Keto and Xanthelasma, High Blood Sugar, Mindset Change | THRR178

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High Blood Sugars

Eric writes:

Hi Robb & Nicki - long time listener and fan! I’m hoping you have some thoughts or suggestions on this one.

Background: I’m a lean, 56 yo male who follows a lower carb (50-75g daily) / higher protein diet (1+g/body weight). I’m very in tune with my diet given my wife is a T1D following Bernstein. I lift weights 3x/week and run about 20 miles/week (because I enjoy it). Admittedly, my work stress is high and I work about 50-60 hours/week. I get about 7.5 hours of sleep nightly and do all the sleep hacks to ensure I’m getting restful sleep. I’ve been wearing a CGM in hopes to better understand a recent A1c test of 6.0. I also had my fasting insulin level checked and it was 3 - so I don’t think I’m insulin resistant.

The CGM consistently shows fasting glucose around 115 and staying there through mid afternoon, when I’ll typically drop into the 90s. I see spikes for exercise as high as 160, but come back down within 1-2 hours.

I’m trying berberine (even though I don’t have a carb load) and l-theanine for the stress spikes, but so far, I’m not seeing much change

Could this all be stress related?

Any suggestions on how to fix this?

Could this be gluconeogenesis from too low calorie? I don’t think I eat too few calories and am about to embark on some tracking to see where I am.

Keto and xanthelasma

Fredrik writes:

Hi Robb and Nikki,

I have a question about a condition I heard you mention once on the podcast, xanthelasma. Basically yellow spots around the eyes. I have been on paleo since 2009 and keto since 2012 and you were some of the first people I found on my journey. It really has changed my life for the better. Back in 2009 I was training 5-6 days a week as a 28-year old with good performance but still had a less than optimal body composition and generally did not feel great.

Now many years later on keto, as you guys often say, I look, feel and perform much better. There is just one nagging issue, yellow spots around my eyes. They started to occur after about three years on keto and I had a couple of them removed surgically but they are now coming back slowly. Obviously I cant keep on having surgery, so what to do? I have theorized that dairy might be a contributing factor but the problem of just trying to remove something is that I will not know if it is effective until years later.

I have tried but it is very hard to find any useful advice for this online. Some people mention that supplementing with bile salt could help, what do you think? Physically and mentally I feel my absolute best on keto bordering to carnivore so I really want to maintain that. Dairy has also been really helpful for me to get enough calories for my workouts (three days a week of heavy weights and two days of either running or cross country skiing). So how do I know what to do and is dairy a likely contributor? Also, what else, other than dairy, could I eat to get in the calories for not just maintaining but building muscle? Protein is at 150-200 grams per day btw and aiming for around 2600-3000 calories a day.

Thanks for all your great work with the books and podcast!

Fredrik

Weight loss/mind change

Mark writes

Robb,

Long time follower, my wife and I went to Nutrition seminar in 2009 at crossfit Monrovia. I like listening to yall.

I am the former football/rugby player that eats too much food and sits at a desk. It has come to a point now that Life Insurance is requiring me to lose 60 pounds. I need to get to 231 pounds at 6'0". Currently i range between 285-295. I have tried diets the last couple of years for challenges, clean it up for a month and lose 30 pounds, super focused, lift, train without burning the joints. Skip meals, Skip Carbs. I lose the weight. Then i go back to normal life and eat my normal food which is too much.

The question is how do i reset my need to eat and take in extra calories. Should I consider counseling? I eat as a feeling. I eat the same as I used to when I was playing rugby.

I do also follow Dan John and I try to use Easy Strength for lifting. But I have not found a balance where i steadily lose. I have been maintaining my weight at about 285 with what i normally eat. My sleep is ok, Normal is 10:30 pm to 6 am. I sit at a desk 30 hours a week. I lift 15 minutes once a week. I play/run/yard work one time a week also. I have heard you talk about this before where we have been trained to gain and grow. Now that I am not trying to keep muscle mass on I have trouble shutting off eating. I still have not written my food down, like in the ketogenic reset. Is it habitual and I need to change how I eat for 25 days? Or is there another mental change needed?

Mark

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