17-year vet with a "hello" and keto question

[Jen]

Hello! I had the DS in Oct. 2001, as performed by Dr. Robert Rabkin (or Rabkin OG, as I like to think of him). I was 26 then and am 43 now (yikes), so I've lived a lot of life since then. I originally lost 150 pounds very quickly (I want to say it was about 9 months), and besides fluctuating between a low of 120 pounds during a time of extreme stress and a high of 180 a few months ago, I've stayed the same weight since the original loss.

I've pretty much lived a normal life but with anemia and smelly diarrhea. As I mentioned, I got up to 180, and in August I started the keto diet because I was the only person I know not doing the keto diet, and it seemed simple enough. Well, it was almost *too* simple, and I'm down 40 pounds since August. My knowledge of the actual science behind the DS is not great and never has been. I've been restricting myself to 70% fat, 25% protein and 5% carbs (which amounts to 20 whole carbs per day).

I'd like to lose 10 or 15 more pounds, but I've been struggling with the fact that the diet is just not sustainable after that. I'm terrified of eating more than 20 carbs, but then again, I really want some damn carbs. Does anyone who has had the DS have experience with macros and how to calculate them for a DSer? I can't find much online.

Thanks!

 

[southernlady]

Welcome Jen
Unfortunately anemia is pretty much a given. Many of us have to have iron infusions.

As far smelly diarrhea, smelly is usually carbs. But if you aren’t eating many, it’s either the type of carbs or your gut is out of balance. And what do you consider diarrhea? Normal DS poop is just slightly firmer than soft serve. Diarrhea is the squirts....liquid type.

Maybe list the carbs you do ingest.

As far as macros, around 100 grams of protein (I watch my protein lab to see if I am eating enough.
Anywhere from 100 to 150 or more of fat. https://bariatricfacts.org/threads/fats-are-not-the-enemy.3185/
And many say below 50 total carbs. I keep mine around 100 to 150 but that’s me.

 

[JackieOnLine]

Hello, Jen!

 

[DianaCox]

What sugar substitutes are you using? Anything ending in “-itol” is a laxative to many of us.

 

[Munchkin]

Hi Jen! Welcome! Keto is sustainable, I have been pretty much on it for decades. I have cheat days where I can eat as I please. Out of town trips, holidays, and birthdays are my free to eat as I please times. Other than that I try to stay under or at 20 carbs per day. Those cheat days keep me from sabotaging myself!

 

[Sheanie]

A really good probiotic might cure the smelly part.

 

[Spiky Bugger]

Welcome Jen
And what do you consider diarrhea?

This EXCELLENT question is one we should ALSO ask our doctors!

If we do, we learn that some doctors consider consistency and urgency.

But there are other doctors who truly believe that either "three or more" or "more than three" bowel movements per day = diarrhea. These are the doctors we need to lose or work around, because they don't get it.


This doesn't address your question, Jen , but welcome!

 

[bearmom]

Wow, 17 years and still working your DS!! I take so much calcium, it never lets things get too soft. The calcium citrate in particular is actually constipating to many DSers. Some things cause diarrhea, like "itols" mentioned above, but I take a strong potassium that would keep me cleaned out if it weren't countered with all that calcium.
Probiotics also help with both, especially smell. I take (usually) several different types of probiotics, which leaves me with almost no gas, and much less poop smell.

 

[LizJ]

Wow, 17 years and still working your DS!! I take so much calcium, it never lets things get too soft. The calcium citrate in particular is actually constipating to many DSers. Some things cause diarrhea, like "itols" mentioned above, but I take a strong potassium that would keep me cleaned out if it weren't countered with all that calcium.
Probiotics also help with both, especially smell. I take (usually) several different types of probiotics, which leaves me with almost no gas, and much less poop smell.

What probiotics do you take? I'm looking for some but I don't want to have to eat more yogurt.
Thanks!
Liz

 

[Jen]

Thanks for all of your replies! I suck at message boards and always forget to come back and respond. But I appreciate hearing from everyone!

Unfortunately anemia is pretty much a given. Many of us have to have iron infusions.

Yup. Iron infusion veteran here. It got so bad that I had to have two blood transfusions, but that was almost 7 years ago.

And what do you consider diarrhea? Normal DS poop is just slightly firmer than soft serve. Diarrhea is the squirts....liquid type.

I pretty much have peanut butter poop. If I eat something like Greek yogurt, well, I have normal poop. It's just ... a lot. Sometimes 5 times a day.

Maybe list the carbs you do ingest.

Pre-keto: All the carbs. I was seriously off track, and it didn't come back to haunt me weight-wise until the beginning of last year. I was sort of obnoxious about it, I'm ashamed to admit. People always commented on how much I ate and how I never gained weight.

Now: Vegetables, dairy (I consume a God-awful amount of heavy whipping cream and cheese), nuts, and crappy foods like Quest bars on the way to work.

As far as macros, around 100 grams of protein (I watch my protein lab to see if I am eating enough.
Anywhere from 100 to 150 or more of fat. https://bariatricfacts.org/threads/fats-are-not-the-enemy.3185/
And many say below 50 total carbs. I keep mine around 100 to 150 but that’s me.

Awesome, and thanks for the link; that was super helpful. I've been trying to recalculate my macros based on 20% fat / 60% carb and protein absorption, and the calculator just goes bonkers and insists I will gain weight if I continue down that path, lol.

What sugar substitutes are you using? Anything ending in “-itol” is a laxative to many of us.

I use erythritol as a sweetener, and Stevia, which I understand is similar to erythritol. I haven't noticed it being a laxative, though. I do still drink Diet Pepsi (can't kick that habit), which uses aspartame, and I do eat sweets sometimes that are sweetened with aspartame. Maltitol, though ... yikes. I kind of know what I'm getting myself into if I eat something with that.

Keto is sustainable, I have been pretty much on it for decades. I have cheat days where I can eat as I please. Out of town trips, holidays, and birthdays are my free to eat as I please times. Other than that I try to stay under or at 20 carbs per day. Those cheat days keep me from sabotaging myself!

Nice! That's awesome that you've been able to sustain it for so long! When you say under 20 carbs a day, is that carbs absorbed at 60%, or 20 actual net carbs?

A really good probiotic might cure the smelly part.

It never occurred to me to try a probiotic ... thanks! I'm sure my boyfriend will appreciate this, as well, lol.

Probiotics also help with both, especially smell. I take (usually) several different types of probiotics, which leaves me with almost no gas, and much less poop smell.

Can I ask what kind you use? I know nothing about them. Is there a particular brand that works well for DSers?

 

[Munchkin]

Actual carbs. I don't bother with the DS math. I absorb more than most. And if it's carbs it will land on my gut to stay. I should revise that to between 20 and 30 carbs per day. I always forget to add condiments!

 

[Jen]

I always forget to add condiments!

Ha ha, same! The little things add up, unfortunately.

How do you know you absorb more than most?

 

[Munchkin]

Ha ha, same! The little things add up, unfortunately.

How do you know you absorb more than most?

I never made it to thin and I have diet constantly to maintain. My CC is supposedly 75CM. I have never had any deficiencies either and honestly I should have.

 

[Sheanie]

Probiotics are so plentiful these days. At my stores, there are entire floor to eye level shelves full.

My normie husband takes Florastor and has seen his IBS go away. If I have gas, I take Florastor. When I can find it, I take the Gas Defense Digestive Advantage. That stuff is miraculous. There are ones for lactose intolerance and bowel support, as well.

Florastor is expensive, but worth it, if DH buys it. (Mr. Cheapskate)

 

[conceit]

Congratulations on 17 DS years. Wishing you continued health and happiness!

I was about to ask for a probiotic recommendation besides Florastor (expensive as Sheanie said above). I'll keep the Gas Defense one in mind. Thanks.

I plan on continuing a heavy lifting program post my DS, largely motivated by keeping the bones strong and body insulin sensitive for as long as possible. I'll be learning more about macros post DS, and will share when I have more info. So far I am planning on following what Liz shared above. 90-120 grams of proteins, 100-150 of fat, 50 or so carbs. Post DS keto, I'd reduce the carbs to 20 (30 max) and replace with more fat and protein as my body and activity level dictates. I don't think I'd count the fats, outside of making sure I wasn't consuming too little. Mostly I'd have a mental protein ticker added to my existing carb one lol.

I am doing keto right now, though more Bernstein inspired so there are times when I do up to 30 grams of carbs a day. But mostly I keep it to 20. I eat fat liberally. I am consuming 60-70 grams of protein, but I was eating 90-100 grams when much more physically active and on a lifting program. Post DS will be similar, high protein, moderate to low carb (lower when needing to lose some weight), high fat.