate to find Answers and Direction. If anyone may give me Direction, PLEASE DO SO. Just eating sausages I feel like I am eating Grease. Books, Blogs, Posts? I WILL READ IT ALL. THANKS SO MUCH,

    • Well, other people can answer this better than I can (for one thing, see the Doctors Eades’ books), but basically, everything you’ve been told about fats (particularly the idea of animal fats being bad for you) is just plain WRONG.

  131. Dr. Eades,
    Though I am a tremendous fan of both Protein Power and Protein Power Life Plan, I’ve found a couple of discrepancies in the supplement recommendations. Chromium Picolinate and Beta Carotene were recommended in Protein Power but aside from Protein Power Life Plans appendix, there’s no recommendation from the two aside from the CARET study which gives me the inclination of possibly stopping my 25,000 IU of Beta Carotene. Any light shed on this issue would greatly be appreciated. And thank you for such wonderful books!!

    • Hi all,
      I hope you don’t have all deserted this blog, as I need some help and clarifications. I am doing Weeks 3 and 4 of the 6 Week Cure, more for a carb addiction and health reasons than weight considerations at this point. Those are the weeks where you increase your calories and fat, but keep the cabs very very low (5-7 g/meal). My correct protein amount for my height and weight is 25-30g protein per meal (3 meals/day). I eat 3 eggs in the morning fried sunny side up in a little (1/2 tsp) butter, plus one slice bacon, and one heaping tsp of salmon caviar or an anchovie, and 3 cups of salad. Lunch is 4 oz fatty wild fish fried in a little butter and 3 cups of salad. Dinner is 4 oz grass fed beef or lamb usually marinated in olive oil and lemon and baked, and 3 cups of salad. I am also taking with each meal 1 tbsp of liquid fish oil (15 g fat in each) that (and a little lemon) I use to season my salad with, as it molecularly distilled and purified and thus has no fish smell at all. I am aiming for 1200 calories to lose the 5-7 lbs I would still like to lose (5’3, 130 lbs right now), then will go up to 1500-1600 calories/day. At this point I am totally off gluten to heal a leaky gut, and off all other grains, legumes and starches to heal a very high sensitivity/addiction to carbs.

      What I am confused about is the fat: the type of fat and quantity. Some people mentioned on the blog that they were eating as high as 70-75% of their daily calories as fat.

      1. How much of the daily fat consumed roughly should be animal saturated fat?

      How much should be plant saturated fat (coconut, palm, etc.)?

      Is animal fat better for us than plant saturated fat or does it not matter?

      3. The rest will be unsaturated fat. As mentioned above, per doctor’s order, I am currently taking a full tbsp of triple strength liquid fish oil with each meal (as a salad dressing or over my cooked veggies) to offset a lifetime overconsumption of plant oil/omega-6 and some resultant health concerns. The fish oil contains 70% omega-3, 7% omega-6, 15% omega-9 and other monounsaturates, and 9% saturated fat.

      To avoid as much as possible omega-6s in my diet, the doctor told me to avoid for a year or two things like coconut oil or cream or milk, avocados, nuts and seeds, even olives, because they are all very high in omega-6s. These are recommended in the 6 Week Cure book to up the fat. So what is left for me right now?

      4. If I wanted to keep carbs at 15-20g max for the next two weeks or so and make fat 70-75% of my daily calories (or even more, of needed, to get to 1200 calories/day), as well as eat the right kinds of fat in the right quantities, how would I amend my current diet?

      Many, many thanks in advance,

      Chris

      • 1. Saturated Fat.
        Saturated fat is very healthy. You could eat over a 100g per day and still be okay. I’d say that saturated fat from animals vs plants would only differ in the types and amounts of fat soluble nutrients. As a side point people can be genuinely allergic to coconut/palm but it is quite rare to be allergic to beef. Therefore I would choose animal saturated fat over plant based. Since I’m not allergic…I eat plenty of both. :p You may want to Google “Epic Saturated Fat Experiment” and click the first couple of links that appear. Good Stuff.

        2. Omega 6.
        A couple of things to consider. (A) Your overall ratio of Omega 6:3 is most important. If you eat fatty fish every week then the amount of omega 6 in a few avocados and a glass of milk isn’t a big deal at all. (B) It is highly likely that oxidized industrial seed oils (soy, rapeseed, etc etc) are the true cause of Omega 6 toxicity and virgin omega 6 from whole foods would not be a problem at all. If you’ve eliminated grains and you eat fish…I wouldn’t worry about it.

        3. Your diet looks healthy. But I’d be concerned with such a reduction in carbs. Caloric restriction and carb restriction induce muscle loss and a slight slowing of metabolism (hypothyroidism). Upping carbs to a range between 50~100 g/day would eliminate this and not add many calories to your diet. I would google “zero carb dangers phd” for a lot more info on the subject.

  132. Dr. Eades, you are a Godsend. I’ve picked a diet plan I want to follow, The Metabolism Miracle by Diane Kress, R.D. The first step of this plan is very low carb and I really suffer after the first few days on it.

    You have given me all the tools I need to succeed. Your generosity in sharing this information freely shows us what kind of a person you are, and I mean that as a sincere compliment.

    No other book/material I have ever read on low carb adaptation has come close to this.

    Thank you so much. You rock!

  133. Hi Dr. Eades:
    I’ve long believed that the fear about salt consumption is misguided and therefore salt my food. I try to rationlize what constitutes a good diet by asking myself would it make sense in the context of evolution. My question then is, what do you think the salt content of paleo guy would have been? Would they have had access to salt? Perhpas from water? Any insights would be appretiated. Thanks for this very informative post.

  134. Dr. E,

    Is there a reason you don’t recommend Iodine supplementation with selenium? I’ve been reading more and more low carb doctors saying that once people cut out a lot of processed food their sodium intake decreases so dramatically that they get hypothyroidism.

    Once I went low carb I did begin experiencing symptoms of this even though my test results showed normal (a common fallacy of thyroid tests I’ve heard) plus I lost my menses, and it has yet to return. Iodine deficiency can apparently be linked to this too.

    I’m curious to know your thoughts. Thank you.

  135. Hi Dr.
    I have found the “king” of what exactly what Ive been looking for. Doc, thanks for the info. I am a correctional officer. I enjoy powerlifting, and bodybuilding, which I prefer now. I am extremely sensitive to carbs, and blow up like a baloon when eaten. I feel just terrible, and feel bloated eating a “pre-workout” meal of ANY carb. Well, prior to finding your website, I did this exact high fat diet (an ebook I bought), high protien, and lost waist inches, and my strength went through the roof. I read studies on fat increasing testosterone. The diet I was following has a max cap of 165 gr fat the beginning weeks starting the diet, and reducing the fat to no less than 70g per day in any week I dont lose 1 to 1.5lbs of fat. Where this diet “differed” it would allow a 24hr carb load period where I drop the fat/protien intake to a relatively low number to replenish muscle glycogen based on a formula for lean body weight. Based on my activity needs, would you agree with a weekly, or bi-weekly carb loads on a low carb diet if one is an avid lifter as long as they dont go “overboard”, and that periodic carb loading would be beneficial in keeping the body from “adaptation”? Because Ive read where cycling carbs like this can be extremely effective, as it keeps the body constantly guessing, and once in ketosis, it takes at least 3 days of carbing to get out of ketosis if youre in it, and that a 24hr gram measured load based on lean body weight is unlikely to do that. Id like your input on the subject. But I love the low carb approach just because of how I feel on the diet. Also, is extra virgin coconut oil known to cause diarehea? I love this fat and the taste of it, but I think I may have an issue with this. Of course, I just started my diet recently again to cut. I appreciate your information.

  136. I just wanted to say thanks and let me make that a heartfelt thanks for these articles. Having followed your program in 2003 and going through periods of living hell with this diet I have to say in my second week of re-starting, this has been the easiest transition to fat burning I’ve ever experienced. Reading the excerpt from the diary from the 1800’s search party and then giving the fat increase a good try has literally made this easy. This has given me a psychological boost since I’ve had no symptoms of the induction flu or muscle pain. My body is actually burning more fat at 45 then I’ve been able to. The potassium and sodium have worked out fantastic! Thanks again!

  137. About Magnesium…

    I found an interesting site that shows simple “taste tests” to determine if you are deficient in some of the electrolytes– http://www.psha-inc.com/guai-support/sf/tastetests.htm

    I tried the Epsom salt test and it would seem I am deficient in Magnesium. I had a big bottle of Magnesium Malate so I started doing the recommended dose (325mg net Mg I think) in the evening. Been doing that all week.

    I’m feeling much better in the morning–normally I wake up with cottonmouth and bone dry mucous membranes and I’ve had periodic sinus congestion that seems to relate to this (and I was definitely drinking enough water). Now my sinuses are clear as can be, and I wake up feeling more hydrated.

  138. Hello Dr. Eades;
    I’m new to this site and I’ve just recently started the low carb diet. My first question is; how much vitamin E as a supplement and why? (you did not discuss that in this blog) and 2. How long does one continue with all these supplements and vitamins? Are they just to help with the initial startup or are they a lasting regimen?

  139. Hi, I have hypercholesterolaemia (the familial type) and take fibrate lipid lowering drug plus ezetimibe. My family has to do this.
    Now I’ve opted for this diet fully. I have really given up all sugar and (with our family being sheep farmers and natural lamb eaters) am really committed. have been on it for 7 days. Do not really notice any weight loss, and please help, I feel frightened. People look aghast when I tell them that I’m on this diet (with my history of bad genes), but somehow I feel it could help even me. I need someone to just make me feel better psychologically about this when al my life I was told to absolutely stay away from ALL animal fat. I unsure as to how much to eat of the permissable stuff and I feel really tense. Fear is setting in I guess.
    Kindest regards

  140. ok you talk about food alot but what about working out i hate working out but i have to what is a good way becouse if you dont work out no fat will leave????

  141. Dr. Eades,

    I don’t know if you still get notifications or monitor the comments of these older articles but I just wanted to point out some literature supporting the idea that coffee (caffeine) is no more a diuretic than water. Good news for those who love americanos I would say!

    “The available studies on hydration found that caffeine intakes up to 400 mg per day did not produce dehydration, even in subjects undergoing exercise testing.” Ruxton 2008

    “These findings question the widely accepted notion that caffeine consumption acts chronically as a diuretic” Armstrong et al. 2005

    “The most ecologically valid of the published studies offers no support for the suggestion that consumption of caffeine-containing beverages as part of a normal lifestyle leads to fluid loss in excess of the volume ingested or is associated with poor hydration status.” Maughan et al 2003

    “caffeine consumption does not result in the following: (a) water-electrolyte imbalances or hyperthermia and (b) reduced exercise-heat tolerance.” Armstrong et al. 2007

  142. Hi,
    If I have well understood, you are on a ketogenic diet (low-carb).
    So why are you drinking alcohol?
    Don’t you know alcohols are like carbs? they give exactly the same result in your metabolism.
    Bye

  143. Dr. Eades,

    What a fantastic post! It really seems to be the definitive guide for electrolyte supplementation while on ketogenic and low-carb diets. I wind up pointing people to this all the time, so if your thinking on any of your recommendations changes, please don’t forget to update your post!

    Thanks again,

    -Michael

  144. I’ve been eating low-carb for 46 days. I stalled and faltered initially, and discovered this was from eating too much protein. So, a few days ago I reduced my protein to about 50g/daily and increased my fat intake, which had been very low. And I began to lose weight again…3 lbs in 4 days, in fact. But almost immediately I began to have muscle pain. Then strained a quadricep/left thigh. Then this morning injured my right wrist just lifting my iron skillet. So I took to the net to find out what is giving me such problems. I was miserable last night…one cramp after another…overall pain in my muscles. I came upon your blog doing a search, and am convinced that, despite drinking about 80 oz. of water/daily, I may be slightly dehydrated, and must be low on sodium/potassium and maybe magnesium. My plan is to do as you say on drinking lots of water, but remineralizing it, as you say. I also took some magnesium, and will continue to supplement it. (Although, I’m concerned that my magnesium with chelated zinc may not be the best source.) I’ll check back in a few days and let you know how I’m feeling. Arrrggghhh… my wrist is killing me, enough typing for now.

  145. OK…amazing. I began adding a pinch of salt, a pinch of salt substitute (potassium) and a pinch of baking soda to 16 oz. glasses of water yesterday. After days of terrible muscle pain and just generally feeling crummy I began to feel dramatically better after only a few hours and have continued to improve all day. Ive just continued adding the very small amount of these minerals to each glass and have had about 8 of my 16 oz glasses today. I am amazed, truly, at what a difference this seems to have made.

    Now I need to know how long to keep this up. My inclination is to back off to maybe a couple glasses with the added minerals per day.

    • I’m glad you’re feeling better. In my experience, low-carbers do well to maintain the increased sodium intake for as long as they’re actively losing weight. You can fiddle with it, though, by backing off and waiting to see what happens. If symptoms return, then crank it back up.

  146. Hi Michael I’ve been Primal for a few weeks short of a year now, and have lost 50lbs… I still have a way to go, I want to lose about another 26lbs. I return to read your part 1 and 2 tips frequently and recommend these articles to friends who are blown away by my transformation. However after a month of Jewish holidays and my 50th birthday, and I am finding it quite difficult to stay focussed and avoid those carbs…. But the reason I’m writing is to ask what quantities of Vitamin e you recommend as you don’t mention it here… and also curious as to why you don’t recommend Omega 3 and 6 supplementation? Thanks so much. Karen in Johannesburg, South Africa (yes we are a separate country and no there are not lions roaming the streets, unless you count the Peugeots.)

  147. Dr. Eades,

    What is your take on Intermittent Fasting? I have had great success with this when done consistently with a low carb higher fat diet.

  148. Hi,

    You have written a very interesting article. I am a long time Atkins dieter and have had great success. But, during the induction phase dizziness and weakness (extreme) has dogged me. I’ve tried the pinch of salt remedy but that kicks me out of ketosis immediately. I eat a couple of slices of bacon and two eggs for breakfast. I wonder if I am getting plenty of salt from the bacon.
    So, if I don’t need salt, what do I need to stop this weakness…it does not pass, I have to recharge with carbs occasionally to get back to functioning. I take Mg,+ Z, K, multi -Vits, drink lots of tap water. What do you think?

    • I don’t have a clue as to why the salt would kick you out of ketosis. It should have no affect on the ketogenic process. You may just have to consume a few more carbs than recommended.

  149. Hi,

    Re my blog about salt and ketosis. I contacted Atkins e-mail and they suggested that I was not really “out of ketosis.”

    I had purchased a new bottle of Ketostix and they said that the product varies widely in accuracy. I did lose weight during this out of ketosis episode. So I suppose that is the answer.

    Regards, Len

  150. Hi Len, I’m trying to cudgel my early-morning, still-drinking-mah-coffee, brain… so I can’t remember WHERE I read a good explanation of still being in ketosis and NOT turning Ketostix pretty colors. Essentially, once you’re well and truly settled into a healthy diet, and your body has turned into Mark Sisson’s “fat-burning beast” — your body is USING the ketones, not excreting them (to make the colors…)! Early on, Ketostix are useful… once your body had adjusted, it isn’t as wasteful of ketones.

    Not sure if that’s accurate or true, but it stuck in my head as a pretty good explanation! (Or it could’ve been somewhere on Robb Wolf’s blog, too…) I’d suggest: go by the fit of your clothes and how you feel (and what you know you’re eating!) not by a somewhat/sometimes-accurate, measuring system…)

    (Alas, I no longer trust “Atkins” — because they’re now a profit-driven company who BOUGHT the rights to Dr Atkins’ name… Not that HE wasn’t profit driven, but HE was committed whole-heartedly to human health, not corporate health!)

  151. I began taking 5 HTP at night time but it started producing panic attacks (the only time I have them is after taking 5HTP). Is this a known side effect? Any suggestions on how to take it differently?

    • It’s not a side effect I’ve seen. You might want to try a different brand to see what happens. I typically give it about 5 PM – not at bedtime. You might see what happens if you do that. Or simply write it off as something that doesn’t work for you.

  152. Dr Eades,

    It appears that I may be having my Gall Bladder removed in the next month do to stones and sludge buildup. I’m wanting to start eating paleo/low carb. Will having my Gall Bladder remove affect me by changing my diet to this. If so what precautions do I need to take to continue low carb?

    Thanks

    v/r
    Ben

    • The gall bladder is a reservoir for bile acids, which are released into the small intestine in response to a fatty meal. The bile acids breakdown the fat and make it digestible. If you have no bile acids to release, a portion of the dietary fat moves into the large intestine undigested. The colon is not designed to deal with fat because most of it has been absorbed in the small intestine before it ever reaches the colon. Consequently, fat in the colon leads to symptoms: gas, diarrhea, sometimes pain, surprise defecation, etc.

      If the gall bladder is removed, the liver still discharges bile acids that will make their way into the small intestine. But the ability to squirt out a healthy dose is diminished. But typically over time the body kind of makes a pseudo gallbladder out of the stump of the bile duct, so in time, everything typically gets back to normal.

      Until then, you need to be careful of large fatty meals. Take it slow, and monitor your symptoms. You can eat as much fat as you can tolerate – just be careful so you don’t have any surprises.

      Any low-carb, Paleo dieters out there who have gone through gall bladder surgery and continued their diets, please feel free to chime in.

    • One can get 100% MCT’s as NOW brand on Amazon. Less than $15 per quart, one shipping fee of about $5 will cover one or more quarts. From Hanson health foods.

      But coconut oil has other very beneficial lipids not found in MCT’s. So, be sure to incorporate some as you can.

  153. I have had my gallbladder removed and do a low carb diet. It is much easier on me than when I eat carbs, that really kills my digestion.

  154. I dropped off Atkins for awhile because of recent medical tests and blood screening by my M.D. When I am on Atkins diet, my Kidney Function Test is skewed and I am declared to be CKD third stage. When I tell my M.D. I am on Atkins diet he says he says he cannot reliably test me for kidney function while on this diet. So, going back to carbs my kidney test is now in normal range. Didn’t Dr. Atkins cover this subject in his first book? Have others on the diet experienced this happening? I’m back on Atkins now.

  155. Don’t know if you received my inquiry about physicians in the Reno/Tahoe area or California, Oregon, or Washington who see patients doing low-carb eating. Any recommendations? Are you accepting new patients? My husband (66) and I (68) have been on low carb eating for about two years. We would like some follow up and support. Thanks

    • Don’t know why I didn’t get your question before. Maybe it got eaten by my spam filter. As it happens, I do know a very good physician in Reno who is a low-carb proponent. Here is his contact info:

      E. James Greenwald, MD
      Medical Director
      SpecialtyHealth, Inc.
      330 East Liberty Street, Suite 200
      Reno, NV 89501
      Telephone: 775-329-6200
      Fax: 775-329-9921

      If you do decide to see him, tell him Hi from me.

      Sorry about the delay.

  156. Dr Eades

    Thanks for all the info on LC diet. I have hashimoto and I read something on the last post about people with hashimoto having a hard time with ketoses. I have many food allergies and after reading a lot of conflicting information about diet I’m at a loss with food. This low carb diet sounds promising but I want to be cautious because of my health. Can you please elaborate on hashimoto and LC diet? i didn’t read all the coments so forgive me if you already answered this.

    • Hashimoto’s is an autoimmune disease. By and large, low-carb diets seem to help with autoimmune disorders in general. Probably because of the effect these diets have on the tight junctions in the bowel. And because, in general, they are anti-inflammatory. You might want to give the diet a try under your doctor’s supervision to see how you do.

  157. I’m on week 2 of a LCHF plan…I’m just not sure what the ratio of F/P/C should be…everything I read tends to differ in opinion. What do you recommend? Week 1 – did well but that was probably all fluid loss. Week 2 – nothing is happening…I’m being patient…but need to know if I’m on the right track.
    thanks

  158. Dr. Eades,
    Read your article describing your dehydration saga. I too have this type of condition, but mine has not yet been resolved. When I read your description of your attitude toward water, it felt like I was reading my own journey. My bigger issue is that after 4-5 days of the LC lifestyle, the late-night leg cramps are unbearable. Only my wife can help me get rid of them when it happens. For the past 2 weekends, the cramps occur after a Monday LC start. I eat some junk food on Saturday, and they go away.

    I discovered your blog post and decided to give it a try. I increased my (tap) water intake to 64 oz/day on May 19th. Feeling like maybe I finally have this under control, the cramps returned again Friday night. This week I have started drinking coconut water and have still maintained my 64 oz.

    In the past I have just toughed it out, but they have moved to my rib cage, arms, and neck if I continue eating low carb. Thing is I can’t seem to lose any weight otherwise. I am at a loss on what to do.

    Any advice on getting rid of these pesky cramps?

    Thanks for your assistance. Most appreciated.

    John

    • Have you tried upping your sodium? That often helps. And potassium and magnesium. Also, you can hydrate with diet tonic water instead of tap water. The quinine in the tonic water will help a little.

      • Do you have any objections to using potassium bicarbonate – taken an hour before any meal – as a way to supplement potassium? I found good research suggesting that the alkalinity spares calcium from the bone, and of course it gives some supplemental potassium.

        The amounts I have seen in research typically supplement about three grams of potassium per day.

        • I have used potassium bicarb. Difficult to find, though. Or at least it used to be.

          Three grams seems like a lot. Most prescription doses of potassium are about 500 mg.

          • Potassium bicarb is available in powder form on Amazon.

            After some experimenting, I am finding that potassium citrate works better for me. I was getting stomach burn with the potassium bicarb.

            There is a vendor selling potassium citrate in bulk powder form on Amazon as well.

  159. Hi John, I also had it severely – so much so that even my arms and fingers cramped up in the middle of a shop or at night. My GP warned me against taking potassium willy nilly so I chucked it. It needs water, but y’know if you persevere it will disappear without you even noticing it. I now don’t get cramps at all. I take magnesium and vit D3 at night – and that’s it. No cramps any longer.

    • It takes some fiddling with to get everything right. First thing is the hydration. Next the sodium. Then go from there. You can even take a Tums here and there to increase calcium.

      • I was curious about the sugar/carb content of Tums, so I looked it up on their site.

        Q.How many carbohydrates are in TUMS® antacids?
        A.Each tablet contains:
        TUMS Regular Strength: .75 gm
        TUMS E-X 750 (Extra Strength): 1.11 gm
        TUMS E-X Sugar Free (Extra Strength): 0.5 gm
        TUMS Smoothies (Extra Strength): 0.54 gm
        TUMS Ultra 1000 (Maximum Strength): 1.45 gm

        I assume most of that is from some sort of starch binder. Doesn’t appear to be much. I assume that it’s some sort of starch binder — but the existent of a “sugar free” version suggests that the others are not. I prefer not to have sugar in my supplements.

        Back when I was following the diet recommended by McDougall, MQ (medical quack), I took enough Tums that I routinely bought the industrial-size bottles at Sam’s to conteract the SIBO it caused. After going LC in 1999, I found that I no longer needed antacids at all. In 2001, I discovered a half-bottle of the stuff while cleaning out the bathroom in preparation for a move, and tossed it.

        From what I’ve read, calcium supplements don’t do much anyway. You have to get K2, D3, Mg, Na, and K (and probably some other things) approximately right first — at which point you probably get enough Ca in a well-formulated LCHF diet. Oh, and another thing I discovered is that the phosphoric acid in one can of the typical cola beverage (diet or otherwise) will leach more calcium from your body than you can replace with any amount of calcium supplementation.

        Strength training appears to improve the body’s absorption of Ca — a lot.

        My conclusion from all that is that you have to first identify and eliminate the things that deplete Ca before trying to supplement.

  160. I enjoy your and MD’s writings, but may I make one small suggestion? Speaking as a person who has performed over 20 years of meedical transcription for a living, and also other secretarial/typesetting/printing/publishing work, would you PLEASE get a proofreader for your future books who can actually spell?

    Oh, yeah, the MT industry is in the toilet, and I’m currently looking for a job. Hope it shows up really soon….

    • I fear you’ve fallen victim to Skitt’s law, which says that anytime anyone corrects another online, the corrector is bound to have at least one error. Take a look at your spelling of medical. Never fails, which is why I no longer ever correct anyone’s grammar online. Every time I did, I would end up with a giant error of my own.

      Cheers

      • Glad to know that at last one doctor can spell that word. Most of the time, when Iim transcribing dictatin, if a doctor spells out something, I always verify, and often it is wrong.

    • now would that be american or english kinda spelling or grammar – so which is it: “different than” or “diferent to”? You are fighting a ship that has sailed. I know some brilliant students (physics, maths… you know – the et al crowd) who don’t care about any of this. They simply want to get some info going. We’re all probably going to start writing differently very soon – Gr8!!

  161. Been low carb high fat for 1 year, decided to restrict carbs more because of dysbiosis/ibs, don’t do well with roughage so very few veggies, right now almost no veggies, when I do this I wake up with pounding heart, elevated hr, my heart rate is usually 65, woken up by 100… EKG totally normal, doc says heart is fine, rc’d electrolytes, got full blood work up everything else is great except sodium on low end of normal… So back to bone broth but question as to whether electrolyte mixes such as Nuun would be fine for replacement? I was scared of taking 400 mg of potassium as discussed in your books, Dr. Eades but I noticed that the Alacer brand of electromix has 408 mg in one packet alone and it says 12% of dv, also does anyone know what amount of pure water we should be drinking daily separate from supplements on this method of eating?

  162. Oh My Goodness. Your sense of humor cracks me up and helps me process the info I am reading. God is good and I am thankful to Him for this information that is just right for me! :)