To successfully make a big change, it is important to capture the initial enthusiasm you feel and use it to generate valuable momentum for launch. This personal enthusiasm is like the jets strapped to a space shuttle for liftoff. It will give you the initial altitude to rise over the abyss of doubts, social pressure, addictions, and pitfalls that almost everyone faces around eating. Abyss avoided, you will soon find yourself afloat at cruising altitude, staying airborne without much effort. The best way to harness this power is to take a little time to plan your trajectory wisely using the following preparatory steps.
Almost anyone can make the transition to primal fat burning and get the benefits, with just a few exceptions that have been mentioned throughout Parts Two and Three. If you consult with your health care practitioner and you likely can consider yourself to be in relatively normal health with no issues you know of, you can get started right away. If you have the resources, doing a basic expanded blood chemistry panel can provide valuable information about where you are starting from. It’s always nice—and recommended—to have that baseline of comparison, though it’s not essential. If you suspect that you may be in something like a borderline diabetic state (with chronically high blood sugar), please undergo a basic health evaluation prior to embarking on the plan. It will be important for you to closely monitor your progress—preferably under the supervision of a qualified professional. If you are already diabetic, then you will want to notify your health care provider about the dietary changes you are making and carefully monitor your blood sugar and blood ketone levels throughout the day during this transition. You may also find the need to rapidly adjust (typically lower) exogenous insulin and other medication levels, which should be done only with a doctor’s careful guidance.
If your health is compromised significantly in any other way, I recommend regular monitoring and supervision by a qualified health care provider during the process of implementation. If you are on medications, be advised that you will almost certainly require a change in those medications (and quite possibly sooner than you might expect) as your body adapts to the changes it will undergo. Be sure you have a licensed health care provider you can readily consult with about making those potentially needed adjustments.
And a note of support: If your doctor hassles or berates you over your proposed change in lifestyle, then consider getting another opinion or finding a different doctor willing to work with you, and to consider health choices outside an antiquated paradigm. There are plenty of MDs, DOs (doctors of osteopathy), naturopaths, nutritionally oriented chiropractors, functional neurologists, and functional medicine specialists who will be more than supportive of your health needs, choices, and journey. And they’re not necessarily that hard to find nowadays.
A basic blood chemistry panel is a useful, albeit optional, tool for evaluating your current health baseline. You can then compare it with a second panel three months after you begin the Primal Fat Burning Plan, to chart your progress. (Three months is appropriate because the hemoglobin A1C test generally provides a window into the last three months’ glycation damage.)
Below are the functional blood levels that I look for and help clients work toward achieving. (Functional levels show a more accurate normal and healthy range than the standard lab range on your printed lab paperwork, which compare you against other patients at your lab.)
If you are already at these levels when you start, that’s great news; the Primal Fat Burning Plan will give you an extra buffer zone of health, an edge in sports and cognitive performance, healthier aging, and resilience from disease.
Fasting glucose: ideally between 70 and 85 mg/dL as long as you are not symptomatic (i.e., you have no issues with hypoglycemia or reactive hypoglycemia).
Triglycerides: below 100 mg/dL.
Fasting insulin: below 10 IU/mL (and ideally closer to 5 IU/mL or below).
Fasting leptin: ideally between 4 and 6 ng/dL.
Total cholesterol: roughly between 225 and 240 mg/dL. (The conventional medical standards are arbitrary and relative. Postmenopausal women, for instance, tend to do better with higher levels.) If your level is higher than this, it may be an indication that there is something else happening for which the extra cholesterol is necessary. Be happy that cholesterol is doing its job, then dig deeper with the help of a qualified health care provider well schooled in functional medicine to get to the bottom of what is generating your apparent increased cholesterol need.
HDL: ideally between 55 and 75 mg/dL. Higher may imply either a genetic tendency or some hidden nonspecific source of inflammation.
Hgb A1C: between 4.7 and 5.4% is a good range.
Uric acid: between 3.2 and 5.5 for women and 3.7 and 6.0 for men.
TSH: between 1.8 and 3.0.
TPO antibodies: below upper reference threshold. (Elevated levels imply thyroid autoimmunity.)
Anti-thyroglobulin antibodies: below upper reference threshold. (Elevated levels imply thyroid autoimmunity.)
Homocysteine: below 6.0 µmol/L.
CRPhs: between 0 and 3 mg/L (and preferably not over 1.0 mg/L).
Fibrinogen: between 193 and 423 mg/dL.
BUN: between 13 and 18 mg/dL.
SGOT (AST): between 10 and 26 IU/L.
SGPT (ALT): between 10 and 26 IU/L.
GGTP: between 10 and 26 IU/L.
Here is where we maximize the aerodynamics of our soon-to-launch shuttle, by carefully plotting the trajectory. Sit down for half an hour and write out your best plan for accomplishing this change. Be brutally honest with yourself and actively anticipate your own vulnerabilities and adverse tendencies.
1. Set a goal. Choose one that’s motivating to you, such as weight loss, improvements in certain symptoms, more energy, better moods and sleep. This will help focus you and keep you on track far more effectively. It’s hard to reach a destination when you don’t quite know where you specifically want to go. Setting a goal far better enhances your odds of getting there!
2. Put the plan on your schedule. Block out three weeks starting on a set date, factoring in a couple of days to shop, go through your pantry, and cook several meals, as this will help you start out on the right foot. Beginning on a Sunday can be helpful for this reason.
3. Remove any obstacles. Remove the “avoid” foods from your fridge and pantry to the extent you can. If others in your home are not on the plan, strike a deal to remove the obvious temptations, such as bread, crackers, tortilla chips, ice cream, and any junk food, if you can.
4. Stock your home with better options right from the get-go. Plan your meals ahead of time; write out a list for the first week by looking through the recipes and meal plans and deciding what you’d like to try. Use the food lists (see page 180) for reference, and shop accordingly. Look through the items listed in the “Supporting Players” section later in this chapter and add what you need to your list.
5. Cook in batches. Making soups and large portions that you can freeze in small containers (glass ones are safest, by the way) will be invaluable in helping you stay on track. Not everything has to be from the recipes: a simple roast chicken can feed you for several lunches, for example. Though you will come to feel quite satiated between meals, it is good to have some primal, low-carb, higher-fat snacks on hand, especially at the start. Pick a few you’d like to make and add the ingredients to your list. And get some Brain Octane MCT oil or coconut oil—a teaspoon of oil here and there can take the edge off hunger.
6. Consider your own areas of vulnerability. Read through the sections below and think about what might trip you up. If you know you are likely to have issues with sugar cravings or symptoms of low blood sugar, then plan ahead for this and purchase a recommended supplement to take the edge off. If you often find reasons not to cook during the week, plan a cooking afternoon over the weekend. If you fall off track easily, try to find a friend or family member to do the plan with you. Do what it takes to minimize your own excuses and anticipate where you need more support.
Shopping for a primal fat-burning diet can take a little getting used to. My clients sometimes tell me that this way of eating looks great on paper, but when they are walking down the aisle at the supermarket, they have trouble making the switch in their shopping lists at first. The truth is, when you commit to eating nutrient-rich foods from healthful and ethical sources, grocery shopping will become a bit more involved; you will likely not be able to do a one-stop shopping trip at your local store unless you have a market that is committed to quality meat and animal-sourced products. Look at this as part of the process: shifting to higher-quality foods involves discovering new sources and providers. It does not need to mean sky-high food budgets. Having read about fat-soluble nutrients, you now know I’m a passionate advocate for meat and eggs from fully pastured animals, as well as clean and safe sources of fish. You will be eating about one-third of the protein in the average American diet, using lots of cheaper cuts of meat (including bones), and saving considerably by cooking satisfying meals at home and minimizing snacks and packaged foods. Eating healthfully does not necessarily mean eating expensively. Some of the most budget-conscious people I know have maintained a primal fat-burning diet while accounting for every penny, and found they saved money over the typical American diet.1 It can be done! The food lists in Chapter 11 and “Nourishing Resources” on page 285 will give you some guidance.
While you are on the plan, make it a point to familiarize yourself with all the available local sources of quality organic and grass-fed food. If you live in an area where these are difficult to obtain, use the websites I recommend to order some of the essential fat-burning items. Spend a little time looking up all the farmers’ markets, co-ops, CSAs, and natural foods markets in your area—which often have screaming deals—and even venture out to local farms that have implemented quality crop-growing and livestock-raising practices (you can find a lot of these folks through www.eatwild.com). Develop firsthand knowledge of where your food comes from. Join a local chapter of the Hunt Gather Grow Foundation for even more resources and support (www.huntgathergrowfoundation.com), which lets you connect with others already dialed in to the sources of the best-quality local foods. Check out the profusion of online sites about nourishing, traditional-style cooking and homesteading, often run by young and not-wealthy home cooks, which offer crafty and budget-conscious tips. My friend Marjory Wildcraft has an entire program showing you how to easily grow most of your own groceries at home, saving a fortune in food costs (www.growyourowngroceries.org).
An inexpensive digital scale that measures in ounces and grams will be very helpful for measuring protein portions until you can eyeball them.
MINERALS: Full-Spectrum (Himalayan and/or Celtic sea salt, potassium citrate supplements (just one 99 mg capsule/day is fine), and liquid ionic (preferably) magnesium (400 to 600 mg/day).
Adopting a low-carbohydrate and higher-fat ketogenic approach to eating will change the way your body uses certain minerals. You will tend to lose a lot more sodium (and stop retaining excess water) once you lose the carbs. This can sometimes result in temporary issues such as constipation. In fact, it’s not uncommon to lose up to five pounds of water weight (plus fat) in the first week for this very reason. But if you don’t replace the sodium, then you run the risk of your kidneys dumping potassium in an effort to keep a relative balance with sodium. Consequently, both these minerals become important during your transition. You don’t need to eat sugary bananas to get your potassium: 4 ounces of meat in a day will give you a banana’s worth, and you can get plenty of potassium from fibrous vegetables and greens in the Primal Fat Burner Plan. Also, however, early on in the EKA process you decrease your urinary excretion of uric acid. Potassium citrate (@99 mg/day) can also help the body get rid of uric acid. Not everyone needs it (males may need more than females). You can test for uric acid with a cheap urinary test strip. That said, it’s also important to use a little extra unrefined Himalayan or Celtic sea salt, which contains a full spectrum of trace minerals, on your food so that you maintain a healthy sodium balance. In conjunction with drinking plenty of water, it should help remedy constipation. Don’t worry, you won’t get bloated by using real full-spectrum salt—that happens from refined sodium chloride and a high-carbohydrate diet. Please be sure not to use regular refined table salt: this is highly pro-inflammatory. Stick to the full-spectrum salt in its most natural, balanced state for best and healthiest results.
It’s also important to consider magnesium. High-carbohydrate diets tend to cause a depletion of intracellular magnesium levels, and so most people are already magnesium-depleted when they shift to a fat-burning diet. If this gets coupled with loss of water, sodium, and potassium, you can experience muscle cramps. I recommend quality magnesium supplementation during the three-week plan (and thereafter only as needed). Please look for liquid ionic magnesium (I like Mineralife brand) or transdermal (topical) magnesium oil preparations that you apply to the skin, or simply enjoy soaking in Epsom salts (magnesium sulfate) dissolved in bathwater, which tends to allow for the transdermal absorption of some of the magnesium and is very relaxing. Magnesium citrate supplements (sold as pills or flavored powders) tend to have more of a laxative effect, for better or worse, but they don’t improve your intracellular magnesium levels significantly. The best approach for rapidly correcting significant intracellular magnesium depletion is a series of what are called “Myers cocktails”—an inexpensive and highly replenishing IV solution that must be administered by a health care provider.
Coconut oil and/or a supplemental derivative known as MCT (medium-chain triglyceride) oil can be taken off a spoon (working up to 1 to 2 tablespoons) or mixed into a smoothie and can be useful additives to your daily regimen early on to provide a very readily usable fat-based energy supply that cannot easily be stored as body fat. A favorite of mine is a particular brand of C8-type MCT oil called Brain Octane, made by Bulletproof (see “Nourishing Resources” on page 285). One to two tablespoons per day (start with less, maybe a teaspoon, and work your way up) can help combat fatigue experienced in the beginning by some not yet adapted to the use of ketones as a primary source of fuel. MCT oil is commonly sold as a bodybuilding supplement since it so readily facilitates fat burning. Bulletproof Brain Octane generates 3 to 5 times more ketones than regular MCT oil, at a savings. Please don’t cook with it, as it isn’t very heat-stable.
Be sure to get sufficient omega-3 supplementation from (preferably) Antarctic krill oil (I like the one sold through www.mercola.com). The amounts people need can vary. If you have inflammation or suffer from depression or autoimmune conditions, you should at least double or triple the standard recommendations on the label. These can be energizing, anti-inflammatory, and mood-stabilizing, too. The standard Western diet is notoriously deficient in omega-3 fatty acids (EPA and DHA), and most folks can benefit from some supplementation. Start with following the directions on the label and increase if needed.
Drinking ample purified water is important and easily overlooked. There are a few desktop or smart phone apps that will remind you periodically (at whatever designated interval you select) to take a drink of water. Something like this might be really useful for those who tend to forget to hydrate regularly throughout the day. The rule of thumb is to calculate your body weight in kilograms (divide your weight in pounds by 2.2) and drink that number of ounces of water per day, ideally sipped at regular intervals. (Note to those Down Under: 1 ounce is just about 30 ml.)
Increasing your intake of unsweetened green veggie drinks during this time can help support the detoxification process quite a bit. They will also supply ample potassium to support your electrolyte balance as your body sheds excess water weight. Don’t load the juice with apples or other fruit. (A few drops of liquid Stevita brand stevia can sweeten the drink if you like, or use lemon or ginger. If you have to use apple, try to limit that to no more than one-quarter of a more tart Granny Smith apple.)
If you already follow a regular workout regimen, there is no reason to change it during the plan. You might find that it is harder to exercise for the first few days, so consider taking it easy. Most people find that exercise begins to feel much easier after about the two-week mark—but this is just an average estimate. Elite athletes are going to need three to six weeks to feel like they are fully back on top of their game, and possibly then some. It’s always good if you can give yourself a couple of months to fully adapt before a competitive event. If you don’t already have a regular routine, I recommend using this time of change to get out for a thirty minute or so brisk daily walk (minimum), which will support all aspects of well-being, including detoxification.
Give yourself the gift of a good eight hours of quality sleep during these weeks. Make sure your bedroom is as dark and quiet as possible. Purchase an inexpensive sleep mask and earplugs if your sleeping space gets too much light or noise. Avoid sleeping next to plugged-in appliances, Wi-Fi routers, or your cell phone, especially if you have issues with less than optimal sleep. If you snore, get an evaluation for possible sleep apnea as soon as possible (find a specialist to evaluate you via www.aadsm.org). Being sleep-deprived can disrupt your circadian rhythms and hormones and make it far more difficult to lose weight!
These optional items may be useful under certain circumstances.
L-carnitine (2 to 5 grams per day) can be helpful to prompt the body to start using fats for energy. If you’re feeling stuck or slow to start, L-carnitine might help. It’s an optional extra to enhance the Primal Fat Burner Plan. If you know or suspect you have low thyroid function, you’ll want to limit L-carnitine use to no more than 2 grams (2,000 mg) per day.
If you happen to have significant issues with clinical or garden-variety reactive hypoglycemia (i.e., low blood sugar symptoms), then you will absolutely need supplemental support to ease this transition. Three supplements to consider are L-glutamine powder (which your brain is able to use for energy in lieu of glucose, something like bicycle training wheels), used in small amounts (1/2 teaspoon or so) under the tongue throughout the day, a herb called Gymnema sylvestre (helpful for carb cravings when taken in doses of 4 to 8 grams of whole herb or 400 mg standardized extract per tablet/capsule three times a day while cravings last), and Bulletproof Brain Octane MCT oil (a source of fats that quickly convert to ketones and can be used preferentially for energy). Coconut oil can also be used as a source of at least some ketone-generating naturally occurring MCTs and has the added benefit of naturally occurring anti-microbial lauric acid, plus you can cook with it.
If you suspect that cravings for sugar or starch will be an issue for you, try using Gymnema sylvestre at a dose of roughly 4 to 8 grams (4,000 mg) of whole herb or 400 mg of standardized extract per tablet/capsule three times a day while cravings last.
Though this is far from essential for achieving and sustaining a fat-burning metabolism, a quality ketone meter can be an indispensable tool for people who are really struggling with effective ketosis or who want to monitor their adaptation process with more precision. It isn’t essential (unless you happen to be diabetic), but if you’re a data geek or a bio-hacker looking to tangibly measure your progress, this is one way to do it. A “gold standard” blood ketone meter such as Precision Xtra (the most accurate, affordable, and convenient tool at the time of writing this book) measures beta-hydroxybutyrate, the most impor-tant ketone, along with blood sugar if you use different test strips. The meter is cheap, but the strips do add up; however, you may not need to use it for long, only until you get confident with your fat-burning program. Keeping your ketone levels between 1 and 3 mmol is the standard goal, though slightly higher is still okay. Up to 7 mmol is fine during fasting. Ketone levels don’t become problematic before 15 to 25 mmol (a concern for type 1 diabetics). If you’re testing your blood sugar, strive for a goal of 70 to 85 mg/dL for fasting blood glucose. If you are hypoglycemic, diabetic, or prediabetic, then this gizmo is the one for you. Use it daily to monitor your ketone and blood sugar levels.
One other useful method for determining whether you have officially arrived at a state of effective ketogenic adaptation (EKA) is the Glucose Ketone Index (GKI) calculator, developed by Dr. Thomas Seyfried of Boston College and his colleagues. It measures your ratio of blood glucose to ketones (specifically, beta hydroxybutyrate) and gives you a single number that tells you whether you’re in that optimal “fat-burning zone” or not. It takes a little rudimentary math, so keep a calculator handy. First, you need to calculate your blood glucose results using your Precision Xtra glucose/ketone meter; then you convert that number (expressed in mg/dL) to mmol by dividing it by 18. Then take that glucose number and divide it by your ketone reading results (which are automatically expressed in mmol, or Mm) to get your GKI. Your goal is to get into the zone of between 0.7 and 2.0. Getting a 1 is spot-on. So, say you have a blood sugar reading of 75 mg/dL. Divide that number by 18 to get 4.16. Then say your blood ketone reading is 3.0 mmol. Take 4.16 and divide by 3.0. The result is 1.386. BAM. That’s your GKI—and you’re square in the zone!
Another option is a breath ketone meter. The Ketonix meter costs about $100 and requires no additional expenditure. Very portable, it recharges by USB and is about the size of a cigar tube. You can’t get precise values with it, only approximate ones—it measures levels as low, medium, or high—and it measures just acetone, but experts I’ve consulted with find that it is generally reliable as a crude, correlary litmus test of whether or not you are “in the zone.”
Please don’t bother with measuring useless urinary ketone levels; this can be terribly misleading and in the long run not that useful as a measurement of actual progress. Save your money and avoid those.
Keeping a log of your meals, snacks, and drinks during the plan is an extra step that can be incredibly helpful to show you any patterns that may emerge with certain foods. Make notes about any changes in mood or energy and any other notable physical symptoms (discomfort, digestion, aches, etc.). If you need to troubleshoot stubborn weight loss or any other problems, this journal will be an invaluable tool for any nutritional therapy practitioner, qualified natural health care provider, or functional medicine specialist.
As you get ready to start, let’s address any bumpiness that may come up along the way. Some people breeze through the transition to a fat-burning metabolism almost as if nothing could be more natural to them. Others experience what has occasionally been called the “ketogenic flu,” characterized by a feeling of general malaise, fatigue, headaches, and brain fog for a few days. There can also be some temporary constipation. Making this adaptation fully can take time (even up to a couple of months), though most people start feeling much better within just a few short days. By the end of the first week, the majority of people start to feel significantly improved, though efforts at exercise may be a bit of a strain at first. But don’t be discouraged if it takes you a while to feel comfortable; that’s normal, too. Positive adaptation (that is, changing to a better way of doing things) is a process, not a single event. You may need to be patient with yourself and this approach in order to arrive at the best possible outcome. A lot depends upon what your former habits were and what your health challenges might be at the outset of this transition. If you are a bit older or suffer from a variety of health problems, then expect this to take a little longer than if you are younger and mostly healthy. You are making some rather significant alterations to your physiological makeup, and your body—not to mention your psychology—will need to adjust, especially when you’ve spent a lifetime doing things very differently.
Discomfort or flu-like symptoms are attributable to a couple of different factors. Number one, you are depriving yourself of the fuel your body and brain have grown used to—sugar—and you have not yet developed the ability to make efficient use of ketones, which you are undoubtedly producing in response to eliminating the sugar and starch. It’s a bit of a temporary “metabolic purgatory”—you’re no longer fully sugar burning and you’re not yet fully fat burning, and though you may be producing ketones, you are not yet fully utilizing them. In some cases, the exorphins (morphine-like compounds) in grains reveal their true impact: coming off grains, you might experience withdrawal, with flu-like symptoms or agitation. If it sounds like coming off a narcotic, that’s apt, because when it comes to dropping your reliance on gluten or sugar, you are doing just that! See “Sugar Blues” on page 173 for ideas about how to tackle this.
Second, you are also basically detoxifying, so any consequential bumpy feelings won’t last long. Pay close attention to your body and your mental and emotional state as you go through your transition, and stay with it! Using a quality infrared sauna to help better facilitate this detox process, along with extra hydration, can help a lot (see Infrared Sauna in “Nourishing Resources” on page 285). Once you have adapted to the utilization of ketones and free fatty acids as your primary sources of fuel, however, you are much more likely to feel substantially improved across the board. You might notice a positive change in energy levels, moods, and cravings; excess weight is beginning to drop off; you may feel less stiffness in the morning and fewer aches and pains during the day or at night. These are all indicators that you are shifting to a much more efficient and anti-inflammatory fat-burning state.
When you begin to focus on eating food from unadulterated and untainted sources, especially if you are more accustomed to a standard American diet, you might initiate a significant measure of detoxification. It’s as if the body finally gets the green light to do some housecleaning; now that the fatty tissue is beginning to be mobilized, the cumulative glut of toxins stored there will work their way out. If your avenues of elimination and detoxification are compromised in some way (i.e., through constipation or liver/biliary issues), then this can feel a little cruddy—active detoxification can certainly mimic a tired and run-down state. This is why extra hydration (adding an extra quart or two of water per day) and quality magnesium supplementation (preferably liquid ionic magnesium, Myers cocktails via IV, or transdermal forms) are so important in the early stages of this program. Magnesium is required for both phase I and phase II liver detoxification and can go a long way toward helping ease this part of the transition. Other signs you may not be getting enough magnesium can include muscle spasms, cramping, headaches, and insomnia. In addition, toning down your expectations, being kind to yourself, and giving yourself the rest you require will go a long way. You are clearing the decks and making way for a whole new standard of real health and metabolic freedom. You are effectively “re-booting” yourself!
If uncomfortable symptoms persist throughout the full three weeks, it might be time to assess whether something might be awry in your body. By “cleaning off the windshield,” so to speak, certain long-standing imbalances can sometimes finally be revealed. There may be underlying metabolic, gastrointestinal, hormonal, or immune conditions that a simple change of diet is not going to automatically fix. Be open to finding a knowledgeable specialist in functional medicine to help diagnose certain conditions that may be present. Further testing may eventually be required to better clarify what’s going on if certain sticking points come up. Don’t expect this to happen to you—just be mindful that it could, and be open to what your body may be telling you.
If cravings or hypoglycemic symptoms are a problem during the plan, start taking or increase the dose of Gymnema sylvestre and/or L-glutamine. If this isn’t sufficient to kill your sugar cravings, then double your dose of gymnema: 400 mg of standardized extract or 4 grams of whole herb taken three times a day. In cases of especially resistant or extreme carbohydrate addiction, doubling the standard 4 grams tends to take care of things. With respect to L-glutamine, I typically recommend 1/2 to 1 teaspoon of the powder under the tongue two or three times a day during the process of ketogenic adaptation, or during times when you are experiencing or anticipating cravings or low blood sugar symptoms. For instance, if you know you are likely to crave a glass or two of wine in the evenings, taking a dose of L-glutamine right when you get home from work can help offset those cravings. Drop-offs in energy levels and increased tiredness, headaches, mood issues, and cravings tend to be more pronounced in those prone to hypoglycemia or reactive hypoglycemia or those who have a very strong sugar habit. Once you’ve achieved EKA, you will likely need neither gymnema nor L-glutamine. Think of these supplements as temporary “training wheels” that can help you get over that initial hump. Until then, though, keep them on hand to help stave off symptoms until you better adapt to a more effective state of ketosis. You won’t be needing them for long!
During this transition you may experience one or more typical symptoms that can be less than pleasant. All can be fairly easily resolved.
Constipation. Add more full-spectrum salt to your diet and use magnesium. Drink plenty of water.
Breath and body odor. During this time your body is beginning to increase its production of ketones. You may not yet have the capacity to make efficient use of these ketones for fuel, so they are likely being handled as a waste product. As such, it is possible to notice changes in breath and body odor that may be mildly unpleasant. This is very temporary. If it becomes problematic for you, consider picking up some chlorophyll tablets and consume more green drinks during this time (with added parsley), which can help neutralize odors considerably.
Gas. For those sensitive to some of the indigestible sugars found in cruciferous vegetables, you might try adding a digestive aid called Beano to meals containing these foods. (If gas persists, see the second tip in the “Troubleshooting Corner” section below.)
This section is a little advanced, but it may help if you come up against obstacles either during or after your three-week plan. These are three of the most common issues that come up for people who become primal fat burners.
A single slip-up (like a piece of birthday cake or a slice of pizza at the office party) can cause fat burning to come to a screeching halt for easily a good three days, or more if food sensitivities are involved. It can also result in quite a bit of water retention, adding significant weight seemingly overnight. Hidden carbohydrates are also a frequent problem. Dried fruits, such as raisins, dates, and figs, are especially problematic: they may seem healthful, but they are adding concentrated sugar to your diet. Although I am not categorically against the notion of having a glass of wine with dinner here and there, if you have weight to lose, then by drinking that wine you are effectively adding lighter fluid to the fire you are trying to put out, and it will likely constitute a backslide for you. I’m just saying. One company, dryfarmwines.com, carries wines that are carb-free and also free from undesirable additives.
Excess protein consumption is another frequently seen issue. If you have been a dyed-in-the-wool sugar burner for the better part of your life, then your body has become extremely efficient at making sugar any way it can. Protein in excess of what you need to meet your physiologic, rebuilding, and regeneration requirements can be converted to sugar in your body and used for ketone-thwarting fuel. I see this issue quite often, and people tell me that as soon as they cut back on the protein to where it should have been and added a little more fat, the weight finally came off. Overconsumption of bone broth can also lead to plateaus.
Many people don’t realize that anything that causes an inflammatory response will typically result in temporary weight gain. I am not a fan of bathroom scales as a general rule, but they can be useful as a crude tool to help you ferret out problem foods. If you monitor your weight daily and discover you are two pounds heavier today than yesterday, you need to question whether something you ate yesterday incited an inflammatory response. This can be a very strong indicator of undiagnosed food sensitivities. Keeping a food journal can make any needed detective work much easier, helping you get to the bottom of problems such as this.
This is a common situation, and it indicates that you may have one or more conditions that require some investigation:
• Small intestinal bacterial overgrowth (SIBO)
• Hydrochloric acid (HCl) insufficiency (often also paired with pancreatic enzyme insufficiency)
• Biliary stasis/gallbladder problems
SIBO is a condition that has been discovered and researched only in recent years. It is frequently found in those having immune reactivity to gluten or a history of alcoholism, but it is also commonly the result of some form of neurological compromise. Chronic neuroinflammation, deterioration, traumatic brain injury, stroke, or advancing dementia can lead to a loss of vagal tone that causes a dysregulation of ileocecal valve function (the otherwise selective gateway between your lower small intestine and your upper colon). When this happens, it can cause even the “good” bacteria in your colon to back up into your small intestine, where they most decidedly do not belong. This can cause plenty of symptoms like gas/bloating or IBS and lead to even bigger issues such as leaky gut. Ironically, many of the things people do to support their colon health (eating extra fiber or taking prebiotics like FOS, Arabinogalactan, or inulin) will actually make SIBO worse. The management of this condition typically requires you to completely avoid even low-sugar, low-starch fibrous vegetables for a period of time, along with anything else that could possibly feed your gut bacteria (save for Acacia gum/Acacia senegal, which is the acceptable exception), though treatment requirements may vary depending upon what the underlying cause of this condition happens to be in a given individual. For more information about this condition, see www.siboinfo.com.
In the case of something like hydrochloric acid insufficiency (also known as hypochlorhydria), you may require supplementation with HCl capsules for a period of time—or possibly even over the long term, depending on the circumstances. Taking extra supplemental pancreatic enzymes can also help. See “Hydrochloric Acid” in Chapter 6.
For information on gallbladder issues, see the “Gallbladder” section in Chapter 6.
Once you’ve fully made the transition to EKA, it is entirely normal for your T3 (active thyroid hormone) levels to drop slightly and to see small elevations in what is called “reverse T3.” This will not typically be accompanied by elevations in TSH. This is merely an expression of improved thyroid efficiency that occurs in tandem with perfectly healthy ketogenic adaptation; in fact, it is even a common longevity marker! Think of it as having reached your most efficient orbit and not needing as much rocket fuel to boost you up anymore. It is not remotely pathological or any source of concern, no matter what you might read in the blogosphere. If you are experiencing actual symptoms of low thyroid, you may want to get the appropriate testing, which should of necessity include thyroid antibody markers to ascertain that you are not dealing with an autoimmune condition. Sometimes, too, improving your healthy foundations can result in what I call a “clean windshield effect,” which can make previously unnoticed symptoms suddenly more obvious. Remember, however, that association is not necessarily causation. There is nothing in a healthfully adapted, nutrient-dense, quality ketogenic diet that is harmful to your thyroid or anything else, for that matter.
If you feel you might have adrenal fatigue, I urge you to read my ebook Rethinking Fatigue: What Your Adrenals Are Really Telling You and What You Can Do About It. It provides rich, detailed information about what it takes to identify and address possible adrenal issues. If your cortisol is chronically low for some reason, then you may experience more stubborn sugar cravings and low blood sugar symptoms.