Keto and PMR

[Neck680]

Almost 2 years PMR diagnosis, started Keto diet 1 week ago, also tapering to 7 mg of Pred (very slowly). Any reason not to do Keto? Thanks for your wisdom and experience.

[HeronNS]

I found this:

theketogenickitchen.com/ket...

[Neck680 in reply to HeronNS]

Thank you for this post!

[PMRpro Ambassador]

Unless you are diabetic probably not, though I'm sure there must be other preexisting conditions where it may not be a good idea (see the dietdoctor link below). However, it depends on how extreme you are going to be. We recommend low carb on the forum, especially in the early stages and higher doses of pred, to reduce the risk of both weight gain and steroid-induced diabetes - low carb means you are not removing valuable sources of nutrients from your diet whereas extreme keto usually excludes all carbs and is quite difficult to stick to longer term as well as having some less pleasant side effects.

The main problem with keto is that, while you will almost certainly lose weight, once you stray from it you may find the weight goes on quite easily - as with any type of diet. You need to find a way of eating you can sustain over a long period, changing your lifestyle really.

health.harvard.edu/blog/ket...

healthline.com/health-news/...

and my personal favourite in terms of sensible and balanced advice

dietdoctor.com/low-carb/keto

which also has a section on the low carb approach to eating.

You are relatively late on the pred journey to think of diet - why are you choosing the keto approach in particular?

[Neck680 in reply to PMRpro]

Thanks for your expertise, as always. Since on prednisone I gained 12 lbs and tried low-carb as recommended on this forum, without much success at weight loss. Friends did have success so thought I would try Keto 1-2 months, lose weight and then try to maintain again with low-carb, or one of the diets posted here. Suggestions from others on Keto?

[PMRpro Ambassador in reply to Neck680]

Fair enough - but was your low carb as low as you thought it was? There have been wails of anguish from a few at not losing weight - but when questioned they were still eating fruit. An apple and a banana is enough to take me to a carb level where I can't lose weight - add in the salad/veg and other bits of carb in milk and things and I would gain!

[Neck680 in reply to PMRpro]

Right, thanks. Recently learned about apples, a major fave of mine. Never touch bananas luckily. After Keto I'll monitor the carbs better than I have been.

[Theziggy]

Are you overweight?

Do you blame carbs for PMR (in which case everyone would have PMR)

I have been diabetic (type 2) for the last 10+ years and have been med free due to a low carb veg diet and exercise, and still developed Palindromic Rheumatism. How did that happen? 😎

[Duketta in reply to Theziggy]

Perhaps too many oxalates and,or, lectins in diet? Too many veggies are not a natural diet for humans. Some of us cannot tolerate them.😽

[Slosh]

I believe that it may not be indicated for those with adrenal insufficiency - perhaps see if you can find anything on that - can't remember where I read that.

[PMRpro Ambassador in reply to Slosh]

Having read this I think it is all fair comment and not biased:

ketosummit.com/can-keto-cau...

and it explains it all reasonably. I can't see it had any effect - except possibly to reduce inflammation by limiting carbs and that would possibly help pred doses required. The lower the pred, the better the likelihood of adrenal function returning.

Longer study of the links that same up showed that there is a lot of disagreement - which usually means it probably doesn't matter significantly!!

[Slosh in reply to PMRpro]

Thank you - my diet has now been complicated / limited by the probable histamine intolerance. I have however been eating too much fruit lately and I don't think it has helped me at all.

[anutycrixp]

not sure what keto diet is;but it sounds a bit harsh.I wonder if its wise to adopt abrupt dietary changes whilst trying to regulate biochemistry with steroid reduction? How to tell what is effective?

[PMRpro Ambassador in reply to anutycrixp]

A keto diet is a diet where carbohydrate is kept below 25g/day which induces the body to use ketogenesis (fat metabolism) to produce the glucose it needs. A very few people need to be that low carb to lose weight - most people will do fine at skightly higher levels.

[Hidden]

I would definitely check with my Dr before doing such a strict regime. Low carb or no carb doesn't work for everyone in terms of weight loss.

[Noosat]

Don't know what Keto diet is. I follow the Mayo clinic diet plan, much the way I have always eaten, but a good reminder of portion size. It is a very healthy way to eat.

[Magnoli-a1]

I decided to eat Keto in June because I had several ah-ha moments. In early June after 5 months of being on Prednisone, I found myself 14 lbs over my pre-PMR weight! I also found myself beginning to feel pain again going up into my head. This was after being on 12 1/2 gr of Prednisone for 5 weeks. Those two factors combined with a real fear of becoming diabetic (all members of my family except for me are diabetic, except my younger brother who is pre-diabetic) compelled me to research how to lose some weight while on Prednisone. I came upon some information that recommended an anti-inflammatory/Keto diet. Since I was not yet overweight, I felt I would be happy to just lose some or maintain where I was at. I started immediately on this diet and I'm happy to say that all pain disappeared within 2 weeks. That alone has made Keto worth it for me to stay on it. I really do hate pain. The other bonus is that weight has slowly been coming off - I have lost 8 of the 14 lbs. I am currently on 8 mg of Prednisone. I do not find this diet difficult. I love that my life has normalized and I feel youthful and no longer feel ill and dependent on my members of my family.

[Neck680]

Thanks for all comments. As with PMR, finding the right diet is an individual journey. Only problem I see so far with the Keto is fatigue. Hoping that will even out soon...

[PMRpro Ambassador in reply to Neck680]

I think that is a problem until your body gets used to the change - and can be reduced by reducing carbs over a few weeks