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Yes, the carb backloading approach can definitely help. Honestly I have SO MANY ARTICLES here on the site about sleep. Just go ahead and use the search bar for sleep and you'll find a plethora of info. For targeted sleep advice, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]
I just discovered your site and have been thoroughly enjoying many of the articles and appreciate that you get so in depth in your explanations. I’m in my late 40’s and, while not an extreme endurance athlete, I am moderately active with 18-20 mile rides 3x a week as well as some boxing and body weight resistance (push up, pull up, etc) mixed in. I’ve generally been paleo and stick to quality macros for the most part (grass fed meats/dairy, organic veg and oils) and zero supplements. I recently started following keto (after reading this article) about 10 days ago and things seem good thus far. I do, however, want to avoid any of the negative side effects you mention and also not lose any lean muscle. I’m currently about 174 lbs, 5’8″ and about 19% bodyfat – I’m taking in about 95g protein, 130g fat and <20g net carbs. I'm eating all quality – wild salmon, grass fed beef, pastured eggs, coconut oil, Brain Octane and Grass fed butter in coffee, sardines, etc. With a smattering of organic veg, but it seems real easy to bust through the carb barrier. *I'M ALSO TAKING KETOCANA PRE-WORKOUT* and I notice this is keeping me going throughout a ride or the gym.
Anticonvulsants suppress epileptic seizures, but they neither cure nor prevent the development of seizure susceptibility. The development of epilepsy (epileptogenesis) is a process that is poorly understood. A few anticonvulsants (valproate, levetiracetam and benzodiazepines) have shown antiepileptogenic properties in animal models of epileptogenesis. However, no anticonvulsant has ever achieved this in a clinical trial in humans. The ketogenic diet has been found to have antiepileptogenic properties in rats.[56]
The ketogenic diet is not a benign, holistic, or natural treatment for epilepsy; as with any serious medical therapy, complications may result.[28] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[28] Common but easily treatable short-term side effects include constipation, low-grade acidosis, and hypoglycaemia if an initial fast is undertaken. Raised levels of lipids in the blood affect up to 60% of children[38] and cholesterol levels may increase by around 30%.[28] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and if persistent, by lowering the ketogenic ratio.[38] Supplements are necessary to counter the dietary deficiency of many micronutrients.[18]
The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients.[18] Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[9] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[1] Some evidence indicates that adolescents and adults may also benefit from the diet.[9]
A lot of changes are happening in your body and you’re going to feel it! The first five to seven days can be pretty rough, but your body is getting over its dependency on sugar. During this time of transition it is essential that you supplement electrolytes. Your body is flushing out lots of water, and with that goes electrolytes. The Keto Flu can be greatly reduced if you add sodium, potassium and magnesium to your diet. Check out our supplements page for a list of electrolyte supplements we recommend. Stay on course and you’ll start feeling better in no time!

-Nervous System Damage: It’s been shown that patients with neuropathy whose after-meal glucose readings were above the diabetic threshold sustained damage to their large nerve fibers. Even neuropathy patients whose glucose readings remained well within the normal range showed damage to their small nerve fibers. Studies have shown that within any blood sugar range, the higher the glucose, the greater the damage to nerve fibers.
I'd recommend starting with glucose and hemoglobin A1C, along with a good multi like https://bengreenfieldfitness.com/multi and a fish oil like the one at greenfieldfitnesssystems.com – Anyways, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
They mimic ketosis, to answer your question in short. Best to get fat adapted and use ketones to get the best of both worlds and to enhance fat burning abilities. They will allow you to use glucose and fatty acids simultaneously, yes. Anyways, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
In this study by Dr. Dominic D’Agostino it is also mentioned that your blood brain barrier (BBB) “is relatively impermeable to most hydrophilic substances, such as ketone bodies. Therefore, the transport of ketones across the BBB is highly dependent on specific carrier-mediated facilitated transport by a family of proton-linked monocarboxylic acid transporters”. Basically, what this means is that MCT powder may act as a carrier to shuttle the ketone bodies across the BBB.
These are the widely recognized LCT’s, or long chain fatty acids in coconut oil, mostly saturated, including stearic acid (C18:0), oleic acid (C18:1), and linoleic acid (18:2). The exact percentage of each depends on region the coconut is grown, time of harvest, and other growing variables. They are good as a fuel source in your food, and have some of the tastiness of coconut oil, if your goal is getting into ketosis fast, you won’t benefit from eating a lot more of them compared to eating true medium chain fatty acids.
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]
^ Greenberg CR, Dilling LA, Thompson GR, Seargeant LE, Haworth JC, Phillips S, Chan A, Vallance HD, Waters PJ, Sinclair G, Lillquist Y, Wanders RJ, Olpin SE (April 2009). "The paradox of the carnitine palmitoyltransferase type Ia P479L variant in Canadian Aboriginal populations". Molecular Genetics and Metabolism. 96 (4): 201–7. doi:10.1016/j.ymgme.2008.12.018. PMID 19217814.
Signs of diabetic ketoacidosis include a high blood glucose level, a high ketone level, dehydration, frequent urination, nausea, difficulty breathing, and dry skin. If you have poorly managed type 1 or type 2 diabetes, test your blood glucose level regularly before and after meals, and make sure you check your ketone level whenever your blood sugar is higher than 240 milligrams per deciliter (mg/dL). (11)
But wait, there’s one loophole. Have polycystic ovary syndrome (PCOS)? Then the keto diet may help regulate your periods. “Women with PCOS have high insulin levels, which cause sex hormone imbalances,” notes Yawitz. In a small study published in the journal Nutrition & Metabolism, subjects with PCOS following a ketogenic diet for six months noted improvements in their menstrual cycles — and a small number of women became pregnant, overcoming previous infertility obstacles. “This study was very small, so we can’t make recommendations for all women with PCOS based on its findings,” says Yawitz. “And really, any diet that leads to weight loss should help in PCOS.”
I'm at 240 now and actually weigh less than I did in high school. Have a decent amount of excess skin that skews my actual weight. Thankfully the government of Canada pays for plastic surgery in my case because it could lead to health problems in the future. Surgery is in about 8 or so months and I'm quite excited to start a completely new chapter of my life once it's done.

Cyclical keto diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes.[9][10]  Learn more here about how carb cycling works.
On the ketogenic diet I feel very shaky/anxious from when I wake up til about noon. Eating doesn’t really help. It could be electrolyte related but seems possibly more related to excess cortisol/adrenaline as noon is also when I start to crash and get tired on a more normal diet, and because those 3 am awakenings that worsen simultaneously in ketosis seem to also have to do with HPA axis stuff. Does this side effect potentially also have to do with my fasting blood sugar being elevated?

Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.[18][50]
Following the ketogenic diet and achieving ketosis may be beneficial if you’re living with type 2 diabetes and need to manage your symptoms. Limiting carbohydrate intake is crucial with type 2 diabetes because too many carbs can increase blood glucose levels, which can damage blood vessels and lead to vision problems, kidney problems, and nerve problems.
Frankly, the results of my foray into ketosis and eventually keto-adaptation were astounding. I had the best Ironman triathlon season of my life and shocking levels of mental focus and physical ease, especially for races and workouts that lasted longer than two hours. Without experiencing muscle loss, hunger pangs or brain fog, I found I could go the entire day without eating, which was enormously helpful for business and personal productivity. My gas, bloating, fermentation and GI “issues” disappeared. My blood levels of inflammatory markers like HS-CRP and cytokines dropped to rock-bottom, while my levels of good cholesterol, vitamin D, and anti-inflammatory fatty acids skyrocketed.
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]
-Cardiovascular Disease: High blood sugar has been shown to increase the risk for cardiovascular events, cardiovascular disease, and cardiovascular mortality—while lower glucose levels result in lower cardiovascular risk. Coronary artery disease risk has been shown to be twice as high in patients with impaired glucose tolerance, compared with patients with more normal glucose tolerance. The risk for stroke increases as fasting glucose levels rise above 83 mg/dL. In fact, every 18 mg/dL increase beyond 83 results in a 27 percent greater risk of dying from stroke. Incidentally, glucose can “stick” to cholesterol particles and render these particles extremely dangerous from a heart health standpoint, which is why it’s all the more important to control blood sugar levels if you’re eating a “high-fat diet.”
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