Getting worse on the regime of Paleo Ketogenic diet and micronutrient supplements when these interventions should make you better

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Getting worse once you start introducing my regime of the Paleo Ketogenic diet and nutritional supplements is a remarkably common problem. There are many possible reasons for this, which, in order of frequency, are -


Western diets are convenient and addictive because they have a high glycaemic index. The brain likes to run a high sugar level so that it can be assured of a good energy supply. However, running a high blood sugar level is very damaging to the body, which strives to maintain blood sugar levels within normal ranges. Western diets mean people tend to run high normal blood sugars; however, the Paleo Ketogenic diet means low normal blood sugars. It takes some adjusting for the body to switch from energy driven by sugar and carbohydrates to energy driven by short chain fatty acids (from the gut flora fermenting soluble fibre) and fats (the ideal fuel supply to the brain). Metabolically, it is harder work for the body to do the latter than the former, but the latter, of course, is far preferable. Once the body has switched, low blood sugar is no longer a problem, the brain is assured of a regular energy supply and stops moving into panic mode, and many of the symptoms of hypoglycaemia melt away. However, there is a nasty “withdrawal symptoms” phase whilst this switch happens. For some people this can last more than a few days or weeks, in which case it is well worth exploring other causes of hypoglycaemia. See also: Hypoglycaemia and Brain fog.


The odd thing about allergies to foods is that other foods, like sugar, can also be addictive. People get relief from symptoms when they eat that food and worsening if they omit to eat it. This may well explain why some conditions are worse at night or first thing in the morning, when the sufferer is maximally withdrawn. The commonest two allergens are, of course, gluten grains and dairy products and allergy can be diagnosed because the sufferer eats them in an addictive fashion. See Allergy.

Fermenting gut

My guess is that this is a much more common problem than we realise. The upper gut should be sterile and free from bacteria or yeast. Bacteria and yeast are as hungry for micronutrients as we are because micronutrients are an essential part of their metabolism, too. The best example of this is iron – a major way that the body defends itself from infection is by having the ability to bind up free iron very quickly and efficiently, so making it unavailable for micro-organisms.

From an evolutionary perspective, mitochondria are derived from bacteria, and so the very supplements needed to support mitochondria will also feed microbes in the gut. For ideas on how to tackle this see Fermentation in the gut and CFS and also Minerals and vitamins in creams.

Detoxification reactions

One of the ways in which the body protects itself from foreign toxins (xenobiotics) is to tuck them away in safe places. Of course, no place is entirely safe – it is always a compromise! So, for example, if I did a fat biopsy on anybody following a western lifestyle, I would be bound to find a range of persistent organic pollutants (POPs) such as pesticides and volatile organic compounds. A provocation urine test almost invariably shows up a range of heavy metals. Taking nutritional supplements has the potential to mobilise these toxins from stores into the blood stream and this results in an acute poisoning. Levels of POPs in fat are measured in mg/kg whilst levels in blood are measured in mcg/kg – i.e. there may be a hundred to a thousandfold increase in blood levels of these toxins once they have mobilised out of fat stores into the blood by the taking of nutritional supplements. Sometimes it can be many weeks before body stores are reduced to levels which do not greatly interfere with internal biochemistry and therefore cause symptoms.

The key to this is to use detoxification techniques which lessen the chance of toxins being mobilised into the bloodstream. This is why far infrared saunaing is my preferred technique of detoxification, but Epsom salts baths will, I guess, turn out to be an equally effective way of treatment. See Detoxification and Detoxing - Far Infrared Sauna (FIRS).

Herxheimer reactions

These are well described in the medical literature. Please see Wikipedia entry on Herxheimer reactions. The idea here is that if one kills microbes in the gut or elsewhere, it is possible to get an allergic reaction to the breakdown materials from these microbes wherever they happen to end up. This is often used as a reason why there may be worsening following an intervention, although it is very hard to prove this! My guess is that it has been overused as an explanation for worsening and the above problems are more common.


The body is a creature of habit and it will instinctively dislike any changes to its routine.

What to do about all the above problems

  • Firstly, relax the regime sufficiently so that it is sustainable. Some of my very ill patients simply cannot afford to be made more ill and it may take some weeks, or months, before the regimes can be fully employed.
  • Secondly, try to identify the possible mechanisms that are making you ill (from the above) because there may well be other interventions that could be put in place to mitigate these problems.

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