Chris Kresser: Yeah, there’s different thresholds for people in terms of how they enter ketosis or what the carbohydrate threshold is for ketosis and what the protein threshold is. You’re just going to have to experiment with decreasing carbohydrate, you’re going to have to experiment with a decreasing protein, you could also experiment, I prefer to just add MCT oil in, which is ketogenic and allows often people to achieve ketosis at a higher carbohydrate and protein level. And people just tend to feel better on that with that approach. You could also try five grams of L-leucine, which is a ketogenic amino acid, and that can put people into ketosis more easily as well with a higher carbohydrate and protein intake.
And in terms of B6, it’s interesting. I’ve seen this in some cases and even without supplementation. The symptoms that tend to be associated with it are neuropathy. Usually the neuropathy comes with excess B6 supplementation and not just high B6 on a serum test. But first thing I would do in this situation is retest the B6. It’s possible you just got him on a bad day, so to speak. But with low platelets, it depends kind of how low they are. We talked about in the blood chem section, I’ll be mentioning that low platelets can be genetically mediated, and some people just always have slightly low levels of low platelets. So you’ve got to get a history and see if he’s had CBC before and if platelets were low. If they have always been low, that could be it. If they’re just low now, one of the concerns here may be autoimmunity, and maybe that’s also contributing to type 2 diabetes. Maybe he actually has type 1.5 diabetes and there’s an autoimmune component. So these are a few ideas to pursue.