May 11 2015

Dear Mark: High HbA1c with Low Blood Sugar; Muscle Glycogen: Is It Local?; and Ketogenic Mosquito Repellant

By Mark Sisson
60 Comments

For today’s edition of Dear Mark, we’ve got a three-parter. First, what could possibly explain an ardent and otherwise healthy low-carber with stellar postprandial (i.e. after a meal) blood sugar levels showing up with an HbA1c reading indicative of pre-diabetes? Who’s messing up — the test or Nancy herself? Next, that pastured chicken you’re about to eat may very well be local, but what about the glycogen in your quads? Is a muscle’s glycogen usable only by that muscle, or can it be shipped to nearby muscles as well? And finally, a reader reports suddenly becoming unattractive to mosquitoes upon adopting a low-carb diet and bouncing in and out of ketosis. Is he imagining things or is there a potential mechanism at play?

Let’s go:

Hi, Mark,

Thank you for all you do! I have been a loyal follower for many years. After my husband was diagnosed with diabetes, I decided to commit to low carb – both as an example for him, and for my own long-term health.

At a recent physical, my doctor reported that my A1c was 6.0. As such, I have been labeled as “pre-diabetic” (which I am certain will raise my health insurance premiums). However, she also reported my triglycerides at only 48!

I have been taking my blood glucose levels each hour for the past three days and they are (with very few exceptions) below 100. Even the few readings after chocolate are still below 128.

What gives? Can you explain?

I want to tell my doctor that the A1c is wrong, as I am pretty certain that it is! Any suggestions?

Thanks!

Nancy

Actually, your A1C reading is probably correct, but you may not have to worry about anything. The power of the test relies on a major, but common, misconception about human physiology.

HbA1c measures the degree of glycation of your red blood cells’ hemoglobin; this is an indirect measure of how much blood sugar your cells are exposed to over time, since a red blood cell that’s exposed to more sugar in the blood over its life cycle will have more glycation. Thus, A1c seeks to establish the average level of blood sugar circulating through your body over the red blood cell’s life cycle, rather than track blood sugar numbers that rapidly fluctuate through the day, week, and month. It’s a measurement of chronic blood sugar levels, not acute. Sounds like a powerful metric for establishing diabetes risk, right?

It would be if everyone’s red blood cells had identical life cycles, but they don’t. Even though the A1c assumes that every person’s red blood cells live three months — no less, no more — the life cycle of an actual red blood cell differs between and even within individuals.

Ironically, the RBC life cycle depends on how well you control blood sugar. One study found that folks with normal blood sugar had red blood cells that lived up to 146 days and RBCs in folks with high blood sugar had life cycles as low as 81 days. For every 1% rise in blood sugar, red blood cell lifespan fell by 6.9 days. In those with better blood sugar control, RBCs lived longer and thus had more time to accumulate sugar and give a bad HbA1c reading. In people with poorer blood sugar control, red blood cells live shorter lives and have less time to accumulate sugar, potentially giving them “better” HbA1c numbers.

Furthermore, anemia can falsely increase HbA1c by decreasing the number of red blood cells (which need iron to fuel their production). If you have fewer red blood cells in circulation, the ones you do have accumulate more sugar since there are fewer cells “competing” for it. Anemia is a serious health condition, but it doesn’t mean you have diabetes.

HbA1c presupposes that everyone, everywhere has the same number of red blood cells in circulation living identical life cycles. It’s predictive over populations (and in most of the populace, a high HbA1c is cause for alarm), but in individuals it offers less value.

A better use of HbA1c is to track your personal trends. If HbA1c is going up over time, then you can and should worry. But if you have great blood sugar control (which likely prolongs the life cycle of your RBCs and gives them a better chance to accumulate sugar) and a high-ish HbA1c that remains stable, don’t freak out right away. Also, make sure you’re not anemic. And, of course, discuss all this with your doctor.

Hey Mark,

Long time reader, books and blog. I’ve read your different postings on glycogen usage by organs and you mentioned liver glycogen can be used by any system that needs it while muscle glycogen can only be used by the muscles. My question is, to dig deeper on that, is the glycogen available only to the specific muscle that is storing it, or can it be used by nearby muscle as well? i.e. a long squat workout would deplete only the quad stores and not any other muscle stores, correct?

Thanks!

Ron

Correct. Muscle glycogen is totally local. Quad glycogen can’t be exported out to calf or hamstring muscle. Or the liver, as you note.

That’s why I like full body compound movements so much. The long squat workout you mention would only deplete the muscle groups it utilizes, but the muscle groups it utilizes are vast and encompass far more than just the quads. Yes, the quads but also the hamstrings, glutes, trunk musculature, and even the upper back are all called into action when squatting with a weight on your back.

Many people have noticed that doing the compound movements, especially with heavy weights, really gets the appetite going and improves nutrient partitioning. A common observation is that you can eat and eat on a program like Starting Strength without gaining as much unwanted body fat as you normally would eating that much. A big reason why is that your muscles become bottomless pits demanding endless amounts of glycogen.*

*They don’t actually become bottomless pits, and you can’t really eat endless amounts of food without gaining fat just because you’re on a 5×3 compound lifting program. But it sure does feel like that sometimes, doesn’t it?

I have experienced an epiphany! As a long term Dr. Atkins disciple, I have recently adopted the Primal Blueprint philosophy at the recommendation of my cardiologist. I have read your book, am following a low-carb lifestyle and am offing ketones as I burn fat.

As a dedicated gardener and yardman selfie, I spend a lot of time outdoors, often amongst many mosquitoes here in springtime North Texas. I have discovered in the last 2-4 weeks that the mosquitoes seem to have no interest in sucking my blood. Not one bite this spring, when in years past I have suffered many, in spite of Deet. Not one. I have checked the internet for articles on ketones repelling mosquitoes and there seems to be quite a history of that “miracle”.

I am truly convinced that I am benefiting from that Primal condition. As our primal ancestors daily burned fat & not carbs, they benefited from a natural pest repellant that we today can do as well. Perhaps you should include in your message that reducing carbs eliminates harassment by pesky mosquitoes! Check it out…

Thanks a bunch for what you do…truly makes a difference!

Garth

Interesting. There may be something to it. When you go very low carb or reach ketosis (or even just reduce carbs), your respiratory quotient (RQ) drops. This means you’re exhaling less carbon dioxide for each unit of oxygen consumed, and it’s a strong indicator of fat burning versus sugar burning.

What’s this got to do with mosquito bites?

Mosquitoes are attracted to exhaled carbon dioxide because it means a live mammal (or human) is nearby and available for feeding. Other odors are also indicators of mammals, but they’re not as time sensitive. A mosquito might smell our body odor left on some linen, or smell our excrement, and we could be miles away. But CO2 is only emitted by living, breathing, delicious mammals in the immediate vicinity. Perhaps by residing in ketosis, you’re exhaling less carbon dioxide than the people around you and this shields you from the mosquitoes’ attention.

Other blood sucking parasites, like ticks, are also drawn to CO2. There’s even a machine called the “Tick Rover” that emits carbon dioxide as it drags insecticide-treated fabric around a tick-infested yard. It works really well, netting and killing between 75% and 100% of the ticks in a given area.

It wouldn’t surprise me if your hunch was correct. I doubt there will ever be a study on this, so let’s get anecdotal:

Any readers notice similar changes as Garth? Have you become less attractive to parasites since dropping carbs? Anyone in full-blown ketosis notice anything in that regard?

Thanks for reading, everyone.

TAGS:  dear mark, Keto

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60 thoughts on “Dear Mark: High HbA1c with Low Blood Sugar; Muscle Glycogen: Is It Local?; and Ketogenic Mosquito Repellant”

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  1. When I went gluten free (long before coming close to ketosis) I noticed I was less of a mosquito magnet than before. I have Celiac Disease, so maybe there was something to do with high inflammation that drew more of the beasties? All I know is that before, I could be in a group of people & be the only one getting eaten alive, while now I get just an average number of bites, & they also stop itching sooner. Yet another perk!

    1. I probably did cut my carbs somewhat when going GF, but at that point I was still eating a lot of rice & GF crackers, etc., so I’m sure I was very rarely in ketosis.

      Now if only my diet would make me impervious to poison ivy, Summer would be a lot more carefree!!

    2. I’m pretty sure you are unto something here because I’ve never been in ketosis (I eat way too much fruits) but I went from I’m the only one who gets bitten to I haven’t been bitten once since I changed my diet before last mosquito season. I was sure it was a coincidence but now I’m not so sure anymore.

  2. I’m pregnant and exhaling much more carbon dioxide as I huff and puff on my wogs (waddling jogs.) Mosquitoes are eating me alive but I can’t find any effective non-DEET (since DEET has been shown to cross over the placenta) bug sprays.

    1. This mixture has worked well for us in the past:
      8 oz water
      2 tsp vanilla extract
      1 tsp. orange oil
      Spray on liberally

      It only worked short-term, up to 20 minutes, but may get you through a wog without as many bites. You can get orange oil at most garden stores, fyi.

      1. I will have to try this – thank you! 20 minutes is long enough for me. I normally wog in the mornings, but if I don’t get up early enough to beat the heat now then I have to do it at night, and that’s when they strike.

        1. Hope it works for you. It smells great, too, which is a great secondary benefit!

    2. The only natural spray that worked for me on mosquitos had clove oil in it. I got it at whole foods and it used to be called Jungle Juice but they changed the name.

      1. I had Jungle Juice in my hand at Walmart a few nights ago but some of the ingredients hadn’t been tested on pregnant women so I put it back. Otherwise the stuff looked great and had positive reviews online!

    3. try half water half apple cider vinegar as a mist. i react very badly to ANY kind of bite (big welts) and i inherited my mum’s attractiveness to flying and crawling critters. never a problem when i use some ACV before going outside. amazing toner and anti-acne treatment too.

    1. Regarding the A1-C readings and FSB, I would look seriously at the accuracy of the BG meter–the FDA allows them to be as much as 20% off in either direction (low or high, which could send people into the hospital). Until we finally get a real-time monitor that reads glucose through a probe, we really won’t know exactly what our BG is doing at any time other than the A1-C.

      The FDA has proposed in the past that meters should tighten this 20% down to a 10 or 5% error rate, but haven’t gone so far as to make it a rule. Of course, the device manufacturer lobby has pushed for “voluntary compliance” (which means nothing), and a couple of companies strive for more accuracy, but the costs involved would put meters out of the reach of many who need them, and then what would you compare the accuracy to?

      Another thing that affects BG readings: weather. Dr. Bernstein says that barometric pressure changes dilate blood vessels, causing more blood (with blood sugar) to flow through the body, causing unexplained high levels, and may be even low levels too.

      1. How do you reconcile your statements
        “The FDA has proposed in the past that meters should tighten this 20% down to a 10 or 5% error rate, but haven’t gone so far as to make it a rule. Of course, the device manufacturer lobby has pushed for ‘voluntary compliance’ (which means nothing), ” and,
        “The costs involved would put meters out of the reach of many who need them” ?
        Are you, like many people out there, just too busy hating on capitalism to notice anything contradictory about what you’re saying?
        You seem to imply that you want the federal gov’t to force mandatory extra-accurate meters yet you’ve just put forth an excellent argument as to why this shouldn’t be done.

  3. I’m super intrigued by the mosquito question. We have a neighbor with a dilapidated swimming pool that now serves no other purpose than to breed mosquitoes. Anyone else with anecdotal evidence? Perhaps we should start a case study? 🙂

    1. Since I hit puberty, I haven’t been much of a mosquito magnet, and am still mosquito-free in menopause. Hubby, OTOH, is a mosquito magnet! I’ve read that carbon dioxide exhalation is what attracts them, but have also read that hormone scent calls to them.

    2. You should chuck some mosquito dunks (organic larvicide) into that pool on a monthly basis. 🙂

      1. That’s funny because I often joke about climbing up on the roof of my house, pretending to clean the gutters, and tossing some in over the fence.

        Great minds think alike!

    3. Toss a bleach bomb over the fence into the pool – that should kill-em.

    4. Check with your city, town or county’s health department, which usually has a mosquito vector control office. Chances are good that there will be regulations in place which require the pool owner to maintain the pool so as to prevent it from becoming a breeding ground for mosquitoes. Failure to comply with either chlorinating or draining a pool, and allowing it to become a place where mosquitoes can breed and spread can result in fines. While that should be a last resort, these offices and the regulations they enforce are there for a reason: to protect public health. It’s a better option than lobbing the occasional chlorine tablet into the pool. If a county health officer shows up, that’s not trespassing!

      1. What would me throwing mosquito dunks from the top of my house count as? Trespassing? Vandalism? Neither sounds quite right…

      2. We had a cat drown in a pool like that. They’re a hazard in more ways than just bugs. Maybe a friendly knock on the door to start with? Offer to help? No need to call down the law unless they’re nasty about it.

  4. Since going primal I’m been bite free too, and I used to be hassled big time when I was a sugar burner! It’s approaching a year and I’m 98:2 primal the entire whole time. Even when there’s no “sweeter” blood to eat they seem to leave me alone. Thankfully I don’t seem to smell so repulsive to my wife.

    Before going primal I stayed in Belgium during a hot rainy period, I returned mentally damaged, looking for the little buggers hanging of the ceilings whenever I went into a room or something buzzed past my head. The entire week I’d walk in a room and be attacked. One night whilst sleeping was bitten on the face about 5 times!

    Needless to say, the mosquito protection is not the only reason I’m staying primal for life but certainly a welcome bonus I wasn’t expecting!!

  5. Mosquitos! Ah yes, I vaguely remember those. ;0) About the time I went VLC, I moved to a drier climate, and have barely seen one, much less been bit. Yay! (Before you get jealous, I grew up in the south near water and had my share AND yours for many years).

    BUT here’s another possible explanation: it’s fairly well known that Mosquitos do not like people who eat a lot of B vitamins. And we LC-ers eat a lot of wonderful, nutrient-dense and B vitamin-dense foods, such as red meat, eggs, etc. Perhaps there’s the explanation?

    1. Ah, the B vitamins could explain it in my case– I was deficient in lots of nutrients (despite a fairly nutritious diet) due to malabsorption from the Celiac Disease.

  6. The body does react quite differently in many ways when on a lower carb higher fat/protein regimen.

    I found I no longer need underarm deodorant. Even on a very hot sweaty day, I have no BO at all.

    The other odd but nice result was that my girlfriend reported that my semen tastes “yummy”. I’m not sure what sort of changes resulted in that, but I’ll take it.

    One more reason to change up your diet…

    1. Lmao. Well, maybe not that extreme, but your girlfriend’s observation is something to take into account.

  7. Garth,
    There could be other mechanisms at work as well. For instance, if you are dipping into ketosis you could be sweating and exhaling acetone from the breakdown of AcAc ketones in amounts too small for you to smell but big enough to repel mosquitoes.

  8. Anemia would normally cause a lower A1C than individual blood sugars would predict. Individual variations in hemoglobin can cause a raised A1C, but in this case, I’m not sure that this A1C is high. A1C represents not only the height of blood sugar, but the length of time that blood sugar is elevated — area under the curve — which can be influenced by several things including the relative insulin resistance that develops as a result of excessive carb restriction.

    The Affordable Care Act makes it illegal to underwrite insurance based on pre-existing conditions, so a pre-diabetes diagnosis can’t raise your insurance premiums.

  9. Thank you, this was an awesome post. Also very enlightening is the local Glycogen usage. And yes, I have noticed that ticks don’t like me as they used to, ( Colorado is a great place for them too).
    one question however, I notes that it is really hard to get a positive ketosis test some times. I eat very low carb. A big day for me is 20g of digestible carbohydrates, including a small ( I mean small, 2 oz.) amount of red wine once in a while,( like twice a week). Am I still burning off the stored glycogen in my muscles? Am I still burning off the glucose on RBC’s? WT-? I have been in and out of ketosis for 4 weeks now, and still bounce in and out of ketosis, according to the pee strips. Any body got any Ideas, its driving me a bit mad.
    BTW. I have been lurking a bit here at MDA for two years now, eating primal for about those two years. Eating keto now for prostate cancer ( or against it really). My a1c was 5.7, my heath care provider would like to see 5.2. My psa has been as hi as 13, last year I got it as low a 4.9 on a keto diet, ( some how it was easy last year to stay in ketosis). ??? I will ask my Health care provider WH-?, too.

    1. Hi, just starting a keto n=1 experiment myself and did quite a bit of reading to prepare. It is my understanding that ketostix urine tests can become unreliable when your body gets better at actually using the ketones, rather than p*ssing them out. It seems that a blood ketone meter is gives a better picture of whether you are in ketosis or not.
      Can’t say if this is the case for you or not, just offering 2cts (from someone who’s also avidly checking the ketostix every morning at the moment)

      1. That would make a lot more sense (cents, as pun). For instance, I have been working on a green house, using just as much energy as I used to back in the construction days, and pee a, trace indication at the end of the day. However, when I bomb my system with a tablespoon full of coconut oil, half hour later, good moderate or 40mg/dL.
        The one that gets me is the negative in the morning. ???
        I do be leave your spot on as for, my body getting used to using all the ketones, I don’t get that fermented apple, or acetone taste any more, I just though I was getting used to it.

  10. Hmm… I have noticed that I am less attractive to mosquitoes these past few years.
    I thought they were just getting tired of dried up old me, when they could choose the fresh juicy children running around each summer.
    If going primal is what got those pesky pests to finally leave me alone, then primal wins yet again!

  11. Regarding the HbA1c, I’ve had the same experience. I test my blood sugar often using 2 different meters. (learned all about this from Blood Sugar 101 website) I’ve even take meters to the official blood draw and compared the results. So I know what my blood sugar has been doing and my A1c said 5.7, which is an average blood glucose level of 116. No way is that right. I rarely go to 116 or higher, only very briefly after a meal. Longer life span of my red blood cells I guess.
    Two other markers that are supposed to tell about blood sugar are fructosamine and free fatty acids; not sure how accurate those are either.

  12. My n=1? I attracted mosquitoes before ketoadaptation
    and I attract mosquitoes after ketoadaptation. No change.

    I get invited to parties just to keep the mosquitoes off other
    people.

    1. Sounds like me. I got a few bites while out in the woods 3 days ago. My ketone levels are pretty high and I eat paleo. However, I didn’t notice the bites until the next day and they hardly bothered me at all (little swelling or itching) — that’s a big change from pre-ketoadaptation/paleo.

  13. When I saw the piece about low fasting blood sugar and high HbA1c…I said did I write that question ?…I have the same issue.
    My last FBG was 88, HbA1c was 6.0 and fasting Insulin was 3.0.
    I’m about 90% Primal and my post-prandials rarely go above 125.
    Being that Diabetes… and worse… runs on my father’s side, I watch my blood sugar numbers.
    I’m the only non-Diabetic I know of who takes occasional glucometer readings.
    I also take a bunch of supplements, am low-carb and hit the gym, etc.
    Being that all my other blood test markers are optimal, I just keep an eye on it and don’t stress too much over it.
    If anyone wants more info on Diabetes read the books by Dr Sherry Rogers MD on the subject.
    She talks about nutritional deficiencies, detailed blood tests, environmental toxins, pharmaceutical dangers, etc.

    1. I have the same problem. My NMD told me to take alpha lipoic acid to lower my HbA1c. I went from a 6.0 down to a 5.6 in 6 months. I’m in excellent health with absolutely no other issues. My FBS is 80.

  14. I’ll raise my hand as one who doesn’t get bit by mosquitos any more. It’s niiiice.

    I’ve also noticed that after a round with a heavy kettlebell, I can’t seem to get satisfied by a meal. After a particularly grueling workout with a newer, heavier kettlebell, it was like I was a teenager again devouring everything in the kitchen. Even after a big steak dinner, I was hungry enough an hour later to eat a six-egg omelet.

  15. Regardless of how long the red blood cell has been alive, it’s still glycated hemoglobin, isn’t it? With all the attendant long term consequences?

    1. And note that it is not just hemoglobin that gets glycated. I think of HbA1c as an index of the damage that is being done by glucose to all your cells and proteins. And once cells and proteins are glycated they tend to stay glycated until they die. This is why reversal of damage done by diabetes takes time with normal blood glucose. It depends upon the life cycle of cells and proteins. Unfortunately some cells in our bodies have a very a long life cycle so the damage is all but permanent.

  16. It is important to talk about the glycating effects of glucose. However, fructose is 7 to 10 times more glycating than glucose. 70% chocolate is still 30% sugar, half of which is added fructose. Dried fruit is also very high in fructose, such as dates. And anyone eating so-called Paleo treats will be ingesting added fructose in their maple syrup or honey. Added and concentrated fructose is the main cause of metabolic syndrome. See davidgillespie.org/category/sugar

  17. Make a necklace out of rosemary and hang around your neck, this should repel the mosquitoes.

  18. Thank you Mark about explaining HBA1C life cycle bit. I am thinking of getting HBA1C myself (just being proactive) and all I have read everywhere is that treat your HBA1C result like 90-day average.

  19. Interesting idea on the Mosquitos! I always thought it had to do with blood type or something else. As long as I can remember I have never been someone they like to bite. Those around me would get attacked while I never get more than one or two bites, if any. I have eaten low carb for the past 15 years or so, the last 5 being Primal. But this has been true for me long before I ever would have been in ketosis, and my husband who has been Primal with me for 5 years gets eaten alive.

  20. I’ve seen the mosquito thing mentioned several times on other forums and sites over the years. I know they leave me alone now; I only get bit a few times per year. Same with fleas.

    Some others have proposed mosquitos need the sugar in blood and avoid those of us with less ‘sweet blood’.

  21. I lived in Alaska, and then Yukon, for many years and I can tell you that high carb low carb makes no friggin difference to mosquitoes. They evolve faster than we do.

  22. Another possible cause of elevated A1c (from Mayo Clinic): Most people have only one type of hemoglobin, called hemoglobin A. If you have an uncommon form of hemoglobin (known as a hemoglobin variant), your A1C test result may be falsely high or falsely low. Hemoglobin variants are most often found in blacks and people of Mediterranean or Southeast Asian heritage. Hemoglobin variants can be confirmed with lab tests. If you’re diagnosed with a hemoglobin variant, your A1C tests may need to be done at a specialized lab for the most accurate results.

  23. A cardiologist is recommending the Primal Blueprint? RIGHT ON. That is excellent news!

  24. Tell’ya what…I’m the newbie here. Was diagnosed T2 diabetic (insulin resistant) a little over a year ago, and have (through diet and exercise) lowered my A1c from 7.9 to 6.0. My endo tells me not to get any lower, to keep it at 6.0 — but the person who started this conversations says an A1c of 6.0 from her doctor is telling her she’s pre-diabetic.

    I’ve even met a few doctors telling patients over 60 to keep their A1c at 7.0 because of a reduced risk of low blood sugar causing a fainting spell – which leads to broken hips….and so forth.

    So what is a good goal for A1c?

    1. Your doctor is a reckless idiot, but I don’t have a medical or biochem degree and it’d be irresponsible of me to tell you what to do… instead try contacting Dr Michael Eades or Robb Wolf (on his podcast) to get them to answer your question. I’m sure they’d get a laugh from your doctors and respond to you.

  25. About the local glycogen thing… what about the lactate shuttle? That part isn’t totally clear to me, or even most exercise physiologists it looks like. I’m referring to Dr. Brooks’s theory in UC Berkeley now. Does that lactate deplete the glycogen from less working muscles? I imagine so, at least partly. Otherwise, how is blood sugar maintained during marathons or long bike rides when the working muscle is mostly the legs?

  26. Boom ketones keeps mosquitoes at bay!

    “Now scientists have discovered key differences in the body odours produced by people who are more prone to insect bites compared to those who seem resistant – they have lower levels of fruity smelling compounds in their sweat.
    The researchers found that these compounds, known as ketones, repel mosquitoes. People who produce high levels are less likely to be bitten.
    They are now developing a new kind of insect repellent to help those whose bodies do not smell so fruity.”

    http://www.telegraph.co.uk/news/science/science-news/6142961/Sweet-smelling-sweat-keeps-mosquitoes-at-bay.html

  27. Thank you so much for the A1c EDUCATED information you have provided. This article has provided such relief for our family, my husband is PRIMAL, he is So healthy and the Dr.s will not stop harassing him about his blood work, saying he needs MORE mcgs of synthroid and now supposedly he is “prediabetic”. When in all actuality he is the healthiest right now then he has been in 30 years. The doctors can not figure him out. He has gone off his high blood pressure medicine thanks to Mark, he does not have the cluster headaches like he once had thanks to Mark, and when they call and say ” you have predabetes”…. and he tells the diatician “I do not consume over 30 carbs a day lady… ” and she does not know what a carb is…. then WE have a failure to communicate….. SOCIETY!!!!!!!!!!!!!!!!!!!!!!!

    So frustrating, thanks for the awesome information as always, we are thankful for all you do for our family, if ever in South Dakota you have a friend. Love, the Hixs

  28. I have experienced mosquito repellant too. I live in Thailand where mosquitos are every where all the time. I have been on keto for several months and noticed that I no longer had mosquito bites! When I was with other people and they complained about mosquitos, I then realized that I did not have that problem any more. It took me a while to think I should google “keto and mosquito”, then I found this post along with other forums that I cannot comment without signing up. This is interesting!

  29. I have recently been diagnosed with anemia but also received a high a1c of 6.5. I don’t eat grains, little fruit, no processed foods and not a lot of paleo treats. I exercise vigorously with kettlebells 4x a week. My instinct is to address anemia then retest a1c. Dr. was ready to put me on metformin already. I am going to a naturopath to see if we can get to the bottom. Thoughts?