What Happens When You're In Ketosis?

Hello Health Champions. Have you ever wondered what really happens

in the body when you're in a state of ketosis. When you're doing

a ketogenic diet, what is really happening

inside? Let's say that you want to start a ketogenic diet you want to get into a

state of ketosis the first thing that's going to happen

is you have to reduce your carbohydrates you've got to

cut them down somewhere in the range of 30 to 50 grams per day and we're

talking net carbs meaning you take the total

number of grams of carbs you subtract the grams of fiber

you end up with net carbs because fiber doesn't really count

and you can cut down the carbs or you could do

intermittent fasting or do both that works the best

but if you're intimate in fasting that's a period of time during the day say 14

16 18 hours where you're not eating anything so obviously you're not eating

any carbohydrate during that time either if you have a fondness for foods

like this then figure out how to find some

alternatives because these foods are not going to work on a

ketogenic diet the first thing that's going to happen

in the very beginning is your body thinks it's been

robbed it thinks it's been robbed of fuel

and you've been training it for years or even

decades to rely on carbohydrates you've been feeding it carbohydrates you've

been topping off the blood sugar every couple

of hours and your body has adapted to that

now when you cut out the carbs it's like you're pulling out the rug from

under it its entire existence has been turned upside down and that's not a

bad thing but if it happens suddenly it's kind of a shock to the body so it

doesn't know where to get the fuel in the short term

and as a result you're going to have a certain number of

symptoms more or less severe but they're going to

be in the very beginning for a few days and they're going to be things like

fatigue and brain fog and insomnia maybe you're going to find

maybe some muscle cramps maybe you even get a rash

and all of this put together people often call

the keto flu and it's not really a flu you don't have the flu it's not an

infection it's just a bunch of unpleasant symptoms

because your body went into a state of shock if you want to avoid this

then just do it slower but if you do it quickly just

know that this can happen and if you try to exercise you probably

find that you have no energy for that you

crash you feel terrible the good news though is

that you'll have some quick weight loss you lose

three to four pounds right off the bat and you get excited

the thing to understand about all this whether it's the bad stuff or the good

stuff is that it's temporary it's an initial

adaptation but if you stick to it if you go from days into

weeks now these symptoms are going to change

they're going to get better you'll find that you have more energy

you have more focus more mental clarity you start sleeping better your hunger

and your cravings go away if you're a woman

and you notice that your periods got more irregular

or your pms got worse in the very beginning

then you'll find that a few weeks into it they'll probably get better again

weight loss is kind of a give or take it's going to work

for some people they get into a steady weight loss but other people

are going to have a little plateau right after those

first few initial days and as far as energy for

exercise you'll find that you have great energy for low intensity things

like walking but if you try some high intensity

chances are you're gonna crash that you don't feel so great if you try something

intense but your body keeps adapting so if you

stay with it for months then these symptoms

are going to go away they're going to be very stable so you

find stable energy you find that you have no cravings you

find that you get better sleep women have less pms than they did even

before they started and you'll find that now you have better

energy for exercise than you did even before while you were eating carbs

and we're going to talk about this in some detail

weight loss is going to be successful for

most people if your primary problem is insulin resistant then for 80

of people at least you're going to find a steady

drop in weight some people are still going to have some stubborn

weight and these are people who have multiple

issues on top of insulin resistance they probably have some leaky gut

some autoimmunity multiple allergies hypothyroid inflammation etc so those

are some of the symptoms that you can

experience at first and how they probably will go away but what is it

actually that's happening inside the body that's responsible for

those symptoms once you understand that then you feel much more

comfortable with this whole process so the early changes in the first few days

is that you're going to have some glycogen stores

glycogen is the body's way of storing carbohydrate we break down carbohydrate

to glucose then we reassemble it into glycogen

which can quickly be broken down back into glucose and

your body can store about one pound of glycogen right that's about

one to one and a half days worth of carbohydrate but what you have to

realize is that glycogen also binds

water that's why it's not a very efficient

form of energy storage that's why the body prefers to store

fat long term it stores a little bit of glycogen short term but it's

inefficient because for every pound of glycogen

that you store it also is like a sponge it pulls about

three to four pounds of water with it and as you're burning through the

glycogen as you're using that up this water is released and you go to the

bathroom all the time for the first two days

and whoopty do you find that you lost about

four to five pounds in the first two to three days and you're ecstatic

and it feels good you look at the scale but realize

that this is just water and it's a good start but it's temporary

unless you stick to this and switch into fat burning

and when you start eating less carbohydrates there is

less reason for the body to make insulin and that's going to be good for blood

sugar and insulin resistance long term but short term insulin promotes

sodium and mineral retention so as insulin goes down before your body has

adapted you're going to lose some minerals and

where minerals go water goes so you lose a little bit more

water but primarily the effect here is with

the minerals where you're going to notice some muscle

cramps that in the first few days your muscles

cramp up more but what you got to do is you got to

keep up on fluids and you have to keep up on the sodium

and some potassium magnesium and so on as carbohydrates

and glucose becomes scarce in the body blood glucose goes down

the body tries to compensate with cortisol so for a

short time there can be some instability in blood glucose and some extra cortisol

and when this happens at night before you're fat adapted

you'll probably find that your sleep is a little bit

disturbed right in the beginning as well but the biggest priority of

all is to make sure that the brain has enough

fuel to function so for the first couple of days

as glycogen drops as blood glucose drops the body tries to compensate with

cortisol the cortisol promotes gluconeogenesis and

at first it tries to make glucose from protein because that's the first

thing available before we start burning fat and it's going to have some amino

acids in an amino acid pool it's going to break down

some tissues and maybe even a little muscle for the first

day or two but this is very short term because

in a couple of days the body is going to become

fat adapted it's going to up regulate fat burning

lipolysis and part of the fat is called glycerol the fat is stored as

triglycerides so as fat is burned glycerol is

liberated the body can use that glycerol to make

more glucose and it stops relying on protein

almost entirely it's going to have some protein available because

as we lose weight we're going to break down some skin

and some there's going to be some dead cells and so forth that

we can recycle as protein but we're not going to have to waste

muscle to do it and then of course the biggest change of all

is that once we get into a state of ketosis

as a result of our ketogenic diet then the brain can run

as much as 75 percent on ketones as an alternative fuel and why is that

important because if you're carb dependent if you've only

fed your body primarily carbohydrates then it's dependent on that and

maybe or probably insulin resistant now even if you have a lot of glucose

available the brain can still be starving because the brain

is also insulin resistant and even though there's a ton of glucose

circling around they can't get into the brain

ketones don't have that problem so as you shift to ketone metabolism

you're just providing your brain a whole bunch of extra fuel that's not dependent

on insulin and this is why a lot of people

start feeling better they get more energy they have more clarity

as soon as they have a few ketones kick in next i want to talk about

acetyl coa and don't worry about the name all right we're going to make

a lot of sense of this it's going to look a little technical but you're going

to get so much out of it i'm really excited here

acetyl-coa is a metabolic intermediary it's a

middle step in making energy in the body so if we're running on glucose we start

off with glucose then we split the glucose through a

process called glycolysis and in the end as we chop it up

there's a bunch of steps missing but we end up with a molecule called acetyl coa

and then we take that intermediary and we

feed it into the energy machinery right the tca cycle don't worry about

the name it's inside the mitochondria 95 percent

of the energy in the body is made in the presence of oxygen through

oxidation and the fuel for that energy machine is called acetyl-coa

and not only glucose can become acetyl-coa but all the fuel is

acetyl-coa as an intermediary or the vast majority

so when we eat fat then we start breaking down the fat molecule we chop

it up in little pieces through a process called beta oxidation

different enzymes but the same idea and we end up with acetyl-coa that we

can feed into the energy machine so this will explain why you can make

fat from glucose but not vice versa because glucose to acetyl-coa the arrow

only goes one way it's irreversible once we break that glucose

it's not coming back the other way and this is how

glucose can become fat but fat cannot become glucose again and this is why the

body makes ketones because the body can use the

glucose but it can't use the fat it can't break

down fat into acetyl coa so we need another intermediary we need another

mechanism and this is where ketones come in so

again it's about acetyl-coa the body takes now the acetyl-coa from

fat from other tissues the brain and it puts it together into ketones and

then it can take the ketones apart again into acetyl

coa and make energy and i wanted to

demystify this to show you that the fuels are

not that different they're just different

tissues can use them at different times so it just

packages the fuels differently so it can use them at the appropriate time

so many times you hear that carbohydrates

is the preferred fuel or fat is the preferred

fuel or this and that but carbohydrates are only the preferred fuel

if that's primarily what you give the body the body

is going to get used to it's going to adapt to using whatever you give it

if you gave the body nothing but alcohol that becomes the preferred fuel all

right it's not a good idea okay don't say that i heard it but from

dr ekberg okay don't use alcohol as the only fuel

but the point is if you give it fat only it uses fat only

if you give it carbs only it uses carbs only

the difference is fat is a stable fuel glucose is an unstable fuel and it

messes with your metabolism with your metabolic machinery over time

that's why a low-carb diet provides stability it's a stable environment for

the brain in the long run but if you stay with this for months now

you have metabolic flexibility you have flex fuel you can

shift from one fuel to the other and not miss

a beat over time as insulin is low your insulin

resistance goes down and your body shifts

from a predominance of storing from a tendency

to store food into using food you start rebuilding you start healing your

metabolism as you become more insulin sensitive you

start breaking down more fat you're promoting

the usage so you're breaking down fat through lipolysis

and another interesting thing is that your leptin starts working again

leptin is a satiety hormone when you eat food

leptin is released and it tells your body you're full

but when you're very insulin resistant the leptin doesn't work

so you eat your body releases leptin but you keep eating anyway because

you're leptin resistant when insulin resistance

dropped now leptin starts working so guess what

you get full you have no hunger as your body repairs and finds its

balance you can go for a long period of time and have

no hunger of course one of the major benefits of reducing insulin resistance

is that you reduce metabolic syndrome so your cholesterol imbalance goes away

your high blood pressure goes down your type 2 diabetes reverses

everything related to metabolic syndrome goes down because

it is about insulin resistance now next is a question that so many people have

what about exercise don't i need carbohydrate

to exercise because they've been told that you can do some aerobic

long distance exercise on fat but you need carbohydrates for high

intensity exercise so both of those are true now

let's clarify how all that works because what

you're going to find is that you'll actually have

months into this you'll have more energy for

both endurance and short burst activity here's a huge misconception

about glycogen we hear so often that you start off with

a full glycogen store and then as you go low

carb then your body is going to burn the

glycogen because you're not eating anything

and it's going to go straight down to zero

and here's what they say you're not going to make

ketones you're not going to burn fat until your glycogen

is depleted right that's not how it works

glycogen is a backup fuel it's an emergency fuel

if you get chased by a wild animal then there's going to be a short burst of

activity as you sprint away or as you climb a tree

there's going to be a need for more short-term energy than you can

burn through fat oxidation so in order for you to survive you can't

have zero glycogen the body is not going to

let that happen the only time you may have seen zero

glycogen is called a bonking when

someone is a long endurance athlete like a marathon runner

or a triathlete and they're many many hours

into the event and they just totally totally crash

when they just fall apart to the point where

they can barely stand up that is when you have zero glycogen but that's

hours into a race your body is not going to let that happen

voluntarily so here is what happens more likely is that in the beginning

it's almost a straight line but as the body senses

that we're starting to run out of this emergency fuel

then it's going to switch to fat metabolism

and it's going to start saving up on the little glucose that we have so even

on a carnivore even on a very low carb

diet the body is going to start saving and as the weeks turn into months it's

going to replenish this glycogen store especially in

athletes if you use glycogen on a regular basis the body is

going to make sure that it has enough and they found in

recent studies i'll probably do a video on that you can

let me know if you'd like to know more that they looked at ultra marathoners

people who run more than one marathon at a time

and they compared a group of high carb and they compared a group of low carb

and they found that they had the same amount of glycogen

before and after their activity that they were very very similar in behavior

here was the main difference though the high carb athletes are not going to be

as good at utilizing fat the low carb

athletes had a more than twice as high

peak burning of fat as the high carb so as you switch to low carb it might

take several months to get fully fat adapted to that

point but eventually you can have a sub maximal activity

and burn 90 percent fat during that activity

so now you have the best of both worlds you

burn primarily fat on the sub maximal activity but through adaptation

you've taught your body to build up some glycogen stores

so you're burning fat but you still have the carbohydrate back up

so this is why you can be both an endurance

athlete and a high intensity athlete on a low carb

or a ketogenic diet but you'll never find out if it's going to work unless

you stay with it for months because in a few days you'll

feel absolutely terrible a few weeks into it you'll probably

still won't have that burst performance but months into it

you're going to have the best of both worlds so i really hope that you're

starting to see how smart the body is that there's

nothing random about this that the production of ketones ketogenesis is

very highly regulated oftentimes they'll say

flippantly that oh ketogenesis is simply a byproduct of fat when you burn

a bunch of fat then ketones result that's not how it is the body makes it

on purpose a bear for example goes through maybe a

hundred or more pounds of fat in a six-month hibernation and still

makes virtually no ketones because they have the fuel supplied to the brain

just from burning the fat they have enough

glycerol to make glucose because the brain is

relatively small humans have a bigger brain so we make it

on purpose and don't worry about these names

but when two signaling molecules called ampk

and glucagon go up and at the same time glucose and insulin goes down that

signals scarcity and that gives the body a reason to make

ketones and now if we're burning a lot of fat

then we're chopping up those fat molecules into

acetyl-coa and we reassemble them into ketones

but again this is on purpose and the reason

is to provide more fuel for the brain because we have a huge brain

in relation to the body size and what's exciting is that recent research

is showing us as well as people's experiences

but it's showing us that this is not just the survival mechanism

but that the ketones in many ways is a superior fuel especially if you're

insulin resistant now you have a fuel for the brain that

doesn't require insulin to get in there and what most

people are going to find out really quick or at least weeks or months

into it is that now you have stable energy

glucose and carb metabolism is very unstable it fluctuates very quickly

so you have to top it off every few hours you become

dependent on frequent meals whereas if you're fat adapted you're making some

ketones now you have an almost endless fuel supply and your energy and

your mood is very stable if you enjoy this video

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thanks so much for watching i'll see you next time