Wednesday, January 21, 2015

A Ketogenic Diet is helping me overcome Mild Cognitive Impairment!

Oops. I had forgotten that I had started a keto-diet diary here. Well, here's the latest...

I have had Mild Cognitive Impairment (MCI) for years, slowly getting worse, and then just over 2 years ago I had a bout of encephalitis that crashed my brain. I recovered a lot from the encephalitis, but it appeared some of that damage might be permanent. I started eating a ketogenic diet 4 weeks ago because it seemed to me it should be a hyped-up version of consuming occasional Medium-Chain-Tryglycerides, so I expected it to help my MCI some, and I blindly hoped it might help some of my remaining symptoms from the encephalitis.
The picture below is a screen-shot of a self-assessment I have been doing, assisted by my family. I am scheduled for objective re-assessments by professionals in March, but this self-assessment is extremely good news and very promising.
There have been multiple studies on adding Medium Chain Triglycerides (MCT) to a diet to boost blood ketones to alleviate some symptoms of Alzhiemer's, MCI, and other neurodegenerative disorders. I tried that. Occasionally eating or drinking MCT's gave me a spike that barely registered on a blood test, lasted for less than an hour, and the increase in brain function was noticeable, but less than useful, so I did not keep it up.
Well, somehow (my notes don't cover this, and I don't remember) I started hearing about ketogenic diets and began to research it. The purpose of eating/drinking MCT's is to increase blood ketones a little bit. A ketogenic diet causes nutritional ketosis, which gives a much higher level of blood ketones (still far below dangerous levels that uncontrolled diabetics get with ketoacidosis), and it keeps them there every minute of every day! Why aren't lots of people with MCI and Alzheimer's using ketogenic diets? I haven't found anyone else who's done it, but it made sense to me, so I started reducing my carbohydrates dramatically as I continued to study.
I attempted to induce ketosis with a high-protein, medium-fat, low-carb diet and did that for 8 days, but my blood ketones were barely registering. Still, I thought I noticed some subtle improvements in brain function. Then I learned that high-protein prevented nutritional ketosis because the liver makes glucose out of all the excess protein. I had gone high-protein instead of high-fat out of a fear of dietary fat ingrained over the decades by "experts." Then I learned a *lot* about ketogenic diets and how high-fat is not only not a problem, it's actually far superior to low-fat, high-carb diets for most people. So, I switched to a high-fat, adequate-protein, very-low-carb diet and my ketones shot up into the nutritional ketosis range and have stayed there.
It takes weeks for the body to fully adjust to ketosis, and I have been seeing steady improvements in my brain function. Most of our body's cells can use fatty acids for energy in addition to glucose, but not the brain cells. The brain cells, however, can make use of ketones for energy. Since people with MCI, Alzheimer's, etc. have brain cells which can no longer use glucose as efficiently as they used to, ketones can fill in the energy gap in the brain. When staring ketosis, though, first there are a number of systemic changes that take weeks to accomplish. Like at first, the muscles may take most of the blood ketones. Later, after various adjustments, more ketones become available to the brain cells. That partly explains why my improvements have been gradual.
In the last week or two, I have also learned a lot about proper levels of sodium, potassium, and magnesium, and have just begun a careful diet supplementation to get those minerals in adequate amounts and in correct proportions. Sodium and potassium control cell membranes, which affects what is allowed into and out of each cell. MCI and other patients have brain cells that have accumulated garbage they have not correctly gotten rid of, so there is a possibility that my new regimen of minerals could help in that regard.
I still have a lot to learn and a lot to do, but it is extremely exciting for me that for the first time since I first noticed symptoms of MCI, I have *improved* rather than continue to slowly decline.

7/23/2014, Began comprehensive calorie-counting to lose weight.
Nov. 2014, Average self-assessment scores during November after 5 months of reduced calories, losing ~15 pounds, mostly off my waist.
12/15/2014, Began a high-protein, medium-fat, low-carb diet in an effort to produce blood ketones to help my brain, not realizing that excess protein would be converted to glucose, suppressing ketone production. I was still under the influence of "dietary fat is always bad" myth.
12/22/2014, Switched to a high-fat, adequate-protein, low-carb diet that is necessary for full nutritional ketosis diet half through the day after 8 days on high-protein diet that produced only .1 to .7 millimolars of serum beta-hydroxybutyrate.
12/23/2014, First full day on a high-fat, adequate-protein, low-carb diet, and the ketones shot up into the nutritional ketosis range of .5 to 5 and stayed there.
12/25/2014, Some brain improvements noticed after only 3 days on ketogenic diet (plus 8 days on low-carb diet).
1/7/2015, 15th day of nutritional ketosis
1/13/2015, 21st day of ketosis
1/20/2015, Tuesday, 28th day of ketosis
1/23/2015, Friday, 31st day of ketosis, comprehensive fasting blood tests
1/24/2015, 20 tests of blood glucose, blood ketones, blood pressure, and pulse over 24 hour period.
3/11/2015, Memory re-assessment with neuropsychologist
??? Get results of objective assessment of memory status from neuropsychologist
??? Neurologist and general practitioner to discuss all improvements and possible return to work
Severity Scale
1 = much better than average
2 = slightly better than average
3 = normal
4 = annoying
5 = interferes with work
6 = too bad to work as a Premier Field Engineer
7 = too bad for any job
8 = too bad to take care of self