Keto and Starvation Signals

Last month, I posted Keto and Carnivore Diets Were Always a No For Me. On that list of reasons was “Chronic starvation signals”. I never considered a keto diet because of the unknown risk of being in a chronic ketosis state for months or years at a time.

Would the body know that the food environment was safe based on calorie intake alone? Or would the body sense the chronic lack of carbs as threatening to its survival?

I suspected that thyroid and reproductive health could be negatively impacted. Before the keto bros get upset, let me explain what I mean here.

For myself, I don’t need to prove that chronic keto is an unhealthy and unnatural diet. Keto needs to demonstrate to me that it is healthy. When keto first hit the scene, there were no populations that engaged in long-term keto where we could see their outcomes. Has it proven itself to be a healthy long-term diet since then? I haven’t seen the evidence. I’ve seen anecdotes mostly from men under 35 who would likely thrive on any diet.

Observations

What pattern am I seeing with men over 35 in the health and fitness space? They are abandoning keto. I cited a few examples in the post Checking in on the Carb Haters. There are a lot more. Why? The stated reasons are the sudden love for high protein diets or the realization that carbs never were the problem.

What are the unstated reasons? Maybe they feel like crap because their thyroid and testosterone levels are low?

We have known for a long time that many people have issues with their thyroid when they go low-carb. What is the mechanism?

From Claude.Ai

What about testosterone? Give a listen to the interview between Dr. Mercola and Jay Feldman. On the topic of men on ketogenic diets having lower testosterone (sub 500), (around 1:27:00) Feldman said:

This is a natural product of a semi-starvation state or starvation state of a low-carb state that mimics starvation. Testosterone and reproduction are not only not important when we are starving but they are intentionally downregulated, because that is energy we can’t expend in that scenario.

This is the bioenergetic Ray Peat view, but it makes total sense to me.

I consume a lot of health podcasts. In the past few years, I’ve noticed a huge trend of low-carb/keto guys talking about TRT. Why? A few have shared their testosterone levels.

  1. Dr. Paul Saladino had a 400 T-level. Then he added carbs and is now up to 600.
  2. Dr. Peter Attia is at 400.
  3. The keto godfather Dr. Dominic D’agostino is around 300 (according to the Mercola interview).

All these men are healthy and live in sunny climates. I’m a few years older than these guys, living in cloudy Seattle, and my last two scores were 841 and 908 (lifetime natural). Potatoes for the win! Please tell me how awful carbs are again and how keto is amazing. No sale.

I haven’t even looked into the female side of the equation, but common sense tells me that a chronic ketogenic diet would not be ideal for conception and pregnancy. I’m reminded of this story from WW2.

The Dutch Hunger Winter has proved unique in unexpected ways. Because it started and ended so abruptly, it has served as an unplanned experiment in human health. Pregnant women, it turns out, were uniquely vulnerable, and the children they gave birth to have been influenced by famine throughout their lives.

When they became adults, they ended up a few pounds heavier than average. In middle age, they had higher levels of triglycerides and LDL cholesterol. They also experienced higher rates of such conditions as obesity, diabetes and schizophrenia.

A ketogenic diet is not a famine diet. I get that. One is calorie secure and the other isn’t. From a hormonal level, is there any overlap? We don’t know. Maybe in a few decades, we will know if the children of ketogenic mothers turned out more or less healthy. In the meantime, I’d pass on signing yourself and your children up for this experiment.

Last Words

I want to be clear in stating that I don’t know if long-term ketogenic diets are healthy. They could be fine. I’m doubtful and my doubt has only grown in recent years.

32 Comments

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  1. 8 years into keto. My T is 1,100. My thyroid is fine.

    It’s just nonsense and fearmongering.

    Saladino was overdosing on liver, a common mistake that most experienced carnivores will tell you to avoid. Attia was never a serious ketoer. Not sure about D’Agostino. Probably too much protein?

    Keto is proven. Carbs have yet to be proved safe, although I am open to the possibility.

  2. @exfatloss – Do you seriously believe that carbs have yet to be proven safe? You have to be trolling. Almost EVERY SINGLE traditional culture had a diet rich in carbohydrates. Some very high.

    Your T-level is impressive for someone 40 pounds overweight. I’m guessing you are under 40. Probably under 35.

  3. My sister and her husband were having trouble getting pregnant. They were doing keto with moderate results. More for him than her. She felt sluggish and cold. after about a year she went back to carbs. Got pregnant shortly after and started feeling better. Her husband’s weight loss has since stalled but he is a believer, so he is still on keto.

  4. @mas: I think the jury is still out if the agricultural revolution can sustain humans in a healthy way. We can make due, yes, but there seem to be definitive downsides as humans have gotten smaller, weaker, and sicker since switching from a meat/fatty animal by default diet to majority carbs.

    I’m 38.

    But clearly, nearly a decade of T is totally compatible with normal thyroid and hormone production – you’ve fallen for scare stories.

  5. Shawn Baker’s T was tested at 230. The carnivore people twisted themselves in knots trying to explain that one.

  6. @exfatloss – Maybe my writing wasn’t clear. I didn’t fall for scare stories to convince me not to go keto. I just wasn’t persuaded by the arguments to try keto. I’m still not persuaded.

    I can always change my mind later. I was in the Army, not the Marines. I’m glad there are people like yourself going first. Figuring out what works and what doesn’t.

    @John – OMG. I had no idea it was that low.

  7. Don’t forget Mark Sisson. He might not have ever been full on keto, but he did suggest it to his followers while promoting a low carb diet. He also had low T and went on TRT. I’m not suggesting it was his diet that was the cause. I would just consider him another relevant data point in the discussion.

  8. @Geoff – I considered adding Sisson, but he is 70.

  9. Shawn Baker eats so much protein he’s likely barely ever in ketosis. I do think eating excess protein is very problematic, but no clue if it could cause low T. He also works out so much that he might just always be using his T for muscle repair, no clue.

    But the idea that keto always causes low T or hypothyroidism (or, as far as I can tell, any other consistent downsides) is clearly false.

    There might be some people who can’t do it, I’m open to that idea. But there’s clearly a large number of people who’ve been doing it for years to decades with no issues.

    I remember Sisson from Paleo/Primal days, he was recommending eating salad and sweet potatoes if I remember correctly.

    Maybe he eventually switched to lower carb, but he wasn’t low-carb when I read his book, I think.

    @MAS

    You likely don’t need keto. Looks like you’ve never been seriously overweight, you have no medical issues it’d help with (AFAIK). So not sure why anyone would try to convince you.

    But there are large groups of people who do significantly better on (some types of) keto, and I don’t see any evidence that there is a downside to it.

  10. @exfatloss — just read your “Slime Mold” interview. Fun stuff! Not to hijack this comment section, but are you still experimenting with that Ex150 protocol?

  11. Sure am! In fact, I just went back to it about a week ago after some other experiments. You can check out my experience reports here: https://www.exfatloss.com/

  12. @exfatloss – A lot of people seem to forget or don’t know that Si$$on was a professional athlete while eating a diet in high in carbs. He was elite on the very diet he mocked and made a fortune doing so.

    IMO, he is a businessman first. He smelled money first in Paleo and later in keto. I bet if thought he could make more money on vegan, he would have went there…and succeeded. Anyone that could finish 4th in the Ironman without training could thrive on any diet.

    I’m reminded of this 10 year old post.
    https://criticalmas.org/2013/02/primal-certification-are-you-kidding/

    I might do a post on how I would approach serious weight loss.

  13. Yea, my impression of him is similar. Current-day Sisson seems the opposite in many ways of 2010-Sisson, around the time I learned of him.

    From your 10 year old post:

    > If it is easy enough for a caveman, then it should be easy enough for us.

    I think, unfortunately, it isn’t, and this is why Paleo failed so dramatically.

    When a caveman ate an animal, there wasn’t 32% PUFAs in there. A caveman wouldn’t have to dodge PUFAs (and who knows what else) like Neo in the Matrix.

    This is actually one of the most compelling parts of PUFA-theory to me over macro based diets like low-fat/low-carb/keto: There exist examples of humans eating pretty much any diet you can imagine before touched by the Evil Western Civilization, including insanely “easy” food environments where they barely had to work whatsoever to acquire incredibly calorically dense foods.

    And they were all very healthy and didn’t have pretty much any diseases of “civilization.”

    So there was definitely a magic “shift” in the (food?) environment. I think PUFA is the best candidate. I used to believe it was carbs, then sugar, but even that’s been pretty thoroughly debunked by now.

    The failure of Paleo was to cosplay Grok the Caveman, instead of finding out what the actual factors were.

    That means they threw out a whole lot of good things, depending on your Paleo sub-tribe: dairy (great for a vast number of people), fatty beef, many carbs (for a vast number of people).

    They also had a huge number of false positives, again depending on tribe: bacon, pretty much any chicken/pork fat or fatty meat, nuts (for many), seeds (for many), vegetables (for many). Somehow the idiotic idea to supplement near-infinite capsules of fish oil per day, which people like Robb Wolff shilled for years (not sure about Sisson).

    What you ended up with was a diet that worked very well for a small number of people, by accident: those that happened to fit the exact profile that Paleo tribe was recommending.

    I think keto hits more people “by accident” and carnivore even more.

    But it’d be great to come up with a framework that doesn’t rely on randomly hitting a bunch of factors for a bunch of people, and doesn’t restrict things that don’t need to be restricted (e.g. dairy in me).

  14. @exfatloss – Paleo failed because they wrapped themselves in a narrative that carbs were bad, despite evidence numerous traditional cultures ate diets rich in carbs. Back in 2010, I hadn’t connected the dots yet. I was a believer in low-carb.

    The magic of paleo was getting people to cook their own meals at home with real ingredients. Even with the poultry PUFA that will help the majority. Then we got Paleo bars, bacon everything, and recipes to make cake using almond flour.

  15. @MAS I’d love to read your take on serious weight loss mate, if that’s something you are tempted to write about. I don’t know what’s wrong with me but I just can’t stomach the spuds ☹️ always ends in nausea and cold sweats!

  16. @MAS:

    The magic of paleo was getting people to cook their own meals at home with real ingredients.

    I gained 100lbs on keto home-cooking 95-99% of my meals. I don’t think I made almond flour anything once. I began eating keto bars in the end, because the home-cooking from real ingredients wasn’t working, so why bother..

    I think home-cooking from “real” ingredients helps some people, but a) the word “real” is doing a lot of work here, and b) it doesn’t help a large % of people (maybe 30% I’d suspect).

    I would also love to read your take on “serious” weight loss, although I’m bound to disagree strongly 🙂

  17. From looking at some of his writings, I think @exfatloss is approaching fat loss from the perspective of an obese person going from, say 300LB to 200LB. That perspective is going to be a bit different (I think) than that of the typical reader of this blog. The pros of losing 100LB may outweigh certain down sides of keto that would not be tolerated by a non-obese person.

  18. @Jim – If I had a 100 pounds to lose, I would use cyclical ketosis. Mostly fasting. I still may do a follow-up post on this topic to clarify a few points.

  19. Tried fasting; didn’t work. It doesn’t for most severely obese people. They don’t have (biochemical/hormonal) access to all that fat.

    I could water fast pretty easily at 200lbs. Barely made the 3 days at 300lbs.

  20. @exfatloss – We agree. A 3-day water fast is one helluva an ask for a severely obese person. Too long and too restrictive for most. I think I need to do the follow-up post this weekend as this comment thread is getting long.

  21. @MAS

    Looking forward to the post.

    But isn’t this super interesting? Why can a person with an extra 100lbs of body fat not fast as long? Shouldn’t it be the opposite?

    This clearly shows, in my opinion, that it’s not about “calories” but about fuel partitioning.

  22. @exfatloss – Check out the fasting fat loss story I reference in this 2017 post.
    https://criticalmas.org/2017/08/thoughts-high-volume-high-protein-fat-loss/

  23. Mark Si$$on for me represents a symbol of my youthful naivete and foolishness. I used to read his daily apple daily and I bought a few of his products (never again and I’m grateful I never bought his book). I bought into the illusion that he was onto something that really produces superior human functioning and performance. Like we would all could become NFL linebackers if we just lower the carbs (can’t have that “insidious weight gain”) and live just like Grok did. What a load of BS. Maybe I’m being a bit harsh and I used to consume other paleo nonsense, but him in particular I feel like I got duped by a huckster.

  24. @Hs – Si$$on finished 4th in the Ironman on the shitty diet that he mocked in his Primal books. He would likely thrive on any diet. He is a great businessman and he sold a story that – initially – was easy to follow – even if parts of it were less than accurate.

    150-300 grams/day – Steady, Insidious Weight Gain.

    Hat tip to Matt Stone for pointing out that there are more than a billion examples that contradict that assertion.

  25. @MAS Yes, indeed it was Matt Stone’s writings that broke the illusion for me (combined with poor results on paleo,). Of course, I then proceeded to take his ideas too seriously as well. At least he was genuine though, so I don’t feel the same way about it. Live and learn.

  26. @Hs – Matt lost credbility with me after his metabolic zone post.
    https://criticalmas.org/2017/08/directionally-accurate-metabolic-unicorns/

    That was 2017. It never went anywhere and he has disappeared.

  27. @John – Thanks! That video answers the mystery of his disappearance.

  28. @All – My hunch about lower Testosterone levels on low-carb appears to be correct – at least according to this researcher that went through several studies.

    https://veganmiche.blog/2023/04/16/meta-analysis-low-carb-diets-high-protein-diets-lower-testosterone-in-men/

  29. @MAS
    My testosterone is consistently over 1,000 after 8 years of keto. Could be that high protein lowers testosterone, but clearly low-carb/keto per se does not.

  30. @exfatloss – She agrees with your point about keto + high protein is worst for T-levels.

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