I'm curious to know how the body reacts to stress if one is in ketosis. From what I understand, when the body goes into a flight-or-fight response, the hormones cortisol and adrenaline are released. These in turn request the liver to start dumping glucose into the bloodstream.

The problem I see here is that while one is still in ketosis, the liver's glycogen stores are completely empty because everyone goes through the keto flu to use up all their glycogen stores and they usually eat under 50g carbs and sometimes even less than that so there's very little glycogen available. So what happens when the body has an emergency and requests the release of glycogen via cortisol and adrenaline but encounters an empty liver?? This seems to me like it can make one prone to anxiety and panic attacks if not enough carbs are ingested.

One of the reasons for me asking about this is that a month ago I had very high levels of stress at work due to deadlines and many activities happening at the same time. I was in ketosis the entire time but I suffered severe anxiety which is completely new for me and I had my first panic attack. I decided to research the topic of how the body handles stress and discovered that the body uses glycogen to deal with stressful situations which is bad news since I'm usually ketogenic and so low on glycogen.

During the stressful month, I actually lost weight but it was all lbm. Since then I have increased carbohydrate intake to about 100g which has helped me cope and I'm no longer losing lbm.

I guess I am lucky in some ways that I have descent carbohydrate tolerance (> 100g) or I would be stuck in a dilemma: if you increase carbohydrate too much, then you trigger insulin resistance and its symptoms. If you don't increase enough, then you may suffer from anxiety, panic, and other hypoglycemic episodes.

Hmmm I've been low carb for 13 years and have never had a panic attack. In fact, I'd say I find myself calmer in stress situations without the extremes of high and low blood sugar. I can approach stressful situations with a quiet confidence.

Of course we are all different.

From a physiological point of view, your body should be able to make glucose/glucagon from excess protein and, in a pinch, body fat. I wonder if your mechanism is awry.

I've had panic attacks before and while LCing, not more one way or the other. But I did notice my hormones were completely out of whack while I was losing the most weight. What is evident in a woman (for obvious reasons) might be less so in a man, but your hormones will be changing, too. It could just be a temporary adjustment period.

It could also be that the month you struggled would have been too much for your body to handle anyway, with or without carbs.

I have found that eating lchf has greatly reduced my anxiety. I used to take klonopin, an anti-anxiety medication, daily. After going low carb I slowly weaned myself off the klonopin and haven't looked back. I suffered from major depression for decades too until I changed my diet. It has disappeared since going lchf. I believe that large swings in blood sugar contributed to both these mood disturbance.

Jean

I find being in ketosis very relaxing (when I want to be), and I still have the ability to summon energy for workouts, physical labor, etc. Note that your body is never completely depleted of glucose, as Liz points out, as there are fat sources (glycerol) and protein sources available to make glucose through gluconeogenesis.

Could the stress you're experiencing be from an external source? Have you measured your BG during these stressful periods? You certainly don't want to attribute your anxiety to the wrong thing.

I agree that the stress was likely a bit too much and perhaps I needed some extra protein since I did lose about 2 lbs of muscle. Apparently, my body must have wanted more protein or it wouldn't have broken the lean tissue down.



I agree. I have only been ketogenic for about 1.5 years and I've never had anything close to the highs and lows of eating high carb. That experience has been the only time, except for going through keto flu, that I've seen anything close to hypoglycemia.



I've never had anxiety before but now I know what it feels like. I don't blame the diet since I've felt great during these last 1.5 years and have enjoyed feeling good independent of high carb consumption.



I thought only the "extra" protein (protein not used for tissue repair) got converted through gluconeogenesis. I'm wondering whether there is such a thing as "glucagon resistance". Perhaps one can be in ketosis for so long that the body becomes inefficient at producing enough glucose in the same manner as insulin resistance? Then during high stress, it can't keep up with demand? Note that I've been unable to do anaerobic exercise (too much stress for me) while ketogenic, but I can do aerobic exercise like running and cycling.

I believe it was from an external source since I was okay for the past 1.5 years. The problem is now I get anxiety from thinking about getting anxiety, especially during stressful moments.

I'm almost certain I'm not hypoglycemic because I feel quite energetic in the mornings even after sleeping 10 or more hours sometimes and don't wake up feeling shaky or anxious. I have no hunger at all and could go the whole day without eating were it not for the fear of possibly getting another attack. During the attacks, I don't actually feel hungry neither do I crave sugar nor do I get those awful afternoon headaches I would get when I use to eat high carb and then went without food.

Still, I do agree with your suggestion on getting a BG meter and using it during these pseudo hypoglycemic episodes.

Jesse, Rob is right: your body is never NOT making glycogen. We need a minimal amount for brain function, and if there's no dietary protein, it will make it from muscle.

But it seems to me that you may want to google some anti-anxiety activities.

One thing that someone pointed out once is that the FEELING of anxiety can be identical to the FEELING of excitement: rapid pulse, shakiness, shallow breathing, etc.

It's hard to control your pulse, although some people very in tune with their bodies can do it. It's hard to keep from being shaky, as well.

But we can consciously control our breathing. When I have pain, or worry, I MAKE myself slow my breathing down. It's become a habit.

You could make it yours, and the feeling of being in control of your breath is a powerful calming tool.

I certainly didn't go without protein, but I guess my intake wasn't high enough to handle the unusual stress. I get pretty close to 100g daily and using Dr. Volek's recommendations puts me in the range of 77 - 115g.

http://www.ketogenic-diet-resource....equirement.html

Yes, that's true for me about the excitement. Even the activities that I'd normally enjoy have turned into things I now dread rather than look forward to.

I did start taking more time to just relax and do nothing and sleep more hours. I know exercise helps a lot with anxiety and it took several false starts trying to re-acquaint myself to the heavy breathing and the rapid heart rates that feel eerily similar to anxiety. It's shocking that all it took was one panic attack to make me not want to exercise anymore even though I've been at it for over a year.

If you have any information on where I could learn some good breathing techniques, I'd certainly look into it. Thanks.

http://www.refinethemind.com/breath...y-kill-anxiety/

This article is fairly in depth. But if you don't like it and/or want more information on breath control, just google "conscious breathing".

Jesse, you probably are aware of this, but just a reminder to anyone referencing Volek's protein recommendation that an ounce (equivalent to 28 grams) of meat is roughly 7-9 grams (depending on the meat) of protein. The remainder is fat, liquid, and other non-protein tissue. This is simply a good rule to follow when tracking protein consumed, as a 6-ounce portion of meat will have from about 42-54 grams of protein.

It's very informative, thanks. I often catch myself subconsciously tensing my stomach when I get anxious and this will no doubt have a pronounced effect on breathing.



Rob, I appreciate the provided info thanks.

Also magnesium is crucial for proper mood handling, it is used by over 300 body processes, and most people are deficient.

Look for chelated types which are readily absorbed, because the regular kind is used as a laxative and you don't always want that Or just see if soaking in an Epsom salt bath feels relaxing because that lets you absorb magnesium through your skin.

From ancient times to as recently as one hundred years ago, people sought out mineral springs to soak in for their health woes, and it often helped. Because they were mineral deficient.

Completely agree. I actually started taking about 400 mg of Magnesium Glycinate when the anxiety started (200 mg morning, 200 mg night). I use to get most of my magnesium from bone broth, avocados, nuts, and green vegetables, but I think that stress has pushed up the requirement and it's likely that our food is no longer as rich in minerals because of the environment. I can literally feel the difference (calming effect) within a half hour or so after taking the supplement so I know I'm very likely deficient. I've even been tempted to increase the magnesium to 600 mg since it's been helping so much.

If I somehow forget to take the morning dose, I feel more nervous and anxious than usual when under stress. When I take it at night, it definitely helps me sleep. The only thing I'm concerned with is I don't know how safe is taking all this extra magnesium for long periods of time.

When I started with chelated magnesium (the kind I use) I was taking a couple of 200mg tablets three times a day. Any more than that, and it would trigger a bit of looseness. I read that you can take it until that point, and then back off.

It's what I did. For a few months. Then it kept telling me to back off until I was taking one a day.

I figure I had a deficit