Well, I’m at it again! This time, I’m trying to improve my chronic pain with the Ketogenic Diet! If you get to know me, you will find that have a certain level of perseverance. I struggle with acceptance, and seem to be in a constant state of “self-improvement”, no matter what area of my life. My perseverance is both a blessing and a curse! Any other Pain Campers out there like me? I see you sheepishly raising your hands! Okay, so my next question is, “How many of you have tried the ketogenic diet to improve your chronic pain?” I’m hearing crickets and getting blank stares. Don’t worry, one month ago, I would’ve answered the same way. This post is the first in a series that will chronicle my journey through trying the Ketogenic diet to help my chronic pain and fibromyalgia. I hesitate to publish this first post in the series, as it will be a long one. However, I want to make sure that you all are aware of where I’m coming from, and be true to sharing my authentic experience. So, get your heating pad, and cup of tea ready (I’m not joking)!
Why am I trying the ketogenic diet?
For the past year, I actually had reached a level of acceptance regarding my chronic pain. I have tried everything that has come across my path to cure my chronic pain. So, over the past year, I have laid low, and just tried to manage, cope, and find ways to thrive, despite the pain.
During that time, a friend of mine mentioned that I should try an anti-inflammatory diet, perhaps even the ketogenic one. I looked at the information briefly, and responded with “Yeah, well, I’ve pretty much tried everything including already being on mostly an anti-inflammatory diet, so thanks, but NO THANKS.” *insert eye roll here* What that person didn’t know was that I was already working on trying to change my eating habits. I started in Spring of 2015 by attending a class at Nutritional Weight & Wellness. I was learning how to eat real, whole foods. I was learning, but it doesn’t mean I was doing most of what was encouraged.
My biggest barrier with food has always been about my “picky eating”. I put that in quotes because it is a lot more than picky eating. Let’s be real, I have a dysfunctional relationship with food. On top of that, I have multiple food sensitivities and issues that prevent me from being able to assimilate certain foods and food groups. You can read more about that story in one of my “Just Taste It” recipes. This is an area that I have continued to work on, not necessarily to decrease my pain, but for other major health benefits as well. I want to be able to put my big girl, Pain Camper pants on, and eat like a “normal” person (whatever that means).
Fast forward to December of 2015. I was in the middle of a stressful job change, had just gained 15 lbs in 2 months after my only child moved out (bring on the sugar, because no 40 year old should be an empty nester!), and my pain was getting worse overall. The brain fog was coming back, my sleep more disrupted, and I had no ability to cope with even simple stressors. Enter headaches, with a few migraines sprinkled in, and increased low back pain from the extra bowling ball I was carrying in my belly! I was sharing my New Year’s goal of kicking the sugar addiction (for the 100th time) with a fellow Pain Camper friend of mine. He told me about the ketogenic diet, and how it can possibly help chronic pain, as well as a number of other diseases that may or may not be auto-immune. He suffers from chronic pain and fibromyalgia as well, and has been practicing this diet on and off for over 25 years. He said it has really helped him with various symptoms. That was enough to get me to do a little research so I started reading some basic information online, and proceeded to loan several books from the library. WHAAA??? They want me to be under 20 grams of carbs TOTAL? In ONE DAY?! This was possibly the most ridiculous idea I’d ever heard! My very-healthy-morning smoothie alone was comprised of 30 grams of carbohydrates! Plus, it seems to be a very controversial diet, and against most of what I’ve learned about nutrition. No.
But, because I live my life based on faith, and spiritual principles, I prayed about it. I opened my heart and mind to the possibility that maybe my higher power was leading me in this direction. Maybe, this would be a journey of transformation and healing. Perhaps, another level of healing in my body. If not, at least I would have a chance to work on overcoming my dysfunctional relationship with food.
I have no clue if this will work, but I’ve committed to a 90 day trial. I will not be tracking my pain on those pain charts, because as we all know, they’re annoying! Circle where you have pain. Well, can I circle my entire body? Because I hurt all over! Plus, it depends on the type of pain. Do you want me to draw little red lines for burning pain, and yellow lightning bolts for the zaps? How about a little dagger to show the sharp and stabbing pain? Give it a number on the Wong-Baker FACES scale? Again, same problem. No thanks. So for now, I’m just going to reveal my anecdotal evidence for or against the ketogenic diet. But, I might change my mind. For the sake of science!
History of low-carbohydrate lifestyle and the development of the Ketogenic Diet
The lifestyle of going low carb, turns out, has been around for quite some time. Back in the day of our ancestors, they didn’t have supermarkets and fast food. They had to hunt and forage for their food. Many groups followed animals that migrated, and survived seasons of fasting. During these long periods of fasting, their bodies were adapted to live off of the fat from the animals that they hunted, and their own fat stores. There are current day cultures that live this way as well.
In the 1800s, there were a couple of gentleman who wrote about carbohydrates, and their role in weight, specifically obesity. The most well known of the two, William Banting, told his own story of consulting with a surgeon (William Harvey), who encouraged him to basically ditch the starch, go low carb, and eat meat and healthy fats. He attributed his life saving weight loss to the diet, and wanted to share his news with everyone so he published a pamphlet (Letter on Corpulence) and shared it with people for free.
In the early 1900s, researchers started to use the concept of fasting (or starvation) as a treatment for epilepsy and seizures in children. They found that the ketones acetone, and beta-hydroxybutyric acid, were found in a subject when carb intake was low, and fat intake was high. In 1921, Dr. Wilder at the Mayo Clinic, found that by treating patients with epilepsy with a ketone producing diet, it could be more effective than fasting. He coined the term “ketogenic diet”. Dr. Peterman, also at the Mayo Clinic (and many more to follow), followed shortly with research showing that not only did the ketogenic diet improve control over seizures, but also showed improvement in cognition and behavior.
Since then, there have been many variations of a low carbohydrate diet that have been developed. I’m sure that everyone has heard of the two most popular: paleo and Atkins. These have continued to be in the mainstream culture, just as “clean eating” has taken off. These diets continue to help people despite the fact that for the past nearly half of a century, we’ve all been brainwashed to think that carbs are good, and fat is bad. This came out of some work by Professor Ancel Keys in the 1970s. Since then, there has been a lot of research that supports the low carbohydrate lifestyle, and more specifically, the ketogenic diet. Oddly enough, I cannot find ANY journal articles that involve studies on the ketogenic diet and how it affects chronic pain in humans. As I no longer work in a hospital setting (and don’t feel like going to use my alumni cards at college libraries), I only have access to open access journal articles (Yay PubMed!). I have found a handful of animal studies that are mainly inconclusive. One study shows support for decrease in inflammation, which they theorize may also apply then to pain related to inflammation. However, this same study did not support their hypothesis for improvement for chemotherapy induced neuropathy.
The ketogenic diet (in a nutshell):
- A way of eating that can create a shift in the body’s metabolism. The body shifts from utilizing glucose as it’s primary fuel, to using ketone bodies.
- Ketone bodies are made by the liver from fat (dietary or stored in the body). The liver will not make many if there is a lot of glucose from diet. So, most of us eating moderate to high carb diets, are running primarily on glucose.
- Ketones can fuel the brain, heart, muscles, etc.
- The diet is considered low carbohydrate, moderate protein, and high fat. Some people count their “macros” (macronutrients) in grams or percentages for the day. The recommended amounts seem to change depending on the “expert” advice that you’re following. My experience has been that this can be a bit overwhelming and confusing at first.
- Protein can come from meat and poultry (the fattier the better), fish, eggs, and dairy.
- Fats should come from both animal and plant sources. Healthy plant sources can include: olive oil, coconut oil, avocados, select nuts. Animal sources can include fat in the meat, poultry, and dairy (butter, cream, cheese).
- Carbs should come from nutrient dense, non-starchy veggies that grow above ground. Sorry, no potatoes, corn, grains, rice, etc (I cried while grieving my potato chips).
- Nicknamed “keto” for short!
- “Nutritional ketosis is by definition a benign metabolic state that gives human metabolism the flexibility to deal with famine or major shifts in available dietary fuels.” from the book The Art and Science of Low Carbohyrdate Living.
I have seen anecdotal evidence in many of the keto facebook groups, as well as online, about the keto diet helping to reduce the amount of medication people are taking, or have eliminated it all together (statins, blood pressure, insulin, pain medication). I’ve heard of people with fibromyalgia where they say that ALL of their symptoms are GONE. People reporting alleviation of chronic pain symptoms, or cessation of them all together! Women with PCOS showing improvement in overall symptoms. The list goes on and on. Plus, then there is the weight loss side of things. Photo collage after photo collage of transformations where you think “Is that seriously the same person!?” While I don’t think that any particular diet is a “one size fits all”, I’ve decided to give this a try and hope it fits me.
I have to admit that I did not consult with my primary care physician prior to starting keto. I had blood panels run several months ago, and everything was fine. I have no history of kidney or liver disease, and other than the chronic pain (and fibro, narcolepsy, and other pain related issues), I am pretty healthy. I was diagnosed with reactive hypoglycemia, and was on the road to a diagnosis of diabetes. Even if I did tell him what I was doing, he would just shake his head at me and promise me to come back if there was an emergency. I have heard that many people report they’re trying keto to their MDs or health professionals, and either they haven’t heard of it, and advise against, or they believe it is the same thing as “ketoacidosis” which can occur in people with diabetes (very dangerous). And then, advise against it. It sounds like they respond to the ketogenic diet much like they respond to chronic pain. You know, when they look at you like you have just sprouted another head. So, I will take my chances and see what happens. I will schedule an appointment after I have completed the first 90 days, just to make sure all of my routine blood work comes back normal (lipids, A1C, fasting glucose, etc). I did run it by my friend who is a traditional naturopath, and she doesn’t know much about it. I also ran it by my acupuncturist friend, and he’s heard of it (and is treating me to address some of the issues that have come up since starting keto – which I will explain in one of my next installments). My point is, if you decide to embark on the ketogenic diet journey, please consult with your trusted health care team.
Whew! Part 1 of this saga is nearing the end. I am excited to share with you my progress (or lack there of). I will be continuing to add links to sites, blogs, journal articles, and books on the resources page. Please go there if you would like to do some super Pain Camper sleuthing for your own journey.
You can also continue with my journey by reading my follow ups:
Part 2 (my 1st month)
Part 3 (my 2nd month)
Part 4 (my 3rd month)
Mancinelli, K. (2015). The Ketogenic Diet: The Scientifically Proven Approach to Fast, Healthy Weight Loss. Berkeley, CA: Ulysses Press.
Masino, S. A., & Ruskin, D. N. (2013). Ketogenic Diets and Pain. Journal of Child Neurology, 28(8), 993-1001. doi: 10.1177/0883073813487595.
Volek, J., & Phinney, S. (2011). The Art and Science of Low Carbohydrate Living. Beyond Obesity, LLC.
Pain Camp is a safe place to share your thoughts, experience, strength and hope. Have you heard of the ketogenic diet before? What types of changes have you made to your diet to help with your pain symptoms?