I'd like to preface this by saying that I am in no way trying to encourage people to to stop doing or start doing keto, I just thought someone might find my insights on why I stopped doing keto interesting or useful.
TL;DR: Having done Keto for over 18 months, I was getting very cold, tired, had a weightloss plateau, looked like hypothyroidism; stopped doing Keto to relieve my liver and I feel a lot better and plan do only do Keto intermittently going forward.
Why did I decide to stop doing Keto?
So I started doing keto in June 2018 when I was 210lbs (I'm 5'10). The first 6-8 months were quite good. This was the first time I was able to lose weight and commit consistently to something because there were strict regimented rules. I ended up getting down to around 180-185lbs, but this is when things went south. I started to feel very cold and tired and I stopped losing weight. I went to have my thyroid and other blood tested but everything seemed to come back normal and nothing really explained my symptoms. I figured it was because I was stressed at work and must be cheating on keto too much (which honestly, maybe I was for a bit). So I went extra strict for the summer but I didn't notice any improvement, my symptoms just became worse. When the fall came I figured I must just need to boost my calorie burn or something so I added in a pretty intensive exercise regimen, and I did start to experience some fat loss again (but no weight loss surprisingly), but the coldness and tiredness became increasingly intensive (to the point where I had to sleep in like many blankets and sweaters and sweatpants and socks and I'd sleep like 10+ hours a night). And I felt so carb restricted and hungry that it was triggering my binge eating disorder issues a lot more than usual.
I realized this was not sustainable for me. I ended up looking back at my blood reports from earlier in the year and spotted that although my TSH-T4 levels were normal (indicating my thyroid was fine), my T3 levels were very low (possible underconversion from T4->T3?). Most T4-T3 conversion happens in the liver... which is also worked quite extensively in ketone production. I'm not a professional in this area, but this was enough to convince me to give Keto a break for a while to see if my symptoms improved.
How did I stop doing Keto? What happened?
I wanted to make sure that if I was going to stop doing Keto, I'd still be following a healthy and regimented diet to adjust. I was very worried about regaining weight or losing self-control in the face of carbs again. I aimed for a 45% carb, 30% protein, 25% fat diet with the same caloric deficit I had one keto (1450 cals). I prohibited packaged snacks and opted for high fiber options whenever possible.
I've been off Keto for about a month and a half now, and I have noticed a significant improvement in my coldness and fatigue. I no longer have to sleep in sweaters and sweatpants and I am not shivering at my desk. I am able to sleep a normal amount of hours again and I feel a physically a lot more energized. I admittedly still cave to unhealthy carby snacks on occasion, but I don't have to feel as guilty about it and I still don't feel like I am out of control (probably from breaking my addiction by doing Keto for so long). I didn't gain back any weight or fat either.
I definitely think Keto was a really an amazing way to kick start myself to start being more focused on what I was eating and break my sugar addiction, but I think I should not have done it longer than 6 months. Going forward I plan to occasional go on Keto for maybe 1-2 month spans at a time, but not again for as long as I did previously.
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