About ketogenesis and fat adaptation


I want to explain a little further what’s happening when we go in ketosis, with a water fast or a ketogenic diet, and the difference between ketosis and fat adaptation.

When we eat carbohydrates, It’s broken down into glucose and we start producing insulin. Glucose is used directly by the brain, which needs at least 30 gr a day, and with the help of insulin it is also used by the rest of the body. Insulin opens the cells so they can absorb glucose, along with the fat we ingested or the fat created directly out of glucose. I read somewhere that 90% of the glucose we eat gets transformed into fat but I guess this varies if someone is on a low carbs, very low carbs or almost zero carbs diet.
Insulin also prevents fat from being burned in order to favor glucose being burned. By eating carbs, we trigger some kind of storage mode in our body where most of the extra calories are stored as fat (some as glucose or glycogen) and all get locks in the cells.

Ketosis is what happens when our blood sugar becomes low. Insulin gets lower and the body starts producing cortisol to get energy out of the cells. This happens every day, during the night or in the morning, as most of the carbs from the day before have been burned or put in reserve. Sugar, triggering insulin, is the reason people get obese. Not fat alone; although sugar and carbs together accelerate the process. Insulin is our storage hormone. If you have too much calorie intake but you’re not eating carbs, you won’t have insulin and the extra calories will not get stored. They will be excreted in the urine which can cause kidney problems if it’s excessive.

I’ve been eating between 1/4 to 1/2 a cup of fat a day for a year and a half and I lost 20 kilos. My body fat is currently around 12% and I have a nice 6 pack. All belly fat is gone.

Cells and liver reserves of glucose can only last up to 48 hours so you will have the most carbs craving on the second day when water fasting longer than 2 days or going into a ketogenic or carnivore diet (more below on the carnivore diet). After that, the body can turn proteins into glucose so the brain can have the minimum 30 gr a day it needs.

Most people are quite inefficient at burning fat as we’ve been eating carbs since we were babies (babies are born in full ketosis and fully fat adapted). The short morning ketosis usually doesn’t last long as we are hungry, some may even be hypoglycemic, and we get some carbs asap; in a coffee for example.
When we produce ketone bodies and can’t burn them all, we just urinate the extra although most people will at least use some of them as energy.

As many knows, I’ve been a proponent of a carnivore / ketogenic diet for a long time. By doing this diet, it eliminated most of my neurological symptoms within a week. Physical symptoms were also improved but sexual ones didn’t change much. I believe this was due to glucose and allergen withdrawal rather than ketosis itself (allergens being removed by eating mostly beef and butter or ghee). At that stage I was not fat adapted but could at least burn some of the fat and also used protein as an energy source. I lost 2.5 kilos in 2 weeks, as by eliminating carbs, I eliminated the water that gets absorbed and stored along with the carbs. We all know how to thicken a sauce with flour or starch, it’s a property of most carbs to absorb water.

Sexual symptoms took 3-6 months to start improving. This is also the time it takes to get fat adapted. Correlation doesn’t mean causation so it might be unrelated.

Getting fat adapted means your body becomes increasingly good at using the ketones as a source of energy. Once this is accomplished, urine tests are no longer accurate in determining ketosis levels as ketone bodies are used in greater number instead of being eliminated in urine. Same goes for breath tests as acetone is being used more efficiently. When fasting, more fat is burned for energy and less protein are used as the fat can supply most of the body’s energy needs. Also note that during a moderate fast, say 2-3 days, the protein used by a fat adapted person are not proteins from the muscle but proteins from damaged senescent cells, excess rejected DNA from within the cells (which can be up to 200 times the size of the DNA itself if the body hasn’t cleansed itself for a long time) and other protein rich useless components of our body that are just waiting for the next fast to be cleansed. You see, fasting is actually a natural, vital function of the body. We shouldn’t go for long periods of time without being hungry.

However, unless you have very large reserves of fat, it’s unlikely you’re going to become fat adapted by fasting (though one guy fasted for 1 year and lost hundreds of kilos… of fat. He had good reserves to start with…)
Here comes the carnivore diet. Not only it’s an elimination diet that removes all carbs and allergens produced by plants, but it also provides you with proteins to burn as you’re getting adapted to burning fat.
Some people say too much protein will kick you out of ketosis but this is unproven. It takes 5 calories of protein to produce 2 calories of glucose. The body will only produce what it needs, around 30 grams for the brain.
If you eat ruminant meat (animals with horns with multiple fermentation stomachs like cows, goats, sheep, dears, bison, antelope etc…) you will get very little carbs as those meat contain almost no carbs at all. This is due to the bacterial fermentation process in their digestive tracks that transform all carbs, including fibers, into fatty acids and proteins (the bacteria themselves are proteins). We classify those animals as herbivores but the truth is, they cultivate bacteria and feed both on the bacteria themselves, as a source of proteins, and from the fat the bacteria produce as a byproduct of their metabolism. Ruminants feed from animals which feed from plants, not directly from plants. They should be called bacteriavores instead of herbivores, unlike koalas, for example, which actually feed from plants.
Many anthropologist believe those ruminants were human’s main source of food during the paleolithic as they are a good source of fat and proteins. Because humans have smaller intestine than chimps but larger brain, we are a very energy dependent specie. Ruminants, using bacteria to transform plants in fatty acids and protein, are very efficient at transforming pasture land into condensed forms of energy. It is theorized that without those ruminants, humans could not have developed such a large brain as a trade off for a smaller intestine. Remember that grains were not evolved at that time and it was humans, by selective breading, that created the large energy dense grains we are cultivating now. But that came later, when we were smart enough to do selective breading of grain.
I will so make the point that the ultimate paleolitic diet is a ruminant based diet as well as the fat produced by those ruminants (butter, ghee, cheese etc…)

I suggest, as a therapeutic approach, to eat ruminant meat and fat in order to eliminate carbs and allergens, get fat adapted, and become more efficient at fasting which ultimately will help repair the body (and as a bonus reverse the effect of aging)

Being fat adapted means you can very easily stop eating a few days and go on with full energy as your body just uses your fat. Fasting is a breeze and your energy is not food dependent, at least not within a few days.

If it takes 3-6 months of a zero carbs diet to get fat adapted, I believe you need to have carbs all the time in the blood for 3-6 months to lose the adaptation, and even then the body would be fast to re-adapt.
Once fat adapted, you can easily eat small quantities of carbs sporadically, as long as you depend mostly on fat for energy you will not lose your fat adaptation. Birthday cakes are not a problem however, all carbs should be avoided for at least 3-6 months to make sure you get fat adapted.

Having ketones in your body has advantages that goes beyond the withdrawal of carbs and allergens.

In some studies I posted on this forum (in the success story thread) it is stated that Butyrate / Butyric acid and BetaHydroxyButyrate (which is a ketone produced by your body from fat, in the absence of carbs and insulin) loosen the DNA from its histone “rolls” and enable an easier gene expression. We often talk about gene methylation as a cause of pfs and the other related diseases here on this forum. Butyrate and BHB does nothing against methylation to my knowledge but if part of the disease is due to DNA tightening around the histones, than it helps with that.

Fasting, however, induce autophagy which in turn uses senescent cells as a source of energy (the body “eating them up”). Cells become senescent not only because of shortened telomeres but also because of epigenetic damage (including methylation) which causes the cells to produce defective, useless proteins. Age causes epigenetic damage, as well as chemicals and other stressful events including medical drugs. I believe this is the cause of many of the symptoms we suffer. Fin and some other drugs has caused epigenetic damage to the endocrine system.

Being fat adapted does not increase the amount of ketones in the blood during a fast but it does increase its usage by the body, making you much more energetic than you would if you were not fat adapted. It can enable you to fast longer and more often. Being fat adapted and burning more ketones also delay the onset of ketoacidosis, a dangerous pathology caused by elevated blood ketosis in later stages of starvation. Ketoacidosis can induce coma, cause irreversible damage and even death.

So there you go, that’s the difference between being in ketosis (full of ketones) and being fat adapted.

All of the above is my understanding of those various subjects. I may have misunderstood some of my readings, but I think as a whole this text is a condensed version of my various readings on those subjects.
I hope it will be useful to some of you.

(Gee, it really looks like I felt like writing today… Lol)

I wish you all the best.



No answers to this wonderful thread explains the number of people on this forum who never get better and enter a pessimistic loop.

Ozeph, you are really different. Thanks for this post.

In my opinion (and I don’t suggest anything to anyone) I think that butyric acid is really the beginning of the cure for our condition. I think that at first we should remove the methyl group from our genes and THEN do something to improve our HPTA if it don’t come back naturally over time. But it is natural that people try to use TRT, Serms and AIs in despair BEFORE repairing the DNA, which results in even more damage to our body and makes it much more difficult to treat our condition.

Maybe the secret to starting healing is ketosis. Then, we should improve the gut (and probiotics play a role in this), digestion, adrenals and estrogen (some people getting better with higher e2 and some people getting better with lower e2 - in my case, I need a little higher estrogen), assuming that serum T and DHT levels are normal.

It may not even be necessary to do anything after just a long period of ketosis, because the body will readjust itself. I myself have had physical changes after feeling the effects of Butyrate acid (remember that the exogenous form of the acid is not the same thing as the body’s own production).

In the end, perhaps, we should try something to improve any physical and residual damage to the tissues of the penis, just in case it does not return to full normality after the return of the presence of DHT in it. But I think that with the androgenic presence in it, it returns to 100% of what it was before with time.

I am still surprised at the emptiness of this thread …


No, it doesn’t. Your statement is frankly insulting to people suffering from an extremely serious physiological disease, many of whom a keto diet just isn’t going to cut it. You are welcome to pursue whatever diet or supplement/substance you like in your own therapeutic endeavours and report the results here. You are not welcome to suggest unwell people, some severely, are remaining that way because they don’t follow a ketogenic diet or want to talk about a ketogenic diet.


Guys, I’m aware that some people have more extensive damage than others. I’m posting here what I believe are some elements that can be used by some to try and get better.

I’m also aware that it’s not a complete protocol (if ever there is one). I’m just discussing the difference between ketosis and fat adaptation, the benefits of eliminating carbs and allergens, at least in the early stages of the disease, and the benefits of fasting, which is good whether or not someone is fat adapted; fat adaptation making it easier.

According to my researches on epigenetics, it appears that aging is in great part due to epigenetic damage. I have an old friend whose skin is falling apart. He’s got small wounds spontaneously appearing all over his body, out of nowhere. Epigenetically, this can be explained by the skin cells having forgotten their role as skin cells and producing a different set of protein than they are supposed to (aka: reading genes inappropriate to their cell type). Those wounds are skin cells acting as flesh cells or something else. This looks a lot like the skin problem of some pfs sufferers and it’s just one example.

I’m still looking at Harvard’s researcher Dr. David Sinclair who has found, among other things, how to remove methyl groups on specific DNA sequences, or use designer viruses to alter some DNA sequences, loosen the histones to get a better gene reading aka protein production, and many more: increased growth hormones, production of stem cells, production of new neurons, more mitochondria and some other stuff I can’t understand yet.

I believe something of a remedy is coming, but it won’t be for our specific condition but rather to the larger group of general epigenetic damage.

Meanwhile, here are Dr. Sinclair’s easy and safe tricks to reverse epigenetic damage caused by aging:

  • Do some water fasts or be hungry often.
  • Take cold showers or hot saunas (or both)
  • Do some exercise and get out of breath. Running seems to be a good choice.
  • Doing weight lifting was suggested to me by my endocrinologist as a way to raise testosterone and create extra androgen receptors.
    (you will find many of those elements in the Success Stories)

Dr. Sinclair also has drugs he’s using, but do your research and be extra careful. I never advise people to take drugs as I’m not a specialist and I know it can have very adverse effects. Nonetheless, here are the drugs he’s using himself:

  • Metformin 500 mg on resting days, not on exercise days
  • Resveratrol, he uses 1 or 2 gr a day, taken with yogurt, but it’s been pointed out on this forum that it’s 5-ari and can be dangerous to us. I don’t advise trying it. Taking fresh, unheated extra-virgin olive oil can have a similar effect and be less dangerous. If the oil smells rancid, it’s toxic and should be discarded.
  • Using NAD+ Boosters. I need more info on this one.

A Russian doctor specializing in epigenetic damage suggest eating only meat. Of course, this also produces more TOR enzyme which ages the body, but it’s been my experience that eating only meat and animal fat, especially from ruminants, has eased my symptoms. This is always my go back to solution when I’m feeling bad.

I’m not proclaiming a cure, I’m not even saying I’m cured myself, I’m just suggesting elements that can help some of us. Obviously, the least affected will be the ones easier to improve. And please: don’t take anything as an insult. I’m just trying to help and showing that science is actually moving forward.
By the way, a 3000 year old stoic trick to be impervious to insults is humility. I myself try to stay as humble as I can, with mixed results, but whenever I manage to be humble no insults can trigger emotions in me. I just acknowledge someone has said something, I’m for freedom of speech so that doesn’t bother me, and the reaction I choose to have is all in me and unrelated to outside influence.

I wish the best to you all. I will post again when I have more (especially how to boost those methyl cutting protein we can produce…)


@dae1 Got it: Sirtuins are the demethylation proteins.

From wikipedia: Sirtuins are a class of proteins that possess either mono-ADP-ribosyltransferase, or deacylase activity, including deacetylase, desuccinylase, demalonylase, demyristoylase and depalmitoylase activity.

From another source: Sirtuins have been found to regulate cellular processes such as DNA transcription, aging, apoptosis, inflammation, immune response and reaction to caloric restriction. They can also control circadian clocks and mitochondrial biogenesis.

How to Increase Sirtuins

  • Glucose restriction extends the lifespan of human fibroblasts because of increased NAD+ and sirtuin activity [xxxviii]. Inhibiting insulin shuttles SIRT1 out of the cell’s nucleus into the cytoplasm. Cancers use primarily glucose and glutamine for fuel with the exception of some ketones in rare cases.
  • Caloric restriction and fasting increase SIRT3 and deacetylate many mitochondrial proteins [xxxix]. Reduction of calorie intake without causing malnutrition is the only known intervention that increases the lifespan of many species including primates[xl][xli]. It’s thought that these effects in longevity require SIRT1[xlii].
  • Activating AMPK elevates NAD+ levels, leading to increased SIRT1 activity[xliii]. AMPK is the fuel sensor that mobilizes the body’s energy stores such as fat.
  • Ketosis and ketone bodies like beta-hydroxybutyrate promote sirtuin activity. SIRT3 deficient mice can’t produce normal levels of ketones while fasting[xliv]. However, a ketogenic diet increases brown fat and improves mitochondrial function but lowers SIRT3 in mice[xlv]. This may be due to the signaling of mTOR by a nutrient-dense diet. Natural ways of caloric restriction and fasting are still the best ways of signaling energy deprivation which promotes longevity. In an everyday context, a low carb diet is still pro-sirtuin to a certain extent because of the low levels of insulin and glucose.
  • Exercise has anti-inflammatory effects and it increases SIRT1 [xlvi]. The long-term benefits of exercise are even thought to be regulated by SIRT1.
  • Cyclic-AMP pathway activates SIRT1 very rapidly to promote fatty acid oxidation independent of NAD+[xlvii]. CAMP is linked with AMPK which gets activated under high energy demands while being energy deprived. This can be accomplished with cold exposure and high-intensity training or exercising in a glycogen depleted state.
  • Heat exposure and saunas increase NAD+ levels which promote SIRT1 as well[xlviii]. Sweating, cardio, yoga, or infrared saunas will probably have a similar effect on activating heat shock proteins.
  • Chronic oxidative stress and DNA damage depletes NAD+ levels and decreases sirtuin activity. This will then disrupt DNA repair and impair mitochondrial functioning. That’s why you want to keep stressors acute and followed by recovery.
  • Melatonin can activate sirtuins and has anti-aging effects [xlix]. It’s also the main sleep hormone and a powerful antioxidant that helps the brain get more recovery from deeper stages of sleep.
  • Sirtuins also affect the circadian clocks so keeping a consistent circadian rhythm is incredibly important for longevity . NAD+ is under circadian control and when you’re misaligned you’ll have less energy and lower SIRT1 and SIRT3 activity[l]

Well Ok. Looks like I had this covered already. Anyway, it just shows the approach I’m suggesting in this thread has some foundation.
Please do compare with what people have done in the success stories. You’ll find similarities.

Source article: https://siimland.com/how-to-increase-sirtuins-for-longevity/

Food sources of Sirtuins: https://www.inner-light-in.com/2015/05/top-ten-sirtuin-foods-for-good-health/

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Ozeph, how much have your recovered from PFS? 90%?

More than 90%

I was disabled, unable to work or drive or even climb two flights of stairs. Sex drive was zero, I had lost morning erections and sensitivity.

The horrible anxiety, the one I thought I would have to kill myself if I had to live with that all the time: it’s gone ! And so is depression and brain fog…

Now everything is back to normal except I still have some insomnia. I keep it under control with drugs and herbs but I still have a messed up day once in a while due to lack of sleep.

I’ve also tried eating junk food instead of my diet and insomnia becomes slightly worst but no other symptoms came back. I will redouble my efforts along the above mentioned lines and I’m pretty sure I can get all of this behind me at one point. It may takes years, but as long as I get there I’m happy.


Here is a video explaining some of that stuff. I don’t know if in that specific video he mentions aging is mostly epigenetic damage and not only telomeres shortening, but what he talks about, plus the 2 articles mentioned above, is not specifically about aging but mostly about repairing epigenetic damage. (and it appears what we have is epigenetic damage…)

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Keto is the fad. Twenty or so years ago it was the opposite. I am sure that if you went to the propecia boards that existed 15 to 20 years ago, guys would be advocating lowfat/grazing type of diets to treat PFS. I think keto or carnivore or paleo or primal can help people with lots of things, but curing PFS or another systemic disorder is silly.

@Crossroads do you think you could fill the survey out? It allows you to stop and save progress in case you can’t give it a go all at once. Thank you!

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It’s not only eating zero carbs. You forgot staying hungry, fasting, exercising, getting out of breath, weight lifting, cold showers and saunas, strict circadian rhythm regularity and you forgot to mention extending life, curing diabetes as well as reducing epigenetic damage, preventing arthritis, strokes, heart attacks and cancer.
(I’m taking the opportunity to list them all.)

If you’re going to be dismissive and make abstraction of the last 20 years of scientific discoveries, which is your right, you might as well be thorough.

(to the admin: I didn’t post my references for the first paragraph as I’m suggesting to dismiss it all. If some claims end up being false, they should be dismissed)

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@Ozeph Yes, the things you mentioned are all good side effects for many people on the keto diet or any other diet that may work for them.

I myself HAVE TRIED all the things you mention. I still have PFS. I still have the problems I had 22 years ago.

My point is that a diet is NOT going to CURE a neurosteroid imbalance that was caused by chemicals taken in the form of drugs that affect the entire human physiology.

How long did you try the diet?

Since last summer. I have also done other diet for several months to several years. Diets don’t work for PFS–it just doesn’t make sense. But I am glad that I lost weight with some of the diets and not happy that I gained weight and other problems with others!

And when did you stop the keto diet?

My topic here is about the difference between ketogenesis and fat adaptation. Diet is just the beginning.

Ultimately, diet, exercise and fasting (especially fasting) did and does cure some. It did make most of my symptoms disappear for 1 1/2 year now. This is not a blanket statement, I didn’t say it will cure all of us.

When you say: diet is NOT going to CURE a neurosteroid imbalance that was caused by chemicals taken in the form of drugs that affect the entire human physiology, that’s a blanket statement. You’re saying it won’t for everyone. That’s not true, beside me I know others for which diet has been of immense help.

Plus my point for this thread is that fat adaptation makes fasting easier, and fasting CAN cure a neurosteroid imbalance. Again, not a blanket statement. It will not for everyone.
Some people cure cancers with fasting. Others don’t.

So I understand the tricks I mentioned didn’t help you, I never said it would help everyone, but please be considerate of those it may help. Some of them may not try because of comments like yours or dae1.


Here’s another video of Sinclair talking about gene demehylation. If I understand what’s being said and pfs correctly (and I probably don’t, but eh !), he’s talking about something that could get us back to where we were before taking fin.( skip to around 25:00 minutes in the video, or watch it all to hear new words you never heard before !)

Ketogenic/carnivore diet causes Diabetis. Red meat, but also chicken, milk, cheese causes diabetis, not carbohydrates or sugar.
Also the Dutch Diabetic foundation warns for meat, chicken and diary

See the docu on Netflix: What the Health from Kip Anderson

Why have people reversed Type 2 diabetes on low carb diets then?
I wasn’t trying to be argumentative @smphead I’m genuinely curious.

I agree with @Chapman. Why some people have cured their diabetes with carnivore / ketogenic diet ?

And why people eating too much sugar gets diabetes ? And it’s a genuine question, not a sarcasm. I’ve read the result of a test conducted around 1950 where the doctor was giving a 96% calories from carbohydrate, up to eating straight bowlful of white sugar and drinking glucose and people were losing weight. I can’t imagine (again no sarcasm) what this did to their insulin and insulin resistance. Did they adapt ?

My conclusion from this experiment was that a near 100% simple carbohydrate diet had similar results to a near 100% fat diet. I can’t remember the conclusion about diabetes but both are elimination diets.

For it’s practicality, high fat / carnivore diet with some leafy greens, only water for drink and less than 20 gr of complex carbohydrate just before sleep (to reduce cortisol by elevating insulin) is way easier and provides more nutriments, minerals and vitamins than an almost pure sugar diet or a standard ketogenic diet.
(ketogenic diets requires calculation and lots of time cooking. You need to search everything and it’s not as effective as an elimination diet.)

What are your sources on this ? I would like to learn more. (I don’t have Netflix. It’s dangerous for my type of personality… Lol !)