http://www.proteinpower.com/drmike/ketones-and-ketosis/metabolism-and-ketosis/

http://perfecthealthdiet.com/?p=2479

One of the main jobs of the liver is to make sure the body (especially the heart and brain) receives enough energy from the blood. It uses energy from fat to convert protein to glucose during gluconeogenesis, and produces ketones as a byproduct which can also be sent out to the blood as needed. Ketones are water soluble fats that can provide energy to muscles and cells, providing the bulk of the energy that the brain needs. They diffuse throughout the body and into cells where they are taken up by the mitochondria and oxidized for energy. Unlike many other types of cells which can burn fat, neurons only run on glucose or ketones, and when glucose metabolism is not active ketones will be the sole provider of energy.

Seems like you may wanna try more of a moderately low carb (not ketosis) paleo diet, getting 75-150g carbs/day. This may help your weight and still give you benefits of being low carb.

Regarding your fear of carbs raising your blood glucose.... a small spike after meals is normal, and your body is most likely very capable of handling it without much problem. You don't need to fear carbs!

You want to eat this kind of diet and you are underweight? Simply add more nuts, seeds, and fruit to your diet. Also "safe starches", like potatoes, winter squashes, and sweet potatoes are good to add for weight gain, or to keep from losing weight.

I've been eating 3600 calories a day to meet my nutritional needs and getting them all from an ancestral eating approach. It's actually pretty easy to do if you pay attention to your calories. To maintain, start with 15 calories/lb of LBM...if you still lose, bump to 16 and so on...

You can use this kind of diet to add mass, to lose fat, to maintain where you are...whatever you want.

If you're losing weight then it would suggest you can afford to eat more. It doesn't have to be carbs, it's not all that difficult to get a lot of calories from fat. Of course this will still be keeping you mainly in ketosis, but it's probably a better position to try eliminating other foods to see if they are causing your problems.

Ketosis is if you dip below a certain level of carbs. Often 50 grams. It doen't take much to keep you out of it.

Drink more water, probably what's happening is that as you burn off your fat stores, you're releasing the toxins stored along with fat, and these are triggering the rashes.

Things like Alpha Lipoic Acid, or better yet, R-Lipoic Acid, Selenium, Cilantro, Chlorella can help chelate out heavy metals, if that's the issue.

You certainly could increase your calories if you want to stop the ketosis, but the ketosis itself isn't the cause of the rashes.

It took me many years to figure out the real culprit of my acne was dairy. Dairy contains a lot of hormones as milk is intended by nature to nourish a baby animal. Even organic dairy or milk labeled "without added hormones" is naturally full of hormones. Dairy IS hormones and hormones cause acne, hence the once a month pre-menstrual breakouts (if you're female, that is). When you're doing a Paleo or ketosis type of diet, you're eating a lot of animal products and dairy. Try eliminating milk and cheese for a couple weeks and see how your skin looks. Sounds like you need more veggies, and more fats to get your calories up.

I believe the thyroid is the real problem. I will expand on this when I get access to my computer.

Hi Bec, I can totally understand. I went to 63kg per 189cm hight this summer (although for a slightly different reason). I can't explain why you still have the acne after going low carb as this approach seems to be working for my acne (I am OK on 50-100g of carbs per day), but I can give you an advice regarding the weight loss.

I also struggled terribly with getting enough calories to stop losing weight, however, this is not an issue since I went high fat. Before I was only eating relatively lean meats and veggies, plus some (not enough) fat from cheese etc. Then I started making my own ghee/clarified butter and also started making purrees from vegetables that I can mix with ghee. I am making a 200g cauliflower/broccoli purree serving infused with 60g of ghee + olive oil + lard. I eat this three times per day with lean meat and this way I can easily get 2000kCal per day. Throw in a few eggs each other day, some heavy cream/berry shake, a fatty fish here and there and I guess you should start getting weight slowly again without having to add any carbs.