Transcription
There are people going carnivore, cutting carbs completely, doing everything right, and their blood sugar is getting worse. Higher fasting glucose, worse insulin resistance. Some are even being told they're pre-diabetic or diabetic. This should not be happening. So, what's going on? Because if carnivore is supposed to improve metabolic health, how does this even happen? And more importantly, could this be happening to you without you even realizing it?
Today, I'm going to break this down in a way that actually makes sense and explain one concept that completely changed the way I look at metabolic health, lipotoxicity. And trust me, if you've been stalled on carnivore, struggling with blood sugar, or feeling like your body isn't responding the way you expected, this video may explain a lot.
A few years ago, my husband and I started carnivore at the same time. I lost 50 lbs. My inflammation improved, my energy improved. Everything moved in the right direction. He had the opposite experience. He didn't lose weight. His blood pressure, his insulin markers, and his inflammation actually got worse. And honestly, it was really confusing because we were eating the same foods. We were following the same general approach. So why were we getting completely different results? And if you've ever felt like you're doing everything right, but your body is just not responding, you know how incredibly frustrating that can be.
Now, that question sent me down a massive rabbit hole into insulin resistance, fat metabolism, visceral fat, mitochondrial dysfunction, and eventually lipotoxicity. And once I understood this concept, suddenly everything started making sense. Because let's zoom out for a second. How can somebody eating almost zero carbohydrates still have elevated blood sugar? That shouldn't happen unless the problem isn't just carbs.
Let's simplify this. Your body runs on two main fuels. Glucose and fat. On carnivore, you're primarily running on fat. That's the goal. But here's where things can go wrong for some people. If your body is already overloaded with stored fat and your fat cells are already oversted, you may have reached what's called your personal fat threshold. That means your body has reached the point where it can no longer safely and efficiently store more energy in the fat tissue. And when that happens, your fat cells don't behave the way healthy fat cells are supposed to behave.
Healthy fat tissue is not just extra weight. It's actually an active metabolic organ. When it's working well, it acts like a storage tank. It takes excess energy, stores it safely, and helps keep that energy out of places it does not belong. But when fat cells become overfilled, inflamed, and dysfunctional, they lose that ability to buffer incoming energy properly. So instead of fat being stored safely in fat tissue, it starts spilling over into places it shouldn't be. That is lipotoxicity.
Lipotoxicity is the harmful effect of excess fat being stored in the wrong places. Fat begins accumulating in places like muscle, the liver, the pancreas, and the heart. Also, deep around the organs in the abdominal cavity. And when fat builds up in those areas, it starts interfering with insulin signaling, glucose control, inflammation, and overall metabolic health.
Now, this is where the blood sugar issue comes in because insulin's job is to help move glucose out of the bloodstream and into the cells. But if those cells are already overloaded with energy, already inflamed, or already dealing with fat accumulation where it doesn't belong, they become less responsive to insulin. So now your body is basically saying, I can't take in more fuel right now. And when glucose can't get into the cells efficiently, it stays in the bloodstream. So blood sugar rises even without carbs.
And this is the part that confuses some people. They think, I'm not eating sugar. I'm not eating bread. I'm not eating any carbs. So why is my fasting glucose still high? Because in this situation, the issue may not be incoming carbohydrates. The issue may be that your body is struggling to handle fuel in general. Your fat metabolism is impaired. Insulin signaling is impaired. Glucose disposal is impaired. And your body is metabolically backed up. That's the traffic jam. You have incoming dietary fat. You have stored body fat. You have fat cells that are already overfilled. And you have organs and tissues that are now storing fat where they shouldn't.
So when someone in that state goes extremely high-fat on carnivore right away, especially lots of added butter, heavy cream, fat bombs, and fatty cuts at every meal, it may not work the same way it works for someone who is already metabolically flexible. For one person, high-fat carnivore feels like rocket fuel. For another person, it feels like pouring more fuel into a system that's already backed up. And that's why two people can eat the same diet and get totally different results.
So let's put this into an analogy. Think of your fat cells like a garage. At first, there's plenty of room. You can put boxes in there. You can park a car in there. You can store things safely. That's healthy fat storage. But over time, if you keep packing more and more into that garage, eventually it becomes completely over stuffed. There's no room left. So now the extra stuff starts spilling into the hallway, the kitchen, the bedroom, the driveway, places where it doesn't belong. That's what happens metabolically. Fat is no longer being stored safely in fat tissue. So it starts spilling over into the liver, pancreas, muscle, heart and visceral area. And once that happens, the whole system becomes disrupted. The cells stop responding properly to insulin, glucose stays elevated, inflammation increases, and the body becomes less metabolically flexible.
So when we talk about lipotoxicity, we're not saying that fat is bad. We are saying fat stored in the wrong places becomes metabolically disruptive. And lipotoxicity and insulin resistance tend to go hand in hand. And this is also why body size alone can be misleading. You can have a relatively thin person who is metabolically unhealthy because they've exceeded their personal fat threshold. They may not look like they have a lot of weight to lose, but internally they may have fatty liver, visceral fat, high insulin, poor glucose control, and low metabolic flexibility. You can have a larger person who at least for a period of time is still storing fat more safely in subcutaneous fat tissue and may have better metabolic markers than you would expect. So lipotoxicity is not just about how much you weigh. It's about how well your body is handling fat storage. It's also about whether your fat cells are still functioning properly. And of course, it's also about whether fat is being stored safely or spilling over into places where it starts causing damage.
Now, this is where people go completely off track. They hear lipotoxicity and think, "So fat is bad, or I need to do low-fat forever now, or carnivore caused this." No, that is not what this means. The issue is not dietary fat itself. The issue is your body's ability to process fat, store fat safely, and burn fat efficiently. And this is where nuance matters. Carnivore can absolutely help improve lipotoxicity, but some people may need a more strategic approach temporarily, especially if they're starting from a place of severe metabolic dysfunction.
Now, let's talk about who this tends to happen to because it is not everybody that goes carnivore. This tends to show up more in people who have had a long history of insulin resistance, have significant visceral fat, have had years of metabolic dysfunction, fatty liver, or poor metabolic flexibility. So, if that's you, this matters because this is why you can see two people start on carnivore, one person improves immediately, and the other person stalls or even looks worse before things improve. Just like what happened with me and my husband.
Let's take a quick pause here because one thing that becomes incredibly important when you're trying to improve insulin sensitivity and metabolic health is hydration and electrolytes. Because when insulin drops on low carbon carnivore, your kidneys excrete more sodium. And if your electrolytes are off, you can end up dealing with fatigue, headaches, low energy, cravings, poor workouts, and even elevated stress hormones. That's why I use Element. Element has a sciencebacked electrolyte ratio with sodium, potassium, and magnesium and no sugar or junk ingredients. And honestly, especially during the summer, I've been loving their new 12 ounce sparkling cans because they're super convenient when I want something cold and refreshing. And their lemonade iced tea flavor is so good. Now, this one has 50 milligrams of caffeine in it as well. So, it's perfect for an afternoon pickme up without a huge caffeine overload. Now, I'm very sensitive to caffeine. I actually drink decaf coffee. But I will say that I can do two packets of these in my 40 oz, you know, big cup of water and I do not feel any jitters or anything like that. It's very smooth and it's a delicious flavor. And of course, if you want something that doesn't have any flavors or sweeteners or anything like that, you can always do the raw unflavored. This is just the minerals. I think this is a great place to start on carnivore. Right now, Element is offering my viewers a free sample pack with any order. So, you can head to the link in the description. It's drinkelement.com/jennymidich. That's d r i n k e l e m e n t.com/jennymidich and get your free sample pack with any order today.
Now, let's talk a little bit about how you can tell if you have lipotoxicity. This is very important because lipotoxicity is not just, oh, I'm not losing weight, therefore I must be lipotoxic. There's actual markers you can look at. We want patterns, not obsession over one isolated number. So, there's a few things to look at.
First, we're going to look at a standard lipid panel. You want to look for triglycerides over 100, HDL under 50, and a triglyceride to HDL ratio above a two. When we're looking at fasting glucose, if it is above 95 milligrams per deciliter, fasting insulin in the double digits, so anything 10 and above, and a homir above a 1.3. So when you're calculating a homir, this is the same for US and international, you're going to take fasting insulin, multiply that by your fasting glucose, and then divide that number by 405. You want that to be above a 1.3.
Next, we're going to look at adiponectin. Adiponectin is a really helpful marker related to fat cell health and insulin sensitivity. Though this test is expensive, so I do think you can just do the other cheaper tests and get a really good idea. But if you want to run this test, you can. I'll put a link in the description to it. For men, generally 15 plus is a good target. And for women, we naturally carry more fat. So, you want a 20 or higher. Now, when your fat cells become dysfunctional, which is what we're looking for in this lipotoxic state, your adiponectin often drops.
We're also going to look at GGT. GGT can be a clue related to liver stress and metabolic dysfunction. Uh GGT above a 30 may suggest something deeper is going on metabolically. It can suggest high visceral fat levels. It can suggest a high amount of fat on your liver. So, that's another great marker to look at. And it's a very, very inexpensive blood test.
Now, another clue that you want to look for is visceral fat levels. This is the deep fat that's inside of your trunk around your organs. This is not the soft fat under your skin that you can pinch. That's subcutaneous. Visceral fat is the kind of fat that you really want to reduce. It does not belong there. Now, a simple way you can estimate risk is a waist to height ratio. I want you to take your waist circumference and divide that by your height in inches. A result under .5 is generally a good target. You can also visually pay attention to if you have a hard distended belly or abdominal firmness that isn't muscle. If you have like an kind of a pot belly, a lot of men have this kind of a pot belly that feels really hard. That is visceral fat. Another thing you can look for is if you're carrying most of your weight centrally. And if you want a more precise measurement, there's a couple things you can do. You can do a DEXA scan. It's one of the best practical tools for measuring visceral fat. It will give you a volume amount of visceral fat. If you want to get like super precise, you can do an MRI that will actually tell you the locations and amounts of the visceral fat in your abdominal cavity and that is a little bit more expensive and harder to access. DEXAs are pretty easy to find. I will put a link to the DEXA locator in the description so you can find a DEXA scan near you and you are looking for a body composition DEXA scan, not a bone density DEXA scan.
All right, so now we know what to look for in biomarkers. Let's talk about some good news cuz it's not all bad news here. If this is going on, if lipotoxicity is going on, it's not a dead end and it does not mean you can never do higher fat carnivore later. It just means you may need a more strategic phase. So, let's talk about some practical solutions here.
Now, all of this information has been derived from Dr. Nadir Ali. He is the one that I learned about lipotoxicity from. I will put a link to my full interview with him at the end of this video. So, if you really want to dive into the nitty-gritty, that's a great interview. It's about an hour long. These solutions are what he uses in his clinical practice to help people deal with lipotoxicity. And this is what we've used with my husband to get his visceral fat levels down from 9 lbs to under three currently. And finally, all of his biomarkers are starting to improve as well. He's also lost an additional 50 lbs. So, it does work. There is a solution. Let's talk about it.
First off, you need to lower your dietary fat temporarily, and you need to raise and prioritize your protein. This is a big one. You do not need to drown everything in butter if your body already has a large amount of stored energy on it. That means stop adding excessive fat. Stop drinking butter coffees. Stop treating added fat like a free food. And instead, I want you to prioritize protein. I want you to choose leaner cuts more often. Not all the time. You can still have your ribeyes a few times a week, but I want you to substitute out maybe a sirloin or a New York strip a couple times a week so you can get those leaner cuts in more often. You want to let your body access your stored fat. So instead of, you know, ribeye for every meal, maybe rotate in sirloin, top round, lean ground beef, chicken breast, or seafood. And this is not forever. This is just strategically.
The second thing you can do to make this process go faster is to incorporate fasting appropriately. Now, fasting helps because it gives the body longer windows to access that stored energy, that fat on your body. Now, this could look like intermittent fasting. So, 16 hours of fasting, eight hour feeding window. It could be 18 hours of fasting with a six-hour feeding a window. You could do an occasional 24-hour water fast. You could do longer fasts. My husband has done up to a 21-day water fast, but typically he would do anywhere between a 5 to 10 day water fast when he was in the very beginning of dealing with this lipotoxic issue. You can also do sardine fasting. Starting fasting is a great protein sparing modified fast where you're still eating some food, but you're really getting all of the benefits of fasting. But you need to remember that fasting is just a tool. It's not a religion. The most important thing is that consistency matters more than extremes. So what we did with my husband was once a month he did a longer water fast and the rest of the time he would eat regular carnivore, making sure we were eating our last meal pretty early in the day before like 4:00 p.m. And that was enough to really start losing that visceral fat.
Now, the third thing you need to do is some movement. You need to build muscle and improve mitochondrial function. So, movement matters a lot here. You're going to build muscle with strength training, but you also need to do zone 2 cardio. Now, that is wonderful for improving fat oxidation and your mitochondrial health. And then the strength training helps to build muscle, which improves your glucose disposal. So, muscle, it acts kind of like a parking lot for glucose. The more muscle you have, the more space you have available. So, even simple walking after meals can also help. Just remember strength training and zone 2 cardio for the movement piece.
Now, I do want to talk about rechecking because it's not as simple as just doing these three things and they're like, "Oh, everything's better." Uh, it's been quite a process with Goran. So, what we did was we we're crazy though. We rechecked blood work and DEXAs once a month. I think for you after you put in if you've determined that you have lipotoxicity through the biomarkers, the blood work, the DEXA, all that kind of stuff, and you start to implement this three-step plan of lower fat carnivore fasting and the zone 2 cardio and strength training. Then from there, retest in about 3 months. What you want to see is all of your biomarkers improving. So your ultimate goal is to have triglycerides under 100, your HDL above a 50. You want your triglyceride to HDL ratio to be under a two. You want to see improvements in your GGT in your adiponectin. If you measured that, you want to see that going up. You want to see in your blood sugar uh 95 or less for your blood sugar. You want to see that fasting insulin moving into the single digits. So 9 or below. Optimally, you eventually want to see your fasting insulin between a two and a six. That is the optimal range. But in the beginning, just seeing it starting to move is great. move down. And then the final thing is visceral fat. When you do a DEXA scan, if you see that your visceral fat is starting to go down, now visceral fat, your body does not want to have it. So when you start to do this intervention, what's going to happen is your body is going to eliminate the most dangerous visceral fat first. So that's around your heart and then it'll start losing everything else. But it does take time. Like I said, Goran had 9 lbs of visceral fat and we have now gotten that down to 2.99. And usually it's about I don't know a quarter of a pound to half a pound of visceral fat every time you measure and doing the three you know interventional lower fat diet higher protein and then doing the fasting when you can and the zone 2 cardio and the strength training doing all of those in conjunction and being really consistent and strict with it. You can really see some amazing reductions in visceral fat.
Now I would say probably retest every 3 months. Make sure everything's moving in the right direction. And once you have everything under control, I think at that point you can safely start to increase the dietary fat a little bit. I always say if you have excess fat on your body, you have sticks of butter stored on your body. You want your body to tap into that. So, you know, using a little bit of animal fat to cook your meats in, not a big deal. eating a stick of butter a day or drowning, you know, your meals in butter or like very fatty like three or four tablespoons of heavy cream or two tablespoons of butter in like three coffees in the morning. That's too much dietary fat if you are 50, 60, 70, 100 lbs overweight. Allow your own body to tap into the butter sticks that are stored on it already. So, uh I would say retest every 3 months. If everything's moving in the right direction, start to add in a little bit more dietary fat and then keep retesting though. And if you see your metabolic markers starting to decline again, back off that fat. It is a long process. We still have about 2 lbs of visceral fat for Goran to lose. But I will say that his HDL went up to 45, which honestly, it's never been that high. That's the highest it's ever been. His vitamin D is going up. His HP is going down. GGT is good. his fasting insulin is in the single digits usually between two and six now. So, we've been seeing a lot of improvements and I hypothesize that that would happen when the visceral fat levels would start decreasing that everything else would start improving. That makes sense because visceral fat is highly inflammatory. So, when you lose it, it goes away. Your body starts to work the way it's supposed to. And it'll be very interesting for you to see within your own data when that starts to happen. So, don't feel like this is hopeless. There is hope and the intervention does work.
If your blood sugar looks worse on carnivore, it does not automatically mean carnivore is failing. It may mean something deeper is happening metabolically. And in many cases, that something is lipotoxicity. If you want to learn more about lipotoxicity and metabolic dysfunction, watch this video right here because I go even deeper into biomarkers and testing with Dr. Nadir Ali. I also have a lipotoxicity cheat sheet. I have laid out all of this information, what to test, where to get testing done, and the intervention to help take care of the lipotoxicity. I've laid that all out into a two-page lipotoxicity document. If you want that document, head over to my Instagram, follow me over there and send me a message that says lipotoxicity. I will send it right over to you. I think it's a great resource and it really just lays everything out so you don't have to keep re-watching this video if you don't want to.
Also, if you want a step-by-step guide to structuring carnivore properly, including fat, protein, troubleshooting stalls, and metabolic health, I also go over all of the exact numbers that my husband experienced in the beginning of his lipotoxic journey. That's all in chapter 5, uh, my troubleshooting chapter in my book, Complete Carnivore. That book is linked in the description below, so you can pick up your own copy.
Now, if you've experienced lipotoxicity yourself or something similar where your effort and your numbers didn't seem to match, I want you to drop a comment and let me know your story because this is way more common than people think and I think it's important for people to hear about it. Thank you so much for watching. I'll see you in the next video.