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Ok, I hate being another person asking how on earth to succeed on Paleo - read: drop weight, look fantastic. However, I'm 33 days in, and somehow larger than before (my diet was moderate carb, lots of veggies, not much protein). I'm a very petite woman, aged 27, and don't own a scale. I measure my weight by how my clothes fit - they don't. The scale at the gym has given me some insight, I've put on about 16 lbs, and needed about 5. My BMR is just under 1200. I have migraines, and was on Topamax - worked beautifully- but I felt it was time to get off daily medicine. I stopped taking it according to the doctor's plan. I gained the weight in the past year, just after stopping the medicine.
My aunt went paleo about 1.5-2 years ago, and is also petite and has done beautifully on paleo. I also read a ketogenic diet would mimic the Topamax (since a ketogenic diet helps control epileptic seizures, and I was on low dose for Topamax- an anti-seizure medicine). Now, for 33 days, I've paleo-ed. I've kept carbs under 20g (minus a couple of days where I just didn't quite realize what foods had how many carbs - I haven't been over 35g/day), PROTEIN at 25-30% and FAT around 60%. The first two weeks I was eating WAY too much - around 1400-1800 cals a day! I read more about BMR and have kept my calories between 700-1250 for two weeks now. I also added coconut oil 3 weeks ago, and have been taking 1-3 tablespoons daily. I do NOT count these calories. My %s of carb/protein/fat have stayed the same. I have no more swelling in my joints, which is great. But,my "skinny fat" (just a little extra all over, a little flabby for lack of a better term) has turned very solid, and my clothes are much tighter, some won't go on, even in the past 2 weeks, I've gained weight (no scale though). I am uncomfortable in my own body. I have absolutely no energy, am upset and getting depressed and very frustrated. I've had 4 migraines, more than usual. Every time I try to exercise, I get a migraine, thus I haven't wanted to exercise much at all. Some light walking and that's it. I have caffeine only 2-4 times weekly - an espresso with 3T of cream (yum!). I drink only water or herbal tea otherwise. What can I change? What have I done wrong. This diet seems to work for absolutely everyone. I must be getting too much of something, or a bad combo of nutrients, or something. I'd really appreciate some advice from any of you who can help me drop the weight, and keep the migraines at bay. Please.

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Not sure what you'd get in percentages if you added the coconut oil into fitday, but for me I had the flip around the the protein to the lesser of the macros and have it at about 25-30% and fat at 50-80%. I have no idea if that'll work for you though. I thought 50-75g of carb was usually the sweet spot for people going LC but not NC, upping the carbs a titch might help with energy. I know it can be a frustrating nut to crack, but hang in there and give yourself time to try another variation. Also, are you sleeping enough? And for migraines some people have good luck with magnesium. – Happy Now Oct 12 2011 at 1:35
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Your BMR is under 1200 but you're taking in 1500 calories a day? I don't understand people who say CO calories don't count. Alchemy in this day and age? And why is your BMR so low. That seriously sucks. You could try lowering your protein a bit. You're around 100 or so now? Cut it to 75ish and see what happens. I agree you're going to have to play around with your macros as un-paleo as that is. Agree that the Topomax issue could be at play here as well. – Shari Bambino Oct 12 2011 at 2:20
Have you tried a daily magnesium supplement for the migraines? – A at Grain Free Diet Oct 12 2011 at 2:30
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How did you calculate or measure the BMR? Does not sound correct... – Eric Oct 12 2011 at 3:41
BMR was done online. I am very small, 5'0" and have a very small frame. My wrists are 5" around. Because of this, even 5lbs on me shows up like 15 on an average sized woman. Yes, I take magnesium daily, as well as a multivitamin heavy on the Bs, melatonin at night, Calcium and Vid D. I'm counting calories now because I got so much bigger after starting paleo. I'm at a loss and don't know what to do. Should I back off on the CO? – Sizzle Oct 12 2011 at 11:42
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21 Answers

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My friend was on Topamax for epilepsy and was very slim. When she went off of it, she gained a ton of weight. Perhaps this is one of the ways that the body responds to going off of this particular medication? I know this is probably not what you wanted to hear, but it is a situation I've seen before.

That being said, I would eat way more fat and cut down on your protein a bit, like Happy Now was saying.

Also, are you sleeping? How are your stress levels? Robb Wolf and Mark Sisson have both noted that you can be doing EVERYTHING right nutritionally, but if you don't have your sleep and stress dialed in, your body is going to hold onto weight like crazy.

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I was on Topamax, got off it because I didn't need it anymore and gained a bunch of weight too. Now it doesn't matter how clean I eat, I can't lose weight anymore. – vdh1979 Oct 12 2011 at 15:23
ugh, it's awful. I was fine for about 6 months after getting off it, but then weight just poured on. Granted, I did eat more. Food on Topamax just didn't interest me, but I still ate. I hope you can figure out something. If I do, I'll let you know! – Sizzle Oct 12 2011 at 17:42
Thanks Farmer's Daughter, vdh1979 and Sizzle -- I was on birth control (mirena IUD -- Levonorgestrel) and when I got off of it, THE WEIGHT GAIN, ACNE, EDEMA AND BLOATING WERE HORRIFIC. I think it made me temporarily into a eunch as well. Drugs s*ck (and I'm a pharmacist haaaa AHAA! – grace Oct 13 2011 at 0:33
There are a lot of exchanges on obesity, CIH and FRH -- they have no idea what they are talking about!! Industrial toxins that we are exposed to know are exponentially more than 100 yrs ago; these effects are much like what we've been through (weight gain despite diet, exercise, rewards, carbs, blah blah blah) with pharmaceuticals. Transfats, estrogenic petroleum products, pthlates, plastics, PCBs, estrogenic pesticides, insulin promoting heavy metals.... the list goes on. – grace Oct 13 2011 at 0:35
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My (newbie) Two Cents:

I think we're missing a few key pieces of information here that would really assist in the community helping you out, Sizzle.

So far there have been suggestions to change macro-nutrient ratios, drop dairy/sweeteners/salt, supplement more, be less stressed, sleep more, and more...but we're making suggestions without necessary information.

  1. We need a current weight. You say you don't own a scale, but that you've used the gym scale and it says you've put on 16 pounds. Give us the "before" weight AND when you last actually weighed that much according to a scale and give us your current weight. Its impossible to tell if your BMR calcs are correct without accurate data to plug in.

  2. Don't be so quick to trust an online BMR calculator...or any BMR calculation. You have to realize that, for the most part, the calculations developed for BMR are meant to hit the "average" person and certain population segments. It doesn't take into account differences in muscle mass, ethnicity, extremes in height/weight, and so on. They CAN be a useful tool in the toolbox...but they are not the best tool for every job.

  3. We have no idea WHAT you're eating, WHEN you're eating it, and HOW much of it you consume. Consuming 700-1250 calories per day is a nice number...but I'd be much more interested (and its more informative) to know the aforementioned things. There's a big difference between someone who eats 1200 calories spread out over the day...and someone who gets 100-200 at breakfast and lunch then pounds back 900+ at dinner.

  4. Coconut oil is not a health supplement...its a food/calorie source. IF you're counting calories, count it. Period.

  5. You say you were previously 19% body fat and now you're 30%. When were you at 19%? When were you at 30% Weights at both measures? How did you get the body fat %? These are valuable data points.

  6. How long (years/months) have you been off the seizure meds?

  7. How is your stress level? You're an attorney, a newly wed, and frustrated by your weight gain...I'm guessing you're stress level is pretty jacked up most of the week.

  8. When you have your espresso with heavy cream 2-4 times per week, do you feel a "buzz" or higher energy level afterwards? Given the ability for heavy cream (lipids) to aid in the transport/absorption of caffeine into the body, if you're not getting a buzz off of it you might be looking at some adrenal fatigue...especially if you're stressed out a lot.

  9. Supplementation: What kind of/how much of/When do you take magnesium? When/how much/why do you take Melatonin at night?

  10. Exercise: What exercises were you doing before going paleo, and how much of it (frequency)? What are you doing now? When? Intensity and volume of said exercise? Why only 5 pound weights?

  11. Sleep: How much do you get? When do you go to bed? Wake up? Dark room?

  12. Last blood profile? Family history of thyroid issues?

  13. Your 33 days: You say that you've been paleo for 33 days. 2 weeks of which you said were at 1400-1800 calories and 2-3 weeks at 700-1250. You say that you've gotten larger the entire time. Its only a guess, but I'd be willing to wager that you'd have started dropping a bit of fat with the 1400-1800 and had better energy with it if you had stuck to it instead of dropping down. We're all well aware of the potential for the "Paleo Flu" for the first 1-3 weeks for some people, you have to ride it out at least for a full month without changing things or tinkering to know how your body is actually responding.

  14. Have you tested to see if you're running in ketosis?

My suggestions: (take with a grain of salt...making assumptions based off incomplete data)

Ditch the caffeine, dairy, sweeteners, and herbal tea for at least two weeks.

Dial your calories back up into the 1600-1800 range.

Tweak your macro-nutrients back towards a 20-30% Protein, 40-50% Fat, and 30-40% Carb ratio. You're running at 60% fat and still putting on weight and feeling low energy...that looks like a possible issue of not enough calories or your body having issues converting protein/fat into ketone bodies. Up the carbs and calories a bit to get a nice steady base line of energy levels and weight gain/loss/maintenance and THEN start dialing down the carbs and dialing up the fat. Without any evidence of severe metabolic derangement, the extra carbs (from good sources, mind you) won't harm you at all.

Write back with answers to the questions I've posed here and I'm sure the community can give you a more defined and accurate response.

P.S. I fully agree with Violet's suggestion of the link to Berardi's calculator as a better tool than most basic BMR calc's you'll find out there.

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1. I was afraid to put my weight, because I don't want to be attacked. I'm small - I don't have anorexia or any other eating disorder. 5'0" currently 98 lbs I think. Lowest weight 2.5 years ago was 81 lbs. It was too small and I looked feeble. Best weight, happiest was around 86-88 lbs. Point is, my pants do not fit, at all. won't go up. Body measurements are NOW 31 bust, 25.25 waist, 38 hips. Best measurements were 31 bust, 23 waist and 36 hips. 3. today's food: breakfast - 2 eggs cooked in 1/2 T CO, 2 pcs bacon, 2 oz espresso, 1/4 splenda oacket, 1.5T heavy cream. lunch (it was a meeting) – Sizzle Oct 13 2011 at 2:10
I ate out: romaine salad with 3 oz london broil, bleu cheese crumbles, 2T blue cheese dressing. Snack (I was so hungry) 1/2 oz Jarlsberg cheese, 3 pcs salami. No dinner, wasn't hungry. 900 cals. Often I eat the same breakfast, or just eggs, salad and meat (tuna, salmon, burger, pork or steak), egg snack, spinach/kale and fish or meat for dinner. That menu gives me about 1100 cals. 5. 19% body fat at 81 lbs. no idea what it was at my best weight. 30% was at around 95 lbs. no idea how the fat came, just did. – Sizzle Oct 13 2011 at 2:17
6. been off topamax since June 2010. highest does was 100mg, once daily. was on it for 1.5 years. 7. Happy, but stressed and busy. I work a lot and am tired. 8. I feel fantastic after coffee and cream, I figured it was the caffeine. always 2 oz espresso, and frothed cream with a little water. I've only added coffee in my diet in the last year. 9. Supplements: am -Super B vitamins from Costco, calcium citrate, vit D, fish oil. pm - 1000mg magnesium, 6mg melatonin (plant derived) 10. Exercise: was running, stopped 6 months ago. no time :(. I've always walked a lot, a few miles at a time, – Sizzle Oct 13 2011 at 2:22
3-6 times a week. 5lb weights, step ups, arm exercises, and lunges. now, during paleo, 2x week, and it's hard - even with 5lbs, i'm very tired. 11. Sleep: 7-9 hours. pitch black room. no TV watching at night in bedroom. I wake up to pee 2-3 times each night. I drink tons of water. 12. blood work (biometrics at work) is tomorrow. no family thyroid problems. I've not had mine checked. 13. larger because jeans that were tight now won't zip/button. Suits are very tight. My husband did notice. 14. I think I'm in ketosis because my breath and pee smell like acrid. – Sizzle Oct 13 2011 at 2:26
Thanks for helping me, I will certainly welcome any of your other suggestions based on your now intimate knowledge of me :) I want this to work. – Sizzle Oct 13 2011 at 2:27
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I was afraid to put my weight, because I don't want to be attacked. I'm small - I don't have anorexia or any other eating disorder. 5'0" currently 98 lbs I think. Lowest weight 2.5 years ago was 81 lbs. It was too small and I looked feeble. Best weight, happiest was around 86-88 lbs.

At 5' and 98lb, that gives you a BMI of 19.

At 5' and 88lb, that gives you a BMI of 17.

Both are under weight, a weight of around 110lb would be right for your height, but you need to put it on slowly and lift some weights to build muscle.

Also you might look in the mirror and see fat, but others might see a healthy girl, get a second opinion from someone your trust.

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Yes, both are "underweight" but neither consider my actual frame. I ahve small bones. I am now lumpy looking in my clothes, and without. there is now a lot of cellulite, in many places, not just my butt (which I think is just inevitable!) I don't look in the mirror and see fat. i see it in a few places, and it's been a huge change. This is exactly the reason i didn't put the numbers, without seeing me you can't make an accurate assessment. – Sizzle Oct 13 2011 at 13:12
I went through a similar experience I'm 5'6" male bodied and I kept cutting calories to lose weight until I was eating only 1400-1600 calories all while exercising like crazy; I had no energy for anything else and was hungry all the time (but convinced myself I wasn't). My weight got as low as 117-118 and I looked emaciated but I was still flabby in places so I wasn't happy. I was afraid of becoming underweight (and I had stopped losing weight anyway) but I could still grab handfuls of skin and fat. – Violet Oct 13 2011 at 21:51
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You need to gain muscle to fill out and the only way to do that is to eat more fat and protein. I did it the wrong way ("balanced" vegan diet with chronic high intensity exercise and not enough rest) and gained 40lbs only about 10 of which was muscle. After reading "Good Calories, Bad Calories" by Gary Taubes I went paleo and my energy has come back and the weight has started dropping off (after I isolated stevia and added salt as triggers). – Violet Oct 13 2011 at 21:52
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Ditch the supplements and eat REAL WHOLE FOOD, at the very least eat 1800 calories; that is your BMR of 1200 with an activity factor of 1.5. Unless you've had your blood levels checked and you are deficient in some particular nutrient you do not need supplements (and even then you can likely get it from WHOLE FOOD). The interactions between different nutrients are not completely understood and blindly supplementing with synthetic vitamins and minerals can be dangerous. Caffeine can also trigger migraines and you shouldn't be relying on it as a crutch for energy. – Violet Oct 13 2011 at 21:52
Thanks,Violet. I can definitely up the weight bearing exercise. I'm still worried about so many calories- over a month with high protein and high fat and I've officially gotten bigger, weight up and clothes very very tight. I feel full most of the time and feel I'm eating plenty(don't feel deprived), yet it still keeps packing on, even faster with the change of diet. Everyone else seems to drop weight fast with VLC and 25/70 protein/fat percentages. Why on earth am I gaining instead? The fat pockets I'm developing are very hard, and I thought should get softer and then leave, I seem to be the – Sizzle Oct 14 2011 at 14:28
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I have absolutely no energy, am upset and getting depressed and very frustrated

I realize you are having physical problems, but you are describing some psychological issues here. Body and mind are intimately connected and problems with one often cause problems with the other. Some of your problems sound quite serious. Are you seeing a psychologist or a psychiatrist?

I was afraid to put my weight, because I don't want to be attacked. I'm small - I don't have anorexia or any other eating disorder. 5'0" currently 98 lbs I think. Lowest weight 2.5 years ago was 81 lbs. It was too small and I looked feeble. Best weight, happiest was around 86-88 lbs.

You say you are small boned, but you should talk to a doctor who can determine whether or not you are really at a healthy weight. There is nothing wrong with buying new clothes. You say you are at 30% body fat but that seems literally impossible. Was that measured by a physician? Because those scales they have at the gym are NOT accurate.

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I agree on the body fat % being off.... – Eric Oct 21 2011 at 5:04
yes, dr did the measurement with pinching (awful) and with a handheld machine. the results were "similar" he said. He said i need to put on some muscle and to lift weights, and do cardio if i wanted, but he wasn't sure about Paleo, and whether I had the energy to run like i used to. – Sizzle Oct 25 2011 at 14:29
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Sizzle!!

Thanxxxs for the updates! New kitten and husband are fantastic! But not nearly enough to negate the other life stressors!!

For the wedding, did you diet? This can cause some insulin resistance if calorically deprived excessively. Plus stressful!

Buying a new house is stressful! On top of a wedding (planning, dealing w/mom/MILs/etc, executing, enjoying)!!

Have you seen this case study? http://www.metametrix.com/learning-center/case-studies/2002/adrenal-stress-biotin-pattern

The diff is your cortisol is peaked AM not noon but otherwise I suspect you are like this case

--high cortisol in the daytime

--low cortisol when you are feeling 'drained' perhaps mid afternoon? pm?

--high cortisol midnight for '2nd wind' or difficulty with full, maximal sleep

--leaky gut (do you have bloating after meals? you have leaky gut, if yes)

--vitamin deficiencies/hormonal dysregulation

Consider ways to address the above which are all REVERSIBLE (!!):

(a) leptin/adrenal reset -- follow Quilt as you mentioned. Keep carbs 25 grams in the morning (2/3 cup any combo organic berries, rice, potato, etc) and some at lunch and dinner to help keep cortisol in ck. Don't skip meals. You are doing great on protein and fats! Keep up the strong work.

(b) lower cortisol by yoga, meditation mixing up mornings and bedtime timing

(c) consider for cortisol and fat loss

-- adaptogens (see Quilt -- any and all are fantastic -- I also like Gaia's Adrenal which Whole Foods carries or iherb.com -- this totally chills me out yet I get energy)

-- Relora (iherb.com)

-- magnesium (which helps migraine prevention as well) and mineral rich food (bone broths, extra sea salt, grassfed organs/meats)

-- omega-3 (high quality, best brand you can afford) 3 to 6 grams daily -- this burns fat, lowers cortisol in studies and improves brain function and brain inflammation

-- vitamin D in the morning -- have you had blood testing?

(d) consider for leaky gut

-- activated B vitamins and 5-HTP (to replace what your gut microbes are aren't making) -- these add'l help with cravings and energy until your gut and adrenals work properly again. Cortisol promotes permeability of the gut directly.

-- digestive enzymes 1-3 caps per meal (Robb Wolf likes NOW Super enzymes and I also like both NOW platinum and pancreatic enzymes; iherb.com) these breakdown food which may be fermenting in leaky gut and malabsorbing instead of being fully 100% digested

--bone broths w/marrow, fermented foods (raw sauerkraut + juice, etc)

Hang in there... I've done all the above myself and all made a huge difference for me for functioning and body recomp. It is not overnight we deplete our essential reserves (in fact we ran ourselves ragged). It's ok to slow down. OR A LOT!!!! Find your joy -- it's worth your time...

Please let us know your progress and all your excellent questions!

G

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I forgot -- the most important thing for adrenals... WEEKLY THERAPEUTIC MASSAGES. I lost the most body fat having weekly deep massages... – grace Oct 24 2011 at 2:37
Thank you Grace! It's so kind of you to helop me. I am taking 2 capsules (2000 mg) of Omega 3's daily now ( was taking only 1). My B vitamins are in a single supplement, which include: Vitamin C 150 mg - 250%, Thiamin (Vit. B1) 100 mg - 6667%, Vit. B2 100 mg - 5882%, Niacin 100 mg - 500%, Vitamin B6 100 mg - 5000%, Folate (Folic Acid) 400 mcg - 100%, Vitamin B12 100 mcg - 1667%, Biotin 300 mcg - 100%, Pantothenic Acid 100 mg - 1000%, Iron 9 mg - 50%, Zinc 15 mg - 100%, Selenium 25 mcg - 36%, Copper 2 mg - 100%, Proprietary Amino Acid blend (Arginine, Glutamine, Taurine) 120 mg – Sizzle Oct 25 2011 at 14:20
Magnesium is 1200 mg at night, 800 in the am. Started on kefir (2 oz in morning) and probiotics 10 billion in each capsule at time of bottling (1 capsule), at lunchtime. if I do have leaky gut, I'm hoping this will help. melatonin is 3mg with with 25 mg Theanine Dr. said my vit D was "good" but I'll find out the numbers to see how good. Right now, my vit D supps are 2 daily, 500 mg each. I haven't yet had my cortisol checked at any time but morning. The Dr. told me mine was high, at 25.4 around 9:30 am (fasting for 15 hrs). I'm going back in 5 weeks for a second test. (this dr. is new to – Sizzle Oct 25 2011 at 14:20
paleo, and is now impressed since my numbers were great). Do I need to schedule a time later in the day for cortisol testing? The leptin reset is difficult, but is going alright. Failed a little yesterday, because I was out of town in court, and only had 2 oz of chicken quickly between cases. Dinner was huge, and included cheese (which I'd stopped eating) because I was famished. "cheated" with a small handful of raspberries and heavy cream to cover them. You mentioned I should have no more than 25 carb at breakfast. Right now, I'm having fewer than 15-20 carb daily, coming from leafy greens – Sizzle Oct 25 2011 at 14:20
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energy for about 5 days now! I have done weightlifting twice, heavy enough that I can't do more than 2 sets of 8-12 reps (and boy am I sore!) - OK to do this on leptin reset? J. Kruse says no, but I've been eating paleo for 1.5 months, and nearly all of it has been in a type of leptin reset diet (I judt didn't know it). the only change now is that my breakfasts are really BAB, so I'm less prone to want to snack at all. Thanks again, and have a great day! – Sizzle Oct 25 2011 at 14:21
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Like the others have said--

Eat some more carbs. Experiment with your macros a bit. Go for 30% protein and 60% fat, and let the rest be carbs. You always want to eat more fat than protein, otherwise you'll feel like crap (which you do).

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Hey Sizzle,

Congrats on making the change, but I have some ideas. As the others have pointed out, make sure stress, sleep, and other variables are in check. If they are...

Calories do count, and it's not a bad thing to track them if you are having trouble gaining weight. Here's what I would do:

  1. Stop eating dairy for at least 4 weeks. I know it's tough, but it can be very inflammatory if your gut was just being punished with grains, as was the case with you.

  2. Increase protein. You need a minimum of .7 grams per pound of body weight, but more protein helps with satiety, glucose control, and ensures no muscle wasting. Get at least 1 gram per pound of body weight, or more.

  3. Increasing carbs might be a good idea, but you'll have to play around with what suits you.

  4. You could also try eating around 800 calories a few days a week, and eating slightly over your caloric needs the other several days. This helps keep your metabolism from adjusting and is beneficial psychologically.

I know you said you get migraines, but weight training is the best way to treat being skinny fat. Even 20 min twice a week would be great.

In all honesty, the best version of the paleo diet I've found yet is here:

http://www.bulletproofexec.com/the-complete-illustrated-one-page-bulletproof-diet/

It takes into account a lot of things most people don't such as denatured casein proteins, mycotoxins, and other details that can cause inflammation.

Hope this helps!

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Thanks, Armi Legge. This was helpful, and I'm really not looking forward to no dairy! But I can give it a shot, nothing else has worked. I read the article, and it's an interesting paleo twist. Hopefully I'll get some positive results. – Sizzle Oct 12 2011 at 17:41
Armi, That link is super. Excellent comments for Sizzle also -- I'd strongly concur. – grace Oct 30 2011 at 8:05
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Too much protein can increase your insulin as well. I agree with the previous person's assessment. Aim for 25-30% calories from protein, 5-10% carbs if you're doing low carb, and the rest from fat. You only need .7-1.0 grams of protein per pound of lean body mass, so I'd adjust accordingly. I hope that helps!

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Sizzle,

I'd concur with a lot of the great suggestions above! Going VLC (very low carb < 20g/day) requires more minerals (read Drs. Mary and Mike Eades, Proteinpower) so perhaps the migraines are secondary to a loss of magnesium? Do you think you may be experiencing reactive hypoglycemia (headaches, migraines, fatigue)? Additionally you listed a bunch of life stressors like being 'an attorney, always tired, married a month ago'. Having 4 migraines is debilitating. Did you move too? WOW. You probably handle stress well but these are significant life stressors and being fatigued is a chronic downer.

Consider being evaluated by an integrative practitioner for adrenal insufficiency -- a lot of the things you are saying are consistent to me. I have it on/off and for me VLC exacerbates it when other stressors are going on (excessive exercise, mental stress, jet lag, etc). When I don't have adrenal issues, I can fast or do VLC with no problems and get easily fat reduction.

However, when I have adrenal fatigue, weight gain occurs with stressors. What I do is up the salt, fish oil, egg yolks, sleep more, exercise less, more yoga, eat small frequent meals that contain carbs (80-120 g/day), fat and protein (no skipping or fasting!!) and some supps which really help me. My paleo friend Christian Wernstedt does these type of consults via long distance: http://blog.vitalobjectives.com/search/label/Cortisol

Topiramate like other pharmaceuticals can mess with cortisol (glucocorticoid) and therefore adrenal-hypothalamus-gut functioning. Scientists haven't even elucidated out the mechanism of action of Topiramate (Topamax) for seizures or migraine prevention. Drugs are potent, synthetic chemicals which can alter many hormone cascades and negative/positive feedback loops. That's my sad clinical and personal experience as well. http://www.nature.com/npp/journal/v29/n2/full/1300331a.html

Personally I think once adrenal function is assessed and improved to more optimal functioning, you will have effortless weight loss, feel super energetic and migraine control. Fertility hinges on a lot of factors but adequate progesterone for fertility depends on adequate adrenal function for a lot gals. It sounds like the current strategy is somehow adding to some internal hormone stress, hence the weight gain. (I've been through this myself and took a long time to realize).

Consider this book in conjunction with a knowledgable practitioner --Natasha Turner 'Hormone Diet' (just ignore the 'whole grain' stuff!) she is really s*xxxy and fun and addresses fat maps, adrenal/thyroid and female hormones. She cured her own PCOS, improved her thyroid and adrenal insufficiency.

Good luck!

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Thanks, Grace. I will go to the Dr. to get tested for my thyriod/adrenal fcn. The stress is pretty good stress (although still stress) - bought a house by myself 6 mo ago, got a kitten, got married, just started by 2nd year of practice, in court often, long hours, but I adore my job. and my new husband :) He's on some thyriod meds, and is doing fabulously on this diet. He looks incredible... and i'm just gaining. I just want it to stop, and leave. It's embarrassing to go to court in tight suit pants, or a skirt that wrinkles from stretching over my hips. – Sizzle Oct 13 2011 at 2:46
You are very kind to help me. Hopefully i'll get some positive results. – Sizzle Oct 13 2011 at 2:46
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You may need to add some weight lifting to your routine. Just a very little bit of it to gain weight. Start slow.

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weight lifting twice now. 8-10 lbs for arms and 45 for legs. After about 8 reps I'm definitely shaking. My arms are noticeably more muscular now, according to my husband, who may just be nice. legs have been harder to know how to lift - squats (feet together and then apart), and lunges are about all i know how to do. Any tips? suggestions? – Sizzle Oct 25 2011 at 14:26
That is awesome! Squats and lunges are great. You night add a bench at some point to do bench press with dumbells. Or you can use an exercise step if you have one. You are hitting the right muscles keep it up. You could do abbs twice a week once you get a hang of the weights. – Eric Oct 26 2011 at 5:56
Last night at the gym i learned to do bench presses with dumbells and an exercise ball - said it would help my core to balance. Attempted some yoga poses (iphone app) after dinner (dinner was after workout - 2 eggs, CO, small salad), and I'm MUCH less sore than I have been, though i felt ridiculous in my living room standing awkwardly :) I'll take any tips you can give me! I appreciate it so much – Sizzle Oct 26 2011 at 17:56
Bench press, squats and lunges are key. I would not add too much more... Make sure you get rest between workouts. Sounds Awesome! – Eric Oct 29 2011 at 8:32
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OOPS! fat is about 60-70%, protein about 25-30%! moderate stress - I'm an attorney, always tired, married a month ago, and sleeping well. I've been off the meds for about a year and a half now, if that helps. very low dose, but after a few months of coming off it, the hunger crept back in and food actually tasted good.

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If the meds caused you to vastly under eat it would make sense for there to be a bit of yo-yo-ing no matter what you eat now. I also wouldn't discount how much stress wedding planning can cause (cheers by the way!), I wouldn't be surprised if you hadn't fully recouped from that yet. – Happy Now Oct 12 2011 at 2:24
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i was taking in 1400-1800 a day. Now I have coconut oil added, and without those calories I'm at 700-1250 cals a day. Average over 2 weeks has been 950

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Oh, and if this helps, I have 30% body fat. I used to be 19%

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It's discouraging but hang in there!! – grace Oct 13 2011 at 0:36
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Thanks, everyone. It's really kind of you to take the time to help me. On the "eat more" front, should I be going over by BMR? I only started to track the calories on fitday.com because i wanted to see how much and what exactly I was eating, and how the %s worked out. I'm surprised that I have actually gotten larger, and have been doing most everything correctly. I am starting to not be hungry, although eating less. As for dairy, mo more than 2 oz hard cheese daily, and a few times a week, heavy cream. This has been very hard. Sweets, bread etc were relatively easy to give up, but dairy is my absolute favorite. Doing well on that though. but why no positive results?

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Topamax has been used off-label as a weight loss drug for over a decade (it was in clinical trials to be approved for that use but I don't know what became of that). I was put on it as an adolescent and dropped 30 lbs in 2 months without trying, because I wasn't eating. I would feel overstuffed, like after thanksgiving dinner, after eating a 6 ounce cup of yogurt.

It seems likely that you regained an appetite once you went off the Topamax. I agree with those who suggest eating more real food (meat, organs, veggies and fruit), and cutting out processed foods like splenda and sugar-free jello. for me, even a little of that stuff throws me way out of wack.

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YES! I ate, but just felt full all the time. And food wasn't interesting. It was like I looked in the mirror one day and looked good, and the next day was skinny and bony, and now... small with fat packed on like pancakes pasted all over me! – Sizzle Oct 13 2011 at 2:32
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Still no results. less hungry every day, and had one day full of energy (yesterday - same eating patterns). Bloodwork was very good. AST and ALT levels a little high, but expected with under 45 days of Paleo. Heard about leptin reset - BAB (will be 4 eggs, 2 bacon slices, 3T cream in coffee), and sticking with the same foods for dinner and lunch - leafy greens mostly for veg and steak, fish, bison, venison, eggs as meat/protein. ALSO, cortisol was "moderately elevated" - which means after fasting all night (7pm-9:30 am) i was at 25.5 cortisol. Evidently the high range of "normal" is 20. I can't do much about stress (new old house, new life, new marriage, stressful job, weight gain, etc) Many of you said eat more, when i did eat more, i was gaining weight. when i ate less (now) i am gaining. Body Fat measured again, went up 30.6%. i have little to no energy to work out. I sort of miss running, but the thought of it now makes me tired. Will get some 15 lb weights to start out. Any ideas? I'm still frustrated.

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I recommend adding some fermented foods to your diet, such as homemade sauerkraut, kim-chi, kefir, or kombucha. Fermented foods are a great way to get your dietary probiotics. Improving your gut flora will help your body digest food better and absorb more nutrients from the foods that you are eating.

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You need to eat more carbs. Low liver glycogen means your body can't deal with stress. For you too much stress shows up as a migraine. You exercise and get a migraine because you are taxing your already low liver glycogen.

Fruit is the best because fructose catalyzes glucose so it can oxidize more efficiently.

When you don't eat enough carbs your t3 will be low unless you take/eat thyroid(like the eskimos) which will push you hypothyroid and cause you to gain weight.

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how many carbs do you recommend? right now I'm under 20. with the new addition of kefir in the a.m. I'm right around 20-22 – Sizzle Oct 25 2011 at 14:24
As much as you want. Eskimos averaged 115g and ate thyroid. 300g is a good start if you aren't eating thyroid. – cliff Oct 25 2011 at 21:45
don't listen to cliff, he's full of carbs. – Dean Oct 26 2011 at 13:06
I can actually think? – cliff Oct 26 2011 at 13:58
ha, love this! should i eat fruit at breakfast, lunch or dinner? (I know, no snacking!) - besides berries, any recommendations? or eat more fruit before exercise (weights, walking, attempting yoga, but really failing at it and laughing instead)? I don't want to throw off cortisol. – Sizzle Oct 26 2011 at 17:57
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Sizzle,

For adrenal stuff you have to go to resources where they've conquered it successfully... Mark Sisson is/was an elite athlete and qualified for Olympic marathon running. Like Quilty, he's a pro at all things hormonal, supplements and optimal health. Ck out his post below!

http://www.marksdailyapple.com/cortisol/

Other great resources that are paleo/primal:

You are doing AWESOMELY!!!

G

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47 days into Paleo, and bigger than when i started. frustrated. migraine yesterday and today, no different eating/sleep patterns. Can't track why. I have gained more FAT - more cellulite, more quishy in my clothes, the few pairs of jeans that would zip now won't. I need help. Please.

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My best advice is to switch to blood type and get more specific about your food. If you happen to be blood type A, for example, that means you remove the meat and eat more fish and eggs. Refine & finesse-- that is what you need to do. Also take a look at your genotype. Peter D'Adamo has written several totally fascinating books about blood type/genetics. I, for example, am a Hunter genotype. So paleo is my diet 100% more or less and yes works quite beautifully. I've found though I don't have to constantly go radical against carbs to be skinny--- just not my genetics. I have to eat the right carbs and limit the wrong ones.

Once you get that info look at intermittent fasting. Eat Stop Eat, Fast 5, Warrior Diet etc.

Also compare notes off of Mark's Daily Apple for even more tips.

If you are an O paleo should work for you. You just tweak it a little, maybe exercise more or eat a little less or more carbs. But it sounds like it isn't working so you need to dig a little deeper.

Yes, I am a genius. :--) No, I just have many years of experience with this.

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I thought that the blood type diet had been thouroughly disproved? chriskresser.com/… Even other primates besides humans have a variance in blood types yet they don't eat different diets from each other... – Grottenolm Oct 27 2011 at 21:01

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