I am a 21 year old female who is treating Crohn's disease and gastroparesis with the Paleo diet to great success. The gastroparesis is a side effect of an allergic reaction to Humira, not diabetes related.
I am an athlete who spins, road bikes, and lifts to stay in shape. My cycling endeavors are around an hour, and my lifting some body weight stuff combined with kettleballs I took from my college ski team workout. I try to do these things 5x/week. I sleep pretty well, am cutting back on coffee to one cup a day, and don't have too much outside stress at the moment. My question is this: Why does my energy die and my head feel like it's going to explode when I attempt LC/VLC?
Because of the Crohn's, I keep my diet pretty simple and stick with grass-fed beef, wild caught fish, coconut oil, ghee, and leafy greens. Much else leaves me in a lot of pain. I eat carrots and sweet potatoes as my main sources of carbs, on workout days usually around 200g. On regular days more like 50-70g.
I am 5'5, 130 lbs. and really wanted to try ketosis to see if it offered any benefits to my Crohn's, and also to kick the 5 lbs I put on during my last semester of college. Stress + too much wine + no exercise = weight gain.
Everytime I get into ketosis (never used ketostix, but have the metal breath, strong smelling pee, all that jazz) it totally kicks my ass. I mean can't focus through the pain in my head. I have been able to do this for a couple of days at a time, struggling the whole way, but just end up feeling terrible. Also, the really high amount of fat causes pain in my small intestine, as that is where fat is digested and also where my Crohn's is concentrated.
After reading all of the banter on the site recently about low carb Paleo v. moderate carb Paleo, I feel like I am missing out on some of the benefits of the diet by having to eat so many carbs. I want to be keto-adapted! Why is my body so resistant? Is having the disease + being low carb just too much stress?
I spent a year on a VLC/ZC diet to treat Crohn's. It seems to have worked well enough that I'm now eating a lot like you are.
In everything I've read, there's no suggestion that ketosis will have any effect on an autoimmune disorder, nor any reason to believe it would specifically have any effect on Crohn's. The Crohn's theory that I like the best is gut dysbiosis/weak gut lining (gluten etc) -> bacterial protein mimicking gut collagen -> confused immune response -> Crohn's. If you fix the first part of the chain by eliminating excess fiber and starches and healing the gut wall, you avoid the rest and voila, no more Crohn's.
Ketones are just alternatives to glucose. Glucose/ketone metabolism should have nothing to do with Crohn's, so don't force yourself into ketosis on that count. If you can find some actual medical evidence that suggests a benefit, that's a different story, but again I can't think of any theoretical reason or empirical evidence that it would matter.
To answer the actual question...
You feel like you're going to die and your head is going to explode for a few reasons:
1) You are not already keto-adapted and are no doubt attempting to keep up heavy activity levels. It took me months before I would say I was fully adapted, and I was never able to keep up the same level of physical activity that I was while carbed.
2) Even if you were fully adapted, you happen to be undertaking exactly the kind of activity which will punish a VLC lifestyle - high volume/intensity endurance work. (5x week hour bike rides assuming a decent pace). Maybe someone who has spent their life adapting to VLC could do better, but most athletes report needing more carb.
So, to sum up:
1) Ketosis is probably irrelevant to Crohn's. The diet's effect on the gut is the important factor.
2) Ketosis + lots of high intensity endurance == very difficult, especially if you just jump right in. If you really want to try, spend a few weeks adapting at a lower level of intensity and then start adding days/time back in to see if you can handle it. Throwing yourself into it will make you want to die.
Some folks that post here report similar issues with very / low carb diets, some folks just seem to need some carbs (i.e. 150-200g) in their diet to maintain a good level of mood and energy. There seems to be a correlation between people who say they do better with more carbs, and those that work out a lot (a somewhat serious workout 5-7x per week). One theory is that doing cardio workouts every day causes your body to require more carbs to burn on a regular basis, it gets into a mode of "I'd better stock up on the glycogen if we're going to run 5 miles again tomorrow".
If you want to try a lower carb diet, you might decrease your overall activity, and go instead for brief, high-intensity workouts (i.e. the strength training you're already doing), little or no cardio (drop the biking and spinning), and more walks and hiking (i.e. low-intensity, longer duration). Many folks on the Paleo diet work out no more than 15-30 minutes 3x per week. This in combination with walking a total of 2-3 hours per week can take off the weight, and often fits better with a low carb diet.
I know that dropping the biking and spinning can seem crazy if that is your main workout outlet, but that is what worked for me. My main form of exercise used to be running 3-4 miles 3-4 times per week, and then I stopped running completely and switched to kettlebells, floor exercises and strength training. The result was that I lost about 6-7 pounds very quickly (including about 1.5 waist sizes, so I think it was all fat), in about 7-10 days, and my mood and sleep is way better, and as a bonus, I spend a lot less time working out. Inverting that statement, it seems that running 10-11 miles per week was keeping 6-7 pounds of fat on me, giving me worse mood and sleep, and I was spending more time on it than I liked. Interesting, no? Totally not what I expected, but I'm glad I tried it.
I generally eat about 30-50g carbs per day and am completely happy with that, though I generally like a low carb diet. I was having a bit of trouble with low carbs and running, I never seemed to gain any strength or endurance even running religiously every other day for 2 years. But the results from the strength training have been very quick and satisfying.
EDIT: reading over what I wrote, I realize that it's probably physically impossible to lose 6-7 pounds of fat in a week without surgery... nonetheless, I lost the weight quickly, kept it off, and have lost a couple of more pounds since then. Maybe not all fat, but I'm glad to be rid of it, whatever it was...
The question I have is how is how does your Crohns react to Ketosis? Those side effects you mention don't seem in line with Crohns flare ups. I have a friend with Crohns and he is basically in remission thanks to strict paleo diet.
Is it possible your lack of focus is not related to diet, but perhaps poor sleep quality, poor hydration or something else? Your diet sounds very well dialed in to me.
I might suggest that if anything perhaps your cortisol is up from your high training schedule. What if you kept a good diet, went LC/VLC and cut out some of the cardio?
At your training load and age its no wonder your body responds negatively when you get rid of the carbs. There is no benefit to being "keto-adapted"(what does this mean?) for athletes maybe if you want to give up your training but I don't get the advantage of that.
Low carb ketosis is for people who have serious issues, epilepsy, chronic obesity etc. I don't think its appropriate at all in your case.
Does the diet with carbs not work for you? Or are you just interested in magical benefits of ketosis?
I had Crohn's for decades and no longer have any symptoms at all. I avoid roughage (I extra microwave the abundant amount of broccoli I eat), sugar, wheat, anything fried, and most carbs. Also I believe vitamin D supplementation is also pivotal in vanquishing my crohn's. Be aware that you may need to take large amounts (I take 50,000 5 times a week but Ive had surgeries before and prolly don't absorb it at same level/rate as others). If you do the above I believe you will see drastic beneficial results.
Hi Cave Biddy, It sounds like you need more food. As to your Crohn's, you know your crohn's best, but my Dad (who has Crohn's) simply can not eat leafy greens and unless they are super well cooked. Perhaps consider cooking all your veg matter and perhaps keep a detailed food/energy diary and see if you can see patterns in your energy and crohn's symptoms. Once your get all the benefit from your food (i.e. your crohn's allows you to absorb nutrients) you should get more energy too. Also this article might be worth a read http://paleodietlifestyle.com/you-and-your-gut-flora/
So glad to hear your trying paleo and not the cover up medicines! Good Luck!
It often takes a week or more to adapt, but if it's that painful, a week is a long time. I've heard of rough transitions, but never pain in the head, wow!
What level of carbs are you trying to get to? Maybe a gradual approach would work better?
Since you currently do about 50-70 grams on non-workout days, and about 200 on workout days, maybe you could also make it more parallel to that. For example, go to 15-25 grams on off days and, say, 50-100 on workout days.
I don't have Crohn's, but I have IBS, and am also active. VLC makes me feel like crap too, and is not sustainable. Not sure why, but we are all different. There are lots of people who feel great on VLC. Most, if not all, of the people who tout the benefits of VLC are among this group. ;)
If you really want to try to make VLC work, you should give up cycling/cardio entirely and get your body adapted to ketosis without working out. I would say the vast majority of people couldn't sustain at that level without at least moderate carbs.
If you're feeling good and performing at the level you want to while eating moderate 'paleo' carbs, I don't know why you'd want to force yourself to function on VLC, though.
If you have crohns, you must have been percribed lots of medicine from a doctor who if you told you were doing Paleo, he/she would consider sending you to a physciatrist from being crazy. But we both know, Paleo is the best chance you have. So what have you done with all the medicine you are perscribed?
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