Resetting Sleep to Reset Ketosis
Let’s recap on how things are going with John, Jennifer Marie and the ketogenic lifestyle they’ve been working on.
Recently both John and Jennifer Marie struggle with sleep. For Jennifer Marie, erratic sleep patterns have caused a decrease in her ketone levels. She now has a weight loss stall. John struggles with staying asleep. Continuing to work on their sleep schedules will improve their ketogenic chemistry and their Dr Boz Ratios.
Jennifer Marie led 146 people on the Beef and Butter Fast. The group as a whole lost 709 pounds with a 4.8-pound average. Jennifer Marie’s Beef and Butter Fast has great science associated with it. Consider joining her community of “fasters” using beef and butter to get into solid ketosis. They encourage one another and share ideas that keep you in the right mindset for sustainable change!
Jennifer Marie has lost 60 pounds in about two years. She really struggles to say NO to all calories and has used the Beef and Butter Fast several times as her “fast.” This time was different, though. For the first time, she did not lose weight on the Beef and Butter fast. I ask Jennifer Marie a few questions about her recent lifestyle that may have impacted her ketosis and weight loss.
Recently her sleep pattern suffered, in part due to her sinus infection. She took antibiotics for a sinus infection.
Prior to her illness, Jennifer Marie’s glucose was running 70-80, and her ketones were averaging 1.5. Her Dr. Boz Ratio (glucose ÷ ketones = Dr. Boz Ratio) stayed in the 40s. Now, her ketones won’t budge above 0.7. She pokes her finger to look at her numbers around 6 a.m.
Jennifer Marie began keto in hopes to reverse her insulin resistance and lose weight. When our consults began, I helped her see that the underlying chemistry struggle that kept her weight on was her insulin resistance. Her insulin does not behave the way it should. Her body has not been listening to the commanding orders of insulin. Ideally, we would check her insulin three to six times a day at the lab. That is not feasible. Each time we check insulin in the lab it costs close to $75.00. The Dr. Boz Ratio approximates insulin levels at a fraction of the cost. The fact that Jennifer Marie’s ketone level is still low indicates that her insulin level is higher than we’d like it to be. Her glucose levels boast of an improved situation in recent weeks. I think this weight loss stall is short-term. We can fix this!
What has changed in Jennifer Marie’s life to upset her ketone production? She has stuck religiously to the low-carb, high-fat, and she continues to fast 12 hours at a time. Staying up late to enjoy movies and game time in the evenings might be the culprit. Jennifer Marie generally awakens before 5:30 a.m. Proper sleep is key to lowering cortisol levels. Cortisol increases glucose and holds the fat inside our fat cells. We cannot achieve weight loss when cortisol is high.
“Dr. Boz, what about using a supplement to manage my high cortisol?”
No. While this can work short-term, using a pill to manage stress is a setup for failure in the long run. It’s better to fix the problem that causes the cortisol to rise in the first place.
Resetting sleep resets brain function. Resetting sleep improves stress. Resetting sleep reduces cortisol. Awakening three or more times in eight hours increases cortisol, stress and fogginess in your brain. It’s important to eliminate problems with disrupted sleep patterns. From dogs, to kids, to busy blatters–our sleep gets interrupted from all angles.
Previously, when Jennifer Marie hit a plateau, we set her on a strict sleep schedule, with absolutely no food or beverage other than water and salt from 5 a.m. to 5 p.m. Now, her sugar levels are still good, but her body is producing only the number of ketones she needs in order to get through the day. We need to boost this if we are going to get her back into the level of ketosis needed for weight loss.
I asked Jennifer Marie to open a 16-hour fasting window for the next four days. The key to success is the morning start time. Your body starts its metabolism at sunrise. This is a steadfast rule. From sunrise onward, the body churns enzymes to manage its needs. Even if you sleep in, your body begins working thanks to your circadian rhythm. To take advantage of the churning chemistry, Jennifer Marie needs to limit her “feeding time” from sunrise to 3:00 p.m. The second rule: When she eats, she needs to eat until she feels full. Third: Add evening checks to her sugars and ketones.
It’s been a couple of weeks since I have caught up with John. He starts out by sharing a huge non-scale victory. For the first time since elementary school, John is wearing a 32-inch waistband! In high school, he purchased his own football pants, because the team did not have a size 40 for him to wear.
Though his non-scale victory is commendable, John does present concerns during this episode. His glucose is higher than it had been. His Dr. Boz Ratio crept up into the 130s instead of the 80s. He has not been fasting as much as he thought he would. I am encouraged by how well he feels and his improved waistline measurement.
One of John’s biggest struggles with his weight has come from a series of injuries. Old high school football injuries were compacted by an on-the-job motorcycle crash recently. He used pain-killers and alcohol to cope with his pain. We tackled that in previous episodes using the intensive sleep protocol. We successfully got him into a nice, deep, refreshing sleep for four nights. He kept a solid sleep pattern until recently. The twinges of pain are nothing like they were in the past, but they do awaken him.
John typically goes to bed between 7:30 and 8 p.m.. Recemtly he reports awakens around 3 a.m. He is unable to return to sleep. When his alarm re-awakens him, he finds that he has less energy than he does when he wakes up in the night.
I suggested that John take the medication we used for the sleep protocol once every fourth night for three cycles to sync his brain. He had a wonderful response to the original sleep protocol. Now he is reluctant to take the medication again. He worries that he will be a zombie again. I have assured him this will not be the case. The process to coax back that good sleeping pattern is much easier once they have been doing well in recent days. A “tiny” reminder (a small dose of the medication) triggers those deep sleep signals. A good night’s sleep is a small dose away. While John needed a “sleep supervisor” during the sleep protocol, this smaller dose for a shorter period of time shouldn’t cause him to sleep quite so heavily that we need safety precautions.
Unlike some other sleep medications, what we are using works well as a training tool to help the brain figure out how to sleep on its own, rather than causing the patient to become dependent upon the medication in order to get good rest.
Tune in next week to see how improved sleep helps this couple continue their journey to ketosis!
For the full story on John’s Sleep Story struggles, read the articles below:
Have you read my book yet?
Anyway You Can is an amazing resource to guide you on your ketogenic journey.
Keto Reference Guide: https://bozmd.com/product/quality-eating-guide/
Boz BHB Exogenous Ketones: https://amzn.to/2GXLlSw
Glucose & Ketone Testing Kit: http://bit.ly/2QKGmKG