Why Am I Not Losing Weight?

Why Am I Not Losing Weight?

Questions??

Whether you’re new to low carb or a well-seasoned dieter, starting a low carb diet can be exciting. Watching the pounds drop that very first week or two can put you in a better frame of mind to keep going, but if you expect that weight loss to continue, you’ll soon be in for a surprise. For those who have used carbohydrate restriction before, the slow-down isn’t discouraging. For a newbie to the low carb way of eating, however, it can be confusing. Questions begin to build up:

• Am I following the diet wrong?
• Has my low carb diet stopped working?
• If I’m exercising and eating correctly, why am I not losing weight?
• How can I be in ketosis and not lose weight?
• What can I do to break my stall?

When your weight loss slows to a crawl or you hit a wall, it’s common to want to know what’s happening. Although there’s no way to know for sure, there are several possibilities.

Dehydration

One of the main reasons you might not be losing weight is due to dehydration or electrolyte imbalances. When you first begin to restrict carbohydrates, that restriction forces the body to use its glycogen stores for fuel. For every molecule of glycogen you have stored, the body also stores four molecules of water. That’s the amount of water needed to process the glycogen. As the glycogen is used, the body drops the water, so initial weight loss can be large and fast. If you experience large drops in weight and water loss, it can cause the body to believe it’s dehydrated.

When that happens, the body will conserve the water it has. That water conservation can mask the fat loss and make it appear that you are not losing weight or inches. The body starts stuffing water into your emptied-out fat cells for storage, and you soon begin to think that your low carb diet isn’t working. This is why losing weight can be an erratic process. While the body must draw upon fat stores if you’re not eating at your maintenance level of calories, water retention can mask what’s actually happening.

In addition to dehydration, water retention can also occur if you are prone to yo-yo dieting. The body will assume that you are going to go off your diet again, and it will prepare for that influx of carbohydrates it believes will be coming soon. When the body chooses to stuff water into your fat cells, you have no alternative other than to wait it out. It can literally take weeks for the body to feel comfortable enough or secure enough to drop the water.

Deep Ketosis Safety Precautions

In a person who does not have Type 1 Diabetes, the body has built-in safety precautions to protect itself from going into a state called ketoacidosis. This is a very serious, life-threatening condition. One of my two nephews who have Type 1 Diabetes died from going into ketoacidosis. It makes the body extremely acidic and occurs when an excessive amount of ketones build up in the blood. If you don’t have Type 1 Diabetes, the body will secrete insulin when your ketone level rises too high. That insulin shuts down ketone production, but it also makes it more difficult for the body to mobilize its fat stores. If that didn’t happen, a low carb diet would not be safe.

Low Carb Metabolic Advantage Stops

Many people throw around the idea that there is a low carb metabolic advantage, but it isn’t as large or as long lasting as most people think. When you begin restricting carbohydrates, your stress hormones come to bat. Their purpose is to help the body find and use alternative methods of fuel that enable you to handle the famine conditions you have created. Initially, the body sees a low carb diet as a metabolic emergency. You are setting up the same pathway the body uses when it goes into starvation.

Initially, that causes the body to pull more fat out of its fat stores than needed to fuel the body. It uses the glycerol backbone along with dietary protein to get the amount of glucose the brain, liver, kidneys, red blood cells and a couple of others need to function. As time processes and some of your brain functions convert to using ketones – somewhere in the neighborhood of three to eight weeks – the body learns how many ketones, fatty acids and glucose molecules you need to keep every system in the body running smoothly.

That shuts down the metabolic advantage.

Although you do experience the benefits that breaking down proteins into amino acids can give you, that’s only slightly higher or equal to the amount of calories it takes to break down carbohydrates into glucose – depending on which carbs you choose.

Cardio Can Slow Down Weight Loss

The idea at the heart of a low carb diet is to correct metabolic imbalances. That happens quickly when you begin to restrict carbohydrates. Basal insulin levels can drop to a more normal level within a few days making it easier for the body to tap into its fat stores, but diet isn’t the only thing that affects insulin levels. Using the alternative metabolic pathway places the body in a stressful situation because it thinks you are starving or caught in a famine situation.

Exercise can contribute to the problem because cardio is fueled by glucose. As your blood sugar level drops, cortisol is released to prod the liver into using your glycogen stores for fuel. If your liver doesn’t have enough glycogen, which is what happens on a very low carb diet, the presence of cortisol alerts the liver that immediate glucose is needed.

Although fatty acids can be burned for fuel after the body has adapted to your low carb diet, for many people, fat stores cannot be converted quick enough to fuel the body’s immediate needs during cardio. That can cause gluconeogenesis to go into high production, and as long as cortisol is around, it won’t shut off. That higher production causes higher insulin levels and less fat store availability. Make sure you are not doing too much exercise, especially when your carbs are very low because a very low carb diet keeps your blood glucose level a little higher than normal.

The Bottom Line

The science behind a low carb diet has evolved over the years because initially when Dr. Atkins came forward with his clinical findings, many things involved in the metabolic weight loss process were unknown. Dr. Atkins saw his diet creation work, but he didn’t always understand why that was. His goal wasn’t to nail down the science behind his work. His goal was to help people lose weight who hadn’t been able to do so by using a standard low calorie diet. He made assumptions and guesses that have turned out not to be true, but that doesn’t make the diet less valuable.

Scientific studies to date have found low carb diets to be comparable to low calorie programs – comparable, but not better. Weight loss between the various dieting groups has been about the same. That means the initial large drop in weight that you experience on a low carb diet will eventually move into a similar rate of loss as those who have chosen to lower their portion sizes instead. That’s because the body always adapts to diet, exercise and environmental conditions.

Although there’s no magic pill that enables you to lose your fat stores overnight, a low carb diet offers many metabolic advantages over a low calorie diet for certain individuals. Those advantages have nothing to do with the speed of fat loss. These advantages include lower insulin levels, stable blood glucose, less hunger and the physical benefits that follow eliminating foods you’re intolerant to. For many individuals, those metabolic advantages can make the difference between failure and weight loss success.

Is a Low-Carb Diet Sustainable for Life?

Is a Low-Carb Diet Sustainable for Life?

Questions??

I recently received a comment from a reader that suggested my lack of dieting success was probably due to my inability to stay with one particular low-carb diet plan long enough to reap results. The advice I received was to go on a low-carb, high-fat diet and give it six months or more to work before analyzing. 

That was similar to the advice I received from the zero-carb folks a few years ago when despite the fact that I had gained about 20 pounds in the first three weeks and was experiencing abnormally high blood glucose levels, they told me to eat only beef, drink only water, and wait six months before reviewing the results. They didn't seem to care about the resurrected neuropathy. They were just sure that their way was the only way. 

The problem with that type of advice is that it doesn't work for everyone. 

Take Responsibility for Your Own Health

Correcting metabolic issues isn't always as easy as lowering your carbohydrate level. For example, I'm juggling vertigo, celiac disease, food sensitivities, and hyperthyroidism (Graves' Disease), so my problems with sustainability are far more complex than simply going back onto a very low-carb, high-fat diet, ignoring the physical ramifications, and giving the plan six months to work -- no matter what.

For those of us with autoimmune thyroid disease, that type of advice is dangerous.

Granted, my health had started to deteriorate before I received the hyperthyroidism diagnosis, but that doesn’t mean that a low-carb diet won't be sustainable for you. For many people, low-carb diets are the best choice out there. What it means is that a very low-carb, high-fat diet is not sustainable for me. I need quite a few more carbs than 20 per day and less fat than a typical low-carb diet has to keep my thyroid purring happily.

That’s one of the main reasons why I continuously stress the importance of finding what works for you. I do not subscribe to the common low-carb community belief that everyone needs to follow a low-carb diet, even the kids. That is not what Dr. Atkins taught, nor is it what he stood for.

Don't Give Up on Low Carb Too Soon

I totally agree that diet hopping isn’t beneficial. I used to watch several people over at Low Carb Friends do that back when the Kimkins diet was popular over there. If they went a single week without losing weight, they would switch something up. That was one of the non-beneficial things that surfaced in regards to Kimkins: this mindset that weight loss needs to be consistently fast.

The body can only mobilize a certain amount of fat per day, and anything more than that is likely to be coming from muscle. The less muscle you have when you reach goal weight, the fewer carbohydrates you’ll be able to eat because your ability to store glycogen depends on how much muscle you have.

In addition, you don’t solve a lifetime weight problem by going onto a low-carb diet (or any diet for that matter) and then come back off it haphazardly. One of the things that Dr. Atkins repeatedly stressed when he was still alive was that losing the weight wasn’t the objective.

The goal is sustainability: keeping the weight off for the rest of your life.

If you can’t do that with some modified version of the diet you’re using to lose the weight, then over the long-term, you won’t be very successful.

That is what I learned from the various dieting experiments that I ran on myself. I learned what worked for me and what didn’t. I learned how my body responded to:

• different levels of carbohydrate content
• different carbohydrate restrictions
• simple calorie counting

I learned what a very low-calorie diet does to me mentally, emotionally and physically. I also learned what a very low-carb, high-fat diet does to me. These are not lessons I regret.

My Regret

Although I regret going off the self-designed low-calorie, low-carb diet I created for myself, I have also come to realize over the past few days that a low-carb diet is not sustainable for me, so it probably didn’t make any difference over the long run that I didn't ignore the low-carb peer pressure.

Steven Phinney's Viewpoint on Sustainability

I watched an interesting video yesterday. It was an interview with Steve Phinney, one of the major names within the low carb community. If I remember correctly, he was involved in writing one of the prior Atkins Diet books along with a couple of other men.

His viewpoint differed greatly from Dr. Atkins as to the sustainability of ketosis long-term. His interest falls into the category of how people adapt to a low-carb diet over time. He believes you should stay in ketosis at maintenance rather than returning to a more moderate-carb diet like Dr. Atkins advised. The basis for that belief is the experiments he has conducted on himself over the past few years.

He moved in and out of several low-carb diets and eventually settled on the one he discovered he could live with for the rest of his life.

Dr. Phinney did not just pick a plan and stick with it. He experimented on himself the same way I did. He discovered that his body runs great on a low-carb, high-fat diet. He eats about 15 percent of his calories from protein, 5 percent from carbs, and somewhere in the neighborhood of 80 percent fat.

That is what works best for him.

He also believes that sustainability is more complex than simply restricting carbohydrates. 

How to Determine Low-Carb Sustainability for Yourself

As for basic sustainability, there are many people who receive a surge of energy from restricting carbohydrates. Their:

• hunger goes down
• sense of well-being goes up
• metabolic markers improve
• health issues reverse themselves or at least get better

These people typically have insulin resistance or metabolic syndrome and not too much excess body weight that their metabolism adjusts to their low-carb, high-fat diet before they reach goal weight.

For them, a low-carb diet works beautifully. It’s corrective and sustainable, especially if you enjoy the food choices and don’t have too many food intolerances that interfere with what you can eat.

On the other hand, if you are insulin sensitive you might find that a low-carb diet makes you feel terrible. There’s:

• no energy surge
• you’re hungry and tired all of the time
• your body consistently tries to sabotage your diet

I’m not talking about mind tricks or emotional eating for comfort. I’m talking about:

• hormonal crashes that occur fairly quickly
• uncontrollable gluconeogenesis
• an inability to control your blood glucose level
• your thyroid crashing
• your metabolism slowing down to a crawl
• blood cholesterol getting worse

and other physical problems that might affect the quality of you life and your sense of well-being.

Low Carb Not Sustainable for Everyone

The cold, hard fact is that a low-carb diet is not sustainable for everyone. For many individuals, a low-calorie diet works better. Sustainability depends on your individual metabolic issues and what you need to personally eat to keep your body functioning at its best. 

That's one of the reasons why Atkins Nutritionals has now divided the Atkins Diet into two different plans: Atkins 20 and Atkins 40. It's also why they now have strict regulations that must be followed in order to remain at 20-net carbs for an extensive length of time. A very-low carb diet is not safe for everyone.

Will a Low Carb Diet Ruin My Metabolism?

Will a Low Carb Diet Ruin My Metabolism?

Questions??

There is a lot of confusion these days about metabolism. It seems to be a scapegoat that people like to blame when weight loss doesn’t happen easily. If they’re following a low carb diet and struggling to succeed, then they believe that all of those years of eating carbohydrates must have destroyed their metabolism and made them fat. On the other side of the argument are those who oppose low carb dieting. These people claim that carbohydrate restriction will permanently alter your metabolism, but what’s the truth? Will eating carbohydrates or following a low carb diet ruin your metabolism – or not?

What is Metabolism?

Low carb dieters generally do not like to hear about the energy equation. Dr. Atkins told us that we no longer need to worry about calories, so most people believe the energy equation isn’t applicable to them. Calories don’t matter, they say. Dr. Eades has tried to set the record straight, but far too many people still do not want to go outside and drag the equation back in from the trash. They’d rather leave it out of sight, pretend it doesn’t exist and let the myths about starvation mode and damaged metabolisms reign in their lives instead.

The energy-out portion of the equation is your metabolic rate. Although the body handles each macronutrient differently, that doesn’t make the energy-out side of the equation false. What you eat must be broken down, processed, utilized, and burned for fuel or stored. You can’t get around that. Over the long-term, if energy in does not balance energy out, you’ll get fat. If energy in is less than what’s needed to fuel your body processes, you’ll lean out. Metabolism isn’t simple. It’s fairly complex and divided into three parts:

• basal metabolic rate (BMR)
• thermic effect of food (TEF)
• thermic effect of activity (TEA)

There is a further breakdown of activity. Activity divides into exercise and non-exercise movements such as fidgeting, wiggling, shaking your foot, rocking, getting up from a sitting position – basically, moving that doesn’t have an exercise benefit.

How Metabolism Functions

When people talk about damaged metabolisms, they’re generally referring to their BMR. However, the thermic effect of food and activity play greater roles in the success of your diet.

Basal Metabolic Rate: BMR is influenced by a variety of factors. Some of those conditions are the amount of lean body mass you have, your body fat level, whether you’ve dieted yourself down to your current weight, your hormonal homeostasis, heredity tendency and other adaptive issues. While a low carb diet will ultimately affect your BMR, that affect is no different from any other diet. It is the hormonal outcome and body composition of weight loss that affects your resulting metabolic rate after dieting, not the type of diet you followed to get there.

Thermic Effect of Food: This energy breaks down the macronutrients you eat and processes them. Protein uses the highest amount of energy. About 20 to 30 percent of the calories in meat, eggs and dairy foods are needed to break them down into amino acids. This is one reason why a low carb diet appears to improve metabolism, but that improvement comes with any diet where you ate the same amount of protein. When processing carbohydrates, the body uses about 5 to 6 percent of its calories to turn them into glucose and store them as glycogen. If glycogen stores are full, it takes up to 23 percent of the calories to convert carbohydrates into triglycerides and store them in fat cells. That’s similar to protein. Fats don’t need much converting, so it only takes 2 to 3 percent of its calories.

Thermic Effect of Activity: This portion of your metabolism is extremely variable. It includes all movement that isn’t a basic body function. Sedentary individuals might burn calories of 10 to 30 percent over their BMR, while more active individuals will burn more. Fitness level really comes into play here, but overdoing exercise in comparison to the number of calories consumed can cause your metabolic rate to fall quicker than anything else. In addition to exercise and daily movement, there are other things that burn calories. Weather cold enough to cause shivering, coming down with a cold or the flu and repairing injuries are just a few.

How Low Carb Dieting Affects Your Metabolism

A low carb diet works extremely well for those with insulin resistance because it quickly lowers basal insulin levels and blood glucose in those with metabolic syndrome. It also requires less first- and second-stage insulin release, which allows the body’s metabolism to function more normally. Many individuals with insulin resistance have a TEF defect that corrects itself when you lose weight and become more sensitive to insulin. Insulin can also trigger hunger, so reducing insulin levels can correct overeating problems.

Not everyone who follows a low carb diet is insulin resistant. For those with only a few pounds to lose, it’s more likely you are insulin sensitive or only slightly resistant. Turning to a low carb diet early puts you ahead of the game because your metabolism isn’t as likely to get depressed from dieting as those with more pounds to lose. You should not have a TEF defect that needs healing. After losing 40 pounds in 1975, I easily maintained that weight for many years eating anything I wanted. It was only after my food sensitivities began to surface and my blood glucose levels started to degrade due to an abnormal amount of stress and trauma in my life that I put on weight.

Whether you have a little to lose or a lot, handling pre-maintenance and maintenance wisely is the key to keeping your metabolism healthy. When you restrict calories, metabolism slows because it senses that fuel is in short supply. The body functions with only one goal in mind: survival. Low carb dieters often refer to this reduction in metabolic rate as starvation mode, but that isn’t accurate. The definition of starvation is less than 50 percent of the calories you need for your BMR. That’s why the famous Minnesota Semi-Starvation Study done on Viet Nam War objectors was called semi-starvation even though they were fed only 50 percent of the calories they needed for maintenance.

Keeping Your Metabolism Healthy

Most people who claim to be following the Atkins Diet are not doing Atkins. They are following an extremely low carbohydrate plan they designed themselves, and they are doing it for extended lengths of time. That’s fine, but keeping your metabolism healthy requires certain precautions. Very low carb diets affect many body functions. Metabolism slows because insulin, blood glucose, thyroid, catecholamines and especially leptin levels drop. Dr. Atkins’ original built-in defense against the slowdown was to raise carbohydrate intake slowly and steadily until you reached a level slightly less than homeostasis.

For many individuals, losing only a pound of week – even if it comes off easily – is far too slow to maintain dietary focus. For that reason, Dr. Atkins allowed many patients to stay at Induction levels a little longer, and he raised their carbohydrate intake slower. In fact, in one interview, he mentioned that for those with 100 pounds to lose, his course of action would be to keep them at 25 net carbs for the major part of the weight loss phase to get the fat off more quickly. To compensate, he administered thyroid hormone to his patients to get them through the rest of the weight loss phase.

Many of us do not have that luxury, so we have to do things a little differently if we want to succeed. That’s why I always recommend Dr. Atkins’ original diet when asked which Atkins version is best, and I fully advocate returning carbohydrates to your diet to keep your thyroid healthy. It is extremely important when you reach lower body fat levels to eat adequate protein and carbohydrates because the thinner you are, the more likely it is that you will sacrifice lean body mass rather than body fat. The ’72 version allows you the freedom to fine-tune your diet to your own metabolic issues and food sensitivities as well as discover your own personal carbohydrate and fat tolerance levels.

If you’ve been dieting for quite some time, you also run the risk of your Leptin levels crashing. If that happens, weight loss will come to a halt, and you’ll be unable to stick to your diet. Your hunger will increase dramatically, you won’t be able to get your thoughts off food, and you’ll begin displaying many of the symptoms associated with the starvation response. That doesn’t mean a low carb diet is bad. It means that your body needs a break. For me, I always move to maintenance to give my body time to adjust back to a normal metabolism because the alternative is what most dieters fear the most: returning to your old way of eating and gaining everything back plus more.

Pre-Maintenance and Maintenance

No matter how much weight you have to lose, no diet will allow you to return to your old way of eating. That old way is what caused you to become overweight. Return to that, and the weight will come back. That much is true. What isn’t true is the type of foods you have to limit. There are many ideas floating around the low carb community that are personal choices projected onto everyone else. For example, Dr. Atkins’ early books didn’t outlaw white potatoes. In fact, in the 1992 version, he showed you how to eat them and continue losing weight. He called it: Real Life.

Unknown to many low carbers, Dr. Atkins also did not put all of his patients on a low carb diet. He did not believe that carbohydrate restriction was necessary for everyone. A low carb diet is for those with insulin resistance and metabolic syndrome. It worked well for his patients who had inflammatory bowel disease. Sometimes, he used it for those who were allergic to wheat, but he did not put everyone who came to him on it.

I know that tidbit of information would shock a lot of low carbers who believe everyone should forever follow the rules of carbohydrate restriction for good health, but in 1981, Dr. Atkins wrote a book called “Dr. Atkins’ Nutrition Breakthrough: How to Treat Your Medical Condition Without Drugs.” In that book, he provided a diet he called, “The Meat and Millet Diet,”that he fine-tuned to fit the patient’s individual metabolism:

“This diet is the best blood-sugar-controlling diet I have been able to devise for the patient who cannot afford to be on a weight-losing regime. It maintains most of the advantages of the Atkins Diet, except the advantages of being in ketosis. But it affords the many clinical advantages of a high ratio of complex (starch) to simple (sugar) carbohydrates. And it provides the added benefit of a high fiber intake.”

The bottom line is that Dr. Atkins was into health, not strictly low carb. His pre-maintenance diet was designed to gently take you out of ketosis, but most low carbers do not want to go there. As a result, their metabolisms stay depressed, so they have to eat a low number of calories to maintain their weight. Their thyroid often becomes trashed, so they end up on thyroid medication for the rest of their lives. They are afraid of refilling their glycogen stores because on the average that represents a 5 to 10 pound regain, so they stay in ketosis even though we don’t know how safe that is for everyone who doesn’t need to be there.

The easy alternative to the glycogen problem is to simply diet yourself down to 10 pounds lower than you want to be, so that when your glycogen refills, you’ll weigh exactly what you want to. Glycogen and the water that attends it are not fat. They are nothing to be afraid of. It’s all that water and glycogen you lost the first two weeks of your diet. That needs to be replaced so your body doesn’t think it’s still starving. The key to a healthy metabolism is to find out the carbohydrate level you feel best at, one that will allow you to maintain your goal weight easily. That doesn’t necessarily mean you give up potatoes, but it does mean you have to stay within your maintenance level of calories.

For many people, that means restricting your carbohydrates for the rest of your lives. For others like my Uncle, it doesn’t. It just depends on the healthy habits you take into maintenance with you. Go back to the amount of food you ate before, and you’ll return to who you were. While low carb doesn’t mean drastic restriction for everyone for the rest of your life, it does mean you have to change. A smaller body needs fewer calories. That’s the price for being thin.

Insulin Insufficiency and a Low Carb Diet

Insulin Insufficiency and a Low Carb Diet

Low Carb Diet Questions??

One of the largest misunderstandings circulating within the low carb community is the mistaken idea that everyone on a low carb diet has insulin resistance. While most of us have some type of metabolic problem or defect, it isn’t always from insulinemia. Sometimes, the problem is not too much insulin; sometimes, it’s actually not enough.

For those with insulin resistance, the problem can be easy to solve: Just restrict carbs to your personal level of tolerance and save carby treats for special occasions. That results in increased sensitivity to insulin and better blood glucose control. If you have insulin insufficiency, however, the problem is more complex.

Role of Insulin

A fear of carbs and insulin is common among low carb dieters, but insulin is vital to survival. If you don’t produce enough insulin, you’ll die. Insulin is a peptide hormone secreted by the beta cells inside the pancreas. It’s released about every 5 to 10 seconds at a very small level, and then in larger quantities after eating. These larger spurts divide into two separate phases.

The first phase is what the body has had a chance to store since dealing with your previous meal or snack. The amount of insulin secreted depends upon how many carbohydrates you ate at your prior meal or snack. It has nothing to do with what you are currently eating. Consistent snacking or eating an inconsistent number of carbohydrates at each meal or snack can seriously affect the amount of insulin you release to handle a meal. First phase insulin is released within a few minutes because it’s triggered by a rise in blood sugar level. This has nothing to do with the height of elevation. It is stimulated by the rise itself.

The second phase is what the body manufacturers and then releases if the blood glucose level hasn’t dropped below 100 mg/dl after about 30 minutes. The purpose of both phases is to keep blood glucose levels within a tight margin of safety. What insulin does is attach itself to insulin receptors on the outside of body cells. That signals the cell that fuel is available. What those body cells cannot immediately use for energy is stored in muscle tissue, the liver or fat cells – in that order. Carbohydrates do not immediately turn into fat. They go to replace your glycogen storage. Carbohydrates are only turned into triglycerides and stored as body fat if your glycogen storage is full.

Once glucose is used or stored, insulin degrades, which shuts down the signaling. This takes about an hour in a normal metabolism. At that point, the body uses either stored glycogen or fatty acids for fuel depending on the body’s needs. Fatty acids take longer to mobilize than glycogen does, so quick bursts of energy such as aerobic exercise use glycogen. That is also glucagon’s first choice for fuel: glucose.

Role of Glucagon

When blood glucose falls to dangerous levels or when there is an excess of amino acids in the blood, the alpha cells within the pancreas secrete glucagon. Like all stress hormones, the role of glucagon is to mobilize energy sources, so that blood glucose can be brought back to a safe level. Glucagon is a stress hormone and mobilizes resources to handle the stressor. It does that by attaching itself to glucagon receptors on the surface of liver cells and then forcing the liver to convert its glycogen stores into glucose. This glucose is immediately dumped into the bloodstream to handle the stress.

Glucagon is an anti-anabolic hormone. It does whatever it needs to do to get the body fuel. That is what swings the metabolism to the low carber’s favor. When glycogen is not available, glucagon stimulates the liver and kidneys to begin the process of gluconeogenesis where amino acids are turned into glucose. To do that, it turns off glycolysis, but only because glucose is not presently available. Glucagon regulates glucose production through lipolysis. It encourages the liver to use fatty acids to fuel the process of gluconeogenesis, so it can save what little glucose there is for the brain and central nervous system.

If ample amino acids are available, the liver will use them to create glucose. About 58 percent of the protein you eat can be used for this purpose, provided you’re eating more than you need for daily tissue and cell repair. The body can also use the glycerin backbone attached to triglycerides, but since that amounts to only 10 percent of the fat molecule, it can’t mobilize enough fat to get the amount of glucose the body needs. When amino acids are not easily available, the body goes into a catabolic state and breaks down muscle tissue instead.

The Dance Between Insulin and Glucagon  

Insulin and glucagon work synergistically to keep the blood glucose level within a narrow margin. The fact that glucagon encourages fat mobilization is a protective device. That makes both hormones essential for health. In a normal situation, glucagon comes into play when insulin levels are low, but that isn’t always the case. When glucagon is triggered due to excess amino acids in the blood, both insulin and glucagon are active and high at the same time. It is not true that when insulin is high, glucagon is always low. Nor do all body cells have insulin receptors. Uptake of glucose by the liver, brain and kidneys occur independently without the help of insulin.

When beta cells become defective or die, the alpha cells within the pancreas become accustomed to lower levels of beta cells or non-functioning beta cells and lose their ability to sense the level of glucose in the bloodstream appropriately. This confuses both the alpha cells and the liver. Without an adequate amount of appropriately functioning beta cells, insulin secretion will not be enough to clear the bloodstream of excess glucose. Alpha cells won’t know when to secrete glucagon and when not to. The result is a tendency to over secrete glucagon rather than under secrete it, which leads to elevated glucose levels and eventually an insulin deficient diabetes.

Insulin Insufficiency’s Effect on a Low Carb Diet

The fewer beta cells you have, the less insulin you can manufacture and secrete. Since elevated blood glucose levels do not inhibit glucagon, the longer glucagon remains elevated the more glucose the liver pumps into the bloodstream. This can result in dangerously high and toxic levels of glucose in the blood, which can then cause insulin resistance to the lower amount of insulin you do have.

A low carb diet causes insulin levels to fall quickly. Generally, insulin production slows down within a few days. If you have insulin resistance and insulinemia, a lower insulin level is a good thing. A low carb diet can bring your insulin down to normal output levels and correct insulin resistance. If you have insulin insufficiency due to a hereditary defect or severely reduced number of beta cells, a low carb diet can cause your glucose levels to skyrocket. If those levels continue, they will cause mild insulin resistance and weight gain rather than fat loss.

Since glucagon can be released by alpha cells when insulin levels are low, insulin defects do not prevent glucagon secretion. But with epinephrine (adrenaline), arginine, alanine, acetylcholine and cholecystokinin also stimulating glucagon production, the liver can get confused and keep dumping glucose into the bloodstream – even when your glucose level is high. This can be particularly problematic if you’re eating a large amount of protein. That’s because glucagon’s job is to raise blood sugar. It works in opposition to insulin, which lowers blood sugar.

My Own Problems With Insulin Insufficiency

Typically, insulin insufficiency surfaces as a young adult. It’s more likely to be diagnosed correctly if you’re a woman because it will surface as gestational diabetes with your first child. That isn’t always the case, however, because many individuals are diagnosed with type 2 diabetes instead. Plus, most physicians are not trained to recognize insulin insufficiency.

I had gestational diabetes starting with my first child but since my blood sugar dropped to a pre-diabetes level after the baby was born, my doctor told me he couldn’t treat me. Neither did any of my other gynecologists when the same thing occurred with each child. Nothing was known about insulin insufficiency back then – only that it existed.

Pregnancy places a large amount of stress on the body, so glucagon mobilizes resources to help provide the fuel the baby needs to grow. While you might have had just enough insulin to take care of your previous needs, when pregnant, you can’t make enough insulin to handle the glucose increase. Once you deliver, glucose levels return to normal because glucagon is no longer being triggered. Physicians see this corrective measure and believe everything is fine – even though it’s not. As the years of insulin insufficiency continue, elevated glucose levels become more common even when you're not pregnant.

Insulin insufficiency is responsible for about 5 percent of all cases of diabetes. Since it’s hereditary, it’s unusual to have the problem without a strong family tendency towards diabetes. Both type 1 and type 1-1/2 runs in my family. While some medical professionals are beginning to recognize the problem and have labeled it type 1-1/2, there are many subdivisions depending on the specific genetic defect.

It is very expensive to test for because you have to test for each problematic gene. Currently, there are six known defects but scientists suspect more. Unlike other hereditary issues, it only takes one gene from a single parent to cause insulin deficiency. If you have a parent with this problem, you have a 50 percent chance of having it yourself. In those who inherit one defective gene from each parent, their diabetes is more likely to be pretty severe.

The good news is that insulin deficiency doesn’t always require injected insulin. Many times, it can be treated through diet, or pills and diet, alone. Insulin deficiency doesn’t always mean you have to go to using insulin, although many people with the problem prefer that method because pills that stimulate insulin release can often be too strong.

When you have insulin deficiency, it is vital to find the correct amount of carbohydrates that will keep your blood sugars as close to normal as possible. That will probably be a higher number than found on a standard low carb diet because you have to keep your insulin level from falling too low. If you don’t, the elevated glucose that results from the release of glucagon can cause serious diabetic complications such as neuropathy even before you are diagnosed with diabetes.

This is why it’s extremely important not to project your own experiences with a low carb diet onto others. A no carb or very low carb diet can make metabolic issues worse rather than better. So far, my own experience has found that 20 to 40 carbs per meal is necessary to keep my glucose levels normal. For someone else, that might be much too high. The specific foods I eat also makes a difference. It just depends upon your own type of defect – which is why a low carb diet works best when you personalize it to fit your own medical condition.