u/OriginalStrawberry41

Hi! Has anyone developed a secondary carnitine deficiency or fatty acid oxidation issues while on keto? I have low free carnitine and high esterified/free carnitine ratio. I can't eat any more protein than I already have or else it will trigger glycogenesis, and I've found I don't tolerate ALCAR or l-carnitine. My GP won't help, my endocrinologist won't help, and not even my keto metabolic psychiatrist or nutritionist was willing to help. I can't afford to sink anymore money into a specialist that doesn't know what they are doing and isn't covered by insurance. I don't know what to do. If I go off of keto it could completely destabilize my mental health. Any help is appreciated. Thanks!

Hi! I went into remission from bipolar disorder and near remission from ocd while on keto. Now it isn't working as well after a year for the OCD. My nutritionist told me to get labs done and my free carnitine was low and my esterified/free carnitine ratio was high. I asked her what to do and she told me to ask the metabolic psychiatrist at the clinic. I went to the meeting with the metabolic psychiatrist and it quickly became evident that she didn't have the expertise she claimed she had and she seemed unfamiliar with supplementing carnitine. My GP won't help me, endocrinologists won't help me... I gave up and just supplemented it myself and I didn't tolerate either alcar or l-carnitine. I can take like 100 mg tops of l-carnitine or I get extremely anxious, and alcar makes anxiety worse and gives me too much energy. I really feel like I don't know where to turn. I don't want to pay hundreds out of pocket to see another specialist; ideally I could find someone covered by my insurance, UHC. I don't think I can just add more meat to my diet, because I will likely go into glycogenesis. Thanks in advance.

Hi! I was in remission from OCD after several months of keto, then only slowly returned. I saw a keto nutritionist and she had me test my ketone levels. My free carnitine was low while my carnitine was normal. My esterified/free carnitine ratio was high. My GP is unwilling to treat it and the metabolic psychiatrist my nutritionist sent me to prescribe it ended up not qualified despite claiming to be a metabolic psychiatrist. My endocrinologist won't help, nor will anyone at my hospital's endocrinology department. Out of desperation, I tried to supplement on my own, but I don't tolerate l-carnitine or alcar. I can't have anymore protein or I'll go into glycogenesis. Any idea on where I turn at this point? Has anyone been in this position before? I don't want to have to pay out of pocket/ I want the person I see to be covered by insurance. Please no ai for answers, because I've already used AI for answers and it led to nowhere.