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Berberine – Worth It or Mythical Unicorn?

berberine plant

Metformin has been the first-line treatment drug for many years for people with a Type 2 Diabetes (DM2) diagnosis; over recent years, it is becoming common to use it “off-label” for a variety of metabolic syndrome symptoms as well, including weight loss, polycystic ovary syndrome(PCOS), and insulin resistance (IR) as calculated by the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) method. However, studies continue to show that significant  numbers of people report side effects that prevent its use; various studies show that as many as 53% of people who start taking metformin report significant diarrhea and about 10% report abdominal cramping; and so these people often stop the medication.

While there are methods that can help patients overcome these side effects, there are multiple factors that contribute to continued avoidance of metformin.  I have had patients report that health care providers never taught them how to slowly and gradually increase the dose or even tell them to simply take metformin in-between bites of food at mealtime.  These simple strategies can improve compliance in some people, but convincing them to try these methods AFTER suffering embarrassing GI effects can be quite difficult.

So, is there anything else that can be recommended? As an advocate of low carb nutrition, I find that many people want to avoid medications, but will take herbs, supplements, and vitamins if provided with adequate information.  For years, I have taught my clients to use specific supplements for optimal nutrition, but to avoid any that seem to be “miracle cures” or “magic pills.”  Media hype always seeks to offer “snake oil” remedies for “anything that ails ya.” Until recently, I believed and taught my patients that berberine was one of these such remedies.  A couple of months ago, I was reading something authored by Dr.  Jeffry Gerber who mentioned berberine, so I began to study and research.  Studies I found astonished me; so I studied even more.  I sought advice from a couple of well-educated professionals who read and studied a couple of links to research articles I had found.   They came to similar conclusions as I did.  To be honest, we were all pretty amazed to find the use of berberine actually seems to be of more clinical benefit than metformin without the troublesome gastrointestinal side effects.  Here is detailed information about what we found.

Used as far back as 3000BC, berberine has been used by Ayurvedic  and Chinese  practitioners for diarrhea and dysentery with good results; obtained from the berberis vulgaris plant, berberine may have beneficial effects on a myriad of conditions in addition to diabetes.  It appears to show improvements in cholesterol levels, hepatitis infections, stomatitis, obesity, cardiovascular disease, cancer, and inflammation.

In a 2008 study published in the Journal, Metabolism, Yin et al published a pilot study with 36 participants and concluded that further testing should be done, but that berberine is a cost-effective and beneficial treatment for diabetes, and it also demonstrated a modest anti-cholesterol effect. More studies have been done, and in February 2018, Wang et al reviewed a large number of studies presenting evidence of recent progress in understanding the actions of metformin and berberine as compared to one another; this study was published in Oncotarget.

Most studies using berberine have used a daily dosing protocol of 500 mg three times daily and reduced doses when participants developed GI side effects.  While berberine and metformin do seem to act in similar pathways, berberine seems to have a much lower impact on the intestinal tract, compared to metformin.  While metformin seems to have a 50% or higher rate of GI side effects, berberine appears to have about a 10% rate of diarrhea and/or abdominal cramping.  With such a dramatic difference in GI symptoms, it may be very beneficial for many patients with diabetes and/or insulin resistance to ask health care professionals about a trial of berberine.

As you can see in the chart below, Yin et al showed that participants in the 2008 study had A1c levels drop from 9.47 to 7.48, over the 13 week study.  Fasting blood sugars dropped from 190 mg/dL (10.6 mmol/L) to 122mg/dL (6.8 mmol/L), and post-prandial glucose levels dropped by nearly half.   Other numbers, including all cholesterol numbers also dropped; HDL showed almost no change at all.  In addition, liver and kidney function tests showed no adverse effects from the berberine; in fact, liver enzymes showed a modest decrease, even in normal, healthy livers.

Comparison of Metformin and Berberine

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2410097/

So, before all of you rush out and start buying up all the berberine, there are a few facts you should know.  Because berberine and metformin seem to work in the same pathways, it is NOT advisable to take both metformin and berberine, or risks of adverse events will likely escalate.  If you are taking metformin and wish to switch to berberine, you should have this discussion with your prescriber who will likely brush off the whole idea.  But it is still ESSENTIAL to discuss this change with the health care professional responsible for your care.  It is recommended to have cholesterol, A1c, and a complete metabolic panel (CMP) tested prior to beginning berberine – similar to testing prior to beginning metformin.

One of the major side effects of metformin is lactic acidosis; theoretically, it’s possible that berberine can also cause lactic acidosis, but I haven’t found evidence of it yet.  Lactic acidosis can be a serious and even fatal form of acidosis that occurs as a result of underlying conditions most of the time; it’s mild form is most commonly associated with exercise or running for a long time.  Lactic acidosis can occur from exercise in even the healthiest of people, but typically resolves within a few minutes of hard breathing and rest. When a medication is the cause of lactic acidosis, however, it cannot resolve within a few minutes because the medication will remain in the bloodstream for hours and even days sometimes. This type of acidosis can become quite severe in a short amount of time. If you ADD berberine to metformin, it’s highly possible that the combination could result in life-threatening lactic acidosis.

As for drug-herb interactions, be aware that berberine may interact with other diabetes medications, much in the same way as metformin; alone, metformin does not directly lower glucose, but when it is ADDED to other medicines like insulin or glimepiride (or many others), the blood sugar level CAN drop significantly because of the synergistic effects of the 2 medications working together.

Additionally, berberine may interact with multiple other drugs that are metabolized through certain pathways in the liver; drugs like cyclosporine, statins, beta-blockers, sulfonylureas, nitrates, and many others are primarily metabolized in the liver and thus can be significantly INCREASED when other medications are also working through those same pathways.  Increasing the amount of available active ingredient of certain medications can be very dangerous, and so berberine should be avoided when taking these kinds of medications.

What do you think about berberine?  Do you think it may be of benefit to you? If so, and you’ve discussed it with your prescriber, treat it the same as you would any other medication; take it regularly and consistently.  Set specific times to take all medicines, including berberine.  Take berberinewith a meal, not before or more than 10 minutes afterwards; optimal dosing of mealtime medicines is between bites of food to minimize gastrointestinal upset.  Do NOT take berberine while taking metformin – not on the same day or even during the same week.  If taking any other medication for diabetes, check with your health care professional about adding berberine; you may have to provide one or both of the reference links below.  Dosing for general use is typically 500 mg 2 or 3 times a day.  Check glucose regularly, especially upon beginning dosing so you can see exactly how much the berberine impacts your glucose.  How much will berberine impact your glucose?

In the 2008 study published in Metabolism, fasting glucose dropped about 68 mg/dL in the berberine users, while fasting glucose dropped about 53 points in metformin users; berberine dropped fasting glucose 15 points more than metformin did.  Berberine lowered post-prandial (after eating) glucose levels by 153 points, compared to metformin, which dropped post-prandial glucose levels by about 140 mg/dL.  As you can see, berberineappears to be just as effective, if not more so, than metformin, at lowering blood sugar.  When combined with low carb eating, you can see that berberine may be a very effective tool in lowering blood sugar levels, but take notice that berberine was not effective at bringing glucose levels into normal range when glucose levels were dangerously elevated.

Although the levels dropped significantly, it is not clear at just how easily berberinewould be able to “normalize” glucose levels, when blood sugars are running over 250 or so.

For people with mildly elevated glucose levels, or A1c levels less than 8.5%, berberine may be quite beneficial as a single agent.  But for those people with A1c levels higher than 8.5%, berberine is likely NOT going to normalize glucose levels, enough to significantly reduce complications of DM2, including organ damage. However, these lower glucose levels may significantly impact those people with DM2 who are trying to avoid prescription medication, but for whom low carb eating doesn’t lower glucose adequately alone.  For those people with an A1c around 7.5% or less, it appears that berberine may have the best results, lowering glucose and A1c levels into more normal range, around or less than 5.5%, where risks of complications of DM2 are eliminated.  For people whose A1c falls between 7.5 and 8.5%, berberine may be effective, but it may require a longer period of time to see the normalization of glucose and A1c levels. There isn’t enough long-term data out that can help us understand this impact yet.

chart metabolism of metformin

As for my N=1 experiment, I began taking berberine around June 15, 2018, when my FBS had increased to 98-110, up significantly from about a year ago, without any “carb creep” or change in diet.  While I’m not a faithful glucose tester, I have tested several times during this experiment and have found that my glucose levels have dropped back into the 80s, consistently, after about 6 weeks of twice daily berberine 500 mg.  For me, that’s a WIN!

 

References

Retrieved August 1, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2410097/

Retrieved August 1, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/

Retrieved August 13, 2018, from https://www.sciencedirect.com/science/article/pii/S037887411400871X

Retrieved August 13, 2018, from https://www.spandidos-publications.com/ol/15/5/7409?text=fulltext

Retrieved August 13, 2018, from https://www.sciencedirect.com/science/article/pii/S0014299915300571

 

 

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Do you check your glucose?

For any of you who have never checked your glucose, maybe it’s worth a try. It is truly the only way to know how food directly impacts glucose.

Use a glucometer to check and monitor your glucose level. They can be purchased over the counter. For inexpensive ones, ask your local pharmacy about the least expensive to use over time. I believe Walmart has one that is fairly inexpensive; it’s the Relion meter.

I recommend testing first thing in the morning, and then after meals to determine how food impacted your glucose. Standard post-meal testing is at 2 hours. Some people, however are not textbook. I usually recommend testing after several different meals over a few different days every 30 minutes after eating to determine your personal peak… once you determine this time frame, you’ll only need to test before and after once. No need to test every single meal at first if you’re worried about costs of testing OR running out of fingers. 😉

But pick a few meals at different times of day. If costs are a factor in buying strips, it’s really important to test before and after different meals — example: test before and after breakfast on Mon, Wed, & Saturday for 2 weeks, before & after lunch on Tue, Thurs, & Fri for 1 week, and supper on Sunday, Tues, Thurs, Sun, for the 2nd week.

Once you’ve determined your personal glucose peak, you can then limit testing to before meals and around your peak.

To determine the impact of certain food on glucose level, test before and after at your personalized peak. Ideally, the readings should not be very different, but readings are allowed to be about 10 numbers diff.

Example: pre-meal is 97; post-meal highest should be about 107 for optimal glucose control.

Even non-diabetics can use meters and learn for themselves how food impacts glucose.

This is where we get the phrase, “eat to your meter.”

Testing glucose is the absolute best method for determining how foods impact your glucose. Knowing how food will affect glucose levels is very important for people on a low carb diet, especially those who take medicines to lower glucose directly. If glucose goes up more than 10 points, it’s probably not a good idea to continue eating that food.

If you’d like help learning to eat to your meter or learning how to eat low carb high fat to reduce the impact of disease on the body, please email me at ketonurses@gmail.com for more information.

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Keto Cauli-Taters

1 head of cauliflower, cut into florets

1/2 stick of butter, softened

3-4 ounces of cream cheese

1 cup grated white cheddar

1 tsp garlic powder

1/4 cup (or less) heavy cream ( optional)

Salt & pepper to taste

Preheat oven to 350 degrees, and grease or butter casserole dish.

Place chopped cauliflower into microwaveable bowl, cover & microwave on high for 6-9 minutes or until all florets are cooked though and softening. (You could steam if you prefer, but drain all water used.)

Add cauliflower, butter, & cream cheese to mixing bowl and mix well. (Sometimes, I throw some of the florets into the blender to get pieces even smaller. I do this before adding the butter and cream cheese.)

I only use the heavy cream when above mixture seems just a bit thick. Sometimes, I use it. Sometimes I skip the heavy cream. I think it depends on how much water is in each head of cauliflower. I don’t like runny taters, but I also don’t want them thick and pasty either. 😂

Add salt, garlic & pepper to taste. Stir in cheddar. Pour into the casserole dish and bake at 350 for about 20-25 minutes. During last 2-3 minutes, you can add a bit more grated cheddar or Parmesan cheese and finish baking.

<<
her options for finishing your taters include topping with chopped onions, bacon crumbs or even grilled chicken bits. You can also serve with a piece of avocado or dollop of sour cream.

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Reversing Dementia IS Possible

This is the story of a friend who wishes to remain anonymous. His words. His experiences. And they are amazing!

“I joined this group (a FB group) to help my mother who is 69 years old, has had type 2 diabetes for about twenty years now and has developed many complications although none of them are quite life threatening YET. She also has Alzheimer’s which makes it very difficult. She had followed the ADA guidelines yet she got progressively worse and now needs insulin. With her Alzheimer’s the doctor put her on a pump. Either one of my sisters, myself, or a visiting nurse checks on her twice a day to make sure she is under control. Recently one of my sisters or myself have been staying with her. She will go to the kitchen and eat huge bowls of cereal with skim milk or anything sweet or carby that is in the refrigerator so her levels have sky rocketed. My sisters have said its okay.

About a year ago I noticed a woman at my gym who I see periodically and has been losing a lot of weight. Then a few months ago I overheard her talking to some other people about her keto diet. I finally talked to her and she told me about her diabetes, she told me about this group, and she suggested ways to get my mother on it but my sisters did not agree at all and it has created a lot of fighting with them. I will admit that they do much more of her monitoring then I do but about three weeks ago I convinced them to take a break and I have been living with her 24/7. I know this woman Karen at the gym is not a health care professional but I hired her to come to the house to help get rid of the foods that are not on the diet and to stock the refrigerator with good foods. I was very afraid that my mother would start complaining about what I fed her especially because she was always complaining that we were trying to starve her even though she’s over a hundred pounds overweight and was eating three or four meals a day plus snacks. I should add that she has neuropathy and because of her Alzheimer’s she forgets to use her walker and so she also falls.

Karen went way beyond the time I paid her for and cooked some meals and visited with my mother. We never told her that we were changing her diet. After a few days she stopped complaining about being hungry even though she was already eating a lot less. Her blood sugar used to be from 60 to 350 and sometimes over 400. Now it has never gone above 172 and is usually under 140.

I cannot believe it in three weeks. She has also lost 18 pounds and is not falling. The biggest surprise to me is that she is not as confused and her memory is so much better that I can not believe it.

My sisters had been out of town but they came back and saw my mother one yesterday and the other two days ago. I showed them her insulin use which is less than half what it has been and her blood sugar levels. But they both cried when my mother started asking them questions about their trips and acted like a completely different person. She remembered their names and when my one sister said she was visiting her son my mother asked what college he was in. Well, she used to ask when he was going to graduate from high school. When my mother told her it was Lehigh she apologized and said oh yes, I’m sorry I forgot what is he studying? She said engineering and my mother was happy and said oh, just like his grandfather he would have been so proud.

We both cried again because my mother used to ask where he was and why he hasn’t come home yet. The other sister has a house down the shore and my mother asked her if that is where she was on her vacation. She never once yelled at them for not visiting her which she used to do even when they would come every day. And she is remembering to use her walker every single time now so she is not falling.

My sisters are now onboard. I have invited one to the group and the other promises to follow whatever I say. We have not seen her doctor yet but she has an appointment in a few weeks.

I have also been eating this way because that is what I have been feeding her and even though I don’t have diabetes I feel a hole lot better.

I want to thank everyone in this group. I have not said anything before because I’m not like that but I had to speak up now and thank every one. I also have to thank Karen V. for introducing me to this. She never asked for money but I had to pay her for some of her time. I’m sure she would have come out for free because she is so into this diet and promotes it at the gym all the time. I honestly thought at first that she must be selling something but I was surprised that no one here is selling anything accept getting healthy.

And one more thing. My mother has stopped asking for more of her Cinnamon Toast Crunch cereal or hot chocolate and now asks for more of the yummy bullet proof coffee which I sometimes make with tea instead.”

—Anonymous

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One Person at a Time – We CAN Change the World

 

It is truly a shame that mainstream medical providers, highly trained and well-educated professionals, continue to encourage hundreds of grams of carbohydrate intake on a daily basis when simple logic shows that the approach is not helping to reduce elevated glucose, decrease weight, lower blood pressure, or improve health in any form at all. For many years, now, the nutritional guidelines have encouraged an intake of 200+ grams of carbohydrates daily, even though our bloodstream only requires 4 grams.  For a person with diabetes and insulin resistance, this advice is detrimental to health.  This recommendation contributes to significant over-eating, poor nutrient intake, and terrible internal chemical imbalance – all of which contribute to chronic metabolic conditions.

This advice does NOT differ for Type 1 diabetics, Type 2 diabetics, or for anyone with insulin resistance. Type 1 patients require insulin administration daily so they can metabolize & properly manage the carb & protein intake.  Type 2 patients often end up using insulin injections because the tablets and diet do not provide enough assistance internally to lower glucose and organ damage.  Patients with insulin resistance often require hundreds of units of insulin a day just to keep glucose levels less than 200.  (Less than 100 is NORMAL.)

Anyone with an over-the-counter glucometer can determine this simple and logical conclusion quite easily. Test glucose prior to eating; test again about 2 hours after eating.  If glucose level changes more than 10 numbers, there are likely many carbohydrates in that meal.  So, next meal, test again, leaving out those particular carbohydrates.  Determine for yourself just how to eat with minimal impact on glucose level.

Even a non-scientist understands the simple anatomy and physiological response within our bodies.

“The problem is that carbohydrates break down into glucose, which causes the body to release insulin—a hormone that is fantastically efficient at storing fat. Meanwhile, fructose, the main sugar in fruit, causes the liver to generate triglycerides and other lipids in the blood that are altogether bad news. Excessive carbohydrates lead not only to obesity but also, over time, to Type 2 diabetes and, very likely, heart disease.” – Excerpt from The Wall Street Journal, https://www.wsj.com/articles/the-questionable-link-between-saturated-fat-and-heart-disease-1399070926, retrieved 2/21/2018.

Why is testing like this necessary? Testing glucose is necessary to gain control of your own illness and health. Medical providers are trained to prescribe medications that are produced and sold to provide a source of steady income to drug companies.  Medical providers need a steady and full schedule of patients in order to provide a steady income for their staffs and themselves.  Medical providers have NO coursework in nutrition, except for a freshman or sophomore course as a pre-requisite to professional medical, nursing, or nutrition school.  There is NO training whatsoever for medical providers to learn how to incorporate nutrition as a part of therapeutic treatment for chronic metabolic conditions.  They never hear the word ketogenic nutrition; they have no idea what normal and natural ketosis is.

That said, mainstream providers do the best they can with info and training they’ve been provided; none of them actually WANT us sick or on meds. It is simply all they know.  Medical providers have guidelines and “standards of care” to which we’re held responsible.  These guidelines encourage us to prescribe certain medications as diabetes is diagnosed and then progresses. We are to obtain certain lab testing at specified intervals.  We are trained to tell patients that an A1c of 7 or less is “NORMAL for a diabetic.”  We are trained to use these guidelines as our “logic” and reasoning, even though very little of the guidelines has any actual research supporting the use; most of the research quoted has been debunked many times over the past 5-8 years by independent experts without financial interest in the outcomes.

Why do our trusted and trained medical providers offer such flawed advice? It goes back 50-70 years.  It started in the 1950s when President Eisenhower suffered a heart attack while in office.  Some strong personalities were already studying and researching diet and the impacts of diet on health.  Ancel Keys is credited with starting this avalanche of low fat diet advice, but others quickly hopped on his bandwagon.  The often-quoted and cited Framingham Study also released only part of the data collected and was used as “evidence” that saturated fats caused high cholesterol which caused deadly heart disease. However, Dr. William Castelli, a former director of the Framingham Heart study, stated in a 1992 editorial published in the Archives of Internal Medicine:

In Framingham, Mass., the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol. The opposite of what… Keys et al would predict…We found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active.”

This major piece of data was NOT released as part of the study; it only came out later as part of the editorial by the former director of the study. By 1980, so much money and time had been invested in low-fat dietary research, it seemed no one could stop it. Thus, the “Standard Dietary Guidelines for Americans” was published. Later, the American Heart Association also joined in the support of these guidelines; the American Diabetes Association also began to support these guidelines.  No science.  No independent research data. Thus, we the people were “fleeced” and fell right in line with this dietary advice.  We began cutting fats and one of the first fats to go was milkfat, and then animal fats.

milkfat pic          animal fat pic

However, look at what happened to the weight of Americans.

 

Multiple resources offer similar trends in weight; notice the trend of weight gain began during the 1970s and 80s, when low-fat dietary advice was pushed forward as “healthy.”

disease trends

Using some simple common sense and logic, we can review history and data and draw some logical conclusions based on these numbers. As fat intake declined, obesity and heart disease rates increased.  What replaced the fat?

carb intake

474 grams of carbohydrates will be converted into 118 TEASPOONS of glucose – that’s 2.5 CUPS of sugar. Just what do medical experts EXPECT our bodies to do with this much glucose?

Even at the lowest ADA recommended intake of 165 grams of carbs per day, those carbs convert into nearly 7 ounces of glucose – almost 1 whole cup of glucose.

Think about our most vulnerable of our population: our children. Then, narrow down that population to Type 1 children. Current recommendations for managing this illness is to eat high amounts of carbohydrates and to administer higher and higher amounts of insulin to lower the glucose load.  How does this advice even seem normal, now that we’ve seen the data? Do their brains develop normally with such significantly elevated glucose levels? Some experts are calling Alzheimer disease Type 3 diabetes because we now recognize the brain damage done by high glucose and high insulin levels – yet, it’s the “standard” treatment for our most vulnerable population?  Why would we actually WANT our children to consume hundreds of grams of carbohydrates daily, just to be able to dose higher amounts of insulin? Why should we continue to advise high carb intake when it has now been linked to higher rates of non-alcoholic fatty liver disease, infertility, and even cancer – even in our children? I fail to see the logic.  Our children deserve better.  Our children deserve NORMAL glucose levels.  They should not be at risk for developing “double diabetes,” because we continue to encourage high carb intake and high insulin use, forcing their bodies to become insulin resistant over time.  These children are one of our most valuable resources; why can’t we provide better advice and care?

One person at a time. One medical provider at a time.  One conversation at a time, we are taking charge of our own health.  We are doing the “research” by checking our own glucose.  We track our intake.  We, at the grassroots level, are doing research that government and agencies and companies should have done half a century ago.  We are cutting out the highly inflammatory grains.  We are cutting out sugar.  We are eliminating the cause of our metabolic disease, and our health improves because we are PRO-active instead of reactive.  We are using food as our medicine…. Isn’t that what Hippocrates said?  “Let food be thy medicine and medicine be thy food.”  And our medical physicians take the Hippocratic oath, which includes the phrase, “do no harm.”  I think it’s time we hold our providers accountable for their advice.  What do YOU think?

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Keto Pepper Poppers

Just in time for the big game, we have a delicious low carb finger food to add to the table!

12 jalapeños, seeded and halved

8 ounces of softened cream cheese

3 tbsp. sour cream

1/2 cup grated cheese (any type or combo)

2 tsp minced garlic (More can be used)

1/2 tsp onion powder

Preheat oven to 375. Mix all in mixer until well blended. Spoon into pepper halves. Place in baking dish or on cookie sheet.

Bake for 9 minutes and then turn to broil for 3-5 minutes, just until tops begin to brown.

Serve.

Depending on the types of cheeses you choose, carb count is approx 1 gram per jalapeño half, or 1.5 -2 grams for every whole pepper.

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Do the Math – Calculate Your Macro Goals

I use the simplest keto calculator available, using IDEAL body weight NOT current body weight – as many calculators do.

First, determine your ideal weight. There are many ranges and charts available, but I use the simplest version from nursing school many years ago. We use ideal weight because we want to lose weight or maintain a healthy weight. If we use current weight for our calculations, then our macro goals will be set to sustain our current weight.

Start with your current height — females are allowed 100 pounds for first 5 feet and 5 pounds per inch over that. Males are allowed the same 100 pounds for the first 5 feet and 6 pounds per inch over.

Example: a 5’5” female would have an AVERAGE ideal weight of 125 lbs, while a male of same height would have average ideal weight of 130lbs. (Let me offer this one tidbit: I understand that many people freak out with these weights, but they really are ideal for the heights. Google images of people from 1950 – BEFORE the low fat craze. People were much thinner and were perfectly healthy. We’ve become desensitized to body weights for lots of reasons, but it has skewed our perspective of what a body should look like.)

Now that you’ve calculated your ideal weight, we will use that number to identify our protein needs per day. At 5’5”, a female’s average ideal weight would be around 125 lbs. Convert that to kilograms using the standard conversion factor, 2.2.

Math would look like: 125/2.2 = 56.8. So your weight in kg is 56.8. For people of average daily activity, the recommendation is 1 gram of protein per 1 kg if body weight.

So, protein needs would be approx 56.8 grams per day — divided into 2 or 3 meals per day, based on lifestyle and personal choices.

For our way of eating, we calculate our protein needs and then use that to determine our fat needs – approx double the protein goal. So you would need about 114 grams for fat per day.

Carb grams are counted as total carbs bc fiber carbohydrates DO impact some people’s glucose levels. Max carb goal should be 20 grams per day or 6-7 per meal.

I hope I’ve kept this as easy and simple as possible. Yes. There are many keto calculators but most do NOT account for metabolic disorders or they are athlete-based, resulting in very high protein intake and excess proteins will be converted into glucose in the absence of carbs — not good for anyone with insulin resistance or diabetes.