THIAMIN
I recently ran through a nutritional consultation with a new client who was suffering some issues metabolising carbohydrates/poor glucose tolerance. She had switched to a traditional keto approach as she assumed it was an insulin resistance issue (as previous diet was very high carbohydrate as a % of total calories), but had began to since notice some issues with her sight since switching.
For some context, this client is vegan, whose protein intake is relatively low. Previous carbohydrate sources before switching to the ketogenic style diet were in the majority refined grains, with protein coming trace from a limited number of vegetables. Upon switching to the ketogenic approach, the calories coming from refined carbohydrate sources were swapped for oils and butter.
This was screaming a thiamin deficiency issue to me, so she went ahead and got a urinalysis for organic acids status, and our suspicions were confirmed!
Since this consultation, we have increased total plant protein intake, increased total carbohydrate intake from fortified sources and all peripheral neuropathy has gone, blood glucose is sitting really nicely in the 70-75mg fasted and post-prandial range and we have been able to increase total calorie intake from carbohydrate pretty hard initially with no metabolic issues or blood glucose intolerance.
I know this is a pretty unique case, as the majority of us are getting more than enough thiamin from plant/animal protein sources, but these individual cases do exist, and it is important that we know how to recognise and correct them when they do crop up in ourselves, or clients.
The attached research in an excellent read into thiamin and the relative clinical effects of its deficiencies:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375232/
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