1. I lost a lot of weight on "keto" but now I have an iron deficiency.
Iron deficiencies can be caused by numerous things. You need to discuss this with your doctor and get the appropriate testing in order to determine what could be the cause.
2. There are fasting mimicking diets for those who can't tolerate strict extended fasting.
Ketogenic protocols are fasting mimicking diets. This is why they produce ketones. Ketones are a signal to the body that there is some form of starvation occurring.
You should not be doing any extended fasting unless you want to remain fat and become fatter. Extended fasting would be perfect for that as it further down regulates leptin very well.
I have a great way of gaining a lot of fat and keeping it on. You fast for about fourteen days and then eat "keto" bread and ice cream for the next seven. Keep doing that for about six months and you won't fit through the door by the end of it. Guaranteed results.
3. "Insulin is fattening". This is why type I diabetics become thin if they stop dosing exogenous insulin.
This is part of the dangerous quackery surrounding the low carb community. They just can't shake the nonsense off to save their own life or anyone else's. They are the ones solely responsible of why low carb diets are not taken seriously by anyone. But let's be realistic here. All diet mongers claim to know the "one thing" that's to blame for obesity, which they magically have the easy "cure" for. The problem is that they always get it wrong. There is only one thing to blame for obesity - blood glucose dysregulation which results in insulin dysfunction and causes a chronic under expression of leptin. There is no known "cure" for it.
Insulin is not an obesity hormone. We all know it helps regulate blood glucose but it also stimulates the uptake of amino acids into cells and protein synthesis in muscle tissue. This means that you cannot have proper lean muscle mass without insulin. But aside from these anabolic properties, insulin is also an anticatabolic hormone. In other words, insulin prevents your body from breaking itself down into sugar and ketones through its regulation of glucagon. Leptin also regulates glucagon and leptin is a slave to insulin.
Type I diabetics do not "become thin" when they stop taking their exogenous insulin. They waste away to nothing and then eventually die from "glucagon gone wild". Leanness and wasting are two very different things, just like weight gain and obesity are two very different things. It doesn't matter that they both make the scale go up or down. Insulin surely does not make body builders obese and some inject it exogenously for gains. So it takes very different metabolic profiles to become lean, obese, muscular or emaciated. All of these metabolic profiles use metabolic hormones, like insulin, to acquire the end result but insulin in of itself is not the problem. The problem is the metabolic profile that it's in.
Insulin in a metabolic profile that does nothing but store fat is bad but so is insulin that doesn't build muscle or that breaks you down into sugar. All metabolic hormones are a slave to whatever metabolic profile you put them in. When you deteriorate insulin function from blood glucose dysregulation, then you will get insulin that stores fat and doesn't build muscle.
4. Coconut does not raise LDL cholesterol.
There are two important issues that are not correctly understood in the fad "keto" world - ketosis and lipids.
The first one, ketosis, is easy. The type of ketosis that a person with metabolic issues wants to be in, is the ketosis produced from the burning of their own body fat. Not the burning of coconut oil, a dietary fat. Burning coconut oil means nothing. It just means you are alive and can produce heat. Being able to burn your own body fat means a lot. It is an indication that your metabolism is on the road to correcting itself. You need properly working leptin to burn body fat and that's not achieved through the consumption of coconut oil, but through the normalization of insulin expression.
Now comes the hard part, lipids. Coconut oil absolutely raises total cholesterol in some individuals more than others. This rise includes both HDL and LDL (lipoproteins) and the rise between the two depends on genetic variability. Coconut oil is composed of a variety of fatty acids but it's the lauric, myristic and palmitic acids which produce the main effects on LDL. What does that mean? We don't know. The reason we don't know is because rise and fall in lipoproteins do not tell us a thing about whether their function is benign or malignant. We usually discover this when you drop dead of a heart attack, not before.
Unfortunately, lipoprotein function is extremely complicated and science has not caught up with what exactly causes lipoprotein pathology. For this reason, the go-to "treatment" is to lower all lipoproteins (total cholesterol). The premise is that lowering them might cause some good and certainly no harm. That has not panned out for the majority of people but it has for a small segment.
There is a small segment of the population that has an LDL abnormality which puts them at high risk for heart disease and no, it's not simply hypercholesterolemia though it falls under that umbrella. There are actually many forms of hypercholesterolemia, many which are benign. After all, hypercholesterolemia simply means "high cholesterol". Instead, this malignant form of hypercholesterolemia is an actual LDL malfunction which is not fully understood as it is not known if the malfunction is in the LDL itself or in various apolipoproteins or both or what. What is known is that these people benefit significantly from an aggressive reduction of LDL. For this reason, we know that LDL is implicated in the atherosclerotic process but no one knows exactly how it becomes pathological.
To make matters even more complicated, many people have LDL malfunction with absolutely no rise in its levels. In fact, that is the most common form of LDL malfunction. This is why the vast majority of people suffer from heart disease or die of heart attacks with low to normal total cholesterol. I am no even taking into account all of the cardiovascular disease that is not lipid related at all.
I tried to keep the above explanation as simple as possible because it's an extremely complex topic and goes way beyond the scope of this blog. It is so complex than even lipidologists, who have dedicated their entire lives researching this, have differing opinions on what has been found so far. Worse, this is not only complex, it is not helpful to you. It's interesting. It's fascinating. But it's not helpful, particularly for those trying to resolve their metabolic syndrome. This is what irks me about "low carb doctors". They are trying to act as if they know about a subject matter that is so incredibly difficult, and goes way beyond the scope of their practice and knowledge, that they shouldn't be advising on it at all. All they want to do is find an excuse for you to continue taking their snake oil, even if it's at your detriment. Well, I don't sacrifice people in order to push an agenda.
For this reason, the best approach that someone should take with their cholesterol is that of caution. That's how we deal with this subject matter on this blog – very cautiously, because unlike "low carb doctors", I do not claim to know everything and I am certainly not a lipidologist.
Use common sense and stay away from coconut oil if it's raising your LDL cholesterol. In fact, you should stay away from coconut oil even if it's not, particularly if you have a family history of heart disease. This is because you can be one of those people that simply cannot metabolize these fatty acids well and end up with early onset heart disease. No one will be able to tell you in advance if you are that person or not until you have heart disease, unless you are able to perform extremely expensive genetic lipid testing that has to be interpreted by a lipidologist. If your doctor has issues prescribing you an insulin test, you can only imagine how they will feel about a rare genetic test, that they might not have even heard of before. Don't wait for your doctor and don't wait for a heart attack to get answers. You also don't want your answers coming from a low carb bozo. You have to advocate for yourself. Stop putting your health in someone else's hands.
The vast majority of us are of ancestry that did not evolve consuming coconut oil. Particularly not out of a hunter/gatherer environment. Coconuts are quite rare. They are only available in very specific regions. This means you can easily swap out coconut oil for ghee and not eat gallons of it. If your lipids are particularly sensitive, you can swap out all saturated fats for monounsaturated fats and still be in ketosis. Like I said before, ketosis is only beneficial if it's coming from the burning of your own body fat and that is achieved through very low carbohydrate intake.
5. I want to follow this diet but I get tired of eating the same foods.
I am assuming that "this diet" is referring to low carb diets as you never specified.
Every time someone comes with this type of complaint, I know they are full of BS. On planet earth, food only comes in two forms - meat and vegetables. This means that there isn't much variety on what to eat except by preparing and combining these items in different ways with varying spices and herbs. What you are truly tired of eating is food. You want junk and I can't help with that.
I have said before, that on this blog, we do not coddle obesity by giving credence to excuses. You either follow the diet properly, or you don't. You always have a choice. You can choose to remain obese.
6. I am struggling with staying carnivore. I just think my “addiction” is very strong.
This is a blog for advice on metabolic health. We are not a sobriety group so we do not recognize “addiction”, in the context of food, as a legitimate condition. Here, we only recognize habits, excuses and negligence.
Changing your diet is a very difficult thing to do as all living things are creatures of habit and seek to continue with familiar norms. But if you are truly concerned with your health and lifespan, then you would do whatever it takes to correct it. This should take precedence over the desire to keep old habits.
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