Effed up good, apparently
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CarrieMoritz
Posts: 34 Member
So I apparently *kitten*ed up, hard. Not sure how, but I hit a literal wall today- got nauseous, lightheaded, was having heart palpitations- and sodium did nothing for it. Started to leave to go home, thinking I probably had the flu, and didn't make it past the break room before almost passing out and scaring the crud out of my coworkers. This was followed by extreme exhaustion and fatigue. A visit to the dr found low potassium (but still within range), low protein (but again within range), and a high BUN/Creatinine ratio (out of range). Diagnosis: chronic dehydration and stressed kidneys resulting in symptoms. These numbers were all well within normal less than a month ago. Well, *kitten*. So I've been ordered to get my carbs up from here on out to help retain some water, to drink more liquids, and to rest for two days. Oh boy.
I've been keto since Sept 27 with few issues besides headaches, am down 27 pounds, and have otherwise never felt better.
Attached: test results for those who might be able to read them.
I've been keto since Sept 27 with few issues besides headaches, am down 27 pounds, and have otherwise never felt better.
Attached: test results for those who might be able to read them.
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Replies
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You absolutely must get no less than 3000mg Every. Single. Day.
Sodium sodium sodium.
Every day.
You cannot wait until there are symptoms.
By the time that happens, your body is dumping magnesium and potassium and then all electrolytes are low.
Increasing carbs will fix your problem but only because it'll increase your insulin which causes sodium retention.
Sodium is the answer no matter what you do with carbs. It's just a matter of what mechanism you want to use to get and keep sodium levels up.
Insulin? Or get between 3000-5000mg. Every. Single. Day. And stay low carb.8 -
I really, really do intake >5,000 mg per day. Im terrible about logging it, but the few times I have, it's up there. I have at least 2 tbsp of sole water (2300 mg per tbsp) per day. I drink at least 64 oz of fluids (usually closer to 75 oz) and at least 80% of those fluids have sole water in them. I'm salting my food. I'm eating high sodium meats and cheese. I can't think of any more ways to get my sodium up. I take one to two 250 mg mag pills per day (glycinate and malate combo). I eat green leafies. I eat plenty of red meat and take a multi. This is why I'm lost. Because I'm doing everything "right." So why hit a wall?0
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Hmm. The bun/creatinine ratio could point to the dehydration. Your ALP is low... Have you been checked for celiac disease? With celiac disease, you could be eating all of the right things but still experience malabsorption of nutrients and minerals. Malnutrition really, due to damaged intestines.
Your numbers aren't really that out of the ordinary. That low ALP is a bit odd though. If you are doing everything right, then CD could be the cause.
How is your blood pressure normally? Are you prone to low BP? if so, that could make you more prone to fainting. If you are fighting off something, that could push you over the edge.
I actually "sort of" fainted a couple of days ago. I'm fighting off a cold, had company coming so I had neglected my salt water for the day, and my back was out. When I got up in the morning, I guess the pain was too much or something. I know I got to a couch because I felt it coming on, but I don't really remember much else for a while. Sooo embarrassing.
I felt a lot better after a glass of salt water. I have lower BP normally so this was not new. Well, pain causing it doesn't happen often.
I hope you figure it out soon. My guess is that LCHF is not the cause of it but it may have helped make it more evident. You are doing everything right. That shouldn't have happened. Doing LCHF right will not cause fainting. A health issue or doing it wrong may though. Or a one time fluke...3 -
Dissolve a bouillon cube in the appropriate amount of water and drink 2 cubs daily. I personally find that I require between 6000-8000mg of sodium every day. You may be one of those lucky people like me whose body just needs more than other people do.3
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Dissolve a bouillon cube in the appropriate amount of water and drink 2 cubs daily. I personally find that I require between 6000-8000mg of sodium every day. You may be one of those lucky people like me whose body just needs more than other people do.
That's what I was going to say next. Some people need even more.
You could increase carbs just a bit and see if it's better. Any change you make might take 2-3 days of consistency before you can be sure if it's made a difference.
Some people find adding a simple sodium tablet makes getting enough sodium easier.
Also, the magnesium dose seems low to me. Even if you got 500mg every day, that's at the low end of recommendations of 400-800 or even more if you want to maximize availability. But that's more an option than a need. I would definitely take two doses for sure to get 500mg.
Definitely consider what @nvmomketo is saying. I don't know much about celiac but the malabsorption possibility seems to make sense too.
It seems like you'd have some loose stool if that were the case though ??? Just thinking out loud.
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Also, looking at the test results... everything seems to be in range. Is this after you were treated?2
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Your BUN and Creatinine are in range. And albumin is too. Honestly, this just looks like someone that eats a decent amount of protein but your kidneys appear to be handling it fine.
http://robbwolf.com/2011/06/16/clearing-up-kidney-confusion-part-deux/
I assume your test wasn't even done fasting so you probably had proteins from a recent meal factoring in too.
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It is important when looking at lab results to know that "normal ranges" are based on a population that the lab tested when they set up the test. A lot of testing is pretty standard and there have been thousands of people tested since the test was developed but a typical lab tests 100 patients who are not known to have any disease, medication or supplementation to determine the "normal range" for them. The problem lies in the "not known to have disease" part. There are always people with silent illness or other factors that are included in the normal population. There are a lot of statistics done to try to minimize the impact but it does impact normal values. The best evaluation is what is normal for you. Look at your labs over a period of time and see how they correlate and closely watch anything at the far end of the "normal" range as it may be abnormal for you. I personally potassium waste, no one knows why but I always have to watch my potassium and eat high potassium foods. For me a potassium under 3.5 is too low and I start having symptoms even though "normal" for my lab is down to 3.2. Some people, me included, have cardiac arrhythmias at 3.2, although that isn't common. Your sodium is at the low end of the normal range so I would consider bumping up your supplementation a little bit more and seeing how you feel.3
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Hmm. I wasn't wanting to overdose on mag, as that definitely causes loose stools for me. On the two a day, it keeps things moving but not watery.
I'd never noticed the ALP and didn't know what it was for. I know a I have a sensitivity to gluten, but have never been tested because I didn't really show symptoms other than face breaking out and bloating. I've mostly given up gluten sources, but last week and esp last weekend definitely had more exposure than I've had in quite a while.
So weird that my sodium was that low, I'd already had 3 tbsp of sole water that morning and 40 oz of liquid. So maybe I was truly low on potassium and my body just kept dumping to get balanced (I had a Charlie horse from hell on Sunday night/early Monday morning that required potassium to stop, I had a glass of water with a pretty decent amount of NuSalt in it, then later followed up with a half tbsp of sole water and two magnesium pills to feel "right" again, so it's not like I wasn't taking corrective steps).
I'm definitely feeling better this morning and much more clear headed. I just downed 16 oz of water and will stay away from the cereal.
Here are my labs done in the middle of January:
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Something I've recently discovered myself is that a number of supplements can cause your kidneys to work harder and/or trigger dehydration. High value Vitamin C is one of them. Doses of 1000 mg at a time or high can by themselves cause mild dehydration. There are a boatload of supps on the list. So if you're taking anything, it's worth a look see.1
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Oh, crud. I normally take 1200 mg Vit C per night, and the night before had taken 2200 mg because I had been exposed to a ton of crud that day (I work in a pediatric clinic in registration).1
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@CarrieMoritz - I think it is the ascorbic acid form that is more concerning. Also, I boost up Vitamin C and Zinc when exposed to crud. I think it is the daily dose that's more concerning, but honestly, if you're not taking a bunch of other stuff or already have existing kidney risks, I don't think this dose of itself is an issue. I just know I switched up a bunch of things in the last year plus, which was when all my dehydration issues ramped up.0
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In regard to the ALP, two possible causes of it being so low could be lack of protein or malnutrition. I know some people who go keto go very low on protein to hit some artificially high fat goal. Given the rate of weight loss, malnutrition is likely not it assuming you are eating nutrient dense foods because the rate looks pretty healthy. Meanwhile, your protein level may be in the "normal" range, but it is at the bottom of that and as was mentioned above does not always mean optimal. Not getting enough protein for a day, a week or even a month is not probably not going to have much negative effect, but if you have gone too low since September, that could be a contributing factor due to lean mass breakdown.0
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Glad to hear that you are going to be ok and your recovery is sounding relatively minor. My T2D mom had ileostomy surgery in October (colitis).... basically felt nauseous since 3 days after the surgery. All medical professionals she spoke with kept chalking it up the "major surgery" and ignored it. Her home care nurse finally called an ambulance on her in early January because she was incoherent on the phone... turns out her blood sugars had dropped to 2... was also extremely dehydrated and kidneys were not functioning. I don't know her actual numbers but they kept her in the hospital for 2 weeks to push fluids and monitor her kidneys. She now has to go for blood work weekly, plus a monthly dr visit. The GP that saw her in emerg (who is also now her regular doc), said she was lucky she didn't get another doctor that day... she was extremely close to completely losing her kidneys.2
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Sunny_Bunny_ wrote: »Dissolve a bouillon cube in the appropriate amount of water and drink 2 cubs daily. I personally find that I require between 6000-8000mg of sodium every day. You may be one of those lucky people like me whose body just needs more than other people do.
That's what I was going to say next. Some people need even more.
You could increase carbs just a bit and see if it's better. Any change you make might take 2-3 days of consistency before you can be sure if it's made a difference.
Some people find adding a simple sodium tablet makes getting enough sodium easier.
Also, the magnesium dose seems low to me. Even if you got 500mg every day, that's at the low end of recommendations of 400-800 or even more if you want to maximize availability. But that's more an option than a need. I would definitely take two doses for sure to get 500mg.
Definitely consider what @nvmomketo is saying. I don't know much about celiac but the malabsorption possibility seems to make sense too.
It seems like you'd have some loose stool if that were the case though ??? Just thinking out loud.
BM issues can vary widely among celiacs. Celiac can cause diarrhea, constipation, or have no effect on BMs. In fact the most common symptom of CD is anemia.
TMI.....
I had constipation my entire life. I thought it was normal because I had known no other way. When I started LCHF my BMs became so easy I thought it was diarrhea. I actually discovered through Dr Google that what I now had was normal. LOL
Edited to add, if you do have some gluten sensitivity, you might want to consider testing.
To test you need to be eating the equivalent of 1-2 slices of bread per day in the 8-12 weeks prior to blood tests (or 2-4 weeks prior to endoscopic biopsy). Since you are low carb, doing so with vital wheat gluten, or a seitan, might be the way to go. Gluten (gliadin) is actually a protein - it just comes in a high carb package in most cases.
The blood tests you want are:- tissue transglutaminase (tTG IgA and tTG IgG)
- deaminated gliadin peptides (DGP IgA and DGP IgG)
- endomysial antibodies (usually only EMA IgA) - this is similar to the tTG tests but tendsto indicate more advanced damage
- total serum immunoglobulin A (IgA) - this is a control test. 1 in 20 celiacs are deficient in IgA so their IgA celiac tests end up as false negatives
- antigliadin antibodies (AGA IgA and AGA IgG) - and older and less reliable test that has largely been replaced by the better DGP tests
Get as many tests done as possible. Celiac tests are not that reliable. The best of them can miss up to 75% of all celiacs (like the tTG) and the worst (AGA IgA) will miss most celiacs. Sometimes the EMA IgA will not be run unless you have a positive TTG IgA; that's reasonable since very few will have a positive EMA IgA without a positive tTG IgA.
Try to get the IgA and IgG based tests run. I know a few celiacs who just had positive IgA based tests even though they were not IgA deficient. I also know a few who only had a positive biopsy and negative blood tests (and vice versa). The biopsy is often a good idea if the blood tests are negative and you have gluten intolerance symptoms.4 -
Sunny_Bunny_ wrote: »Dissolve a bouillon cube in the appropriate amount of water and drink 2 cubs daily. I personally find that I require between 6000-8000mg of sodium every day. You may be one of those lucky people like me whose body just needs more than other people do.
That's what I was going to say next. Some people need even more.
You could increase carbs just a bit and see if it's better. Any change you make might take 2-3 days of consistency before you can be sure if it's made a difference.
Some people find adding a simple sodium tablet makes getting enough sodium easier.
Also, the magnesium dose seems low to me. Even if you got 500mg every day, that's at the low end of recommendations of 400-800 or even more if you want to maximize availability. But that's more an option than a need. I would definitely take two doses for sure to get 500mg.
Definitely consider what @nvmomketo is saying. I don't know much about celiac but the malabsorption possibility seems to make sense too.
It seems like you'd have some loose stool if that were the case though ??? Just thinking out loud.
BM issues can vary widely among celiacs. Celiac can cause diarrhea, constipation, or have no effect on BMs. In fact the most common symptom of CD is anemia.
TMI.....
I had constipation my entire life. I thought it was normal because I had known no other way. When I started LCHF my BMs became so easy I thought it was diarrhea. I actually discovered through Dr Google that what I now had was normal. LOL
Edited to add, if you do have some gluten sensitivity, you might want to consider testing.
To test you need to be eating the equivalent of 1-2 slices of bread per day in the 8-12 weeks prior to blood tests (or 2-4 weeks prior to endoscopic biopsy). Since you are low carb, doing so with vital wheat gluten, or a seitan, might be the way to go. Gluten (gliadin) is actually a protein - it just comes in a high carb package in most cases.
The blood tests you want are:- tissue transglutaminase (tTG IgA and tTG IgG)
- deaminated gliadin peptides (DGP IgA and DGP IgG)
- endomysial antibodies (usually only EMA IgA) - this is similar to the tTG tests but tendsto indicate more advanced damage
- total serum immunoglobulin A (IgA) - this is a control test. 1 in 20 celiacs are deficient in IgA so their IgA celiac tests end up as false negatives
- antigliadin antibodies (AGA IgA and AGA IgG) - and older and less reliable test that has largely been replaced by the better DGP tests
Get as many tests done as possible. Celiac tests are not that reliable. The best of them can miss up to 75% of all celiacs (like the tTG) and the worst (AGA IgA) will miss most celiacs. Sometimes the EMA IgA will not be run unless you have a positive TTG IgA; that's reasonable since very few will have a positive EMA IgA without a positive tTG IgA.
Try to get the IgA and IgG based tests run. I know a few celiacs who just had positive IgA based tests even though they were not IgA deficient. I also know a few who only had a positive biopsy and negative blood tests (and vice versa). The biopsy is often a good idea if the blood tests are negative and you have gluten intolerance symptoms.
Wow. Very good info. I don't know much about celiac. My daughter was tested and it returned fine but who knows if it was really done right. Though that doctor was very anti gluten.
Anyway, I was more wondering if celiac were a potential cause of sodium malabsorption... since when sodium is poorly absorbed or I guess just taken in large enough doses to not be fully absorbed it tends to act as a cleanse... that's where my thoughts were going on that. Since OP does get decent sodium, I was wondering if malabsorption at her intake might be seen with the cleanse-like symptoms.
Idk. What do you think about that thought?0 -
Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »Dissolve a bouillon cube in the appropriate amount of water and drink 2 cubs daily. I personally find that I require between 6000-8000mg of sodium every day. You may be one of those lucky people like me whose body just needs more than other people do.
That's what I was going to say next. Some people need even more.
You could increase carbs just a bit and see if it's better. Any change you make might take 2-3 days of consistency before you can be sure if it's made a difference.
Some people find adding a simple sodium tablet makes getting enough sodium easier.
Also, the magnesium dose seems low to me. Even if you got 500mg every day, that's at the low end of recommendations of 400-800 or even more if you want to maximize availability. But that's more an option than a need. I would definitely take two doses for sure to get 500mg.
Definitely consider what @nvmomketo is saying. I don't know much about celiac but the malabsorption possibility seems to make sense too.
It seems like you'd have some loose stool if that were the case though ??? Just thinking out loud.
BM issues can vary widely among celiacs. Celiac can cause diarrhea, constipation, or have no effect on BMs. In fact the most common symptom of CD is anemia.
TMI.....
I had constipation my entire life. I thought it was normal because I had known no other way. When I started LCHF my BMs became so easy I thought it was diarrhea. I actually discovered through Dr Google that what I now had was normal. LOL
Edited to add, if you do have some gluten sensitivity, you might want to consider testing.
To test you need to be eating the equivalent of 1-2 slices of bread per day in the 8-12 weeks prior to blood tests (or 2-4 weeks prior to endoscopic biopsy). Since you are low carb, doing so with vital wheat gluten, or a seitan, might be the way to go. Gluten (gliadin) is actually a protein - it just comes in a high carb package in most cases.
The blood tests you want are:- tissue transglutaminase (tTG IgA and tTG IgG)
- deaminated gliadin peptides (DGP IgA and DGP IgG)
- endomysial antibodies (usually only EMA IgA) - this is similar to the tTG tests but tendsto indicate more advanced damage
- total serum immunoglobulin A (IgA) - this is a control test. 1 in 20 celiacs are deficient in IgA so their IgA celiac tests end up as false negatives
- antigliadin antibodies (AGA IgA and AGA IgG) - and older and less reliable test that has largely been replaced by the better DGP tests
Get as many tests done as possible. Celiac tests are not that reliable. The best of them can miss up to 75% of all celiacs (like the tTG) and the worst (AGA IgA) will miss most celiacs. Sometimes the EMA IgA will not be run unless you have a positive TTG IgA; that's reasonable since very few will have a positive EMA IgA without a positive tTG IgA.
Try to get the IgA and IgG based tests run. I know a few celiacs who just had positive IgA based tests even though they were not IgA deficient. I also know a few who only had a positive biopsy and negative blood tests (and vice versa). The biopsy is often a good idea if the blood tests are negative and you have gluten intolerance symptoms.
Wow. Very good info. I don't know much about celiac. My daughter was tested and it returned fine but who knows if it was really done right. Though that doctor was very anti gluten.
Anyway, I was more wondering if celiac were a potential cause of sodium malabsorption... since when sodium is poorly absorbed or I guess just taken in large enough doses to not be fully absorbed it tends to act as a cleanse... that's where my thoughts were going on that. Since OP does get decent sodium, I was wondering if malabsorption at her intake might be seen with the cleanse-like symptoms.
Idk. What do you think about that thought?
One of the presenters on the recent Autoimmune Summit was explaining the terminology a bit here that might be helpful. He had a slide showing a bubble in the center labeled "Gluten Sensitivity" that branched out in many directions. One of those was Celiac disease, another fibromyalgia, and so on. I can't remember all the different things he had that could be rooted in gluten intolerance. Many of them could have other causes as well.
The other key point he made was that gluten is actually a family of grain based proteins. The one found in wheat, barley and rye is the most studied, but often those who are sensitive to it are also sensitive to those in other grains such as corn, millet, etc. I believe he said there were over 1000 different proteins in this family. He did say preliminary studies showed that some of the others were actually more likely to cause adverse effects. This was one reason why he said there were so many people who went "gluten free" based on just the one type but saw no relief from symptoms. They were changing out their flour tortillas for corn tortillas and the form of gluten in the corn was negatively affecting them as much or more than what was in the wheat as an example.
He was very clear he was not advocating everyone going grain free. He was advocating proper testing if there was reason to suspect intolerance which would include just about every autoimmune disease out there.0 -
Wow, really good info! I did see relief from going keto: almost instant reduction in acne, bloating, gut aches, mood swings (that took more like a month to even out). My hair stopped falling out in large quantities (it was getting suuuuper thin. Still thin now but is reversing.). 90% of the time now I'm gluten free and grain free without even trying. Hunger became something different and I stopped having issues with cravings. Some of those cravings have popped back in since Christmas, though I was attributing it more to having let the reigns out at Christmas and wanting to do it again (and now that I think about it, post Christmas my hair was falling out a lot again for a few weeks). I picked exercise (light/moderate) back up in January and started to ramp it up a bit at the beginning of last week. Last week saw a major uptick in cravings as well as an uptick in grains and carbs, especially over the weekend. So now I really do have to wonder if there was an underlying condition I didn't know about.
My goal macros each day are 120 g protein, 76-110 g fat, and 20-30 g carbs, 1250-1500 calories. I'm 5'7" and currently bouncing around between 153-156 lbs. The protein goal is almost non-negotiable and I come within 15 g of it most of the time.
I did make a follow up with my pcp for Monday so we can go over things together. He's usually pretty good. The CNP I had yesterday was most definitely anti-keto and gave me the bull about how our brains need glucose to function.
Side note: my hubby literally just called and said he was feeling off now, too. He's most definitely not eating keto! I could be dealing with a few things here...
Attached- daily macros for last week and beginning of this week (Monday was a fasting day, and I didn't record on Sat or Sun).
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kimberwolf71 wrote: »Glad to hear that you are going to be ok and your recovery is sounding relatively minor. My T2D mom had ileostomy surgery in October (colitis).... basically felt nauseous since 3 days after the surgery. All medical professionals she spoke with kept chalking it up the "major surgery" and ignored it. Her home care nurse finally called an ambulance on her in early January because she was incoherent on the phone... turns out her blood sugars had dropped to 2... was also extremely dehydrated and kidneys were not functioning. I don't know her actual numbers but they kept her in the hospital for 2 weeks to push fluids and monitor her kidneys. She now has to go for blood work weekly, plus a monthly dr visit. The GP that saw her in emerg (who is also now her regular doc), said she was lucky she didn't get another doctor that day... she was extremely close to completely losing her kidneys.
That ^^ is insane. Wow. So glad they caught it!!
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Regarding your brain needing glucose, that is true, but it is only about 100g a day and your body makes more than that even if you eat no carbs or protein. The amount varies by person, but it is well over the small amount your brain needs. It can even make it from the glycerol in a triglyceride (3 fatty acids attached to a glycerol molecule) so even if your diet was 100% fat, your liver could still produce glucose for your brain.
The picking up of exercise may have played a part if you didn't also up your water and electrolytes a bit.0
