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This is a continuation of the keto journey. Previous articles:

Diet progress update:

Diet progress

Diet progress

I have now updated the graph to include a moving average (7 days) for calorie intake, indicated by the red dashed line. The idea is to get an idea of calorie intake over time on average, as it's not clear based on daily intake, even looking at the raw line.

As you can see, the average calorie intake has mostly stayed under 1000 kcal, other than at Christmas where some celebrations were had. In the last month or so though, I have been averaging about 1250 kcal. I have been exercising more to match, walking almost every day for 30 minutes or more. I suspect this increased exercise has driven me subconsciously to increase intake too, but now that I see it, I must control it.

The extra 250 calories may have contributed to a slow-down in weight loss. As it stands I am about 20kg away from where I believe I should be at this graph, and realistically my chances of catching up now are almost impossible. I will need to do a rain check soon about whether it will still be possible to begin to end this diet around the Christmas period, or whether I will be looking to continue it past this time.

Recap

As is now tradition, I will address the points I previously made:

Next up...

Social

This section has worked well for tracking my updates through the use of the #keto tag. Here I will address the points since the last update.

I never did get to the bottom of the ill feeling. I have noticed that foods containing high amounts of sweetener, such a low-carbohydrate chocolate containing tonnes of Stevia, really screw me up. Getting steak and broccoli into my system really seems to fix it, it seems to be a good balance for me personally.

I've noticed generally that I am much more accountable for each individual food I eat now. When I was eating more, I think there was some 'dilution' effect and I could essentially eat anything with little to no compromise. During these days I need to be a lot more careful.

I remember seeing this news about a meat tax being introduced and was quite annoyed, especially as somebody who consumes so much of it. I will eventually return to the UK and be hit by this, but also many Countries in the Five Eyes seem to tend to test laws in one region before rolling it out to the others. I am very sure that if it's successful, New Zealand will also roll out such a tax (but not without massive backlash from their meat industry).

I don't doubt that there is not some issue with the meat industry and methane emissions, etc, but there is probably a better way to deal with the problem. This seems like something that could potentially be solved almost outright. I really hate these heavy-handed approaches that do not even encourage better solutions, i.e. at least a meat tax based on how much damage is done to the environment.

Bare in mind also that this is essentially a tax on poor people's nutrition. Middle-class and upper-class earners will still buy meat as normal, it'll only be the poorer people who suffer as a result of this tax. Given how much health benefit a high-meat diet has had for me over the last months, I think this is truly a disservice to the working class.

I intend to discuss this shortly in the Medical Results section.

This is for sure one of the largest problems with being in ketosis - if you over burn through your energy reserves it takes a while to bounce back. This has happened to me a few times now. This is certainly where carbohydrates excel over fats and proteins.

Hearing that the UK's Labour MP Jess Phillips had been successful on a keto diet was pretty awesome news, even if it was not really reported on in the press itself. I really hope that more people become aware of the benefits of a keto diet. One of the most effective ways to improve quality of life, live longer, think better, beat depression and survive COVID is simply to lose weight. I really feel like the benefits of weight loss are not hammered home enough, and our 'fat acceptance' society let people get away with believing that medical Science will somehow keep them running indefinitely as they abuse their bodies. This simply is not true.

I unfortunately got an ear infection due to a mishap with falling asleep with headphones in, damaging the inside of my ear. Apparently it was only an outer-ear infection, which as ear infections go is the one you want as it's most easily treatable.

One thing that seemed to surprise many people was my complete lack of fever as a result. Apparently it almost guaranteed that a person gets a fever, which is a good sign they are tackling the infection. I got nothing. I'm not entirely sure if that's good or bad, either my immune system refused to wake up to deal with the problem, or it's too powerful and barely put in any effort to deal with the problem.

This isn't the first time I have somehow gotten off lightly from being ill either. Some weeks back I was in close proximity with two people that were very ill, and got absolutely nothing. I have no idea what is going on there.

It turned out that my other ear did end up going, which means I suspect the infection travelled through the sinus system. Mine doesn't work particularly great at the best of times anyway, with congestion always being something I'm fighting back. On the plus side, the other ear did clear up pretty quick due to me being pretty fast to treat it.

The painkillers have so far absolutely screwed me over, they make me feel really rough. To combat that I have increased calories to try and push back on the feeling, but this has only helped so much. I need to go back to reduced calories soon though, as the graph shows.

I'll discuss this shortly in the Medical Results section.

We still have no idea what is causing the muscle cramps, but in the next few days I have an appointment to see a dietician and I guess we will go over things in quite a lot of detail. The muscle cramps are still really quite real, and have now spread to my arms. Just the other day during shopping I almost dropped the shopping basket as my arm went into cramp. I'm getting better at noticing when they are about to occur though, and can usually position my muscles in such a way that they do not go fully into cramp. One amusing side-effect is that it has made some friends cautious to be around me whilst out and about, as the chances of a cramp whilst doing something seems quite high during these days.

The GuyLian no added sugar milk chocolate is dangerously good, it's night and day compared to the Well Natural brand and doesn't give me a stomach ache. That said, the carbohydrates are higher and it's extremely easy to consume too much. I will have to stop buying it as I see it as a potential trap for weight loss. I have a goal to reach ultimately.

This was a realization that was quite close to home after watching a video discussing somebody with an eating disorder, I am for sure very high risk of being there myself. I have to be obsessive about my food intake in order to make the keto diet work correctly, but as a result, this has induced some of the non-ideal mentality I remember from previous weight loss, specifically that of anorexia.

Looking at me now you certainly wouldn't think that I previously had an issue with anorexia or that I am currently at very high risk of it, but that's the truth. Currently the idea of eating sugar repulses me and I don't really want to stop this diet, even if I had to.

So far all of the safe guards I put in place (i.e. people to keep an eye on me) have been ineffective, as they have a habit of being overly cautious and I cannot reliably give them information about the current state of the diet without them panicking too much. Essentially any problem I raise has them suggesting 'maybe you should stop the keto diet' or 'try a less strict keto diet', without really knowing what they are talking about. Somehow I need better safeguards to actually protect me against being underweight or from malnutrition.

For now though things are okay - but the idea is not to wait until they are not okay. Being consciously aware of my thought process, I aim to try and prevent issues occurring - especially when so far from home. I will continue to think about this problem and look towards a proper solution.

Medical Results

TL;DR: I got some blood tests done to try and figure out why I have muscle spasms. The suspicion was that I have a vitamin deficiency due to this strict diet, but looking at these results there is no such issue. My levels are remarkably normal.

The GP also seemed to be quite impressed with the results. Given my current weight, the values shouldn't be nearly this good. Generally my numbers reflect that of a younger, healthier person. You can't really ask for much more than that!

I apologise for the format, but it's pretty much how I received the results - and should help for anybody searching online for results to compare theirs too. Usefully these results were uploaded by the GP to an electronic system and they also indicate normal ranges beside the values to help more easily flag up any weirdness.

As you read through this, bare in mind that I am not a medical doctor, so take my words and advice with a pinch of salt. So, now for the juicy details.

Complete Blood Count

According to Mayo Clinic:

A complete blood count test measures several components and features of your blood, including:

  • Red blood cells, which carry oxygen
  • White blood cells, which fight infection
  • Hemoglobin, the oxygen-carrying protein in red blood cells
  • Hematocrit, the proportion of red blood cells to the fluid component, or plasma, in your blood
  • Platelets, which help with blood clotting

Abnormal increases or decreases in cell counts as revealed in a complete blood count may indicate that you have an underlying medical condition that calls for further evaluation.

Haemoglobin:155 g/L ( 130 - 175 )

Haematocrit:0.48 Ratio ( 0.40 - 0.52 )

MCV:91 fL ( 80 - 99 )

MCH:30 pg ( 27 - 33 )

Platelets:313 x10e9/L ( 150 - 400 )

WBC:8.1 x10e9/L ( 4.0 - 11.0 )

Neutrophils:4.9 x10e9/L ( 1.9 - 7.5 )

Lymphocytes:2.2 x10e9/L ( 1.0 - 4.0 )

Monocytes:0.8 x10e9/L ( 0.2 - 1.0 )

Eosinophils:0.1 x10e9/L ( < 0.6 )

Basophils:0.1 x10e9/L ( < 0.3 )

Liver Function Panel

According to Mayo Clinic:

Liver function tests can be used to:

  • Screen for liver infections, such as hepatitis
  • Monitor the progression of a disease, such as viral or alcoholic hepatitis, and determine how well a treatment is working
  • Measure the severity of a disease, particularly scarring of the liver (cirrhosis)
  • Monitor possible side effects of medications

Liver function tests check the levels of certain enzymes and proteins in your blood. Levels that are higher or lower than normal can indicate liver problems.

Total Bilirubin:15 umol/L ( 2 - 20 )

Alk. Phosphatase:70 U/L ( 30 - 150 )

GGT:15 U/L ( 10 - 50 )

ALT:17 U/L ( 0 - 40 )

AST:16 U/L ( 10 - 50 )

Total Protein:80 g/L ( 64 - 83 )

Albumin:47 g/L ( 32 - 48 )

Globulin:33 g/L ( 25 - 41 )

The albumin levels are pretty high, but this is expected as it plays a large part in fat metabolism. Being on a keto diet, one would expect a lot of fat metabolism happening.

Calcium/Phosphate

According to Privia Medical Group:

Calcium - most calcium is in the bones. This test does not measure that. This is calcium in the bloodstream, important for proper function of the muscles. Abnormal calcium levels are usually associated with malfunction of the parathyroid glands, or with severe illness. Often calcium levels will be slightly outside normal ranges associated with either high or low total protein levels. This is because calcium is attached to proteins in the blood. In this case, calcium is probably normal.

Albumin - Albumin is a protein produced by the liver. Low levels of Albumin are associated with liver disease.

Additionally, according to Web MD:

Phosphate is what you get when you combine the mineral phosphorus with oxygen. When you eat certain foods -- such as beans, nuts, cereal, milk, eggs, beef, chicken, and fish -- phosphorous enters your intestines. When it meets up with oxygen, it becomes phosphate.

Most phosphates team up with calcium to build and repair your bones and teeth. Some support your muscles and nerves.

Calcium:2.6 mmol/L ( 2.2 - 2.6 )

Phosphate:1.2 mmol/L ( 0.8 - 1.5 )

Albumin:47 g/L ( 32 - 48 )

Adjusted Calcium:2.5 mmol/L ( 2.2 - 2.6 )

Adjusted calcium is less reliable when albumin is < 25 or > 45 g/L.

Interpret with caution.

Calcium is borderline high, but I eat a lot of cheese in my diet. Adjusted calcium is about what is expected.

Renal Function Panel

According to Health Labs:

Sodium - Sodium is the final of the three major electrolytes your body utilizes to control fluid balance inside and out of cells, among other functions. High sodium levels could indicate kidney disease because the body is unable to effectively remove the correct amount.

Potassium - Potassium is an electrolyte that assists in many bodily functions like water balance, digestion, and nerve impulses. Kidney disease can cause both high and low potassium levels

Creatinine - A waste product that comes from normal wear and tear on the body’s muscles. Creatinine levels in the blood vary depending on age, race, and body size, but a creatinine level greater than 1.2 for women or greater than 1.4 for men may be an indicator that the kidneys are not working properly. The level of creatinine in the blood rises as kidney disease progresses.

Estimated Glomerular Filtration Rate (calculated) - This is a calculated measurement of how well the kidneys are removing waste and excess fluid from the blood. Your age, race, sex, and creatinine levels are all considerations when this calculation is made. The normal value for eGFR is 90 or above but this can decrease with age. An eGFR below 60 is a sign that the kidneys are not working properly. An eGFR below 15 indicates kidney failure.

Sodium:140 mmol/L ( 135 - 145 )

Potassium:4.4 mmol/L ( 3.5 - 5.2 )

Creatinine:66 umol/L ( 50 - 110 )

eGFR:126 mL/min/1.73m2

Reporting of eGFR assumes stable renal function. The GFR range for a young

adult male is 87-167. From age 30, values fall by approximately 1

mL/min/year.

Lipids Master Panel

According to Self Decode:

Total Cholesterol - Total cholesterol is just the total amount of cholesterol in the blood. It is a combination of LDL-C, VLDL-C, and HDL-C. Higher total cholesterol levels are linked to an increased risk of heart disease.

LDL Cholesterol - LDL-C is known as “bad cholesterol” because it can become lodged in the walls of blood vessels and cause fatty plaques and hardened arteries. As you would expect, high levels are strongly linked to heart disease.

VLDL Cholesterol - VLDL-C is also considered “bad cholesterol” because it can become lodged in blood vessel walls and contribute to plaque formation. Like LDL-C, it can cause hardening of the arteries and higher levels are linked to an increased risk of heart disease. VLDL-C is usually not measured directly but is instead calculated using your triglyceride levels. You can calculate your VLDL-C by simply dividing your triglycerides value by 5 if it is in mg/dL. If your triglycerides value is in mmol/L, then divide by 2.2.

HDL Cholesterol - HDL-C is known as the “good cholesterol” because it counteracts the effects of LDL-C by removing cholesterol from blood vessel walls and taking it to the liver to be removed. As a result, higher levels are linked to a decreased risk of heart disease.

Triglycerides - Triglycerides don’t cause heart disease directly but high levels are linked to an increased risk of heart disease due to their association with high VLDL-C levels. Very high levels (> 1,000 mg/dL) can also increase the risk of an inflamed pancreas (pancreatitis).

Fasting status:Not stated

Cholesterol:4.7 mmol/L HH

Triglyceride:1.0 mmol/L

HDL Cholesterol:1.37 mmol/L

LDL cholesterol:2.9 mmol/L HH

Chol/HDL Ratio:3.4

Comment:Optimal levels are suggested by the Guidelines Group (see https://tinyurl.com/CVRA-NZ-18) although an individualised multi-factorial approach is preferred. Address all risk factors where 5y risk >10%.

Glycated Haemoglobin

According to Web MD:

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. It’s a lot like a baseball player's season batting average. A single game doesn't tell you how a player is performing in their career. And 1 day's test results don't give you the complete picture of how your treatment is working.

HbA1c:29 mmol/mol ( 20 - 40 )

If used as a screening test, diabetes is virtually excluded.

If diabetic and treated with insulin/sulphonylureas, the risk for

hypoglycaemia is increased.

HbA1c may be misleading in some situations (e.g.

haemoglobinopathies, increased red cell turnover or after recent

blood transfusion). Glucose-based diagnostic criteria should

always be used in situations where HbA1c is unreliable.

The GP seemed particularly pleased about this result, suggesting I am low risk of becoming diabetic. This also reflects the attitude of the doctor in my medical for my visa.

Iron Studies

According to Web MD:

A ferritin test measures the amount of a blood protein called ferritin, which stores iron. Think of your body as a kitchen pantry. Most of it is stocked with food you use every day. But you keep some items in there long-term -- an extra box of pasta or can of beans to have on hand when supplies get low.

Your body stores iron the same way. It uses some of the iron it gets from food right away to make oxygen in your blood. But it also keeps some iron on hand for times when you aren’t getting enough from the food you eat.

The iron is stored in a protein called ferritin. To see how much is in your body, your doctor might order a ferritin blood test.

Ferritin:145 ug/L ( 20 - 350 )

Thyroid Function Tests

According to Healthline:

A thyroid-stimulating hormone (TSH) test measures the amount of TSH in the blood. TSH is produced by the pituitary gland, which is located at the base of your brain. It’s responsible for regulating the amount of hormones released by the thyroid.

The thyroid is small, butterfly-shaped gland located in the front of the neck. It’s an important gland that creates three primary hormones:

  • triiodothyronine (T3)
  • thyroxine (T4)
  • calcitonin

The thyroid controls numerous different bodily functions, including metabolism and growth, through the release of these three hormones.

TSH:2.4 mIU/L ( 0.40 - 4.00 )

B12/Folate

According to Health Research Funding:

B12 is essential for nerve function. Folate helps B12 be able to form normal red blood cells, help to repair cells and tissues, and even provide DNA synthesis. If these vitamins are not at normal levels, the damage that occurs within the body may not completely repair itself, which is why this blood test is ordered on a regular basis to determine the state of a person’s general health.

Serum B12:679 pmol/L ( 170 - 600 ) HH

Serum Folate:13.3 nmol/L ( > 8.0 )

The B12value is quite high, I specifically recount telling my GP that my urine goes bright yellow after taking a multivitamin. Despite this, the GP still recommends that I take one once every 2-3 days, but honestly I suspect this is still too high for me. It's only slightly out of range and apparently there is really not so much harm in this value being elevated, especially as we know it is attributed to increased vitamin intake.

Medical Conclusion

As you can see, all of my results are within normal expected range and the only value outside of range (B12) is through over supplementing via vitamins, and not a sign of anything crazy going on. I still do not know what is causing muscle spasms, but generally it is good to know you are in good health in any case.

Although your medical mileage may vary, this may act as a good baseline for somebody to compare their results to, especially if they are in their late 20's and male, with no known previous medical issues. Again, this is not medical advice. Take this all with a pinch of salt.

Next Steps

In the next steps, I plan to:

Until next time!