5 months on a low carb high fat diet and most of my issues have resolved but not completely (12 years of chronic fatigue, so come a long way). I've consistently been in ketosis, <50 g carbs, but now considering increasing between 50-100 g. I have a lot of joint pain and don't feel like I'm recovering as well from workouts, or in general, as the first few months on this diet. It feels like I've taken a step backwards towards fatigue and non-recovery. Perhaps I'm bonking, low on glycogen, and protein is being diverted from tissue repair to gluconeogenisis, or even some catabolism. I'm adding back some fat lbs. I exercise moderate to intense 5x/week, short workouts, sprints and weights, plus 1-2 short easy walks. Recovery with a low carb diet points to issues with diabetes, pre-diabetes, or metabolic syndrome. It appears we are all a little diabetic or heading in that direction with the standard high carb diet. Since diabetic issues produce damaging elevated glucose, how does one manage the reduction of blood glucose along with finding the carbohydrate intake sweet spot? My fasting blood glucose is currently in the 120 range, so pre-diabetes. I'm considering metformin to reduce glucose but it feels counterproductive to be taking metformin while adding back some carbs. Will the glucose reducing benefits of metformin interfere with glycogen storage? Any comments, tips, ideas?
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To Metformin or not to Metformin?