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Strange health fads are not a new or novel idea. For thousands of years, people have been doing strange things to their bodies in order to feel better, lose weight, or simply to fit in. However, the rise of things like the internet, social media, influencers, and celebrity endorsement, as well as the $4 trillion […]

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Research of the Week

Among the working urban poor of Chennai, naps are more effective than more sleep at night.

In the Netherlands, those drinking between 5 and 15 grams of ethanol—or one standard beer, glass of wine, or drink—each day had the highest chance of reaching 90 years of age.

Of milk and health.

Tone deaf? Blame your parents.

Brown fat linked to better metabolic health and lower blood pressure.

New Primal Blueprint Podcasts

Episode 403: Dr. Mark Hyman: Host Elle Russ chats with the man himself, Dr. Mark Hyman.

Primal Health Coach Radio, Episode 47: Laura and Erin chat with Sam Miller, who likes to keep it super simple.

Media, Schmedia

A medical imaging office goes vegan for a month and loses weight, mostly muscle.

Interesting Blog Posts

Did the rest of the world luck out because the coronavirus hit China first?

How to reduce deaths on the road.

Social Notes

Important reminder.

How to eat in a Chinese city on medical lockdown.

Everything Else

The latest Alzheimer’s drug trial fails. “We don’t have anything now.” Maybe try the root cause?

Researcher explores the origin of the common Inuit genetic variant that inhibits ketosis.

I get that IPAs are getting out of hand, but this is ridiculous.

Ancient dates sprout.

Things I’m Up to and Interested In

Podcast I enjoyed doing: Max Lugavere’s Genius Life, where we chatted metabolic flexibility.

Sad news: Dr. Richard Veech passes. RIP.

I simply can’t get my mind around this: A third of British dog owners hope to feed their dogs vegan meals.

Some good, albeit preliminary news: Coronavirus does not appear to affect pregnancy.

Interesting article: Does the nuclear family need revamping?

Question I’m Asking

Do you think the nuclear family model is outdated? How would you update it, if at all?

Recipe Corner

• Everyone should know how to make a good rack of lamb.
• Tasso, the Cajun cured pork.

Time Capsule

One year ago (Feb 8 – Feb 14)

• Is Keto Bad for Cholesterol?– Well, is it?
• How to Accelerate Weight Loss with Fasting– How to speed things up.

Comment of the Week

“Plus workers have to get up so damn early to milk all the almonds!”

– It really is a terrible industry, Lisa.

The post Weekly Link Love – Edition 68 appeared first on Mark’s Daily Apple.

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Close social connections matter for us as healthcare practitioners—in our personal and professional lives. Find out how to cultivate a supportive professional network in the realm of Functional Medicine.

The post The Importance of Social Connection for Functional Medicine Practitioners appeared first on Chris Kresser.

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By now, you’re probably used to seeing food recalls and aren’t surprised when yet another batch of lettuce is contaminated by E. Coli or some other prepackaged product has salmonella or listeria bacteria. When it gets to the point that eating starts to feel like playing Russian Roulette and the recalls just keep coming, it […]

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We have unparalleled abilities to peer inside our bodies and take detailed snapshots of physiological processes and the state of our health. We can measure the hormones in our blood, the cholesterol in our veins, the nutrient deficiencies we may have. We can go deep. But it doesn’t always make sense to take that deeper, more detailed look at the numbers. It gets expensive, for one. It gets intrusive. Our doctors may be resistant. And it can provide a bit too much of a close look when a broader view might suffice.

When do more detailed tests make sense, though? What kind of scenarios call for a second, deeper look at our numbers?

“You’re fit as a fiddle, you’ve clearly lost a ton of weight, but your cholesterol’s a little high. We better get that handled.”

This is the classic scenario seen time and time again in the Primal and keto community.

Killing it in the gym.

Leaner than you’ve been since your teens.

Off all meds.

Pre-diabetes trend reversed.

More energy than ever.

Just feeling great overall.

But your LDL’s a little high. Or a lot. And the doc’s recommending that, while all these improvements are great, we do something about the cholesterol. Before you “take action,” let’s confirm you actually have elevated LDL.

If your triglycerides are under 100, and your LDL is calculated using the Friedewald equation, it will significantly overestimate your LDL numbers.

Say they directly measure your LDL-C and it’s still high. What then?

Then you should measure your LDL particle number. Elevated LDL particle number is what many “progressive” lipid experts say is the true cause of atherosclerosis—by increasing the number of particles in circulation, you increase the number that will penetrate the arterial wall and trigger an atherosclerotic lesion. ApoB is another measurement to take; it’s roughly analogous to LDL particle number, as each LDL particle contains an ApoB protein.

If your LDL-P or ApoB is still high and in the “danger zone,” what do you do? Do you go back on everything that worked for all the other health barometers?

I honestly don’t know. The question of elevated LDL particle number as an independently sufficient cause of heart disease is far from settled (and I suspect there’s more to it than that). But at least with more detailed testing you’re better equipped to have that conversation.

“Your TSH is normal. I don’t know why you’re feeling rundown all the time, but it’s not the thyroid.”

For most people, TSH is the best barometer of thyroid function. After all, if thyroid-stimulating hormone is normal, then your body feels like it’s getting plenty of thyroid hormone. There’s no “emergency.” If TSH is elevated, then your body doesn’t feel like it’s getting enough thyroid hormone. That’s how it usually works. In theory.

But what if your TSH is normal, not elevated, but you’re still feeling all the symptoms of low thyroid activity? What if you can’t get up in the morning, you’ve been gaining weight, you’re freezing all the time, and you generally feel very low energy?

What you don’t want to do is take the “expert” opinion at face value. No, that person who isn’t you doesn’t have unique and superior insight into how you’re feeling. No, the number doesn’t negate your subjective experience of symptoms. If you’re feeling bad, you need to do further testing.

Okay, so what should you test?

You’ll want to start with T4. T4 is “inactive” thyroid hormone that gets converted to “active” thyroid hormone (called T3) throughout the body. The thyroid gland makes mostly T4 and some T3 directly. In most people, a normal T4 means normal thyroid function.

Can you have normal TSH, normal T4, and still have underactive thyroid function? Yes.

If your peripheral tissues that normally convert T4 to active T3 aren’t doing it, you will effectively have poor thyroid function. The thyroid hormone is there, the tests look good; it’s just not doing its job.

Okay, so then you test T3 in addition to T4 and TSH. All good, right?

It’s better because it gives you an idea of active thyroid hormone in circulation, but it might not be enough. Even if your T4 and T3 levels are good, if they remain bound to the protein carrier that delivers them around the body, they can’t perform the jobs we all expect our thyroid hormones to perform.

You may need to test Free T3 and Free T4. Those are “unbound” thyroid hormones. They are the truly active ones.

Another test to consider is the thyroid antibody test. This helps determine whether your thyroid dysfunction is caused by an autoimmune response, and it can help you map your response.

“You’re pregnant.”

You hear these words and time stops. It’s really happening. You’re actually building an entire human being from start to finish—inside your body.

At least, I imagine that’s probably what it feels like. I wouldn’t know from personal experience. Being a father (and now grandfather) is powerful enough.

But it’s a big deal. And it’s a lot of responsibility, especially as a health-conscious individual who reads nutrition blogs and forks out cash for grass-fed meat and avocado oil mayo will understand. You know how important each day of your pregnancy is. You know how the food you eat and the nutrients you are and are not deficient in can affect the trajectory of your baby’s development.

Vitamin D is one of the more important things to test as a pregnant lady. Ideally you’d do this well ahead of time, so you go into it with good vitamin D levels, but testing early in the pregnancy is also a good move. Emerging evidence suggests that vitamin D deficiencies during pregnancy can increase the risk of ADHD in the child.

It isn’t standard. You’ll have to request it. But it might be worth the trouble if you think you’re deficient, especially since it’s an easy fix.

“Your testosterone is normal. I don’t know why you think you might need HRT.”

You can have normal testosterone and still have symptoms of low-T.

Lack of energy. Reduced libido or absent morning wood. Middling results in the gym. Decreased motivation and drive. These aren’t “serious medical conditions,” and many doctors will disregard them if your numbers turn out normal. That doesn’t help you, though, does it? These symptoms are no small matter. They seriously impact your quality of life, productivity, relationships (with yourself and with others), and they presage warning signs for your health down the road (muscle, insulin sensitivity, etc).

If your testosterone looks normal but you still have symptoms, what you need is a full panel that at the very least checks:

• Free testosterone: active testosterone. Just like thyroid hormone, you can have normal testosterone levels but if it’s all bound up and inaccessible, you may have symptoms of low testosterone. Free T gives you a good picture.
• Sex hormone binding globulin: high levels can bind to your testosterone, rendering less of it “free” and bioavailable.

Once you have good information, you can figure out a plan of attack to address your testosterone situation.

That’s it for today, everyone. Can you think of any other situations that call for detailed testing? Let me know down below!

References

Ahmadi SA, Boroumand MA, Gohari-moghaddam K, Tajik P, Dibaj SM. The impact of low serum triglyceride on LDL-cholesterol estimation. Arch Iran Med. 2008;11(3):318-21.

The post 4 Scenarios When Detailed Testing Makes Sense appeared first on Mark’s Daily Apple.

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So many of our behaviors are the default of a faulty environmental set-up. An alarm, a pre-staged gym bag, and a drawer full of healthy snacks can go a long way. But, say your environment is designed to the hilt and your plan is impeccable. You still have to show up and execute.

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Health coaches are trained to help their clients recognize their strengths and tap into that potential to change. Read on for real-world examples of how health coaches help their clients transform their lives.

The post Health Coaching and Client Transformations: Health Coaching in Action appeared first on Chris Kresser.

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There’s a lot to learn when you first go keto, so I figured hey, why not put all the info in one place?

Without further ado, here are my responses to the questions I get asked most often.

What is keto in the fewest words possible?

“Keto” is any diet where carbohydrate intake is low enough that the liver starts producing ketones (hence the name).

Wait a sec, I thought keto is a high-fat diet? Isn’t eating high fat the point of keto?

Nope. It doesn’t matter how much fat you eat; carb intake is the only criterion that makes a diet ketogenic.

That said, on keto most of your calories do come from fat. You need energy, and when carb intake is very low, the body relies on fat and ketones as its primary energy sources. Still, eating more fat doesn’t make you “more keto.”

What’s the difference between Primal and keto?

Some diets are Primal. Some diets are keto. Some diets are both.

Primal is first and foremost about the types of foods you do and do not eat. The Primal Blueprint doesn’t specifically restrict carbs to a certain level, but it’s naturally low-carb by today’s standards. If you aren’t eating grains, added sugars, or (many) legumes, your carb intake will be considerably lower than the average standard American dieter’s.

Keto diets are agnostic when it comes to food quality. The only thing that technically matters is carb intake. Although many versions of keto do recommend grass-fed meat and organic veggies while avoiding seed oils (very Primal sounding, eh?), it’s also possible to be keto, eating cheap hot dogs and “cheez” out of a can.

Of course, I think the healthiest version of keto is one in which you start out with the Primal Blueprint Food Pyramid and reduce carb intake until you are at ketogenic levels (more on this below).

Read more: How Does the Primal Blueprint Fit Into the Keto Reset Diet (and Vice Versa)

What are macros?

The three macronutrients are carbohydrates, fat, and protein. They can all be metabolized into usable energy in the body. Sometimes ketones are called the “fourth macronutrient.”

When folks in the keto diet world talk about their macros, they mean how much carb, fat, and protein they eat daily.

How do I figure out my macros?

Different keto programs offer somewhat different recommendations. In The Keto Reset Diet and Keto for Life, I suggest starting with:

• 50 grams of carbs (gross, or total, not net)
• 0.7 grams of protein per pound of lean body mass
• As much fat as you need to get enough calories and feel satisfied

This is just a starting point. You’ll probably have to tweak your macros to find exactly what works for you. If you do keto for four to six weeks and don’t see any results, try something different. Likewise, if you lose a lot of weight or your goals change, your macros will probably change too.

Notes:

• You might need to start at 30 grams of carbs if you are insulin resistant or have type 2 diabetes.
• If you’re very active or building muscle is your primary goal, increase protein up to 1.0 grams per pound of lean body mass.
• Don’t rely on food tracking apps to set your macros. Calculate them yourself using absolute amounts (grams), not percentages (e.g., 5% carb, 20% protein, 75% fat).

Do I have to calculate my macros and track my food?

There are people who are perfectly happy doing “lazy keto,” where they eyeball everything and hope for the best. I don’t think it’s the best strategy, especially not if you’re new to all this. Most people don’t have a clue how many carbs are in their breakfast or how much protein they eat in a day.

You have to get your carb intake down to get into ketosis. For your body to stay healthy and fit, you also have to eat enough protein and total calories. Yes, weighing and measuring your food takes time and it sucks some of the joy out of eating. Do it anyway—at least do it for the first week. If you have no problem staying below 50 grams of carbs, and you’re getting enough protein and calories, then you’re good. Stop tracking if you want. If at some point you stop making progress, track your food for a few days again.

What app should I use?

I recommend using the Cron-o-meter website or app.

What are net carbs?

Total carbs minus fiber.

Some people subtract the fiber from their carb count because fiber doesn’t significantly affect blood glucose or ketosis. I don’t bother with net carbs because there isn’t a consensus about whether to subtract fiber in all foods or just vegetables. Anyway, people who recommend using net carbs usually limit net carb intake to 20 or 30 grams per day. In practice, that isn’t so different from 50 grams gross (total) if you’re eating mostly whole foods. It’s just another layer of fussiness as far as I’m concerned.

Does fat need to be higher than protein?

In grams, no. However, calories from fat will end up being greater than calories from protein.

Fat has 9 kcal per gram, while protein has only 4 kcal per gram. Even if you were eating 150 grams of protein and 100 grams of fat, that’s only 600 kcal from protein and 900 kcal from fat.

Do I have to limit protein on keto?

The short answer is no. The whole idea that “too much” protein kicks you out of ketosis comes from misunderstanding gluconeogenesis (GNG). GNG is the process whereby your liver makes glucose when your body needs it. (Yes, your body always needs some glucose, even on a keto diet.) GNG is both natural and desirable. Among other things, it ensures the brain always has enough fuel.

The faulty thinking goes like this:

(A) Too much glucose can kick you out of ketosis.

(B) The liver can use certain amino acids from protein to make glucose via GNG.

(C) Therefore too much protein will kick you out of ketosis.

In this case, though, A plus B does not equal C. The liver doesn’t make more glucose than it needs to—it’s a demand-driven process. It’s not going to start dumping huge amounts of glucose into the bloodstream just because you splurged for the tomahawk steak. There are some specific instances in which people doing a therapeutic (medical) ketogenic diet do need to watch their intake. For the average, metabolically healthy person doing keto for general health or weight loss, it’s not a concern.

Read more: Protein Intake During Keto: Why It Matters and How Much You Should Have

What is the keto flu?

It’s when people go keto and feel like they got hit by a truck. The most common complaints are wicked headaches and low energy.

Keto flu can last a few days to up to a week, but it’s largely avoidable. First, if you’re eating a high-carb diet, take a few weeks to taper down your carbs. Give your body time to adjust and build some of its fat-burning machinery rather than dive-bombing into ketosis. Second, make sure you up your electrolyte intake as soon as you drop your carbs to ketogenic levels. Insufficient electrolytes are the number one cause of keto flu. Speaking of which…

What’s up with supplementing electrolytes on keto?

One of the first things that happen when you go keto is that your kidneys start excreting sodium. With sodium goes water (which is why people usually see a big drop in the scale at the beginning) and potassium.

You need to supplement these, along with magnesium, especially during the keto transition. Most people continue to supplement as long as they remain keto. You’d be surprised at how often problems like headaches, fatigue, poor workout performance, and mood swings come down to simply needing more electrolytes, especially salt.

If you’re feeling “off” in any way, the first thing to check is electrolytes. Cron-o-meter (and other food tracking apps) will give you that info. You need 3-5 grams of sodium, 1-3.5 grams of potassium, and 300-500 mg of magnesium.

Read more: Electrolytes and Keto: Why They Matter for the Transition

I heard that __[wheat/rice/mangos/beets]__ aren’t allowed on keto. Is that true?

Foods aren’t “keto” or “not keto.” No food will automatically knock you out of ketosis in a single bite.

Of course, the more carbs a food contains, the harder it is to fit into a keto diet. Bananas are tasty and pack a decent amount of potassium, but a medium banana contains 27 grams of carbohydrate—more than half your daily target. Probably not worth it.

A lot of these so-called rules for keto aren’t really about keto per se. They’re about eating a nutrient-dense, anti-inflammatory diet. It makes me chuckle when I hear people say that you shouldn’t have refined seed and vegetable oils like canola and soybean on keto. You shouldn’t have them on any diet. They aren’t un-ketogenic, they’re just terrible, period.

Read more: Why “Is It Keto?” Is the Wrong Question

How do I know if I’m in ketosis or not?

The only accurate way is by using a blood ketone meter. Don’t waste your time on pee strips. They’re not accurate. Most people who do keto for a while find they don’t pee out many ketones, presumably because their bodies are using them. That’s what you want, obviously.

However, I don’t think it’s important for most people who are doing keto for general health and weight loss to measure their ketones. It’s fine to go by subjective assessments. If you have plenty of energy, can delay or skip a meal without getting hangry, and otherwise feel good, do you need to know your blood ketone level? Probably not.

Read more: Why Am I Getting Low Ketone Readings on a Ketogenic Diet?

How long does it take to become fat- and keto-adapted?

This is a hard question to answer. It’s not a yes/no thing.

Here’s what we know: Once you drop your carbs to ketogenic levels, it takes about two to three days for your liver to start pumping out ketones. Making ketones is different than using ketones, though. Various studies have shown that it takes at least a couple of weeks for the body to upregulate the “machinery” it needs to burn fat and ketones efficiently for energy. The process continues over several months, as different organs and tissues continue to become better adapted.

The short answer is: Expect it to take a few weeks to start feeling “normal” again after going keto. For people who place a lot of energy demands on their bodies, it will likely take longer. I’ve had endurance athletes tell me it took anywhere from three to six months for their performance and energy to return to baseline. Patience is key.

Read more: What Does it Mean to Be Fat-Adapted?

When should I start fasting?

You never have to start fasting. A lot of keto folks end up fasting intermittently because their appetite is reduced. Fasting also supports ketosis—it’s the ultimate carb restriction. However, it’s also possible to do keto successfully without ever fasting.

If you’re new to keto, I think it’s a good idea to wait a few weeks for your body to adapt before adding the additional challenge of intermittent fasting. Doing an overnight fast of 12 to 14 hours should be no problem, but I wouldn’t go keto and start eating in a 6-hour window at the same time. Your body will struggle to fuel itself.

Once you start, increase your fasting window gradually and pay attention to how your body responds. My general rule is eat W.H.E.N.—when hunger ensues naturally.

Read more: Benefits of Pairing Low-Carb Eating with Intermittent Fasting for Health and Weight Loss

I have no energy and my workouts suck all of a sudden. What am I doing wrong?

A few things might be happening here. One, you might not be eating enough food to fuel your activity level. Two, you might need more electrolytes. See the section on supplementing electrolytes above.

Three, you might be working out too hard for how keto-adapted you are. High-intensity workouts are fueled mainly by glycogen (glucose stored in the muscles and, to a lesser degree, liver). When you go keto, glycogen is depleted. Your body is looking to use a fuel that’s not there, at least not in the amounts it needs. That’s why you feel underpowered and draggy.

I recommend scaling back your high-intensity workouts during the transition period. Endurance athletes might also need to shorten their longest training sessions. Even once you’re well adapted, you might continue to struggle depending on how demanding your workouts are. In my experience, keto and hard-core CrossFit don’t mix well, for example. The workouts are just too glycolytic for a lot of people.

You can also try adding back some carbs before or during your hard workouts. It’s called “targeted keto.” I wouldn’t experiment with that for at least the first six weeks, though, to give your body time to adapt.

Read more: Can Keto and Cardio Mix? 

I’m not losing weight. What am I doing wrong?

Weight loss isn’t a guaranteed side effect of going keto, despite how keto is sometimes portrayed. Losing weight can be easier with keto because hunger is usually managed and cravings reduced, but it’s not automatic. You can gain, lose, or maintain weight on keto.

There are lots of reasons why you might not be losing. The most obvious place to start is that you’re eating too much. Yes, calories still matter on keto. Hormones matter too—a lot—but at the end of the day, if you’re eating more energy (calories) than you’re expending, you won’t lose weight.

If you feel pretty confident that your food intake is appropriate for your body and activity level, other variables to consider are:

• Sleep and stress: Besides food, these are the two biggest determinants of fat storage or burning.
• Movement: Exercise isn’t as important as food intake for weight loss, but it still matters. Too little is bad, but too much can also undermine your efforts by increasing your stress levels.
• Medical conditions, hormonal issues. People with hypothyroid issues often find weight loss to be challenging, for example.
• Certain medications
• Menopause

Read more: 9 Ways You Might Be Inadvertently Sabotaging Your Weight Loss Efforts 

Can I do keto if I don’t eat dairy?

Absolutely, lots of keto folks don’t eat dairy. Get your fats from coconut, olive, and avocado products; nuts and nut butters; and canned small, oily fish. Coconut milk can substitute for cream in many recipes.

Can I do keto if I’m a vegetarian/vegan?

It’s very challenging to get adequate protein from non-meat sources and keep carbs below 50 grams per day. If you’re a vegetarian who’s willing to eat eggs, maybe some mollusks, and dairy, you can probably make it work. Vegan keto is possible but extremely difficult. I’m not sure I’d try it.

Read more: How to Do Keto as a Vegetarian 
Read more: Can a Vegan Go Keto?

Can I do keto if I’m an athlete?

You can. As I mentioned above, keto is better suited to sports where intensity is kept relatively low—think ultrarunning, for example. The more glycolytic the activity, the more athletes might need to tweak keto to make it work for them.

Of course all athletes benefit from being metabolically flexible. Not to mention, keto athletes frequently report improved body composition and shortened recovery times, likely due to the anti-inflammatory nature of the diet.

My key recommendations for athletes are:

1. Don’t go keto during periods of heavy training or right before an important competition. Save the Keto Reset for your off season.
2. Don’t fear carbs. When used strategically and appropriately, there’s no doubt that athletes benefit from some carbs (that doesn’t mean sugary gels). Also, athletes can probably get away with eating more than 50 grams of carbs per day and stay in ketosis. If you want to experiment, invest in a blood ketone meter to find your personal threshold.

Read more: Can Keto Actually Work For Hard-Training Endurance or Power/Strength Athletes? 

If I’m happy with how I’m eating now, do I have to go keto?

Not at all. I’m usually of the “if it ain’t broke, don’t fix it” mindset.

That said, over the past several years I have come to appreciate that keto offers something unique over and above a generally low-carb approach like my typical Primal diet. Keto is the pinnacle of metabolic flexibility. It makes fasting easier if that’s your goal. It seems to have numerous potentially exciting health benefits.

You don’t have to commit to keto long-term. Doing a Keto Reset a couple times a year adds another tool to your metabolic toolbox. If you’re already Primal, dropping your carbs for three to six weeks gives you that added flexibility that you can tap into whenever you need it. Consider it next time you’re bored and looking to shake things up.

Read more: Benefits of Keto

Is all this fat I’m eating on keto bad for my heart?

I have been arguing for years, along with many other people in the medical and ancestral health communities, that fat has been unfairly demonized when it comes to heart health. Neither dietary fat nor dietary cholesterol is the villain when it comes to cardiovascular disease risk and mortality. Instead, we should be looking first at chronic inflammation from the Standard American Diet (SAD), chronic stress, and other lifestyle and environmental factors.

There is abundant evidence to support that position, but let me just drop two recent meta-analyses here:

• This one concluded that, in fact, low-carb diets have a beneficial effect on cardiovascular risk factors.
• And this one that found that the only risk factor for cardiovascular disease was consuming more trans fats. Otherwise, fat intake was unrelated to heart disease.

My cholesterol went up on keto. Is this dangerous?

I’m not your doctor. I don’t know what’s “dangerous” for you. However, I’m also on record as being highly skeptical of the traditional lipid hypothesis of heart disease. I’m not at all convinced that “high” cholesterol is always bad, nor that lowering cholesterol is always desirable.

Anecdotally, many people do find that their LDL and total cholesterol go up in the first few months of keto. It makes sense. Lipoproteins—as in low-density lipoproteins (LDL) and high-density lipoproteins (HDL)—transport fat in the bloodstream. It’s not there to cause trouble, it’s there to do a job.

In studies, keto diets have been shown over and over and over to result in more favorable lipid profiles—lower triglycerides, higher HDL, and more favorable HDL:TG ratios—over time, compared to low-fat diets. Many people also find that LDL decreases, although this varies from person to person.

If your cholesterol really skyrockets and stays high after several months of keto, you might be a hyper-responder. The jury is still out on whether it’s safe to continue with keto if this is the case. Talk to your doctor and consider going back to a more low-to-moderate-carb Primal diet.

Read more: The Definitive Guide to Cholesterol 

Is eating all this fat bad for my liver?

People hear “fatty liver” and assume that it is caused by eating too much fat. In fact, non-alcoholic fatty liver disease is related to hyperglycemia (high blood sugar), insulin resistance, and metabolic syndrome—all things related to eating too many carbs. Keto is known to reduce each of those risk factors.

Can I do keto without a gallbladder?

Probably yes. You might need to supplement with ox bile salts.

Can I have alcohol on keto?

You can, although you’re likely to get knocked out of ketosis temporarily. If being in ketosis 24/7 is important to you, I wouldn’t risk it.

If you decide to imbibe, opt for dry wines, champagne, or clear spirits with non-sugary mixers. Most people find that they are much more sensitive to alcohol on keto, so be careful. That third glass of wine might find you dancing on the table.

Read more: Alcohol While Keto? 

Should I buy this keto supplement? My neighbor swears it helped her lose 15 pounds.

No.

Listen, I’m not opposed to exogenous ketones in certain circumstances (that’s ketones you take as a supplement, as opposed to ketones your liver produces). However, weight loss never comes in a bottle. Eat well, move, sleep, manage stress.

Read more: Keto Pills: Why I’m Highly Skeptical 

When should I start cycling carbs back in?

There’s no “should” here. You can stay keto as long as you want, provided you continue to feel good and like how you’re eating. Try to stick to strict keto for six weeks at least before adding carbs back in if that’s what you decide to do.

Read more: Does Carb Cycling Work? It Depends. 

Why is my hair falling out?

First, don’t panic. There are a few possibilities here. One is telogen effluvium, the apparently harmless and temporary hair loss that can follow any major stressor, dietary change, or significant weight loss. It usually manifests around three months after the stressful event/period. There’s nothing that needs to be done about telogen effluvium. Support yourself as always with a generally healthy diet and lifestyle, and your hair will return on its own.

Hair loss can also be caused by dietary factors, especially not getting sufficient protein or B vitamins, or not eating enough calories overall. Try tracking your food for a week and see where you are with those.

Finally, hair loss can be a symptom of thyroid issues. If you are also experiencing any other troubling or mysterious symptoms, see your doctor.

Read more: Explaining Keto and Hair Loss (and Why Any Dietary Change Might Cause It)

Anything else I need to know?

One last thing you should know about going keto: If you are on any prescription meds, make sure your doctor knows about your plan. Certain medications will need to be adjusted as you become more insulin sensitive, lose weight, or otherwise improve your health. In particular, if you use insulin to manage type 2 diabetes, your dose might change within the first few weeks of keto.

Thanks for reading everyone! For even more keto resources, check on the keto hub on Mark’s Daily Apple. For answers to questions I didn’t cover here, head to the Keto Reset Facebook community, or post your questions in the comments below.

The post Keto FAQs: Top 30 Most Common Keto Questions Answered appeared first on Mark’s Daily Apple.

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The chances are high that you consume more sugar than you know. Perhaps you have cut out sweet treats, but do you still enjoy things like salad dressing, dairy foods, and fruits like bananas? Even foods that may seem healthy can contain a lot of sugar, natural, and processed. If you are having issues dropping […]