Doctor Wants Me To Go Ketogenic - Help With Talking Points?

[Saracatt]

I'm seeing a new Functional Medicine doctor. He seems quite knowledgeable from the discussions I've had with him.

I went because I still have some work to do with my hormones and I wanted someone to run the right tests.

However, now they are telling me that they want me to go on a ketogenic diet. They rolled out all of the meal plans with the awful almond flour pancakes and sugarless dessert replacements. I have been down this road before.

On a ketogenic diet I am a mess - running on coritsol, stressed, can't concentrate, no energy, can't sleep, chronic pain.

After a little over a year of Peating, most of that is better. I feel calm and I can concentrate, I have energy, I sleep like a baby. I just still have a hormonal imbalance, and my gut needs some work. I think the thing I need to fix now is gut infections that are causing endotoxins to overwhelm my liver and keep me from detoxing estrogen.

I may have overeaten on sugar for a while, but I am now balancing out and I find that I don't need half as much as I did, and I can go for longer periods of time without out feeling hungry or low energy, and I don't need to lose any weight. I've always been thin.

It's frustrating because every functional medicine type doctor that I can find in my area seems to recommend low carb. Are there any doctors out there that know about Peat?

I'm not as clear on the science as most people on this forum. What would your biggest reasons for not going back to a low carb diet be?

 

[ravster02]

what's your current diet?

 

[whodathunkit]

Peat's articles are where you can find the best evidence for sugar burning metabolism and high-carb. Also scour his reference lists and try to get the articles or at least the abstracts.

Have you told your doc what you just told us (that you feel horrible on keto, have done better for a year on high carb, etc.)? If not, I would do that. Presenting it to him/her as an already failed experiment for you will probably help them move on from that idea. But then politely but firmly decline to go low-carb if they try the "But you just haven't done it *my* way" argument. Boy I hate that one Wish I had a dollar for every allopathic doctor who tried to get me to go on birth control pills with that argument.

But then simply move on to another doc if this one won't treat you unless you do his/her preferred diet. Tough, I know, because it can take a while to get in to see a doctor you're really looking forward to seeing, and then finding out the treatment isn't for you...bummer. But it's for the best and there are other places you can get the tests.

On the whole, though, I find that most alternative doctors or at least docs who are open to alternative medicine are amenable to what I want to do regarding tests as long as I'm armed with good evidence going in. Most of them enjoy an intelligent partnership with their patients. The ones who just want you to do everything they say without question aren't worth seeing, IMO.

Good luck! :)

 

[Saracatt]

Lots of fruit - Grapes, Apples, Pears, Peaches, Cherries, Melons
Cheese, Lactose Free Milk
Eggs
Hydrolyzed Collagen
Various soups made with homemade bone broth
Beef, Lamb, Chicken, Fish, Oysters
Dates
Use only butter, coconuts oil and olive oil for cooking
Potatoes, Rice, Beets, Carrots (Not raw - It feels like the carrot salad has a bad effect.)
Occasional Ice Cream.
Coke, Juice and Coffee, Carbonated Water
I experiment with different ratios of the macros according to how I feel. I'm also experimenting with adding in more veggies again.

Supplements:
All the fat soluble vitamins -
Progesterone
Pregnenolone and DHEA
B Vitamins, especially niacin and B1
Magnesium Glycinate
Calcium Carbonate when I'm not getting enough from food.

Apple Cider Vinegar/Lemon Juice drink before meals - Really helps with digestion.

Experimenting with Aspirin and various things to kill yeast and bacteria in the gut.

 

[Richiebogie]

If you have faith in a Ray Peat style moderate to high fruit diet and think you only need to discover a few tweaks to perfect it, and if you have no faith in a ketogenic diet then it is a bad idea to follow this doctor's plan at this time.

You can always try his method next year or in 2018!

 

[Giraffe]

What would your biggest reasons for not going back to a low carb diet be?

On a ketogenic diet I am a mess - running on coritsol, stressed, can't concentrate, no energy, can't sleep, chronic pain.

This.

 

[SarahBeara]

I would just say as you said: Tried it, it was bad for my health for the following reasons. No doctor in his right mind would want anyone to be in chronic pain!

 

[ravster02]

your supps are a mess lol unless you have some before and after blood work. you should cut them out, except maybe magnesium.

also, cut down on the starch and get some blood work done and go from there.

 

[SolidSteele]

If you've gone in for a hormone imbalance, I'd ask why he's even consider a dietary plan that is going to tank your good hormones? It seems counter intuitive to me.

 

[Saracatt]

Peat's articles are where you can find the best evidence for sugar burning metabolism and high-carb. Also scour his reference lists and try to get the articles or at least the abstracts.

Have you told your doc what you just told us (that you feel horrible on keto, have done better for a year on high carb, etc.)? If not, I would do that. Presenting it to him/her as an already failed experiment for you will probably help them move on from that idea. But then politely but firmly decline to go low-carb if they try the "But you just haven't done it *my* way" argument. Boy I hate that one Wish I had a dollar for every allopathic doctor who tried to get me to go on birth control pills with that argument.

But then simply move on to another doc if this one won't treat you unless you do his/her preferred diet. Tough, I know, because it can take a while to get in to see a doctor you're really looking forward to seeing, and then finding out the treatment isn't for you...bummer. But it's for the best and there are other places you can get the tests.

On the whole, though, I find that most alternative doctors or at least docs who are open to alternative medicine are amenable to what I want to do regarding tests as long as I'm armed with good evidence going in. Most of them enjoy an intelligent partnership with their patients. The ones who just want you to do everything they say without question aren't worth seeing, IMO.

We talked about all of that at the initial consult, but not about diet, or that I have tried low carb before and felt awful. Yes, it's frustrating, but if this doesn't work out, I may just have to try and convince my PCP to do the tests that I want, and then post here for help. It's so crazy. Every time I have asked a regular doc to test my hormones, they just kind of look at me like I am a bug and say "That's not something that we do."

If you have faith in a Ray Peat style moderate to high fruit diet and think you only need to discover a few tweaks to perfect it, and if you have no faith in a ketogenic diet then it is a bad idea to follow this doctor's plan at this time.

You can always try his method next year or in 2018!

I doubt it! I don't want to go back to the mess that I was!

I would just say as you said: Tried it, it was bad for my health for the following reasons. No doctor in his right mind would want anyone to be in chronic pain!

That is probably what I'll have to do. I can't argue the science enough to sound knowledgeable.

your supps are a mess lol unless you have some before and after blood work. you should cut them out, except maybe magnesium.

also, cut down on the starch and get some blood work done and go from there.

Why do you think the supps are a mess specifically? I agree that reducing starch might be a good idea.

If you've gone in for a hormone imbalance, I'd ask why he's even consider a dietary plan that is going to tank your good hormones? It seems counter intuitive to me.

My only guess is that he doesn't see it that way. I haven't talked to him about the diet yet. I had the initial consult last week, and then I just checked my email today and saw the diet plan from his health coach and I freaked out!

 

[Saracatt]

↑
What would your biggest reasons for not going back to a low carb diet be?
Saracatt said: ↑
On a ketogenic diet I am a mess - running on coritsol, stressed, can't concentrate, no energy, can't sleep, chronic pain.
This.

Yes! Exactly. What is confusing to me is why so many doctors seem to think that low carb will fix those things.

 

[tankasnowgod]

However, now they are telling me that they want me to go on a ketogenic diet. They rolled out all of the meal plans with the awful almond flour pancakes and sugarless dessert replacements. I have been down this road before.

Why do they want you to go on a ketogenic diet?

 

[Saracatt]

Why do they want you to go on a ketogenic diet?

I'm not sure yet. I had an intake consult last week. I just checked my email today and he had the health coach from the office had sent me a bunch of attachments with meal plans and recipes. It is a ketogenic diet. I wrote her back, but she hasn't answered yet. So then I came on here for moral support.

 

[tankasnowgod]

I'm not sure yet. I had an intake consult last week. I just checked my email today and he had the health coach from the office had sent me a bunch of attachments with meal plans and recipes. It is a ketogenic diet. I wrote her back, but she hasn't answered yet. So then I came on here for moral support.

Got it. Some quick things you could point out- Ketogenic diets are notorious for depleting magnesium and potassium. Also, they impair conversion of T4 to T3, so they can make you functionally hypothyroid, or induce "Euthroid Sick Syndrome." They can also cause side effects like constipation and bad breath. Some studies have found they have induced heart arrhythmia in some subjects.

If they were prescribing it for weight loss, it's worth noting that, in 27 Metabolic Ward studies dating back to 1935, ketogenic and low carb diets have shown no fat loss advantage over isocaloric higher carb diets. Other than therapeutic use in epilepsy, there's really no reason to go on ketogenic diet.

 

[Saracatt]

Got it. Some quick things you could point out- Ketogenic diets are notorious for depleting magnesium and potassium. Also, they impair conversion of T4 to T3, so they can make you functionally hypothyroid, or induce "Euthroid Sick Syndrome." They can also cause side effects like constipation and bad breath. Some studies have found they have induced heart arrhythmia in some subjects.

If they were prescribing it for weight loss, it's worth noting that, in 27 Metabolic Ward studies dating back to 1935, ketogenic and low carb diets have shown no fat loss advantage over isocaloric higher carb diets. Other than therapeutic use in epilepsy, there's really no reason to go on ketogenic diet.

Thanks!

 

[Velve921]

If gut issues seems to be an issue it could be worth exploring boiled white button mushrooms. I've done 2 rounds of tetracycline before and I've felt the same symptoms as eating boiled mushrooms...it cleans me out and increasing heart rate/temp and causes relaxation. I've found boiled mushrooms with butter and hard cheese to be a delicious and fulfilling meal.

I've been through a long list of doctors who've been condescending and authoritative...your desire to stand up for yourself takes a lot of courage. Your own emotional feedback to past experiences with ketogenic diets appears to be powerful knowledge that no one else can ever understand more than yourself. I believe you have that courage...stay strong.

 

[Saracatt]

If gut issues seems to be an issue it could be worth exploring boiled white button mushrooms. I've done 2 rounds of tetracycline before and I've felt the same symptoms as eating boiled mushrooms...it cleans me out and increasing heart rate/temp and causes relaxation. I've found boiled mushrooms with butter and hard cheese to be a delicious and fulfilling meal.

I've been through a long list of doctors who've been condescending and authoritative...your desire to stand up for yourself takes a lot of courage. Your own emotional feedback to past experiences with ketogenic diets appears to be powerful knowledge that no one else can ever understand more than yourself. I believe you have that courage...stay strong.

Thank you! It is overwhelming having to be your own doctor and have conversations with them about this stuff when I am just beginning to understand it.

I will look into the white button mushrooms. I love mushrooms. Do they have to be white button mushrooms - not other types - and do they have to be boiled? Would cooking them in butter give the same results?

 

[Velve921]

Boiling them for 1-3 hours inhibits hydrazine according to Dr. Peat...he sent out a newsletter this year that discussed his whole premise behind them. White button has yielded the strongest for me in comparison to other mushrooms.

 

[Velve921]

Anti-Aromatase Activity of Phytochemicals in White Button Mushrooms (Agaricus bisporus) | Cancer Research

Someone posted this on another thread. Almost forgot that that mushrooms actually have a decent amount of sugar combined with some good nutrients...could be another reason it raises my metabolism.

I boil in water and then pour mushrooms in bowl of butter. Mix butter then shred cheese on top...delicious!

 

[Saracatt]

Awesome! I knew butter had to come in somewhere....

I'm definitely going to try this then. Sounds like it could also help control estrogen as well.