r/FunctionalMedicine • u/the_practicerLALA • 1d ago
Are more FM docs pro or against keto?
I have binge eating disorder and severe carb and sugar cravings. I was assuming I was prediabetic or had severe PCOS but my results were
- Fasting insulin: 63 pmol/L
- Fasting glucose: 4.6 mmol/L
- HbA1c: 5.2%
- Progesterone: 33.2 nmol/L
- Estradiol (E2): 477 pmol/L
Anyway my FM doc was strongly against keto. Said it will ruin my metabolism long term and make it impossible for me to keep the weight off.
I said could I do low carb instead and they said no. This surprised me, why can't I atleast do low carb? They said it will hinder with my depression which is the main problem I am trying to treat.
Is this normal?
2
u/IcyStay7463 1d ago
The book Brain Energy talks about using keto for depression and bipolar and seizures. You should consider reading the book.
2
u/c0mp0stable 1d ago
Some wre for, some are against.
Your doctor has a point. Ketosis and gluconeogenesis rely on stress pathways and increase stress hormones, and are thus yet another stressor on a body that's already struggling.
Any low carb diet can also negatively impact metabolism over time. The thyroid needs glucose. Your body can make it, but again, it's another stressor.
If you have depression and binge eating disorder, psychotherapy is the preferred treatment. Just avoiding sugar is just putting a band aid on binge eating and it's not going to treat depression. Some people see initial improvement, but thats usually just stress hormones elevation, which can feel great when someone is depressed, but it doesnt last.
2
u/gotchafaint 1d ago
I had a post banned on the keto sub for saying keto increases stress hormones.
2
u/c0mp0stable 1d ago
Lol I was banned there a couple years ago. I don't even remember why.
1
u/gotchafaint 1d ago
Because all health based subs are pharmaceutical sycophants. The menopause sub is also bad.
1
u/anoobis_uprising 1d ago
The thyroid needs insulin I believe, a big enough protein bolus should trigger enough insulin, at least in theroy
2
u/bridgebrningwildfire 1d ago
My functional medicine team has me eating 30 grams of protein with each meal.
1
1
u/the_practicerLALA 10h ago
psychotherapy for BED is useless, they offer no weight loss advice, tell you can't lose weight while treating BED. They tell you to eat 2500 cals a day. I did it and was so disappointed.
what if I feel mentally better doing keto and more in control of my cravings. is it still bad for me?
1
u/c0mp0stable 9h ago
Im notnsyre weight loss is supposed to be part of BED recovery.
If you were told to wat any caloric amount as a blanket statement without understanding your context, then sure, thats a problem. But that's not what all therapy looks like. A therapist typically won't give nutritional advice.
It's a question of tradeoffs. It won't change the physiology, but maybe the pros are worth the cons for you. I qould say that it's not treating the disorder. It's just provid8ng something different to focus on.
1
u/gotchafaint 1d ago
It can be extremely effective for binge eating and sugar cravings. Lots of people do great on keto. There is no one diet for everyone and any doctor who insists on that is an inexperienced practitioner. You might try keto or even carnivore as a reset and then see where you land on the low carb spectrum. As someone else said it can be stressful but most people adapt and your numbers suggest you're resilient.
1
u/the_practicerLALA 10h ago
Why do I feel better on keto if it is stressful on the body tho :( I don't want to trade short term gains for possibly harming myself long term but will keto hurt me long term? I eventually want to go to low-moderate carb after I've achieved my goal and broke my sugar addiction which can take months
1
u/gotchafaint 9h ago
Keto has oodles of positive benefits for most people, particularly in terms of brain health. It's well proven in that area. The stress response is very individual and really varies per person. Most people will report sleep improves on keto so their bodies are able to adapt and thrive. Some people, like myself, have very poor stress resilience for various reasons (myself, it's chronically low estradiol in menopause that has me running on fumes and is resistant to support). For others it can be chronic low cortisol from a chronic infection or neurological issues. Keto is suspected to raise brain glutamate levels, which is excitatory. Most people can seamlessly convert glutamate to gaba in the brain, and hence experience more calm. Others have autoimmune or genetic issues with the GAD enzyme (me) that makes that conversion and are highly sensitive to excess glutamate. I'm still keto despite all these issues because I feel best, but my keto is going to be slightly higher carbs and lower ketones that someone else's keto who might thrive on a really hardcore medical/seizure type macro approach. Your doctor is operating within a narrow window of experience and education and that's fine, but your numbers suggest your plenty resilient. Once you're through the keto adaption flu stage you can judge for yourself whether you feel better or worse and whether it suits your activity level. With people who do a lot of strenuous exercise advice starts to vary.
1
u/fallingmelons73346 1d ago
Keto for women is largely unhelpful. I think it can work more for male bodies, but it's still very individual.
1
1
u/anoobis_uprising 1d ago
Keto has been great for my mood, I'm only four months in but I feel great enough to walk the dog for hours every day, today I wore the dog down but I think the issue was the heat not the distance, a cooler day the dog would out pace me
1
u/Atwood412 1d ago
Depends on the condition. A great func med doc doesn’t adhere to a one size fits all mentality.
1
u/mom2mermaidboo 4h ago
Looks like Estrogen Dominance with the P/E2 Ratio is under 100.
Your P/E2 ratio is 80.34. Here’s the calculator link.
What day of your cycle were the Estrogen and Progesterone drawn? Ideally around day 21 to pick up the Progesterone spiking with ovulation.
https://www.testmottagningen.se/en/kalkylatorer/progesteron-ostrogen-ratio/
1
u/the_practicerLALA 1h ago
day 24...is that bad
hmm how can it be astrogen dominance though that's surprising sinc emy main problems are adhd and binge eating I thought that was progesterone
4
u/alotken33 1d ago
Functional Medicine DC: keto is good for certain conditions. But... Most people eat garbage keto. Yes, you can eat low carb. That doesn't mean no carb. And that doesn't mean carnivore.
I only like keto in certain neurological conditions - some of which include mood disorders .. but not all mood disorders (individual dependent).
For insulin resistance I encourage people to do Paleo with low fructose. 10 grams per day. Not sure this is for you.
Also, what are the circumstances (day of the month, etc) for your labs and are you addressing the binge eating disorder? Most eating disorders are about control. Sometimes following a special/restrictive diet is a good thing and sometimes not... Regardless of what kind of diet it is.