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Old 03-22-2013, 04:32 PM   #1
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My Doctor told me I need a minimum of 150 carbs a day! WTH!

Like wow. She reviewed some of my lab work. Everything was normal except for it showed my ketones were high. For the past month, I've been going back to low carb because it makes me feel better and to kickup my weight loss. She then said it was dangerous to be in ketosis and that I needed to eat a minimum of 150 carbs a day. That seems crazy. Even when I don't low carb I doubt I get 150 a day. Just wanted to vent. It is so hard finding a doctor who understands low carb living.
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Old 03-22-2013, 04:46 PM   #2
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No one NEEDS 150g of carbs a day, even if their goal wasn't to be in ketosis. Too bad she doesn't understand, but you don't have to listen.
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Old 03-22-2013, 05:11 PM   #3
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Typical. One of my older relative's doctor told him the same... and he has both T1 AND T2 diabetes. Doctors seem to know nothing about nutrition, even ones that specialize in metabolic disorders.
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Old 03-22-2013, 05:18 PM   #4
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It USED to be thought that Ketosis was harmful. Dr Atkins addressed this in 1972. Some doctors don't believe in low carb. Mine didn't back in 01 but I'd already lost a lot of the weight he wanted me to after failing the calorie counting. 2013... again failled other plans, he wants me to lose the weight any way I can.
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Old 03-22-2013, 05:19 PM   #5
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Shameful.

My doctor told me today that I should limit all protein to 10% of my diet, mostly from plant sources.


Yeah, no.

She also tried to tell me that hemp and flax were good sources of Omega 3 fatty acids, which isn't true. When I reminded her that it is hard for the body to convert ALA to the EPA and DHA that the body actually needs, she admitted that she had forgotten, so I should keep taking the fish oil that I already was.

She's great as an internist and diagnostician, but knows nothing about nutrition, so I simply ignore that part of her counsel.
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Old 03-22-2013, 05:24 PM   #6
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I wouldn't be going back to that doctor again.
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Old 03-22-2013, 06:13 PM   #7
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lol... I guess she did not realize how foolish she sounded?

Doctors generally know next to nothing about nutrition - and what they think they know is usually wrong.

I don't discuss my nutrition with doctors. If they ask they hear about the healthy foods I eat - never a diet by name and never ever low carb.

Last edited by DiamondDeb; 03-22-2013 at 06:15 PM..
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Old 03-22-2013, 06:54 PM   #8
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Dietary ketosis is not dangerous, but diabetic ketoacidosis is. She probably knows nothing about nutrition (like most CW docs), and has them confused by reading your test results. If it were me, I would get a second opinion before you take that advice, especially if you're trying to lose body fat. Good luck!
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Old 03-22-2013, 07:39 PM   #9
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My doctors make me give them 30 minute lectures on lipidology and cholesterol They all listen very well and we have great conversations. It feels kind of weird, like, shouldn't they know this stuff? But I'm glad that my doctors are all very open minded and really fascinated by it, just like I am. I always wrap up my lectures... er, doctors visits with "But this could be wrong, too," and also "wait a second, I have to pay you for this visit????" when they hand me the yellow slip.

But to be fair, my last dr gave me a ton of free drugz
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Old 03-22-2013, 11:56 PM   #10
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We are all different. A large portion of our carbohydrate tolerance depends on our genetics and early childhood upbringing.

A significant portion of the population thrives on 50g or less carbs per day (metabolically resistant). For many of us, eating at this level means we can stop or slow the insidious weight gain over the years.

But, there are a good number of people who thrive on 150g of carbs a day or more. These people are usually genetically adapted to this environment and have never had a weight problem in the past (probably like your doctor!).

Anyway, the problem occurs when the people who handle carbs well generalize this to the entire population. They think that we simply eat too much bad food and don't exercise enough - or that we have no will power, not that carbs are the problem.

Last edited by unna; 03-22-2013 at 11:57 PM..
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Old 03-23-2013, 12:31 AM   #11
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When I told my doctor I was following Atkins, he just said that he encourages his patients to lose weight in whichever way works for them. I love my doctor, he's adorable
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Old 03-23-2013, 03:51 AM   #12
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From what I understand, the metabolic syndrome that can eventually lead to diabetes in some people isn't curable. However in some people it is only temporary and a normal response to carbs can be created using a LC diet. For people who just need to reset their metabolism to allow for normal carb tolerance it means progressing from VLC to roughly 150g a day. Which could be why your doctor thinks this. People who have the metabolic syndrome which doesn't just develop from carb and exercise abuse. Ie. the ones that have the genetic factor, they probably have to be on some form of LC diet for the rest of their lives.

To figure out which one you are, you probably have to go through the steps, many of the LC approaches talk about this type of progression. ie. atkins, the diabetes miracle, etc.

I don't know if there is an advantage to someone with a normal metabolic response to carbs staying VLC for years on end. Insulin is responsible for the building of muscle, storing of fat and storing of glycogen and seems to be a useful metabolic process. Technically carbs are not needed, but once all your body fat is gone what next?
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Old 03-23-2013, 06:49 AM   #13
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If they ask they hear about the healthy foods I eat - never a diet by name and never ever low carb.
Exactly. I say "no sugar, no processed foods" and they're pleased.
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Old 03-23-2013, 07:02 AM   #14
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I very clearly told my doctor I'm doing Atkins.

I have no reason to hide it, it's not up for debate, and part of the reason there's still such resistence to it in the medical community is that too many people aren't clear about what it is, and what it isn't. She shared her knee-jerk concern (kidney damage! ZOMG!!1!), and I shot it down with research. Then we moved on.
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Old 03-23-2013, 07:42 AM   #15
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The idea that you need around 150 carbs a day seems to come from the number of carbs your organs will burn if you aren't burning fat. People interpret that to mean that you need that many carbs, just like you need a certain amount of vitamin A - when in fact you can substitute fatty acids for those carbs.
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Old 03-23-2013, 09:15 AM   #16
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Scares me when a DOCTOR fails to appreciate the difference between benign dietary ketosis and ketoacidosis which is a life threatening condition that's pretty impossible to develop if you're not a type I diabetic.
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Old 03-23-2013, 09:32 AM   #17
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some cells do need glucose for energy, but I think most cells can either use glucose or fatty acids. I think we tend to underestimate just how much our body prefers fat as a fuel. I think it is part of the reason why over-exercising can lead to insulin resistance slowly over time, even in the most lean of individuals. The role of the liver is to buffer your blood sugar for the cells that need glucose but most of the time having a constant source of FFAs keeps the body pretty happy. I think the body can covert both protein and fat to glucose, if needed in order to keep the blood sugar stable but the process slow. Problems only arise when something causes your blood sugar to fluctuate wildly, such as over producing insulin in response to carbs, or stressing your body with too much exercise. Things like that drive your insulin levels and blood sugar out of wack. Even people with difficult metabolisms might be able to tolerate 120g carbs a day, if they are spread out evenly, and if they are lower impact carbs. But needing and tolerating are two different things.
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Old 03-25-2013, 11:24 AM   #18
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This doctor scares me. If I understand you correctly, she not only doesn't understand what benign dietary ketosis is, but if she thinks you need to eat 150 gms of carbs to stay out of ketosis, she is way off base. It's my understanding that most "normal" people get out of ketosis at 50 to 60 carbs. Those with metabolic problems may have to go much lower on carbs to stay in ketosis, if that's their goal. I'm not sure where I read that. Can anyone help me out hers?
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Old 03-28-2013, 05:26 AM   #19
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So I have a very close friend who is a geriatric physician at a hospital in southern CA. She is so excited because her hospital was chosen for a large study on statins and measuring cholesterol. I asked her if she knew if they were using VAP or NMR to measure the cholesterol and LDL particles and she said, AND I QUOTE FROM HER FACEBOOK WALL, "What is that?"

I posted an article on HDL cholesterol and heart disease biomarkers (HDL not being a very good one) and she chimed in that she has had excellent results with using statins to raise HDL and lower LDL. I said nothing in response, but basically, I feel like this woman has never read anything about lipidology and yet she feels perfectly comfortable prescribing statins and other drugs and just looking blindly at estimated LDL numbers from the basic test derived 30 years ago that does not even accurately depict these stats.

But I can't argue with her because she is the person in our group of friends with an MD and I just read a lot.

She doesn't know what an NMR is. WTH? When I was an undergrad, the first organic chem laboratory used NMR and in organic geochem I have also used NMR to characterize lipids, it's quite standard. There is a huge gap in the education of doctors and it's really pissing me off!
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Old 03-28-2013, 06:31 AM   #20
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I have been surviving quite nicely on less than 50 carbs a day, and so are many others.
But think about it...Most people take in way more than 150 carbs at each meal.
By American dietary standards 150 g. of carbs daily is a major reduction for most people, and would be a tremendous step forward in health.
I agree however that doc should know better.
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Old 03-28-2013, 06:34 PM   #21
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How on earth did she come up with the 150g carb/day number??


As a doctor (MD), who works all day with other doctors.... may I just say = never underestimate the potential stupidity of a doctor.
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Old 03-28-2013, 06:46 PM   #22
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Originally Posted by Janknitz View Post
Scares me when a DOCTOR fails to appreciate the difference between benign dietary ketosis and ketoacidosis which is a life threatening condition that's pretty impossible to develop if you're not a type I diabetic.
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Old 03-28-2013, 06:51 PM   #23
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2/2 of my docs are ok with my LC WOE. They are out there.
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Old 03-28-2013, 08:54 PM   #24
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My doctor told me, when he told me I was diabetic, to "eat as few carbs as possible"; and at my last visit he mentioned that he was eating low carb in order to lose weight (he's a string bean, so must have wanted to lose 5 pounds, max!). So he's fine with the low carb eating plan. He's willing to read whatever I give him about cholesterol, but still wants me to go on a statin because the lab results say my LDL is too high (though my triglycerides are way low). So that is my next battle...
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Old 03-29-2013, 08:11 AM   #25
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My doc doesn't specify what to eat and what not, but when we talked about it, she mentioned avoiding too much bread and sugars, and gave me as an example that she keeps nuts in her office for a mid-morning snack, because it won't make her too hungry later. Sounds pretty low-carb to me!

Now, the CDE I went to when I was first dx pre-Diabetic pushed 30-45 carbs/meal and 15-30/snack for diabetics. That would be about 120-180/day. Still "lower-carb" compared to the SAD, but higher than my blood sugar meter allows for me.

I think many docs confuse the idea that the brain needs 120-150 grams of glucose a day for optimal function with the idea that therefore we need to EAT 120-150 grams of carbs to feed our brains. In truth, our bodies will provide what the brain needs from whatever we eat, whether it's glucose from food or glucose from the liver converting it from protein.
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Old 03-29-2013, 09:58 AM   #26
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Originally Posted by Jakelilydad View Post
My doctor told me, when he told me I was diabetic, to "eat as few carbs as possible"; and at my last visit he mentioned that he was eating low carb in order to lose weight (he's a string bean, so must have wanted to lose 5 pounds, max!). So he's fine with the low carb eating plan. He's willing to read whatever I give him about cholesterol, but still wants me to go on a statin because the lab results say my LDL is too high (though my triglycerides are way low). So that is my next battle...
Is he willing to listen to a podcast about cholesterol? Jimmy Moore has an excellent one:

Google 'jimmy moore Lipidologist Dr. Thomas Dayspring Explains The Truth About Cholesterol'.

And these:

Google 'jimmy moore All Things Lipids (Cholesterol 101) | Chris Masterjohn' - I haven't listened to this one.

Google 'jimmy moore Dr. Malcolm Kendrick Debunks The Great Cholesterol Con' - I don't think I've listened to this one yet.

On statins:

Google 'jimmy moore Dr. Dwight Lundell Says Statins Are No Cure For Heart Disease' - not sure if I've listened to this one.

Google 'jimmy moore Dr. Jonny Bowden Explains Why Lowering Cholesterol With Statins Is Foolish' - really excellent.

You could put them on your phone and transfer them to his phone with a bluetooth file transfer program from the Play market.
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Old 03-29-2013, 12:41 PM   #27
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I very clearly told my doctor I'm doing Atkins.

I have no reason to hide it, it's not up for debate,
I REALLY like this approach - straightforward and no debate!
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Old 03-29-2013, 05:55 PM   #28
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Thats funny because my doc took a look at my labs and thou my cholesterol was alittle high he recommends Paleo to all his patients. When I told him I already eat LC he said he would have liked to have know that before hand and done a lab afew months ago and done a comparison to see if it was higher or lower.
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Old 04-03-2013, 06:14 AM   #29
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I would gain on that amount of carbs no matter what my calorie level was.
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Old 04-03-2013, 07:21 AM   #30
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I would gain on that amount of carbs no matter what my calorie level was.
So would I. I'm good at up to 50g of carbs a day...after that I start to gain.
So NO....150 is too much, at least for me.
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