Got Fatigue from Low-Carb Diet?

This Post Has 88 Comments

1. 1) Female, 27, 5”8, 63kg starting, 60ish kg now

   2) So, I am relatively new to the low-carb thing. I started about a month ago!

   3) I had a baby 16 weeks ago by emergency c-section (despite my extreme attempts to avoid it – a bit of a sore point). I had already been told a few years ago that I had thyroid antibodies and – despite being recommended thyroid hormone tablets BEFORE that for having a few underactive results, which I didn’t take because back then I just wanted to do more research & see if I’d be ok in the end- been told that my thyroid function was normal so there was no need to do anything. Anyway, after my daughter was about 10 weeks old I started becoming super stressed out. I was on the brink of being diagnosed with postnatal depression, but had also had a recent thyroid check on advice of my lactation consultant. It turned out I had overactive thyroid hormones…when checked again they’d soared. My antibodies were above the range where they stop counting.
   Seeing as how I can’t remember a time where I woke up feeling good or energised, and having a very speckled, frustrating medical history: depression, eating disorder, anxiety, numerous injuries, constant bowel problems/pain including an emergency admission to hospital in 2009 (severe bleeding/diahrea, fever, tachycardia etc) that led to an appendecectomy (appendix was normal, but they found lots of excess fluid in abdominal cavity. I am yet to figure out EXACTLY why I was so horribly ill. Although it did lead to the discovery of the fact I have polycystic kidney disease!)adult chickenpox despite having it as a child, and so on…I have been pretty desperate to feel better. And when researching the thyroid and listening, in particular, to a couple of older interviews Sean Croxton has done , it got me thinking that perhaps my thyroid antibodies could explain a heck of a lot. So, I decided to say goodbye to gluten. I lost about 4kg in a couple of weeks (bearing in mind my pre-pregnancy weight was 56/7kg, so I am still above that). I have also started limiting grains in general.
   Recently I was told I had reflux after going urgently to see a doctor with strong pains in my upper left abdominal area. I now realise I’ve had this a few times including the other day after eating a simple rice cracker and cheese (gluten free). I actually think the rice crackers hurt my stomach, bizarrely!
   As well as this, I have been to and from the GP and had a specialist appointment with the endocrinologist. I am on beta blockers, but have stopped taking them so much now. The endocrinologist says probable ‘Postpartum Thyroiditis’ or possibly ‘Grave’s Disease’. She also said they don’t believe in adrenal fatigue which was something that I felt ticked all the boxes for me.
   Anyway, at first I was amazed how little I felt I was missing out on, having been a big consumer of bread and such like beforehand. But now, after a month or so, I am finding it harder and harder to feel like I’m getting enough food fuel! I am fully breastfeeding my baby, on demand, and try to get good nourishment….but I do feel I am still in need of help, and possibly a lot of healing from many years of bad eating habits, including daily vomiting.
   I had bloods taken on the 5th July and my thyroid hormones/TSH had come down into normal ranges except for serum T4 which is now slightly low: 53nmol/L. I still feel a bit anxious/stressed but quite a bit better than when things were at their peak, but I still feel very low on energy, especially in the mornings and still have bowel problems/reflux and so on.

   4) Most recent results were:
   6th June 2012: T3= 11, T4 = 39, TSH = <0.01
   5th July 2012: (after being almost completely gluten free for almost a month)
   Serum T4 = 53, Free T4 Index = 57, Serum T3 = 1.55, Serum TSH = 0.26 & Morning Cortisol (10.40am) = 302nmol
   Blood tests for celiac = negative.

   5)My mother has PCOS (but has 3 children 2 unplanned), is overweight and on blood pressure medication (last time I heard)
   It seems that the Polycystic Kidneys run on my Dad’s side, perhaps. Breast cancer has been on both sides of the family.

2. Hi Dr. Cate,

   1. I’m Male/6’/320#’s at the start/ 269#’s as of today.

   2. Last August leading up to the Malibu triathlon in September, I was training 6 days a week. I Severely Injured my shoulder in a fall at work. I stopped all training and fell into a deep depression. That all lead to the dysfunctional eating and a weight gain of 70#’s.

   I was 6 months into Rehab when it was finally decided I needed surgery. The timing was perfect The Paleo Summit was starting and I decided I was not going under the knife at 320#’s. I lost 40#’s of pure fat in the eight weeks leading to the surgery. I am now 10 weeks out and have only lost 11#’s. I was stuck at 279 for 6 weeks. You can Imagine the frustration I am starting to feel. I haven’t been to the gym in 10 months only recently started doing legs a walking. The shoulder just cant take must banging around yet.

   I went full Paleo 3/2/12, I’m following Dr. Kruse’s Leptin reset using Mark Sisson Primal Blueprint as my Resource. After getting Sean Croxton’s Paleo Summit I found these presenters perfect for me. I started having fatigue about a month ago and my weight has hit a Plateau.

   3. I must start by telling you my carb intake is almost zero. I eat Spinach, Kale, Tomato,Romaine Lettuce. I just put some berries in a few days a week but not much.

   I have not Informed my Doctor of the Paleo Diet they were dead set against it as you can Imagine. I started this on my own well Informed by all the Guests on Seans show over the past year.

   4. I didn’t get any Blood work prior to starting Paleo, I do However take my blood glucose readings on a regular basis. My blood pressure is always good but on occasion slides up. My family has always had high cholesterol levels, I am the one exception my last Dr. visit it was 168 hdl was low at 38. This is the first thing i will have checked at my august appointment. I have yet to make any adjustment’s.

   5. My father had a triple Bypass at 55 and angina 8 years before that. My mother passed away 3 years ago from Lung cancer at 77 she was a smoker for 53 years. My family is all of average size a few of us have some extra pounds, but I am by far the heaviest. I was always between 215 and 230 until my back injury in 2000 when I gained 100#’s and since have Yo-Yoed always above 250.

3. Wow, a couple of those stories are very similar to mine!

   1) Female, 23 yo, 5ft 4in. My weight fluctuates a lot, but tends to stay within 125-135 lbs, with an upward trend in recent years. Currently at the high end, about 133.

   2) I started Primal-style low-carb about 2 years ago, for health reasons. I suspect most of my health problems are caused by long-term chronic stress. I was a high achiever all through school (my parents say I would cry over a B in elementary school). In college, I chose a very difficult type of engineering for my major. Didn’t have a social life or any extracurricular activities, averaged about 6 hours of sleep, and rarely exercised. I remember realizing that I felt guilty any time I relaxed or did something fun, because I “should be working.” On top of all the mental/emotional stress and exhaustion, I also started really dieting for the first time to get rid of the bulging tummy that has plagued me since I was a kid. I ate conventionally “healthy” – skim dairy, artificial sweeteners, high-fiber cereal, LOTS of coffee… And skipping meals very, very frequently. I’d occasionally binge guiltily on peanut butter – probably my body screaming for some fat/protein! Looking back, I can’t believe I ate so little for so long. I did lose weight (though I kept the dang belly), but that’s when my health started deteriorating. Obvious hormonal issues – my periods were sometimes heavy and lasted for weeks, and sometimes were absent for months. I had seasonal allergies for the first time in my life, got sick all the time, and had a chronic cough for about a year. I had three kidney stones in two years. After a very stressful study-abroad trip to Brazil I returned with eczema, IBS, awful GERD, unexplainable lethargy, and a new tendency towards anxiety, crying jags, and random emotional outbursts. I had always been healthy and very even tempered, but now I felt so sick and completely out of control and it terrified me. That’s when I started low-carb. I’ve never been one for calorie trackers, so I don’t know my exact carb count or anything, and I’m sure it was far from consistent. But I started using animal or coconut fat for all my cooking and went grain-free. Occasional cheats – bread basket or chips & salsa at a restaurant, corn tortilla, birthday cake, etc. I’ve never been a fan of beans or potatoes so I wasn’t even tempted by those. So my main carb source was small amounts of dairy (plain yogurt and cream in my coffee). I also started some traditional food practices like making bone broth, kombucha, and sauerkraut.

   3) Low carb was great for a while – I felt better, and I loved how much my hunger was decreased – now when I skipped meals (frequently still), I didn’t even feel it. I only lost a couple pounds, but most was off my tummy, so I was happy. GERD, eczema, and energy levels also vastly improved at first. But about a year in, I started having reflux after small cheats, and soon even after good home-cooked Primal meals sometimes. My IBS symptoms never got a lot better, but at this point they started to worsen, eventually becoming pretty debilitating. My energy levels became less consistent, and the mysterious lethargy became more and more common, especially after meals. My eczema also returned with a vengeance, on my lips of all places – ow! I thought it was because I had relaxed a bit more on my LC eating, so I decided to go full-on strict Paleo (no more dairy, far less fruit, no more cheats!) until my wedding to lose some weight and hopefully feel a lot better for the big day. Unfortunately, I didn’t lose any weight, and experienced only modest improvements in my symptoms. Then I started trying a bunch of eliminations to see if I was allergic to anything, always with a low-carb framework. I tried avoiding eggs, dairy, nightshades, nuts… I had to stop eating at restaurants altogether because I always felt terrible when we ate out. Everything got worse – eczema, headaches, runny nose, IBS, nausea, acid reflux, anxiety, foggy brain, dizziness, and extreme fatigue and depression. Didn’t help that I started my first Real Job and quickly realized that I hated it (still do) – more stress, yay! At one point I just threw up my hands and ate “like a normal person” (i.e. McDonalds and pizza) for like 3 weeks until my (very concerned) husband made me stop. Then it was back to low carb, as clean as I could get, and trying desperately to get it to work for me again like it did the first time. I was miserable, sick, and never wanted to do anything. My husband started to gently suggest seeing a therapist for my depression.

   About a month ago I was in the middle of doing Whole30 and getting really frustrated when I finally read that crazy heretic Matt Stone’s ebook (180 Degree Health), and it struck a chord. (For anyone who’s unfamiliar, his theory is that any kind of restricted eating lowers your thyroid function / metabolism, which can be confirmed by tracking your waking temperature – I discovered that mine is consistently in the mid 96’s. This causes all sorts of widespread mischief in your body, since your metabolism is kind of a big deal. This problem is exacerbated by any other stress you might be under. His “rehab” program for sluggish thyroids / metabolisms is called Rehabilitative Rest and Aggressive Re-Feeding (RRARF), and it’s just what it sounds like. You basically eat a ton of real food to create a “nutritional superabundance” and give your body all the tools it could possibly need, and you get as much sleep and rest as possible to encourage healing.) I figured I had nothing to lose, and if he was right, I’d end up with a much stronger digestive system, rather than a list of foods that I had to avoid, which was really the best-case scenario with my previous approach. I’ve been doing RRARF for about 2 weeks, focusing on carbs since that’s what I’ve been restricting – sprouted/fermented grains, dairy, soaked beans, potatoes… And eating as nutritionally dense as I can in general. And oh my gosh, I feel so much better! My energy levels are steadily rising, I’m not depressed anymore, I haven’t had acid reflux for a week, and my IBS is finally, FINALLY improving. We ate at a restaurant last night and I felt 100% fine afterwards, which is incredible. This morning I found myself humming and doing a little dance while I made breakfast (whaaat?)!

   My theory now is that it was all about stress for me, and that any sort of restricted diet was too much for my body to handle so it just broke down. I was high-carb/ low-fat originally, so the first low-carb/ high-fat diet gave my body what it needed at that point. But now my body seems to need carbs. Hopefully, RRARF will work as advertised and I’ll continue to improve, and then I can just eat an unrestricted real food diet, and trust my body to know what it needs – as in, eat whatever sounds good, as long as it’s a real food, and stop when I’m full. That’s certainly an appealing thought. I have gained a few pounds, but at this point I do not care at ALL as long as I continue to feel better (which is… good I guess?). I’m of course concerned that I’ve always held so much weight in my middle, so I hope that I’ll creep towards a healthier fat distribution once I’ve held a healthier hormonal profile for a while, but we shall see. Maybe if I continue to feel well I can eventually try lowering my carbs again to slim down.

   4) I honestly avoid doctors, and being so young I haven’t had a lot of blood-work done. My gyno ordered a basic panel for the first time at my last appointment (was doing dairy-free Paleo at the time, I believe), but they’re in the process of updating their online system and I can’t view the results anymore. Everything was normal though, I think my total cholesterol was high-ish. I don’t take any medications.

   5) My dad’s brother has Type 1 diabetes but otherwise everyone on his side is fairly healthy – both grandparents are alive, minor complaints but no metabolic syndrome and doing great for a couple in their eighties. Dad has always been active and slim, and is currently healthy as a horse, aside from lower back pain and a bad knee. There’s some heart disease and rheumatoid arthritis on my mom’s side, and her mother died of Alzheimer’s, pretty early-onset. Mom’s got similar digestive and fatigue problems to mine, actually – her lifetime GERD has progressed to Barrett’s Esophagus, unfortunately, which is excellent motivation for me to get mine under control. I introduced her to Paleo when I started down that road, and she’s actually doing great with it! She’s lost a ton of weight and seems to have a lot more energy now. She does a combination of SCD and Paleo, and she’s encouraging my dad and brother towards that style of diet, so we’ll see how they do!

   Wow, I wrote a lot. I hope it’s helpful… I think it’s a great idea to collect anecdotes like this. You hear a lot of success stories but it’s nice to know I’m not the only one who didn’t become a beautiful superhero on low-carb. I think real foods are probably a more universal answer, in an ideal combination that varies for each individual.

4. 1. I am a female, I am 40 years old and I am 5 ft 3. I weighed around 140 when I started on the GAPS diet and went down to 136. I have since gone up to 142.

   2. I started on the GAPS diet in January of 2011 to improve my health and to improve my infertility. I also am a diabetic and I have been for 30 years. I wanted better control over my diabetes and to heal my body and possibly get off insulin.

   3. My problems are a type 1 diabetic, infertility, trouble losing weight and high cholesterol. I was seeing and endocrinologist for many years, but when I accidentally came across the wholefoods lifestyle I began to see that we were not seeing eye to eye and that her methods were more for how much money she could make verses healing my body. I began looking for a new primary doctor and ran into the same problem until my husband gave me the name of a family doctor that believes in the whole foods life style. We still disagree on a few things, but he supports my decisions. I just started going to him in May and he does use supplements. He did immediately put me on a magnesium supplement a probiotic and a pure lean nutrient. After we received my test results back I found out that I was very low on vitamin D, even though I was taking fermented cod liver oil, and that I had very high levels of lead and mercury in my body. He has put me on a slew of supplements to get it out of my body. He seems to think that my body can then heal after we get rid of it. I am in agreements. He also believes that we will be able to get rid of my type 1 diabetes after we do this. He said it could take w years. I always new our bodies can heal themselves and I do believe the mercury and lead were keeping my body from healing. I really do not like taking supplements, but lead and mercury is something that I am not familiar with, so I am leaving it up to him. I have gained 4 pounds since starting the supplement regimen, so I am concerned about that. I did adjust my diet to add more muffins made with almond flour or a bread with coconut flour. They seem to keep me regular. He said to call if I had an issues with that, but when I started to eat these items the problem went away. The fermented vegetables were not working in this case.

   4. I am not on any other medications because I will not take anything to lower my cholesterol. My last doctor said my cholesterol was high, but this doctor did not say it was high at all. He just said my vitamin D was at 14 and it should be 50.

   The high lead and mercury levels showed up in an 8 hour urine test.

   My blood pressure is normal and for years it was always low, but since I went through the GAPS intro in April and continued the GAPS full diet, I have had no problems with my blood pressure and my body temperature as come up form 97.9 to 98.9. From what I have read that is good, but the last time my temp was taken at the old doctors office it was done on the forehead and the new doctor takes by the mouth. That could be what it is. I am not sure.

   My next biggest problem right now is hair loss. When I was drinking cows milk I did not have that problem, but about 6 months of switching to goats milk my hair started to fall out. My current doctor said it could be from the iodine, but wouldn’t goats milk have iodine? I figured I will cover this with the doctor after we get rid of the lead.

   My husband and I have been trying to get pregnant for almost 4 years. When I when gluten-free I did start to ovulate again. My husbands counts are low, but not enough that it would keep us from getting pregnant. I do know that lead will cause miscarriage. I was pregnant when I was 25 and had a miscarriage. Now I know why.

   5. My family did not really have major health issues. Only my great uncle had type 1 diabetes and my Mom and Dad neither one did. My Mom was overweight, but that was by choice. She did not do a lot during the day and did not exercise. Her favorite food was peanut butter. My mother also had trouble getting pregnant, but after adopting 2 children she had me. Neither one of my grandparents had weight issues until they were up there in age. Even then it was not totally out of hand. I do know that I had the flu right before i became a diabetic. I would not drink anything and when everyone made me drink something at that point I could not stop. It was 1 month later I was diagnosed with diabetes. I was 10 years old. I have always had bad teeth and had a mouth full of mercury most of my life. I recently (in June) had the last of the mercury fillings replaced.

5. 1) Female, 5-2, started at 184, now 157

   2) Began one year ago, to loose fat, to deal with low blood sugar, started with strict Atkins combined with going grain free.

   3) Consulted doctors for sleep apnea, sinus issues, difficulty losing weight, tried WW and Cardio – it didn’t help at all, I was constantly starving and hating myself for my lack of will power. The advice was sinus surgery, it didn’t help the apnea, developed tachycardia, was given beta blockers, the doc’s advice for body fat was Canada’s food guide and potion control AND be happy with my size.

   4) My triglycerides one year ago were 1.4 (Canadian) and two months into new diet they were 0.7. My tachycardia improved when I went off sugar, still started when I had sugar occasionally for the first few months, off beta blockers 6 months later, one year later a little sugar does not bring on tachy anymore.

   5) Father died of heart attack at 65 (slender – low cholesterol), mom had brain aneurysm (vegetarian) at 63, all females in my family either heavy or really struggle to keep weight low, grandmother had diabetes (type 2), my father and I had seasonal allergies, I have food allergies.

6. 1. Female, 52, 5’4″, 205lbs, 165 lbs
   2. I started GAPS January 2011, because foggy thinking, irritability, sugar and alcohol cravings, almost daily migraines and, most recently, 24/7 indigestion all contributed to my inability to do much that helped myself or my family. My family and I have witnessed considerable improvement, so I am a real foods low carb believer. Nonetheless, my recovery has not been a straight path, and I have yet to give up alcohol. I notice that my occasional carb feasts can make me feel either horrible for days or great for a short time followed by feeling horrible for many days. Salt also helps, and I suspect that your theory relating insulin and salt is correct, at least, for me.
   3. My health problems started when I was around 11 years old. It took me a long time to learn to verbalize my problems and even longer to learn how to talk to doctors. I have been told that I just need to live with my problems, to get over it, that I am healthy, and, eventually, to take antacids. My faith in doctors declined, and, this makes the fact that my daughter has just started medical school interesting! Just about one year ago I visited an alternative doctor. I was hopeful to have someone help me, but, again, I was dissatisfied when she prescribed protein powders that contained sugars and other unpronounceable ingredients. I suggested that this powder aggravated my migraines, and she responded that it was impossible. Furthermore, she was very expensive.
   4. Last August my fasting glucose was 106. I have a physical scheduled in three weeks.
   5. My father had dentures and died of a heart attack at age 41. My mother is grossly obese, has multiple allergies, psoriasis, and toe-nail fungus. She loves me and listens to me, but she thinks that my health and diet ideas are nuts! My brother and sister share gluten sensitivities with me. My sister has recently been diagnosed as having as ethers.

7. Just wanted to say thank you, Dr. Cate, for collecting these stories. I’d thought I was doing so well low carbing, and had finally lost weight (to a point, anyway) and felt great – then it all went south. It’s nice to hear other people having the same experience – helps me not feel so frustrated. It’s difficult when you’ve been so, so diligent about health and nutrition for so long to suddenly be hit with a bunch of problems.

8. 1. Female, 57 yo, started at 155, currently 145.
   2. Reduced carbs in April 2011 when my husband was diagnosed with coronary plaque and we found Dr. William G. Davis’ website/book “Track Your Plaque.” He lost 16 lbs, I lost nothing. . . . We had done South Beach several years before, losing about 10 lbs each. Since then I have gravitated to a primal diet (no grains, minimal sugars, minimal dairy, lots of veggies, protein at every meal). Still no weight loss although I cheated whenever someone brought homemade baked goods into the office. Went seriously lo-carb and tracking it in mid-May this year. At that point I was 152 lbs and in the first week lost 4, then plateaued. I made sure carbs were around 35-40g/day, reduced protein to 55-60g/day and lost another 3 lbs. I think I’ve plateaued again at 145. Problems really started two weeks ago.
   3. I suffer nighttime leg cramps that propel me out of bed – and upped my magnesium intake to about 450 mg/day as of yesterday based on Jeff Volek/Steve Phinney’s books. I have always been prone to leg cramps but they’ve gotten much worse with cramping in unusual places (ankles, outside of my calves). Two weeks ago I decided to get a glucose/ketone monitor to see if I’m in ketosis. Daily a.m. fasting readings run from .5 to 1.1. Fasting blood glucose usually less than 90 (70-85 most days). I am not experiencing the sustained energy energy described in Volek/Phinney’s book; in fact, my butt is dragging through my step aerobics classes (Monday and Wednesday evenings). I have less trouble with my mat Pilates and Group Power (adjustable barbell) classes. My husband and I bike on weekends and I generally am okay but don’t have the energy I used to before low-carb.
   4. I’ve not had blood tests done since going really low carb. Blood pressure normally runs 115/70. Last time cholesterol was checked it was 170, HDL around 80, LDL around 60, triglycerides at 42 (I remember that because it was so low). Hormones on the low end of normal for a post-menopausal woman. I supplement with a good multivitamin, omega 3s, magnesium, b-complex and butterbur for migraine prevention, probiotics, C, D3. If I don’t feel better in another week or two, I’ll be making a doctor’s appt. My PCP is into nutrition and alternative treatments like homeopathy so I should get good support from her.

9. 1) Female, 37, 5’2″, started low carbing over 6 years ago weighing 140lbs. Took about 2 years to get down to 116lbs, where I stalled until last spring, when I suddenly gained 10lbs in about a month, subsequently lost it, and then this year (again in spring) 10lbs gain in a month. Currently 126lbs. Weight gain for me is mainly in my belly, also typical thighs/hips/upper arms. I have never had a flat belly, even as a kid – the roundness has decreased, but still concentrate sub-q fat there. My sister and mother have the same fat distribution pattern.

   2) I started LCing for weight loss (Atkins), then found out I was celiac so went LC/Paleo. Weight loss was extremely slow – I tried variations from zero carb, VLC, Atkins style, no dairy, SCD, intermittent fasting. I struggled with ongoing gut issues for awhile at first. I started having problems last spring – the sudden weight gain, plus fatigue, slight vertigo, loss of libido, mood issues (depression, apathy, irritability etc), puffiness in hands, feet and face in mornings, dry scalp and skin, poor memory, brain fog. Thinking it was gut-related, I did SCD (basically broth, well-cooked meat and veg) for a month or two and felt better, and the weight came off – went back to my usual low carb diet, and it all came back again this spring.

   3) See above – also last spring I had GI issues along with the other symptoms, but this spring none. I ordered a thyroid/hormone panel last spring and numbers were ok except estradiol/progesterone ratio was low. This spring, I ordered tests again and free T3 was very low as well. Labs listed below:

   I tested in June 2011 (marked P for previous), and again in March 2012 (marked C for current) via ZRT, so blood spot and saliva.

   TSH: 2.5 (P) ; 2.8 (C) (0.5 – 3.0)
   Free T3: 3 (P) ; 1.3 (C) this is in pg/ml (2.5 – 6.5)
   Free T4: 1.6 (P) ; 1.2 (C) (0.7 – 2.5)
   TPO: 28 (P) ; 34 (C) (0 – 150)

   Estradiol: 1.4 pg/ml (P) ; 2.4 pg/ml (C) (1.3 – 3.3)
   Progesterone: 134 (P) ; 101 (C) (75 – 270)
   Ratio Pg/E2: 96 (P) ; 42 (C) (100 – 500)

   Cortisol Morning: 10.7 (P), 9.3 (C) (3.7-9.5)
   Cortisol Noon: 2.6 (P), 2 (C) (1.2-3.0)
   Cortisol Evening: 1.6 (P), 0.9 (C) (0.6-1.9)
   Cortisol Night: 1 (P), 0.7 (C) (0.4-1.0)

   Vit D dropped from 50 (P) to 35 (C)

   This is from April 2012:

   Insulin: 7.1 (1-15, optimal 2-6)
   Fasting glucose recently was 83 (in US values; 4.6 in Canadian).

   4) I’ve not taken any medications in years, so no meds to report. Diet during first test was avg 50g carbs/day or less from veg, dairy – no grains. I began adding safe starches to my diet March 22, 2012 (potatoes and white rice) for under 100g carbs total per day – my blood/saliva samples were taken March 30, 2012. I noticed an improvement in energy when I added starches, and no additional weight gain, cravings, hunger etc. Currently seeing an ND who has me on supplements to support thyroid, metabolism. I supplement Vitamin D/K. Some symptoms are improving somewhat, mainly energy levels and mood. No weight loss.

   5) No known thyroid issues or diabetes in my family history, though I don’t know a lot of my family history. My sister is also celiac. Obesity – some struggle with weight gain (paternal grandmother, me) but mainly slim. Paternal cousin has MS. Mother has history of neural tube defects in babies (sister has occult spina bifida, 1 baby died after birth due to anencephaly, another pregnancy miscarried). My father’s side tends to die of stomach/colon cancers. Paternal aunt recently dx’ed with vascular dementia, has suffered headaches her whole life (she’s 63). I suspect celiac issues on my Dad’s side.

   1. Forgot a few labs (from March 2012):

      hsCRP 0.3 (< 3)
      Hemoglobin A1c 4.9% (< 6%)

      Cholesterol 176 (< 200)
      HDL 43 (40 or higher)
      LDL 120 (< 130)
      VLDL 13 (< 30)

10. I am a 59 yr old woman, 5′ 61/2″ tall, currently 150 lbs.

    I weighed 167 when I changed my diet to a low carb plan 2 months ago. I had been a vegetarian for the last seven years and in that time I gained 36 pounds. I had no major health concerns other than the weight gain. I evaluated my veg diet and concluded that most of the food I ate was starch. Beans= starch, rice= starch, pasta= starch. I ate whole grain pasta, brown rice, whole wheat bread, but whole grains are still starch. I did eat LOTS of fresh fruit and vegetables too as well as dairy. I found myself wandering to the kitchen every night after dinner craving more starchy or sugary snacks.

    Since eliminating starchy carbs and sugars from my diet, I have lost 17 lbs in just 2 months. My cravings for sweet and starchy foods are gone. I do not count my carb grams, calories, fat or protein grams. I simply include a protein with every meal and continue to eat plenty of fresh vegetables. I limit fruit to 1 or 2 servings per day. I make bone broth and enjoy cooking with it and having soup several times each week. I eat sprouted grain bread 3 or 4 times a week at breakfast. I eat wild salmon 1 or 2 times each week and roast a chicken every week for dinner and to use in lunches later. Eggs, bacon, sausage with sauerkraut, are staples now. I eat yogurt, butter and cheese, but raw dairy is illegal in the state I live in so I buy these organic. There is a dairy that sells non homogenized milk which is pasteurized though, but milk only, no other dairy products. I have not managed to include any organ meats yet, I always hated the taste and particularly the texture of liver as a child, but plan to try it again soon.

    I have enjoyed the weight loss, increased energy, tasty foods and feeling of happiness and general well being. The weight loss has slowed the last few weeks and every evening after dinner, I find myself napping. This never happened before. I also have been getting headaches a couple times a week, and that hasn’t happened in years. The problem which bothers me most is occasional constipation which has caused a hemroid that I had forgotten I ever had to flare up, both problems I never had as a vegetarian.

    I have not consulted a physician or had any blood work done since my change in diet. I have always had low to normal blood pressure and still do. I take no prescription medicine or supplements of any kind.

    I have read a lot of books about nutrition. After all I’ve read, Deep Nutrition rings true for me. I am trying to follow the principles of the 4 pillars in my diet and think I may have to change a bit more to obtain optimum health, but thanks Dr. Cate for all your work.

11. Hi Dr. Cate,
    First let me tell you how much I appreciate your willingness to sincerely look at this issue, because for many of us, low carb diets are simply the wrong way to go. My first low carb experience was when i was a teenager and i went on the atkins diet. I was in ketosis but lost no weight, although my sister lost 30 pounds! After a month i gave it up as i had no energy and my usually good mood was replaced by depression and a terrible sinking feeling. Later, as an adult and a member of the Weston A. Price Foundation, I began to eat low carb again (not quite as low as Atkins) as all the “experts” touted the negative, deadly dreaded grains as true killers, many saying you don’t need any carbs at all and that we should only be burning fats for fuel. The lower i went on carbs the hungrier I got. I ate so much fat and meat and non starchy veggies and I was starving! And I gained a lot of weight when I added cream and cheese. I developed acid reflux which i had for 12 years straight and it was terrible. My food was so restricted. If i ate even one bite of bread, I was sick with reflux for days! I was always shaking and trembling, and my blood sugar was high… fasting at 100, HbA1C at 5.9. This shocked me as i was eating no grains, no fruit, and no sugars/honey! My blood sugar stayed borderline high for years as i continued the low carb diet. I never lost a pound and in fact, I was freezing cold and i knew my thyroid was not right. All the “great” doctors told me to lower my carbs even further because I was sure to become a diabetic. One doctor even wanted to put me on Metformin and practically 0 carbs! My night times were terrible as I would wake from involuntary twitching and jerking – another doctor told me it was toxins on my nerves and I needed to be grain and fruit and dairy free! I was desperate for help! Thank goodness I attended the Weston A. Price Foundation conference in Dallas last Nov where I met Matt Stone of 180Degreehealth.com. I heard him speak and something inside said this guy knows what’s he talking about. So, I consulted with him. He explained to me that carbs/sugars do not cause diabetes, that carbs are very good for us and that the whole low carb/paleo lifestyle can do some serious damage to the endocrine system. He also helped me understand that my blood sugar was always on the high side because I was suffering from constant hypoglycemia and absolute sugar deprivation that was causing terrible adrenal stress. He put me on a plan that included carbs/starches/grains at every meal, banana bread, pancakes and waffles, maple syrup, dessert after lunch, sweet potatoes, breads, sandwiches, and all the foods i had avoided for years. To my shock, the acid reflux was gone in 3 days. My fasting sugar came down from 100 to 84 and has never gone back up again. The shaking and terrible trembling stopped, I started sleeping through the night, and my body warmed up as my temperature went from 96.8 back to where it belongs at 98.6. I will never do low carb again! I am so much healthier with starches and grains in my diet, but I dare not tell any of the doctors who are associated with the Weston A. Price Foundation because they would not believe me. They think sugar and grains are inherently bad and that they cause diabetes, when really, they don’t! In fact, they often help to prevent and cure it! As Matt Stone pointed out, there are plenty of doctors out there curing diabetes with fruit and rice, just as there are low carb docs doing the same with meat and fat. Everyone is different. While there are plenty of people who would probably do well without the carbs, I am not one of them. Now, I fuly enjoy a ‘normal” diet that includes bread, potatoes, fruit and grains. If i want a sandwich, I have one. I eat toast and eggs in the morning, sandwiches and salads at lunch, and chicken and rice with veggies for dinner. I have a much healthier metabolism (thanks to Mr. Stone)! And you know, when I went back and read the words of Dr. Price himself, in a letter he wrote to his neices and nephews, he talked about the healhiest foods they should eat and feed their children, and whole grains were among the best. The foundation does not recommend low carb, just properly prepared grains. Yet the doctors associated with the foundation are low carb because they are also fat (especially sat fat) friendly. Again, thank you so much for your willingness to address this issue.

    1. Alana
       I would be delighted if you could share an A1c done after at least 3months on your current diet.

       1. Dear Dr. Cate,
          I would be happy to request an A1c on my next blood test. Since I plan to continue eating a healthy, balanced diet including carbs/starches/grains for the rest of my life, it will be interesting to see how the number changes. I can tell you that just a couple of days ago a diabetic friend came over with her blood sugar monitor. We tested me before dinner (after a 5 1/2 hour fast). It was 84 – that seems to be the magic number for me, for some reason). After a dinner of chicken, rice (maybe one cupfull as I don’t restrict starches anymore and eat what my body wants/needs, and sauteed veggies, it went up to 119 an hour after i finished. An hour after that it was 99, and then about 50 minutes later (my friend had to leave), it was back to 84. Pretty good sugar handling compared to my low carb diet numbers. Thank you again. By the way, I love the way you write. I have given your book Food Rules to many people as a wonderful guideline for healthy eating. While the carb recommendations may be too low for me, I know they may be just what someone else may need. ~ Alana

12. Dear Dr. Cate,

    I have a question for you about carb restrictions. I have reduced my intake of breads and grain substantially, but then I realized that so many other foods have carbs in them such as lentils, beans, nuts, eggs, etc. I don’t understand how I will be able to maintain all of these restrictions without severely restricting my diet to mostly fat, vegetables, and meat. In addition, I am lactose intolerant so I can’t eat a substantial amount of dairy (I take lactase tablets sometimes). In your book you call into question the idea of “all things in moderation”. When you refer to carb restrictions, you are no doubt including all of these other foods, is that correct? I am a little lost. Any help would be appreciated.

    Thanks,
    Mia

    1. Though many foods contain carbs they may have very little or none. Lentils and beans have the most, but you actually reduce their carb content around 10-20% by sprouting, which increases their nutritional value as well (see Deep Nutrition, Ch 7, the Fermented and Sprouted Pillar). Nuts contain about 5 gm per 30 gm (1 ounce/handful). Eggs have almost no carb. Many with lactose intolerance can handle hard cheeses because the lactose has been fermented away by bacteria.

13. 1) Female, 39 years old, 5’8”, start weight: 65kg, current weight: 65kg.

    2) Began low-carb nutrition in September 2011 in attempt to deal with hypothyroid and fertility issues. Started on GAPS. Problems could be seen as expectations, such as a consistent increase in energy, pregnancy, etc. not being met. More explanation below.

    3) and 4) Just graduating from graduate school and going abroad to start working, I had experienced boarderline (according to blood values) hypothyroid. By now, it has been existing for probably more than 10 years. I remember seeking medical help from a ‘natural minded’ medical doctor when I was living in Europe. He ended up trying to treat my iron deficiency anemia, thinking that was the biggest problem. His treatments were unsuccessful and I refused to see an endocrinologist to be put on synthetic thyroid medication.

    Some years later, after getting married and moving to Asia I had assessed that my immunity was probably at it’s lowest that it’s ever been. I had frequent yeast infections, colds, bad coughs that would last several months, upper urinary tract infection requiring antibiotics, streptococcus infection in the throat also requiring antibiotics. (I usually do everything possible not to take medications!) After 4 years of my husband and I trying to conceive, I reopened my investigation into the thyroid issues thinking that they could be a contributing factor in the fertility challenges. (During the 4 years, I had tried unsuccessfully nutritional supplementation with hair analysis and Chinese herbs.) After lots of reading, among which was Dr. Kharrazian’s thyroid book, I was drawn to the attention of GAPS nutrition (Dr. Campbell-McBride). I decided to start right into GAPS intro diet at the beginning of September 2011, having eliminated wheat for probably 1 month prior to that. I had added fermented cod liver oil and probiotics supplementation several weeks into GAPS.

    My thyroid blood values before starting GAPS were as follows: July 29, 2011 – TSH 7.620 mU/L, FT3 3.57 pmol/L, FT4 11.19 pmol/L, TgAb >4000.00 IU/ml, TPOAb 54.78 IU/ml.

    About 5-6 weeks later, my husband and I decided to try having a baby using IVF. The IVF hospital had tested the following blood values in their lab (different lab from the one I used previously): October 4, 2011 – TSH3UL 4.852 uIU/ml, FT3 3.72 pmol/L, FT4 14.45 pmol/L, T3 1.42 nmol/L, T4 99.6 nmol/L. Also GLU 96 mg/dL, TG 66 mg/dL, Total CHOL 432 mg/dL (I know… doesn’t mean anything by itself, but they didn’t do HDL, LDL)

    6 months of minimal stimulation IVF followed, using synthetic hormones (not as many as normal IVF). We had 2 unsuccessful attempts of embryo transfer. I had stayed firm on the GAPS nutritional protocol throughout the whole time.

    I rechecked my thyroid hormone blood values after the IVF: May 3, 2012 – TSH 5.2 mU/L, FT3 3.66 pmol/L, rT3 0.36 nmol/L, FT4 12.20 pmol/L, TgAb >4000.00 IU/ml, TPOAb 49.13 IU/ml.

    At that time I had started researching Paleolithic nutrition and Dr. Kruse’s Leptin prescription thinking that I can complement GAPS with these ideas. I read about the importance of not snacking and have been trying not to snack between meals as well as not eating 3-4 hours prior to sleeping.

    Since starting GAPS I have noticed a TREMENDOUS improvement in my immunity. I have had nothing to complain of in that respect and I am very thankful for this. I can remember having achy joints and ‘feeling old’ in the previous years. That has also greatly diminished. Energy levels are still up and down. Often I still feel really tired. With respect to the thyroid blood values, I feel that not much has changed. Maybe because of the 6 months of synthetic hormone use it hasn’t had a fair chance. I’m not sure… and maybe I need to be more patient.

    My current blood values are: June 24, 2012 –
    GLU 95 mg/dL, TG 51 mg/dL, Total CHOL 371 mg/dL, HDL 100 mg/dl, LDL 260 mg/dl
    CRP <1.00 mg/L, HbA1c 5.3%, TSH 6.230 mU/L, FT3 3.45 pmol/L, FT4 11.81 pmol/L

    My next step is going to be eliminating dairy and incorporating regular exercise. We'll see what happens.

    5) Family history: Father – high blood pressure, high cholesterol, adult onset type-2 diabetes, arthritis in knees (1 knee replacement), alcoholic, cardiovascular disease. Mother – high cholesterol, hormonal issues? (hysterectomy), osteoporosis. Grandfather (dad’s side) – cancer following MVA. Grandmother (dad’s side) – cardiovascular disease.

14. Could part of the issue be breathing? If huge benefits are available from improving the diet, note that the vast majority of energy comes not from food, but from oxygen. Food is just half of the equation (or perhaps even much less than half):

    http://www.westonaprice.org/notes-from-yesteryear/100-years-before-weston-price

15. Oops! I’m not 6’6″, I’m 5’6″. Minor difference ;-P

16. 1. Female, 35, 6’6”, 205, 185

    2. I began trying a low carb diet – probably closest to Atkins since I continued to consume dairy products – about 10 weeks ago. The reason I tried the diet is because I am currently on anti-anxiety medication and I want to get off of it. I started out on Lexapro and gained 40lbs in 2 yrs!!! I switched to Prozac hoping to stop the weight gain – and it has worked. Now I’m trying to lose the weight and get off of medication all together. So — I began the low carb diet after doing a lot of reading on how to improve brain function. I saw a lot of research on the importance of fats in the diet for good brain function.

    3. I had cut out sugar for about 4 weeks when I decided to ditch ALL the carbs. About 48 hours into doing this, my heart began pumping hard. Not fast, but hard. It scared me, so I added back in some fruit the next day and it disappeared. I tried to get rid of all carbs again a few days later, and my heart started pumping hard again. So… I have added back fruit into my diet permanently. I’ve recently decided to give up dairy – so now I suppose I’m more along the Paleo spectrum. Still eating fruit – maybe 3-4 servings a day. Weight loss is slow but steady – maybe 2 lbs a month. But I feel good.

    I did not consult a physician.

    4. No blood tests to provide.

    5. Dad’s side – struggles with depression/anxiety, and obesity. Never heard of any thyroid issues.
    Mom’s side – I’ve heard of a couple of my great aunts from my grandpa’s side who have thyroid issues and struggle with weight. That’s it.

    Hope this is helpful. Glad you are addressing this issue, because I thought it was just me!! I’m excited to hear what you find 🙂

17. 1. Age: 48 Height: 167cm Weight: 59kg
    2. Began no-carb diet a couple of years ago and lasted 10 days before a low mood set in. Went off the diet and permanently lost weight even though I re-introduced carbs! The reason I went on it was not weight, however, it was CFS. An overgrowth of Lactic Acid causing Enteroccocus and Streptococcus, fed by carbs, was the cause (definitively proven over three years of going on courses of antibiotics (as prescribed by Prof Henry Butt of Bioscreen via my fabulous Doctor, Lyn Tendek): when I was on an antibiotics I recovered quickly, then months later, the bugs and symptoms would return). There is also a strong correlation with CFS and runny nose, with the Strep from the latter re-inoculating the gut. Sugar directly triggers the runny nose (as does cheese) so it’s imperative I limit carbs. However, I don’t like the effect on my mood and have been told serotonin production is reliant on carbs?? I find that if I have carbs for breakfast I feel quite sustained and can do without them for the rest of the day (though it’s a little challenging during Winter!). Would love to see a post on carbs and mood!

18. Here’s my info for the survey.

    1) female, 34, 5’10”, 140 pre-preg, 160 post partum, now around 150. Weight isn’t really my concern.

    2) I started medium-low carb on the (very insistent) advice of my OB. I didn’t have problems with my labs or anything, but he was seeing a huge rise in carb-based weight gain & resultant c-sections that he was very, very insistent that I avoid most carbs. He gave me a free pass on fruit. I also gave up my one-a-day unsweetened latte habit then, to cut caffeine.

    I do have a very sweet tooth, but it’s not constant, if that makes sense. I will occasionally (2 or 3 times a month?) want to eat something very sweet, or starchy. The rest of the time I’m fine with meat, veg, dairy & occasional homemade bread. My current way to deal with a sugar/bread craving is to eat a little oil or butter instead- seems to work well.

    When pregnant I mostly craved watery fruit (watermelon etc) and salmon (in season during my 1st & 2nd trimesters, yay). After delivery I’m sure I had food cravings, but my husband did the shopping and cooking the first month & so ate generic sad food or whatever he came up with. I went through a bout of mastitis early on (took antibiotics for that.) and went back to my previous eating habits when baby started having fairly significant reflux issues around 2 months. I also cut out dairy for a month to see if that helped (no) then completely cut legumes, especially peanuts, and this helped tremendously. I’ve been avoiding soy for a few years now, but was extra strict when pregnant. After reading your book, I have been adding fermented foods, liver & generally trying to follow an anti-inflammation diet. Last time I had a regular cookie it gave me a pretty bad headache (couple days ago).

    3) So, while we are all healthier & generally happier, baby sleeps through the night, etc., my milk production took a dive after going Primal/lowish carb. Previously I had made plenty of milk (and fortunately stored some in the freezer, which we’ve since needed.) I’ve managed to keep it up with him, supplementing from frozen supplies, and avoided having to give any formula, but it was and continues to be just barely enough. Baby is starting to eat solids (he likes liver!), so I am hopeful we will squeak by without formula. This is my big concern.

    Possibly unrelated, but: Two weeks ago we ran out of our normal toothpaste, and bought a different kind (very foamy, yuck). After using it once my lips started to blister and peel (allergic to mint oil), which was annoying & I stopped using it. Three days later I developed itchy patches, like hives, between my fingers, on the tops of my feet, on my arms and under my chin. Never had anything like this before! After a week of really following the anti-inflammatory diet to a T, avoiding toothpaste (baking soda now), and intensively moisturizing with olive oil everything has cleared up.

    4) My labs during pregnancy were all very good. I don’t have the numbers, but the doc always said they were great, including the fasting blood sugar, the only time I’ve had it tested. My blood pressure always runs on the low-side of good (generally 110/60-ish) and my cholesterol total hovers near 200, but the breakdown is good enough that the doc seems happy with it. I might have a minority wonky thyroid – always have cold hands and feet (even in the summer), sleep a lot (not after the baby though), and have a hard time warming back up after getting chilled. Nothing has been severe enough that any doc has suggested getting my thyroid tested though.

    5) The women in my family have all struggled with weight (I’m the first that hasn’t in 3 generations). My mom’s mom has bad arthritis (only in the last 8 years) and is allergic to tons of meeds, and has a pace maker. Mom’s dad had a degenerative muscle disorder (not well diagnosed during his life), a heart valve replacement & died of heart failure. Both mom’s parents were the last of a bunch of kids with much healthier elder siblings who were out gardening in their late 90’s.

    Dad’s dad is quite deaf, but otherwise fairly healthy at 96, including sometimes still mowing the lawn. He also has a pace maker, and takes Lasix as needed. Dad’s mom died from complications from a blood clot (arrhythmia), but was otherwise fairly active till her death. She had had a hysterectomy in her 60’s & took HRT.

    Mom takes meeds for high blood pressure, low thyroid, cardizem and has high cholesterol (no statins b/c of side effects). Dad takes statins. A sibling has a mood disorder. I don’t take prescription meeds, but do take supplements: cod liver oil, whole food vitamin, brewers yeast, D3, probiotics and lactation boosting herbs/teas as needed.

19. 1) male 71 5′ 10″ 222lbs 185lbs
    2) Diabetes2 diagnosed four or five years ago. I was given dietary advice (conventional) and encouraged to be more active. Took up calorie counting and low fat as per the advice, but felt I would be in trouble as I seem to have been yo-yo dieting all my adult life. Still, the blood results were encouraging, and I did refuse any medication or to self monitor. Then in June 2011 I had a fortnight’s holiday with very little bread or cereal, and noticed on returning home how much better I was feeling. So began my interest in paleo and the notion of cutting down on the carbs. Read several books and felt reassured I wouldn’t be harming myself by eating fatty meat, butter, real yogurt, nuts, and leafy greens, occasionally I indulge with any fruit in season. I’ve cut out all starchy foods, grains, and all processed foods. No sweetened foods or drinks either.
    3) Have been under some pressure from the diabetic nurse to cut down the fats and go back to following NHS guidelines, but unless my health deteriorates then I will resist this. I did get amazing foot cramps for a while, usually at night in bed (wife not amused by my attempts at stretching the cramp away). Eventually I upped my salt intake which solved the problem. Another condition early on was constipation, especially hard stools. This was sorted after several very uncomfortable weeks, by realising it was caused by dehydration. So drinking lots of water nailed that one too.
    4) Bloods now okay, sorry I don’t keep the printouts any more so can’t give them. The waistline continues to shrink, and I generally feel very healthy, I am active, but nothing like when I was young. Mostly walking and gardening these days, and the rare swim.
    5) Dad died aged 53 He was a heavy smoker and not very active. Heart attack, I think. Mum lived well into her eighties.
    Think I need to just add that my 74 year old wife has been very sceptical about my diet and has shown a lot of resistance. However, as a consequence, she too has cut down on potatoes, and now eats much less bread pasta etc. She too has lost weight, dropped a couple of dress sizes and is looking years younger. Our evening meal together is always real food home cooked, usually, but not always, by her.
    Hope this ramble is of some help.
    Thank you for all your posts.

    1. Hi David, I am also a type 2. It is said that 90% of type 2 have weight issue. For people like us it is not only cutting down the waist but also to take care of our blood sugar levels. Since you mention that you dad passed away of heart attack you might need to be more careful when dealing with high protein diet. Following is a link to diabetes eating guide site, hope it helps.

       http://www.diabetes-and-diabetic-diet.com/

20. 1) Female, 33 years old, 5 ft 3 in, weight before low carb: about 113; weight now: probably about 117
    2) I started about six months ago, sort of semi-following the Specific Carbohydrate Diet. I was not having any health problems, but we decided to have my husband try SCD to address fatigue, excessive gas, and also severe canker sores, which have plagued him since childhood. It was just easier to eat the same foods as him, so I gradually started getting rid of more and more grains and cereal. Then about maybe 3 months ago I listened to several talks at Underground Wellness’s Paleo Summit, which inspired me to read Deep Nutrition. At that point I started trying to cut back my carbs even more (stopped putting agave in my coffee, stopped putting honey in my homemade yogurt, etc.).
    3) Gradually over the past few months I have just felt more and more fatigued. I keep falling asleep at night while putting my 4-year-old daughter to bed and then waking up at like 11 PM only to realize that I’ve completely lost my evening. I have also been experiencing what I would call “brain fog” a lot. I just feel kind of out of it, and it’s very annoying. I typically work out 5 or 6 days a week doing a cross-fit style workout (GSP’s Rushfit) and also running, but during the past couple of months that has probably dropped to 3 days a week, which is the least that I’ve exercised in 15 years. This has been due to the fatigue.
    4) I haven’t had any tests done yet, as it’s only been the past couple of weeks that I’ve really acknowledged that I am in fact not doing very well on this diet regimen. I’m hoping to figure out the next step to take soon!
    5) My dad has high blood pressure and is on cholesterol-lowering drugs, my grandfather died of a heart attack. Not a lot besides that to share.

    If it’s okay, I’d like to share a bit of info about my husband as well:
    1) male, 34 years old, 5 ft 10 in; not sure what his weight is but he is very lean and has a good amount of muscle; his weight has not changed during any of the diet changes we’ve done recently
    2) As I said above, Jonathan started out on the Specific Carbohydrate Diet about 6 months ago to address fatigue, excessive gas, and also severe canker sores, which have plagued him since childhood. He followed this quite religiously for a few months, and gradually has experimented over time with including some sprouted grains in his diet. He has since taken those back out.
    3) In April of this year Jonathan suffered an attack of pancreatitis that landed him in the ER. Fortunately he has not had any recurrences.
    4) Although the doctors performed all sorts of blood tests and did ultrasounds they were unable to determine a cause. I can’t help but wonder if his diet changes have had something to do with it! Everything checked out as right in the middle of the “normal” range.
    5) Jonathan was diagnosed with coxsackie B virus when he was about 4 years old, and it was at that time that his problem with canker sores began. I don’t have a lot of information about family history. His mother is pretty healthy, but his dad died when Jonathan was very little and we don’t know much about his side of the family.

21. 1) I’m 56, female, 5’6″. I think my starting weight was around 212 (2008), now 205.

    2) I began low-carb in about March 2008, when I was diagnosed with type 2 diabetes. I was roughly following an Atkins type plan at the time, but I’d read just about everything on the subject.

    My first few days, I thought I was just going to fall on the ground and not get up again. Grabbed a hard candy and sucked on it, and got energy to get to my car. At the time, I was probably eating around 75g carbs/day (big change from my previous WOE).

    3)I tried to manage my T2D on my own for a year. I did have someone who helped me get a glucose meter. By fall 2008, my bs was creeping up, regardless of my diet, and I was still trying to eat less than 100g/day. I finally saw a doctor in Jan/2009, and began taking Metformin and eventually lisinopril (my usual low bp got up to 135/90). My A1c went from 9.6 down to 6.4 over 6 months or so.

    Note that my diet up until May 2011 included grains and low carb protein bars, plus whey-based lc protein powders. I did work on reducing my carbs over time.

    In May 2011 I went grain-free and dropped around 30lbs. I didn’t have a scale, but in July I weighed 192, so I had gained quite a bit of weight, still doing low carb. By this time I had not seen a doctor for almost a year, and had stopped all meds in March 2011.

    I maintained my weight loss until November 2011, when it started creeping back up. I was very sedentary from November to March 2012, and hit a high of 207. My blood sugars had gone up into the 200s on a regular basis. I had low back pain to the point of not being able to get up and down very easily, and was taking 2 ibuprofen every night in order to get to sleep.

    In March I gave up dairy, and then nuts. No change with the loss of dairy, but lost 6lbs in a week with no nuts, and all back pain went away. The next week, the weight started back up, even though I did not change my diet.

    At this time (June 2012) I am back to eating some dairy, and nuts only rarely, if at all. I’m still grain-free, except for a cheat once a week or two. My weight this morning was 206.5. I stopped recording my food intake, but imagine it is between 50-60g of carbs daily. My blood sugars are varied between 168-270. No medications except occasional ibuprofen, St. John’s Wort, and/or Melatonin.

    I’ve been trying to get more sleep, but lately (with the cheats with wheat), I’m having some trouble getting to sleep and staying there.

    5) My father died of a 2nd heart attack. His mother and brother died of heart disease, and his sisters both had bypasses and pacemakers. His blood pressure and cholesterol readings were low.

    My mother had a hysterectomy at age 40 (2 yrs after my birth), and gained weight. She took Premarin until 1972-3, when she stopped for 6 months. She began taking it again, and 6 months later (May 1974) had 2 5lb ovarian tumors. She survived this (radiation therapy, no chemo), and had a heart attack in 1993 with subsequent bypass. Gallbladder attack 3 months after the heart bypass, removal. She died in 2001 from COPD, complications of bronchiectasis. Her cholesterol was high, but refused to take statins (made her very ill).

    Both sisters lost their gallbladders early (one was 33, the other was 43), and both had hysterectomies in their 40s. No thyroid issues ever diagnosed. No Alzheimer’s or diabetes (except for me) in my family.

    No one in my immediate family was obese. I had gestational diabetes with both of my children (I was 33 and 35), and gained quite a bit of weight with both pregnancies. Have never lost the pregnancy weight. The most weight I lost was giving up all grains a year ago. I am still fairly sedentary.

22. 1) sex, age, height, weight on starting low carb, current weight.
    I am female, age 52, height 63”, and starting weight was 254. Current weight is 210.

    2) When did you begin low-carb and why (for weight/other health issue) and did you do Atkins, South Beach, Paleo or other and when did you start having problems?
    I started low carb in June of 2011 for health issues. I was in really bad shape, very obese, short of breath and in pain just walking across the room. I have sleep apnea and severe GERD. I have PCOS that was helped by low carb in the past.

    I am doing a general LCHF plan–Net carbs 20 – 30 grams/day (around 40 total), no grains, no sugars, no starchy vegetables. No fruit except occasionally berries or a very small slice of melon. I eat high fat, mostly coconut oil, olive oil, butter, grass fed meats and high fat dairy. Fat is 70 to 75% of my calories, I try to keep carbs below 10%. We eat primarily organic, and grass fed, eggs from pastured chickens. I try to stay around 1500 calories a day. I did really well at first but then completely stalled after 2 to 3 months. Even lowering my calories to 900 to 1100 per day did not break the stall. In February 2012 I started Metformin and have seen very slow and erratic weight loss since. I feel great on low carb (plenty of energy!), but very frustrated with the slow, stop/start weight loss! I fear that I won’t lose any more and I’m very obese still.

    This is my second low carb attempt. In 1999, I was put on a regimen of low carb (Protein Power) and Metformin to treat PCOS. It worked very well. I lost 40 lbs easily and got pregnant (surprise!).

    3) Please outline your problems the more you can share, the better. If you sought advice from a health professional what was the advise and did it help?
    The biggest issue for me is months of no weight loss, with occasional modest loss of 2 to 4 lbs despite strict low carbing. I have slightly elevated TSH (see below) so my doctor has offered Levethyroxine (I haven’t decided if I should take it or not) and put me on Metformin.

    After low carbing for 3 months, I experienced intermittent but very heavy bleeding which I believe was due to phytoestrogens in flax I was eating daily (when I stopped eating flax, the bleeding stopped, too). I bled heavily for 8 weeks and iron levels dropped very low (16 ug/dL). I started iron supplements—this was around the same time as my stall began. I lost a little more weight once I was done with the iron supplements 3 months later, but the rate of loss is still very slow and often stalls completely.

    4) If you provide blood test results, please put them into context of by providing dates and information on what your diet was like and what your problems were at the time. Same for medications particularly blood glucose/blood pressure/thyroid/other hormone/anti-depressants/sleep aids. Please include any adjustments made, why, and what the effects of the adjustments were.
    Labs:
    January 2011—I did not get baseline labs, this was after 6 months of LCHF described above with calories ranging 900 to 1100/day. I had been stalled since August at this point. My weight was about 224 lbs.
    FBG = 100
    Cholesterol=235
    Triglycerides=71
    HDL=79
    LDL=142
    TSH=5.49
    HbA1C=5.8
    Vitamin D=40

    March 2011 (I went on Metformin 500 mg BID in February and increased my calories to 1600/day to see if it would help my TSH). My weight was about 217 lbs.
    TSH = 5.27
    Free T4 = 1.3 (My HMO won’t test other thyroid markers)
    HbA1C= 5.2
    FBG=93

    June 2012 (Continuing LCHF described above, Metformin 500 mg. BID. My weight was about 211 lbs)
    HbA1C = 5.5
    FBG=93

    BP ran 130 – 140 over 80 before low carbing, now runs 120 over 80.

    I take my own FBG with a glucometer. It runs between 84 and 96 most of the time, with occasional jumps into the 100 – 110 range.

    Medications:
    Metformin 500 mg. BID (began February 2012)
    Asthma meds (Singulair, Advair, Loratadine)
    Omeprezole (I have reduced my dosage to one time daily, but still have occasional reflux)

    Supplements:
    Fish Oil 1200 mg combined DHA and EPA TID
    Vitamin D capsules 1000 mg QID
    Magnesium Citrate, 200 mg. TID

    5) Highlights of your family history, ie obesity, auto-immune diseases, hormone problems particularly thyroid.
    My mom was obese. She had hypothyroidism and I believe she had PCOS. She eventually developed Diabetes Type II, CAD, Alzheimer’s and Multi-infarct dementia. Her mother was not obese but also had Alzheimers and Multi-infarct dementia. My dad died of colon cancer at age 67 and had a history of CAD.

    I was treated for hypothyroidism about 6 years ago, but it was after a very bad bout of pneumonia and prolonged asthmatic bronchitis. I felt horrible from the hypothyroid (cold and very tired) and didn’t tolerate the treatment well either—it made me feel too jumpy and hot. When we switched to a new HMO and I couldn’t get good endocrinology care I stopped taking the Synthroid and actually felt much better. My TSH stayed low 2-3, but wasn’t monitored regularly. I don’t have a baseline before I started low carb, but it is now over 5. However, I don’t feel hypothyroid symptoms. I’m warm and energetic. I’m not certain if my elevated TSH is a normal consequence of dieting or indicates a problem.

    I have PCOS and have had issues with hypoglycemia my entire life. I was very thin until starting infertility treatments in my late 20’s. I wasn’t obese until after the birth of my first child (IVF) at age 33. 7 years later I started new PCOS treatment (low carb diet, Metformin) and unexpectedly became pregnant with my second child. I gained even more weight after that.

    My 11 year old daughter has also been diagnosed with PCOS based on severe acne and LH/FSH ratio. Her BMI is perfect.

23. Thanks so much for the reply. What are your thoughts on alcohol? In particular and increased risk for cancer and cancer reoccurrence?

    1. In Food Rules, there’s a Doctor’s Order to rethink cancer. While alcohol in excess is not a good idea, my feeling is that many other dietary factors play a much larger role to your immune health than a glass of red wine in the evening. Especially if you live in wine country!

24. How much protein is considered excessive for female, 160#? Also, what are your thoughts on ETOH, in particular wine (which is low CHO) and also vodka mixed wtih no CHO mixer (like seltzer)?? Thanks for all of the great information! Lisa

    1. Defining a number above which protein intake would be too much is actually complicated and dependent on age, activity, body structure, genetics, metabolism, and the quality of the protein itself (for example, 15 grams of sushi tuna protein has more value to your body than 15 grams of whey protein powder protein. Nobody really knows the answer to this although many make claims none are evidence based. If someone were to offer me a million bucks to pick a number I’d say more than 100gm is definitely to much for an average height woman who is exercising moderately.

25. 1. Female, 68, 5’7″, 190 lbs (this time), 168 lbs

    2. Started this time Jan 1 2012, for weight loss. My fasting BG and HbA1c was higher than I wanted. I did Dr. Kruse’s Leptin Reset, and I’m still on this plan. The LR diet immediately stopped my cravings; what a relief! Several weeks in, I was feeling very tired, and my BG got super-responsive to any meal with carbs.

    3. I was feeling very fatigued, and very cold. Could not get warm. I would sit in the hot tub every night to try to get warmed up. I had my thyroid hormones tested. My free T4, free T3 were OK, and my TSH was low, but reverse T3 was high and also TPO (hashimoto’s antibodies) were slightly out of range (40, normal is 0-32).
    I went to a naturopath when I saw these results. I mentioned I had good results in previous low-carb situations with doing carb-cycling, as Rob Faigin suggests (Natural Hormonal Enhancement), and she suggested I try this again. She also reassured me about my symptoms and bloodwork. She did not think I should treat the rT3 with thyroid hormones; she said it was a result of going very-low-carb in my diet and would work out.

    4. The thyroid test stated above was through DirectLabs, drawn on 2/2/2012. I got a glucometer and started testing my BG, fasting and after each meal. I also tested my blood pressure daily, and my morning temperature. My oral temperature was always in the 96s, and still is. My blood pressure has come down since then, back into normal range most of the time. As time went on with the carb-cycling low-carb diet, my BG numbers have improved, and now I only test once in the morning. Readings are usually in the high 80s.

    My diet now: a big breakfast with 50 gr protein and some fat (Dr Kruse’s BAB); a small lunch of veggies, 2 brazil nuts (for the selenium), small serving of meat and perhaps a couple of spoonfuls of coconut manna; supper another smallish meal, meat and two low-carb vegetables. Twice a week, dinner has a moderate serving of white rice, winter squash, tapioca, or other starch source. I ate no fruit until June, when fruit
    came in season where I live, and now eat 1 serving most days. So, still pretty low carb, moderate protein, and fairly high fat. I am not eating dairy products; they caused cravings for me even with the BAB. Never a speck of sugar; no fast food; no junk food.

    I have also had saliva tests for daily cortisol, progesterone, and estradiol this year, which were normal. My omega6-omega3 test shows a balanced ratio of 4:1. My latest cholesterol reading was low actually, 143 total, lower than I would like, from April. So all that meat and fat certainly doesn’t raise my levels.

    5. I was diagnosed with celiac disease at age 50, and have been strict about avoiding gluten since then. My mother and at least one son also had/have celiac disease. My father and sister have struggled with weight issues, much more so than me. He had gout and diabetes, took medications, and ate huge loads of carbs every day. My sister has serious problems with fatigue when trying low-carb. I have done low-carb diets many times in the past, about half of them successful up to a certain point when I hit a plateau that would not budge. My other attempts foundered right away with fatigue, depression, and feeling cold.

    If I eat carbs as much as I want, my weight will zoom upward at a pound a week or more until I finally regain control and start a low-carb diet again. My highest weight was 220, while eating a low-fat vegetarian diet; it was then that my celiac disease became overt.

26. 1) Female, 55, 6’ 0.5”, 293 lbs starting low carb and current weight
    2) Formally began Atkins on 5/31/12. But I had cut out sugars (first HFCS, then all sugars) a few months earlier, and eliminated all refined carbs about a month before. I started Atkins for health reasons, and because I was not having success in losing weight by simply cutting calories and reducing refined carbs. Within a few days of starting Atkins I started getting terrible headaches, and some mid-back pain.
    3) The headaches were mostly at the back of my head, at the base of my skull. There was also intermittent pain on my temples. The back pain was located just above waist level. There was no explanation based on activities in the previous days. The back pain lasted just a few days, and the headaches took about 10 days to start to fade away.
    4)Taking 25mcg of Mirapex nightly for restless leg.
    End of October 2011; In hospital after bout of atrial fibrillation
    Total Chol: 201
    HDL: 38
    LDL: 146
    Triglycerides: 98
    TSH: 5.58
    Started on synthroid for hypothyroidism. Spent the next several months working at trying to lose weight the low fat, count calories way. A few pounds came off, but I hoped the changes in my diet would show up in my bloodwork. Tested again on 3/29/2012
    Total Chol: 211
    HDL: 36
    LDL: 155
    Triglycerides: 82
    TSH:3.71
    Increased dose of synthroid. Began cutting back further on carbs. Cut out all refined carbs. Started learning more about the faulty premise of low-fat diets. Starting including more nuts in my diet, and very little processed foods. Finally went on Atkins diet on 5/31/2012. Retested again 6/7/2012
    Total Chol: 210
    HDL: 50
    LDL: 151
    Triglycerides: 43
    TSH: 2.84
    5) Paternal family history of heart disease. All nine siblings died of heart disease, father at 67 from heart attack. He struggled with his weight most of his life. Most of my siblings have had a similar struggle. Maternal family history of diabetes and hypertension. Sister with hypothyroidism.

    1. current weight missing from previous comment….287. Down six pounds since starting low carb.

27. 1) sex-F, age-54, height-5’7”, weight on starting low carb-183, current weight-162.

    2 &3) I read an article in a magazine about insulin resistance, hypoglycemia, and overeating in response to low blood sugar. I had always tried to eat low fat, high carbohydrate diet and had multiple episodes of feeling shaky, tired, and lethargic and would need to eat carbs to feel better. Although, I was thin until I was 30, I have steadily gained weight over the years. Then I read “A new Atkins for a new you.” and began the Atkins diet. The first few days were fine, then I began to experience terrible fatigue, dizziness, and weakness. I tried drinking bouillon as suggested by the book,but it didn’t help. I would lay on the floor and try to will myself through this diet! While I did lose weight at first (I lost 20 pounds, which I have kept off), I felt terrible most of the time. I went off the diet for a while and then tried to do it again. I did NOT cheat, I checked my urine and was in ketosis, but I have not been able to lose any more weight. Plus, I felt terrible again–finally, I added carbs back into my diet. I feel some what better when I eat them…

    4) I have had my blood sugar, cholesterol, and thyriod checked and all were normal. I do take a synthetic thyroid medicine. Also, I checked my blood sugar with a glucometer at home when I was shaking, trembling, and felt like I was going to pass out and it was always NORMAL!

    5) No one in my family is heavy or obese. I have hypothyroidism and take a supplement.

28. 1) Male, 41, 5’11”, 140 pounds, starting 100g or less of carbs tomorrow!

    2) I figured I’d do things a bit differently than most. To keep myself accountable, I figured I’d start tomorrow and kind of update at periodic intervals. I’ve been having health issues primarily since getting a series of Anthrax shots back in around the year 2000 when deploying to the Middle East.

    3) In the summer of 2000, after receiving the Anthrax shots, I had a significant amount of weight loss. This ended up being about 50 pounds in a few months – I couldn’t keep any food down. Foods that particularly aggravated me were fatty foods, tomatoes, onions, garlic, etc. I also had a significant number of issues digesting meat; when I ate it, it felt as if it just was stuck in my esophagus all day. If I did eat it, I was not hungry the rest of the day and felt ill. I tried numerous number of nutrition plans, including vegetarian/vegan, and although I felt better on those, I had a very difficult time digesting veggies such as broccoli and beans. They produced effects worse than meat. I recently decided to move to a more paleo-type diet, but am still having significant issues with sugar. I can cut out grains with no problem, but sugar is getting the best of me. I recently took a food addiction test and I actually could be ‘diagnosed’ with a food addiction to sugar.

    Other health issues include psoriasis and extreme fatigue. Psoriasis started at the same time I received the anthrax shots and isn’t widespread, but occurs on certain areas of the body, including a couple of patches on my scalp on my back, and in some unmentionable areas. Fatigue is extremely worrisome. I work full time, go to school, and then also volunteer. In essence, I’m working two full time jobs and that doesn’t include study time. I also enjoy biking and running, but have been told that if I’m only getting four-five hours of sleep a night, to not exercise. Unfortunately, that isn’t an option – I need some exercise. Back to the fatigue; it gets so bad at times, that I feel myself dozing off at stop lights.

    Other GI issues I’ve had: significant GERD (Dr. even said that in most people with GERD it refluxes up then goes back down; with mine it just stayed up. hiatal hernia.

    Other tidbits: lactose intolerant. susceptible to cold weather; I get cold easily probably because I have very little body fat on my extremites although I do carry some on my torso/abdomen — I’m the classic definition of the skinny fat person. low blood pressure (typically 100/60 range). resting pulse is usually around 60.

    Health Professional Advice: I sought out professional advice from my doctors. At one point, a specialist diagnosed me with Chron’s Diesease due to a high ANA reading; however, that was almost the only sign/symptom I had so it was later overturned by my PCP. No one has been able to give me answers. I’ve had upper/lower GI series done and they were normal. A biopsy said I did not have celiac disease, but I was not eating gluten at that time. I have noticed that if I do not eat gluten for awhile, then have something with gluten in it, I have significant GI distress.

    4) All my blood test results from my most recent physical were within normal reference ranges. Fasting blood glucose level was a bit high at my most recent physical – about 80. The only other abnormality was that my potassium level was a bit elevated and above the reference range (I believe it was 5.4 and the top of the reference range was 5.0). That’s more of a cardiac issue than anything (susceptible to arryhthmias).

    5) Unknown. My family history includes considerable cardiac history on my father’s side and cancer on my mother’s side. I expect some autoimmune issues on my mother’s side. My mom has GI issues as well.

    Any help is appreciated.

29. Thank you for the video. I have been on paleo for couple of years ( less than 20 carbs during this period.) , my transition I thought was gradual, but I could be wrong though. I didn’t do 2 weeks at a time transition . Recent blood results shows TSH at 7.85 uIU/mL(hypo thyroidism) and others numbers at total cholestrol at 287 Triglycerides 79 mg/dl , HDL cholestrol 69 VLDL cholesterol Cal 16 mg/DL LDL cholestrol Cal 202 mg/DL, and High Vitamin D , 1, 23+ 25-Hydroxy Calcitriol ( 1,24 di-OH Vit D) 163.7 pg/mL and Vitamin D , 25 -Hydroxy 127.0 ng/mL . I have been on high stress job until recently that I hated it ( now I realize thyroid has its contributing factor )
    . My doctor wants to be go on synthroid. I have the history of using synthroid decade back, later it was stopped when blood test showed normal levels. so it looks my thyroid issue is back. I dont want to go back to synthroid knowing its ineffectiveness. I use idorol once in a while with selenium. Any suggestions to bringing back thyroid level to normal levels.

30. 1) Female 64, 5’2″ Weight before starting 82kg. Weight now 73kgs.
    2) Started early 2011 by giving up sugars and gradually reduced wheat products. In 2012 I seriously began eating Paleo but found it too restricted so turned to Primal.
    Why because my tryglycerides were 5 (now 1) and I was having joint problems and I have had bowel cancer. I also have a bicuspid aortic valve.
    3) Giving up sugar was the hardest but after a year my cravings have gone. I still eat a small amount of potato and kumera. Occasionally (once a week) I crave carbohydrates so I have bread with lots of butter and some fruit spread. This seems to work for me. I feel more energised rather than tired, my nails and joints are stronger and my depression gone. I can again walk up and down steps.
    4) I am not on any medications but I take 1000mg of fish oil per day, cod liver oil, 500mg of vit C, and a milk thistle tablet. I also do aerobic exercise three times per week and stretching exercises daily. February 2012 my tryglycerides had decreased from 5 to 1 and my HDL has raised to 1.9 and my LDL is 1.5. My Blood pressure at last testing was 130/82 which has come down a little.
    5) Family problems are cancer, hypertension and bicuspide aortic valve.
    I have to say that I am just delighted with the changes in my health and my emotional well being and I would recomend a low carb diet to anyone. After 18 months I find it is getting a lot easier.

31. 1. sex, age, height, weight on starting low carb, current weight
    Female, 41, 5′-4″, 140 pounds starting, 121 pounds current

    2. When did you begin low-carb and why?
    Two and a half years ago for acid reflux. I had already dumped wheat, figuring it was responsible for my weight gain. I didn’t follow any plan. I’ve had some problems along the way, but found solutions to them.

    3. Please outline your problems the more you can share, the better.
    *Trouble swallowing (it got worse when I started LC). The solution was magnesium supplements.
    *Heart palpitations when I went VLC. The solution was potassium pills as needed.
    *Feeling sluggish now and then. For me, this is almost always because of a big meal. I know frequent meals aren’t as good for your teeth or for inflammation, but I don’t feel good on large meals. I absolutely can’t do intermittent fasting.
    *Bloating (happened this weekend!)
    According to the book Heartburn Cured, fat and protein produce little if any gas when digested, but carbs produce a lot. Lately, some delicious recipes involving nut flour and flax seeds have come out. I can’t eat very many of these goodies without getting gas bloating.
    *Constipation.
    Magnesium helps; so does eating an avocado.
    Cravings stopped being a problem for me when I entirely gave up certain foods (like anything made of wheat). My sensitivity to sweetness has gone up to the point that most perfumes smell sickening sweet.

    4. I don’t take any medications. My HDL at the beginning of the diet was 42; six months later it was 57. Last February it was 65.

    5) Highlights of your family history, ie obesity, auto-immune diseases, hormone problems particularly thyroid.

    My family is full of obesity, diabetes and hypoglycemia. A family member had Addison’s Disease (an adrenal gland disorder).

32. I began the GAPS diet while nursing my second child at age 26. I was 5’8 and about 144. I wanted to help my hypoglycemia issues, get more energy (I was tired all the time),improve my gut health, and lose the ten extra pounds of mainly belly fat that would not budge no matter what I did. My two daughters aged 15 months and 3 years also did the diet with me because I wanted to heal their allergies/eczema. I began with a week on the intro diet which consists of mainly broths and soups with a few veggies and lots of good fats added in. The first couple of days, I would wake up shaking terribly from low blood sugar. My body gradually adjusted as I added a few more plant based carbs. I lost no weight after eating like this for more than a week. When I started adding in a few nut flours and the occasional fruit, my weight slowly began to climb. Soon, 148 became my base weight, even though I ate very low carb (very little fruit, squash or nut flours) in an effort to kill candida and I nursed a walking toddler round the clock. I became even more tired. My blood sugar levels caused about the same amount of discomfort they always had. My keratosis pilaris worsened and my undereye circles seemed to get darker. My hair fell out everywhere until I purchased dessicated adrenal capsules which helped a lot. After 6 months, my daughters’ allergy symptoms and eczema improved drastically. With the help of candida killing supplements, they both gained much needed weight. We began to ease off the diet. I still tried to keep my carbs less than 100 grams a day, but my weight increased on the diet that had previously been okay for me. I went up to 152, despite nursing round the clock. I weaned my daughter and began to count calories (about 1600 a day with one binge day) on a 40-50% good fats, low carb diet. I exercised several times a week and, after a 12 week weight loss challenge, got down to 143. After the challenge, I tried to go back to my normal Weston Price diet and got up in the 150’s again. It seems that every time I went low carb, my metabolism shut down just a little bit more and my “baseline weight” climbed a few pounds. Now, I am pregnant again and eat when I am hungry – I try to get a good supply of whole grains, good fats, fruits, veggies and proteins and base my diet on what my body is craving rather than obsessing about percentages of fats vs carbs etc. My weight gain has been on the high side, but I don’t think too much about it since I’m more concerned with nourishing my baby. I don’t think I’ll ever go back to low carb, but I am looking into enzyme therapy to possibly help with my obvious thyroid and blood sugar issues

33. What I didn’t see on the list of possible reasons for hitting the wall is “rabbit starvation”, i.e. not enough FAT. After years of experience eating only meat and fat, I believe it is absolutely critical to keep fat% above 70, better 80%, of calories. I believe that women especially are fearful of eating the quantities of fat that are required on very low carb. Also, the meat we can buy in stores is much too lean. Unless you purposefully seek out fatty meat or ADD large amounts of fat to food, you will not get enough to have energy. If there are no carbs and not enough fat, your body is starving.

    1. Hear hear.

    2. Thanks Kathryn. Excess dietary protein can be problematic, for sure. Dr Ron Rosendale talks about the importance of fat, as does the DietDoctor, for exactly the reasons you describe.

34. I wanted to add that fatigue hasn”t been a real issue for me on the GAPS diet. I was quite fatigued before I started GAPS. I remember the first two days of GAPS being really fatigued, and then on the 3rd day, I woke up feeling quite energized. The fog that was keeping me down in the many months prior had lifted.

    The only problem I’ve had with staying low-carb is that I feel insatiably hungry. I added a lot of fat to my diet to help stay full, but it often makes me feel nauseous.

    Other than that, going low-carb was one of the best decisions I’ve ever made.

35. I’m a 43 y.o. female, 5’2″. Started low carb in Jan 09, weight approx 118. Current weight 108. Although I’ve never been all that much overweight, and always fairly active, I decided to try low carb after coming across articles posted on Mark’s Daily Apple. I also got my hands on a copy of Protein Power by Michael Eades and started reading his blog. Everything made sense nutritionally, and it seemed like a reasonable argument despite everything I learned in Nutrition and Health classes in college. The first few weeks were a little tough, but after that, I’m happy to report smooth sailing! I used to start my day out with a big bowl of oatmeal with fruit, and a glass of OJ. Inevitably 3 hours later, I’d be starving. The biggest change for me is that I don’t have the appetite swings (and subsequent nasty attitude) that I used to have. At this point, I can skip a meal here and there without problems, hunger pains, or wanting to bite someone’s head off. I also don’t get that bloated feeling after eating, and the general gassiness is pretty much gone too. Prior to my starting low carb, I had AWFUL periods marked by irregularity, cramps that would double me over, heavy bleeding, migraine variants, and then there was the mood… I started taking the Pill – also prior to starting low carb – and that seemed to take care of all menstrual problems. Recently, I’ve been giving some thought to coming off it and seeing if my low carb diet would regulate things a bit better. Unfortunately, I’m not sure I want to even risk going back to that little nightmare. Other than that, I’m still active with weightlifing, golf, softball, floor hockey, flag football, wrestling with my nephews, and anything else that comes my way. I’m definitely not perfect…I still give in to occasional ice cream and sweet treats, but I’m far better than I was before I started!

36. 1. Female, 28 years old, 5’1’’, weight starting on low carb: 108, current weight: 98

    2. I began low carb in about November 2011 because I was having issues with food allergies. I started having problems in about February 2011.

    3. Due to an injury in early 2011, I started having health issues. Before the injury, I was very healthy, but after the injury, I was constantly fatigued, had a dry cough, had a terrible rash all over my face and body, had skin lesions that were “leaky,” and have had major problems regulating my mood as well. In about October 2011 I was diagnosed with allergies to several foods, and my doctor advised that I cut out the following from my diet: wheat, gluten, soy, dairy, peanut. I cut out those foods which greatly reduced my symptoms, and then started the GAPS diet a short time later when a colleague told me about it.

    4. In March 2012, after having been on a low-carb diet for about 6 months, I had a health screening. Total cholesterol was 221 mg/dl,
    HDL cholesterol was 78 mg/dl,
    LDL cholesterol was 0 mg/dl,
    Total Cholesterol to HDL ratio was 2.8,
    triglycerides were 45 mg/dl,
    non-fasting glucose was 64 mg/dl,
    blood pressure 100/74.
    At this time, rash on my body was mostly gone as was the cough. Mood was rather low around this time though, and my weight was at about 95 pounds.

    5. Family history – diabetes, glaucoma.

37. Male, 48, 5’8″, 160
    About 6 mos ago, tried Paleo (based on Brian Peskin’s 24 Hr Diet). I was already mostly gluten/dairy/legume free due to my wife having MS, but we were not eating enough protien/fat. So I tried Paleo for health reasons, not to lose weight. I did not ease into it, apparently as I should have. Went almost “no carb”, added lots of protein/fat. I did have yogurt and kefir too (some say that’s not Paleo). I had incredible energy for the first 2 weeks. Not sleepy till midnight, feeling refreshed in the am, sharp thinking, etc.

    About 2 weeks into it, I hit that wall. Zero energy. Felt like a human slug. Foggy thinking, constipated. I was eating good fats, but maybe not enough. Went back to eating more carbs.

    Slowly added more protein over time, but eating too many carbs to be considered fully Paleo. Still at it though… Went on high blood pressure meds last month, after trying various natural remedies without success. High stress load is too much for the natural remedies I guess.

    Family history of high blood pressure, and dad had diabetes.

38. Very interesting ideas! Would like to learn more about enzymes…

    My health history:

    Adolescence till about 2010 (age 30)

    –Consumed strict lacto-ovo vegetarian diet (vegetarian since birth), with two years of veganism as a teenager. Lots and lots of whole grains, veggies, FRUIT, more whole grains, beans, and even more fruit.

    –Increasingly severe hypoglycemia. Never overweight, although increasing abdominal bloating in my twenties; 5’7″, about 135 pounds.

    –Extremely horrible, painful menstrual cramps.

    –“Moodiness”/PMS/Cyclical anxiety/depression.

    –“Needed lots of sleep” (about 10 hours per night).

    –Severe post-partum-depression after Baby #1 (2004), including two years of undiagnosed pelvic pain, breastfeeding issues (pain, oversupply), “vulvodynia,” exhaustion. Baby developed autism-spectrum
    and severe digestive issues after a very colicky infancy with reflux, etc.

    –Less-intense post-partum-depression after baby #2 (2008), some strange gastro symptoms, more exhaustion but less severe.

    —-

    Spring 2010, changed to a nutrient-dense, high-animal-fat, high-protein, grain-free diet (GAPS protocol; started initially to heal my child).

    –Hypoglycemia got a LOT better

    –Monthly bleeding shortened from five days to 2-3, was much lighter and less “clumpy,” my cycle shortened from 35-45 to 28-30 days, and my basal body temps became both more even and 1 degree higher overall (even though they were still about 1 degree lower than normal).

    –My depression/anxiety got WAY way way better, and my PMS pretty much disappeared.

    –I only needed 7-8 hours of sleep, the rest was better, more sound, and I woke up feeling great…

    —-

    Spring 2011

    –Went more low-carb–no nuts, no fruit, but still tons of cooked, raw, and fermented non-starchy veggies.

    –My blood sugar “hypoglycemia” issues were absolutely amazing. I couldn’t believe it. I was eating three meals a day, but really…I never got hungry any more!

    –I got constipated for the first time in my life, and needed daily enemas for about ten months.

    –My periods were still pretty good, but mood and energy problems were back, and in a very specific pattern: totally fine between my period and ovulation…and then, I would ovulate and feel more or less depressed and moody and anxious until my period, at which point I’d feel good again. There were some months that were worse than others, but no months where I felt as good as before.

    —-

    Fall 2011

    –Got pregnant with Baby #3 in October. Three weeks later, I hit a wall.

    –Moodiness like I had recently been feeling at ovulation…but way, way worse.

    –High anxiety, panic, BAD depression, coming as increasingly longer “attacks” with decreasing amounts of time between “attacks”. Worse at night. Lots of specifically social anxiety.

    –Super-crazy (and unprecedented–never in my life did I ever have these) cravings for starch and carbs, and near-complete repulsion for meat and fat.

    –Less energy than I’ve ever had in my life (even in my previous pregnancies)–near total exhaustion. Could barely leave the couch on many days.

    –No more constipation (silver lining!!).

    –Had to force myself to eat–everything was unappetizing.

    –Dry skin, pallid face, headaches, pimples, thin and limp hair, occasional small skin lesions on hands and face, poor sense of balance, thin diagonal lines of white (no pigment) on each wrist, skin around eyes is thin, wrinkling, and almost painful, no endurance for exercise, my heart often pounded when I walked up the stairs, I kept getting bizarre gastro issues that nobody else in the house was getting, I felt very chilled with the slightest exposure to a cold draft, decreased tolerance for bright lights, loud sounds, small children, and strong smells, and I felt like I was going insane!

    Bloodwork showed moderately low D (30), very-low-end of normal TSH, Free T3, and Free T4, along with moderately low B12.

    —-

    Spring 2012:

    –Gained great relief from mood symptoms after forcing myself to follow Dr. Jack Kruse’ “leptin reset” (essentially, a huge protein breakfast, followed by 4-5 hours of no snacking, followed by a big protein lunch, followed by 4-5 hours of no snacking, and then dinner, with no food consumed after 7pm–lots and lots of fat, but I didn’t limit GAPS-legal carbs). I literally had to gag and cry my way through meals, but it was the only thing that seemed to help the bizarre food issues, and helped me get to the point where my mental health was stable…

    –I also temporarily started taking magnesium, sublingual methyl B12, Vit. D3, selenium, seaweed, multi-mineral supplement (no iron), fish oil, fermented cod liver oil, and evening primrose oil.

    –I started drinking home made herb teas instead of water: dandelion root, milk thistle, nettles, raspberry leaf, oatstraw, vitex, yellow dock root, ginger.

    Am now nearly due with baby #3, and will see how post-partum issues progress…hopefully much better if I’m able to eat fat and ferments and continue with GAPS!

39. […] about my pre-agricultural, low-carb diet. Here is one clean-coming over at PaleoHacks. And here is another one, on the Deep Nutrition website. It’s in the comments section and will take a […]

40. 1) Female, age 34, Began Paleo Jan.2012 for health reasons (foggy headed and hormone dysfunctions). Tested gluten sensitive so I just cut out all grains. 5’4″ and 117 pounds at start. Dropped down to 102 and got infections (shingles). Stopped Paleo and went back on Nourishing Traditions foods (WAPF), but this time gluten free. Slowly gaining my weight back and feeling better overall. In two weeks on WAPF diet weighed 106 pounds. Sleeping better too. I’m soaking and sprouting my gluten free legumes and grains. I plan to stick with this diet for life – no more fad diets for me.

    2) ran some lab work through FDN (saliva and urine) during this Paleo time. My adrenals showed exhaustion and my estrogen wasw low (early menopause from prior bone marrow transplant 2 yrs ago). My DHEA was very low too. My UBAS was higher than ideal showing liver needs support. Urinarey lipid peroxides are higher than ideal. I have also struggled with weak immune system, low blood pressure commonly under 90/60, and constipation. I’m getting blood work done in a few weeks from my transplant doctor. I’m noticing improvements already in these areas now that I’m off Paleo.

    3) I added 50mg DHEA since my tests showed I was low and I’m sleeping better and feeling more energy during the day. I don’t understand why the doctor only prescribed estrogen and progesterone for early menopause because there are a lot more hormones necessary for good health. I MIGHT add pregnonolone but I’m going to discuss with my doctor 1st. I also added okra peppin with meals since my chiropractor suggested it during muscle testing. The chiropractor said my small intestine is weak and needs support first to get rid of heavy metals (mercury, lead, and gold). I was told not to eat honey too. I also take green pastures fermented cod liver oil high vitamin butter blend and probiotics.

    4) On paper I sound bad, but I actually look very healthy with strong nails and thick shiny hair. Considering my age and radiation exposure my skin is very youthful and I still get carded (when my kids aren’t with me). I’m a very upbeat, happy person and I love my life. I just wish I had the energy to do all the things that I want to do (I’m a very active person with an active family and sometimes I run out of steam). I also wish I wasn’t so senstive to my environment. I could feel energized and clear headed and walk into the wrong room and get dizzy from frangrances or eating the wrong food. It is annoying to have to eat at home all the time – but I feel best that way. I would like to build up a stronger capacity for CRAP like regular folks.

    I feel like I’m on the right path now. It’s less stress to eat whole foods properly prepared from a wide range of choices – cutting out sugar, veg. oil, and gluten is hard enough and Paleo just made me SICK! At first, I felt so much better on Paleo, but now I’m sure it was due to cutting out the gluten.

    I think more people should read “nutrition and physical degeneration” by Price and “nourishing traditions” by Fallon. I also liked your book Dr. Cate. Your book is a great beginner book and my brother is reading it and sharing it with his friends – you are motivating him to stop the fried foods and chronic alcohol consumption. I told him for so long, but it was your book that is making him believe, thanks!

41. I have been low carb (under 40g a day most days (unless I have raw fresh milk; occasionally a tick over 100g in summer fruit harvest season) for 12 years and have no fatigue at all, Cate. I didn’t take on low carb to lose weight, just as a rational, intellectual decision based in palaeo principles. My weight fluctuates between 75 and 82kg, depending on the amount of muscle I am building or losing on different exercise protocols (height 175cm). I had no problems back in 1999 and have no problems now. Never been prescribed a medication and take none now. I take vitamin D3 in winter. I sleep 5-7 hours a day and have not used an alarm clock once since my retirement in 2003 (age 63). My only sickness since going palaeo has been one or two very mild colds. All palaeo food + some raw milk. I cycle 4 miles to the gym for a heavy weights workout and 4 miles back 3 times a week, sometimes spending all day on my feet in the garden on in the shed. Body fat 8%-15% according to professional assessment. I have never had any reason to associate low carb with fatigue.

    1. Keith you remind me to solicit success stories too, thank you. So far women seem to have more issues low-carbing than men but N=8 is not a big N.

       1. Sorry if what I wrote sounded boastful, but I wanted to squeeze my contribution into the framework you gave, while making the point that fatigue is not an inevitable – even expected – result of low carb.

42. 1) Female, 43 years old, 5’5″, 125 before, 125 now.

    2) When did you begin low-carb?
    July 1, 2011

    And why?
    not weight loss necessarily but to to decrease cellulite, increase muscle- and skin-tone, lean out; overall health—skin, hair, nails, energy; and mental health big time—a nice clean anti-inflammatory diet did wonders for my self-esteem and cleared up my life-long anxiety and depression. It was a revelation and I felt born-again, zealous and on top of the world.

    I went Primal and then full Paleo just a few weeks ago, eliminating dairy, which is HARD and not sustainable, IMO.

    When did you start having problems?
    Six months in—December 2011/January 2012—emotional symptoms began creeping back. I blogged about this extensively. It is on record.

    3) Please outline your problems the more you can share, the better. If you sought advice from a health professional what was the advise and did it help?

    My family rescued a dog in December and my anxiety went through the roof. There was sleep deprivation involved so I have to count that as a suspect. Shortly after that I started a rigorous exercise program—kettlebells and bootcamp classes, one hour each, 2-days per week, and my depression made an ugly comeback, complete with self-loathing, irritability and suicidal thoughts. (I have since begun therapeutic treatment with a psychologist.)

    Bloating, constipation and fatigue were constant issues from the beginning. I am a former vegetarian, and before that, a junk-atarian who paid little mind to food quality and never equated food with physical or emotional health.

    I take daily probiotics, L-Tyrosine, super enzymes, calcium-magnesium capsules, vitamin D and cod liver oil pills; and vitamin Bs, GABA Calm and 5-HTP as needed—so many more supplements than I ever took before, all to help these symptoms.

    4) If you provide blood test results, please put them into context of by providing dates and information on what your diet was like and what your problems were at the time. Same for medications particularly blood glucose/blood pressure/thyroid/other hormone/anti-depressants/sleep aids. Please include any adjustments made, why, and what the effects of the adjustments were.

    No medications. My total cholesterol measured 263 in June 2010 when I’d been eating a Weston Price style diet; it rose to 286 in November 2011 eating Primally and my GP wanted to put me on statins which I refused.

    I tested low for vitamin D in November 2011 and low for Alkaline Phosphatase in June 2010. I am waiting for thyroid test results from my midwives clinic. I have an appointment to see an endocrinologist for adrenals, cortisol, and any other hormone under the sun that might be affecting my mood and energy levels. That’s in mid-July.

    5) Highlights of your family history, ie obesity, auto-immune diseases, hormone problems particularly thyroid.

    My mother was on Synthroid for a number of years. My father and mother have both been on prescription anti-depressants and anti-anxiety meds. No one is obese in my family.

43. Powerful stories. Please continue to provide as much detail about symptoms as they related to specific changes including diet/supplements/activity and as many lab numbers and weight/height data as you can.

    The most important LAB numbers are:
    First morning (fasting) blood glucose
    LDL, HDL, Triglyceride (total cholesterol is an amalgamation of good and bad and therefore not helpful)
    thyroid, cortisol AM and PM, c-reactive protein are all also very useful.

    Thanks to everyone so far for getting this started!

44. Would taking “Wobenzym N” help with the enzyme transition? And would the iodine in Kelp help the thyroid? Great information, thanks Cate.

    1. Wobenzyme N is a blend of extracted pancreatic enzymes (from unknown animal sources) that may support digestion in those people with pancreatic enzyme deficiencies. It does not stand much chance to fulfill many of the other “anti-inflammatory” promises made. Iodine would help those with inadequate dietary iodine, which may be a very common problem. Sadly, this kind of basic nutrition information is lacking.

45. 1. Female, 47, 5’1″, 111lb (at start of Paleo this year, 114.5 lb (current).
    2. Dieted all my life due to being overweight. Marathon runner until age 40. Post knee surgery without running, started weight gain. In 2010, cut out refined carbs. Ate quinoa, veggies/LOTS of fruit and Kashi cereal . Also ate low fat at that time. Lost weight but had constant carb cravings that I indulged on weekends. Fell off wagon after reaching 102lbs. Tried HCG drops. Lost weight, but easier and easier to regain. In Feb 2012, I started “Paleo” by doing a Whole30 to lose weight. Lasted 45 days, but missed drinking wine ocasionally. Weighed 111 lb at the end of Whole30. I had indigestion and felt bloated during that whole 45 days. In retrospect, I did not drop carbs to 100 gr during the Whole30 time because I ate sweet potato and butternut squash after exercise.
    3. I CRAVE sugar. It is an addiction and I binge eat. That is the most disturbing problem that impacts my life. Other issues include: I have trouble feeling energized when I exercise. Not able to recover from weight lifting & aerobic workouts with serious fatigue and muscle stiffness/soreness. My legs get cramps during exercise. My knees hurt. My weight gain is concentrated around my waist. Fasting blood sugars are increasing with my weight. Currently at 91. I am worried because I know about diabetes. My husband is a Type 2, controlling with food only. I also have itchy eczema on my neck. I suspect allergy to dairy, but eliminating it did not rid the rash. Eating Paleo has been giving me indigestion and bloating. I do not seek advice from most health care professionals because they have little useful knowledge about nutrition. I learn through reading Deep Nutrition(Dr Cate), Dr Bernsteing Diabetes Book, Good Calories-Bad Calories(Gary Taubes), Wheat Belly , The Primal Blueprint (Mark Sisson) and Palet Diet (Robb Wolff) & Paleo Summit.
    4. In Oct 2011, my A1c = 5.5, total cholestrol= 188; HDL=99, LDL=79. I had same symptoms as I do now…and weighed 115 lbs then. I started in April 2012 400mg Magnesium and 100mg 5-HTP for sleep and contipation. I also take fish oil and Vit D. Started bone broth in April 2012. No noticable improvement in indigestion.
    5. Family history : Dad has high blood pressure and marginal cholestrol. Mom has bone loss, tooth loss through gum disease, eventhough she has excellent hygene. I have the same problem. She eats carb all day long, but is very skinny. Siblings both have high cholestrol.

46. 1. Female, 44, 5′ 4″, weight hasn’t changed much – maybe i’ve dropped a kg, 58 to 57

    2. I started a four pillars diet late in January this year. It has been up and down. I’m still playing with the details, and since my fatigue problem has been chronic for over 2 decades, i hadn’t drawn any firm conclusions yet. I’m trying to pin down certain perceived patterns. It went really well for the first weeks, then really dropped off, and i’ve had good patches and bad patches for the last few months.

    3. I’m not sure when my problem really started. My mom noticed i was sleeping way too much when i was 12, but i remember thinking i’d been doing that for a while. She blamed it on tuberculosis meds i was taking – i tested right on the line as positive at the end of grade 5, my red patch was just big enough. We had never travelled to anyplace where i might have been exposed. I think about that, now that i’ve gotten Weston Price’s seminal book, and read how he comments on the outbreaks of tuberculosis in modern food populations. I was taken off the meds. The fatigue just kept getting worse, but i regarded it as laziness for a long time.
    My family were always big tea drinkers in the English style, so was i. Throughout my childhood my caffeine and sugar intake was high, i always had a sweet-tooth. My approach until my 30’s was to push through fatigue with caffeine and sugar, and eat a lot of take-out and junk food because i was too tired to cook. Getting up in the morning was always super hard. I preferred to sleep 10 to 12 hrs a day. By my 30s i was also taking afternoon naps. My mood was typically rather low unless i was on a sugar/caffeine rush. I have always been clumsy. I have always tired at almost any task faster than those around me. I became bookish because that was the easiest and most enjoyable, i did well in school. I am socially withdrawn and awkward. After a few hours of socializing i feel exhausted. I deeply dislike noisy environments. It mystifies me how people don’t seem to notice ambient noise i find strongly irritating.
    My lungs are part of my problem. I notice when singing that i have to draw a breath more often than others. Heading into college the doctor for my physical asked about shadows on my chest xray at the bottom of my lungs i had no idea were there. My parents smoked throughout my childhood, including in the car, back in the good’ol days. I had asthmatic bronchitis when i was 3, i was put in an oxygen tent for a bit. But i had never smoked. A few years after that i had a brief brush with smoking, but quit after a few months without ever having got above maybe half a pack a day, simply because my body rejected it – i started stubbing them out after a couple of puffs in distaste. I tried my mom’s lung-volume exercise tool when she had it after getting out of hospital for an aneurysm (she had aspirated vomit), and scored in the very bottom of the normal range. I have toyed a bit with lung volume exercises, but i budget my energy in order to maximise the chances of completing the basics each day, and lung exercises don’t fit. Besides, i have lived at 7000 feet for the last 9 years, probably enough lung conditioning for now. That situation isn’t supposed to continue for more than another year or two, then we will return to Canada. When we visit Canada or go to the sea, i feel wonderful. Hyped on energy. Up at 6 am because i don’t want to sleep. I think the altitude is the main reason.
    My waistline is bigger than it should be by a few inches, but i don’t have extra fat elsewhere. I used to skateboard and bike as transportation everywhere, as a poor college student. I have always been fond of long walks. I really like being outdoors, if it wasn’t for my fatigue i’m sure i’d be a very active person. Between the age of 3 and 6 we lived on a farm. We had chickens, pigs, and goats. I drank only fresh goat’s milk, we had only fresh eggs, and lots of fresh pork. There was also veggies from the garden. But then we moved back to the city.
    I moved to Mexico 9 years ago, where i live with my Mexican husband. By the time i left Canada i was struggling to hold a job, often depressed. My plan in Mexico was to get back to my artwork and writing. I have been able to do that some, but have definitely not yielded what i would consider 9 years of work. At first my fatigue was worse, due to the effort of learning Spanish, the elevation, and the general shock of change. With my schedule free, i concentrated on finding a solution to my fatigue, sure i could find a dietary/exercise solution. After extensive, mostly disappointing experimentation, i learned that i had to avoid some foods – all beans, caffeine, alcohol (which i rarely drank anyhow), sugar in more than small amounts infrequently, raw tomatoes, eggplant, spinach, beets, oats. I discovered that a 24 hr fast was a sure way to restore my energy level if i was having a really bad time. Eventually i noticed that eating in the evening caused me no fatigue afterwards, whereas eating during the day would make it extremely hard to resist napping, and leave me tired and foggy for several hours. I stopped eating before 5 pm, and that was a significant help. After reading online about fermented foods, i started making kefir water. Once i started drinking that daily, my repetitive UTIs ceased. Starting 2 years after arriving in Mexico, i had started getting UTIs. By the time i started the kefir water, i had had 4 or 5 in the previous year. I have not had a UTI in over 7 months despite ceasing to take several precautions that had become standard.
    A few times in the past i have tried keeping a food log and health diary, but have quickly realised it just gives me information overload and doesn’t help in pattern detection. The frustrating thing is that even years ago, when most of the time my energy was very low, i would suddenly have a few days or even a few weeks of good energy levels, for no apparent reason. This is what caused me to home in on the dietary explanation. But i’ve never figured out a reliable system, they all fail eventually. Because one of the main effects of my condition is an inability to concentrate and a pernicious, generalised lack of motivation, the more complex the plan, the more likely it is to fall apart. If my energy drops i fail to stick to all the details, and it gets worse, without me being able to identify the reason. But i think i can say a few things with confidence. Lentils – i need to eat lentils every day. That has only really struck me over the last year, and the every-day part only over the last month or so. Meat fat, especially pork fat, is really helpful. I suck down 8 litres of raw milk every week and it also strikes me as very supportive. I used to substitute with a litre or two of store milk if i ran out, but that seems to contribute to lows. When i feel good my bread intake tends to creep up, but i have become a lot more hard-core about that recently, i resist it with all my might. No bread. When i have good access to good fat sources, this isn’t really hard. A few months ago i was completely awake through an entire night, and did not sleep until the following evening, after a meal of fatty pork ribs the night before. It is hard to express how weird that is. Fatty meals close to bedtime seemed to contribute to much briefer insomnia three or four other times, but the original run didn’t repeat. An experiment in having a small very high fat meal in the morning sputtered and failed pretty quickly. Then i had to struggle for a few weeks to return to the after 5 routine – but now its okay to eat at 4, sometimes 3. Sundays used to trip me up entirely – Sunday brunch has been a major vice of mine, and one of the few routines i can keep with my husband, who works very hard, including half-days on Saturdays. But now we have really been trying to eat much later on Sunday and stick to things that aren’t really heavy on my system – a picnic with a roast chicken and fruit is ideal, round about 2 or 3. That way i don’t write-off Monday, and often Tuesday too. Usually i sleep quite well. In the past i would have insomnia once or twice a month, and i could always associate it with something i ate. I always woke up between 3 and 5, couldn’t sleep for 2 to 4 hours, and then dozed off. More recently that happens much less. If i am feeling tired, it is very typical that my bowels are also not moving very well, but there are exceptions.
    I ferment my lentils, and also garbanzos. Sometimes i have potatoes. Occasionally i eat rice or a couple of tortillas but i really limit grain starches. These measures are not tied to visible results and i do them strictly based on belief in their long term benefit. The same goes for eating only free-range eggs, quality natural yoghurt now and then, bone broths and organ meats every week (liver, sometimes kidney), and complete elimination of seed oils. I roast cocoa beans to snack on, that seems to do no harm and gives me a snack option i enjoy. I have started lightly fermenting and roasting nuts and seeds, to reduce their heaviness, but this is experimental. I haven’t been consistent about any of this stuff because it has seemed less effective in the near term, but my constistency is slowly improvng.
    4. I have taken modafinil every day for the last 2.5 years. I started at 50 mg and now need 100 mg. If my diet is inadequate the modafinil is completely ineffective. If my diet is good it helps. Sometimes it really helps. During my first blush of success with four pillars, i skipped taking it a few times because it was making me jittery. Now i need it again. Modafinil is non-prescription in Mexico, and i started using it based on a self-diagnosis of hypersomnia. As in Canada, going to a doctor here about fatigue got me nowhere. A thyroid test put me in the low-normal range. Another blood test showed it was ‘thickened’, which the doctor paid no attention to at all. The elevation, i guess. But all these tests are old and i think i threw them out.
    5.My grandmother (mom’s mom) is 98 and still clear-headed and fairly active. She would still go out for short walks if she didn’t have trouble with her balance, she lives in her own home with the assistance of relatives. She shows every indication of making it well past 100. I call her and we have good conversations about complex topics. My dad is now 76, he was diagnosed as borderline diabetic a couple of years ago, but considering what he has been eating for the last 50 years he has held up quite well. He stopped playing hockey at the age of 70. The same goes for my brother, who has had a drinking problem since his teens. He is now 50, with no health problems aside from his drinking, the proper weight, more active than average. My mom, 71, is also doing well, she has a blueberry farm with my stepfather. She quit smoking 10 years ago after a brain anuerysm.
    I have given serious thought to having a consultation with you, but i think it would be premature at the moment. It feels like i aaaalmost have it. I want to be consistent long enough to say with confidence that x or y is a problem or a help, and to be able to frame clear questions and give clear data. Even with the lows and gaps i’ve had, i am clearly experiencing steady improvement. Of course, if you asked me on a worse day i might offer a starkly different opinion about the whole cockamammy thing. I’m a tweaker, i want to tweak a bit more, and then i might arrange a phone consult.

47. 1) female, 29, 5’7″, weight on starting low carb 147, current weight 135.

    2) I began low carb when I was 22 (I think? it’s been awhile…). I did it for health. When I was 20 I was diagnosed with mitral valve prolapse and from the reading I did at the time it seemed like low carb paleo was the way to go, but I didn’t actually get down to it until after I graduated college. I was probably 80/20 with the low carb paleo thing and I tried to keep my carbs to 70g/day or under. I felt great at first, lost some weight, lots of annoying minor problems cleared up including the heart palpitations I was having due to the MVP. I started having problems maybe 3 years into it and finally abandoned it after about 5 years.

    3) These problems slowly cropped up one by one over the course of about 2 years. My periods became debilitating monthly ordeals where I would have to take like 8 ibuprofen just to take the edge off my cramps and just sit curled into a ball rocking back and forth on the couch all day. I was absolutely exhausted all day every day despite getting 10 hours of sleep every night. I lost all motivation to do anything outside the house. My digestion got so touchy that if I didn’t stick to a relatively small list of things I knew were “ok” to eat that I would end up on the toilet all night. I had headaches at least four days out of every week. I started having mild dizziness. I also tried to get pregnant during this time period and was unsuccessful for 2 years. I started becoming extremely bloated and gassy no matter what I ate or drank, even if it was just water. The icing on the cake was getting a random bout of colitis where I was passing mucus and blood. But hey, I was thin. ;P I did go to a naturally minded doctor about the terrible monthly cramps and the extreme fatigue and headaches. The doctor found borderline low thyroid function, but nothing else came up on blood tests. Attempts to use supplements and lifestyle changes did nothing to help. I also tried taking Armour thyroid for a month which also did nothing to help.

    4) My TSH was slightly over 3 and I took Armour for a month which actually caused a slight worsening of my TSH. My diet at the time was something along the lines of eggs/sausage for breakfast, big salad with meat and olive oil dressing for lunch, meat and two non starchy veggies covered in butter or coconut oil for dinner, fruit and nuts for snacks. Sometimes I did “paleo” baked goods with almond flour. On the weekends I would loosen up and have something a little carbier or cheat-y like half a piece of pita bread with my kabob and salad. My macronutrients were usually about 65% fat, 20-25% protein, 10-15% carb according to fitday.

    5) No one in my family is overweight or has any diagnosed thyroid problems.

    epilogue: I quit both low carb and paleo in late 2009 after doing it in some form or fashion since approximately 2005. I experienced an immediate small increase in weight from 132 to 135 pounds. My quality of life improved DRAMATICALLY. The laundry list of problems from question 2 disappeared and I finally successfully became pregnant. I now pretty much eat whatever the heck I want as long as it’s real food and I don’t count any macronutrients at all. I only gained 20 lbs when pregnant and lost it all within 2 weeks of giving birth. I am still at 135 lbs even eating whatever I want. I kind of hate low carb. I never want to eat a salad again in my life. I think maybe low carb was good for me initially when I started it, as I was definitely out of whack at that point just in a different way, but continuing it “for my health” was one of the worst things I ever did.

    I don’t even really care about being entered into any drawing or whatever, but I just feel it’s important to get my story out. Back when I started having these problems in 2008/2009 NO ONE was saying a single negative thing about low carb, it was all unicorns and rainbows and puppies. I was so into the whole low carb paleo as a lifetyle thing, reading all the blogs, it honestly DIDN’T EVEN OCCUR to me that all the problems I was developing could be because of my diet. I thought something else horrible was wrong with me. It took like two years of steadily worsening health for me to muddle it out myself that it was the food, stupid. Sigh. I just don’t want anyone else to have to experience what I did.

    Meanwhile, my husband ate the same things I did and had no problems to speak of. He initially lost about 30 lbs in about a year but has remained plateaued ever since then. He still has about 20 lbs to lose.

    BTW I bought Deep Nutrition back in 2010 when my daughter was a newborn and read the whole thing parceled out over naptimes. I really enjoyed it and your four pillars are part of my “ideal” diet. Which maybe I’ll get around to once I get over my “&*@% it I’ll eat what I want” phase. ;P

    Sorry for the wall of text. I got all riled up.

    1. This.

       Low carb worked excellently to cure my GERD and a few other seemingly random health problems like heart palpitations. Then after 6 months all hell broke loose and LC turned out to be the diet that would bring me to my knees. My story sounds similar to yours, llama lover, and thank you for sharing. Like you, I kind of hate low carb now. Regretting all my early days indiscriminantly evangelizing about it to my friends and relatives too. Cringe.

       However, always an optimist, I remain open that I will discover the cause of my trouble with LC, allowing me to try again to benefit from it the way some others do. I’d never go down to 30-70g/d though – that’s way too low, IMO. Until then, I stick to a real foods diet and don’t sweat it. At the moment, going LC would make me feel physically about as good as going SAD.

       1. MW: Would you mind sharing more details? The more stories collected the more readily we can begin to see patterns emerge and the sooner I can give clearer guidance.

48. 1) I am 59, 5’7″, started at 192, currently 181
    2) Started South Beach when it came out, saw no results so switched to Atkins. Induction worked so well I stayed there pretty much until I hit a plateau around 165-170, and decided to stay there for a while. I kept carbs under 70 gm/day for years, but that is average, with lots of swings (cheats) that got worse in the last few years, leading to my current weight gain.
    3) I don’t have cravings, but never lost the taste for carbs and (artificial) sweeteners. Lately trying to keep under 50 gm/day and going primal has had no effect on weight loss, so I’m trying the fat fast. I’m not having problems with that either, and the scale is moving, but the challenge will be to moderate the off days so I don’t regain in between “fat” days. If this doesn’t work I’ll be going to a paleo-friendly doctor for some help.
    4) I don’t test regularly because I’ve not had issues. A few years ago I remember surprising my doc with trigs of 44 and hdl of 85, but I don’t remember the other numbers. Recent bp was 114/77.
    5) No one in my large family is obese, but my mother and sister are about as overweight as I am. Mom had colon cancer twice, gall bladder removal, and takes metformin for borderline diabetes (developed at about 70 yo.) The men seem to have no problems. Yet.

49. 1) I’m 34, 5’9′, started out at 172 (was 8 months pregnant at the time), immediate postpartum was around 148, current weight 130-134.

    2) Started the end of July 2011 at the end of a very difficult pregnancy, did it to support my husband, but quickly realized its positive effects it had on my health, both during the last month of my pregnancy and beyond. Started out Primal, but have moved to more paleo. Started noticing fatigue and continued hair loss (more hair coming out and also longer past my normal postpartum hair loss experience). That was probably about 4 months ago or so (baby is 9.5 months old now, exclusively breastfed).

    3) Constant fatigue, not helped much at all by a daytime nap and good nighttime sleeping habits. Hair falling out more than I think it should, compared to past experiences with postpartum hair loss (6th baby).

    4) Last thyroid panel was in pregnancy, and the doctor commented that all was within normal range. I can’t remember numbers right off hand. I have, in the past (eating traditional SAD), been severely deficient in vitamin D, so I supplement with D3 daily & try to get sun every day. D3 and topical iodine supplementation boosted immune system and energy. Similar treatment now is not helping as much as I’d like them to.

    5) Mother has struggled with obesity all my life, taking Armor thyroid for hypothyroidism (likely autoimmune-related). Father slender, like me. Father struggles with having high blood pressure (can’t remember which one, but only one number is abnormally high, the other is normal), plus high LDL and triglyceride numbers. Father also has Parkinson’s disease (his mother, one sister, 2 aunts, and a cousin also have had PD, with similar symptoms).

50. Great contest! I am sharing this with my coworkers at the Gap.

    1) I am 32, five five, started low carbing two weeks ago at 234. Down to 230.
    2) My goal is weight loss and my doctor told me I am prediabetic and needed to lose weight. I started having problems right off the bat but I think it may be because I went too fast. I am doing Dukkan.
    3) Pretty much feel like I was hit by a truck. Also I’m horribly constipated and think I will go back to my lunchtime bran muffin.
    4) I don’t know what any of my blood tests are. sorry!
    5) Everyone in my family is thin except me. My brother has ulcerating colitis.

    1. Hi Paula,

       I just wanted to let you know to hang in there. When I started eating low carb, I too felt fatigued. Your body has to get used to burning fat for energy. Trust me the energy will come. As far as the constipation goes, are you eating enough fiber. You should be eating a lot of leafy greens, which will give you the fiber you need. A probiotic can help also. Don’t go back to your bran muffin! Fruits and vegetables are all the fiber we need, I promise you. Are you actually constipated or just not going? I know when I started eating more meats and less vegetables, I just didn’t go for a couple of days, but as soon as I ate a really big salad I was fine. Constipation is when you have the urge to go but it is difficult to pass. Hang in there! I promise it gets easier and it is well worth it. I don’t even worry about calories anymore. It is great!

Comments are closed.

Note: Please do not share personal information with a medical question in our comment section. Comments containing this content will be deleted due to HIPAA regulations.