LCHF not keto and metformin for IR and prediabetes

Hello everyone, I have IR and prediabetes. My doctor suggested to me to go on LCHF diet with Metformin (3x750ER). Now I´m on paleo diet, my daily intake of net carbs is about 70g. I´m feel really well (I don´t take metformin yet) but have a question because recently one dietician told me that we need glucose for our brain and body, nervous system (min. 120g of carbs per day) so only high carbs is good for us or a keto diet, according to him all diets between 50-120g of carbs are bad for our brain and muscle, our body doesn´t have enough glucose to function properly and doesn´t have ketons to replace glucose flue. Is it true or myth? I read something similar on google call ¨low carb limbo¨ that is bad for us and we should stay away from this (again only keto or high carb low fat is good) but is what, for example, Mark Sission from BluePrint Paleo call ¨sweet spot¨ (50-100g of carbs per day) so now I´m confused.
Also, can I take metformin on LCHF with average 70g of carbs per day? I don´t want and I´m afraid of returning to high carb, when I was eating about 150g of carbs per day, one day, suddenly I starded gain weight and I gained 30kg in almost one year and I was diagnosed with IR and prediabetes … On 70g of carbs I don´t gain weight, I feel ok, I have energy and don´t have to sleep all day long after meals but I´dont know how it will works with metformin and what about my brain and other organs haha on this amount of carbs because I´m not in ketosis and I´m not on high carb diet, I´m on low carb limbo-sweet spot :smiley: Is it bad or no?

PS: Sorry for my English, it´s not my native lenguage :blush:

Look up Dr. Bernsteins book Diabetes Solution. It is a low carb high protein diet and he is a type 1 diabetic and has been eating this way for decades. I personally wouldn’t worry about how much fat I am eating but remember if you take something away from your diet that contributes to your daily calorie needs then you need to replace it with something else, for instance if you take away the majority of carbs then you need to either add in fat or protein to make up for it.

Ok :slight_smile: I’ve just read that we can’t eat under 130g of carbs per day, that our brain and nervous system need glucose from carbs to function. We can only be on keto as a fat (ketons) flue or if we don’t want to, we can be on high carb, min. 150g of carbs, so I ended up a little bit confused 'cause I eat about 70g net carbs per day and I dont think that I’m in ketosis neither I’m on high carb but I feel good.

And anyone is here on about 50-70g of net carbs a day and metformin or a little bit more? How are you feeling?

I’ve been doing low carb/high fat for about 7 years now. Rather I should say medium carb because I aim to stay under 100 carbs a day.
Feeling good, and taking the same amount of Metformin as I did when diagnosed.

It’s my understanding and experience that the body will convert protein and fat to glucose when needed. Search gluconeogenesis.

This 130 grams of carbs/day minimum was used by dietitian associations for decades to argue that low carb eating was dangerous. There are many of us who do well consuming much less than 130 grams of carbs/day and our brains are functioning normally!

In nutrition science there are essential fatty acids, essential proteins, but no such thing as essential carbohydrates.

I consume about 50-70 grams of carbs per day but I don’t use Metformin.

Unfortunately, this kind of statement is why dietitians get a bad rep with scientists and some doctors. To put it very, very simply, your dietitian is completely, absolutely, 100% wrong on all fronts. You can eat 0% carbs and your body is perfectly happy to produce enough glucose to feed your brain and other glucose-hungry organs and tissues (like muscles) from what it has on had.

As long as you get enough calories, vitamin C, minerals, protein, and certain kinds of fat in your diet, almost everything else can be manufactured “in house.” You can safely vary carbs and fat (within a certain tolerance) in a diet to hit the right calories and help with BG control. Any dietitian that says otherwise isn’t familiar enough with metabolism and basic science to being dispensing advice.


There have been studies that show a very low carb diet can affect the growth of children. By very low carb, I mean the ketogenic diet though.

I’d be happy to link the studies later today, but I’m on my phone at the moment.

Also, it may be helpful to know why people on the keto diet opt for fat over protein. It may be better to do some research before dropping to those levels. I worry a bit about kidneys when people talk high protein, but I haven’t researched this in depth.

I personally don’t see a reason to not limit carb intake to around 100 grams/day. This is significantly higher than the ketogenic diet. Just make sure you’re getting enough calories :slight_smile:

Terry, good to know that you’re doing well on low carb :slight_smile: I’ve read about gluconeogenesis but my dietician said it only work if you’re in keto and that I will lose my muscle because all my protein from meal will be converted into glucose and not for my muscle, he was like ‘you will die in a year if you eat only 70g’ :smile: so he really confused me because my doctor didn’t say anything like that, just to eliminate grain, potatos and sugar, eat a lot of veggies and some fruits/legumes, some protein and healthy fats.

David, ok, I get it :slight_smile: so I can eat any amount of carbs that I want? It’s no matter if it is keto or low carb? Just to observe how I feel and what my BG is? I shouldn’t go to this detician cause I ended up with a mess in my head :smile:
I like idea that everything can be manufactured ‘in house’ if we eat enough calories etc :slight_smile:

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I can´t be on 100g or more because I just starting gain weight and I´m hungry all day long :frowning:
I have to stay under/or 80g/day. I´ll observe myself and see how I feel. I don´t want be on keto because I want to have some low glycemic fruits etc

Do what works best for you! The quality of the carbs is as (if not more) important as the quantity, right?

If you have any of the early signs of kidney disease though, then upping protein intake can be a major concern. You could google that though… I doubt a dietitian would be more helpful.

Ok, I will :slight_smile: I eat onlyvarbs with low glycemic index.
Kindey disease? I have only IR, my blood sugar after meals is ok, only fasting sugar is high, about 120 and also fasting insuline 30.

Right. Ignore the dietician. She is plain wrong. Eat what you feel good with and the level at which you can well control your blood sugars. If that is 70 g of carbs, great. If that is 20 g of carbs, also great. IF that were 150g of carbs then that’s also perfectly fine.

Our bodies are not some weird system that can only function at 20 g or > 130 g of carbs. It doesn’t work that way!