We’ve been gone for several weeks as Jimmy and Will have dealt with the busyness that comes with summer, but we’re back for a couple of months before Jimmy heads off for his much deserved six-month sabbatical (more on this coming up). In this episode of Keto Talk, Jimmy and Dr. Will Cole answer your questions about Therapeutic vs. Fat Loss Ketosis, Impact Of Dietary Fat On Reflux, Trigeminal & Occipital Neuralgia Migraines, Ankle Swelling, and more!

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“Sometimes even in the context of the Keto Diet, you need to address other problems like binge eating.”

— Dr. Will Cole

 Where have Jimmy and Will been the past two months?

• Jimmy’s experience and insights slowing down heading into his 6-month sabbatical
• Will’s successful new podcast goopfellas and the new opportunities that have come his way

HOT TOPICS:

• Why do I still want to binge eat even eating low-carb, ketogenic foods?
• What’s the deal with dietary fat intake when you first start keto vs. when you become fat-adapted? 
• Why does my menopause keep making me want to go back to eating carbs again?
• What impact do essential oils have on blood ketone levels? Mine go way up when I use them!
• Are the at-home A1c testing kits (like A1c Now) accurate or should it be tested at your doctor’s office?

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“I’ve noticed that just the act of slowing down has caused me to think about things I haven’t had time to think about and it’s spilling out.”

— Jimmy Moore

HEALTH HEADLINES:

• 6 Signs Your Keto Obsession Has Spiraled Into An Eating Disorder
• On Keto? 8 Signs the High-Fat, Low-Carb Diet Isn’t Right for You
• I lost more than 120 pounds on the keto diet. Here’s why I’m quitting it.
• Defense Department to ban beer and pizza? Mandatory keto diet may enhance military performance
• Arby’s has flipped the vegan ‘meat’ trend on its head with the ‘megetable,’ a carrot made out of turkey that looks and tastes almost exactly like the vegetable
• STUDY: Low-Carb ‘Keto’ Diet (‘Atkins-Style’) May Modestly Improve Cognition in Older Adults

Your Questions:

– Is it possible to be in a therapeutic level of ketosis that isn’t ideal for producing adequate fat loss?

Hey guys,

I have been doing keto religiously for the last six weeks and I already love it! I lost eight pounds pretty quickly and then it slowed down dramatically ever since. I started testing my blood ketones and had a 2.5 reading in the morning. When I calculated my glucose/ketone index, it was 1.67 and I’m concerned that I have reached a therapeutic level of ketosis that’s not conducive necessarily for weight loss. How do I get the fat-burning benefits of ketosis to kick in so I can get off this plateau? I am in a caloric deficit right now eating 1300 calories with my macros being 12g total carbs, 130g fat, and 82g protein.  I try to reach a gallon of water a day, I sleep 7-8 hours a night, and my stress levels are good. I also workout 5-6 days a week, do 3 days of heavy lifting a week, and two days of HIIT training. Overall, I feel great in terms of my energy and strength. What do you think is going on with me?

I really appreciate any and all help you can provide,

Chani 

– Is the high-fat aspect of keto making the symptoms of LPR worse? What can someone with this do?

Hi Jimmy and Will, 

Ever since going keto I’ve developed a case of laryngopharyngeal reflux (LPR)—no real heartburn, just throat burning, trouble breathing, coughing, ear ache, stuffy nose, etc. I’m convinced all these symptoms are a result of the high-fat intake on my ketogenic diet. A number of people online have been reporting similar symptoms after starting on nutritional ketosis and seeing it resolve after going off of it. I’ve even seen my dad who had this same condition and doesn’t eat keto have problems, too, because of the fat he eats in his diet. So what do I do? I’ve tried using digestive enzymes, eating smaller meals, reducing my fat as much as possible while still trying to maintain ketosis, but nothing seems to work. I’ve been tested for H. Pylori twice, but both times it came back negative. I’m using keto specifically for my mental health, so I really don’t want to give it up since I’m getting those benefits. I’m at a loss about what to do. Can you help?

Many thanks, 

Eric

– Will a ketogenic diet give me relief from my constant migraines due to trigeminal/occipital neuralgia?

Hi Jimmy and Dr. Cole,

I recently discovered the Keto Talk podcast in January and I’m really loving it so far. I have been experimenting with a keto diet for managing trigeminal/occipital neuralgia that gives me nearly constant migraines all the time. I had nerve decompression surgery last year and while it has helped, it’s still not as much as we’d hoped it would be. I’m hearing a lot of people in the migraine community say they have eliminated their migraines completely with keto nutrition. My doctor are completely skeptical about that and they keep saying I’ll see little to no effect from changing my diet. The ironic part is the daily medicines that I am taking to manage this—Lyrica, Vimpat, Metroprolol and the emergency pain medicines Trammadol, OxyContin, and a clonidine tablet for high blood pressure negatively impacts my metabolism enough that it makes someone like me trying to get into ketosis that much harder. What do you think about this and how I should proceed?

Thank you for all you do, I appreciate your show and I have learned so much listening. I’m working my way through older podcasts as well as the current ones.

Rebekah

– What do I need to tweak in my ketogenic diet to keep my ankles from swelling up in warmer weather?

Hi Jimmy and Will,

I’ve been keto for 10 months with blood ketones ranging from 0.4-2.1 and my A1c is very healthy at 5.0.  I’ve learned so much from your show and was hoping you could offer advice on how a ketogenic diet and/or certain supplements could help me control swelling in my ankles that tends to happen when the weather warms up.  I’m 53 years old and have lost about 30 pounds since starting keto. Three different doctors have all told me that need to be wearing compression socks or taking water pills to help with this. I was really hoping that keto would help with this problem,  but with the warmer weather my left ankle is swelling up.  I walk 3 miles a day for exercise but also sit a lot for my work.  The swelling generally goes away overnight, but returns the next time I have to sit a lot for work or when I travel.  I drink plenty of water and supplement with 400-600mg of  magnesium oxide and pink Himalayan sea salt everyday.  Is there anything else I can do to help control this swelling?

Thank you so much for any advice you can offer!

Tamara

KETO TALK MAILBOX:

– How can eating a ketogenic diet help me with the loud tinnitus I’m experiencing from Meniere’s disease?

Hi Jimmy and Dr Cole,

I love you two SO SO much! I never miss an episode. Dr Cole worked with my mother and completely changed her life! My question for you guys is about Meniere’s disease and keto. I was recently diagnosed with this and I have had tinnitus ever since I can remember. Two and a half months ago, the ringing suddenly got really loud nearly overpowering all the other noises surrounding me. Needless to say, my sleep quality dropped and after seeing an ENT, Chiropractor, Audiologist, an Acupuncturist, and even an Atlas Orthogonal, I am spiraling out of control, exhausted, and not knowing where to turn. My general practitioner told me I had to change my diet from keto to eating more FRUITS, VEGETABLES, and WHOLE GRAINS. He also said I had to lower my salt significantly. Honestly I would do anything at this point to make it go away, but I can’t with good conscious and two other autoimmune diseases (Interstitial Cystitis and Reynauds) switch to a high-carb, low salt diet. I tried to explain to my doctor that on keto that it was necessary for electrolytes. What do you guys think about this? 

Thank you for your help,

Sharon