30: Healing Metabolism, How Much Fat, Keto IV, High Insulin, & Measuring Insulin Resistance

Now I’ve been following a keto diet of 80% fat, 14% protein and 6% carbs for the past 3 weeks. I have zero sugar cravings, but I’m not yet fat adapted. Fortunately, you’ve armed me with the knowledge that this will take several weeks so I’m being patient and sticking with it! I understand that the body can be mysterious and tricky. So my question is this—will my metabolism alter itself throughout the years in a way that will make it harder and harder for me to stay in ketosis long-term? In other words, does the body ever evolve to have lower thresholds for carb/protein intake after years of being ketogenic that would subvert my best efforts to maintain ketosis?

Thanks for all you do!

I love listening to you and your insights on this way of eating! Thank you so much for sharing your wonderful knowledge. I’ve been doing keto for 2 months now and was wondering if there is a suggested percentage of saturated, monounsaturated and polyunsaturated fat that you would suggest that should make up my % for the day? It seems like I’m very high in saturated fat and low on the others. I’ve heard from others online that it should be 20% saturated and 80% poly/monounsaturated fats. What say you?

Best in Health,

I’m a subscriber, and listener since Episode 1. About a month ago, I had an emergency hospitalization with my gall bladder. I’ve been ketogenic for 18 months and getting amazing results. While I was in the hospital, they hooked me up to a glucose IV for the five days I was there. My records show my blood sugars got as high as 175. But being insulin resistant with glucose running 24/7, I suppose that’s not a surprise.  I could tell I was on glucose because I got hungry and pretty much stayed hungry until I was home for a few days and eating low-carb, high-fat again.  Is there an alternative us Ketonians can ask the hospital for?  I don’t suppose they make IVs of exogenous ketones or beta-hydroxybutyrate do they?

Have either of you measured your insulin levels directly both in ketosis and out of ketosis, to verify:
1) that your insulin levels are too high out of ketosis (i.e., hyperinsulinemia / insulin-resistant), and
2) that being in ketosis normalizes the insulin levels?

Because there are many hormones and other factors at play, it strikes me that indirect markers of insulin levels such as blood glucose and BHB levels are potentially a weak proxy, at best. It would be like assuming that everyone who is excessively tired must have adrenal fatigue, when in fact there are many other possible causes for that symptom. If you haven’t done the direct testing of insulin levels for your individual cases, then are you not merely operating on educated speculation?

I fully understand that testing insulin per se is more difficult and much more expensive than testing BG or BHB. However, I am concerned that the widespread assumption of elevated insulin levels in discussions around weight, diet, carb levels, and more has become an across-the-board reflexive answer, rather than an empirically confirmed cause in individualized cases.

Regards,

Thank you so much for your podcast.  I have listened to about half of them and enjoy both the information and your synergy and humor. I have been on a ketogenic diet for 4 months and am happy to report I’m improving my hip to waist ratio and decreasing my disease risk factors.

I am curious how someone could determine how insulin resistant they might be?  I understand from listening that you both know you are very sensitive.  What are the indicators that help people figure this out?  And do epigenetics play a role such as the MTHFR gene mutation?

Really appreciate your message and the work you both are doing for all of us!

Sincerely,